WO2016008293A1 - Urinary system stone intraluminal sleeving and removal apparatus - Google Patents

Abstract

A urinary system stone intraluminal sleeving and removal apparatus, which is provided with a catheter (1) and a guidewire (2). A mesh basket (7) is provided at the distal end of the guidewire (2). A stone-sleeving pocket (4) is fixed on the mesh basket (7). The stone-sleeving pocket (4) is pre-molded into an elongated pocket shape opened at the proximal side. Micropores (8) are also provided on the stone-sleeving pocket (4). The urinary system stone intraluminal sleeving and removal apparatus can sleeve and remove large quantities of fragmented stones, blood clots, and pus clots in a single run, is not restricted by either the lumen diameter of a ureter or the inner diameter of an operating channel, does not leave behind any fragmented stone during stone removal, can effectively prevent fragmented stones from being flushed back into a kidney by a water flow, also can prevent the fragmented stones from damaging the ureter wall, and is safe and reliable.

Description

Urinary system stone cavity inner sheathing device Technical field

The invention relates to the field of medical instruments, in particular to a urinary system stone cavity inner sheathing device.

Background technique

Kidney stones are one of the most common diseases in urology. Minimally invasive treatment technology has replaced traditional open surgery as the most important treatment for kidney stones. The ultimate goal of minimally invasive treatment is to completely remove stones. The ureteroscope enters the kidney through the natural cavity of the human body, and the calculus is crushed by holmium laser. The effect is exact, and it is one of the main minimally invasive treatments for kidney stones. In order to improve the removal rate of stones, after the smashing of the stone by the krypton laser, the stone basket is often used to take larger gravel.

At present, the set of stone baskets applied at home and abroad is mostly a simple basket structure. Such as the Chinese patent ZL20122032508.7 (announcement date January 16, 2013; announcement number: CN202665632U) a set of stone baskets for urology endoscopy supporting the removal of ureters and kidney stones, set of stone basket core head It is a plurality of elastic steel wires wound, and the tension switch locks the stone basket core into the outer tube, and the outer tube has a diameter of 0.5-3 mm. However, this triangular set of stone baskets is not efficient in grabbing. It can only grab gravel of a certain diameter. The gravel is too large to pass through the operation channel. The gravel is too small to be easily missed from the gap of the steel wire. When the inner core is tightened, the basket is spherical, and its diameter often exceeds the inner diameter of the operation channel or the ureter, which may cause damage to the ureter or cannot be removed. Another example is a Chinese patent ZL200620040173.7 (announcement date March 7, 2007; announcement number: CN2875338Y) disclosed in a ureteral mesh set stone basket, made of non-toxic, fiber nylon yarn, after the stone is covered gravel. The set of stone baskets does not have the function of taking the gravel, and can only passively cover the stones for easy operation, but does not actively grasp the function of the gravel.

It is concluded that the current stone baskets still have the following shortcomings: 1) Whether it is a triangular stone basket or a mesh stone basket, the design of centripetal convergence is adopted, and the stone is spherical after the stone is taken instead of the ellipse. The number of spheres and sets of stones is limited by the inner diameter of the ureteral lumen or the inner diameter of the operation channel, and it is necessary to repeatedly enter the urinary tract to remove stones. The efficiency is low; 2) There is a gap between the steel wires after the stone basket is collected, especially the mesh set stone basket is tightened. After the inner core, the mesh is easy to miss the gravel, and the stone basket itself can not block the stone. The small stone and the gravel are easily washed back into the kidney under the reverse water flow; 3) the edge of the stone is exposed to the net of the stone basket Outside the hole, it is easy to cause the stone basket to pass through the operation channel, and it is easy to scratch the ureteral wall, causing surgical complications; 4) For the blood clot or pus that accumulates in the kidney, it is difficult to apply the stone basket under the soft microscope. low efficiency.

In summary, there is a need for a high-efficiency stone extraction system that does not miss the gravel, can simultaneously take blood clots and pus, safe and reliable urinary system stone cavity extraction device, but there is no report on this type of device. .

Summary of the invention

The object of the present invention is to provide a urinary system stone cavity inner sheathing device for the deficiencies in the prior art.

In order to achieve the above object, the technical solution adopted by the present invention is:

A urinary system stone intracavity entraining device is provided with a catheter and a guide wire, a distal end of the guide wire is provided with a basket, and the basket is fixed with a set of stone pockets, and the set of stone pockets is pre-formed The pocket-shaped and proximal side is open, and the set of stone pockets is further provided with micropores.

The set of stone pockets has a long strip shape and the distal surface is curved.

The set of stone pockets is made of a polymer material.

The polymer material may be PU, TPU, Pebax, FEP, ETFE or TPFE.

The basket is composed of a basket wire which is curved in use, and the distal end of the basket wire is gathered toward the central axis of the catheter and fixed to the stone pocket.

The distal end of the basket wire is bifurcated into a first basket wire and a second basket wire, and the first basket wire and the second basket wire are fixed with the stone pocket.

The basket is composed of a plurality of elliptical baskets, each of which is arranged in an equilateral geometric pattern, and the proximal ends of the baskets are merged into a distal end fixed to the guide wire; Next, the surface formed by each of the baskets has a curved surface and is gathered toward the central axis of the catheter.

There are three or four baskets of silk, and each basket of yarns is arranged in a triangle or a square.

The proximal edge of the set of stone pockets is circumferentially secured to a section of the basket adjacent the distal end.

The basket has an elliptical shape with a circular projection on a plane perpendicular to the guidewire.

The basket wire is made of a shape memory material.

The micropores have a diameter of 50-150 nm.

The advantages of the invention are:

The invention aims at the problem of blocking and high-efficiency removal of urinary stone, and designs a urinary system stone disposable device with a permeable microporous stone pocket structure:

1. A set of stone pockets with a long strip shape and a cross-sectional dimension equal to the inner diameter of the surgical channel sheath. It can accommodate a large amount of gravel. Even if the net pocket is filled with stones, its shape will not change and it can still pass through the sheath. , greatly improving the efficiency of stone removal;

2, the stone pocket does not contain large mesh, there is no gap, and it has a certain shaping effect, so it can effectively avoid the missing gravel, blood clot and pus after the gravel is taken, and the edge of the gravel is not Will be exposed, and thus will not damage the ureteral wall;

3, the basket design has many forms, single-line, three-line, four-line or multi-line basket can adapt to the removal of stones of different volume and position, and can better maintain the shape of the stone pocket; elliptical ring basket Can minimize the damage The obstruction effect of the stone is conducive to the smooth entry of the gravel into the interior of the stone pocket;

4. The net basket wire is a memory wire, and the stone bag is a polymer material film, which can be shrunk into a small volume and accommodated in the catheter to facilitate the insertion of the stone extractor of the present invention, and does not push the stone back to the kidney. It is also not easy to damage the ureteral wall.

DRAWINGS

BRIEF DESCRIPTION OF THE DRAWINGS Fig. 1 is a schematic view showing the structure of a urinary system stone cavity inner sheathing device of the present invention.

Figure 2 is an enlarged view of A in Figure 1.

Figure 3 is a schematic view showing the structure of the basket yarn of the second embodiment.

4 is a schematic structural view of a basket yarn of Embodiment 3.

Figure 5 is a schematic view showing the structure of the basket yarn of the fourth embodiment.

detailed description

The specific embodiments provided by the present invention are described in detail below with reference to the accompanying drawings.

The reference numerals and components referred to in the drawings are as follows:

1. catheter 2. guide wire

3. Net basket silk 31. The first net basket silk

32. The second net basket wire 4. Set of stone pockets

5. Catheter handle 51. First thread

6. Guide wire handle 61. Second thread

7. Baskets 8. Micropores

Example 1

Please refer to FIG. 1. FIG. 1 is a schematic structural view of a urinary system stone cavity inner sheathing device according to the present invention. The urinary system stone cavity inner sheathing device is provided with a catheter 1, a guide wire 2, a basket 7 and a set of stone pockets 4. The catheter 1 is a cylindrical hollow tube body, and the outer periphery of the proximal end is provided with a catheter handle 5, and the inner wall of the proximal end of the catheter handle 5 is provided with a first thread 51. The guide wire 2 is an elongated wire that penetrates the inside of the catheter 1. The proximal end of the guide wire 2 is provided with a guide wire handle 6, and the outer end of the distal end of the guide wire handle 6 is provided with a second thread 61. The second thread 61 and the first thread 51 are matched to each other, and the guide wire 2 can be fixed to the catheter 1 after being screwed. The distal end of the guide wire 2 is provided with a basket 7.

Please refer to FIG. 2. FIG. 2 is an enlarged view of A in FIG. 1. The basket 7 comprises three baskets of yarns 3. The proximal end of each basket wire 3 is fixed to a guide wire 2 (not shown) which is bifurcated into a first basket wire 31 and a second basket wire 32. In the state of use, the basket wire 3 is curved, and the distal end of each basket wire 3 is directed toward the middle of the catheter 1. The direction of the mandrel is closed. The set of stone pockets 4 is expanded into a strip shape, and the outer surface of the distal end of the stone pocket 4 is curved, the proximal end is open, and the outer wall of the proximal end and the three outer baskets of the basket 3 The first basket wire 31 and the second basket wire 32 are fixed. The set of stone pockets 4 is further provided with micropores 8.

It should be noted:

In the urinary system stone cavity inner sheathing device of the present invention, in the unused state, that is, when shipped from the factory, the basket wire 3 and the stone pocket 4 are housed in the cavity of the distal end of the catheter 1, and the basket wire 3 is The tube 1 cavity is gathered into a bundle under the definition of the cavity, and the stone pocket 4 is also pleated and gathered into a bundle.

The set of stone pockets 4 is preferably made of a polymer material film, specifically PU, TPU, Pebax, FEP, ETFE, TPFE, etc., and may also be made of a non-woven fabric, as long as the volume of the folds is folded. It is small and can be accommodated in the thin catheter 1. The set of stone pockets 4 is pre-formed into a strip-shaped pocket shape, which is similar to the shape of the bullet, and the shape can accommodate more gravel, which significantly improves the stone removal efficiency. The largest diameter of the cross section of the stone pocket 4 is designed to be equivalent to the inner diameter of the surgical channel sheath. Even if the net pocket is filled with stones, its shape will not change and it can still pass through the sheath. Since the stone pocket 4 does not contain a large mesh, there is no gap, and it has a certain shaping effect, so that the gravel, the blood clot and the pus can be effectively avoided, and the corners of the gravel are not exposed. It will not rub the ureteral wall. The set of stone pockets 4 is provided with micropores 8, which preferably have a diameter of 50-150 nm, most preferably 100 nm, for smooth passage of water and passage of gravel, blood clots and pustules.

The basket wire 3 is made of a memory material, such as a memory wire, such as a titanium-nickel alloy material, which can be naturally expanded and restored into a curved shape after being released from the cavity of the catheter 1. The function of the basket wire 3 is to fix and maintain the shape of the stone pocket 4, to ensure that the proximal edge of the sleeve is unfolded and fits as far as possible to the ureter wall, does not deform under the impact of the water flow, and does not deform when the stone is dragged. The number of the baskets 3 is not limited to the embodiment, and may be three, four, five, seven, eight, etc., as long as it can effectively support the stone pocket 4 and its density does not hinder the fragmentation. Stone can enter. The manner in which the basket wire 3 and the stone pocket 4 are fixed is not limited to the embodiment. The basket wire 3 may also be fixed on the inner wall of the stone pocket 4, and the distal end of the basket wire 3 may not be first. The double-fork structure of the basket wire 31 and the second basket wire 32 can be effectively fixed with the stone pocket 4, but the double-forked basket wire 3 increases the fixed area with the stone pocket 4. The fixing effect is better.

The catheter 1 can store the basket wire 3 and the stone pocket 4 in the cavity, and when the device is placed in the urinary stone cavity of the invention, the stone can be easily circumvented, and the stone is not easily displaced. It will not damage the ureteral wall. The guide wire 2 is used for handling the storage and release of the basket wire 3 and the stone pocket 4. The catheter handle 5 and the guide wire handle 6 are provided with matching threads. When the urinary system stone cavity inner sheathing device of the present invention reaches the target position, the catheter 1 and the guide wire 2 can be fixed, thereby ensuring the net. The basket wire 3 and the set of stone pockets 4 are not deformed.

As used herein, "proximal" refers to the end of the procedure that is closer to the surgeon, and the "distal" is Refers to the end of the surgery that is far from the surgeon.

The method for using the urinary system stone cavity inner sheathing device of the present invention is as follows: when ureteroscope lithotripsy is performed, an endoscope working channel is formed, an endoscope is placed; and the urinary system stone cavity inner sheathing device of the present invention is disassembled In the factory package, the hand-held catheter handle 5 and the guide wire handle 6 enter the distal end of the catheter 1 into the ureter, bypass the stone and place it over the stone, push the guide wire handle 6 distally, and then screw the guide wire handle 6 and catheter The handle 5 fixes the catheter 1 and the guide wire 2, and at this time, the basket wire 3 is stretched and restored to a curved shape, and the stone pocket 4 is also stretched; the gravel operation is performed, and the stone is broken into about 2-4 mm. In the case of debris, while slowly withdrawing from the urinary system stone cavity sheathing device of the present invention, the water is continuously injected into the ureter through the working channel of the endoscope, so that the stone debris, blood clots and pus are washed into the stone pocket 4, and the water Then, it is exposed through the micropores 8 outside the stone pocket 4; finally, the stone debris, the blood clot, and the pus are stored in the stone pocket 4 and are taken out.

The urinary system stone cavity inner sheathing device of the invention can take a large amount of gravel, blood clot and pus in a single time, and is not restricted by the inner diameter of the ureteral lumen or the inner diameter of the operation channel, and the stone composition is not easy to miss the gravel, thereby effectively avoiding the gravel It is infused back into the kidney by water, and it can also prevent the damage of the ureteral wall caused by gravel, which is safe and reliable.

The urinary system stone cavity inner sheathing device of the invention can be used not only for the sealing and removal of ureteral stones, but also for the sealing of other body cavity and foreign body removal, including but not limited to the following applications: for the sealing of kidney stones Blocking and removal, vascular thrombus sealing and removal, vascular puncture hole sealing and hemostasis, body cavity foreign body sealing and removal such as airway, intestinal foreign body treatment.

Example 2

Please refer to FIG. 3. FIG. 3 is a schematic structural view of the basket wire of Embodiment 2. The basket 7 is a three-line basket. Specifically, the basket 7 is composed of three elliptical baskets 3, and the three baskets 3 are arranged in a triangle; each basket 3 is near the proximal end. The half sections are merged with the other two baskets of yarns 3, and finally the proximal ends of the three baskets of yarns 3 merge and merge into a distal end fixed to the guide wire 2; in the state of use, each basket of yarns 3 is formed. The faces are curved and are all gathered toward the central axis of the catheter 1 (not shown); the proximal edge of the set of stone pockets 4 (not shown) is circumferentially fixed to the basket 7 near On the far end section.

Example 3

Please refer to FIG. 4. FIG. 4 is a schematic structural view of a basket wire of Embodiment 3. The basket 7 is a four-line basket. Specifically, the basket 7 is composed of four elliptical baskets 3, and the four baskets 3 are arranged in a square shape; each basket 3 is close to each other. The half sections of the end are merged with the adjacent two baskets of yarns 3, and finally the proximal ends of the four baskets of yarns 3 merge and merge into a distal end fixed to the guide wire 2; in the state of use, each net The surface formed by the basket yarn 3 is curved, and both are gathered toward the central axis of the catheter 1 (not shown).

It should be noted that the three-wire and four-line baskets of Embodiments 2 and 3 can be adapted to stones of different volumes and positions. The take-out, and the net basket 7 of this shape makes the proximal edge of the stone pocket 4 fixed, so that the shape of the stone pocket 4 can be better maintained. In the present invention, the basket 7 is not limited to the three shapes of the embodiments 1-3, and other shapes can be made as long as it is effective to support the stone pocket 4 and its density does not hinder the entry of the gravel.

Example 4

Please refer to FIG. 5. FIG. 5 is a schematic structural view of a basket wire of Embodiment 4. The basket 7 is substantially elliptical in shape, and the formed surface is curved, and its projection on a plane perpendicular to the guide wire 2 is a circular shape. Specifically, the basket 7 is constituted by an elliptical basket wire 3, and one end end of its long axis is fixed to the distal end of the guide wire 2. The proximal edge of the set of stone pockets 4 is circumferentially fixed to the basket 7.

In this embodiment, the basket 7 is composed of a single basket wire 3 to form an elliptical ring shape, and the number of the basket wire 3 is minimized, thereby minimizing the hindrance to the crushed stone and facilitating the crushed stone. Smoothly entered the inside of the set of stone pockets 4.

The above description is only a preferred embodiment of the present invention, and it should be noted that those skilled in the art can make several improvements and additions without departing from the method of the present invention. These improvements and additions should also be considered. It is the scope of protection of the present invention.

Claims (10)

A urinary calculi intracavity entrapment device is provided with a catheter and a guide wire, wherein a distal end of the guide wire is provided with a basket, and the basket is fixed with a set of stone pockets, and the set of stone pockets It is pre-formed into a pocket and the proximal side is open, and the set of stone pockets is also provided with micropores. The urinary system stone cavity inner sheathing device according to claim 1, wherein the set of stone pockets has a long strip shape and the distal end surface has a curved shape. The urinary system stone cavity inner sheathing device according to claim 1, wherein the stone pocket is made of a polymer material. The urinary system intracavitary entrapment device according to claim 1, wherein said basket is composed of a basket wire which is curved in use, and the distal end of said basket wire is directed toward the center of the catheter. The axis is folded and fixed with a set of stone pockets. The urinary system intracavitary capping device according to claim 4, wherein the distal end of the basket wire is bifurcated into a first basket wire and a second basket wire, the first basket wire And the second basket of silk and set of stone pockets fixed. The urinary system stone cavity inner sheathing device according to claim 1, wherein the basket is composed of a plurality of elliptical basket wires, and each basket wire is arranged according to an equilateral geometric pattern, and each The proximal end of the basket wire merges into a distal end fixed to the guide wire; in the state of use, the surface formed by each basket wire is curved, and both are gathered toward the central axis of the catheter. The urinary system stone cavity inner sheathing device according to claim 6, wherein the basket wire has three or four wires, and each of the basket wires is arranged in a triangle or a square. The urinary system intracavitary entrapment device according to claim 7, wherein the proximal edge of the set of stone pockets is circumferentially fixed to a section of the basket near the distal end. The urinary system intracavitary entrapment device according to claim 1, wherein said basket has an elliptical shape, and its projection on a plane perpendicular to the guide wire is a circular shape. The urinary system intracavitary entrapment device according to claim 1, wherein said basket wire is made of a shape memory material.

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