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CN108814711B - Novel mucous membrane incision sword - Google Patents

Novel mucous membrane incision sword Download PDF

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Publication number
CN108814711B
CN108814711B CN201810924871.0A CN201810924871A CN108814711B CN 108814711 B CN108814711 B CN 108814711B CN 201810924871 A CN201810924871 A CN 201810924871A CN 108814711 B CN108814711 B CN 108814711B
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injection
tube
handle
wire
connector
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CN108814711A (en
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李卫华
赵哲光
李晓东
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Zhejiang Chuangxiang Medical Technology Co ltd
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Zhejiang Chuangxiang Medical Technology Co ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00482Digestive system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00982Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention provides a novel mucous membrane incision knife integrating functions of a mucous membrane incision knife and an injection needle. The novel mucous membrane incision knife comprises a handle part and a sheath pipe part, wherein the sheath pipe part comprises an outer sheath pipe, a shredding, a guide wire, an injection needle, a first heat-shrinkable sleeve and an injection joint, the shredding is fixedly connected with the guide wire, the guide wire is connected with the handle part, the outer sheath pipe is connected with the handle part and the injection joint through the first heat-shrinkable sleeve, and the handle part and the injection joint are positioned at the same end part of the first heat-shrinkable sleeve; the inside at least two lumen that is equipped with of sheath pipe, the lumen is including being used for holding the shredding chamber of shredding and seal wire and being used for holding the injection chamber of injection needle, the end cap is through first heat shrinkage bush intercommunication shredding chamber, injection joint is through first heat shrinkage bush intercommunication injection chamber. The invention realizes the peeling and water injection of tissues before and during endoscopic mucosa peeling operation, can continuously fill lost moisture in the operation process, and avoids the conditions of tissue over-cutting and perforation caused by moisture loss.

Description

Novel mucous membrane incision sword
Technical Field
The invention relates to a surgical incision knife, in particular to a novel mucous membrane incision knife, and belongs to the technical field of medical machinery.
Background
The endoscopic mucosa resection is a new treatment means which appears in recent years and is also a technology with good clinical application prospect, so that more early-stage digestive tract cancers can be completely resected under the endoscope at one time, pain of an open surgery and resection of organs are avoided, and an important surgical instrument of the endoscopic mucosa resection is a mucosa resection knife. The common incisors for early cancer dissection in the market include needle cutters, IT cutters (with ceramic heads), hook cutters, triangular cutters, flush cutters (with flushing holes in the cutter heads), woodpecker cutters, and the like.
As an important means in the treatment of digestive tract lesions, in order to prevent perforation during operation, doctors often need to first inject submucosal saline to raise the position of the lesion, after injection with an injection needle, the mucosal incision needs to be replaced, the injected saline will be lost with operation time during operation, and a great deal of time will be wasted during the process of re-injecting saline, because the loss of saline during operation cannot be timely supplemented, increasing the risk of perforation during operation.
The invention patent with the patent application number of CN201410281645.7 discloses a combined electrotome, wherein the tool head part comprises at least two or more tool heads which can move or rotate relative to each other, and doctors can analyze and judge the situation of tissue at a focus part according to the situation of using the proper electrotome to select the proper electrotome type for the tissue at the focus part in different states, so that the operation is safe and quick.
The invention patent with the patent application number 201510937882.9 discloses a multifunctional knife combining an IT knife, a needle knife and water spraying, has the functions of the IT knife and the needle knife, also has the water spraying function, and can wash bleeding points, improve the field of view of an endoscope and wash burnt tissues adhered on an electrode.
Therefore, doctors frequently replace surgical instruments in the surgical process so as to meet different requirements of various operations. However, frequent replacement of surgical instruments is cumbersome and time consuming, which is not beneficial to patient surgery, and the need for a multifunctional combined incision knife saves the time for replacing the instruments. Said invention can implement that doctor can conveniently select different electrotome tool bits instead of changing electrotome or implement water-spraying function to improve internal diameter visual field, but when the injection operation of submucosal physiological saline is required, the prior art has no product capable of saving time for changing mucous membrane cutting-out operation after injection of injection needle.
Disclosure of Invention
The invention aims to provide a novel mucous membrane incision knife integrating functions of a mucous membrane incision knife and an injection needle, which can effectively avoid perforation and improve operation efficiency in endoscopic mucous membrane peeling operation and solve the problems in the prior art.
The technical scheme adopted for solving the technical problems is as follows:
The novel mucous membrane incision knife comprises a handle part and a sheath pipe part, wherein the handle part comprises a handle, a sliding handle and an end cap, a clamping block is arranged on the sliding handle, the sliding handle is in sliding connection with the handle through the clamping block, the handle is connected with the sheath pipe part through the end cap, the sheath pipe part comprises an outer sheath pipe, a shredding, a guide wire, an injection needle, a first heat-shrinkable sleeve and an injection joint, the shredding is fixedly connected with the guide wire, the guide wire is connected with the handle part, the outer sheath pipe is connected with the handle part and the injection joint through the first heat-shrinkable sleeve, and the handle part and the injection joint are positioned at the same end part of the first heat-shrinkable sleeve; the inside of the outer sheath tube is provided with at least two tube cavities, each tube cavity comprises a shredding cavity for accommodating shredding and guide wires and an injection cavity for accommodating an injection needle, the end caps are communicated with the shredding cavity through first heat-shrinkable sleeves, and the injection joints are communicated with the injection cavities through the first heat-shrinkable sleeves; the first limiting tube used for limiting the extension length of the shredding is arranged on the inner wall of the end part of the shredding cavity far away from the handle part, and the second limiting tube used for limiting the extension length of the injection needle is arranged on the inner wall of the end part of the injection cavity far away from the handle part.
Preferably, a wire rope is arranged between the shredding and the guide wire, a first connecting pipe and a second connecting pipe are respectively arranged at two ends of the wire rope, the shredding is fixedly connected with the wire rope through the first connecting pipe, the guide wire is fixedly connected with the wire rope through the second connecting pipe, and the outer diameter of the first connecting pipe is larger than the inner diameter of the first limiting pipe.
Preferably, the outer wall of the injection needle is provided with a fixed tube, the fixed tube is fixedly connected with the injection needle, and the outer diameter of the fixed tube is larger than the inner diameter of the second limiting tube.
Preferably, the outer walls of the first limiting tube and the second limiting tube are provided with a plurality of barbs, the first limiting tube is tightly matched with the shredding cavity through the barbs, and the second limiting tube is tightly matched with the injection cavity through the barbs.
Preferably, the injection connector comprises a fixed connector and a movable luer connector for connecting an external infusion apparatus, one end of the fixed connector is inserted into the first heat shrinkage sleeve and connected with the injection needle, the other end of the fixed connector is connected with the movable luer connector, and a sealing ring is arranged at one end of the injection needle connected with the fixed connector.
Preferably, a second heat-shrinkable sleeve is arranged between the end cap and the first heat-shrinkable sleeve, and two ends of the second heat-shrinkable sleeve are respectively and fixedly connected with the first heat-shrinkable sleeve and the end cap.
Preferably, a conductive spring and an electrode for connecting with external high-frequency electrotome equipment are arranged in the end cap, and the guide wire is connected with the electrode through the conductive spring.
Preferably, a guide pipe is arranged in the handle, and the guide wire extends into the guide pipe to be fixedly connected with the clamping block.
Preferably, the outer wall of the end part of the outer sheath tube far away from the handle part is provided with a marking line for distinguishing the moving distance.
Preferably, the inner diameter of the shredding cavity is smaller than that of the injection cavity.
The beneficial effects of the invention are as follows:
The novel mucous membrane incision knife provided by the invention realizes the peeling and water injection of tissues before and during endoscopic mucous membrane peeling operation, can continuously fill lost moisture in the operation process, avoids the situation of tissue over-cutting and perforation caused by moisture loss, integrates the functions of the mucous membrane incision knife and an injection needle, reduces the replacement time of surgical instruments, saves the operation effort of doctors, and ensures that the operation is more efficient and safer.
Drawings
FIG. 1 is a schematic diagram of the front view of the present invention;
FIG. 2 is a schematic view of the shredding operation of the present invention;
FIG. 3 is a schematic view of the needle of the present invention in operation;
FIG. 4 is a schematic view of the present invention in a non-operative state;
FIG. 5 is a schematic view of the end structure of the outer sheath tube of the present invention;
FIG. 6 is a schematic view of the operation of the present invention;
FIG. 7 is a schematic cross-sectional view of an outer sheath of the present invention.
In the figure: 101. the handle, 102, sliding handle, 103, end cap, 104, fixture block, 105, conductive spring, 106, electrode, 107, catheter, 201, sheath, 202, filament, 203, guide wire, 204, injection needle, 205, first heat shrink sleeve, 206, injection joint, 207, filament cavity, 208, injection cavity, 209, first limiting tube, 210, second limiting tube, 211, barb, 212, wire rope, 213, first connecting tube, 214, second connecting tube, 215, fixed tube, 216, fixed joint, 217, mobile luer joint, 218, sealing ring, 219, second heat shrink sleeve, 220, marking wire.
Detailed Description
The technical scheme of the invention is further specifically described below through specific embodiments and with reference to the accompanying drawings. It should be understood that the practice of the invention is not limited to the following examples, but is intended to be within the scope of the invention in any form and/or modification thereof.
Examples:
A novel mucosal cutting knife as shown in fig. 1 and 5, comprising a handle part and a sheath part.
The handle part comprises a handle 101, a sliding handle 102 and an end cap 103, a clamping block 104 is arranged on the sliding handle, the sliding handle is in sliding connection with the handle through the clamping block, and the handle is connected with the sheath pipe part through the end cap.
The sheath portion includes an outer sheath 201, a filament 202, a guidewire 203, an injection needle 204, a first heat shrink 205, and an injection fitting 206. The shredding is fixedly connected with a guide wire which is connected with the handle part. The sheath tube is connected with the handle part and the injection joint through the first heat-shrinkable sleeve, and the handle part and the injection joint are positioned at the same end part of the first heat-shrinkable sleeve.
As shown in fig. 7, two lumens are provided inside the outer sheath, and the lumens include a shredding lumen 207 for accommodating shreds and guide wires and an injection lumen 208 for accommodating injection needles, the shredding lumen having an inner diameter smaller than the injection lumen inner diameter. The end cap is communicated with the shredding cavity through the first heat-shrinkable sleeve, and the injection joint is communicated with the injection cavity through the first heat-shrinkable sleeve.
The first limiting tube 209 for limiting the extension length of the shreds is arranged on the inner wall of the end part of the shredding cavity far away from the handle part, and the second limiting tube 210 for limiting the extension length of the injection needle is arranged on the inner wall of the end part of the injection cavity far away from the handle part. The outer walls of the first limiting tube and the second limiting tube are provided with a plurality of barbs 211, the first limiting tube is tightly matched with the shredding cavity through the barbs, and the second limiting tube is tightly matched with the injection cavity through the barbs.
Be equipped with wire rope 212 between shredding and the seal wire, wire rope is used for increasing this novel mucous membrane incision sword in the bendability in the operation. The wire rope both ends are equipped with first connecting pipe 213 and second connecting pipe 214 respectively, and the filament is through first connecting pipe and wire rope fixed connection, and the seal wire passes through second connecting pipe and wire rope fixed connection. The external diameter of first connecting pipe is greater than the internal diameter of first spacing pipe, through the cooperation of first connecting pipe and first spacing pipe, control the length that the shredding stretched out when shredding forward movement. The first connecting pipe is fixedly connected with the shredding and the steel wire rope through laser welding.
The outer wall of the injection needle is provided with a fixing tube 215 which is fixedly connected with the injection needle. The external diameter of the fixed pipe is larger than the internal diameter of the second limiting pipe, and the length of the extending injection needle is controlled when the injection needle moves forwards through the cooperation of the fixed pipe and the second limiting pipe. The fixed tube is fixedly connected with the injection needle through laser welding.
The injection joint comprises a fixed joint 216 and a movable luer joint 217 for connecting an external infusion apparatus, one end of the fixed joint is inserted into the first heat shrinkage sleeve and connected with the injection needle, the other end of the fixed joint is connected with the movable luer joint, and the movable luer joint can drive the injection needle to move back and forth in the outer sheath tube. The needle is provided with a sealing ring 218 at one end connected to the fixed joint for preventing reverse flow of body fluid when the needle moves back and forth.
A second heat-shrinkable sleeve 219 is arranged between the end cap and the first heat-shrinkable sleeve, and two ends of the second heat-shrinkable sleeve are respectively and fixedly connected with the first heat-shrinkable sleeve and the end cap.
The end cap is internally provided with a conductive spring 105 and an electrode 106 for connecting with external high-frequency electric knife equipment, the guide wire is connected with the electrode through the conductive spring, and the electrode is connected with the external high-frequency electric knife equipment to electrify the guide wire.
The handle is internally provided with a guide pipe 107, the guide wire stretches into the guide pipe to be fixedly connected with a clamping block, the guide wire penetrates through the end cap and the guide pipe and is fixedly connected with the clamping block of the sliding handle, and the sliding handle and the handle can relatively slide to drive the shredding to move back and forth in the outer sheath.
To facilitate viewing of the extended length of the needle and the filament, the outer wall of the sheath tube at the end distal from the handle portion is provided with a marker line 220 for resolving the distance of movement.
The novel mucous membrane incision knife comprises the following using steps:
1. As shown in fig. 4, the sliding handle and the moving luer are pulled back in the direction of the arrow shown in the drawing, and the needle and filament are simultaneously received within the sheath.
2. The novel mucous membrane incision knife is inserted into a human body through an endoscope forceps channel pipe.
3. As shown in fig. 2, the sliding handle is pushed forward in the direction of the arrow shown in the drawing, and the filament is extended out of the outer sheath.
4. As shown in fig. 6, panels a and B, burn marks the lesion size range on normal mucosa at the margin of diseased tissue.
5. As shown in fig. 3, the sliding handle is pulled back in the direction of the arrow shown, the filaments are retracted, and the movable luer is pushed forward in the direction of the arrow shown, extending the needle.
6. As shown in fig. 6C, an injection needle is inserted from the lesion edge, and a liquid is injected into the submucosa to swell the lesion tissue.
7. As shown in fig. 2, the sliding handle is pushed forward in the direction of the arrow shown, the filament extends out of the sheath, the movable luer is pulled back in the direction of the arrow shown, and the needle is retracted.
8. As shown in fig. 6D, the lesion tissue is peeled along the marked point.
9. The operations of steps 5, 6, 7, 8 can be repeated if necessary to inject liquid into submucosa during the dissection process until the diseased tissue is completely isolated.
10. The diseased tissue is removed with a snare or a net bag for pathological analysis.
The above-described embodiment is only a preferred embodiment of the present invention, and is not limited in any way, and other variations and modifications may be made without departing from the technical aspects set forth in the claims.

Claims (7)

1.一种新型黏膜切开刀,包括手柄部和鞘管部,所述的手柄部包括手柄、滑动把手和端帽,滑动把手上设有卡块,滑动把手通过卡块与手柄滑动连接,手柄通过端帽连接鞘管部,其特征在于:所述的鞘管部包括外鞘管、切丝、导丝、注射针、第一热缩套管和注射接头,切丝与导丝固定连接,导丝连接手柄部,外鞘管通过第一热缩套管连接手柄部和注射接头,手柄部和注射接头位于第一热缩套管的同一端部;所述的切丝与导丝之间设有钢丝绳,钢丝绳两端分别设有第一连接管和第二连接管,切丝通过第一连接管与钢丝绳固定连接,导丝通过第二连接管与钢丝绳固定连接,第一连接管的外径大于第一限位管的内径;所述的注射接头包括固定接头和用于连接外部输液器的移动鲁尔接头,固定接头一端插入第一热缩套管内并连接注射针,固定接头另一端连接移动鲁尔接头,注射针在与固定接头连接的一端设有密封圈;所述的外鞘管内部设有至少两个管腔,管腔包括用于容纳切丝和导丝的切丝腔以及用于容纳注射针的注射腔,端帽通过第一热缩套管连通切丝腔,注射接头通过第一热缩套管连通注射腔;所述的切丝腔在远离手柄部的一端端部内壁设有用于限定切丝伸出长度的第一限位管,所述的注射腔在远离手柄部的一端端部内壁设有用于限定注射针伸出长度的第二限位管;所述的第一限位管和第二限位管外壁均设有若干倒刺,第一限位管通过倒刺与切丝腔紧密配合,第二限位管通过倒刺与注射腔紧密配合。1. A novel mucosal incision knife comprises a handle part and a sheath part, wherein the handle part comprises a handle, a sliding handle and an end cap, a clamping block is provided on the sliding handle, the sliding handle is slidably connected to the handle through the clamping block, and the handle is connected to the sheath part through the end cap, characterized in that: the sheath part comprises an outer sheath, a cutting wire, a guide wire, an injection needle, a first heat shrinkable sleeve and an injection connector, the cutting wire is fixedly connected to the guide wire, the guide wire is connected to the handle part, the outer sheath is connected to the handle part and the injection connector through the first heat shrinkable sleeve, and the handle part and the injection connector are located at the same end of the first heat shrinkable sleeve; a steel wire rope is provided between the cutting wire and the guide wire, and a first connecting tube and a second connecting tube are respectively provided at both ends of the steel wire rope, the cutting wire is fixedly connected to the steel wire rope through the first connecting tube, and the guide wire is fixedly connected to the steel wire rope through the second connecting tube, and the outer diameter of the first connecting tube is larger than the inner diameter of the first limiting tube; the injection connector comprises a fixed connector and a connector for connecting A mobile Luer connector connected to an external infusion set, one end of the fixed connector is inserted into the first heat shrink sleeve and connected to the injection needle, the other end of the fixed connector is connected to the mobile Luer connector, and the injection needle is provided with a sealing ring at the end connected to the fixed connector; at least two cavities are provided inside the outer sheath, the cavities include a wire cutting cavity for accommodating cut wires and guide wires and an injection cavity for accommodating the injection needle, the end cap is connected to the wire cutting cavity through the first heat shrink sleeve, and the injection connector is connected to the injection cavity through the first heat shrink sleeve; the wire cutting cavity is provided with a first limiting tube for limiting the extension length of the cut wire at the inner wall at the end away from the handle portion, and the injection cavity is provided with a second limiting tube for limiting the extension length of the injection needle at the inner wall at the end away from the handle portion; the outer walls of the first limiting tube and the second limiting tube are both provided with a plurality of barbs, the first limiting tube is tightly matched with the wire cutting cavity through the barbs, and the second limiting tube is tightly matched with the injection cavity through the barbs. 2.根据权利要求1所述的一种新型黏膜切开刀,其特征在于:所述的注射针外壁设有固定管,固定管与注射针固定连接,固定管的外径大于第二限位管的内径。2. A new type of mucosal incision knife according to claim 1, characterized in that: a fixed tube is provided on the outer wall of the injection needle, the fixed tube is fixedly connected to the injection needle, and the outer diameter of the fixed tube is larger than the inner diameter of the second limiting tube. 3.根据权利要求1所述的一种新型黏膜切开刀,其特征在于:所述的端帽与第一热缩套管之间设有第二热缩套管,第二热缩套管两端分别固定连接第一热缩套管和端帽。3. A new type of mucosal incision knife according to claim 1, characterized in that: a second heat shrinkable tube is provided between the end cap and the first heat shrinkable tube, and two ends of the second heat shrinkable tube are respectively fixedly connected to the first heat shrinkable tube and the end cap. 4.根据权利要求1所述的一种新型黏膜切开刀,其特征在于:所述的端帽内设有导电弹簧和用于连接外部高频电刀设备的电极,导丝通过导电弹簧连接电极。4. A new type of mucosal incision knife according to claim 1, characterized in that: a conductive spring and an electrode for connecting to an external high-frequency electric knife device are provided in the end cap, and the guide wire is connected to the electrode through the conductive spring. 5.根据权利要求1所述的一种新型黏膜切开刀,其特征在于:所述的手柄内设有导管,导丝伸入导管固定连接卡块。5. A novel mucosal incision knife according to claim 1, characterized in that: a catheter is provided in the handle, and a guide wire is inserted into the catheter to be fixedly connected to a clamp block. 6.根据权利要求1所述的一种新型黏膜切开刀,其特征在于:所述的外鞘管在远离手柄部的一端端部外壁设有用于分辨移动距离的标记线。6. A novel mucosal incision knife according to claim 1, characterized in that: a marking line for distinguishing the moving distance is provided on the outer wall of the end of the outer sheath tube away from the handle. 7.根据权利要求1所述的一种新型黏膜切开刀,其特征在于:所述的切丝腔内径小于注射腔内径。7. A new type of mucosal incision knife according to claim 1, characterized in that the inner diameter of the cutting cavity is smaller than the inner diameter of the injection cavity.
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CN110123415A (en) * 2019-04-23 2019-08-16 齐从虎 A kind of endoscopic hemostasis removing integrated knife
CN110833441A (en) * 2019-06-19 2020-02-25 宋健 A novel multifunctional mucosal incision knife
CN112790856B (en) * 2021-01-18 2022-04-05 山东第一医科大学附属肿瘤医院(山东省肿瘤防治研究院、山东省肿瘤医院) Disposable mucosa incision knife with injection needle and use method
CN115530960B (en) * 2021-06-30 2025-09-12 深圳开立生物医疗科技股份有限公司 A two-in-one therapeutic device
CN114404031B (en) * 2022-02-15 2024-05-03 珠海市司迈科技有限公司 Electric cutting mirror assembly and sealing structure thereof
CN119454218B (en) * 2025-01-14 2025-04-01 成都安捷畅医疗科技有限公司 Endoscopic mucous membrane incision knife capable of uplifting tissues

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