WO2024001634A1

WO2024001634A1 - Negative-pressure suction ureteral sheath and ureteral insertion apparatus

Info

Publication number: WO2024001634A1
Application number: PCT/CN2023/096797
Authority: WO
Inventors: 唐剑; 张翔
Original assignee: 湖南省华芯医疗器械有限公司
Priority date: 2022-06-27
Filing date: 2023-05-29
Publication date: 2024-01-04
Also published as: CN217828057U

Abstract

Provided are a negative-pressure suction ureteral sheath and a ureteral insertion apparatus. The negative-pressure suction ureteral sheath comprises a tube sheath (100) and a guide sleeve (200), the tube sheath (100) comprising a base tube segment (110) and a flexible tube segment (120). The flexible tube segment (120) is connected to a distal end of the base tube segment (110), and the rigidity of the base tube segment (110) is greater than the rigidity of the flexible tube segment(120). The guide sleeve (200) is connected to a proximal end of the base tube segment (110), and the guide sleeve (200) is provided with a suction nozzle (211) and a pressure measurement nozzle (212) in communication with the base tube segment (110). The flexible tube segment (120) can be bent along with the bending of an endoscope insertion part (600), so that the distal end of the tube sheath (100) can enter a deep position of the renal pelvis, and a negative-pressure attraction force at the distal end of the tube sheath (100) can form a certain attraction and fixing effect on target calculus to facilitate rapid laser lithotripsy, and reduce the operation time and the operation difficulty. Meanwhile, the pressure measurement nozzle (212) is connected to a pressure measurement apparatus, which can detect the pressure of the renal pelvis in real time, thereby making it convenient for medical staff to make an accurate judgment and avoiding urine-derived sepsis caused by prolonged increase of pressure in the renal pelvis

Description

A negative pressure suction ureteral sheath and ureteral insertion device

Technical field

The utility model relates to the technical field of medical devices, in particular to a negative pressure suction ureteral sheath and a ureteral insertion device.

Background technique

The ureteral sheath is used in urological surgery to establish a passage for the endoscope and other instruments to enter the urinary tract. During the operation, some blood clots, small stones, and purulent floc are also naturally discharged from the ureteral sheath. , but this natural drainage method takes a long time to drain, which greatly increases the length of the operation.

The ureteral sheath in the related art is usually connected to a negative pressure mechanism to suck out blood clots, small stones and purulent floc during surgery. However, since the distal end of the ureteral sheath cannot be bent to approach the lesion area, the suction effect is not good. Ideally, for example, small stones cannot enter the ureteral sheath, which increases the difficulty and time of the operation. At the same time, during the operation, the pressure in the renal pelvis can easily increase. If the operation time is too long, urogenic sepsis can easily occur. blood.

Therefore, providing a negative pressure suction ureteral sheath that has high drainage efficiency and can detect the pressure in the renal pelvis in real time is an urgent technical problem that needs to be solved by those skilled in the art.

Utility model content

The utility model discloses a negative pressure suction ureteral sheath to solve the technical problems of poor suction effect, long operation time and inability to detect the pressure in the renal pelvis of the ureteral sheath in the related art.

In order to solve the above problems, the present utility model adopts the following technical solutions:

In a first aspect, the utility model provides a negative pressure suction ureteral sheath, which includes:

Pipe sheath, the pipe sheath includes a base pipe section and a flexible pipe section, the flexible pipe section is connected to the base pipe section At the distal end, the rigidity of the base pipe section is greater than the rigidity of the flexible pipe section;

A guide sleeve is connected to the proximal end of the base pipe section, and the guide sleeve is provided with a suction nozzle and a pressure measuring nozzle that are connected with the base pipe section.

Furthermore, the guide sleeve is provided with a guide channel that is in contact with the pipe sheath, the guide channel is provided with an elastic seal, and the elastic seal is provided with a through hole that penetrates the elastic seal.

Further, the guide sleeve includes a connecting part and a guide part, the guide channel passes through the connecting part and the guide part, the connecting part is connected to the base tube section, in the insertion direction of the tube sheath, The diameter of the guide portion gradually decreases.

Further, the guide portion is tapered in the axial direction of the guide sleeve.

Further, the tube sheath is detachably connected to the guide sleeve.

Further, a temperature sensing probe is provided at the distal end of the sheath.

Further, the length of the flexible tube section matches the length of the active bending section of the endoscope insertion part inserted into the sheath.

Further, a partition wall is provided in the sheath, and the partition wall separates the sheath into an endoscope channel and a suction channel, and the endoscope insertion portion inserted into the sheath is located in the endoscope channel. Inside.

Further, the base pipe section and the flexible pipe section are integrally formed, or the base pipe section and the flexible pipe section are bonded and connected.

In a second aspect, embodiments of the present application also provide a ureteral insertion device. The ureteral insertion device includes an inner sheath, a limiting sleeve and the aforementioned negative pressure suction ureteral sheath. The limiting sleeve is provided at the proximal end of the guide sleeve. , the inner sheath is inserted into the pipe sheath, and the inner sheath is limitedly matched with the limiting sleeve.

The technical solution adopted by this utility model can achieve the following beneficial effects:

First, the negative pressure suction ureteral sheath disclosed in the embodiment of the application has the suction nozzle connected to the negative pressure mechanism. The front section of the sheath is a flexible tube section. After the endoscope insertion part extends into the sheath, the endoscope insertion part is actively The curved section can drive the flexible tube section to bend, so that the distal end of the sheath can enter the depth of the renal pelvis. During the operation, the negative pressure attraction of the distal end of the sheath can form a certain attraction and fixation effect on the target stone. In order to facilitate rapid laser lithotripsy and reduce operation time and difficulty; at the same time, the pressure measuring nozzle is connected to the pressure measuring device to detect the pressure deep in the renal pelvis in real time to facilitate medical staff to accurately judge and control the operation. time to avoid excessive increase in pressure in the renal pelvis causing urogenic sepsis;

Second, the broken stone fragments can be excreted out of the body through the sheath along with the perfusion fluid, which avoids the accumulation of large amounts of gravel in the ureter to form a stone street after surgery and avoids urinary tract obstruction;

Third, the flexible tube segment follows the active bending section of the endoscope insertion part, so that the distal end of the flexible tube segment and the distal end of the endoscope insertion part can always be in a close position in the renal pelvis, so that the sheath is A good water circulation is formed at the distal end close to the stone, which can not only avoid the snowstorm phenomenon, make the observation field clear, but also avoid the risk of infection caused by increasing the perfusion volume;

Fourth, the elastic seal provided in the guide sleeve allows the insertion part of the endoscope to enter and blocks the leakage of the perfusion liquid;

Fifth, the length of the flexible tube section matches the length of the active bending section of the endoscope insertion part inserted into the sheath, so that the bending amplitude of the flexible tube section is as close or the same as the active bending section, so that the two The orientation of the distal end of the patient should be as consistent as possible to facilitate observation and surgery;

Sixth, the distal end of the tube sheath is equipped with a temperature-sensing probe. The temperature-sensing probe can monitor the temperature in the renal pelvis and provide a reference for medical staff to avoid damaging the patient's kidneys due to high temperatures generated during laser lithotripsy.

Description of drawings

In order to explain the embodiments of the present invention or the technical solutions in the prior art more clearly, the drawings needed to be used in the description of the embodiments or the prior art will be briefly introduced below. Obviously, the drawings in the following description These are only some embodiments of the present invention. For those of ordinary skill in the art, other drawings can be obtained based on these drawings without exerting creative efforts.

Figure 1 is a schematic structural diagram of a negative pressure suction ureteral sheath according to an embodiment of the present application;

Figure 2 is one of the cross-sectional views of the negative pressure suction ureteral sheath according to the embodiment of the present application;

Figure 3 is the second cross-sectional view of the negative pressure suction ureteral sheath according to the embodiment of the present application;

Figure 4 is a partially enlarged schematic diagram of position A in Figure 3;

Figure 5 is a schematic structural diagram of the guide sleeve according to the embodiment of the present application;

Figure 6 is a schematic structural diagram of the tube sheath according to the embodiment of the present application;

Figure 7 is a schematic structural diagram of the ureteral insertion device according to the embodiment of the present application.

In the picture:

100-pipe sheath, 110-base pipe section, 120-flexible pipe section; 200-guide sleeve, 210-connection part, 211-suction nozzle, 212-pressure measuring nozzle, 220-guide part; 300-elastic seal, 310- Through hole; 400-inner sheath, 410-protruding part, 500-limiting sleeve; 600-endoscope insertion part; 700-temperature sensor probe.

Detailed ways

In order to make the purpose, technical solutions and advantages of the present utility model clearer, the technical solutions of the present utility model will be described in detail below. Obviously, the described embodiments are only some, not all, of the embodiments of the present invention. Based on the embodiments of the present utility model, all other implementations obtained by those of ordinary skill in the art without any creative work fall within the scope of protection of the present utility model.

The terms "first", "second", etc. in the description and claims of this application are used to distinguish similar objects and are not used to describe a specific order or sequence. It is to be understood that the figures so used are interchangeable under appropriate circumstances so that the embodiments of the present application can be practiced in orders other than those illustrated or described herein, and that "first," "second," etc. are distinguished Objects are usually of one type, and the number of objects is not limited. For example, the first object can be one or multiple. In addition, "and/or" in the description and claims indicates at least one of the connected objects, and the character "/" generally indicates that the related objects are in an "or" relationship.

In the present utility model, “proximal end” and “distal end” refer to the far and near positions of the structure relative to human body operation in the use environment, so as to facilitate the description of the positional relationship between components and facilitate understanding; “proximal end” "" and "remote" are relative positional relationships, not absolute.

The negative pressure suction ureteral sheath and ureteral insertion device provided by the embodiments of the present application will be described in detail below through specific embodiments and application scenarios with reference to the accompanying drawings 1 to 7 .

Referring to FIGS. 1 to 7 , an embodiment of the present application discloses a negative pressure suction ureteral sheath. The disclosed negative pressure suction ureteral sheath includes a sheath 100 and a guide sleeve 200 .

Among them, the sheath 100 is the basic component of the negative pressure suction ureteral sheath, which can be used in conjunction with an endoscope. Specifically, the sheath 100 has an inner channel, and the inner channel extends along the axial direction of the sheath 100. After the sheath 100 is inserted into the human body, the endoscope insertion part 600 can be inserted into the human body through the inner channel.

In the embodiment of the present application, the sheath 100 includes a base tube section 110 and a flexible tube section 120. The flexible tube section 120 is connected to the distal end of the base tube section 110. The rigidity of the base tube section 110 is greater than the rigidity of the flexible tube section 120. Endoscope When the active bending section of the insertion part 600 performs a bending action, the flexible tube section 120 can bend following the bending of the active bending section, thereby allowing the flexible tube section 120 to bend and penetrate deep into the renal pelvis. It should be noted that in the embodiment of the present application, the flexibility of the flexible pipe section 120 is greater than the flexibility of the base pipe section 110, and the base pipe section 110 itself may have a certain degree of bending elasticity, for example, it may be a structural member made of plastic material. , the base tube section 110 can adapt to the physiological moderate curvature of the ureter, and the flexible tube section 120 can be a structural member made of rubber or silicone rubber.

The guide sleeve 200 is connected to the proximal end of the sheath 100. The guide sleeve 200 is provided with a guide channel. The guide sleeve 200 is provided with a suction nozzle 211 and a pressure measuring nozzle 212 connected with the guide channel. When the guide sleeve 200 is connected to the sheath 100, The suction nozzle 211 and the pressure measuring nozzle 212 are respectively connected with the inner channel of the sheath 100. The suction nozzle 211 is used to connect to the negative pressure mechanism, and the pressure measuring nozzle 212 is used to connect to the pressure measuring device. It should be noted that the diameter of the endoscope insertion part 600 is smaller than the inner diameter of the sheath 100 , so that when the endoscope insertion part 600 extends into the sheath 100 , the inner wall of the sheath 100 and the surface of the endoscope insertion part 600 A gap is formed, which can be used to absorb blood clots, small stones, and purulent floc during surgery, and can also be used to detect the pressure in the renal pelvis.

In the negative pressure suction ureteral sheath disclosed in the embodiment of the present application, the active bending section of the endoscope insertion part 600 can drive the flexible tube section 120 to bend, so that the distal end of the sheath 100 can enter the depth of the renal pelvis. During the operation, The negative pressure attraction at the distal end of the sheath 100 can form a certain attraction and fixation effect on the target stone, so as to facilitate rapid laser lithotripsy and reduce the operation time and difficulty; the broken stone fragments can be discharged through the sheath 100 following the perfusion fluid. In vitro, it avoids the accumulation of a large amount of gravel in the ureter to form a stone street after surgery and avoids urinary tract obstruction. At the same time, the pressure measuring device connected to the pressure measuring nozzle can detect the pressure deep in the renal pelvis in real time, which facilitates medical staff to accurately judge and control the operation time and avoid urogenic sepsis caused by excessive increase in pressure in the renal pelvis.

During the research process, the inventor found that because the distal end of the existing ureteral sheath is usually placed at the upper end of the ureter or the renal pelvis, when treating kidney stones, water circulation cannot be formed at the front end of the camera component of the endoscope insertion part, resulting in gravel. Dust can easily block the camera components, causing the observation field to be unclear, commonly known as the blizzard phenomenon. In order to pursue a clear field of view, increasing the perfusion volume will lead to high pressure in the kidneys, the risk of infection, and even sepsis. In the negative pressure suction ureteral sheath of the present application, the flexible tube section 120 bends following the endoscope insertion part 600, so that the distal end of the flexible tube section 120 and the distal end of the endoscope insertion part 600 can always be close to each other in the renal pelvis. position, in the embodiment of the present application, the perfusate is injected into the renal pelvis through the endoscope, the distal end of the endoscope insertion part 600 injects the perfusate, and the distal end of the flexible tube section 120 absorbs the perfusate, and the perfusate is injected into the renal pelvis through the endoscope. A good water circulation is formed at the distal end close to the stone, which can not only avoid snowstorms, provide a clear observation field, but also avoid the risk of infection caused by increasing the perfusion volume.

An elastic seal 300 is provided in the guide sleeve 200. The elastic seal 300 is located at the proximal end of the suction nozzle 211 and the pressure measuring nozzle 212 to prevent the elastic seal 300 from blocking the connection between the suction nozzle 211 and the pressure measuring nozzle 212 and the inner channel. The elastic seal 300 is provided with a through hole penetrating the elastic seal 300 , and the endoscope insertion part 600 can be inserted into the sheath 100 through the through hole.

In the embodiment of the present application, the elastic seal 300 is a structural member made of polymer material, such as rubber material. When the endoscope insertion part 600 is inserted into the sheath 100 through the through hole, the elastic seal 300 is elastically squeezed. The endoscope insertion part 600 is pressed to achieve a sealing effect.

In the embodiment of the present application, the sheath 100 and the guide sleeve 200 are detachably connected. When the sheath 100 is inserted, the sheath 100 and the guide sleeve 200 are in a separated state to facilitate medical staff to insert the sheath 100 through the inner sheath 400. In the ureter, when the sheath 100 is inserted into a suitable position, the inner sheath 400 is withdrawn, and the guide sleeve 200 is connected to the sheath 100, thereby facilitating the insertion of the endoscope insertion part 600 and achieving sealing of the sheath 100.

In a further technical solution, the length of the active bending section of the endoscope insertion part 600 matches the length of the flexible tube section 120, so that when the active bending section is bent, the bending amplitude of the flexible tube section 120 is as close as possible to the active bending section. The segments should be kept close or the same, so that the orientation of the distal ends of the two should be as consistent as possible to facilitate observation and surgery.

In an optional embodiment, the pipe sheath 100 and the guide sleeve 200 are threaded to achieve detachable connection. For example, the pipe sheath 100 is provided with external threads, and the guide sleeve 200 is provided with internal threads. The pipe sheath 100 and the guide sleeve 200 pass through The threads of the external thread and the internal thread cooperate to achieve a threaded connection; the threaded connection has a stable and reliable connection and is not prone to loosening.

In related technologies, laser lithotripsy is usually used to break kidney stones. That is, the laser generated by an external laser generator is guided into the human body. After a channel is established through a ureteroscope and a nephroscope, the stone is approached with a scope, and then the stone is The laser is aimed at the stones to strike. Because the laser has this high-energy and high-efficiency feature, it can break larger stones into small pieces. The inventor found in the research that high-power laser technology is helpful for successful ureteroscopy surgery on large and complex stones, but it will significantly increase the temperature of the fluid in the renal collection system, and nearby tissues may also be thermally damaged; based on this In this case, in an optional implementation, the negative pressure suction ureteral sheath in the embodiment of the present application also includes a temperature-sensing probe 700. The temperature-sensing probe 700 is provided at the distal end of the sheath 100, and the renal pelvis can be monitored through the temperature-sensing probe 700. The internal temperature is convenient for medical staff to understand the temperature in the renal pelvis, especially at the gravel site, to avoid kidney damage caused by excessive temperature.

In a further technical solution, the guide sleeve 200 includes a connecting part 210 and a guide part 220. The guide channel passes through the connecting part 210 and the guide part 220. The connecting part 210 is connected to the base pipe section 110. The aforementioned internal threads can be provided on the connecting part 210. The aforementioned external threads can be provided on the base pipe section 110. In the insertion direction of the pipe sheath 100, the diameter of the guide portion 220 gradually decreases; for example, the guide portion 220 is tapered in the axial direction of the guide sleeve 200. The portion 220 can be in the shape of a trumpet with gradually decreasing diameter; with this arrangement, when inserting the endoscope insertion portion 600, the trumpet-shaped guide portion 220 can facilitate the insertion of the endoscope insertion portion 600 into the sheath 100, thereby improving the efficiency of the operation. Convenience.

During the research process, the inventor found that due to the supporting effect of the sheath 100 on the endoscope insertion part 600, it is difficult for the bending of the sheath 100 and the bending of the endoscope insertion part 600 to be completely consistent, so that the endoscope insertion part 600 and It is difficult to keep the gap between the inner walls of the sheath 100 consistent. In the extension direction of the sheath 100, the gap changes so that the endoscope insertion part 600 occupies a larger size in the radial direction of the sheath 100, which is not conducive to the removal of stone fragments and easily causing blockage. Based on this situation, in a further technical solution, a partition wall 130 is provided inside the sheath 100. The partition wall 130 separates the sheath 100 into an endoscope channel 140 and a suction channel 150. The endoscope The dimensions of the channel 140 match the dimensions of the endoscope insertion portion 600, The endoscope insertion part 600 inserted into the sheath 100 is located in the endoscope channel 140, and the suction nozzle 211 and the pressure measuring nozzle 212 are respectively connected with the suction channel 150; in this embodiment, The partition wall 130 can extend to both ends of the sheath 100 along the axial direction of the sheath 100. With this arrangement, the endoscope channel 140 can limit the space occupied by the endoscope insertion part 600 in the radial direction of the sheath 100. , so that the stone fragments can be sucked through the suction channel 150, and the endoscope insertion part 600 is prevented from blocking or interfering with the discharge of blood clots, purulent floc or stone fragments.

In this embodiment of the present application, the base pipe section 110 and the flexible pipe section 120 can be connected by integral molding or bonding.

The embodiment of the present application also provides a ureteral insertion device. The ureteral insertion device includes an inner sheath 400, a limiting sleeve 500 and the aforementioned negative pressure suction ureteral sheath. The limiting sleeve 500 is located at the proximal end of the guide sleeve 200, and the inner sheath 400 Insert into the tube sheath 100, and the inner sheath 400 and the limiting sleeve 500 are limitedly matched.

When in use, insert the inner sheath 400 into the inner channel of the sheath 100, then use the inner sheath 400 to insert the sheath 100 into the ureter, withdraw the inner sheath 400, connect the guide sleeve 200 to the proximal end of the sheath 100, and then The endoscope insertion part 600 is inserted into the sheath 100 . In this application, the limiting sleeve 500 is provided with a perforation for passing through the inner sheath 400. The inner sheath 400 has a radially protruding protruding portion 410. In the insertion direction of the inner sheath 400, the protruding portion 410 and the end surface where the perforation is located are limited. fit, thereby preventing over-insertion of the inner sheath 400.

It should be noted that, in this document, the terms "comprising", "comprises" or any other variations thereof are intended to cover a non-exclusive inclusion, such that a process, method, article or device that includes a series of elements not only includes those elements, It also includes other elements not expressly listed or inherent in the process, method, article or apparatus. Without further limitation, an element defined by the statement "comprises a..." does not exclude the presence of additional identical elements in a process, method, article or apparatus that includes that element. In addition, it should be pointed out that the scope of the methods and devices in the embodiments of the present application is not limited to performing functions in the order shown or discussed, but may also include performing functions in a substantially simultaneous manner or in reverse order according to the functions involved. Functions may be performed, for example, the methods described may be performed in an order different from that described, and various steps may be added, omitted, or combined. Additionally, features described with reference to certain examples may be combined in other examples.

The above are only specific implementations of the present utility model, but the protection scope of the present utility model is not limited thereto. Any person familiar with the technical field can easily think of changes or modifications within the technical scope disclosed by the present utility model. Replacements shall be covered by the protection scope of the present utility model.

Claims

A negative pressure suction ureteral sheath is characterized by including:

Pipe sheath (100), the pipe sheath (100) includes a base pipe section (110) and a flexible pipe section (120), the flexible pipe section (120) is connected to the distal end of the base pipe section (110), the The rigidity of the base pipe section (110) is greater than the rigidity of the flexible pipe section (120);

Guide sleeve (200), the guide sleeve (200) is connected to the proximal end of the base pipe section (110), the guide sleeve (200) is provided with a suction nozzle (211) connected with the base pipe section (110) and Pressure measuring nozzle (212).
The negative pressure suction ureteral sheath according to claim 1, wherein the guide sleeve (200) is provided with a guide channel that is connected with the sheath (100), and the guide channel is provided with an elastic seal ( 300), the elastic sealing member (300) is provided with a through hole penetrating the elastic sealing member (300).
The negative pressure suction ureteral sheath according to claim 2, characterized in that the guide sleeve (200) includes a connecting part (210) and a guide part (220), and the guide channel passes through the connecting part (210) and the guide part (220). The guide part (220), the connecting part (210) is connected to the base tube section (110), and the diameter of the guide part (220) gradually decreases in the insertion direction of the sheath (100). .
The negative pressure suction ureteral sheath according to claim 3, wherein the guide portion (220) is tapered in the axial direction of the guide sleeve (200).
The negative pressure suction ureteral sheath according to claim 1, characterized in that the sheath (100) and the guide sleeve (200) are detachably connected.
The negative pressure suction ureteral sheath according to claim 1, characterized in that a temperature-sensing probe (700) is provided at the distal end of the sheath (100).
The negative pressure suction ureteral sheath according to claim 1, characterized in that the length of the flexible tube section (120) is equal to the length of the active bending section of the endoscope insertion part (600) inserted into the tube sheath (100). length to match.
The negative pressure suction ureteral sheath according to claim 1, characterized in that a partition wall (130) is provided inside the sheath (100), and the partition wall (130) separates the sheath (100) into Endoscope channel (140) and suction channel (150), the endoscope insertion part (600) inserted into the sheath (100) is located in the endoscope channel (140), and the suction nozzle (211) and the pressure measuring nozzle (212) respectively Communicated with the suction channel (150).
The negative pressure suction ureteral sheath according to any one of claims 1 to 8, characterized in that the base tube section (110) and the flexible tube section (120) are integrally formed, or the base tube section (110) and The flexible pipe sections (120) are adhesively connected.
A ureteral insertion device, characterized in that it includes an inner sheath (400), a limiting sleeve (500) and the negative pressure suction ureteral sheath according to any one of claims 1 to 9, and the limiting sleeve (500) is located on The inner sheath (400) is inserted into the proximal end of the guide sheath (200) into the tube sheath (100), and the inner sheath (400) is limitedly matched with the limiting sleeve (500).