WO2011066760A1 - 组合式软硬质内窥镜 - Google Patents

组合式软硬质内窥镜 Download PDF

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Publication number
WO2011066760A1
WO2011066760A1 PCT/CN2010/076974 CN2010076974W WO2011066760A1 WO 2011066760 A1 WO2011066760 A1 WO 2011066760A1 CN 2010076974 W CN2010076974 W CN 2010076974W WO 2011066760 A1 WO2011066760 A1 WO 2011066760A1
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WO
WIPO (PCT)
Prior art keywords
handle
tube
hard
steering
hose
Prior art date
Application number
PCT/CN2010/076974
Other languages
English (en)
French (fr)
Inventor
龙刚
宋磊
陈志强
吴耀辉
夏萍
Original Assignee
武汉佑康科技有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from CN200910251256.9A external-priority patent/CN101732027B/zh
Priority claimed from CN200910273215XA external-priority patent/CN101744600B/zh
Priority claimed from CN2010102665514A external-priority patent/CN101933795B/zh
Application filed by 武汉佑康科技有限公司 filed Critical 武汉佑康科技有限公司
Publication of WO2011066760A1 publication Critical patent/WO2011066760A1/zh
Priority to US13/485,959 priority Critical patent/US9398838B2/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00066—Proximal part of endoscope body, e.g. handles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A61B1/0052—Constructional details of control elements, e.g. handles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00082—Balloons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/303—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the vagina, i.e. vaginoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/307—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the urinary organs, e.g. urethroscopes, cystoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes

Definitions

  • the present invention relates to the field of medical devices, and in particular to a combined soft and hard endoscope. Background technique
  • the rigid ureteroscope is easy to operate and can easily reach the renal pelvis through the ureter.
  • the soft ureteroscope can not be adjusted into the renal pelvis after entering the renal pelvis for various diagnosis and treatment.
  • the soft ureteroscope can be unidirectional. Or more than a large angle of bending, turning, but difficult to enter the renal pelvis and renal pelvis through the ureter, although under the guidance of X-ray can enter the renal pelvis and renal pelvis, but X-ray damage to doctors and patients.
  • the development of a soft and rigid ureteroscope has been the goal pursued by both ureteroscope manufacturers and urology surgeons.
  • the object of the present invention is to overcome the deficiencies of the above-mentioned background art and to provide a combined soft and hard endoscope which has the characteristics of being easy to operate and easy to turn.
  • the present invention provides a combined soft and hard endoscope comprising a catheter portion, a steering handle for controlling the bending of the catheter, and a pipe connector, the conduit portion including the outer tube and the inner tube, and the outer tube sleeve Outside the tube, the steering handle comprises a handle sleeve, a handle cover, and a handle sleeve An axial guide rail and a slider are disposed between the handle sleeve and the handle cover outside the handle cover, and the guide rail and the slider are respectively fixed on the handle sleeve or the handle cover, and the outer tube is fixedly connected with the handle sleeve.
  • the inner tube passes through a through hole in the handle sleeve, is connected to an interface of the pipe connector and is fixed at the interface, and the pipe connector is fixedly connected with the handle cover in the handle cover, and the remaining interfaces of the pipe connector are respectively Connect to each channel port on the handle cover.
  • the handle cover and the handle cover are all in the shape of a cylinder.
  • each channel port on the handle cover is an endoscope fiber channel port, a water injection channel port, and an instrument channel port
  • the endoscope fiber channel port is located at the center of the end of the handle body cover, the water injection channel port and at least one The instrument passage openings are respectively located at the edge of the end of the handle cover.
  • the guide rail is a strip-shaped chute disposed on the outer surface of the handle cover in the axial direction
  • the slider is a limit bolt disposed in the screw hole of the side wall of the handle sleeve, and the bolt is matched with the chute.
  • a cervical plug for preventing backflow of liquid in the cavity is further provided on the outer wall of the rigid tube.
  • the cervical plug is a ball which is disposed on the outer wall of the rigid tube, and the ball is connected to the inflation nozzle through an inflation duct located on the outer wall of the hard tube.
  • the outer tube is a rigid tube
  • the inner tube is an elbow tube
  • one end of the elbow tube is curved
  • the other end is connected to an interface of the pipe connector and fixed at the interface.
  • the outer tube is a hard tube
  • the inner tube is a hose
  • the hose is provided with a steering passage and a working channel
  • the steering channel is provided with a steering wire
  • the hose The outer end is provided with a hard sheath 8
  • a positioning sleeve 2 is arranged in the steering passage 11 in the hose
  • an elastic tube 7 is arranged in the hose 6 between the positioning sleeve 2 and the hard sheath 8 .
  • the steering wire 5 passes through the positioning sleeve 2 and the elastic tube 7, the end is fixedly connected with the hard sheath 8, and the other end passes through the interface of the pipe connector and the steering control valve on the handle cover that can control the expansion and contraction of the steering wire connection.
  • the working channel comprises an instrument channel, a fiber channel and a water injection channel arranged side by side.
  • the steering channel disposed within the hose is offset from the centerline of the hose.
  • the invention utilizes the relative movement between the handle sleeve and the handle cover in the steering handle to realize the outer tube and Relative expansion and rotation between the inner tubes, the handle sleeve and the handle cover are axially extended and contracted by the guide rail and the slider; when the slider is withdrawn from the guide rail, the handle sleeve and the handle cover can be rotated.
  • the handle sleeve and the handle cover are axially extended and contracted by the guide rail and the slider; when the slider is withdrawn from the guide rail, the handle sleeve and the handle cover can be rotated.
  • the inner tube passes through the through hole in the center of the handle sleeve, the pipe connector and the soft connection tube fixed in the handle cover are respectively connected with the respective passage ports on the handle cover, and the outer tube is fixed to the handle sleeve. Connected, therefore, the outer tube and the inner tube can be easily telescoped and rotated without affecting the work of the endoscope fiber channel port, the water injection channel port and the instrument
  • the combined soft and hard endoscope of the invention has the advantages of simple structure, convenient operation and flexible steering, and can be used for fallopian tube and ureteroscope and other department endoscopes.
  • Embodiment 1 is a schematic structural view of Embodiment 1;
  • Figure 2 is a plan view of Figure 1;
  • Figure 3 is a schematic structural view of a steering handle
  • Figure 4 is a cross-sectional view of the hose head
  • Figure 5 is a cross-sectional view taken along line A-A of Figure 4.
  • Figure 6 is a view taken along line M of Figure 4.
  • Figure 7 is a schematic structural view of Embodiment 2.
  • Figure 8 is a plan view of Figure 7;
  • Figure 9 is a schematic structural view of Embodiment 3.
  • Figure 10 is a plan view of Figure 9.
  • Figure 11 is a perspective view of the steering handle.
  • Embodiment 1 provides a bendable steering endoscope, see FIGS. 1 and 2, which includes a catheter portion, a steering handle that controls bending of the catheter, and a tubing connector, the catheter portion including a plastic portion.
  • the rigid tube 1 and the hose 2 are placed outside the hose 2.
  • the steering handle includes a handle sleeve 3 and a handle cover 4 .
  • the handle sleeve and the handle cover are all in the shape of a cylinder.
  • the handle sleeve is sleeved on the outside of the handle cover, and the handle sleeve and the handle body are respectively
  • An axial guide and a slider are provided between the covers.
  • the guide rail is a strip-shaped sliding groove 6 disposed on the outer surface of the handle body cover in the axial direction.
  • the slider is a limit bolt 5 disposed in the screw hole of the side wall of the handle sleeve, and the bolt 5 is matched with the sliding groove 6.
  • the rigid tube 1 and the handle sleeve 3 are fixedly connected by a connecting flange 7 which is threaded through a through hole in the center of the handle sleeve 3, and is connected to an interface of the pipe connector 8 and fixed at the interface.
  • the hose 2 has a steering passage and a working passage, and a steering wire 14 is provided in the steering passage, and the working passage includes an instrument passage, a fiber passage, and a hose water injection passage arranged side by side.
  • the outer end of the hose 2 is provided with a hard sheath 16 made of a metal material, and the hard sheath is annular, which is placed outside the hose head and is integrally molded with the hose. .
  • a bevel is also provided at the outer end of the hose 2 (see Figure 4) to facilitate the insertion of the hose head into the organ.
  • a positioning sleeve is disposed in the steering passage in the hose, the positioning sleeve 17 is a stainless steel tube, and an elastic tube 18 is disposed in the hose between the positioning sleeve 17 and the hard sheath 16, and the elastic tube 18 is high.
  • the steering wire 14 passes through the positioning sleeve and the elastic tube, one end is fixedly connected to the hard sheath, and the other end is connected to the steering control valve on the handle cover which can control the expansion and contraction of the steering wire 14 through the interface of the pipe connector 8.
  • the steering control valve is a rotary handle 9 , and the rotating shaft of the rotating handle is mounted on the handle cover.
  • the rotating shaft is provided with a rotating wheel 10 .
  • the rotating wheel 10 is located in the handle cover, and the steering wire 14 is fixed on the rotating wheel 10 . .
  • Each channel port on the handle cover is an endoscope fiber channel port 11, a hose water inlet port 12.
  • the instrument passage opening 13, the endoscope fiber channel port 11 is located at the center of the end of the handle body cover, and the endoscope fiber 15 extends from the endoscope fiber channel port 11 and protrudes from the head of the hose 2.
  • the water injection passage port and the instrument passage opening are respectively located at the edge portions of the end of the handle body, and are respectively connected with the water injection passage and the instrument passage in the hose through the pipe connector 8.
  • the pipe connector 8 is a four-way pipe, which is connected by bolts between the handle cover and the handle cover, and one end of the pipe connector 8 is connected with the hose; the outer ends of the other ends of the other end pass through the respective
  • the soft connecting tubes are respectively connected to the endoscope fiber channel port 11, the water injecting port port 12 and the instrument channel port 13 on the handle body cover; the inner ends are respectively connected with the instrument channel, the fiber channel and the water injection channel in the hose 2.
  • the three working channels in the hose of the present invention can have different specifications in channel size depending on different needs.
  • the present invention controls the angle of the front end of the hose directly through the steering handle and the steering control valve.
  • the rotary handle of the steering control valve When the rotary handle of the steering control valve is rotated, the steering wire is retracted, the elastic tube is compressed, and the front end of the hose is pulled, as shown in Figure 1. After the rotating handle is released, the elastic tube is returned, causing the entire hose to return. .
  • the bending process not only operates the single cylinder, but also can accurately control the steering angle.
  • the angle of the hose turning and bending depends on the length of the elastic tube, up to 180 degrees or more, and the whole bending process cooperates with the expansion and contraction between the soft and hard tubes.
  • the movement can achieve a full range of orientation (including bending direction and angle), telescopic, and the viewing angle can be 360 degrees, completely eliminating the blind angle.
  • ureteroscope can not only observe the ureter, bladder, renal pelvis and renal pelvis, but also take biopsy, take foreign bodies, take stones, remove small tumors, electrocoagulate and stop bleeding, and cut stenosis, which becomes an important method for diagnosing and treating upper urinary tract diseases.
  • Multi-channel hose combines all the advantages of current rigid mirror and elastic soft mirror. It can be widely used to treat hydrocephalus, intraventricular/parallel lesions, Skull base surgery, pituitary tumor, aneurysm, intracranial hematoma, especially subdural septal hematoma, endoscopic percutaneous push discectomy, and even for intratumoral tumor biopsy and small tumor resection, trigeminal Neurovascular decompression and vestibular neurotomy.
  • gynecology in the application of gynecology: can be combined with a hard tube as a fallopian tube, can also optimize the current hysteroscopy, laparoscopy and colposcopy.
  • anti-cancer pictures found in abnormal cells, cervical lesions after follow-up treatment, to understand the treatment effect, with or without recurrence or new lesions, abnormal uterine bleeding: uterus Endoluminal fibroids, polyps and endometrial cancer, abnormal ultrasound imaging findings, infertility and family planning comorbidities, hormone replacement and application of tamoxifen-induced physiological or special changes in the endometrium, previous IVF (in vitro fertilization) Failure patients, replacement hysteroscopy endometrial conditions, habitual abortion, examination of uterine cavity malformation, uterine adhesions, foreign body in the uterus, and examination of benign gynecologic tumors, diagnosis and treatment of ectopic pregnancy, ovary Bloated
  • Embodiment 2 Referring to FIG. 7 and FIG. 8, this embodiment is basically the same as the structure of Embodiment 1, except that the outer wall of the hard pipe is further provided with a ball cymbal 19 for preventing backflow of liquid in the cavity, and a hard The water injection passage port 21 is provided.
  • the ball ⁇ 19 is connected to the inflation nozzle 20 through an inflation duct located on the outer wall of the hard tube. When in use, the ball is not inflated first, and when inserted into the cavity, the ball is inflated.
  • the hard pipe water injection port 21 is for injecting water into the cavity through the hard pipe 1.
  • Embodiment 3 This embodiment is basically the same as the structure of Embodiment 1, except that the outer tube 1 is a guiding tube, the inner tube 2 is an elbow tube, and one end of the elbow tube is curved, and the other end is curved. It is connected to an interface of the pipe connector 8 and fixed at the interface, and a guide wire or an optical fiber can be passed through the elbow pipe.
  • the guide wire 22 is made of a stainless steel material, and the diameter of the guide wire 2 is in the range of 0.015 mm to 0.35 mm.
  • the outer end of the elbow is curved, and the curved end of the elbow is made of a softer material than the rest of the material.
  • the guide tube is made of polypropylene.
  • a ball yoke 19 for preventing backflow of liquid in the chamber, and a hard pipe water injection passage port 21 are also provided on the outer wall of the guide tube.
  • the ball sill 19 is coupled to the inflation nozzle 20 by an inflation duct located on the outer wall of the guide tube.
  • Method 1 Wear the image and illumination fiber first, then wear the guide wire
  • the guiding tube is first introduced from the patient's vaginal opening and placed in the patient's reproductive passage to reach the expansion of the vagina.
  • the elbow tube is then inserted into the guiding tube, and the front end of the elbow tube is assisted by the guiding tube or enters the fallopian tube mouth at the bottom of the uterus to provide support for the subsequent water injection or the lower device dredging.
  • the image and the illumination fiber are passed through the fiber channel and the elbow tube, and then the guide wire is directly passed through the elbow tube, and directly passed through the tubal interstitial portion under the guidance of the guiding tube to reach the isthmus, and even reach the ampulla.
  • the image and illumination fiber is connected to the camera system.
  • the imaging system of up to 20,000 pixels and the slimmer diameter of the hysteroscope make it possible to perform gynecological operations under the microscope.
  • the image and the illumination fiber are taken out, and the guide wire is passed through the guide wire channel and the elbow tube.
  • the obstruction of the fallopian tube is serious or the fallopian tube is thin, and the image and the illumination fiber cannot enter.
  • the wire is directly used to dredge.
  • the guiding tube guides the elbow tube to the uterus through the cervix, and the elbow tube guides the guide wire 3 through the fallopian tube to the interstitial portion of the fallopian tube.
  • the tubal occlusion can be treated by direct dredging. This embodiment should be under the X-ray by means of contrast agent. carry out.
  • Method 3 Remove the image and illumination fiber, and access the instrument/laser fiber (without guide wire). In this case, there is no guide wire 22 . After observing the diagnosis through the image and the illumination fiber, the image and the illumination fiber are taken out, and the device or the laser fiber is passed through, and the laser is used for dredging. At this time, the guide wire is not passed.
  • this embodiment can also enter the uterine cavity by means of a hysteroscopic instrument channel.

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  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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Description

组合式软^^内窥镜
技术领域
本发明涉及医疗器械领域， 特别是涉及一种组合式软硬质内窥镜。 背景技术
目前， 国际上分别已有单独的软性输尿管镜和硬性输尿管镜。硬性输尿 管镜操作方便， 可以方便通过输尿管到达肾盂，但由于硬性输尿管镜前端不 可弯曲， 它进入肾盂后不能调节方向进入各组肾盏进行各种诊断和治疗； 软 性输尿管镜虽然前端可单向或多向大角度弯曲、转向， 却难以经输尿管进入 肾盂及肾盏，在 X射线的引导下虽然可以进入肾盂及肾盏，但 X射线对医生 和病人损伤较大。开发一种软硬结合的输尿管镜，一直是广大输尿管镜厂商 和泌尿外科医生共同追求的目标。
传统的内窥镜一般通过剪刀式手柄和转向钢丝控制其弯曲转向，操作精 确度不高， 对转向角度的控制不够准确， 可视角度较小， 由于管道尺寸及视 盲角导致的技术瓶颈， 给手术的安全带来隐患。
针对上述不足， 在本申请提出之前， 本申请人曾申请了一种名称为 "一 种可弯曲转向内窥镜"， 申请号为 2009 1 0251256.9, 该发明创造虽然解决了 上述不足， 但在实施过程中仍有不足之处。 发明内容
本发明的目的是为了克服上述背景技术的不足， 提供一种组合式软硬 质内窥镜， 使其具有操作筒单， 转向方便的特点。
为实现上述方案，本发明提供的组合式软硬质内窥镜，它包括导管部分、 控制导管弯曲的转向手柄和管道连接器， 所述导管部分包括外管和内管，外 管套在内管外面， 其特征是， 所述转向手柄包括手柄套、 柄体盖， 手柄套套 在柄体盖外面，在手柄套与柄体盖之间设有轴向导轨和滑块，导轨和滑块分 别固定于手柄套或柄体盖上， 所述外管与手柄套固定相连，所述内管穿过手 柄套中的通孔， 与管道连接器的一个接口相连并固定在接口处，所述管道连 接器位于柄体盖内与柄体盖固定相连，管道连接器的其余接口分别与柄体盖 上的各个通道口连接。
作为本发明的优选实施例， 所述手柄套、 柄体盖均为圓筒体形状。
优选地，位于柄体盖上的各个通道口为内窥镜光纤通道口、注水通道口、 器械通道口， 所述内窥镜光纤通道口位于柄体盖端部中央， 注水通道口和至 少一个器械通道口分别位于柄体盖端部边缘部位。
优选地， 所述导轨为沿轴向设置在柄体盖外表面上的条状滑槽， 滑块为 设置在手柄套侧壁螺孔中的限位螺栓， 螺栓与滑槽相配。
优选地， 在硬管的外壁上还设有用于防止腔内液体回流的宫颈塞。
具体地说，所述宫颈塞为设置于硬管的外壁上的球嚢，该球嚢通过位于 硬管外壁上的充气管道与充气嘴连接。
作为本发明的优选另一个实施例，所述外管为硬管，所述内管为弯头管， 弯头管一端呈弯曲状， 另一端与管道连接器的一个接口相连并固定在接口 处， 在弯头管中穿过有导丝或光纤。
作为本发明的优选另一个实施例， 所述外管为硬管， 所述内管为软管， 软管内设有转向通道和工作通道，转向通道中设有转向钢丝， 所述软管的外 端设置有硬质护套 8, 在软管内的转向通道 11中设有定位套管 2,在定位套 管 2与硬质护套 8之间的软管 6中设有弹性管 7 , 转向钢丝 5穿过定位套管 2和弹性管 7, —端与硬质护套 8固定连接， 另一端穿过管道连接器的接口 与位于柄体盖上的能控制转向钢丝伸缩的转向控制阀连接。
优选地，所述工作通道包括并排排列的器械通道、光纤通道和注水通道。 优选地， 设置在软管内的转向通道偏离软管的中心线。
本发明利用转向手柄中的手柄套与柄体盖之间的相对运动实现外管与 内管之间的相对伸缩和转动，手柄套与柄体盖之间通过导轨和滑块实现轴向 伸缩； 当将滑块从导轨中退出后， 手柄套与柄体盖之间可以实现转动。 在转 动过程中，由于内管穿过手柄套中央的通孔通过固定在柄体盖中管道连接器 和软连接管分别与柄体盖上的各个通道口连接， 而外管又与手柄套固定相 连， 因此， 外管和内管之间可以方便伸缩、 转动， 且不影响内窥镜光纤通道 口、 注水通道口和器械通道口的工作。
本发明所述的组合式软硬质内窥镜具有结构筒单，操作方便，转向灵活 的特点， 可以用于输卵管镜和输尿管镜及其他科室内窥镜。
以下结合附图通过实施例对本发明的特征及相关特征做进一步详细说 明， 以便于同行业技术人员的理解。 附图说明
图 1为实施例 1的结构示意图；
图 2为图 1的俯视图；
图 3为转向手柄的结构示意图；
图 4为软管头部剖视图；
图 5为图 4的 A-A剖视图；
图 6为图 4的 M向视图；
图 7为实施例 2结构示意图；
图 8为图 7的俯视图；
图 9为实施例 3的结构示意图；
图 10为图 9的俯视图。
图 11为转向手柄立体图。
图中： 1-硬管， 2-软管， 3-手柄套， 4-柄体盖， 5-螺栓， 6-滑槽， 7-连接 法兰， 8-管道连接器， 9-旋转手柄， 10-转轮， 11-内窥镜光纤通道口， 12-软 管注水通道口， 13-器械通道口， 14-转向钢丝， 15-内窥镜光纤， 16-硬质护 套， 17-定位套管， 18-弹性管， 19-气嚢， 20-充气嘴， 21-硬管注水通道口， 22-导丝。 具体实施方式
实施例 1 : 本实施例提供一种可弯曲转向内窥镜， 参见图 1和图 2, 它 包括导管部分、控制导管弯曲的转向手柄和管道连接器，所述导管部分包括 用塑料制成的硬管 1和软管 2, 硬管 1套在软管 2外面。
参见图 3、 图 11 , 所述转向手柄包括手柄套 3、 柄体盖 4, 所述手柄套、 柄体盖均为圓筒体形状，手柄套套在柄体盖外面，在手柄套与柄体盖之间设 有轴向导轨和滑块。 所述导轨为沿轴向设置在柄体盖外表面上的条状滑槽 6, 滑块为设置在手柄套侧壁螺孔中的限位螺栓 5 , 螺栓 5与滑槽 6相配。
所述硬管 1与手柄套 3通过连接法兰 7以螺纹形式固定相连，所述软管 2穿过手柄套 3中央的通孔， 与管道连接器 8的一个接口相连并固定在接口 处。 软管 2 内设有转向通道和工作通道， 转向通道中设有转向钢丝 14, 所 述工作通道包括并排排列的器械通道、 光纤通道和软管注水通道。
参见图 4-图 6, 所述软管 2的外端设置有金属材料制成的硬质护套 16, 硬质护套为环状， 套在软管头部外面， 与软管注塑为一体。 在软管 2的外端 还设有斜面 （见图 4 ), 便于软管头部伸入器官内。 在软管内的转向通道中 设有定位套管， 定位套管 17为不锈钢管， 在定位套管 17与硬质护套 16之 间的软管中设有弹性管 18, 弹性管 18采用高分子材料制成， 一端与定位套 管接触， 另一端与硬质护套接触。 转向钢丝 14穿过定位套管和弹性管， 一 端与硬质护套固定连接，另一端穿过管道连接器 8的接口与位于柄体盖上的 能控制转向钢丝 14伸缩的转向控制阀连接。 所述转向控制阀为旋转手柄 9, 旋转手柄的旋转轴装在柄体盖上， 该旋转轴上装有转轮 10, 转轮 10位于柄 体盖内， 转向钢丝 14固定在该转轮 10上。
位于柄体盖上的各个通道口为内窥镜光纤通道口 11、 软管注水通道口 12、 器械通道口 13 , 所述内窥镜光纤通道口 11位于柄体盖端部中央， 内窥 镜光纤 15从内窥镜光纤通道口 11伸入，从软管 2头部伸出。 注水通道口和 器械通道口分别位于柄体盖端部边缘部位，通过管道连接器 8分别与软管中 的注水通道和器械通道相连通。
所述管道连接器 8为四通管，位于柄体盖内与柄体盖之间用螺栓固定相 连， 管道连接器 8—端的一个接口与软管连接； 另一端的其余接口的外端通 过各自的软连接管分别与柄体盖上的内窥镜光纤通道口 11、 注水通道口 12 和器械通道口 13连接； 内端分别与软管 2中的器械通道、 光纤通道和注水 通道连接。
本发明所述软管内的三个工作通道可以根据不同的需要而在通道尺寸 上有不同的规格。本发明直接通过转向手柄和转向控制阀来控制软管前端的 角度。 旋转转向控制阀的旋转手柄时， 带动转向钢丝回缩， 弹性管被压缩， 拉动软管前端转向， 参见图 1所示； 松开旋转手柄后， 弹性管回位， 导致整 根软管回位。 弯曲过程不仅操作筒单， 而且能够准确控制转向角度， 软管转 向弯曲的角度依据弹性管的长度而定， 可达 180度或更大，整个弯曲过程配 合软、硬管之间的伸缩、旋转运动能够实现全范围的变向（包括弯曲方向和 角度）， 伸缩， 视角可呈 360度， 彻底消除盲角。
下面筒单列举几种常规应用：
1、 在泌尿外科上的应用： 与输尿管硬管组合使用， 配合多种器械， 组 成输尿管肾镜。 输尿管肾镜不仅能观察输尿管、 膀胱、 肾盂及肾盏， 还能取 活检、 取异物、 取结石， 切除小肿瘤， 电凝止血， 切开狭窄， 从而成为诊断 和治疗上尿路疾病的重要方法。
2、 在神经外科上的应用： 可与硬管组合使用， 多通道的软管结合了目 前的硬性镜和弹性软镜的所有优点， 可广泛用于治疗脑积水、 脑室内 /旁病 变、颅底外科手术、垂体瘤、动脉瘤、颅内血肿， 特别是硬膜下分隔性血肿、 内镜经皮推间盘切除术、甚至可用于脑实质内肿瘤活检及小肿瘤切除， 三叉 神经微血管减压术及前庭神经切断术等。
3、 在妇科上的应用： 可与硬管组合作为输卵管镜使用， 也可以优化目 前的宫腔镜、 腹腔镜及阴道镜。 用于临床上宫颈病变有癌前期或癌可疑者、 防癌图片中发现有异常细胞者、 随访治疗后的宫颈病变， 以了解治疗效果， 有无复发或新的病变出现、 异常子宫出血： 子宫腔内肌瘤、 息肉及子宫内膜 癌、 异常超声声像所见、 不孕症与计划生育合并症、 激素替代与应用三苯氧 胺所致子宫内膜的生理或特殊改变、 前次 IVF (体外受精）失败的患者， 替 代宫腔镜检查子宫内膜情况、 习惯性流产、检视有无子宫腔畸形、 子宫腔粘 连、 子宫腔内异物等检查及良性妇科肿瘤的切除、 宫外孕的诊断和治疗、 卵 巢嚢肿的疗、 骨盆内粘连剥离、 子宫内膜异位症烧灼治疗、 输卵管结扎等治 疗。
此外， 还可以运用在消化内科、 胰腺外科、 血管外科、 呼吸科等方面。 实施例 2: 参见图 7和图 8, 本实施例与实施例 1的结构基本相同， 不 同之处在于， 在硬管的外壁上还设有用于防止腔内液体回流的球嚢 19, 以 及硬管注水通道口 21。球嚢 19通过位于硬管外壁上的充气管道与充气嘴 20 连接。 使用时， 球嚢先不充气， 当插入腔内后， 再对球嚢进行充气。 硬管注 水通道口 21用于通过硬管 1向腔内注水。
实施例 3: 本实施例与实施例 1的结构基本相同， 不同之处在于， 所述 外管 1为引导管， 所述内管 2为弯头管， 弯头管一端呈弯曲状， 另一端与管 道连接器 8的一个接口相连并固定在接口处，在弯头管中可以穿过有导丝或 光纤。 导丝 22采用不锈钢材料制成， 导丝 2的直径在 0.015mm~0.35mm范 围之内。 弯头管外端呈弯曲状， 弯头管呈弯曲状的端部采用的材质可以比其 余部分采用的材料软。 引导管采用聚丙烯制成。
在引导管的外壁上还设有用于防止腔内液体回流的球嚢 19, 以及硬管 注水通道口 21。 球嚢 19通过位于引导管外壁上的充气管道与充气嘴 20连 接。 使用时， 球嚢先不充气， 当插入腔内后， 再对球嚢进行充气。 根据实际情况需要，手术操作中可采取三种操作方案， 下面通过三种使 用方法对本实施例进行说明。
方法 1 : 先穿图像及照明光纤， 再穿导丝
先将引导管由患者的阴道口进入，放置在患者的生殖通道内， 以到达扩 张阴道的作用。再将弯头管插入引导管内，其前端在引导管的协助下到达或 者进入子宫底部的输卵管口， 为后面的注水或者下器械疏通提供支持。将图 像及照明光纤穿过光纤通道、 弯头管， 再直接将导丝穿过弯头管， 在引导管 的引导下直接通过输卵管间质部， 到达峡部， 甚至可以到达壶腹部， 本实施 例使用时，可以边注水边通过图像及照明光纤来观察病情。 图像及照明光纤 与摄像系统连接， 高达 2万像素的成像系统及较宫腔镜更纤细的直径，使它 完全可以在镜下完成相关妇科手术操作。
方法 2: 只穿导丝
通过图像及照明光纤观察诊断后，取出图像及照明光纤，将导丝穿过导 丝通道、弯头管，此时主要是对于那些输卵管堵塞比较严重或者输卵管较细、 图像及照明光纤无法进入的，在注水无效的情况下改为直接用导丝疏通。 引 导管引导弯头管通过宫颈口到达子宫，弯头管引导导丝 3通过输卵管口到达 输卵管间质部， 可以采用直接疏通的方式来处理输卵管堵塞， 此实施例应该 借助造影剂在 X光下完成。
方法 3: 取出图像及照明光纤， 通入器械 /激光光纤（无导丝） 此种情况下无导丝 22。 通过图像及照明光纤观察诊断后， 将图像及照 明光纤取出， 通入器械或激光光纤， 打激光进行疏通， 此时不通入导丝。
在实际手术操作中， 本实施例也可以借助宫腔镜的器械通道进入宫腔，

Claims

权 利 要 求 书
1、 组合式软硬质内窥镜， 它包括导管部分、 控制导管弯曲的转向手柄 和管道连接器， 所述导管部分包括外管和内管， 外管套在内管外面， 其特征 是， 所述转向手柄包括手柄套、 柄体盖， 手柄套套在柄体盖外面， 在手柄套 与柄体盖之间设有轴向导轨和滑块，导轨和滑块分别固定于手柄套或柄体盖 上， 所述外管与手柄套固定相连， 所述内管穿过手柄套中的通孔， 与管道连 接器的一个接口相连并固定在接口处，所述管道连接器位于柄体盖内与柄体 盖固定相连， 管道连接器的其余接口分别与柄体盖上的各个通道口连接。
2、 如权利要求 1所述的组合式软硬质内窥镜， 其特征是， 所述手柄套、 柄体盖均为圓筒体形状。
3、 如权利要求 1所述的组合式软硬质内窥镜， 其特征是， 位于柄体盖 上的各个通道口为内窥镜光纤通道口、 注水通道口、 器械通道口， 所述内窥 镜光纤通道口位于柄体盖端部中央，注水通道口和至少一个器械通道口分别 位于柄体盖端部边缘部位。
4、 如权利要求 1所述的组合式软硬质内窥镜， 其特征是， 所述导轨为 沿轴向设置在柄体盖外表面上的条状滑槽，滑块为设置在手柄套侧壁螺孔中 的限位螺栓， 螺栓与滑槽相配。
5、 如权利要求 1所述的组合式软硬质内窥镜， 其特征是， 在硬管的外 壁上还设有用于防止腔内液体回流的宫颈塞。
6、 如权利要求 5所述的组合式软硬质内窥镜， 其特征是， 所述宫颈塞 为设置于硬管的外壁上的球嚢，该球嚢通过位于硬管外壁上的充气管道与充 气嘴连接。
7、 如权利要求 1至 6中任一权利要求所述的组合式软硬质内窥镜， 其 特征是， 所述外管为硬管， 所述内管为弯头管， 弯头管一端呈弯曲状， 另一 端与管道连接器的一个接口相连并固定在接口处，在弯头管中穿过有导丝或 光纤。
8、 如权利要求 1至 6中任一权利要求所述的组合式软硬质内窥镜， 其 特征是， 所述外管为硬管， 所述内管为软管， 软管内设有转向通道和工作通 道， 转向通道中设有转向钢丝， 所述软管的外端设置有硬质护套（8 ), 在软 管内的转向通道（11 ) 中设有定位套管 （2 ), 在定位套管 （2 ) 与硬质护套
( 8 )之间的软管（ 6 )中设有弹性管（ 7 ) , 转向钢丝（ 5 )穿过定位套管（ 2 ) 和弹性管 （7 ), —端与硬质护套（8 ) 固定连接， 另一端穿过管道连接器的 接口与位于柄体盖上的能控制转向钢丝伸缩的转向控制阀连接。
9、 如权利要求 8所述的组合式软硬质内窥镜， 其特征是， 所述工作通 道包括并排排列的器械通道、 光纤通道和注水通道。
10、 如权利要求 8所述的组合式软硬质内窥镜， 其特征是， 设置在软管 内的转向通道偏离软管的中心线。
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JP2014532489A (ja) * 2011-11-01 2014-12-08 ロン，ガン 軟硬性シースのガイド機構およびその全方位に調整可能な一体型の軟硬性内視鏡
CN108577904A (zh) * 2018-06-22 2018-09-28 西安交通大学医学院第附属医院 一种双钳道单孔可弯曲腹腔镜系统
CN108577904B (zh) * 2018-06-22 2024-06-11 西安交通大学医学院第一附属医院 一种双钳道单孔可弯曲腹腔镜系统
CN108937830A (zh) * 2018-08-27 2018-12-07 广州瑞派医疗器械有限责任公司 一次性胃镜隔离装置及胃镜
CN108937830B (zh) * 2018-08-27 2023-12-05 广州瑞派医疗器械有限责任公司 一次性胃镜隔离装置及胃镜
CN110051318A (zh) * 2019-06-05 2019-07-26 南昌沃克医疗科技有限公司 一种组合式软性纤维输尿管肾镜

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