CN211156228U

CN211156228U - Laser catheter for lithotripsy

Info

Publication number: CN211156228U
Application number: CN201920923763.1U
Authority: CN
Inventors: 张保; 汪清
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-06-23
Filing date: 2019-06-23
Publication date: 2020-08-04
Anticipated expiration: 2029-06-23

Abstract

The utility model relates to a rubble laser catheter, the clinical stone and clear stone that are used for. Through setting up independent negative pressure suction channel and absorption window, independent fiber channel, suction channel and fiber channel combination become 1 body, and optic fibre conveying mechanism has realized that the laser window is in time promoted near absorption window and is close to the calculus, and the calculus is smashed by laser high efficiency, is adsorbed by the negative pressure source that rubble laser pipe is connected simultaneously and is cleared up outside the human body. The aspiration channel and the fiber channel can be repositioned relative to each other so that the laser window can be held proximate to the adsorbed stone during the procedure.

Description

Laser catheter for lithotripsy

Technical Field

The invention belongs to a lithotripsy laser catheter device for minimally invasive laser lithotripsy, which is matched with laser surgery equipment, an endoscope and the like for use together. The device is arranged in an instrument channel of an endoscope in an operation, and optical fibers transmit laser energy to crush calculus and suck the crushed calculus out of a human body through an adsorption channel, so that the calculus crushing and the calculus removing are synchronous in the operation, and the purpose of treatment is achieved.

Background

Urinary calculi in human bodies are common diseases and high incidence diseases and relapse, so the clinical treatment of the calculi is continuously pursued in a minimally invasive way. Wherein, the broken stones are completely moved out of the human body in the stone breaking process, thereby avoiding the residual stones and the residual stones from being left as the source of the stone re-sending after the operation, and the stone breaking device is an important work in the operation of an operating doctor. It is a common practice to use urinary calculus to suck the broken calculus out of the body by negative pressure suction.

The earliest negative pressure suction was successfully applied to the ultrasonic lithotripsy apparatus as shown in fig. 1, the core apparatus thereof is an ultrasonic probe 200, the ultrasonic negative pressure channel 210 thereof is a hollow conduit, the conduit generates ultrasonic waves through the conduit wall to break up stones, and the broken stones are adsorbed outside the human body under the action of an external negative pressure suction source through the hollow conduit, so that a very good clinical lithotripsy effect is obtained, the concept of synchronizing lithotripsy and stone removal of urinary lithotripsy is established, and the device is simulated by other lithotripsy techniques.

Laser is an important lithotripsy energy source, has very important function in the present urinary lithotripsy field, and different from ultrasonic lithotripsy, laser lithotripsy no matter calculus composition and hardness, can both effectively smash, has more advantage than ultrasonic lithotripsy, and the optic fibre can also be crooked simultaneously, has realized through the clinical application of human natural passageway treatment kidney stone promptly soft mirror lithotripsy. The optical fiber is generally composed of an energy transmission optical fiber, a proximal optical fiber connector and a distal or operation end laser window, and the laser window emits laser energy to a focus to realize the functions of crushing stones, cutting off and ablating soft tissues and the like.

However, when the synchronous pursuit of laser stone breaking and stone clearing is realized, the ultrasonic probe rod can be used as a conductor of an energy source and can also be used as an attraction catheter, the position of the optical fiber is completely different, the optical fiber is made of glass materials and is fragile in texture, the energy of the laser stone breaking is concentrated at the tail end of the optical fiber, the stone can be crushed, other organs and surgical instruments such as an endoscope can be damaged, the problem that how to synchronously and efficiently break stone and clear stone is a troublesome problem is solved, the optical fiber is like an empty tail, and researchers are dissatisfied.

For example, in the hard convection negative pressure channel calculus crushing and cleaning device for transurethral ureter, patent application No. 201710402743.5, the outer sheath of the calculus cleaning sheath is a part of the endoscope, and forms a calculus cleaning channel together with the inner sheath of the endoscope. The optical fiber protrudes out of the stone remover through the instrument channel of the endoscope, namely, is placed between the stone and the distal end (or the operation end) of the stone removing sheath as shown in fig. 2. The crushed stones are brought out of the human body by the water flow. The device does not bring much improvement to the stone removing work, but plays a certain role in reducing the pressure of washing water in the kidney. That is, the stone removing sheath does not really absorb the stones and the broken stones by the negative pressure suction force like the ultrasonic stone breaking and removing device. The negative pressure suction device is basically the same principle, and is different from the negative pressure suction device which is a component of an independent instrument instead of an endoscope, the complete endoscope such as a percutaneous nephroscope is inserted through the channel of the device, and the optical fiber completes the lithotripsy treatment through the instrument channel of the endoscope.

A laser minimally invasive surgery waste removing device (an authorization publication No. CN 201692051U) has the same disadvantages of the above-mentioned techniques because the surgical waste suction channel is not effectively integrated with the optical fiber channel.

In a word, the common characteristics of the prior calculus cleaning device for laser calculus crushing are shown in fig. 2, namely a calculus crushing optical fiber is placed between the far end of a calculus cleaning sheath and a calculus, and the crushed calculus is brought out of a human body through water flow (negative pressure increases a part of water flow power). Thus, the calculus at the focus is not really adsorbed and relatively fixed by negative pressure, and meanwhile, the broken calculus is not adsorbed by the negative pressure and is sucked out of the human body, and the function of water flow is determined.

In addition, the energy of common operation laser such as holmium laser is the absorption peak of water molecules, and most of the conditions are that water is used for cooling, the operation visual field is clear and operation wastes are taken away on the premise of the existing minimally invasive operation as shown in figures 6 and 7. When the optical fiber laser window leaves the surgical focus, the laser energy is absorbed by water molecules between the optical fiber laser window and the surgical focus, so that the effective work-doing efficiency of the laser energy is reduced. In addition, the fiber laser window has certain loss in the operation process, so that the gap between the laser window and the operation focus is enlarged, and the effective efficiency of laser work is reduced. In order to ensure the operation lithotripsy or cutting effect, the laser window needs to be close to the focus at any time.

Disclosure of Invention

A lithotripsy laser catheter or device for minimally invasive lithotripsy is shown in figure 8, independent negative pressure suction hollow channels, namely a negative pressure channel 10 (sucking calculus and water flow) and a hollow optical fiber channel 20 are arranged, a window, namely an adsorption window 11, is arranged at the far end (operation end) of the negative pressure channel, the adsorption window 11 directly adsorbs calculus and laser-broken calculus under the action of negative pressure, and a laser window 21 is arranged at the operation end of the optical fiber channel, so that an optical fiber laser window 31 reaches the adsorption window 11. The suction channel and the optical fiber channel are integrated, and the optical fiber channel 20 puts the optical fiber laser emission window, laser window 31 for short, at the position of the adsorption window 11 and keeps close to the surgical focus by operating the laser window conveying mechanism 26, so as to obtain the best surgical effect. The fiber optic window delivery device 26 is designed in one embodiment on the operating handle 6 of the lithotripsy laser catheter. The lithotripsy laser catheter is composed of a negative pressure suction channel, an optical fiber conveying device and an operating handle, wherein an adsorption window is formed at the operation end of the negative pressure suction channel and used for adsorbing calculus, and the near end of the negative pressure suction channel is connected with a negative pressure suction source, and the lithotripsy laser catheter is characterized in that: the negative pressure suction channel and the optical fiber channel are combined into a whole, and the position of the optical fiber laser window is changed through the optical fiber conveying device so that the optical fiber laser window can be kept in contact with the calculus. The lithotripsy laser catheter is characterized in that an adsorption window of an adsorption channel is arranged at the top end of the operation end of the adsorption guide catheter, or is arranged on the side surface of the operation end, or the combination of the two openings is adopted, so that the lithotripsy laser catheter is suitable for application of different stones and different parts. The lithotripsy laser catheter is characterized in that the relative position of the optical fiber channel and the suction channel is arranged on the outer wall of the suction catheter or on the inner wall or inside of the suction catheter. The suction channel and the optical fiber channel are characterized in that the relative positions are relatively fixed. The suction channel and the optical fiber channel are characterized in that the suction channel changes relative position relative to the optical fiber channel through rotation, so that the laser window is closer to the calculus. The lithotripsy laser catheter is characterized in that the suction channel and the optical fiber channel are made of materials, such as a hard stainless steel pipe or a flexible high polymer material; is transparent and non-transparent. The lithotripsy laser catheter is characterized in that a negative pressure suction switch is designed to enable a laser window to be kept close to a focus in the operation process.

In the device, the adsorption window 11 can adsorb the calculus and the crushed calculus, so that the calculus and the like are not displaced in the operation, and the calculus crushing and the calculus removing are synchronous. The position of laser window 31 can more press close to the calculus in the art, can hit the garrulous calculus high-efficiently, does not hinder the attraction effect of absorption window 11 again, and laser window 31 is in a relatively safe state again simultaneously, is difficult to hit by the calculus and breaks up, promotes the efficiency of laser lithotripsy operation by a wide margin.

Drawings

FIG. 1 is a schematic illustration of ultrasonic lithotripsy;

FIG. 2 is a general schematic diagram of a current laser stone breaking and removing device;

FIG. 3A is a schematic side view of an embodiment of the lithotripsy laser catheter of the present patent, wherein the suction window 11 is located on the suction channel 10;

FIG. 3B is a schematic end view of an absorption window 11 in the absorption channel 10 in another embodiment of the lithotripsy laser catheter of this patent;

FIG. 4 is a schematic view of an embodiment of an optical fiber delivery mechanism;

FIG. 5 is an embodiment of a rotation mechanism to change the position of the suction channel and laser window;

FIG. 6 is a schematic view of a negative pressure water suction flow and a broken stone channel for sucking a laser sheath (broken stone) through an opening at the top end of a suction channel in the embodiment of the present patent;

FIG. 7 is a schematic view of a lithotripsy laser catheter operating in conjunction with an endoscope;

figure 8 is a schematic view of one embodiment of a lithotripsy laser catheter.

Detailed Description

Depending on the size of the endoscopic surgical instrument channel 110, a hollow catheter is selected to form the aspiration channel 10. The proximal end (operation end) 12 of the suction channel is connected with a negative pressure suction source end (generally, a calculus collector is arranged in the middle and is not identified in the patent specification) through a pipeline, and the distal end is provided with an adsorption window 11 for calculus. The suction window 11 may be opened at the end face or the end face + side of the distal end of the suction passage 10 as shown in fig. 3B, or may be opened at the side of the suction passage 10 as shown in fig. 3A. The material of the catheter must be selected from materials that are biocompatible with the human body, such as stainless steel, polymer materials, and the like. The material itself may be transparent or opaque.

The fiber channel 20 is formed by selecting a hollow catheter that can satisfy the outer diameter of the optical fiber and normally allow the optical fiber to pass through, and the distal end of the fiber channel 20 has an opening 21 (surgical end) through which the optical fiber 30 can pass. The fiber optic catheter 20 constrains and stabilizes the position of the laser window 31, which is critical to the positioning of the laser window 31 of the fiber optic 30 as close to the stone as possible.

The aspiration catheter 10 and the fiber optic catheter 20 may be integrated by welding, bonding, or die fabrication. The embodiments in the present specification attract the axes of the aspiration catheter 10 and the fiber optic catheter 20 in the laser sheath to be parallel to each other, and the intersection line formed at the junction and the extension line thereof pass through the center of the side opening. In this combination, the suction channel 10 and the fiber channel 20 are fixed. The installation shown in fig. 5 may be adopted in which the rotational movement of the suction catheter 10 about the axis is restricted by the guide rail 24 on the optical fiber catheter 20, and functions to stabilize and limit the rotation of the suction catheter 10. The component 14 of the suction catheter 10 limits the suction catheter 10 to only rotate around its axis, and has a certain damping and limiting design when rotating under the action of external force. Such a combination allows for relative rotation between the aspiration catheter 10 and the laser window 30 in both clockwise and counterclockwise directions, with movement limited to a certain angle, such as 30. As shown in fig. 8, the member 14, which in this embodiment is a part of the operating handle 6, is fastened and fixed to the handle 6 by means of screws as a whole.

There are many ways of implementing the invention in combination. Including but not limited to, the fiber channel 20 may be placed against the aspiration channel 10, i.e., cut outside the catheter of the aspiration channel 10; but also inside the duct of the suction channel 10. In the case of the combination of the optical fiber tube 20 on the back surface of the suction channel 10, the optical fiber tube 20 may not be in close contact with the inner wall of the suction channel 10 in the middle of the suction channel 10, or may be in close contact with the inner wall of the suction channel 10.

Fig. 3A, B shows the combination structure of two embodiments of the present patent, the side opening 11 at the distal end of the suction channel 10 of the embodiment in fig. 3A, and the end surface and the side opening at the distal end of the suction catheter 10 of the embodiment in fig. 3B are combined into the adsorption window 11, and both embodiments adopt the optical fiber channel 20 being cut on the outer side of the suction channel 10.

The position of the laser window 31 can be changed as shown in fig. 4 by the fiber feeding mechanism 26, that is, the position can be adjusted in the direction parallel to the axis of the fiber guide 20. The present embodiment employs an optical fiber delivery mechanism 26 and is mounted on the operating handle 6 of the lithotripsy laser catheter.

The optical fiber conveying mechanism 26 is designed to be more convenient for a doctor to operate, and the function of the optical fiber conveying mechanism mainly comprises the following three points, namely, the relative position of the laser window 31 on the adsorption window 11 of the negative pressure suction channel 10 is adjusted to obtain the optimal operation efficiency such as lithotripsy. Secondly, when the fiber laser window is consumed, such as the ablation of the fiber or the damage and the breakage of the stone, the position of the laser window 31 is adjusted in time. Third, the fiber 30 is changed to move forward or backward a sufficient distance to facilitate repair of the laser window 31.

The independent suction channel 10 in the device can effectively adsorb the calculus and the calculus powder through the adsorption window 11, and the interference of the optical fiber laser window 31 is avoided or reduced. The relative rotation movement of the optical fiber catheter 10, the optical fiber delivery device 26 and the suction channel 10 enables the laser window 31 to be close to the calculus effectively in the operation process, so that the absorption or attenuation of water to laser energy is reduced, and a high laser lithotripsy effect is achieved.

In both of the above embodiments, the end face 21 of the fibre channel 20 is typically spaced from the nearest edge of the suction channel window 11 by a distance, typically around 5-10mm, to facilitate viewing in the surgical field.

When the optical fiber channel 20 is outside the adsorption channel 10, the diameter of the outer circle of the lithotripsy laser catheter, i.e. the combination of the suction catheter 10 and the optical fiber catheter 20, needs to be smaller than the diameter of the surgical instrument channel 110 of the endoscope 100, so as to meet the requirement that the suction laser sheath can be inserted into the instrument channel 110 of the endoscope to reach the surgical lesion. The laser window 31 and the absorption window 11 are extended out of the endoscope 100 and monitored by the camera lens 120 of the endoscope, so that the doctor can perform the operation under direct vision. Of course, the instrument can also be used for blindly beating, similar to ultrasonic lithotripsy, but on the premise of safety.

The lithotripsy laser catheter of the present invention may or may not itself have a negative pressure suction switch 16. If the negative pressure suction switch 16 is provided, the suction force can be conveniently switched on and off at any time when an operator performs an operation, so that the relative position of the adsorption window 11 and the calculus can be adjusted. The adsorption switch 16 may be in an on/off structure design, and may be in a design of implementing the size of an opening channel in addition to the on/off structure, and the design may be implemented by using a stroke switch. The negative pressure suction switch 16 is mounted on the operation handle 6 in the embodiment of the present invention.

The laser catheter for lithotripsy is convenient for doctors to operate, and is provided with an operating handle 6, wherein the operating handle 6 is provided with an adsorption switch 16 for controlling the opening and closing of an adsorption channel, an optical fiber conveying mechanism 26 for pushing an optical fiber, and a control mechanism 14 for sucking the catheter 10. Of course, the physician may directly operate the combination of the aspiration channel 10 and the fiber channel 20 without a functional handle.

The optical fiber delivery mechanism 26 can perform two functions of delivering optical fiber, one is the delivery of optical fiber back and forth within a small range, such as a distance of 10mm, and gives the doctor a hand feeling, and is performed by pushing and pulling the button 26-1 of the optical fiber delivery mechanism 26 back and forth with the thumb. If a distance exceeding 10mm is needed for conveying the optical fiber, the optical fiber 30 can be pushed manually by unlocking the optical fiber through the fiber supplementing structure 26-2. When the optical fiber 30 is passed through the fiber channel 20 and the laser window 31 is brought into close proximity with the stone or adsorption window 11, the control button 26-2 is pressed and the mechanism 26-3 unlocks the optical fiber 30.

As an example of a specific surgical operation, before the operation, the optical fiber 30 is installed in the optical fiber channel 20 by unlocking the optical fiber button 26-2 and adjusting the position of the laser window 31 at the proximal edge of the suction window 11, and then the optical fiber is locked. In operation, a doctor can make the adsorption window 11 of the lithotripsy laser catheter with the optical fiber contact with the calculus through the instrument channel 110 of the endoscope, as shown in fig. 7, the negative pressure suction switch 16 is opened, so that the adsorption window 11 of the device can adsorb the calculus, then laser is excited, the calculus at the laser window 31 is crushed and simultaneously sucked through the channel 10 to the outside of a human body, and the therapeutic effects of lithotripsy and stone removal are achieved. Such as by ablation of the laser window, or by breaking, which results in poor lithotripsy, the laser window 31 may be advanced through 26-1 of the fiber positioning mechanism 26 to improve lithotripsy efficiency. If the suction efficiency becomes low or the surgical field needs to be changed, the suction switch 16 can be turned off to change the position where the stone is adsorbed. Alternatively, after suction switch 16 is turned off, suction catheter 10 can be rotated to change the proximity of laser window 31 to the stone.

As shown in fig. 6 and 7, the water channel flows from the water inlet (common in the industry, not shown) of the endoscope 100 to the stone, carries the crushed stone powder, is sucked into the suction channel 10 through the suction window 11 of the lithotripsy laser catheter under the combined action of negative pressure and other external force such as a perfusion pump or gravity, and is then cleaned out of the human body.

Claims

1. The utility model provides a rubble laser catheter, comprises negative pressure suction channel, fibre channel and its optic fibre conveyor, operating handle, and its negative pressure suction channel operation end is opened has the absorption window, is used for adsorbing the calculus, and negative pressure suction channel near-end then connects the negative pressure and attracts the source, characterized by: the negative pressure suction channel and the optical fiber channel are combined into a whole, and the position of the optical fiber laser window is changed through the optical fiber conveying device so that the optical fiber laser window can be kept in contact with the calculus.

2. The lithotripsy laser catheter as claimed in claim 1, wherein the suction channel has a suction window either at the top of the surgical end of the suction catheter or at the side of the surgical end, or a combination of both openings to accommodate different lithotripsy and different site applications.

3. The lithotripsy laser catheter of claim 1, wherein the fiber channel is positioned opposite the aspiration channel or on an outer wall of the aspiration channel or on an inner wall or interior of the aspiration channel.

4. A lithotripsy laser catheter as claimed in claim 3, wherein the position of the aspiration channel relative to the optical fibre channel is fixed.

5. The lithotripsy laser catheter of claim 3 wherein the aspiration channel is rotationally repositioned relative to the fiber channel to bring the laser window closer to the stone.

6. The lithotripsy laser catheter of claim 1, wherein the aspiration channel, the fiber channel material is either a rigid stainless steel tube or a flexible polymer material.

7. The lithotripsy laser catheter as claimed in claim 1, wherein the laser window is held close to the lesion during surgery by the design of a vacuum suction switch.