WO2015058329A1 - 一种具有腔道连续灌注及回流功能的内窥镜 - Google Patents
一种具有腔道连续灌注及回流功能的内窥镜 Download PDFInfo
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- WO2015058329A1 WO2015058329A1 PCT/CN2013/085544 CN2013085544W WO2015058329A1 WO 2015058329 A1 WO2015058329 A1 WO 2015058329A1 CN 2013085544 W CN2013085544 W CN 2013085544W WO 2015058329 A1 WO2015058329 A1 WO 2015058329A1
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- sheath
- endoscope
- hard
- soft
- wall
- Prior art date
Links
- 230000010412 perfusion Effects 0.000 title claims abstract description 21
- 238000010992 reflux Methods 0.000 title claims abstract description 11
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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
- A61B1/012—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 characterised by internal passages or accessories therefor
- A61B1/015—Control of fluid supply or evacuation
-
- 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
- A61B1/00131—Accessories for endoscopes
- A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
-
- 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
Definitions
- the present invention relates to medical devices, and more particularly to an endoscope having a continuous perfusion and reflow function of a lumen. Background technique
- endoscopic treatment is one of the most commonly used methods of diagnosis and treatment. This method is called minimally invasive treatment because of less damage to patients.
- endoscopic treatment In the process of medical treatment using an endoscope, in order to ensure a clear vision of the operation, it is necessary to inject physiological saline into the human organs from time to time with appropriate pressure.
- Conventional endoscopes do not have a water outlet, or they share a channel with water and water, and cannot form a circulation state.
- the amount of physiological saline injected into the patient will also increase. Excessive amounts of saline injected into the patient may cause surgical infection or even swelling of the organ, resulting in damage to the patient's body organs. Therefore, conventional endoscopes have higher requirements for the skills and experience of physicians.
- the object of the present invention is to overcome the deficiencies of the above-mentioned background art and to provide an endoscope having a continuous perfusion and reflow function of a lumen, which has the characteristics of simple operation and high surgical safety.
- an endoscope having a continuous channel perfusion and reflow function which comprises an endoscope handle, a hard sheath, a soft sheath, the inner end of the hard sheath and the endoscope
- the mirror handle is connected, the soft sheath is located in the hard sheath, the soft sheath can protrude axially from the hard sheath, and rotates in the circumferential direction, and is characterized in that: the outer wall of the soft sheath and the inner wall of the hard sheath are axially
- a drain passage is provided, and a water inlet communicating with the drain passage is provided in a circumferential direction of the outer end portion of the hard sheath, and a drain port communicating with the drain passage is provided at a middle rear portion of the hard sheath.
- the outer end of the soft sheath is provided with a head end cap 5 which can be blocked by the end of the hard sheath and thicker than the soft sheath.
- the outer diameter of the head end cap 5 is equal to the outer diameter of the corresponding hard sheath.
- a gap is provided between the outer wall of the soft sheath and the inner wall of the hard sheath, and the drainage channel is located in the gap.
- the water inlet is located on the outer side wall of the hard sheath.
- the water inlet is constituted by small holes uniformly distributed on the side wall of the hard sheath in the circumferential direction.
- the hard sheath is composed of a sheath 4 and a thick sheath 2 which are integrally coupled coaxially, and the outer diameter and the inner diameter of the thick sheath 2 are respectively larger than the outer diameter and the inner diameter of the sheath 4, and the sheath 4 and the sheath are thick.
- the joint portion of the sheath 2 is fixedly sheathed with a sheath ring 3, and the sheath ring 3 is sleeved on the sheath 4 and the sheath 2, and the inner surface of the sheath ring 3 and the sheath corresponding to the sheath 2 is outwardly large.
- the inner conical shape is located on the wall of the thick sheath in the conical region.
- the outer shape of the sheath ring 3 is a concave curved handle.
- the invention has the advantages of simple structure, convenient processing and assembly, in particular, a technical solution for providing a drainage channel between the outer wall of the soft sheath and the inner wall of the hard sheath, so that the waterproof passage can be used for drainage and perfusion during surgery, from the soft sheath
- One of the channels injects water into the human organs, and the water of the human organs enters the small holes in the sheath wall of the hard sheath at a negative pressure, and the continuous drainage is formed by the drainage of the hard sheath and the soft sheath.
- the endoscope with continuous channel perfusion and reflow function according to the present invention is inserted into the human body during the operation process, and the physiological saline in the human body is flown under the negative pressure by the water inlet provided at the outer end of the hard sheath. Inside the drain channel, and drain from the drain located in the back of the hard sheath. Since the drain port is facing the water outlet direction and is blocked by the sheath ring 3, it prevents the dirty water overflowing from the drain port from escaping and polluting the environment.
- the technical solution of the outer diameter of the head end cap 5 of the present invention is equal to the outer diameter of the corresponding hard sheath, and the endoscope can be smoothly entered into the human body without causing damage to human tissues.
- the sheath ring has a concave curved shape, but is not limited to this shape, and one end is sleeved on the thin sheath, and one end is sleeved on the thick sheath to facilitate pulling and beautifying the joint.
- Figure 1 is a front view of the present invention.
- Figure 2 is an axial cross-sectional view of Figure 1.
- Figure 3 is a cross-sectional view taken along line C-C of Figure 1.
- Figure 4 is a partial enlarged view of B of Figure 2 .
- Figure 5 is a partial enlarged view of A of Figure 1.
- This embodiment relates to an endoscope having continuous perfusion and reflow functions, mainly including a head end cap 5, a sheath 4, a thick sheath 2, a soft sheath 6, a sheath ring 3, an endoscope Mirror handle 1 .
- the sheath 4 and the sheath 2 constitute a hard sheath, and the material thereof may be an existing medical material or other novel materials.
- the sheath 4 is coaxially integrated with the sheath 2, and the outer diameter and the inner diameter of the sheath 2 are larger than the outer diameter and the inner diameter of the sheath 4, respectively, and a part of the sheath 4 is inserted into the inner hole of the sheath 2 to be combined in the sheath.
- the joint portion with the thick sheath 2 is fixedly sheathed with a sheath ring 3, and the outer surface of the sheath ring 3 has a concave curved handle shape, one end of the inner surface is a circular arc surface, and the other end is a conical surface.
- the arcuate surface portion of the sheath ring 3 is sleeved on the sheath 4, and the other conical surface is located outside the sheath 2, and the inner surface of the sheath ring 3 and the sheath corresponding to the sheath 2 is outwardly large.
- the small conical shape has a drain opening 7 in the wall of the thick sheath in the conical region.
- the number and size of the drains are not limited, and water can be installed at the drain to adjust the amount of displacement.
- the drain port of this embodiment is preferably constituted by small holes uniformly distributed in the circumferential direction on the outer wall of the thick sheath.
- the other end of the thick sheath 2 is connected to the endoscope handle 1.
- the endoscope handle 1 of the present embodiment and other endoscope components inside and behind the endoscope handle may be the same as the PCT/CN2010/076974 patent entitled "Combined Soft and Hard Endoscope".
- the soft sheath 6 of this embodiment is inserted into the sheath 4 and the sheath 2, and the sheath 6 is made of a medical polymer material. It can protrude from the outer end of the sheath 4, and the outer diameter of the sheath 6 is slightly smaller than the inner diameter of the sheath 4, and a gap of 0.4 mm is formed therebetween. This gap is the drainage channel 9.
- a water inlet 8 communicating with the drainage channel 9 is provided on the sheath wall at the outer end of the sheath 4, and the water inlet is formed by a small hole uniformly distributed on the outer side wall of the hard sheath in the circumferential direction, and the diameter of the small hole is 1.0mm, the adjacent small room 3 is 1.8mm.
- the outer end portion of the soft sheath is provided with a head end cap 5 which can be blocked by the end portion of the sheath 4 and which is thicker than the soft sheath.
- the outer diameter of the head end cap 5 is equal to the outer diameter of the sheath 4, and the surfaces of the two parts are aligned to be smooth and easy to enter the human body.
- the end cap 5 is provided with a through hole corresponding to each channel in the soft sheath, and the head end cap 5 is sleeved on the soft sheath 6 and tightly coupled.
- the material of the head cap 5 is medical metal, non-metal or other novel materials.
- the endoscope of the present invention enters the human body, and in order to maintain the intraoperative visual field clarity, the doctor continuously injects physiological saline into the human body or the organ through the endoscope, and the pressure in the organ increases with the amount of water injection. Increasingly, in this case, part of the water in the organ passes through the water inlet 8 at the front end of the sheath 4 into the gap between the soft sheath 6 and the sheath 4, that is, the drainage channel 9, and finally through the drainage on the coarse sheath 5. The mouth 7 flows out of the body. Located outside the drain when draining The sheath ring 3 prevents the dirty water overflowing from the drain port from squirting and polluting the environment. At the same time, the sheath ring 3 has a concave curved handle-like outer surface which can be held by a doctor for hand, and is convenient for pulling the soft and hard sheath.
- urology in the application of urology: can be used for ureteroscopy, percutaneous nephrolithotomy, cystoscopy, laparoscopy.
- the function of continuous perfusion reduces intrarenal pressure and maintains a clear view of the surgery, preventing the spread of malignant tumor cells.
- kidney stones, renal edema, intrarenal tumors and other operations for the treatment of kidney stones, renal edema, intrarenal tumors and other operations.
- continuous perfusion function can reduce intracranial pressure, to ensure safe and reliable surgery.
- choledochoscopy in the application of percutaneous choledochoscopy: can be used for choledochoscopy, enter the biliary tract or biliary tract through the esophagus to treat diseases, can also assist in the treatment of cholestasis and polypoid lesions through the incision of the abdomen, preserve biliary function, and help improve the quality of life after surgery , reduce postoperative complications.
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- Radiology & Medical Imaging (AREA)
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Abstract
一种具有腔道连续灌注及回流功能的内窥镜,包括内窥镜手柄(1)、硬鞘、软鞘(6),所述硬鞘近端与内窥镜手柄(1)相连,所述软鞘(6)位于硬鞘内,软鞘(6)可以从硬鞘内沿轴向伸出,并沿周向转动,其特征在于:所述软鞘(6)外壁与硬鞘内壁之间沿轴向设有排水通道(9),在所述硬鞘远端部周向设有与所述排水通道(9)连通的进水口(8),在所述硬鞘中后部设有与所述排水通道(9)连通的排水口(7)。所述内窥镜结构简单,加工装配方便,采用在软鞘(6)外壁与硬鞘内壁之间设置排水通道(9)的技术方案,使其在手术时能够利用该排水通道(9)进行排水和灌流。
Description
一种具有腔道连续灌注及回流功能的内窥镜
技术领域
本发明涉及医疗器械,具体地说是涉及一种具有腔道连续灌注及回流功能的内窥镜。 背景技术
临床医学上, 釆用内窥镜进行治疗是目前最常用的诊疗方式之一, 该方式因对患者 损伤较小, 又被称为微创诊疗方式。 在使用内窥镜进行医学治疗的过程中, 为保证手术 视野清晰, 需要不时以适当的压力向人体器官内注入生理盐水。 传统的内窥镜没有出水 通道, 或者入水出水共用一个通道, 不能形成循环状态。 当遇到复杂病例时, 伴随着手 术时间的增长, 势必增加内窥镜在患者体内侵入时间, 被注入患者体内的生理盐水的量 也会随之增加。注入患者体内的生理盐水的量过多,有可能引发手术感染甚至撑胀器官, 导致患者身体器官的损伤。 因此传统的内窥镜对于医师的技术和经验要求较高。
另外, 釆用^:创疗法时, 手术器械进入人体时形成的腔道大小对于患者术后的身体 恢复也有很大的影响; 因此在满足手术操作需求的前提下, 内窥镜的外径越小越有利于 术后的恢复。 基于此, 为内窥镜增加连续灌注及回流的功能, 是十分必要的。 发明内容
本发明的目的是为了克服上述背景技术的不足, 提供一种具有腔道连续灌注及回流 功能的内窥镜, 使其具有操作简单, 手术安全性高的特点。
为实现上述目的, 本发明釆用如下技术方案, 一种具有腔道连续灌注及回流功能的 内窥镜, 它包括内窥镜手柄、 硬鞘、 软鞘, 所述硬鞘内端与内窥镜手柄相连, 所述软鞘 位于硬鞘内, 软鞘可以从硬鞘内沿轴向伸出, 并沿周向转动, 其特征在于: 所述软鞘外 壁与硬鞘内壁之间沿轴向设有排水通道, 在所述硬鞘外端部周向设有与所述排水通道连 通的进水口, 在所述硬鞘的中后部设有与所述排水通道连通的排水口。
优选地, 所述软鞘外端部设有头端帽 5 , 头端帽 5能被硬鞘端部挡住, 并比软鞘粗。 优选地,所述头端帽 5的外径与其对应处硬鞘的外径相等。
优选地,所述软鞘外壁与硬鞘内壁之间设有间隙, 所述排水通道位于该间隙内。
优选地,所述进水口位于硬鞘外端侧壁上。
优选地,所述进水口由沿圆周方向均匀分布在硬鞘侧壁上的小孔构成。
优选地, 所述硬鞘由同轴结合为一体的细鞘 4与粗鞘 2构成, 所述粗鞘 2的外径和 内径分别大于细鞘 4的外径和内径, 在细鞘 4与粗鞘 2的结合部位固定套装有鞘环 3, 所述鞘环 3套在细鞘 4和粗鞘 2上, 所述套在粗鞘 2上的鞘环 3与粗鞘对应的内表面呈 外大内小的圆锥形, 所述排水口位于该锥形区域内的粗鞘鞘壁上。
优选地, 所述鞘环 3外形呈内凹弧形把手。
本发明具有结构简单、 加工装配方便的优点, 尤其釆用在软鞘外壁与硬鞘内壁之间 设置排水通道的技术方案, 使其在手术时能够利用该防水通道进行排水和灌注, 从软鞘 内的一个腔道注入水到人体器官内,人体器官的水在负压下进入硬鞘头端鞘壁上的小孔, 利用硬鞘与软鞘的间隙排水即形成连续回流。 本发明所述的具有腔道连续灌注及回流功 能的内窥镜在插入人体进行手术过程中, 人体器官内的生理盐水在负压作用下, 通过设 置于硬鞘外端部的进水口, 流入排水通道内, 并从位于硬鞘中后部的排水口排出。 由于 排水口正对出水方向且被鞘环 3遮挡住, 因此, 出水时可以防止从排水口溢出的脏水四 处喷涌、 污染环境。
另外, 本发明釆用头端帽 5的外径与其对应处硬鞘的外径相等的技术方案, 可以保 证内窥镜进入人体顺畅, 不会对人体组织造成损伤。 鞘环釆用内凹弧形形状, 但不限于 此造型, 其一端套在细鞘上, 一端套在粗鞘上, 起方便拉拽和美化连接处的作用。 附图说明
图 1为本发明的主视图。
图 2是图 1的轴向剖视图。
图 3是图 1的 C-C剖视图。
图 4是图 2的 B处局部放大图。
图 5是图 1的 A处局部放大图。
图中: 1.内窥镜手柄, 2.粗鞘, 3.鞘环, 4.细鞘, 5.头端帽, 6软鞘, 7.排水口, 8.进水 口, 9.排水通道,
具体实施方式:
下面结合附图详细说明本发明的实施情况, 但它们并不构成对本发明的限制, 仅作 举例而已。
参照图 1-4所示: 本实施例涉及一种具有连续灌注及回流功能的内窥镜, 主要包括 头端帽 5、 细鞘 4、 粗鞘 2、 软鞘 6、 鞘环 3、 内窥镜手柄 1 。 其中, 细鞘 4和粗鞘 2构 成硬鞘, 其材料可为现有医用材料或其他新型材料。 细鞘 4与粗鞘 2同轴结合为一体, 粗鞘 2的外径和内径分别大于细鞘 4的外径和内径, 细鞘 4根部一部分插入粗鞘 2的内 孔中结合, 在细鞘 4与粗鞘 2的结合部位固定套装有鞘环 3 , 鞘环 3外表面呈内凹弧形 把手状, 内表面一端为圆弧面, 另一端为圆锥面。 所述鞘环 3的圆弧面部分套在细鞘 4 上, 另一部分圆锥面位于粗鞘 2外面, 所述套在粗鞘 2上的鞘环 3与粗鞘对应的内表面 呈外大内小的圆锥形, 在该锥形区域内的粗鞘鞘壁上开设有排水口 7。 排水口的数量及 尺寸不受限制, 且可在排水口处安装水阔用以调节排水量的大小。 本实施例所述排水口 优选由沿圆周方向均匀分布在粗鞘外壁上的小孔构成。 粗鞘 2的另一端与内窥镜手柄 1 相连。 本实施例所述内窥镜手柄 1及内窥镜手柄内部及后面的其它内窥镜组成部分可以 与名称为"组合式软硬内窥镜"的 PCT/CN2010/076974 专利相同。
本实施例的软鞘 6插入细鞘 4和粗鞘 2内, 软鞘 6由医用高分子材料制成。 可以从 细鞘 4外端部伸出, 软鞘 6的外径稍小于细鞘 4的内经, 两者之间形成 0.4mm间隙。 该 间隙即为排水通道 9。在细鞘 4外端部的鞘壁上设有与排水通道 9连通的进水口 8 ,所述 进水口由沿圆周方向均匀分布在硬鞘外端侧壁上的小孔构成, 小孔直径为 1.0mm, 相邻 小 间 3巨为 1.8mm。
本实施例在软鞘外端部设有能被细鞘 4端部挡住的并比软鞘粗的头端帽 5。 所述头 端帽 5的外径与细鞘 4的外径相等, 两零件对齐时表面光滑, 易于进入人体。 头端帽 5 端面开设有与软鞘中各通道对应的通孔, 头端帽 5套在软鞘 6上, 并紧密结合。 所述头 端帽 5的材料为医用金属、 非金属或其他新型材料。
手术中, 本发明所述的内窥镜进入人体, 为保持术中视野清晰度, 医生会连续地通 过内窥镜向人体或器官内注入生理盐水, 随着注水量的增加, 器官内的压力随之增大, 在此情况下, 器官内的部分水会通过细鞘 4前端的进水口 8进入软鞘 6与细鞘 4之间的 间隙即排水通道 9, 最后通过粗鞘 5上的排水口 7流出体外。 在排水时位于排水口外的
鞘环 3可以防止从排水口溢出的脏水四处喷涌、 污染环境, 同时鞘环 3呈内凹弧形把手 状外表面可以供医生用手握住, 方便拉拽软硬鞘。
关于内窥镜的其它构件及连接结构均为现有技术, 在此不作具体说明。
下面简单列举几种常规应用 :
1、 在泌尿外科上的应用: 可用于输尿管镜、 经皮肾镜、 膀胱镜、 腹腔镜。 连续灌流 的功能可降低肾内压力并保持手术视野清晰, 防止恶性肿瘤细胞扩散。用于治疗肾结石、 肾嚢肿、 肾内肿瘤等手术。
2、 在神经外科上的应用: 软硬鞘结合使用, 连续灌流的功能可降低颅内压, 保证手 术的安全可靠。 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: 可用于生殖内镜及宫腔镜下的输卵管手术。 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 有异常细胞者的宫颈病变随访治疗, 以了解治疗效果, 确定有无复发或新的病变出现。 也可用于异常子宫出血症状的检查与治疗; 可用于包括子宫腔内肌瘤、 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 )失败等病症的患者; 可替代宫腔镜应用 于子宫内膜情况、 习惯性流产、 子宫腔畸形、子宫腔粘连、子宫腔内异物等病症的检查, 以及良性妇科肿瘤的切除,宫外孕的诊断和治疗,卵巢嚢肿的治疗,骨盆内粘连剥离、 子 宫内膜异位症烧灼治疗、 输卵管结扎治疗等。
4、 在经皮胆道镜上的应用: 可用于胆道镜, 通过食道进入胆道或胆嚢处理疾病, 也 可通过腹部的切口协助治疗胆嚢息肉样病变, 保留胆嚢功能, 有利于提高患者术后生活 质量, 减少术后并发症。
此外, 还可以运用在普通外科、 消化内科、 胰腺外科、 血管外科、 呼吸科、 骨 科等方面, 在此不——赘述。
Claims
1、 一种具有腔道连续灌注及回流功能的内窥镜, 包括内窥镜手柄(1 )、硬鞘、软鞘, 所述硬鞘内端与内窥镜手柄( 1 )相连, 所述软鞘位于硬鞘内, 软鞘可以从硬鞘内沿轴向 伸出, 并沿周向转动, 其特征在于: 所述软鞘外壁与硬鞘内壁之间沿轴向设有排水通道, 在所述硬鞘外端部周向设有与所述排水通道连通的进水口, 在所述硬鞘中后部设有与所 述排水通道连通的排水口。
2、根据权利要求 1所述的一种具有腔道连续灌注及回流功能的内窥镜,其特征在于, 所述软鞘外端部设有头端帽 (5 ), 所述头端帽 (5 ) 能被硬鞘端部挡住, 并比软鞘粗。
3、根据权利要求 2所述的一种具有腔道连续灌注及回流功能的内窥镜,其特征在于, 所述头端帽 (5 ) 的外径与其对应处硬鞘的外径相等。
4、根据权利要求 1所述的一种具有腔道连续灌注及回流功能的内窥镜,其特征在于, 所述软鞘外壁与硬鞘内壁之间设有间隙, 所述排水通道位于该间隙内。
5、根据权利要求 1-4中任一权利要求所述的一种具有腔道连续灌注及回流功能的内 窥镜, 其特征在于, 所述进水口位于硬鞘外端侧壁上。
6、根据权利要求 5所述的一种具有腔道连续灌注及回流功能的内窥镜,其特征在于, 所述进水口由沿圆周方向均匀分布在硬鞘外端侧壁上的小孔构成。
7、根据权利要求 1-4中任一权利要求所述的一种具有腔道连续灌注及回流功能的内 窥镜, 其特征在于, 所述硬鞘由同轴结合为一体的细鞘(4 ) 与粗鞘(2 )构成, 所述粗 鞘(2 ) 的外径和内径分别大于细鞘(4 ) 的外径和内径, 在细鞘(4 ) 与粗鞘(2 ) 的结 合部位固定套装有鞘环(3 ), 所述鞘环(3 )套在细鞘(4 )和粗鞘(2 )上, 所述套在粗 鞘(2 )上的鞘环 (3 ) 与粗鞘对应的内表面呈外大内小的圆锥形, 所述排水口位于该锥
形区域内的粗鞘鞘壁上。
8、根据权利要求 7所述的一种具有腔道连续灌注及回流功能的内窥镜,其特征在于, 所述鞘环 ( 3 )外形呈内凹弧形把手。
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