CN107320154B - Percutaneous nephroscopic visualization of the expandable sheath - Google Patents
Percutaneous nephroscopic visualization of the expandable sheath Download PDFInfo
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- CN107320154B CN107320154B CN201710561706.9A CN201710561706A CN107320154B CN 107320154 B CN107320154 B CN 107320154B CN 201710561706 A CN201710561706 A CN 201710561706A CN 107320154 B CN107320154 B CN 107320154B
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- 238000012800 visualization Methods 0.000 title 1
- 239000013307 optical fiber Substances 0.000 claims abstract description 44
- 230000010339 dilation Effects 0.000 claims abstract description 25
- 230000000007 visual effect Effects 0.000 claims abstract description 9
- 230000000916 dilatatory effect Effects 0.000 claims description 24
- 238000002347 injection Methods 0.000 claims description 7
- 239000007924 injection Substances 0.000 claims description 7
- 230000001681 protective effect Effects 0.000 claims description 7
- 239000007788 liquid Substances 0.000 claims description 6
- 206010038460 Renal haemorrhage Diseases 0.000 abstract description 4
- 230000009286 beneficial effect Effects 0.000 abstract description 3
- 238000003384 imaging method Methods 0.000 abstract 1
- 238000000034 method Methods 0.000 description 4
- 210000001624 hip Anatomy 0.000 description 3
- 210000003734 kidney Anatomy 0.000 description 3
- 238000003825 pressing Methods 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 210000000244 kidney pelvis Anatomy 0.000 description 2
- 210000003205 muscle Anatomy 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 208000032843 Hemorrhage Diseases 0.000 description 1
- 208000000913 Kidney Calculi Diseases 0.000 description 1
- 206010029148 Nephrolithiasis Diseases 0.000 description 1
- 238000004026 adhesive bonding Methods 0.000 description 1
- 230000003796 beauty Effects 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 230000003907 kidney function Effects 0.000 description 1
- 238000002504 lithotomy Methods 0.000 description 1
- 238000002844 melting Methods 0.000 description 1
- 230000008018 melting Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 239000004575 stone Substances 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/0034—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22072—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other
- A61B2017/22074—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
- A61B2017/22077—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel with a part piercing the tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
- A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
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Abstract
本发明涉及经皮肾镜可视扩张鞘，扩张管为圆筒状，前端为圆锥，圆锥的顶端为圆形平面，扩张管内设置有用于通道导丝和光纤的工作通道，工作通道与扩张管平行设置并且工作通道与扩张管的横截面同心，并且工作通道从圆形平面穿出。本发明的有益效果是：使用可视扩张鞘在进行扩张穿刺时能够应用可视影像系统有效的对穿刺扩张定位，杜绝常规手术穿刺过深造成肾出血等医疗事故。
The invention relates to a percutaneous nephroscopic visual expansion sheath. The expansion tube is cylindrical, the front end is a cone, and the top end of the cone is a circular plane. The expansion tube is provided with a working channel for channel guide wire and optical fiber, and the working channel and the expansion tube are arranged in the expansion tube. The working channels are arranged in parallel and are concentric with the cross-section of the expansion tube, and the working channels emerge from the circular plane. The beneficial effects of the present invention are: the use of the visible dilatation sheath can effectively locate the puncture expansion by using the visual imaging system when performing the dilation puncture, and prevent medical accidents such as renal hemorrhage caused by the deep puncture of the conventional operation.
Description
Technical Field
The invention relates to medical equipment, in particular to a percutaneous nephroscope.
Background
The surgical treatment method for kidney stone comprises the following steps: incision lithotomy, extracorporeal lithotripsy, percutaneous nephrolithotomy. The traditional method of 'knife-cutting and stone-taking' needs to make a large incision about 20cm on the waist, cut the muscle of the waist, separate the kidney, cut a small opening on the renal pelvis or renal parenchyma, and take out the stone. The method has the advantages of large injury, more hemorrhage, pain, and slow recovery. Usually, the patient needs to be hospitalized for about 7 days after the operation. Because the operation incision is large, not only the skin is not beautiful, but also the physical strength of the patient after the operation is greatly influenced. Compared with open surgery, percutaneous nephrolithotomy has the advantages of small injury, light pain, thorough calculus removal, quick recovery and the like. The incision of the waist is usually less than 1cm, because no muscle is cut, so that not only the beauty is not influenced, but also the post-operation has little influence on the labor force. The patient can be discharged after the operation for 2-3 days. Compared with laparoscopic calculus removal, percutaneous nephrolithotomy has little influence on the kidney and surrounding structures, and does not influence various renal operations in the future. Compared with the external lithotripsy, the method has short treatment period, instant effect and less influence on the kidney function.
However, the conventional percutaneous nephroscope has a drawback that, for example, when the dilatation sheath is expanded after the puncture is finished, the conventional dilatation sheath cannot observe the advancing position of the dilatation sheath, and the puncture is too deep, which causes medical accidents such as renal hemorrhage and the like.
Disclosure of Invention
The invention aims to solve the problems and overcome the problems existing in percutaneous nephroscope puncture expansion in the prior art, and provides a percutaneous nephroscope visual expansion sheath to meet the requirements.
In order to achieve the purpose, the technical scheme of the invention is as follows:
the visible dilation sheath for the percutaneous nephroscope comprises a tearing sheath and a dilation tube arranged in the tearing sheath, and is characterized in that the dilation tube is cylindrical, the front end of the dilation tube is conical, the top end of the conical dilation tube is a circular plane, a working channel for a channel guide wire and an optical fiber is arranged in the dilation tube, the working channel and the dilation tube are arranged in parallel, the working channel is concentric with the cross section of the dilation tube, and the working channel penetrates out of the circular plane.
The visible dilating sheath of the percutaneous nephroscope is characterized in that the cross section of the working channel is circular, the optical fiber is sleeved with an optical fiber protecting sleeve, and the diameter of the optical fiber protecting sleeve is smaller than that of the working channel.
The visible dilating sheath of the percutaneous nephroscope is characterized in that the inner wall of the working channel is also provided with an auxiliary channel parallel to the working channel.
The visible dilating sheath for the percutaneous nephroscope is characterized by further comprising a tearing sheath joint and a dilating tube joint, wherein the tearing sheath joint is connected with the tearing sheath, and the tearing sheath joint and the tearing sheath are arranged on the outer wall of the dilating tube; the expansion pipe joint is connected with the expansion pipe, and the expansion pipe joint is connected with the tearing sheath joint.
The visible expansion sheath for the percutaneous nephroscope is characterized in that the expansion pipe joint comprises three cavities, namely a guide wire cavity, an optical fiber cavity and a liquid injection cavity, and the guide wire cavity, the optical fiber cavity and the liquid injection cavity are communicated with the working channel.
The visible dilating sheath for the percutaneous nephroscope is characterized by further comprising a connector for connecting the dilating tube joint and the tearing sheath joint, wherein two ends of the connector are detachably connected with the dilating tube joint and the tearing sheath joint respectively.
The visible dilating sheath for the percutaneous nephroscope is characterized in that a suction channel is arranged on the joint of the tearing sheath.
The visible dilating sheath for the percutaneous nephroscope is characterized in that the tearing sheath joint is provided with two suction channels, one of the suction channels is a through hole, the other suction channel is a blind channel, and the two suction channels are symmetrically arranged.
The visible dilating sheath for the percutaneous nephroscope is characterized in that steps are arranged on the inner walls of the guide wire cavity and the optical fiber cavity, external threads are arranged on the outer walls of the guide wire cavity and the optical fiber cavity, the visible dilating sheath further comprises a locking connector and a locking plug, the locking plug is arranged at the step, internal threads corresponding to the external threads on the outer walls of the guide wire cavity and the optical fiber cavity are arranged on the inner wall of the locking connector, a circle of squeezing ring is further arranged on the inner side of the inner wall of the locking connector, and the top end of the squeezing ring is in contact with the locking plug.
The invention has the beneficial effects that: the visual expansion sheath can be used for effectively positioning puncture expansion by using a visual image system when the puncture is expanded, and medical accidents such as renal hemorrhage caused by too deep puncture in conventional operations are avoided.
Drawings
FIG. 1 is a schematic sectional view of example 1;
FIG. 2 is a schematic side view of the stent of example 1;
FIG. 3 is an enlarged schematic view at A in FIG. 1;
FIG. 4 is a schematic sectional view of embodiment 2;
FIG. 5 is a schematic side view of the dilation tube of example 2;
fig. 6 is an enlarged schematic view of a portion a in fig. 4.
Detailed Description
In order to make the technical means, the creation characteristics, the achievement purposes and the effects of the invention easy to understand, the invention is further explained below by combining the specific drawings.
Example 1:
referring to fig. 1-2, the visible dilating sheath for percutaneous nephroscope comprises a tearing sheath 100 and a dilating tube 200 arranged in the tearing sheath 100, wherein the dilating tube 200 is cylindrical, the front end of the dilating tube is conical, the top end of the conical is a circular plane 230, and a guide wire and an optical fiber working channel 210 for passage are arranged in the dilating tube 200. The working channel 210 is disposed parallel to the dilation tube 200 and the working channel 210 is concentric with the cross-section of the dilation tube 200 and the working channel 210 exits from a circular plane 230. The cross section of the working channel 210 is circular, the optical fiber protective sleeve is arranged on the optical fiber outer sleeve, the diameter of the optical fiber protective sleeve is smaller than that of the working channel 210, and the optical fiber protective sleeve is arranged on the optical fiber outer sleeve in the invention, so that the diameter of the working channel is limited by the diameter of the expansion pipe 200, the diameter of the working channel needs to be maximized, and the optical fiber and the guide wire with the optical fiber protective sleeve can pass through simultaneously, so that the working channel 210 is arranged to be a channel with the diameter close to the circular plane 230, the optical fiber can be ensured to pass through smoothly, the optical fiber is not eccentric, and the observation by a user is facilitated.
The pipe further comprises a tearing sheath joint 300 and an expansion pipe joint 400, wherein the tearing sheath joint 300 is connected with the tearing sheath 100, the tearing sheath joint 300 is connected with the tearing sheath 100 through a hot melting or glue bonding process, and the tearing sheath joint 300 and the tearing sheath 100 are sleeved on the outer wall of the expansion pipe 200; the expansion joint 400 is connected to the expansion pipe 200, and the expansion joint 400 is connected to the tearing sheath joint 300. The anti-interference type pipe joint further comprises a connector 500 used for connecting the expansion pipe joint 400 and the tearing sheath joint 300, two ends of the connector 500 are detachably connected with the expansion pipe joint 400 and the tearing sheath joint 300 respectively, and the connection mode can be a buckling mode and can also be an interference fit mode.
The expansion pipe joint 400 comprises three channels, namely a guide wire channel 410, an optical fiber channel 420 and a liquid injection channel 430, wherein the guide wire channel 410, the optical fiber channel 420 and the liquid injection channel 430 are communicated with the working channel 210.
The tearing sheath connector 300 is provided with a suction channel 310. And the tearing sheath joint 300 is provided with two suction channels 310, wherein one suction channel 310 is a through hole, the other suction channel 320 is a blind channel, and the two suction channels 310 are symmetrically arranged.
Referring to fig. 3, steps 610 are respectively arranged on the inner walls of the guide wire lumen 410 and the optical fiber lumen 420, external threads 620 are arranged on the outer walls of the guide wire lumen 410 and the optical fiber lumen 420, the optical fiber lumen further comprises a locking joint 630 and a locking plug 640, the locking plug 640 is arranged at the steps 610, internal threads 650 corresponding to the external threads 620 on the outer walls of the guide wire lumen 410 and the optical fiber lumen 420 are arranged on the inner wall of the locking joint 630, a ring of pressing ring 660 is further arranged on the inner side of the inner wall of the locking joint 630, the top end of the pressing ring 660 is in contact with the locking plug 640, and by installing the locking joint 630 on the guide wire lumen 410 and the optical fiber lumen 420, the pressing ring 660 presses the locking plug 640 by twisting the threads, so that the locking plug 640 is deformed, and the guide wire and the optical fiber passing through the locking plug 640 are locked.
In operation, the optical fiber and guidewire are advanced into the working channel 210 through the fiber lumen 420 and guidewire lumen 410, respectively, and finally the guidewire extends out of the tip of the working channel 210 with the optical fiber flush with the tip of the working channel 210. Then the dilating tube 200 dilates the puncture hole, and due to the existence of the optical fiber, an operator can clearly see the advancing position of the dilating tube 200, if the field of vision at the front end of the optical fiber is not clear, water can be injected through the injection cavity channel 430, and when the dilating tube 200 reaches the renal pelvis, the advancing is stopped, so that the condition of over-puncturing or puncturing the kidney cannot occur. The tearing sheath is then left in the puncture while the expansion joint 400 is detached from the tearing sheath joint 300, and then the expansion tube 200 is pulled out. Subsequent surgical instruments are then attached to the tear sheath 300.
Example 2:
referring to fig. 4 to 6, embodiment 2 differs from embodiment 1 in that: an auxiliary channel 220 parallel to the working channel 210 is further disposed on the inner wall of the working channel 210, and in actual operation, the optical fiber with the optical fiber protective sleeve passes through the working channel 210, and the guide wire passes through the auxiliary channel 220, so as to further optimize the space.
The invention has the beneficial effects that: the visual expansion sheath can be used for effectively positioning puncture expansion by using a visual image system when the puncture is expanded, and medical accidents such as renal hemorrhage caused by too deep puncture in conventional operations are avoided.
The foregoing shows and describes the general principles, essential features, and advantages of the invention. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, which are given by way of illustration of the principles of the present invention, and that various changes and modifications may be made without departing from the spirit and scope of the invention as defined by the appended claims. The scope of the invention is defined by the appended claims and equivalents thereof.
Claims (9)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710561706.9A CN107320154B (en) | 2017-07-11 | 2017-07-11 | Percutaneous nephroscopic visualization of the expandable sheath |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710561706.9A CN107320154B (en) | 2017-07-11 | 2017-07-11 | Percutaneous nephroscopic visualization of the expandable sheath |
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| Publication Number | Publication Date |
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| CN107320154A CN107320154A (en) | 2017-11-07 |
| CN107320154B true CN107320154B (en) | 2021-11-02 |
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| CN201710561706.9A Active CN107320154B (en) | 2017-07-11 | 2017-07-11 | Percutaneous nephroscopic visualization of the expandable sheath |
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Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111012414A (en) * | 2019-12-23 | 2020-04-17 | 合肥市第三人民医院 | Fascial dilator for percutaneous nephroscopy and application thereof |
| CN115227942A (en) * | 2022-07-29 | 2022-10-25 | 浙江迪远医疗器械有限公司 | sheath device |
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