CN112618008A - High-frequency mucosa incision knife - Google Patents
High-frequency mucosa incision knife Download PDFInfo
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- CN112618008A CN112618008A CN202011640081.3A CN202011640081A CN112618008A CN 112618008 A CN112618008 A CN 112618008A CN 202011640081 A CN202011640081 A CN 202011640081A CN 112618008 A CN112618008 A CN 112618008A
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- 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
- A61B18/04—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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- 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
- A61B18/04—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
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- 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
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00607—Coagulation and cutting with the same instrument
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- 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
- A61B18/04—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
- A61B2018/1412—Blade
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Abstract
The invention discloses a high-frequency mucosa incision knife, which comprises: the sheath pipe is internally penetrated with an operating wire; the first electrode and the second electrode are arranged in the far end of the sheath tube and can extend out or retract along the axial direction of the sheath tube; the near end of the first electrode is connected with the far end of the operating wire and is fixedly provided with a pushing piece; a friction piece is arranged between the second electrode and the sheath tube; when the operating wire pushes the first electrode out of the sheath to the first working position, the second electrode is still with the sheath under the action of the friction piece; when the operating wire pushes the first electrode positioned at the first working position towards the far end, the pushing piece pushes the second electrode to move so as to enable the second electrode to extend to the second working position; when the operating wire pulls the first electrode to retract to the set position, the second electrode is acted by the friction piece and keeps still with the sheath. The invention realizes convenient switching operation of the two cutters, and has simple structure, strong flexibility, low operation cost and low operation risk.
Description
Technical Field
The invention relates to the technical field of mucosa incision knives, in particular to a high-frequency mucosa incision knife.
Background
At present, a common high-frequency mucosa incision knife realizes the charring or the vaporization of tissues through the contact of a knife thread and the tissues so as to achieve the effects of incision, stripping, blood coagulation and the like. The mucosa incision knife has a plurality of types, and can realize different operation purposes in various shapes.
The needle-shaped knife is a revolving body needle-shaped knife with a rectangular section, has better flexibility and cutting performance due to smaller outer diameter, but is easy to perforate when being marked, and can not realize effective hemostasis.
The utility model also comprises a knife thread which is a T-shaped revolving body structure knife shape, compared with a needle-shaped knife shape with a rectangular section, the utility model enhances the marking or hemostasis function, simultaneously is not easy to perforate, and has perforation risk in the submucosal peeling process.
In addition, the knife type with the insulator arranged at the far end is provided, in clinical operation, the cutting and stripping operation is carried out by the discharging of the knife wire, the insulating head is abutted against tissues which do not need to be cut, the tissues are prevented from being burnt by the discharging of the far end of the knife wire, and the possibility that the tissues which are not pathological changed are burnt and perforated due to misoperation in the operation is greatly reduced. However, it does not have a marking function, and the operator generally marks the mark with another knife-type high-frequency mucosa incision knife.
In addition, there are other knife types. In the prior art, in order to realize targeted operation, two or more types of operation may need to be performed by using two or more types of knives in one operation process, and frequent knife changing is usually required, which increases operation cost, increases burden of patients to a certain extent, increases operation time, and increases burden of doctor operation.
In summary, how to avoid increasing the operation burden of doctors and patients due to frequent tool changing is a problem to be solved urgently by those skilled in the art.
Disclosure of Invention
In view of the above, an object of the present invention is to provide a high-frequency mucosa incision knife, which can switch two electrodes, i.e., a knife head, by using one operation wire, so that the knife changing operation in the surgical procedure is convenient and fast, and a high surgical burden due to the knife changing is not required.
In order to achieve the above purpose, the invention provides the following technical scheme:
a high frequency muco-incising knife comprising:
the sheath pipe is internally penetrated with an operating wire;
the first electrode and the second electrode are arranged in the distal end of the sheath and can extend out or retract along the axial direction of the sheath;
the near end of the first electrode is connected with the far end of the operating wire and is fixedly provided with a pushing piece; a friction piece is arranged between the second electrode and the sheath tube;
when the operating wire pushes the first electrode out of the sheath to a first working position, the second electrode is acted by the friction piece and keeps still with the sheath;
when the operating wire pushes the first electrode located at the first working position towards the distal end, the pushing member pushes the second electrode to move, so that the second electrode extends to a second working position;
when the operating wire pulls the first electrode to retract to the set position, the second electrode is acted by the friction piece and keeps still with the sheath.
Preferably, the second electrode is tubular, and the first electrode penetrates through the second electrode.
Preferably, the friction member surrounds a gap between the second electrode and the sheath.
Preferably, a limiting part abutting against the friction part is arranged at the proximal end of the second electrode, and when the second electrode moves towards the distal end, the limiting part drives the friction part to move towards the distal end; when the pushing piece pushes the second electrode to move, the far end of the pushing piece is abutted to the near end of the limiting piece.
Preferably, the limiting member is annular and is fixedly arranged on the periphery of the proximal end of the second electrode.
Preferably, the pushing member is a conductive member connecting the first electrode and the operating wire.
Preferably, the conductive member is tubular and is fixedly arranged on the periphery of the first electrode and the operating wire.
Preferably, the friction member is fixedly connected to the second electrode or the sheath.
Preferably, a pulling member is fixedly arranged at the distal end of the first electrode, and when the operating wire pulls the first electrode located at the set position to retract, the pulling member pulls the second electrode to retract, and the second electrode overcomes the friction force of the friction member to retract from the second working position.
Preferably, the distal end of the first electrode has a large diameter portion with an outer diameter larger than an inner diameter of the second electrode, and when the first electrode is retracted from the set position, the proximal end of the large diameter portion abuts the distal end of the second electrode to pull the second electrode to retract from the second working position against the friction of the friction member.
Preferably, the distal end of the second electrode is provided with a top end insulation head with a through hole, the first electrode passes through the through hole, and the inner diameter of the through hole is smaller than the outer diameter of the large-diameter part;
a counter bore communicated with the through hole is formed in the far end of the top end insulating head, the inner diameter of the counter bore is larger than that of the through hole, and the depth of the counter bore is larger than the height of the large-diameter part;
the large diameter portion is received in the counterbore when the first electrode is in the set position;
when the first electrode retracts from the set position, the large-diameter portion abuts against the counter bore to drive the second electrode to move towards the near end.
Preferably, the proximal end of the sheath is connected to an operating portion, the operating portion including:
a handle;
and the sliding block is arranged on the handle in a sliding manner and is connected with the near end of the operating wire.
Preferably, the operating portion further includes an elastic member having an elastic force that tends to move the slider toward the proximal end, and the elastic force is smaller than a frictional force between the frictional member and the sheath.
Preferably, the elastic element is a spring, and two ends of the elastic element are respectively abutted against or connected with the sliding block and the handle.
Preferably, the slider is connected with the operating line through a driving pipe, and the spring is sleeved outside the driving pipe.
Preferably, the proximal end of the driving tube is fixed to a lock block through an electrode lock cylinder, and the lock block is fixedly connected with the sliding block.
Preferably, the spring is a spring with a non-uniform lead, and the lead at both ends is less than the lead at the middle part.
Preferably, the sliding block and the handle are respectively provided with an elastic bulge and an accommodating groove which are used for matching and clamping, and when the sliding block slides under external force, the elastic bulge can slide into or slide out of the accommodating groove;
wherein, the quantity and the position of elastic bulge with the holding tank satisfy:
when the sliding block moves to a position where the first electrode is located at the first working position, the elastic bulge is clamped with the accommodating groove;
and/or the presence of a gas in the gas,
when the slider moves to make the second electrode be located when the second operating position, the elastic bulge with the holding tank joint.
Preferably, the distal end of the sheath is provided with an insulating member having a through hole passing through the first electrode and the second electrode, and the insulating member blocks the friction member from protruding from the sheath when the second electrode is protruding.
The high-frequency mucosa incision knife integrates two cutters of different types into one structure, and realizes the switching of two electrodes, namely the switching of a knife head by taking one operating wire as a source. Compared with the mode that two cutters are respectively controlled by two control parts in the prior art, the cutter control device is simple in structure and simple and convenient in operation mode, and the flexibility degree of operation is greatly improved; meanwhile, frequent replacement of different cutters is avoided, the cost of the operation is reduced, and the risk of complex operation is reduced.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the provided drawings without creative efforts.
FIG. 1 is a schematic structural view of a high-frequency mucosa incision knife provided by the present invention;
FIG. 2 is a cross-sectional view of the high-frequency mucosa incision knife provided by the present invention in its original state;
FIG. 3 is a sectional view showing a state where a first electrode of the high-frequency mucosa incision knife according to the present invention is extended;
FIG. 4 is a sectional view showing an intermediate state of the high-frequency mucosa-cutting blade according to the present invention;
FIG. 5 is a sectional view showing a state where a second electrode of the high-frequency mucosa cutting knife according to the present invention is extended;
FIG. 6 is a cross-sectional view showing the adjustment process of the high-frequency mucosa cutter according to the present invention;
FIG. 7 is a sectional view of the handle of the high-frequency mucosa cutting knife provided by the present invention;
FIG. 8 is a partial cross-sectional view of the handle;
FIG. 9 is a schematic view showing a clamping state of the bump elastic sheet and the accommodating groove;
FIG. 10 is a schematic view of a bump spring;
fig. 11 is a schematic view of a spring.
In fig. 1 to 11, reference numerals include:
the device comprises a sheath tube 1, an operating wire 2, a pushing piece 3, a first electrode 4, a second electrode 5, a friction piece 6, a limiting piece 7, a third electrode 8, a top end insulating head 9 and an insulating piece 10;
an operating part 11, a handle 111, a slider 112, a locking block 113, an electrode locking column 114, a driving pipe 115, an elastic piece 116, a fixing cap 117 and a bump elastic piece 118;
the receiving groove 1111, the convex groove 1121, the protruding column 1181 and the concave pit 1182.
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.
The core of the invention is to provide a high-frequency mucosa incision knife which can utilize one operating wire as a source to realize the operation of two electrodes and realize the switching of the electrodes, namely the switching of knife heads, thereby ensuring that the knife changing operation in the operation process is convenient and rapid, and higher operation burden is not required to be generated due to knife changing.
The near-end in this application refers to the operation side of high frequency mucosa incision sword, and the distal end refers to and is close to affected part one side, and is corresponding, and the near-end of each part is the one side that the high frequency mucosa incision sword near-end that this part is close to, and the distal end of each part is the one side that this part is close to high frequency mucosa incision sword distal end.
Referring to fig. 1 to 11, the present invention provides a high-frequency mucosa incision knife, mainly used for contacting tissues to perform marking and incision operations, and mainly comprising: sheath 1, operation wire 2, first electrode 4 and second electrode 5.
The sheath 1 is internally provided with an operating wire 2, and the operating wire 2 can move along the length of the sheath to realize penetration.
The first electrode 4 and the second electrode 5 are both arranged in the distal end of the sheath tube 1 and can extend out or retract along the axial direction of the sheath tube 1; the near end of the first electrode 4 is also connected with the far end of the operating wire 2, the operating wire 2 is used for providing electric energy for the first electrode 4, the near end of the first electrode 4 is fixedly provided with the pushing piece 3, and a friction piece 6 for increasing the friction resistance of the relative sliding between the second electrode 5 and the sheath tube 1 is arranged between the two. The first electrode 4 and the second electrode 5 may be two types of blades having different functions when energized.
The operation wire 2 has a certain rigidity, and can apply a pushing force or a pulling force to the first electrode 4, so as to drive the first electrode 4 to move along the axial direction of the sheath 1, so as to extend and retract relative to the sheath 1, that is, relative to the second electrode 5, when the first electrode 4 extends out of the sheath 1 or the second electrode 5, and the first electrode 4 is powered on, the first electrode 4 can perform corresponding operation on the tissue.
When the operation wire 2 pushes the first electrode 4 towards the distal end and the first electrode 4 extends out of the sheath 1 to the first working position, referring to fig. 3, the second electrode 5 is under the static friction force of the friction member 6 and keeps stationary with the sheath 1.
Before the first electrode 4 moves to the working position, the friction force of the first electrode 4 to the second electrode 5 in the moving direction is smaller than the friction force of the friction member 6 to the second electrode 5 under the action of the pushing force of the operating wire 2.
When the first electrode 4 is at the first working position, and the operation wire 2 pushes the first electrode 4 at the first working position to the far end, referring to fig. 4, the pushing member 3 pushes the second electrode 5 to move, so that the second electrode 5 extends out of the sheath 1 to the second working position, and the acting force of the pushing member 3 on the second electrode 5 needs to be greater than the friction force of the friction member 6, so as to overcome the friction force to extend out.
When the second electrode 5 is moved to the second working position, the second electrode 5 is in radial contact with the first electrode 4 due to the presence of the deflection, and the first electrode 4 can be used to conduct electricity to the second electrode 5. It should be noted that the pushing element 3 may be specifically a first electrode 4 or a boss or an abutting element provided thereon for abutting against, and when the first electrode 4 moves to the first working position, the abutting structure contacts or indirectly applies a force on the second electrode 5 to drive the second electrode 5 to move towards the distal end. Optionally, the first electrode 4 may drive the second electrode 5 and the friction member 6 to move simultaneously, specifically, a structure abutting against a boss or an abutting part is provided on the first electrode 4 or the operating wire 2, the movement of the first electrode 4 drives the second electrode 5 to move, the second electrode 5 is provided with a structure abutting against the friction member 6, so that the second electrode 5 and the friction member 6 move together.
In the state that the first electrode 4 is extended from the second electrode 5, when the operation wire 2 is moved proximally to pull the first electrode 4 to retract to the set position, referring to fig. 5, the second electrode 5 is still with the sheath 1 under the action of the friction member 6. In the process of controlling the first electrode 4 to move proximally by the operating wire 2, so that the first electrode 4 retracts to the second electrode 5, the second electrode 5 is kept stationary relative to the sheath 1 by the static friction force of the friction member 6, and the second electrode 5 can be prevented from retracting by the friction force (for example, when the second electrode abuts against the human tissue). Because the second electrode 5 is driven to move by the butting of the unidirectional limiting structure in the former state, the second electrode 5 is free from the action of force when the first electrode 4 moves reversely.
The application provides a high frequency mucosa incision sword is in the use, can be through the removal of 2 control first electrodes 4 of control wire, realize relative flexible, can carry out the operation that corresponds under the state of stretching out, after removing first working position, operation wire 2 can also drive second electrode 5 and outwards stretch out to second working position, steerable first electrode 4 withdrawal and second electrode do not retract this moment to carry out the operation of second electrode 5.
The high frequency mucosa incision sword that this application provided is integrated in a structure with the cutter of different grade type, utilizes 2 realization of an operation line to switch operation, the switching of tool bit promptly to two electrodes. Compared with the mode that two cutters are respectively controlled by two control parts in the prior art, the cutter control device is simple in structure and simple and convenient in operation mode, and the flexibility degree of operation is greatly improved; meanwhile, the overhigh operation cost caused by frequent replacement of different cutters is avoided, and the risk of complex operation is reduced.
Optionally, the sheath 1 in the present application is a main structure of an exposed portion of the single-stage high-frequency mucosa incision knife, and may have an extremely high insulation property and a certain self-lubricity, and may be a PTFE (polytetrafluoroethylene) material, or a metal spring spiral tube coated with a single-layer FEP (perfluoroethylene propylene copolymer) material.
In order to more stably drive the second electrode 5 to move towards the distal end, on the basis of any one of the above embodiments, the second electrode 5 is tubular, and the first electrode 4 penetrates through the second electrode 5.
The first electrode 4 and the second electrode 5 are sleeved to conveniently realize guiding, and meanwhile, the connection and the conductivity of the two are ensured.
Referring to fig. 1, the friction member 6 surrounds the gap between the second electrode 5 and the sheath 1. The friction member 6 surrounds the gap between the second electrode 5 and the sheath 1, and can provide a friction force uniformly in the circumferential direction.
In addition, a limiting piece 7 abutting against the friction piece 6 is arranged at the proximal end of the second electrode 5, and when the second electrode 5 moves towards the distal end, the limiting piece 7 drives the friction piece 6 to move towards the distal end; when the pushing member 3 pushes the second electrode 5 to move, the distal end of the pushing member 3 abuts against the proximal end of the limiting member 7.
The limiting member 7 is fixedly arranged on the second electrode 5 and used for providing a pushing force for the friction member 6, so that the second electrode 5 is always connected with the friction member 6 in the moving process.
In a specific embodiment, the friction member 6 is fixedly connected to the second electrode 5 or the sheath 1, and when fixedly connected to the second electrode 5, the friction member 6 is always connected to the friction member 6 during the movement of the second electrode 5, and is subjected to the friction action of the sheath 1 on the friction member 6.
If the proximal end of the second electrode 5 is fixedly connected to the friction member 6, the friction member 6 and the second electrode 5 can be moved synchronously. In the using process, the friction member 6 mainly functions to prevent the second electrode 5 from moving relative to the sheath 1, and only when the pushing member 3 or the boss of the first electrode 4 abuts against the second electrode 5 and the pushing force is greater than the friction force of the sheath 1 to the friction member 6, the second electrode 5 will move distally relative to the sheath 1. The friction member 6 may be a member having a function of increasing friction and blocking movement, such as an O-ring. In the state shown in fig. 6, i.e., the cross-sectional view in the process of changing from the state shown in fig. 3 to the state shown in fig. 4, the second electrode 5 has been projected from the sheath 1, and the friction member 6 may be fixedly provided with the second electrode 5 so as to move synchronously.
Alternatively, the friction member 6 is nested in the second electrode 5 and can slide axially relative thereto. If the electrode is relatively slidable, the stopper 7 is used to provide one-way stopping for the friction member 6, i.e. when the second electrode 5 moves distally, the stopper 7 drives the friction member 6 to move distally. Both the friction member 6 and the second electrode 5 may be relatively fixed with a slight movement, whereas a large range of relative movement occurs between the friction member 6 and the sheath 1.
With respect to the above-mentioned structure of the friction member 6, the friction member 6 may be a ring-shaped structure that is compressed after being assembled, and has a friction force against both the second electrode 5 and the sheath 1. So that it can achieve the effect of increasing the resistance of the second electrode 5 to the movement of the sheath 1 to restrict the movement.
Alternatively, the friction member 6 may also be a block structure fixed on the inner wall of the sheath 1 or the outer wall of the second electrode 5, so as to achieve the same function and effect.
The other end face and the friction member 6 may be fixed to the second electrode 5 by, for example, bonding, welding, or the like, and may be fixed to the second electrode 5 by welding, caulking, or the like, and the end face may overlap with the end face of the second electrode 5, or may fall on the second electrode 5 or outside the second electrode 5.
Optionally, the limiting member 7 is an annular structure and is fixedly disposed on the outer periphery of the proximal end of the second electrode 5. The use of a ring shape may facilitate a full abutment with the ring-shaped friction member 6 for the pushing effect.
The limiting member 7 and the second electrode 5 are specifically fixed by bonding or other connection methods, one end face of the limiting member 7 is coplanar with the proximal end face of the second electrode 5, and the other end face is used for abutting against the friction member 6.
On the basis of any of the above embodiments, the pushing member 3 is a conductive member connecting the first electrode 4 and the operation wire 2. Optionally, the conductive member is tubular and is fixedly disposed on the outer periphery of the first electrode 4 and the operation wire 2. The conductive member is connected to the first electrode 4, and the first electrode 4 penetrates through the second electrode 5, and the two electrodes are in contact connection, so that the pushing member 3 not only has the function of connecting the first electrode 4 and the operating wire 2, but also can simultaneously supply power to the first electrode 4 and the second electrode 5.
Specifically, the first electrode 4 is sleeved with a pushing member 3 capable of pushing the second electrode 5, and the outer diameter of the pushing member 3 is larger than the inner diameter of the second electrode 5. The pushing piece 3 is used for welding and fixing the steel wire rope and the first electrode 4 in an additive mode after the steel wire rope and the first electrode are in butt joint, and the outer diameter of the pushing piece is larger than the inner diameter of the second electrode 5. Or a multi-strand steel wire rope is used, the near end of the first electrode 4 is inserted into an integral structure formed by the multi-strand steel wire rope and is welded, the combined outer diameter of the first electrode is larger than the inner diameter of the second electrode 5, and the second electrode 5 is pushed by the steel wire rope.
With the movement of the first electrode 4, the pushing member 3 can synchronously move to abut against the proximal end of the second electrode 5, the first electrode 4 continues to move, and the pushing member 3 can push the second electrode 5 to move.
The pushing member 3 is disposed at a connecting position of the first electrode 4 and the operating wire 2, and can be used for reinforcing the first electrode 4 and the operating wire 2. In this embodiment, the pushing member 3 sleeved on the first electrode 4 is used to push the second electrode 5, and the position of the pushing member 3 can be adjusted as required.
Alternatively, the pushing member 3 and the boss may directly abut against and push the friction member 6, in addition to directly abutting against and pushing the second electrode 5 to move.
The operation wire 2 provided by the present application has a certain rigidity, and is used for providing a pushing force or a pulling force for the first electrode 4 along the moving direction of the first electrode 4, and may be a steel wire rope with axial supporting rigidity.
In this application, the first electrode 4 includes a needle-shaped knife (i.e., an I-shaped knife) or a T-shaped knife having a T-shaped longitudinal section, wherein the T-shaped knife has a large diameter portion at a tip end of the needle-shaped knife, and the second electrode 5 includes a knife having an insulating tip at an end portion thereof, which is referred to as an O-shaped knife.
When the T-shaped knife is used as the first electrode 4, the large-diameter part structure at the end part of the T-shaped knife can be used for driving the second electrode 5 to retract, and when the O-shaped knife is used as the second electrode 5, the insulating head of the T-shaped knife can be used for accommodating the large-diameter part of the T-shaped knife so as to prevent the T-shaped knife from continuing to cut when the T-shaped knife extends into tissues. When the I-shaped knife is used as the first electrode 4, it has no function of pulling the second electrode 5 to retract, and optionally, a pulling member (e.g., a protrusion) is provided on the I-shaped knife, so as to achieve the purpose that the I-shaped knife drives the second electrode 5 to retract. The first electrode 4 can also use a hook-shaped knife, and the second electrode 5 can be accommodated only by arranging a corresponding groove shape. Of course, both may be other types of knives.
In a specific embodiment, a pulling member is fixed at the distal end of the first electrode 4, and when the operation wire 2 pulls the first electrode 4 located at the set position to retract, the pulling member pulls the second electrode 5 to retract, and the second electrode 5 overcomes the friction force of the friction member 6 to retract from the second working position.
Alternatively, in the embodiment where the second electrode 5 is tubular and the first electrode 4 extends through the second electrode 5, the distal end of the first electrode 4 has a large diameter portion with an outer diameter larger than the inner diameter of the second electrode 5, and when the first electrode is retracted from the set position, the proximal end of the large diameter portion abuts against the distal end of the second electrode 5 to pull the second electrode 5 to overcome the friction of the friction member 6 and retract from the second working position.
In both cases, the pulling element may be in the form inherent in the first electrode 4 or in a structure fixedly arranged thereon, and needs to have a radial projection in order to form a pulling of the second electrode 5 during the retraction of the first electrode 4.
In a specific embodiment, the distal end of the second electrode 5 is provided with a tip insulating head 9 of a through hole, the first electrode 4 passes through the through hole, and the inner diameter of the through hole is smaller than the outer diameter of the large-diameter part;
the far end of the top end insulating head 9 is provided with a counter bore communicated with the through hole, the inner diameter of the counter bore is larger than that of the through hole, and the depth of the counter bore is larger than the height of the large-diameter part;
when the first electrode 4 is at the set position, the large diameter portion is accommodated in the counter bore; when the first electrode 4 is retracted from the set position, the large-diameter portion abuts against the counter bore, and the second electrode 5 is driven to move towards the proximal end.
Referring to fig. 5, the first electrode 4 in fig. 5 is a set position, the first electrode 4 penetrates through the through hole of the top insulating head 9, and when the first electrode 4 moves to the set position, the counter bore at the end of the through hole abuts against the large diameter portion, and the proximal movement of the first electrode 4 can drive the proximal movement of the second electrode 5.
Optionally, the end of the second electrode 5 is sleeved with a third electrode 8, which can be used to fix the top end insulating head 9, and the third electrode 8 is fastened on the second electrode 5 by welding, riveting, screwing, and the like.
The depth of the counter bore is larger than the height of the thick head of the T-shaped head of the first electrode 4, and all the holes of the top insulating head 9 are larger than the thinnest part of the first electrode 4. In fig. 2, the tip insulating head 9 has 3 continuous holes with different cross-sectional sizes, and is used for abutting against the T-knife to reset the second electrode 5, to pass through the body of the T-knife, and to abut against the third electrode 8. Of course, the number of the holes may be 2, and when the first electrode 4 is located at the proximal end with respect to the tip insulating tip 9, the first electrode 4 is in direct contact with the third electrode 8.
The tip insulating head 9 is specifically an insulating material such as alumina or zirconia, and can be connected to the third electrode 8 by in-mold insert casting, bonding, or the like.
In the above embodiment, there are at least three operations, first, the first electrode 4 is protruded out of the second electrode 5, and the second electrode 5 is held in the sheath 1; secondly, the second electrode 5 is driven by the first electrode 4 to extend out of the sheath tube 1; third, the first electrode 4 is moved proximally and retracted into the second electrode 5. It should be noted that the second process is not the working state of the tool.
In practical use, when the two electrodes are accommodated and the forceps channel is to be withdrawn, or when the T-shaped knife needs to be reused after the O-shaped knife is used, the second electrode 5 and the first electrode 4 need to be reset to the proximal end, that is, the fourth operation process, specifically, the first electrode 4 may be a T-shaped knife, and the T-shaped knife located at the first working position is used for marking.
In a specific embodiment, the distal end of the sheath 1 is provided with an insulating member 10, the insulating member 10 has a through hole for passing through the first electrode 4 and the second electrode 5, and when the second electrode 5 is extended, the insulating member 10 blocks the friction member 6 from being extended from the sheath 1.
In this application, the protruding end of the second electrode 5 has a tip insulating head 9, and the distal end of the sheath 1 is provided with an insulating member 10.
It should be noted that, in general, the O-knife is provided with a top insulation head 9 at the distal end, and an insulation member 10 at the distal end of the sheath 1, when in use, the insulation head is abutted against the tissue which is not to be cut, so as to prevent the distal end of the electrode from discharging and burning the tissue. The insulator 10 may also serve to limit the entry of the tip insulator 9 into the sheath 1 and to limit the removal of the friction element 6 from the sheath 1.
The insulator 10 needs to have the function of isolating high-frequency electricity to improve the safety, and simultaneously in order to realize the extension and retraction of the first electrode 4, the top end insulator head 9 is an annular structure sleeved on the far end of the second electrode 5, and the top end insulator head 9 is provided with a middle hole for penetrating the first electrode 4, so that the first electrode 4 extends out or retracts back.
The insulating part 10 is made of insulating materials such as alumina and zirconia, and is fixed with the sheath tube 1 in a bonding mode, an interference fit mode and the like, and the insulating part 10 is used for limiting the second electrode 5 and is matched with the top end insulating head 9 to provide far-end insulation protection for the single-stage high-frequency mucosa incision knife.
Optionally, the first electrode 4 may be an I-shaped knife or another knife shape, and another limiting structure capable of abutting against the groove is disposed at a distal end of the first electrode 4, so that the first electrode 4 drives the second electrode 5 to retract.
On the basis of any one of the above embodiments, the proximal end of the sheath tube 1 is connected to the operation portion 11, the operation portion 11 includes a handle 111 and a slider 112, the slider 112 is slidably disposed on the handle 111, and is connected to the proximal end of the operation wire 2 for driving the operation wire 2 to move.
The movement of the slider 112 can drive the operation wire 2 connected thereto to move, so that the user can control the slider 112 to move relative to the handle 111, and then can drive the operation wire 2 to move relative to the handle 111 and the sheath 1. Optionally, the slider 112 is sleeved outside the handle 111.
Specifically, the operation part 11 further includes an elastic member 116 having an elastic force that tends to move the slider 112 proximally, which is smaller than the frictional force between the friction member 6 and the sheath 1.
When only an elastic force acts on the manipulation wire 2, the second electrode 5 cannot move against the frictional force. The elastic member 116 provided in the operation portion 11 can facilitate the return of the operation wire 2 and the first electrode 4 when no external force is applied. The elastic member 116 may be connected or abutted between the fixed position of the handle 111 and the slider 112, and drives the slider 112 to return by its own elastic restoring force.
Optionally, the elastic member 116 is a spring, and two ends of the elastic member respectively abut against or connect the slider 112 and the handle 111.
Referring to fig. 7 to 11, the pushing force of the elastic element 116 on the sliding block 112 is used to drive the operation wire 2 to move towards the proximal end, and during the above operations, under the action of no external force, the elastic force of the elastic element 116 causes the first electrode 4 to move towards the proximal end or has a tendency to approach the proximal end, so that the first electrode 4 automatically returns to the set position; but the elastic force is smaller than the friction force between the friction member 6 and the sheath 1, so that the second electrode is not separated from the second working position. When the slider 112 is subjected to an external applied force (pushing force or pulling force), the elastic member 116 deforms, and the slider 112 moves against the elastic member 116 to perform work.
Optionally, the slider 112 is connected to the operating wire 2 through a driving tube 115, and the spring is sleeved outside the driving tube 115.
Specifically, the driving tube 115 and the operation wire 2 may be fixed by means of caulking, silver welding, or the like.
Optionally, the spring is a spring with a uniform lead, or a spring with a non-uniform lead, and the leads at two ends of the spring are smaller than the lead in the middle of the spring.
In accordance with any of the above embodiments, the proximal end of the drive tube 115 is secured to the lock 113 by the electrode lock 114, and the lock 113 is fixedly attached to the slider 112.
Specifically, the driving tube 115 is disposed through the locking block 113, and the driving tube 115 and the locking block 113 are inserted and fixedly connected through the electrode locking column 114, and the slider 112 is integrally fixed to the operating wire 2, the driving tube 115 and the locking block 113 through the electrode locking column 114.
In order to provide better use experience for an operator in the using process, in a specific embodiment, the sliding block 112 and the handle 111 are respectively provided with an elastic protrusion and a receiving groove 1111 for matching clamping, and when the sliding block 112 slides under an external force, the elastic protrusion can slide into or slide out of the receiving groove 1111;
wherein, the quantity and the position of elastic bulge and holding tank 1111 satisfy:
when the sliding block 112 moves to a position where the first electrode 4 is located at the first working position, the elastic protrusion is clamped with the receiving groove 1111;
and/or, when the sliding block 112 moves to a position where the second electrode 5 is located at the second working position, the elastic protrusion is clamped with the receiving groove 1111.
In a specific embodiment, the snap-fit relationship of the resilient projection and the receiving slot 1111 is used to allow the operator to know the transition between the first operating position and the second operating position. When the sliding block 112 moves to a position where the first electrode 4 is located at the first working position, the elastic protrusion is clamped with the receiving groove 1111; when the second electrode 5 is located at the second working position, the elastic protrusion is disengaged from the receiving groove 1111.
Further, in the moving process of the slider 112, the elastic protrusion can be clamped into the receiving groove 1111 to form a temporary positioning and provide a feeling of clamping for an operator, the clamping state of the two corresponds to the state that the first electrode 4 moves to the first working position, that is, the movement of the slider 112 drives the operating wire 2 and the first electrode 4 to move, and when the first electrode 4 moves to the working position, the elastic protrusion can be clamped into the receiving groove 1111. When the sliding block 112 is pushed continuously, the elastic protrusion disengages from the receiving groove 1111, and the first electrode 4 pushes the second electrode 5 to move to the second working position, at this time, if the external acting force is cancelled, the sliding block 112 is acted by the elastic member 116 to drive the sliding block 112 to move towards the proximal end, and correspondingly, the first electrode 4 can retract into the second electrode 5.
For the removal of operating wire 2 provides operating handle in this embodiment, slider 112 and elastic component 116 on the handle 111, elastic bulge and holding tank 1111 cooperation form to operating wire 2, the temporary location of two electrode moving processes, provide for the operator and pause to frustrate and feel in order to indicate the current position, can realize the accurate control grasp of operating wire 2 and electrode removal, and elastic component 116 drives slider 112 and resets, can realize convenient and fast's operation. When the operator moves the slider 112 to feel the pause, the operator can know that the electrode is in the corresponding working position, and the operation force on the slider 112 can be released, so that the electrode can not be separated from the working position even if the operator uses a small force to operate by mistake.
In a specific embodiment, the operation portion 11 includes a handle 111, a slider 112, a locking block 113, an electrode locking column 114, a driving tube 115, an elastic member 116, a fixing cap 117, and a protruding point elastic sheet 118, wherein the protruding point elastic sheet 118 is a specific form of the above elastic protrusion, and the protruding point elastic sheet 118 has elasticity and is provided with a protruding point or a protruding pillar protruding outwards. The sheath 1 is fixed to the operation part 11 by a fixing cap 117, and the two are communicated with each other. The wire rope is a specific form of the operating wire 2, and is connected to the drive pipe 115.
The slider 112 is sleeved outside the handle 111, the handle 111 is provided with an accommodating groove 1111, the slider 112 is provided with a convex groove 1121, a convex point elastic sheet 118 is arranged in the convex groove 1121, and a convex point or convex column 1181 used for being clamped with the accommodating groove 1111 is arranged on the convex point elastic sheet 118. Optionally, a concave pit 1182 is disposed on the protruding point or the protruding column 1181, or a concave pit 1182 is disposed at a position where the protruding point or the protruding column 1181 is disposed on the protruding point spring piece 118, so as to form a gap, so that the protruding point or the protruding column 1181 has a space to move relative to the protruding point spring piece 118 when being subjected to an external extrusion force.
The convex-shaped groove 1121 may be disposed at the proximal end of the slider 112, a convex-point spring piece 118 is disposed in the convex-shaped groove 1121 in an inserting or sliding manner, a through hole is disposed at one side of the convex-shaped groove 1121 facing the receiving groove 1111, and a convex point or a convex column 1181 of the convex-point spring piece 118 extends out of the through hole to achieve clamping with the receiving groove 1111.
The shape of the convex groove 1121 is various, and may be an i shape, a dovetail shape, etc., the convex groove 1121 and the convex elastic piece 118 disposed therein may be fixed in an interference manner, or the two are in clearance fit, after the convex elastic piece 118 is installed, the end portion of the convex groove 1121 is sealed with glue or sealed by a sealing member, or the end portion of the convex groove 1121 may be sealed by thermal deformation.
The bump elastic sheet 118 may be a sheet metal structural member or a plastic structural member, specifically, in the range of the relative movement between the slider 112 and the handle 111, when only the bump elastic sheet 118 and the receiving groove 1111 are clamped and limited, the bump or the convex column 1181 on the bump elastic sheet 118 is located in the receiving groove 1111, and when the bump or the convex column 1181 slides into the receiving groove 1111, the bump or the convex column 1181 may elastically deform, and when sliding into, the elastic deformation will be reduced or partially reduced.
The sliding block 112 and the handle 111 have at least one clamping position, and when the sliding block 112 and the handle 111 are located at the position, the sliding block 112 and the handle 111 are limited in a clamping mode through the convex point elastic sheet 118 and the accommodating groove 1111 arranged on the sliding block. Optionally, the handle 111 is provided with a plurality of protruding point spring pieces 118 and receiving grooves 1111, or the protruding point spring pieces 118 are provided with a plurality of protruding points or convex columns 1181 for clamping connection. When the bumps or columns 1181 are arranged in a double number, they may be respectively arranged at two sides of the axis of the moving direction of the slider 112, and are preferably symmetrically arranged. Correspondingly, when the handle 111 is provided with the plurality of accommodating grooves 1111, the accommodating grooves may be through holes, half through holes, or hemispherical recesses, and the number of the accommodating grooves may be related to the number of the protruding points or the protruding columns 1181, or a plurality of accommodating grooves may be arranged along the moving direction of the slider 112, that is, the positioning of different stroke positions of the slider 112 is formed, and the number of the accommodating grooves may be separately set according to the gear position requirement of the positioning, for example, the positioning of the slider 112 may be respectively set for different position states of the first electrode 4 and the second electrode 5.
Optionally, the bump elastic piece 118 may be a high elastic polymer material, so as to achieve the function of being snapped into the receiving groove 1111 through the bump elastic piece 118 itself.
Alternatively, the receiving groove 1111 may be a through hole or a blind hole (a pit).
Handle 111 in this application is used for the removal of operation line 2 to realize the control of first electrode 4, second electrode 5, the shell fragment that sets up on handle 111 and holding tank 1111 can provide the response to the power of slider 112 position to the operator, and elastic component 116 in the handle 111 can be used for driving slider 112 to reset simultaneously, realizes swift, convenient operation.
In a specific embodiment, the use of the single-stage high-frequency mucotomy includes an initial state, a first electrode 4 extended state, an intermediate state, and a second electrode 5 extended state.
When the slider 112 is located at the proximal end of the high-frequency mucosa incision knife, the protruding column 1181 is located outside the receiving groove 1111 and forms friction extrusion with the outer end surface of the receiving groove 1111, the protruding column 1181 is in a deformation state, the slider 112 is only under the action of the spring, the position is kept fixed, the operation wire 2 is controlled by the slider 112 and is also located at the proximal end, please refer to fig. 2, and both electrodes are in a contraction state, that is, the initial state.
When an external force acts on the slider 112 to overcome the action of the spring and move to the far end until the protruding column 1181 is located in the receiving groove 1111, the protruding column 1181 releases elastic potential energy and is clamped with the receiving groove 1111 at the moment, so that the user can feel jerked.
The steel wire rope is moved towards the far end by the sliding block 112 to drive the pushing piece 3 and the first electrode 4 to move forwards, and the operation can push the first electrode 4 out to the first working position, so that the operation can be carried out by using the first electrode 4. When the pushing member 3 contacts the second electrode 5, if the pushing force is smaller than the larger friction force provided by the friction member 6 on the second electrode 5 and the force of the groove 1111 on the elastic protrusion, the second electrode 5 cannot move distally. When the external force is increased to continue acting on the slider 112 to move the slider 112 to the distal end, the protruding column 1181 moves out of the receiving groove 1111, referring to fig. 4, under the pushing of the slider 112 and the pushing member 3, in the axial direction, the end surface of the limiting member 7 abuts against the end surface of the friction member 6 to form a limiting position, the second electrode 5 and the friction member 6 move to the distal end, the distal end surface of the friction member 6 abuts against the proximal end surface of the insulating member 10, so that the movement is terminated, at this time, the first electrode 4 and the second electrode 5 are respectively pushed to the first working position and the second working position, and are both in the extending state, at this time, any working state is not, that is, the above-mentioned intermediate state. Of course, the limit of electrode extension can also be defined (alerting the operator) by providing a more distal resilient projection and/or receiving groove 1111, without the friction member 6 having to bear against the insulating member 10. If the position is defined (reminded) in this manner, the slider 112 will not inadvertently move distally, optionally with the spring being set or removed.
In the intermediate state, if the external force toward the distal end is cancelled, the slider 112 moves toward the proximal end under the action of the spring, and drives the first electrode 4 to move toward the proximal end.
In the retraction process of the first electrode 4, the end part of the T-shaped knife of the first electrode 4 contacts the top end insulation head 9 to be limited, and at this time, both the first electrode 4 and the top end insulation head 9 have a tendency to move towards the proximal end under the action of the spring. However, since the friction force of the friction member 6 is greater than the pulling force of the spring, the second electrode 5 will not move proximally, and referring to fig. 5, the first electrode 4 is retracted into the second electrode 5, and the second electrode 5 is kept outside the sheath, i.e. the tubular knife is extended. So that there is a gap between the insulator 10 and the tip insulator 9 so that the second electrode 5 can perform an O-knife surgical operation.
In this operating state, the distal end insulating tip 9 receives a force to move the distal end insulating tip 9 proximally when it abuts against the tissue, but the protruding length of the second electrode 5 is not changed because the friction force of the friction member 6 is large and larger than the tightening force of the wire rope.
In the extended state of the tubular knife, if the control slider 112 moves to the proximal end, for example, under the action of the hand pulling force of the operator, the control slider moves to the proximal end and returns to the initial state to realize the reset, the wire rope drives the first electrode 4 and the second electrode 5 to move to the proximal end simultaneously under the action of the pulling force, and the thick end (the end of the T-shaped knife) of the first electrode 4 drives the end face of the top end insulation head 9 and the second electrode 5 to move to reset. A high frequency mucotomy can thus achieve a cyclic operation, but this reduction operation is not a common operation in surgery, and is only used when it is necessary to re-use the first electrode 4.
The first electrode 4 in this application is a needle-like structure, and is disposed inside the second electrode 5, and may be called an inner cutter wire, specifically, a metal conductor, which is one of the cutting structures. The electrode is a needle-like structure having a conductor portion extending from one end surface and having an outer diameter larger than the entire outer diameter of the first electrode 4, and may be a T-shaped blade or an I-shaped blade. When the inner cutter wire adopts an I-shaped cutter (needle-shaped cutter), a high-frequency mucosa incision cutter without a resetting function can be realized, or a pulling part (such as a bulge on the outer surface) is added at the proximal end of the inner cutter wire to be matched with a corresponding structure of the tubular cutter (such as a guide groove with a specific length arranged at the proximal end) to realize a resetting process.
The second electrode 5 in this application is embodied as a metal conductor, which is one of the cutting structures. It is a tubular structure, which can be called as an outer knife pipe, and is nested outside the first electrode 4, so its inner diameter is larger than the outer diameter of the first electrode 4.
The steel wire rope is particularly a flexible conductor and has certain axial support. The cable can be pushed forward when the slider 112 is pushed distally and pulled backward when the slider is pulled proximally, and can pass current when the electrode lock cylinder 114 is powered on.
In addition to the main structure and the connection relationship of the parts of the high-frequency mucosa incision knife provided in the above embodiments, please refer to the prior art for the structure of other parts of the high-frequency mucosa incision knife, the common parts and the structure, and no further description is given herein.
The embodiments in the present description are described in a progressive manner, each embodiment focuses on differences from other embodiments, and the same and similar parts among the embodiments are referred to each other.
The high-frequency mucosal incision knife provided by the present invention is described in detail above. The principles and embodiments of the present invention are explained herein using specific examples, which are presented only to assist in understanding the method and its core concepts. It should be noted that, for those skilled in the art, it is possible to make various improvements and modifications to the present invention without departing from the principle of the present invention, and those improvements and modifications also fall within the scope of the claims of the present invention.
Claims (19)
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|---|---|---|---|
| CN202011640081.3A CN112618008A (en) | 2020-12-31 | 2020-12-31 | High-frequency mucosa incision knife |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202011640081.3A CN112618008A (en) | 2020-12-31 | 2020-12-31 | High-frequency mucosa incision knife |
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| CN112618008A true CN112618008A (en) | 2021-04-09 |
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| CN202011640081.3A Pending CN112618008A (en) | 2020-12-31 | 2020-12-31 | High-frequency mucosa incision knife |
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| CN115590601A (en) * | 2021-06-28 | 2023-01-13 | 深圳市美好创亿医疗科技股份有限公司（Cn） | High-frequency incision knife |
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