Multidirectional sphincterotomy

Abstract

The present invention provides a multi-directional papillary sphincterotomy knife. The present invention comprises an outer sleeve, an electric knife mechanism arranged on the outer sleeve, and a guide wire channel and a contrast medium channel arranged inside the outer sleeve. The front end of the outer sleeve is conical and has an opening. The main body of the guide wire channel and the contrast medium channel is a cavity parallel to each other. A connecting rod is arranged between the two metal wires of the incision knife. The metal wire length adjustment mechanism is connected to the tail end of the root metal wire, and the metal wire angle adjustment mechanism is connected to one of the electric knife metal wires. The two incision knife metal wires at the front end of the present invention can realize the rotation of the incision knife metal wires by moving the sliding handle, and then control the distance between the two guide wires, so that the two incision knife guide wires are close to the incision of the papillary sphincter at the 9 o'clock and 0 o'clock directions respectively, thereby reducing the incidence of postoperative pancreatitis. By rotating the duodenoscope to the left, a squeezing effect can be produced on the duodenal annular folds, which can increase the field of view while avoiding electrocautery damage to the duodenal folds.

Description

Technical Field

[0001] The invention relates to the technical field of bile and pancreatic duct medical instruments, and in particular to a multi-directional papillary 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 conical 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 has the following disadvantages: 1. The opening of the tip of the sphincterotomy tool is cone-shaped, and it is difficult to insert the sphincterotomy tool into the common channel of the duodenal papilla. The sphincterotomy tool can be directly inserted into the bile duct or pancreatic duct, especially for the duodenal papilla with a single-hole opening. In addition, repeated intubation can easily lead to edema of the duodenal papilla, increase the difficulty of intubation and the incidence of complications such as intraoperative bleeding and postoperative pancreatitis; 2. The adjustable range of the incision direction is small. After tightening the metal wire, the metal wire is mostly located at the 12 o'clock direction of the nipple, and the incision site is too close to the 1 o'clock direction of the duodenal papilla, which can easily lead to edema of the pancreatic duct sphincter papilla and postoperative pancreatitis; 3. The duodenal papilla of some patients is blocked by the duodenal annular folds, resulting in unclear observation of the duodenal papilla. The use of the papillary sphincter incision process can easily cause burns to the duodenal folds, and there is even a risk of intestinal wall necrosis and perforation. Summary of the invention

[0005] According to the technical problem raised above, a multi-directional papillary sphincterotomy knife is provided. The technical means adopted by the present invention are as follows:

[0006] A multi-directional papillary sphincterotomy knife comprises an outer sleeve, an electric knife mechanism arranged on the outer sleeve, and a guide wire channel and a contrast medium channel arranged inside the outer sleeve. The front end of the outer sleeve is conical and has an opening. The main bodies of the guide wire channel and the contrast medium channel are cavities parallel to each other. The 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 sleeve, and the other ends enter the wire channel inside the outer sleeve through a through hole on the side wall of the middle part 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] Furthermore, the outer tube comprises a first tube segment, a second tube segment and a third tube segment, the side wall of the third tube segment is provided with a first joint and a second joint, the first joint is connected to the guide wire channel, and the second joint is connected to the contrast agent channel;

[0008] The second pipe section is a four-channel pipe, in which a third channel connected to the first channel and a fourth channel connected to the second channel are provided, and the fifth channel and the 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 joint is connected to the seventh channel, and the second joint is connected to the eighth channel;

[0010] In the working state, the first tube segment and the second tube segment enter 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 diameter of the angiography catheter is 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 joint and the second joint 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 head end of the tube of the present invention is conical, with an opening at the head end and a hydrophilic coating on the surface, 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 head end of the tube of the present invention is conical, with an opening at the head end and a hydrophilic coating on the surface, making it easier to pass through a narrow bile duct;

[0022] 3. The head end of the present invention contains two cutting knife wires, and a rear connecting rod is arranged between the wires. By moving the sliding handle, the cutting knife wires can be rotated, thereby controlling the distance between the two guide wires.

[0023] 4. The moving range of the metal wire I of the present invention is between nipples 9 and 12, and can be away from the 1 o'clock direction, thereby avoiding damage to the pancreatic duct and reducing the incidence of postoperative pancreatitis.

[0024] 5. The head end of the present invention contains two cutting knife wires. When the wires are tightened and the duodenoscope is rotated counterclockwise, the wire II moves upward, which can squeeze the duodenal annular folds, thereby increasing the field of view and avoiding electrocautery damage to the duodenal folds. BRIEF DESCRIPTION OF THE DRAWINGS

[0025] 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.

[0026] Figure 1 It is a schematic diagram of the overall structure of the present invention.

[0027] Figure 2 It is a cross-sectional view of the second pipe section in an embodiment of the present invention.

[0028] Figure 3 It is a schematic diagram of the overall structure of the cutting knife after the handle of the cutting knife is pulled.

[0029] Figure 4 It is a schematic diagram of the front end of the outer sleeve of the present invention.

[0030] Figure 5 It is a state schematic diagram of the present invention when it is in working state.

[0031] In the figure: 101, guide wire channel; 102, contrast agent channel; 201, first through hole; 202, second through hole; 203, third through hole; 204, fourth through hole; 205, first electrosurgical wire; 206, second electrosurgical wire; 207, connecting rod; 301, first joint; 302, second joint; 303, sliding handle; 304, sliding handle connecting rod; 305, pulley; 306, incision knife handle; 307, incision knife connecting rod; 308, electrosurgical knife connecting joint; 309, handle ring; 310, cylindrical handle; 311, fifth channel; 312, sixth 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 4 As shown, the embodiment of the present invention discloses a multi-directional papillary sphincterotomy knife, comprising an outer sleeve, an electric knife mechanism arranged on the outer sleeve, and a guide wire channel 101 and a contrast medium channel 102 arranged inside the outer sleeve, wherein the front end of the outer sleeve is conical and has an opening, and the main bodies of the guide wire channel 101 and the contrast medium channel 102 are cavities parallel to each other, and the knife comprises a first electric knife wire 205, a second electric knife wire 206, a connecting rod 207, a wire length adjustment mechanism and a wire angle adjustment mechanism, wherein the first electric knife wire The head ends of the wire 205 and the second electrosurgical wire 206 are respectively tied to the outer sleeve through the first through hole 201 and the second through hole 202, and the other ends enter the wire channel inside the outer sleeve through the third through hole 203 and the fourth through hole 204 on the middle side wall of the second tube section. The connecting rod is arranged between the first electrosurgical wire and the second electrosurgical wire, 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.

[0034] The outer tube comprises a first tube segment, a second tube segment and a third tube segment, the side wall of the third tube segment is provided with a first joint 301 and a second joint 302, the first joint is connected to the guide wire channel, and the second joint is connected to the contrast agent channel;

[0035] The second pipe section is a four-channel pipe, in which a third channel connected to the first channel and a fourth channel connected to the second channel are provided, and the fifth channel 311 and the sixth channel 312 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 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 joint is connected to the seventh channel, and the second joint is connected to the eighth channel;

[0037] In the working state, the first tube segment and the second tube segment enter the human body, and the third tube segment is located outside the human body.

[0038] 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 205 and the second electric knife wire 206, 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 307; the wire angle adjustment mechanism includes a sliding handle 303 and a sliding handle connecting rod 304. 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 310 sleeved thereon for rotating the catheter, and handle rings 309 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.

[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 diameter of the angiography catheter is 7Fr.

[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] The diameter of the first joint 301 and the second joint 302 is 1 mm, the electrosurgical wire channel is 0.7 mm, the electrosurgical wire length at the head end is 2 cm, the wire diameter is 0.5 mm, and the wire connecting rod is 1 cm.

[0046] The specific method of use of this embodiment is as follows: Figure 5 As shown, the duodenoscope is inserted through the mouth, passed through the esophagus into the stomach, and into the duodenum through the pylorus to find the duodenal papilla.

[0047] Insert the choledochopancreatography catheter through the duodenoscope forceps channel, rotate the handle so that the metal wires on the ends of the sphincterotomy tool are located at the 12 o'clock direction of the nipple, and the sphincterotomy tool enters the common channel of the duodenal papilla through the duodenal papilla opening. Injecting contrast agent through the contrast agent injection hole can simultaneously visualize the morphology of the bile duct and pancreatic duct.

[0048] Adjust the direction of the sphincterotomy tip in the common channel of the duodenal papilla, slide it into the pancreatic duct through the papilla at 1 o'clock, or slide it into the common bile duct through the papilla at 11 o'clock, 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 tool fails, an elbow guide wire is inserted through the bile duct connector of the sphincterotomy tool, and the guide wire passes through the tip of the sphincterotomy tool into the bile duct or pancreatic duct.

[0050] After successful bile duct cannulation, place the tip of the sphincterotomy knife wire in the common channel of the duodenal papilla, tighten the wire to make the tip of the sphincterotomy knife bow-shaped, rotate the duodenoscope to the left and move the sliding handle up and down, adjust the distance between the two wires at the tip of the knife, so that wire II moves upward against the duodenal fold, and wire I moves downward and close to the 9 o'clock direction of the nipple, connect the high-frequency generator, and use the electric knife guide wire to cut the sphincterotomy knife.

[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 multi-directional sphincterotomy knife, characterized in that: It comprises an outer sleeve, an electric knife mechanism arranged on the outer sleeve, and a guide wire channel and a contrast medium channel arranged inside the outer sleeve. The front end of the outer sleeve is conical and has an opening. The main bodies of the guide wire channel and the contrast medium channel are cavities parallel to each other. The incision 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 sleeve, and the other ends enter the wire channel inside the outer sleeve 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. The outer tube comprises a first tube segment, a second tube segment and a third tube segment, the side wall of the third tube segment is provided with a first joint and a second joint, the first joint is connected to the guide wire channel, and the second joint is connected to the contrast agent channel; The second pipe section is a four-channel pipe, in which a third channel connected to the first channel and a fourth channel connected to the second channel are provided, and the fifth channel and the 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 joint is connected to the seventh channel, and the second joint is connected to the eighth channel; In the working state, the first pipe section and the second pipe section enter the human body, and the third pipe section 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 outer wall of the third pipe section is also provided with a cylindrical handle for rotating the catheter 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; 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.

2. The multidirectional sphincterotomy knife according to claim 1, characterized in that: The surface of the first pipe section is coated with a hydrophilic coating.

3. The multidirectional sphincterotomy knife according to claim 1, characterized in that: The outer diameter of the angiography catheter is 7Fr.

4. The multidirectional sphincterotomy knife 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.

5. The multidirectional sphincterotomy knife according to claim 1, characterized in that: The diameter of the first joint and the second joint is 1mm, the electrosurgical wire channel is 0.7mm, the length of the electrosurgical wire at the head end is 2cm, the wire diameter is 0.5mm, and the wire connecting rod is 1cm.

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