Peritoneal cavity puncture device and puncture method

Abstract

The present invention provides a peritoneal cavity puncture device, comprising a needle sleeve, the needle sleeve comprising a needle sleeve sleeve tube and a needle sleeve seat, the needle sleeve sleeve tube comprising a sleeve front end and a sleeve rear end, the needle sleeve seat being disposed at the sleeve rear end, the side wall of the sleeve front end being provided with a plurality of elongated side holes, and the sleeve front end varying from thick to thin; a needle core, the needle core comprising a needle body and a needle core seat, the needle body comprising a needle body front end and a needle body rear end, the needle core seat being connected to the needle body rear end, and the needle body front end being provided with an inclined surface; and a Y-type valve, the Y-type valve comprising a main pipe and a branch pipe, one end of the main pipe being compatible with the needle core seat and the needle sleeve seat. The present invention also provides a puncture method for the puncture device. The peritoneal cavity puncture and method provided by the present invention can improve the success rate of peritoneal cavity puncture.

Description

Technical Field

[0001] The present invention relates to the field of medical devices, and in particular to a peritoneal cavity puncture device and a puncture method. Background Art

[0002] The human peritoneal cavity is composed of two layers of peritoneum (the parietal peritoneum and the visceral peritoneum), forming an irregular, enclosed potential space. These two layers are closely adjacent to each other and normally contain minimal serous fluid, no gas, and maintain a slight positive or negative pressure. In clinical practice, percutaneous access to the peritoneal cavity is often required for procedures such as percutaneous placement of an indwelling catheter for hyperthermic peritoneal perfusion therapy, implantation of a peritoneal chemotherapy pump, and the initial dissection of the peritoneal cavity during laparoscopy. Previously, these procedures often involved incisions through the abdominal wall layer by layer, which was highly invasive. However, with the recent development of minimally invasive techniques, percutaneous access to the peritoneal cavity has reduced trauma.

[0003] Because the peritoneum is extremely thin (less than 0.1 mm), the two layers fit tightly together, leaving virtually no gap between them. Under normal circumstances, percutaneous puncture into this space is not only difficult but can also easily damage subperitoneal organs. In the presence of a large ascites, the fluid separates the peritoneal cavity, which can be clearly seen on ultrasound. Under ultrasound guidance, a standard puncture needle can penetrate the parietal peritoneum and enter the fluid, effectively entering the peritoneal cavity. Therefore, clinical procedures such as percutaneous peritoneal catheterization are often performed in the presence of ascites.

[0004] The existing puncture device is a puncture needle with a beveled needle head. During puncture, gravity water is introduced from the tail end of the puncture needle. Figure 1 The ideal state of puncture is that the bevel 2 of the needle 1 is located exactly between the parietal peritoneum 3 and the visceral peritoneum 4. Gravity water flows from the bevel 2 of the needle 1 into the space between the parietal peritoneum and the visceral peritoneum ( Figure 1 The arrows in the figure indicate the direction of water flow), using water pressure to expand the peritoneal cavity. However, in practice, the double peritoneum is a relatively strong and resilient membrane. A conventional puncture needle pushes forward against the double peritoneum, puncturing it in an "umbrella" shape. This puncture is not detectable externally, and the needle often continues forward, penetrating both layers simultaneously. The bevel of the needle 1 is often positioned below both layers. When the bevel of the needle penetrates the peritoneum, gravity prevents water from entering the peritoneal cavity. At this point, the needle must be withdrawn a certain distance to position the bevel between the parietal and visceral peritoneum. However, in most cases, the needle bevel is very short (approximately 1 mm), making it extremely difficult for the physician to manually withdraw the needle this short distance. Consequently, the probability of the needle bevel being positioned precisely between the parietal and visceral peritoneum is very small, resulting in a very low success rate for peritoneal puncture. Summary of the Invention

[0005] According to one aspect of the present invention, there is provided a peritoneal cavity puncture device, comprising:

[0006] The needle sleeve includes a needle sleeve sleeve and a needle sleeve seat. The needle sleeve sleeve includes a sleeve front end and a sleeve tail end. The needle sleeve seat is arranged at the sleeve tail end. The side wall of the sleeve front end is provided with a plurality of long strip side holes. The sleeve front end changes from thick to thin.

[0007] The needle core comprises a needle body and a needle core seat, the needle body comprises a front end and a rear end, the needle core seat is connected to the rear end of the needle body, and the front end of the needle body is provided with an inclined surface; and

[0008] Y-type valve, the Y-type valve includes a main pipe and a branch pipe, one end of the main pipe can be adapted to the needle core seat and the needle sleeve seat.

[0009] The beneficial effects of the trocar of this embodiment are as follows: the design of the needle sleeve, the long strip side hole and the front end of the needle sleeve from thick to thin increases the chance of gravity water entering the peritoneal cavity, thereby improving the success rate of puncture.

[0010] In certain embodiments, a cannula outlet is provided on an end surface of the front end of the cannula, and the side hole extends to the cannula outlet.

[0011] In certain embodiments, the front end of the cannula is flat-headed. The flat-head design can prevent the puncture device from damaging subperitoneal organs, thereby avoiding and reducing serious complications.

[0012] In certain embodiments, the side holes are 5 mm in length.

[0013] In some embodiments, the outer side of the front end of the sleeve is bullet-shaped.

[0014] In some embodiments, a back hole is provided at the front end of the needle body, and the back hole is provided on a side opposite to the inclined surface.

[0015] In certain embodiments, when the puncture device is in an assembled state, the needle sleeve seat is connected to the needle core seat, and the needle core seat is connected to the main pipe of the Y-type valve.

[0016] In certain embodiments, the number of side holes is 2-4.

[0017] A puncture method using a peritoneal cavity puncture device comprises the following steps:

[0018] S1: Assemble the needle sheath, needle core, and Y-type valve, and connect the branch of the Y-type valve to the extracorporeal gravity drip system;

[0019] S2: Under ultrasound monitoring, puncture the peritoneum. If water drips into the peritoneal cavity, introduce the first J-type guidewire matched with the needle core from the main tube of the Y-type valve. After the first J-type guidewire enters the peritoneal cavity, withdraw the needle sheath and needle core, and leave the first J-type guidewire in the peritoneal cavity. If no water drips into the peritoneal cavity, when the puncture device approaches the abdominal intestinal tract and other organs under ultrasound monitoring, pull out the needle core, connect the needle sheath seat with the Y-type valve, and then gradually retract the needle sheath until water drips into the peritoneal cavity. Then, introduce the second J-type guidewire matched with the needle sheath through the main tube of the Y-type valve, and the second J-type guidewire enters the peritoneal cavity from the sheath outlet or side hole.

[0020] The method for using the trocar of this embodiment has a high puncture success rate. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] Figure 1 Schematic diagram of existing peritoneal cavity puncture methods.

[0022] Figure 2 This is a schematic diagram of a trocar in an assembled state according to an embodiment of the present disclosure.

[0023] Figure 3 Schematic diagram of a needle cover of a puncture device according to an embodiment of the present disclosure.

[0024] Figure 4 Cut along AA plane Figure 3 Schematic diagram of the front end of the cannula obtained by the needle sleeve shown.

[0025] Figure 5 Schematic diagram of the needle core of the puncture device according to one embodiment of the present disclosure.

[0026] Figure 6 Cut along BB plane Figure 5 Schematic diagram of the front end of the needle body obtained by the needle core shown.

[0027] Figure 7 This is a first state diagram of the trocar according to an embodiment of the present disclosure.

[0028] Figure 8 This is a schematic diagram of the state of the puncture device according to one embodiment of the present disclosure when it pierces the peritoneum without dripping.

[0029] Figure 9 For Figure 8 Schematic diagram of the state of further slowly pushing the puncture device based on the state shown.

[0030] Figure 10 This is a diagram of the state when the guide wire is introduced after the needle sheath is retracted until the peritoneum is separated and water dripping occurs.

[0031] Needle sleeve 100: needle sleeve cannula 101, needle sleeve seat 102, cannula front end 103, cannula tail end 104, needle sleeve lumen 105, side hole 106, cannula outlet 107

[0032] Needle core 200: needle body 201, needle core seat 202, needle body front end 203, needle body tail end 204, needle body lumen 205, back hole 206, inclined surface 207

[0033] Y-type valve 300: main pipe 301 and branch pipe 302 DETAILED DESCRIPTION

[0034] The present invention will be further described in detail below with reference to the accompanying drawings.

[0035] Please refer to Figure 2 In various embodiments of the present invention, the peritoneal cavity puncture device includes a needle sheath 100 , a needle core 200 and a Y-type valve 300 .

[0036] Please refer to Figure 3-4 The needle cannula 100 comprises a cannula 101 and a cannula seat 102. The cannula 101 is a hollow tubular structure, defining a cannula lumen 105 therein. The cannula lumen 105 extends throughout the cannula 101, and the diameter of any cross-section of the cannula lumen 105 is uniform. The cannula 101 comprises a cannula front end 103 and a cannula rear end 104, with the cannula seat 102 disposed at the cannula rear end 104. The cannula front end 103 has a thick-to-thin design. Specifically, the cross-sectional outer diameter of the cannula front end 103 gradually decreases from larger to smaller along the direction proximal to the cannula front end 103. The outer surface of the cannula front end 103 is streamlined, for example, in the shape of a bullet. The cannula front end 103 has a flat end face and is provided with a cannula outlet 107. The sidewall of the cannula front end 103 is provided with a side hole 106. Specifically, the side holes 106 are elongated and extend along the sidewall of the cannula front end 103 to the cannula outlet 107. The side holes 106 are elongated holes of appropriate length, for example, the length of the side holes 106 can be selected to be 5-10 mm. The number of side holes 106 can be one, two, three, four, or more.

[0037] Please refer to Figure 5-6 The needle core 200 includes a needle body 201 and a needle core seat 202. The needle body 201 is a hollow tubular structure, the interior of which is a needle body lumen 205. The outer diameter of the needle body 201 is slightly smaller than the needle cannula lumen 105 to ensure that the needle body 201 can be inserted into the needle cannula lumen 105, and the outer wall of the needle body 201 is in contact with or approximately in contact with the inner wall of the needle cannula lumen 105. The needle body 201 includes a needle body front end 203 and a needle body tail end 204, and the needle core seat 202 is connected to the needle body tail end 204. The needle body front end 203 has a bevel 207, which makes the needle body front end 203 sharp, making it easier for the needle core 200 to puncture the peritoneum.

[0038] Please refer to Figure 2The Y-shaped valve 300 comprises a main tube 301 and a branch tube 302 connected to the side of the main tube 301, forming a roughly Y-shape. The ends of the main tube 301 are designed to fit within the needle holder 102 and the needle core holder 202. A silicone diaphragm is provided within the main tube 301, with a central hole for the guidewire to enter. Once the guidewire is inserted, the hole seals due to the properties of the silicone, preventing water leakage.

[0039] In certain embodiments, see Figure 6 The front end 203 of the needle body is provided with a back hole 206. The back hole 206 is arranged on the side opposite to the inclined surface 207. The back hole 206 increases the chance of gravity water and the guide wire entering the peritoneal cavity from the front end 203 of the needle body.

[0040] Referring to Figure 1, the needle core 200 is inserted into the cannula lumen 105. The needle core holder 202 is connected to the cannula holder 102, and the main tube 301 of the Y-shaped valve 300 is connected to the needle core holder 202. The needle tip 203 extends from the cannula outlet 107, allowing the tip of the bevel 207 to be exposed outside the needle cannula 100, facilitating puncture of the peritoneum by the puncture device. However, the exposed tip of the needle front end 203 should not be too long, generally 1-1.5 mm is sufficient, to avoid damage to the subperitoneal intestine and other internal organs caused by excessive exposure when the cannula front end 103 penetrates the peritoneum. Luer connectors can be used to connect the needle core holder 202 to the needle cannula holder 102, and the main tube 301 of the Y-shaped valve 300 to the needle core holder 202. This prevents the components from disengaging during puncture and also prevents microscopic leakage of fluid.

[0041] According to another aspect of the present invention, a puncture method using a peritoneal cavity puncture device is provided:

[0042] S1: Assemble the needle sheath 100, the needle core 200 and the Y-type valve 300, and connect the branch tube 302 of the Y-type valve 300 to an extracorporeal gravity drip;

[0043] S2: Under ultrasound monitoring, the puncture device is inserted into the peritoneum. If water drips into the peritoneal cavity, the first J-shaped guide wire 400 matched with the needle core 200 is introduced from the main tube 301 of the Y-shaped valve 300. After the first J-shaped guide wire 400 enters the peritoneal cavity, the needle sheath 100 and the needle core 200 are withdrawn, and the first J-shaped guide wire 400 is retained in the peritoneal cavity. If no water drips into the peritoneal cavity, when the puncture device approaches the abdominal intestinal tract and other organs under ultrasound monitoring, the needle core 200 is pulled out, the needle sheath seat 102 is connected to the Y-shaped valve 300, and then the needle sheath 200 is gradually retracted until water drips into the peritoneal cavity. Then, the second J-shaped guide wire 500 matched with the needle sheath 200 is introduced through the main tube 301 of the Y-shaped valve 300, and the second J-shaped guide wire 500 enters the peritoneal cavity from the sheath outlet 107 or the side hole 106.

[0044] In step S1 , the needle core 200 is inserted into the needle sheath 100 , and the needle core seat 202 is connected to the needle sheath seat 102 , the Y-shaped valve 300 is connected to the needle core seat 202 , and the branch tube 302 is connected to an extracorporeal gravity drip.

[0045] Before reaching the peritoneum and after penetrating the peritoneum, no obvious dripping of water by gravity is observed in vitro because there is no cavity in tissues such as skin and subcutaneous fat. Only when the inclined surface 207 or the dorsal hole 206 is aligned with the gap between the parietal peritoneum and the visceral peritoneum can the water by gravity enter the peritoneal cavity, and obvious dripping can be observed in vitro.

[0046] Slow puncture of the peritoneal cavity may lead to the following two possibilities:

[0047] Please refer to Figure 7 The first possibility is that the bevel 207 or dorsal hole 206 is located exactly on the peritoneum, that is, the bevel 207 or dorsal hole 206 is connected to the peritoneal cavity, and gravity water enters the peritoneal cavity, which can be clearly seen dripping in vitro, and the dripping water separates the two layers of peritoneum. In this case, it is only necessary to introduce the first J-shaped guidewire 400 matched with the needle core 200 through the main tube 301 into the needle body lumen 205. After the first J-shaped guidewire 400 enters the peritoneal cavity through the bevel 207 or dorsal hole 206, the needle guard 100 and needle core 200 are withdrawn, and the first J-shaped guidewire 400 remains in the peritoneal cavity.

[0048] Please refer to Figure 8 The second possibility is that the inclined plane 207 crosses two layers of peritoneum, and gravity water cannot enter the peritoneal cavity. For this situation, please combine Figure 9-10 Under ultrasound monitoring, the trocar is slowly advanced, causing the peritoneum to move toward the thick end of the cannula front end 103. When the trocar approaches the abdominal cavity, intestines, or other internal organs, the needle core 200 is removed, the needle guard 100 is connected to the Y-valve 300, and the needle guard 100 is slowly retracted. If dripping is observed externally, retraction is stopped. At this point, the side hole 106 or the cannula outlet 107 is aligned with the position where the parietal peritoneum and visceral peritoneum meet, indicating that the side hole 106 or the cannula outlet 107 is in communication with the peritoneal cavity, allowing gravity-fed water to enter. A second J-shaped guidewire 500, compatible with the needle guard 200, is then introduced through the main tube 301 of the Y-valve 300 and enters the peritoneal cavity through the side hole 106 or the cannula outlet 107. Since most of the abdominal organs are in a state of motion (such as breathing, intestinal peristalsis, etc.), the patient's slight movement and the next operation (such as changing instruments, etc.) require time, the front end 103 of the cannula has no sharp corners, which can prevent the organs from being damaged by the needle sheath 100 during movement, thereby avoiding and reducing serious complications.

[0049] The side hole 106 of the front end 103 of the cannula and the design from thick to thin are conducive to separating the peritoneal cavity and increasing the chance of gravity water entering the peritoneal cavity. This is specifically manifested in the following aspects: (1) The thick end of the front end 103 of the cannula is located in the parietal peritoneum, and the thin end is located in the visceral peritoneum. After penetrating the two layers of peritoneum, the friction between the thick end and the thin end and the peritoneum is equal. However, during the process of retracting the needle sleeve 100, the friction between the thin end and the peritoneum (especially the visceral peritoneum in contact with it) gradually decreases, while the friction between the thick end and the parietal peritoneum is greater than the friction between the thin end and the peritoneum. The visceral peritoneum is removed from the gradually tapering thin end, making it easier to separate the two layers of peritoneum; (2) The long side hole 106 is easier to communicate with the peritoneal cavity, which is more conducive to dripping water into the peritoneal cavity to separate the peritoneal cavity, and is also more conducive to the matching second J-type guide wire 500 entering the peritoneal cavity.

[0050] The above are only some embodiments of the present invention. For those skilled in the art, several modifications and improvements can be made without departing from the inventive concept of the present invention, which all fall within the scope of protection of the present invention.

Claims

1. A peritoneal cavity puncture device, characterized in that: include: The needle sleeve comprises a needle sleeve tube and a needle sleeve seat, the needle sleeve tube comprises a tube front end and a tube tail end, the needle sleeve seat is arranged at the tube tail end, the side wall of the tube front end is provided with a plurality of long strip side holes, and the tube front end changes from thick to thin; A needle core, the needle core comprising a needle body and a needle core seat, the needle body comprising a front end and a rear end, the needle core seat being connected to the rear end of the needle body, and the front end of the needle body being provided with an inclined surface; and A Y-shaped valve comprising a main pipe and a branch pipe, wherein one end of the main pipe is adapted to fit the needle core seat and the needle sleeve seat; The end surface of the front end of the sleeve is provided with a sleeve outlet, and the side hole extends to the sleeve outlet; A back hole is provided at the front end of the needle body, and the back hole is arranged on a side opposite to the inclined surface; The puncture method of the peritoneal cavity puncture device includes the following steps: S1: Assemble the needle sheath, needle core, and Y-type valve, and connect the branch of the Y-type valve to the extracorporeal gravity drip system; S2: Under ultrasound monitoring, puncture the peritoneum. If water drips into the peritoneal cavity, introduce the first J-type guidewire that matches the needle core from the main tube of the Y-type valve. After the first J-type guidewire enters the peritoneal cavity, withdraw the needle sheath and needle core, and leave the first J-type guidewire in the peritoneal cavity. If no water drips into the peritoneal cavity, when the puncture device approaches the abdominal organs under ultrasound monitoring, pull out the needle core, connect the needle sheath seat to the Y-type valve, and then gradually retract the needle sheath until water drips into the peritoneal cavity. Then, introduce the second J-type guidewire that matches the needle sheath through the main tube of the Y-type valve, and the second J-type guidewire enters the peritoneal cavity from the cannula outlet or side hole.

2. The peritoneal cavity puncture device according to claim 1, characterized in that: The end surface of the front end of the sleeve is flat head shaped.

3. The peritoneal cavity puncture device according to claim 1, characterized in that: The length of the side hole is 5 mm.

4. The peritoneal cavity puncture device according to claim 1, characterized in that: The outer side surface of the front end of the sleeve is in the shape of a bullet head.

5. The peritoneal cavity puncture device according to claim 1, characterized in that: When the puncture device is in an assembled state, the needle sleeve seat is connected to the needle core seat, and the needle core seat is connected to the main pipe of the Y-shaped valve.

6. The peritoneal cavity puncture device according to claim 1, characterized in that: The number of side holes at the front end of the sleeve is 2-4.

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