WO2017004861A1 - 经鞘内镜取石术用负压吸引调节装置 - Google Patents

经鞘内镜取石术用负压吸引调节装置 Download PDF

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WO2017004861A1
WO2017004861A1 PCT/CN2015/085908 CN2015085908W WO2017004861A1 WO 2017004861 A1 WO2017004861 A1 WO 2017004861A1 CN 2015085908 W CN2015085908 W CN 2015085908W WO 2017004861 A1 WO2017004861 A1 WO 2017004861A1
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negative pressure
sheath
negative
pressure
endoscope
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PCT/CN2015/085908
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English (en)
French (fr)
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陈勇
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陈勇
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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
    • A61M1/0023—
    • 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
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/0003—
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/73—Suction drainage systems comprising sensors or indicators for physical values
    • A61M1/732—Visual indicating means for vacuum pressure
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • 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
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/0014—Special media to be introduced, removed or treated removed from the body
    • 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
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/06—Solids

Definitions

  • the invention belongs to the field of medical instruments, and in particular relates to a negative pressure suction adjusting device for transsphenoidal stone removal.
  • Urinary calculi is a common clinical disease.
  • Percutaneous endoscopic lithotripsy and ureteroscopy are the most common treatments for renal and ureteral stones.
  • Endoscopic surgery is a minimally invasive procedure in which the hollow sheath is placed in the human body and reaches the surgical site (the upper part of the renal pelvis and the ureter) and then placed into the endoscopic stone. The endoscopic scope is required during the operation.
  • the water injection channel injects saline into the kidney to ensure a clear view of the operation, but this can lead to an increase in the internal pressure of the renal pelvis and easy to cause bacteria to flow back into the blood, causing urinary sepsis, shock, death; transsacral and endoscopic
  • the natural drainage of the inter-mirror space to drain the perfusate does not fully limit the perfusion flow, which often affects the clarity of the visual field and affects the efficiency of the gravel.
  • the stone removal method mainly relies on stone pliers or stone baskets to repeatedly remove stones or high-pressure water to rush out the stones, which takes a long time; The perfusion solution overflows into the wet surgical area to interfere with the operation.
  • the use of negative pressure suction to reduce intrarenal pressure and improve stone removal efficiency in intrathecal endoscopic stone removal is an important technical development direction.
  • the existing negative pressure suction gravel technology includes: 1. Ultrasonic crushed stone probe and equipment, disadvantages: ultrasonic gravel efficiency is low, often need to cooperate with other gravel equipment, the suction channel inside the probe is narrow, can not clear large Block gravel, low stone removal efficiency; 2. Special sheath or mirror body with suction channel and / or intrarenal pressure measurement channel, can be equipped with negative pressure monitoring and regulation equipment. Disadvantages: 1. A special channel for vacuum suction or intra-renal pressure measurement should be set on the sheath or the mirror body.
  • the technical difficulty is large, and the diameter of the sheath or the mirror body is increased, which limits the other operation channels and increases the channel-related damage;
  • Simple vacuum suction without the use of accurate negative pressure suction control equipment, can cause excessive negative pressure, easily lead to intrarenal hemorrhage, tissue attachment endoscopy, unclear vision, or negative pressure, renal low pressure or negative pressure The state cannot be maintained, the drainage is not smooth, and the gravel cannot be sucked out. 3.
  • the special vacuum suction and monitoring equipment can adjust the negative pressure and monitor the intra-renal pressure in real time, it needs special operation, and the operator cannot set and regulate the negative pressure state. In fact, intraoperative renal pelvic pressure does not have to be accurately monitored in real time.
  • the most widely used intrathecal stone removal surgery is the one-time stripping sheath or ureter through the sheath, and the vacuum suction device should be able to connect with it easily. It is not a special sheath or mirror; 5.
  • the existing metal or plastic vacuum suction connection device can not observe the drainage of the sheath, and the crushed stone in the operation can often block the pipeline, causing the circulation to be unsmooth and cannot be processed in time. Causes low blood pressure or negative pressure in the kidney to be maintained. Therefore, the existing vacuum suction gravel system has technical difficulties, complicated structure, inconvenient use, multiple auxiliary equipment and high cost, and is not suitable for wide application.
  • the present invention provides a negative pressure suction adjusting device for transcerebral endoscopic stone removal.
  • a negative pressure suction adjusting device for sheath endoscopic stone removal comprising a casing of transparent medical plastic, wherein the casing is provided with an endoscope inlet, a sheath mounting port and a negative pressure inlet, the endoscope inlet and The sheath mounting port is not in the same plane; further comprising a negative pressure adjusting mechanism in communication with the internal chamber of the housing, and the negative pressure adjusting mechanism is vertically disposed.
  • the invention relates to a lumen-like closed connection device, which realizes the connection of the existing clinically widely used percutaneous nephrostomy sheath/ureter through a sheath and a vacuum suction, without using a sheath body specially designed with a vacuum suction or pressure measuring channel or
  • the mirror body ensures that the endoscope is free to enter and exit.
  • the endoscope inlet is disposed opposite to the sheath mounting opening.
  • the endoscope entrance is opposite to the sheath mounting port to ensure that the path through which the endoscope passes is straight, thereby ensuring that the endoscope can easily enter the sheath.
  • the method further includes an endoscope guiding tube extending from the endoscope inlet into the interior of the housing chamber, and a tail end of the endoscope guiding tube is spaced apart from the sheath mounting opening, And the separation distance is greater than the endoscope of the sheath.
  • the endoscope guiding tube sets up a passage for the endoscope to ensure that the soft and hard endoscope can smoothly enter the sheath tube, thereby improving the operation accuracy.
  • the distance between the tail end of the guiding tube and the sheath mounting opening is larger than the diameter of the sheath opening, which ensures that the gravel can be smoothly discharged into the housing chamber through the negative pressure suction from the sheath mounting port, and then discharged through the negative pressure inlet.
  • the utility model further comprises an anti-overflow valve for preventing the perfusion liquid from overflowing from the front end of the endoscope guiding tube, wherein the anti-overflow valve is a hollow anti-overflow valve, and the anti-overflow valve is provided with an up-and-down penetrating through the anti-overflow valve.
  • the passage is formed in the shape of a double horn having a narrow width at both ends, and the side wall of the passage is made of an elastic material.
  • the front and rear directions are the operation direction, the direction toward the operator is the front direction, and the direction close to the patient is the rear direction.
  • the anti-overflow valve has an accurate sealing effect and good durability, and is suitable for convenient passage of soft and hard mirror bodies of various specifications, and can avoid damage of the soft mirror.
  • the sheath mounting opening is provided with a sealing nozzle
  • the sealing nozzle is made of an elastic material
  • the sealing nozzle is provided with a through hole which can cooperate with the sheath tube.
  • the seal can be matched to and fit the multi-standard sheath to ensure relative airtightness within the housing cavity and secure the sheath.
  • the negative pressure inlet is disposed on a bottom side of the housing.
  • the negative pressure inlet opening is formed on the lowest side wall of the casing chamber, and the diameter thereof is larger than the diameter of the sheath tube and is funnel-shaped, which is convenient for the gravel and the blood clot to quickly enter the stone collection under the action of gravity and vacuum suction. Device.
  • the negative pressure regulating mechanism includes a pressure display tube and an air filling chamber; the pressure display tube is a vertically disposed tube body, and the pressure display tube communicates the air filling chamber with the chamber.
  • An exhaust valve is disposed on the air-filled chamber.
  • the negative pressure regulating mechanism is a structure for directly observing the change of the negative pressure and adjusting the magnitude of the negative pressure: before the negative pressure suction is opened, the perfusate is injected into the renal pelvis through the endoscope channel and then drained through the sheath to the housing chamber and enters the pressure display. In the tube, the air is exhausted from the exhaust valve, and when only the air is filled in the air to close the exhaust valve, the pressure display tube is filled with the perfusate. After the vacuum suction starts, the liquid level in the pressure display tube will decrease. According to Boyle's law and the gas equation, the pressure becomes smaller when the air volume becomes larger, and the operator can judge the negative pressure by the pressure level of the liquid level in the tube.
  • the pressure display tube is further provided with a negative pressure pressure mark along its long axis.
  • the negative pressure suction setting in the housing cavity is completed, thereby providing the operator with a simple and intuitive operation indication.
  • the operator can accurately adjust the negative pressure by using the negative pressure regulating valve connected to the negative pressure inlet according to the intraoperative perfusion fluid flow, perfusion pressure, visual field clarity, bleeding condition, size of the kidney, and whether the stones are smoothly sucked out. Size, It is optimally suctioned and in a safe range.
  • the intraoperative drainage can be determined by directly observing the change of the liquid level in the pressure display tube. If the height of the liquid level is significantly reduced, the negative pressure in the shell cavity is too large, and the perfusate outflow in the sheath is blocked. There is gravel or blood. The clot is blocked and needs to be removed immediately.
  • the operator can intuitively and accurately set and adjust the negative suction force to an appropriate safety value, and can avoid excessive negative pressure, lead to excessive intra-renal hemorrhage and low negative pressure, resulting in poor drainage, and the renal low-pressure state cannot be Maintenance, the stone can not be sucked out, etc., can directly observe the negative pressure drainage of the sheath, timely discover and deal with the situation of the intracranial drainage channel blocked by the gravel and blood clot.
  • the use of a central vacuum suction source in the operating room does not require special special vacuum control and monitoring equipment.
  • the device is compact, simple in structure, convenient to use, low in cost, and easy to be widely used.
  • Figure 1 is a perspective view showing the structure of a vacuum suction adjusting device for percutaneous nephrolithotomy
  • Figure 2 is a cross-sectional view of Figure 1;
  • Figure 3 is a perspective view showing the structure of a vacuum suction adjusting device for ureteroscope soft stone removal according to the present invention
  • Figure 4 is a cross-sectional view of Figure 3.
  • housing 2, negative pressure adjustment mechanism; 3, anti-overflow valve; 11, sheath installation port; 12, endoscope inlet; 13, negative pressure inlet; 14, sealing nozzle; Display tube; 22, air-filled chamber; 23, exhaust valve; 31, endoscope guide tube; 5, mirror holder.
  • the present invention provides a negative pressure suction adjusting device for sheath endoscopic stone removal, comprising a housing 1 having an endoscope inlet 12 and a sheath mounting opening 11; And the negative pressure inlet 13 , the housing 1 is also vertically provided with a negative pressure adjusting mechanism 2 communicating with the chamber of the housing 1 .
  • Adopting the split design the shell is divided into a detachable cover body and two parts with the seat body, and the insertion of the sheath tube is facilitated in the disassembled state.
  • the cover and the seat body can be sealed and integrated to form an internal closed chamber.
  • the cover body is provided with an endoscope inlet, an endoscope guiding tube and a negative pressure adjusting mechanism.
  • a sheath mounting port and a negative pressure inlet are formed in the seat body for respectively mounting the sheath tube and connecting the vacuum suction. They are made of transparent, lightweight and hard medical plastic materials, such as polypropylene.
  • the sealing nozzle 14 is provided with a sealing nozzle 14; the sealing nozzle 14 is made of an elastic material, and the sealing nozzle 14 is provided with a through hole, and the through hole can be made into a multi-aperture to be used with a sheath of different specifications. Fitted to ensure relative air tightness in the housing.
  • the endoscope inlet 12 is not in the same plane as the sheath mounting opening 11. After the endoscope enters the entrance of the endoscope, the through space formed by the housing 1 and the negative pressure regulating mechanism 2 can be in a non-sealed state. Therefore, the overflow prevention valve 3 must be provided to isolate the outside air and prevent the perfusion liquid from flowing out.
  • the anti-overflow valve 3 is provided with a double bell mouth passage made of a thin layer of elastic material, such as natural rubber, synthetic rubber, polyvinyl chloride and various elastomers (for example, urethane, polyisoprene).
  • the negative pressure adjusting mechanism 2 includes a pressure display tube 21 and an air filling chamber 22, and the air filling chamber 22 and the pressure display tube 21 communicate with the chamber of the housing 1 to form a relatively sealed cavity of air and perfusate. .
  • the pressure display tube is vertically disposed, and a negative pressure pressure mark is further disposed along the length direction thereof.
  • Embodiment 1 Negative pressure suction adjusting device for percutaneous nephrolithotomy
  • the sheath In the percutaneous nephrolithotomy, the sheath is generally vertically disposed. As shown in Figures 1-2, the device includes a spill valve 3, a negative pressure regulating mechanism 2, and a housing 1.
  • the negative pressure adjusting mechanism mainly includes a pressure display tube 21 and an air filling chamber 22 that communicate with each other. After the front end of the endoscope guiding tube 31 is engaged with the anti-overflow valve 3, the tube body passes through the air filling chamber 22 and the pressure display tube 21 in sequence (ie, the endoscope guiding tube 31 is nested inside the inner shaft of the negative pressure adjusting mechanism 2, The negative pressure regulating mechanism 2 is located below the endoscope inlet 12) and ultimately extends into the chamber 1 of the housing.
  • the air-filled chamber 22 has a funnel shape having a volume of 5 ml, and an exhaust valve is provided on the side wall thereof.
  • the pressure display tube 21 is a hollow and transparent tube body, and a surface of the tube wall is provided with a negative pressure value mark.
  • the vacuum suction force required to maintain the intrarenal safety low pressure ( ⁇ 30 mmHg) under normal perfusion flow (300-600 ml/min) and perfusion pressure (250-300 mmHg) during surgery is generally 100-250 mmHg.
  • the volume of air reserved in the air-filled chamber is 5 ml.
  • the negative pressure in the tube cavity is 100mmHg.
  • the negative pressure in the tube cavity is 250 mmHg.
  • the pressure display tube volume can be set to 3 ml, the length is set to 3 cm, and the upper pressure mark is 100-250 mmHg.
  • the negative pressure adjusting mechanism is integrally formed, screwed to the housing seat, or other connection mode to ensure the relative airtightness of the two.
  • the complete vacuum suction adjustment device is cup-shaped, with a length of about 5 cm and a self-weight of no more than 15 g.
  • Plastic stone collection bottle one end is connected to the negative pressure inlet through the connecting pipe, and the other end is connected to the negative pressure suction source. Removable for collecting gravel and separating blood clots and perfusate.
  • a negative pressure regulating valve is arranged on the connecting pipe to accurately adjust the negative pressure.
  • the pressure negative pressure suction source can be a common central vacuum suction source (constant negative pressure 500mmHg) in the operating room, and no special negative pressure equipment is needed.
  • the side wall of the stone collecting bottle is provided with a filling port of the perfusion liquid collecting bag, and is connected with a large-capacity washing liquid collecting bag (10L) through a connecting pipe, and the perfusate enters the collecting bag under the action of gravity and vacuum suction, and is convenient for collecting and transporting the perfusate.
  • This design prevents the perfusate from entering the central vacuum suction source conduit while avoiding excessive depletion of the suction of the central vacuum suction source.
  • Embodiment 2 Vacuum suction microscopy device for ureteral soft lithotripsy
  • the apparatus includes a connected anti-overflow valve 3, a negative pressure adjusting mechanism 2, and a casing 1 in three parts.
  • the ureter In the ureteroscope, the ureter is generally horizontal through the sheath. Therefore, the difference from Embodiment 1 is that the endoscope inlet 12 is disposed opposite to the sheath mounting opening 11 and is maintained on the same horizontal line, and the negative pressure adjusting mechanism 2 is not disposed below the endoscope inlet 12, but is vertically disposed. Above the housing chamber. Since the ureteroscope is a soft endoscope, the anti-overflow valve 3 is also provided with a mirror holder 5 for guiding and supporting the soft-lens mirror.

Abstract

一种经鞘内镜取石术用负压吸引调节装置，包括壳体（1），该壳体上开设有内镜入口（12）、鞘管安装口（11）和负压接入口（13），壳体上还设置与壳体的腔室连通的负压调节机构（2）。通过该负压吸引调节装置，术者本人可以直接准确设置和调控负压吸力大小至合理值，避免负压过高导致肾内出血加重和负压过低导致引流不畅，肾内低压状态无法维持，碎石无法吸出等情况，可直接观察鞘管负压引流状况，及时发现和处理碎石、血凝块所致鞘内引流通道阻塞等情况；可直接使用手术室常用中央负压吸引源，无需专用特殊负压控制和监测设备；适用于临床各种口径剥皮鞘和输尿管通过鞘及软硬内镜；装置小巧，结构简单，使用方便，费用低廉。

Description

经鞘内镜取石术用负压吸引调节装置 技术领域
本发明属于医疗器械领域，具体涉及一种经鞘内镜取石术用负压吸引调节装置。
背景技术
尿路结石是临床常见病，经皮肾镜碎石术和输尿管软镜取石术等经鞘内镜取石手术是处理肾与输尿管结石为最常见治疗方式。经鞘内镜取石手术实质是通过将空心鞘置入人体内并到达手术部位(肾盂和输尿管上段)后再经鞘置入内镜取石的微创手术术式，术中需经内镜镜体中注水通道向肾内灌注生理盐水以保证手术视野清晰，但这可导致肾盂内压升高而易致细菌返流入血，出现尿源性脓毒血症、休克、死亡；经鞘与内镜镜体间空隙自然引流排出灌注液不充分限制了灌注流量,常影响视野清晰度从而影响碎石效率；取石方式主要靠取石钳或套石篮反复取石或高压水流冲出结石，耗时长；术中灌注液四溢浸湿手术区域干扰操作。
现今经鞘内镜取石手术中利用负压吸引降低肾内压和提高取石效率是一个重要的技术发展方向。现有的负压吸引碎石技术包括：1.超声碎石吸石探杆及设备，缺点：超声碎石效率低，常需配合其他碎石设备，探杆内吸石通道狭小，无法清除大块碎石，取石效率低；2.具有吸石通道和/或肾内测压通道的特制鞘体或镜体，可配套有负压监测和调控设备仪器。缺点：1.鞘或镜体上需设置负压吸引或肾内压测压专用通道，技术难度大，增加了鞘或镜体直径，既限制了其他操作通道也增加了通道相关的损伤；2.单纯负压吸引，不使用准确负压吸力控制设备，可致负压过大，易导致引起肾内出血、组织贴附内镜、视野不清，或负压过小，肾内低压或负压状态无法维持，引流不畅，碎石无法吸出。3.专用负压吸引和监测设备虽可实时调节负压大小和监测肾内压力，但需专人操作，术者本人无法设置和调控负压状态。事实上术中肾盂内压不必实时精确监控， 而是只需保持适当肾内低压或负压即可；4.目前经鞘内镜取石手术中最广泛使用的是一次性剥皮鞘或输尿管通过鞘，负压吸引装置应可以与其便捷连接，而不是另外特制鞘体或镜体；5.现有金属或塑料负压吸引连接装置无法观察鞘管引流状况，术中吸出的碎石可以经常阻塞管道，造成引流通而不畅且不能及时处理，导致肾内低压或负压不能维持。因此，现有负压吸引碎石系统存在技术困难，结构复杂，使用不便，需多个配套设备仪器且费用高昂等缺陷，不适合广泛开展应用。
发明内容
为了解决现有技术存在的上述问题，本发明提供了一种经鞘内镜取石术用负压吸引调节装置。
本发明所采用的技术方案为：
一种经鞘内镜取石术用负压吸引调节装置，包括透明医用塑料的壳体，所述壳体上开设有内镜入口、鞘管安装口和负压接入口，所述内镜入口与所述鞘管安装口不在同一平面上；还包括与所述壳体的内部腔室连通的负压调节机构，且所述负压调节机构竖直设置。本发明为管腔状密闭连接装置，实现将现有的临床广泛使用的经皮肾造瘘鞘/输尿管通过鞘和负压吸引连接，不用专门设计有负压吸引或测压通道的鞘体或镜体，同时保证内镜自由进出。
优选的，所述内镜入口与所述鞘管安装口相对设置。将内镜入口与鞘管安装口相对设置，保证内镜通过的路径为直线，从而保证内镜能便捷进入鞘管。
优选的，还包括内镜引导管，所述内镜引导管由所述内镜入口伸入所述壳体腔室内部，所述内镜引导管的尾端与所述鞘管安装口间隔设置，且间隔距离大于鞘管的内镜。内镜引导管为内镜搭设了一条通路，保证软硬内镜均可经此顺畅进入鞘管内，从而提高操作的准确性。引导管尾端与鞘管安装口间隔距离大于鞘口直径，保证了碎石可以通过负压吸引自鞘管安装口处鞘口顺畅排出至壳体腔室内，再经负压接入口排出。
进一步的，还包括用以防止灌注液从所述内镜引导管前端溢出的防溢阀，防溢阀为中空的防溢阀，所述防溢阀上开设有上下贯穿所述防溢阀的通道，所述通道的形状为中间窄两端宽的双喇叭形，所述通道的侧壁采用的材料为弹性材料。本发明所指前、后方向为手术时，靠近术者方向为前方向，靠近患者方向为后方向。主要利用术中引导管内负压和管外大气压作用实现引导管管口和内镜体之间缝隙(双喇叭口通道的中间缩窄部分)的密闭，而不仅仅单纯依赖弹力材料弹性回缩作用封闭管口。所述防溢阀密闭效果确切，耐用性好，适合各种规格的软硬镜体便捷通过，且可避免软镜受损。
优选的，所述鞘管安装口上设有密封嘴，所述密封嘴采用弹性材料制成，且所述密封嘴上开设有可与鞘管过盈配合的通孔。所述密封件可匹配多规格的鞘管并与之过盈配合，从而保证所述壳体腔内的相对气密性并固定鞘管。
优选的，所述负压接入口设置于所述壳体的底侧。所述壳体腔室的最低位侧壁上开设所述负压接入口，其口径大于鞘管口径并呈漏斗状，有利于碎石和血凝块在重力和负压吸引作用下快速进入结石收集器。
进一步的，所述负压调节机构包括压力显示管和空气填充室；所述压力显示管为竖直设置的管体，且所述压力显示管将所述空气填充室与所述腔室连通。所述空气填充室上设有排气阀。负压调节机构是直接观察负压变化和调节负压引力大小的结构：术中在开启负压吸引前，灌注液经内镜通道注入肾盂再经鞘口引流出至壳体腔室并进入压力显示管内，排挤其中空气自排气阀逸出，当仅空气填充室内留有空气时关闭排气阀，此时压力显示管内为灌注液所充填。负压吸引开始后，压力显示管内液面将下降，根据波义耳定律及气体方程，空气体积变大则压力变小，术者可通过压力显示管内液面的高低来判断负压大小。
优选的，所述压力显示管上沿其长轴还设置有负压压力标记。术中当所述压力显示管内液面下降到标记的手术拟设负压压力值时即表示所述壳体腔内负压吸力设置完成，从而为术者提供简单而直观的操作指示。术者本人可根据术中灌注液流量、灌注压力、视野清晰程度、出血状况、肾内空间大小、结石是否顺畅吸出等情况，利用所述负压接入口连接的负压调节阀准确调节负压大小， 使其达到最佳负压吸力并处于安全范围内。同时，术中可以通过直接观察压力显示管内液平高度变化判定鞘管引流状况，如液平高度明显降低，说明壳体腔内负压过大，鞘管中灌注液流出受阻，有碎石或血凝块阻塞，需立即清除。
本发明的有益效果为：术者本人可以直观准确设置和调控负压吸力大小至恰当安全值，可避免负压过大导致肾内出血加重和负压过低导致引流不畅，肾内低压状态无法维持，碎石无法吸出等情况，可直接观察鞘管负压引流状况，及时发现和处理碎石、血凝块所致鞘内引流通道阻塞等情况。使用手术室常用中央负压吸引源，不需要专用特殊负压控制和监测设备。适用于常用各种口径剥皮鞘和输尿管通过鞘，适用于各种软硬内镜，无需特制鞘或镜体。装置小巧，结构简单，使用方便，费用低廉，易于广泛应用。
附图说明
图1是本发明经皮肾镜碎石术所用负压吸引调节装置的立体结构示意图；
图2是图1的剖视图；
图3是本发明输尿管软镜取石术所用负压吸引调节装置的立体结构示意图；
图4是图3的剖视图。
图中：1、壳体；2、负压调节机构；3、防溢阀；11、鞘管安装口；12、内镜入口；13、负压接入口；14、密封嘴；；21、压力显示管；22、空气填充室；23、排气阀；31、内镜引导管；5、镜托。
具体实施方式
如图1～4所示，本发明提供了一种经鞘内镜取石术用负压吸引调节装置，包括壳体1，所述壳体1上开设有内镜入口12、鞘管安装口11和负压接入口13，所述壳体1上还竖直设置有与所述壳体1的腔室连通的负压调节机构2。采用分体设计，壳体分为可拆开的盖体和与座体两部分，分解状态下便于插入鞘管， 盖与座体可密封配合成一体，形成内部密闭腔室。在盖体上设有内镜入口，内镜引导管，负压调节机构。座体上开设鞘管安装口和负压接入口，分别用于安装鞘管和连接负压吸引。均用透明轻薄硬质医用塑料材料制成，如聚丙烯。
鞘管安装口11上设有密封嘴14；密封嘴14采用的材料为弹性材料，且所述密封嘴14上开设有通孔，该通孔可制成多孔径以与不同规格的鞘管过盈配合，保证壳体内的相对气密性。
所述内镜入口12与所述鞘管安装口11不在同一平面上。内镜进入内镜入口后可使壳体1和负压调节机构2组成的贯通空间处于非密封状态，因此，须设置防溢阀3以隔绝外部的空气，且防止灌注液外流。所述防溢阀3内设薄层弹性材料制成的双喇叭口形通道，如天然橡胶、合成橡胶、聚氯乙烯以及各种弹性体(例如氨基甲酸乙酯、聚异戊二烯)。
负压调节机构2包括压力显示管21和空气填充室22，所述空气填充室22、所述压力显示管21与壳体1的腔室连通，形成空气和灌注液的相对密封的容质腔。所述压力显示管竖直设置，沿其长度方向还设置有负压压力标记。
实施例1经皮肾镜碎石用负压吸引调节装置
经皮肾镜碎石术中鞘管一般为竖直安置，如图1～2所示，该装置包括防溢阀3、负压调节机构2和壳体1三部分。
负压调节机构：主要包括相互连通的压力显示管21和空气填充室22。内镜引导管31的前端与防溢阀3配合后，其管身依次穿过空气填充室22、压力显示管21(即内镜引导管31嵌套在负压调节机构2的内部中轴，负压调节机构2位于内镜入口12的下方)，并最终伸入至壳体1腔室内。空气填充室22为容积5ml的漏斗形，其侧壁上设置有排气阀。压力显示管21为中空透明的管体，管壁表面设置负压压力值标记。手术中常规灌注液流量(300～600ml/min)和灌注压力(250～300mmHg)状态下维持肾内安全低压(<30mmHg)所需负压吸力一般为100～250mmHg。空气填充室内预留空气体积为5ml，当负压吸引开启压力显示管内液面下降，空气体积相应增大至5.75ml时，管体腔内负压值为 100mmHg。空气体积相应增大至7.45ml时，管体腔内负压值为250mmHg。故压力显示管容积可设为3ml，长度设为3cm，其上压力标记100-250mmHg。负压调节机构为一体成型，与壳体座螺纹连接，或其他保证两者相对气密性的连接方式。完整负压吸引调节装置呈杯状，长度约为5cm，自重不超过15g。
塑料结石收集瓶：一端通过连接管与负压接入口连接，另一端接负压吸引源。可拆卸，用于收集碎石，分离血凝块和灌注液。其连接管上设置负压调节阀以准确调节负压大小。压力负压吸引源可为手术室常用中央负压吸引源(恒定负压500mmHg)，不需要另外专用负压设备。结石收集瓶侧壁设有灌注液收集袋连接口，通过连接管与大容量冲洗液收集袋(10L)连接，灌注液在重力和负压吸引作用下进入收集袋，便于收集转运灌注液。此设计可避免灌注液进入中央负压吸引源管道内，同时避免中央负压吸引源吸力的过度减损。
实施例2输尿管软镜碎石术用负压吸引调节装置
如图3～4所示，该装置包括有连接的防溢阀3、负压调节机构2和壳体1三部分。
输尿管软镜碎石术中输尿管通过鞘一般为水平位。因此，与实施例1的区别在于，内镜入口12与鞘管安装口11相对设置，并保持在同一水平线上，而负压调节机构2未设置在内镜入口12的下方，而是垂直设置于壳体腔室上方。由于输尿管软镜为软体内镜，防溢阀3前还设有镜托5，用以引导支撑软体内镜进出。
本发明的有益效果为：
1、可以广泛应用于经皮肾造瘘/输尿管软镜等经鞘内镜取石手术中；
2、通过术者本人设置并调控适当负压吸引，降低术中肾盂内压，减少手术并发症；在维持肾盂内低压同时适当提高术中灌注流速，保证手术视野，提高碎石效率；可经鞘管快速吸取较大碎石，有利于减少术后结石残留，可提高结石清除率；
3、完全经管内引流灌注液，维护手术区域清洁，减少术中干扰；
4、不需要复杂辅助设备，不需要特制鞘体和镜体，技术简单，使用方便，效果确切，经济适用，易于广泛推广。
本发明不局限于上述最佳实施方式，任何人在本发明的启示下都可得出其他各种形式的产品，但不论在其形状或结构上作任何变化，凡是具有与本申请相同或相近似的技术方案，均落在本发明的保护范围之内。

Claims (10)

  1. 一种经鞘内镜取石术用负压吸引调节装置，其特征在于：包括壳体，所述壳体上开设有内镜入口、鞘管安装口和负压接入口，所述内镜入口与所述鞘管安装口不在同一平面上；还包括与所述壳体的内部腔室连通的负压调节机构，且所述负压调节机构竖直设置。
  2. 根据权利要求1所述的经鞘内镜取石术用负压吸引调节装置，其特征在于：还包括内镜引导管，所述内镜引导管由所述内镜入口伸入至所述腔室的内部，所述内镜引导管的尾端与所述鞘管安装口间隔设置，且间隔距离大于鞘管的内径。
  3. 根据权利要求2所述的经鞘内镜取石术用负压吸引调节装置，其特征在于：还包括用以防止灌洗液从所述内镜引导管前端溢出的防溢阀。
  4. 根据权利要求3所述的经鞘内镜取石术用负压吸引调节装置，其特征在于：防溢阀为中空的防溢阀，所述防溢阀上开设有上下贯穿所述防溢阀的通道，所述通道的形状为中间窄两端宽的双喇叭形，所述通道的侧壁采用的材料为弹性材料；所述通道的下端与所述内镜引导管的前端过盈配合。
  5. 根据权利要求4所述的经鞘内镜取石术用负压吸引调节装置，其特征在于：所述内镜入口与所述鞘管安装口相对设置。
  6. 根据权利要求1所述的经鞘内镜取石术用负压吸引调节装置，其特征在于：所述鞘管安装口上设有密封嘴，所述密封嘴采用弹性材料制成，且所述密封嘴上开设有可与鞘管过盈配合的通孔。
  7. 根据权利要求1所述的经鞘内镜取石术用负压吸引调节装置，其特征在于：所述负压接入口设置于所述壳体的底侧，且负压接入口的直径大于鞘管的内径。
  8. 根据权利要求1～7任一项所述的经鞘内镜取石术用负压吸引调节装置，其特征在于：所述负压调节机构包括压力显示管和空气填充室；所述压力显示管为竖直设置，且所述压力显示管将所述空气填充室与所述腔室连通。
  9. 根据权利要求8所述的经鞘内镜取石术用负压吸引调节装置，其特征在于：所述空气填充室上设有排气阀。
  10. 根据权利要求9所述的经鞘内镜取石术用负压吸引调节装置，其特征在于：所述压力显示管上沿其长度方向还设置有显示负压压力的标记。
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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110464421A (zh) * 2019-08-15 2019-11-19 广州医科大学附属第一医院 灌注吸引器
CN115737008A (zh) * 2022-11-01 2023-03-07 山东第一医科大学附属省立医院(山东省立医院) 消化道内镜标本收集装置

Families Citing this family (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104398302B (zh) * 2014-10-20 2017-04-05 周均洪 一种与输尿管鞘连接的负压调节装置
CN106937876B (zh) * 2017-03-20 2023-09-19 庞广富 对流负压通道碎石集滤装置
CN107080569A (zh) * 2017-06-01 2017-08-22 庞广富 经尿道输尿管硬性对流负压通道碎石清石器
CN107495992A (zh) * 2017-09-26 2017-12-22 珠海康弘发展有限公司 医用节流阀组件
CN111449617B (zh) * 2020-04-10 2023-07-25 西安交通大学医学院第二附属医院 带有抽吸功能的膀胱镜
CN112842461A (zh) * 2021-01-28 2021-05-28 阳江市人民医院 一种用于输尿管镜手术的可接负压吸引的内冲洗不锈钢鞘
CN116458958B (zh) * 2023-03-16 2023-11-03 常州市第一人民医院 基于形变感应的敞口调节型结石吸取装置及控制方法

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030181787A1 (en) * 2002-03-22 2003-09-25 Mitsuo Kondo Suction valve for endoscope use
CN201987662U (zh) * 2010-10-26 2011-09-28 罗洪波 经皮肾通道鞘
CN102406497A (zh) * 2010-09-22 2012-04-11 富士胶片株式会社 内窥镜的吸引按钮组件
CN103429134A (zh) * 2011-12-28 2013-12-04 奥林巴斯医疗株式会社 体腔内压调整装置以及内窥镜系统
WO2015029496A1 (ja) * 2013-08-27 2015-03-05 オリンパスメディカルシステムズ株式会社 内視鏡用流体制御装置
CN204815001U (zh) * 2015-07-03 2015-12-02 陈勇 经鞘内镜取石术用负压吸引调节装置

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104225693B (zh) * 2014-10-09 2017-04-19 周玉虹 负压微控便携引流器
CN204169926U (zh) * 2014-10-20 2015-02-25 周均洪 一种与输尿管鞘连接的负压调节装置

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030181787A1 (en) * 2002-03-22 2003-09-25 Mitsuo Kondo Suction valve for endoscope use
CN102406497A (zh) * 2010-09-22 2012-04-11 富士胶片株式会社 内窥镜的吸引按钮组件
CN201987662U (zh) * 2010-10-26 2011-09-28 罗洪波 经皮肾通道鞘
CN103429134A (zh) * 2011-12-28 2013-12-04 奥林巴斯医疗株式会社 体腔内压调整装置以及内窥镜系统
WO2015029496A1 (ja) * 2013-08-27 2015-03-05 オリンパスメディカルシステムズ株式会社 内視鏡用流体制御装置
CN204815001U (zh) * 2015-07-03 2015-12-02 陈勇 经鞘内镜取石术用负压吸引调节装置

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110464421A (zh) * 2019-08-15 2019-11-19 广州医科大学附属第一医院 灌注吸引器
CN115737008A (zh) * 2022-11-01 2023-03-07 山东第一医科大学附属省立医院(山东省立医院) 消化道内镜标本收集装置
CN115737008B (zh) * 2022-11-01 2023-09-08 山东第一医科大学附属省立医院(山东省立医院) 消化道内镜标本收集装置

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