Lithotripsy Basket Catheter
By designing a stone gravel mesh catheter, the problem of difficult gravel and removal of huge common bile duct stones is solved, and efficient and low-cost treatment effects are achieved in grassroots hospitals, and are suitable for high-risk patients.
Patent Information
- Application Number
- CN202010819603.X
- Authority / Receiving Office
- CN · China
- Patent Type
- Patents(China)
- Current Assignee / Owner
- Filing Date
- 2020-08-14
- Publication Date
- 2025-01-14
- Estimated Expiration
- 2040-08-14
AI Technical Summary
The existing bile duct stone treatment methods are at high risk for elderly patients with advanced age, many underlying diseases and cardiopulmonary dysfunction, especially huge common bile duct stones that are difficult to effectively graft and remove, and the high-cost SpyGlass direct vision technology is difficult to popularize.
A stone gravel net basket catheter has been designed, including a catheter and a connecting rod mesh basket. The front end of the catheter is conical and spherical, and it is equipped with gravel electrodes and mesh wires. It can be used for plasma or laser gravel under X-ray. In grassroots hospitals, large stones can be taken and dragged into the duodenum.
It improves the gravel efficiency of huge common bile duct stones, reduces the risk of complications, is suitable for grassroots hospitals, reduces treatment costs, and avoids dependence on choledoscopy.
Smart Images
Figure CN111839664B_ABST
Abstract
Description
Technical Field
[0001] The invention relates to the technical field of bile duct medical devices, and in particular to a lithotripsy basket catheter. Background Art
[0002] Common bile duct stones are a common and frequently occurring disease in my country. Long-term blockage of the common bile duct by stones can induce complications such as acute cholangitis, obstructive jaundice, and acute biliary pancreatitis, with symptoms such as chills, fever, abdominal pain, and jaundice. In severe cases, it can even lead to shock. Long-term stimulation by stones can lead to the risk of developing bile duct cancer, making it an important disease that endangers human health. Currently, the treatment options for common bile duct stones include open biliary exploration and stone removal, laparoscopic biliary exploration and stone removal, endoscopic retrograde pancreaticocholangiopancreatography (ERCP) stone removal, percutaneous transhepatic bile duct puncture (PTCD) + fistula dilation + percutaneous transhepatic choledochoscopy (PTCS) stone removal, and duodenal papilla balloon dilatation stone removal via PTCD.
[0003] For patients who are elderly, have multiple underlying diseases, or have cardiopulmonary dysfunction and are not suitable for general anesthesia bile duct exploration surgery, ERCP lithotripsy is often used. First, the papillary sphincterotomy and balloon dilatation are performed, and then the stone is dragged into the common bile duct using a lithotripsy balloon. However, for giant common bile duct stones with a diameter of more than 1.5 cm, ERCP-assisted mechanical lithotripsy with a basket or lithotripsy under direct vision with SpyGlass is used. The above-mentioned technical tips have the following shortcomings: 1. Large papillary sphincterotomy and large balloon papillary dilatation are risky before complete stone removal. Short-term complications such as papillary bleeding, acute pancreatitis, and perforation are prone to occur during the perioperative period, as well as long-term complications such as reflux cholangitis, early recurrence of stones, and cholangitis; 2. Giant common bile duct stones often cause common bile duct obstruction. Due to the narrow space, it is difficult to remove giant common bile duct stones by inserting a lithotripsy basket through ERCP; 3. The efficiency of mechanical lithotripsy with a basket is low, and some of the stones are hard. Cholesterol stones are difficult to be crushed by the basket; 4. If the stones cannot be crushed after being taken out, and if the stones cannot be discharged through the basket, the lithotripsy basket cannot be removed, and general anesthesia biliary exploration surgery is the only option, which is risky; 5. Lithotripsy under direct vision via ERCP with SpyGlass is a new technology that has been recently developed. It has a high lithotripsy efficiency and low complications, but the cost of SpyGlass instruments and consumables is extremely high. Ordinary hospitals have not developed this technology, and ordinary families cannot afford the huge high cost of treatment.
[0004] For patients who are old, have multiple underlying diseases, have cardiopulmonary dysfunction, have a history of upper gastrointestinal surgery, etc. and are not suitable for biliary exploration or ERCP, PTCD via duodenal papilla balloon dilatation or PTCS lithotripsy is often used. For common bile duct stones with a diameter of more than 1.5 cm, this treatment plan has the following shortcomings: 1. Using a balloon with a diameter of more than 1.5 cm for duodenal papillary sphincter balloon dilatation is prone to short-term complications such as papillary laceration and bleeding, acute pancreatitis, and perforation, as well as long-term complications such as reflux cholangitis, stone recurrence, and bile duct cancer; 2. Before PTCS surgery, the fistula needs to be dilated before the choledochoscope can enter the common bile duct. Repeated dilatation of the fistula in one operation is prone to complications such as fistula laceration, bleeding, and liver abscess; multiple operations to dilate the fistula have a lower risk, but the total cost is high, the course of the disease is long, and patients who carry an external bile duct drainage tube for a long time have poor medical compliance and are difficult to care for; 3. PTCS stone removal requires the use of a choledochoscope, and the cost of choledochoscope equipment is relatively high, and general hospitals do not have choledochoscope equipment. Summary of the invention
[0005] According to the technical problem raised above, a lithotripsy basket catheter is provided. The technical means adopted by the present invention are as follows:
[0006] A stone crushing basket conduit comprises a conduit and a connecting rod type basket arranged in the conduit, wherein the conduit comprises a first conduit section, a second conduit section and a third conduit section which are connected in sequence.
[0007] The front end of the first pipe section is conical and has a curved surface, the head end of the pipe is spherical, and a first lithotripsy electrode, a second lithotripsy electrode and a first channel are arranged inside the pipe section;
[0008] The second pipe section is a double-channel pipe, and a plurality of basket wire mounting holes are arranged on the side wall of the head end thereof, a metal connecting rod is arranged in the second channel of the double-channel pipe opened inside the second channel, the head end of the metal connecting rod is connected to each metal wire, and the third channel is connected to the first channel;
[0009] The third pipe section is a double-channel pipe, wherein the fourth channel of the double-channel pipe opened inside the third pipe section is connected with the second channel, and the fifth channel is connected with the third channel;
[0010] The second channel and the fourth channel are channels for displacement of the metal connecting rod, the first channel, the third channel and the fifth channel are injection channels, and the first lithotripsy electrode and the second lithotripsy electrode are connected to the lithotripsy electrode connector on the third pipe section after passing through the second pipe section;
[0011] 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.
[0012] Furthermore, the surface of the first pipe section is coated with a hydrophilic coating.
[0013] Furthermore, the number of the basket wire mounting holes is 4 and they are evenly distributed on the circumferential tube wall, the head end of the second channel is a blind end, the connecting rod type basket comprises four metal wires, the metal connecting rod and a basket connecting rod connected to the tail end of the metal connecting rod, the tail of the basket connecting rod is connected to a basket handle, the head ends of the four metal wires are connected, and the intersection is located on the straight line where the radial center of the catheter is located.
[0014] Furthermore, the first lithotripsy electrode, the second lithotripsy electrode, the metal connecting rod displacement channel, and the main body of the injection channel are parallel to each other and do not contact each other.
[0015] Furthermore, the diameter of the gravel basket connecting rod is 1 mm, the diameter of the basket connecting rod channel is 1.2 mm, and the maximum diameter of the released basket is 3 cm.
[0016] Furthermore, a branch at the bottom end of the fifth channel is connected to the injection joint on the side wall of the third pipe segment, and another branch continues to extend to the end of the third pipe segment to serve as a guide wire channel, and the guide wire channel has a diameter of 1 mm.
[0017] Further, the outer diameter of the catheter comprises 8.5 Fr.
[0018] Furthermore, the total length of the catheter is 40 to 60 cm.
[0019] Furthermore, the total length of the catheter is 2.2 to 2.8 m.
[0020] Furthermore, the outer wall of the third pipe section is also provided with a handle sleeve fixed thereon for easy grasping, where the lithotripsy electrode joint and the injection joint are both arranged, and left and right handles are also provided on the outside of the handle sleeve.
[0021] The present invention has the following advantages:
[0022] 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 bile duct through the duodenal papilla;
[0023] 2. The metal wires of the basket of the present invention pass through the side wall of the catheter, so that the distance between the metal wires of the basket is constant, which can avoid deformation of the basket and facilitate the collection of stones;
[0024] 3. After the stone is taken out by the basket of the present invention, the basket is tightened to fix the stone and make it close to the lithotripsy electrode at the catheter head end;
[0025] 4. The head end of the present invention is provided with a lithotripsy electrode, which can perform plasma, microelectrode and laser lithotripsy under X-ray for larger common bile duct stones without the assistance of a choledochoscope, and is more suitable for primary hospitals;
[0026] 5. The lithotripsy electrode of the present invention is located in the center of the catheter and the lithotripsy basket. After the stone is removed, the electrode can be kept away from the bile duct wall to prevent the electrode from damaging the bile duct wall during the lithotripsy process.
[0027] 6. The net basket of the present invention can collect large pieces of gravel and drag them into the duodenum. BRIEF DESCRIPTION OF THE DRAWINGS
[0028] 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.
[0029] Figure 1 This is a schematic diagram of the main structure of the net basket of the present invention when it is retracted;
[0030] Figure 2 The cross-sectional view and the front view of the pipe segment of the present invention are schematic diagrams, wherein (a) is a top view of the first pipe segment; (b) is a cross-sectional view of the head end of the second pipe segment; (c) is a cross-sectional view of the third pipe segment; and (d) is a front view of the first pipe segment.
[0031] Figure 3 This is a schematic diagram of the main structure of the net basket of the present invention when it is in an extended state;
[0032] Figure 4 (a), (b), and (c) are diagrams of the three states of stone removal and crushing in Example 1 of the present invention.
[0033] Figure 5 (a), (b), and (c) are diagrams of the three states of stone removal and crushing in Example 2 of the present invention.
[0034] In the figure: 1. first pipe section; 11. first lithotripsy electrode; 12. second lithotripsy electrode; 13. metal wire; 14. first channel; 2. second pipe section; 21. second channel; 22. third channel; 3. third pipe section; 31. fourth channel; 32. fifth channel; 33. injection joint; 34. lithotripsy electrode joint; 35. handle sleeve; 36. handle; 37. basket connecting rod; 38. basket handle; 39. guide wire channel. DETAILED DESCRIPTION
[0035] 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.
[0036] like Figure 1 ,2 As shown in (a) to (d) and 3, this embodiment discloses a stone crushing basket catheter, including a catheter and a connecting rod type basket arranged in the catheter, wherein the catheter includes a first pipe section 1, a second pipe section 2 and a third pipe section 3 which are connected in sequence,
[0037] The front end of the first pipe section is conical and has a curved surface, the head end of the pipe body is spherical, the length of the conical head end is 3mm, and a first lithotripsy electrode 11, a second lithotripsy electrode 12 and a first channel 14 are arranged inside the first pipe section;
[0038] The second pipe section is a double-channel pipe, and a plurality of basket wire mounting holes are provided on the side wall of the head end thereof. A metal connecting rod is provided in the second channel 21 of the double-channel pipe opened inside the second channel, and the head end of the metal connecting rod is connected to each metal wire 13, and the third channel 22 is connected to the first channel;
[0039] The third pipe section is a double-channel pipe, in which a fourth channel 31 of the double-channel pipe opened inside is connected with the second channel, and a fifth channel 32 is connected with the third channel;
[0040] The second channel and the fourth channel are channels for displacement of the metal connecting rod, the first channel, the third channel and the fifth channel are injection channels, and the first lithotripsy electrode and the second lithotripsy electrode are connected to the lithotripsy electrode connector 34 on the third pipe section after passing through the second pipe section;
[0041] 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.
[0042] In this embodiment, the catheter is made of polyethylene.
[0043] As a preferred embodiment, the surface of the first pipe section is coated with a hydrophilic coating.
[0044] As a preferred embodiment, the number of the basket wire mounting holes is 4 and they are evenly distributed on the circumferential tube wall. The head end of the second channel is a blind end. The connecting rod type basket comprises four metal wires, the metal connecting rod and a basket connecting rod 37 connected to the tail end of the metal connecting rod. The tail of the basket connecting rod is connected to a basket handle 38. The head ends of the four metal wires are connected, and the intersection is located on the straight line where the radial center of the catheter is located.
[0045] As a preferred embodiment, the first lithotripsy electrode, the second lithotripsy electrode, the metal connecting rod displacement channel, and the injection channel body are parallel to each other and do not contact each other.
[0046] As a preferred embodiment, the diameter of the gravel basket connecting rod is 1 mm, the diameter of the basket connecting rod channel is 1.2 mm, and the maximum diameter of the released basket is 3 cm.
[0047] As a preferred embodiment, a branch at the bottom end of the fifth channel is connected to the injection joint on the side wall of the third pipe segment, and another branch continues to extend to the end of the third pipe segment to serve as a guide wire channel 39, and the guide wire channel diameter is 1 mm.
[0048] As a preferred embodiment, the outer diameter of the catheter comprises 8.5 Fr.
[0049] As a preferred embodiment, the outer wall of the third pipe segment is also provided with a handle cover 35 fixed thereon for easy grasping, and the lithotripsy electrode connector and the injection connector 33 connected to the injection channel are both arranged here. In this embodiment, the injection connector is mainly a contrast agent connector, and physiological saline can also be injected through the connector. Left and right handles 36 are also provided on the outside of the handle cover.
[0050] Example 1
[0051] In this embodiment, the total length of the catheter is 40 to 60 cm.
[0052] PTCD was performed first to drain bile to control biliary infection and jaundice, and the PTCD tube was left in place for 2 months.
[0053] A zebra guidewire was inserted through the original PTCD tube, and the guidewire passed over the stone and entered the distal duodenum through the duodenal papilla.
[0054] Leave the guide wire in place and remove the original PTCD tube. Figure 4 As shown in (a), (b), and (c), a guide wire is inserted through the tip of the lithotripsy basket catheter. Under the guidance of the guide wire, the lithotripsy basket catheter is sent into the common bile duct. The guide wire is withdrawn, the basket is released, and the common bile duct stones are removed.
[0055] Tighten the basket and fix the common bile duct stones, quickly drip normal saline through the contrast agent injection connector, and perform plasma, microelectrode or laser lithotripsy. During the lithotripsy process, the basket is continuously tightened to gradually break up the common bile duct stones.
[0056] Example 2
[0057] In this embodiment, the total length of the catheter is 2.2 to 2.8 m.
[0058] After the duodenoscope was inserted orally and the bile duct was cannulated successfully, endoscopic retrograde cholangiography was performed first to determine the number, location and size of the stones, and then a small sphincter incision was made, and a cylindrical balloon with a diameter of 1.0 cm was used to dilate the duodenal papilla.
[0059] like Figure 5As shown in (a), (b), and (c), the lithotripsy basket catheter is inserted through the duodenal forceps under the guidance of a guide wire, and the basket is released to collect smaller stones in the common bile duct and directly drag them into the duodenum. When the stone diameter exceeds 1 cm, the basket catheter is released to collect the stone, and when the basket is tightened, the stone is close to the catheter tip electrode, and plasma, microelectrode or laser lithotripsy is performed to break up large stones in the common bile duct.
[0060] After the stone is broken, the basket is released to collect the stone and drag large pieces of stone into the duodenum. Smaller pieces of stone are dragged into the duodenum using a stone removal balloon.
[0061] 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 lithotripsy basket catheter, characterized in that: It comprises a catheter and a connecting rod basket arranged in the catheter, wherein the catheter comprises a first pipe section, a second pipe section and a third pipe section which are connected in sequence, the front end of the first pipe section is conical and has an arc surface, the head end of the pipe section is spherical, and a first lithotripsy electrode, a second lithotripsy electrode and a first channel are arranged inside the first pipe section; The second pipe section is a double-channel pipe, and a plurality of basket wire mounting holes are arranged on the side wall of the head end thereof, a metal connecting rod is arranged in the second channel of the double-channel pipe opened inside the second channel, the head end of the metal connecting rod is connected to each metal wire, and the third channel is connected to the first channel; The number of the mesh basket wire installation holes is 4 and they are evenly distributed on the circumferential tube wall. The head end of the second channel is a blind end. The connecting rod type mesh basket comprises four metal wires, the metal connecting rod and a mesh basket connecting rod connected to the tail end of the metal connecting rod. The tail of the mesh basket connecting rod is connected to a mesh basket handle. The head ends of the four metal wires are connected, and the intersection is located on the straight line where the radial center of the catheter is located. The third pipe section is a double-channel pipe, wherein the fourth channel of the double-channel pipe opened inside the third pipe section is connected with the second channel, and the fifth channel is connected with the third channel; The second channel and the fourth channel are channels for displacement of the metal connecting rod, the first channel, the third channel and the fifth channel are injection channels, and the first lithotripsy electrode and the second lithotripsy electrode are connected to the lithotripsy electrode connector on the third pipe section after passing through the second pipe section; After the stone is taken by the basket, the basket is tightened to fix the stone and make it close to the lithotripsy electrode at the catheter head end; The lithotripsy electrode is located in the center of the catheter and the lithotripsy basket. After the stone is removed, the electrode is kept away from the bile duct wall to prevent the electrode from damaging the bile duct wall during the lithotripsy process. 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.
2. The lithotripsy basket catheter according to claim 1, characterized in that: The surface of the first pipe section is coated with a hydrophilic coating.
3. The lithotripsy basket catheter according to claim 1, characterized in that: The first lithotripsy electrode, the second lithotripsy electrode, the metal connecting rod displacement channel, and the main body of the injection channel are parallel to each other and do not contact each other.
4. The lithotripsy basket catheter according to claim 1, characterized in that: The diameter of the gravel basket connecting rod is 1mm, the diameter of the basket connecting rod channel is 1.2mm, and the maximum diameter of the released basket is 3cm.
5. The lithotripsy basket catheter according to claim 1 or 4, characterized in that: A branch at the bottom end of the fifth channel is connected to the injection joint on the side wall of the third pipe segment, and another branch continues to extend to the end of the third pipe segment to serve as a guide wire channel with a diameter of 1 mm.
6. The lithotripsy basket catheter according to claim 1, characterized in that: The outer diameter of the catheter includes 8.5Fr.
7. The lithotripsy basket catheter according to claim 1, characterized in that: The total length of the catheter is 40 to 60 cm.
8. The lithotripsy basket catheter according to claim 1, characterized in that: The total length of the catheter is 2.2 to 2.8 meters.
9. The lithotripsy basket catheter according to claim 1, characterized in that: The outer wall of the third pipe section is also provided with a handle sleeve fixed thereon for easy grasping, where the lithotripsy electrode joint and the injection joint are both arranged, and left and right handles are also arranged on the outside of the handle sleeve.
Citation Information
Patent Citations
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