Medical water jet scalpel system

Abstract

A medical water jet scalpel system is provided with an insertion part and a handle part connected to the near end of the insertion part, and the medical water jet scalpel system comprises a water jet scalpel assembly, a laser assembly and a suction control assembly. The water jet assembly comprises a water jet channel penetrating through the insertion part and the handle part and is configured to output jet flow; the laser assembly comprises a laser channel penetrating through the insertion part and the handle part and is configured to output laser energy; the aspiration control assembly includes an aspiration channel through the insertion portion and the handle portion configured to aspirate fluid. According to the medical water jet scalpel instrument, the water jet scalpel technology and the laser technology are combined, prostate tissue excision can be carried out under the condition of no thermal damage, and meanwhile hemostasis is achieved; in addition, the medical water jet scalpel instrument can complete the whole operation at the same time, surgical instruments do not need to be replaced midway, operation is easy, and the learning curve is short.

Description

Technical Field

[0001] Embodiments of the present disclosure relate to a medical water knife system. Background Art

[0002] Benign prostatic hyperplasia is a common benign disease that causes urinary dysfunction in middle-aged and elderly men. Approximately 50% of men over 50 years old have prostatic hyperplasia, and the prevalence rate in men over 80 years old is as high as 90%. Currently, the treatment of prostatic hyperplasia mainly includes lifestyle guidance, drug treatment, surgical treatment, etc. Among them, surgical treatment is the most radical treatment method at present.

[0003] Surgical treatment of prostatic hyperplasia mainly includes open prostatectomy, laparoscopic prostatectomy, transurethral resection of the prostate (TURP), laser vaporization, laser enucleation, etc. During the resection of prostatic hyperplasia tissue, it is necessary to separate the capsule interface. The depth of thermal damage of TURP is about 5 mm, while the thickness of the surgical capsule is 2 mm. Therefore, during the resection of prostatic hyperplasia tissue, it is easy to cause thermal damage to the tissue behind the surgical capsule, resulting in complications such as bleeding, infection, sexual dysfunction, etc. With the development of instrument technology, the thermal damage generated during the cutting process of the instrument is gradually decreasing. For example, the common thermal damage of TURP is about 5 mm, the thermal damage of plasma instruments is about 2 mm - 4 mm, the thermal damage of holmium laser is about 0.4 mm, and the thermal damage of thulium laser is about 0.1 mm. Reducing thermal damage is of great significance for avoiding complications and postoperative rehabilitation, etc. Summary of the Utility Model

[0004] At least one embodiment of the present disclosure provides a medical water knife system, which has an insertion part and a handle part connected to the proximal end of the insertion part, and the medical water knife system includes a water knife component, a laser component, and a suction control component; the water knife component includes a water knife channel that penetrates the insertion part and the handle part, and is configured to output a jet; the laser component includes a laser channel that penetrates the insertion part and the handle part, and is configured to output laser energy; the suction control component includes a suction channel that penetrates the insertion part and the handle part, and is configured to suck fluid.

[0005] For example, the medical water knife system provided by at least one embodiment of the present disclosure further includes: a pressure control component, including a pressure sensor and a pressure control module communicatively connected to the pressure sensor, wherein the pressure sensor is located at the distal end of the insertion part, and is configured to detect the pressure value of the fluid in the environment where the distal end of the insertion part is located, and feedback it to the pressure control module; the pressure control module is configured to receive the pressure value detected by the pressure sensor, and control the suction speed of the suction control component and / or control the medical water knife system to stop according to the pressure value.

[0006] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the pressure control module controls the suction speed of the suction control component according to the pressure value, including: when the pressure value is greater than the first upper threshold and less than or equal to the second upper threshold, controlling the suction control component to increase the suction speed; when the pressure value is less than the first lower threshold and greater than or equal to the second lower threshold, controlling the suction control component to decrease the suction speed; wherein, the first upper threshold is greater than the first lower threshold.

[0007] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the pressure control module controlling the suction speed of the suction control component according to the pressure value further includes: when the pressure value is less than or equal to the first upper threshold and greater than or equal to the first lower threshold, controlling the suction control component to maintain the current suction speed.

[0008] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the pressure control module controlling the shutdown of the medical water jet system includes:

[0009] When the pressure value is greater than the second upper threshold or the pressure value is less than the second lower threshold, the pressure control module outputs a shutdown signal to control the medical water jet system to stop outputting the jet.

[0010] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the water jet channel and / or the laser channel are located inside the suction channel.

[0011] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the axes of the water jet channel and the laser channel are parallel, and the water jet channel and the laser channel are respectively located on opposite sides of the suction channel in the radial direction.

[0012] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the water jet channel or the laser channel is located on the central axis of the insertion part.

[0013] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the outer diameter of the insertion part is R1, and the outer diameter of the suction channel is R2, where 0.4R1 ≤ R2 ≤ 0.6R1.

[0014] For example, the medical water jet system provided by at least one embodiment of the present disclosure further includes: an image control component, including a lens located at the distal end of the insertion part, and the image control component is configured to acquire an image through the lens; wherein, on the cross-section at the distal end of the insertion part, the centers of the lens, the water jet channel, and the laser channel are located on the same straight line in the radial direction.

[0015] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the suction control assembly further includes a water inlet channel that penetrates through the insertion part and the handle part. The water inlet channel is configured to output fluid. On the cross-section at the distal end of the insertion part, the water inlet channel and the pressure sensor are respectively located on opposite sides of the central connection line between the water jet channel and the laser channel, and the water inlet channel is away from the pressure sensor.

[0016] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the laser energy adopts at least one of green laser, holmium laser, thulium laser, and semiconductor laser.

[0017] For example, the medical water jet system provided by at least one embodiment of the present disclosure further includes a host part, and the host part includes a main control module. The main control module is communicatively connected to at least one of the laser assembly, the water jet assembly, the pressure control assembly, the image control assembly, and the suction control assembly.

[0018] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the water jet assembly further includes a nozzle connected to the distal end of the water jet channel. The nozzle includes a vibration cavity, and the vibration cavity includes a throat hole and a cavity located on the far side of the throat hole. The ratio of the diameter of the cavity to the diameter of the throat hole is between 10:1 and 1:1, and the diameter of the throat hole is smaller than the diameter of the distal end of the water jet channel.

[0019] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the nozzle includes a plurality of the vibration cavities connected in sequence from the proximal end to the distal end.

[0020] The medical water jet system provided by the present disclosure has the following beneficial effects: The medical water jet system of the embodiments of the present disclosure includes a water jet assembly, a laser assembly, and a suction control assembly, and can simultaneously achieve cutting and separating of tissues and hemostasis. On this basis, it also improves the efficiency of cutting and hemostasis, improves the surgical effect, significantly reduces the possible thermal damage to tissues, reduces complications and postoperative rehabilitation time. Further, the medical water jet system provided by some embodiments of the present disclosure has a clever layout of the water jet channel and the laser channel, which is more conducive to the doctor's observation and operation; the pressure control module controls the suction speed of the suction control assembly according to the pressure value, keeping the medical water jet system in a safe and stable working state, further reducing the patient's secondary injuries and complications, and improving the safety of surgery and operation. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] In order to more clearly illustrate the technical solutions of the embodiments of the present disclosure, the drawings of the embodiments will be briefly introduced below. Obviously, the drawings described below only relate to some embodiments of the present disclosure and do not limit the present disclosure.

[0022] Figure 1 Structural schematic diagram of a medical water jet instrument provided by at least one embodiment of the present disclosure;

[0023] Figure 2 Cross-sectional schematic diagram of the distal end of the insertion part of a medical water jet instrument provided by at least one embodiment of the present disclosure;

[0024] Figure 3 Overall framework diagram of a medical water jet instrument provided by at least one embodiment of the present disclosure;

[0025] Figure 4 Control logic diagram of the pressure control module of a medical water jet instrument provided by at least one embodiment of the present disclosure;

[0026] Figure 5 Another overall framework diagram of a medical water jet instrument provided by at least one embodiment of the present disclosure;

[0027] Figure 6 Arrangement schematic diagram of the water jet channel, laser channel and suction channel of a medical water jet instrument on the cross-section of the distal end of the insertion part provided by at least one embodiment of the present disclosure;

[0028] Figure 7 Another arrangement schematic diagram of the water jet channel, laser channel and suction channel of a medical water jet instrument on the cross-section of the distal end of the insertion part provided by at least one embodiment of the present disclosure;

[0029] Figure 8 and Figure 9 Structural schematic diagrams of two kinds of cavitation nozzles of a medical water jet instrument provided by at least one embodiment of the present disclosure respectively;

[0030] Figure 10 Experimental test results of the cavitation nozzle of a medical water jet instrument provided by at least one embodiment of the present disclosure;

[0031] Figure 11 Another structural schematic diagram of the cavitation nozzle of a medical water jet instrument provided by at least one embodiment of the present disclosure;

[0032] Figure 12 Structural schematic diagram of another medical water jet instrument provided by at least one embodiment of the present disclosure; and

[0033] Figure 13 is Figure 1 Enlarged schematic diagram of the medical water jet instrument in [reference number] circled by a dashed line. Detailed implementation manners

[0034] To make the objectives, technical solutions, and advantages of the embodiments of the present disclosure clearer, the technical solutions of the embodiments of the present disclosure will be clearly and completely described below with reference to the accompanying drawings of the embodiments of the present disclosure. Apparently, the described embodiments are only a part rather than all of the embodiments of the present disclosure. Based on the described embodiments of the present disclosure, all other embodiments obtained by those of ordinary skill in the art without creative efforts shall fall within the scope of protection of the present disclosure.

[0035] Unless otherwise defined, the technical terms or scientific terms used in the present disclosure shall have the ordinary meanings understood by those of ordinary skill in the art to which the present disclosure pertains. The terms "first", "second", and similar terms used in the present disclosure do not denote any order, quantity, or importance, but are only used to distinguish different components. The terms such as "comprising" or "including" mean that the elements or items appearing before this term cover the elements or items listed after this term and their equivalents, without excluding other elements or items. The terms such as "connected" or "coupled" are not limited to physical or mechanical connections, but may include electrical connections, whether direct or indirect. The terms such as "upper", "lower", "left", and "right" are only used to indicate relative positional relationships, and when the absolute position of the object being described changes, the relative positional relationship may also change accordingly.

[0036] In the embodiments of the present disclosure, the term "proximal" refers to the part of the component or structure involved that is close to the clinician, and the term "distal" refers to the part of the component or structure involved that is far from the clinician. The term "plurality" means two or more.

[0037] For the surgical treatment of benign prostatic hyperplasia, after the resection of the hyperplastic prostatic tissue, the stem cells within the surgical capsule will regenerate and transform into transitional epithelial cells to cover the new surface of the surgical capsule to form new epithelial tissue. Therefore, the protection of the surgical capsule surface during the operation is of great significance for the postoperative recovery of the patient.

[0038] However, currently, the resection methods for the resection of hyperplastic prostatic tissue in clinical practice often have thermal damage, which is likely to cause tissue cauterization and carbonization, resulting in a certain degree of damage to the surgical capsule and causing postoperative complications. At the same time, the learning curve of laser surgery is long and it is not easy for doctors to master.

[0039] In this regard, the surgical procedure using the water cavitation ablation technique has no risk of thermal damage and can protect the surgical capsule to a certain extent. Specifically, the water cavitation ablation technique utilizes a water jet to generate cavitation in a submerged flow state, and uses the energy generated by cavitation bubbles to effectively ablate glandular tissue while being able to retain structures such as blood vessels and the surgical capsule. The water ablation technique does not generate heat energy and is a tissue cutting and separation technique without thermal damage, but it is difficult to stop bleeding during ablation.

[0040] In addition, the existing components for prostate enucleation / resection surgery are numerous, and different surgical instruments often need to be replaced during the operation, resulting in cumbersome operations and prone to urethral injuries.

[0041] At least one embodiment of the present disclosure provides a medical water knife system. The medical water knife instrument has an insertion portion and a handle portion connected to the proximal end of the insertion portion, and includes a water knife assembly, a laser assembly, and a suction control assembly; the water knife assembly includes a water knife channel penetrating through the insertion portion and the handle portion, configured to output a jet; the laser assembly includes a laser channel penetrating through the insertion portion and the handle portion, configured to output laser energy; the suction control assembly includes a suction channel penetrating through the insertion portion and the handle portion, configured to suction fluid.

[0042] The medical water knife system provided by the embodiments of the present disclosure combines the water knife technology and the laser technology, can achieve prostate tissue resection without thermal damage, and simultaneously achieve hemostasis, which is of great significance for the protection of stem cells within the surgical capsule; in addition, the medical water knife instrument has functions such as water knife resection, laser hemostasis, and waste liquid collection at the same time, and can complete the entire operation with one instrument. The operator does not need to replace surgical instruments midway during the operation, and the operation is simple with a short learning curve.

[0043] The medical water knife instrument provided by the embodiments of the present disclosure will be described below through several specific embodiments.

[0044] At least one embodiment of the present disclosure provides a medical water knife instrument, Figure 1 showing a schematic structural diagram of the medical water knife instrument, Figure 2 showing a cross-sectional / end face schematic diagram of the distal end of the insertion portion of the medical water knife instrument, Figure 3 showing an overall framework diagram of the medical water knife instrument. As Figure 3 shown, the medical water knife system includes an operation part and a host part. The operation part, for example, includes as Figure 1The insertion part 12 shown and the handle part 11 connected to the proximal end of the insertion part 12. The insertion part 12 can enter the target area of the human body, for example, to perform corresponding operations; the handle part 11 can be grasped by the operator to control the insertion part 12. For example, the medical water jet system further includes a water jet component, a laser component, an image control component, a suction control component, etc. At least some of these components respectively include structures located in the operation part and control modules located in the host part.

[0045] For example, the water jet component includes a water jet channel 101 penetrating through the insertion part 12 and the handle part 11, which is used to convey the fluid forming the jet. The water jet component also includes a jet output module and a nozzle, for example. The nozzle is arranged at the distal end of the insertion part 12. The water jet component is configured to output a jet with a certain pressure through the cooperation of various structures of the water jet component, and can be used for crushing, resection, etc. of the treatment sites such as prostate tissue.

[0046] For example, the jet output module is configured to regulate the output pressure or output flow rate of the nozzle. For example, the jet is conveyed to the nozzle through a high-pressure pipe arranged in the water jet channel 101 to form a cavitation jet. For example, through control, the nozzle can produce a cavitation effect (introduced in detail later) under the submerged flow in the surgical environment, and the generated pressure range is 1 MPa to 15 MPa, such as 4 MPa to 6 MPa, such as 4 MPa, 4.5 MPa, 5 MPa, 5.5 MPa or 6 MPa, etc.

[0047] For example, the laser component includes a laser channel 201 penetrating through the insertion part 12 and the handle part 11. For example, it also includes a laser generating device (such as a laser), a laser output module, and a laser optical fiber arranged in the laser channel 201. The laser component is configured to output laser energy through the cooperation of the above various structures, and can be used for operations such as vaporization, cutting, hemostasis, etc. of the treatment sites such as prostate tissue.

[0048] For example, the laser output module is configured to regulate the output power, pulse energy, pulse frequency, indicated spot size, indicated optical power, etc. of the laser, and output laser energy through the laser optical fiber in the laser channel 201. For example, the laser optical fiber is a direct fiber.

[0049] For example, in some examples, the core diameter of the laser fiber is from 50 microns to 1000 microns, such as 50 microns, 100 microns, 200 microns, 300 microns, 400 microns, 500 microns, 550 microns, 600 microns, 700 microns, 800 microns, 900 microns or 1000 microns, etc. The laser fiber can be in various forms such as circular fiber, square fiber, annular fiber, etc. For example, the laser energy can be at least one of green laser, holmium laser, thulium laser, semiconductor laser, etc. For example, in one example, the type of laser used is thulium laser, and its central wavelength is 1940 nm ± 10 nm. Thulium laser can produce less thermal damage, reduce the damage to the surgical capsule, facilitate the differentiation of basal cells in the surgical capsule into urothelial cells after surgery, and accelerate wound repair.

[0050] For example, the image control component includes a lens 301. For example, it further includes an image control module. The proximal end of the insertion portion 12 is connected to the handle portion 11, and the lens 301 is located at the distal end of the insertion portion 12. The image control component is configured to acquire images.

[0051] For example, the image control module is configured to process the images collected by the lens 301 and output the processed information to a display for an operator, such as a doctor, to view.

[0052] For example, in some embodiments, the lens 301 may include an image sensor (such as a CMOS image sensor) and a light source, which are connected to an interface 302 through a connecting wire. The interface 302 of the lens 301 is connected to the image control module through a connecting wire for outputting the images captured in real time by the lens 301 or the processed images on a display, for example, so as to facilitate the operator to perform corresponding surgical operations. For example, as Figure 2 shown, the position of the lens 301 on the cross-section of the insertion portion 12 or on the end face of the distal end is at the 12 o'clock direction, and the viewing angle of the lens (i.e., the angle relative to the axial direction of the insertion portion 12) can be 12°, 30°, 45°, etc. For example, in some examples, the lens 301, the connecting wire, and the interface 302 can be used as an independent component and detachably installed in the insertion portion 12 and the handle portion 11. After use, it can be removed and reused after sterilization and other treatments.

[0053] For example, the aspiration control component includes an aspiration channel 401 that penetrates the insertion portion 12 and the handle portion 11. For example, it further includes an aspiration control module. The aspiration control component is configured to aspirate fluid, such as aspirating the waste liquid in the environment where the distal end of the insertion portion 12 is located.

[0054] As Figure 2As shown, for example, in some embodiments, the aspiration control assembly may further include a water inlet passage 601 that penetrates through the insertion portion 12 and the handle portion 11, configured to output a fluid, such as outputting the fluid in the direction of the distal end of the insertion portion 12, for example, for cleaning the prostate tissue waiting for treatment and structures such as the lens 301.

[0055] As Figure 2 shown, for example, the aspiration control module is configured to control the on / off and the flow rate of the fluid in the aspiration passage 401 or the water inlet passage 601, thereby realizing a safer and more timely flushing operation.

[0056] For example, the proximal end of the handle portion 11 provides interfaces for each component. As Figure 1 shown, the handle portion 11 includes a housing portion 111 and a gripping portion 112. The interface 202 corresponding to the laser passage 201 and the interface 102 corresponding to the water jet passage 101 extend from the housing portion 111 of the handle portion 11, and are respectively used to connect to a laser source and a fluid source.

[0057] For example, the interface 302 corresponding to the lens 301, the interface 402 corresponding to the aspiration passage 401, and the interface 602 corresponding to the water inlet passage 601 extend from the gripping portion 112 of the handle portion 11. For example, a tube body, such as a high-pressure tube, may be provided in the water inlet passage 601, and it is connected to a water source such as physiological saline through the interface 602. For example, one or more, such as two, water inlet passages 601 may be provided. Figure 2 As shown in one example. For example, a tube body, such as a negative pressure tube, may be provided in the aspiration passage 401, and its interface 402 is connected to a waste liquid tank through an aspiration pump and a collection device, for collecting tissues, waste liquids, etc. For example, referring to Figure 3 and 5 shown, the collection device can be used to collect the excised prostate tissue in vitro and can be used for tissue inspection after the operation.

[0058] For example, in some embodiments, in combination with Figure 2 and Figure 3 , the medical water jet instrument may further include a pressure control assembly. The pressure control assembly includes a pressure sensor 501 and a pressure control module communicatively connected to the pressure sensor. The pressure sensor 501 is located at the distal end of the insertion portion 12 and is configured to detect the pressure value of the fluid in the environment where the distal end of the insertion portion 12 is located, for example, for real-time monitoring and feedback to the pressure control module; the pressure control module is configured to receive the pressure value detected by the pressure sensor 501 and control the aspiration speed of the aspiration control assembly according to the pressure value.

[0059] For example, as Figure 2As shown, the pressure sensor 501 is disposed on the end face of the distal end of the insertion portion 12 to better measure the fluid pressure in the environment where the farthest end of the insertion portion 12 is located. For example, in some other embodiments, the pressure sensor 501 may also be disposed on the side surface of the distal end of the insertion portion 12, and the embodiments of the present disclosure do not specifically limit this.

[0060] For example, Figure 4 The control logic diagram of the pressure control module in the medical water jet instrument provided by at least one embodiment of the present disclosure is shown. In some embodiments, such as Figure 4 As shown, the pressure control module controls the suction speed of the suction control component according to the pressure value, including: when the pressure value is greater than the first upper limit threshold and less than or equal to the second upper limit threshold, controlling the suction control component to increase the suction speed; when the pressure value is lower than the first lower limit threshold and greater than or equal to the second lower limit threshold, controlling the suction control component to decrease the suction speed.

[0061] For example, in some embodiments, such as Figure 4 As shown, the pressure control module controls the suction speed of the suction control component and / or the jet of the water jet component according to the pressure value, and may further include: when the pressure value is greater than the second upper limit threshold, or the pressure value is lower than the second lower limit threshold, the pressure control module outputs a shutdown signal to control the medical water jet system to shut down. For example, the pressure control module (for example, through the main control module) outputs a shutdown signal to the water jet component, and the water jet component stops outputting the jet. In another embodiment, the pressure control module may also output a shutdown signal to the suction control component to control its water inlet channel 601 to stop outputting fluid. When the pressure value is less than or equal to the first upper limit threshold and the pressure value is greater than or equal to the first lower limit threshold, the suction control component is controlled to maintain the current suction speed.

[0062] For example, the first upper limit threshold is greater than the first lower limit threshold. The first upper limit threshold is the warning upper limit value, for example, 13 mmHg. If the pressure value is greater than this value, it may cause damage to the human body. Therefore, the pressure value needs to be controlled within this value. The second upper limit threshold is the limit upper limit value, for example, 30 mmHg. If the pressure value is greater than this value, there may be safety risks. Therefore, the pressure value cannot exceed this value. For example, the first lower limit threshold is the warning lower limit value, for example, 0 - 13 mmHg. If the pressure value is less than this value, it may cause damage to the human body. Therefore, the pressure value needs to be controlled above this value; the second lower limit threshold is the limit lower limit value, for example, 0 mmHg. If the pressure value is less than this value, there may be safety risks. Therefore, the pressure value cannot be lower than this value. Thus, through the above control method, for example, through the PID control method, the medical water jet instrument can be maintained in a safe and stable working state, improving the operation safety.

[0063] For example, in the specific control process, the control logic of the PID is that the pressure sensor 501 makes a measurement every certain period of time (for example, at intervals of 1 s, 1 ms, etc.), compares the pressure value detected by the current pressure sensor 501 with the pressure value detected by the pressure sensor 501 last time to obtain a pressure difference, calculates the negative pressure change value of the suction pump (such as a negative pressure pump) corresponding to the pressure difference through the PID, and then adjusts the suction negative pressure of the suction pump (such as a negative pressure pump) according to the negative pressure change value, thereby adjusting the suction speed; during specific control, the above process can be repeated until the pressure value detected by the pressure sensor 501 returns to the safe value range, that is, the range between the first upper limit threshold and the first lower limit threshold.

[0064] For example, the pressure control module can receive the pressure data from the pressure sensor 501 in real time and achieve feedback, regulation, and provide alarm or prompt information under the control logic as Figure 4 shown.

[0065] For example, the pressure control module can control the suction flow by directly controlling the negative pressure value of the suction pump of the suction component, thereby controlling different suction speeds. The embodiments of the present disclosure do not make specific limitations on this, as long as the effect of controlling the suction speed can be achieved.

[0066] The medical water jet system can achieve different suction speeds and can control the pressure of the fluid in the environment (patient treatment site, such as the bladder and urethra) where the distal end of the insertion part is located in real time, thereby reducing the secondary injuries and complications of the patient. For example, if the pressure value is too high and exceeds the pressure threshold for preventing backflow of the bladder-ureteral valve, the liquid will enter the kidney along the ureter, causing pressure damage to the kidney; in addition, in the working environment where the distal end of the insertion part is located, some venous blood vessels are in an open state, and if the pressure is too high, it is easy to cause venous reflux and cause complications. Therefore, by controlling the suction speed in real time according to the pressure value of the fluid in the environment where the distal end of the insertion part is located, the urethra can be maintained in a relatively constant liquid environment to ensure the safety of the operation.

[0067] For example, in some embodiments, as Figure 3 shown, the host part may further include a main control module, and the main control module is communicatively connected to at least one of the laser component, the water jet component, the pressure control component, the image control component, and the suction control component. For example, the main control module is communicatively connected to the laser output module, the jet output module, the pressure control module, the image control module, and the suction control module, etc. For example, according to various control instructions of the operator, such as a doctor, such as control information input from control buttons, foot pedals, etc., the main control module can perform on-off control or parameter adjustment on each module, or, it can also perform feedback control, etc. according to the feedback information of the module.

[0068] For example, in other embodiments, as Figure 5As shown, the host part may not include a laser output module. At this time, the host part can be compatible with and connected to the existing laser treatment equipment in the hospital. The laser treatment equipment can be connected by using the laser channel 201 provided by the medical water jet instrument. At this time, the control of the laser equipment can be controlled by its own foot pedal and control buttons or keys. Thus, the functions of the laser assembly can also be realized.

[0069] For example, the water jet channel 101 and / or the laser channel 201 are located inside the suction channel 401; in some embodiments, as Figure 2 shown, the water jet channel 101 is located inside the suction channel 401. For example, in some embodiments, the laser channel 201 is located inside the suction channel 401. For example, in some embodiments, both the water jet channel 101 and the laser channel 201 are located inside the suction channel 401. Thus, a certain traction force can be formed on the tissue by using the suction force of the suction channel 401 to hold the tissue and prevent the water jet cavitation jet from blowing the tissue away; on the other hand, this setting can make the space occupied by the suction channel 401 larger to achieve a better suction effect.

[0070] For example, the water jet channel 101 or the laser channel 201 is located on the central axis of the insertion part 12. For example, in Figure 2 the embodiment, the water jet channel 101 is located on the central axis of the insertion part 12, and the position of the laser channel 201 is at the 6 o'clock direction in the cross-section of the insertion part 12. The water jet channel 101 being arranged at the middle position of the insertion part 12 can facilitate the balance during the operation at the water jet nozzle. The laser channel 201 is located beside the water jet channel 101 to facilitate the realization of auxiliary functions such as hemostasis; for example, in some other examples, the positions of the water jet channel 101 and the laser channel 201 can also be interchanged. If the positions are set randomly, the water jet channel 101 or the laser channel 201 needs to extend a relatively long length from the distal end face of the insertion part 12 to be exposed in the doctor's field of view, which affects the doctor's surgical operation. In addition, if the water jet channel 101 or the laser channel 201 is at the edge of the field of view, it is also not conducive to the doctor observing the state of the tissue during ablation.

[0071] For example, in some embodiments, as Figure 2 shown, the axes of the water jet channel 101 and the laser channel 201 are parallel, and the water jet channel 101 and the laser channel 201 are respectively located on the opposite sides of the suction channel 401 along the radial direction. Thus, when switching between cutting and coagulation, that is, when switching between the water jet operation and the laser operation, since the energy of each operation needs to be placed at the center of the field of view, through the above setting, the movement of the insertion part 12 of the operation handle during the cutting and coagulation switching can be minimized, and at the same time, the rotation of the insertion part 12 can be avoided.

[0072] For example, Figure 6Shows a schematic layout diagram of the water jet channel 101, the laser channel 201, and the suction channel 401 on the cross-section / end face at the distal end of the insertion portion 12. In some embodiments, in combination with Figure 2 and Figure 6 , on the cross-section / end face at the distal end of the insertion portion 12, the center O1 of the lens 301, the center O2 of the water jet channel 101, and the center O3 of the laser channel 201 are located on the same straight line radially, as shown by the dashed line in Figure 6 . Thus, the lens 301 can be directly opposite the water jet channel 101 and the laser channel 201, enabling the operator to fully observe and control the working states of the water jet assembly and the laser assembly.

[0073] For example, in some embodiments, in combination with Figure 2 and Figure 6 , on the cross-section / end face at the distal end of the insertion portion 12, the water inlet channel 601 and the pressure sensor 501 are located on opposite sides of the above-mentioned same straight line (such as the dashed line in Figure 6 ), that is, on opposite sides of the center connection line of the water jet channel 101 and the laser channel 201, and the water inlet channel 601 is far from the pressure sensor 501. Thus, the pressure sensor 501 is spaced from the water inlet channel 601, which can prevent the fluid pressure of the water inlet channel 601 from affecting the detection of the pressure sensor 501.

[0074] For example, Figure 7 shows another schematic layout diagram of the water jet channel 101, the laser channel 201, and the suction channel 401 on the cross-section / end face at the distal end of the insertion portion 12. As shown in Figure 7 , in some other embodiments, the water jet channel 101 is located inside the suction channel 401, and the laser channel 201 is located outside the suction channel 401. At this time, the water jet channel 101 and the laser channel 201 are respectively located on opposite sides of the suction channel 401 radially. At this time, the suction force of the suction channel 401 can also form a certain traction force on the tissue, sucking the tissue to prevent the water jet cavitation jet from blowing the tissue away.

[0075] For example, in some embodiments, referring to Figure 7 , the outer diameter of the insertion portion 12 is R1, and the outer diameter of the suction channel 401 is R2, 0.4R1 ≤ R2 ≤ 0.6R1, for example, R2 = 0.5R1. Thus, the suction channel 401 occupies more space in the insertion portion 12, and a better suction effect can be achieved. For example, in some examples, the outer diameter R2 of the insertion portion 12 is 20F - 26F (French, 1 French = 1 / 3 mm), such as 20F, 21F, 22F, 23F, 24F, 25F, or 26F, etc., and R1 is, for example, 7 mm - 9 mm.

[0076] For example, in some embodiments, the nozzle 103 of the water jet assembly can be assembled or disassembled as an independent component on the water jet channel 101 at the distal end of the insertion part 12.

[0077] For example, in some embodiments, the nozzle 103 is a cavitation nozzle, and the cavitation nozzle has an oscillation chamber. For example, a single-stage or multi-stage oscillation chamber design can be adopted, and the multi-stage oscillation chamber design can produce a better cavitation effect than the single-stage oscillation chamber.

[0078] For example, Figure 8 and Figure 9 respectively show schematic structural diagrams of two types of cavitation nozzles. Figure 8 and Figure 9 The oscillation chambers of the cavitation nozzles adopt different structures. In Figure 8 , the oscillation chamber includes a throat hole Q1 and a cavity Q2' located distally of the throat hole Q1. The cavity structures on both sides of the throat hole Q1 are different. The cavity Q2 (i.e., the distal cavity of the water jet channel 101) located on the upper side (i.e., the proximal end) is columnar, and the cavity Q2' located on the lower side (i.e., the distal end) is conical; in Figure 9 , the cavity Q2' distally of the throat hole Q1 has the same structure as the distal cavity Q2 of the water jet channel 101, both being columnar. For example, Figure 8 and Figure 9 show a single-stage oscillation chamber. During use, multiple oscillation chambers can be connected in series in sequence from the proximal end to the distal end, that is, in series, to form a multi-stage oscillation chamber, thereby achieving a better cavitation effect.

[0079] For example, when the high-pressure water flow passes through the cavity Q2 at the distal end of the water jet channel 101, through the throat hole Q1, and reaches the cavity Q2' of the oscillation chamber, the space expands sharply, the pressure decreases instantaneously, the gas dissolved in the water flow will release small bubbles from the fluid and continue to grow, forming a cavitation bubble cluster (appearing like many cavitation bubbles), until it detaches and ruptures, that is, the cavitation effect is generated. These bubbles can ablate tissues.

[0080] For example, in some embodiments, as shown in Figure 8 and Figure 9 , assuming the diameter of the cavity Q2' of the oscillation chamber is b (in Figure 8 , the value of the diameter b gradually increases from the proximal end to the distal end along the axial direction), and the diameter of the throat hole Q1 is d, then the value of b:d can be between 10:1 and 1:1, such as 10:1, 8:1, 7:1, 6:1, 5:1, 4:1, 3:1, or 1:1, etc. For example, the diameter d of the throat hole Q1 is smaller than the diameter of the distal cavity Q2 of the water jet channel 101.

[0081] The jet ejected from the nozzle generates cavitation in the liquid environment. The part of the jet with cavitation bubbles is simply referred to as the vapor plume, which has the function of cutting tissue. By experimentally detecting water jet nozzles with different b:d values, Figure 10 shows the results of the experimental detection, as Figure 10 shown. Under the same test conditions, that is, when the water pressure generated by the nozzle is 5 MPa and the flow rate is 3.3 mL / min, only changing the b:d value. For example, when the value of d is selected as 0.25 mm and only the value of b is changed. When b is 0.75 mm and the b / d ratio is 3:1, the length of the vapor plume obtained is 14 mm; when b is 1.6 mm and the b / d ratio is 6.4:1, the length of the vapor plume obtained is 13 mm; when b is 1.25 mm and the b / d ratio is 5:1, the length of the vapor plume obtained is 17 mm. That is, when the b / d ratio is 5:1, the length of the vapor plume obtained is the longest, and a better cavitation effect can be achieved.

[0082] For example, in actual operation, the length of the vapor plume generated by the cavitation nozzle under submerged flow can reach 2 mm to 20 mm, such as 2 mm to 10 mm, such as 2 mm to 5 mm. At this time, the vapor plume generated by the cavitation nozzle is less likely to cause secondary damage and has a larger ablation area.

[0083] For example, in some embodiments, the jet direction of the cavitation jet of the water jet nozzle is parallel to the axis direction of the insertion part 12; for example, in some other embodiments, as Figure 11 shown, the jet direction of the cavitation jet of the water jet nozzle has an angle α with the axis direction of the insertion part 12. The angle α is, for example, 10°, 12°, 20°, 30°, 45°, 90°, 12°, 180°, etc. For example, the jet direction of the nozzle cavitation jet is the same as the extension direction of the throat hole Q1 of the oscillation cavity. Therefore, the jet direction of the nozzle cavitation jet can be adjusted by designing the throat hole Q1.

[0084] For example, Figure 13 shows Figure 1 an enlarged schematic view of the medical water jet instrument in the dotted line box. In some embodiments, as Figure 13 shown, the end face of the distal end of the insertion part 12 is arranged at an angle with the axis direction of the insertion part 12. Let the angle between the perpendicular line of the end face of the distal end of the insertion part 12 and the axis direction of the insertion part 12 be β, then β can be 12° to 45°, such as 12°, 30° or 45°, etc. This angle is more convenient for the operator to view and operate on the surgical area.

[0085] For example, Figure 12 shows a schematic structural diagram of another medical water jet instrument provided by at least one embodiment of the present disclosure, as Figure 12As shown, in some embodiments, the proximal end of the laser channel 201 or the water jet channel 101 has a water stop valve A. The water stop valve A can allow the laser optical fiber in the laser channel 201 or the pipeline connected to the water jet nozzle to pass through the corresponding channel, and at the same time can prevent the liquid or fragmented tissue in the surgical area from flowing out through this channel. For example, the insertion part 12 can penetrate through the handle part 11, and the part of the insertion part 12 located within the handle part 11 is labeled as B.

[0086] For example, the medical water jet instrument provided by the embodiments of the present disclosure can be used for surgical treatments such as prostate hyperplasia, bladder stones, bladder tumors, uterine fibroids, etc. During the treatment process, the jet flow of the water jet can be used to break and selectively excise tissues. This process is fast and efficient, and can excise hyperplastic tissues without thermal damage, protecting the surgical capsule and reducing surgical complications; at the same time, laser energy can be used to cut, coagulate, and vaporize tissues to ensure the hemostasis effect; on the other hand, by designing the laser and water jet technologies in the same instrument, hemostasis can be achieved while breaking and ablating tissues with laser energy, and the thermal damage generated by the laser can be reduced by the water jet. The two achieve a synergistic effect, reducing complications and postoperative recovery time, and significantly improving the treatment effect; on the other hand, doctors do not need to replace instruments during the surgical process, reducing the surgical steps and avoiding the damage to the urethra caused by instrument replacement; on yet another hand, using the lens to provide real-time vision images for the surgery can facilitate the precise conduct of the surgery, and using the pressure sensor can control the pressure in the bladder and urethra, reducing the secondary injuries and complications of patients; moreover, the medical water jet instrument also has the function of flushing positions such as the lens and the surgical area, and also has the function of sucking the flushing waste liquid, tissue debris, excised tissues, etc. generated during the surgery. This medical water jet instrument integrates multiple functions into one, avoiding the replacement of instruments during the surgical process, thereby improving the surgical efficiency.

[0087] There are also the following points to note:

[0088] (1) The drawings of the embodiments of the present disclosure only relate to the structures involved in the embodiments of the present disclosure, and other structures can refer to the general design.

[0089] (2) For clarity, in the drawings used to describe the embodiments of the present disclosure, the thickness of the layer or region is enlarged or reduced, that is, these drawings are not drawn according to the actual scale.

[0090] (3) Without conflict, the embodiments of the present disclosure and the features in the embodiments can be combined with each other to obtain new embodiments.

[0091] The above is only the specific implementation manner of the present disclosure, but the protection scope of the present disclosure is not limited thereto. The protection scope of the present disclosure should be subject to the protection scope of the claims.

Claims

1. A medical water jet system, characterized in that: The medical water jet system has an insertion portion and a handle portion connected to the proximal end of the insertion portion, and the medical water jet system includes: A water jet assembly, including a water jet channel extending through the insert portion and the handle portion, configured to output a jet; a laser assembly, comprising a laser channel penetrating the insertion portion and the handle portion, configured to output laser energy; and The suction control assembly includes a suction channel passing through the insertion portion and the handle portion, and is configured to suction fluid.

2. The medical water jet system according to claim 1, characterized in that: Also includes: A pressure control assembly includes a pressure sensor and a pressure control module in communication with the pressure sensor. Wherein, the pressure sensor is located at the distal end of the insertion portion, and is configured to detect the pressure value of the fluid in the environment where the distal end of the insertion portion is located, and feed back to the pressure control module; The pressure control module is configured to receive the pressure value detected by the pressure sensor, and control the suction speed of the suction control assembly and / or control the medical water jet system to shut down according to the pressure value.

3. The medical water jet system according to claim 2, characterized in that: The pressure control module controls the suction speed of the suction control component according to the pressure value, including: When the pressure value is greater than a first upper threshold value and less than or equal to a second upper threshold value, controlling the suction control component to increase the suction speed; When the pressure value is less than a first lower threshold value and greater than or equal to a second lower threshold value, controlling the suction control component to reduce the suction speed; Among them, the first upper limit threshold is greater than the first lower limit threshold.

4. The medical water jet system according to claim 3, characterized in that: The pressure control module controls the suction speed of the suction control component according to the pressure value, and further comprises: When the pressure value is less than or equal to the first upper threshold value, and the pressure value is greater than or equal to the first lower threshold value, the suction control component is controlled to maintain a current suction speed.

5. The medical water jet system according to claim 2, characterized in that: The pressure control module controls the medical water jet system to stop according to the pressure value, including: When the pressure value is greater than a second upper threshold value, or when the pressure value is less than a second lower threshold value, the pressure control module outputs a shutdown signal to control the medical water jet system to stop outputting a jet.

6. The medical water jet system according to any one of claims 1 to 5, characterized in that: The water jet channel and / or the laser channel is located inside the suction channel.

7. The medical water jet system according to claim 6, characterized in that: The axes of the water jet channel and the laser channel are parallel, and the water jet channel and the laser channel are respectively located on opposite sides of the suction channel in the radial direction.

8. The medical water jet system according to claim 6, characterized in that: The water jet channel or the laser channel is located on the central axis of the insertion portion.

9. The medical water jet system according to any one of claims 1 to 5, characterized in that: The outer diameter of the insertion portion is R1, the outer diameter of the suction channel is R2, and 0.4R1≤R2≤0.6R1.

10. The medical water jet system according to any one of claims 2 to 5, characterized in that: Also includes: an image control assembly, comprising a lens located at a distal end of the insertion portion, the image control assembly being configured to acquire an image through the lens; Wherein, on the cross section of the distal end of the insertion portion, the center of the lens, the center of the water jet channel and the center of the laser channel are located on the same straight line in the radial direction.

11. The medical water jet system according to any one of claims 2 to 5, characterized in that: The suction control assembly further includes a water inlet channel that passes through the insertion portion and the handle portion, and the water inlet channel is configured to output fluid. In the cross section of the distal end of the insertion portion, the water inlet channel and the pressure sensor are respectively located on opposite sides of a center line connecting the water jet channel and the laser channel, and the water inlet channel is far away from the pressure sensor.

12. The medical water jet system according to claim 1, characterized in that: The laser energy adopts at least one of green laser, holmium laser, thulium laser and semiconductor laser.

13. The medical water jet system according to claim 10, characterized in that: It also includes a host part, which includes a main control module. The main control module is communicatively connected with at least one of the laser component, the water jet component, the pressure control component, the image control component and the suction control component.

14. The medical water jet system according to any one of claims 1 to 5, characterized in that: The water jet assembly also includes a nozzle connected to the distal end of the water jet channel. The nozzle includes an oscillation chamber, which includes a throat hole and a cavity located far away from the throat hole. The ratio of the diameter of the cavity to the diameter of the throat hole is between 10:1 and 1:1, and the diameter of the throat hole is smaller than the diameter of the far end of the water jet channel.

15. The medical water jet system according to claim 14, characterized in that: The nozzle includes a plurality of the oscillation chambers connected in sequence from the proximal end to the distal end.

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