CN108652739A - A kind of percutaneous nephrolithy with independent bending instrument channel - Google Patents

Abstract

The invention relates to a percutaneous nephroscope with an independent curved device channel, which belongs to the technical field of medical devices. The device includes a rigid mirror body and a holding part; Developing system, there is an instrument channel in the water channel, the front end of the instrument channel is a curved end, and the end of the optical developing system is equipped with a lens. Department; the holding part is used for holding and providing passage. The percutaneous nephroscope of the present invention increases the viewing angle of the lens and sets up an independent instrument channel with a curved front end. When dealing with complex calculi such as parallel calyceal calculi in clinical practice, it can assist Traditional hard mirrors perform holmium laser lithotripsy for stones under direct vision, which reduces the damage to kidney tissue caused by multiple punctures, improves the efficiency of lithotripsy, reduces residual stones, and improves the lithotripsy effect of primary percutaneous nephroscopic surgery.

Description

A percutaneous nephroscope with independent curved instrument channel

technical field

The invention relates to a percutaneous nephroscope with an independent curved instrument channel, which belongs to the technical field of medical instruments.

Background technique

Percutaneous nephroscopy is a common method for clinical treatment of staghorn calculi, calices or diverticulum calculi. The operator first establishes a puncture channel through the skin of the lower back under the guidance of B-ultrasound or X-ray, and then inserts the transdermal nephroscopy through the expanded channel. Percutaneous nephroscopic surgery uses ultrasound, laser and other technologies to carry out lithotripsy. For patients with solitary renal pelvis stones with moderate or greater hydrops, percutaneous nephroscopic surgery has the advantages of small wound, short time, and good lithotripsy effect. When dealing with calculi in parallel calyxes or other calculus in dead corners, since the viewing angle of the end of the traditional hardscape lens is generally 12 degrees, the viewing range is limited, which may make it difficult to find the calculi, and the instrument channel is integrated with the water channel, even if the calculus is in a safe place. Within the scope of vision, because the laser fiber cannot be bent by itself, it is still impossible to aim at the lithotripsy. If the angle of the lens is changed forcibly or the puncture channel is increased, it will cause damage to the kidney tissue, prolong the operation time, and increase the chance of complications such as channel bleeding. . Percutaneous nephroscopy combined with flexible ureteroscopy is currently an effective means of dealing with complex stones. However, due to the limitation of the bending radius of the flexible ureteroscope, for some patients with lower renal calyceal stones and calices neck stenosis, the effect of lithotripsy is still unsatisfactory. Increased operation time and difficulty.

The Chinese patent document (publication number CN103622661A) discloses a rigid percutaneous nephroscope with a bendable front end. The front end is designed as a curved instrument channel. There will be a bending radius, which will increase the difficulty of the operation. It is not practical in percutaneous nephroscopic surgery, especially when the hydronephrosis is not obvious and the neck of the calices is narrow. The complexity of the anatomical structure of the renal collecting system determines the straight line The mirror body is the best choice for percutaneous nephroscopic surgery, but the linear mirror body still has many shortcomings mentioned above.

Contents of the invention

Aiming at the deficiencies of the prior art, the present invention provides a percutaneous nephroscope device, which assists traditional hard mirrors to perform laser fragmentation of complex stones by changing the viewing angle of the tip of the lens and setting an independent instrument channel with a curved front end. Stones can improve the lithotripsy effect of traditional percutaneous nephroscopy, shorten the operation time, and reduce the chance of postoperative complications.

Technical scheme of the present invention is as follows:

A percutaneous nephroscope with an independent curved instrument channel, including a rigid mirror body and a holding part;

The hard mirror body is a straight mirror body, and there is a water channel and an optical development system in the hard mirror body. There is an instrument channel in the water channel. The front end of the instrument channel is a curved end. The end of the optical development system is equipped with a lens. The radial plane of the body is inclined, and one end of the hard mirror body is connected with a holding part;

The holding part includes an operation channel, which is connected with one end of the hard mirror body, and one end of the operation channel is provided with an instrument channel inlet and a water inlet and outlet valve.

Preferably, according to the present invention, the included angle between the plane where the lens is located and the radial plane of the hard mirror body is the viewing angle of the lens, and the viewing angle of the lens is 15-90 degrees.

Preferably according to the present invention, the front curved end of the instrument channel is located inside the rigid mirror body. The instrument channel does not exceed the external shape of the rigid mirror body, so the rigid mirror body of the whole device is still linear.

Further preferably, the lens is located at the front end of the curved end of the instrument channel. The front end is the front end of the hard mirror body in the axial direction. The lens is in front for observation and operation, and it is also convenient to match the curved instrument channel and different viewing angles of the lens; the entrance of the instrument channel is located at the rear end of the lens.

Further preferably, the bending radius of the curved end of the instrument channel is 2.5-3.5 mm.

Further preferably, the diameter of the holmium laser fiber currently used in the market is 200 μm-1 mm, and the inner diameter of the instrument channel of the present invention is set to 1-1.5 mm.

Further preferably, the projected length of the lens tip of the lens on the radial plane of the hard mirror body is L, and L is 2.5 mm to 6 mm. The tip of the lens is tilted at different angles in the hard mirror body, corresponding to different lengths of L. L is the length of the lens after changing the viewing angle of the lens. The projected length of the tip of the lens is also different under different viewing angles of the lens.

Preferably, according to the present invention, the holding part further includes an optical conduction channel, the optical conduction channel is connected to the operation channel, and the optical conduction channel is connected to the optical development system in the hard mirror through the operation channel. The two parts are connected as the development path of the whole device.

Further preferably, an eyepiece is provided at the rear end of the optical transmission channel. It is used for the operator to observe the condition of the affected part.

Further preferably, a semi-circular finger ring is provided at the connection between the optical conduction channel and the operation channel. As the focus point of the main operator during the operation.

The beneficial effects of the present invention are:

The percutaneous nephroscope of the present invention increases the viewing angle of the lens and sets up an independent instrument channel with a curved front end. When dealing with complex calculi such as parallel calyx calculus in clinical practice, it can assist Traditional hard mirrors perform holmium laser lithotripsy for stones under direct vision, which reduces the damage to kidney tissue caused by multiple punctures, improves the efficiency of lithotripsy, reduces residual stones, and improves the lithotripsy effect of primary percutaneous nephroscopic surgery.

This device does not extend and bend the mirror body additionally, but sets an independent instrument channel with a curved front end in the lumen of the traditional linear mirror body, and cooperates with the change of the viewing angle of the lens to complete the laser lithotripsy under direct vision. It is not practical in percutaneous nephroscopic surgery, especially when the hydronephrosis is not obvious and the calyx neck is narrow. The complexity of the anatomical structure of the renal collecting system determines that the linear lens is the best choice for percutaneous nephroscopic surgery. The present invention changes the inclination angle of the lens at the tip of the mirror body on the basis of ensuring the traditional straight mirror body, and sets an independent instrument channel with a curved front end, so that the stones that are difficult to be detected by traditional hard mirrors can be directly viewed with laser light. gravel.

The characteristic multi-dimensional viewing angle of traditional hard mirrors ranges from 6 to 15 degrees, and the optimal viewing angle is 12 degrees. But the present invention is just by increasing the angle of view (15-90 degrees) and cooperating with the independent instrument channel with a curved front end to complete the operation that is difficult to complete with traditional rigid mirrors.

Description of drawings

Fig. 1a is the overall structure diagram of the present invention, wherein the viewing angle of the front end of the hard mirror body is 15-89 degrees, and the hard mirror body is broken due to the length factor;

Fig. 1 b is the overall structure diagram of the present invention, wherein the viewing angle of the front end of the hard mirror body is 90 degrees, and the hard mirror body is broken due to the length factor;

Fig. 2 is a sectional view of the lens tip structure of the present invention (viewing angle 15-89 degrees);

Fig. 3 is the sectional view of lens tip portion structure of the present invention (viewing angle 90 degrees);

Among them: 1 is the hard lens body, 2 is the optical development system, 3 is the instrument channel, 3-1 is the curved end, 4 is the water channel, 5 is the water inlet and outlet valve, 6 is the entrance of the instrument channel, 7 is a semi-circular ring, 8 is an eyepiece, 9 is an operation channel, 10 is a lens, and 11 is an optical transmission channel.

Detailed ways

The present invention will be further described below through the embodiments and in conjunction with the accompanying drawings, but not limited thereto.

Example 1:

A percutaneous nephroscope with an independent curved instrument channel includes a rigid mirror body and a holding part.

The hard mirror body is a straight mirror body, and there is a water channel and an optical development system in the hard mirror body. There is an instrument channel in the water channel. The front end of the instrument channel is a curved end. The end of the optical development system is equipped with a lens. The radial plane of the body is inclined. The angle between the plane where the lens is located and the radial plane of the hard mirror body is the viewing angle of the lens. The viewing angle of the lens is 15 degrees. One end of the hard mirror body is connected with a holding part.

The holding part includes an operation channel, which is connected with one end of the hard mirror body, and one end of the operation channel is provided with an instrument channel inlet and a water inlet and outlet valve.

Example 2:

A percutaneous nephroscope with an independent curved instrument channel has a structure as described in Embodiment 1, except that the viewing angle α of the lens is 45 degrees, as shown in FIG. 2 .

Example 3:

A percutaneous nephroscope with an independent curved instrument channel has a structure as described in Embodiment 1, except that the viewing angle α of the lens is 90 degrees, as shown in FIG. 3 .

Example 4:

A percutaneous nephroscope with an independent curved instrument channel, its structure is as described in Embodiment 1, the difference is that the front curved end of the instrument channel is located inside the rigid mirror body. The instrument channel does not exceed the external shape of the rigid mirror body, so the rigid mirror body of the whole device is still linear, as shown in Figure 1a and Figure 1b.

Example 5:

A percutaneous nephroscope with an independent curved instrument channel, its structure is as described in Embodiment 1, the difference is that the lens is located at the front end of the curved end of the instrument channel. The front end is the front end of the hard mirror body in the axial direction. The lens is in front for observation and operation, and it is also convenient to match the curved instrument channel and different viewing angles of the lens; the entrance of the instrument channel is located at the rear end of the lens.

Embodiment 6:

A percutaneous nephroscope with an independent curved instrument channel has a structure as described in Embodiment 4, except that the bending radius of the curved end of the instrument channel is 2.5 mm, and the inner diameter of the instrument channel is set to 1 mm.

Embodiment 7:

A percutaneous nephroscope with an independent curved instrument channel has a structure as described in Embodiment 4, except that the bending radius of the curved end of the instrument channel is 3.5 mm, and the inner diameter of the instrument channel is set to 1.5 mm.

Embodiment 8:

A kind of percutaneous nephroscope with independent curved instrument channel, its structure is as described in embodiment 1, the difference is that the projection length of the lens tip of the lens on the radial plane of the hard lens body is L, and L is 2.5 mm, when the viewing angle of the lens is small, the tip of the lens and the hard mirror body tend to be parallel, and the projected length of a small unit is used to match the specifications of the hard mirror body, so that the developing angle can be guaranteed, and it can also be used for rear equipment Channels leave room.

Embodiment 9:

A percutaneous nephroscope with an independent curved instrument channel, its structure is as described in embodiment 3, the difference is that the projected length of the lens tip of the lens on the radial plane of the hard lens body is L, and L is 6mm , when the viewing angle of the lens is 90°, the tip of the lens and the hard mirror body are in a state of perpendicular crossing, and the projection length of the tip of the lens is at most 6mm, so that the optical development system and the instrument channel are inside the hard mirror body, ensuring The rectilinear state of the rigid mirror body.

Example 10:

A percutaneous nephroscope with an independent curved instrument channel, its structure is as described in Embodiment 1, the difference is that the holding part also includes an optical conduction channel, the optical conduction channel is connected with the operation channel, and the optical conduction channel passes through the operation channel The channel is connected with the optical development system in the hard mirror body, and the two parts are connected as the development path of the whole device.

Example 11:

A percutaneous nephroscope with an independent curved instrument channel, the structure of which is as described in Embodiment 10, the difference is that an eyepiece is provided at the rear end of the optical conduction channel for the operator to observe the condition of the affected part.

Example 12:

A kind of percutaneous nephroscope with independent curved instrument channel, its structure is as described in embodiment 10, the difference is that the junction of the optical conduction channel and the operating channel is provided with a semi-circular finger ring, which is used as the main operating hand when the operation is performed. focus.

Experimental example

Utilizing the device of the present invention as described in Example 1, in the course of operation, when encountering the situation that the traditional hard mirror cannot see the stones clearly, the percutaneous nephroscope of the present invention is inserted into the puncture sheath, and by moderate adjustment of the puncture sheath Combined with the rotating nephroscope, the calculus is exposed in the center of the visual field, and the laser fiber is placed at the entrance 6 of the instrument channel, because the rigid mirror of the present invention is provided with an independent instrument channel 3 with a curved front end, and the laser fiber is bent through the instrument channel. , can carry out precise stone crushing within the field of vision.

Claims (10)

1. A percutaneous nephroscope with an independent curved instrument channel, characterized in that it comprises a hard mirror body and a holding portion; The hard mirror body is a straight mirror body, and there is a water channel and an optical development system in the hard mirror body. There is an instrument channel in the water channel. The front end of the instrument channel is a curved end. The end of the optical development system is equipped with a lens. The radial plane of the body is inclined, and one end of the hard mirror body is connected with a holding part; The holding part includes an operation channel, which is connected with one end of the hard mirror body, and one end of the operation channel is provided with an instrument channel inlet and a water inlet and outlet valve. 2. the percutaneous nephroscope with independent curved instrument channel according to claim 1, is characterized in that, the included angle between the plane of camera lens and the radial plane of hard lens body is the angle of view of camera lens, and the direction of view of camera lens The angle is 15-90 degrees. 3. The percutaneous nephroscope with independent curved instrument channel according to claim 1, characterized in that, the front curved end of the instrument channel is located inside the rigid mirror body. 4. The percutaneous nephroscope with an independent curved instrument channel according to claim 3, wherein the lens is located at the front end of the curved end of the instrument channel. 5. The percutaneous nephroscope with independent curved instrument channel according to claim 1, characterized in that, the bending radius of the curved end of the instrument channel is 2.5-3.5 mm. 6. The percutaneous nephroscope with independent curved instrument channel according to claim 1, characterized in that the inner diameter of the instrument channel is 1-1.5 mm. 7. The percutaneous nephroscope with independent curved instrument channel according to claim 2, characterized in that the projected length of the lens tip of the lens on the radial plane of the hard mirror body is L, and L is 2.5mm～6mm . 8. The percutaneous nephroscope with independent curved instrument channel according to claim 1, characterized in that, the holding part also includes an optical conduction channel, the optical conduction channel is connected with the operation channel, and the optical conduction channel is connected to the hard tube through the operation channel. The optical developing system in the mirror body is connected. 9. The percutaneous nephroscope with independent curved instrument channel according to claim 8, characterized in that an eyepiece is provided at the rear end of the optical conduction channel. 10. The percutaneous nephroscope with an independent curved instrument channel according to claim 8, characterized in that a semi-circular finger ring is provided at the junction of the optical conduction channel and the operating channel.