CN204815001U - Through sheath vacuum aspiration adjusting device for endoscopic stone extraction technique - Google Patents
Through sheath vacuum aspiration adjusting device for endoscopic stone extraction technique Download PDFInfo
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Abstract
本实用新型涉及一种经鞘内镜取石术所用负压吸引调节装置，包括壳体，壳体上开设有内镜入口、鞘管安装口和负压接入口，壳体上还设置与壳体的腔室连通的负压调节机构。本实用新型的有益效果为：术者本人可以直接准确设置和调控负压吸力大小至合理值，可避免负压过高导致肾内出血加重和负压过低导致引流不畅，肾内低压状态无法维持，碎石无法吸出等情况，可直接观察鞘管负压引流状况，及时发现和处理碎石、血凝块所致鞘内引流通道阻塞等情况；可直接使用手术室常用中央负压吸引源，不需要专用特殊负压控制和监测设备；广泛适用于临床各种口径剥皮鞘和输尿管通过鞘，适用于各种软硬内镜，无需特制鞘或镜体；装置小巧，结构简单，使用方便，费用低廉。
The utility model relates to a negative pressure suction adjustment device used in transsheath endoscopic lithotomy, which comprises a casing, on which an endoscope inlet, a sheath tube installation port and a negative pressure inlet are arranged, and the casing is also provided with the casing. The chamber communicates with the negative pressure regulating mechanism. The beneficial effects of the utility model are: the surgeon can directly and accurately set and regulate the negative pressure suction to a reasonable value, which can avoid the aggravation of intrarenal hemorrhage caused by too high negative pressure and poor drainage caused by too low negative pressure, and the low pressure in the kidney cannot Maintenance, broken stones cannot be sucked out, etc., you can directly observe the negative pressure drainage status of the sheath tube, and timely find and deal with the blockage of the intrathecal drainage channel caused by broken stones and blood clots; you can directly use the central negative pressure suction source commonly used in the operating room , does not require special negative pressure control and monitoring equipment; it is widely applicable to various caliber skinning sheaths and ureteral passage sheaths in clinical practice, and is suitable for various soft and hard endoscopes, without special sheath or mirror body; the device is compact, simple in structure, and easy to use , low cost.
Description
技术领域technical field
本实用新型属于医疗器械领域，具体涉及一种经鞘内镜取石术用负压吸引调节装置。The utility model belongs to the field of medical equipment, in particular to a negative pressure suction adjustment device for transsheath endoscopic lithotomy.
背景技术Background technique
尿路结石是临床常见病，经皮肾镜碎石术和输尿管软镜取石术等经鞘内镜取石手术是处理肾与输尿管结石为最常见治疗方式。经鞘内镜取石手术实质是通过将空心鞘置入人体内并到达手术部位(肾盂和输尿管上段)后再经鞘置入内镜取石的微创手术术式，术中需经内镜镜体中注水通道向肾内灌注生理盐水以保证手术视野清晰，但这可导致肾盂内压升高而易致细菌返流入血，出现尿源性脓毒血症、休克、死亡；经鞘与内镜镜体间空隙自然引流排出灌注液不充分限制了灌注流量,常影响视野清晰度从而影响碎石效率；取石方式主要靠取石钳或套石篮反复取石或高压水流冲出结石，耗时长；术中灌注液四溢浸湿手术区域干扰操作。Urinary tract stones are a common clinical disease. Percutaneous nephrolithotripsy and flexible ureteroscopy and other transsheath endoscopic stone removal operations are the most common treatment methods for kidney and ureteral stones. The essence of transthecal endoscopic stone extraction is a minimally invasive surgical procedure in which a hollow sheath is inserted into the human body and reaches the surgical site (renal pelvis and upper ureter), and then the sheath is placed into the endoscopic stone extraction. The central water injection channel infuses physiological saline into the kidney to ensure a clear surgical field of view, but this can lead to an increase in the internal pressure of the renal pelvis, which can easily cause bacteria to flow back into the blood, causing urogenous sepsis, shock, and death; Insufficient drainage of the perfusion fluid from the space between the lens bodies limits the perfusion flow, which often affects the clarity of the field of view and thus affects the efficiency of lithotripsy; the stone extraction method mainly relies on stone extraction forceps or stone baskets to repeatedly extract stones or high-pressure water to wash out stones, which takes a long time; The medium perfusate overflows and wets the operation area and interferes with the operation.
现今经鞘内镜取石手术中利用负压吸引降低肾内压和提高取石效率是一个重要的技术发展方向。现有的负压吸引碎石技术包括：1.超声碎石吸石探杆及设备，缺点：超声碎石效率低，常需配合其他碎石设备，探杆内吸石通道狭小，无法清除大块碎石，取石效率低；2.具有吸石通道和/或肾内测压通道的特制鞘体或镜体，可配套有负压监测和调控设备仪器。缺点：1.鞘或镜体上需设置负压吸引或肾内压测压专用通道，技术难度大，增加了鞘或镜体直径，既限制了其他操作通道也增加了通道相关的损伤；2.单纯负压吸引，不使用准确负压吸力控制设备，可致负压过大，易导致引起肾内出血、组织贴附内镜、视野不清，或负压过小，肾内低压或负压状态无法维持，引流不畅，碎石无法吸出。3.专用负压吸引和监测设备虽可实时调节负压大小和监测肾内压力，但需专人操作，术者本人无法设置和调控负压状态。事实上术中肾盂内压不必实时精确监控，而是只需保持适当肾内低压或负压即可；4.目前经鞘内镜取石手术中最广泛使用的是一次性剥皮鞘或输尿管通过鞘，负压吸引装置应可以与其便捷连接，而不是另外特制鞘体或镜体；5.现有金属或塑料负压吸引连接装置无法观察鞘管引流状况，术中吸出的碎石可以经常阻塞管道，造成引流通而不畅且不能及时处理，导致肾内低压或负压不能维持。因此，现有负压吸引碎石系统存在技术困难，结构复杂，使用不便，需多个配套设备仪器且费用高昂等缺陷，不适合广泛开展应用。It is an important technical development direction to use negative pressure suction to reduce the intrarenal pressure and improve the efficiency of stone removal in transthecal endoscopic stone removal. Existing negative pressure lithotripsy techniques include: 1. Ultrasonic lithotripsy probe rod and equipment. Disadvantages: Ultrasonic lithotripsy has low efficiency and often needs to cooperate with other lithotripsy equipment. 2. A special sheath body or mirror body with stone suction channel and/or intrarenal pressure measurement channel can be equipped with negative pressure monitoring and control equipment. Disadvantages: 1. Special channel for negative pressure suction or intrarenal pressure measurement needs to be set on the sheath or mirror body, which is technically difficult and increases the diameter of the sheath or mirror body, which not only limits other operating channels but also increases channel-related damage; 2 .Pure negative pressure suction without accurate negative pressure suction control equipment can cause excessive negative pressure, which can easily lead to intrarenal hemorrhage, tissue-attached endoscopy, unclear vision, or too small negative pressure, low pressure or negative pressure in the kidney The state cannot be maintained, the drainage is not smooth, and the gravel cannot be sucked out. 3. Although the special negative pressure suction and monitoring equipment can adjust the negative pressure and monitor the intrarenal pressure in real time, it needs to be operated by a special person, and the operator cannot set and control the negative pressure state. In fact, the intra-renal pelvic pressure does not need to be monitored accurately in real time, but only needs to maintain an appropriate intrarenal low pressure or negative pressure; 4. At present, the most widely used one-time peeling sheath or ureteral passage sheath is the most widely used in transsheath endoscopic stone extraction , the negative pressure suction device should be easily connected to it, instead of a special sheath or mirror body; 5. The existing metal or plastic negative pressure suction connection device cannot observe the drainage status of the sheath tube, and the aspirated debris during the operation can often block the pipeline , resulting in poor drainage and cannot be dealt with in time, resulting in low pressure or negative pressure in the kidneys that cannot be maintained. Therefore, the existing negative pressure suction crushing system has defects such as technical difficulties, complex structure, inconvenient use, multiple supporting equipment and instruments, and high cost, and is not suitable for wide application.
实用新型内容Utility model content
为了解决现有技术存在的上述问题，本实用新型提供了一种经鞘内镜取石术用负压吸引调节装置。In order to solve the above-mentioned problems in the prior art, the utility model provides a negative pressure suction adjustment device for transthecal endoscopic lithotomy.
本实用新型所采用的技术方案为：The technical scheme adopted in the utility model is:
一种经鞘内镜取石术用负压吸引调节装置，包括透明医用塑料的壳体，所述壳体上开设有内镜入口、鞘管安装口和负压接入口，所述内镜入口与所述鞘管安装口不在同一平面上；还包括与所述壳体的内部腔室连通的负压调节机构，且所述负压调节机构竖直设置。本实用新型为管腔状密闭连接装置，实现将现有的临床广泛使用的经皮肾造瘘鞘/输尿管通过鞘和负压吸引连接，不用专门设计有负压吸引或测压通道的鞘体或镜体，同时保证内镜自由进出。A negative pressure suction adjustment device for transthecal endoscopic lithotomy, comprising a transparent medical plastic shell, the shell is provided with an endoscope inlet, a sheath tube installation port and a negative pressure inlet, the endoscope inlet and The sheath tube installation openings are not on the same plane; it also includes a negative pressure adjustment mechanism communicated with the inner chamber of the housing, and the negative pressure adjustment mechanism is vertically arranged. The utility model is a lumen-shaped airtight connection device, which realizes the connection of the existing clinically widely used percutaneous nephrostomy sheath/ureter through the sheath and negative pressure suction, and does not need a sheath specially designed with negative pressure suction or pressure measurement channels Or the mirror body, while ensuring the free entry and exit of the endoscope.
优选的，所述内镜入口与所述鞘管安装口相对设置。将内镜入口与鞘管安装口相对设置，保证内镜通过的路径为直线，从而保证内镜能便捷进入鞘管。Preferably, the inlet of the endoscope is set opposite to the installation port of the sheath. The entrance of the endoscope is arranged opposite to the installation port of the sheath to ensure that the passage of the endoscope is a straight line, thereby ensuring that the endoscope can easily enter the sheath.
优选的，还包括内镜引导管，所述内镜引导管由所述内镜入口伸入所述壳体腔室内部，所述内镜引导管的尾端与所述鞘管安装口间隔设置，且间隔距离大于鞘管的内镜。内镜引导管为内镜搭设了一条通路，保证软硬内镜均可经此顺畅进入鞘管内，从而提高操作的准确性。引导管尾端与鞘管安装口间隔距离大于鞘口直径，保证了碎石可以通过负压吸引自鞘管安装口处鞘口顺畅排出至壳体腔室内，再经负压接入口排出。Preferably, it also includes an endoscope guide tube, the endoscope guide tube extends into the housing chamber from the endoscope inlet, and the tail end of the endoscope guide tube is spaced apart from the sheath tube installation port, Endoscopes with a separation distance greater than that of the sheath. The endoscopic guide tube sets up a passage for the endoscope to ensure that both soft and hard endoscopes can enter the sheath smoothly through this, thereby improving the accuracy of the operation. The distance between the tail end of the guide tube and the installation port of the sheath tube is greater than the diameter of the sheath port, which ensures that the gravel can be smoothly discharged from the sheath port at the installation port of the sheath tube through negative pressure suction and discharged into the housing chamber, and then discharged through the negative pressure inlet.
进一步的，还包括用以防止灌注液从所述内镜引导管前端溢出的防溢阀，防溢阀为中空的防溢阀，所述防溢阀上开设有上下贯穿所述防溢阀的通道，所述通道的形状为中间窄两端宽的双喇叭形，所述通道的侧壁采用的材料为弹性材料。本实用新型所指前、后方向为手术时，靠近术者方向为前方向，靠近患者方向为后方向。主要利用术中引导管内负压和管外大气压作用实现引导管管口和内镜体之间缝隙(双喇叭口通道的中间缩窄部分)的密闭，而不仅仅单纯依赖弹力材料弹性回缩作用封闭管口。所述防溢阀密闭效果确切，耐用性好，适合各种规格的软硬镜体便捷通过，且可避免软镜受损。Further, it also includes an anti-overflow valve for preventing perfusate from overflowing from the front end of the endoscope guide tube, the anti-overflow valve is a hollow anti-overflow valve, and the anti-overflow valve is provided with a hole that runs through the anti-overflow valve up and down. The channel is shaped like a double trumpet with a narrow center and wide ends, and the side wall of the channel is made of elastic material. When the utility model refers to anterior and posterior directions for surgery, the direction close to the operator is the front direction, and the direction close to the patient is the posterior direction. Mainly use the negative pressure inside the guide tube and the atmospheric pressure outside the tube to seal the gap between the guide tube nozzle and the endoscope body (the middle narrowing part of the double bell mouth channel), instead of relying solely on the elastic retraction of the elastic material Close the orifice. The anti-overflow valve has accurate sealing effect and good durability, and is suitable for flexible and hard mirror bodies of various specifications to pass through easily, and can avoid damage to the flexible mirror.
优选的，所述鞘管安装口上设有密封嘴，所述密封嘴采用弹性材料制成，且所述密封嘴上开设有可与鞘管过盈配合的通孔。所述密封件可匹配多规格的鞘管并与之过盈配合，从而保证所述壳体腔内的相对气密性并固定鞘管。Preferably, a sealing mouth is provided on the installation port of the sheath tube, and the sealing mouth is made of elastic material, and a through hole capable of interference fit with the sheath tube is opened on the sealing mouth. The sealing member can match and interfere with multi-standard sheath tubes, so as to ensure the relative airtightness in the cavity of the housing and fix the sheath tubes.
优选的，所述负压接入口设置于所述壳体的底侧。所述壳体腔室的最低位侧壁上开设所述负压接入口，其口径大于鞘管口径并呈漏斗状，有利于碎石和血凝块在重力和负压吸引作用下快速进入结石收集器。Preferably, the negative pressure inlet is provided on the bottom side of the housing. The negative pressure inlet is provided on the lowest side wall of the housing chamber, and its caliber is larger than the caliber of the sheath tube and is funnel-shaped, which is beneficial for gravel and blood clots to quickly enter the stone collection under the action of gravity and negative pressure attraction. device.
进一步的，所述负压调节机构包括压力显示管和空气填充室；所述压力显示管为竖直设置的管体，且所述压力显示管将所述空气填充室与所述腔室连通。所述空气填充室上设有排气阀。负压调节机构是直接观察负压变化和调节负压引力大小的结构：术中在开启负压吸引前，灌注液经内镜通道注入肾盂再经鞘口引流出至壳体腔室并进入压力显示管内，排挤其中空气自排气阀逸出，当仅空气填充室内留有空气时关闭排气阀，此时压力显示管内为灌注液所充填。负压吸引开始后，压力显示管内液面将下降，根据波义耳定律及气体方程，空气体积变大则压力变小，术者可通过压力显示管内液面的高低来判断负压大小。Further, the negative pressure regulating mechanism includes a pressure display tube and an air filling chamber; the pressure display tube is a vertical tube body, and the pressure display tube communicates the air filling chamber with the chamber. The air-filled chamber is provided with an exhaust valve. The negative pressure adjustment mechanism is a structure that directly observes the change of negative pressure and adjusts the magnitude of the negative pressure gravity: before the negative pressure suction is turned on during the operation, the perfusion fluid is injected into the renal pelvis through the endoscopic channel and then drained out to the shell chamber through the sheath port and enters the pressure display. In the tube, squeeze out the air and escape from the exhaust valve. When there is only air in the air-filled chamber, close the exhaust valve. At this time, the pressure shows that the tube is filled with perfusate. After the negative pressure suction starts, the liquid level in the pressure display tube will drop. According to Boyle's law and the gas equation, the pressure will decrease as the air volume increases. The surgeon can judge the negative pressure by the level of the liquid level in the pressure display tube.
优选的，所述压力显示管上沿其长轴还设置有负压压力标记。术中当所述压力显示管内液面下降到标记的手术拟设负压压力值时即表示所述壳体腔内负压吸力设置完成，从而为术者提供简单而直观的操作指示。术者本人可根据术中灌注液流量、灌注压力、视野清晰程度、出血状况、肾内空间大小、结石是否顺畅吸出等情况，利用所述负压接入口连接的负压调节阀准确调节负压大小，使其达到最佳负压吸力并处于安全范围内。同时，术中可以通过直接观察压力显示管内液平高度变化判定鞘管引流状况，如液平高度明显降低，说明壳体腔内负压过大，鞘管中灌注液流出受阻，有碎石或血凝块阻塞，需立即清除。Preferably, the pressure display tube is also provided with a negative pressure mark along its long axis. During the operation, when the liquid level in the pressure display tube drops to the marked surgical negative pressure value, it means that the negative pressure suction in the housing cavity is set, thereby providing simple and intuitive operation instructions for the operator. The operator himself can use the negative pressure regulating valve connected to the negative pressure inlet to accurately adjust the negative pressure according to the intraoperative perfusion fluid flow rate, perfusion pressure, visual field clarity, bleeding status, space size in the kidney, and whether the stones are sucked out smoothly. Size, so that it can reach the best negative pressure suction and be in a safe range. At the same time, during the operation, the sheath drainage status can be judged by directly observing the change of the liquid level in the pressure display tube. If the liquid level drops significantly, it indicates that the negative pressure in the shell cavity is too large, the outflow of the perfusate in the sheath tube is blocked, and there are stones or blood. The clot is obstructed and needs to be removed immediately.
本实用新型的有益效果为：术者本人可以直观准确设置和调控负压吸力大小至恰当安全值，可避免负压过大导致肾内出血加重和负压过低导致引流不畅，肾内低压状态无法维持，碎石无法吸出等情况，可直接观察鞘管负压引流状况，及时发现和处理碎石、血凝块所致鞘内引流通道阻塞等情况。使用手术室常用中央负压吸引源，不需要专用特殊负压控制和监测设备。适用于常用各种口径剥皮鞘和输尿管通过鞘，适用于各种软硬内镜，无需特制鞘或镜体。装置小巧，结构简单，使用方便，费用低廉，易于广泛应用。The beneficial effects of the utility model are: the operator can intuitively and accurately set and regulate the negative pressure suction to an appropriate safe value, which can avoid the aggravation of intrarenal hemorrhage caused by excessive negative pressure and poor drainage and low pressure in the kidney caused by low negative pressure. If it cannot be maintained or the crushed stones cannot be sucked out, etc., the negative pressure drainage status of the sheath tube can be directly observed, and timely detection and treatment of the blockage of the intrathecal drainage channel caused by crushed stones and blood clots can be made. Using the common central negative pressure suction source in the operating room does not require special negative pressure control and monitoring equipment. It is suitable for commonly used various caliber peeling sheaths and ureteral passage sheaths, and is suitable for all kinds of flexible and hard endoscopes, without special sheaths or mirror bodies. The device is compact, simple in structure, convenient to use, low in cost and easy to be widely used.
附图说明Description of drawings
图1是本实用新型经皮肾镜碎石术所用负压吸引调节装置的立体结构示意图；Fig. 1 is the three-dimensional structure schematic diagram of the negative pressure suction adjusting device used in the percutaneous nephrolithotripsy of the utility model;
图2是图1的剖视图；Fig. 2 is a sectional view of Fig. 1;
图3是本实用新型输尿管软镜取石术所用负压吸引调节装置的立体结构示意图；Fig. 3 is a three-dimensional structural schematic diagram of the negative pressure suction adjustment device used in the flexible ureteroscope stone removal operation of the present invention;
图4是图3的剖视图。FIG. 4 is a sectional view of FIG. 3 .
图中：1、壳体；2、负压调节机构；3、防溢阀；11、鞘管安装口；12、内镜入口；13、负压接入口；14、密封嘴；；21、压力显示管；22、空气填充室；23、排气阀；31、内镜引导管；5、镜托。In the figure: 1. Shell; 2. Negative pressure adjustment mechanism; 3. Anti-overflow valve; 11. Sheath installation port; 12. Endoscope inlet; 13. Negative pressure inlet; 14. Sealing mouth; 21. Pressure Display tube; 22, air filling chamber; 23, exhaust valve; 31, endoscope guide tube; 5, mirror holder.
具体实施方式Detailed ways
如图1～4所示，本实用新型提供了一种经鞘内镜取石术用负压吸引调节装置，包括壳体1，所述壳体1上开设有内镜入口12、鞘管安装口11和负压接入口13，所述壳体1上还竖直设置有与所述壳体1的腔室连通的负压调节机构2。采用分体设计，壳体分为可拆开的盖体和与座体两部分，分解状态下便于插入鞘管，盖与座体可密封配合成一体，形成内部密闭腔室。在盖体上设有内镜入口，内镜引导管，负压调节机构。座体上开设鞘管安装口和负压接入口，分别用于安装鞘管和连接负压吸引。均用透明轻薄硬质医用塑料材料制成，如聚丙烯。As shown in Figures 1 to 4, the utility model provides a negative pressure suction adjustment device for transthecal endoscopic lithotomy, which includes a housing 1, and the housing 1 is provided with an endoscope inlet 12 and a sheath tube installation port. 11 and a negative pressure inlet 13, the housing 1 is also vertically provided with a negative pressure regulating mechanism 2 communicating with the chamber of the housing 1 . The split design is adopted, and the shell is divided into two parts: the detachable cover and the base. It is easy to insert the sheath in the disassembled state, and the cover and the base can be sealed and integrated to form an internal airtight chamber. An endoscope inlet, an endoscope guide tube and a negative pressure regulating mechanism are arranged on the cover body. A sheath tube installation port and a negative pressure inlet port are provided on the seat body, which are respectively used for installing the sheath tube and connecting with negative pressure suction. Both are made of transparent light thin rigid medical plastic material such as polypropylene.
鞘管安装口11上设有密封嘴14；密封嘴14采用的材料为弹性材料，且所述密封嘴14上开设有通孔，该通孔可制成多孔径以与不同规格的鞘管过盈配合，保证壳体内的相对气密性。The sheath tube installation port 11 is provided with a sealing mouth 14; the material used for the sealing mouth 14 is an elastic material, and a through hole is provided on the sealing mouth 14, and the through hole can be made into multiple diameters to pass through the sheath tubes of different specifications. The tight fit ensures the relative airtightness in the housing.
所述内镜入口12与所述鞘管安装口11不在同一平面上。内镜进入内镜入口后可使壳体1和负压调节机构2组成的贯通空间处于非密封状态，因此，须设置防溢阀3以隔绝外部的空气，且防止灌注液外流。所述防溢阀3内设薄层弹性材料制成的双喇叭口形通道，如天然橡胶、合成橡胶、聚氯乙烯以及各种弹性体(例如氨基甲酸乙酯、聚异戊二烯)。The endoscope entrance 12 is not on the same plane as the sheath installation opening 11 . After the endoscope enters the endoscope inlet, the through space formed by the housing 1 and the negative pressure adjustment mechanism 2 can be in an unsealed state. Therefore, an anti-overflow valve 3 must be provided to isolate the external air and prevent the perfusate from flowing out. The anti-overflow valve 3 is provided with a double-flare-shaped channel made of thin-layer elastic material, such as natural rubber, synthetic rubber, polyvinyl chloride, and various elastomers (such as urethane, polyisoprene).
负压调节机构2包括压力显示管21和空气填充室22，所述空气填充室22、所述压力显示管21与壳体1的腔室连通，形成空气和灌注液的相对密封的容质腔。所述压力显示管竖直设置，沿其长度方向还设置有负压压力标记。The negative pressure regulating mechanism 2 includes a pressure display tube 21 and an air-filled chamber 22. The air-filled chamber 22 and the pressure display tube 21 communicate with the chamber of the housing 1 to form a relatively sealed volume chamber for air and perfusate. . The pressure display tube is arranged vertically, and a negative pressure mark is also arranged along its length direction.
实施例1经皮肾镜碎石用负压吸引调节装置Example 1 Negative pressure suction adjustment device for percutaneous nephrolithotomy
经皮肾镜碎石术中鞘管一般为竖直安置，如图1～2所示，该装置包括防溢阀3、负压调节机构2和壳体1三部分。The sheath tube in percutaneous nephrolithotripsy is generally placed vertically, as shown in FIGS.
负压调节机构：主要包括相互连通的压力显示管21和空气填充室22。内镜引导管31的前端与防溢阀3配合后，其管身依次穿过空气填充室22、压力显示管21(即内镜引导管31嵌套在负压调节机构2的内部中轴，负压调节机构2位于内镜入口12的下方)，并最终伸入至壳体1腔室内。空气填充室22为容积5ml的漏斗形，其侧壁上设置有排气阀。压力显示管21为中空透明的管体，管壁表面设置负压压力值标记。手术中常规灌注液流量(300～600ml/min)和灌注压力(250～300mmHg)状态下维持肾内安全低压(<30mmHg)所需负压吸力一般为100～250mmHg。空气填充室内预留空气体积为5ml，当负压吸引开启压力显示管内液面下降，空气体积相应增大至5.75ml时，管体腔内负压值为100mmHg。空气体积相应增大至7.45ml时，管体腔内负压值为250mmHg。故压力显示管容积可设为3ml，长度设为3cm，其上压力标记100-250mmHg。负压调节机构为一体成型，与壳体座螺纹连接，或其他保证两者相对气密性的连接方式。完整负压吸引调节装置呈杯状，长度约为5cm，自重不超过15g。Negative pressure regulating mechanism: mainly includes a pressure display tube 21 and an air filling chamber 22 which communicate with each other. After the front end of the endoscope guide tube 31 cooperates with the anti-overflow valve 3, its tube body passes through the air filling chamber 22 and the pressure display tube 21 in sequence (that is, the endoscope guide tube 31 is nested in the inner axis of the negative pressure adjustment mechanism 2, The negative pressure regulating mechanism 2 is located below the endoscope inlet 12), and finally extends into the chamber of the housing 1. The air-filled chamber 22 is funnel-shaped with a volume of 5 ml, and an exhaust valve is arranged on its side wall. The pressure display tube 21 is a hollow and transparent tube body, and negative pressure pressure value marks are set on the tube wall surface. The negative pressure suction required to maintain a safe low pressure (<30 mmHg) in the kidney is generally 100-250 mmHg under the normal perfusion fluid flow rate (300-600ml/min) and perfusion pressure (250-300mmHg) during the operation. The reserved air volume in the air filling chamber is 5ml. When the opening pressure of negative pressure suction shows that the liquid level in the tube drops, and the air volume increases to 5.75ml accordingly, the negative pressure in the tube cavity is 100mmHg. When the air volume increases to 7.45ml correspondingly, the negative pressure in the tube cavity is 250mmHg. Therefore, the volume of the pressure display tube can be set as 3ml, the length is set as 3cm, and the pressure mark on it is 100-250mmHg. The negative pressure regulating mechanism is integrally formed, and is threadedly connected with the shell seat, or other connection methods to ensure the relative airtightness of the two. The complete negative pressure suction adjustment device is cup-shaped, about 5cm in length, and weighs no more than 15g.
塑料结石收集瓶：一端通过连接管与负压接入口连接，另一端接负压吸引源。可拆卸，用于收集碎石，分离血凝块和灌注液。其连接管上设置负压调节阀以准确调节负压大小。压力负压吸引源可为手术室常用中央负压吸引源(恒定负压500mmHg)，不需要另外专用负压设备。结石收集瓶侧壁设有灌注液收集袋连接口，通过连接管与大容量冲洗液收集袋(10L)连接，灌注液在重力和负压吸引作用下进入收集袋，便于收集转运灌注液。此设计可避免灌注液进入中央负压吸引源管道内，同时避免中央负压吸引源吸力的过度减损。Plastic stone collection bottle: one end is connected to the negative pressure inlet through a connecting tube, and the other end is connected to the negative pressure suction source. Removable, used to collect gravel, separate blood clot and perfusate. A negative pressure regulating valve is set on the connecting pipe to accurately adjust the negative pressure. The pressure negative pressure suction source can be the central negative pressure suction source (constant negative pressure 500mmHg) commonly used in the operating room, and no additional special negative pressure equipment is required. The side wall of the stone collection bottle is provided with a perfusion fluid collection bag connection port, which is connected to a large-capacity irrigation fluid collection bag (10L) through a connecting tube. The perfusion fluid enters the collection bag under the action of gravity and negative pressure, which is convenient for collecting and transporting the perfusate. This design can prevent perfusate from entering the pipeline of the central negative pressure suction source, and at the same time avoid excessive loss of suction of the central negative pressure suction source.
实施例2输尿管软镜碎石术用负压吸引调节装置Example 2 Negative pressure suction adjustment device for flexible ureteroscopy lithotripsy
如图3～4所示，该装置包括有连接的防溢阀3、负压调节机构2和壳体1三部分。As shown in FIGS. 3-4 , the device includes three parts: a connected anti-overflow valve 3 , a negative pressure regulating mechanism 2 and a casing 1 .
输尿管软镜碎石术中输尿管通过鞘一般为水平位。因此，与实施例1的区别在于，内镜入口12与鞘管安装口11相对设置，并保持在同一水平线上，而负压调节机构2未设置在内镜入口12的下方，而是垂直设置于壳体腔室上方。由于输尿管软镜为软体内镜，防溢阀3前还设有镜托5，用以引导支撑软体内镜进出。During flexible ureteroscopic lithotripsy, the ureter passes through the sheath in a horizontal position. Therefore, the difference from Embodiment 1 is that the endoscope inlet 12 is arranged opposite to the sheath tube installation port 11 and kept on the same horizontal line, while the negative pressure adjustment mechanism 2 is not arranged below the endoscope inlet 12, but vertically arranged above the housing chamber. Because the flexible ureteroscope is a soft endoscope, a mirror holder 5 is also provided in front of the anti-overflow valve 3 to guide the supporting soft endoscope to go in and out.
本实用新型的有益效果为：The beneficial effects of the utility model are:
1、可以广泛应用于经皮肾造瘘/输尿管软镜等经鞘内镜取石手术中；1. It can be widely used in percutaneous nephrostomy/flexible ureteroscopy and other transthecal endoscopic stone removal operations;
2、通过术者本人设置并调控适当负压吸引，降低术中肾盂内压，减少手术并发症；在维持肾盂内低压同时适当提高术中灌注流速，保证手术视野，提高碎石效率；可经鞘管快速吸取较大碎石，有利于减少术后结石残留，可提高结石清除率；2. By setting and adjusting proper negative pressure suction by the operator himself, the intraoperative pressure of the renal pelvis can be reduced, and surgical complications can be reduced; while maintaining the low pressure in the renal pelvis, the intraoperative perfusion flow rate can be appropriately increased to ensure the surgical field of view and improve the efficiency of lithotripsy; The sheath quickly absorbs larger stones, which is beneficial to reduce the residual stones after operation and improve the stone clearance rate;
3、完全经管内引流灌注液，维护手术区域清洁，减少术中干扰；3. The perfusion fluid is completely drained through the tube to maintain the cleanliness of the surgical area and reduce intraoperative interference;
4、不需要复杂辅助设备，不需要特制鞘体和镜体，技术简单，使用方便，效果确切，经济适用，易于广泛推广。4. It does not require complex auxiliary equipment, special sheath body and mirror body, simple technology, convenient use, exact effect, economical and applicable, and easy to be widely promoted.
本实用新型不局限于上述最佳实施方式，任何人在本实用新型的启示下都可得出其他各种形式的产品，但不论在其形状或结构上作任何变化，凡是具有与本申请相同或相近似的技术方案，均落在本实用新型的保护范围之内。The utility model is not limited to the above-mentioned best implementation mode, anyone can draw other various forms of products under the enlightenment of the utility model, but no matter make any changes in its shape or structure, all have the same features as the application Or similar technical solutions all fall within the protection scope of the present utility model.
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104922742A (en) * | 2015-07-03 | 2015-09-23 | 陈勇 | Negative-pressure suction adjustment device for trans-sheath stone extraction with endoscope |
| CN111315307A (en) * | 2017-11-08 | 2020-06-19 | 波士顿科学医学有限公司 | Capture device and related method of use |
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Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104922742A (en) * | 2015-07-03 | 2015-09-23 | 陈勇 | Negative-pressure suction adjustment device for trans-sheath stone extraction with endoscope |
| WO2017004861A1 (en) * | 2015-07-03 | 2017-01-12 | 陈勇 | Negative-pressure suction adjustment device used in technology for extracting calculuses by using trans-sheath endoscope |
| CN104922742B (en) * | 2015-07-03 | 2018-04-27 | 重庆医科大学附属第一医院 | Through sheath endoscopic stone extraction technique vacuum suction regulating device |
| CN111315307A (en) * | 2017-11-08 | 2020-06-19 | 波士顿科学医学有限公司 | Capture device and related method of use |
| CN111315307B (en) * | 2017-11-08 | 2024-02-06 | 波士顿科学医学有限公司 | Capture devices and related methods of use |
| US12004756B2 (en) | 2017-11-08 | 2024-06-11 | Boston Scientific Scimed, Inc. | Capture devices and related methods of use |
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