RU2460551C1 - Operated catheter for endoscopic interventions - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: catheter comprises in-built rods on bent portions with distal and proximal side. Pressure rings fasten a spiral through which the rods attached to the pressure ring extend. The proximal end of the catheter extends through a handle with an attachment point of the rods in vertical arrangement of the bent portions. The handle is rocking on the portion from the proximal side to pull some rods which is transferred on the portion of the catheter from the distal end. The spirals are one-side bent together with the portions of the catheter. The bend of the portion of the catheter on the proximal side is copied over the bend of the portion of the catheter on the distal side but on the opposite side. It results in endoscopically-assisted introduction of the catheter in narrowed and deformed passages in complicated clinical situations for the purpose of both diagnostic, and therapeutic endoscopic interventions, by the introduction of the other endoscopic instruments in the catheter.

EFFECT: invention may be used for diagnostic (contrast enhancement) and therapeutic endoscopic introductions (extraction of concrements, masses, cord conduction, recovered passability, etc) in complicated clinical situations.

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Description

The invention relates to medicine, namely to endoscopic surgery, and can be used for endoscopic interventions. Endoscopic transcapillary interventions are actively used in biliary surgery. Currently, endoscopic decompression of the extrahepatic bile ducts, in the form of stenting, calculus removal, etc. with biliary hypertension of various origins, occupies a significant place in endoscopic surgery.

The essence of these operations is as follows: after bringing the duodenoscope to the large duodenal nipple (BDS) of the duodenum (duodenum) and performing a papillotomy, a basket probe is inserted into the lumen of the common bile duct and stones are removed. If it is necessary to install a stent for bile duct, a catheter is inserted into the lumen of the common bile duct, which is performed above the area of obstruction (calculus, tumor, cicatricial stricture, compression from the outside, etc.). Further along the catheter, into the lumen of the common bile duct, a string is installed. After installing the string, the catheter is removed, holding the string in a predetermined position, and the stent is installed along the string. There are clinical situations when the bile duct is deformed (cicatricial stricture, compression from the outside, deformation after previous surgery, etc.) and it is not possible to conduct a basket probe or uncontrolled catheter with the aim of placing the stent behind the narrowing zone.

The objective is the invention of a catheter with a controlled distal end, allowing you to go beyond the area of narrowing or deformation with the ability to perform not only diagnostic, but also therapeutic interventions.

An analogue of the proposed solution can be a catheter according to EP 2005874 A1, 12/24/2008, abstract, figure 2. This solution makes it difficult to catheterize duct structures in difficult clinical situations due to the fact that this catheter bends in one direction.

The objective is to ensure:

- the ability to control the bend of the distal end of the catheter in any direction;

- the possibility of installing other endoscopic instruments in the catheter, which allows not only contrasting, but also therapeutic endoscopic interventions: removal of calculi, removal of tumor-like structures, restoration of duct obstruction, etc.

The essence of the invention is that a support ring is provided on the distal end of the catheter, on which, along the perimeter, flexible rods are fastened, passing through the restrictive ring together with the catheter, and on the support and restriction rings, on the bend of the catheter, a spiral is fixed, covering the rods along with the catheter, and at the proximal end of the catheter there is a similar section of the catheter with continued traction, with a spiral covering the traction together with the catheter, fixed to the supporting and restrictive rings, and the rods together with the catheter are installed in the handle with screws for fastening them when the sections of the catheter with spirals are vertically arranged, and at the proximal end of the catheter, handles are provided for moving the catheter and the collar, when the portion with the spiral is bent to either side on the proximal side tension of the rods, from bending, the catheter is bent with a spiral on the distal side to the opposite side.

The proposed solution guided catheter will provide:

- the ability to control the bend of the distal end of the catheter in any direction;

- the ability to install other endoscopic instruments in a controlled catheter to perform not only diagnostic, but also therapeutic interventions (contrasting, calculus removal, removal of tumor-like structures by electrocoagulation method, etc.) in complex clinical cases.

The design of the guided catheter is shown in FIG. 1 and FIG. 2.

Figure 1 is a General view with a variant of the optionally installed on the catheter device for catheterization with the supply of the solution to the place of contrast.

Figure 2 is a section along aa.

The catheter - 1 is installed in the endoscope - 2, on the distal end of the catheter - 1 there is a support ring - 3 with rods attached to it - 4 passing through the endoscope - 2 together with the catheter - 1. A spiral - 5 is fixed on the ring - 3, covering the distal the end of the catheter - 1 together with the rods - 4. The spiral - 5 is fixed to the restrictive ring - 6, sitting on the catheter - 1. At the proximal end, the catheter - 1 at the bend - 7 has a spiral - 8, fixed to the rings - 9 and 10. The catheter - 1 together with the rods - 4 is installed in the control handle - 11 with a ring - 12 screws and - 13 for tension rods - 4 with a vertical arrangement of sections of the bend of the catheter - 1.

On an optionally installed on the catheter - 1 device for catheterization - 14 there are handles - 15 for supporting the device - 14 when moving the rod - 16 with the handle - 17 with the rod and the gimlet at the distal end - 18 when it passes into the lobar duct - 19. The rod is fixed with gimlet - 18 on the rod - 16 is carried out by a screw - 20. Place for connecting the supply of contrasting solutions - 21.

The operation of a controlled catheter is as follows.

At the distal end of the catheter - 1 in the area to be bent - 7, a restriction ring - 6, a support ring - 3 with rods - 4 are installed. Rods - 4 are held under the restriction ring - 6, a spiral - 5 is attached to rings - 3 and 6. Traction - 4 together with the catheter - 1 are carried out into the endoscope - 2 to the restrictive ring - 6 from the distal side. On the proximal side of the endoscope - 2 in the area to be bent - 7, the rods - 9 and 10 and the spiral - 8 fixed to the rings - 9 and 10 are installed on the rods - 4. The rods - 4 together with the catheter - 1 are installed in the handle - 11 In the vertical position of the sections for bending - 7, the rods - 4 are straightened and stretched, and fastened with screws - 13 on the ring - 12. At the end of the catheter - 1 protruding from the handle - 11, it is possible to attach devices for interventions in the duct structures.

An example of the installation is a device for catheterization - 14, in which there are handles - 15 for supporting the device when moving the rod - 16 by means of the handle - 17 with a rod with a gimlet - 18, installed in the catheter from the distal side, fixed to the rod - 16 by means of a screw - 20 .

When working with a catheter, adjustable in conjunction with a device for catheterization, the shaft gimlet - 18 is installed in the catheter. The endoscope - 2 is brought to the site of intervention by the distal end with the coaxial arrangement of the bending sections and the tie rods equally positioned - 4 with screw fixing - 13.

By bending the handle - 11 catheters in the proximal section - 7 with a spiral - 8 bends the spiral - 8 and pulls individual rods - 4, which bend the catheter - 1 on the distal side of the section - 7.

By choosing the direction of the bending of the proximal section - 7, the handle bends the section - 7 on the distal side, which ensures the possibility of getting into the lobar duct - 19. By means of the handle - 17, the pinch of the rod is removed from the catheter - 1. Turning the pinch - 18 by the handle - 17 facilitates the penetration of the catheter - 1 into the lobar duct - 19. A contrasting solution is supplied through the connection point - 21.

Claims (1)

A catheter controlled for endoscopic interventions, comprising flexible rods and a handle, characterized in that a support ring is provided at the distal end of the catheter, on which flexible rods are fixed along the perimeter, passing through the restrictive ring together with the catheter, and on the supporting and restrictive rings at the bend section of the catheter a spiral is fixed, covering the traction together with the catheter, and at the proximal end of the catheter a similar section of the catheter is provided with the continuation of the traction, with a spiral covering the traction together but with a catheter fixed to the support and restrictive rings, and the rods together with the catheter are installed in the handle with screws for fastening them with vertical sections of the catheter with spirals, and at the proximal end of the catheter, handles are provided for moving the catheter and the handle, when bending to any side by the handle of the plot with a spiral on the proximal side by tension of the rods, from bending, the catheter is bent with a spiral on the distal side to the opposite side.

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