WO2015113315A1 - 输尿管镜 - Google Patents

输尿管镜 Download PDF

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Publication number
WO2015113315A1
WO2015113315A1 PCT/CN2014/071859 CN2014071859W WO2015113315A1 WO 2015113315 A1 WO2015113315 A1 WO 2015113315A1 CN 2014071859 W CN2014071859 W CN 2014071859W WO 2015113315 A1 WO2015113315 A1 WO 2015113315A1
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WO
WIPO (PCT)
Prior art keywords
ureteroscope
lens
wall
tube
drainage
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PCT/CN2014/071859
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English (en)
French (fr)
Inventor
林超
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上海林超医疗设备科技有限公司
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Application filed by 上海林超医疗设备科技有限公司 filed Critical 上海林超医疗设备科技有限公司
Priority to PCT/CN2014/071859 priority Critical patent/WO2015113315A1/zh
Publication of WO2015113315A1 publication Critical patent/WO2015113315A1/zh

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    • 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
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/00073—Insertion part of the endoscope body with externally grooved shaft
    • 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
    • A61B1/12—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 with cooling or rinsing arrangements
    • A61B1/126—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 with cooling or rinsing arrangements provided with means for cleaning in-use
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/10—Trunk
    • A61M2210/1078—Urinary tract
    • A61M2210/1085—Bladder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains

Definitions

  • the present invention relates to a medical device, and in particular to an improved ureteroscope.
  • a ureteroscope is a slender device made up of light-guiding fibers, working channels, and various work accessories for different purposes. Ureteroscopy is through a slender speculum, through the urethra, bladder, ureteral orifice into the ureter, under direct vision or by means of a television surveillance system, can clearly observe the lesions in the ureter, such as stones, tumors, etc. Diagnosis and treatment of ureteral diseases.
  • the current ureteroscope as shown in Figure 1, generally includes a field of view lens 6 , the instrument tube opening 7 at the front end of the tube tube, and the lens tube 5 (in the tube tube)
  • the upper is the light source
  • the lower is the inlet and the instrument channel
  • the light source interface 2 the handle 3
  • the inlet and outlet water switching valve 4 The upper is the light source, the lower is the inlet and the instrument channel
  • the field of view lens is generally installed at the forefront of the ureteroscope, the instrument channel opening at the front end of the lens tube is generally obliquely facing downward, and the ureteroscope is observed through the field of view lens when entering the ureteral opening.
  • problems with existing openings and lenses As shown 2a As shown in the case of the existing ureteroscope into the ureteral opening, it can be seen that because the field of view lens is arranged at the foremost end, its field of view is the front end area, which cannot illuminate the instrument exit position, when the instrument exits the instrument outlet, Lack of observation can easily lead to damage to the ureteral wall, perforation or damage to the ureteral opening. As shown 2b is shown.
  • ureteroscope 1 Entering the ureteral opening requires pressing down to provoke the ureteral opening. The process is unclear because of the angle problem, and it is easy to tear the ureteral opening. Because the front end opening is inclined, the catheter and guide wire are inserted 1-1.5cm.
  • the diameter of the ureteroscope is required to be as small as possible.
  • the diameter of the lumen of the lens body is required to be as large as possible, so the outer wall of the existing ureteroscope is already thin, and the mirror body is only One channel (ie lumen) .
  • the physician extends the instrument from the instrument end of the lens body into the lumen for surgery, and continuously injects a large amount of water into the surgical site through the lumen. To keep the vision clear. As the operation progresses, the water at the surgical site will gradually become cloudy, affecting the clarity of the doctor's field of vision.
  • the existing ureteroscope has the following defects in the water inlet and outlet: the water injection and the drainage can only be carried out through the same channel, and the water injection and the drainage can only be operated separately and cannot be formed.
  • the water circulation causes the visual field to be unclear during the operation, which also affects the efficiency of the operation and prolongs the operation time.
  • Continuous water injection causes the water pressure in the front end of the mirror and the kidney to be too high, such as a long operation time, and even causes water pressure in the bladder.
  • the ureteroscope has no function of discharging water and urine in the bladder.
  • the operation time is long, the water pressure in the bladder is gradually increased, causing water and urine retention in the bladder. Need to pull out the ureteroscope to discharge the water in the bladder, then insert the ureteroscope operation, repeated operations can easily cause ureteral injury, causing pain to the patient.
  • the existing ureteroscope has a wide field of vision and clarity in the lens, water in and out, and poor water flow. , water pressure and damage in organs, prevention of hyperthermia, easy operation, etc.
  • the outer wall of the lens tube There is a depression and or bulge, and a groove is formed on the surface of the outer wall, so that there is a gap between the outer wall of the ureter and the wall of the ureter after entering the ureter as a water outlet channel.
  • the groove may be formed on an outer wall portion or a full length region of the lens tube
  • the groove is formed at two-thirds of the area of the outer wall of the lens tube from the front end.
  • the number of the grooves is plural; preferably two.
  • the grooves are disposed along the axial direction of the mirror tube.
  • the lens tube has a concave triangular shape or a figure-eight or elliptical shape in a radial section.
  • the passage opening of the front end of the ureteroscope has a sloped surface, and the front end of the opening gradually becomes smaller.
  • the lens is located at the rear of the opening at the obliquely upper side, not the front end.
  • a drainage channel is added to the posterior segment of the ureteroscope.
  • the drainage channel is a drainage sleeve that can be moved over the sheath sheath. Drainage sleeves can be designed to grow short depending on the urethra of male and female patients.
  • the drain sleeve can also be provided with a switching valve.
  • a drainage hole may also be provided on the drainage sleeve.
  • the ureteroscope according to the present invention realizes continuous water injection through the lumen of the lens body during the operation, and the drainage of the outer wall of the lens body continuously drains, which can speed up the drainage speed during the operation and form a continuous water circulation. Under the premise of affecting the operation, it can increase the drainage volume during the operation, not only can maintain the clear vision during the operation, improve the efficiency of the operation, but also reduce the water pressure in the kidney and ureter, and prevent postoperative hyperthermia. Occurs while preventing the water pressure in the bladder from rising;
  • the front end of the mirror is gradually smaller, which is advantageous for gradually expanding the ureteral opening; the inclined surface is designed to slide into the ureteral opening; the rear of the lens allows the entire process of entering the opening to be visible, and the existing ureter is easily inserted into the catheter and the instrument. Perforation problem.
  • the invention adds a drainage pipe at the end of the handle of the ureteroscope tube, which is beneficial to dredge the accelerated water discharge and improve the problem of poor water discharge of the existing ureteroscope.
  • the visual field of the ureteroscope needs to be maintained by the flow of water, it is very important to strengthen the effluent between the ureteroscope and the ureteral wall; it can also discharge the water and urine retained in the bladder, and improve the bladder water and urinary retention in the existing ureteroscopy.
  • the problem and it is not necessary to repeatedly remove the ureteroscope due to bladder retention during the operation, so that the ureteroscope repeatedly enters the urethra.
  • Figure 1 is a schematic view of a ureteroscope in the prior art
  • 2a is a schematic view of a field of view lens in the prior art
  • Figure 2b is a schematic view showing the operation of the ureteroscope instrument opening in the prior art
  • 2c is a schematic view showing the operation of the ureteroscope in the prior art when the ureteral opening is smaller than the ureteral lens end;
  • FIG. 3 is a schematic illustration of a ureteroscope in accordance with one embodiment of the present invention.
  • FIG. 4 is a cross-sectional view of a lens tube of a ureteroscope according to an embodiment of the present invention.
  • Figure 5 is a schematic view showing a front end opening portion of a ureteroscope according to an embodiment of the present invention.
  • Figure 6 is a schematic illustration of a ureteroscope in accordance with one embodiment of the present invention.
  • Figure 7a is a schematic view of a field of view lens according to the present invention.
  • Figure 7b is a schematic view showing the opening operation of the ureteroscope instrument according to the present invention.
  • Figure 7c is a schematic view showing the operation of the ureteroscope according to the present invention when the ureteral opening is smaller than the ureteral lens end;
  • a ureteroscope 13 includes an eyepiece 1, a light source interface 2, and a handle 3. , inlet and outlet water switch valve 4, mirror tube 5, field of view lens 6, front end channel opening 7 .
  • a ureteroscope 13 includes an eyepiece 1, a light source interface 2, and a handle 3. , inlet and outlet water switch valve 4, mirror tube 5, field of view lens 6, front end channel opening 7 .
  • the outer wall 10 of the lens tube 5 is provided with a groove 8 such that the ureteroscope 13 after entering the ureter has its outer wall 10 There is a gap between the wall and the ureter as a water outlet channel.
  • the groove in Figure 3 is provided on two-thirds of the outer wall of the mirror tube, optionally on the outer wall 10
  • a groove is provided in a partial area, and a groove may be provided on the entire length of the outer wall.
  • the grooves can be arranged along the axial direction of the lens tube. It can also be set around the curve of the outer wall of the tube.
  • the number of grooves may be a plurality of grooves, preferably two grooves disposed along the axial direction of the mirror tube.
  • the cross section of the lens tube 8 is concavely triangular, or 8-shaped, or elliptical, etc. due to the presence of the groove, as shown in Fig. 4a, Fig. 4b, Fig. 4c
  • the groove can be used as a water outlet. Therefore, the water inlet channel of the ureteroscope, that is, the water entering through the lens tube, is separated from the water outlet channel, that is, the groove. Achieve smooth flow of water and keep the vision clear.
  • Figure 5 shows the front end of the ureteroscope according to one embodiment of the present invention, the passage opening at the front end 7
  • the upward inclined surface is gradually smaller, the front end of the opening lens 6 is located at the obliquely upper rear portion of the opening, and the outer wall 14 of the front end opening of the mirror is curved, as shown in Figure 7.1.
  • the front end of the mirror is angled upward so that when the instrument is inserted, the catheter can be controlled to easily cross the lesion.
  • FIG. 6 is a schematic view of a ureteroscope according to an embodiment of the present invention.
  • a drainage sleeve 11 is added outside the lens tube.
  • the drainage switch valve 12 The drainage sleeve can be provided with a drainage hole 14.
  • the inside of the cannula reaches the bladder and the external urethra is external.
  • the bladder water and urine can be drained during the urinary tract uninterrupted operation. Due to the short length of the urethra of men and women, the cannula can be designed as a male or female drainage cannula of different lengths.
  • Figure 7a is a schematic view of a field of view lens in accordance with the present invention; it can be seen that the field of view of the lens according to the present invention is expanded.
  • Figure 7b is a schematic view showing the opening operation of the ureteroscope instrument according to the present invention. It can be seen that the ureteroscope according to the present invention can well treat lesions at different locations during operation of the instrument and does not easily damage the ureter.
  • Figure 7c is a schematic view showing the operation of the ureteroscope according to the present invention when the ureteral opening is smaller than the ureteral lens end; It can be seen that when the ureteral opening is smaller than the ureteral lens end, it is easier to insert. There is no damage that is easily caused in the prior art.
  • the ureteroscope according to the present invention is provided with a movable drainage
  • the cannula is used to continuously inject water through the lumen of the lens body during operation, and the drainage of the outer wall of the lens body continuously drains, which can speed up the drainage speed during the operation and form a continuous water circulation, which can increase the surgical procedure without affecting the operation operation.
  • the displacement in the middle can not only keep the visual field clear during the operation, improve the efficiency of the operation, but also reduce the water pressure in the kidney and ureter, prevent the occurrence of postoperative hyperthermia, and prevent the water pressure in the bladder. Raise
  • the front end of the mirror is gradually smaller, which is advantageous for gradually expanding the ureteral opening; the inclined surface is designed to slide into the ureteral opening; the rear of the lens allows the entire process of entering the opening to be visible, and the existing ureter is easily inserted into the catheter and the instrument. Perforation problem.
  • the invention adds drainage at the end of the ureteroscope tube handle
  • the pipeline is beneficial to dredge the accelerated effluent and improve the poor effluent of the existing ureteroscope.
  • the visual field of the ureteroscope needs to be maintained by the flow of water, it is very important to strengthen the effluent between the ureteroscope and the ureteral wall;
  • the water and urine retained in the urethra improve the problems of bladder water and urinary retention in the existing ureteroscopy, and it is not necessary to repeatedly insert and insert the ureteroscope during the operation due to bladder retention, so that the ureteroscope repeatedly enters the urethra.
  • the ureteroscope according to the present invention realizes continuous water injection through the lumen of the lens body during the operation, and the drainage of the outer wall of the lens body continuously drains, which can accelerate the drainage speed during the operation and form a continuous water circulation. It can increase the drainage volume during the operation without affecting the operation of the operation, not only can maintain the clear vision during the operation, improve the efficiency of the operation, but also reduce the water pressure in the kidney and ureter, and prevent post-operative hyperthermia The occurrence of blood, while also preventing the increase of water pressure in the bladder;
  • the front end of the mirror is gradually smaller, which is advantageous for gradually expanding the ureteral opening; the inclined surface is designed to slide into the ureteral opening; the rear of the lens allows the entire process of entering the opening to be visible, and the existing ureter is easily inserted into the catheter and the instrument. Perforation problem.
  • the invention adds a drainage pipe at the end of the ureteroscope tube handle, which is beneficial to dredge the accelerated water discharge, improves the problem of poor effluent of the existing ureteroscope, and because the visual field of the ureteroscope needs to be maintained by the flow of water, the ureteroscope and the ureter wall are strengthened.
  • the effluent between the water is very important; it can also discharge the water and urine in the bladder, improve the problem of bladder water and urinary retention in the existing ureteroscopy, and it is not necessary to repeatedly insert the ureteroscope due to bladder retention during the operation to make the ureter
  • the mirror repeatedly enters and exits the urethra.

Abstract

一种输尿管镜（13），包括视野镜头（6）、通道开口（7）、镜管（5）和操作手柄。所述镜管（5）的外壁（10）设有沟槽（8），从而保持水引流通畅，使进水、出水平衡。该沟槽（8）还能够保持手术过程中视野的清晰，减小肾及输尿管内的水压，防止术后高热菌血症的发生。所述镜管（5）前端开口斜面向上，目镜（1）开口后移，利于进入输尿管开口并在视野下插入导管、器械，预防损伤输尿管壁。所述镜管（5）的管壁外设有可沿镜管外壁（10）移动的带有引流孔（14）的引流套管（11），所述引流套管（11）与镜体外壁形成引流通道，并设有开关阀门（12），以在不间断手术过程中同时排出膀胱内水、尿的储留。

Description

输尿管镜 技术领域
本发明涉及一种医疗器械，具体涉及一种改进型的输尿管镜。
背景技术
输尿管镜是一种纤细的、由导光纤维、工作腔道和各种不同用途的工作配件构成的器械。输尿管镜手术是通过一细长的窥镜，经尿道、膀胱、输尿管口进入输尿管，在直视下或借助电视监视系统，可以很清晰地观察到输尿管内的病变，如有结石、肿瘤等，对输尿管疾病进行诊断与治疗。
目前输尿管镜，如图 1 所示，一般包括视野镜头 6 、 镜管前端器械通道开口 7 、镜管 5 （ 镜管内 上方为光源、下方为进水及器械通道）、光源接口 2 、手柄 3 、进出水开关阀 4 。
其中，视野镜头一般安装在输尿管镜的最前端，镜管前端的器械通道开口一般斜面向下，输尿管镜在进入输尿管开口时，通过视野镜头进行观察。但是现有开口和镜头存在问题。如图 2a 所示，为现有输尿管镜进入输尿管开口时的情况，可以看到，因为视野镜头安排在最前端，其视野范围为前端区域，无法照亮器械出口位置，当器械从器械出口出来时，由于缺乏观察，容易导致输尿管壁损伤、穿孔或者输尿管开口的损伤、撕裂。如图 2b 所示。且在输尿管开口小于输尿管镜头前端时，因医生不能看到镜管的下边，容易导致开口下边的损伤，如图 2c 所示。因此，目前的输尿管镜中，输尿管的视野镜头部分在使用中存在以下问题：输尿管镜 1 进入输尿管开口需要下压挑起输尿管开口，其过程因为角度问题，有视野不清，且易撕裂输尿管开口；因前端开口呈斜面的关系，导管、导丝插出 1-1.5cm ，医生看不见，易造成输尿管穿孔；因前端开口呈斜面向下的关系，器械导管、导丝插出时，因镜管在输尿管内移动性差及镜管上部有光束镜头的原因，越过结石困难，如图 2d 所述。
其中，输尿管镜的进出水方面存在问题。为了减轻病人的痛苦，要求输尿管镜的镜身直径尽可能小；而为了医师便于操作，又要求镜身的管腔直径尽可能大，所以现有的输尿管镜的外壁已经很薄，镜身只有一个腔道 ( 即管腔 ) 。手术过程中，医师将操作器械从镜体尾部的器械伸入口伸入管腔进行手术，并通过管腔向手术部位持续注入大量的水。以保持视野清楚。随着手术的进展，手术部位的水会逐渐变浑浊，影响医师视野的清晰度，这时就必须停止注水，而将已经浑浊的水通过管腔排出，或者在手术部位另外插入一根导管专门用于污水的排出，待污水排完后再重新注入新水。
因此现有的输尿管镜在使用过程中，这就使现有的输尿管镜的进出水方面存在着以下缺陷：注水和排水都只能通过同一腔道进行，注水与排水只能分开操作，无法形成水循环，导致手术过程中视野经常不清楚，还会影响手术的效率，使手术时间延长；持续注水使镜前端及肾脏内水压过高，如手术时间较长，甚至会导致膀胱内的水压过高，这时就必须拔出输尿管镜排出膀胱内水后，再插入输尿管镜重新操作；因镜管长出水管细，出水阻力大，出水不畅在镜接近结石及肉芽组织时，不够达到使视野清晰的出水量；镜身内设计出水管，占用镜身有限空间；在水流动力学上讲，进水出水在一个通道的两个方向 ，角度小，引流通畅差，如图 3a 所示。
此外，目前输尿管镜无排出膀胱内水、尿的功能，操作时间长时膀胱内水压力也逐渐增高，造成膀胱内水、尿储留。需拔出输尿管镜排出膀胱内水后，再插入输尿管镜操作，反复操作容易造成输尿管损伤，给病人带来痛苦。
 技术问题
为了解决上述技术问题，克服现有输尿管镜在镜头视野 广度与清晰度 、出入水方式、出水不畅 、脏器内水压及损伤、预防高热菌血症、操作便利 等问题，
技术解决方案
本发明输尿管镜的技术解决方案为：
包括视野镜头、镜管前端通道开口、镜管、光源接口、手柄、进出水开关阀等，所述镜管外壁 有凹陷和或隆起，在外壁表面形成 沟槽，使得输尿管镜在进入输尿管后其外壁与输尿管壁之间存在间隙，作为出水通道。
所述沟槽可以形成在镜管外壁部分或全长区域上；
优选地，所述沟槽形成在镜管外壁从前端开始的三分之二段区域处。
所述沟槽的数量为多条；优选为两条。
优选地，所述沟槽沿着镜管的轴向设置。
优选地，所述镜管 径向 截面呈凹形三角形或 8 字形或椭圆形。
优选地，所述输尿管镜前端的通道开口呈斜面，向上，开口前端逐渐变小。镜头位于开口的斜上方后部，而不是最前端。
优选地，在所述输尿管 镜管 后段增设引流通道 。所述 引流通道为 可以在镜鞘上移动 的引流套管 ， 引流套管 根据男、女病人不同的尿道可以设计成长短不同的。所述 引流套管 还可以带有开关阀门。 引流套管上还可以设有引流孔。
 有益效果
本发明可以达到的技术效果是：
根据本发明的输尿管镜通过增设可移动排水套管，实现手术中通过镜身的管腔持续注水，镜身外壁的沟槽持续排水，能够加快手术中的排水速度，形成连续的水循环，在不影响手术操作的前提下能够加大手术过程中的排水量，不仅能够保持手术过程中视野的清晰，提高手术的效率，而且能够减小肾及输尿管内的水压，防止术后高热菌血症的发生，同时还能够防止膀胱内的水压升高；
根据本发明的输尿管镜，镜前端逐渐变小，利于逐渐扩张输尿管开口；其斜面设计利于滑入输尿管开口；镜头后置，使得进入开口的整个过程可见，克服现有输尿管插入导管、器械时易穿孔的问题。
本发明在输尿管镜管手柄末端处加排水管道，有利于疏通加速出水，改进现有输尿管镜出水不畅的问题， 而且由于输尿管镜的视野需要靠水的流动来保持，加强输尿管镜与输尿管壁之间的出水很关键；还可以排出膀胱内潴留的水、尿，改进现有输尿管镜术中膀胱水、尿潴留的问题，而且不必在术中因膀胱潴留而反复拔插输尿管镜，使输尿管镜反复出入尿道。
 附图说明
下面结合附图和具体实施方式对本发明作进一步详细的说明：
图 1 是现有技术中的输尿管镜示意图；
图 2a 是现有技术中的视野镜头视野示意图；
图 2b 是现有技术中输尿管镜器械开口操作示意图；
图 2c 是现有技术中的输尿管镜中输尿管开口小于输尿管镜头端时操作示意图；
图 3 是根据本发明的一个实施例的输尿管镜示意图；
图 4 是根据本发明的实施例的输尿管镜的镜管的横截面图；
图 5 是根据本发明的一个实施例的输尿管镜的前端开口部分示意图；
图 6 是根据本发明的一个实施例的输尿管镜的示意图；
图 7a 是根据本发明的视野镜头视野示意图；
图 7b 是根据本发明的输尿管镜器械开口操作示意图；
图 7c 是根据本发明的输尿管镜中输尿管开口小于输尿管镜头端时操作示意图；
图中附图标记说明：
1 目镜， 2 光源接口， 3 手柄， 4 进出水开关阀， 5 镜管， 6 视野镜头， 7 通道开口
8 镜管外壁的沟槽， 9 输尿管壁， 10 镜管外壁， 11 排水套管， 12 排水开关阀门 13 输尿管镜 14引流孔
 本发明的最佳实施方式
如图 3 所示，根据本发明的一个实施例的输尿管镜 13 包括目镜 1 、光源接口 2 、手柄 3 ，进出水开关阀 4 ，镜管 5 ，视野镜头 6 、前端通道开口 7 。
本发明的实施方式
如图 3 所示，根据本发明的一个实施例的输尿管镜 13 包括目镜 1 、光源接口 2 、手柄 3 ，进出水开关阀 4 ，镜管 5 ，视野镜头 6 、前端通道开口 7 。
镜管 5 的外壁 10 设有沟槽 8 ，使得输尿管镜 13 在进入输尿管后，其外壁 10 与输尿管壁之间存在间隙，作为出水通道。 图3中的沟槽设在镜管外壁的三分之二的区域上，可选的，可以在外壁10 的部分区域上设置沟槽，也可以在外壁全长上设置沟槽。沟槽可以沿着镜管的轴向设置。也可以绕镜管外壁曲线设置。沟槽的数量可以为多条，优选为沿镜管轴向设置的两条沟槽。 可选地，镜管 8 的横截面由于沟槽的存在而呈凹形三角形、或 8 字形，或椭圆形 等 ，如图 4 a 、图4b、图4c 所示，使沟槽能够作为出水通道。因此将输尿管镜的进水通道，即通过镜管进水，与出水通道，即沟槽，分开。达到水通畅流动，保持视野清晰的目的。
图 5 所示为根据本发明的一个实施例的输尿管镜的前端，在前端的通道开口 7 呈向上的斜面，开口前端逐渐变小，视野镜头 6 位于开口的斜上方后部，镜前端开口外壁 14 呈弧线设计 ，如图5中7.1所示 。镜前端斜面向上使得，当插入器械时，可以控制导管较容易地越过病变。
图 6 所示为根据本发明的一个实施例的输尿管镜的示意图，在本实施例中，在镜管外增加了 引流 套管 11 ，和 引流 开关阀门 12. 引流套管上可以设置有引流孔14. 套管内达膀胱，外达尿道外口。可以在输尿管镜不间断操作中，排出膀胱内水和尿液。套管因男女尿道短长短不同，可以设计为不同长度的男用或女用 引流 套管。
图 7a 是根据本发明的视野镜头视野示意图； 可以看出，根据本发明的镜头视野扩大了。
图 7b 是根据本发明的输尿管镜器械开口操作示意图； 可以看出，根据本发明的输尿管镜在器械操作时，可以很好的处理不同位置的病灶，并且不容易损伤输尿管。
图 7c 是根据本发明的输尿管镜中输尿管开口小于输尿管镜头端时操作示意图； 可以看出当输尿管开口小于输尿管镜头端的时候，比较容易插入。不会出现现有技术中容易造成的损伤。
由此，根据本发明的输尿管镜通过增设可移动 引流 套管，实现手术中通过镜身的管腔持续注水，镜身外壁的沟槽持续排水，能够加快手术中的排水速度，形成连续的水循环，在不影响手术操作的前提下能够加大手术过程中的排水量，不仅能够保持手术过程中视野的清晰，提高手术的效率，而且能够减小肾及输尿管内的水压，防止术后高热菌血症的发生，同时还能够防止膀胱内的水压升高；
根据本发明的输尿管镜，镜前端逐渐变小，利于逐渐扩张输尿管开口；其斜面设计利于滑入输尿管开口；镜头后置，使得进入开口的整个过程可见，克服现有输尿管插入导管、器械时易穿孔的问题。
本发明在输尿管镜管手柄末端处加 引流 管道，有利于疏通加速出水，改进现有输尿管镜出水不畅的问题，而且由于输尿管镜的视野需要靠水的流动来保持，加强输尿管镜与输尿管壁之间的出水很关键；还可以排出膀胱内潴留的水、尿，改进现有输尿管镜术中膀胱水、尿潴留的问题，而且不必在术中因膀胱潴留而反复拔插输尿管镜，使输尿管镜反复出入尿道。
工业实用性
由此，根据本发明的输尿管镜通过增设可移动排水套管，实现手术中通过镜身的管腔持续注水，镜身外壁的沟槽持续排水，能够加快手术中的排水速度，形成连续的水循环，在不影响手术操作的前提下能够加大手术过程中的排水量，不仅能够保持手术过程中视野的清晰，提高手术的效率，而且能够减小肾及输尿管内的水压，防止术后高热菌血症的发生，同时还能够防止膀胱内的水压升高；
根据本发明的输尿管镜，镜前端逐渐变小，利于逐渐扩张输尿管开口；其斜面设计利于滑入输尿管开口；镜头后置，使得进入开口的整个过程可见，克服现有输尿管插入导管、器械时易穿孔的问题。
本发明在输尿管镜管手柄末端处加排水管道，有利于疏通加速出水，改进现有输尿管镜出水不畅的问题，而且由于输尿管镜的视野需要靠水的流动来保持，加强输尿管镜与输尿管壁之间的出水很关键；还可以排出膀胱内潴留的水、尿，改进现有输尿管镜术中膀胱水、尿潴留的问题，而且不必在术中因膀胱潴留而反复拔插输尿管镜，使输尿管镜反复出入尿道。
此外，本说明书中所描述的具体实施例，其零部件的形状、所取名称等可以不同。凡依本发明构思所述的构造、特征及原理所做的等效或简单变化，均包括于本实用新型专利的保护范围内。本实用新型所属技术领域的技术人员可以对所描述的具体实施例做各种各样的修改或补充或采用类似的方式替代，只要不偏离本发明的结构或者超越本权利要求书所定义的范围，均应属于本发明的保护范围。
序列表自由内容

Claims (1)

  1. 1. 一种输尿管镜，包括视野镜头、通道开口、 目镜、光源接口、操作手柄和 镜管 ，其中 ：所述镜管外壁上有凹陷 和/或隆起 。
    2、根据权利要求1所述的输尿管镜，其特征在于：所述镜管 外壁 的凹陷 和/或隆起 在镜管 外壁 上形成沟槽。
    3 、根据权利要求2所述的输尿管镜，其特征在于：所述沟槽形成在镜管外壁的全长区域上。
    4 、根据权利要求2所述的输尿管镜，其特征在于：所述沟槽形成在镜管外壁的三分之二区域段上。
    5 、根据权利要求1-4之一所述的输尿管镜，其特征在于：所述沟槽的数量为多条。
    6 、根据权利要5所述的输尿管镜，其特征在于：所述沟槽的数量为两条。
    7 、根据权利要求1所述的输尿管镜，其特征在于：所述镜管横截面呈8字形或椭圆形。
    8 、根据权利要求1所述的输尿管镜，其特征在于：所述输尿管镜前端的通道开口向上，呈斜面。
    9 、根据权利要求 1-4 ，6-8之一 所述的输尿管镜，其特征在于：所述通道开口的前端逐渐变小，前端镜管外壁呈弧形。
    10 、根据权利要求 5 所述的输尿管镜，其特征在于：所述视野镜头设置在通道开口的斜上方后部。
    11 、根据权利要求1- 4 ，6-8 之一所述的输尿管镜，其特征在于：所述镜管的外壁上设有可移动的 引流 套管。
    12 、根据权利要求11所述的输尿管镜，其特征在于：所述引流套管上带有引流孔。
    13 、根据权利要求 11 或12 所述的输尿管镜，其特征在于：所述镜管外壁上还设有与 引流套管连接 的开关阀门。
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CN109008930A (zh) * 2018-06-29 2018-12-18 江苏柯汇医疗科技有限公司 输尿管镜
CN112401809A (zh) * 2020-11-25 2021-02-26 瑞惜康(苏州)医疗科技有限公司 一种便于进行检查的一次性泌尿镜
CN115105722A (zh) * 2022-06-27 2022-09-27 佛山市妇幼保健院 支架管的置入方法及输尿管镜
WO2023045772A1 (zh) * 2021-09-22 2023-03-30 宁波新跃医疗科技股份有限公司 医疗用输尿管镜系统
WO2023045773A1 (zh) * 2021-09-22 2023-03-30 宁波新跃医疗科技股份有限公司 输尿管镜用先端和术中用输尿管镜
WO2023045771A1 (zh) * 2021-09-22 2023-03-30 宁波新跃医疗科技股份有限公司 可视型输尿管镜
WO2024061277A1 (zh) * 2022-09-21 2024-03-28 宁波大学附属第一医院 集中排布式电子输尿管硬镜

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CN112401809A (zh) * 2020-11-25 2021-02-26 瑞惜康(苏州)医疗科技有限公司 一种便于进行检查的一次性泌尿镜
WO2023045772A1 (zh) * 2021-09-22 2023-03-30 宁波新跃医疗科技股份有限公司 医疗用输尿管镜系统
WO2023045773A1 (zh) * 2021-09-22 2023-03-30 宁波新跃医疗科技股份有限公司 输尿管镜用先端和术中用输尿管镜
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