CN116965757A - Protective medical endoscope device and ureteral lithotripsy operation system - Google Patents

Abstract

The invention provides a protective medical endoscope device and a transureteral lithotripsy operation system, which relate to the field of medical appliances, wherein the head of an endoscope main body is provided with an inflatable bag body structure, an endoscope sheath is integrated with the head protection, and the endoscope sheath is integrally and synchronously arranged; the flexible balloon shielding part structure avoids the head edge of the hard sheath tube main body from contacting with the soft mucosa of the natural cavity, when the device is pushed in the natural cavity to meet resistance, fluid is filled into the inner cavity of the balloon from outside to expand the radial flexible expansion natural cavity, the balloon is restored by releasing the filling, the natural cavity after the expansion is not restored in the state of restoration at the moment, the resistance is minimum when the pushing is continued, and the value of the device is particularly outstanding when the natural cavity is met, so that the device can fully ensure the safety of the natural cavity of a patient, eliminate complicated steps and improve the operation efficiency.

Description

Protective medical endoscopic device and transureteral lithotripsy surgical system

Technical field

The invention relates to a protective medical endoscope device and a transureteral lithotripsy surgical system, and belongs to the technical field of medical device products.

Background technique

Existing medical endoscopes are divided into hard endoscopes with a slender body that cannot or are not easily bent, soft endoscopes with an easy-to-bend body, and combined endoscopes with a soft lens inside a hard endoscope. Hard endoscopes are strong but easy to enter life. Although soft scopes have the disadvantage of being difficult to insert into the body's natural orifice or pathological sinus passages, they are more slender and softer and can be in contact with the natural orifice for a longer period of time during operation and cause less damage than hard scopes; For example, transurethral laser kidney stone surgery usually uses 1. The rigid scope enters the bladder and ureter from the urethra; 2. Then inserts the guide wire through the working channel of the rigid scope to the renal pelvis; 3. Exits the rigid scope, leaving only the guide wire in the urinary tract. ; 4. Then insert the ureteral sheath and the sheath core inside the sheath through the guide wire; 5. Pull out the sheath core inside the ureteral sheath; 6. Then insert the flexible lens from the ureteral sheath and open into the working channel of the soft lens It undertakes functions such as fiber optic lithotripsy, cooling and flushing, and stone extraction; inserting a soft lens requires multiple steps and is cumbersome to operate; and regardless of whether the hard lens or the soft lens is advanced in the natural cavity of the living body, the head of the endoscope assembly is hard and The edge part of the substance is in continuous dynamic contact with the natural orifice mucosa, and shear damage is unavoidable. When encountering the narrow part of the natural orifice, the shear damage is more serious, and even perforation occurs; safety protection measures during the lens placement process in the existing technology Weak or even no safety protection measures, shear damage to the natural orifice mucosa is prone to secondary infection and dysfunction.

Contents of the invention

The invention provides a protective medical endoscope device and a transureteral lithotripsy surgical system. The head of the main body of the endoscope is equipped with an expandable bladder structure, the scope sheath is integrated with the head protection, and the scope sheath is integrated and synchronously inserted; The flexible capsule shielding structure prevents the head edge of the hard sheath body from contacting the soft mucosa of the natural orifice. When the device encounters resistance when advancing in the natural orifice, fluid is filled from outside the body into the inner cavity of the capsule to make it The expansion radially flexibly expands the natural cavity, and the filling is released to restore the capsule. At this time, the expanded natural cavity has not yet returned to its original state. If it continues to advance, the resistance will be minimal. The value of the present invention is particularly prominent when the natural cavity is narrowed. The invention fully ensures the safety of the patient's natural orifice while eliminating cumbersome steps and improving operating efficiency.

The purpose of the present invention is achieved as follows:

A protective medical endoscope device. The slender endoscope body is provided with optical components. The endoscope body is provided with a working channel that runs through the head and tail. The working channel is provided with an opening in the working channel that enters the body during use. And the outer opening of the working channel located outside the body when in use; the sheath, the slender sheath body is sleeved outside the endoscope body, and the sheath body is provided with an inner opening of the sheath body that enters the body in the use state. The main body of the sheath is opened outside the body. The top end of the head of the endoscope body is covered with an inflatable balloon. The balloon is composed of a balloon connection part and a free part of the balloon. The balloon connection part is cylindrical and connected with the endoscope. The outer surface of the main body head is connected, and the free part of the balloon is the expandable part of the balloon. The gap between the free part of the balloon and the top of the head of the endoscope body forms the inner cavity of the balloon; the maximum outer diameter of the free part of the balloon after expansion At least larger than the outer diameter of the endoscope body head; the free part of the capsule is transparent or at least the area corresponding to the optical component at the top of the endoscope body head is transparent; the inner cavity of the capsule is connected to the working channel; the outer opening of the sheath body is There is a fastening mechanism that can be tightly connected to the tail of the endoscope. When in use, the top of the head of the endoscope body is poked out of the opening in the sheath body, and at least part of the free part of the capsule at the top of the head is exposed. Activate the fastening mechanism to tightly connect the sheath body and the endoscope body to realize the synchronous advancement and retreat of the endoscope and the sheath; when the endoscope body encounters obstacles in the natural cavity of the living body, it can be moved outside the working channel. The opening fills the inner cavity of the balloon with fluid to expand it, and radially and flexibly expands the tissue in the narrow part of the natural lumen, allowing the endoscope body to continue moving forward in the natural lumen; after the device reaches the target position, the fastening mechanism is loosened, and the endoscope The body can freely rotate or move forward and backward within the sheath body.

The balloon body is preferably made of compliant material and can extend forward while flexibly expanding the natural cavity in the radial direction; the connection part of the balloon body is cylindrical and is connected to the outer surface of the endoscope body head in an easy-to-separate connection to expose the internal cavity. The working channel of the endoscope body is used for other subsequent medical operations; the area adjacent to the outer opening of the sheath body is provided with a fastening mechanism that can be closely connected to the tail of the endoscope. The fastening mechanism can be provided at the tail of the sheath body, or can be It is arranged at the tail of the endoscope body, preferably at the tail of the sheath body; the protective medical endoscope device in the present invention covers a flexible endoscope body with a flexible endoscope body and a hard endoscope body with an inflexible body. Electronic mirrors and optical mirrors.

In order to meet some clinical needs, the area on the free part of the capsule corresponding to the working channel is a vulnerable area that is easily punctured by the guide wire, and one or more vulnerable structures are provided on the vulnerable area.

When there is one vulnerable structure, the guide wire can be accurately positioned when the balloon is not inflated; when there are multiple vulnerable structures, the guide wire can easily contact a vulnerable structure even when the balloon is inflated.

The free part of the capsule has a guide wire hole for the guide wire to pass through; the guide wire hole has no gap contact with the guide wire; a reinforcing structure is provided around the guide wire hole, including at least one of a reinforcing rib, an upper extension section, and a lower extension section. By.

When using an endoscope with a sheath to advance under guidewire guidance or using a balloon to expand the natural lumen and then advancing under guidewire guidance, there is no gap between the guidewire hole and the guidewire that penetrates it. Contact, preferably interference contact. In order to ensure that the fluid in the inner cavity of the balloon will not leak from the possible gap between the guide wire and the guide wire hole when the free part of the balloon is inflated, the free part of the balloon is provided around the guide wire hole. The reinforcing structure includes an annular reinforcing rib raised around the guide wire hole, and a hollow upper extension section and a lower extension section integrated with the guide wire hole; when the reinforcing structure is an upper extension section and a lower extension section, the guide wire extends from the extension section Through the inner part, the contact area is larger, making it less likely for fluid leakage to occur when the free part of the balloon is inflated. Even if partial fluid leakage occurs during specific use, it will not seriously affect the effect of the balloon's expansion of the natural cavity.

A refined design is that in order to increase the expanded volume, the free part of the balloon is provided with a protruding body extending toward the distal papilla; or, the free part of the balloon is provided with one or more annular wrinkles.

The hollow protruding body and annular wrinkle structure significantly increase the surface area of the free part of the capsule while keeping the projected area of the top end of the endoscope body unchanged, thereby increasing the expansion of the inner cavity of the capsule. The volume is conducive to the axial extension and expansion along the natural lumen during filling, and expands more narrow lumens; if the probing body is designed to be non-hollow, the non-hollow solid probing body can easily move forward along the narrow natural lumen, It plays a certain guiding role for subsequent capsule expansion.

In order to ensure that there will be no fluid leakage when the balloon is inflated, the balloon connecting portion is sealed with the outer surface of the endoscope body head. In order to increase the friction between the two, the balloon connecting portion is sealed with the endoscope body head. The surface is preferably an interference fit. This interference fit can be detached when the free part of the bladder is pulled by a greater external force; in order to increase the stability of the connection and make the free part of the bladder easier to expand, it is preferred that the bladder connection The wall thickness of the part is greater than the free part of the capsule.

A key safety design is to extend a flexible bladder shielding portion outward from the junction of the free portion of the bladder and the bladder connection portion.

Further, a flexible bladder shielding portion that can cover the outer edge of the inner opening of the sheath body extends outward from the junction between the free portion of the bladder and the bladder connection portion. The flexible bladder shielding portion is provided with a cylindrical flange. The shaped flange covers the outer edge of the inner opening of the sheath main body.

The thin-walled outer edge of the inner opening of the main body of the sheath is relatively sharp, and it is very easy to shear and damage the intima of the natural cavity that it touches when moving forward. The flexible bladder shielding part covers the outer edge of the inner opening of the main body of the sheath, eliminating the above-mentioned problems. The risk of shear injury, combined with the expansion and forward characteristics of the free part of the capsule, has a double protective effect.

A solution that can be used to inflate the bladder manually is to connect a hollow elastic power bladder to the outer opening of the working channel. Squeezing the elastic power bladder can fill the fluid inside the bladder into the inner cavity of the bladder, causing the free part of the bladder to expand; release the After extrusion, the fluid in the inner cavity of the bladder returns to the inner cavity of the elastic power bladder, and the shape of the free part of the bladder body returns to before expansion.

The elastic power bag can be squeezed or relaxed with fingers repeatedly, and the bag body will be filled, expanded or restored simultaneously, making full use of the elastic power bag's own recovery ability, which is easy to use. The elastic power bag is connected to the outer opening of the working channel through an extension section, and the elastic power bag is elastic. The power bag can be provided with a communication hole. When squeezing, press and close the communication hole with your fingers. The gas in the elastic power bag will be filled into the inner cavity of the bag. After the free part of the bag expands for a certain period of time, relax your fingers and the elastic power bag will rebound. In addition, the gas flows out from the communication hole, allowing the free part of the capsule to recover faster; it can also be connected to an external syringe or other electronically controlled perfusion device and negative pressure suction device.

For flexible operation, a section of the sheath body adjacent to the opening in the sheath body is a flexible section of the sheath body, and/or a section of the endoscope body adjacent to the opening in the working channel is a flexible section of the endoscope.

The flexible section makes the endoscope less prone to visual and operational blind spots in the renal pelvis and renal calyces.

A transureteral lithotripsy surgical system also includes at least one of a perfusion device, a lithotripsy optical fiber, a negative pressure suction device, a pressure sensor, a temperature sensor, a stone basket, and a guide wire.

The pressure sensor and temperature sensor can be installed in the area adjacent to the opening in the sheath body, or in the endoscope lens, to facilitate the monitoring of the pressure and temperature in the urinary tract during the operation and ensure the safety of the operation; in order to reduce friction during insertion and operation, At least one of the free part of the capsule, the endoscope main body, the sheath main body, and the guide wire is provided with a hydrophilic coating.

The beneficial effects of the present invention are:

1. During the advancement of this device into the natural orifice, the hard head edge of the sheath body is protected by the flexible capsule shield throughout the entire process, significantly reducing mucosal shear damage during the lens placement process.

2. When the natural orifice is narrowed during the endoscope placement process, the capsule at the head of the endoscope body is filled and expanded. After radially expanding the tissue at the stenosis, the capsule is released to facilitate subsequent passage.

3. The endoscope and sheath are advanced simultaneously, which reduces operating steps and improves efficiency.

4. The expansion-type forward movement of the head capsule based on visualization can save the use of guide wires during the lens placement process.

5. The head capsule expands the natural cavity under pressure monitoring, and the expansion effect is more reliable.

6. When inserted into the urethra, the endoscope body head capsule can slowly radially expand the urethral membrane, protect the external urethral sphincter, and avoid postoperative urinary control disorders to the greatest extent.

7. Flexibly expand the junction between the ureter and the bladder to protect the Valdel sheath and avoid postoperative vesicoureteral reflux to the greatest extent.

It significantly simplifies the operation steps, reduces tissue damage, greatly saves operation time, and reduces treatment costs.

Description of the drawings

The accompanying drawings that do not limit the present invention are as follows:

Figure 1A: Schematic diagram of the use of sheath tubes, sheath cores, and guide wires in the prior art;

Among them, 1A-1: the sheath tube, sheath core, and guide wire are combined together; 1A-2: shows the rigid endoscope inserted into the guide wire G into the renal pelvis P; 1A-3: the sheath core is inserted into the main body of the sheath tube , go up along the guide wire G;

Figure 1B: Schematic diagram of the endoscope body entering the sheath body in the prior art;

Among them, 1B-1: The main body of the endoscope enters the main body of the sheath, and the bendable head part of the main body of the endoscope protrudes from the opening in the main body of the sheath; 1B-2: The head of the main body of the sheath is located close to the ureter U-renal pelvis P connection ; 1B-3: The bendable head portion of the endoscope body extends out of the opening in the sheath body and into the renal pelvis P;

Figure 1C: Schematic diagram of the endoscope in Embodiment 1. The head of the main body of the endoscope is covered with an inflatable bladder;

Figure 1D: Schematic diagram of the sheath tube in Embodiment 1, with a cross-section showing the fastening mechanism T at the tail of the sheath tube body;

Figure 1E: Schematic diagram of the combination of the endoscope and the sheath in Embodiment 1. Partial cross-section shows the elastic power bag connected to the bag at the head of the endoscope body and the tight end of the sheath body connected to the handle of the endoscope. Solid mechanism T;

Figure 1F: Schematic diagram of the separation state of the two holding arms T1 and the fastening knob T2 of the sheath body tail fastening mechanism T in Embodiment 1, with the endoscope body tail 14 placed inside it;

Figure 1G: A cross-sectional view of a type of free balloon portion 22 covered by the head of the endoscope body in Embodiment 1 in an unexpanded state. The free balloon portion is provided with a hollow protruding body extending toward the distal papilla;

Figure 1H: Another cross-sectional view of the free part 22 of the balloon body in Embodiment 1 with an annular wrinkle structure;

Figure 1I: A cross-sectional view of another solid protruding body extending toward the distal papilla of the free portion 22 of the balloon in Embodiment 1;

Figure 1J: A schematic cross-sectional view of the capsule shielding part 23 in Embodiment 1;

Figure 1K: A schematic cross-sectional view of the cylindrical flange 232 of the capsule shielding part 23 in Embodiment 1;

Figure 1L: A schematic cross-sectional view of the free part 22 of the balloon at the stricture N of the ureter U in Embodiment 1;

Figure 1M: A schematic cross-sectional view of the expanded state of the free part 22 of the balloon in Embodiment 1, where the stricture N of the ureter U is radially expanded;

Figure 1N: Embodiment 1, the endoscope and the sheath are advanced in one piece. The partial cross-section shows that the head of the sheath body is located at the junction of the ureter, U and renal pelvis, and the holding arm T1 and the fastening knob T2 are separated;

Figure 1O: Embodiment 1 The endoscope body withdraws from the body lumen 31 of the sheath body toward the outside of the body, and the partial cross-section shows the reverse deformation state of the shielding portion 23 of the free part of the balloon;

Figure 2A: A cross-sectional view of the vulnerable area 220 of the free part 22 of the balloon that is easily punctured by the guide wire G and the vulnerable structure 221 on the vulnerable area in Embodiment 2;

Figure 2B: A schematic three-dimensional view of Embodiment 2;

Figure 2C: A schematic three-dimensional view of the guide wire G puncturing the vulnerable structure 221 in Embodiment 2;

Figure 3A: A partial cross-sectional view of the guide wire hole 222 and the surrounding reinforcing ribs 223 on the free part 22 of the balloon body in Embodiment 3;

Figure 3B: Embodiment 3 is a partial cross-sectional view of the guidewire G inserted into the guide wire hole 222 on the free part 22 of the balloon and the free part 22 of the balloon is in an expanded state;

Figure 3C: A modified structure of Embodiment 3, a cross-sectional view of an upper extension section 224 provided around the guide wire hole 222;

Figure 3D: A modified structure of Embodiment 3, a cross-sectional view of the upper extension section 224 moving forward as the free part 22 of the balloon expands;

Figure 3E: Another modified structure of Embodiment 3. A partial cross-section shows that the free part 22 of the capsule is provided with a lower extension section 225 around the guide wire hole 222 and the capsule shielding part 23 has a cylindrical flange 232.

Detailed ways

Examples that do not limit the present invention are as follows:

Example 1:

As shown in Figure 1C, a protective medical endoscope device, a bendable and slender endoscope body 1 includes an endoscope body head 12, an endoscope body middle part 13 and an endoscope body tail 14 , The endoscope body 1 is provided with a main channel 11 that runs through the head and tail. The main channel 11 is provided with an inner opening 111 of the main channel that enters the body when in use and an outer opening 112 of the main channel located outside the body in use. The tail of the endoscope body 14 is connected to an operating handle 15 for the user to operate the endoscope, and the operating handle 15 is provided with a power interface 151; the top end 121 of the head of the endoscope body 1 is covered with an inflatable capsule 2, and the capsule 2 is composed of a capsule The connecting part 21 is composed of a balloon free part 22. The balloon connecting part 21 is cylindrical and connected to the outer surface of the endoscope body head 12. The balloon free part 22 is an expandable part of the balloon 2. The balloon free part 22 The gap between the top end 121 of the head of the endoscope body 1 forms the inner cavity of the balloon 20; the maximum outer diameter of the expanded free portion of the balloon 22 is at least larger than the outer diameter of the head 12 of the endoscope body; the free portion of the balloon 22 is transparent or at least the area corresponding to the optical component at the top 121 of the head of the endoscope body 1 is transparent; the inner cavity 20 of the capsule is connected to the working channel 11; as shown in Figure 1G, a Lens 10, two optical windows 101; pressure and temperature two-in-one sensor 102; as shown in Figure 1D, a sheath matched with the endoscope. When in use, the slender sheath body 3 is inserted outside the endoscope body 1. The sheath body 3 includes a sheath body head 32, a sheath body middle part 33, and a sheath body tail 34. The sheath body 3 has an internal opening 311 that enters the body during use and a sheath body that is located outside the body during use. The outer opening 312 and the side branch opening 313 of the sheath main body are provided with an adjustment button 341 on the side branch of the sheath main body. When the side branch opening 313 of the sheath main body is connected to a negative pressure suction device (not shown), the adjustment button 341 is used to adjust the sheath. Whether the inner cavity 340 of the side branch of the tube body is connected to the outside; the outer opening 312 of the sheath body is provided with a fastening mechanism T that can be tightly connected to the tail 14 of the endoscope body. In this embodiment, the fastening mechanism T is made of an arc-shaped sheet. It consists of a holding arm T1 and a hollow fastening knob T2. The fastening knob T2 has a circular opening T22 outside the knob. The holding arm T1 is set in two pieces. The holding arm T1 passes through the base T12 on it and the tail 34 of the sheath tube body. Connected, after the internal thread T21 of the fastening knob T2 matches the external thread T11 of the holding arm, the holding arm T1 moves toward the axis L, clamping the tail part 14 of the endoscope body located in the holding arm (as shown in Figure 1E) so that the scope sheath can be synchronized Advance; Figure 1F shows that the two holding arms T1 are separated from the fastening knob T2, and the clamping of the tail 14 part of the endoscope body by the holding arms T1 is released. In this case, the sheath is no longer tightly coupled, and the endoscope body 1 can move forward and backward freely and rotate within the sheath body 3.

In order to better expand the balloon 2, there are several refinement schemes: as shown in Figure 1G, the free part 22 of the balloon is provided with a hollow protruding body 226 extending toward the distal papilla; as shown in Figure 1H, the free part of the balloon 22 is provided with a plurality of annular wrinkles 227; as shown in Figure 1I, the free part 22 of the balloon is provided with a solid protruding body 228 extending toward the distal papilla; in order to increase the volume of the free part 22 of the balloon after expansion, a hollow The structure of the protruding body 226 and annular wrinkles 227 significantly increases the surface area of the free balloon portion 22 while keeping the projected area of the top 121 area of the head of the endoscope body 1 unchanged, thereby increasing the expansion rate after expansion. The volume of the inner cavity of the balloon is conducive to the axial extension and expansion of the free part 22 of the balloon along the natural lumen when it is filled, and expands more narrow lumens; the non-hollow solid protruding body 228 can also be used at the front end of the expanded balloon. Extends and expands narrow channels and has stronger breakthrough power.

As shown in Figure 1E, the outer opening 112 of the working channel on the endoscope handle is connected to a hollow elastic power bag 5. The elastic power bag 5 is connected to the handle 15 through an extension 51. The inner cavity 50 of the elastic power bag can be filled with gas or liquid. , the elastic power bag 5 is provided with a communication hole 52 communicating with the external space; as shown in Figure 1L, when the device and the sheath of the present invention are advanced in the ureter U, and it is difficult to move forward when encountering the stenosis N, as shown in Figure 1M, in Squeezing the elastic power balloon 5 outside the body can inflate the fluid (air in this example) into the inner cavity 20 of the balloon, causing the free part 22 of the balloon to expand. The narrow part N of the ureter U is subject to flexible radial expansion. Under the premise of shearing and damaging the mucosa, the obstruction of the forward movement of the stenosis N is eliminated, which facilitates the passage of the endoscope; after the extrusion is released, the fluid in the inner cavity 20 of the balloon returns to the inner cavity 50 of the elastic dynamic bag, and the free part 22 of the balloon body The shape is restored to before expansion; the elastic power bag 5 can be squeezed or relaxed with fingers repeatedly, and the bag body 2 is simultaneously filled, expanded or restored, making full use of the elastic power bag 5's own recovery ability and easy to use; the elastic power bag 5 is on The connecting hole 52 is particularly suitable for gas circulation. When squeezing, press and close the connecting hole 52 with your finger. The gas in the elastic power bag 5 will be filled into the inner cavity 20 of the bag. After the free part 22 of the bag expands for a certain period of time, relax your finger. The recovery of the bladder 5 itself and the outflow of gas from the communication hole 52 allow the free part 22 of the bladder to recover faster; of course, the elastic power bladder 5 can also be controlled by an external syringe or other electronically controlled perfusion device and negative pressure suction device.

Because the outer edge 322 of the inner opening of the thin-walled sheath body 3 is relatively sharp, it is easy to shear and damage the mucosa in the lumen that comes into contact when moving forward. In order to protect the natural lumen mucosa, as shown in Figure 1J, the free part 22 of the balloon body is separated from the balloon body. A flexible bladder shielding part 23 extends outward from the junction of the connecting part 21 and can shield the outer edge 322 of the inner opening of the sheath main body 3. This figure shows that the horizontal part 231 of the flexible shielding part 23 shields the outer edge 322 of the inner opening of the sheath main body 3. 322 block, blocking the upper opening of the scope sheath gap 130, and will not shear and damage the mucosa of the ureter U when advancing in the ureter U (Fig. 1L); the further optimization plan is shown in Fig. 1K, the horizontal part of the flexible bladder blocking part 23 231 is connected with a cylindrical flange 232, and the cylindrical flange 232 more completely covers the outer edge 322 of the inner opening of the sheath body 3; combined with the characteristics of the expansion forward movement of the free part of the capsule 22, it has a double protection effect.

When the present invention is used, the top end 121 of the endoscope body 1 is poked out from the inner opening 311 of the sheath body, at least the free part 22 of the balloon is exposed, and the fastening mechanism T is activated to make the sheath body 3 and the endoscope body 1 are tightly connected to realize the synchronous advancement and retreat of the scope and sheath as one; when the endoscope body 1 encounters obstacles in moving forward in the natural cavity of the living body, fluid can be filled into the capsule inner cavity 20 through the outer opening 112 of the working channel to expand it. Radially flexibly expands the narrow part of the natural lumen to facilitate the endoscope body 1 to continue moving forward in the natural lumen; after the device reaches the target position, the fastening mechanism T is loosened, and the endoscope body 1 can freely rotate within the sheath body 3 Or move forward and backward.

Description of the positions of various types of tube bodies described in the present invention: the head is towards the distal end and enters the body during use; the tail is towards the proximal end and is usually located outside the body during use; the inner opening is the distal opening, and the outer opening is the proximal opening. The end is open; "forward" means toward the distal direction, and "retreating" means toward the proximal direction.

The balloon body 2 is preferably made of a compliant material and can extend forward while flexibly radially expanding the natural cavity.

When in use, as shown in Figure 1N, after the device sheath is pushed integrally to the target position, the holding arm T1 is separated from the fastening knob T2, and the clamping of the tail part 14 of the endoscope body by the holding arm T1 is released, and the endoscope body The head 12 protrudes from the inner opening 311 of the sheath body into the renal pelvis P; as shown in Figure 1O, the endoscope body 1 withdraws backward from the inner cavity 31 of the sheath body, and in the scope 130 gap 130, the free part 22 of the capsule blocks the 23 is deformed and tilted upward; when the endoscope body head 12 withdraws from the outer opening 312 of the sheath body, remove the capsule 2 covering the endoscope body head 12 to expose the working channel 11, and then The endoscope body 1 is inserted into the inner cavity 31 of the sheath body to perform subsequent lithotripsy or other medical operations (figure omitted).

The connection between the cylindrical balloon connection part 21 and the outer surface of the endoscope body head 12 is an easy-to-separate connection, in order to expose the working channel 11 and perform other subsequent medical operations;

The existing endoscopic system is as shown in Figures 1A and 1B, in which the hollow sheath body 3 includes a sheath body head 32, a sheath body middle part 33, and a sheath body tail 34. There are an inner opening 311 of the sheath body that enters the body during use, an outer opening 312 of the sheath body located outside the body during use, and a side branch opening 313 of the sheath body. There is an adjustment button 341 on the side branch of the sheath body. When the side of the sheath body is When the branch opening 313 is connected to a negative pressure suction device (not shown), the adjustment button 341 is used to control whether the side branch lumen 340 of the sheath body is connected to the outside. A hollow elastic sealing plug S is provided in the outer opening 312 of the sheath body; The core 4 includes a sheath core head 42, a sheath core middle part 43, and a sheath core tail 44. The sheath core inner cavity 41 is provided with a sheath core inner opening 411 and a sheath core outer opening 412. The sheath core outer opening 412 pokes out the tail of the sheath tube body. 34. The end of the sheath core tail 44 is located outside the inner cavity 31 of the sheath core body. The end of the sheath core tail 44 is provided with a buckle body 441. The buckle body 441 is buckled with the receiving body 342 at the end of the sheath body tail 34. The buckle connection The sheath and the sheath core can then advance and retreat simultaneously. The head 42 of the sheath core tapers out from the inner opening 311 of the sheath main body. In the figure, the top 321 of the head of the sheath main body 3 and the sharp sheath can be seen. At the inner opening edge 322 of the main body 3, the guide wire G passes through the inner cavity 41 of the sheath core and protrudes from the inner opening 411 of the sheath core.

The steps of setting up the endoscope for transureteral nephrolithiasis surgery in the prior art are as follows: 1. As shown in Figure 1A-2, the rigid endoscope lens part 12 enters the bladder from the urethra and then into the ureter U; 2. Place the endoscope along the working channel of the rigid endoscope. Insert the guidewire G into the renal pelvis P; 3. Withdraw the rigid scope, leaving only the guidewire in the urinary tract; 4. As shown in 1A-3, insert the ureteral sheath and the sheath core through the guidewire; 5. Pull out the ureter The sheath core in the guide sheath (picture omitted); 6. As shown in Figure 1B-1, insert the flexible endoscope from the ureteral sheath main body cavity 31. 1B-2 shows that the sheath main body head 32 is located close to At the junction of the ureter U and the renal pelvis P, the inner opening 311 of the sheath body faces the renal pelvis P; 1B-3 shows that the flexible endoscope body head 12 of the endoscope partially extends out of the inner opening 311 of the sheath body and extends into the renal pelvis P; The working channel 11 opened at the head 12 of the main body of the soft endoscope is responsible for the functions of fiber optic lithotripsy, cooling and flushing, stone extraction, etc. The process of inserting the soft endoscope is cumbersome.

During the advancement of the natural orifice of the protective endoscope device of the present invention, the hard head edge of the sheath body is protected by the flexible shielding part throughout the entire process, significantly reducing mucosal shear damage during the lens placement process; When the natural orifice is narrowed, the capsule in the head of the endoscope body is filled and expanded, and the capsule is released after radial expansion of the stenosis to facilitate subsequent passage; the scope and sheath are advanced simultaneously, which reduces operating steps, improves efficiency, and eliminates the need for a sheath The core 4 component can also save the use of guide wire G; the head balloon moves forward based on visualization; the head balloon expands the natural orifice under pressure monitoring, and the expansion effect is more reliable; when inserted into the urethra The head capsule can slowly radially expand the urethral membrane, protect the external urethral sphincter, and avoid postoperative urinary control disorders to the greatest extent; it can flexibly expand the connection between the ureter and the bladder, protect the Valder sheath, and avoid postoperative urinary continence disorders to the greatest extent. The occurrence of vesicoureteral reflux; significantly simplifies the operation steps, reduces tissue damage, greatly saves operation time, and reduces treatment costs.

Example 2:

As shown in Figures 2A-2C, in this example, the free part 22 of the capsule is provided with a vulnerable area 220 that is easily punctured by the guide wire G and a vulnerable structure 221 located in the vulnerable area 220. In order to meet the needs of individual cases during clinical use There may be a need for the guide wire G to pass through the free part 22 of the balloon. During the insertion process, the guide wire G must be directly inserted through the endoscope working channel 11 without removing the balloon 2; the vulnerable area 220 is Local thin-walled areas are more prone to deformation and rupture. The vulnerable structure 221 is a thin-walled structure with guided local micro-areas in various shapes. In this example, a cross-shaped structure is set in the center of the vulnerable area 220 to make it thinner. The fragile structure 221 is not easily damaged when the free part of the balloon 22 is inflated, but is easy to rupture when punctured by the thin-diameter guide wire G. However, the guide wire G will still hold tightly after the rupture. Tests have shown that the guide wire G is not easily damaged when the guide wire G is punctured. After the fragile structure 221 is transparent, the free part 22 of the balloon can still be filled and expanded multiple times. Even if there is a small amount of fluid leakage, it will not affect the expansion of the natural cavity by the free part 22 of the balloon.

Example 3:

As shown in Figures 3A-3E, the difference between this embodiment and Embodiment 2 is that a guide wire hole 222 is preset on the free part 22 of the balloon, and a reinforcing structure is provided around the guide wire hole 222, so that the guide wire G can still easily pass through it. A good seal means that it is difficult for fluid to escape and leak from between the guide wire G and the guide wire hole 222; Figure 3A shows an annular thick-walled reinforcing rib 223 around the guide wire hole 222, and the outer diameter of the guide wire hole 222 within the reinforcing rib 223. Less than or equal to the outer diameter of the guide wire G passing through the guide wire hole 222; at the same time, the wall thickness of the balloon connection part 21 is larger than the balloon free part 22, in order to ensure that no fluid will be connected from the balloon when the balloon 2 is inflated. part 21 leaks, the balloon connection part 21 is sealed with the outer surface of the endoscope body head 12, the wall thickness of the balloon connection part 21 is larger than the balloon free part 22, and the balloon connection part 21 is connected with the endoscope body head 12 12 The outer surface is preferably an interference fit, that is, the assembled capsule connection part 21 deforms slightly outward in the lens sheath gap 130. Although it is an interference fit, the characteristics of the elastic material of the capsule 2 can cause the free part 22 of the capsule to be When a large external force is pulled, the balloon connecting portion 21 deforms and detaches from the endoscope body head 12; Figure 3B shows that the balloon free portion 22 is in an expanded state, and the guide wire hole 222 tightly embraces the guide wire G inside it. , and the annular reinforcing ribs 223 strengthen this holding force, so that the gas or liquid in the inner cavity of the balloon 20 is not easy to leak from between the guide wire hole 222 and the guide wire G. This figure shows the sharp inner opening of the sheath body 3 The outer edge 322 touches the mucosa of the ureter U and is prone to shear injury when moving forward.

Another reinforced structure of the guide wire hole 222 is shown in Figure 3C. The guide wire hole 222 is connected to a tubular upper extension section 224. The upper extension section 224 can be configured with a structure with unequal inner diameters, that is, the upper opening or the lower opening is slightly larger, and the lower opening is slightly larger. It can be used as a guide when the guide wire G penetrates through the lower opening; Figure 3D shows the expansion state of the free part 22 of the balloon, the upper extension section 224 wraps the guide wire G, and the fluid part of the balloon inner cavity 20 does not leak or only leaks slightly.

Figure 3E shows another reinforced structure of the guide wire hole 222. The guide wire hole 222 is connected with a tubular lower extension section 225. At the same time, the capsule shielding part 23 has a soft cylindrical flange 232 to better protect the natural orifice mucosa. .

The hollow upper extension section 224 and the lower extension section 225 are integrated with the guide wire hole 222. When the guide wire passes through the extension section, the contact area is larger, making it less likely for fluid leakage to occur when the free part 22 of the balloon expands. Tests have shown that , even if some trace leakage occurs during specific use, it will not seriously affect the effect of balloon expansion and expansion of the natural cavity.

In order to clearly display key structures, the reduction in wall thickness of the free part 22 of the balloon after expansion is not shown in the drawings of the present invention.

When the present invention is used for kidney stone surgery, the section of the sheath body 3 adjacent to the inner opening 311 of the sheath body is the flexible section of the sheath body, and/or the section of the endoscope body adjacent to the inner opening 111 of the working channel is the endoscope. Flexible section: The flexible section of the endoscope prevents visual and operational blind spots in the renal pelvis and calyces of the main body of the endoscope.

When used in a transureteral lithotripsy surgical system, the present invention also includes a perfusion device (not shown), an optical fiber for lithotripsy (not shown), a negative pressure suction device (not shown), a pressure sensor, a temperature sensor (not shown), and a stone basket. (Figure omitted), at least one of the guide wire; the pressure sensor and the temperature sensor can be arranged in the area adjacent to the opening 311 in the sheath body, or can also be arranged in the head 12 area of the endoscope body to facilitate monitoring of the pressure in the urinary tract during the operation. and temperature monitoring to ensure surgical safety; in order to reduce friction during insertion and operation, the free part of the capsule 22, the endoscope body 1, the sheath body 3, and the guide wire G are equipped with hydrophilic coatings.

The protective medical endoscope of the present invention significantly simplifies the operating steps, reduces tissue damage, saves operation time, and reduces treatment costs; it can be used in cardiovascular and respiratory tracts, ear canals, tear ducts, reproductive tracts, and digestive tracts. It can be used for medical operations in various natural cavities or third spaces such as the thorax and abdominal cavity of living bodies. It can also be used for medical operations on penetrating injury tracts, pathological sinus tracts, etc.

Claims (10)

1. A protective medical endoscope device, wherein: Endoscope, the slender endoscope body (1) is provided with optical components, the endoscope body (1) is provided with a working channel (11) that runs through the head and tail, and the working channel (11) is provided with an inlet when in use. The inner opening (111) of the working channel in the body and the outer opening (112) of the working channel located outside the body in use; The sheath tube has an elongated sheath body (3) that is sleeved outside the endoscope body (1). The sheath body (3) is provided with an opening (311) in the sheath body that enters the body during use. The outer opening (312) of the sheath body located outside the body; It is characterized in that: the top end (121) of the head of the endoscope body (1) is covered with an inflatable balloon (2), and the balloon (2) consists of a balloon connection part (21) and a free balloon part (22). The balloon connection part (21) is cylindrically connected to the outer surface of the endoscope body head (12), and the balloon free part (22) is the expandable part of the balloon (2). The balloon free part (22) ) and the top end (121) of the endoscope body (1) form the inner cavity of the balloon (20); the maximum outer diameter of the expanded free part of the balloon (22) is at least larger than that of the head of the endoscope body (12) ) outer diameter; the free part of the capsule (22) is transparent or at least the area corresponding to the optical component of the endoscope body (1) head top (121) is transparent; the capsule inner cavity (20) and the working channel (11 ) connected; The area adjacent to the outer opening (312) of the sheath body is provided with a fastening mechanism (T) that can be tightly connected to the tail (14) of the endoscope body. When in use, remove the top end (121) of the head of the endoscope body (1) from The opening (311) in the sheath body is protruded, exposing at least part of the free part of the capsule (22) at the top of the head (121), and the fastening mechanism (T) is activated to connect the sheath body (3) with the endoscope body. (1) Tightly connected to achieve synchronous advancement and retreat of the endoscope and sheath; When the endoscope body (1) encounters obstacles when moving forward in the natural cavity of the living body, fluid can be filled into the inner cavity (20) of the capsule (20) through the outer opening of the working channel (112) to expand it, and the natural cavity can be flexibly expanded radially. The tissue at the stenosis is convenient for the endoscope body (1) to continue moving forward in the natural lumen; after the device reaches the target position, loosen the fastening mechanism (T), and the endoscope body (1) can be placed in the inner cavity of the sheath body (31 ) freely rotate or move forward and backward. 2. A protective medical endoscope device according to claim 1, characterized in that the area on the free part (22) of the capsule (2) corresponding to the working channel (11) is easy to be guided. The vulnerable area (220) punctured by the wire (G) is provided with one or more vulnerable structures (221) on the vulnerable area. 3. A protective medical endoscope device according to claim 1, characterized in that the free part (22) of the capsule (2) has a guide wire hole for the guide wire (G) to pass through. (222); there is no gap between the guide wire hole (222) and the guide wire (G); a reinforcing structure is provided around the guide wire hole (222), and the reinforcing structure includes a reinforcing rib (223), an upper extension section (224), and a lower extension section. At least one of paragraphs (225). 4. A protective medical endoscope device according to claim 1, characterized in that the free part (22) of the capsule (2) is provided with a probe extending toward the distal papilla; or , the free part of the bladder (22) is provided with one or more annular wrinkles (227). 5. A protective medical endoscope device according to claim 1, characterized in that the wall thickness of the balloon connecting portion (21) of the balloon (2) is greater than the free portion (22) of the balloon. 6. A protective medical endoscope device according to claim 1, characterized in that the junction of the free part (22) of the capsule (2) and the connection part (21) of the capsule extends outward. The flexible bladder shielding part (23) can shield the outer edge (322) of the inner opening of the sheath body (3). 7. A protective medical endoscope device according to claim 1, characterized in that the junction of the free part (22) of the capsule (2) and the connection part (21) of the capsule extends outward. The flexible capsule shielding part (23) can shield the outer edge (322) of the inner opening of the sheath body (3). The flexible capsule shielding part (23) is provided with a cylindrical flange (232), and the cylindrical flange ( 232) covers the outer edge (322) of the inner opening of the sheath body (3). 8. A protective medical endoscope device according to claim 1, characterized in that the outer opening (112) of the working channel is connected with a hollow elastic power bag (5), and the elastic power bag (5) can be squeezed to The fluid in the bladder inner cavity (20) is filled to expand the free part of the bladder (22); after the extrusion is released, the fluid in the bladder inner cavity (20) flows back to the elastic power bladder inner cavity (50). 9. A protective medical endoscope device according to claim 1, characterized in that a section of the sheath body head (32) adjacent to the inner opening (311) of the sheath body is a bendable section of the sheath body. , and/or a section of the endoscope body head (12) adjacent to the opening (111) in the working channel is a bendable section of the endoscope. 10. A transureteral lithotripsy surgical system, characterized in that it includes the protective medical endoscope device according to any one of claims 1 to 9, and also includes a perfusion device, a lithotripsy optical fiber, and a negative pressure suction device. At least one of a pressure sensor, a temperature sensor, a stone basket, and a guide wire.