WO2021088339A1 - Cutting device for endoscope - Google Patents

Abstract

Disclosed is a cutting device for an endoscope. The cutting device comprises a handle assembly, and a distal side of the handle assembly can be fixed onto an endoscope; and a length-adjustable outer tube component (301) extends out of a distal end of the handle assembly in an axial direction of the handle assembly, and an electric cutter (302) is arranged at a distal end of the outer tube component (301). The cutting device further comprises a length-adjustable inner tube component (303) which can extend out of the distal end of the outer tube component (301), with a distal end of the inner tube component (303) being provided with a needle head part (3031) capable of piercing tissue, and a proximal end of the inner tube component (303) being connected to the handle assembly; and the inner tube component (303) is of a tube structure which is hollow and extends in an axial direction thereof. The cutting device is capable of efficiently piercing and flaring tissues, thereby realizing the piercing of two pieces of tissue that are far away from each other; and operation steps can also be reduced, and a guide wire (304) can be conveniently and efficiently placed.

Description

Cutting device for endoscope

This application claims the priority of a Chinese patent application filed with the Chinese Patent Office, the application number is 201911077353.0, and the invention title is "a cutting device for endoscopes" on November 6, 2019, the entire content of which is incorporated into this application by reference in.

Technical field

This application relates to the technical field of endoscopes, in particular to a cutting device for endoscopes.

Background technique

Endoscopes are commonly used optical instruments in minimally invasive surgery, including rigid endoscopes and soft endoscopes. Among them, in the flexible endoscope equipment, there will be a pipeline for the passage of surgical forceps and other instruments, and the pipeline is called the forceps channel of the endoscope. A cutting device for an endoscope, such as a cyst cutter, can enter the corresponding cyst position from the clamp channel of the endoscope to perform a puncture and drainage operation. A cystotomy is an electrosurgical medical device that cuts tissue by applying an electric current to enter, for example, a pancreatic pseudocyst. Once the tissue is incised and entered into the pseudocyst, subsequent operations can be performed on the pseudocyst, such as inserting a stent into the pseudocyst and/or draining fluid from the pseudocyst.

In a prior art, please refer to FIG. 1, which is a schematic structural diagram of a cutting device for an endoscope in the prior art. This prior art comes from the technical solution disclosed in the prior patent with the patent title "Electrosurgical Device with a Single Conductive Tubular Element Used to Enter the Anatomical Structure" and the publication number "CN109715097A".

As shown in FIG. 1, the cutting device for an endoscope includes an outer tube member 101, an electrocutter 102 provided at the distal end of the outer tube member, and a guide wire 103 inside the outer tube member. During the operation, the first tissue 104 and the second tissue 105 are cut through the electric knife 102, and then the guide wire 103 is inserted. Then, the outer tube member 101 is extended. Under the guiding action of the guide wire 103, the guide stent is introduced into the incision to perform drainage work. However, this cutting device for an endoscope has the following problems:

When the electrocutter 102 performs electrical cutting on two tissues, since the cutting surface is not sharp and relatively blunt, although the cutting opening can be finally realized under the action of electric current, it is more difficult and time-consuming and labor-intensive to perform.

In addition, as shown in FIG. 1, after the electrocutter 102 cuts the second tissue 105, only when the first tissue 104 and the second tissue 105 fit together, can the first tissue 104 be further cut. However, when the first tissue 104 and the second tissue 105 are far apart, due to the peristalsis of the human tissue, after the second tissue 105 is punctured, the electrocutter cannot accurately cut the first tissue 104, and the puncture process is prone to risk.

In another prior art, please refer to FIG. 2, which is a schematic structural diagram of another cutting device for an endoscope in the prior art. This prior art comes from the technical solution disclosed in the US Patent Publication No. "US2013/0090654A1".

As shown in FIG. 2, the cutting device for an endoscope includes an outer tube member 201, an electrocutter 202, an inner needle member 203, and an insulating tube 204. During the operation, the inner needle member 203 protrudes from the insulating tube 204, and the needle head 2031 punctures the tissue. Then, the electric knife 202 expands along the puncture position. In this structural design, since the inner needle member 203 with a sharp tip is punctured and then expanded by the electrocutter 202, the opening to the tissue can be realized very conveniently and efficiently. Therefore, the problems of the above-mentioned cutting device in FIG. 1 are solved. However, the following problems still exist:

As shown in Figure 2, when the guide wire is inserted, the inner needle member 203 needs to be withdrawn first, or the inner needle member 203 and the insulating tube 204 need to be withdrawn at the same time, so as to make room for the guide wire, and then pass the guide wire through the free space. The space left out is placed in the tissue, and then the cutting device for the endoscope is withdrawn along the guide wire, and then the subsequent operation is continued. This method adds the two steps of withdrawing the internal structure and inserting the guide wire before the subsequent operation, which increases the operation time and operation risk.

In addition, as shown in FIG. 2, the insulating tube 204 can be extended or retracted in the axial direction relative to the electric cutter 202. If the insulating tube 204 protrudes in the axial direction as shown in FIG. 2 and thus exceeds the electric cutter 202, when the electric cutter 202 cuts the tissue, the insulating tube 204 will hinder the smooth advance of the electric cutter 202. Affect cutting. If the insulating tube 204 is retracted to the inside of the outer tube member 201 in the axial direction, the electric cutter 202 and the inner needle member 203 cannot be insulated from each other.

Furthermore, in FIG. 2, in order to allow the insulating tube 204 to move relative to the electric cutter 202 in the axial direction, there is a certain gap between the two, or during the cutting process, the insulating tube 204 is retracted relative to the electric cutter 202 More, these two factors cause the inner surface of the electrocutter 202 to be in contact with the tissue. As the surface area in contact with the tissue is increased, the current density is reduced and the cutting effect is weakened.

Finally, regardless of the prior art shown in Fig. 1 or Fig. 2, the entire cutting device cannot be fixed on the endoscope. Therefore, during the operation, the endoscope and the cyst knife will move relative to each other, resulting in poor puncture stability. This is not conducive to the smooth completion of the operation.

In view of this, combined with the problems in Figure 1 and Figure 2, how to improve the cutting device for the endoscope, so that on the one hand, it can effectively puncture and expand the tissue, especially to smoothly achieve the puncture of two tissues that are far away from each other. On the other hand, it can reduce the operation steps and realize the insertion of the guide wire conveniently and efficiently. Moreover, the device can be relatively fixed with the endoscope, which improves the puncture stability and facilitates the smooth completion of the operation, which is urgently needed by those skilled in the art problem.

Summary of the invention

The technical problem to be solved by this application is to provide a cutting device for an endoscope. The traditional cutting device cannot achieve the problem of puncturing two tissues that are far away from each other.

In order to solve the above technical problems, the present application provides a cutting device for an endoscope, including a handle assembly, the distal side of the handle assembly can be fixed on the endoscope;

The distal end of the handle assembly protrudes along its axial direction with an outer tube member with an adjustable extension length, and an electric cutter is provided on the distal end of the outer tube member;

The cutting device for endoscope further includes an inner needle member that can be extended from the distal end of the outer tube member and has an adjustable extension length, and the distal end of the inner needle member is provided with a needle that can pierce tissue Part, the proximal end of the inner needle member is connected to the handle assembly;

The inner needle member is an inner tube member extending hollowly along its axial direction, so that compatible instruments for endoscopic surgery can be inserted or withdrawn from the inner tube member.

Optionally, the cutting device for an endoscope further includes an insulating member that isolates the electric cutter from the inner tube member.

Optionally, the insulating member is a middle tube member arranged inside the outer tube member, and the middle tube member and the outer tube member are fixed in an axial direction;

The inner tube member is further arranged inside the middle tube member, and is extended or recovered from the distal end of the middle tube member.

Optionally, the electric cutter is a ring cutter, and the inner wall of the ring cutter is fixedly sleeved on the outer wall of the distal end of the middle tube member.

Optionally, the electric cutter is a ring cutter, the outer wall of the ring cutter is provided with a recessed mounting portion on a circumference; the distal end of the outer tube member is fixedly mounted on the outer wall of the recessed mounting portion with its inner wall on.

Optionally, the distal end of the outer tube member is fixedly mounted on the outer wall of the recessed mounting portion with its inner wall through a circular barb or threaded fit.

Optionally, the outer wall of the distal end of the outer tube member is provided with a fastening ring; through the fastening ring, the distal end of the outer tube member is fixedly mounted on the outer wall of the recessed mounting portion with its inner wall .

Optionally, the electric cutter is a ring cutter, and the inner wall of the ring cutter is fixedly sleeved on the outer wall of the distal end of the outer tube member.

Optionally, the distal end of the middle tube member protrudes from the outer tube member in the axial direction to form a middle tube extension;

The inner wall of the proximal side of the ring cutter is provided with a circular ring clamping groove, and the proximal side of the circular cutter is fixed on the outer wall of the outer tube member through the circular ring clamping groove. The distal end is fixed on the outer wall of the middle tube extension.

Optionally, the distal end surface of the middle tube member is flush with the end surface of the distal end of the electrocutter.

Optionally, the handle assembly includes a distal handle assembly and a proximal handle assembly; the distal handle assembly includes a second core rod, a second handle that slides along the second core rod, and a positioning mechanism The second positioning lock at the relative position between the second core rod and the second handle; the outer tube member is connected to the second handle at the proximal end, and the middle tube member is connected to the second handle at the proximal end. The second handle is connected.

Optionally, the outer tube member further includes a wire electrically connected to the electric cutter, and the wire extends to the second handle inside the outer tube member.

Optionally, the handle assembly further includes a conductive screw seat and a conductive screw provided on the conductive screw seat; the wire is drawn from the second handle and electrically connected with the conductive screw.

Optionally, the electric cutter is a ring cutter, and the insulating member is an insulating coating covering the inner wall of the ring cutter.

Optionally, the electric cutter includes an insulating head, and a cutting wire for cutting animal body is provided in the circumferential direction of the insulating head.

Optionally, the handle assembly includes a distal handle assembly and a proximal handle assembly; the proximal handle assembly includes a first core rod, a first handle sliding along the first core rod, and a positioning mechanism The first positioning lock of the relative position between the first core rod and the first handle.

Optionally, the proximal handle assembly further includes a guide wire lock and an inner tube member seat provided at the proximal end of the first handle; the guide wire can be locked by the guide wire lock, and the guide wire The lock is connected with the inner tube member seat; the inner tube member is connected with the inner tube member seat at the proximal end.

Optionally, the outer diameter of the outer tube member ranges from 5Fr to 10Fr.

The cutting device for an endoscope provided in the present application includes a handle assembly, the distal side of the handle assembly can be fixed on the endoscope; the distal end of the handle assembly protrudes along its axial direction with an adjustable extension length The outer tube member of the outer tube member, the distal end of the outer tube member is provided with an electric cutter; the cutting device for the endoscope also includes an inner tube that can be extended from the distal end of the outer tube member and has an adjustable extension length A tube member, the distal end of the inner tube member is provided with a needle head that can pierce tissue, and the proximal end of the inner tube member is connected to the handle assembly; the inner tube member is hollow extending along its axial direction The tube structure, so that compatible instruments for endoscopic surgery can be inserted or withdrawn from the inner tube member.

Since the distal end of the inner tube member is provided with a needle head capable of penetrating side tissue, the tissue can be effectively punctured, especially the puncture of two tissues that are far away from each other smoothly. In addition, the inner tube member is a hollow tube, so the guide wire can be inserted from the inside of the inner tube member, and the guide wire can be inserted into the tissue without returning the inner tube member. The guide wire can also be pre-installed into the inner tube member before the operation, and received at the distal end of the inner tube member during puncture, which does not affect the puncture, and realizes the tissue placement of the guide wire very conveniently and efficiently. In addition, the distal side of the handle assembly can be fixed on the endoscope and relatively fixed with the endoscope, so that the stability of puncture can be improved and the operation can be completed smoothly.

In summary, the structural design of the cutting device provided by the present application can effectively puncture and expand the tissue on the one hand, and especially smoothly achieve the puncture of two tissues that are far away from each other; on the other hand, it can reduce the operation steps and achieve convenient and efficient implementation. Insertion of the guide wire; the device can also be relatively fixed with the endoscope to improve the puncture stability.

Description of the drawings

Fig. 1 is a schematic structural diagram of a cutting device for an endoscope in the prior art;

Fig. 2 is a schematic structural diagram of another cutting device for an endoscope in the prior art;

Fig. 3 is a schematic structural diagram of a cutting device for an endoscope in a first exemplary embodiment of the application;

4 is a schematic diagram of the working state of the cutting device for the endoscope in FIG. 3 under a working condition;

Fig. 5 is a schematic structural diagram of a cutting device for an endoscope in a second exemplary embodiment of the application;

6 is a schematic structural diagram of a cutting device for an endoscope in a third exemplary embodiment of this application;

Fig. 7 is a schematic structural diagram of a cutting device for an endoscope in a fourth exemplary embodiment of the application;

Fig. 8 is a schematic structural diagram of a cutting device for an endoscope in a fifth exemplary embodiment of the application;

9 is a schematic structural diagram of a cutting device for an endoscope showing a handle assembly in a sixth exemplary embodiment in this application;

Fig. 10-1 is a schematic diagram of the working state of the cutting device for the endoscope in Fig. 3 in working condition 1: close to the tissue;

Figure 10-2 is a schematic diagram of the working state of the cutting device for the endoscope in Figure 3 based on working condition one and working condition two: the inner tube member punctures the tissue;

Fig. 10-3 is a schematic diagram of the working state of the cutting device for the endoscope in Fig. 3 based on working condition two, in working condition three: when the built-in guide wire enters the tissue;

Fig. 10-4 is a schematic diagram of the working state of the cutting device for endoscope in Fig. 3 based on working condition three, in working condition four: the inner tube member is retracted from the tissue;

Fig. 10-5 is a schematic diagram of the working state of the cutting device for endoscope in Fig. 3 based on working condition four, in working condition five: the electric cutter of the outer tube member further expands the tissue;

Fig. 10-6 is a schematic diagram of the working state of the cutting device for endoscope in Fig. 3 based on working condition 5 and working condition 6: the outer tube member is retracted from the tissue;

Fig. 10-7 is a schematic diagram of the working state of the cutting device for endoscope in Fig. 3 based on working condition five, in working condition seven: the inner tube member is withdrawn from the middle tube member;

10-8 is a schematic diagram of the working state of the cutting device for the endoscope in FIG. 3 based on working condition 7 and working condition 8: another guide wire enters the tissue from the middle tube member;

10-9 is a schematic diagram of the working state of the cutting device for the endoscope in FIG. 3 based on working condition 8 and working condition 9: the outer tube member is retracted from the tissue.

Detailed ways

The embodiments will be described in detail below, and examples thereof are shown in the accompanying drawings. When the following description refers to the drawings, unless otherwise indicated, the same numbers in different drawings indicate the same or similar elements. The implementation manners described in the following examples do not represent all implementation manners consistent with this application. It is only an example of the system and method consistent with some aspects of this application as detailed in the claims.

Please refer to FIG. 3, which is a schematic structural diagram of a cutting device for an endoscope in a first exemplary embodiment of this application.

In the first embodiment of the present application, as shown in FIG. 3, the cutting device for the endoscope includes a handle assembly, and the distal side of the handle assembly is fixed on the endoscope; specifically, the handle assembly may The proximal handle component or the distal handle component is fixed on the forceps opening of the endoscope. This application does not limit the fixing position and fixing method, for example, fixing clips, threaded connections, flexible buckles, etc. can be used.

The distal end of the handle assembly protrudes along its axial direction with an outer tube member 301 whose extension length is adjustable, and the distal end of the outer tube member 301 is provided with an electric cutter 302; the cutting device for endoscopes also includes an outer tube The distal end of the member 301 extends and an inner tube member 303 with adjustable extension length. The distal end of the inner tube member 303 is provided with a needle head 3031 capable of piercing the tissue, and the proximal end of the inner tube member 303 is connected to the handle assembly .

The inner tube member 303 is a tube structure that extends hollowly along its axial direction, so that compatible instruments for endoscopic surgery can be inserted or withdrawn from the inner tube member 303. Among them, the compatible instrument is an independent accessory as a cutting device. When an operation is performed, a compatible instrument is inserted through the inner tube member 303.

The compatible device may be a guide wire 304, that is, the guide wire 304 in FIGS. 10-1 to 10-9. Compatible instruments can also be support wires and probes. The main function of the support wires is to enhance the rigidity of the inner tube member 303 to facilitate puncture. The probe can push out the substance in the needle cavity or play a supporting function.

It should be noted that the distal side is defined as the side close to the cyst tissue and away from the operator, that is, the side close to the patient's tissue; the proximal side is defined as the side away from the patient's tissue, that is, the side close to the operator. The distal end is defined as the distal end position; the proximal end is the proximal end position.

In the cutting device for endoscope provided in the present application, since the inner tube member 303 is present, and the distal end of the inner tube member is provided with a needle head 3031 capable of penetrating side tissue, the tissue can be effectively punctured, especially smoothly. Realize the puncture of two tissues far away from each other. In addition, the inner tube member 303 is a hollow tube extending hollow in its axial direction, so that the guide wire 304 can be inserted from the inside of the inner tube member 303, so there is no need to retract the inner tube member 303, and the guide can be made in one step. The wire 304 is placed in the tissue, so that the guide wire 304 can be placed in the tissue conveniently and efficiently. In addition, the distal side of the handle assembly can be fixed on the endoscope and relatively fixed with the endoscope, so that the stability of puncture can be improved and the operation can be completed smoothly.

In particular, it should be noted that when two tissues, that is, the first tissue and the second tissue, are attached to each other, the cutting device for endoscopes provided in the present application can achieve puncture well. Moreover, when the first tissue and the second tissue are far away from each other, as shown in Figure 10-2, when the puncture of the second tissue is completed, the puncture of the first tissue can be smoothly achieved, thereby solving the problem in Figure 2 There are technical problems. In addition, in the present application, the distal side of the handle assembly is fixed on the endoscope, specifically, it is fixed on the forceps opening of the endoscope, so that the cutting device is fixed relative to the endoscope, and the operation is smooth. carry out.

In the above-mentioned first embodiment, a further improved design is made. For example, the cutting device for an endoscope further includes an insulating member that separates the electric cutter 302 from the inner tube member 303. It should be noted that the present application does not limit the structure of the insulating member, as long as the insulating structure can achieve the purpose of isolating the electric cutter 302 and the inner tube member 303. Due to the isolation effect of the insulating member, the electric current of the electric cutter 302 can be concentrated on the electric cutter 302 without spreading, and the current density is increased, thereby enhancing the cutting performance.

Specifically, as shown in FIG. 3, in a specific structural design, the insulating member is a middle tube member 305 arranged inside the outer tube member 301, and the middle tube member 305 and the outer tube member 301 are fixed along the axial direction; The tube member 303 is further arranged inside the middle tube member 305 and can be extended or recovered at the distal end of the middle tube member 305. In this structural design, the middle tube member 305 is a hollow tubular component, and this structural design can facilitate the extension or recovery of the inner tube member 303.

In addition, as shown in FIG. 4, FIG. 4 is a schematic diagram of the working state of the cutting device for the endoscope in FIG. 3 under a working condition. In this working condition, due to the isolation effect of the middle tube member 305, when the guide wire 304 is bent, the electric cutter 302 can be prevented from scratching the guide wire 304. In addition, under some working conditions, when the electrocutter 302 is advanced along the guide wire 304, due to the isolation effect of the middle tube member 305, the electrocutter 302 can be prevented from being embedded in the polymer coating on the surface of the guide wire 304, which may cause difficulty in advancing. .

In an alternative embodiment, as shown in FIG. 3, the electric cutter 302 is a circular cutter, and the inner wall of the circular cutter is fixedly sleeved on the outer wall of the distal end of the middle tube member 305, so that the electric cutter 302 It has a more stable fixed support, and the electric cutter 302 is fixed around the circumference to improve the stability during cutting.

In an alternative embodiment, as shown in FIGS. 3, 4 and 5, the distal end surface of the middle tube member 305 is flush with the end surface of the distal end of the electrocutter 302. The middle tube member 305 can be fixed in the inner surface of the electric cutter 302, and the end surface of the distal end of the middle tube member 305 is flush or substantially flush with the distal end surface of the electric cutter 302, which can enhance the cutting performance of the ring knife. Since the middle tube member 305 covers the inner surface of the electric cutter 302, and the distal end of the middle tube member 305 is flush or substantially flush with the distal end surface of the electric cutter 302, the electric cutter 302 and the tissue can be reduced. The surface area of the contact increases the current density, thereby enhancing the cutting effect.

Further, as shown in FIG. 3, it relates to the connection between the electric cutter 302 and the outer tube member 301. The electric cutter 302 is a ring cutter, and the outer wall of the ring cutter is provided with a recessed mounting portion 3021 on a circumference; the outer tube The distal end of the member 301 is fixedly mounted on the outer wall of the recessed mounting portion 3021 with its inner wall. Correspondingly, the distal end of the outer tube member 301 is fixedly mounted on the outer wall of the recessed mounting portion 3021 with its inner wall through an annular barb or threaded fit, so as to achieve a stable connection between the electrocutter 302 and the outer tube member 301. At the same time, the electric cutter 302 is clamped and fixed to each other by the middle tube member 305 and the outer tube member 301 on both sides, so the structure is more stable and it is convenient to perform cutting.

In addition, the connection between the electric cutter 302, the outer tube member 301, and the middle tube member 305 may also be a fixed connection method without threads or barbs. For example, a fastening ring 306 may be used, which is described in the present application. In some embodiments, as shown in FIG. 5, the outer wall of the distal end of the outer tube member 301 is provided with a fastening ring 306. Through the fastening ring 306, the distal end of the outer tube member 301 is fixedly mounted on the outer wall of the recessed mounting portion 3021 with its inner wall. Through the action of the fastening force of the fastening ring 306, the sleeved middle tube member 305, the electric cutter 302, and the outer tube member 301 are crimped and fastened, thereby having a good fixing and connection performance.

In an alternative embodiment, as shown in FIG. 6, the electric cutter 302 is a ring cutter, and the insulating member is an insulating coating 307 covering the inner wall of the ring cutter. Compared with the insulating structure of the middle tube member 305, the insulating coating 307 is arranged on the inner wall of the electric cutter 302, which can reduce the extension length in the axial direction, thereby saving material and making the structure of the entire cutting device simpler and more compact.

In addition, in any of the foregoing embodiments, the electric cutter 302 may be an all-metal annular cutter structure. When energized, the current fills the surface of each cutter to realize tissue cutting. In an alternative embodiment, as shown in FIG. 7, the electric cutter 302 includes an insulating head 308, and a cutting wire 3081 is provided on the circumference of the insulating head 308. The material of the insulating head 308 may be ceramic or other insulating materials, which is not limited in this application. Compared with the design of the all-metal cutter, the cutting wire 3081 can significantly increase the current density and significantly enhance the cutting performance. In addition, as shown in FIG. 7, since the substrate is an insulating material, the cutting wire 3081 is wound on the insulating material, so that the insulation performance can be enhanced, so that the cutting wire 3081 is insulated from the inner tube member 303.

In an alternative embodiment, as shown in FIG. 8, the electric cutter 302 is fixed to the inside of the outer tube member 301. In this embodiment, the electric cutter 302 may be fixed to the outside of the outer tube member 301. For example, the electric cutter 302 is a circular cutter, and the circular cutter is fixedly sleeved on the outer wall of the distal end of the outer tube member 301 with its inner wall. As shown in FIG. 8, the distal end of the middle tube member 305 protrudes from the outer tube member 301 in the axial direction, forming a middle tube extension 3051. The inner wall of the proximal side of the ring cutter is provided with a ring groove 3022, the proximal side of the ring cutter is fixed to the outer wall of the outer tube member 301 through the ring groove 3022, and the distal end of the ring cutter is fixed to the middle tube On the outer wall of the extension 3051. The specific fixing method can be glued with an adhesive.

In the above-mentioned embodiment, the wire 601 may pass through the inside of the wall of the outer tube member 301, or through the cavity between the outer tube member 301 and the middle tube member 305. In any of the above embodiments, we can design the outer diameter range of the outer tube member. For example, the outer diameter of the outer tube member 301 ranges from 5Fr to 10Fr. Since the common specifications of stents or other drainage devices are in the range of 5Fr～10Fr, if the flaring is too large, the stent may not be well fixed, causing the stent to fall off; and if the flaring is too small, it will be difficult to insert the stent. Therefore, the outer diameter of the outer tube member 301 ranges from 5Fr to 10Fr. It should be noted that Fr is the abbreviation of French, which is a medical catheter diameter unit, 3Fr=1mm.

In an alternative embodiment, as shown in FIG. 9, the handle assembly includes a distal handle assembly and a proximal handle assembly. The proximal handle assembly includes a first core rod 401, a first handle 402 sliding along the first core rod 401, and a first positioning lock 403 for positioning the relative position between the first core rod 401 and the first handle 402. The proximal handle assembly also includes a guide wire lock 404 and an inner needle member seat 405 provided at the proximal end of the first handle 402.

In practical applications, the first positioning lock 403 can be released, and the first handle 402 can be moved along the first core rod 401, thereby adjusting the extension length H of the inner tube member 303. When it is adjusted to a proper length, it is fixed by the first positioning lock 403. The first positioning lock 403 and the first handle 402 may be operated separately. That is, the length of the puncture is determined according to the endoscopic image, the first positioning lock 403 is adjusted to the required length, and then the first handle 402 is quickly pushed to the first positioning lock 403, and due to the effective puncture of the inner tube member 303 The effect, and the relative fixation of the cutting device and the endoscope, makes the advancing process fast and accurate.

As shown in FIG. 9, the guide wire 304 and the guide wire lock 404 can be connected by means of attachment, and are connected to the inner needle member seat 405 by Luer. The inner tube member 303 and the inner needle member seat 405 at the proximal end may also be connected by attachment. In addition, the inner needle member seat 405 and the first handle 402 can also be connected by attachment.

It should be noted that, as shown in FIG. 9, the way of attaching the guide wire 304 to the guide wire lock 404 can be: the guide wire lock 404 is provided with a buckle groove, and the proximal end of the guide wire 304 can be bent and jammed. Into the buckle groove to achieve attachment and fixation.

In addition, as shown in FIG. 9, the distal handle assembly includes a second core rod 501, a second handle 502 sliding along the second core rod 501, and a positioning between the second core rod 501 and the second handle 502. Position of the second positioning lock 503. A second positioning lock 503 is provided on the second handle 502, and the second positioning lock 503 is released so that the second handle 502 slides back and forth along the second core rod 501, thereby adjusting the extension length L of the outer tube member 301. When extended to a proper length, it can be locked by the second positioning lock 503. In addition, the distal end of the lower end cap 504 is connected to the jaw of the ultrasonic endoscope, and the proximal end is attached to the second core rod 501. The outer tube member 301 is connected to the second handle 502 at the proximal end, and the middle tube member 305 is connected to the second handle 502 at the proximal end.

In addition, as shown in FIG. 9, the outer tube member 301 further includes a wire 601 electrically connected to the electric cutter 302, and the wire 601 extends to the second handle 502 inside the outer tube member 301. The handle assembly further includes a conductive screw seat 602 and a conductive screw 603 arranged on the conductive screw seat 602; the wire 601 is led out from the second handle 502 and electrically connected to the conductive screw 603. Power is supplied to the electric cutter 302 through the conductive screw 603 and the wire 601, so that the electric cutter 302 cuts.

Based on the above scheme, this article takes the structure in Figure 3 as an example to introduce the working conditions, including:

Please refer to Fig. 10-1. Fig. 10-1 is a schematic diagram of the working condition of the cutting device for endoscope in Fig. 3 under working condition 1: approaching tissue. In this working condition, the cutting device is close to the first tissue 701 and the second tissue 702. It can be seen from the figure that, in this working condition, the inner tube member 303 is all recovered into the inside of the middle tube member 305.

Please refer to Fig. 10-2. Fig. 10-2 is a schematic diagram of the working state of the cutting device for the endoscope in Fig. 3 based on working condition one and working condition two: the inner needle member punctures tissue. In this working condition, the inner tube member 303 extends from the middle tube member 305, first punctures the second tissue 702, and then punctures the first tissue 701, thereby completing the positioning puncture of the tissue.

Please refer to Figure 10-3. Figure 10-3 is a schematic diagram of the working state of the cutting device for the endoscope in Figure 3 based on working condition two and working condition three: when the built-in guide wire enters the tissue. In this working condition, the guide wire 304 protrudes from the inner tube member 303 and enters the inside of the first tissue 701. Obviously, since the inner tube member 303 has a good extension and guiding function, the guide wire 304 is very easy to extend and insert.

Please refer to Fig. 10-4. Fig. 10-4 is a schematic diagram of the working state of the cutting device for endoscope in Fig. 3 based on working condition three and working condition four: the inner tube member is retracted from the tissue. In this working condition, the inner tube member 303 is recovered from the tissue to prepare for the next working condition, the electric cutter 302 cuts and expands.

Please refer to Figure 10-5. Figure 10-5 is a schematic diagram of the working state of the cutting device for the endoscope in Figure 3 based on working condition four, in working condition five: the electric cutter of the outer tube member further expands the tissue. In this working condition, the outer tube member 301 is approached forward, and the puncture site is flared by the electric cutter 302. Obviously, due to the first puncture of the inner tube member 303, the flaring of the electrocutter 302 becomes relatively easy and accurate.

Please refer to Fig. 10-6. Fig. 10-6 is a schematic diagram of the working state of the cutting device for the endoscope in Fig. 3 based on working condition 5 and working condition 6: the outer tube member is retracted from the tissue. In this working condition, both the outer tube member 301 and the inner tube member are recovered from the body, and only the guide wire 304 is left, so subsequent operations such as placement of drainage stents are performed.

Please refer to Figures 10-7. Figure 10-7 is a schematic diagram of the working state of the cutting device for the endoscope in Figure 3 based on working condition five, in working condition seven: the inner needle member is withdrawn from the middle tube member. In this working condition, the inner tube member 303 is completely withdrawn, so as to prepare another guide wire 304 for the next working condition.

Please refer to Figs. 10-8, Fig. 10-8 is a schematic diagram of the working state of the cutting device for endoscope in Fig. 3 based on working condition 7 and working condition 8: another guide wire enters the tissue from the middle tube member. In this working condition, the other guide wire 304 is guided by the middle tube member 305 to completely enter the inside of the first tissue 701. It can be seen that the design of the middle tube member 305 can play a guiding role in addition to the insulation function described above, so as to realize the guiding of the insertion of another guide wire 304.

Please refer to Figures 10-9. Figure 10-9 is a schematic diagram of the working state of the cutting device for the endoscope in Figure 3 based on working condition eight, in working condition nine: the outer tube member is retracted from the tissue. In this working condition, the cutting device is withdrawn and only two guide wires 304 are left. Therefore, under the guidance of the two guide wires 304, a dual drainage stent, or a stent and a nasal irrigation tube can be placed.

The similar parts between the embodiments provided in this application can be referred to each other. The specific implementations provided above are only a few examples under the general concept of this application, and do not constitute a limitation of the protection scope of this application. For those skilled in the art, any other implementation manners expanded according to the scheme of this application without creative work shall fall within the protection scope of this application.

Claims (18)

A cutting device for an endoscope, characterized in that it comprises a handle assembly, the distal side of the handle assembly can be fixed on the endoscope; The distal end of the handle assembly protrudes along its axial direction with an outer tube member with an adjustable extension length, and an electric cutter is provided on the distal end of the outer tube member; It also includes an inner tube member that can be extended from the distal end of the outer tube member and whose extension length is adjustable. The distal end of the inner tube member is provided with a needle head that can pierce tissue. The proximal end is connected to the handle assembly; The inner tube member is a tube structure that is hollow in the axial direction, so that compatible instruments for endoscopic surgery can be inserted or withdrawn from the inner tube member. The cutting device for an endoscope according to claim 1, wherein the cutting device for an endoscope further comprises an insulating member that isolates the electric cutter and the inner tube member. The cutting device for an endoscope according to claim 2, wherein the insulating member is a middle tube member provided inside the outer tube member, and the middle tube member and the outer tube member are along an axis. To fix The inner tube member is arranged inside the middle tube member, and is extended or recovered from the distal end of the middle tube member. The cutting device for an endoscope according to claim 3, wherein the electric cutter is a ring cutter, and the electric cutter is fixedly sleeved on the outer wall of the distal end of the middle tube member with its inner wall . The cutting device for an endoscope according to claim 4, wherein the outer wall of the electrocutter is provided with a recessed mounting part; the distal end of the outer tube member is fixedly mounted on the recessed mounting with its inner wall On the outer wall of the department. 5. The cutting device for an endoscope according to claim 5, wherein the distal end of the outer tube member is fixedly mounted on the outer wall of the recessed mounting portion with its inner wall through an annular barb or threaded fit. The cutting device for an endoscope according to claim 5, wherein the outer wall of the distal end of the outer tube member is provided with a fastening ring; through the fastening ring, the distal end of the outer tube member The inner wall is fixedly installed on the outer wall of the recessed installation part. The cutting device for an endoscope according to claim 3, wherein the electric cutter is a ring cutter, and the electric cutter is fixedly sleeved on the outer wall of the distal end of the outer tube member with its inner wall . 8. The cutting device for an endoscope according to claim 8, wherein the distal end of the middle tube member protrudes from the outer tube member in the axial direction to form a middle tube extension; The inner wall of the proximal side of the electric knife is provided with a circular ring clamping groove, the proximal side of the circular cutting knife is fixed on the outer wall of the outer tube member through the circular circular clamping groove, and the distal end of the circular cutting knife The side end is fixed on the outer wall of the middle tube extension. The cutting device for an endoscope according to any one of claims 3-9, wherein the distal end surface of the middle tube member is flush with the end surface of the distal end of the electrocutter. The cutting device for an endoscope according to any one of claims 3-9, wherein the handle assembly includes a distal handle assembly and a proximal handle assembly; the distal handle assembly includes a second core rod, And a second handle that slides along the second core rod, and a second positioning lock that positions the relative position between the second core rod and the second handle; the outer tube member is at the proximal end of the The second handle is connected, and the middle tube member is connected with the second handle at the proximal end. The cutting device for an endoscope according to claim 11, wherein the outer tube member further comprises a lead wire electrically connected to the electrocutter, and the lead wire extends to the inside of the outer tube member. Mentioned second handle. The cutting device for an endoscope according to claim 12, wherein the handle assembly further comprises a conductive screw seat and a conductive screw provided on the conductive screw seat; the wire is provided by the second handle After being led out, it is electrically connected with the conductive screw. 3. The cutting device for an endoscope according to claim 2, wherein the electric cutter is a ring cutter, and the insulating member is an insulating coating covering the inner wall of the electric cutter. The cutting device for an endoscope according to any one of claims 1-9, wherein the electric cutter comprises an insulating head, and a cutting wire is provided on the circumference of the insulating head. The cutting device for an endoscope according to any one of claims 1-9, wherein the handle assembly includes a distal handle assembly and a proximal handle assembly; the proximal handle assembly includes a first core rod , And a first handle that slides along the first core rod, and a first positioning lock that positions the relative position between the first core rod and the first handle. The cutting device for an endoscope according to claim 16, wherein the proximal handle assembly further comprises a guide wire lock and an inner tube member seat provided at the proximal end of the first handle; the guide wire It can be locked by the guide wire lock, the guide wire lock is connected with the inner tube member seat; the inner tube member is connected with the inner tube member seat at the proximal end. The cutting device for an endoscope according to any one of claims 1-9, wherein the outer diameter of the outer tube member ranges from 5Fr to 10Fr.

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