KR102478190B1 - Apparatus for removing calculus - Google Patents

Abstract

Stone removal device according to an embodiment of the present invention is provided in the lumen of the catheter, the guide wire moving in the lumen; a trapping means extending from one end of the guide wire and configured to capture stones while being drawn in and out of the catheter according to the movement of the guide wire; Expansion means configured to expand one end of the catheter outward when external gas is injected; and operating means for controlling the movement of the trapping means and the expansion means.

Description

Stone removal device {APPARATUS FOR REMOVING CALCULUS}

The present invention relates to a stone removal device.

Stones that occur in the biliary tract, that is, biliary stones are largely divided into primary biliary stones and secondary biliary stones. Primary biliary gallstones are gallstones caused by changes in microorganisms or environmental composition in the biliary tract, and secondary biliary gallstones are caused by the movement of gallstones from the gallbladder into the biliary tract. Primary or secondary biliary gallstones eventually obstruct the flow of bile in the biliary tract, thus causing serious complications such as cholangitis, cholelithiasis and pancreatitis, so complete removal is absolutely necessary. Usually, in order to remove gallstones in the biliary tract, removal surgery using various endoscopic instruments is performed under an endoscopic approach, but in some cases it is impossible to perform invasive and surgical treatment that can cause many complications. Consequently, it is important to efficiently and completely perform gallstone removal in the biliary tract using appropriate endoscopic tools under an endoscopic approach.

Recently, with the development of endoscopic procedures, endoscopic retrograde biliary pancreatic surgery (ERCP) is performed to remove gallstones, and the treatment instruments used for complete removal of gallstones are also diversified. Representatively used surgical instruments include a basket catheter and a balloon catheter. The operator prefers to use one of the two according to his or her own judgment, or uses both and attempts to remove gallstones.

However, as mentioned above, in the process of inserting and performing the procedure using the basket catheter or the balloon catheter, the procedure time is prolonged, and the burden on the endoscopist and the assistant increases due to the repeated replacement of instruments. In this process, the instability of the endoscopic procedure also increases due to the movement of the instrument.

In the embodiment of the present invention, relatively large stones are captured and lifted using the trapping means, and then expanded by the expansion means to discharge relatively small stones first, so that large stones are not trapped between small stones and discharged. It is an object of the present invention to provide a stone removal device capable of removing a large amount of stones even with a smaller number of procedures by preventing the situation from not occurring and using a trapping means and an expansion means together during the procedure.

On the other hand, the technical problems to be achieved in the present invention are not limited to the above-mentioned technical problems, and other technical problems that are not mentioned will become clear to those skilled in the art from the description below. You will be able to understand.

Stone removal device according to an embodiment of the present invention is provided in the lumen of the catheter, the guide wire moving in the lumen; a trapping means extending from one end of the guide wire and configured to capture stones while being drawn in and out of the catheter according to the movement of the guide wire; Expansion means configured to expand one end of the catheter outward when external gas is injected; and operating means for controlling the movement of the trapping means and the expansion means.

The catheter may include a first tube and a second tube having a lumen, the second tube may be provided in the lumen of the first tube, and the guide wire may be provided in the lumen of the second tube.

The trapping means is a basket composed of a plurality of elastic trapping wires, and when the trapping wire is withdrawn from the catheter, the central regions of the basket are spaced apart from each other by an elastic force to form a trapping region capable of trapping stones. can

The catching means further includes a head, and the head is provided at an end of the catching wire; When the capture wire is drawn into the catheter, one end of the catheter may be sealed.

The manipulation means includes: a capture manipulation unit provided to surround the other end of the guide wire and manipulating the capture means to be pulled in or out from the catheter by moving the guide wire toward one end or the other end of the catheter; and an expansion control unit provided at the other end of the catheter and configured to expand or contract the expansion unit by injecting or discharging external gas into the expansion unit.

A gas passage is formed between the first tube and the second tube for the external gas to be injected toward one end of the expansion means or for the external gas to be discharged from the expansion means, and one end of the first tube is It may be coupled to one end of the second tube to seal one end of the expansion means.

An expansion area corresponding to the expansion means of the first tube may be provided with a first inflatable material, and a remaining area of the first tube and the second tube may be provided with a second material.

In the expansion means, when the external gas is injected by the expansion operation unit, the expansion area of the first tube expands, and the remaining area of the first tube and the second tube do not expand in the outer direction of the catheter. It can be configured to expand to.

The expansion operation unit includes: an air pump configured to inject the external gas into the expansion means; an inlet provided on one side of the air pump and sucking in the external gas; a gas valve provided at a portion where the air pump and the gas passage are connected, opened when the external gas is injected into the expansion means, and closed in other cases; And it may include a discharge button for discharging the gas injected into the expansion means to the outside.

When the air pump is compressed, the intake port is closed and the gas valve is opened so that the external gas inside the air pump is injected into the expansion means through the gas passage, and when the air pump is restored to its original state, The external gas may be supplied to the inside of the air pump by opening the intake port and closing the gas valve.

The stone removal device according to an embodiment of the present invention captures and lifts relatively large stones using the trapping means, and then expands the expansion means to discharge the relatively small stones first, so that the large stones are placed between the small stones. It is possible to prevent a situation in which the stone is not discharged due to being caught in the stone, and a large amount of stone can be removed with a smaller number of procedures by using both the trapping means and the expansion means during the procedure.

On the other hand, the effects obtainable in the present invention are not limited to the effects mentioned above, and other effects not mentioned will be clearly understood by those skilled in the art from the description below. You will be able to.

1 is a view schematically showing the appearance of a stone removal device in one embodiment of the present invention.
2 is a view schematically showing how a plurality of stones are removed after the stone removal device according to an embodiment of the present invention is inserted into the bile duct.
3 is a perspective view of one end of a catheter according to one embodiment of the present invention.
4 is a view showing a state in which the capture means is withdrawn from one end of the catheter and the expansion means is inflated according to an embodiment of the present invention.
5 is a perspective view of the other end of the stone removal device according to an embodiment of the present invention.
6 is an internal view of the other end of the stone removal device according to an embodiment of the present invention.
7 is a view schematically showing the appearance of an expansion means and an expansion operation unit according to an embodiment of the present invention.

Other advantages and features of the present invention, and methods for achieving them, will become clear with reference to the embodiments described below in detail in conjunction with the accompanying drawings. However, the present invention is not limited to the embodiments disclosed below and may be implemented in various different forms, but only the present embodiments make the disclosure of the present invention complete, and the common knowledge in the art to which the present invention belongs It is provided to fully inform the holder of the scope of the invention, and the present invention is only defined by the scope of the claims.

Even if not defined, all terms (including technical or scientific terms) used herein have the same meaning as generally accepted by common technology in the prior art to which this invention belongs. Terms defined by general dictionaries may be interpreted to have the same meaning as they have in the related art and/or the text of the present application, and are not conceptualized or overly formalized, even if not expressly defined herein. won't

Terms used in this specification are for describing embodiments and are not intended to limit the present invention. In this specification, singular forms also include plural forms unless specifically stated otherwise in a phrase. As used in the specification, 'comprise' and/or various conjugations of this verb, such as 'comprise', 'comprising', 'comprising', 'comprising', etc., refer to a mentioned composition, ingredient, component, Steps, acts and/or elements do not preclude the presence or addition of one or more other compositions, ingredients, components, steps, acts and/or elements. In this specification, the term 'and/or' refers to each of the listed elements or various combinations thereof.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings of this specification.

1 is a view schematically showing the appearance of a stone removal device 10 according to an embodiment of the present invention.

Referring to FIG. 1 , the stone removal device 10 includes a catheter 100, a guide wire 200, a capture unit 300, an expansion unit 400, and a control unit 500. The catheter 100 refers to a tube inserted into a site where the stone 20 is formed, and may be inserted into a site where stones may occur, such as the bile duct 30 and the urethra. Hereinafter, the bile duct 30 will be described as an example. An empty lumen is provided inside the catheter 100 . A guide wire 200 is provided in the lumen of the catheter 100 . The guide wire 200 prevents the catheter 100 from being excessively bent while the catheter 100 is inserted into the bile duct 30 so that it can be easily inserted into the site where the bile duct 20 is created. The guide wire 200 may be moved in the direction of one end or the other end of the catheter 100 in the lumen of the catheter 100 by an externally applied force by an operator. The catching means 300 includes a catching wire 310, and the catching wire 310 is provided to extend from one end of the guide wire 200 as a steel wire that can be bent into a semicircular shape rich in elasticity and flexibility. The capture wire 310 may be pulled in or out from one end of the catheter 100 in response to the movement of the guide wire 200, and when pulled out from one end of the catheter 100, each capture wire 310 has a semicircular shape. It opens to form a basket shape in which the trapping area 311 is formed in the middle. After allowing the first stone 20a, which is a relatively large stone, to be inserted into the capture area 311, the operator pulls the guide wire 200 so that the capture wire 310 is drawn into the lumen of the catheter 10. to hold the first stone 20a firmly by reducing the volume of the trapping area 311. An expansion means 400 is provided at one end of the catheter 100 . When external gas 40 is injected, the expansion means 400 expands outwardly of the catheter 100 to come into contact with the bile duct 30. After that, when the operator pulls the catheter 100, the calculus is relatively small in size. The second phosphorus stone 20b is pushed out by the expansion means 400 and comes out of the human body. A manipulation means 500 is provided at the other end of the catheter 100 . The control means 500 includes a capture control unit 510 and an expansion control unit 520, through which the movement of the capture unit 300 and the expansion unit 400 is controlled. In other words, the capture unit 510 and the expansion unit 520 release the second stone (after the trapping unit 300 grabs the first stone 20a and the expansion unit 400 expands to come into contact with the bile duct 30). 20b) controls the movement of each component during the pushing process.

FIG. 2 is a view schematically showing how a plurality of stones 20 are removed after the stone removal device 10 according to an embodiment of the present invention is inserted into the bile duct 30. Referring to FIG.

Referring to FIG. 2 , the stone removing device 20 may be divided into five steps (a) to (e).

Step (a) is a view schematically showing the appearance of the insertion step in which the stone removal device 10 is inserted into the site where the stone 20 is located in the bile duct 30. In the insertion step, the capture means 300 is provided in a state inserted into the lumen of the catheter 100, and the expansion means 400 is provided in a contracted state. As a result, the overall appearance of the stone removal device 10 has a tubular shape, so that it can be easily inserted along the bile duct 30 to the site where the stone 20 is formed.

Step (b) is a capturing step in which the capturing unit 300 is withdrawn from one end of the catheter 100 and then capturing the first stone 20a, which is a relatively large stone 20, in the capturing area 311 of the basket. It is a diagram schematically showing the appearance of In the capture step, the capture wire 310 is pulled out from one end of the catheter 100, and the drawn capture wire 310 forms a hemispherical shape due to its elasticity and flexibility. In other words, a separation occurs between the middle regions of the catching wires 310, and the plurality of catching wires 310 form a basket shape, thereby forming the catching region 311 inside the basket. The operator adjusts the positions of the guide wire 200 and the capture wire 310 so that the first stone 20a enters the capture area 311. When the first stone 20a enters the capture area 311, the guide wire 200 is pulled toward the other end of the catheter 100 so that the capture wire 310 is drawn into the catheter 100. As a result, the volume of the trapping area 311 is reduced, and in this process, the first stone 20a is captured by the trapping wire 310.

In the step (c), the first stone 20a is captured using the trapping means 300 and then the catheter 100 is further pushed into the bile duct 30 to lift the first stone 20a. 20a) is a diagram schematically showing the appearance of the separation step of separating the second stone (20b). In the separation step, the user captures the first stone 20a with the trapping means 300 and then pushes the catheter 100 further into the bile duct to lift the first stone 20a. In this process, the first stone 20a is lifted. There is a gap between (20a) and the second stone (20b).

Step (d) is a view schematically showing the appearance of the expansion step of inflating the expansion means 400 by blowing external gas 40 into the expansion means 400 provided at one end of the catheter 100. The expansion unit 400 into which the external gas 40 is injected through the expansion control unit 500 expands outwardly of the catheter 100 and comes into contact with the bile duct 30 . At this time, the expansion means 400 may be in close contact with the inner wall of the bile duct 30, and does not adhere to the bile duct 30 according to the amount of external gas 40 injected by the user, but the distance from the bile duct 30 is the second. It may be provided smaller than the diameter of stone 20b. In summary, the expanded expansion means 400 has a sieve located between the first stone 20a and the second stone 20b, and the distance between the inner wall of the bile duct 30 is at least greater than the diameter of the second stone 20b. It expands to be smaller.

Step (e) is a view schematically showing the appearance of the discharge step, which is a step in which the user pulls the stone removal device 10 and separates it from the bile duct 30. When the user pulls the catheter 100 and the guide wire 200 to bring the stone removal device 10 out of the bile duct 30, the first stone 20a is captured by the trapping means 300 in the process. And the second stone (20b) is pushed out of the bile duct (30) by the expansion means (400).

3 is a perspective view of one end of catheter 100 according to one embodiment of the present invention.

Referring to FIG. 3 , the catheter 100 includes a first tube 110 and a second tube 120 in which a lumen is formed. The first tube 110 refers to a tube provided on the outermost side of the catheter 100 . A lumen is formed in the first tube 110 , and a second tube 120 is provided in the lumen of the first tube 110 . The second tube 120 also has a lumen, and a spirally twisted guide wire 200 is provided in the lumen of the second tube 120 . That is, the guide wire 200 is provided in the lumen of the catheter 100 and is provided to be movable in the direction of one end or the other end of the catheter 100, to be precise, the body provided in the lumen of the second tube 120 is movable. can be provided.

An expansion means 400 is provided at one end of the catheter 100 . The expansion means 400 is configured such that one end of the catheter 100 expands in an outward direction of the catheter 100 when external gas 40 is injected. A more detailed configuration of the expansion means 400 will be described later.

The catching means 300 provided at one end of the guide wire 200 is formed extending from one end of the guide wire 200 . The capture means 300 may be provided as a steel wire having stronger elasticity and flexibility than the guide wire 200, and through this, when pulled out of the catheter 100, it is provided to form a basket shape with a gap between them. When the guide wire 200 moves in the lumen of the catheter 100, the trapping means 300 is withdrawn or drawn in from the catheter 100. In this process, it is configured to capture stones inside the basket. However, as shown in FIG. 3, when present in the lumen of the catheter 100, it cannot be opened by an external force applied from the catheter 100 and may be provided in a spirally twisted state like the guide wire 200. A more detailed configuration of the trapping means 300 will be described later.

4 is a view showing a state in which the capture means 300 is withdrawn from one end of the catheter 100 and the expansion means 400 is inflated according to an embodiment of the present invention.

Referring to FIG. 4 , the catching means 300 includes a catching wire 310 and a head part 320 . When the capture wire 310 is pulled out of the catheter 100, it refers to a wire that is spaced apart from each other and forms a basket. A head portion 320 is provided at the end of the catching wire 310 . The head portion 320 is configured to seal one end of the catheter 100 when the capture wire 310 is introduced into the catheter 100 .

That is, the capture means 300 refers to a basket composed of a plurality of capture wires 310 having elasticity, and when the capture wire 310 is withdrawn from the catheter 100, the basket is spread apart from each other in the middle due to the elastic force. It forms a trapping area 311 capable of trapping stones 20.

As mentioned above, the guide wire 200 may move in the direction of one end or the other end of the catheter 100. When the guide wire 200 moves in the direction of one end of the catheter 100, the trapping means 300 may move toward the catheter 100. ) and form a basket shape. At this time, the user places the first stone 20a in the trapping area 311 inside the basket to remove the stone 20 . When the first stone 20a is located in the capture area 311, the user pulls the guide wire 200 toward the other end of the catheter 100. When the guide wire 200 moves in the direction of the other end of the catheter 100, the capture wire 310 is drawn into the catheter 100, and as a result, the size of the capture area 311 is reduced, so that the capture means 300 It becomes possible to firmly capture the first stone 20a.

The expansion means 400 is provided at one end of the catheter 100, and refers to a configuration that expands in an outward direction of the catheter 100 when external gas 40 is injected. In other words, the expansion means 400 refers to an expansion area 111 of the first tube 110 that can expand in an outward direction of the catheter 100 when external gas 40 is injected.

The first tube 110 is divided into an expansion area 111 and a remaining area 112, wherein the expansion area 111 is provided with a first material and the remaining area 112 is provided with a second material. The first material is provided as a material that is more expandable than the second material, and therefore, when external gas 40 is injected, the remaining area 112 corresponding to the second material does not expand, and the expansion area provided with the first material ( 111 is able to expand in the outer direction of the catheter 100.

External gas 40 is injected into the expansion means 400 through the gas passage 130 . The gas passage 130 is provided between the first tube 110 and the second tube 120, and refers to a passage through which the external gas 40 injected from the expansion manipulator 520 flows. That is, the gas passage 130 includes the first tube 110 provided so that the external gas 40 is injected toward one end of the expansion means 400 or the external gas 40 is discharged from the expansion means 400. It refers to the space between the second tubes 120. At this time, one end of the first tube 110 is coupled to one end of the second tube 120 to seal the expansion means 400 to prevent the external gas 40 injected into the expansion means 400 from escaping.

Figure 5 is a perspective view of the other end of the stone removal device 10 according to an embodiment of the present invention, Figure 6 is an internal view of the other end of the stone removal device 10 according to an embodiment of the present invention, Figure 7 is It is a diagram schematically showing the appearance of the expansion means 400 and the expansion manipulation unit 520 according to an embodiment of the present invention.

5 to 7, the stone removal device 10 according to an embodiment of the present invention is provided at the other end of the catheter 100 and controls the movement of the capture means 300 and the expansion means 400. Means 500 are included. The control means 500 includes a capture control unit 510 and an expansion control unit 520 .

The capture manipulation unit 510 is provided to surround the other end of the guide wire 200, and by moving the guide wire 200 toward one end or the other end of the catheter 100, the capture means 300 is pulled in or out of the catheter 100. to be withdrawn In other words, when the user fixes the position by holding the catheter 100 with one hand, and then pushes the capture manipulator 510 to one end of the catheter 100 or pulls it to the other end of the catheter 100 with the other hand The guide wire 200 is moved in the direction of one end or the other end of the catheter 100 in the lumen of the catheter 100 . As a result, the trapping means 300 provided at one end of the guide wire 200 is pulled in or out from one end of the catheter 100, and the stone 20 can be captured.

The expansion control unit 520 is provided at the other end of the catheter 100 and manipulates the expansion means 400 to expand or contract by injecting or discharging external gas 40 into the expansion means 400 . The expansion control unit 520 is provided on one side of the air pump 521 configured to inject external gas 40 into the expansion means 400 and the air pump 521, and the intake port 522 for sucking the external gas 40 , The gas valve 523 and the expansion means provided at the part where the air pump 521 and the gas passage 130 are connected and opened when external gas 40 is injected into the expansion means 400 and closed in other cases ( 400) includes a discharge button 524 for discharging the injected gas to the outside.

The air pump 521 may be made of a material having elasticity and restoring force such as rubber. When the air pump 521 is compressed by an external force applied by the user, the inlet port 522 is closed and the gas valve 523 is opened so that the external gas 40 introduced into the air pump 521 passes through the gas passage 130 ) is injected into the expansion means 400 through. In addition, when the user no longer applies an external force, the shape of the air pump 521 is restored to its original state by the elasticity and restoring force of the air pump 521 itself, and at this time, the intake port 522 is opened and the gas valve 523 is closed As a result, the external gas 40 is injected into the air pump 521 again.

When the intake port 522 and the gas valve 523 are made of rubber, they operate as described above by their own elastic force, and when a separate spring is provided inside, they operate by their own elastic force and the elastic force of the spring. It operates as follows, and for each detailed driving method, a known technology used in an air pump or the like can be applied without limitation.

The discharge button 524 is configured to discharge the gas injected into the expansion means 400 to the outside, and may be provided on the gas passage 130 in an area adjacent to the air pump 521 . For example, the discharge button 524 forms a protrusion to the outside, covers the screw cap on the outside, inserts a valve that receives the elastic force of the spring inside, and forms a push rod inside the screw cap, so that the screw cap By turning the pressure bar inside can be configured to release the air inside the balloon by pressing and opening the valve. However, in addition to this, any known technique used to remove the injected gas in a configuration in which gas is injected, such as the expansion means 400, can be applied without limitation.

The stone removal device 10 according to an embodiment of the present invention captures and lifts a relatively large stone 20a using the trapping means 300 and then inflates the expansion means 400 to form a relatively small stone. By ejecting the stone 20b first, it is possible to prevent a situation in which a large stone 20a is caught between small stones 20b and is not discharged, and the trapping means 300 and the expansion means 400 can be used together during the procedure. As a result, it is possible to remove a large amount of stones with fewer procedures.

Although the present invention has been described through examples above, the above examples are only for explaining the idea of the present invention and are not limited thereto. Those skilled in the art will understand that various modifications can be made to the above-described embodiments. The scope of the present invention is defined only through the interpretation of the appended claims.

10: stone removal device 20: stone stone
20a: 1st absence 20b: 2nd absence
30: bile duct 40: external gas
100: catheter 110: first tube
111: expansion area 120: second tube
130: gas passage 200: guide wire
300: capture means 310: capture wire
311: capture area 320: head part
400: Expansion means 500: Manipulation means
510: capture operation unit 520: expansion operation unit
521: air pump 522: intake port
523: gas valve 524: discharge button

Claims (10)

catheters inserted into the stone formation site;
a guide wire provided in the lumen of the catheter and moving in the lumen;
a trapping means extending from one end of the guide wire and configured to capture stones while being drawn in and out of the catheter according to the movement of the guide wire;
Expansion means configured to expand one end of the catheter outward when external gas is injected; and
And a manipulation means for controlling the movement of the trapping means and the expansion means,
The catheter includes a first tube and a second tube in which a lumen is formed,
The second tube is provided in the lumen of the first tube,
The guide wire is provided in the lumen of the second tube,
An expansion area corresponding to the expansion means in the first tube is provided with an expandable first material,
The remaining area of the first tube and the second tube are provided with a second material,
When the external gas is injected into the expansion means by an expansion operation unit provided at the other end of the catheter, the expansion area of the first tube expands, and the remaining area of the first tube and the second tube do not expand. Stone removal device configured to expand in an outward direction of the catheter by the.
delete According to claim 1,
The catching means is a basket composed of a plurality of catching wires having elasticity,
The basket is a stone removal device in which central regions are spaced apart from each other by an elastic force when the capturing wire is withdrawn from the catheter and form a capturing region capable of capturing stones.
According to claim 3,
The catching means further comprises a head portion,
The head portion:
provided at the end of the catching wire;
Stone removal device configured to seal one end of the catheter when the capture wire is drawn into the catheter.
According to claim 4,
The operating means is:
a capture manipulation unit provided to surround the other end of the guide wire and manipulating the capture means to be pulled in or out from the catheter by moving the guide wire toward one end or the other end of the catheter; and
Stone removal device comprising an expansion control unit provided at the other end of the catheter and configured to expand or contract the expansion unit by injecting or discharging external gas into the expansion unit.
According to claim 5,
A gas passage is formed between the first tube and the second tube for injecting the external gas toward one end of the expansion means or discharging the external gas from the expansion means,
One end of the first tube is coupled to one end of the second tube to seal one end of the expansion means.
delete delete According to claim 6,
The expansion operation unit:
an air pump configured to inject the external gas into the expansion unit;
an inlet provided on one side of the air pump and sucking in the external gas;
a gas valve provided at a portion where the air pump and the gas passage are connected, opened when the external gas is injected into the expansion means, and closed in other cases; and
Stone removal device comprising a discharge button for discharging the gas injected into the expansion means to the outside.
According to claim 9,
When the air pump is compressed, the intake port is closed and the gas valve is opened so that the external gas inside the air pump is injected into the expansion means through the gas passage;
When the air pump is restored, the inlet is opened and the gas valve is closed so that the external gas is provided to the inside of the air pump.

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