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Lithotripsy basket catheter with lithotripsy balloon

A technology of mesh basket and catheter, which is applied to the parts of surgical instruments, medical science, heating surgical instruments, etc., can solve the problems of common bile duct obstruction, difficulty in nursing, and difficulty in extracting huge common bile duct stones.

Pending Publication Date: 2020-10-30
SHANGHAI EAST HOSPITAL EAST HOSPITAL TONGJI UNIV SCHOOL OF MEDICINE
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

The diameter of choledocholithiasis is more than 1.5cm. This treatment has the following disadvantages: 1. Using a balloon with a diameter of more than 1.5cm to dilate the duodenal papillary sphincter is prone to papillary tear bleeding, acute pancreatitis, perforation, etc. Short-term complications, as well as long-term complications such as reflux cholangitis, recurrence of stones, and cholangiocarcinoma; 2. Before PTCS, the fistula tract needs to be dilated before choledochoscopy can enter the common bile duct. Repeated dilation of the fistula tract in one operation is prone to fistula tract tear, hemorrhage, liver abscess and other complications; multiple operations to dilate the fistula tract are less risky, but the total cost is high, the course of disease is longer, and patients who carry external biliary drainage tubes for a long time have poor medical compliance and difficult nursing; 3. Biliary endoscopy is required for PTCS removal of stones, and the cost of choledochoscopy equipment is relatively high, and general hospitals do not have choledochoscopy equipment
The head end of the above-mentioned technique has the following disadvantages: 1. Before the stone is completely removed, the risk of large papillary sphincter incision and large balloon papillary expansion is relatively high, and short-term complications such as nipple hemorrhage, acute pancreatitis, and perforation are prone to occur during the perioperative period. And long-term complications such as reflux cholangitis, early recurrence of stones, and cholangitis; 2. Huge common bile duct stones often cause common bile duct obstruction. Due to the narrow space, it is difficult to remove huge common bile duct stones by placing a stone basket through ERCP ;3. The efficiency of mechanical stone crushing with mesh basket is low, and some hard cholesterol stones are difficult to be crushed by the mesh basket; , can only choose general anesthesia for biliary tract exploration surgery, which is risky; 5. The placement of SpyGlass lithotripsy under direct vision through ERCP is a new technology developed recently. The cost is extremely high, ordinary hospitals have not carried out this technology, and ordinary families cannot afford the huge and high treatment costs

Method used

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  • Lithotripsy basket catheter with lithotripsy balloon
  • Lithotripsy basket catheter with lithotripsy balloon
  • Lithotripsy basket catheter with lithotripsy balloon

Examples

Experimental program
Comparison scheme
Effect test

Embodiment 1

[0055] In this embodiment, the basket configuration of Scheme 1 is selected, and the total length of the catheter is 40-60 cm.

[0056] PTCD drainage of bile was performed first to control biliary infection and jaundice, and the PTCD tube was left in place for 2 months.

[0057] A zebra guide wire was inserted through the original PTCD tube, and the guide wire crossed the stone and entered the distal end of the duodenum through the duodenal papilla.

[0058] The guide wire was indwelled and the original PTCD tube was withdrawn, and the duodenal papilla balloon dilation catheter was inserted into the duodenal papilla through the guide wire to dilate the duodenal papilla.

[0059] Indwell the guide wire and withdraw the duodenal papilla balloon dilatation catheter, insert the guide wire through the tip of the crushed stone basket catheter, and send the crushed stone basket catheter into the common bile duct under the guidance of the guide wire, withdraw the guide wire, and relea...

Embodiment 2

[0065] In this embodiment, the basket configuration of Scheme 1 is selected, and the total length of the catheter is 2.2-2.8 m.

[0066] Such as Figure 7 As shown in (a) to (e), a duodenoscope was inserted through the mouth, and after successful bile duct intubation, endoscopic retrograde cholangiography was performed first to determine the number, location and size of stones, and then duodenal papillary sphincter A small incision was made and the duodenal papilla was dilated using a 1.0 cm diameter cylindrical balloon.

[0067] Under the guidance of the guide wire, the basket catheter is inserted through the duodenal clamp, the balloon is filled or the basket is released, and the small common bile duct stones are captured and directly dragged into the duodenum. When the diameter of the stone exceeds 1cm, release the basket catheter to collect the stone. When the basket is tightened, the stone is close to the electrode at the tip of the catheter, and the balloon is filled to...

Embodiment 3

[0070] In this embodiment, the basket configuration of Scheme 2 is selected, and the total length of the catheter is 40-60 cm.

[0071] PTCD drainage of bile was performed first to control biliary infection and jaundice, and the PTCD tube was left in place for 2 months.

[0072] Insert the cup-shaped crushed stone basket catheter into the common bile duct through the PTCD fistula tract, push the basket catheter forward, and release the basket.

[0073] Push the snare connecting rod forward, the head end of the net basket is open, and the net basket is cup-shaped.

[0074] Push the outer cannula forward, and the choledocholith enters the basket.

[0075] Pull back on the snare to tighten the mouth of the cup.

[0076] Pull back the gravel basket catheter, the basket is tightened, and the stone is fixed at the head end of the outer casing.

[0077] Inflate the balloon and secure the lithotripsy catheter.

[0078] Plasma, microelectrode or laser lithotripsy are performed, and...

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Abstract

The invention provides a lithotripsy basket catheter with a lithotripsy balloon. The lithotripsy basket catheter comprises a catheter e and a connecting rod type basket arranged in the catheter. The catheter comprises a first catheter section, a second catheter section and a third catheter section which are sequentially communicated; a balloon is arranged outside the second catheter section; and aballoon inflation channel and a basket connecting rod channel for displacement are arranged in the catheter. After calculi are taken by the basket, the basket is tightened, and the calculi can be fixed and tightly attached to the lithotripsy electrode at the head end of the catheter. After the balloon is filled, broken calculi can be prevented from entering an intrahepatic bile duct in the calculi breaking process. After the common bile duct calculi are crushed, the broken calculi can be dragged into the common bile duct by using the balloon, or after the common bile duct calculi are crushed,the broken calculi are dragged into the duodenum by using the balloon or the basket. By arranging the lithotripsy electrode, large common bile duct calculi can be subjected to plasma lithotripsy, microelectrode lithotripsy and laser lithotripsy under X-ray, choledochoscope assistance is not needed, and the lithotripsy basket catheter is more suitable for primary hospitals.

Description

technical field [0001] The invention relates to the technical field of bile duct medical devices, in particular to a lithotripsy basket catheter with a stone retrieval balloon. Background technique [0002] Choledocholithiasis is a common and frequently-occurring disease in my country. Blockage of the common bile duct by stones can induce complications such as acute cholangitis, obstructive jaundice, and acute biliary pancreatitis. Symptoms include chills, fever, abdominal pain, and jaundice. Cause shock, long-term calculus stimulation has the risk of cholangiocarcinoma, which is an important disease that endangers human health. Treatment options for common bile duct stones include open biliary tract exploration, laparoscopic biliary exploration, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic bile duct puncture (PTCD) + fistula expansion + percutaneous transhepatic Tractoscopy (PTCS) stone extraction, duodenal papillary balloon dilation caps...

Claims

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Application Information

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Patent Type & Authority Applications(China)
IPC IPC(8): A61B17/22A61B18/04A61B18/26A61B18/00A61B17/221
CPCA61B17/22022A61B18/042A61B17/221A61B18/26A61B2017/2215A61B2017/22069A61B2017/22092A61B2018/00535A61B2018/00142A61B2018/0022A61B2018/00285
Inventor 张诚杨玉龙
Owner SHANGHAI EAST HOSPITAL EAST HOSPITAL TONGJI UNIV SCHOOL OF MEDICINE
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