WO2022057243A1

WO2022057243A1 - Rotary excision surgical device and operation method thereof

Info

Publication number: WO2022057243A1
Application number: PCT/CN2021/086607
Authority: WO
Inventors: 张学斌; 李汉忠
Original assignee: 张学斌; 李汉忠
Priority date: 2020-09-15
Filing date: 2021-04-12
Publication date: 2022-03-24
Also published as: CN112022336A

Abstract

A rotary excision surgical device, comprising an outer sheath tube (1), an inner sheath tube (2), a water inlet (3), a water outlet (4) and a cable (6). The rotary excision surgical device further comprises a rotating shaft (7) and a motor (501). The rotating shaft (7) can be driven by the motor (501) to rotate. A cutting ring is arranged at an end of the rotating shaft (7). The outer sheath tube (1) and the inner sheath tube (2) are nested one with respect to the other. The rotating shaft (7) is positioned in the inner sheath tube (2).

Description

Rotary resection surgical device and operation method

This application claims the priority of the prior application with the patent application number 202010970603.X and the title of "Rotary Resection Surgical Device and Operation Method" filed with the State Intellectual Property Office of China on September 15, 2020. The entire contents of said prior applications are incorporated herein by reference.

technical field

The invention belongs to the technical field of medical devices. Specifically, it relates to a rotary resection surgical device with high resection efficiency and high accuracy and an operation method thereof.

Background technique

In 1929, McLean first studied and proposed the principle of electrosurgery. After the introduction of the electrosurgical generator device developed by Bovie and Cushing, its initial application was the successful resectoscope developed in the 1930s. In the earliest resectoscopes, a resection ring was mounted on a fitted cystoscope, and a high-frequency electrosurgical generator was able to deliver both cutting and coagulation currents.

In the following decades, the technology of resectoscope has undergone a comprehensive innovation, including high-frequency electrosurgery, better resectoscope and loop materials, better perfusion, etc., but the technical principle behind it is still the same as that of 80 years. The same as before, its derived disadvantages include the use of hypotonic irrigation fluid, which may lead to Trans Urethral Resection Prostate (TURP) syndrome.

The emergence of plasma resectoscope fundamentally solved the problem of TURP syndrome. Because the plasma resectoscope uses normal saline as the flushing fluid, the occurrence of dilutional hyponatremia is avoided, and there is basically no occurrence of TURS. Therefore, plasma electrosurgery improves surgical safety and tissue resection rate. In addition, it is less limited by the size of the prostate, relatively prolongs the surgical cutting time, expands the surgical indications, reduces the surgical risk, and facilitates the more thorough removal of hyperplastic prostate tissue.

Nevertheless, plasma resectoscope still has many shortcomings, such as low cutting efficiency, uneven cutting surface, long learning curve and so on. It is against this background that the present invention has been made.

SUMMARY OF THE INVENTION

An embodiment of the present invention provides a rotary resection surgical device, comprising an outer sheath tube (1), an inner sheath tube (2), a water inlet (3), a water outlet (4) and a cable (6), characterized in that , the rotary resection surgical device further comprises a rotating shaft (7) and a motor (501), the rotating shaft (7) can be rotated under the driving of the motor (501), and the end of the rotating shaft (7) A cutting ring is provided, the outer sheath (1) and the inner sheath (2) are nested with each other, and the rotating shaft (7) is located in the inner sheath (2).

According to an embodiment of the present invention, for example, the rotary resection surgical device further comprises a resectoscope body (5), and the motor (501) is arranged inside the resectoscope body (5), and is arranged through a gear set. is connected with the rotating shaft (7) to provide power for the rotation of the rotating shaft (7) and the expansion and contraction along the axial direction;

Preferably, the gear set includes a worm (502), a turbine (503), a first bevel gear (504) and a second bevel gear (507); the first bevel gear (504) is fixedly mounted on the rotating shaft On the other end of (7) opposite to the cutting ring, the worm (502) is fixedly installed on the rotating shaft (7) adjacent to the first bevel gear (504), and the turbine (503) is fixedly installed At the end of the rotating shaft of the electric motor (501), the second bevel gear (507) is installed on the rotating shaft of the electric motor (501) next to the turbine (503).

According to an embodiment of the present invention, for example, several limiting pieces (201) are installed at different positions of the rotating shaft (7);

Preferably, 1-6 limit pieces (201) are installed at different positions of the rotating shaft (7);

Preferably, 2-4 limit pieces (201) are installed at different positions of the rotating shaft (7);

Preferably, a circular hole is arranged in the center of the limiting piece (201), and the diameter of the circular hole is 1.01-1.1 times the diameter of the rotating shaft (7); or the diameter of the circular hole is The diameter of the rotating shaft (7) is 1.01-1.05 times; or the diameter of the circular hole is 1.01-1.02 times the diameter of the rotating shaft (7).

According to one embodiment of the present invention, for example, the rotary resection surgical device further comprises a fiber optic camera (202);

Preferably, the optical fiber camera (202) is arranged in the inner sheath tube (2) near one end of the excision ring;

Preferably, two optical fiber cameras (202) are provided;

Preferably, the two optical fiber cameras (202) are arranged on the limiting piece (201) closest to the excision ring.

According to an embodiment of the present invention, for example, the rotary resection surgical device further includes an electric control module (505), the electric control module (505) includes an optical fiber image processing module and an electric wire cutting power module, the optical fiber The image processing module converts the image obtained by the optical fiber camera (202) into a digital signal that can be processed; the electric cutting wire power supply module provides power for rotating the electric cutting wire, and then transmits it to data processing through the cable (6) device;

Preferably, the electronic control module (505) is arranged inside the resectoscope body (5).

According to an embodiment of the present invention, for example, the excision ring includes a first collar (701), a second collar (706), a spring (705) and several sections of electric cutting wire; the first collar ( 701) is fixedly installed at the end of the rotating shaft (7), the second collar (706) is sleeved outside the rotating shaft (7), and the spring (705) is sleeved outside the rotating shaft (7) , and the two ends of the spring (705) are respectively fixed on the first collar (701) and the second collar (706);

The first collar (701) and the second collar (706) are respectively connected to the positive and negative poles of the external circuit, and between the first collar (701) and the second collar (706) Including at least one group of electric cutting wires, each group of electric cutting wires is formed by connecting several sections of electric cutting wires end to end;

Preferably, four sets of electric cutting wires are included between the first loop (701) and the second loop (706), and each set of electric cutting wires is composed of the first electric cutting wire (702), the second electric cutting wire The cut wire (703) and the third electric cut wire (704) are composed of three sections of electric cut wire, and the passage between the three sections of electric cut wire and between the electric cut wire and the collar (701, 706) is movable and conductive connected by a mechanical connection, preferably, the connection is hinged.

According to an embodiment of the present invention, for example, the excision ring comprises an electric cutting wire (703) formed by a piece of rigid metal wire, and the electric cutting wire (703) and the rotating shaft (7) form a rectangle, so The side length of the rectangle perpendicular to the rotation axis (7) is smaller than the inner diameter of the inner sheath (2);

Preferably, the number of the electric cutting wires (703) is 1-8;

Preferably, when the number of the electric cutting filaments (703) is multiple, the multiple electric cutting filaments (703) are evenly and symmetrically distributed.

According to an embodiment of the present invention, for example, the excision ring includes an electric cutting wire (703) formed by a length of arc-shaped wire;

Preferably, the electric cutting wire (703) is formed of rigid metal, and the maximum vertical distance from any point on the electric cutting wire (703) to the rotating shaft (7) is smaller than the inner diameter of the inner sheath (2);

Preferably, the electric cutting wire (703) is formed of flexible metal, and the maximum vertical distance from any point on the electric cutting wire (703) to the rotating shaft (7) is greater than or equal to the inner sheath tube (2) the inner diameter;

Preferably, the number of the electric cutting wires (703) is 1-8;

According to an embodiment of the present invention, for example, the limiting piece 201 is provided with 5 holes, wherein the circular hole (2011) in the center is used for the rotating shaft 7 to pass through, and the left and right holes (2012) are used for installation In the two optical fiber cameras (202), the upper and lower holes (2013) are used as fluid through holes of the water inlet (3) and the water outlet (4).

Embodiments of the present invention also provide a method for operating the rotary resection surgical device as described above, the method comprising the following steps:

1) Press the first button (506) on the resectoscope body (5) to control the rotating shaft (7) to extend out of the inner sheath (2);

2) Press the second button (506) on the resectoscope body (5) to control the rotation of the rotating shaft (7);

3) Press the third button (506) on the resectoscope body (5) to control the rotating shaft (7) to retract the inner sheath (2).

Description of drawings

FIG. 1 is a schematic structural diagram of a plasma resectoscope common in the art.

FIG. 2 is a schematic diagram of the structure of the slicing ring in the plasma resectoscope.

FIG. 3 is a schematic diagram of the external structure of the rotary excision surgical device in a working state according to an embodiment of the present invention.

FIG. 4 is a schematic diagram of the internal structure of the rotary excision surgical device in a working state according to an embodiment of the present invention.

FIG. 5 is a schematic diagram of the internal transmission structure of the rotary excision surgical device provided by the embodiment of the present invention.

FIG. 6 is a further enlarged schematic diagram of the internal transmission structure of the rotary resection surgical device provided by the embodiment of the present invention.

7 is a schematic structural diagram of a resection ring of a rotary resection surgical device provided by an embodiment of the present invention.

FIG. 8 is a schematic diagram of the external structure of the rotary excision surgical device in a non-working state provided by an embodiment of the present invention.

FIG. 9 is a schematic diagram of the external structure of the rotary resection surgical device in a working state according to an embodiment of the present invention, wherein three buttons on the resectoscope body are shown.

FIG. 10 is a schematic structural diagram of a possible excision ring provided by an embodiment of the present invention.

FIG. 11 is a schematic diagram of another possible excision ring structure provided by an embodiment of the present invention.

FIG. 12 is a schematic structural diagram of a limiting piece provided by an embodiment of the present invention.

FIG. 13 is a schematic structural diagram of a rotary excision surgical device with two sets of electric cutting wires and excision rings according to an embodiment of the present invention.

FIG. 14 is a partial enlarged view of the excised ring portion of FIG. 13 .

FIG. 15 is a schematic three-dimensional structure diagram of the structure shown in FIG. 11 .

FIG. 16 is a partial enlarged view of the excised ring portion of FIG. 15 .

FIG. 17 is a schematic diagram of the external structure of the rotary resection surgical device in a working state according to an embodiment of the present invention, wherein an inner sheath tube with regular circular ports is shown.

FIG. 18 is a partial enlarged view of the excised ring portion of FIG. 17 .

detailed description

In order to make the objectives, technical solutions and advantages of the present invention clearer, the present invention will be further described in detail below with reference to specific embodiments and accompanying drawings. However, those skilled in the art know that the present invention is not limited to the accompanying drawings and the following embodiments.

In the description of the invention, it should be noted that the orientation or positional relationship indicated by the terms "length", "width", "upper", "lower", "far", "near", etc., is based on The orientation or positional relationship shown in the drawings is only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the indicated device or element must have a specific orientation, be constructed and operated in a specific orientation, and should not be construed as limiting the present invention. The specific protection scope of the invention. In addition, the terms "first" and "second" are only used for descriptive purposes to distinguish technical features, have no substantive meaning, and cannot be understood as indicating or implying relative importance or implicitly indicating the number of technical features.

Referring to FIG. 1, FIG. 1 shows the basic structure of a plasma resectoscope common in the art. As can be seen from Figure 1, plasma resectoscope generally includes endoscope 01, resectoscope handle 02, resectoscope outer sheath 03, sheath body obturator 04, resectoscope inner sheath 05, power cord 06 and working handle 07 . An objective lens is mounted on one end (in the case of FIG. 1 , the left end) of the resectoscope inner sheath 05 , and the objective lens is combined with the endoscope 01 to provide the doctor with an image of the lesion location. The distal end of the resectoscope sheath 03 (ie, the other end opposite to the endoscope 01 in FIG. 1 ) is mounted with a resectoscope ring 08 .

FIG. 2 shows the detailed structure of the electric cutting ring 08 . The operating principle based on plasma technology is: using a bipolar circuit, through radio frequency energy, the electrolyte between the cutter head (or cutting ring) and the tissue forms a plasma thin layer, the ions in the thin layer are accelerated by the electric field, and the energy Delivered to tissues, molecular bonds are opened, carbohydrates and chlorides are produced, resulting in tissue coagulation and necrosis. After the necrotic tissue falls off and absorbs, the fibrous tissue is repaired to produce scar contraction, the ablation site is uniform, without carbonization, the treatment head does not touch the tissue, and the precision and selectivity is high, and there is no damage to the surrounding tissue. Due to the low kinetic energy of the plasma, the temperature of the working interface is between 400 and 700 degrees Celsius, so it is also called low temperature plasma ablation. Because of its low working temperature, the remaining mucosa is less damaged, and the wound surface is smooth and tidy after cutting, which is conducive to the formation of postoperative protein pseudomembrane and wound healing, and reduces the probability of postoperative adhesion. In addition, plasma radiofrequency also has the effect of intraoperative hemostasis, which can stop bleeding while cutting, which facilitates the operation process. As shown in FIG. 2 , the electric cutting ring 08 includes two electrodes and a metal wire between the two electrodes. Generally, the shape of the metal wire is an arc, such as a semicircle. During surgery, the wire is energized, and by controlling the voltage between the two electrodes, the wire either cuts dead tissue or stops bleeding. During the operation, the doctor scrapes the necrotic tissue by holding the handle of the resectoscope according to the lesion site information obtained from the endoscope 01. This action is somewhat similar to a carpenter's shavings of wood. The necrotic tissue is scraped off "layer by layer". . It is conceivable that if there is a lot of necrotic tissue to be removed, the doctor needs to repeat the above-mentioned layer-by-layer scraping action a lot. Over time, the doctor’s arm will inevitably be sore, the accuracy of the action will decrease, and the effect of the operation will be affected. In addition, a large number of repetitive layer-by-layer scraping actions will also prolong the operation time and bring unnecessary risks. At present, surgical robots have developed rapidly, and more and more operations can be performed using surgical robots. Even if a surgical robot is used to perform electrical resection, it can only solve the problem of fatigue of the doctor's arm, and the problem of prolonged operation time caused by repeated scraping action still exists.

Therefore, the structure of the resectoscope itself also needs to be improved to solve the above problems.

3-4 show the external structure ( FIG. 3 ) and the internal structure ( FIG. 4 ) of the rotary resection surgical device provided by an embodiment of the present invention in a working state. It should be noted that, for the sake of simplicity, FIGS. 3-4 do not show all the components of the rotary resection surgical device, but only depict the improvements of the present invention and the components closely related to the improvements of the present invention. The structure of components not shown in Figures 3-4 can be seen in Figure 1.

As shown in FIG. 3 , viewed from the outside, the rotary resection surgical device includes an outer sheath 1, an inner sheath 2, a water inlet 3, a water outlet 4, a resectoscope body 5, a cable 6, and a rotating shaft 7; wherein, The end of the rotating shaft 7 has a cutting ring, the outer sheath tube 1 and the inner sheath tube 2 are nested with each other, and the rotating shaft 7 is located in the inner sheath tube 2 .

As shown in FIG. 4 , the rotary excision surgical device further includes a motor 501, which is arranged inside the resectoscope body 5 and is connected to the rotating shaft 7 through a gear set to provide power for the rotation of the rotating shaft 7 and the front and rear expansion and contraction; The group includes a worm 502, a turbine 503, a first bevel gear 504 and a second bevel gear 507; as shown in Figures 5 and 6, the first bevel gear 504 is fixedly installed at the other end of the rotating shaft 7 (that is, with the cutting ring The opposite end), the worm 502 is fixedly installed on the rotating shaft 7 next to the first bevel gear 504, the turbine 503 is fixedly installed at the end of the rotating shaft of the motor 501, and the second bevel gear 507 is adjacent to the turbine 503 is installed on the rotating shaft of the motor 501 . Appropriate teeth are provided on the worm 502 , the turbine 503 , the first bevel gear 504 and the second bevel gear 507 , so that the motor 501 can drive the rotating shaft 7 to rotate, and can also drive the rotating shaft 7 to expand and contract back and forth. The combination of the gear sets can be switched by the electromagnetic switch, so that the movement of the rotating shaft 7 can be switched between rotation and forward and backward telescopic. As shown in FIG. 6 , the worm gear 503 meshes with the worm 502 for transmission to realize the front and rear telescopic movement of the rotating shaft 7; and when the tail of the worm 502 meshes with the worm 503, the first bevel gear 504 is connected to the second gear on the motor through the electromagnetic switch. The bevel gears 507 mesh with each other, thereby providing rotational power for the rotating shaft 7 to realize the rotation of the rotating shaft 7 .

In order to fix the rotating shaft 7 and at the same time to make the rotating shaft 7 rotate stably, several limiting pieces 201 are installed at different positions of the rotating shaft. FIG. 4 shows that three limiting pieces 201 are arranged at different positions. The limiting piece 201 is fixedly installed inside the inner sheath tube 2, and there is a circular hole in the middle. The diameter of the circular hole is slightly larger than the diameter of the rotating shaft 7, so that the rotating shaft 7 can pass through it, Able to turn smoothly without shaking too much. For example, the diameter of the circular hole is 1.01-1.1 times the diameter of the rotating shaft 7; or the diameter of the circular hole is 1.01-1.05 times the diameter of the rotating shaft 7; or the diameter of the circular hole is 1.01-1.05 times the diameter of the rotating shaft 7 The diameter is 1.01-1.02 times the diameter of the rotating shaft 7 . Preferably, a coating for reducing frictional resistance can be applied on the side wall of the circular hole, and a coating for reducing frictional resistance can also be applied on the surface of the rotating shaft 7, for example, the above-mentioned coating can be an air plasma spray coating ( Air Plasma Spray, referred to as APS) and so on.

As shown in FIG. 4 , the rotary resection surgical device further includes a fiber optic camera 202 . The fiber optic camera 202 is generally disposed in the inner sheath tube 2 near one end of the cutting ring. In order to obtain a stereoscopic image, preferably, two optical fiber cameras 202 can be provided. For example, two optical fiber cameras 202 can be arranged on the limiting piece 201 closest to the cutting ring. FIG. 12 shows a possible structure of the limiting piece 201. Five holes are opened on the limiting piece 201, wherein the central hole 2011 is the circular hole described above, for the rotating shaft 7 to pass through. The holes 2012 are used to install the above two optical fiber cameras 202 , and the upper and lower holes 2013 are used as the fluid passage holes for the water inlet 3 and the water outlet 4 .

As shown in FIG. 4 , the rotary resection surgical device further includes an electronic control module 505 , the electronic control module includes an optical fiber image processing module and an electric wire cutting power supply module, and the optical fiber image processing module converts the images obtained by the two optical fiber cameras 202 Converted into a digital signal that can be processed, and transmitted to a data processing device (eg, a computer) through a cable 6 . Preferably, the electric control module 505 can also be arranged inside the resectoscope body 5, so that the rotary resection surgical device is simple and beautiful as a whole.

As shown in FIG. 7 , the excision ring includes a first ferrule 701 , a second ferrule 706 , a spring 705 and several sections of electric cutting wire. Wherein, the first collar 701 is fixedly installed at the end of the rotating shaft 7 (or integrally formed), and the second collar 706 is sheathed outside the rotating shaft 7, so the second collar can slide forward and backward along the rotating shaft 7, and can follow the rotation axis 7. The rotary shaft 7 rotates together. The spring 705 is sleeved on the outside of the rotating shaft 7 , and the two ends are respectively fixed on the first collar 701 and the second collar 706 . When the rotating shaft 7 rotates, it will rotate along with the electric cutting wires, so as to perform rotary cutting of the tissue to be resected. Therefore, the number of electric cutting wires can be at least one group, and can be as many as 2 groups, 3 groups, and 4-8 groups. FIG. 7 shows 4 groups of electric cutting filaments evenly and symmetrically distributed, each group of electric cutting filaments consists of a first electric cutting filament 702, a second electric cutting filament 703 and a third electric cutting filament 704, a total of 3 sections of electric cutting filaments, The three sections of electric cutting wires and between the electric cutting wires and the collar 701/706 are connected by a movable and conductive mechanical connection, for example, a hinge. The two collars 701/706 are respectively connected to the positive and negative electrodes of the external circuit, so that the electric cutting wire can be rotated and driven by the rotating shaft 7 to perform rotary cutting of the tissue to be resected. Figures 13 and 14 show 2 groups of electrocutting filaments evenly and symmetrically distributed, wherein Figure 14 is a partial enlarged view of the excision ring of Figure 13 .

When the rotary excision surgical device works, driven by the motor 501, the rotating shaft 7 protrudes from the inner sheath tube 2, the electric cutting wire is no longer constrained by the inner sheath tube 2, and the spring 705 contracts to drive the second collar 706. Move in the direction of the first collar 701 , so that the electric cutting wire composed of the first electric cutting wire 702 , the second electric cutting wire 703 and the third electric cutting wire 704 “arches” in the direction away from the rotating shaft 7 as a whole , it is conceivable that the effective cutting radius of the electric cutting wire increases at this time.

When the rotary excision surgical device is not working, driven by the motor 501, the rotating shaft 7 is retracted into the inner sheath tube 2, as shown in FIG. A certain position of the third electric cutting wire 704 will be in contact with the edge of the inner sheath tube 2 (for example, the midpoint of the third electric cutting wire 704 will be in contact with the edge of the inner sheath tube 2), the rotating shaft 7 is further retracted, Under the interference of the edge of the inner sheath tube 2, the spring 705 is stretched, and the electric cutting wire "falls down" as a whole, and the effective cutting radius decreases until the effective cutting radius is smaller than the inner diameter of the inner sheath tube 2, and the electric cutting wire all shrinks into the inner Inside the sheath 2. Therefore, when the rotary excision surgical device is not working, the electric cutting wire cannot be seen from the outside, and its external structure diagram is shown in FIG. 8 .

FIG. 9 is a schematic diagram of the external structure of the rotary resection surgical device in a working state, wherein three buttons 506 on the resectoscope body 5 are shown. The three buttons 506 are used to control the forward and backward telescopic and rotational movement of the rotating shaft 7 and the on-off current of the electric cut.

The rotary resection surgical device provided by the above embodiments of the present invention is not only suitable for a doctor to carry out a surgical operation by hand, but also suitable for performing an operation as a surgical implement terminal of a surgical robot. When the doctor holds the rotary excision surgical device of the present invention for surgical operation, the operation button 506 can be used to control the rotating shaft 7 to extend out of the inner sheath 2, and the effective cutting radius of the electric cutting wire increases. 7 rotates and drives the electric cutting wire to rotate, the doctor only needs to hold the rotary excision surgical device, and align the end of the rotating shaft 7 with the lesion to be excised. Scrape off layer by layer in the traditional way. It is conceivable that the use of the rotary excision surgical device of the present invention greatly improves the excision efficiency and greatly shortens the operation time.

When the rotary resection surgical apparatus of the present invention is used as the surgical implement terminal of the surgical robot to perform surgery, the mechanical arm of the surgical robot replaces the doctor's arm to operate. The lesion site to be resected can be scanned and positioned in advance, and the relevant position parameters can be input into the control center of the surgical robot.

That is, the embodiment of the present invention proposes a rotary excision surgical device, which uses rotary excision to excise the lesion site. The advantages of this "rotational cut" include: it can quickly and comprehensively remove the lesion. Compared with ordinary plasma cutting, the rotary cut has a smoother and smoother position of the lesion, and provides the possibility for the robotic hand to automatically remove the lesion tissue in the future.

According to the above description, one of the important designs of the rotary resection surgical device provided by the embodiment of the present invention is the rotatable and telescopic rotation shaft 7 , and the resection ring disposed at the end of the rotation shaft 7 and rotatable with the rotation shaft 7 . FIG. 7 of the present invention only shows one possible structure of the excision ring, and the excision ring may also have other structures.

For example, as shown in FIG. 10 , the excision ring can be an electric cutting wire 703 formed by a piece of rigid metal wire. The electric cutting wire 703 and the rotating shaft 7 form a rectangle, and the width h of the rectangle can be smaller than the inner diameter of the inner sheath tube 2 any size. Since h is smaller than the inner diameter of the inner sheath tube 2 , after the operation is completed, the electric cutting wire 703 can be retracted into the interior of the inner sheath tube 2 together with the rotating shaft 7 . One electric cutting wire 703 may be provided, or a plurality of them may be provided. When a plurality of electric cutting wires 703 are provided, the plurality of electric cutting wires 703 may be distributed evenly and symmetrically, or may be distributed irregularly.

For another example, as shown in FIG. 11 , the cutting ring may be an electric cutting wire 703 formed by a length of arc-shaped wire. If the electric cutting wire 703 is formed of rigid metal, h is set to any size smaller than the inner diameter of the inner sheath 2 . Since h is smaller than the inner diameter of the inner sheath tube 2 , after the operation is completed, the electric cutting wire 703 can be retracted into the interior of the inner sheath tube 2 together with the rotating shaft 7 . If the electric cutting wire 703 is formed of flexible metal, h can be larger than the inner diameter of the inner sheath 2. After the operation is completed, the rotating shaft 7 is retracted into the inner sheath 2, and the electric cutting wire 703 is carried to the inside of the inner sheath. "Squeeze", the electric cutting wire 703 is deformed under the restriction of the outer wall of the inner sheath tube, so as to shrink into the interior of the inner sheath tube 2 along with the rotating shaft 7 . Similarly, one electric cutting wire 703 may be provided, or a plurality of them may be provided. When a plurality of electric cutting wires 703 are provided, the plurality of electric cutting wires 703 may be distributed evenly and symmetrically, or may be distributed irregularly.

15 and 16 further illustrate the three-dimensional structure of FIG. 11 , wherein FIG. 16 is a partial enlarged view of the cut ring portion in FIG. 15 . As shown in Figures 15 and 16, the excision ring consists of 4 segments of electric wire, each of which is formed by a length of arcuate wire. In Figs. 15 and 16, the above-mentioned 4-segment electric cut wires are evenly, symmetrically and equally spaced.

FIG. 17 is a schematic diagram of the external structure of the rotary resection surgical device in a working state according to an embodiment of the present invention, wherein an inner sheath tube with regular circular ports is shown, and FIG. 18 is a partial enlarged view of the resection ring. Because the electric cutting wire of the rotary excision surgical device provided by the embodiment of the present invention can be deformed, when the rotary excision surgical device is in a non-working state, the electric cutting wire can be completely received inside the inner sheath tube 2, so the port of the inner sheath tube 2 It does not need to be set to an asymmetrical irregular shape, and can be set directly to the most conventional circular port. This simplifies the manufacturing procedure of the inner sheath tube and reduces the manufacturing cost.

Claims

A rotary excision surgical device comprising an outer sheath tube (1), an inner sheath tube (2), a water inlet (3), a water outlet (4) and a cable (6), characterized in that In that, the rotary resection surgical device further comprises a rotating shaft (7) and a motor (501), the rotating shaft (7) can be rotated under the driving of the motor (501), and the rotating shaft (7) A cutting ring is provided at the end, the outer sheath tube (1) and the inner sheath tube (2) are nested with each other, and the rotating shaft (7) is located in the inner sheath tube (2).
The rotary excision surgical device according to claim 1, characterized in that, the rotary excision surgical device further comprises a resectoscope body (5), and the motor (501) is arranged on the resectoscope body (5). ) inside, connected with the rotating shaft (7) through a gear set to provide power for the rotation of the rotating shaft (7) and the expansion and contraction along the axial direction;

Preferably, the gear set includes a worm (502), a turbine (503), a first bevel gear (504) and a second bevel gear (507); the first bevel gear (504) is fixedly mounted on the rotating shaft On the other end of (7) opposite to the cutting ring, the worm (502) is fixedly installed on the rotating shaft (7) adjacent to the first bevel gear (504), and the turbine (503) is fixedly installed At the end of the rotating shaft of the electric motor (501), the second bevel gear (507) is installed on the rotating shaft of the electric motor (501) next to the turbine (503).
The rotary excision surgical device according to claim 1 or 2, characterized in that, several limit pieces (201) are installed at different positions of the rotation shaft (7);

Preferably, 1-6 limit pieces (201) are installed at different positions of the rotating shaft (7);

Preferably, 2-4 limit pieces (201) are installed at different positions of the rotating shaft (7);

Preferably, a circular hole is arranged in the center of the limiting piece (201), and the diameter of the circular hole is 1.01-1.1 times the diameter of the rotating shaft (7); or the diameter of the circular hole is The diameter of the rotating shaft (7) is 1.01-1.05 times; or the diameter of the circular hole is 1.01-1.02 times the diameter of the rotating shaft (7).
The rotary resection surgical device according to any one of claims 1-3, characterized in that, the rotary resection surgical device further comprises an optical fiber camera (202);

Preferably, the optical fiber camera (202) is arranged in the inner sheath tube (2) near one end of the excision ring;

Preferably, two optical fiber cameras (202) are provided;

Preferably, the two optical fiber cameras (202) are arranged on the limiting piece (201) closest to the excision ring.
The rotary resection surgical device according to any one of claims 1-4, characterized in that, the rotary resection surgical device further comprises an optical fiber image processing module (505), and the optical fiber image processing module (505) The image obtained by the optical fiber camera (202) is converted into a digital signal that can be processed, and is transmitted to the data processing device through the cable (6);

Preferably, the optical fiber image processing module (505) is arranged inside the resectoscope body (5).
The rotary resection surgical device according to any one of claims 1-5, wherein the resection ring comprises a first collar (701), a second collar (706), a spring (705) and several segments Electric wire cutting; the first collar (701) is fixedly installed at the end of the rotating shaft (7), the second collar (706) is sleeved on the outside of the rotating shaft (7), the spring (705) ) is sleeved on the outside of the rotating shaft (7), and the two ends of the spring (705) are respectively fixed on the first sleeve ring (701) and the second sleeve ring (706);

The first collar (701) and the second collar (706) are respectively connected to the positive and negative poles of the external circuit, and between the first collar (701) and the second collar (706) Including at least one group of electric cutting wires, each group of electric cutting wires is formed by connecting several sections of electric cutting wires end to end;

Preferably, four sets of electric cutting wires are included between the first loop (701) and the second loop (706), and each set of electric cutting wires is composed of the first electric cutting wire (702), the second electric cutting wire The cut wire (703) and the third electric cut wire (704) are composed of three sections of electric cut wire, and the passage between the three sections of electric cut wire and between the electric cut wire and the collar (701, 706) is movable and conductive connected by a mechanical connection, preferably, the connection is hinged.
The rotary surgical resection device according to any one of claims 1-5, wherein the resection ring comprises an electric cutting wire (703) formed by a piece of rigid metal wire, and the electric cutting wire (703) is connected to the electric cutting wire (703). The rotating shaft (7) forms a rectangle, and the side length of the rectangle perpendicular to the rotating shaft (7) is smaller than the inner diameter of the inner sheath (2);

Preferably, the number of the electric cutting wires (703) is 1-8;

Preferably, when the number of the electric cutting filaments (703) is multiple, the multiple electric cutting filaments (703) are evenly and symmetrically distributed.
The rotary resection surgical device according to any one of claims 1-5, wherein the resection ring comprises an electric cutting wire (703) formed by a section of arc-shaped wire;

Preferably, the electric cutting wire (703) is formed of rigid metal, and the maximum vertical distance from any point on the electric cutting wire (703) to the rotating shaft (7) is smaller than the inner diameter of the inner sheath (2);

Preferably, the electric cutting wire (703) is formed of flexible metal, and the maximum vertical distance from any point on the electric cutting wire (703) to the rotating shaft (7) is greater than or equal to the inner sheath tube (2) the inner diameter;

Preferably, the number of the electric cutting wires (703) is 1-8;

Preferably, when the number of the electric cutting filaments (703) is multiple, the multiple electric cutting filaments (703) are evenly and symmetrically distributed.
The rotary excision surgical device according to any one of claims 4-8, characterized in that, the limiting piece 201 is provided with 5 holes, wherein the circular hole (2011) in the center is for the rotation shaft 7 to pass through. However, the left and right holes (2012) are used to install the two optical fiber cameras (202), and the upper and lower holes (2013) are used as fluid through holes for the water inlet (3) and the water outlet (4).
The operation method of the rotary resection surgical device according to any one of claims 1-9, wherein the method comprises the following steps:

1) Press the first button (506) on the resectoscope body (5) to control the rotating shaft (7) to extend out of the inner sheath (2);

2) Press the second button (506) on the resectoscope body (5) to control the rotation of the rotating shaft (7);

3) Press the third button (506) on the resectoscope body (5) to control the rotating shaft (7) to retract the inner sheath (2).