Liver segment dyeing device through portal vein or hepatic artery path

Abstract

The invention relates to the technical field of liver segment dyeing devices, in particular to a liver segment dyeing device through a portal vein or hepatic artery path. The device comprises a catheter internally provided with a plurality of cavity pipelines, and the catheter can be used in cooperation with a guide wire to reach the target position of a blood vessel. An inflatable balloon is arranged on the outer wall, close to the insertion end, of the catheter, an inflation channel is formed in the catheter and communicated with the balloon, the input end of the inflation channel is arranged at the end, reserved outside the human body, of the catheter, and a guide wire channel is further formed in the position, located at the insertion end, of the catheter. The guide wire channel is a deformable channel penetrating through the balloon in the direction parallel to the axis of the catheter, when the balloon is in an expansion state, the deformable channel is subjected to closed deformation, an existing catheter provided with the balloon and used for interventional operation is transformed and applied to liver subunit structure dyeing, and therefore the catheter can be applied to liver subunit structure dyeing. The target blood vessel is blocked and the dyeing medicine is injected into the target blood vessel, so that the dyeing success rate of the target liver subunit structure is improved.

Description

Technical Field

[0001] The present invention relates to the technical field of liver segment and subsegment staining devices, and in particular to a liver segment staining device via the portal vein or hepatic artery pathway. Background Art

[0002] Anatomical liver resection is a commonly used surgical procedure for treating both benign and malignant liver diseases. Anatomical liver resection involves segmental liver resection, including lobe, segment, and subsegmental resection. It is suitable for tumors confined to a specific liver segment. It allows for radical tumor resection while preserving normal liver tissue to the greatest extent possible, helping to maintain normal liver function and promoting postoperative recovery.

[0003] In order for doctors to more accurately identify and remove the diseased liver segment during surgery, while avoiding damage to the surrounding normal liver tissue, and accurately perform liver lobe, liver segment and sub-segment resection, it is generally necessary to stain the liver segment before surgery. The liver segment staining steps are roughly the same as existing interventional surgical operations. First, a puncture needle is used to puncture the hepatic artery or portal vein. Then a positioning guide wire is inserted into the inside of the puncture needle so that the positioning guide wire enters the blood vessel. The puncture needle is pulled out to retain the positioning guide wire. Then, the sheath is quickly placed on the guide wire and inserted into the blood vessel. The positioning guide wire is pulled out. At this time, only the hose end of the sheath is inserted into the blood vessel. The end of the sheath reserved outside the blood vessel has a jack connected to the inside of the hose. The inside of the sheath generally has a valve structure (or a one-way valve) to prevent blood from spraying out without affecting the subsequent insertion of the guide wire and catheter. The guide wire is removed from the sheath. The guidewire is inserted into the blood vessel through the sheath's jack. During this time, the position of the guidewire's insertion end is constantly monitored using imaging equipment (ultrasound or DSA). The guidewire's insertion end is typically a reshaping structure, meaning it can be bent to a certain angle and inserted through the sheath's jack, facilitating passage through vascular branches and reaching the target location. Once the guidewire's insertion end has reached the target location, a catheter is placed into the vessel, guided by the guidewire. The catheter's insertion end position is also determined using imaging equipment. Once the catheter's insertion end has reached the target location, a dye is injected into the target location through the catheter. Existing staining techniques use dyes to stain the liver, most commonly indocyanine green (ICG). In segmental liver resection, ICG staining techniques are divided into two methods: positive staining and counterstaining. Positive staining involves injecting ICG via portal vein puncture to fluorescently stain the target liver segment. Counterstaining involves blocking blood flow to the target segment and then injecting ICG into a peripheral vein to stain the intended liver segment. Regardless of whether positive staining or counterstaining is used, ICG may flow back into other shunts, causing unnecessary staining. Existing liver segment staining devices lack a device that can block the injected ICG shunt, which can easily lead to dye reflux and staining failure. Based on this problem, it is necessary to design a liver segment staining device via the portal vein or hepatic artery to solve the above problem. It can visualize the complex liver anatomical structure, accurately locate the sub-anatomical unit structure such as liver segments or subsegments during surgery, plan the surgical operation plan, accurately develop the target surgical resection area, guide the liver parenchyma separation plane in real time, and guide precise anatomical liver resection. Summary of the Invention

[0004] The present invention provides a liver segment staining device via the portal vein or hepatic artery pathway. The device transforms an existing catheter with a balloon used for interventional surgery and applies it to liver segment staining surgery, thereby achieving occlusion of the target blood vessel and injection of a staining agent from the target blood vessel, thereby improving the staining success rate of the target liver segment.

[0005] The technical problem solved by the present invention is achieved by adopting the following technical solutions: The present invention provides a liver segment staining device via a portal vein or hepatic artery pathway, comprising a catheter having a cavity therein and capable of being used in conjunction with a guidewire to reach a target blood vessel position, wherein an inflatable balloon is provided on the outer wall of the catheter near the insertion end, and an inflation channel is further provided inside the catheter, wherein the output end of the inflation channel is communicated with the interior of the balloon, and the input end of the inflation channel is provided at an end of the catheter reserved for the outside of the human body, and a guidewire channel is further provided at the insertion end of the catheter, wherein the guidewire channel is a deformable channel that passes through the balloon in a direction parallel to the axis of the catheter, and when the balloon is in an inflated state, the deformable channel undergoes a closed deformation, and wherein a drug injection port is further provided at the end of the catheter reserved for the outside of the human body, and the drug injection port is communicated with the drug delivery channel inside the catheter.

[0006] Preferably, the drug liquid delivery channel is defined by the inner wall of the catheter and the outer wall of the inflation channel.

[0007] Preferably, the guidewire channel further includes a first wear-resistant channel and a second wear-resistant channel, wherein the first wear-resistant channel extends from the catheter insertion end to the input end of the deformable channel, and the second wear-resistant channel is spaced apart from the first wear-resistant channel and is located at the output end of the deformable channel.

[0008] Preferably, the first wear-resistant channel extends from the inside of the catheter insertion end to the outside of the catheter and then communicates with the deformable channel.

[0009] Preferably, the first wear-resistant channel extends from the outside of the catheter insertion end to communicate with the deformable channel.

[0010] Preferably, the inner wall diameters of the first wear-resistant channel and the second wear-resistant channel are both smaller than the inner wall diameter of the deformable channel.

[0011] Preferably, the elastic modulus of the side wall of the deformable channel is smaller than the elastic modulus of the balloon.

[0012] Preferably, the elastic modulus of the side wall of the deformable channel is smaller than the elastic modulus of the balloon by making the two of them use the same material with different thicknesses or different materials.

[0013] The beneficial effect of the present invention is that it transforms the existing catheter with a balloon used for interventional surgery and applies it to liver segment staining surgery, thereby achieving the blockage of the target blood vessel and the injection of the dye from the target blood vessel, thereby improving the staining success rate of the target liver segment and helping doctors to accurately resect the target liver segment. BRIEF DESCRIPTION OF THE DRAWINGS

[0014] In order to more clearly illustrate the technical solutions in the embodiments of the present application or the prior art, the accompanying drawings needed to be used in the embodiments or prior art description will be briefly introduced. Obviously, the accompanying drawings in the following description only show some embodiments of the present application, and for those skilled in the art, other drawings can also be obtained from these drawings without any creative effort.

[0015] Figure 1 A schematic diagram of the present application in use; Figure 2 A schematic diagram of the existing interventional treatment catheter provided by the present application; Figure 3 A schematic diagram of the existing interventional treatment catheter provided by the present application; Figure 4 A schematic diagram of the existing interventional treatment catheter provided by the present application; Figure 3 An enlarged structural schematic diagram of A in the present application; Figure 5 A schematic diagram of the existing interventional treatment catheter provided by the present application in cooperation with a guide wire; Figure 6 A schematic diagram of the existing interventional treatment catheter provided by the present application; Figure 5 An enlarged structural schematic diagram of B in the present application; Figure 7 A schematic diagram of the present application; Figure 8 A schematic diagram of the present application; Figure 9 A schematic diagram of the present application; Figure 8 An enlarged structural schematic diagram of C in the present application; Figure 10 A schematic diagram of the present application in cooperation with a guide wire; Figure 11 A schematic diagram of the present application; Figure 10 An enlarged structural schematic diagram of D in the present application; Figure 12 A schematic diagram of the first embodiment structure of the guide wire channel provided by the present application; Figure 13 A schematic diagram of the second embodiment structure of the guide wire channel provided by the present application.

[0016] In the figure, 1. catheter; 2. balloon; 3. inflation channel; 4. inflation port; 5. air outlet; 6. guidewire channel; 601. first wear-resistant channel; 602. deformable channel; 603. second wear-resistant channel; 7. guidewire insertion end; 8. guidewire output end; 9. guidewire; 10. drug injection port; 11. drug delivery channel; 12. sheath; 13. tumor lesion area; 14. liver main body; 15. portal vein; 16. first portal vein branch; 17. second portal vein branch; 18. intersection. DETAILED DESCRIPTION

[0017] In order to make the technical means, creative features, objectives and effects achieved by the present invention easier to understand, the present invention is further described below with reference to specific illustrations.

[0018] First, in order to enable those skilled in the art to better understand the innovative features of the present invention, this application first introduces the existing liver segment resection process, referring to Figure 1 The traditional liver can be divided into eight segments, including segments I, II, III, IV, V, VI, VII, and VIII (Since segment I of the liver is located in the caudate lobe of the liver and is smaller in size, it is attached to the Figure 1 (Segment I is not shown in the planar shape structure of the liver provided in the figure). Segment IV of the liver can be divided into segment IVA and segment IVB. Each liver segment has independent portal vein, hepatic artery and bile duct branches. The segmentation of the liver is mainly based on the distribution characteristics of the intrahepatic portal system. Each liver has its own inflow and outflow vascular system and biliary system. Through liver CT or MRI, doctors can further clarify the specific location of liver space-occupying lesions and their proximity to surrounding blood vessels. This is crucial for the accurate diagnosis of liver diseases, especially malignant tumors. The segmentation of the liver is epoch-making. It can not only shorten the operation time, but also better reduce intraoperative and postoperative bleeding and complications such as bile fistula. Especially for regular liver segment or lobectomy, liver segmentation allows doctors to retain meaningful portal veins, bile ducts and hepatic arteries to the maximum extent, thereby ensuring the safety and effectiveness of the operation. For certain specific liver lesions, only partial liver segment resection may be required instead of entire liver lobe resection. This can not only reduce surgical trauma, but also accelerate the patient's postoperative recovery. In the attached Figure 1The figure shows a tumor lesion area 13 at segment II. When performing tumor cell resection, doctors cannot accurately determine the tumor boundary, which can lead to incomplete tumor resection or significant damage to normal liver tissue. Therefore, clearly defining the tumor boundary is key to ensuring surgical success. Liver segment staining techniques, such as fluorescent staining with indocyanine green (ICG) or methylene blue, can clearly show the boundary between the target liver segment and surrounding normal liver tissue, helping doctors accurately determine the extent of the tumor during surgery and achieve precise resection. The principle of liver segment staining is as follows. For example, indocyanine green (ICG) is a commonly used fluorescent dye. It is rapidly metabolized and excreted in normal liver tissue, but in diseased tissues such as tumors, metabolism is slow due to the lack of a bile duct system, resulting in a green color under fluorescent mode. As described above, liver segment staining plays an important role in guiding liver segment resection surgery.

[0019] There are many reasons for the failure of liver segment staining in existing liver segment staining operations. One common reason for staining failure is that the dye refluxes from the target blood vessel to other branch ducts, causing the adjacent liver segments to be stained, resulting in staining failure. The main reason for this phenomenon is that when the dye is injected into the existing interventional puncture device, the dye refluxes to other branch ducts. The reason for the dye reflux is the lack of blockage of the target blood vessel.

[0020] In order to better understand the improvements of the present invention over the prior art for those skilled in the art, the existing interventional treatment device is first introduced. Figures 1-6It is a schematic diagram of the structure of an existing interventional treatment catheter 1 and its usage status. First of all, it should be noted that the guide wire 9 in the present invention is delivered to the target blood vessel of the liver through conventional interventional instruments such as a puncture needle and a sheath 12. The detailed process is not elaborated in detail here. It is the same as the steps of conventional interventional surgical treatment. When the guide wire 9 is inserted into the target blood vessel position, the catheter 1 with a balloon 2 can be inserted into the target blood vessel position through the cooperation of the guide wire 9, and then the balloon is inflated by a pressure pump to expand the balloon, and finally the dyeing agent is injected through the catheter 1 to achieve dyeing. The specific structure of the existing catheter 1 with a balloon 2 is a tubular structure with a hollow interior. One end of the tube 1 is an insertion end that can reach the target position of the blood vessel by cooperating with the guide wire 9, and the other end is reserved outside the human body. An inflatable balloon 2 is provided on the outer wall of the catheter 1 near the insertion end, and the balloon 2 is inflated through an inflation channel 3 provided inside the catheter 1. The output end of the inflation channel 3 passes through the outer wall of the catheter 1 and is communicated with the interior of the balloon 2. The input end of the inflation channel 3 is provided at the end of the catheter 1 reserved outside the human body. When the balloon 2 is inflated, the inflation port 4 at the input end of the inflation channel 3 is connected to the air supply equipment, and the air flow enters the interior of the balloon 2 through the air outlet 5 of the inflation channel 3, that is, the expansion of the balloon 2 is realized, thereby achieving the blocking of the target position of the blood vessel. One end outside the body is also provided with a liquid medicine injection port 10, which is connected to the cavity inside the catheter 1. A person can inject the dye liquid into the target position of the human blood vessel through the liquid medicine injection port 10 and the cavity inside the catheter 1. However, after the existing dye liquid is injected into the target position of the human blood vessel, although it has the occlusion of the balloon 2, it is also easy to reflux. The reason for the reflux phenomenon is that the liquid medicine refluxes through the guide wire channel 6, passes through the occlusion area of ​​the balloon, and enters other blood vessel branches, resulting in dyeing failure. The existing guide wire channel 6 extends from the insertion end position of the catheter 1 to the end of the catheter 1 reserved for the human body. When the extended position completely passes through the balloon, it passes through the outside of the catheter 1. When in use, the guide wire line 9 is pre- The end remaining outside the human body passes through the guidewire channel 6, and then the catheter 1 is slowly pushed along the path of the guidewire 9 until the balloon 2 reaches the target position of the blood vessel. Since the diameter of the guidewire channel 6 is larger than the diameter of the guidewire 9 (the clearance between the two is matched), the smoothness of the catheter 1 can be guaranteed when it is pushed. When the balloon 2 expands to block the target position of the blood vessel, the blocking area is the blocking area formed between the outer wall of the catheter 1 and the inner wall of the blood vessel. When the pressure of the dye delivered to the target area of ​​the blood vessel is slightly higher or the injection speed is faster, the blood vessel will reflux, and the dye will flow back through the guidewire channel 6 over the blocking area formed by the balloon 2 into other blood vessel branches, resulting in uncontrollable dyeing area, dyeing failure, and in the attached Figure 1In the figure, after the dye is injected into the first portal vein branch 16, it flows back across the intersection 18 and enters the second portal vein branch 17, causing segment III of the liver body 14 to be stained, resulting in staining failure. Of course, it may also flow back to other vascular branches, resulting in staining failure.

[0021] Based on this, the present invention provides a liver segment staining device via the portal vein or hepatic artery route. The similarity between the present invention and the existing technology is that it also includes a catheter 1 with a cavity inside and can be used in conjunction with a guide wire 9, so that the balloon 2 on the catheter 1 can be delivered to the target position of the blood vessel. The arrangement of the inflation channel 3 of the pipeline is also the same as the existing technology. The improvement over the existing technology is that the position of the guide wire channel 6 is different. The present invention sets the existing guide wire channel 6 in a deformable channel 602 that passes through the balloon 2 in a direction parallel to the axis of the catheter 1. When the balloon 2 is in a non-expanded state, the deformable channel 602 can allow the guide wire 9 to pass through (at this time it is a gap fit). When the balloon 2 reaches the target position of the blood vessel, When inflated, the deformable channel 602 also expands and deforms, and the expansion deformation causes the deformable channel 602 to close. That is, when the balloon 2 is inflated, the gap between the guide wire 9 and the deformable channel 602 disappears due to the expansion deformation of the deformable channel 602. At this time, the dyeing liquid is injected through the liquid injection port 10 reserved at one end of the catheter 1 outside the human body. The dyeing liquid can only enter the designated position from the liquid delivery channel 11 (the area channel enclosed by the inner wall of the catheter 1 and the outer wall of the inflation channel 3, that is, the liquid delivery channel 11). After the deformable channel 602 is closed, there will be no reflux path for the liquid, which can avoid the reflux of the dyeing liquid and the resulting dyeing failure.

[0022] Furthermore, when the guidewire 9 passes through the deformable channel 602 mentioned above and the catheter 1 is pushed forward to the target position of the blood vessel, mutual friction will occur between the guidewire 9 and the deformable channel 602, especially when the balloon 2 advances along the path of the guidewire 9 and turns, the wear between the two ends of the deformable channel 602 and the guidewire 9 is relatively strong. In order to avoid more serious wear of the deformable channel 602, a first wear-resistant channel 601 as a guidewire insertion end 7 and a second wear-resistant channel 603 as a guidewire output end 8 are respectively provided at the two ends of the deformable channel 602. The setting of the wear-resistant channel can reduce the wear between the guidewire 9 and the deformable channel 602, and avoid the subsequent blocking effect of the deformable channel 602 being deteriorated due to wear. Specifically, the inner wall diameters of the first wear-resistant channel 601 and the second wear-resistant channel 603 are both smaller than the inner wall diameter of the deformable channel 602, so as to avoid the guidewire 9 from contacting the inner wall of the deformable channel 602 when it is slightly bent.

[0023] Specifically, the first wear-resistant channel 601 is arranged at the input end of the deformable channel 602 (the direction of insertion of the guidewire 9, close to the direction of the insertion end of the catheter 1). It extends from the inside of the insertion end of the catheter 1 to the outside of the catheter 1 and then communicates with the deformable channel 602. It can fully ensure the size of the insertion end of the catheter 1 and better insert it into the sheath 12. When it is pushed along the blood vessel path under the traction of the guidewire 9, it is easier to pass through when encountering obstacles. However, when it cooperates with the guidewire 9, the guidewire 9 is always in a bent state. When pushing the catheter 1, since the bending position of the guidewire 9 changes all the time, the guidewire 9 is always in a swinging state. Of course, it can also extend from the outside of the insertion end of the catheter 1 to communicate with the deformable channel 602. It is arranged inside relative to the first wear-resistant channel 601, which can prevent the guidewire 9 from always being in a larger bend and cooperating with the guidewire channel 6. However, the shape of the corresponding insertion end of the catheter 1 not only includes the insertion end of the catheter 1 itself, but also includes the first wear-resistant channel 601, and its passability in the blood vessel is correspondingly reduced.

[0024] Furthermore, in order to ensure that the deformable channel 602 is in a closed state when the balloon 2 is in an expanded state, and to avoid the problem of incomplete closing deformation of the deformable channel 602 and backflow of the dye after the balloon 2 is inflated, the elastic modulus of the side wall of the deformable channel 602 is set to be smaller than the elastic modulus of the balloon 2, thereby ensuring that the deformable channel 602 has been closed and deformed before the balloon 2 is inflated. Specifically, the elastic modulus of the side wall of the deformable channel 602 is smaller than the elastic modulus of the balloon 2 by using the same material but different thicknesses or using different materials for the two.

[0025] For specific usage, refer to Figure 1 Taking the liver segment II region with a diseased tumor area as an example, first, the guide wire 9 is inserted into the human body through the interventional treatment device, and the insertion end of the guide wire 9 reaches the target position of the blood vessel. In the figure, the target blood vessel is the portal vein 15 as an example (the hepatic artery may also be selected during the specific operation process). Figure 1 In the figure, the target position is the first portal vein branch 16 corresponding to segment II in the liver body. After the catheter 1 with the balloon 2 is pushed to the first portal vein branch 16 through the guide wire 9, the balloon 2 is inflated through the inflation port 4, and then the dye is injected into the first portal vein branch 16 through the drug injection port 10. Since the first portal vein branch 16 is completely blocked by the balloon 2, the dye solution cannot flow back in the first portal vein branch 16, avoiding the diffusion of dye to other liver segments.

[0026] The basic principles, main features, and advantages of the present invention are shown and described above. Those skilled in the art should understand that the present invention is not limited to the above-described embodiments. The above-described embodiments and descriptions are merely illustrative of the principles of the present invention. Various changes and modifications may be made to the present invention without departing from the spirit and scope of the present invention. Such changes and modifications are intended to fall within the scope of the present invention. The scope of protection claimed in the present invention is defined by the appended claims and their equivalents.

Claims

1. A liver segment staining device via the portal vein or hepatic artery path, comprising a catheter (1) having an internal cavity and capable of being used in conjunction with a guide wire (9) to reach a target position in a blood vessel, wherein an expandable balloon (2) is provided on the outer wall of the catheter (1) near the insertion end, an inflation channel (3) is further provided inside the catheter (1), an output end of the inflation channel (3) is communicated with the interior of the balloon (2), an input end of the inflation channel (3) is provided at an end of the catheter (1) reserved for the outside of the human body, and a guide wire channel (6) is further provided at the insertion end of the catheter (1), characterized in that: The guidewire channel (6) is a deformable channel (602) that passes through the balloon (2) in a direction parallel to the axis of the catheter (1). When the balloon (2) is in an expanded state, the deformable channel (602) undergoes a closed deformation. The catheter (1) is also provided with a liquid medicine injection port (10) at a position reserved for the outside of the human body. The liquid medicine injection port (10) is connected to the liquid medicine delivery channel (11) inside the catheter (1).

2. The device for staining liver segments via portal vein or hepatic artery according to claim 1, characterized in that: The liquid medicine delivery channel (11) is defined by the inner wall of the catheter (1) and the outer wall of the inflation channel (3).

3. The liver segment staining device via portal vein or hepatic artery according to claim 1, characterized in that: The guidewire channel (6) further comprises a first wear-resistant channel (601) and a second wear-resistant channel (603), wherein the first wear-resistant channel (601) extends from the insertion end of the catheter (1) to the input end of the deformable channel (602), and the second wear-resistant channel (603) is spaced apart from the first wear-resistant channel (601) and is located at the output end of the deformable channel (602).

4. The device for staining liver segments via portal vein or hepatic artery according to claim 3, characterized in that: The first wear-resistant channel (601) extends from the inside of the insertion end of the catheter (1) to the outside of the catheter (1) and then communicates with the deformable channel (602).

5. The device for staining liver segments via portal vein or hepatic artery according to claim 3, characterized in that: The first wear-resistant channel (601) extends from the outside of the insertion end of the catheter (1) to communicate with the deformable channel (602).

6. The device for staining liver segments via portal vein or hepatic artery according to claim 3, characterized in that: The inner wall diameters of the first wear-resistant channel (601) and the second wear-resistant channel (603) are both smaller than the inner wall diameter of the deformable channel (602).

7. The device for staining liver segments via portal vein or hepatic artery according to claim 1, characterized in that: The elastic modulus of the side wall of the deformable channel (602) is smaller than the elastic modulus of the balloon (2).

8. The device for staining liver segments via portal vein or hepatic artery according to claim 7, characterized in that: The elastic modulus of the side wall of the deformable channel (602) is smaller than the elastic modulus of the balloon (2) by using the same material but different thicknesses or using different materials for both.

Images