WO2023078168A1

WO2023078168A1 - Medical optical fiber guide structure and guide method

Info

Publication number: WO2023078168A1
Application number: PCT/CN2022/128191
Authority: WO
Inventors: 曹鹏; 金慧杰; 史鼎盛; 夏良道
Original assignee: 杭州佳量医疗科技有限公司
Priority date: 2021-11-05
Filing date: 2022-10-28
Publication date: 2023-05-11
Also published as: CN113995508A

Abstract

A medical optical fiber guide structure and a guide method, which belong to the technical field of medical instruments and solve the problem whereby an optical fiber in the prior art can only ablate lesion tissue in a limited area surrounding the part of a straight ablation channel that the optical fiber runs through in the straight ablation channel created by an ablation catheter. The medical optical fiber guide structure comprises an optical fiber guide tube (1), the optical fiber guide tube (1) comprising a first tube segment and a second tube segment, wherein the first tube segment has a lumen extending in an axial direction, and the second tube segment has an opening that is in communication with the lumen, with a set included angle being formed between an extension direction of the portion where the opening is in communication with the lumen and an extension direction of the lumen and same being an obtuse angle. The present invention improves the flexibility and diversity of options for a pathway that avoids important tissues, and also provides a procedure of implementing the ablation of large lesion tissue from a single channel, which not only improves the efficiency of an operation, but also improves the safety and effectiveness of an operation.

Description

A medical optical fiber guiding structure and guiding method

Cross References to Related Applications

This application claims the priority of the Chinese patent application filed on November 05, 2021 with application number 202111306280.5 and titled "A medical optical fiber guiding structure and guiding method".

technical field

The invention relates to the technical field of medical devices, in particular to a medical optical fiber guiding structure and guiding method.

Background technique

As a new technology, compared with traditional treatment methods, laser ablation has the advantages of precise and controllable ablation range, little damage to normal structures around the lesion, small surgical trauma, short operation time, and fast postoperative recovery. There is hope for patients with lesions located deep in the brain who cannot tolerate conventional craniotomy. At present, the ablation catheter used to transmit laser energy to achieve tissue damage restricts the internal optical fiber to a straight surgical channel. Due to the influence of the microenvironment, the plan of the non-linear surgical channel is what the surgical operator wants. In particular, when the tumor is located in the deep part of the brain and it is adjacent to important tissues, it is more beneficial to adopt the treatment strategy of "curve to save the country" for better conformal ablation and global ablation, avoiding important brain tissues .

It is not easy to establish a non-linear surgical channel in the cranium, and it will increase the operation time and puncture difficulty accordingly. However, in the existing ablation catheter, the medical optical fiber installed inside it can only realize tissue ablation in a linear channel and a limited area, that is, it can only ablate the lesion tissue in the axial direction of the linear channel and in a limited area nearby. For ablation of larger lesions, multiple linear ablation channels need to be considered.

In addition, in the existing laser ablation surgery plan, if sampling before ablation is required, sampling must be performed before the ablation catheter is inserted; if sampling is required after ablation, sampling must be performed after the ablation catheter is pulled out, and the operation is difficult The risk of injury and infection to the patient is also extremely high.

Contents of the invention

In view of the above analysis, the embodiment of the present invention aims to provide a medical optical fiber guiding structure and guiding method to solve the problem that the existing optical fiber can only pass through the lesions in the limited area around it in the straight ablation channel established by the ablation catheter. The problem of tissue ablation has achieved the therapeutic purpose of "curve to save the country".

In one aspect, the present invention provides a medical optical fiber guiding structure, which includes an optical fiber guiding tube, and the optical fiber guiding tube includes a first tube section and a second tube section;

The first pipe section has a lumen extending in the axial direction,

The second tube section has an opening communicating with the lumen;

An extension direction in which the opening communicates with the lumen and an extension direction of the lumen form a set angle, and the set angle is an obtuse angle.

Further, a medical optical fiber is detachably connected in the fiber guide tube;

The medical optical fiber can pass through the opening for guiding bending.

Further, the first pipe section is the straight pipe part of the fiber guide tube, and the second pipe section is the bent part of the fiber guide tube; the medical optical fiber passes through the bent part to realize guiding and bending.

Further, it also includes a guide tube base, a fixing cover and a skull nail, one end of the guide tube base is arranged in the end of the skull nail, and the other end is screwed to the fixing cover.

Further, a sealing plug is also included, and the sealing plug is arranged in the through hole where the guide tube base is connected with the fixed cover.

Further, the guide tube base includes a first threaded part and an optical axis part, the first threaded part and the optical axis part are respectively located at both ends of the guide tube base, and the first threaded part is provided with external threads.

Further, the center of the guide tube base is provided with a coaxial and communicating first through hole, a second through hole and a third through hole, the first through hole and the second through hole are respectively located in the guide tube The two ends of the base and the rear end of the fiber guide tube are arranged in the second through hole.

Further, the diameter of the second through hole is smaller than the diameter of the first through hole and larger than the diameter of the third through hole; the diameter of the third through hole is larger than the diameter of the medical optical fiber, the The diameter of the second through hole is equal to the outer diameter of the fiber guide tube.

Further, the center of the fixed cover is provided with a coaxial and communicating threaded hole and a fourth through hole, the diameter of the fourth through hole is greater than or equal to the diameter of the medical optical fiber, and the first threaded part is arranged on the inside the threaded hole.

Further, the sealing plug is arranged in the first through hole, the outer wall of the sealing plug is attached to the inner wall of the first through hole, and the central hole of the sealing plug is sleeved with the medical optical fiber and is in contact with the first through hole. The outer wall of the medical optical fiber is bonded.

Further, the skull nail includes a first connecting part, a second connecting part and a second threaded part connected in sequence, the first connecting part is connected to the optical axis part, and the second threaded part is provided with an external thread , and connected to the skull.

In another aspect, the present invention provides a medical optical fiber guiding method, using the above-mentioned medical optical fiber guiding structure, the steps include:

Step 1: Fix the cranial nail to the skull;

Step 2: Insert the medical optical fiber into the optical fiber guide tube. At this time, the front end of the medical optical fiber does not exceed the bending part of the optical fiber guide tube; one end of the guide tube base is connected to the optical fiber guide tube, and the other end is installed with a sealing plug and the fixed cover is tightened;

Step 3: Insert the fiber optic guide tube to the designated position through the skull nail;

Loosen the fixed cover, apply a push force from the outside, and move the medical optical fiber to the front end of the fiber guide tube, so that the medical optical fiber passes through the bending part and changes direction by the bending part; then tighten the fixing cover;

Step 4: Loosen the fixed cover and pull the medical fiber backward so that the front end of the medical fiber does not exceed the bending part, rotate the base of the guide tube to adjust the direction of the bend, and then extend the medical fiber out of the fiber guide tube, and the other The area is ablated.

Compared with the prior art, the present invention can achieve at least one of the following beneficial effects:

(1) The front end of the optical fiber guide tube of the present invention is a curved part, and the front end of the curved part is provided with an arc-shaped incision. The important tissue of the target lesion area can be conformally ablated without re-planning a new channel, which improves the efficiency of the operation.

(2) The front end of the optical fiber guide tube of the present invention presents a sharp arc edge, which can easily penetrate through the brain tissue. At the same time, the projection of the entire curved part towards the straight tube part is located in the cross section of the straight tube part, so only It is necessary to open a small circular hole in the skull, and through the guidance and positioning of the skull nail, the guide tube can be extended into the brain. At the same time, only a cylindrical channel is established in the brain, and it will not pull the tissue when it is pulled out. Injury, achieve minimally invasive treatment.

(3) The present invention realizes the self-bending deformation of the medical optical fiber through the optical fiber guide tube, which can avoid important areas that are not suitable for puncture; by adjusting the opening orientation of the optical fiber guide tube, the range of the ablation area can be further expanded, and the originally required The ablation can only be completed by opening two or more channels, which improves the efficiency.

(4) The present invention cooperates with different medical optical fibers, such as side-firing optical fibers, and by changing the opening orientation of the optical fiber guide tube, it can more conveniently match lesions of different shapes, complete conformal ablation, and realize multi-regional ablation in the same channel .

(5) The limiting portion of the present invention is provided with a scale line, and the skull nail is provided with a marking line. By rotating the guide tube base, the rotation angle of the optical fiber guide tube can be quantitatively changed to ablate other areas, expanding the ablation area without The operation path is re-planned to improve the operation efficiency; at the same time, by loosening the fixed cover, the medical optical fiber can be advanced or retreated along the axial direction of the optical fiber guide tube, and the ablation area can be expanded.

(6) The optical fiber guide tube of the present invention is not only suitable for optical fiber ablation surgery, but also can be used with a soft tube sampling needle to realize bending sampling or suction of damaged tissue after ablation.

(7) The materials used in parts of the present invention are all made of nuclear magnetic compatible materials, such as glass, polytetrafluoroethylene or PC (Polycarbonate, polycarbonate), etc., which can be carried out in MR (Magnetic Resonance, magnetic resonance) Operations, whether it is ablation surgery or residual sampling, can be performed under MR scanning, and the surgical process can be monitored in real time, which is safer.

(8) The guide structure of the present invention can not only realize laser ablation operation, but also realize sampling operation according to the different appliances (such as medical optical fiber, sampling needle or sampler) used inside; the sampling and laser ablation can be reasonably arranged according to actual needs Sequence, as well as the sampling devices used, do not need to establish additional sampling channels in the brain, and do not need to replace the guide structure with other auxiliary devices, which expands the range of use of the device, improves surgical efficiency, and reduces damage to patients and infection risk.

(9) The front end of the optical fiber guide tube of the present invention is a curved portion with a lateral opening, and the medical optical fiber can pass through the lateral opening of the curved portion, which is more flexible in puncturing angle and puncturing direction. On the one hand, it increases the flexibility and diversity of path options to avoid important tissues, and on the other hand, it also provides an ablation solution that can realize large lesion tissue from a single channel, which not only improves the efficiency of the operation, but also greatly improves the operation efficiency. It can be said that the minimally invasive and effective treatment of "overtaking on a curve" has been realized.

In the present invention, the above technical solutions can also be combined with each other to realize more preferred combination solutions. Additional features and advantages of the invention will be set forth in the description which follows, and some of the advantages will be apparent from the description, or may be learned by practice of the invention. The objectives and other advantages of the invention will be realized and attained by the matter particularly pointed out in the written description and appended drawings.

Description of drawings

The drawings are for the purpose of illustrating specific embodiments only and are not to be considered as limitations of the invention, and like reference numerals refer to like parts throughout the drawings.

Fig. 1 is the structural representation of the optical fiber guiding tube of specific embodiment;

Fig. 2 is the cross-sectional view of the fiber guide tube of the specific embodiment;

Fig. 3 is a schematic diagram (1) of the state of the medical optical fiber passing through the bending part of the specific embodiment;

Fig. 4 is the structural representation (1) of the medical optical fiber guiding structure of specific embodiment;

Fig. 5 is the structural representation (two) of the medical optical fiber guiding structure of specific embodiment;

Fig. 6 is a schematic view of the structure of the guide tube base of a specific embodiment (1);

Fig. 7 is a schematic structural view of a fixed cover of a specific embodiment;

Fig. 8 is a structural schematic diagram of a skull nail in a specific embodiment;

Fig. 9 is a schematic diagram of multiple ablation regions obtained by changing the extension length of the medical optical fiber in a specific embodiment;

Fig. 10 is a structural schematic diagram (3) of the medical optical fiber guiding structure of a specific embodiment;

Fig. 11 is a schematic view of the structure of the guide tube base of a specific embodiment (2);

Fig. 12 is the structural representation (four) of the medical optical fiber guiding structure of specific embodiment;

Fig. 13 is a sectional view (1) of the medical optical fiber guiding structure of a specific embodiment;

Fig. 14 is a partial structural exploded view of the medical optical fiber guiding structure of a specific embodiment;

Fig. 15 is a schematic diagram of the state where the 0 scale of the guide tube base is aligned with the marking line of the skull nail in a specific embodiment;

Fig. 16 is a schematic diagram of the state where the scale of the guide tube base 60 of the specific embodiment is aligned with the marking line of the skull nail;

Fig. 17 is a schematic diagram of the ablation in the state where the mark on the light-emitting side of the medical optical fiber corresponds to the 0 scale of the specific embodiment;

Fig. 18 is a schematic diagram of ablation in a state in which the mark on the light-emitting side of the medical optical fiber does not correspond to the 0 scale of the specific embodiment;

Fig. 19 is a schematic cross-sectional view (1) of an optical fiber guide tube of a specific embodiment;

Fig. 20 is a cross-sectional schematic view (2) of an optical fiber guide tube of a specific embodiment;

Fig. 21 is a schematic cross-sectional view of an optical fiber guide tube of a specific embodiment (3);

Fig. 22 is a cross-sectional schematic view (four) of an optical fiber guide tube of a specific embodiment;

Fig. 23 is a cross-sectional schematic view (five) of an optical fiber guide tube of a specific embodiment;

Fig. 24 is a schematic cross-sectional view of an optical fiber guide tube of a specific embodiment (6);

Fig. 25 is a cross-sectional schematic view (7) of an optical fiber guide tube of a specific embodiment;

Fig. 26 is a cross-sectional schematic view (eight) of an optical fiber guide tube of a specific embodiment;

Fig. 27 is a sectional view (2) of the medical optical fiber guiding structure of a specific embodiment;

Fig. 28 is a schematic diagram (2) of the state of the medical optical fiber passing through the bending part of the specific embodiment;

Fig. 29 is a schematic structural view of a lateral sampling needle in a specific embodiment;

Fig. 30 is a schematic structural view of the lateral sampling needle in the specific embodiment located in the fiber guide tube;

Figure 31 is a schematic diagram of sampling with a lateral sampling needle in a specific embodiment;

Fig. 32 is a schematic diagram of the state in which the end surface sampling needle of the specific embodiment is extended out of the fiber guide tube;

Fig. 33 is a schematic diagram of sampler sampling in a specific embodiment.

Reference signs:

1-fiber guide tube; 11-curved part; 111-arc incision; 12-straight tube part; 13-reflective film; 14-lens structure; 15-opening; Guide tube base; 21-first threaded part; 211-first through hole; 22-optical axis part; 221-second through hole; 23-limiting part; 231-third through hole; 3-fixed cover; 31-threaded hole; 32-fourth through hole; 4-skull nail; 41-first connecting part; 411-fifth through hole; 412-marking line; 42-second connecting part; 421-sixth through hole; 43-second threaded part; 5-sealing plug; 6-sheath locking screw;

100-medical optical fiber; 101-light-emitting side mark; 200-skull; 300-target lesion area; 301-first ablation area; 302-second ablation area; 400-obstacle; 500-lateral sampling needle; 501-side Sampling port; 502-inclined surface; 600-tissue to be removed; 700-end face incision sampling needle; 701-end face sampling port; 800-sampler.

Detailed ways

The preferred embodiments of the present invention will be specifically described below in conjunction with the accompanying drawings, wherein the accompanying drawings constitute a part of the present invention and together with the embodiments of the present invention are used to explain the principles of the present invention and are not intended to limit the scope of the present invention.

In the description of the embodiments of the present invention, it should be noted that unless otherwise specified and limited, the term "connected" should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integral connection , can be mechanically connected, can also be electrically connected, can be directly connected, and can also be indirectly connected through an intermediary. Those of ordinary skill in the art can understand the specific meanings of the above terms in the present invention according to specific situations.

The terms "top", "bottom", "above", "below" and "on" are used throughout the description to refer to relative positions of components of the device, such as top and bottom substrates inside the device relative position. It will be appreciated that the devices are multifunctional independent of their orientation in space.

Example 1

A specific embodiment of the present invention, as shown in Fig. 1-Fig. 2, discloses a kind of medical optical fiber guiding structure, comprises optical fiber guiding tube 1, and medical optical fiber 100 is arranged in described optical fiber guiding tube 1, and described optical fiber guiding tube 1 includes a curved part 11 and a straight tube part 12, the curved part 11 is located at the front end of the straight tube part 12, the front end of the curved part 11 is provided with an incision, preferably, the incision is an arc-shaped incision 111, the medical optical fiber 100 It can pass through the straight tube part 12 and the curved part 11 in sequence, and pass through the arc-shaped incision 111 to realize the guiding and bending of the medical optical fiber 100 .

Since the optical fiber guide tube 1 is made of a transparent material, it is preferably an optically transparent material. The medical optical fiber 100 can realize laser ablation in the straight tube part 12 , or can realize laser ablation after passing through the curved part 11 . That is to say, during ablation, the laser light path can only pass through the medical optical fiber 100 to achieve damage to the lesion, or can realize laser ablation through the medical optical fiber 100 and the straight tube portion 12 .

Compared with the prior art, in the medical optical fiber guiding structure provided by this embodiment, the front end of the optical fiber guide tube is a curved part, and the front end of the curved part is provided with an arc-shaped cutout, and the medical optical fiber will pass through the curved part when passing through the optical fiber guide tube. The bending can be realized under the action of the channel, which can avoid the important tissue on the channel, and then can conformally ablate the target lesion area 300 without re-planning a new channel, which improves the efficiency of the operation.

When using the existing ablation catheter for ablation, if a larger ablation range or conformal ablation or complete ablation is to be achieved, it is best to plan the surgical path and establish the ablation channel along the mesial axis of the lesion tissue Enter. However, given the influence of the tumor microenvironment, this mesial axis approach is not always desirable or ideal. In this embodiment, the front end of the optical fiber guide tube 1 is a curved portion 11 with a lateral opening, and the medical optical fiber 100 can pass through the lateral opening of the curved portion 11, and the puncture angle and direction are more precise. flexibility. On the one hand, it increases the flexibility and diversity of path options to avoid important tissues, and on the other hand, it also provides an ablation solution that can realize large lesion tissue from a single channel, which not only improves the efficiency of the operation, but also greatly improves the operation efficiency. It can be said that the minimally invasive and effective treatment of "overtaking on a curve" has been realized.

The projection of the curved portion 11 toward the straight pipe portion 12 is located in the cross section of the straight pipe portion 12 (the interface perpendicular to the axis of the fiber guide tube 1), that is, the outer contour of the curved portion 11 along the axial direction of the straight pipe portion 12 does not exceed the straight pipe portion 12. Axial outer contour of the tube part 12 .

In this embodiment, the front end of the fiber guide tube 1 presents a sharp arc edge, which can easily penetrate through the brain tissue, and at the same time, the entire curved part is also in a circle defined by the outer contour of the straight tube part 12, so only It is necessary to open a small circular hole in the skull, and through the guidance and positioning of the skull nail, the optical fiber guide tube 1 can be extended into the brain. At the same time, only a cylindrical channel is established in the brain without damaging other tissues. It will not cause damage to the tissue by hooking and pulling, and realizes minimally invasive treatment.

The fiber guide tube 1 is bent at the head end, and this structure can go deep into the brain through the through hole on the skull nail 4 for guiding. At the same time, the medical optical fiber 100 can be guided through the bending structure at the front end.

It should be noted that the angle between the curved portion 11 and the straight pipe portion 12 should not be too small to avoid breaking the medical optical fiber 100. Preferably, as shown in FIG. 3 , the arrangement of the curved portion 11 and the straight pipe portion 12 is preferably as follows: When the medical optical fiber 100 protrudes from the bending portion 11 for a certain distance, the angle A between the axis of the unbent portion of the medical optical fiber 100 and the axis of the bending portion of the medical optical fiber 100 is between 140° ~170°.

As shown in Figures 4-5, the medical optical fiber guiding structure also includes a guide tube base 2, a fixed cover 3, a skull nail 4 and a sealing plug 5, and one end of the guide tube base 2 is located at the end of the skull nail 4. In the through hole, the other end is threadedly connected with the fixed cover 3 , and the sealing plug 5 is arranged in the end of the guide tube base 2 .

As shown in Figure 6, the guide tube base 2 is a structure of revolution, including a first threaded part 21 and an optical axis part 22, the first threaded part 21 and the optical axis part 22 are respectively located at ends. The first threaded portion 21 is provided with external threads.

The center of the first threaded part 21 is provided with a first through hole 211, and the center of the optical axis part 22 is provided with a second through hole 221, the first through hole 211 and the second through hole 221 communicate, and the The diameter of the first through hole 211 is greater than the diameter of the second through hole 221 , and the diameter of the second through hole 221 is equal to the outer diameter of the fiber guide tube 1 . The end of the straight tube portion 12 of the fiber guide tube 1 is disposed in the second through hole 221 . The first through hole 211 is coaxial with the second through hole 221 .

In order to limit the end of the fiber guide tube 1, the guide tube base 2 is also provided with a third through hole 231 located between the first through hole 211 and the second through hole 221, the third through hole 231 communicates with the first through hole 211 and the second through hole 221, and the diameter of the third through hole 231 is smaller than the diameter of the second through hole 221, and the diameter of the third through hole 231 is slightly larger than the medical The diameter of the optical fiber 100 is such that the medical optical fiber 100 can pass through smoothly. The third through hole 231 is coaxial with the second through hole 221 .

As shown in FIG. 7 , the fixed cover 3 is a revolving structure, and is provided with a threaded hole 31 and a fourth through hole 32 , and the threaded hole 31 and the fourth through hole 32 are connected and coaxial. The diameter of the fourth through hole 32 is larger than the diameter of the medical optical fiber 100 and smaller than the diameter of the threaded hole 31 . The first threaded portion 21 is disposed in the threaded hole 31 .

The sealing plug 5 is a cylindrical structure, the sealing plug 5 is arranged in the first through hole 211, the outer diameter of the sealing plug 5 is the same as the diameter of the first through hole 211, and the center of the sealing plug 5 The hole diameter is equal to the diameter of the medical optical fiber 100 . The length of the sealing plug 5 is greater than the length of the first through hole 211 , preferably, the length of the sealing plug 5 is 1.3˜1.4 times the length of the first through hole 211 .

In this embodiment, the medical optical fiber 100 passes through the fourth through hole 32, the central hole of the sealing plug 5 arranged in the first through hole 211 and the third through hole 231 in sequence, and then enters the second through hole 231. The fiber guide tube 1 in the through hole 221 passes through the front end of the fiber guide tube 1 .

The sealing plug 5 is set in the first through hole 211 for guiding and limiting the medical optical fiber 100. When the fixed cover 3 is tightened, the central hole of the sealing plug 5 is an interference fit with the medical optical fiber 100, and the sealing plug 5 The outer diameter of the first through hole 211 is an interference fit, so that the medical optical fiber 100 can be firmly arranged in the guide tube base 2 . After the fixing cover 3 is screwed to the first threaded part 21, the medical optical fiber 100 is firmly connected with the guide tube base 2, and the movement of the medical optical fiber 100 in the axial direction and the rotation around its own axis are restricted.

As shown in Figure 8, the skull nail 4 is a structure of revolution, including a first connecting portion 41, a second connecting portion 42 and a second threaded portion 43, the first connecting portion 41, the second connecting portion 42 and the second The two threaded parts 43 are connected in sequence. The first connecting portion 41 is connected to the optical axis portion 22 of the guide tube base 2 , and the second threaded portion 43 is provided with external threads and connected to the skull 200 .

The first connecting portion 41 is provided with a fifth through hole 411, the diameter of the fifth through hole 411 is equal to the outer diameter of the optical axis portion 22, and the length of the fifth through hole 411 is greater than the length of the optical axis portion 22, so that The guide tube base 2 has a sufficient moving distance in the axial direction of the fifth through hole 411 .

The second connecting portion 42 is provided with a sixth through hole 421, the sixth through hole 421 communicates with the fifth through hole 411 and is coaxial, the sixth through hole 421 passes through the second threaded portion 43, and its diameter is equal to that of the optical fiber The outer diameter of the guide tube 1.

In this embodiment, the optical fiber guide tube 1 is installed on the guide tube base 2, and the guide tube base 2 is used to fix the optical fiber guide tube 1 and the medical optical fiber 100, through the sealing plug 5 and the fixed cover 3 cooperate to complete the relative fixing of the medical optical fiber 100. At the same time, the guide tube base 2 cooperates with the skull nail 4 to complete the fixation of the optical fiber guide tube 1 . Wherein the skull nail 4 is fixed on the skull 200 to establish a guiding channel and fix the optical fiber guide tube 1 .

The medical optical fiber 100 can be a bare optical fiber, or an optical fiber conduit structure with a cooling system or an optical fiber conduit structure without a cooling system. Both the optical fiber conduit with a cooling system and the optical fiber conduit structure without a cooling system are in the prior art, and are not described here. Do repeat.

Understandably, as shown in FIG. 9 , by changing the length of the medical optical fiber 100 protruding along the fiber guide tube 1 and/or the orientation of the arc-shaped incision 111 , and/or the medical optical fiber 100 at the straight tube portion The relative positions within 12 can realize multi-regional ablation in the same channel to treat lesions in larger regions. For example, the first ablation region 301 and The second ablation zone 302 . Certainly, as shown in FIG. 4 and FIG. 10 , the medical optical fiber 100 can also realize laser ablation in the straight tube portion 12 .

Example 2

Another specific embodiment of the present invention, as shown in Fig. 1-Fig. 2, discloses a kind of medical optical fiber guiding structure, comprises optical fiber guiding tube 1, and described optical fiber guiding tube 1 is a slender tube, and medical optical fiber 100 is arranged on In the fiber guide tube 1 , the front end of the fiber guide tube 1 is a bending portion 11 , and the medical optical fiber 100 passes through the bending portion 11 to realize the guiding and bending of the medical optical fiber 100 .

Compared with the prior art, in the medical optical fiber guiding structure provided by this embodiment, the front end of the optical fiber guiding tube is a curved part. The important tissue can be ablated conformally to the target lesion area 300, which improves the efficiency of the operation.

The fiber optic guide tube 1 is bent at the front end, so that it can pass through the central hole of the skull nail 4 for guidance and go deep into the brain. At the same time, the medical optical fiber 100 can also be guided through the bending structure at the front end.

The front end of the bending part 11 is provided with an arc-shaped cutout 111 , and the medical optical fiber 100 passes through the arc-shaped cutout 111 of the bending part 11 to realize the guiding and bending of the medical optical fiber 100 .

As shown in Figure 10, the medical optical fiber guiding structure also includes a guide tube base 2, a fixed cover 3, a skull nail 4 and a sealing plug 5, and one end of the guide tube base 2 is connected to one end of the skull nail 4, so that The other end of the skull nail 4 is connected to the skull 200 , the sealing plug 5 is arranged in the other end of the guide tube base 2 , and the other end of the guide tube base 2 is connected to the fixed cover 3 outside.

As shown in FIG. 11 , the guide tube base 2 is a rotary body structure, including a first threaded part 21, an optical axis part 22 and a limiting part 23, and the first threaded part 21 and the optical axis part 22 are respectively located on the Both ends of the guide tube base 2 , the limiting portion 23 is located between the first threaded portion 21 and the optical axis portion 22 . The first threaded portion 21 is provided with an external thread, and the outer diameters of the first threaded portion 21 and the optical axis portion 22 are both smaller than the outer diameter of the limiting portion 23 .

A scale line is provided on the outer cylindrical surface of the limiting portion 23 , and the scale line equally divides the circumferential angle and is set close to the optical axis portion 22 .

The center of the guide tube base 2 is provided with a first through hole 211, a second through hole 221 and a third through hole 231, and the first through hole 211 and the second through hole 221 are located at the center of the guide tube base 2 respectively. At both ends, the first through hole 211 , the second through hole 221 and the third through hole 231 communicate and are coaxial.

The diameter of the second through hole 221 is smaller than the diameter of the first through hole 211 and larger than the diameter of the third through hole 231 , and the diameter of the second through hole 221 is equal to the outer diameter of the fiber guide tube 1 . The rear end of the fiber guide tube 1 is disposed in the second through hole 221 . The diameter of the third through hole 231 is slightly larger than the diameter of the medical optical fiber 100 so that the medical optical fiber 100 can pass through smoothly.

As shown in FIG. 7 , the fixing cover 3 is provided with a threaded hole 31 and a fourth through hole 32 , and the threaded hole 31 and the fourth through hole 32 are connected and coaxial. The diameter of the fourth through hole 32 is equal to the diameter of the medical optical fiber 100 and smaller than the diameter of the threaded hole 31 . The first threaded portion 21 is disposed in the threaded hole 31 .

The sealing plug 5 is a cylindrical elastic member disposed in the first through hole 211 . The outer diameter of the sealing plug 5 is slightly larger than the diameter of the first through hole 211, and the diameter of the central hole of the sealing plug 5 is slightly smaller than the diameter of the medical optical fiber 100, so that the medical optical fiber 100 and the guide tube base connected by the sealing plug 5 2 solid and reliable. The length of the sealing plug 5 is greater than the length of the first through hole 211 , preferably, the length of the sealing plug 5 is 1.3˜1.4 times the length of the first through hole 211 .

The sealing plug 5 is set in the first through hole 211 for guiding and limiting the medical optical fiber 100. Since the sealing plug 5 is elastic, its outer diameter is slightly larger than the first through hole 211, and its inner diameter is slightly smaller than the medical optical fiber 100. The outer diameter of the medical optical fiber 100 can be stably arranged in the guide tube base 2 . In addition, after the fixing cover 3 is screwed onto the first threaded part 21 , the medical optical fiber 100 is firmly connected to the guide tube base 2 , and the movement of the medical optical fiber 100 in the axial direction and the rotation around its own axis are restricted.

As shown in FIG. 8 , the skull nail 4 includes a first connecting portion 41 , a second connecting portion 42 and a second threaded portion 43 connected in sequence. The first connecting portion 41 is connected to the optical axis portion 22 of the guide tube base 2 , and the second threaded portion 43 is provided with external threads and connected to the skull 200 .

The center of the skull nail 4 is provided with a coaxial and communicating fifth through hole 411 and a sixth through hole 421, the fifth through hole 411 is located at the end of the first connecting part 41, and the diameter of the fifth through hole 411 is equal to The outer diameter of the optical axis portion 22 and the length of the fifth through hole 411 are greater than the length of the optical axis portion 22 , so that the guide tube base 2 has a sufficient moving distance in the axial direction of the fifth through hole 411 . The sixth through hole 421 passes through the second threaded portion 43 and has a diameter equal to the outer diameter of the fiber guide tube 1 .

In this embodiment, the medical optical fiber 100 passes through the fourth through hole 32 , the central hole of the sealing plug 5 and the third through hole 231 sequentially, and then enters the fiber guide tube 1 disposed in the second through hole 221 . The optical fiber guide tube 1 passes through the fifth through hole 411 and the sixth through hole 421, and then passes through the end of the second threaded part 43 to go deep into the brain, and the medical optical fiber 100 can pass through the fiber guide tube 1 The bending part 11 is pierced for laser ablation operation.

In order to further limit the optical fiber guide tube 1, as shown in Figure 12, Figure 13, and Figure 14, the medical optical fiber guide structure also includes a sheath locking screw 6, and the axis of the sheath locking screw 6 is aligned with the optical fiber guide tube 1. The axis of the shaft is vertical, and the sheath locking screw 6 can pass through the through hole arranged radially along the first connecting portion 41 and press against the outer wall of the optical shaft portion 22 .

It is worth noting that a marking line 412 is provided on the cylindrical surface of the first connecting portion 41, and the marking line 412 is parallel to the axis of the skull nail 4 and set near the end of the first connecting portion 41, so as to determine the guide tube The angle at which the base 2 rotates relative to the skull nail 4 . Since the skull nail 4 is fixedly connected to the skull 200 through threads, one end of the medical optical fiber 100 and the guide tube base 2 is tightly connected through a sealing plug 5, and the other end of the optical fiber guide tube 1 and the guide tube base 2 Due to the tight fit, the rotation of the guide tube base 2 can change the direction of the arc-shaped incision 111 of the medical optical fiber 100 , so that the target lesion area 300 can be conformally ablated.

Understandably, in order to facilitate the better operation of the medical optical fiber guiding structure, the scale line of the limiting part 23 is provided with a 0 mark point (ie: 0 scale), and the scale line corresponding to the 0 mark point is aligned with the mark line 412. The structure is the starting position of the medical fiber optic guiding structure.

In this embodiment, the optical fiber guide tube 1 is installed on the guide tube base 2, and the guide tube base 2 is used to fix the optical fiber guide tube 1 and the medical optical fiber 100, through the sealing plug 5 and the fixed cover 3 cooperate to complete the relative fixing of the medical optical fiber 100. At the same time, the guide tube base 2 cooperates with the skull nail 4 and the sheath locking screw 6 to complete the fixing and guiding structure of the medical optical fiber 100 . Wherein the skull nail 4 is fixed on the skull 200 to establish a guiding channel and fix the optical fiber guide tube 1 . The position and direction of the optical fiber guide tube 1 can be judged by the marking line 412 on the skull nail 4 and the angle scale line on the guide tube base 2 .

In the actual operation process, according to the 0° scale in the above description, the first area is ablated. At this time, the medical optical fiber 100 is pulled back by unscrewing the fixing cover 3 so that the front end of the medical optical fiber 100 does not exceed the bending part 11. , then loosen the sheath locking screw 6, rotate the guide tube base 2 to adjust the orientation of the arc-shaped incision 111, and then tighten the sheath locking screw 6, at this time the outlet bending position of the fiber guide tube 1 has been Changes occur, so that the medical optical fiber 100 is extended out of the optical fiber guide tube 1 to ablate the second area. The ablation area can be expanded not only in the axial direction where the medical optical fiber 100 protrudes, but also in the radial direction of the guide tube 1 .

Exemplarily, as shown in Figure 15 and Figure 16, the first area is ablated at 0 scale, at this time, the optical fiber is retracted by loosening the fixing cover 3, the sheath locking screw 6 is loosened, and the base of the guide tube is rotated 2 to 60 scale, and then tighten the sheath locking screw 6. At this time, the bending direction of the exit of the fiber guide tube 1 has changed, so that the medical optical fiber 100 can be extended out of the fiber guide tube 1, and the second area can be ablated. Or keep the medical optical fiber 100 still, and directly rotate the guide tube base 2 to 60 scales after loosening the sheath locking screw 6 .

Example 3

Another specific embodiment of the present invention discloses a medical optical fiber guiding structure. The medical optical fiber 100 is a medical optical fiber that can emit light from the side (that is, a side-firing optical fiber). On the basis of Embodiment 2, as shown in Figure 17, As shown in FIG. 18 , the medical optical fiber 100 has a light exit side mark 101 to mark the direction of the light exit. At this time, by loosening the fixing cover 3 and adjusting the direction of the light exit of the medical optical fiber 100, the ablation area can be further controlled. The position and size are easier to conformal ablation. Other structures and beneficial effects are the same as those in Embodiment 2, and will not be repeated here.

Example 4

Another specific embodiment of the present invention discloses a medical optical fiber guiding structure. The medical optical fiber guiding structure has a certain degree of light transmission and can transmit light paths. Further, the front end of the optical fiber guide tube 1 is provided with an optical path adjustment component, and the optical path adjustment component is arranged on the front end side wall of the straight tube part of the optical fiber guide tube 1. When the front end of the medical optical fiber 100 is located in the straight tube When inside, the optical path adjustment component can change the optical path of the laser light emitted by the medical optical fiber 100 located in the optical fiber guide tube 1 to ablate the target lesion area 300 .

The optical path adjustment component includes a reflective film 13 and a lens structure 14, the reflective film 13 is used to direct the light emitted by the medical optical fiber 100 to the direction of the target lesion area 300, so as to achieve unidirectional emission; the reflective film 13 and the lens structure 14 can adapt to more tumors of different shapes.

The lens structure 14 can change the size and/or shape of the ablation zone. Because of the increase of the lens structure 14, the original circular ablation area is transformed into a specific shape ablation area (as shown in Fig. 22 and Fig. 26 ), and more irregular tumors can be adapted.

The lens structure 14 is located on the fiber guide tube 1. Understandably, the lens structure 14 can be arranged on the inner wall of the fiber guide tube 1 as a separate component, for example, the lens structure 14 is pasted on the inner wall of the fiber guide tube 1, It can also be used as a part of the fiber guide tube 1 .

In this embodiment, in order to reduce the volume of the sheath structure, the lens structure 14 and the fiber guide tube 1 are integrally structured. Of course, the lens structure 14 can also be made on the side wall of the fiber guide tube 1 , and the lens structure 14 is embedded in the groove provided on the side wall of the fiber guide tube 1 .

The lens structure 14 can be a converging lens or a diverging mirror, wherein the concentrating lens is preferably a convex lens, and the diverging mirror is preferably a concave lens.

When the lens structure 14 is a convex lens, the laser light emitted by the medical optical fiber 100 diverges in the circumferential direction, and becomes parallel light after passing through the convex lens, which can locally highlight and/or deepen the focus on the target lesion area 300 where the lens structure 14 is located. ablation.

When the lens structure 14 is a concave lens, the laser light emitted by the medical optical fiber 100 diverges in the circumferential direction, and becomes more divergent after passing through the concave lens, which expands the coverage of the light emitted by the lens structure 14 and enhances the ablation effect.

The sheath structure provided in this embodiment is provided with a lens structure 14 on the optical fiber guide tube 1. When the medical optical fiber 100 is used for ablation surgery, the medical optical fiber is changed through the lens structure 14 arranged on the optical fiber guide tube 1. 100 laser paths, so the ablation of tumors with irregular shapes becomes more flexible and easy to operate.

The reflective film 13 and the lens structure 14 are arranged oppositely, and are respectively located on two sides of the medical optical fiber 100 . As shown in Figures 19-22, the lens structure 14 is a convex lens, and the laser light emitted circumferentially by the medical optical fiber 100 is returned to the convex lens in parallel when it encounters the reflective film 13 and then focused, and the medical optical fiber 100 directly passes through the convex lens The formed parallel light beam can enhance the ablation of a certain area of the target lesion area 300 .

As shown in Figures 23-26, the lens structure 14 is a concave lens, and the laser light emitted in the circumferential direction of the medical optical fiber 100 is returned to the concave lens in parallel after encountering the reflective film 13, and is refracted by the concave lens at a larger refraction angle. Diffusion, together with the light beam refracted directly through the concave lens by the medical optical fiber 100 , can enhance the ablation of a specific range of the target lesion area 300 .

Understandably, in this embodiment, it is also possible to obtain different light output ranges by changing the coverage area of the reflective film 13 along the radial direction of the fiber guide tube 1 and/or by changing the structure of the arc-shaped surface where the reflective film 13 is provided. I won't repeat them here.

Compared with Embodiment 1 to Embodiment 4, an optical path adjustment component is provided at the front end of the optical fiber guide tube 1 , which can expand the types of the medical optical fiber 100 . In Embodiment 4, the medical optical fiber 100 may be any one of side-fired optical fiber, diffused optical fiber or ring optical fiber.

Example 5

Another specific embodiment of the present invention discloses a medical optical fiber guiding method, using the above-mentioned medical optical fiber guiding structure, the steps include:

Step 1: Fix the skull nail 4 on the planned path according to the operation plan, and keep it in a fixed state with the skull 200 .

Step 2: Insert the medical optical fiber 100 into the optical fiber guide tube 1 , at this time, the front end of the medical optical fiber 100 does not exceed the bending portion 11 of the optical fiber guide tube 1 . One end of the guide tube base 2 is connected to the fiber guide tube 1 , and the other end is installed with the sealing plug 5 and the fixed cover 3 is screwed tightly.

The medical optical fiber 100 is kept in a straight state so that when the optical fiber guiding tube 1 is inserted into the brain, other substances will not enter the optical fiber guiding tube 1 and cause subsequent blockage. The medical optical fiber 100 can also achieve laser ablation in the straight tube portion 12 , that is, the front end of the medical optical fiber 100 is located in the straight tube portion 12 and does not enter or protrude from the curved portion 11 .

Understandably, the medical optical fiber 100 can also be retrofitted.

Step 3: According to the operation plan, insert the optical fiber guide tube 1 into the designated position through the skull nail 4, avoiding the area that needs to be avoided. There are corresponding graduation marks on the optical fiber guide tube 1, so that the insertion depth can be visually confirmed.

At this time, by loosening the fixing cover 3, the uniaxial translation between the medical optical fiber 100 and the optical fiber guide tube 1 can be performed. By applying a thrust from the outside, the medical optical fiber 100 can be slowly moved inward. Because the front end of the optical fiber guide tube 1 With a curved structure, the medical optical fiber 100 will bend along with the curved surface. The curved surface should be smooth, otherwise it may be stuck. The medical optical fiber 100 passing through the bending part 11 will become straight again due to the influence of its own characteristics. At this time, the light-emitting part of the front end of the medical optical fiber 100 reaches the target lesion area 300, and skillfully avoids the area with obstacles 400. Tighten the fixed cover 3. Ablation therapy can be further completed.

Step 4: Loosen the fixing cover 3 and pull the medical optical fiber 100 backward so that the front end of the medical optical fiber 100 does not exceed the bending part 11, then loosen the sheath locking screw 6, and rotate the guide tube base 2 to adjust The orientation of the arc-shaped incision 111, and then tighten the sheath locking screw 6, at this time the outlet bending position of the optical fiber guide tube 1 has changed, so that the medical optical fiber 100 is stretched out of the optical fiber guide tube 1, and the second The area is ablated. The ablation area can be expanded not only in the axial direction where the medical optical fiber 100 protrudes, but also in the radial direction of the guide tube 1 .

The present invention realizes the self-bending deformation of the medical optical fiber through the optical fiber guide tube, which can avoid important areas that are not suitable for puncture; by adjusting the direction of the optical fiber guide tube, the range of the ablation area can be further expanded, realizing the need to open two channels originally. The ablation can only be completed, which improves the efficiency; with different medical optical fibers, it can more conveniently match lesions of different shapes and complete conformal ablation.

It is worth noting that the front end of the existing ablation catheter (that is, the end that contacts the lesion tissue for ablation) is closed, and it is only a linear ablation channel, and the medical optical fiber can only move within the axial range of the ablation catheter. The tissue ablation range is only limited in the limited area around the ablation catheter. In the medical optical fiber guiding structure provided by the present invention, the front end of the optical fiber guiding tube 1 is a curved portion 11 with a lateral opening (that is, the arc-shaped incision 111 ), and the medical optical fiber 100 passes through the curved portion 11. Lateral openings allow for guided bending. This structural feature expands the range of motion of the medical optical fiber 100, which can not only move in the axial direction, but also realize the movement in the radial direction, and then realize the ablation of large lesion tissues in a single channel. At the same time, when the tumor microenvironment is not very ideal, for example, the tumor is located in the deep part of the brain, and there are many important tissues and blood vessels around the tumor, the medical optical fiber guiding structure of the present invention also increases the choice of path options that avoid important tissues. Flexibility and variety.

Example 6

A specific embodiment of the present invention, as shown in FIGS. 27-28 , discloses a medical optical fiber guiding structure, including an optical fiber guiding tube 1 . In the above embodiments, the front end of the optical fiber guide tube 1 is made into a curved shape to achieve bending when the medical optical fiber 100 passes through. In Embodiment 6, the fiber guide tube 1 is a tubular body with a tubular structure as a whole. At this time, to realize the bending of the medical optical fiber 100 when passing out, an opening 15 needs to be opened on the front side wall of the fiber guide tube 1 .

Specifically, the fiber guide tube 1 includes a first tube section and a second tube section, the first tube section has a lumen extending in the axial direction, and the side wall of the second tube section has a The communicating opening 15 , so that the passage connecting the opening 15 and the lumen is a curved passage 16 . Preferably, the lumen and the opening 15 are smoothly and excessively connected, and there is a set angle α between the extension direction of the curved channel 16 and the extension direction of the lumen, and the set angle α is an obtuse angle .

It should be noted that the front end of the second pipe section is the puncture head 17 .

The medical optical fiber 100 or other sampling devices (such as sampling needles, samplers, etc.) can pass through the opening to achieve guided bending, and the set angle α is preferably set to be , the angle A between the axis of the unbent portion of the medical optical fiber 100 and the axis of the bent portion of the medical optical fiber 100 is between 140° and 170°.

Further, the first pipe section is the straight pipe part 12 of the fiber guide tube 1, and the second pipe section is the bent part 11 of the fiber guide tube 1; the medical optical fiber 100 passes through the bent part 11 Out to achieve guided bending.

Example 7

After ablation surgery, problems such as edema may occur, and the risk can be reduced by removing a portion of the damaged tissue. At the same time, the target tissue can be sampled and tested before and after the ablation operation, so as to facilitate its pathological analysis.

Another specific embodiment of the present invention, as shown in Fig. 29-Fig. 31, adopts the above-mentioned medical optical fiber guiding structure, and replaces the medical optical fiber 100 with a lateral sampling needle 500, and the lateral sampling needle 500 is connected with the medical optical fiber guiding structure. The connection relationship of the structure is the same as the connection relationship between the medical optical fiber 100 and the medical optical fiber guiding structure, and will not be repeated here.

The side sampling needle 500 is arranged in the fiber guide tube 1, and the front side wall of the side sampling needle 500 is provided with a side sampling port 501, and the front side wall of the side sampling port 501 is an inclined surface 502, preferably Specifically, the inclined surface 502 is inclined towards the rear end of the lateral sampling needle 500, so that when the lateral sampling needle 500 is taken out, the inclined surface 502 can be used to cut off the sample from the tissue to be removed 600, and the lateral sampling needle The front end of the 500 is tapered.

In this embodiment, the lateral sampling needle is a hollow hose as a whole. The hose has a certain strength to ensure its own straightness, but it can be bent due to the influence of the structure of the bending part. The basic characteristics are consistent with the optical fiber. The preferred Teflon tubes are used. The head end of the lateral sampling needle is made into a tapered shape for easy puncture, one side is provided with an opening for sampling, and the front end of the opening is made into a sharp incision shape for cutting the sample from the tissue. The rear end of the hose can be connected with a negative pressure pump, and the pressure difference in the hollow tube can be adjusted to absorb fluid samples and the like.

When the lateral sampling needle 500 is used together with the medical optical fiber guide structure, first fix the skull nail 4 and the optical fiber guide tube 1, and confirm the path. After the ablation operation is completed, the medical optical fiber 100 is taken out, and then the lateral sampling needle 500 is inserted from one end of the fiber guide tube 1, and the tip is inserted into the brain to reach the indicated position. At this time, the negative pressure pump at the end of the lateral sampling needle 500 works to absorb the tissue to be sampled to the hollow part of the lateral sampling needle 500 . If it is some fluids such as cerebrospinal fluid and blood, the purpose can be achieved by slowly sucking. If it is some hard tissues, after the adsorption, pull back the lateral sampling needle 500 and use the inclined surface 502 to cut off the tissue to complete the sampling or Clear job.

It can be understood that the side wall at the rear end of the side sampling port 501 is an inclined surface, and the inclined surface is inclined towards the front end of the lateral sampling needle 500. When the lateral sampling needle 500 enters, the tissue to be removed 600 can be cut away. The sample is stored in the hollow part at the front end of the lateral sampling needle 500, and a negative pressure pump is not needed when the lateral sampling needle 500 is pulled out.

Further, like the medical optical fiber 100 in the above-mentioned embodiment, the lateral sampling needle 500 can also be adjusted radially and axially. Through multiple adjustments and sampling, sampling operations in different regions can be completed, and excessive damage after ablation can be removed. It also facilitates the pathological analysis of the sampled tissue by medical staff. The specific adjustment method will not be repeated.

Still further, the side sampling port 501 of the side sampling needle 500 is coated with a developing coating. When the operation is performed in the MR environment, the position of the sampling needle can be monitored through the MR scanning image, so that the sampling is more accurate and safe. Will not harm other substances in the brain.

It should be noted that the lateral sampling needle 500 can be used in combination with the aforementioned medical optical fiber 100 , that is, the lateral sampling needle 500 can be used for sampling before or after ablation with the medical optical fiber 100 .

Example 8

Another specific embodiment of the present invention, as shown in FIG. 32, adopts the above-mentioned medical optical fiber guiding structure. If the position to be sampled is relatively close to the optical fiber guide tube 1 or the orientation to be sampled is relatively large, the medical optical fiber 100 is replaced with an end face. The incision sampling needle 700, the connection relationship between the end surface incision sampling needle 700 and the medical optical fiber guiding structure is the same as the connection relationship between the medical optical fiber 100 and the medical optical fiber guiding structure, and will not be repeated here.

The end face sampling port 701 (notch) of the end face incision sampling needle 700 is arranged at the front end. During the insertion process, the incision will cut off the tissue and store it in the hollow tube of the end face incision sampling needle 700. , the negative pressure pump connected to the rear end of the end face incision sampling needle 700 ensures that the tissue in the hollow tube will not protrude, and leaves together with the end face incision sampling needle 700 .

Understandably, the lateral sampling needle 500 in Example 7 can also be adjusted radially and axially in conjunction with the medical optical fiber guide structure, and can sample in a wider range or remove damaged tissue, with high efficiency and convenient sampling.

It is worth noting that the end face incision sampling needle 700 can be used in combination with the above-mentioned medical optical fiber 100 , that is, the end face incision sampling needle 700 can be used for sampling before or after ablation with the medical optical fiber 100 .

Example 9

Another specific embodiment of the present invention, as shown in Figure 33, adopts the above-mentioned medical optical fiber guiding structure. Understandably, the medical optical fiber guiding structure can also cooperate with a sampler 800 that can meet the requirements for sampling. The sampler 800 is a prior art , often used in endoscope tubes, the specific structure will not be repeated, there is a silk thread on the sampler 800 to control the closing and opening of the front-end sampler, after the sampler 800 extends out of the optical fiber guide tube 1, open the front-end sampler 800 , after reaching the position, it is closed by structural pulling, and then exits along the fiber guide tube 1.

It should be noted that the sampler 800 can be used in combination with the above-mentioned medical optical fiber 100 , that is, the sampler 800 can be used for sampling before or after ablation with the medical optical fiber 100 .

It should be noted that the lateral sampling needle 500 in Embodiment 7, the end surface incision sampling needle 700 in Embodiment 8, and the sampler 800 in Embodiment 9 can be a hose as a whole, and the hose has a certain strength. It can guarantee its own straightness, but it can be bent due to the influence of the structure of the bending part, and its basic characteristics are consistent with those of optical fibers. It is preferably a polytetrafluoroethylene tube.

The optical fiber guide tube 1 of the present invention is not only a surgical channel for laser ablation, but also can become a sampling channel for a side sampling needle 500 or an end face incision sampling needle 700 or a sampler 800 when the ablation is completed, which can be completed in the same operation In addition to the damage to the lesion, the sampling of the lesion after the damage can be completed. In addition, the hardness of the optical fiber guide tube 1 is much greater than that of the medical optical fiber 100 , the lateral sampling needle 500 , the end face incision sampling needle 700 and the sampler 800 . The lateral sampling needle 500, the end surface incision sampling needle 700 and the sampler 800 can all be realized by means of existing technologies, and will not be described in detail here.

The above is only a preferred embodiment of the present invention, but the scope of protection of the present invention is not limited thereto. Any person skilled in the art within the technical scope disclosed in the present invention can easily think of changes or Replacement should be covered within the protection scope of the present invention.

Claims

A medical optical fiber guiding structure, characterized in that it comprises an optical fiber guiding tube (1), and the optical fiber guiding tube (1) comprises a first tube section and a second tube section;

The first pipe section has a lumen extending in the axial direction,

The second tube section has an opening communicating with the lumen;

An extension direction in which the opening communicates with the lumen and an extension direction of the lumen form a set angle, and the set angle is an obtuse angle.
The medical optical fiber guiding structure according to claim 1, characterized in that, a medical optical fiber (100) is detachably connected in the optical fiber guiding tube (1);

The medical optical fiber (100) can pass through the opening to realize guiding bending.
The medical optical fiber guiding structure according to claim 1 or 2, characterized in that, the first pipe section is the straight pipe portion (12) of the optical fiber guiding pipe (1), and the second pipe section is the optical fiber guiding pipe section (12). The bending part of the tube (1); the medical optical fiber (100) passes through the bending part (11) to realize guiding bending.
The medical optical fiber guiding structure according to claim 1, characterized in that it also includes a guide tube base (2), a fixed cover (3) and a skull nail (4), and one end of the guide tube base (2) is provided with Inside the end of the skull nail (4), the other end is threadedly connected with the fixing cover (3).
The medical optical fiber guiding structure according to claim 4, characterized in that it also includes a sealing plug (5), the sealing plug (5) is arranged on the guide tube base (2) and is connected with the fixed cover (3 ) through holes.
The medical optical fiber guiding structure according to claim 4, characterized in that, the guide tube base (2) includes a first threaded part (21) and an optical axis part (22), and the first threaded part (21) and the optical axis The shaft parts (22) are respectively located at both ends of the guide tube base (2), and the first threaded part (21) is provided with external threads.
The medical optical fiber guiding structure according to claim 5, characterized in that, the center of the guide tube base (2) is provided with a coaxial and communicated first through hole (211), a second through hole (221) and The third through hole (231), the first through hole (211) and the second through hole (221) are respectively located at both ends of the guide tube base (2), and the rear of the fiber guide tube (1) The end is arranged in the second through hole (221).
The medical optical fiber guiding structure according to claim 7, characterized in that, the sealing plug (5) is arranged in the first through hole (211), and the outer wall of the sealing plug (5) is in contact with the first The inner wall of the through hole (211) is bonded, and the central hole of the sealing plug (5) is sheathed with the medical optical fiber (100) and bonded with the outer wall of the medical optical fiber (100).
The medical optical fiber guiding structure according to claim 6, characterized in that, the skull nail (4) comprises a first connecting portion (41), a second connecting portion (42) and a second threaded portion (43) connected in sequence , the first connecting portion (41) is connected to the optical axis portion (22), and the second threaded portion (43) is provided with external threads and connected to the skull (200).
A medical optical fiber guiding method, characterized in that the medical optical fiber guiding structure according to any one of claims 1-9 is used, and the steps include:

Step 1: Fixing the skull nail (4) to the skull (200);

Step 2: Insert the medical optical fiber (100) into the optical fiber guide tube (1), at this time, the front end of the medical optical fiber (100) does not exceed the bending part (11) of the optical fiber guide tube (1); one end of the guide tube base (2) Connect with the fiber guide tube (1), install the sealing plug (5) at the other end and tighten the fixed cover (3);

Step 3: Insert the fiber optic guide tube (1) to the designated position through the skull nail (4);

Unscrew the fixed cover (3), apply a pushing force from the outside, and move the medical optical fiber (100) to the front end of the optical fiber guide tube (1), so that the medical optical fiber (100) passes through the bending part (11) and relies on the bending part (11) change direction; then tighten the fixed cap (3);

Step 4: Unscrew the fixing cover (3) and pull the medical optical fiber (100) backward so that the front end of the medical optical fiber (100) does not exceed the bending part (11), and rotate the guide tube base (2) to adjust the bending part (11 ), and then extend the medical optical fiber (100) out of the optical fiber guide tube (1) to ablate another area.