CN115581428A - Mirror for urinary surgery - Google Patents

Abstract

The present invention provides a mirror for urological surgery. The mirror for urinary surgery includes an expansion sheath and a nephroscope main body, and the expansion sheath is detachably socketed on the nephroscope main body. The kidney mirror main body has an outer end surface. The outer end surface is provided with a suction and discharge port. On the premise of keeping the radial length unchanged, the discharge space of the suction and discharge port for gravel is increased. The injected flushing fluid returns to the suction and discharge port on the inner wall of the kidney to form a vortex. It is convenient to hold crushed kidney stones and speed up the discharge efficiency of the crushed stones. The outer end surface is provided with a visible part, and the visible part is arranged at the rear end of the suction and discharge port to observe the blockage of the suction and discharge port.

Description

urological surgery mirror

technical field

The invention relates to the field of medical instruments, in particular to a mirror for urinary surgery.

Background technique

As a disease with high incidence in the urinary system, kidney stones often plague many people, causing pain and other abnormal phenomena.

Percutaneous nephrolithotomy is a surgical procedure for the treatment of kidney stones, which are larger, granular stones that accumulate in the kidneys. Although percutaneous nephrolithotomy has been widely used as a surgical method, there are still many problems in the specific operation process.

After the traditional percutaneous nephroscope uses laser to pulverize the calculi, the crushed stone residue flows into the gap between the percutaneous nephroscope and the extended sheath along with the flushing fluid. Since the percutaneous nephroscope is a minimally invasive operation, the wound to the injured should be kept as small as possible, so the overall percutaneous nephroscope should also be made small. However, the structure of the traditional percutaneous nephroscope does not centralize the arrangement of the flushing part, and the channel for discharging the flushing fluid is arranged on the peripheral side of the percutaneous nephroscope on the nephroscope body with a small inner diameter, which makes it very easy to appear unshattered. The problem of stones blocking the passage. The blockage of the discharge channel is likely to cause a series of problems such as excessive pressure difference in the kidney and damage to the percutaneous nephroscopic equipment.

When traditional percutaneous nephroscopes are inserted into the dilated part of the kidney, although the use scene can be monitored with X-ray intermittent perspective, the position of the camera is also set at the front end of the main mirror body to ensure a better field of view. However, the camera cannot observe the blockage of the discharge channel on the rear side, and cannot fully cover the visual processing of key parts of the equipment.

During the flushing process of the traditional percutaneous nephroscope inside the renal pelvis, due to the layout of the suction outlet and flushing outlet, it cannot generate strong liquid backflow, resulting in the inability to provide enough force to attract the crushed stones. The discharge efficiency of the flushing fluid is low, resulting in increased intrarenal pressure, prone to renal pelvis burst and other phenomena.

Therefore, an optimized nephroscopic structure is needed to prevent clogging of gravel and improve the efficiency of gravel discharge.

Contents of the invention

One advantage of the present invention is to provide a mirror for urological surgery. While the suction and discharge are integrated, the mirror for urological surgery adopts a centralized arrangement of channels on the outer end surface to ensure that the size of the suction and discharge port is large enough.

Another advantage of the present invention is to provide a mirror for urological surgery. The flushing port of the mirror for urological surgery is set on the surrounding side, and the suction and discharge ports on the outer end surface are turned back on the inner wall of the kidney to form a vortex to promote the flushing fluid. cycle.

Another advantage of the present invention is to provide a mirror for urological surgery. The main mirror body of the mirror for urological surgery is tapered, which is convenient for inserting the mirror for urological surgery into the patient's body during the operation, reducing the number of operators. The difficulty of operation further reduces the damage to the patient during the entry process.

Another advantage of the present invention is to provide a scope for urological surgery, the scope for urological surgery has an expansion sheath, and the expansion sheath is sleeved on the main body of the nephroscope to serve as a stable bridge channel leading to the kidney and provide expansion support.

Another advantage of the present invention is to provide a mirror for urological surgery, the visible part of the mirror for urological surgery is arranged at the rear end of the suction and discharge port, and the suction and discharge port is located within the visual field of the visible part, so as to observe the Describe the blockage of the suction and discharge ports.

Another advantage of the present invention is to provide a mirror for urological surgery, the remaining channels of the mirror for urological surgery occupy less space, and the size of the discharge channel is reserved to increase the size of the suction and discharge ports.

Another advantage of the present invention is to provide a mirror for urology surgery. The mirror for urology surgery preferably uses an electronic mirror as the visible part, which simplifies the connection method of the visible part and optimizes the wiring layout of the connecting wires.

Another advantage of the present invention is to provide a mirror for urological surgery, the injection channel of the mirror for urological surgery is independent from the discharge channel, the layout of the channels is optimized, the mutual interference is reduced, and the efficiency of stone removal is improved.

Another advantage of the present invention is to provide a mirror for urological surgery. During the surgical operation, the visible part of the mirror for urological surgery avoids misuse of puncturing too deep or too shallow, and reduces potential damage to patients.

Another advantage of the present invention is to provide a mirror for urological surgery. The mirror for urinary surgery has an instrument port, and a lithotripsy instrument can pass through the instrument port to crush stones inside the kidney. A clear view of the visible portion is ensured.

According to one aspect of the present invention, the present invention provides a urological surgery mirror, which includes an expansion sheath and a nephroscope main body, wherein the expansion sheath is detachably socketed on the nephroscope main body, The nephroscope main body includes a main mirror body and a visible part, the main mirror body has an outer end surface, the main mirror body includes a first working area and a second working area, and a suction and discharge port is located at the The second working area, the first working area surrounds the second working area, the visible part is located in the first working area, the main mirror body is provided with a flush port, and the main mirror body has A discharge channel and an injection channel, the discharge channel is connected to the suction port, the injection channel is connected to the flushing port, and the discharge channel and the injection channel are independent of each other.

Description of drawings

Fig. 1 is a schematic diagram of an assembled state of a urological surgery mirror according to a preferred embodiment of the present invention.

Fig. 2 is an exploded schematic diagram of the assembled state of the urological surgery mirror according to the above-mentioned preferred embodiment of the present invention.

Fig. 3A is a partial schematic diagram of the expansion sheath of the urological surgery mirror according to the above-mentioned preferred embodiment of the present invention.

Fig. 3B is a partial cross-sectional view of the urological surgery mirror according to the above-mentioned preferred embodiment of the present invention.

Fig. 4 is a partial schematic view of the expansion sheath of the urological surgery mirror according to the above-mentioned preferred embodiment of the present invention.

Fig. 5A is one of the schematic diagrams of the working process of the urological surgery mirror according to the above-mentioned preferred embodiment of the present invention.

Fig. 5B is one of the schematic diagrams of the working process of the urological surgery mirror according to the above-mentioned preferred embodiment of the present invention.

Fig. 5C is one of the schematic diagrams of the working process of the urological surgery mirror according to the above-mentioned preferred embodiment of the present invention.

detailed description

The following description serves to disclose the present invention to enable those skilled in the art to carry out the present invention. The preferred embodiments described below are only examples, and those skilled in the art can devise other obvious variations. The basic principles of the present invention defined in the following description can be applied to other embodiments, variations, improvements, equivalents and other technical solutions without departing from the spirit and scope of the present invention.

Those skilled in the art should understand that in the disclosure of the present invention, the terms "vertical", "transverse", "upper", "lower", "front", "rear", "left", "right", " The orientation or positional relationship indicated by "vertical", "horizontal", "top", "bottom", "inner", "outer", etc. is based on the orientation or positional relationship shown in the drawings, which are only for the convenience of describing the present invention and simplified description, rather than indicating or implying that the device or element referred to must have a specific orientation, be constructed and operate in a specific orientation, so the above terms should not be construed as limiting the present invention.

It can be understood that the term "a" should be understood as "at least one" or "one or more", that is, in one embodiment, the number of an element can be one, while in another embodiment, the number of the element The quantity can be multiple, and the term "a" cannot be understood as a limitation on the quantity.

As shown in FIGS. 1 to 5C , a urological surgery mirror according to a preferred embodiment of the present invention is illustrated. The urological surgery mirror 1 is suitable for being applied to percutaneous nephrolithotomy. During the operation, the doctor operates a puncture needle 2 to penetrate the outer skin of the human body and the kidney K in a straight line, and introduces a wire 3 Build a bridge channel between the outer skin and the inside of the kidney K. Then the puncture needle 2 is drawn out, the urological mirror 1 is inserted into the channel along the guide wire 3, and finally the kidney stone S is crushed and recovered inside the kidney K. During the lithotripsy process, the lithotripsy device passing through the urological mirror 1 cools down with the scouring of the irrigating fluid, and the irrigating fluid entrains the crushed gravel during the rinsing process. The flushing fluid goes along the urological mirror 1 to the inside of the kidney K, and returns to the urological mirror 1 on the inner wall of the kidney K, forming a vortex, which is suitable for entraining the pulverized kidney stones S. Finally, the pulverized kidney stone S is excreted from the body to complete the operation.

As shown in FIGS. 1 to 2 , the urological surgery mirror 1 includes an expansion sheath 10 and a nephroscope main body 20 , and the expansion sheath 10 is detachably sleeved on the nephroscope main body 20 . In this embodiment, the structural rigidity of the expansion sheath 10 is greater than that of the nephroscope main body 20 . That is to say, the expansion sheath 10 provides sufficient rigidity for the nephroscope main body 20 . When the urological mirror 1 enters the channel along the guide wire 3 , the outer wall of the expanding sheath 10 abuts against the inner wall of the channel. That is to say, the expanding sheath 10 supports the nephroscope main body 20 to enter the interior of the kidney K. In other words, since the puncture needle 2 cuts the channel open, the skin has the property of self-healing. In order to prevent the skin from being cut and closed automatically on both sides, the expansion sheath 10 widens and stabilizes the channel within the safe range of the operation. Facilitate the entry of the nephroscope main body 10 . Therefore, the nephroscope main body 10 should also be kept within the safe range of the operation.

For ease of description, it is defined here that during the surgical operation of the urological surgery mirror 1, the side of the urological surgery mirror 1 inserted into the skin is the inner side, and the side of the urological surgery mirror 1 away from the skin is the outer side. . The medial side is defined as the front end and the lateral side is defined as the rear end.

The nephroscope main body 20 has an outer end surface 210 and a surrounding side surface 220 , the outer end surface 210 is arranged inside the uroscope 1 . The surrounding side surface 220 surrounds the side of the outer end surface 210 , that is, the surrounding side surface 220 extends rearward from the outer edge of the outer end surface 210 along the axial direction of the nephroscope main body 20 . In one embodiment, the plane where the outer end surface 210 is located is perpendicular to the plane where the surrounding side surface 220 is located. In another embodiment, the plane where the outer end surface 210 is located is perpendicular to the plane where the surrounding side surface 220 is located. obliquely intersect each other.

In one embodiment of the present invention, the urological mirror 1 has a discharge channel 212 and an injection channel 213 . The injection channel 213 is suitable for the flow of flushing fluid from the outside to the human kidney K. The discharge channel 212 is suitable for the circulation of flushing fluid from the kidney K to the outside. That is to say, the flushing liquid can enter the interior of the kidney K along the injection channel 213 to complete the flushing work, and then recover the flushing waste water along the discharge channel 212 . The injection channel 213 and the discharge channel 212 are independent of each other, optimizing the arrangement of the channels and improving the stone discharge efficiency.

It is worth mentioning that the discharge channel 212 has a larger radial area than the injection channel 213 . When the lithotripsy instrument enters the interior of the kidney K through the urological mirror 1 to crush the kidney stone S, the flushing fluid plays the role of cooling down and recovering the crushed stone. Therefore, the discharge channel 212 also needs to take over the task of crushing stone circulation. Compared with the traditional percutaneous nephroscope, the path for the circulation of crushed stones is changed from the annular gap between the nephroscope main body 20 and the expansion sheath 10 to the current discharge channel 212 . Stones are easier to pass out of the body, greatly reducing the situation of stone blockage.

As shown in FIGS. 3A and 3B , the nephroscope main body 20 includes a main mirror body 21 , and the main mirror body 21 includes a main mirror tube 211 and has a discharge channel 212 and an injection channel 213 . The discharge channel 212 and the injection channel 213 are disposed on the main mirror tube 211 . Further, the discharge channel 212 and the injection channel 213 are configured to penetrate through the outer end surface 210 . The urological mirror 1 includes a suction and discharge port 60 and a flushing port 70 , the suction and discharge port 60 communicates with the discharge channel 212 , and the flushing port 70 communicates with the injection channel 213 . In this embodiment, the flushing port 70 is disposed on the outer end surface 210 such that the flushing port 70 is located at the end of the nephroscope main body 20 . The diameter of the suction and discharge port 60 is greater than the diameter of the flushing port 70 . The flushing port 70 is suitable for injecting flushing liquid into the kidney K, and the suction and discharge port 60 is suitable for absorbing residual flushing liquid in the kidney K including debris entrained by the flushing liquid. That is to say, the flushing liquid enters the interior of the kidney K through the injection channel 213 from the flushing port 70, and at the same time flushes and cools down, flows back to the suction and discharge port 60 with a larger radial area through the inner wall of the kidney K, engulfing the broken parts. Stones enter the discharge channel 212 and are finally excreted from the body. In other words, the flushing and suction channels of the urological surgery mirror 1 are isolated from each other and do not affect each other. Therefore, what passes through the injection channel 213 and the flushing outlet 70 is flushing fluid, and what the discharge channel 212 and the suction outlet 60 passes through is flushing fluid and gravel.

When the urological mirror 1 is in working state, the operator can suck and recover the flushing fluid inside the kidney K through the suction device connected to the discharge channel 212 . During the suction process, a pressure difference is formed inside the kidney K, so that gravel and the like are easily discharged out of the body along the discharge channel 212 . Although percutaneous nephrolithotomy is a minimally invasive operation, it is still necessary to control the wound within a safe operation range, so that the radial area of the expansion sheath 10 sleeved on the nephroscope main body 20 will not be too large. Further, the discharge path of broken stones is improved so that the arrangement of the outer end surface 210 of the urological mirror 1 is centralized. Compared with traditional percutaneous nephroscopes, the allowable passage range of the annular gap is smaller, and the cross-sectional shape of the suction and discharge port 60 greatly increases the allowable discharge volume of gravel, and the congestion of the suction and discharge port 60 is not easy to occur . For example, the cross-sectional shape of the suction and discharge port 60 may be a shape such as a circle or a crescent that allows crushed stones to pass through, which is not limited by the present invention.

The nephroscope main body 20 also includes an operation part 23 , and the operation part 23 is arranged on the outside of the urology mirror 1 . That is to say, the operation part 23 is connected to the rear end of the main mirror body 21 . Specifically, the operating part 23 is an operating handle that is easy for the operator to hold and use. The operation part 23 has a first operation cavity 231 and a second operation cavity 232 . The first operation chamber 231 is adapted to communicate with the discharge channel 212 , and the second operation chamber 232 is communicated with the injection channel 213 . That is to say, the instrument for injecting irrigation fluid injects irrigation fluid into the injection channel 213 through the second operating chamber 232, and passes through the self-circulation inside the kidney K, and the residual irrigation fluid and entrained gravel flow through the discharge channel 212. to the first operating cavity 231, and finally discharged from the body.

The operating part 23 also has a third operating chamber 233 , and the urological mirror 1 also includes an instrument port 80 . The third operating chamber 233 is provided outside the urological mirror 1 . The instrument port 80 is provided inside the urological mirror 1 . The third operating chamber 233 communicates with the instrument port 80 to allow lithotripsy instruments to pass through. That is to say, the lithotripsy instrument passes through the third operating chamber of the urological mirror 1 and extends from the instrument port 80 to the interior of the kidney K for lithotripsy. In other words, the instrument port and the third operation chamber 233 provide a lithotripsy instrument to communicate with the interior of the kidney K. In this embodiment, the lithotripsy instrument may optionally be a surgical instrument such as a lithotripsy optical fiber, which is not limited by the present invention.

As shown in FIGS. 1 to 2 , the operation part 23 is integrally connected to the main mirror body 21 , or the main mirror body 21 is detachably connected to the operation part 23 . When the expansion sheath 10 is sleeved on the main mirror body 21 , the expansion sheath 10 is detachably connected to the operation part 23 . That is to say, the expansion sheath 10 is detachably mounted on the nephroscope main body 20 .

The expansion sheath 10 includes an inner end portion 111, an outer end portion 112 and a middle portion 113, the inner end portion 111 is located on the inner side of the urological mirror 1, and the outer end portion 112 is located on the inner side of the urological mirror 1. On the outer side of the surgical mirror 1 , the middle portion 113 is located in the region between the inner end portion 111 and the outer end portion 112 . The outer end portion 112 has an internal thread, and the connecting portion of the operating portion 23 and the main mirror body 21 is surrounded by an external thread, and the external thread is suitable for matching with the internal thread. Thus, the outer end portion 112 of the expansion sheath 10 is detachably connected to the operating portion 23 . That is to say, the expansion sheath 10 is detachably connected to the nephroscope main body 20 . The expansion sheath 10 also has an inner side and an outer side, the inner side is adapted to abut against the surrounding side wall, and the outer side is adapted to abut against the channel formed by the puncture needle and the skin to support the main mirror body, as A channel is built.

It is worth mentioning that the radial area of the expansion sheath 10 gradually decreases from the outer end portion 112 to the inner end portion 111 . That is to say, the cross-sectional area of the outer end portion 112 is smaller than the cross-sectional area of the inner end portion 111 . During the operation, when the operator penetrates the urological surgery mirror 1 that enters along the guide wire 3 into the skin, the inner end 111 of the expansion sheath 10 is easier to insert into the skin, preventing the The above-mentioned phenomenon that the radial area of the inner end surface 111 is too large causes severe skin damage at the piercing position.

What is more worth mentioning is that the expansion sheath 10 also has an expansion cavity 11 , and the expansion cavity 11 is suitable for storing the main mirror body 21 . That is to say, the main mirror body 21 is embedded in the expansion cavity 11 . The main mirror body 21 is tapered from the rear end to the front end. In other words, the radial area of the main mirror body 21 decreases gradually from the side away from the outer end surface 210 to the side of the outer end surface 210 . Further, the shape of the main mirror body 21 tends to be a truncated cone, and the upper bottom surface of the truncated cone corresponds to the outer end surface 210 . The shape of the main mirror body 21 is also conducive to inserting the nephroscope main body 20 directly into the skin to the inside of the kidney K.

As shown in FIG. 3A to FIG. 4 , the nephroscope main body 20 further includes a visible part 22 , and the visible part 22 is arranged inside the urological mirror 1 . Further, the visible portion 22 is disposed on the outer end surface 210 , and its direction is consistent with that from the discharge channel 212 to the suction and discharge port 60 . During the operation, combined with the intermittent X-ray irradiation and the visualization of the visual part 22, the location requiring operation, the dilated part of the kidney K, can be accurately reached. There will be no potential safety hazards caused by puncturing too deep or too shallow. Specifically, in this embodiment, the visible part 22 is preferably composed of a camera, and the visible part 22 is arranged flush with the flushing port 70 and the instrument port 80 . Further, in some embodiments, the visible part 22 is disposed between the flushing port 70 and the instrument port 80 . During lithotripsy in surgery, the visible part 22 is easy to observe the lithotripsy. That is to say, the progress of surgical lithotripsy is maintained through the visible part 22 .

The main mirror body 21 includes a first working area 2101 and a second working area 2102 . The first working area 2101 surrounds the second working area 2102 . That is to say, the second working area 2102 is surrounded by the first working area 2101 . The outer edge of the first working area 2101 extends successively along the axial direction of the main mirror body 21 to form the surrounding side surface 220 . Further, the second working area 2102 includes the suction and discharge port 60 disposed in the middle area of the outer end surface 210 . The visible part 22 , the flushing port 70 and the instrument port 80 are located in the first working area 2101 . The visible part 22 , the flushing port 70 and the instrument port 80 are isolated from each other. Such components have less influence on the position arrangement. And the second working area 2102 includes the outer peripheral side of the suction and discharge port 60 . That is to say, in one embodiment, the shape of the orthographic projection of the suction and discharge port 60 in the axial direction is crescent-shaped; in another embodiment, the shape of the orthographic projection of the suction and discharge port 60 in the axial direction is round. Therefore, the cross-sectional shape of the suction and discharge port 60 is not limited, it only needs to allow crushed gravel to pass through. In particular, the arrangement of the second working area 2102 is more stringent than the arrangement of the first working area 2101. Under the condition that the overall radial area of the outer end surface 210 remains unchanged, the second The layout of the second working area 2102 is relatively expanded to be a means to solve the pulverized kidney stone S.

It is worth mentioning that the suction and discharge port 60 is located in the second working area 2102 , and the visible part 22 is located in the first working area 2101 . During the operation, in order to make the visual field of the visible part 22 cover as much as possible the suction and discharge port 60 , which is an important part of the urological mirror 1 . In one embodiment, as shown in FIG. 3A , the suction and discharge port 60 is arranged at the front end of the visible portion 22 , specifically, the suction and discharge port 60 is arranged closer to the visible portion 22 than the visible portion 22 . The inner side of the mirror 1 for urological surgery. That is to say, the visible part 22 can easily observe the blockage of the suction and discharge port 60 . In other words, the suction and discharge port 60 is located within the field of vision of the visible portion 22 . In another embodiment, as shown in FIG. 4 , the suction and discharge port 60 and the visible portion 22 are arranged on the same plane, and the visible portion 22 cannot observe the suction and discharge port 60 .

It is worth mentioning that, in a preferred embodiment, the nephroscope main body has a steep zone and a gentle zone, the plane where the gentle zone is located is parallel to the plane where the radial direction of the main mirror body 21 is located, the The plane where the steep region is located and the plane where the radial direction of the main mirror body 21 is located obliquely intersect each other. Further, the visible part 22 is located in the gentle area, and the suction and discharge port 60 is located in the steep area, so that when the radial section of the outer end surface 210 remains unchanged, the suction and discharge port 60 is located in the The front end of the visible part 22. That is to say, the suction and discharge port 60 is located within the visible range of the visible portion 22 . In other words, the visible part 22 can observe the blockage of the suction and discharge port 60 .

The visible part 22 is connected to an image transmission device, that is to say, the operator can connect the image transmission device to project the image observed by the visible part 22, which is beneficial to accurately place the urological surgery mirror 1 Inserting the appropriate renal expansion position enhances the safety of the operation. If the puncture distance is too shallow, the location of the kidney stone S cannot be reached, and the lithotripsy cannot be completed; if the puncture distance is too deep, the vein may be touched, causing blood to flow out, which is life-threatening to the patient. Therefore, an appropriate puncture distance makes the visible part 22 of inescapable importance in controlling the entry position of the urological mirror 1 .

During the lithotripsy process, the lithotripsy instrument crushes the kidney stone S through the instrument port 80, and with the self-circulation of the flushing fluid in the kidney K, the flushing fluid entrained in the crushed stone is sucked out from the suction and discharge port 60 to the body. Therefore, the suction force between the flushing port 70 and the suction and discharge port 60 is required. If the suction force of the suction device arranged at the suction and discharge port 60 is too large, the flushing fluid will be sucked by the suction device immediately after being released from the injection channel 213 from the flushing port 70 , and will flow directly from the suction and discharge port 60 . flow out to the discharge channel 212 . During this period, the crushed stones produced during the crushing process cannot be contained, resulting in the crushed kidney stone S still remaining in the kidney K, accompanied by the erratic collision of the liquid in the kidney K, scratching the inner wall of the kidney K, and causing damage to the kidney K.

When the suction force of the suction device is too small, the flushing liquid will be released from the injection channel 213 and the flushing port 70, and the suction device arranged at the suction and discharge port 60 cannot recover the injected flushing liquid, which directly leads to The pressure in the kidney K increases, and it is very easy to damage the kidney K due to excessive water pressure in the kidney K. The attraction force of the attraction device must therefore be properly controlled. For this, the operating part 23 is provided with an air valve regulator, which controllably adjusts the suction force of the suction device, and then controls the air pressure in the kidney K to be stable.

In particular, in one embodiment, the injection port 70 is disposed on the surrounding side 220 . When ensuring that the injection port 70 is independent from the channel of the suction and discharge port 60 , that is, the injection port 70 and the suction and discharge port 60 are isolated from each other. The suction and discharge port 60 is located in the second working area 2102 , that is, the suction and discharge port 60 is disposed on the outer end surface 210 . Further, the injection port 70 is not on the same plane as the suction port 60 . The injection port 70 is disposed on a side close to the steep region. During the operation, the irrigation fluid flows out from the injection port 70 disposed on the surrounding side 220 . That is to say, the flushing fluid is injected perpendicular to the direction of the kidney mirror main body 20, changes its direction through the obstruction of the inner wall of the kidney K, is attracted by the suction device provided at the suction and discharge port 60, and turns back to the kidney K inner wall. The exit channel 212 exits the body. During this period, passing through the front end of the nephroscope main body 20, the debris of kidney stones S produced by the lithotripsy device is washed away, the turbid liquid in the kidney K is dispersed, and the visual field of the visible part 22 is expanded. In other words, the irrigating fluid forms a vortex from the injection port 70 to the suction and discharge port 60, which is conducive to dispersing the turbid liquid, avoiding the blurred vision of the visible part 22, and entraining the waste generated by the lithotripsy device. Kidney calculus S remains to the discharge channel 212, and finally discharged from the body. The formation of the vortex drives the improvement of circulation and stone removal efficiency, and the flushing fluid will not stay too much inside the kidney K, preventing excessive pressure inside the kidney K.

The instrument port 80 and the flushing port 70 are located in the first working area 2101 , and the lithotripsy instrument is extended to a proper length through the instrument port 80 to perform lithotripsy. The flushing port 70 is located on the side close to the gentle zone, and can cover the lithotripsy device when the flushing fluid circulates in a vortex. During this process, the maximum extension length of the lithotripsy instrument should not exceed the cross-sectional position of the surrounding side 220 closest to the innermost end of the urological mirror 1 . This prevents that when the flushing fluid is injected from the flushing port 70 , the region where the flushing fluid appears to vortex cannot accurately cover the working region of the lithotripsy device. That is to say, it is prevented that the rinsing liquid cannot entrain and carry away the gravel and be discharged from the suction and discharge port 60 . Further, the working state of the lithotripsy instrument is always within the field of vision of the visible part 22 .

During the operation of the mirror 1 for urology, the visible part 22 is preferably composed of an electronic mirror. Compared with the optical fiber pixelated optical fiber transmission image information previously used, the pixel points of the electronic mirror are higher and can The transmitted picture is made clearer, which is conducive to the stability of the operation operation and improves the safety of the operation. One pixel corresponds to one optical fiber line, that is to say, in the original optical fiber transmission, due to the limitation of the radial length of the nephroscope main body 20, the radial length of the main mirror tube 211 is limited, so The radial length of the first working area 2101 should not be too large, so that the passage of the visible part 22 is limited. Therefore, the number of optical fibers arranged in the visible part 22 is limited, so that the pixels of the transmitted image are not high enough, and the image is blurred. The modified electronic mirror can meet the characteristics of higher image quality than optical fiber. Secondly, the connection space occupied by the electronic mirror is small, and only the electronic transmission of the fibrous wire is required.

The operation process of the urological mirror 1 for treating the kidney stone S located in the kidney K is introduced as an example.

Step 1: As shown in FIG. 5A , at a predetermined proper position, the operator wraps the puncture needle 2 with the guide wire 3 and inserts it into the renal expansion position of the kidney K and is close to the kidney stone S.

Step 2: As shown in FIG. 5B , the puncture needle 2 is removed, and the guide wire 3 is retained in the body. The punctured skin builds a channel from the outside of the human body to the kidney K through the guide wire 3 .

Step 3: As shown in FIG. 5C , the operator inserts the urological surgery mirror 1 into the inside of the kidney K along the channel built by the guide wire 3 . Since the shape setting of the expansion sheath 10 and the nephroscope main body 20 is more convenient for puncture, during the insertion process, X-rays are intermittently irradiated and transmitted by the visible part 22 arranged on the outer end surface 210. The image determines the appropriate depth for insertion. The lithotripsy instrument is extended to a suitable length through the instrument port 80 to pulverize the kidney stone S. During the lithotripsy process, the irrigating fluid injected into the injection port 70 cooperates with the inner wall of the kidney K and the suction of the suction device provided at the suction and discharge port 60 to form a vortex circulation, flushing and entraining the stone generated by the operation of the lithotripsy instrument. The gravel is discharged out of the body through the suction and discharge port. During the vortex flushing process, the turbid liquid in the kidney K is diluted, the visual field of the visible part 22 is restored, and the condition of the broken stone is judged.

Step 4: Complete the operation of crushing stones and crushing stones recovery, and take out the urological surgery mirror 1 . Suture the wound.

To sum up, the urological surgery mirror 1 is clarified, wherein the urological surgery mirror 1 replaces the original percutaneous nephroscope, and the device originally arranged between the nephroscope main body 20 and the expansion sheath 10 The suction and discharge port 60 is changed to the suction and discharge port 60 disposed on the outer end surface 210 . From the original annular channel to a channel with a larger radial area. The design flexibility for the radial dimension of the suction and discharge port 60 is increased. The spatial layout of the outer end surface 210 is optimized to prevent the pulverized kidney stones S from clogging the suction and discharge opening 60 .

Exemplary percutaneous nephroscopy

As shown in FIGS. 1 to 5C , a urological surgery mirror 1 according to an embodiment of the present application is illustrated. The urological surgery mirror 1 can be applied in the operation process of treating kidney stone S by percutaneous nephrolithotomy. Specifically, the urological mirror 1 is adapted to pass through the skin of the patient at a preset position to reach the target position of the kidney k for treating kidney stones S (as shown in FIG. 5C ), and the stones S in the kidney k are struck. After being crushed, the crushed stone S can be discharged from the body through the urological mirror 1 .

For the convenience of description, in the embodiment of the present application, the end of the urological surgery mirror 1 inserted into the patient's skin during the operation is taken as the front end of the urological surgery mirror 1, and the front end of the urological surgery mirror 1 is opposite to the front end of the urological surgery mirror 1. one end as its back end.

In the embodiment of the present application, the urological surgery mirror 1 includes: a guide sheath 10 and an endoscope body 20 disposed on the guide sheath 10 , as shown in FIGS. 1 and 2 . The guide sheath 10 has a guide channel 11 passing through the guide sheath 10 , and the endoscope body 20 is disposed in the guide channel 11 in the guide sheath 10 . The endoscope body 20 includes a mirror main body 21 capable of being inserted into the patient's skin, and the effective working length of the mirror main body 21 is greater than or equal to the length from the patient's skin at a preset position to the target position of the kidney k. The total length of the mirror body 21 is greater than its effective working length.

The introducer sheath 10 includes an insertion section capable of being inserted into the kidney and an operation section connected to the rear end of the insertion section. The operating section includes an operating body, at least one gripping piece and at least one spare operating piece disposed on the operating body. During the operation, the medical personnel can place their fingers on the at least one holding member, so as to facilitate the medical personnel to hold it. Some surgical instruments can be coupled to the at least one spare operating part, so that medical personnel can perform functional operations (for example, perfusing perfusate, aspirating fluid or crushing stones) through the surgical instruments connected to the at least one spare operating part . The insertion section may be detachably installed on the operation section for easy replacement of the insertion section, or fixedly installed on the operation section, which is not limited by the present application.

The mirror body 21 includes a main body 211 and a discharge channel 212 disposed in the main body 211 , and crushed stones S can be discharged from the body through the discharge channel 212 . Specifically, suction can be performed through a suction device connected to the discharge channel 212, so that the channel cavity of the discharge channel 212 is in a negative pressure state, so that the crushed stones S entering the discharge channel 212 are crushed. excreted. More specifically, the inner mirror body 20 further includes a gripping portion 23 disposed on the mirror body 21, the gripping portion 23 includes a housing, at least one auxiliary tube disposed in the housing, and, Corresponding to at least one interface of the at least one auxiliary pipe body. The at least one auxiliary pipe body includes a first auxiliary pipe body connected to the main body 211, the first auxiliary pipe body has a first auxiliary passage connected to the discharge passage 212, and the at least one interface includes a communication In the first interface 231 of the first auxiliary channel, the suction device can communicate with the discharge channel 212 through the first interface 231 and the first auxiliary channel.

The at least one auxiliary pipe body can be integrally formed on the main pipe body 211 through a molding process, or can be combined with the main pipe body 211 through a process such as welding, which is not limited by the present application.

Preferably, the outer diameter of the mirror body 21 is smaller than or equal to the inner diameter of the guide channel 11 , and the mirror body 21 is movably disposed in the guide channel 11 . In a specific example of the present application, the mirror main body 21 is movably disposed in the guiding channel 11 in a telescopic manner. During the operation, the scope body 21 can be removed from the introducer sheath 10 , and other surgical instruments can be placed in the introducer sheath 10 .

The guide channel 11 is arranged between the insertion section and the operation section. The guide channel 11 includes a front guide opening 111 located at the front end of the introducer sheath 10 and a rear guide opening 112 located at the rear end of the guide sheath 10, and extends from the front guide opening 111 and the channel body 113 between the rear guide opening 112, the mirror body 21 can pass through the front guide opening 111 and the rear guide opening 112, the mirror body 21 has a front end wall 210 and surrounds the The outer peripheral wall 220 extending backward from the outer peripheral edge of the front end wall 210 .

In a specific embodiment of the present application, the inner peripheral wall of the rear guide opening 112 has an internal thread, and the outer peripheral wall 220 of the mirror body 21 has an external thread corresponding to the internal thread. The inner mirror body 20 makes the mirror main body 21 protrude from the front guide opening 111 or retract into the guide channel 11 . Since the thread is provided between the rear guide opening 112 and the mirror main body 21, the doctor can more stably control the protruding length of the endoscopic body 20, and avoid the protruding length of the endoscopic body 20 from being too long. and cause damage to the patient's tissues and organs. It should be understood that the inner peripheral wall of the rear guide opening 112 and/or the outer peripheral wall 220 of the mirror body 21 can also be designed as a threadless structure, and the mirror body 20 can be pulled to make the mirror The main body 21 protrudes from the front guiding opening 111 or retracts into the guiding channel 11 , which is not limited by the present application.

More preferably, when the mirror body 21 protrudes from the front guide opening 111, there is no gap between the outer peripheral wall 220 of the mirror body 21 and the inner peripheral wall of the front guide opening 111, so as to avoid being hit. Broken stones S are difficult to be expelled from the body because they are stuck in the gap between the outer peripheral wall 220 of the mirror body 21 and the inner peripheral wall of the front guide opening 11111, and this can provide sufficient pressure for the inner mirror body 20. The radial dimension of each channel and opening, as well as other necessary structures or equipment, can be arranged more flexibly.

Correspondingly, in a specific example of the present application, the shape of the cross section of the outer peripheral wall 220 of the mirror body 21 is consistent with the shape of the cross section of the inner peripheral wall of the front guide opening 111, and the mirror body The outer diameter of 21 is equal to the inner diameter of the front guide opening 111 . It should be noted that there are inevitable errors in the outer diameter of the mirror body 21 and the inner diameter of the front guiding opening 111 and the inner diameter of the front guiding opening 111 . Therefore, the outer diameter of the mirror body 21 is equal to the inner diameter of the front guide opening 111. The inner diameter of the front guide opening 111 means that the outer diameter of the mirror body 21 is approximately equal to the inner diameter of the front guide opening 111. The inner diameter of the front guide opening 111 includes that the outer diameter of the mirror body 21 is equal to the inner diameter of the front guide opening 111, and the outer diameter of the mirror body 21 is slightly smaller than the front guide opening 111. to ensure that the mirror body 21 can pass through the front guide opening 111 .

In a specific embodiment, the gap between the outer peripheral wall 220 of the mirror main body 21 and the inner peripheral wall of the front guide opening 111 is smaller than a preset value, and the preset value is 0.5 millimeters, that is, the mirror The gap between the outer peripheral wall 220 of the main body 21 and the inner peripheral wall of the front guiding opening 111 is less than 0.5mm.

The channel main body 113 of the guide channel 11 can be attached to the mirror main body 21 or have a gap with the mirror main body 21 . Correspondingly, in a specific example of the present application, the shape of the cross-section of the outer peripheral wall 220 of the mirror body 21 is consistent with the shape of the cross-section of the inner peripheral wall of the channel body 113 , and the guide channel 11 The inner diameter of the channel main body 113 is equal to the outer diameter of the mirror main body 21 , and the channel main body 113 of the guide channel 11 can be attached to the mirror main body 21 . In another specific example of the present application, the inner diameter of the channel body 113 of the guide channel 11 is smaller than that of the mirror body, that is, the distance between the inner peripheral wall of the channel body 113 of the guide channel 11 and the mirror body 21 There is a gap in between. Moreover, in a specific embodiment of this specific example, the peripheral wall of the introducer sheath 10 has a conduction opening that communicates with the channel body 113, and the inner peripheral wall of the channel body 113 of the guide channel 11 is connected to the channel body 113. The gap between the mirror bodies 21 allows the perfusate to pass through and emerge from the conduction opening, that is to say, the gap between the inner peripheral wall of the channel body 113 of the guide channel 11 and the mirror body 21 can be Serving as an infusion channel, the through opening can be used as an infusion port.

It is worth mentioning that, in the embodiments of the present application, the inner diameter or the outer diameter both refer to the equivalent circle diameter. That is, when the shape of the cross-section of the structure is circular, the diameter of the structure is the diameter of the corresponding circle; when the shape of the cross-section of the structure is non-circular, the diameter of the structure is the area and the structure The area of the cross-section is the same as the diameter of a circle. The cross-section of a structure refers to: the common area (or non-empty intersection) of the structure and the plane perpendicular to the axial direction set by the structure.

During the operation process of treating kidney stone S with the urological mirror 1, the endoscope body 20 needs to be prepared for some surgical instruments (for example, lithotripsy fiber, guide wire 3) and other necessary structures or equipment. The remaining space, for example, in some embodiments of the present application, is provided with a channel for allowing perfusate to pass through, a channel for allowing lithotripsy optical fibers to pass through, an image acquisition device 22 and the like. Taking the image acquisition device 22 as an example for illustration, during the operation process of treating kidney stone S with the urological mirror 1, the protruding length of the endoscopic body 20 should be appropriate. When the endoscopic body 20 When the depth of entering the kidney is relatively deep, it may stray into the renal vein or even the vena cava, causing massive hemorrhage. Correspondingly, as shown in FIG. 3A and FIG. 3B , the endoscope body 20 further includes an image acquisition device 22 arranged on the mirror main body 21, so that the position reached by the urological surgery mirror 1 can be monitored in real time, improving Surgical safety.

It is worth mentioning that, in the embodiment of the present application, under the condition that the radial space of the inner mirror body 20 is limited, and the necessary radial space is reserved for necessary structures and equipment, the remaining radial space A discharge channel 212 for discharging crushed stones S may be arranged. In order to leave more space (mainly radial space), the necessary structures and equipment can be concentrated in a specific area. In theory, this specific area can be designed in any area of the mirror body 21, and the remaining area can be used for the The discharge channel 212 is routed. However, the inventors of the present application have found that when the specific region is set in the radial direction set by the mirror body 21 at an area away from the outer peripheral edge of the front end wall 210 of the mirror body 21, the remaining When the area surrounding the specific area is used for arranging the discharge channel 212, the remaining area will be difficult to be fully utilized to play its role.

For example, when the specific area is set in the central area of the mirror main body 21, and the distance between each part of the outer periphery of the specific area and the outer peripheral edge of the mirror main body 21 is equal, the remaining area is to surround the central area The annular area, the discharge channel provided in the remaining area can be designed as an annular channel or a semi-annular channel. The radial size of the remaining area is equal to the difference between the radial size of the specific area and the radial size of the mirror body 21, however, the size of the stones allowed to pass through the annular passage is less than or equal to the radial size of the specific area and One-half of the difference between the radial dimensions of the mirror main body 21 , that is, less than or equal to one-half of the radial dimension of the remaining area, larger stones are prone to blockage when passing through. Moreover, a whole circle of inner wall of the annular channel protrudes toward the outer wall of the annular channel, which is not conducive to the passage of crushed stones. Of course, the discharge channel arranged in the remaining area can be designed with a plurality of circular channels surrounding the remaining area, however, the radial dimension of the circular channel is also smaller than or equal to the radial dimension of the specific area One-half of the difference from the radial dimension of the mirror main body 21 , larger stones are prone to blockage when passing through. In this way, it is difficult to make full use of the radial space in the remaining area.

Compared with the area in the radial direction set by the mirror body 21 that is farther away from the outer peripheral edge of the front end wall 210 of the mirror body 21 than the specific area, when the specific area is located in the mirror body 21 When the set radial direction is arranged in an area adjacent to the outer peripheral edge of the front end wall 210 of the mirror body 21 , the space utilization rate of the remaining area is relatively high. Specifically, when the specific area is provided in an area adjacent to the outer peripheral edge of the front end wall 210 of the mirror main body 21 in the radial direction set by the mirror main body 21, the remaining The area only surrounds the outer circumference of a part of the specific area, and the discharge channel can be provided on the outer circumference of the part of the specific area and the front end in the radial direction set by the mirror body 21 Between the outer periphery of the wall 210. The radial size of the specific area is still equal to the difference between the radial size of the specific area and the radial size of the mirror body 21, and the radial size of the discharge channel may be equal to or slightly smaller than the radial size of the specific area The difference from the radial dimension of the mirror main body 21, thus, the utilization rate of the remaining space is relatively high.

Correspondingly, in the embodiment of the present application, the mirror main body 21 has a concentrated arrangement area adjacent to the peripheral wall thereof and a dedicated arrangement area around the concentrated arrangement area. The image acquisition device 22 is located in the centralized arrangement area, and the discharge channel 212 is located in the dedicated arrangement area. The front end wall 210 includes a reserved concentrated area 2101 adjacent to a corner of its outer periphery and a vacant dedicated area 2102 around the reserved concentrated area 2101. Preferably, at least a part of the reserved concentrated area 2101 is connected to The front end wall 210 shares an outer periphery. The image acquisition device 22 is installed in the reserved concentrated area 2101 of the front end wall 210 , preferably, the front end of the urology mirror 1 is within the field of view of the image acquisition device 22 . The discharge passage 212 has a discharge port 60 formed on the front end wall 210 , and the discharge port 60 is disposed in the vacant dedicated area 2102 .

Preferably, the shape of the orthographic projection of the outlet 60 along the axial direction set by the mirror body 21 is a crescent shape, as shown in FIG. 3B . Further preferably, the cross-sectional shape of the part of the discharge channel 212 adjacent to the discharge port 60 is consistent with the shape of the orthographic projection of the discharge port 60 along the axial direction set by the mirror body 21 , which is crescent-shaped. The shape of the cross-section of the part of the discharge channel 212 that is far from the discharge port 60 may be consistent with the shape of the orthographic projection of the discharge port 60 along the axial direction set by the mirror body 21, and also It may be inconsistent with the shape of the orthographic projection of the discharge port 60 along the axial direction set by the mirror body 21. For example, the cross-sectional shape of the rear end portion of the discharge channel 212 may be circular. Therefore, this application is not limited.

Here, the axial direction set by the mirror main body 21 refers to the forward direction along the central axis of the mirror main body 21 . Correspondingly, the radial direction set by the mirror body 21 refers to a direction perpendicular to the axial direction set by the mirror body 21 . The orthographic projection of the discharge port 60 along the axial direction set by the mirror body 21 refers to: when the light irradiates the discharge port 60 along the axial direction set by the mirror body 21, the An orthographic projection of the outlet 60 on a plane perpendicular to the central axis of the mirror body 21 .

In some embodiments of the present application, the inner diameter of the discharge passage 212 is greater than or equal to one-half of the inner diameter of the main body 211 , and the area of the discharge port 60 is greater than or equal to half the area of the front end wall 210 One of them is to prevent crushed stones S from clogging the discharge port 60 , thereby ensuring a space for discharging stones S.

It is worth mentioning that the image acquisition device 22 is adapted to be communicably connected to an image output device (for example, an image display), so that medical personnel can observe the conditions of the urological mirror 1 and the kidney k through the image output device. . The image acquisition device 22 includes at least one camera. Preferably, the field of view of the camera can cover most of the front end wall 210 of the urology mirror 1 .

Further, the discharge port 60 is within the field of view of the image acquisition device 22, so that the status of the discharge port 60 can be observed in real time, so as to improve stone removal efficiency and surgical safety. For example, when it is observed that the discharge port 60 is blocked, the stone S blocked in the discharge port 60 can be removed in time, or the injection of perfusate and the suction of fluid and the crushed stone S can be stopped in time to maintain the internal pressure of the kidney k balance.

In order to make the discharge port 60 within the field of view of the image capture device 22, the image capture device 22 may be located behind the discharge port 60, where the image capture device 22 may be located at the discharge port The rear of 60 means that the front end point of the light receiving surface of the image capture device 22 that receives the light reflected by the object is located behind the rear end point of the discharge port 60 . Correspondingly, the vacant dedicated area 2102 of the front end wall 210 may be located behind the image capture device 22 . And, preferably, the discharge port 60 and the image capture device 22 are close to each other from back to front, so that the discharge port 60 is within the field of view of the image capture device 22, and correspondingly, the image The collection device 22 and/or the outlet opening 60 can be arranged obliquely relative to a plane perpendicular to the set axial direction of the mirror body 10 .

Further, the outlet 60 may extend on a plane perpendicular to the axial direction set by the mirror body 21 , or extend obliquely relative to a plane perpendicular to the axial direction set by the mirror body 10 . Correspondingly, the vacant dedicated area 2102 of the front end wall 210 may extend on a plane perpendicular to the axial direction set by the mirror body 21 , or may be perpendicular to the axial direction set by the mirror body 10 The plane extends obliquely.

In a specific example of the present application, the vacant dedicated area 2102 of the front end wall 210 is perpendicular to the central axis of the mirror body 21 . The light-receiving surface of the image acquisition device 22 is located behind the discharge port 60 , and is disposed on the front end wall obliquely toward the discharge port 60 relative to a plane perpendicular to the axial direction set by the mirror body 10 210 reserves a concentration area 2101 so that at least a part of the outlet 60 is within the field of view of the image capture device 22 .

In another specific example of the present application, the vacant dedicated area 2102 of the front end wall 210 extends obliquely relative to a plane perpendicular to the axial direction set by the mirror body 10 , as shown in FIG. 3A . The free dedicated area 2102 of the front end wall 210 extends obliquely forward from its first side adjacent to the reserved concentration area 2101 to a second side opposite to the first side along a preset extending direction. The image acquisition device 22 is located at the rear of the free dedicated area 2102, and is disposed on the predetermined front wall 210 towards the discharge port 60 with respect to a plane perpendicular to the axial direction set by the mirror body 10. A concentration area 2101 is left such that at least a portion of the outlet 60 is within the field of view of the image capture device 22 .

It should be understood that the greater the inclination of the vacant dedicated area 2102, that is, the smaller the angle with the central axis of the mirror body 21, the steeper the vacant dedicated area 2102 will be, and the outlet 60 will The closer the mirror main body 21 is set to the image capture device 22 in the radial direction, the greater the possibility that the image capture device 22 can capture the discharge port 60 .

In this specific example, the vacant dedicated area 2102 includes a steep area extending obliquely forward from its first side adjacent to the reserved concentrated area 2101 to its second side away from the reserved concentrated area 2101 and a gentle area extending from the steep area to its second side away from the reserved concentration area 2101, at least a part of the discharge port 60 is located in the steep area, and the discharge port 60 may include a The steep section of the steep zone and the gentle section corresponding to the gentle zone. Optionally, the discharge port 60 can be entirely located in the steep region so that the image acquisition device 22 can capture the entire discharge port 60 and its surroundings as much as possible, or it can be partially located in the steep region . In an implementation of this specific example, the included angle between the preset extension direction and the axis set by the mirror body 21 is less than half of the field of view angle of the camera of the image acquisition device 22 one.

Further, in this specific example, the included angle between the preset extension direction (that is, the extension direction of the vacant dedicated area 2102 of the front end wall 210 ) and the axial direction set by the mirror body 21 From the first side of the spare dedicated area 2102 to the second side, it first decreases and then increases. Correspondingly, the included angle between the preset extension direction of the steep region and the axial direction set by the mirror body 21 gradually decreases from the first side of the free dedicated region 2102 to the gentle region. Smaller, more and more steep, and partially recessed inward, so as not to block the light reflected to the image acquisition device 22 due to the protrusion of the vacant dedicated area 2102 of the front end wall 210 . That is, at least a part of the steep region of the free dedicated area 2102 is recessed inward.

It is worth mentioning that, in this specific example, the front end wall 210 as a whole extends obliquely from a first side adjacent to the image capture device 22 to a second side opposite to the first side, and adjacent to the first side The inclination (that is, the angle between the front end wall 210 and the plane perpendicular to the axial direction set by the mirror main body 21 ) of the second side peripheral portion of the two sides is low so as not to be located on the front end wall. The second side peripheral part in front of the first side peripheral part of 210 is too sharp to damage the patient's organ tissue, which can improve the safety of the operation.

In other specific examples, the front end of the light receiving surface of the image capture device 22 may also be flush with the rear end of the discharge port 60 . Moreover, it can be designed that any one of the image acquisition device 22 and the vacant dedicated area 2102 of the front end wall 210 is arranged obliquely relative to the plane perpendicular to the axial direction set by the mirror body 21, or it can be It is designed that the image acquisition device 22 and the free dedicated area 2102 of the front end wall 210 are both arranged obliquely relative to a plane perpendicular to the axial direction set by the mirror body 21 .

In the embodiment of the present application, the mirror body 21 further includes an injection channel disposed on the main body 211 , and the injection channel has an injection port 70 located at the front end of the mirror body 21 . The infusion channel is adapted to communicate with the perfusion device to allow the perfusate to pass through and be injected into the kidney k. The perfusate exiting from the infusion port 70 can impact the crushed stone S, and when it encounters the inner wall of the renal pelvis or other When the solid body is rebounded, when it reaches the vicinity of the discharge port 60 , it carries the crushed stone S into the discharge port 60 and is discharged from the body through the discharge channel 212 communicating with the discharge port 60 .

It is worth mentioning that, as mentioned above, when there is a gap between the inner peripheral wall of the channel body 113 of the guiding channel 11 and the mirror body 21, and the peripheral wall of the introducing sheath 10 has a When the conduction opening of the channel body 113 is used, the gap between the inner peripheral wall of the channel body 113 of the guide channel 11 and the mirror body 21 can be used as an injection channel, and the conduction opening can be used as an injection channel. mouth.

Correspondingly, the at least one auxiliary pipe body includes a second auxiliary pipe body connected to the main body 211, the second auxiliary pipe body has a second auxiliary channel connected to the injection channel, and the at least one auxiliary pipe body The interface includes a second interface 232 (not shown in the figure) connected to the second auxiliary channel, and the perfusion device can communicate with the infusion channel through the second interface 232 and the second auxiliary channel.

The injection port 70 can be disposed on the front end wall 210 of the mirror body 21 or the peripheral wall 220 . In a specific example of the present application, the injection port 70 is disposed in the reserved concentration area 2101 of the front end wall 210 , as shown in FIG. 4 . Preferably, when the injection port 70 is arranged in the reserved concentrated area 2101 of the front end wall 210, the injection port 70 is arranged at a position adjacent to the image acquisition device 22, that is, the The injection port 70 is adjacent to the image acquisition device 22, so that the injection port 70 and the image acquisition device 22 are compactly arranged in the reserved concentration area 2101, reducing the reserved concentration area The radial dimension occupied by 2101 relatively increases the radial dimension of the spare dedicated area 2102 .

In another specific example of the present application, the injection port 70 is disposed at the front end of the outer peripheral wall 220 and is adjacent to the discharge port 60 in the axial direction set by the mirror body 21 . When the injection port 70 is arranged on the outer peripheral wall 220, the injection port 70 mainly occupies the space in the axial direction of the mirror body 21, which can save the radial space of the mirror body 21 The layout of the discharge ports 60 makes the design of the size, shape, quantity and other structural features of the injection ports 70 and the discharge ports 60 more flexible.

The shape, size and quantity of the injection ports 70 are not limited in this application. For example, the injection port 70 can be designed in a semi-circular shape, a drop shape, a circle, etc., the size of the injection port 70 can be designed according to actual application requirements, and the number of the injection ports 70 can be 1, 2, or other values.

In the embodiment of the present application, the mirror body 21 further includes a first working channel for allowing working components (for example, lithotripsy optical fiber, guide wire 3 and other surgical instruments) to pass through, and the first working channel is set on the The above-mentioned main body 211 can be isolated from other passages to avoid mutual interference between the passages, and can also be connected to other passages, which is not limited by the present application.

Correspondingly, in a specific example of the present application, the mirror body 21 further includes a first working channel connected to the outlet 60 . The endoscopic body 20 further includes at least one working part telescopically arranged in the first working channel, the head of the at least one working part is adapted to protrude from the outlet 60, so that the at least one working part When the head of the working part extends out of the outlet 60 , it is within the field of view of the image acquisition device 22 , and the at least one working part includes the lithotripsy fiber.

In another specific example of the present application, the mirror body 21 further includes a first working channel provided on the main body 211, and the front end wall 210 is provided with a first working opening communicating with the first working channel. 80, as shown in Figure 4. Preferably, the first working opening 80 is within the field of view of the image capture device 20 . When the first working opening 80 is located in the reserved concentrated area 2101 of the front wall, preferably, the first working opening 80 is arranged at a position adjacent to the image acquisition device 22, that is, the first The working opening 80 is adjacent to the image capture device 22, so that the first working opening 80 and the image capture device 22 are compactly arranged in the reserved concentrated area 2101, reducing the reserved concentrated area 2101 The occupied radial size relatively increases the radial size of the spare dedicated area 2102 . The discharge port 60 can also be used as the first working opening 80. Specifically, as mentioned above, the first working channel communicates with the discharge port 60 of the discharge channel 212. In this way, the The discharge port 60 serves as the first working opening 80 .

The endoscopic body 20 further includes at least one working part telescopically arranged in the first working channel, the head of the at least one working part is adapted to protrude from the first working opening 80, and the When the head of the at least one working part extends out of the first working opening 80 , it is within the field of view of the image acquisition device 22 .

Correspondingly, the at least one auxiliary pipe body includes a third auxiliary pipe body connected to the main body 211, the third auxiliary pipe body has a third auxiliary channel connected to the first working channel, and the at least one auxiliary pipe body An interface includes a third interface 233 connected to the third auxiliary channel, and the working component can enter the first working channel through the third interface 233 .

Those skilled in the art should understand that the working parts can be arranged in other channels, for example, the guide wire 3 can pass through the injection port 70 and the injection channel or the discharge port 60 and the The discharge channel 212 is used to guide the urological surgery mirror 1 into the kidney k, and the guide wire 3 can guide the urological surgery mirror 1 into the kidney k and then be withdrawn from the infusion channel so as not to affect the output volume of the perfusate or The export of the stone S may affect the passage of other working parts. For another example, the gravel fiber can be movably arranged in the discharge channel 212 and protrude from the discharge port 60 .

The working process of treating kidney stone S by percutaneous nephrolithotomy using the urological mirror 1 will be described below.

Step 1: Insert the urological surgical mirror 1 into the renal collecting system. Specifically, firstly, a stone extraction channel is established between the patient's skin and the renal collecting system. An incision (about 0.5 mm) can be made on the skin of the patient at a predetermined position, and under the guidance of an X-ray machine or a B-ultrasound machine, puncture the kidney k with a puncture needle 2 to establish the stone removal channel, as shown in Figure 5A shown. It should be noted that the depth of puncture is crucial to the operation. When the depth of puncture is shallow, the puncture needle 2 may only enter the renal parenchyma, but not the collecting system of the kidney, not only failing to achieve the purpose of treating kidney stone S , and may cause renal hemorrhage; when the puncture depth is deep, the puncture needle 2 may stray into the renal vein or even the vena cava, which may cause massive hemorrhage.

Next, the guide wire 3 is inserted into the kidney collecting system, as shown in FIG. 5B . Specifically, the puncture needle 2 includes a needle sheath and a needle core movably arranged on the needle sheath. After the puncture needle 2 punctures the kidney k and enters the renal collecting system, it can exit the kidney k. inserting the needle core and inserting the guide wire 3 into the needle sheath so that the guide wire 3 is inserted into the kidney collecting system along the needle sheath.

Then, insert the urological surgery mirror 1 to the target position of the kidney k, as shown in FIG. 5C . Specifically, the urological surgery mirror 1 is inserted into the kidney collecting system along the guide wire 3, and the guide wire 3 can be withdrawn after the urological surgery mirror 1 enters the target position of the kidney k.

In some embodiments of the present application, firstly, the guide sheath 10 of the urological surgical mirror 1 and the dilation tube disposed in the guide sheath 10 can be inserted into the kidney collecting system along the guide wire 3 , the guide wire 3 can pass through the operating channel of the dilation tube so that the introducer sheath 10 and the dilation tube can enter the kidney collecting system along the guide wire 3 . The insertion end of the expansion tube inserted into the kidney collection system has a tapered structure from back to front, that is, the front end of the insertion end of the expansion tube has a small size, which can easily pass through the patient's skin and Enter the kidney collecting system, then withdraw from the expansion tube in the urological mirror 1, insert the endoscopic body 20 of the urological surgical mirror 1 into the guide sheath 10, until the endoscopic body 20 The mirror body 21 reaches the target position of the kidney k.

In some other embodiments of the present application, the guide sheath 10 of the urological surgery mirror 1 and the endoscope body 20 disposed in the guide sheath 10 are directly inserted into the The target position of the kidney k, the guide wire 3 can pass through the discharge channel 212 or infusion channel of the endoscope body 20, or the first working channel, so that the guide sheath 10 and the endoscope body 20 The target position of the kidney k can be entered along the guide wire 3 . Preferably, the front end of the mirror body 21 has a tapered structure from back to front, which can easily pass through the patient's skin and enter the kidney collection system, and the mirror body 21 is provided with The image output device is communicatively connected to the image acquisition device 22 to collect images of the mirror body 21 and the tissues around the mirror body 21, so that medical personnel can observe the mirror body 21 and the mirror body 21 through the image output device. Describe the condition of kidney k.

Step 2: crush the kidney stone S by the lithotripsy equipment. Specifically, the lithotripsy equipment can enter the first working channel through the third interface 233 of the urological mirror 1 connected to the first working channel and protrude from the first working opening 80 or the discharge port 60, so as to Hit the kidney stone S. The lithotripsy device may be implemented as a pneumatic lithotripter, a holmium laser, an ultrasonic lithotripter, etc., which is not limited by the present application.

Step 3: The crushed stone S is discharged from the body through the discharge channel 212 of the urological mirror 1 . Specifically, during the crushing of kidney stones S by the lithotripsy device, perfusion fluid can be injected into the kidney k, and the perfusion fluid can be emitted from the infusion port 70 communicating with the fluid channel to impact the crushed stones S. As shown in Figure 5C, the perfusate is rebounded when it encounters the inner wall of the renal pelvis or other entities, and when it reaches the vicinity of the outlet 60, it enters the outlet 60 with crushed stones S, and flows out from the outlet 60. The discharge channel 212 communicated with the outlet 60 is discharged from the body. In the process of crushing the kidney stone S by the lithotripsy equipment, suction can also be performed through the suction equipment connected to the discharge channel 212, so that the channel cavity of the discharge channel 212 is in a negative pressure state, and then enters the The crushed stones S in the discharge channel 212 are discharged from the body.

In summary, the urological surgery mirror 1 based on the embodiment of the present application is elucidated, wherein the urological surgery mirror 1 reduces the distance between its guide sheath 10 and the endoscope body 20 disposed in the guide sheath 10 The gap between them relatively increases the design flexibility of the radial dimension of the endoscopic body 20, so as to relatively increase the space of the discharge channel provided on the endoscopic body 20 for discharging stones. Moreover, the urological mirror 1 relatively increases the space for leading out the crushed stones S through the design of the spatial arrangement and structural features of the discharge channel 212, so as to avoid crushed stones S as much as possible. Stone S is blocked.

It should be understood by those skilled in the art that the embodiments of the present invention shown in the foregoing description and drawings are only examples and do not limit the present invention. The objects of the present invention have been fully and effectively accomplished. The functions and structural principles of the present invention have been shown and described in the embodiments, and the embodiments of the present invention may have any deformation or modification without departing from the principles.

Claims (15)

1. A mirror for urological surgery, characterized in that it comprises: an extension sheath; and A nephroscope main body, wherein the expansion sheath is detachably sleeved on the nephroscope main body, the nephroscope main body includes a main mirror body and a visible part, wherein the main mirror body includes a first working area and a second working area, the first working area surrounds the second working area, the visible part is located in the first working area, the main mirror body is provided with a suction outlet and a flushing outlet, The suction outlet and the flushing outlet are respectively located in the second working area and the first working area, and the main mirror body has a discharge channel and an injection channel independent of each other, wherein the discharge channel communicates with The suction and discharge port and the injection channel are connected to the flushing port, and the flushing fluid flows out from the flushing port and returns to the suction and discharge port on the inner wall of the kidney to form a vortex circulation to be discharged from the body. 2. The urological surgical mirror according to claim 1, wherein the main mirror body has a surrounding side, and the surrounding side extends axially rearward from the outer edge of the first working area along the main mirror body , wherein the flushing port is arranged on the surrounding side. 3. The urological surgery mirror according to claim 2, wherein the suction and discharge port is arranged at the front end of the visible part, and the suction and discharge port is kept within the visual field of the visible part. 4. The mirror for urological surgery according to claim 3, wherein the diameter of the suction and discharge port is larger than the diameter of the flushing port. 5. The mirror for urological surgery according to claim 2, wherein the main mirror body includes an outer end surface, and the outer end surface is provided with an instrument port, and the instrument port is connected with the flushing port and the visible part The first working area is located in isolation from each other, and the instrument port is located within the field of view of the visible part, so that a lithotripsy instrument can be extended to the lesion through the instrument port to complete lithotripsy in a visualized state. 6. The urological mirror according to claim 5, wherein the flushing port is provided on the outer end surface such that the flushing port is located at the end of the nephroscope body. 7. The mirror for urological surgery according to claim 5, wherein the outer end surface has a steep area and a gentle area, the steep area is connected to the gentle area, and the visible part is located in the gentle area, The suction and discharge ports are located in the steep region, and the flushing ports are located on a side close to the gentle region. 8 . The mirror for urological surgery according to claim 7 , wherein the plane where the steep area is located obliquely intersects the plane where the gentle area is located, and the plane where the gentle area is located is parallel to the radial plane of the main mirror body. 9. The mirror for urological surgery according to claim 8, wherein the main mirror body is tapered from the rear end to the front end, and the radial section of the main mirror body gradually decreases. 10. The urological surgical mirror according to any one of claims 2 to 9, wherein the expanding sheath has an inner side and an outer side, the inner side is adapted to abut against the surrounding side, and the outer side is adapted to abut against a Puncture the channel formed by the needle and the skin to support the primary mirror body. 11. A mirror for urological surgery, characterized in that it comprises: an extension sheath; and A nephroscope main body, wherein the expansion sheath is detachably sleeved on the nephroscope main body, the nephroscope main body includes a main mirror body and a visible part, wherein the main mirror body includes a first working area and a second working area, the first working area surrounds the second working area, the visible part is located in the first working area, the main mirror body is provided with a suction outlet and a flushing outlet, The suction outlet and the flushing outlet are respectively located in the second working area and the first working area, and the main mirror body has a discharge channel and an injection channel independent of each other, wherein the discharge channel communicates with The suction and discharge port, the injection channel is connected to the flushing port, and the flushing fluid flows out from the flushing port and returns to the suction and discharge port on the inner wall of the kidney to form a vortex cycle to be excreted from the body, wherein the expanded The sheath has an expanding cavity, and the expanding cavity is suitable for placing the main mirror body. 12. The mirror for urological surgery according to claim 11, wherein the visible part communicates with an image transmission device, and the image transmission device is suitable for transforming images. 13. The mirror for urological surgery according to claim 11, wherein the shape of the orthographic projection of the suction and discharge port along the axial direction of the main mirror body is a crescent shape. 14. The mirror for urological surgery according to claim 13, wherein the nephroscope main body further comprises an operating part, and the operating part is connected to the tail end of the main mirror body to control the main mirror body to perform corresponding operations. operate. 15. The urological mirror according to claim 11, wherein said expanding sheath has an inner side and an outer side, said inner side is adapted to abut against said surrounding side, said outer side is adapted to abut against a puncture needle and skin A channel is formed to support the primary mirror body.

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