CN103431907B - Percutaneous nephroscope set calculus removing lens with lockable calculus crushing end - Google Patents

Abstract

The invention relates to a percutaneous nephrolithotomy device with a closed lithotripsy end, comprising an outer scope sheath and a scope body, the outer scope sheath is provided with a rotating sheath and an endoscope sheath, and the rotation sheath can be rotatably sleeved outside the endoscope sheath , and there will be no axial relative displacement between the rotating sheath and the endoscopic sheath; the endoscopic sheath away from the endoscope body is provided with a stone picking assembly, and an opening is provided on the side wall of the stone picking assembly, and the opening can be closed by a closing assembly Covering, an instrument channel tube is arranged in the cavity of the endoscope sheath, and the crushed stone component is arranged in the instrument channel tube, and its crushed stone end extends into the stone picking component. The percutaneous nephrolithotomy device of the present invention can place stones in a closed space for stone crushing, and the stone residues are not without residues, and there is little damage to surrounding tissues, and the interference of stone debris on the field of view of the endoscope is small, and can significantly The efficiency and effect of the operation are improved, and the pain and burden of the patient are reduced.

Description

A percutaneous nephrolithotomy device with sealable stone crushing end

technical field

The invention relates to the technical field of medical instruments, in particular to a percutaneous nephrolithotomy device with a sealable stone-crushing end.

Background technique

Clinically, renal cast stones, multiple calculi, and calyceal calculi are refractory renal calculi. Extracorporeal shock wave lithotripsy (ESWL) has little effect on such calculi and has many complications. Injury, massive kidney hemorrhage, or nephrectomy. The emergence of percutaneous nephroscopy has opened up a new path for the treatment of kidney stones, especially for such refractory stones, such as large cast stones, multiple stones, calices, etc. Existing percutaneous nephroscopes can cooperate with pneumatic ballistics, ultrasound, laser and other lithotripsy. However, due to the special structure of the kidney and the special environment in which the renal pelvis communicates with the ureter and calyces during the lithotripsy process, the stones in the renal pelvis will be broken during the lithotripsy process. During the process, stone fragments easily enter the calices and ureter, resulting in residual stones, causing calyceal stones and ureteral stones, and even stones enter the bladder along the ureter to cause bladder stones, which often require reoperation or follow-up treatment, increasing the patient’s trauma, pain. In addition, lithotripsy equipment and stone fragments can also cause certain damage to the kidney and ureter during lithotripsy. Stone fragments can also interfere with the surgical field of view, affect the surgical effect, prolong the operation time, increase the risk of surgery, and increase the pain and burden of the patient. .

Contents of the invention

The purpose of the present invention is to solve the deficiencies of the above technical problems, to provide a percutaneous nephrolithotomy device with a closed stone crushing end, which is suitable for single large stones or multiple stones, etc., and can place stones in a closed space Lithotripsy is carried out, and there is no residual stone residue, no damage to the surrounding tissues, and little interference with the endoscopic field of view by the stone debris, which can significantly improve the efficiency and effect of the operation, and reduce the pain and burden of the patient.

In order to solve the deficiencies of the above technical problems, the technical solution adopted by the present invention is: a percutaneous nephrolithotomy device with a sealable end of the crushed stone, comprising a straight tubular outer mirror sheath with two ends open and an outer mirror sheath connected to one end of the outer mirror sheath. A mirror body, a lithotripsy assembly and an endoscopic imaging assembly are arranged in the outer mirror sheath, and the end of the mirror body corresponding to the lithotripsy assembly and the endoscopic imaging assembly are respectively connected to the entrance of the stone passage on the mirror body and the entrance of the optical fiber;

A rotating sheath and an endoscopic sheath are arranged inside the outer scope sheath. The rotation sheath and the endoscope sheath are both straight tubular sheaths with open ends. The rotation sheath can be rotatably placed outside the endoscope sheath, and There will be no axial relative displacement between them;

The rotating sheath and the endoscope sheath can move axially in the outer mirror sheath simultaneously through the driving assembly, and both the rotating sheath and the endoscope sheath can be rotated respectively through the driving assembly;

The endoscopic sheath away from the mirror body is provided with a stone picking assembly, which has a skeleton covered with an elastic film; the skeleton is composed of a fixed ring, a support dome and multiple elastic keels to form an elliptical cage-like skeleton; stone picking The component is fixedly connected with the end face of the endoscope sheath through the fixing ring;

An opening is also provided on the side wall of the calculus picking assembly, and the opening can be covered by a closing assembly. The closing assembly is composed of a rotating ring and an arc-shaped side wall. The rotating ring is sleeved on the circumference of the supporting round cover, and the arc-shaped side wall It consists of multiple elastic keels and an elastic film covering the keels, and the two ends of the keel are fixedly connected with the rotating ring and the rotating sheath respectively.

The driving assembly includes a rotating sheath driving unit, an endoscope sheath driving unit and a return spring. The endoscope sheath driving unit is composed of a guide rod assembly I and a control button I. The guide rod assembly I is installed in the lens body, and the guide rod assembly I One end of the endoscope sheath is fixedly connected with the endoscope sheath, and the other end protrudes from the endoscope body to connect with the control button Ⅰ. The driving unit of the rotating sheath is composed of the guide rod assembly II and the control button II. The guide rod assembly II is installed in the endoscope body. It is fixedly connected with the rotating sheath, and the other end extends out of the mirror body to connect to the control button II. The length of the guide rod assembly I extending out of the mirror body is greater than the length of the guide rod assembly II out of the mirror body. The reset assembly is symmetrically arranged on the mirror body. Composed of two brackets, torsion springs, connecting rods and rotating collars, the two torsion springs are respectively set at the end of the bracket away from the mirror body, the rotating collars can be set on the circumference of the control button II, the rotating collars and the two torsion The springs are all connected by connecting rods.

The inner wall of the rotating sheath is provided with an annular groove, and the outer wall of the endoscope sheath is provided with a tab that snaps into the annular groove.

The cavity of the endoscope sheath is provided with an instrument channel tube and an optical fiber channel tube, the lithotripsy component is arranged in the instrument channel tube, and its crushed stone end extends into the calculus picking component, and the endoscopic imaging component is arranged in the optical fiber channel tube, Its objective lens end is disposed at the port of the endoscope sheath.

The cavity of the endoscope sheath is also provided with a water inlet channel pipe, which is connected with the water inlet on the mirror body, and the gap in the endoscope sheath is a water outlet channel, and the water outlet channel is connected with the water outlet provided on the mirror body. valve is connected.

The calculus picking assembly is shrunk in the endoscope sheath in a non-working state.

The lithotripsy component is a pneumatic lithotripsy device or a laser lithotripsy device.

The endoscopic imaging assembly also includes an eyepiece, a light source, a light source fiber and an imaging return fiber, the eyepiece and the light source are respectively arranged on the mirror body, one end of the imaging return fiber is connected to the eyepiece, and the other end passes through the fiber channel tube to connect with the objective lens Connecting, one end of the light source fiber is connected to the light source, and the other end passes through the fiber channel tube and extends to the end of the fiber channel tube.

Beneficial effect

The percutaneous nephrolithotomy device of the present invention can confine the calculus in a closed space in the kidney, and when the lithotripsy operation is performed in the closed space, the calculus residue will not enter the bladder, and there will be no residual calculus after operation, and will not affect the kidney. The kidney wall and surrounding tissues are damaged, and the calculus debris has little interference with the endoscopic field of view and has little impact on the operation process, which can significantly improve the efficiency and effect of the operation, and significantly reduce the pain and burden of the patient.

Description of drawings

Fig. 1 is the structural representation of percutaneous nephrolithotomy device of the present invention;

Fig. 2 is a schematic structural view of the drive assembly of the present invention;

Fig. 3 is the cooperation schematic diagram of rotating sheath and endoscopic sheath of the present invention;

Fig. 4 is a schematic structural view of the stone picking assembly of the present invention;

Fig. 5 is a schematic diagram of an exploded structure of a stone picking assembly of the present invention;

Fig. 6 is a schematic structural view of the closure assembly of the present invention;

Fig. 7 is a schematic diagram of cooperation between the stone picking assembly and the closing assembly of the present invention;

Fig. 8 is a schematic diagram II of cooperation between the stone picking component and the closing component of the present invention;

Marks in the figure: 1, outer mirror sheath, 2, mirror body, 3, rotating sheath, 301, annular groove, 4, endoscope sheath, 401, protruding piece, 5, stone picking component, 501, fixing ring, 502, Supporting dome, 503, elastic keel, 504, opening, 601, rotating ring, 602, curved side wall, 7, drive assembly, 701, guide rod assembly I, 702, control button I, 703, guide rod assembly II, 704, control button II, 705, bracket, 706, torsion spring, 707, connecting rod, 708, rotating collar, 8, gravel component, 901, light source, 10, water inlet, 11, water outlet valve.

Detailed ways

As shown in Figures 1, 2, and 3: a percutaneous nephrolithotomy device with a closed lithotripsy end, comprising a straight tubular outer mirror sheath 1 with open ends and a mirror body 2 connected to one end of the outer mirror sheath 1, the outer A lithotripsy assembly 8 and an endoscopic imaging assembly are arranged inside the mirror sheath 1 , and the end of the lithotripsy assembly 8 and the endoscopic imaging assembly corresponding to the mirror body 2 are respectively connected to the stone crushing channel inlet and the optical fiber inlet on the mirror body 2 . The lithotripsy assembly 8 is a pneumatic lithotripsy device or a laser lithotripsy device. The outer mirror sheath 1 is provided with a rotating sheath 3 and an endoscope sheath 4, the rotating sheath 3 and the endoscope sheath 4 are straight tubular mirror sheaths with open ends, the rotating sheath 3 can be rotatably sleeved outside the endoscope sheath 4, so The inner wall of the rotating sheath 3 is provided with an annular groove 301, and the outer wall of the endoscope sheath 4 is provided with a tab 401 that snaps into the annular groove 301, and there is no axial relative between the rotating sheath 3 and the endoscope sheath 4. Displacement; the rotating sheath 3 and the endoscope sheath 4 can move axially in the outer mirror sheath 1 simultaneously through the driving assembly 7 , and both the rotating sheath 3 and the endoscope sheath 4 can be rotated respectively through the driving assembly 7 . That is to say, the axial displacement of the rotating sheath 3 and the endoscopic sheath 4 is always at the same time, no matter which one of the rotating sheath 3 and the endoscopic sheath 4 is controlled to move axially, the other will move simultaneously, but the rotating sheath 3 There will be relative rotation with the endoscope sheath 4 again.

The cavity of the endoscope sheath 4 is provided with an instrument channel tube and an optical fiber channel tube, the lithotripsy assembly 8 is arranged in the instrument channel tube, and its endoscopic stone end extends into the calculus picking assembly 5, and the endoscopic imaging assembly is arranged in the optical fiber channel In the tube, its objective lens end is set at the port of the endoscope sheath 4. The cavity of the endoscope sheath 4 is also provided with a water inlet channel pipe, which is connected with the water inlet 10 on the mirror body 2. The water outlet valve 11 on the top is connected.

The endoscopic imaging assembly also includes an eyepiece, a light source 901, a light source fiber and an imaging return fiber, the eyepiece and the light source 901 are respectively arranged on the mirror body 2, one end of the imaging return fiber is connected to the eyepiece, and the other end passes through the fiber channel tube It is connected with the objective lens, one end of the light source fiber is connected with the light source 901, and the other end passes through the fiber channel tube and extends to the end of the fiber channel tube.

As shown in Figure 2: the driving assembly 7 includes a rotating sheath driving unit, an endoscope sheath driving unit and a return spring 705, the endoscope sheath driving unit is composed of a guide rod assembly I701 and a control button I702, and the guide rod assembly I701 is penetrated In the mirror body 2, one end of the guide rod assembly I701 is fixedly connected to the endoscope sheath 4, and the other end extends out of the mirror body 2 to connect to the control button I702. The rotating sheath drive unit is composed of a guide rod assembly II703 and a control button II704. Penetrated in the mirror body 2, one end of the guide rod assembly II703 is fixedly connected to the rotating sheath 3, and the other end extends out of the mirror body 2 to connect to the control button II704. Out of the length of the mirror body 2, the reset assembly is composed of two brackets 705 symmetrically arranged on the mirror body 2, a torsion spring 706, a connecting rod 707 and a rotating collar 708. The two torsion springs 706 are respectively arranged on the brackets 705 away from the mirror. At one end of the body 2 , a rotating collar 708 is rotatably disposed on the circumference of the control button II 704 , and the rotating collar 708 and the two torsion springs 706 are connected through a connecting rod 707 . The control button II 704 has a central through hole through which the guide rod assembly I 701 is connected to the control button I 702.

As shown in Figures 1, 4, 5, and 6: the endoscope sheath 4 is provided with a calculus pickup assembly 5 away from the endoscope body 2, and the calculus pickup assembly 5 has a skeleton, and the surface of the skeleton is covered with an elastic film; the skeleton consists of a fixed ring 501, the support dome 502 and a plurality of elastic keels 503 form an elliptical cage frame; the stone picking assembly 5 is fixedly connected with the end face of the endoscope sheath 4 through the fixing ring 501; the side wall of the stone picking assembly 5 is also provided with An opening 504, the opening 504 can be covered by a closure assembly, the closure assembly consists of a rotating ring 601 and an arc-shaped side wall 602, the rotating ring 601 is sleeved on the circumference of the supporting round cover 502, and the arc-shaped side wall 602 is composed of multiple elastic keels 503 and an elastic film covering the keel, and the two ends of the keel are fixedly connected with the rotating ring 601 and the rotating sheath 3 respectively.

In the percutaneous nephrolithotomy device of the present invention, in the non-working state, the stone picking assembly 5 is shrunk in the endoscope sheath 4, and the cage-like framework is in a compressed state at this time. Use the imaging component to make the gravel end of the lithoscope reach the stone. At this time, push the control button I702 to make the stone picking component 5 protrude out of the sheath, and then rotate the control button II704 to drive the rotating sheath 3 to rotate and change the arc side. The position of the wall 602 makes the opening 504 of the stone picking assembly 5 unobstructed, and then with the assistance of the imaging assembly, the stones are loaded into the inner cavity of the stone picking assembly 5 through the opening 504, and the control button II 704 is continuously rotated to change the arc shape. The position of the side wall 602 makes the opening 504 of the calculus pick-up assembly 5 in a blocked state. At this time, a closed gravel environment is formed at the crushed stone end, and the calculus can be crushed by the crushed stone assembly. When the stone becomes smaller, the elastic skeleton of the stone picking component 5 will also retract synchronously, keeping the stone in a small space all the time, preventing the stone from being in a fixed position, and increasing the difficulty of crushing the stone. Under the action of the torsion spring 706, the stone is picked up Assembly 5 will be slowly withdrawn in the sheath, and a lithotripsy work is completed at this moment. The lithotripsy operation is carried out in this closed space, and stone residues will not enter the body, and there will be no stone residue after operation, and will not cause damage to surrounding tissues, and the interference of stone debris on the endoscopic field of view is small, which is very important for surgery. The impact on the process is small, which can significantly improve the efficiency and effect of the operation, and significantly reduce the pain and burden of the patient.

Claims (2)

1. the closed device for percutaneous nephrolithotomy of rubble end, comprise the straight tube-like epi mirror sheath (1) of both ends open and be connected to the mirror body (2) of epi mirror sheath (1) one end, be provided with rubble assembly (8) and based endoscopic imaging assembly in epi mirror sheath (1), it is characterized in that:

Be provided with in epi mirror sheath (1) and rotate sheath (3) and scope sheath (4), rotation sheath (3) and scope sheath (4) are the straight tube-like mirror sheath of both ends open, rotation sheath (3) is rotatable is set in scope sheath (4) outward, and can not produce axial relative displacement between rotation sheath (3) and scope sheath (4);

Rotation sheath (3) and scope sheath (4) can be moved vertically by driven unit (7) in epi mirror sheath (1) simultaneously, and rotation sheath (3) and scope sheath (4) all rotate respectively by driven unit (7);

Scope sheath (4) is provided with calculus picking up assembly (5) away from mirror body (2) one end, and calculus picking up assembly (5) has a skeleton, and skeleton surface is coated with elastic film; Skeleton forms oval cage skeleton by retainer ring (501), support dome (502) and many elastic keels (503); Calculus picking up assembly (5) is fixedly connected with by the end face of retainer ring (501) with scope sheath (4);

The sidewall of described calculus picking up assembly (5) is also provided with an opening (504), opening (504) can be hidden by a closed component, closed component is made up of rotating ring (601) and curved wall (602), rotating ring (601) is set in and supports dome (502) circumferentially, curved wall (602) is made up of many elastic keels (503) and the elastic film be covered on Os Draconis, the two ends of the Os Draconis of closed component respectively with rotating ring (601) with rotate sheath (3) and be fixedly connected with;

Described driven unit (7) comprises rotation sheath driver element, scope sheath driver element and reset assembly, scope sheath driver element is made up of guide rod assembly I (701) and control knob I (702), guide rod assembly I (701) is located in mirror body (2), one end of guide rod assembly I (701) is fixedly connected with scope sheath (4), the other end stretches out mirror body (2) connection control button I (702), rotate sheath (3) driver element by guide rod assembly II (703), control knob II (704) forms, guide rod assembly II (703) is located in mirror body (2), one end of guide rod assembly II (703) is fixedly connected with scope sheath (4), the other end stretches out mirror body (2) connection control button II (704), the length that described guide rod assembly I (701) stretches out mirror body (2) is greater than the length that guide rod assembly II (703) stretches out mirror body (2), control knob II (704) has a center hole, described guide rod assembly I (701) is connected with control knob I (702) through the center hole of control knob II (704), described reset assembly is by two supports (705) be symmetricly set on mirror body (2), torque spring (706), connecting rod (707) and the rotation collar (708) composition, two torque springs (706) are separately positioned on support (705) away from mirror body (2) one end, the rotation collar (708) is rotatable is set on control knob II (704) circumferentially, rotate between the collar (708) and two torque springs (706) and all connected by connecting rod (707),

The inwall of described rotation sheath (3) is provided with annular groove (301), and the outer wall of scope sheath (4) is provided with the tab (401) snapping in annular groove (301);

The intracavity of described scope sheath (4) is provided with instrument channel pipe and optical-fibre channel pipe, rubble assembly (8) is arranged in instrument channel pipe, the rubble end of rubble assembly (8) stretches in calculus picking up assembly (5), based endoscopic imaging assembly is arranged in optical-fibre channel pipe, and the objective end of based endoscopic imaging assembly is arranged on the port of scope sheath (4);

The intracavity of described scope sheath (4) is also provided with intake tunnel pipe, water inlet (10) on intake tunnel Guan Yujing body (2) is connected, space in scope sheath (4) is exhalant canal, and exhalant canal is connected with the outlet valve (11) be arranged on mirror body (2);

Described calculus picking up assembly (5) shrinks in scope sheath (4) when off working state;

Described rubble assembly (8) is pneumatic ballistic lithotripsy apparatus or laser lithotripsy apparatus.

2. the closed device for percutaneous nephrolithotomy of a kind of rubble end as claimed in claim 1, it is characterized in that: described based endoscopic imaging assembly also comprises eyepiece, light source (901), luminous source optical fiber and imaging and returns optical fiber, eyepiece and light source (901) are separately positioned on mirror body, one end that imaging returns optical fiber is connected with eyepiece, the other end is connected with object lens through optical-fibre channel pipe, one end of luminous source optical fiber is connected with light source (901), and the other end passes optical-fibre channel pipe and extends to the end of optical-fibre channel pipe.