WO2012022123A1 - 一种具有半环形横截面和前端可调节弯度的镜身的输尿管镜 - Google Patents

一种具有半环形横截面和前端可调节弯度的镜身的输尿管镜 Download PDF

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WO2012022123A1
WO2012022123A1 PCT/CN2011/001384 CN2011001384W WO2012022123A1 WO 2012022123 A1 WO2012022123 A1 WO 2012022123A1 CN 2011001384 W CN2011001384 W CN 2011001384W WO 2012022123 A1 WO2012022123 A1 WO 2012022123A1
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ureteroscope
semi
channel
endoscope
sheath
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PCT/CN2011/001384
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English (en)
French (fr)
Inventor
林超
段孝敏
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上海祥秀医药科技有限公司
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Publication of WO2012022123A1 publication Critical patent/WO2012022123A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/307—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the urinary organs, e.g. urethroscopes, cystoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/201—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser with beam delivery through a hollow tube, e.g. forming an articulated arm ; Hand-pieces therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • A61B18/245—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter for removing obstructions in blood vessels or calculi

Definitions

  • the invention belongs to the technical field of minimally invasive surgery medical instruments in urology, and particularly relates to a ureteroscope with adjustable curvature at the front end of a semi-annular body. Background technique
  • the ureteroscope is an endoscope for minimally invasive surgery in urology. During the operation, the ureteroscope is extended into the bladder through the urethra, and then the ureteroscope is inserted from the ureteral opening. The ureteroscope is used for exploration in the ureter, and the stones in the ureter can be broken by the gravel instrument.
  • the diameter of the ureteroscope is required to be as small as possible; and for the convenience of the doctor, the diameter of the lumen of the lens body is as large as possible, so the outer wall of the existing ureteroscope is thin, and the body has only one body.
  • the lumen ie the lumen.
  • the doctor extends the instrument from the instrument at the end of the lens into the lumen for surgery, and continuously injects a large amount of water into the surgical site through the lumen to keep the vision clear.
  • the water gradually becomes cloudy due to bleeding at the surgical site, which affects the clarity of the physician's field of vision.
  • the water injection must be stopped, the already turbid water is discharged through the lumen, or another catheter is inserted into the surgical site for the discharge of sewage, and the new water is refilled after the sewage is discharged.
  • the technical problem to be solved by the present invention is to provide a ureteroscope with a front end adjustable curvature of a semicircular mirror and a variable diameter ureteroscope sheath, a variable diameter ureteroscope sheath having an elliptical shape, and a semicircular mirror front end adjustable curvature ureter
  • the mirror is semi-annular, with water in the mirror body and water flowing out of the mirror-variable ureteroscope sheath.
  • the visual field is clear during operation and easy to operate; the instrument can enter the ureter directly to the renal pelvis, and the laser crushing stones and broken stones can be discharged simultaneously, and the operation efficiency is high.
  • a ureteroscope with a curved end at the front end of the semi-annular body including a lens body, a mirror body, a multi-channel operation hand placed at the end of the lens body, and a variable diameter ureteroscope
  • the sheath is characterized in that: the lens body is semi-annular, the front end portion is semi-soft, and the lens body is rigid.
  • the lens angle can be adjusted by a lens angle adjustment knob placed at the rear of the lens body; the guide tube of the variable diameter ureteroscope sheath is elliptical.
  • variable diameter ureteroscope sheath has a crescent-shaped semi-rigid material on both sides in the longitudinal direction of the radial cross section, and the biire-shaped semi-rigid materials are connected to each other by a flexible elastic material.
  • the lens body has an optical system channel, an illumination fiber channel, a water inlet channel and an instrument channel.
  • the lens angle adjustment knob is connected to the multi-channel operation hand card slot and the camera sight glass, and the semi-annular body can enter the ureter to reach the renal pelvis through the variable diameter ureteroscope sheath.
  • variable diameter ureteroscope sheath catheter is a double channel, the upper channel is inserted into the semicircular ureteroscope as a working channel, and the lower channel is connected to the negative pressure suction stone discharge channel.
  • the vacuum suction stone discharge channel is under negative pressure suction and has an anti-backflow flap.
  • the beneficial effects of the invention are: a semi-circular body, a lens angle adjustable in all directions, and a variable diameter ureteroscope sheath design, the instrument enters the ureter and reaches the renal pelvis, and can be used for treating ureteral stones and kidney stones, realizing laser lithotripsy and Negative pressure attracts the stones at the same time, which improves the operation efficiency and shortens the operation time. It can also reduce the water pressure in the kidney and ureter, prevent the water pressure in the bladder from rising, and avoid the occurrence of postoperative hyperthermia.
  • FIG. 1 is a schematic structural view of a ureteroscope with adjustable curvature at the front end of the semicircular mirror of the present invention
  • FIG. 2 is a schematic view of the A-direction of the front end portion of the semi-soft body of FIG. 1 (enlarged);
  • Figure 3 is a schematic view showing the structure of a variable diameter ureteroscope sheath
  • Figure 4 is a schematic cross-sectional view of the BB section of Figure 3 (enlarged).
  • 1 a front end of a semi-soft body with adjustable camber; 2—mirror body; 3—inlet valve; 4 one lens angle adjustment knob; 5—multi-channel operation hand piece; 6—illumination fiber channel; - optical system channel; 8 - water inlet channel; 9 - instrument channel; 10 - mirror body; 11 a variable diameter ureteroscope sheath 12 - ureteroscope working channel; 13 - negative pressure suction stone discharge channel; Soft material; 15 - crescent-shaped semi-rigid material; 16 - anti-reflux flap.
  • a ureteroscope with a curved end of the semicircular mirror and a variable diameter ureteroscope sheath as an example.
  • the present invention is not limited to the application of a variable diameter ureteroscope sheath, and the front end of the semicircular mirror can adjust the curvature.
  • the ureteroscope can also be used alone.
  • a semicircular ureteroscope with adjustable front end curvature of the lens body includes a rigid body 2, a scope 10 and a multi-channel operating member 5 placed at the end of the mirror body 10, and
  • the variable diameter ureteroscope sheath 11 is characterized in that: the lens body 2 is semi-annular, the front end portion is semi-soft, the lens body 2 is rigid, and the lens angle can be passed through the lens angle adjustment knob 4 placed at the rear of the lens body 10.
  • the catheter of the variable diameter ureteroscope sheath 11 has an elliptical shape.
  • variable diameter ureteroscope sheath 11 has a crescent-shaped semi-rigid material 15 on both sides in the longitudinal direction of the radial section of the catheter, and the biire-shaped semi-rigid materials 15 are connected to each other by a flexible elastic material 14 .
  • the lens body 2 has an optical system channel 7, an illumination fiber channel 6, a water inlet channel 8 and an instrument channel
  • the lens angle adjusting knob 4 is connected to the multi-channel operating hand 5 card slot and the camera sight glass; the semi-circular lens body 2 can enter the ureter and the renal pelvis through the variable diameter ureteroscope sheath 11 to treat the kidney stone.
  • variable diameter ureteroscope sheath 11 has an enlarged diameter portion at the end of the catheter, and the upper channel is inserted into the semicircular ureteroscope as a working channel, and the lower channel is connected to the negative pressure to attract the stone discharge channel.
  • the vacuum suction stone discharge passage 13 is provided with an anti-reflux flap 16 under vacuum suction.
  • the front end of the semi-circular mirror of the invention can adjust the curvature of the ureteroscope, and the lens body has a semi-annular design, mainly for occupying the ureteral cavity and increasing the stone cavity.
  • the guide wire is rubbed into the ureter through a cystoscope, and the variable diameter ureteroscope sheath 11 enters the ureter along the guide wire.
  • the ureteroscope with a bendable front end of the semicircular mirror enters the variable diameter ureteroscope sheath 11, and the variable diameter ureteroscope sheath 11 is enlarged in diameter under the support of the semicircular ureteroscope. Increased stone access. Under negative pressure suction, it is more conducive to drainage and drainage.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Physics & Mathematics (AREA)
  • Urology & Nephrology (AREA)
  • Biomedical Technology (AREA)
  • Biophysics (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
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Description

一种具有半环形横截面和前端可调节弯度的镜身的输尿管镜 技术领域
本发明属泌尿外科微创手术医疗器械技术领域，具体涉及一种半环形镜身前 端可调节弯度的输尿管镜。 背景技术
输尿管镜是用于泌尿外科微创手术的内窥镜。手术时将输尿管镜通过尿道伸 入膀胱， 再从输尿管开口处伸入输尿管镜， 通过输尿管镜在输尿管内进探査， 并 可通过碎石器械将输尿管内的结石打碎。
为了减轻病人的痛苦，要求输尿管镜的镜身直径尽可能小；而医师为便于操 作， 又希望镜身的管腔直径尽可能大， 所以现有的输尿管镜的外壁很薄， 镜身只 有一个腔道 （即管腔）。 手术过程中， 医师将操作器械从镜体尾部的器械伸入口 伸入管腔进行手术， 并需通过管腔向手术部位持续注入大量的水以保持视野清 楚。 随着手术的进行， 由于手术部位渗血等原因， 水逐渐变浑浊， 影响医师视野 的清晰度。这时必须停止注水， 将已经浑浊的水通过管腔排出， 或者在手术部位 再另外***一根导管专门用于污水的排出， 待污水排完后再重新注入新水。
因此现有的输尿管镜的使用过程中，注水和排水都只能通过腔体的同一道进 行。 注水与排水不能同时进行， 这就意味着现有的输尿管镜存在以下缺点：
1、 由于注水与排水只能分开操作， 无法形成水循环， 导致手术过程中视野 经常不清楚， 影响手术的效率， 使手术时间延长；
2、 持续注水使镜前端及肾脏内水压过高， 如手术时间较长， 甚至会导致膀 胱内的水压过高，这时就必须拔出输尿管镜排出膀胱内水后，再***输尿管镜重 新操作；
3结石击碎后由于输尿管镜直径本身占据输尿管腔隙， 结石排出需要用钳子 或套石篮夹住结石与输尿管镜本身一起退出，需再次进入输尿管内取石，往往需 要反复多次取石。 发明内容
确认本 本发明所要解决的技术问题是：提供一种半环形镜前端可调节弯度的输尿管 镜及其可变直径输尿管镜鞘，可变直径输尿管镜鞘呈椭圆形，半环形镜前端可调 节弯度的输尿管镜呈半环形，镜身内进水，水从镜下可变直径输尿管镜鞘内流出。 手术过程中视野清晰， 操作方便； 器械进入输尿管可直达肾盂， 实现激光击碎结 石和碎结石排出同时进行， 手术效率高。
为达到上述目的，采用的技术方案是：半环形镜身前端可调节弯度的输尿管 镜， 包括镜身、镜体、 置于所述镜体尾端的多通道操作手件， 以及可变直径输尿 管镜鞘， 其特征在于： 所述镜身呈半环形， 前端部半软性， 镜身呈硬性。镜头角 度可通过置于镜体后部的镜头角度调节旋钮调节；所述可变直径输尿管镜鞘的导 管呈椭圆形。
所述可变直径输尿管镜鞘的导管径向截面长轴方向两侧分别为月牙形半硬 性材料， 所述两月牙形半硬性材料相互之间由带弹性的软性材料连接。
所述镜身内置光学***通道， 照明光纤通道， 进水通道和器械通道。
所述镜头角度调节旋钮，连接多通道操作手件卡槽和接摄像头窥镜，半环形 镜身可通过变直径输尿管镜鞘进入输尿管达肾盂。
所述可变直径输尿管镜鞘导管端部直径增大部分为双通道，上通道***半环 形输尿管镜为工作通道， 下通道接负压吸引结石排出通道。
所述负压吸引结石排出通道负压吸引处置有抗反流瓣。
本发明的有益效果是： 半环形镜身、镜头角度可调节弯向各个方向， 和可变 直径输尿管镜鞘设计，器械进入输尿管直达肾盂，可用于治疗输尿管结石和肾结 石， 实现激光碎石和负压吸引排石同时进行， 提高手术效率， 縮短手术时间； 而 且能够减小肾及输尿管内的水压，防止膀胱内的水压升高，避免术后高热菌血症 的发生。 附图说明
下面结合附图和具体实施方式对本发明作进一步说明：
图 1是本发明半环形镜前端可调节弯度的输尿管镜的结构示意图； 图 2为 图 1中半软性镜身前端部 A向结构示意图 （放大）；
图 3为可变直径输尿管镜鞘的结构示意图； 图 4为图 3中 B-B剖面结构示意图 （放大）。
图中， 1一可调节弯度的半软性镜身前端部； 2—镜身； 3—进水阀门； 4一 镜头角度调节旋钮； 5—多通道操作手件； 6—照明光纤通道； 7—光学***通道; 8—进水通道； 9一器械通道； 10—镜体； 11一可变直径输尿管镜鞘 12—输尿管 镜工作通道； 13—接负压吸引的结石排出通道； 14一带弹性的软性材料； 15—月 牙形的半硬性材料； 16—抗反流瓣。 具体实施方式
以下实施例以半环形镜前端可调节弯度的输尿管镜及可变直径输尿管镜鞘 为例进行说明，但本发明并不限于与可变直径输尿管镜鞘配套应用，半环形镜前 端可调节弯度的输尿管镜也可以单独应用。
如图 1和图 2所示，一种镜身前端弯度可调节的半环形输尿管镜，包括硬性 镜身 2、 镜体 10和置于所述镜体 10尾端的多通道操作手件 5, 以及可变直径输 尿管镜鞘 11 ; 其特征在于： 所述镜身 2呈半环形， 前端部半软性， 镜身 2呈硬 性， 镜头角度可通过置于镜体 10后部的镜头角度调节旋钮 4调节； 所述可变直 径输尿管镜鞘 11的导管呈椭圆形。
所述可变直径输尿管镜鞘 11的导管径向截面长轴方向两侧分别为月牙形半 硬性材料 15， 所述两月牙形半硬性材料 15相互之间由带弹性的软性材料 14连 接。
所述镜身 2内置光学***通道 7， 照明光纤通道 6， 进水通道 8和器械通道
9。
所述镜头角度调节旋钮 4， 连接多通道操作手件 5卡槽和接摄像头窥镜； 半 环形镜身 2可通过变直径输尿管镜鞘 11进入输尿管达肾盂治疗肾结石。
所述的可变直径输尿管镜鞘 11导管端部直径增大部分为双通道， 上通道插 入半环形输尿管镜为工作通道， 下通道接负压吸引结石排出通道。
所述负压吸引结石排出通道 13负压吸引处置有抗反流瓣 16。
本发明半环形镜前端可调节弯度的输尿管镜， 镜身 2半环形设计， 主要是 为了少占用输尿管腔隙， 增加排石腔隙。
经膀胱镜擦入导丝进入输尿管，可变直径输尿管镜鞘 11沿导丝进入输尿管 内。 半环形镜前端可调节弯度的输尿管镜进入可变直径输尿管镜鞘 11， 可变直 径输尿管镜鞘 11在半环形输尿管镜支撑下直径增大。 增大了排石通道。 在负压 吸引下更利于排水、 排石。
以上对具体实施方式的描述旨在于为了描述和说明本发明涉及的技术方 案，揭示本发明的最佳实施方法，使本领域的普通技术人员能够应用实施本发明。 但应当注意到本发明并不限于上文讨论的实施方式，基于本发明启示，任何显而 易见的变换或替代， 也应当被认为落入本发明的保护范围。

Claims

权利要求：
1. 半环形镜身前端可调节弯度的输尿管镜， 包括镜身、 镜体和置于所述镜体尾 端的多通道操作手件， 以及可变直径输尿管镜鞘； 其特征在于： 所述镜身呈半环 形， 前端部半软性， 镜身呈硬性， 镜头角度可通过置于镜体后部的镜头角度调节 旋钮调节； 所述可变直径输尿管镜鞘的导管呈椭圆形。
2. 根据权利要求 1所述半环形镜身前端可调节弯度的输尿管镜， 其特征在于： 所述可变直径输尿管镜鞘的导管径向截面长轴方向两侧分别为月牙形半硬性材 料， 所述两月牙形半硬性材料相互之间由弹性软性材料连接。
3. 根据权利要求 1所述半环形镜身前端可调节弯度的输尿管镜， 其特征在于： 所述镜身内置光学***通道， 照明光纤通道， 进水通道和器械通道。
4. 根据权利要求 1所述半环形镜身前端可调节弯度的输尿管镜， 其特征在于： 所述镜头角度调节旋钮， 连接多通道操作手件卡槽和接摄像头窥镜。
5. 根据权利要求 1所述半环形镜身前端可调节弯度的输尿管镜， 其特征在于： 所述半环形镜身可通过可变直径输尿管镜鞘进入输尿管达肾盂。
6. 根据权利要求 4所述半环形镜身前端可调节弯度的输尿管镜， 其特征在于： 所述可变直径输尿管镜鞘导管端部直径增大部分为双通道，上通道***半环形输 尿管镜为工作通道， 下通道接负压吸引结石排出通道。
7根据权利要求 6所述半环形镜身前端可调节弯度的输尿管镜， 其特征在于： 所 述负压吸引结石排出通道负压吸引处置有抗反流瓣。
PCT/CN2011/001384 2010-08-20 2011-08-19 一种具有半环形横截面和前端可调节弯度的镜身的输尿管镜 WO2012022123A1 (zh)

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CN201010259159.7A CN101972169B (zh) 2010-08-20 2010-08-20 半环形镜身前端可调节弯度的输尿管镜

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