CN211157863U - A trigeminy trocar device for deep tissue puncture - Google Patents
A trigeminy trocar device for deep tissue puncture Download PDFInfo
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- CN211157863U CN211157863U CN201921350407.1U CN201921350407U CN211157863U CN 211157863 U CN211157863 U CN 211157863U CN 201921350407 U CN201921350407 U CN 201921350407U CN 211157863 U CN211157863 U CN 211157863U
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Abstract
The present application provides a triple trocar device for deep tissue penetration, which includes: a coarse puncture needle, a puncture cannula and a fine puncture needle; in the puncture process, when the shallow tissue punctures, the tips of the coarse puncture needle, the puncture cannula and the fine puncture needle are aligned; when the deep tissue punctures, the puncture cannula and the thin puncture needle extend out from the first end of the thick puncture needle, and then the deep tissue is punctured together, and then the thin puncture needle is withdrawn, and a channel between the deep tissue and the outside of the body of the subject is established through the puncture cannula. Through the puncture device, the injury of organs of important tissues can be reduced when the deep tissues are punctured, the sensitivity to the deep tissues is increased when the deep tissues are punctured, and the puncture success rate is improved, so that the clinical prognosis is improved, and the puncture device can be applied to clinical practices, such as pericardial effusion puncture drainage and subclavian vein puncture catheterization, and has a very strong clinical application value.
Description
Technical Field
The present application relates to deep tissue penetration techniques, and more particularly to triple trocars and methods for penetrating deep tissue without ultrasound guidance.
Background
In clinical work, deep tissues are often required to be punctured, for example, pericardiocentesis drainage is performed when acute pericardial stuffing is filled, a tube is placed through daily subclavian venipuncture, 18G or 20G thick puncture needles (the outer diameters are 1.2mm and 0.9mm respectively) are used for direct puncture, and then a guide wire and a sheath tube are exchanged by utilizing a seldinger technology. The first step of successful puncture is that the coarse puncture needle punctures into a target position such as a pericardial cavity or a blood vessel cavity of a subclavian vein, and the steel needle structure of the wall of the coarse puncture needle is beneficial to penetrating superficial hard tissues and fixing a channel under the condition of a plurality of surrounding bony structures. However, the problem exists that the deep tissue is directly punctured by the thick needle to increase direct damage of the deep tissue, especially when puncturing for many times is unsuccessful, and possibly when puncturing the pericardium and other operations, because the breakthrough feeling of the thick needle to the deep structure is not obvious, the thick needle directly penetrates through the left/right chamber walls, and a guide wire and a sheath tube are further placed under the condition that the thick needle is not found in time, the irretrievable result is caused, and the life is threatened.
The conventional pericardium or subclavian vein puncture is also performed by using a common trocar sometimes, a built-in steel needle is slightly advanced after being drawn out and returned with blood, the puncture cannula is ensured to enter the pericardium or the blood vessel, the cannula is pushed into the pericardial cavity or the blood vessel without resistance, the steel needle is withdrawn, and then a guide wire and a sheath tube are exchanged by utilizing the seldinger technology. The existing problems are that when puncturing deep tissues, the sleeve is easily extruded and deformed by shallow tissues, even the tip position moves to be separated from a pericardium or a blood vessel cavity, so that puncturing failure is caused, and even a guide wire or a sheath tube is mistakenly inserted into a false cavity to cause adverse effects. Therefore, the conventional trocar puncture is more suitable for superficial tissue puncture, such as superficial vein puncture, radial artery puncture and the like.
The puncture process can be seen in the whole process of puncture under ultrasonic guidance, which is equivalent to direct vision operation, especially when the technology is skilled, but the clinical situation is very critical sometimes, such as acute pericardial stuffing, and the puncture can only be blind-punctured, so as to compete for second-taking rescue life. The subclavian vein catheterization belongs to clinical routine operation, a plurality of patients are blindly punctured according to experience of operators, only individual complicated and difficult or high-risk patients can try to perform ultrasonic guided puncture, and the large-scale routine application is difficult.
SUMMERY OF THE UTILITY MODEL
In view of the above, the present application is directed to a triple trocar device for deep tissue penetration that facilitates both penetration of shallow tissue and penetration into deep tissue. The present application is also directed to a method of deep tissue penetration using the triple trocar device of the present application.
The present application provides a triple trocar device for deep tissue penetration, comprising: a coarse puncture needle, a puncture cannula and a fine puncture needle;
the thick puncture needle is formed into a tubular shape, and the first end of the thick puncture needle is formed into a tip comprising a bevel;
the puncture cannula is formed in a tubular shape with a first end formed as a tip comprising a bevel and a second end formed as an end seat;
the fine puncture needle is formed into a tubular shape, the first end of the fine puncture needle is formed into a tip comprising a bevel, and the second end of the fine puncture needle is formed into an end seat;
the lengths of the puncture cannula and the thin puncture needle are larger than that of the thick puncture needle;
the puncture cannula is inserted into the coarse puncture needle, and the puncture cannula and the coarse puncture needle form air tightness;
the fine puncture needle is inserted into the puncture cannula, and the air tightness is formed between the fine puncture needle and the puncture cannula;
in the puncture process, when the shallow tissue punctures, the tips of the coarse puncture needle, the puncture cannula and the fine puncture needle are aligned; when the deep tissue punctures, the puncture cannula and the thin puncture needle extend out from the first end of the thick puncture needle, and then the deep tissue is punctured together, and then the thin puncture needle is withdrawn, and a channel between the deep tissue and the outside of the body of the subject is established through the puncture cannula.
Preferably, the inclined planes of the tips of the coarse puncture needle, the puncture cannula and the fine puncture needle are aligned to form a flat inclined plane.
Preferably, the end seat of the second end of the fine puncture needle is used for connecting a negative pressure suction device.
Preferably, scales are formed on the outer side of the coarse puncture needle; scales are formed on the outer side of the puncture catheter.
Preferably, the tip seat of the fine puncture needle and the tip seat of the puncture cannula are detachably combined.
Preferably, the second side of the end seat of the puncture cannula forms a recess; a bulge is formed on the first side of the end seat of the fine puncture needle; the projection is retained in the pocket.
A method for deep tissue penetration of the present application utilizing the triple trocar device described above;
a coarse puncture needle carries a puncture cannula and a fine puncture needle to puncture the shallow tissue, and a channel penetrating through the shallow tissue is suggested;
under the condition of continuous negative pressure suction of the external injector, the puncture cannula and the fine puncture needle are further pushed;
the fine puncture needle carries the puncture cannula to enter the deep tissue of the target, and the puncture cannula is in place when the blood return is drawn out; fixing the fine puncture needle, and directly pushing the puncture cannula without resistance so that the puncture cannula further enters the target tissue;
the seldinger technique is utilized, a guide wire is used for exchanging a thin puncture needle, and a sheath tube or a drainage tube is arranged.
Preferably, the target deep tissue is a pericardial cavity or a subclavian vein.
Through the deep tissue puncture device and the application method, the injury of important organs of tissues can be reduced when the deep tissues are punctured, the sensitivity to the deep tissues is increased when the deep tissues are punctured, and the puncture success rate is improved, so that the clinical prognosis is improved, and the deep tissue puncture device can be applied to clinical practice, such as pericardial effusion puncture drainage and subclavian venipuncture tube placement, and has a very strong clinical application value.
Drawings
FIG. 1 is a schematic cross-sectional view of the components of a triple trocar device for deep tissue penetration according to the present application;
FIG. 2 is a schematic structural view of the triple trocar device for deep tissue penetration of the present application when used to penetrate shallow tissue;
FIG. 3 is a schematic structural view of the triple trocar device for deep tissue penetration of the present application when used to penetrate deep tissue;
FIG. 4 is a schematic view of the withdrawn configuration of the fine puncture needle of the triple trocar assembly for deep tissue penetration of the present application;
FIG. 5 is a view of the subclavian vein anatomy;
fig. 6 is a schematic diagram of pericardial effusion.
Detailed Description
The present application will be described in detail below with reference to the accompanying drawings.
The present application provides a triple trocar device for deep tissue penetration, comprising: the rough puncture needle 10 pierces the cannula 20 and the needle 30.
The rough puncture needle 10 is formed in a tubular shape, and a first end 11 thereof is formed as a tip including a slope; the puncture cannula 20 is formed in a tubular shape with a first end 21 formed as a tip comprising a bevel and a second end formed as an end seat 22; the stylet 30 is formed in a tubular shape with a first end 31 formed as a tip including a bevel and a second end formed as an end seat 32.
The puncture cannula 20 and the fine puncture needle 30 have a length larger than that of the coarse puncture needle 10.
The puncture cannula 20 is inserted into the rough puncture needle 10, and the puncture cannula 20 and the rough puncture needle 10 are formed to be airtight; the airtightness may be formed by the close contact between the puncture cannula 20 and the rough puncture needle 10, for example, such that the outer diameter of the puncture cannula 20 is equal to the inner diameter of the rough puncture needle 10, or a seal or a gasket is provided between the puncture cannula 20 and the rough puncture needle 10.
The fine puncture needle 30 is inserted into the puncture cannula 20, and the fine puncture needle 30 and the puncture cannula 20 are formed to be airtight; the air-tightness may be formed by the close contact between the piercing cannula 30 and the piercing cannula 20, for example, such that the inner diameter of the piercing cannula 20 is equal to the outer diameter of the piercing needle 30, or a seal or gasket is provided between the piercing cannula 20 and the piercing needle 30.
In the process of puncturing, when a shallow tissue is punctured, the tips of the rough puncture needle 10, the puncture sleeve 20 and the fine puncture needle 30 are aligned and penetrate through the shallow tissue together; during deep tissue penetration, the puncture cannula 20 and the fine puncture needle 30 protrude from the first end of the coarse puncture needle 10, penetrate the deep tissue together, then exit the fine puncture needle, and establish a passage in the deep tissue and outside the body of the subject via the puncture cannula.
The inclined planes of the tips 11, 21 and 31 of the coarse puncture needle, the puncture cannula and the fine puncture needle are aligned to form a flat inclined plane so as to facilitate the puncture of shallow tissues.
The end seat 32 at the second end of the spike 30 is adapted for connection to a negative pressure aspiration device, such as a syringe. The end seat 32 may be seen to form a socket 33 for connection to the nipple of a syringe.
The second end of the coarse needle may also be formed with an end seat 12 to facilitate manipulation of the coarse needle 10, such as by grasping the end seat 12 to push the coarse needle to carry the puncture cannula and the fine needle to puncture the anterior tissue.
Scales are formed on the outer side of the coarse puncture needle 10 so as to conveniently judge the entering depth of the coarse puncture needle; the outside of the puncture catheter 20 is formed with graduations to facilitate the determination of the depth of penetration of the puncture cannula.
The tip seat 32 of the fine puncture needle is removably coupled to the seat 22 of the puncture cannula. A second side of the end seat 22 of the puncture cannula 20 forms a recess 23; the first side of the tip seat 32 of the thin puncture needle 30 is formed as a protrusion; the projection is captured in the pocket 23.
A method for deep tissue penetration of the present application utilizing the triple trocar device described above;
a coarse puncture needle carries a puncture cannula and a fine puncture needle to puncture the shallow tissue, and a channel penetrating through the shallow tissue is suggested;
under the condition of continuous negative pressure suction of the external injector, the puncture cannula and the fine puncture needle are further pushed;
the fine puncture needle carries the puncture cannula to enter target tissues, such as a pericardial cavity or a subclavian vein, and the puncture cannula is in place when blood return is pumped out; fixing the fine puncture needle, and directly pushing the puncture cannula without resistance so that the puncture cannula further enters the target tissue;
the seldinger technique is utilized, a guide wire is used for exchanging a thin puncture needle, and a sheath tube or a drainage tube is arranged.
Example 1: puncture subclavian vein
1. The patient lies down on the bed, goes to the pillow, and the conventional disinfection is spread singly, carries puncture cannula and thin pjncture needle with thick pjncture needle, keeps the most advanced parallel and level, punctures the shallow tissue under the clavicle in the outer 1/3 department in the clavicle of right side, uses thick pjncture needle point top to the clavicle earlier, then establishes a passageway that passes through the shallow tissue in the bone seam under the clavicle, controls the depth of inserting the needle, fixes thick pjncture needle before predicting the puncture subclavian vein.
2. Under the continuous negative pressure suction condition of the external injector, the puncture sleeve and the fine puncture needle are further pushed, and the needle inserting depth is controlled by the scales on the surface of the puncture sleeve. The fine puncture needle is used for carrying the puncture sleeve to puncture into the subclavian vein, blood return is drawn out to prompt that the puncture sleeve is in place, the fine puncture needle is fixed, the puncture sleeve is directly pushed without resistance, the puncture sleeve is prompted to accurately enter a target position, and the fine puncture needle can be properly deeply inserted into the subclavian vein to avoid falling.
3. Then the fine puncture needle is withdrawn, the guide wire is exchanged by utilizing the seldinger technology through the puncture cannula, and the sheath or the drainage tube is arranged.
Example 2: puncturing pericardial effusion
1. The patient with acute pericardial tamponade or chronic massive pericardial effusion is put in a horizontal position and is subjected to conventional disinfection and laying, a puncture sleeve and a thin puncture needle are carried by a thick puncture needle, the tip is kept to be parallel and level, the shallow tissue of the chest wall is punctured under the xiphoid process or the apex of the heart, a channel penetrating through the shallow tissue of the chest wall is established by the thick puncture needle, the depth of the needle insertion is controlled, and the thick puncture needle is fixed before the pericardium is predicted to be punctured.
2. Under the continuous negative pressure suction condition of the external injector, the puncture sleeve and the fine puncture needle are further pushed, and the needle inserting depth is controlled by the scales on the surface of the puncture sleeve. The fine puncture needle is used for puncturing the pericardium with the puncture sleeve, blood return is drawn out to prompt that the puncture sleeve is in place, the fine puncture needle is fixed, the puncture sleeve is directly pushed under the non-resistance condition, the puncture sleeve is prompted to accurately enter a target position, and the fine puncture needle can be properly inserted into the pericardium to avoid falling.
3. The thin puncture needle only needs to penetrate through the pericardium of the wall layer, the resistance is small, the blood can be pumped back, and the force of inserting the needle is better controlled. When the thin puncture needle touches the chamber wall, the risk of penetrating the chamber wall under the condition of limited needle inserting force is greatly reduced because the chamber wall has certain thickness and is ceaselessly contracted and expanded, and the operation is safer.
And 4, withdrawing the fine puncture needle, replacing the guide wire by utilizing a seldinger technology through the puncture cannula, and placing the sheath or the drainage tube.
Compared with the prior art, the invention has the following advantages and effects:
1. the puncture needle does not depend on ultrasonic guidance, but utilizes the structural characteristics of the puncture needle, the thin puncture needle carries the puncture sleeve to puncture deep tissues, the breakthrough feeling is stronger than that of a thick puncture needle, the puncture sleeve is further pushed without resistance to verify that the sleeve is positioned in a target lacuna, and the vital first step of puncture and tube placement is completed. Complete access of the puncture cannula to a target lumen, such as the subclavian vein, also reduces unsuccessful exchange of the guide wire. Optimizes clinical operation and has good clinical transformation value.
2. When the pericardium is punctured, the fine puncture needle only needs to penetrate through the pericardium of the wall layer, the resistance is small, the blood can be pumped back, and the force of inserting the needle is better controlled. When the thin puncture needle touches the chamber wall, the risk of penetrating the chamber wall under the condition of limited needle inserting force is greatly reduced because the chamber wall has certain thickness and is ceaselessly contracted and expanded, and the operation is safer.
3. The coarse puncture needle is used for guiding and penetrating shallow tissues such as a chest wall or a subclavian area, a channel is built in the middle of the tissues with bone structures on the periphery, the fixation is not moved, the stability is higher than that of a full-range plastic cannula, the possibility of displacement or falling of the puncture cannula is obviously reduced, and the puncture success rate is increased.
4. The fine puncture needle carries the puncture cannula to puncture deep tissues, so that direct tissue damage is reduced, and the fine puncture needle is particularly important when puncturing subclavian veins for multiple times.
Claims (6)
1. A triple trocar device for deep tissue penetration comprising: a coarse puncture needle, a puncture cannula and a fine puncture needle;
the thick puncture needle is formed into a tubular shape, and the first end of the thick puncture needle is formed into a tip comprising a bevel;
the puncture cannula is formed in a tubular shape with a first end formed as a tip comprising a bevel and a second end formed as an end seat;
the fine puncture needle is formed into a tubular shape, the first end of the fine puncture needle is formed into a tip comprising a bevel, and the second end of the fine puncture needle is formed into an end seat;
the lengths of the puncture cannula and the thin puncture needle are larger than that of the thick puncture needle;
the puncture cannula is inserted into the coarse puncture needle, and the puncture cannula and the coarse puncture needle form air tightness;
the fine puncture needle is inserted into the puncture cannula, and the air tightness is formed between the fine puncture needle and the puncture cannula;
in the puncture process, when the shallow tissue punctures, the tips of the coarse puncture needle, the puncture cannula and the fine puncture needle are aligned; when the deep tissue punctures, the puncture cannula and the thin puncture needle extend out from the first end of the thick puncture needle, and then the deep tissue is punctured together, and then the thin puncture needle is withdrawn, and a channel between the deep tissue and the outside of the body of the subject is established through the puncture cannula.
2. The triple trocar device for deep tissue penetration of claim 1, wherein:
the inclined planes of the tips of the coarse puncture needle, the puncture cannula and the fine puncture needle are aligned to form a flat inclined plane.
3. The triple trocar device for deep tissue penetration of claim 1, wherein:
and the end seat of the second end of the fine puncture needle is used for connecting a negative pressure suction device.
4. The triple trocar device for deep tissue penetration of claim 1, wherein:
scales are formed on the outer side of the coarse puncture needle; scales are formed on the outer side of the puncture cannula.
5. The triple trocar device for deep tissue penetration of claim 1, wherein:
the tip seat of the fine puncture needle is detachably combined with the tip seat of the puncture cannula.
6. The triple trocar device for deep tissue penetration of claim 5, wherein:
a second side of the end seat of the puncture cannula forms a recess; a bulge is formed on the first side of the end seat of the fine puncture needle; the projection is retained in the pocket.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201921350407.1U CN211157863U (en) | 2019-08-20 | 2019-08-20 | A trigeminy trocar device for deep tissue puncture |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201921350407.1U CN211157863U (en) | 2019-08-20 | 2019-08-20 | A trigeminy trocar device for deep tissue puncture |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110339435A (en) * | 2019-08-20 | 2019-10-18 | 中国人民解放军总医院 | A kind of three trocar Assemblies and method for deep tissue puncture |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110339435A (en) * | 2019-08-20 | 2019-10-18 | 中国人民解放军总医院 | A kind of three trocar Assemblies and method for deep tissue puncture |
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Effective date of registration: 20230504 Address after: 100853 Fuxing Road 28, Beijing, Haidian District Patentee after: CHINESE PLA GENERAL Hospital Address before: 100853 Fuxing Road 28, Beijing, Haidian District Patentee before: CHINESE PLA GENERAL Hospital Patentee before: Cao Feng |
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