Multifunctional sphincterotomy knife

Abstract

The present invention provides a multifunctional papillary sphincterotomy knife. The first tube section of the present invention is generally conical, and the front end is spherical. The first tube section is provided with a guide wire outlet, and the third tube section is provided with a guide wire inlet. The sphincterotomy knife includes a first electrosurgical wire, a second electrosurgical wire, a connecting rod, a wire length adjustment mechanism, and a wire angle adjustment mechanism. The head ends of the first electrosurgical wire and the second electrosurgical wire are both tied to the outer wall of the head end of the second tube section. A connecting rod is arranged between the two electrosurgical wires. The wire length adjustment mechanism is connected to the tail ends of the first electrosurgical wire and the second electrosurgical wire, and the wire angle adjustment mechanism is connected to one of the electrosurgical wires. The present invention is easy to enter the common channel of the duodenal papilla and does not damage the papillary mucosa. By adjusting the angles of the two wires, the two sphincterotomy knife guide wires can achieve accurate incision of the papilla in the 9-11 o'clock direction after the current is turned on, avoiding pancreatic duct damage and reducing the incidence of postoperative pancreatitis.

Description

Technical Field

[0001] The invention relates to the technical field of bile and pancreatic duct medical instruments, and in particular to a multifunctional sphincterotomy knife. Background Art

[0002] With the continuous development of endoscopic technology and the continuous improvement of its accessories, endoscopic endoscopic resection (ERCP) has become an important measure for the diagnosis and treatment of hepatobiliary and pancreatic diseases, including common bile duct stones, bile duct injury, bile duct stenosis, and biliary complications after liver transplantation. Compared with traditional open surgery, this technology has the advantages of less trauma, higher safety factor, and faster recovery. Under direct observation, it can detect hepatobiliary and pancreatic diseases that cannot be found by conventional hepatobiliary, spleen and pancreas CT, ultrasound, and magnetic resonance imaging, and treat them at the same time, such as duodenal papillitis, papillary stenosis, juxtapapillary diverticulum, excessive length of duodenal papilla, and abnormal bile and pancreatic confluence.

[0003] Although ERCP has the above advantages in treating hepatobiliary and pancreatic diseases, its operation difficulty coefficient is relatively high. The key to the success of ERCP surgery lies in the successful selective cannulation of the pancreaticobiliary duct and sphincterotomy. Some patients directly fail the ERCP surgery due to cannulation failure. Repeated cannulation of the duodenal papilla not only prolongs the operation time and increases the surgical risk, but also easily induces acute pancreatitis, thereby increasing the cost of treatment, prolonging the hospitalization time, causing great pain to the patient, and there is a certain mortality rate. Clinically, in order to improve the success rate of papillary cannulation in ERCP surgery, guidewire-assisted papillary sphincterotomy is often used for bile duct cannulation or pancreatic duct occupation method is used for bile duct cannulation.

[0004] The sphincterotomy tube used clinically is cylindrical in shape, with a cone-shaped head. The sphincterotomy head is open, and the guide wire is used for intubation or angiography. When intubating the bile duct, the sphincterotomy is first inserted into the common channel of the duodenal sphincter, and then the zebra guide wire is inserted through the sphincterotomy. The guide wire is inserted into the bile duct or pancreatic duct by adjusting the direction of the sphincterotomy head, and then the guide wire is tightened to make its head arched, and the sphincterotomy is performed. The sphincterotomy tool for making papillae has the following shortcomings: 1. The opening of the head end of the papillary sphincterotomy tool is a circular plane, and it is difficult to insert the papillary sphincterotomy tool into the common channel of the duodenal papilla. The papillary sphincterotomy tool cannot be directly inserted into the bile duct or pancreatic duct, especially for the duodenal papilla with a single-hole opening. In addition, repeated cannulation can easily lead to edema of the duodenal papilla, increase the difficulty of cannulation and the incidence of complications such as intraoperative bleeding and postoperative pancreatitis; 2. After the papillary sphincterotomy tool is inserted into the common channel of the duodenal papilla, its opening is easily blocked by the bile-pancreatic duct diaphragm or muscle septum, making it difficult for the guide wire to enter the bile duct or pancreatic duct, and the depth of the papillary sphincterotomy tool entering the common channel of the duodenal papilla needs to be repeatedly adjusted, which prolongs the operation time. 3. After the sphincterotomy tool is inserted into the common channel of the duodenal papilla, the direction of the guide wire cannot be controlled, resulting in the guide wire entering the pancreatic duct during bile duct cannulation and the guide wire entering the bile duct during pancreatic duct cannulation, which not only reduces the success rate of selective bile and pancreatic duct cannulation and prolongs the operation time, but also easily leads to edema of the duodenal papilla, increases the incidence of complications such as intraoperative bleeding and postoperative pancreatitis; 4. When there is stenosis of the bile duct or pancreatic duct, it is difficult for the sphincterotomy tool to pass through the stenosis smoothly, and it is easy to damage the mucosa at the head end, resulting in bleeding and mucosal damage; 5. The adjustable range of the cutting direction of the sphincterotomy tool is small, and the cutting direction is too close to the 1 o'clock direction of the duodenal papilla, which is easy to cause edema of the pancreatic duct sphincter papilla and postoperative pancreatitis. Summary of the invention

[0005] According to the above technical problems, a multifunctional sphincterotomy knife is provided. The technical means adopted by the present invention are as follows:

[0006] A multifunctional papillary sphincterotomy knife comprises a first tube section, a second tube section and a third tube section, all of which are hollow cavities; the first tube section is generally conical in shape, and the front end is spherical; the first tube section has a first side hole and a second side hole arranged opposite to each other on the side wall of the conical section of the first tube section; the third tube section has a first guide wire inlet and a second guide wire inlet on the side wall; the first guide wire inlet is connected to the first side hole through a first guide wire channel; the second guide wire inlet is connected to the second side hole through a second guide wire channel; the sphincterotomy knife comprises a first electric knife wire, a second electric knife wire, a connecting rod, a wire length adjustment mechanism and a wire angle adjustment mechanism; the head ends of the first electric knife wire and the second electric knife wire are both attached to the outer wall of the head end of the second tube section, and the other ends enter the wire channel inside the second tube section through the through hole of the side wall in the middle of the second tube section; the connecting rod is arranged between the first electric knife wire and the second electric knife wire; the wire length adjustment mechanism is connected to the tail ends of the first electric knife wire and the second electric knife wire; and the wire angle adjustment mechanism is connected to one of the electric knife wires;

[0007] A first through hole and a second through hole are formed on the bottom surface of the conical section of the first pipe section, the first side hole is connected to the first through hole to form a first channel, and the second side hole is connected to the second through hole to form a second channel;

[0008] The second tube section is a four-channel tube, in which a third channel connected to the first through hole and a fourth channel connected to the second through hole are provided, and a fifth channel and a sixth channel are metal wire channels for accommodating the first electrosurgical wire and the second electrosurgical wire respectively;

[0009] The third pipe section is a four-channel pipe, in which a seventh channel connected to the third channel, an eighth channel connected to the fourth channel, a ninth channel connected to the fifth channel, and a tenth channel connected to the sixth channel are provided, the first guide wire inlet is connected to the seventh channel, and the second guide wire inlet is connected to the eighth channel;

[0010] In the working state, the first side hole of the first tube segment faces the bile duct or the pancreatic duct, the second side hole faces the pancreatic duct or the bile duct, the second tube segment enters the human body, and the third tube segment is located outside the human body.

[0011] Furthermore, the wire length adjustment mechanism includes a metal connecting rod arranged in the ninth channel and the tenth channel, a pulley arranged inside the third pipe section, and a cutting knife handle. The upper ends of the metal connecting rods in the ninth channel and the tenth channel are respectively connected to the first electric knife wire and the second electric knife wire, and the lower ends are connected to the electric knife wire that bypasses the pulley. The cutting knife handle is connected to the pulley shaft through the cutting knife connecting rod; the wire angle adjustment mechanism includes a sliding handle and a sliding handle connecting rod, and the sliding handle is connected to the metal connecting rod of one of the electric knife wires through the sliding handle connecting rod.

[0012] Furthermore, the outer wall of the third pipe section is also provided with a cylindrical handle for rotating the catheter which is sleeved thereon, and handle rings are provided at both ends of the cylindrical handle. The cylindrical handle is provided with a longitudinal crack, and the sliding handle is arranged therein.

[0013] Furthermore, the tail end of the cutting knife connecting rod is connected to the cutting knife handle, and an electric knife connecting connector is arranged on the side wall of the metal rod.

[0014] Furthermore, the first side hole and the second side hole are opened at the same height, both are 3 mm away from the top of the head, and the total length of the tapered head end is 10 mm.

[0015] Furthermore, the surface of the first pipe section is coated with a hydrophilic coating.

[0016] Furthermore, the outer diameters of the two guide wire entrances are both 7Fr.

[0017] Furthermore, the third channel and the fourth channel have an intersecting portion, the length of the intersection line is smaller than the outer diameter of the guide wire, and the specifications of the seventh channel and the eighth channel are the same.

[0018] Furthermore, the diameters of the first guide wire inlet and the second guide wire inlet are 1 mm, the electrosurgical wire channel is 0.7 mm, the length of the electrosurgical wire at the head end is 2 cm, the wire diameter is 0.5 mm, and the wire connecting rod is 1 cm.

[0019] The present invention has the following advantages:

[0020] 1. The front end of the tube body of the present invention is conical, the head end of the tube body is spherical, and the surface is coated with a hydrophilic coating, which makes it easier to enter the common channel of the duodenal papilla, or directly enter the bile duct and pancreatic duct, and does not damage the papilla mucosa;

[0021] 2. The front end of the tube body of the present invention is conical, the head end of the tube body is spherical, and the surface is coated with a hydrophilic coating, which makes it easier to pass through the narrow bile duct;

[0022] 3. Dual channels for bile duct and pancreatic duct cannulation are arranged on both sides of the head end of the present invention. The dual channels of the tube body are opened at the side wall of the conical head end. A guide wire is inserted through the bile duct channel. The conical head end of the drainage tube can block the opening of the pancreatic duct sphincter, thereby reducing the probability of the guide wire entering the pancreatic duct. A guide wire is inserted through the pancreatic duct channel. The conical head end of the drainage tube can block the opening of the bile duct sphincter, thereby reducing the probability of the guide wire entering the bile duct, thereby achieving selective bile duct or pancreatic duct cannulation;

[0023] 4. The channel for the guide wire in the tube body of the present invention adopts a double-circle cross design, which prevents the guide wire from entering the adjacent channel and reduces the outer diameter of the drainage tube.

[0024] 5. The proximal end of the tube body of the present invention is provided with a catheter rotating handle to control the angle between the two side hole planes of the catheter head end and the bile duct plane, thereby increasing the success rate of guidewire intubation.

[0025] 6. The front end of the present invention contains two cutting knife wires, and a rear connecting rod between the wires. By moving the sliding handle, the rotation of the cutting knife wire is realized, and then the distance between the two guide wires is controlled, so that the two cutting knife guide wires are close to the 9 o'clock and 0 o'clock directions of the nipple sphincter respectively. After the current is turned on, the precise incision of the nipple in the 9-11 o'clock direction is realized, avoiding pancreatic duct damage and reducing the incidence of postoperative pancreatitis. BRIEF DESCRIPTION OF THE DRAWINGS

[0026] In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings required for use in the embodiments or the description of the prior art will be briefly introduced below. Obviously, the drawings described below are some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative labor.

[0027] Figure 1 It is a schematic diagram of the overall structure of the present invention.

[0028] Figure 2 It is a cross-sectional view of the third pipe section in an embodiment of the present invention.

[0029] Figure 3 It is a schematic diagram of the overall structure of the cutting knife after the handle of the cutting knife is pulled.

[0030] Figure 4 It is a state schematic diagram of the present invention when it is in working state.

[0031] In the figure: 101, first side hole; 102, second side hole; 103, spherical front end of the first pipe section; 104, conical body of the first pipe section; 201, first through hole; 202, second through hole; 203, third through hole; 204, fourth through hole; 205, first electric knife wire; 206, second electric knife wire; 207, connecting rod; 301, first guide wire inlet; 302, second guide wire inlet; 303, sliding handle; 304, sliding handle connecting rod; 305, pulley; 306, cutting knife handle; 307, cutting knife connecting rod; 308, electric knife connecting joint; 309, handle ring; 310, handle cover; 311, seventh channel; 312, eighth channel; 313, ninth channel; 314, tenth channel. DETAILED DESCRIPTION

[0032] In order to make the purpose, technical solution and advantages of the embodiments of the present invention clearer, the technical solution in the embodiments of the present invention will be clearly and completely described below in conjunction with the drawings in the embodiments of the present invention. Obviously, the described embodiments are part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0033] like Figures 1 to 3 As shown, the present embodiment discloses a multifunctional papillary sphincterotomy knife, comprising a first tube segment, a second tube segment and a third tube segment, all of which are hollow cavities; the first tube segment as a whole 104 is conical, and the front end 103 is spherical, the conical section side wall of the first tube segment is provided with a first side hole 101 and a second side hole 102 which are arranged opposite to each other, the side wall of the third tube segment is provided with a first guide wire inlet 301 and a second guide wire inlet 302, the first guide wire inlet is connected to the first side hole through a first guide wire channel, and the second guide wire inlet is connected to the second side hole through a second guide wire channel, the sphincterotomy knife comprises a first electric knife wire, a second electric knife wire, a connecting rod, a wire length adjustment mechanism and a wire angle adjustment mechanism, the head ends of the first electric knife wire 205 and the second electric knife wire 206 are respectively passed through the first through hole 2 01 and the second through hole 202 are on the outer wall of the head end of the second pipe segment, and the other end enters into the wire channel inside the second pipe segment through the third through hole 203 and the fourth through hole 204 on the side wall of the middle part of the second pipe segment, the connecting rod 207 is arranged between the first electric knife wire and the second electric knife wire, the wire length adjustment mechanism is connected to the tail ends of the first electric knife wire and the second electric knife wire, the wire angle adjustment mechanism is connected to one of the electric knife wires, the wire channel does not contact the first guide wire channel and the second guide wire channel, and the two wire channels do not contact each other, there is a preset angle between the first guide wire inlet and the second guide wire inlet and the third pipe segment, the angle makes it easy for the guide wire to be inserted, specifically, the angle range between the first guide wire inlet and the head end of the first pipe segment is 90°<α<180°.

[0034] Specifically, a first through hole and a second through hole are formed on the bottom surface of the conical section of the first pipe section, the first side hole is connected to the first through hole to form a first channel, and the second side hole is connected to the second through hole to form a second channel;

[0035] The second tube section is a four-channel tube, in which a third channel connected to the first through hole and a fourth channel connected to the second through hole are provided, and a fifth channel and a sixth channel are metal wire channels for accommodating the first electrosurgical wire and the second electrosurgical wire respectively;

[0036] The third pipe section is a four-channel pipe, in which a seventh channel 311 connected to the third channel, an eighth channel 312 connected to the fourth channel, a ninth channel 313 connected to the fifth channel, and a tenth channel 314 connected to the sixth channel are provided, the first guide wire inlet is connected to the seventh channel, and the second guide wire inlet is connected to the eighth channel;

[0037] In the working state, the first side hole of the first tube segment faces the bile duct or the pancreatic duct, the second side hole faces the pancreatic duct or the bile duct, the second tube segment enters the human body, and the third tube segment is located outside the human body.

[0038] As a preferred embodiment, the wire length adjustment mechanism includes a metal connecting rod arranged in the ninth channel and the tenth channel, a pulley 305 arranged inside the third pipe section, and a cutting knife handle 306. The upper ends of the metal connecting rods in the ninth channel and the tenth channel are respectively connected to the first electric knife wire and the second electric knife wire, and the lower ends are connected to the electric knife wire bypassing the pulley. The cutting knife handle 306 is connected to the pulley shaft through the cutting knife connecting rod 307; the wire angle adjustment mechanism includes a sliding handle 303 and a sliding handle connecting rod 304, and the sliding handle is connected to the metal connecting rod of one of the electric knife wires through the sliding handle connecting rod.

[0039] The outer wall of the third pipe section is also provided with a cylindrical handle for rotating the catheter which is sleeved thereon via a handle sleeve 310. Handle rings 309 are provided at both ends of the cylindrical handle. The cylindrical handle is provided with a longitudinal crack in which the sliding handle is arranged.

[0040] The tail end of the cutting knife connecting rod is connected to the cutting knife handle, and an electric knife connecting joint 308 is arranged on the side wall of the metal rod.

[0041] The first side hole and the second side hole are opened at the same height, both are 3 mm away from the top of the head, and the total length of the tapered head end is 10 mm.

[0042] The surface of the first pipe section is coated with a hydrophilic coating.

[0043] The outer diameters of the two guide wire entrances are both 7Fr, and the guide wire entrances are connector type.

[0044] The third channel and the fourth channel have an intersecting portion, the length of the intersection line is less than the outer diameter of the guide wire, and the specifications of the seventh channel and the eighth channel are the same.

[0045] Furthermore, the diameters of the first guide wire inlet and the second guide wire inlet are 1 mm, the electrosurgical wire channel is 0.7 mm, the length of the electrosurgical wire at the head end is 2 cm, the wire diameter is 0.5 mm, and the wire connecting rod is 1 cm.

[0046] like Figure 4As shown, the specific application method of this embodiment is as follows: insert the duodenoscope through the mouth, the duodenoscope enters the stomach through the esophagus, enters the duodenum through the pylorus, and finds the duodenal papilla.

[0047] A cholepancreatography catheter is inserted through the duodenoscope forceps channel, and the handle is rotated so that the two side holes of the sphincterotomy knife head are located on the left and right sides of the field of view respectively. The sphincterotomy knife enters the common channel of the duodenal papilla through the duodenal papilla opening, and contrast agent is injected through the contrast agent injection hole to simultaneously visualize the morphology of the bile duct and pancreatic duct. In this embodiment, when the guide wire is inserted into the first guide wire entrance, the second guide wire entrance is used for imaging, and vice versa.

[0048] Adjust the direction of the sphincterotomy tip in the common channel of the duodenal papilla, slide it into the pancreatic duct at the 1 o'clock direction, or slide it into the common bile duct at the 11 o'clock direction, and inject contrast agent through the injection connector of the sphincterotomy tip to display the morphology of the bile duct or pancreatic duct.

[0049] When direct insertion of the sphincterotomy knife fails, an elbow guidewire is inserted through the first guidewire inlet or the second guidewire inlet, and the guidewire enters the bile duct through the first guidewire channel or enters the pancreatic duct through the second guidewire channel.

[0050] After successful intubation, place the tip of the sphincterotomy knife's metal wire in the common channel of the duodenal papilla, tighten the metal wire of the electrosurgical knife so that the tip of the sphincterotomy knife is in a bow shape, move the sliding handle up and down, adjust the distance between the two metal wires at the tip of the knife, and then make the guide wire on the left side of the field of vision closer to the 9 o'clock direction, connect the high-frequency generator, and use the electrosurgical knife guide wire to cut the nipple sphincter.

[0051] Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention, rather than to limit it. Although the present invention has been described in detail with reference to the aforementioned embodiments, those skilled in the art should understand that they can still modify the technical solutions described in the aforementioned embodiments, or replace some or all of the technical features therein with equivalents. However, these modifications or replacements do not cause the essence of the corresponding technical solutions to deviate from the scope of the technical solutions of the embodiments of the present invention.

Claims

1. A multifunctional sphincterotomy knife, characterized in that: The invention comprises a first pipe section, a second pipe section and a third pipe section, all of which are hollow cavities; the first pipe section is generally conical, and the front end is spherical; the first pipe section has a first side hole and a second side hole arranged opposite to each other on the side wall of the conical section of the first pipe section; the third pipe section has a first guide wire inlet and a second guide wire inlet on the side wall; the first guide wire inlet is connected to the first side hole through a first guide wire channel; the second guide wire inlet is connected to the second side hole through a second guide wire channel; the cutting knife comprises a first electric knife wire, a second electric knife wire, a connecting rod, a wire length adjustment mechanism and a wire angle adjustment mechanism; the head ends of the first electric knife wire and the second electric knife wire are both tied to the outer wall of the head end of the second pipe section, and the other ends enter the wire channel inside the second pipe section through the through hole of the side wall in the middle part of the second pipe section; the connecting rod is arranged between the first electric knife wire and the second electric knife wire; the wire length adjustment mechanism is connected to the tail ends of the first electric knife wire and the second electric knife wire; and the wire angle adjustment mechanism is connected to one of the electric knife wires; A first through hole and a second through hole are formed on the bottom surface of the conical section of the first pipe section, the first side hole is connected to the first through hole to form a first channel, and the second side hole is connected to the second through hole to form a second channel; The second tube section is a four-channel tube, in which a third channel connected to the first through hole and a fourth channel connected to the second through hole are provided, and a fifth channel and a sixth channel are metal wire channels for accommodating the first electrosurgical wire and the second electrosurgical wire respectively; The third pipe section is a four-channel pipe, in which a seventh channel connected to the third channel, an eighth channel connected to the fourth channel, a ninth channel connected to the fifth channel, and a tenth channel connected to the sixth channel are provided, the first guide wire inlet is connected to the seventh channel, and the second guide wire inlet is connected to the eighth channel; In the working state, the first side hole of the first tube segment faces the bile duct or the pancreatic duct, the second side hole faces the pancreatic duct or the bile duct, the second tube segment enters the human body, and the third tube segment is located outside the human body; The metal wire length adjustment mechanism includes a metal connecting rod arranged in the ninth channel and the tenth channel, a pulley arranged inside the third pipe section, and a cutting knife handle. The upper ends of the metal connecting rods in the ninth channel and the tenth channel are respectively connected to the first electric knife wire and the second electric knife wire, and the lower ends are connected to the electric knife wire bypassing the pulley. The cutting knife handle is connected to the pulley shaft through the cutting knife connecting rod. The metal wire angle adjustment mechanism includes a sliding handle and a sliding handle connecting rod. The sliding handle is connected to the metal connecting rod of one of the electric knife wires through the sliding handle connecting rod. The surface of the first pipe section is coated with a hydrophilic coating.

2. The multifunctional sphincterotomy knife according to claim 1, characterized in that: The outer wall of the third pipe section is also provided with a cylindrical handle for rotating the catheter which is sleeved thereon, and handle rings are provided at both ends of the cylindrical handle. The cylindrical handle is provided with a longitudinal crack, and the sliding handle is arranged therein.

3. The multifunctional sphincterotomy knife according to claim 2, characterized in that: The tail end of the cutting knife connecting rod is connected to the cutting knife handle, and an electric knife connecting joint is arranged on the side wall of the metal rod.

4. The multifunctional sphincterotomy tool according to claim 1, characterized in that: The first side hole and the second side hole are opened at the same height, both are 3 mm away from the top of the head, and the total length of the tapered head end is 10 mm.

5. The multifunctional sphincterotomy tool according to claim 1, characterized in that: The outer diameter of the two guide wire entrances is 7Fr.

6. The multifunctional sphincterotomy tool according to claim 1, characterized in that: The third channel and the fourth channel have an intersecting portion, the length of the intersection line is less than the outer diameter of the guide wire, and the specifications of the seventh channel and the eighth channel are the same.

7. The multifunctional sphincterotomy tool according to claim 1, characterized in that: The diameters of the first guide wire inlet and the second guide wire inlet are 1 mm, the electrosurgical wire channel is 0.7 mm, the length of the electrosurgical wire at the head end is 2 cm, the wire diameter is 0.5 mm, and the wire connecting rod is 1 cm.

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