CN110477972B

CN110477972B - Hysteromyoma excision system under palace peritoneoscope

Info

Publication number: CN110477972B
Application number: CN201910881243.3A
Authority: CN
Inventors: 颜磊; 张芳芳
Original assignee: Shandong University
Current assignee: Suzhou Basecare Medical Device Co ltd
Priority date: 2019-09-18
Filing date: 2019-09-18
Publication date: 2020-06-23
Anticipated expiration: 2039-09-18
Also published as: CN110477972A

Abstract

The invention discloses a hysteroscope resection system under a hysteroscope, which comprises a laparoscope system, a hysteroscope system and an imaging system, wherein the laparoscope system is respectively connected with a light source illumination module, an optical imaging module and an ultrasonic imaging module in the imaging system; the invention adds the ultrasonic probe in the laparoscope and fuses the ultrasonic image with the magnetic resonance image before operation, thereby accurately imaging the invisible myoma between muscle walls; and the hysteromyoma is integrally resected, so that myoma tissue fragment residue is avoided, the hysteromyoma is completely resected, the hysteromyoma resecting instrument has the advantages of convenience in operation, small wound, less bleeding, quickness in recovery, high myoma stripping rate and the like, postoperative residue and recurrence rate can be effectively reduced, and the prognosis effect is good.

Description

Hysteromyoma excision system under palace peritoneoscope

Technical Field

The invention relates to the technical field of medical instruments, in particular to a hysteromyoma resection system under a hysteroscope.

Background

Hysteromyoma is a common gynecological tumor, generally presents clinical symptoms such as uterine bleeding, abdominal mass, pain, leukorrhagia and the like, and if the hysteromyoma is not treated in time, the tumor may be deteriorated and seriously harms the physical and psychological health of a patient. The traditional treatment method for the hysteromyoma is an open surgery, but the method has high risk and trauma, slow postoperative recovery and certain influence on the fertility of a patient, so that the hysteroscope and the laparoscope are gradually replaced by the hysteroscope and the laparoscope which have small damage, quick recovery and smaller influence on organs. At present, hysteroscopic surgery and laparoscopic surgery are two common surgical methods for hysteromyoma excision, can be used independently or jointly, and the hysteroscopic and laparoscopic combined with the hysteroscopic and laparoscopic can combine the characteristics of the two surgical methods, so that the hysteromyoma treatment device has better treatment advantages for multiple hysteromyoma with wider myoma dispersion range.

Since hysteromyoma is highly prevalent and can grow in any part of the uterus, it is mainly classified into intramural myoma, subserous myoma, and submucosal myoma, depending on the part of the myoma. In practical application, the laparoscope is mainly used for excising the subserous myoma on the outer surface of the uterus and the intertrochanteric myoma between the uterine muscle walls, and the subserous myoma on the inner surface of the uterus is more suitable for excising through the hysteroscope, so that the combined use of the laparoscope has a positive effect on comprehensively removing the uterine myoma, but the hysteroscope is still easy to miss due to the lack of touch sense and limitation of operative field in the operation, and has certain limitation.

The patent with publication number CN107569277A discloses a hysteromyoma enucleation system under a hysteroscope, which is characterized in that a vibration device is controlled to drive a camera to vibrate periodically to collect intrauterine images, so that the image range of the collection examination area is enlarged, and the operative field is enlarged; however, the method can only observe and excise visible hysteromyoma, but is difficult to discover the non-visible intramural myoma under the laparoscope, so that the myoma is incompletely excised, and partial myoma residues are caused.

Compared with the muscular wall myoma which is difficult to find under the laparoscope, the submucosal myoma under the hysteroscope is easier to observe, but has certain hidden trouble when being resected. The hysteromyoma is crushed and taken out mainly by the hysteromyoma rotary cutter at present, and the hidden tumor is easily spread due to the fact that the small tissues which are difficult to clear are crushed, and the recurrence rate of the hysteromyoma is high. Therefore, there is still a need for a hysteroscopic system that can fully visualize and completely resect a hysteromyoma.

Disclosure of Invention

The invention aims to solve the problems and provides a hysteromyoma resection system under a hysteroscope, wherein an ultrasonic probe is additionally arranged in the laparoscope, and an obtained ultrasonic image is fused with a preoperative magnetic resonance image, so that the invisible hysteromyoma is accurately imaged; and the hysteromyoma is cut in a rotary mode in the bag, and is integrally resected, so that myoma tissues are prevented from being crushed and remaining in uterus, the hysteromyoma is completely resected, postoperative residues and recurrence rate are effectively reduced, and the prognosis effect is good.

In order to achieve the purpose, the invention adopts the technical scheme that:

a hysteromyoma resection system under a hysteroscope comprises a hysteroscope system, a laparoscope system and an imaging system; the imaging system comprises a power supply control module, a light source illumination module, an optical imaging module, an ultrasonic imaging module and a fusion imaging module, wherein the power supply control module is respectively connected with the light source illumination module and the ultrasonic imaging module, the optical imaging module is connected with the light source illumination module, and the fusion imaging module is connected with the ultrasonic imaging module; the laparoscope system is respectively connected with the light source illumination module, the optical imaging module and the ultrasonic imaging module; the hysteroscope system is respectively connected with the light source lighting module and the optical imaging module, and comprises a resection instrument for performing overall resection on the hysteromyoma.

Furthermore, the hysteroscope system also comprises a hysteroscope main body, one end of the hysteroscope main body is provided with a hysteroscope end part communicated with the hysteroscope main body, and the hysteroscope main body is provided with a hysteroscope cold light source input end communicated with the hysteroscope main body, two hysteroscope instrument input ends, a hysteroscope water inlet end, a hysteroscope water outlet end and a hysteroscope optical lens interface; the cold light source input end of the hysteroscope is connected with the light source lighting module, and the optical lens interface of the hysteroscope is connected with the optical imaging module.

Furthermore, the end part of the hysteroscope is provided with a hysteroscope light-guiding optical fiber, a hysteroscope optical lens, a hysteroscope instrument outlet, a water inlet and a water outlet; the hysteroscope light guide fiber is connected with the input end of the cold light source of the hysteroscope, the hysteroscope optical lens is connected with the interface of the hysteroscope optical lens, the water inlet is connected with the water outlet end of the hysteroscope, and the water outlet is connected with the water inlet end of the hysteroscope.

Further, the resection instrument enters from the input end of the hysteroscope instrument and extends out from the outlet of the hysteroscope instrument; the cutting instrument comprises an electrocoagulation spiral drill, a stripping rod, a shovel-shaped cutter body and a fixed tube, wherein one end of the fixed tube is open, the other end of the fixed tube is provided with three holes, and the electrocoagulation spiral drill, the stripping rod and the shovel-shaped cutter body are fixed in the fixed tube through the three holes of the fixed tube respectively and can move along the length direction of the fixed tube.

Further, the electrocoagulation auger comprises a auger bit, a connecting rod, a control handle and a joint; the spiral drill bit is connected with one end of a connecting rod, the other end of the connecting rod is connected with one end of a control handle, and the other end of the control handle is connected with the joint; the outer layer of the connecting rod is provided with an insulating layer, the control handle is provided with an electrocoagulation control switch, and the joint is used for being connected with a power supply.

Furthermore, the stripping rod comprises a rod body and a detachable handle, one end of the rod body is connected with the detachable handle, and the other end of the rod body is bent; the shovel form cutter body includes tool bit, connector and can dismantle the handle of a knife, open the tool bit both sides has the cutting edge, the connector is platelike structure, the one end fixed connection of tool bit and connector to personally submit 150 jiaos with the connector body board, the other end of connector with can dismantle the handle of a knife and be connected.

Furthermore, the hysteroscope system also comprises an electric cutting ring and a specimen collecting device, wherein the electric cutting ring comprises an electrode, a conveying pipe, a lead, a sealing head and a control mechanism, two ends of the electrode are respectively connected with the lead, two ends of the electrode enter the conveying pipe from an opening at the front end of the conveying pipe, the lead penetrates through the conveying pipe and extends out from the tail end of the conveying pipe, the sealing head is arranged at the opening at the front end of the conveying pipe and is used for ensuring the sealing property inside the conveying pipe, and the control mechanism is arranged at the tail end of the conveying pipe; the specimen collecting device comprises a waterproof adhesive film, a hole, a specimen collecting bag, a filter screen and a drain pipe, wherein the hole is formed in the position, corresponding to the operation position, on the waterproof adhesive film, the specimen collecting bag is of a bag structure arranged at the lower end of the hole, the bottom of the specimen collecting bag is arranged on the filter screen, and the drain pipe is arranged at the bottom of the waterproof adhesive film.

Further, the laparoscopic system comprises a laparoscopic body, a laparoscopic sheath, and a rotary cutting pouch; the laparoscope main body is provided with a connecting shaft with external threads, the laparoscope sheath tube is provided with a connecting piece with internal threads, and the laparoscope sheath tube is in threaded connection with the connecting shaft of the laparoscope main body through the connecting piece; the rotary cutting bag comprises a sleeve and a rubber bag, the rubber bag is arranged at the bottom of the sleeve, a mouth tying belt is arranged at the bag mouth of the rubber bag, and a lens placing opening and two instrument operation openings are further arranged below the mouth tying bag on the rubber bag.

Furthermore, the laparoscope sheath comprises a sheath end, a sheath main body, a water inlet end and a water outlet end; the sheath pipe end is located the one end of sheath pipe main part, it is located to intake end and play water end the sheath pipe main part is last, and with the sheath pipe main part is linked together.

Furthermore, the laparoscope body comprises an endoscope end part and an endoscope body, wherein the endoscope end part is positioned at one end of the endoscope body, is communicated with the endoscope body and penetrates through the sheath tube end part; the endoscope main body is provided with a cold light source input end, an optical lens interface, an ultrasonic data interface and an instrument input end which are communicated with the endoscope main body; the cold light source input end is connected with the light source lighting module, the optical lens interface is connected with the optical imaging module, and the ultrasonic data interface is connected with the ultrasonic imaging module.

Furthermore, the endoscope end part is provided with a light guide optical fiber, an optical lens, an instrument outlet and an ultrasonic probe; the light guide optical fiber is connected with the input end of the cold light source, the optical lens is connected with the optical lens interface, and the ultrasonic probe is arranged by protruding the plane of the end part of the endoscope and is connected with the ultrasonic data interface.

Compared with the prior art, the invention has the beneficial effects that:

1. the hysteromyoma resection system under the hysteroscope provided by the invention has the advantages that the ultrasonic probe is additionally arranged, and the hysteromyoma is integrally stripped, so that the hysteromyoma of each part can be observed, identified and completely resected, further, the hysteromyoma or fragments thereof are prevented from remaining in the body, and the hysteromyoma is completely resected;

2. the invention fuses the ultrasonic image in the operation with the magnetic resonance image before the operation, and makes up the problems of low fraction and unclear boundary of the single ultrasonic image, thereby accurately imaging the invisible myoma between muscle walls in the operation, avoiding omission of the myoma, facilitating the selection of the incision position by a doctor and accurately and completely cutting the myoma; the myoma is subjected to rotary cutting in the bag, so that the pollution of abdominal cavity tissues and the scattering of the myoma tissues are avoided;

3. according to the invention, by arranging two input ends of the hysteroscope instrument, a hot knife instrument and a cold knife instrument can be used at the same time, so that cold and hot integration is realized; the electric coagulation twist drill is used for drawing and fixing the uterine fibroids, the pedicles of the exposed fibroids are cut and eradicated by using the shovel-shaped cutter body, and the pedicles-free fibroids are stripped layer by using the stripping rod, so that all uterine fibroids are stripped integrally, and fibroid fragment residue is avoided; the invention also can cut off tissues with larger size by using the electric cutting ring with variable size for less times, and collect the cut tissues by arranging the specimen collecting bag, thereby facilitating the subsequent pathological analysis;

4. the hysteromyoma resection system under the hysteroscope provided by the invention has the advantages of convenience and rapidness in operation, small wound, less bleeding, rapidness in recovery, high myoma stripping rate and the like when the hysteromyoma is resected, and can effectively reduce postoperative residues and recurrence rate, and has a good prognosis effect.

Drawings

FIG. 1 is a schematic structural diagram of a hysteromyoma resecting system under a hysteroscope;

FIG. 2 is a schematic view of the hysteroscope system of the present invention;

FIG. 3 is a schematic view of the configuration of the hysteroscope tip of the hysteroscope system of the present invention;

FIG. 4 is a schematic representation of the construction of the removal instrument of the hysteroscope system of the present invention;

FIG. 5 is a front view of an electrotomy ring in the hysteroscope system of the present invention;

FIG. 6 is a side view of an electrosurgical cutting ring in a hysteroscope system of the present invention;

FIG. 7 is a schematic view of the structure of a specimen collection device in the hysteroscope system of the present invention;

FIG. 8 is a schematic view of the construction of the laparoscopic system of the present invention;

FIG. 9 is a schematic view showing the construction of an endoscope tip in the laparoscopic system of the present invention;

FIG. 10 is a schematic view of a rotary cutting pocket in the laparoscopic system of the present invention;

the parts in the drawings are numbered as follows: 1. a hysteroscope body; 11. the end part of a hysteroscope; 111. a hysteroscope light guide fiber; 112. a hysteroscope optical lens; 113. an outlet of a hysteroscope instrument; 114. a water inlet; 115. a water outlet; 12. a cold light source input end of the hysteroscope; 13. a hysteroscope instrument input end; 14. a water inlet end of the hysteroscope; 15. a hysteroscope water outlet end; 16. a hysteroscope optical lens interface; 21. electrocoagulation auger; 211. a helical drill bit; 212. a connecting rod; 213. a control handle; 214. a joint; 22. a stripping bar; 221. a rod body; 222. a detachable handle; 23. a shovel-shaped cutter body; 231. a cutter head; 232. a linker; 233. the tool handle can be disassembled; 24. a fixed tube; 251. an electrode; 252. a delivery pipe; 253. a wire; 254. a sealing head; 255. a control mechanism; 261. a waterproof adhesive film; 262. a hole; 263. a specimen collection bag; 264. filtering with a screen; 265. a drain pipe; 31. a connecting shaft; 32. an endoscope end; 321. a light guide optical fiber; 322. an optical lens; 323. an instrument outlet; 324. an ultrasonic probe; 33. an endoscope main body; 34. a cold light source input end; 35. an optical lens interface; 36. an ultrasound data interface; 37. an instrument input; 41. a connecting member; 42. the end part of the sheath tube; 43. a sheath body; 44. a water inlet end; 45. a water outlet end; 51. a sleeve; 52. a rubber bag; 521. a bag bundling; 522. placing a lens opening; 523. an instrument operation port.

Detailed Description

The following detailed description of the preferred embodiments of the present invention, taken in conjunction with the accompanying drawings, will make the advantages and features of the invention easier to understand by those skilled in the art, and thus will clearly and clearly define the scope of the invention. It is to be understood that the described embodiments are merely a few embodiments of the invention, and not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments of the present invention without any inventive step, are within the scope of the present invention.

Examples

Referring to fig. 1, an embodiment of the present invention provides a hysteromyoma resecting system under a hysteroscope, including a laparoscope system, a hysteroscope system and an imaging system; the imaging system comprises a power supply control module, a light source illumination module, an optical imaging module, an ultrasonic imaging module and a fusion imaging module, wherein the power supply control module is respectively connected with the light source illumination module and the ultrasonic imaging module, the optical imaging module is connected with the light source illumination module, and the fusion imaging module is connected with the ultrasonic imaging module; the laparoscope system is respectively connected with the light source illumination module, the optical imaging module and the ultrasonic imaging module; the hysteroscope system is respectively connected with the light source lighting module and the optical imaging module, and comprises a resection instrument for performing overall resection on the hysteromyoma.

With reference to fig. 2, the hysteroscope system further comprises a hysteroscope main body 1, one end of the hysteroscope main body 1 is provided with a hysteroscope end 11 communicated with the hysteroscope main body 1, the hysteroscope main body 1 is provided with a hysteroscope cold light source input end 12 communicated with the hysteroscope main body 1, two hysteroscope instrument input ends 13, a hysteroscope water inlet end 14, a hysteroscope water outlet end 15 and a hysteroscope optical lens interface 16; the cold light source input end 12 of the hysteroscope is connected with the light source lighting module, and the optical lens interface 16 of the hysteroscope is connected with the optical imaging module.

Referring to fig. 3 in combination, the hysteroscope end 11 is provided with a hysteroscope light guide fiber 111, a hysteroscope optical lens 112, a hysteroscope instrument outlet 113, a water inlet 114 and a water outlet 115; the hysteroscope light guide fiber 111 is connected with the cold light source input end 12 of the hysteroscope, the hysteroscope optical lens 112 is connected with the hysteroscope optical lens interface 16, the water inlet 114 is connected with the water outlet end 15 of the hysteroscope, and the water outlet 115 is connected with the water inlet end 14 of the hysteroscope.

With reference to fig. 4, the removal instrument enters through the hysteroscope instrument input end 13 and extends out through the hysteroscope instrument output port 113; the excision instrument comprises an electrocoagulation auger 21, a stripping rod 22, a shovel-shaped cutter body 23 and a fixed tube 24, wherein one end of the fixed tube 24 is open, the other end of the fixed tube 24 is provided with three holes, and the electrocoagulation auger 21, the stripping rod 22 and the shovel-shaped cutter body 23 are fixed in the fixed tube 24 through the three holes of the fixed tube 24 respectively and can move along the length direction of the fixed tube 24.

Specifically, the electrocoagulation auger 21 includes a auger bit 211, a connecting rod 212, a control handle 213, and a fitting 214; the auger bit 211 is connected with one end of a connecting rod 212, the other end of the connecting rod 212 is connected with one end of a control handle 213, and the other end of the control handle 213 is connected with the joint 214; the outer layer of the connecting rod 212 is provided with an insulating layer, the control handle 213 is provided with an electrocoagulation control switch, and the joint 214 is used for connecting with a power supply.

The peeling rod 22 comprises a rod body 221 and a detachable handle 222, wherein one end of the rod body 221 is connected with the detachable handle 222, and the other end of the rod body is bent; the shovel form cutter body 23 includes tool bit 231, connector 232 and can dismantle handle of a knife 233, open tool bit 231 both sides has the cutting edge, connector 232 is platelike structure, tool bit 231 and connector 232's one end fixed connection to be 150 jiaos with connector 232 face, connector 232's the other end and can dismantle handle of a knife 233 and be connected.

With reference to fig. 5-7, the hysteroscope system further comprises an electric cutting ring and a specimen collecting device, the electric cutting ring comprises an electrode 251, a delivery tube 252, a conducting wire 253, a sealing head 254 and a control mechanism 255, two ends of the electrode 251 are respectively connected with the conducting wire 253, two ends of the electrode 251 enter the delivery tube 252 from an opening at the front end of the delivery tube 252, the conducting wire 253 penetrates through the delivery tube 252 and extends out from the tail end of the delivery tube 252, the sealing head 254 is mounted at the opening at the front end of the delivery tube 252 for ensuring the sealing performance inside the delivery tube 252, and the control mechanism 255 is arranged at the tail end of the delivery tube 252; the specimen collection device comprises a waterproof adhesive film 261, a hole 262, a specimen collection bag 263, a filter screen 264 and a drain pipe 265, the hole 262 is arranged on the waterproof adhesive film 261 and corresponds to a surgical site, the specimen collection bag 263 is a bag structure arranged at the lower end of the hole 262, the filter screen 264 is arranged at the bottom of the specimen collection bag 263, and the drain pipe 265 is arranged at the bottom of the waterproof adhesive film 261.

With reference to fig. 8-10, the laparoscopic system includes a laparoscopic body, a laparoscopic sheath, and a rotary cutting pocket; the laparoscope main body is provided with a connecting shaft 31 with external threads, the laparoscope sheath tube is provided with a connecting piece 41 with internal threads, and the laparoscope sheath tube is in threaded connection with the connecting shaft 31 of the laparoscope main body through the connecting piece 41; the rotary cutting bag comprises a sleeve 51 and a rubber bag 52, the rubber bag 52 is arranged at the bottom of the sleeve 51, a mouth-tying belt 521 is arranged at the mouth of the rubber bag 52, and a lens placing opening 522 and two instrument operation openings 523 are further arranged below the mouth-tying bag 521 on the rubber bag 52.

Specifically, the laparoscopic sheath comprises a sheath end 42, a sheath body 43, a water inlet end 44 and a water outlet end 45; the sheath end 42 is located at one end of the sheath main body 43, and the water inlet end 44 and the water outlet end 45 are located on the sheath main body 43 and are communicated with the sheath main body 43.

The laparoscope body comprises an endoscope end part 32 and an endoscope body 33, wherein the endoscope end part 32 is positioned at one end of the endoscope body 33, is communicated with the endoscope body 33 and penetrates through the sheath tube end part 42; the endoscope main body 33 is provided with a cold light source input end 34, an optical lens interface 35, an ultrasonic data interface 36 and an instrument input end 37 which are communicated with the endoscope main body 33; the cold light source input end 34 is connected with the light source lighting module, the optical lens interface 35 is connected with the optical imaging module, and the ultrasonic data interface 36 is connected with the ultrasonic imaging module.

The endoscope end part 32 is provided with a light guide optical fiber 321, an optical lens 322, an instrument outlet 323 and an ultrasonic probe 324; the light guide optical fiber 321 is connected with the cold light source input end 34, the optical lens 322 is connected with the optical lens interface 35, and the ultrasonic probe 324 is arranged to protrude out of the plane of the endoscope end 32 and is connected with the ultrasonic data interface 36.

When the hysteromyoma resection system under the hysteroscope is used, the cervix of a patient is dilated by using the dilator, the hysteroscope main body is placed in, the cold light source input end 12 of the hysteroscope main body is connected with the light source lighting module and used for lighting the uterine cavity and observing the situation in the uterine cavity of the patient through the hysteroscope optical lens 112 arranged on the end part 11 of the hysteroscope, and image data collected by the hysteroscope optical lens 112 is transmitted to the optical imaging module through the hysteroscope optical lens interface 16 and is imaged on a display in real time; the removal instrument is then inserted through the hysteroscope instrument input end 13 and extends out of the hysteroscope instrument outlet 113 for removing the observed visible hysteromyoma.

When the hysteromyoma is resected, the connector 214 of the electrocoagulation screw drill 21 in the resection instrument is connected with a power supply, the screw drill bit 211 of the electrocoagulation screw drill 21 is penetrated into the myoma tissue, and the screw drill bit 211 locally generates heat energy by controlling an electrocoagulation control switch, so that the myoma tissue and blood vessels at the embedded part of the screw drill bit 211 are heated, coagulated and necrotized, the hemostatic effect is achieved, and the scattering and transfer of myoma cells are avoided; meanwhile, the screw drill 211 is used for pulling and fixing myoma tissues, the shovel-shaped cutter body 23 is controlled by holding the detachable handle 222, and the cutting edge at the cutter head 231 of the shovel-shaped cutter body 23 is used for cutting the pedicle, so that the myoma is stripped from the pedicle; for non-pedicle myomas, the detachable cutter handle 233 is held by hand to control the stripping rod 22, and the myomas are stripped layer by utilizing the bent end of the stripping rod 22 on the rod body 221; the stripped myoma is then removed in its entirety by electrocoagulation auger 21.

For myomas with larger sizes, an electric cutting ring is used for cutting, and the guide wire 253 is stretched through the adjusting control mechanism 255, so that the length of the electrode 251 extending out of the conveying pipe 252 is controlled, and the size of the electrode 251 is adjusted; adjust electrode 251 size earlier through control mechanism 255 to can pass through hysteroscope apparatus input 13, with the electricity cut ring put into patient internal back, rethread control mechanism 255 adjusts electrode 251's size to can wrap up completely and treat and remove the myoma, with electrode 251 hug closely the root of treating to remove the myoma after, tighten up electrode 251 through control mechanism 255 to start electrode 251 and excise the myoma, later close electrode 251, take out the myoma that downcuts. The myoma visible in the uterine cavity is cut off one by one according to the same mode, the cut tissue is taken out by the hysteroscope and is collected by a specimen collecting device adhered to the operation part, when the hysteroscope is taken out from the hole 262, the myoma tissue, uterine swelling liquid, blood and other liquid are taken out, flow into a specimen collecting bag 263 and are filtered by a filter screen 264, the myoma tissue is left in the filter screen 264 for collection, and other liquid flows out through a drain pipe 265; after the process is finished, normal saline is input through the water inlet end 14 of the hysteroscope to clean the uterine cavity, and the cleaned liquid is discharged from the water outlet end 15 of the hysteroscope.

Performing conventional abdominal puncture on a patient, placing a laparoscopic system through a puncture port, connecting a cold light source input end 34 in the laparoscopic system with a light source illumination module, illuminating the abdominal cavity, observing the condition in the abdominal cavity of the patient through an optical lens 322 arranged on an endoscope end 32, transmitting image data acquired by the optical lens 322 to an optical imaging module through an optical lens interface 35, performing real-time imaging on a display, placing a surgical instrument through an instrument input end 37, and performing conventional excision on visible hysteromyoma; meanwhile, because there are also invisible myomas between muscle walls, the myomas need to be detected by the ultrasonic probe 324 arranged on the endoscope end 32, the ultrasonic data acquired by the ultrasonic probe 324 is transmitted to the ultrasonic imaging module through the ultrasonic data interface 36 and is led into the fusion imaging module to be fused and imaged with the preoperative magnetic resonance image data of the patient.

The fusion imaging module is used for fusing and imaging the ultrasonic image data and the magnetic resonance image data, and the fusion imaging method comprises the following steps:

(1) image data acquisition: the ultrasonic image data is acquired by the ultrasonic probe 324, and is transmitted to the ultrasonic imaging module through the ultrasonic data interface 36, and then is imported to the fusion imaging module by the ultrasonic imaging module; the magnetic resonance image data is collected before operation and is imported to the fusion imaging module before operation;

(2) image segmentation: carrying out multi-scale filtering processing on the ultrasonic image to strengthen the edge information of the image; setting gray threshold values corresponding to the myoma in the ultrasonic image and the magnetic resonance image respectively according to the gray difference of the images, carrying out image segmentation on the ultrasonic image and the magnetic resonance image, and distinguishing the myoma from normal tissues;

(3) image registration and fusion: and (3) extracting the myoma characteristics of the magnetic resonance image segmentation graph and the ultrasonic image segmentation graph respectively by using an edge detection algorithm, correspondingly registering the myoma characteristics, and fusing the ultrasonic image segmentation graph by using the magnetic resonance image segmentation graph to obtain a clear fusion image with higher resolution.

Through fusing the formation of image, can obtain the image of myoma between the invisible flesh wall to find the incision position, cut the flesh wall, make the invisible myoma that is located between the flesh wall expose, and cut it. When the size of the cut myoma is too large and the myoma cannot be taken out from the incision directly, the myoma is subjected to rotary cutting in the bag, the sleeve 51 is stretched into the incision, the rubber bag 52 is inflated through the sleeve, the cut myoma is placed from the bag opening and is tightly bound with the bag opening, then the rotary cutter and other instruments are respectively placed into the rubber bag through the two instrument operation openings 523, the port of the laparoscope is stretched into the rubber bag through the endoscope opening 522, the rotary cutter is used for rotary cutting in the bag under the observation of the laparoscope, after the myoma is cut into fragments, the rubber bag is pumped out, and then the myoma tissue is taken out integrally, so that the pollution of the abdominal cavity tissue and the scattering of the myoma tissue are avoided. The abdominal cavity is comprehensively explored through a mobile laparoscope system, all myomas are completely removed according to the same method, then physiological saline is input through the water inlet end 44 to clean the abdominal cavity, and the cleaned liquid is discharged through the water outlet end 45.

Through the mode, the hysteromyoma resection system under the hysteroscope can realize the comprehensive resection of various hysteromyomas, has the advantages of convenience and rapidness in operation, small wound, less bleeding, quickness in recovery, high myoma resection rate and the like, can effectively reduce postoperative residues and recurrence rate, and has a good prognosis effect.

The above description is only for the purpose of illustrating the technical solutions of the present invention and is not intended to limit the same; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; all the equivalent structures or equivalent processes performed by using the contents of the specification and the drawings of the invention, or directly or indirectly applied to other related technical fields, are included in the scope of the present invention.

Claims

1. The utility model provides a hysteromyoma excision system under palace peritoneoscope which characterized in that: comprises a laparoscope system, a hysteroscope system and an imaging system; the imaging system comprises a power supply control module, a light source illumination module, an optical imaging module, an ultrasonic imaging module and a fusion imaging module, wherein the power supply control module is respectively connected with the light source illumination module and the ultrasonic imaging module, the optical imaging module is connected with the light source illumination module, and the fusion imaging module is connected with the ultrasonic imaging module; the laparoscope system is respectively connected with the light source illumination module, the optical imaging module and the ultrasonic imaging module; the hysteroscope system is respectively connected with the light source lighting module and the optical imaging module, and comprises a resection instrument for performing overall resection on the hysteromyoma; the hysteroscope system also comprises a hysteroscope main body (1), one end of the hysteroscope main body (1) is provided with a hysteroscope end part (11) communicated with the hysteroscope main body (1), the hysteroscope main body (1) is provided with a hysteroscope cold light source input end (12) communicated with the hysteroscope main body (1), two hysteroscope instrument input ends (13), a hysteroscope water inlet end (14), a hysteroscope water outlet end (15) and a hysteroscope optical lens interface (16); the cold light source input end (12) of the hysteroscope is connected with the light source lighting module, and the optical lens interface (16) of the hysteroscope is connected with the optical imaging module; the end part (11) of the hysteroscope is provided with a hysteroscope light guide fiber (111), a hysteroscope optical lens (112), a hysteroscope instrument outlet (113), a water inlet (114) and a water outlet (115); the hysteroscope light guide fiber (111) is connected with the cold light source input end (12) of the hysteroscope, the hysteroscope optical lens (112) is connected with the hysteroscope optical lens interface (16), the water inlet (114) is connected with the water outlet end (15) of the hysteroscope, and the water outlet (115) is connected with the water inlet end (14) of the hysteroscope; the resection instrument enters from the input end (13) of the hysteroscope instrument and extends out from the outlet (113) of the hysteroscope instrument; the cutting instrument comprises an electrocoagulation auger (21), a stripping rod (22), a shovel-shaped cutter body (23) and a fixed tube (24), wherein one end of the fixed tube (24) is open, the other end of the fixed tube is provided with three holes, and the electrocoagulation auger (21), the stripping rod (22) and the shovel-shaped cutter body (23) are fixed in the fixed tube (24) through the three holes of the fixed tube (24) respectively and can move along the length direction of the fixed tube (24); the electrocoagulation auger (21) comprises an auger bit (211), a connecting rod (212), a control handle (213) and a connector (214); the auger bit (211) is connected with one end of a connecting rod (212), the other end of the connecting rod (212) is connected with one end of a control handle (213), and the other end of the control handle (213) is connected with the joint (214); the outer layer of the connecting rod (212) is provided with an insulating layer, the control handle (213) is provided with an electrocoagulation control switch, and the joint (214) is used for being connected with a power supply; the peeling rod (22) comprises a rod body (221) and a detachable handle (222), one end of the rod body (221) is connected with the detachable handle (222), and the other end of the rod body is bent; the shovel-shaped cutter body (23) comprises a cutter head (231), a connecting body (232) and a detachable cutter handle (233), cutting edges are arranged on two sides of the cutter head (231), the connecting body (232) is of a plate-shaped structure, the cutter head (231) is fixedly connected with one end of the connecting body (232) and forms an angle of 150 degrees with the surface of the connecting body (232), and the other end of the connecting body (232) is connected with the detachable cutter handle (233); the hysteroscope system further comprises an electric cutting ring and a specimen collecting device, wherein the electric cutting ring comprises an electrode (251), a conveying pipe (252), a lead (253), a sealing head (254) and a control mechanism (255), two ends of the electrode (251) are respectively connected with the lead (253), two ends of the electrode (251) enter the conveying pipe (252) from an opening at the front end of the conveying pipe (252), the lead (253) penetrates through the conveying pipe (252) and extends out of the tail end of the conveying pipe (252), the sealing head (254) is installed at the opening at the front end of the conveying pipe (252) and is used for ensuring the sealing property inside the conveying pipe (252), and the control mechanism (255) is arranged at the tail end of the conveying pipe (252); the specimen collecting device comprises a waterproof adhesive film (261), a hole (262), a specimen collecting bag (263), a filter screen (264) and a drain pipe (265), wherein the hole (262) is formed in the waterproof adhesive film (261) and corresponds to a surgical site, the specimen collecting bag (263) is of a bag-shaped structure arranged at the lower end of the hole (262), the filter screen (264) is arranged at the bottom of the specimen collecting bag (263), and the drain pipe (265) is arranged at the bottom of the waterproof adhesive film (261); the laparoscope system comprises a laparoscope main body, a laparoscope sheath tube and a rotary cutting bag, wherein the laparoscope main body is provided with a connecting shaft (31) with external threads, the laparoscope sheath tube is provided with a connecting piece (41) with internal threads, and the laparoscope sheath tube is in threaded connection with the connecting shaft (31) of the laparoscope main body through the connecting piece (41); the rotary cutting bag comprises a sleeve (51) and a rubber bag (52), the rubber bag (52) is arranged at the bottom of the sleeve (51), a mouth-tying belt (521) is arranged at the mouth of the rubber bag (52), and a lens placing opening (522) and two instrument operation openings (523) are further arranged below the mouth-tying belt (521) on the rubber bag (52).

2. The hysteroscopic myomectomy system of claim 1, wherein: the laparoscope sheath comprises a sheath end (42), a sheath main body (43), a water inlet end (44) and a water outlet end (45); sheath tip (42) are located the one end of sheath main part (43), it is located to advance water end (44) and play water end (45) sheath main part (43) is last, and with sheath main part (43) are linked together.

3. The hysteroscopic myomectomy system of claim 2, wherein: the laparoscope body comprises an endoscope end part (32) and an endoscope body (33), wherein the endoscope end part (32) is positioned at one end of the endoscope body (33), is communicated with the endoscope body (33), and penetrates through the sheath tube end part (42); the endoscope main body (33) is provided with a cold light source input end (34), an optical lens interface (35), an ultrasonic data interface (36) and an instrument input end (37) which are communicated with the endoscope main body (33); the cold light source input end (34) is connected with the light source lighting module, the optical lens interface (35) is connected with the optical imaging module, and the ultrasonic data interface (36) is connected with the ultrasonic imaging module.

4. The hysteroscopic myomectomy system of claim 3, wherein: the endoscope end part (32) is provided with a light guide optical fiber (321), an optical lens (322), an instrument outlet (323) and an ultrasonic probe (324); the light guide optical fiber (321) is connected with the cold light source input end (34), the optical lens (322) is connected with the optical lens interface (35), and the ultrasonic probe (324) protrudes out of the plane of the endoscope end part (32) and is connected with the ultrasonic data interface (36).