WO2021233385A1 - 可控旋转黏膜切开刀 - Google Patents

可控旋转黏膜切开刀 Download PDF

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Publication number
WO2021233385A1
WO2021233385A1 PCT/CN2021/094914 CN2021094914W WO2021233385A1 WO 2021233385 A1 WO2021233385 A1 WO 2021233385A1 CN 2021094914 W CN2021094914 W CN 2021094914W WO 2021233385 A1 WO2021233385 A1 WO 2021233385A1
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WIPO (PCT)
Prior art keywords
fixed
cable
rotating
slip ring
knife
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PCT/CN2021/094914
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English (en)
French (fr)
Inventor
鲍少鹏
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常州市久虹医疗器械有限公司
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Publication of WO2021233385A1 publication Critical patent/WO2021233385A1/zh

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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
    • A61B18/04—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
    • 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
    • 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
    • A61B2018/00482—Digestive system
    • A61B2018/00494—Stomach, intestines or bowel
    • 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
    • A61B2018/0091—Handpieces of the surgical instrument or device

Definitions

  • the invention relates to the technical field of medical devices, particularly incision knives, in particular to a controllable rotating mucosal incision knife.
  • endoscopic mucosal dissection As a means of treating early gastrointestinal cancer and precancerous lesions, endoscopic mucosal dissection has the characteristics of small trauma, good curative effect, and quick recovery. The pathological changes can be completely removed through ESD to achieve the effect of radical treatment of gastrointestinal tumors. It is a new treatment method that has emerged in recent years, and it is also a technology with good clinical application prospects, allowing more early gastrointestinal cancers to be endoscopic Complete resection at one time eliminates the pain of laparotomy and the removal of organs.
  • the mucosal incision knife has a variety of knife types, among which the hook knife is a commonly used knife type in mucosal peeling surgery.
  • the hook knife has a fast peeling speed and can be used for incision, peeling and hemostasis.
  • the cutter head needs a specific angle.
  • the existing hook cutter can only move forward and backward along the length direction.
  • CN20385-2407U discloses a minimally invasive surgical access catheter built-in hook knife, which consists of a hook blade, a built-in hook knife slot, an internal guide wire, an intervention catheter, a fixed top wire button, a scale line, a back non-slip handle, and a front non-slip Handle composition; using a built-in hook knife head in the front of the interventional catheter, before use with electronic imaging, cold light source, and electrocoagulation system, first retract the hook knife head into the built-in hook knife slot at the front of the intervention catheter, and insert the intervention catheter In the human body, by controlling the front handle and the front handle, the inner guide wire and the hook cutter head are driven to perform the scribing operation.
  • the scale line on the inner guide wire is convenient to control the length of the hook cutter protruding out of the intervention catheter.
  • the head of the hook knife can only move forward and backward, and cannot effectively rotate the angle and use it in a directional direction.
  • the hook knife is used to operate the operation, which is difficult to operate. It is necessary for this situation to be used in the existing hook. Further improved design based on the knife.
  • the present invention provides a reasonable structure design, which can adjust the rotation angle of the hook knife according to the demand and fix the angle of the directional operation, the adjustment is convenient and reliable, and is beneficial to reduce the risk of surgery.
  • the controllable rotating mucosal incision knife is: in order to overcome the shortcomings of the prior art, the present invention provides a reasonable structure design, which can adjust the rotation angle of the hook knife according to the demand and fix the angle of the directional operation, the adjustment is convenient and reliable, and is beneficial to reduce the risk of surgery.
  • the controllable rotating mucosal incision knife is: in order to overcome the shortcomings of the prior art, the present invention provides a reasonable structure design, which can adjust the rotation angle of the hook knife according to the demand and fix the angle of the directional operation, the adjustment is convenient and reliable, and is beneficial to reduce the risk of surgery.
  • a controllable rotating mucosal incision knife comprising a core rod, a slip ring and a hook knife
  • the slip ring is sheathed and slidably connected to the core rod
  • the hook knife It includes a cutter head arranged at the front end and a pull cable connected to the rear end of the cutter head. The tail end of the pull cable is connected with a slip ring.
  • a rotating handle is fixed, the mounting hole is arranged at the front end of the rotating handle, a mounting seat that can rotate in the mounting hole is matched and connected at the position of the mounting hole, the center of the mounting seat has a through hole, and the inner wall of the front end of the mounting seat
  • a matching part is fixed on the upper part; a brake part is fixed on the outer peripheral surface of the cable of the hook knife.
  • the braking part and the mating part are relatively fixed in the radial direction. When the braking part and the mating part are axially separated, the braking part and the mating part can rotate relatively in the radial direction.
  • the mating part and the braking part are cleverly designed.
  • the slip ring can be pulled to drive the braking part and the cable backward to unlock the braking part and the mating part.
  • the seat and the braking part can be installed as required.
  • Rotate the handle relative to rotate adjust the cutter head to a proper angle and push the slip ring toward the front end, the brake part and the mating part are snapped and locked, and the angle of the cutter head is locked. If you continue to push the slip ring forward, only the depth and angle of the cutter can be adjusted. It is locked, which is convenient for ESD operation.
  • the inner wall of the mating part is circumferentially distributed with a number of clamping grooves, and the outer peripheral surface of the braking part is provided with at least one clamping tooth corresponding to the groove of the inner wall of the mating part.
  • the mating portion includes a smooth front section and a toothed rear section
  • the inner wall of the smooth front section is a smooth circumferential circular surface
  • the locking groove is correspondingly provided on the inner wall of the toothed rear section
  • the braking portion is It includes a rotating front section and a rotating rear section.
  • the outer peripheral surface of the rotating front section is a smooth circumferential circular surface, and the clamping teeth are correspondingly arranged on the outer peripheral surface of the rotating rear section.
  • the tooth shape of the clamping tooth is triangular or wavy.
  • the controllable rotary mucosal incision knife further includes an insulating outer tube, the insulating outer tube is fixed at the front end of the mounting seat, and the matching part is arranged on the inner wall of the front end of the insulating outer tube.
  • the front end of the insulating outer tube is interference-fitted with an insulating head, the inside of the insulating head is hollow with a through hole through which the cable of the hook knife penetrates, and the front end of the mating part is tightly fixed with the rear face of the insulating head;
  • the distance between the rear end surface of the insulating head and the most front end of the rear segment with teeth is not greater than the overall axial length of the braking part.
  • the design of the insulating head has a good insulation effect on the front end, and at the same time, the maximum extension length of the cutter head is limited at the front end to avoid excessive extension of the cutter head.
  • a rotating copper sleeve is fixed in the through hole of the core rod, and the slip ring is relatively slidably connected to the rotating shaft.
  • the pull cable and the spring tube are fixedly connected with the slip ring after extending into the rotating copper sleeve; the circumferential inner wall of the rear end of the mounting seat protrudes with a boss structure, and the front end of the rotating copper sleeve is crimped on the convex On the end surface of the table structure, the rear end is crimped on the end surface of the through hole.
  • the slip ring can stably drive the cable forward or backward to move steadily, and a booster tube can also be designed outside the cable and the spring tube.
  • a booster tube, the booster tube is fixedly connected to a slip ring, an electrode fixing seat is fixed on the slip ring, the lower end of the electrode fixing seat extends into the core rod and is connected with the booster tube, and the electrode fixing seat is An electrode is provided, and the electrode is connected to the cable circuit in the booster tube through a set screw.
  • a spring tube is connected to the rear end of the mating part, one end of the spring tube is connected to the rear end of the mating part, and the other end is connected to the slip ring.
  • the beneficial effect of the present invention is that the controllable rotating mucosal incision knife provided by the present invention has a reasonable structure design, and can easily and quickly realize the rotation and orientation locking of the hook cutter bit through the cooperation of the matching part and the braking part. It is convenient to adjust the rotation angle of the hook knife and fix the angle of the directional operation. The adjustment is convenient and reliable, which is convenient for control and use in clinical operations, and is beneficial to simplify the operation and reduce the risk of ESD operation.
  • Fig. 1 is a schematic structural diagram of an embodiment of the present invention.
  • Fig. 2 is an enlarged cross-sectional view of BB in Fig. 1.
  • Fig. 3 is a partial cross-sectional view of the cutter head extended in the embodiment of the present invention.
  • Fig. 4 is a partial cross-sectional view of the cutter head during recovery in the embodiment of the present invention.
  • Fig. 5 is a perspective view of a braking part in an embodiment of the present invention.
  • Fig. 6 is a perspective view of a mating part in an embodiment of the present invention.
  • Fig. 7 is a cross-sectional view of the rotating tower sleeve in the embodiment of the present invention.
  • cutter head 2 insulating outer tube 3, insulating head 4, mating part 4-1, smooth front section 4-2, toothed rear section 4-3, card slot 5, braking section 5-1, rotating front section 5-2, Rotating back section 5-3, Claw teeth 6, Spring tube 7, Mounting seat 8, Rotating copper sleeve 9, Booster tube 10, Set screw 11, Electrode fixing seat 12, Electrode 13, Core rod 14, Slip ring 15, boss structure 16, cable 17, rotating handle.
  • a controllable rotating mucosal incision knife as shown in Figures 1 to 7 is an embodiment of the present invention and includes a core rod 13, a slip ring 14 and a hook knife.
  • the slip ring 14 is sheathed and slidably connected to Outside the core rod 13, the hook knife includes a cutter head 1 provided at the front end and a pull cable 16 connected to the rear end of the cutter head 1.
  • the tail end of the pull cable 16 is connected to the slip ring 14, and the front end of the core rod 13 There is a mounting hole for the cable 16 to extend into.
  • the front end of the core rod 13 is fixed with a rotating handle, the mounting hole is provided at the front end of the rotating handle, and a mounting seat 7 that can rotate in the mounting hole is connected to the position of the mounting hole.
  • An insulating outer tube 2 is fixed at the front end of the mounting seat 7, and a matching portion 4 is fixed on the inner wall of the front end of the insulating outer tube 2.
  • a spring tube 6 is connected to the rear end of the matching portion 4, one end of the spring tube 6 is connected to the rear end of the matching portion 4, and the other end is connected to the slip ring 14.
  • the spring tube 6 is effectively connected between the mating part 4 and the slip ring 14.
  • a braking portion 5 is fixed on the outer peripheral surface of the pull cable 16 of the hook knife.
  • the mating portion 4 and the braking portion 5 are axially movable butt-fitted.
  • the braking portion 5 and the mating portion 4 are relatively fixed in a radial direction, and the braking portion
  • the braking part 5 and the mating part 4 can rotate relative to each other in the radial direction.
  • the axial locking of the braking part 5 and the mating part 4 can be realized by the cooperation of the locking groove 4-3 and the locking teeth 5-3.
  • the inner wall of the mating portion 4 has 8 locking grooves 4-3 uniformly distributed in the circumferential direction, and the outer peripheral surface of the braking portion 5 is provided with 8 locking teeth 5-3 corresponding to the inner wall of the locking groove 4-3 of the mating portion 4.
  • the mating portion 4 includes a smooth front section 4-1 and a toothed rear section 4-2.
  • the inner wall of the smooth front section 4-1 is a smooth circumferential circular surface, and the slot 4-3 is correspondingly provided in the toothed rear section 4-2 on the inner wall;
  • the braking portion 5 includes a rotating front section 5-1 and a rotating rear section 5-2, the outer peripheral surface of the rotating front section 5-1 is a smooth circumferential circular surface, and the clamping teeth 5-3 Correspondingly, it is arranged on the outer peripheral surface of the rotating rear section 5-2.
  • the brake part 5 and the mating part 4 are unlocked in rotation and can be rotated relative to each other, which is convenient for adjusting the rotation angle of the cutter head 1 of the hook knife .
  • the rotating rear section 5-2 of the braking part 5 enters the toothed rear section 4-2, and the clamping tooth 5-3 is engaged with the groove 4-3, the angle between the braking part 5 and the mating part 4 is locked , The rotation angle of the cutter head 1 is also locked accordingly.
  • the insulating head 3 can be designed with an interference fit at the front end of the insulating outer tube 2.
  • the insulating head 3 has a hollow through hole through which the cable 16 of the hook knife penetrates.
  • the front end of the mating part 4 is tightly fixed with the rear end of the insulating head 3; the rear end of the insulating head 3 and the rear section 4 with teeth -2
  • the distance between the foremost ends is not greater than the overall axial length of the braking portion 5.
  • the design of the insulating head 3 has a good insulation effect at the front end, and at the same time, the front end is a limit for the maximum extension length of the cutter head 1 to avoid excessive extension of the cutter head 1.
  • the distance between the rear end surface of the insulating head 3 and the front end of the toothed rear section 4-2 can be reasonably designed to control the maximum distance that the brake section 5 extends forward to avoid the brake section 5 from the toothed rear section 4- 2
  • the prolapse of the front section affects the positioning effect.
  • a rotating copper sleeve 8 is fixed in the through hole of the core rod 13, and the slip ring 14 slides relatively.
  • the pull cable 16 and the spring tube 6 extend into the rotating copper sleeve 8 and then are fixedly connected with the slip ring 14; the circumferential inner wall of the rear end of the mounting seat 7 protrudes with a boss structure 15, The front end of the rotating copper sleeve 8 is crimped on the end surface of the boss structure 15, and the rear end is crimped on the end surface of the through hole.
  • a booster tube 9 can also be designed outside the cable 16 and the spring tube 6.
  • the outer peripheral surface of the tail end of the cable 16 A booster tube 9 is wrapped on the upper part.
  • the booster tube 9 can be made of a harder material compared to the cable 16 and the spring.
  • the booster tube 9 is fixedly connected to the slip ring 14.
  • the electrode 12 is fixed on the slip ring 14 and the end of the electrode 12 is fixed to the cable 16.
  • the slip ring 14 is fixed with an electrode fixing seat 11, and the lower end of the electrode fixing seat 11 extends into the core 13 and connects with the booster tube. 9 is connected, the electrode 12 is provided in the electrode fixing seat 11, and the electrode 12 is electrically connected to the cable 16 in the booster tube 9 through the set screw 10.
  • the connection between the cable 16 and the set screw 10 can be achieved by designing a groove on the outer peripheral surface of the cable 16, and the end of the set screw 10 is in contact with the bottom surface of the groove to conduct electricity, so that the electrode 12 and the cable 16 are electrically connected.
  • the set screw 10 can rotate in an annular shape along the groove on the outer circumferential surface, which will not interfere with the rotation of the cable 16 while ensuring the circuit connection.
  • the tooth shape of the clamping teeth 5-3 is triangular or wavy or other shapes, and the number of the clamping slots 4-3 and the number of the clamping teeth 5-3 can also be designed according to requirements.
  • the number of -3 and the number of teeth 5-3 are designed to be equal in number, that is, the slot 4-3 corresponds to the teeth 5-3 one by one, and the rotation angle of the cutting knife is divided equally.
  • the number of card slots 4-3 and the number of teeth 5-3 can also be designed to be unequal.
  • the number of card slots 4-3 is designed to be 9 and the number of teeth 5-3 is designed to be 3. Orientation can still be achieved.
  • the number of clamping teeth 5-3 is designed to be one, and it can also be locked with the clamping slot 4-3 to realize the function of directional fixing.
  • the hook knife can cut human tissues
  • the controllable rotating mucosal incision knife designed in this way has a reasonable structure design.
  • the rotation and orientation lock of the cutter head 1 of the hook cutter head 1 can be quickly and conveniently realized, which is convenient for adjusting the hook.
  • the rotation angle of the knife and the fixed angle directional operation are convenient and reliable to adjust, which is convenient for control and use in clinical operations, and is beneficial to simplify the operation of the operation and reduce the risk of ESD operation.

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Abstract

一种可控旋转黏膜切开刀，包括芯杆（13）、滑环（14）、电极装置和钩刀，钩刀包括刀头（1）和拉索（16），芯杆（13）前端面开有供拉索（16）伸入的安装孔，安装孔位置处配合连接有可在安装孔内转动的安装座（7），安装座（7）前端则固定有绝缘外管（2），绝缘外管（2）前端内壁上固定有配合部（4）；钩刀的拉索（16）外周面上固定有制动部（5），配合部（4）与制动部（5）轴向活动对接配合。该可控旋转黏膜切开刀结构设计合理，通过配合部（4）和制动部（5）的配合，可方便快捷地实现钩刀刀头（1）的刀头（1）旋转和定向锁定，方便需求调整钩刀旋转角度并固定角度定向操作，调整方便且可靠，便于临床操作中的控制和使用，有利于简化手术操作、降低ESD手术的风险。

Description

可控旋转黏膜切开刀 技术领域
本发明涉及医疗器械特别是切开刀技术领域，尤其涉及一种可控旋转黏膜切开刀。
背景技术
内镜下黏膜剥离术作为一种治疗胃肠道早期癌及癌前期病变的手段，具有创伤小、疗效好、恢复快等特点。通过ESD可以完整地切除病变，达到根治消化道肿瘤的效果，是近年来出现的一项新的治疗手段，也是临床应用前景很好的技术，让更多的早期消化道癌能够在内镜下一次性完全切除，免除了开腹手术的痛苦和器官的切除。
内镜下黏膜剥离术的重要手术器具为黏膜切开刀。黏膜切开刀具有多种刀型，其中钩刀是黏膜剥离手术中常用的一种刀型。钩刀剥离速度快，可用于切开、剥离、止血。但是采用钩刀刀头进行切割时，其刀头需要一个特定的角度，目前现有的钩刀通常只可沿长度方向进行向前和向后运动。例如CN20385-2407U公开了一种微创手术接入导管内置钩刀，由钩刀头、内置钩刀槽、内导丝、介入导管、固定顶丝钮、刻度尺线、后防滑手柄、前防滑手柄组成；采用在介入导管前部内置钩刀头，使用前配合电子成像、冷光源、电凝系统，先将钩刀头内缩入介入导管前部的内置钩刀槽中，将介入导管插入人体内，通过控制前置手柄和前置手柄，带动内导丝和钩刀头实施勾割操作，内导丝上的刻度尺线便于控制钩刀探出介入导管外的长度。在操作中，钩刀的刀头仅能做前后运动，并不能有效旋转角度并定向使用，在ESD中，使用钩刀操作手术，操作难度较大，有必要这对这一情况在现有钩刀基础上进行进一步的改进设计。
发明内容
本发明要解决的技术问题是：为了克服现有技术之不足，本发明提供一种结构设计合理，可根据需求调整钩刀旋转角度并固定角度定向操作，调整方便且可靠，有利于降低手术风险的可控旋转黏膜切开刀。
本发明解决其技术问题所采用的技术方案是：一种可控旋转黏膜切开刀，包括芯杆、滑环和钩刀，所述滑环外套并滑动连接在芯杆外，所述钩刀包括设置在前端的刀头和连接在刀头后端的拉索，所述拉索尾端与滑环连接，所述芯杆前端面开有供拉索伸入的安装孔，所述芯杆前端固定有旋转手柄，所述安装孔设置在旋转手柄前端，所述安装孔位置处配合连接有可在安装孔内转动的安装座，所述安装座中心贯通具有贯通孔，所述安装座前端内壁上固定有配合部；所述钩刀的拉索外周面上固定有制动部，所述配合部与制动部轴向活动对接配合，所述制动部与配合部轴向配合连接时、制动部与配合部径向相对固定，所述制动部与配合部轴向分离时、制动部与配合部径向可相对转动。
在上述方案中，巧妙地设计了配合部和制动部，在使用中可拉动滑环向后带动制动部和拉索，将制动部与配合部解锁，此时可根据需求安装座和旋转手柄相对旋转，将刀头调整到合适角度后向前端推动滑环，制动部与配合部卡接锁定，刀头角度锁定，继续向前推动滑环仅能调节进刀深度，进刀角度则被锁定，便于ESD手术操作。
优选的，所述配合部内壁环向分布有若干卡槽，所述制动部的外周面则对应配合部内壁卡槽设有至少一个卡齿。
进一步的，所述配合部包括平滑前段和带齿后段，所述平滑前段的内壁为平滑的周向圆面，所述卡槽则对应设置在带齿后段的内壁上；所述制动部则包括旋转前段和旋转后段，所述旋转前段外周面为平滑的周向圆面，所述卡齿则对应设置在旋转后段的外周面上。
优选的，所述卡齿的齿形为三角形或波浪形。
所述可控旋转黏膜切开刀还包括绝缘外管，所述绝缘外管固定在安装座前端，所述配合部设置在绝缘外管的前端内壁。
进一步的，所述绝缘外管前端过盈配合有绝缘头，所述绝缘头内部中空开有供钩刀的拉索贯穿的通孔，所述配合部前端与绝缘头后端面顶紧固定；所述绝缘头后端面与带齿后段最前端之间的间距不大于制动部的整体轴向长度。绝缘头的设计在前端起到了良好的绝缘作用，同时在前端为刀头的最大伸出长度做出限位，避免刀头伸出过度。另外合理设计绝缘头后端面与带齿后段最前端之间的间距，则可控制制动部向前伸出的最大距离，避免制动部从带齿后段前段脱出，影响定位效果。
进一步的，为了便于带动拉索稳定转动，避免芯杆内部空间过大导致转动过程中拉索发生晃动，所述芯杆的贯通孔内固定有旋转铜套，所述滑环相对滑动连接在旋转铜套上，所述拉索和弹簧管伸入旋转铜套后与滑环固定连接；所述安装座尾端的周向内壁上凸出具有凸台结构，所述旋转铜套前端压接在凸台结构端面上，后端压接在贯通孔的尾端端面上。
进一步的，为了提高助推效果，在滑环可稳定带动拉索向前或向后稳定运动，在拉索和弹簧管外还可设计助推管，所述拉索尾端外周面上包裹有助推管，所述助推管与滑环固定连接，所述滑环上固定有电极固定座，所述电极固定座下端伸入芯杆内部并与助推管连接，所述电极固定座内设有电极，所述电极通过紧定螺钉与助推管内的拉索电路导通。
优选的，配合部后端连接有弹簧管，所述弹簧管一端与配合部后端连接、另一端则与滑环连接。
本发明的有益效果是，本发明提供的可控旋转黏膜切开刀，结构设计合理， 通过配合部和制动部的配合，可方便快捷地实现钩刀刀头的刀头旋转和定向锁定，方便需求调整钩刀旋转角度并固定角度定向操作，调整方便且可靠，便于临床操作中的控制和使用，有利于简化手术操作、降低ESD手术的风险。
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是本发明实施例的结构示意图。
图2是图1中BB的剖视放大图。
图3是本发明实施例中刀头伸出时的局部剖视图。
图4是本发明实施例中刀头回收时的局部剖视图。
图5是本发明实施例中制动部的立体图。
图6是本发明实施例中配合部的立体图。
图7是本发明实施例中旋转塔套的剖视图。
图中1、刀头 2、绝缘外管 3、绝缘头 4、配合部 4-1、平滑前段 4-2、带齿后段 4-3、卡槽 5、制动部 5-1、旋转前段 5-2、旋转后段 5-3、卡齿 6、弹簧管 7、安装座 8、旋转铜套 9、助推管 10、紧定螺钉 11、电极固定座 12、电极 13、芯杆 14、滑环 15、凸台结构 16、拉索 17、旋转手柄。
具体实施方式
现在结合附图对本发明作进一步详细的说明。这些附图均为简化的示意图，仅以示意方式说明本发明的基本结构，因此其仅显示与本发明有关的构成。
如图1至图7所示的一种可控旋转黏膜切开刀，是本发明的一种实施例， 包括芯杆13、滑环14和钩刀，所述滑环14外套并滑动连接在芯杆13外，所述钩刀包括设置在前端的刀头1和连接在刀头1后端的拉索16，所述拉索16尾端与滑环14连接，所述芯杆13前端面开有供拉索16伸入的安装孔。
所述芯杆13前端固定有旋转手柄，所述安装孔设置在旋转手柄前端，所述安装孔位置处配合连接有可在安装孔内转动的安装座7，所述安装座7中心贯通具有贯通孔，所述安装座7前端则固定有绝缘外管2，所述绝缘外管2前端内壁上固定有配合部4。所述配合部4后端则连接有弹簧管6，所述弹簧管6一端与配合部4后端连接、另一端则与滑环14连接。弹簧管6有效地连接在配合部4和滑环14之间，当需要刀头1伸出时，滑环14向前运动，弹簧管6被压缩，当刀头1回收时，滑环14向后运动，弹簧管6回弹，同时当拉索16相对于绝缘外管2转动时，弹簧管6也不会对该转动造成干涉。
所述钩刀的拉索16外周面上固定有制动部5。所述配合部4与制动部5轴向活动对接配合，所述制动部5与配合部4轴向配合连接时、制动部5与配合部4径向相对固定，所述制动部5与配合部4轴向分离时、制动部5与配合部4径向可相对转动。在实际设计中，制动部5与配合部4的轴向锁定，可通过卡槽4-3与卡齿5-3的配合实现。所述配合部4内壁环向均布具有8个卡槽4-3，所述制动部5的外周面则对应配合部4内壁卡槽4-3设有8个卡齿5-3。所述配合部4包括平滑前段4-1和带齿后段4-2，所述平滑前段4-1的内壁为平滑的周向圆面，所述卡槽4-3则对应设置在带齿后段4-2的内壁上；所述制动部5则包括旋转前段5-1和旋转后段5-2，所述旋转前段5-1外周面为平滑的周向圆面，所述卡齿5-3则对应设置在旋转后段5-2的外周面上。在操作时，可通过通过带动滑环14的前进和后退，带动制动部5与配合部4之间发生相对运动。当制动部5的旋转后段5-2脱离带齿后段4-2时，制动部5与配合部4在旋转上解 锁，可进行相对转动，便于钩刀的刀头1调整旋转角度。当制动部5的旋转后段5-2进入带齿后段4-2，卡齿5-3与卡槽4-3配合卡接时，制动部5和配合部4之间则角度锁定，刀头1的旋转角度也随之锁定。
在设计中，可在绝缘外管2的前端过盈配合设计绝缘头3。所述绝缘头3内部中空开有供钩刀的拉索16贯穿的通孔，所述配合部4前端与绝缘头3后端面顶紧固定；所述绝缘头3后端面与带齿后段4-2最前端之间的间距不大于制动部5的整体轴向长度。绝缘头3的设计在前端起到了良好的绝缘作用，同时在前端为刀头1的最大伸出长度做出限位，避免刀头1伸出过度。另外合理设计绝缘头3后端面与带齿后段4-2最前端之间的间距，则可控制制动部5向前伸出的最大距离，避免制动部5从带齿后段4-2前段脱出，影响定位效果。
为了便于带动拉索16稳定转动，避免芯杆13内部空间过大导致转动过程中拉索16发生晃动，所述芯杆13的贯通孔内固定有旋转铜套8，所述滑环14相对滑动连接在旋转铜套8上，所述拉索16和弹簧管6伸入旋转铜套8后与滑环14固定连接；所述安装座7尾端的周向内壁上凸出具有凸台结构15，所述旋转铜套8前端压接在凸台结构15端面上，后端压接在贯通孔的尾端端面上。
为了提高助推效果，在滑环14可稳定带动拉索16向前或向后稳定运动，在拉索16和弹簧管6外还可设计助推管9，所述拉索16尾端外周面上包裹有助推管9，助推管9材质相对于拉索16和弹簧，可采用较为硬质的材料制作，所述助推管9与滑环14固定连接。
电极12固定在滑环14上且电极12端部与拉索16固定，所述滑环14上固定有电极固定座11，所述电极固定座11下端伸入芯杆13内部并与助推管9连接，所述所述电极固定座11内设有电极12，所述电极12通过紧定螺钉10与助推管9内的拉索16电路导通。拉索16与紧定螺钉10的连接，可通过在拉索16 外周面上设计槽体，紧定螺钉10端部与该槽体的底面接触导电，将电极12与拉索16电路连通。当拉索16转动时，紧定螺钉10可沿外周面的槽体环形转动，在保证电路连通的同时，不会对拉索16的转动造成干涉。
在实际设计中，所述卡齿5-3的齿形为三角形或波浪形或者其他形状，卡槽4-3的数量和卡齿5-3数量，也可根据需求设计，可将卡槽4-3数量与卡齿5-3数量设计为数量相等，即卡槽4-3与卡齿5-3一一对应，则切开刀的旋转角度被等分分度。也可将卡槽4-3数量与卡齿5-3数量设计为不等数量，例如将卡槽4-3数量设计为9个，卡齿5-3数量设计为3个，依旧可实现定向固定的作用，卡齿5-3数量设计为1个，也可与卡槽4-3锁定，实现定向固定的作用。
工作步骤：
1、在电极12通电状态下，钩刀可对人体组织进行切割；
2、在拉动滑环14带动制动部5、拉索16同步向后端移动，制动部5的卡齿5-3推出配合部4，相对于安装座7转动旋转手柄，安装座7、绝缘外管2位置不变，刀头1、拉索16、滑环14和芯杆13相对于安装座7、绝缘外管2同步转动；
3、刀头1旋转至需要角度后，向前端刀头1端推动滑环14，带动制动部5、拉索16向前移动，制动部5卡齿5-3与配合部4内卡槽4-3配合卡接，此时当安装座7与旋转手柄相对保持位置固定时，制动部5不可发生转动，制动部5只可在滑环14向前向后的一定滑动范围内进行前后移动，不可旋转，即刀头1被固定角度，实现定向；
4、需要调整刀头1的角度时，则重复步骤2、3。
如此设计的可控旋转黏膜切开刀，结构设计合理，通过配合部4和制动部5的配合，可方便快捷地实现钩刀刀头1的刀头1旋转和定向锁定，方便需求调 整钩刀旋转角度并固定角度定向操作，调整方便且可靠，便于临床操作中的控制和使用，有利于简化手术操作、降低ESD手术的风险。
以上述依据本发明的理想实施例为启示，通过上述的说明内容，相关工作人员完全可以在不偏离本项发明技术思想的范围内，进行多样的变更以及修改。本项发明的技术性范围并不局限于说明书上的内容，必须要根据权利要求范围来确定其技术性范围。

Claims (9)

  1. 一种可控旋转黏膜切开刀，包括芯杆(13)、滑环(14)和钩刀，所述滑环(14)外套并滑动连接在芯杆(13)外，所述钩刀包括设置在前端的刀头(1)和连接在刀头(1)后端的拉索(16)，所述拉索(16)尾端与滑环(14)连接，所述芯杆(13)前端面开有供拉索(16)伸入的安装孔，其特征在于：所述芯杆(13)前端固定有旋转手柄，所述安装孔设置在旋转手柄前端，所述安装孔位置处配合连接有可在安装孔内转动的安装座(7)，所述安装座(7)中心贯通具有贯通孔，所述安装座(7)前端内壁上固定有配合部(4)；所述钩刀的拉索(16)外周面上固定有制动部(5)，所述配合部(4)与制动部(5)轴向活动对接配合，所述制动部(5)与配合部(4)轴向配合连接时，制动部(5)与配合部(4)径向相对固定；所述制动部(5)与配合部(4)轴向分离时，制动部(5)与配合部(4)径向可相对转动。
  2. 如权利要求1所述的可控旋转黏膜切开刀，其特征在于：所述配合部(4)内壁环向分布有若干卡槽(4-3)，所述制动部(5)的外周面则对应配合部(4)内壁卡槽(4-3)设有至少一个卡齿(5-3)。
  3. 如权利要求2所述的可控旋转黏膜切开刀，其特征在于：所述配合部(4)包括平滑前段(4-1)和带齿后段(4-2)，所述平滑前段(4-1)的内壁为平滑的周向圆面，所述卡槽(4-3)则对应设置在带齿后段(4-2)的内壁上；所述制动部(5)则包括旋转前段(5-1)和旋转后段(5-2)，所述旋转前段(5-1)外周面为平滑的周向圆面，所述卡齿(5-3)则对应设置在旋转后段(5-2)的外周面上。
  4. 如权利要求3所述的可控旋转黏膜切开刀，其特征在于：所述卡齿(5-3)的齿形为三角形或波浪形。
  5. 如权利要求3所述的可控旋转黏膜切开刀，其特征在于：所述可控旋转 黏膜切开刀还包括绝缘外管(3)，所述绝缘外管(2)固定在安装座(7)前端，所述配合部(4)设置在绝缘外管(2)的前端内壁。
  6. 如权利要求5所述的可控旋转黏膜切开刀，其特征在于：所述绝缘外管(2)前端过盈配合有绝缘头(3)，所述绝缘头(3)内部中空开有供钩刀的拉索(16)贯穿的通孔，所述配合部(4)前端与绝缘头(3)后端面顶紧固定；所述绝缘头(3)后端面与带齿后段(4-2)最前端之间的间距不大于制动部(5)的整体轴向长度。
  7. 如权利要求1所述的可控旋转黏膜切开刀，其特征在于：所述芯杆(13)的贯通孔内固定有旋转铜套(8)，所述滑环(14)相对滑动连接在旋转铜套(8)上，所述拉索(16)和弹簧管(6)伸入旋转铜套(8)后与滑环(14)固定连接；所述安装座(7)尾端的周向内壁上凸出具有凸台结构(15)，所述旋转铜套(8)前端压接在凸台结构(15)端面上，后端压接在贯通孔的尾端端面上。
  8. 如权利要求1所述的可控旋转黏膜切开刀，其特征在于：所述拉索(16)尾端外周面上包裹有助推管(9)，所述助推管(9)与滑环(14)固定连接，所述滑环(14)上固定有电极固定座(11)，所述电极固定座(11)下端伸入芯杆(13)内部并与助推管(9)连接，所述电极固定座(11)内设有电极(12)，所述电极(12)通过紧定螺钉(10)与助推管(9)内的拉索(16)电路导通。
  9. 如权利要求1所述的可控旋转黏膜切开刀，其特征在于：所述配合部(4)后端连接有弹簧管(6)，所述弹簧管(6)一端与配合部(4)后端连接、另一端则与滑环(14)连接。
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