CN111345891B - Novel hook-shaped structure transurethral bladder tumor electric cutting electrode - Google Patents
Novel hook-shaped structure transurethral bladder tumor electric cutting electrode Download PDFInfo
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- CN111345891B CN111345891B CN202010174901.8A CN202010174901A CN111345891B CN 111345891 B CN111345891 B CN 111345891B CN 202010174901 A CN202010174901 A CN 202010174901A CN 111345891 B CN111345891 B CN 111345891B
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
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- A61B2018/00601—Cutting
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- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
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Abstract
The invention provides a novel hook-shaped structure transurethral bladder tumor electrosection electrode which comprises a urethral catheter with a smooth surface and no sharp-pointed bulge-shaped structure, wherein a speculum tube and an electrode catheter are arranged inside the urethral catheter; hollow bearings are symmetrically fixed at two ends of the interior of the electrode catheter, cable catheters penetrate through the two groups of bearings, and one end of each cable catheter, which is placed into the bladder, is connected with an electrotomy electrode with a hook-shaped structure; the angle direction of the electrotomy electrode is convenient to rotate and adjust, the urethral catheter is stably attached to the urethra in the adjusting process, and the injury of the catheter to the urethral wall is reduced; the electric cutting electrode is of a hook-shaped structure, the contact surface with the tumor is reduced, burn damage to the bladder inner wall is reduced during electric cutting, the hook end of the hook-shaped structure can be lifted and pulled to tear the tumor, the tumor is separated from the bladder inner wall, and the electric cutting electrode is convenient to use.
Description
Technical Field
The invention belongs to the technical field of tumor treatment equipment, and particularly relates to a novel hook-shaped structure transurethral bladder tumor electrosection electrode.
Background
Clinically, bladder tumors are common diseases of the urinary system, the incidence rate of the bladder tumors is prostate, and the main treatment method is operation treatment or operation combined postoperative bladder perfusion chemotherapy. The bladder tumor has high recurrence rate, so that the bladder tumor is usually treated by secondary operation or multiple operations, but the open operation has large trauma, slow postoperative recovery and poor repeatability, and is gradually eliminated. Transurethral resection of bladder tumor (TURBT) has small wound, quick postoperative recovery, strong repeatability, few operative mortality and can keep the function of bladder urination, and gradually replaces open surgery, thus becoming a main treatment method for superficial non-invasive tumors of the bladder. The bladder tumor electrosection device used in clinical practice at present is basically a plasma electrosection device, and includes a ring-shaped electrode, a shovel-shaped electrode, a needle-shaped electrode, a button-shaped electrode and the like. The annular electrode has been popular for many years and has the characteristics of convenient operation and high excision efficiency.
1. When the existing urethra-bladder tumor electrotomy electrode is used for tumor excision surgery, the angle direction of the electrotomy electrode needs to be changed, the angle direction change of the electrotomy electrode is realized by rotating a urethral catheter in a conventional operation, in the actual operation, the operation easily causes the friction damage of the urethra by the urethral catheter, the inner wall of the urethra is not easy to recover after being damaged, and complications such as inflammation and the like easily occur;
2. the prior urethra-bladder tumor electrotomy electrode is mostly an electrode with an annular structure, has a larger contact surface with tumor, is convenient to operate, but increases the damage surfaces to the inner wall of the bladder, leads to a larger tumor electrotomy surface burnt part, easily damages the artery at the papillary tumor basal layer of the bladder to cause massive hemorrhage, and is not favorable for the observation of the excision surface in the operation and the postoperative recovery;
3. the prior urethra-bladder tumor electrotomy electrode is mostly an electrode with an annular structure, has a larger contact surface with the tumor, is easy to damage the artery at the basal layer of the papillary tumor of the bladder to cause a large amount of bleeding when the papillary tumor is cut off, and the arterial bleeding from a muscle layer is not easy to be electrically coagulated, so the hemostasis is not beneficial to the observation of the operation visual field after the formation of the blood stasis, thereby prolonging the operation time and increasing the possibility of blood clot accumulation and shock complications caused by the blood clot accumulation;
4. the existing electrotomy electrode with a single structure cannot meet the requirement of a urethral bladder tumor resection operation, the whole device is often required to be pulled out of the urethra due to the structure of the replaced electrotomy electrode, the replaced electrotomy electrode is inserted into the urethra again, and the urethra is greatly damaged.
Disclosure of Invention
To solve the problems set forth in the background art described above. The invention provides a novel hook-shaped structure transurethral bladder tumor electrosection electrode which has the characteristics that the direction of the electrosection electrode is convenient to change, the electrosection electrode can be quickly replaced by a built-in retention device, and the damage to the urethra and the bladder inner wall is small in the using process.
In order to achieve the purpose, the invention provides the following technical scheme: the utility model provides a novel collude column structure through urethra bladder tumour electrotomy electrode, does not have the urethra pipe of sharp-pointed protruding column structure including the smooth nothing in outward appearance, the inside of urethra pipe is provided with peeps pipe and electrode catheter, peeps the pipe and bonds in inner wall one side of urethra pipe, electrode catheter sets up the inner wall opposite side of urethra pipe, peep the pipe with electrode catheter is the axisymmetric installation inside the urethra pipe:
an endoscope is fixed at one end of the endoscope tube, which is placed in the bladder, the outer surface of the endoscope is fixed with a lens with an arc-shaped structure, the lens is a transparent waterproof component, a miniature camera is fixed inside the endoscope, the miniature camera inside the endoscope tube is connected with a transmission cable, and one end of the transmission cable, which penetrates through the endoscope tube, is connected with external imaging equipment;
the urethra catheter is characterized in that an indwelling device sleeved on the outer wall of the electrode catheter is further arranged inside the urethra catheter, the indwelling device comprises two arc-shaped supporting bars, the two arc-shaped supporting bars and the electrode catheter are concentric and symmetrically arranged on two sides of the outer wall of the electrode catheter, one side end face of each arc-shaped supporting bar is in contact bonding with the speculum tube, the other side end face of each arc-shaped supporting bar is in contact bonding with the inner wall of the urethra catheter, a supporting piece is poured in an interlayer between each supporting bar and the urethra catheter, a slideway matched with the outer diameter of the electrode catheter is formed in the inner wall of each supporting bar, and the electrode catheter is in sliding connection with the corresponding supporting bar through the slideway;
the electrode catheter is characterized in that hollow bearings are symmetrically fixed at two ends of the interior of the electrode catheter, cable catheters penetrate through the two groups of bearings, one end of each cable catheter, which is placed into a bladder, is connected with an electrotomy electrode with a hook-shaped structure, a raised electrode clamping column is fixed at the tail of each electrotomy electrode, an electrode clamping groove matched with the electrode clamping column is formed in the cable catheter, and the electrotomy electrodes and the cable catheters are fixedly connected with each other through the electrode clamping grooves and the electrode clamping columns in an inserted mode.
Preferably, the internal gap of the urethral catheter is respectively provided with a high-pressure water channel and an administration channel, and the two channels are attached to two sides of the contact end surfaces of the speculum tube and the electrode catheter. The high-pressure water channel and the opening of the drug delivery channel directly act on the tumor resection position, so that the tumor resection position can be cleaned and loaded conveniently.
Preferably, the urethral catheter has a length of 20-25 CM. The urethral catheter length is designed according to the adult urethral length.
Preferably, the cable guide pipe is rotatably connected with a hollow through hole inside the bearing, and the rotation angle is 360 degrees. The hollow through hole of the cable catheter in the bearing rotates to assist the cable catheter to penetrate into the electrotomy electrode connected with the bladder end to rotate in an angle.
Preferably, one end of the electrotomy electrode, which penetrates into the bladder, is attached to the end face of the tumor, and the length of the electrotomy electrode is 7-10 mm. The electrotomy electrode is attached to the tumor section to perform electrotomy operation, the specification of the electrotomy electrode is suitable for the electrotomy operation, the phenomenon that the visual field of the endoscope is affected by the large-specification electrotomy electrode is prevented, and the operation is convenient.
Preferably, the angle of the hook section of the electrotomy electrode is 45-135 degrees, and the hook with a larger angle is beneficial to flexibly operating the whole bladder tumor enucleation, and a single-pole needle electrode can be simulated if the hook with a small angle is used.
Preferably, the electric cutting electrode is made of steel and needs to be hard and firm enough.
Preferably, the outer wall of the joint of the electrotomy electrode and the cable guide pipe is provided with an insulating sealing layer, and the outer wall of the sealing layer is smooth and has no protrusion. The insulating sealing layer is arranged to prevent the cable from leaking electricity and burning the urethra or bladder of a patient, and the use safety of the electrotomy electrode is improved.
Preferably, an operating handle for holding operation is fixed to the other end of the cable guide.
Preferably, the operating handle is a metal member fitted with a ring-shaped grip. The operating handle is used for holding, thereby driving the cable guide pipe to move in multiple directions such as up-down, left-right and the like, and driving the electrotomy electrode to excise the tumor.
Preferably, the material of the outer wall of the urethral catheter is an insulating sterile rubber component. The aseptic rubber component is made of material, which can prevent the urethra from being infected by external bacteria and urinary tract infection.
Compared with the prior art, the invention has the beneficial effects that:
1. the angle direction of the electric cutting electrode is convenient to rotate and adjust, the urethral catheter is stably attached to the urethra in the adjusting process, the injury of the catheter to the urethral wall is reduced, and the use safety is high.
2. The electric cutting electrode has a hook-shaped structure, the contact surface with the tumor is reduced, the burn damage to the inner wall of the bladder is reduced during electric cutting, and the hook end of the hook-shaped structure can be lifted and tear the tumor to separate the tumor from the inner wall of the bladder, so that the electric cutting electrode is convenient to use.
3. The electric cutting electrode is of a hook-shaped structure, so that an operator can cut from one side of a tumor to the other side of the tumor conveniently, cut off the broad-base papillary bladder tumor with a smaller area, reduce the possibility of bleeding caused by injuring the artery at the basal layer of the papillary bladder tumor, reduce the amount of arterial bleeding as much as possible to keep a full operation visual field and reduce the possibility of blood clot accumulation and shock complications caused by the blood clot accumulation;
4. the design of the indwelling device can facilitate the extraction of the electrode catheter, so that the electrode catheter can be quickly replaced by the electrotomy electrode installed on the electrode catheter, the electrode catheter is inserted into the supporting bar again to be placed into the bladder of a patient after the electrotomy electrodes with different shapes are replaced, the electrode catheter is not in contact with the urethra in the operation process, no damage is caused to the inner wall of the urethra, and the secondary intubation is convenient.
5. The high-pressure water channel and the drug delivery channel are additionally arranged, high-pressure cleaning water can be transmitted into the bladder through the high-pressure water channel, the transmitted high-pressure cleaning water can be used for spraying a burned surface to clean, and can be used for cleaning blood stains on the surface of the endoscope, so that the definition of shooting in the bladder is kept; the drug delivery channel can deliver drugs for hemostasis and nursing into the bladder through the drug delivery channel, so that the recovery of the operation surface is facilitated.
6. The invention has smooth and non-convex whole edge, adopts insulating material, has small damage to the inner wall of urethra and bladder, and has high use safety.
Drawings
The accompanying drawings, which are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the principles of the invention and not to limit the invention. In the drawings:
FIG. 1 is a schematic structural view of the present invention;
FIG. 2 is a schematic side view of the present invention;
FIG. 3 is a schematic view of the electrotomy electrode and cable catheter connection of the present invention;
FIG. 4 is a schematic diagram of the operation of the present invention;
in the figure: 1. a urethral catheter; 2. a speculum tube; 21. an endoscope; 22. a transmission cable; 3. an electrode catheter; 31. a bearing; 32. a cable guide; 33. electrically cutting the electrode; 34. an operating handle; 35. an electrode card slot; 36. an electrode clamping column; 4. an indwelling device; 41. a supporting strip; 42. a support member; 43. a slideway.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Example 1
Referring to fig. 1-4, the present invention provides a technical solution: the utility model provides a novel collude column structure through urethra bladder tumour electrotomy electrode, including the smooth no sharp-pointed protruding column structure of outward appearance (prevent urethra pipe edge's protruding structure fish tail urethra) urethra pipe 1, including the smooth no sharp-pointed protruding column structure's of outward appearance urethra pipe 1, the inside of urethra pipe 1 is provided with peeps mirror tube 2 and electrode catheter 3, peeps mirror tube 2 and bonds in urethra pipe 1's inner wall one side, and electrode catheter 3 sets up the inner wall opposite side at urethra pipe 1, peeps mirror tube 2 and electrode catheter 3 and is the axisymmetric installation in urethra pipe 1 inside:
an endoscope 21 is fixed at one end of the endoscope tube 2 placed in the bladder, a lens with an arc-shaped structure is fixed on the outer surface of the endoscope 21, the lens is a transparent waterproof component, a micro camera is fixed inside the endoscope 21, the micro camera inside the endoscope tube 2 is connected with a transmission cable 22, and one end of the transmission cable 22 penetrating through the endoscope tube 2 is connected with an external imaging device.
An endoscope 21 is fixed at one end of the endoscope tube 2 which is placed in the bladder, and a transmission cable 22 for transmitting shooting information penetrates through the endoscope tube 2; the other end of the transmission cable 22 is connected to a display device, video information shot by the endoscope 21 is displayed on the display device and is used for a doctor to observe the operation surface in the bladder, and the endoscope 21 and the electric cutting electrode 33 are arranged in parallel, so that the operation surface of the electric cutting electrode 33 can be observed conveniently.
In this embodiment, indwelling device 4 sets up inside urethral catheter 1, through support bar 41 structure, can realize the plug of electrode catheter 3 in support bar 41, and plug process electrode catheter 3 slides through slide 43 and supports, indwelling device 4's design can make things convenient for taking out of electrode catheter 3, thereby the change of the electrotomy electrode 33 of installation on the electrode catheter 3 fast, insert electrode catheter 3 into support bar 41 built-in patient's bladder again after changing different shapes electrotomy electrode 33, electrode catheter 3 does not have the contact with the urethra in the operation process, to the urethra inner wall not damaged, and the secondary intubate is convenient.
It should be noted that: the electrotomy electrode 33 of single structure can't satisfy the operation demand, when the electrotomy electrode 33 is changed, takes the electrode card post 36 out of the electrode card slot 35, and the needle type electrotomy electrode or the electrotomy electrode of other structures to be replaced are inserted into the electrode card slot 35 again through the electrode card post 36, so that the change of the electrotomy electrode of different structures is realized, and the operation is convenient.
Preferably, the cable guide 32 is rotatably connected with the bearing 31, and the rotation angle is 360 degrees; the bearings 31 are provided in two sets, which are respectively arranged at the left and right ends in the electrode guide tube 3, and stably support the cable guide tube 32, and the cable guide tube 32 can stably rotate in the bearings 31.
In an alternative embodiment, an operating handle 34 for holding operation is fixed at the other end of the cable conduit 32, and the operating handle 34 is a metal component provided with a ring-shaped grip; the annular grip is convenient to hold, and a doctor controls the cable catheter 32 to move up, down, left and right in multiple directions in the urethral catheter 1 by holding the operating handle 34 to assist the electrotomy operation of the electrotomy electrode 33 on the tumor in the bladder.
In this embodiment, when carrying out the electrotomy operation of electrotomy electrode 33 to tumour in patient's bladder, when needing to improve the angle direction of electrotomy electrode 33, grip operating handle 34, it is rotatory to drive cable pipe 32 on bearing 31, and then drive the change of electrotomy electrode 33 angle that the cable pipe 32 other end is connected, in operation process, only take place the rotation of cable pipe 32, urethra pipe 1 is stably attached in the urethra, prevent that urethra pipe 1 from taking place rotatory and causing the damage to the urethra, promote the security of operation.
The length of the urethral catheter 1 in the embodiment is 20-25CM, and the material of the outer wall of the urethral catheter 1 is an insulating sterile rubber component; the length from the urethra to the inner wall of the bladder of a person is at least 18CM, the urethra catheter 1 is used for being inserted into the urethra and the bladder to be implanted before an operation, the insulating sterile rubber component can prevent the urethra catheter 1 from being in electric shock with the contact surface of a patient, and the sterile material has the capability of preventing bacteria from breeding and is safe to use.
One end of the electrotomy electrode 33 penetrating into the bladder is attached to the tumor end face, the length of the electrotomy electrode 33 is 7-10 mm, the length of the electrotomy electrode 33 adopted in the embodiment is preferably 7 mm, the hook section angle of the electrotomy electrode 33 is 45-135 degrees, and the hook section angle of the electrotomy electrode 33 in the embodiment is preferably 45 degrees.
In an alternative embodiment, the outer wall of the junction between the resectoscope electrode 33 and the cable catheter 32 is provided with an insulating sealing layer, the outer wall of the sealing layer is smooth and has no protrusion, the sealing layer is made of an insulating material, the electric leakage at the junction between the resectoscope electrode 33 and the electric wire in the cable catheter 32 is prevented, the stability of power supply of the resectoscope electrode 33 is maintained, and the smooth structure can prevent the sealing layer from damaging the urethra and the bladder.
It should be noted that: the electric cutting electrode 33 with the hook-shaped structure and the tumor contact surface are reduced, the burn damage to the bladder inner wall is reduced during electric cutting, the hook end with the hook-shaped structure can be lifted and pulled to tear the tumor, and the tumor is separated from the bladder inner wall, so that the use is convenient.
Example 2
In the rest of the embodiment 1, the urethra catheter 1 in this embodiment is provided with a high pressure water channel and a drug administration channel at the inner gap thereof, and the two channels are attached to the two sides of the contact end surfaces of the speculum tube 2 and the electrode catheter 3.
As an application example of the high-pressure water channel, high-pressure cleaning water can be transmitted into the bladder through the high-pressure water channel, the transmitted high-pressure cleaning water can spray a burned surface for cleaning, and can clean blood stains on the surface of the endoscope 21 together to keep the definition of shooting in the bladder;
as an application example of the administration channel, the medicine for hemostasis care can be transmitted into the bladder through the administration channel, and the recovery of the operation surface is facilitated.
In summary, when a tumor in the urinary bladder is removed, the urethral catheter 1 is inserted into the urethra and inserted into the bladder to insert the preoperative device, in the operation process, video information shot by the endoscope 21 is transmitted and displayed on the display device through the transmission cable 22 and is used for observing a working surface in the bladder by a doctor, the contact surface between the electric cutting electrode 33 with the hook-shaped structure and the tumor is lowered, burn damage to the inner wall of the bladder is reduced during electric cutting, and when the angle direction of the electric cutting electrode 33 needs to be improved, the operation handle 34 is held to drive the cable catheter 32 to rotate on the bearing 31, so that the electric cutting electrode 33 connected to the other end of the cable catheter 32 is driven to change the angle, and the hook end of the hook-shaped structure can lift and tear the tumor and separate the tumor from the inner wall of the bladder.
Finally, it should be noted that: the foregoing shows and describes the general principles, essential features, and advantages of the invention. The present invention is not limited to the above embodiments, and the above embodiments and the description are only preferred embodiments of the present invention, and are not intended to limit the present invention, and although the present invention has been described in detail with reference to the above embodiments, it will be apparent to those skilled in the art that modifications may be made in the technical solutions described in the above embodiments, or equivalents may be substituted for some of the technical features. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (8)
1. The utility model provides a novel collude column structure bladder tumour electricity and cut electrode through urethra which characterized in that: urethral catheter (1) including the smooth no sharp-pointed protruding column structure in outward appearance, the inside of urethral catheter (1) is provided with peeps mirror tube (2) and electrode pipe (3), peep mirror tube (2) and bond in inner wall one side of urethral catheter (1), electrode pipe (3) set up the inner wall opposite side of urethral catheter (1), peep mirror tube (2) with electrode pipe (3) are the axisymmetric installation in urethral catheter (1) inside, the internal clearance punishment of urethral catheter (1) do not is provided with high pressure water channel and administration channel, and two channels are attached peep mirror tube (2) with the both sides of electrode pipe (3) contact terminal surface:
an endoscope (21) is fixed at one end of the endoscope tube (2) placed in the bladder, a lens of an arc-shaped structure is fixed on the outer surface of the endoscope (21), the lens is a transparent waterproof component, a micro camera is fixed inside the endoscope (21), the micro camera inside the endoscope tube (2) is connected with a transmission cable (22), and one end, penetrating through the endoscope tube (2), of the transmission cable (22) is connected with external imaging equipment;
an indwelling device (4) sleeved on the outer wall of the electrode catheter (3) is also arranged in the urethral catheter (1), the indwelling device (4) comprises two arc-shaped supporting strips (41), the two arc-shaped supporting strips (41) and the electrode catheter (3) are concentric and symmetrically arranged at two sides of the outer wall of the electrode catheter (3), the end surface of one side of the two arc-shaped supporting strips (41) is contacted and adhered with the speculum tube (2), the end surface of the other side is contacted and adhered with the inner wall of the urethra catheter (1), a supporting piece (42) is poured in an interlayer between the supporting strip (41) and the urethral catheter (1), the inner wall of the supporting strip (41) is provided with a slideway (43) matched with the outer diameter of the electrode conduit (3), the electrode guide tube (3) is connected with the supporting strip (41) in a sliding way through the slide way (43);
hollow bearings (31) are symmetrically fixed at two ends of the interior of the electrode catheter (3), cable catheters (32) penetrate through the two groups of bearings (31), one end, placed into a bladder, of each cable catheter (32) is connected with an electrotomy electrode (33) with a hook-shaped structure, a raised electrode clamping column (36) is fixed at the tail of each electrotomy electrode (33), an electrode clamping groove (35) matched with the electrode clamping column (36) is formed in the cable catheter (32), and the electrotomy electrodes (33) and the cable catheters (32) are fixedly connected through the electrode clamping grooves (35) and the electrode clamping columns (36) in an inserted mode;
the angle of the hook section of the electric cutting electrode (33) is 30-80 degrees.
2. The novel hook-shaped structure transurethral bladder tumor electrosection electrode as claimed in claim 1, wherein: the length of the urethral catheter (1) is 20-25 CM.
3. The novel hook-shaped structure transurethral bladder tumor electrosection electrode as claimed in claim 1, wherein: the cable guide pipe (32) is rotatably connected with a hollow through hole in the bearing (31), and the rotating angle is 360 degrees.
4. The novel hook-shaped structure transurethral bladder tumor electrosection electrode as claimed in claim 1, wherein: one end of the electrotomy electrode (33) penetrating into the bladder is attached to the end face of the tumor, and the length of the electrotomy electrode (33) is 7-10 mm.
5. The novel hook-shaped structure transurethral bladder tumor electrosection electrode as claimed in claim 1, wherein: and an insulating sealing layer is arranged on the outer wall of the joint of the electrotomy electrode (33) and the cable guide pipe (32), and the outer wall of the sealing layer is smooth and has no protrusion.
6. The novel hook-shaped structure transurethral bladder tumor electrosection electrode as claimed in claim 1, wherein: an operating handle (34) for holding operation is fixed at the other end of the cable conduit (32).
7. The novel hook-shaped structure transurethral bladder tumor electrosection electrode as claimed in claim 6, wherein: the operating handle (34) is a metal component provided with an annular grip.
8. The novel hook-shaped structure transurethral bladder tumor electrosection electrode as claimed in claim 1, wherein: the outer wall of the urethral catheter (1) is made of an insulated sterile rubber component.
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