CN104095666A - Internal extracting device for calculus cavities of urinary systems - Google Patents

Internal extracting device for calculus cavities of urinary systems Download PDF

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Publication number
CN104095666A
CN104095666A CN201410334420.3A CN201410334420A CN104095666A CN 104095666 A CN104095666 A CN 104095666A CN 201410334420 A CN201410334420 A CN 201410334420A CN 104095666 A CN104095666 A CN 104095666A
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CN
China
Prior art keywords
basket
calculus
silk
urinary system
pocket
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Granted
Application number
CN201410334420.3A
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Chinese (zh)
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CN104095666B (en
Inventor
孙颖浩
彭泳涵
高小峰
肖亮
盛夏
李凌
徐斌
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Second Military Medical University SMMU
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Second Military Medical University SMMU
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Priority to CN201410334420.3A priority Critical patent/CN104095666B/en
Publication of CN104095666A publication Critical patent/CN104095666A/en
Priority to PCT/CN2015/071184 priority patent/WO2016008293A1/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00867Material properties shape memory effect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00982General structural features
    • A61B2017/00995General structural features having a thin film
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop

Abstract

The invention relates to an internal extracting device for calculus cavities of urinary systems. The internal extracting device comprises a guide tube and a guide wire. A net basket is arranged at a far end of the guide wire, a calculus extracting pocket is fixed onto the net basket and is in the shape of an elongated pocket by means of pre-plasticizing, an opening is formed in a surface of a near end of the calculus extracting pocket, and tiny holes are further formed in the calculus extracting pocket. The internal extracting device for the calculus cavities of the urinary systems has the advantages that large quantities of broken calculi, blood clots and pus clots can be extracted by the internal extracting device at one step, the internal extracting device is free of constraints of the inner diameters of the lumens of the ureters or the inner diameters of operation channels, broken calculus missing in calculus extracting procedures can be prevented, and the broken calculi can be effectively prevented from being poured into the kidneys by water current; injury to the walls of the ureters due to the broken calculi can be prevented, and accordingly the internal extracting device is safe and reliable.

Description

Urinary system calculus intracavity is extracted device
Technical field
The present invention relates to medical instruments field, specifically, relate to a kind of urinary system calculus intracavity and extract device.
Background technology
Renal calculus is one of modal disease of Urology Surgery, and minimally-invasive treatment technology has replaced traditional open surgery becomes the most important treatment means of renal calculus.Minimally-invasive treatment basic goal is to remove calculus completely.Ureter soft lens enters kidney by human body natural's tract, and by holmium laser crushed stone, definite effect, is one of main minimally-invasive treatment means of kidney stone.In order to improve the clearance rate of calculus, after holmium laser crushed stone, often adopt calculus catching net-like means to extract larger rubble.
The calculus catching net-like means of domestic and international application mostly is simple cover basket structure at present.As January 16 2013 Chinese patent ZL20122032508.7(day for announcing; Notification number: CN202665632U) disclosed a kind of calculus catching net-like means, for urology department endoscope is supporting, ureter and renal calculus are taken out, calculus catching net-like means core head is several to be had elastic wire and is coiled into, and in tension switch lock calculus catching net-like means core indentation outer tube, outer tube diameter is 0.5-3mm.It is not high that but this triangle calculus catching net-like means captures efficiency, can only capture the rubble of certain diameter size, rubble is excessive cannot pass through operating walk way, rubble is too small easily to be omitted from steel wire gap, disposable crawl is too much, while tightening up inner core, basket is spherical in shape, and its diameter often surpasses operating walk way or ureter internal diameter and easily causes injury of ureter maybe cannot take out.For another March 7 2007 Chinese patent ZL200620040173.7(day for announcing; Notification number: CN2875338Y) the netted calculus catching net-like means of disclosed a kind of ureter, adopt nontoxic, fiber nylon yarn to make, after being entangled, calculus carries out again rubble.This calculus catching net-like means does not have the function of extracting rubble, can only passively entangle calculus convenient operation, and there is no initiatively to capture the function of rubble.
Summary draws, current calculus catching net-like means is got stone and is still had the following disadvantages: 1) no matter be triangle calculus catching net-like means or netted calculus catching net-like means, all adopted the design of centration pinching, extract after stone spherical in shape, but not elliposoidal, the limited amount of cover stone, in the internal diameter of ureter lumen diameter or operating walk way, need to repeatedly enter uriniferous tubule and get stone, inefficiency; 2) calculus catching net-like means is collected between rear steel wire and is had gap, and after especially netted calculus catching net-like means tightens up inner core, mesh is easily omitted rubble, and calculus catching net-like means itself can not stop calculus, finger stone and rubble under the perfusion of reverse current easily by refunds kidney; 3) corner angle of calculus can be exposed to outside the mesh of calculus catching net-like means, easily cause calculus catching net-like means cannot pass through operating walk way, and very easily scratch ureter wall, cause postoperative complication; 4), for clot or the pus piece of kidney inner accumulated, under soft lens, apply calculus catching net-like means and capture difficulty, inefficiency.
In sum, need badly a kind of get stone efficiency high, can not omit rubble, can extract clot and pus piece, safe and reliable urinary system calculus intracavity are extracted device simultaneously, but about such device, have not been reported at present.
Summary of the invention
The object of the invention is for deficiency of the prior art, provide a kind of urinary system calculus intracavity to extract device.
For achieving the above object, the technical scheme that the present invention takes is:
Urinary system calculus intracavity is extracted a device, is provided with conduit and seal wire, and the far-end of described seal wire is provided with basket, is fixed with cover stone pocket on described basket, and the one side that described cover stone pocket is moulded pocketed and near-end is in advance opening, on described cover stone pocket, is also provided with micropore.
The described elongated pocketed of cover stone pocket, and distal surface is curved surface shape.
Described cover stone pocket is made by plastics or non-woven fabrics.
Described basket is comprised of the basket silk of curved shape under using state, and the far-end of described basket silk draws in and fixes with cover stone pocket towards the central axis direction of conduit.
The two bifurcateds of described basket silk far-end are the first basket silk and the second basket silk, and described the first basket silk and the second basket silk are fixed with cover stone pocket.
Described basket is comprised of several oval-shaped basket silks, and each basket silk is arranged according to equilateral geometric figure, and the near-end of each basket silk crosses and is fused into the far-end that one is fixed on seal wire; Under using state, the formed face of each basket silk is curved surface shape, and all the central axis direction towards conduit draws in.
Described basket silk has three or four, and each basket silk is arranged according to triangle or square.
The proximal edge of described cover stone pocket is around being fixed on the section of described basket near far-end.
Described basket is ellipse annular, and it is projected as annular in the plane perpendicular to seal wire.
Described basket silk is made by shape-memory material.
Described micro-pore diameter is 50-150nm.
The invention has the advantages that:
The present invention is directed to stopping and efficient taking-up problem of urinary system calculus, designed the disposable removal equipment of urinary system calculus with permeable micropore cover stone pocket structure:
1, be provided with the cover stone pocket that strip pocketed and cross sectional dimensions are suitable with operation path sheath internal diameter, can hold a large amount of rubbles, even if fill calculus in the string bag, its profile also can not change, and still can in sheath, pass through, and has greatly improved and has got stone efficiency;
2, on cover stone pocket, do not contain large-scale mesh, therefore there is not gap, and itself there is certain moulding effect, can effectively avoid extracting rubble after rubble, clot and pus piece and omit, outside simultaneously the corner angle of rubble can not be exposed to, and then can frictionally damage ureter wall;
3, basket is designed with various ways, and three lines, four-wire type basket can adapt to the taking-up of the calculus of different volumes, position, but also can better maintain the shape of cover stone pocket; Ellipse annular basket can farthest reduce the inhibition to rubble, is conducive to the inside that rubble enters into cover stone pocket smoothly;
4, basket silk is memory wire, and cover stone pocket is plastics or non-woven fabrics material thin film, all can be shrunk to very small size, is contained in conduit, is convenient to inserting of lithiasis extractor of the present invention, can not promote the calculus kidney that drives in the wrong direction back, also easy damaged ureter wall not.
Accompanying drawing explanation
Accompanying drawing 1 is the structural representation that urinary system calculus intracavity of the present invention is extracted device.
Accompanying drawing 2 is the enlarged drawings of A in Fig. 1.
Accompanying drawing 3 is structural representations of the basket silk of embodiment 2.
Accompanying drawing 4 is structural representations of the basket silk of embodiment 3.
Accompanying drawing 5 is structural representations of the basket silk of embodiment 4.
The specific embodiment
Below in conjunction with accompanying drawing, the specific embodiment provided by the invention is elaborated.
The Reference numeral and the ingredient that in accompanying drawing, relate to are as follows:
1. conduit 2. seal wires
3. basket silk 31. first basket silks
32. second basket silk 4. cover stone pockets
5. modular catheter 51. first screw threads
6. seal wire handle 61. second screw threads
7. basket 8. micropores
embodiment 1
Please refer to Fig. 1, Fig. 1 is the structural representation that urinary system calculus intracavity of the present invention is extracted device.Described urinary system calculus intracavity is extracted device and is provided with conduit 1, seal wire 2, basket 7 and cover stone pocket 4.Described conduit 1 is cylindrical hollow body, and the periphery of near-end is provided with modular catheter 5, and the inwall of described modular catheter 5 near-ends is provided with the first screw thread 51.Described seal wire 2 is a fine filaments, through the inside of conduit 1.The near-end of seal wire 2 is provided with seal wire handle 6, and the outside of described seal wire handle 6 far-ends is provided with the second screw thread 61.The second described screw thread 61 mates mutually with the first described screw thread 51, can seal wire 2 is fixing with conduit 1 after screwing.The far-end of described seal wire 2 is provided with basket 7.
Please refer to Fig. 2, Fig. 2 is the enlarged drawing of A in Fig. 1.Described basket 7 comprises three basket silks 3.The near-end of every basket silk 3 and seal wire 2(are not shown) fixing, the two bifurcateds of distal section are the first basket silk 31 and the second basket silk 32.Under using state, the described curved shape of basket silk 3, the far-end of every basket silk 3 all draws in towards the central axis direction of conduit 1.The pocketed of described cover stone pocket 4 softened growth bar shapeds, the outer surface of cover stone pocket 4 far-ends is curved surface shape, and the one side of near-end is opening, and the first basket silk 31 of the outer wall of near-end and three basket silks 3 and the second basket silk 32 are fixed.On described cover stone pocket 4, be also provided with micropore 8.
It should be noted that:
Urinary system calculus intracavity of the present invention is extracted device under unused state, while also dispatching from the factory, described basket silk 3 and cover stone pocket 4 are all accommodated in the cavity of conduit 1 far-end, and basket silk 3 is gathered into a branch of under the restriction of conduit 1 cavity, and cover stone pocket 4 also fold is gathered into a branch of.
Described cover stone pocket 4 is preferably used plastic foil to make, and can be specifically the materials such as TPU, Pebax, FEP, ETFE, TPFE, and it also can use the materials such as non-woven fabrics, as long as guarantee that fold volume after folding is less, can be accommodated in thinner conduit 1.Described cover stone pocket 4, by the pocketed of preformed growth bar shaped, is similar to the shape of bullet, and this shape can be held more rubble, significantly improves and gets stone efficiency.The diameter of cover stone pocket 4 transverse section maximums is designed to suitable with operation path sheath internal diameter, even if fill calculus in the string bag, its profile also can not change, and still can in sheath, pass through.Owing to not containing large-scale mesh on cover stone pocket 4, there is not gap, and itself there is certain moulding effect, therefore can effectively avoid rubble, clot and pus piece to omit, outside the corner angle of rubble can not be exposed to simultaneously, also just can not frictionally damage ureter wall.Cover stone pocket 4 is provided with micropore 8, and described micropore 8 diameters are preferably 50-150nm, 100nm most preferably, can supply water smooth and easy by and rubble, clot and pus piece all can not pass through.
Described basket silk 3 is made for memory material, and as memory wire, concrete as Ti-Ni alloy material, discharging in conduit 1 cavity, it can launch to revert to curve shape naturally.The effect of basket silk 3 is fixing and maintains the shape of cover stone pocket 4, guarantees that its proximal edge launches and try one's best and ureter wall is fitted, and can under the impact of current, not be out of shape, and while dragging calculus, also can not be out of shape.The quantity of basket silk 3 is not limited only to the present embodiment, can be also three, four, five, seven, eight etc. some, as long as guarantee effective support set stone pocket 4 and its density degree, can not hinder rubble and enters.The fixed form of described basket silk 3 and cover stone pocket 4 is also not limited only to the present embodiment, basket silk 3 also can be fixed on the inwall of cover stone pocket 4, the far-end of basket silk 3 also can not established two bifurcation structures of the first basket silk 31 and the second basket silk 32, as long as guarantee with to overlap stone pocket 4 effectively fixing, but the basket silk 3 of two bifurcateds has increased the fixed-area with cover stone pocket 4, and fixed effect is better.
Described conduit 1 can be accommodated in intracavity by basket silk 3 and cover stone pocket 4, inserting urinary system calculus intracavity of the present invention while extracting device, can get around at an easy rate calculus, is difficult for causing calculus displacement, also can not damage ureter wall.Described seal wire 2 is for controlling taking in and discharging of basket silk 3 and cover stone pocket 4.Described modular catheter 5 and seal wire handle 6 are provided with the screw thread matching each other, and extract device reach behind target location when urinary system calculus intracavity of the present invention, conduit 1 and seal wire 2 can be fixed, thereby guarantee basket silk 3 and overlap stone pocket 4 indeformable.
Herein, described " near-end " refers to nearer one end of distance patient in operation process, and described " far-end " refers to distance patient one end far away in operation process.
The using method that urinary system calculus intracavity of the present invention is extracted device is as follows: during ureteroscope lithotrity, form endoscopic working channel, insert endoscope; Take urinary system calculus intracavity of the present invention apart and extract the packing of dispatching from the factory of device, hand-held modular catheter 5 and seal wire handle 6 enter into ureter by the far-end of conduit 1, get around calculus and be placed on calculus top, to far-end, promote seal wire handle 6, then screw thread screws seal wire handle 6 and modular catheter 5 with A/C 1 and seal wire 2, now basket silk 3 struts and reverts to curve-like, and cover stone pocket 4 is thereupon also softened; Carry out rubble operation, when calculus is all broken into the chip of 2mm left and right, slowly exiting urinary system calculus intracavity of the present invention extracts device on one side, on one side by endoscopic working channel to ureter sustained water injection, calculus chip, clot, pus piece are poured in cover stone pocket 4, and water appears outside cover stone pocket 4 by micropore 8; Finally, calculus chip, clot, pus piece are stored in cover stone pocket 4 and are removed.
Urinary system calculus intracavity of the present invention is extracted device can disposablely extract a large amount of rubbles, clot and pus piece, be not subject to the restriction of ureter lumen diameter or operating walk way internal diameter, get stone formation and be not easy to omit rubble, effectively avoid rubble to be poured into back kidney by current, can also avoid rubble to cause damage to ureter wall simultaneously, safe and reliable.
Urinary system calculus intracavity of the present invention is extracted device and not only be can be used for the shutoff of ureteral calculus and remove, the shutoff and the foreign body that also can be applicable to other body cavitys remove, include but not limited to following application: for the shutoff of renal calculus and remove, the shutoff of vascular thrombosis and removing, vascular puncture hole shutoff hemostasis, the shutoff of body cavity foreign body and removing as the processing of foreign body in trachea, intestinal.
embodiment 2
Please refer to Fig. 3, Fig. 3 is the structural representation of the basket silk of embodiment 2.Described basket 7 is three line style baskets, and particularly, basket 7 consists of three oval-shaped basket silks 3, three triangular in shape arranging of basket silk 3; Every basket silk 3 near half section of near-end all with the fusion that crosses of other two basket silks 3, the near-end of final three basket silks 3 crosses and is fused into the far-end that one is fixed on seal wire 2; Under using state, every formed of basket silk 3 is curved surface shape, all not shown towards conduit 1() central axis direction draw in; Described cover stone pocket 4(is not shown) proximal edge around being fixed on the section of described basket 7 near far-end.
embodiment 3
Please refer to Fig. 4, Fig. 4 is the structural representation of the basket silk of embodiment 3.Described basket 7 is four-wire type basket, and particularly, basket 7 consists of four oval-shaped basket silks 3, and four basket silks 3 are square and arrange; Every basket silk 3 near half section of near-end all with two adjacent basket silks 3 fusion that crosses, the near-end of final four basket silks 3 crosses and is fused into the far-end that one is fixed on seal wire 2; Under using state, every formed of basket silk 3 is curved surface shape, all not shown towards conduit 1() central axis direction draw in.
It should be noted that, embodiment 2 and 3 three lines, the taking-up that four-wire type basket can adapt to the calculus of different volumes, position, and the basket 7 of this kind of shape makes to overlap stone pocket 4 proximal edge all in stationary state, so can better maintain the shape of cover stone pocket 4.In the present invention, basket 7 is not limited in tri-kinds of shapes of embodiment 1-3, can also make other shape, as long as guarantee effective support set stone pocket 4 and its density degree, can not hinder rubble and enters.
embodiment 4
Please refer to Fig. 5, Fig. 5 is the structural representation of the basket silk of embodiment 4.Described basket 7 is ellipse annular substantially, and formed is curved surface shape, and it is projected as annular in the plane perpendicular to seal wire 2.Particularly, described basket 7 consists of an oval-shaped basket silk 3, and one end end points of its major axis is fixed on the far-end of seal wire 2.The proximal edge of described cover stone pocket 4 is around being fixed on basket 7.
In the present embodiment, described basket 7 only forms an ellipse annular by single basket silk 3, and the number of basket silk 3 minimizes, and can farthest reduce the inhibition to rubble, is conducive to rubble and enters into smoothly cover stone pocket 4 inside.
The above is only the preferred embodiment of the present invention; it should be pointed out that for those skilled in the art, do not departing under the prerequisite of the inventive method; can also make some improvement and supplement, these improvement and supplement and also should be considered as protection scope of the present invention.

Claims (10)

1. urinary system calculus intracavity is extracted a device, is provided with conduit and seal wire, it is characterized in that, the far-end of described seal wire is provided with basket, on described basket, be fixed with cover stone pocket, the one side that described cover stone pocket is moulded pocketed and near-end is in advance opening, on described cover stone pocket, is also provided with micropore.
2. urinary system calculus intracavity according to claim 1 is extracted device, it is characterized in that, the described elongated pocketed of cover stone pocket, and distal surface is curved surface shape.
3. urinary system calculus intracavity according to claim 1 is extracted device, it is characterized in that, described cover stone pocket is made by plastics or non-woven fabrics.
4. urinary system calculus intracavity according to claim 1 is extracted device, it is characterized in that, described basket is comprised of the basket silk of curved shape under using state, and the far-end of described basket silk draws in and fixes with cover stone pocket towards the central axis direction of conduit.
5. urinary system calculus intracavity according to claim 4 is extracted device, it is characterized in that, the two bifurcateds of described basket silk far-end are the first basket silk and the second basket silk, and described the first basket silk and the second basket silk are fixed with cover stone pocket.
6. urinary system calculus intracavity according to claim 1 is extracted device, it is characterized in that, described basket is comprised of several oval-shaped basket silks, and each basket silk is arranged according to equilateral geometric figure, and the near-end of each basket silk crosses and is fused into the far-end that one is fixed on seal wire; Under using state, the formed face of each basket silk is curved surface shape, and all the central axis direction towards conduit draws in.
7. urinary system calculus intracavity according to claim 6 is extracted device, it is characterized in that, described basket silk has three or four, and each basket silk is arranged according to triangle or square.
8. urinary system calculus intracavity according to claim 7 is extracted device, it is characterized in that, the proximal edge of described cover stone pocket is around being fixed on the section of described basket near far-end.
9. urinary system calculus intracavity according to claim 1 is extracted device, it is characterized in that, described basket is ellipse annular, and it is projected as annular in the plane perpendicular to seal wire.
10. urinary system calculus intracavity according to claim 1 is extracted device, it is characterized in that, described basket silk is made by shape-memory material.
CN201410334420.3A 2014-07-15 2014-07-15 Urinary system calculus intracavity extracts device Active CN104095666B (en)

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PCT/CN2015/071184 WO2016008293A1 (en) 2014-07-15 2015-01-21 Urinary system stone intraluminal sleeving and removal apparatus

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Inventor after: Sun Yinghao

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