WO2016062196A1 - 一种与输尿管鞘连接的负压调节装置 - Google Patents

一种与输尿管鞘连接的负压调节装置 Download PDF

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WO2016062196A1
WO2016062196A1 PCT/CN2015/091634 CN2015091634W WO2016062196A1 WO 2016062196 A1 WO2016062196 A1 WO 2016062196A1 CN 2015091634 W CN2015091634 W CN 2015091634W WO 2016062196 A1 WO2016062196 A1 WO 2016062196A1
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negative pressure
sealing
ureteroscope
valve seat
ureter sheath
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PCT/CN2015/091634
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French (fr)
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周均洪
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周均洪
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/26—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor for producing a shock wave, e.g. laser lithotripsy

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  • the present invention relates to a medical device, and more particularly to a negative pressure regulating device connected to a ureter sheath.
  • a ureteral sheath should be placed in the natural passage as a surgical channel, so that the ureteroscope can be quickly in and out of the kidney through the ureter sheath for operation, avoiding multiple ingress and egress damage to the ureter, and shortening
  • the operation time improves the safety of the operation.
  • ureteral ureteroscopy is performed with holmium laser for calculi with renal calculus, the ureteroscope is required to continuously flush into the rinsing fluid to keep the visual field clear.
  • the irrigating fluid in the renal collecting system is continuously poured to make the volume more
  • the small renal collection system has increased pressure, and the gap between the ureteroscope and the ureter sheath as the drainage channel is limited, and the pipeline is long, and the drainage effect is poor. It is easy to cause high pressure in the renal collection system during the operation, causing damage to the kidney. Especially for patients with kidney stones and infection, bacteria and toxins will enter the bloodstream. In the case of the ring system, it causes a urinary infection, which may endanger the patient's life in severe cases.
  • the stone powder and slag generated in laser lithotripsy may affect the surgical field of view and need to be repeatedly taken out by a stone basket or a stone pliers. Stone slag, which affects the efficiency of surgery, prolongs the operation time and increases the risk of surgery.
  • the present invention provides a negative pressure regulating device connected to a ureter sheath.
  • a vacuum regulating device connected to a ureter sheath comprising a sealing connector connected to the end of the ureter sheath, wherein the sealing connector has a hollow cavity formed therein, and a connection port connecting the ureter sheath and a connection negative pressure are opened thereon
  • the negative pressure inlet of the suction device, the mirror body inlet for the ureteroscope, and the air inlet with the intake valve, the intake valve is changed by the air
  • the size of the airflow passage between the cavity and the atmosphere is used to adjust the size of the negative pressure in the cavity;
  • the mirror body inlet is provided with a sealing cover, and the sealing cover is provided with an elastic sealing sealingly matched with the outer wall of the tubular portion of the ureteroscope hole.
  • the air intake adjusting valve includes a valve seat disposed at an air inlet of the sealing connector and an adjusting knob disposed on an outer wall of the valve seat, the side wall of the valve seat is provided with a ventilation window, and the inner wall of the adjusting knob is opened a venting groove matched with the louver, controlling the alignment or offset of the louver and the venting groove by rotating the adjusting knob to change the size of the airflow passage between the cavity and the atmosphere, and realizing the adjustment air The amount of negative pressure in the cavity.
  • the top end side wall of the valve seat extends out of the pointer, corresponding to the position of the ventilation window, the top of the adjustment knob is provided with a pointer chute, and the position of the pointer in the pointer chute can determine that the ventilation window and the ventilation slot are aligned Or the degree of offset to get the required negative pressure.
  • valve seat and the air inlet are correspondingly provided with barbs and a slot to fix the valve seat to the air inlet of the sealing connector.
  • the sealing cover comprises an elastic thin glue and a pressing cover, and the elastic sealing hole is located on the elastic thin glue, and the pressing cover presses the elastic thin glue to the mirror body inlet.
  • the negative pressure regulating device of the present invention is connected to the ureter sheath through a sealing joint, and is provided with a scope inlet for the ureteroscope, a connection port of the ureter sheath, and a negative connection with the vacuum suction device.
  • the pressure inlet and the air inlet with the air inlet adjusting valve, the above-mentioned ports and the cavity in the sealing connector form a space for communication, when the ureteroscope penetrates the mirror body inlet of the sealing connector for kidney stone surgery
  • the space forms a sealed working channel.
  • the intake regulating valve can be adjusted to control the negative pressure in the cavity.
  • the ureteroscope can be injected into the renal collecting system between the ureteroscope and the ureter sheath. Clearance Quickly sucking out from the negative pressure connection channel of the negative pressure regulating device, effectively controlling the pressure of the renal collecting system, avoiding the harm caused by the high pressure of the renal collecting system, ensuring the safety of the operation, and simultaneously quickly sucking out the stone powder and broken in the operation.
  • Figure 1 is a schematic view showing the state of use of the present invention
  • Figure 2 is a schematic exploded view of the present invention
  • Figure 3 is a cross-sectional view of the present invention.
  • the negative pressure regulating device of the present invention includes a sealing connector 9 connected to the end of the ureter sheath 7, and a hollow cavity 5 is formed in the interior of the sealing connector 9, and a connection port connecting the ureter sheath 7 is opened thereon.
  • the negative pressure inlet 2 of the vacuum suction device 6 is connected, the mirror body inlet 3 through which the ureteroscope 8 is inserted, and the air inlet 41 to which the intake valve 4 is mounted.
  • the mirror body inlet 3 is provided with a seal.
  • the cover is provided with a resilient sealing hole 33 that is sealingly engaged with the outer wall of the tubular portion 81 of the ureteroscope 8.
  • the sealing cover includes an elastic thin rubber 31 and a pressing cover 32, the elastic sealing hole 33 is located on the elastic thin plastic 31, and the pressing cover 32 will be an elastic thin plastic 31 is pressed and fixed at the mirror body inlet 3. Since the elastic sealing hole 33 of the gel has good flexibility, it can ensure a good sealing fit with the outer wall of the tubular portion of the ureteroscope during surgery.
  • the ureter sheath 7 When the ureter sheath 7 enters the renal collecting system through the natural passage, the ureter sheath 7 is indwelled as a working channel for the direct connection of the renal collecting system in vitro, the end of which is connected to the sealing connector 9, and the negative pressure inlet 2 of the sealing connector 9 is connected to the negative pressure.
  • the ureteroscope 8 is inserted from the scope inlet 3, and the outer wall of the tubular portion 81 of the ureteroscope 8 is sealingly fitted with the elastic sealing hole 33 on the sealing cover 3, so that the entire device forms a sealed working channel.
  • the ureteroscope 8 is placed into the ureter sheath 7 through the sealed working channel to reach the renal collecting system for the crushed stone.
  • the lavage fluid continuously injected through the ureteroscope 8 enables the renal collecting system to maintain a clear view under the endoscope, and is convenient for observing the kidney collection.
  • the doctor can adjust the intake regulator valve 4 as needed, so that the flushing fluid continuously poured into the renal collecting system is under the action of the vacuum suction device 6, from the ureteroscope 8 and the ureter sheath 7
  • the gap between the two is quickly sucked out, which effectively controls the pressure of the renal collecting system, avoids the harm caused by the high pressure of the renal collecting system, and greatly reduces the operation of the surgery.
  • the rapid flushing of the rinsing liquid can also take away the stone powder and slag during the operation, effectively remove the slag and improve the clarity of the surgical field of vision, avoid repeated use of inefficient sets of stone baskets or stone pliers, and shorten the operation. Time, so that the efficiency of surgery and the safety of surgery are greatly improved.
  • the intake regulator valve 4 includes a valve seat 43 disposed at the intake port 41 of the seal joint 9, and an adjustment knob 42 fitted to the outer wall of the valve seat 43, the valve
  • the seat 43 is provided with a barb 48 and a slot 49 corresponding to the air inlet 41 to securely connect the valve seat 43 to the air inlet 41 of the sealing connector.
  • the side wall of the valve seat 43 is provided with a louver 44.
  • the inner wall of the adjusting knob 42 is provided with a venting groove 45 which cooperates with the louver 44. As the ventilating knob 42 rotates, the air passage between the venting groove 45 and the louver 44 is continuously sized.
  • the knob type regulating valve structure of the embodiment is convenient for one-hand operation during the doctor's operation, and has high sensitivity, convenient operation and easy operation. Control, the effect is good.
  • the pointer 46 extends from the top end wall of the valve seat 43 to adjust the position of the ventilation window 44.
  • the top of the knob 42 is provided with a pointer chute 47.
  • the sealing joint 9 of the present invention can also be integrally formed with the ureteroscope sheath 7, and the like, which are not enumerated here.

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Abstract

一种与输尿管鞘连接的负压调节装置，包括与输尿管鞘（7）末端连接的密封连接头（9），密封连接头（9）内部中空形成空腔（5），其上开设有连通输尿管鞘（7）的连接口（1）、连接负压吸引装置（6）的负压接入口（2）、供输尿管镜（8）穿入的镜体接入口（3）和安装有进气调节阀（4）的进气口（41），进气调节阀（4）通过改变空腔（5）与大气之间的气流通道大小，以调节空腔（5）内的负压大小，镜体接入口（3）处设置有密封盖，密封盖上设置有与输尿管镜（8）的管状部外壁密封配合的弹性密封孔（33）；可以快速吸出经输尿管镜（8）注入肾集合系统的液体，有效控制肾集合系统压力，避免肾集合系统高压造成对患者的危害，同时可快速吸出术中产生的结石粉末及碎渣，提高手术视野清晰度，使手术效率更高，手术时间更短，大大提高手术安全性。

Description

一种与输尿管鞘连接的负压调节装置 技术领域
本发明涉及一种医疗器械，尤其涉及一种与输尿管鞘连接的负压调节装置。
背景技术
随着生活水平的提高，人们日常饮食结构也在发生着改变，上尿路结石的患者逐年增加，其中尤以肾结石患者为甚。目前主流的手术治疗方式有经自然通道(即尿道、膀胱、输尿管)作为手术路径碎石取石以及经皮肾造瘘等非自然通道碎石取石，由于经非自然通道碎石取石存在大出血、肾功能破坏以及损伤周围组织器官等并发症，近年来医学界逐渐推崇以自然通道(即尿道、膀胱、输尿管)作为手术路径进行肾结石手术。
在经自然通道进行肾结石手术时，术中需经自然通道留置一根输尿管鞘作为手术通道，以便输尿管镜可以经输尿管鞘快速进出肾脏进行手术，避免多次进出对输尿管造成损伤，同时可以缩短手术时间，提高手术的安全性。在经输尿管鞘置入输尿管镜用钬激光进行肾结石碎石手术时，需经输尿管镜不断冲入冲洗液，以保持视野清晰，可是，不断灌入肾脏集合系统内的冲洗液，使容积较小的肾脏集合系统压力增高，而作为排水通道的输尿管镜与输尿管鞘之间的间隙有限，且管道较长，自行排水效果较差，手术过程中很容易造成肾脏集合系统高压，对肾脏造成损害，尤其对于肾结石合并感染患者，还会出现细菌及毒素进入血液循 环系统的情况，造成尿源性感染，严重时可能危及患者性命；另一方面，激光碎石术中所产生的结石粉末及碎渣会影响手术视野，需要反复用套石篮或取石钳取出结石碎渣，这样就影响了手术效率，使手术时间延长，增加了手术风险。
鉴于上述原因，《泌尿外科疾病诊断治疗指南》中提到：国内经自然通道作为手术路径治疗肾结石不推荐作为处理大于2cm结石的首选治疗方法；这意味着，超过2cm的结石，不适宜采用这种手术方法。但即便如此，对于不超过2cm的肾结石取出手术，采用这种手术方法仍旧很容易出现肾脏集合系统压力高的情形，导致尿源性感染发生率高，影响该手术方式的开展。
因此，能否有效控制肾脏集合系统的内部压力，对于提高经自然通道作为手术路径治疗肾结石手术的安全性尤为重要，且对于术中能否提供清晰视野及快速有效清除结石粉末碎渣，以保证手术快速完成及保证手术效果都具有重要意义。
发明内容
为解决现有技术存在的问题，本发明提供一种与输尿管鞘连接的负压调节装置。
本发明解决其技术问题所采用的技术方案是：
一种与输尿管鞘连接的负压调节装置，该装置包括与输尿管鞘末端连接的密封连接头，密封连接头内部中空形成空腔，其上开设有连通所述输尿管鞘的连接口、连接负压吸引装置的负压接入口、供输尿管镜穿入的镜体接入口和安装有进气调节阀的进气口，进气调节阀通过改变空 腔与大气之间的气流通道大小，来实现调节空腔内的负压大小；镜体接入口处设置有密封盖，所述密封盖上设置有与输尿管镜的管状部外壁密封配合的弹性密封孔。
所述进气调节阀包括设置在所述密封连接头的进气口处的阀座和与阀座外壁套装的调节旋钮，所述阀座侧壁开设有通气窗，所述调节旋钮内壁开设有与所述通气窗配合的通气槽，通过旋转所述调节旋钮，控制所述通气窗与通气槽的对正或偏移，以改变所述空腔与大气之间的气流通道大小，实现调节空腔内的负压大小。
所述阀座的顶端侧壁延伸出指针，对应通气窗所在位置，所述调节旋钮顶部设置有指针滑槽，通过指针在指针滑槽内所处的位置可以判断出通气窗与通气槽对正或偏移程度从而得到需要的负压。
所述阀座与所述进气口处对应设置有倒钩和卡槽将所述阀座固定连接在所述密封连接头的进气口处。
所述密封盖包括弹性薄胶和压紧盖，所述弹性密封孔位于所述弹性薄胶上，所述压紧盖将所述弹性薄胶压紧固定在所述镜体接入口处。
本发明的有益效果是：本发明的负压调节装置通过密封连接头与输尿管鞘连接，并设置有供输尿管镜穿入的镜体接入口、输尿管鞘的连接口、连接负压吸引装置的负压接入口、安装有进气调节阀的进气口，上述各口与密封连接头内的空腔组成相互连通的空间，当输尿管镜穿入密封连接头的镜体接入口进行肾结石手术时，该空间就形成了一个密封的工作通道，术中可根据需要调节进气调节阀来控制空腔内负压大小，可以把经输尿管镜注入肾集合系统的液体经输尿管镜与输尿管鞘之间间隙 从负压调节装置的负压连接通道快速吸出，有效控制肾集合系统压力，避免肾集合系统高压造成对患者危害，保证手术的安全性，同时，还可以快速吸出术中产生的结石粉末及碎渣，提高手术视野清晰度，有效清除结石，避免反复使用低效的套石篮或取石钳，使手术效率更高，手术时间更短，手术安全性更高；更为重要的是：该综合性能的提高使超过2cm的结石可以更多地采用经自然通道作为手术路径的处理方式，避免采用经皮肾造瘘等非自然通道碎石取石而带来的多种并发症，使该手术路径处理结石的适用范围更加广泛，给广大患者带来了福音。
附图说明
下面结合附图和实施例对本发明进一步说明。
图1是本发明的使用状态示意图；
图2是本发明的分解结构示意图；
图3是本发明的剖视图。
具体实施方式
参照图1、图2，在本发明的负压调节装置包括与输尿管鞘7末端连接的密封连接头9，密封连接头9内部中空形成空腔5，其上开设有连通输尿管鞘7的连接口1、连接负压吸引装置6的负压接入口2、供输尿管镜8穿入的镜体接入口3和安装有进气调节阀4的进气口41，镜体接入口3处设置有密封盖，密封盖上设置有与输尿管镜8的管状部81外壁密封配合的弹性密封孔33。
作为本发明的优选实施例，参照图3，密封盖包括弹性薄胶31和压紧盖32，所述弹性密封孔33位于弹性薄胶31上，压紧盖32将弹性薄胶 31压紧固定在镜体接入口3处。由于胶质的弹性密封孔33具有良好的伸缩性，可以保证手术中与输尿管镜的管状部外壁实现良好的密封配合。
当输尿管鞘7经自然通道进入肾脏集合系统后，输尿管鞘7被留置作为体外直接连通肾脏集合系统的工作通道，其末端连接密封连接头9，密封连接头9的负压接入口2连接负压吸引装置6，此时，将输尿管镜8从镜体接入口3穿入，输尿管镜8的管状部81外壁与密封盖3上的弹性密封孔33密封配合，使整个装置形成一个密封的工作通道，输尿管镜8经密封工作通道置入输尿管鞘7内到达肾脏集合系统进行碎石，经输尿管镜8不断灌入的冲洗液使肾脏集合系统在内窥镜下能保持视野清晰，便于观察肾脏集合系统内的碎石情况，同时，医生可根据需要调节进气调节阀4，使不断灌入肾脏集合系统内的冲洗液在负压吸引装置6的作用下，从输尿管镜8与输尿管鞘7之间的间隙快速吸出，从而有效控制肾脏集合系统的压力，避免肾集合系统高压造成对患者的危害，大大降低手术的风险；另一方面，快速吸出的冲洗液还能带走手术中的结石粉末及碎渣，有效清除碎渣及提高手术视野清晰度，避免反复使用低效的套石篮或取石钳，缩短手术时间，使手术效率及手术安全性都大大提高。
作为本发明的优选实施例，参照图2、图3，进气调节阀4包括设置在密封连接头9的进气口41处的阀座43和与阀座43外壁套装的调节旋钮42，阀座43与进气口41处对应设置有倒钩48和卡槽49将阀座43固定连接在密封连接头的进气口41处。阀座43侧壁开设有通气窗44，调节旋钮42内壁开设有与通气窗44配合的通气槽45，随着调气旋扭42的转动，通气槽45与通气窗44之间的气流通道大小不断变化，改变空腔5 内的负压，从而改变负压吸引装置6从肾脏集合系统内吸出冲洗液的速度；本实施例的旋钮式调节阀结构，便于医生手术过程中单手操作，且灵敏度高，操作方便、易于控制，使用效果好。
为了便于医生根据调节旋钮42的旋转程度来得知气流通道的大小，以便控制冲洗液的流速，本实施例中，在阀座43的顶端侧壁延伸出指针46，对应通气窗44所在位置，调节旋钮42顶部设置有指针滑槽47，通过指针46在指针滑槽47内所处的位置，医生就可以判断出通气窗44与通气槽45对正或偏移的程度，从而得到需要的负压及冲洗液流速。
以上，是对本发明工作原理及控制过程的阐述。
显然，上述的实施例和附图仅为本发明的优选实施例，并非全部实施例，本领域的技术人员在不付出创造性劳动的前提下，还可以根据上述实施例获得其他等同变形或替换的技术方案，这些变形或替换的技术方案均应属于本申请的保护范围。例如，为便于加工成型，本发明的密封连接头9还可以与输尿管镜鞘7一体成型制作，诸如此类，在此不一一列举。

Claims (5)

  1. 一种与输尿管鞘连接的负压调节装置，其特征在于：该装置包括与输尿管鞘(7)末端连接的密封连接头(9)，密封连接头(9)内部中空形成空腔(5)，其上开设有连通所述输尿管鞘(7)的连接口(1)、连接负压吸引装置(6)的负压接入口(2)、供输尿管镜(8)穿入的镜体接入口(3)和安装有进气调节阀(4)的进气口(41)，所述进气调节阀(4)通过改变所述空腔(5)与大气之间的气流通道大小，来实现调节空腔(5)内的负压大小；所述镜体接入口(3)处设置有密封盖，所述密封盖上设置有与输尿管镜(8)的管状部(81)外壁密封配合的弹性密封孔(33)。
  2. 根据权利要求1所述的负压调节装置，其特征在于：所述进气调节阀(4)包括设置在所述密封连接头(9)的进气口(41)处的阀座(43)和与阀座(43)外壁套装的调节旋钮(42)，所述阀座(43)侧壁开设有通气窗(44)，所述调节旋钮(42)内壁开设有与所述通气窗(44)配合的通气槽(45)，通过旋转所述调节旋钮(42)，控制所述通气窗(44)与通气槽(45)的对正或偏移，以改变所述空腔(5)与大气之间的气流通道大小，实现调节空腔(5)内的负压大小。
  3. 根据权利要求2所述的负压调节装置，其特征在于：所述阀座(43)的顶端侧壁延伸出指针(46)，对应通气窗(44)所在位置，所述调节旋钮(42)顶部设置有指针滑槽(47)，通过指针(46)在指针滑槽(47)内所处的位置可以判断出通气窗(44)与通气槽(45)对正或偏移程度从而得到需要的负压。
  4. 根据权利要求2或3所述的负压调节装置，其特征在于：所述阀座(43) 与所述进气口(41)处对应设置有倒钩(48)和卡槽(49)将所述阀座(43)固定连接在所述密封连接头的进气口(41)处。
  5. 根据权利要求1所述的负压调节装置，其特征在于：所述密封盖包括弹性薄胶(31)和压紧盖(32)，所述弹性密封孔(33)位于所述弹性薄胶(31)上，所述压紧盖(32)将所述弹性薄胶(31)压紧固定在所述镜体接入口(3)处。
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