WO2020244602A1 - 一种多功能腔道检查及治疗内镜系统 - Google Patents

一种多功能腔道检查及治疗内镜系统 Download PDF

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WO2020244602A1
WO2020244602A1 PCT/CN2020/094464 CN2020094464W WO2020244602A1 WO 2020244602 A1 WO2020244602 A1 WO 2020244602A1 CN 2020094464 W CN2020094464 W CN 2020094464W WO 2020244602 A1 WO2020244602 A1 WO 2020244602A1
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Prior art keywords
piece
endoscope
internal incision
treatment
operating handle
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PCT/CN2020/094464
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English (en)
French (fr)
Inventor
李学松
周利群
郭应禄
包国华
周燕
马建强
丁光璞
龚侃
王刚
杨昆霖
熊耕砚
洪鹏
樊书菠
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北京大学第一医院
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Priority to EP20818131.3A priority Critical patent/EP3884842A4/en
Publication of WO2020244602A1 publication Critical patent/WO2020244602A1/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
    • A61B1/012—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
    • A61B1/018—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 for receiving instruments
    • 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
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00105—Constructional details of the endoscope body characterised by modular construction
    • 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
    • A61B1/307—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
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3209—Incision instruments
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00505—Urinary tract
    • A61B2018/00517—Urinary bladder or urethra
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • 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
    • A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
    • 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
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • 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
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • 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
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1425—Needle

Definitions

  • the application relates to a multifunctional cavity inspection and treatment endoscopy system, in particular to a multifunctional cavity inspection and treatment endoscopy system applied to the diagnosis and treatment of the ureteral cavity.
  • Ureteral stenosis and obstruction are common causes of hydronephrosis.
  • Various diseases including benign and malignant diseases can cause ureteral stricture.
  • Ureteroscopy is an important way to treat and diagnose ureteral obstruction. According to the structural characteristics of ureteroscopy, it can be divided into flexible ureteroscope, rigid ureteroscope, semi-rigid ureteroscope and so on.
  • the existing ureteroscope has a single function, and different ureteroscopes need to be replaced for different treatment operations, which brings a lot of inconvenience to the operation of medical staff.
  • the purpose of this application is to provide a multifunctional cavity inspection and treatment endoscopic system.
  • a multifunctional cavity inspection and treatment endoscopy system which is characterized in that it includes:
  • the internal incision piece, the fixed card is set on the internal incision work piece,
  • the scope sheath is clamped on the front end of the endoscopic work piece, and the endotomy component and the extension part of the endoscope are axially sleeved into the scope sheath.
  • the internal incision work piece adopts a cold knife type internal incision work piece, which includes a fixed hand piece, which is arranged on the fixed hand piece and is used to push the internal incision piece along the endoscope
  • the internal incision work piece adopts a single and bipolar mixed type internal incision work piece, which includes a fixed hand piece, which is arranged on the fixed hand piece and is used to push the internal incision piece along the An operating handle for axially advancing and retreating the extension of the endoscope, and a V-shaped rebound piece for resetting the operating handle; between the fixed hand piece and the operating handle is formed for the extension of the endoscope to pass through Through the passage, an installation slot for fixing the internal incision is formed between the fixed hand piece and the operating handle, and an electrode connecting seat is provided on the operating handle.
  • the inner cutting piece adopts an inner cutting knife, the front end of the inner cutting piece forms a blade portion, the rear end forms a clamping part, and the inner cutting piece is arranged at intervals on the outer side wall of the middle part.
  • a cylindrical connecting piece, both ends of the connecting piece are open.
  • the internal incision knife is a long-handled cold knife; the blade of the internal incision knife is straight, semicircular or hook-shaped.
  • the internal cutting part adopts internal cutting electrodes
  • the front end of the internal cutting part is formed with an electrode part
  • the rear end is formed with a clamping part
  • a tube is arranged on the outer side wall of the middle part of the internal cutting part.
  • a shaped connecting piece, both ends of the connecting piece (26) are open.
  • the electrode part of the inscribed electrode is a needle electrode or a ring electrode.
  • a limiting block is protrudingly provided on the operating handle on the side close to the fixed hand piece, and a groove for receiving the limiting block is provided on the operating handle, and the limiting block rotates Set in the tank.
  • a mirror bridge which includes a main channel for replacing the endotomy work piece and connected with the endoscope and the sheath, and a bypass channel communicating with the main channel , An on-off valve is provided on the bypass channel.
  • the endoscope adopts a straight rigid tube fiber endoscope with a diameter less than ⁇ 2mm; the diameter of the scope sheath is less than ⁇ 2.5mm.
  • this application provides a multifunctional cavity inspection and treatment endoscopy system, which includes an internal incision working handpiece, and an internal incision installed on the internal incision working handpiece Parts, the sheath connected to the tip end of the endotomy handpiece, and the endoscope connected to the rear end of the endotomy handpiece.
  • the endotomy part can use an endotomy knife or an endotomy electrode.
  • the open work handpiece adopts cold knife type internal incision work handpiece or single and bipolar mixed type internal incision work handpiece. According to the treatment needs, different instruments can be selected for treatment, and ureteroscopy can be performed on the ureter.
  • Figure 1 is a schematic diagram of the overall structure of Embodiment 1 of the present application.
  • FIG. 2 is a schematic diagram of the structure of the mirror bridge in Embodiment 1 of the present application.
  • Figure 3 is a schematic front view of the internal incision knife in Example 1 of the present application.
  • Example 4 is a schematic diagram of the top structure of the internal incision knife in Example 1 of the present application.
  • FIG. 5 is a schematic diagram of the structure of the single and bipolar hybrid internal incision working handpiece of Example 2 of the present application;
  • FIG. 6 is a schematic diagram of the structure of the needle electrode in Embodiment 2 of the present application.
  • FIG. 7 is a schematic front view of the structure of the ring electrode in Embodiment 2 of the present application.
  • FIG. 8 is a schematic top view of the structure of the ring electrode in Embodiment 2 of the present application.
  • this embodiment provides a multifunctional cavity inspection and treatment endoscopy system, which includes:
  • the endoscope 3 is inserted from the rear end of the inner incision work piece 1 into the inner incision work piece 1, and the head 31 of the endoscope 3 is clamped on the rear end of the endoscope work piece 1.
  • the extension 32 of the endoscope 3 passes through the inner cavity of the internal incision hand piece 1 and extends from its front end;
  • the endotomy knife 2 is located under the extension 32 of the endoscope 3 and distributed along its axial direction, and the rear end of the endotomy knife 2 is fixedly clamped on the endotomy work piece 1;
  • the sheath 4 is clamped on the front end of the endotomy working handpiece 1, and the endotomy knife 2 and the extension 32 of the endoscope 3 are axially sleeved into the sheath 4.
  • this embodiment also includes a mirror bridge 5, which includes a main channel 51 used to replace the endotomy work piece 1 and connected to the endoscope 3 and the scope 4, and the main channel 51 is connected to the bypass channel 52, the bypass channel 52 is provided with an on-off valve 53; the bypass channel 52 is opened when performing treatment operations such as laser resection, tube placement, and clamping.
  • a mirror bridge 5 which includes a main channel 51 used to replace the endotomy work piece 1 and connected to the endoscope 3 and the scope 4, and the main channel 51 is connected to the bypass channel 52, the bypass channel 52 is provided with an on-off valve 53; the bypass channel 52 is opened when performing treatment operations such as laser resection, tube placement, and clamping.
  • the internal incision work piece 1 adopts a cold knife type internal incision work piece, which includes a fixed hand piece 11, which is arranged on the fixed hand piece 11 and is used to push the endoscope knife 2 to extend along the endoscope 3.
  • the operating handle 12 of the portion 32 axially advances and retreats, and the V-shaped resilient member 13 arranged between the fixed hand piece 11 and the operating handle 12.
  • the V-shaped resilient piece 13 is used for the reset of the operating handle 12; the fixed hand piece 11 and A channel 14 through which the extension 32 of the endoscope 3 passes is formed between the operating handle 12, and an installation slot 15 for fixing the endotome 2 is formed between the fixing hand piece 11 and the operating handle 12.
  • a limit block (not shown in the figure) is protrudingly provided on the operating handle 12 on the side close to the fixed hand piece 11.
  • the operator pushes the incision knife 2 through the operating handle 12 to move and extend the mirror
  • the stop block is against the side wall of the fixed hand piece 11, the internal incision knife 2 stops continuing to extend, and the operator can know that the internal incision knife 2 has reached the specified length, which is convenient for the operator Operation to improve operation efficiency.
  • a groove (not shown in the figure) for receiving a limit block is provided on the operating handle 12, and the limit block is rotatably arranged in the groove.
  • the front end of the inner incision knife 2 forms a blade portion 21, the rear end forms a clamping portion 22, and a plurality of cylindrical shapes are spaced apart on the outer side wall of the middle portion of the inner incision knife 2.
  • the connecting piece 23, the two ends of the connecting piece 23 are open, the extension 32 of the endoscope 3 passes through the multiple connecting pieces 23 in turn, so that the endotomy knife 2 is axially distributed on the extension 32 of the endoscope 3
  • the rear end of the internal incision knife 2 is inserted into the internal incision work piece 1, and the internal incision knife 2 is fixedly clamped on the internal incision work piece 1 by using the clamping portion 22 on the internal incision knife 2
  • the connecting piece 23 plays a guiding role.
  • the internal slitting knife 2 is a long-handled cold knife; the blade of the internal slitting knife 2 may be straight, semicircular or hook-shaped.
  • the endoscope 3 adopts a straight rigid tube fiber endoscope with a diameter less than ⁇ 2mm; the diameter of the scope 4 is less than ⁇ 2.5mm.
  • the guide wire is inserted through the mirror bridge 5, and the mirror enters the ureter under the guide wire to the stenosis.
  • the guide wire is forwarded, and if it passes through the narrow section retrogradely, the guide wire is fixed and the lens is withdrawn.
  • 2Disassembly and connection disassemble the endoscope 3, the sheath 4, and the bridge 5, connect the endoscope 3 with the endotomy work piece 1, and insert the endotomy knife 2 into the endotomy work piece 1 and use it by hand The parts are locked and fixed, the endoscope 3 and the endotomy knife 2 are sleeved into the scope sheath 4, and the scope sheath 4 is connected to the front end of the endotomy work piece 1.
  • this embodiment provides a multifunctional cavity inspection and treatment endoscopy system, which includes:
  • the internal incision electrode 2 the fixed card is set on the single and bipolar mixed internal incision work piece 1;
  • the sheath 4 is clamped on the front end of the single and bipolar hybrid endotomy working handpiece 1, the endotomy electrode 2 and the extension 32 of the endoscope 3 are axially sleeved into the sheath 4.
  • the single and bipolar hybrid endotomy working hand piece 1 includes a fixed hand piece 11, which is arranged on the fixed hand piece 11 and used for pushing the endotomy electrode 2 to advance and retreat axially along the extension portion 32 of the endoscope 3.
  • the electrode connection base 16 includes a unipolar socket and a bipolar socket provided on the operating handle 12.
  • an electrode portion 24 is formed at the front end of the inscribing electrode 2 and a clamping portion 25 is formed at the rear end.
  • a cylindrical connector 26 is provided on the outer side wall of the middle of the inscribing electrode 2. Both ends of the connector 26 Open, the extension 32 of the endoscope 3 passes through the connecting piece 26 in turn, so that the endoscopic electrode 2 is axially distributed below the extension 32 of the endoscope 3, and the rear end of the endoscopic electrode 2 is inserted into the single and double In the polar hybrid type internal incision work piece 1, the internal incision electrode 2 is fixedly clamped on the single and bipolar hybrid type incision work piece 1 by using the clamping part 25 on the internal incision electrode 2. When the bipolar hybrid endotomy working hand piece 1 pushes the endotomy electrode 2 to move along the axial direction of the extension 32 of the endoscope 3, the connecting piece 26 plays a guiding role.
  • the electrode portion 24 at the tip of the insected electrode 2 can be a needle electrode or a ring electrode.
  • this embodiment also includes a mirror bridge 5, which includes a main channel 51 used to replace the single and bipolar hybrid endotomy handpiece 1 and connected to the endoscope 3 and the scope 4, and to the main channel 51 is connected to the bypass channel 52, the bypass channel 52 is provided with an on-off valve 53; the bypass channel 52 is opened when performing treatment operations such as laser resection, tube placement, and clamping.
  • a mirror bridge 5 which includes a main channel 51 used to replace the single and bipolar hybrid endotomy handpiece 1 and connected to the endoscope 3 and the scope 4, and to the main channel 51 is connected to the bypass channel 52, the bypass channel 52 is provided with an on-off valve 53; the bypass channel 52 is opened when performing treatment operations such as laser resection, tube placement, and clamping.
  • Example 2 Using the multifunctional cavity inspection and treatment provided in Example 2 to treat the upper and middle ureter through the urethra
  • 4% mannitol or 5% glucose solution is used during the operation.
  • the guide wire is inserted through the mirror bridge 5, and the mirror enters the ureter under the guide wire to the stenosis.
  • the guide wire is forwarded, and if it passes through the narrow section retrogradely, the guide wire is fixed and the lens is withdrawn.
  • 2Disassembly and connection disassemble the endoscope 3, the sheath 4, and the bridge 5, connect the endoscope 3 with the single-bipolar hybrid endotomy work piece 1, and install the endoscopic electrode 2 into the single-bipolar hybrid
  • the endotomy work piece 1 is attached and locked with the hand piece.
  • the endotomy electrode 2 and the endoscope 3 are put into the scope sheath 4, and the scope sheath 4 is connected to the single and bipolar hybrid type endotomy work piece 1 Front end,
  • One end of the single and bipolar lead wire is inserted into the unipolar socket of the single and bipolar hybrid internal incision work piece 1, and the other end of the single and bipolar lead wire is connected to the unipolar output port of the energy platform.
  • 3Microscopic unipolar resection endotomy guided by the guide wire, the assembled inspection and treatment endoscopic system follows the guide wire to the narrow part to control the single and bipolar hybrid type endoscopic work handpiece 1 Action to make the endotomy electrode 2 extend out of the scope sheath 4, after incising the narrow section according to the treatment principle, then retract the endotomy electrode 2 into the scope sheath 4, enter the scope through the stenosis section, and after confirmation by microscopy,

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Abstract

一种多功能腔道检查及治疗内镜系统，包括：内切开工作手件（1）；内切开件（2），固定卡设在内切开工作手件（1）上；内窥镜（3），自内切开工作手件（1）的后端插置于内切开工作手件（1）内，该内窥镜（3）的头部（31）卡装在内切开工作手件（1）的后端，内窥镜（3）的延伸部（32）穿过内切开工作手件（1）的内腔并自其前端伸出；镜鞘（4），卡装在内切开工作手件（1）的前端，内切开件（2）以及内窥镜（3）的延伸部（32）轴向套入镜鞘（4）内。

Description

一种多功能腔道检查及治疗内镜系统 技术领域
本申请涉及一种多功能腔道检查及治疗内镜系统，特别涉及一种应用于输尿管腔内诊断与治疗的多功能腔道检查及治疗内镜系统。
背景技术
输尿管狭窄及梗阻是导致肾盂积水的常见原因。包括良性、恶性疾病在内的多种疾病可以导致输尿管狭窄。输尿管镜是一种重要的治疗及诊断输尿管梗阻的方式。根据输尿管镜的结构特点可以分为输尿管软镜、输尿管硬镜、半硬质输尿管镜等。现有的输尿管镜功能单一，针对不同的治疗操作需要更换不同的输尿管镜，给医护人员操作带来诸多不便。
因此，亟需开发一种多功能腔道检查及治疗内镜系统，能够对输尿管进行输尿管镜检查，并进行包括内切开、单极电切除、双极电切除、激光切除、置管、钳夹等多项治疗操作。
发明内容
针对上述问题，本申请的目的是提供一种多功能腔道检查及治疗内镜系统。
为实现上述目的，本申请采用以下技术方案，一种多功能腔道检查及治疗内镜系统，其特征在于，包括：
内切开工作手件；
内切开件，固定卡设在所述内切开工作手件上，
内窥镜，自所述内切开工作手件的后端插置于所述内切开工作手件内，所述内窥镜的头部卡装在所述内切开工作手件的后端，所述内窥镜的延伸部穿过所述内切开工作手件的内腔并自其前端伸出；
镜鞘，卡装在所述内切开工作手件的前端，内切开件以及内窥镜的延伸部轴向套入所述镜鞘内。
优选地，所述内切开工作手件采用冷刀型内切开工作手件，其包括固定手件，设置在所述固定手件上并用于推动所述内切开件沿所述内窥镜的延伸部轴向进退的操作手柄，以及用于所述操作手柄复位的V型回弹件；所述固定手件和操作手柄之间形成有供所述内窥镜的延伸部穿过的通道，所述固定手件和操作手柄之间形成用于固定所述内切开件的安装卡槽。
优选地，所述内切开工作手件采用单双极混合型内切开工作手件，其包括固定手件，设置在所述固定手件上并用于推动所述内切开件沿所述内窥镜的延伸部轴向进退的操作手柄，以及用于所述操作手柄复位的V型回弹件；所述固定手件和操作手柄之间形成有供所述内窥镜的延伸部穿过的通道，所述固定手件和操作手柄之间形成用于固定内切开件的安装卡槽，所述操作手柄上设置电极连接座。
优选地，所述内切开件采用内切开刀，所述内切开件的前端形成刀刃部，后端形成卡接部，在所述内切开刀的中部的外侧壁上间隔设置多个筒状的连接件，所述连接件的两端敞口。
优选地，所述内切开刀为长柄型冷刀；所述内切开刀的刀头为直形、半圆形或钩形。
优选地，所述内切开件采用内切开电极，所述内切开件的前端形成有电极部，后端形成有卡接部，在所述内切开件中部的外侧壁上设置筒状的连接件，所述连接件(26)的两端敞口。
优选地，所述内切开电极的电极部采用针状电极或环状电极。
优选地，在靠近所述固定手件一侧的所述操作手柄上凸出设置限位块，在所述操作手柄上设置用于收纳所述限位块的槽体，所述限位块转动设置在所述槽体内。
优选地，还包括镜桥，所述镜桥包括用于替换所述内切开工作手件并与所述内窥镜、镜鞘连接的主通道，以及与所述主通道连通的旁路通道，所述旁路通道上设置有开关阀门。
优选地，所述内窥镜采用直形硬管纤维内窥镜，直径小于φ2mm；所述镜鞘的直径小于φ2.5mm。
本申请采用以上技术方案，其具有如下优点：本申请提供一种多功能腔道检查及治疗内镜系统，其包括内切开工作手件、安装在内切开工作手件上的内切开件、连接在内切开工作手件头端的镜鞘以及连接在内切开工作手件后端的内窥镜，内切开件可采用内切开刀或内切开电极，对应该的内切开工作手件采用冷刀型内切开工作手件或单双极混合型内切开工作手件，根据治疗需要，选择不同的器械搭配进行治疗，能够对输尿管进行输尿管镜检查，并进行包括内切开、单极电切除、双极电切除、激光切除等多项治疗操作，方便医护人员进行操作治疗。本申请的镜管鞘纤细，指向精确，功能齐全，可较易进狭窄段进行诊断，并可根据治疗需要，选择不同的器械治疗方式。
附图说明
图1是本申请实施例1的整体结构示意图；
图2是本申请实施例1中镜桥的结构示意图；
图3是本申请实施例1中内切开刀的正视结构示意图；
图4是本申请实施例1中内切开刀的俯视结构示意图；
图5是本申请实施例2的单双极混合型内切开工作手件的结构示意图；
图6是本申请实施例2中针状电极的结构示意图；
图7是本申请实施例2中环状电极的正视结构示意图；
图8是本申请实施例2中环状电极的俯视结构示意图。
具体实施方式
下面结合附图和实施例对本申请进行详细的描述。然而应当理解，附图的提供仅为了更好地理解本申请，它们不应该理解成对本申请的限制。
实施例1
如图1所示，本实施例提供了一种多功能腔道检查及治疗内镜系统，其包括：
内切开工作手件1；
内窥镜3，自内切开工作手件1的后端插置于内切开工作手件1内，内窥镜3的头部31卡装在内切开工作手件1的后端，内窥镜3的延伸部32穿过内切开工作手件1的内腔并自其前端伸出；
内切开刀2，位于内窥镜3的延伸部32的下方并沿其轴向分布，内切开刀2的后端固定卡设在内切开工作手件1上；
镜鞘4，卡装在内切开工作手件1的前端，内切开刀2以及内窥镜3的延伸部32轴向套入镜鞘4内。
进一步地，如图2所示，本实施例还包括镜桥5，其包括用于替换内切开工作手件1并与内窥镜3、镜鞘4连接的主通道51，以及与主通道51连通的旁路通道52，旁路通道52上设置有开关阀门53；在进行激光切除、置管、钳夹等治疗操作时，打开旁路通道52。
进一步地，内切开工作手件1采用冷刀型内切开工作手件，其包括固定手件11，设置在固定手件11上并用于推动内切开刀2沿内窥镜3的延伸部32轴向进退的操作手柄12，以及设置在固定手件11和操作手柄12之间的V型回弹件13，V型回弹件13用于操作手柄12的复位；固定手件11和操作手柄12之间形成有供内窥镜3的延伸部32穿过的通道14，固定手件11和操作手柄12之间形成用于固定内切开刀2的安装卡槽15。
进一步地，在靠近固定手件11一侧的操作手柄12上凸出设置一限位块(图中未示出)，使用时，手术人员通过操作手柄12推动内切开刀2运动，伸出镜鞘4的外部，当限位块与固定手件11的侧壁相抵时，内切开刀2停止继续伸出，手术人员即可知晓内切开刀2已到达指定长度，这样，方便手术人员操作，提高操作效率。优选地，在操作手柄12上设置用于收纳限位块的槽体(图中未示出)，限位块转动设置在槽体内。
进一步地，如图3、图4所示，内切开刀2的前端形成刀刃部21，后端形成卡接部22，在内切开刀2的中部的外侧壁上间隔设置多个筒状的连接件23，连接件23的两端敞口，内窥镜3的延伸部32依次穿过多个连接件23，使得内切开刀2轴向分布于内窥镜3的延伸部32的下方，内切开刀2的后端插入内切开工作手件1内，利用内切开刀2上的卡接部22使内切开刀2固定卡设在内切开工作手件1上，利用内切开工作手件1推动内切开刀2沿内窥镜3的延伸部32的轴向运动时，连接件23起到导向作用。
进一步地，内切开刀2为长柄型冷刀；内切开刀2的刀头可为直形、半圆形或钩形。
进一步地，内窥镜3采用直形硬管纤维内窥镜，直径小于φ2mm；镜鞘4的直径小于φ2.5mm。
本实施例的使用方法如下：
以运用本实施例中的检查及治疗内镜系统经尿道治疗输尿管中上段狭窄为例，术中使用生理盐水灌注。
①插管：将内窥镜3与镜鞘4、镜桥5连接，并与光源摄像系统、灌注泵连接，开机运行。经尿道进入膀胱；
经镜桥5置入导丝，在导丝导引下镜子进入输尿管，直至狭窄处。导丝前探，若逆行通过狭窄段后，固定导丝退镜。
②拆卸与连接：拆卸内窥镜3、镜鞘4、镜桥5，将内窥镜3与内切开工作手件1连接，内切开刀2装入内切开工作手件1并用手件卡锁固定，内窥镜3与内切开刀2套入镜鞘4，镜鞘4连接在内切开工作手件1的前端。
③镜下冷刀内切开：经导丝导引，组装好的检查及治疗内镜系统沿导丝旁进镜至狭窄处，控制内切开工作手件1工作，使内切开刀2伸出镜鞘4外部，按治疗原则切开狭窄段后，缩回内切开刀2至镜鞘4内，进镜通过狭窄段，经镜检确认后，固定导丝退镜。经导丝置入双J管，镜下退出导丝，观察双J管摆放位置，确认后退镜结束手术。其间视需要使用C臂X光机监测引导。
实施例2
如图5～8所示，与实施例1相比，本实施例提供了一种多功能腔道检查及治疗内镜系统，其包括：
单双极混合型内切开工作手件1，
内切开电极2，固定卡设在单双极混合型内切开工作手件1上；
内窥镜3，自单双极混合型内切开工作手件1的后端插置于其内部，内窥镜3的头部31卡装在单双极混合型内切开工作手件1的后端，内窥镜3的延伸部32穿过单双极混合型内切开工作手件1的内腔并自其前端伸出；
镜鞘4，卡装在单双极混合型内切开工作手件1的前端，内切开电极2以及内窥镜3的延伸部32轴向套入镜鞘4内。
进一步地，单双极混合型内切开工作手件1包括固定手件11，设置在固定手件11上并用于推动内切开电极2沿内窥镜3的延伸部32轴向进退的操作手柄12，以及用于操作手柄12复位的V型回弹件13；固定手件11和操作手柄12之间形成有供内窥镜3的延伸部32穿过的通道14，固定手件11和操作手柄12之间形成用于固定内切开电极2的安装卡槽15，操作手柄12上设置电极连接座16，方便电极的接入。
进一步地，电极连接座16包括设置在操作手柄12上的单极插座和双极插座。
进一步地，内切开电极2的前端形成有电极部24，后端形成有卡接部25，在内切开电极2中部的外侧壁上设置筒状的连接件26，连接件26的两端敞口，内窥镜3的延伸部32依次穿过连接件26，使得内切开电极2轴向分布于内窥镜3的延伸部32的下方，内切开电极2的后端插入单双极混合型内切开工作手件1内，利用内切开电极2上的卡接部25使内切开电极2固定卡设在单双极混合型内切开工作手件1上，利用单双极混合型内切开工作手件1推动内切开电极2沿内窥镜3的延伸部32的轴向运动时，连接件26起到导向作用。
进一步地，如图6～8所示，内切开电极2的前端的电极部24可采用针状电极或环状电极。
进一步地，本实施例中还包括镜桥5，其包括用于替换单双极混合型内切开工作手件1并与内窥镜3、镜鞘4连接的主通道51，以及与主通道51连通的旁路通道52，旁路通道52上设置有开关阀门53；在进行激光切除、置管、钳夹等治疗操作时，打开旁路通道52。
本实施例的使用方法如下：
以运用实施例2中提供的多功能腔道检查及治疗内镜系统经尿道治疗输尿管中上
段狭窄为例，术中使用4％甘露醇或者是5％的葡萄糖液灌注。
①插管：将内窥镜3与镜鞘4、镜桥5连接，并与光源摄像系统、灌注泵连接， 开机运行。经尿道进入膀胱；
经镜桥5置入导丝，在导丝导引下镜子进入输尿管，直至狭窄处。导丝前探，若逆行通过狭窄段后，固定导丝退镜。
②拆卸与连接：拆卸内窥镜3、镜鞘4、镜桥5，内窥镜3与单双极混合型内切开工作手件1连接，内切开电极2装入单双极混合型内切开工作手件1上，并用手件卡锁固定，内切开电极2和内窥镜3套入镜鞘4内，镜鞘4连接在单双极混合型内切开工作手件1的前端，
将单双极导联线的一端插接在单双极混合型内切开工作手件1的单极插座上，单双极导联线的另一端与能量平台的单极输出端口连接。
③镜下单极电切型内切开：经导丝导引，组装好的检查及治疗内镜系统沿导丝旁进镜至狭窄处，控制单双极混合型内切开工作手件1动作，使内切开电极2伸出镜鞘4的外部，按治疗原则切开狭窄段后，然后缩回内切开电极2至镜鞘4内，进镜通过狭窄段，经镜检确认后，
固定导丝退镜。经导丝置入双J管，镜下退出导丝，观察双J管摆放位置，确认后退镜结束手术。其间视需要使用C臂X光机监测引导。
另外，本实施例中另一使用方法如下：
与上述的使用方法相比，其他过程不变，仅将单双极导联线的一端插接在单双极混合型内切开工作手件1的双极插座上，单双极导联线的另一端与能量平台的双极输出端口连接，这样可进行镜下双极电切型内切开。
本申请仅以上述实施例进行说明，各部件的结构、设置位置及其连接都是可以有所变化的。在本申请技术方案的基础上，凡根据本申请原理对个别部件进行的改进或等同变换，均不应排除在本申请的保护范围之外。

Claims (10)

  1. 一种多功能腔道检查及治疗内镜系统，其特征在于，包括：
    内切开工作手件(1)；
    内切开件(2)，固定卡设在所述内切开工作手件(1)上，
    内窥镜(3)，自所述内切开工作手件(1)的后端插置于所述内切开工作手件(1)内，所述内窥镜(3)的头部(31)卡装在所述内切开工作手件(1)的后端，所述内窥镜(3)的延伸部(32)穿过所述内切开工作手件(1)的内腔并自其前端伸出；
    镜鞘(4)，卡装在所述内切开工作手件(1)的前端，内切开件(2)以及内窥镜(3)的延伸部(32)轴向套入所述镜鞘(4)内。
  2. 如权利要求1所述的一种多功能腔道检查及治疗内镜系统，其特征在于：所述内切开工作手件(1)采用冷刀型内切开工作手件，其包括固定手件(11)，设置在所述固定手件(11)上并用于推动所述内切开件(2)沿所述内窥镜(3)的延伸部(32)轴向进退的操作手柄(12)，以及用于所述操作手柄(12)复位的V型回弹件(13)；所述固定手件(11)和操作手柄(12)之间形成有供所述内窥镜(3)的延伸部(32)穿过的通道(14)，所述固定手件(11)和操作手柄(12)之间形成用于固定所述内切开件(2)的安装卡槽(15)。
  3. 如权利要求1所述的一种多功能腔道检查及治疗内镜系统，其特征在于：所述内切开工作手件(1)采用单双极混合型内切开工作手件，其包括固定手件(11)，设置在所述固定手件(11)上并用于推动所述内切开件(2)沿所述内窥镜(3)的延伸部(32)轴向进退的操作手柄(12)，以及用于所述操作手柄(12)复位的V型回弹件(13)；所述固定手件(11)和操作手柄(12)之间形成有供所述内窥镜(3)的延伸部(32)穿过的通道(14)，所述固定手件(11)和操作手柄(12)之间形成用于固定内切开件(2)的安装卡槽(15)，所述操作手柄(12)上设置电极连接座(16)。
  4. 如权利要求1所述的一种多功能腔道检查及治疗内镜系统，其特征在于：所述内切开件(2)采用内切开刀，所述内切开件(2)的前端形成刀刃部(21)，后端形成卡接部(22)，在所述内切开件(2)的中部的外侧壁上间隔设置多个筒状的连接件(23)，所述连接件(23)的两端敞口。
  5. 如权利要求4所述的一种多功能腔道检查及治疗内镜系统，其特征在于：所述内切开刀为长柄型冷刀；所述内切开刀的刀头为直形、半圆形或钩形。
  6. 如权利要求1所述的一种多功能腔道检查及治疗内镜系统，其特征在于：所述内切开件(2)采用内切开电极，所述内切开件(2)的前端形成有电极部(24)，后端形成有卡接部(25)，在所述内切开件(2)中部的外侧壁上设置筒状的连接件(26)，所述连接件(26)的两端敞口。
  7. 如权利要求6所述的一种多功能腔道检查及治疗内镜系统，其特征在于：所述内切开电极的电极部(24)采用针状电极或环状电极。
  8. 如权利要求2或3所述的一种多功能腔道检查及治疗内镜系统，其特征在于：在靠近所述固定手件(11)一侧的所述操作手柄(12)上凸出设置限位块，在所述操作手柄(12)上设置用于收纳所述限位块的槽体，所述限位块转动设置在所述槽体内。
  9. 如权利要求1所述的一种多功能腔道检查及治疗内镜系统，其特征在于：还包括镜桥(5)，所述镜桥(5)包括用于替换所述内切开工作手件(1)并与所述内窥镜(3)、镜鞘(4)连接的主通道(51)，以及与所述主通道(51)连通的旁路通道(52)，所述旁路通道(52)上设置有开关阀门(53)。
  10. 如权利要求1所述的一种多功能腔道检查及治疗内镜系统，其特征在于：所述内窥镜(3)采用直形硬管纤维内窥镜，直径小于φ2mm；所述镜鞘(4)的直径小于φ2.5mm。
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