A multi-dimensional endoscopic knife used in urinary tract repair

Abstract

The present invention discloses a multi-dimensional internal cutting knife used in urinary tract repair surgery, which relates to the technical field of medical surgical instruments, and specifically comprises an outer tube, a guide column and three groups of cutting knife units distributed in a star shape; the structural design of the present invention can at least bring the following technical effects, on the one hand, the present invention is the first to propose a multi-dimensional simultaneous cutting scheme, which can synchronously cut the lumen at multiple angles, and at the same time, three transmitting ends work, and can cut in three dimensions at the same time, and the cutting process is fast and efficient; on the other hand, if the resection caliber requirement is still not met after the three-point synchronous incision, the present invention newly adds a retaining spring structure, and the cutting electrode is radially expanded outward by means of the retaining spring, which can ensure a wider resection range.

Description

Technical Field

[0001] The invention relates to human daily necessities, in particular to medical surgical instruments, in particular to a multi-dimensional endo-cutting knife used in urinary tract repair surgery. Background Art

[0002] At present, intracavitary ureteral surgery accounts for more than 40% of all intracavitary surgeries in urology. Although ureteroscopy is a minimally invasive surgical method, it does not mean that it is absolutely risk-free. It is very easy to cause ureteral obstruction, which is difficult to effectively treat clinically. On the one hand, this greatly increases the patient's pain, and on the other hand, it also greatly increases medical expenses. Foreign large-sample epidemiological statistics show that intracavitary ureteral surgery has a ureteral injury incidence rate of about 4%-17%, and patients with ureteral stenosis account for about 30% of the total.

[0003] At present, in the process of treating post-injury obstruction caused by intraureteral surgery, with the continuous improvement of intracavitary ureteral surgical technology and the continuous improvement of auxiliary instruments, although the number of urologists who tend to use intracavitary urological surgery technology is increasing, it is still necessary to fully evaluate the obstruction of the affected ureter before surgical intervention, and make full use of imaging methods and endoscopic examinations in this process. Generally speaking, the long-term efficacy of simple ureteroscopic high-pressure balloon dilatation or holmium laser obstruction segment incision in the treatment of such patients is unsatisfactory and has a high recurrence rate. The fundamental reason is that the operation will cause additional thermal damage to the ureter due to the presence of holmium laser while the original mechanical injury, and this state also increases the recurrence rate of late stenosis. At present, in clinical surgery, only the surgical method of completely removing the ureteral stenosis segment and reconstructing the continuity of the ureter may be able to achieve satisfactory treatment effects. However, this operation is performed under a surgical laparoscopic system, and patients need to have a long recovery period after surgery, which is far less fast than the former.

[0004] At present, cold knife is often used as the incision tool for ureteral stricture in clinical ureteroscopic endotomy (such as Figure 1 ); Compared with open surgery, ureteroscopic cold knife endotomy for the treatment of ureteral stenosis is relatively simple to operate, less traumatic to patients, and can be performed repeatedly. The cold knife can avoid fibrosis around the ureter and effectively prevent scar formation. However, the cold knife has no hemostatic function. Excessive bleeding leads to blurred vision and increases the difficulty of operation. The cutting length and depth are difficult to control. The incidence of complications such as ureteral perforation and urine extravasation is high. Excessive urine extravasation after surgery can lead to scar hyperplasia of tissue around the ureter and recurrence of stenosis. In severe cases, it can damage the surrounding large blood vessels and cause massive bleeding.

[0005] In pursuit of a higher cure rate and to reduce the occurrence of surgical complications, urologists are constantly seeking better tools for the intracavitary treatment of ureteral stenosis. With the introduction of various energy platforms into the clinic, intracavitary treatment of ureteral stenosis has made rapid progress. The role of plasma bipolar cutter in tissue vaporization has been recognized. It can also be used as a tool for cutting tissue. The saline is stimulated into a large number of pairs of charged positive and negative ions through the transmitter. The charged particles with sufficient kinetic energy are accelerated to break the molecular bonds in the target tissue, causing the target tissue to be split into gases such as O2, CO2, and N2, thereby forming a cut. Because of its extremely superficial tissue penetration and good hemostasis function, it can achieve precise cutting. The plasma bipolar cutter causes little thermal damage to the surrounding normal tissues, and most of the energy is absorbed by water. More and more urologists choose it as a new tool for the treatment of ureteral stenosis.

[0006] In the prior art, the ureteral stenosis needs to be cut evenly at three points. However, due to the small size of the ureteral cavity, in many cases, after one angle cut, the entire ureteral cavity collapses, making it difficult to cut the stenosis evenly again. Summary of the invention

[0007] The purpose of the present invention is to provide a multi-dimensional endo-cutting knife used in urinary tract repair surgery, which is intended to solve the technical problem in the prior art that the entire lumen collapses after the ureter is cut at an angle.

[0008] The multi-dimensional internal cutting knife used in urinary tract repair surgery of the present invention comprises an outer tube, a guide column and three groups of cutting knife units distributed in a star shape; each group of the cutting knife units comprises an insulating tube, two loop electrode tubes and a cutting electrode; a double-core wire is passed through the insulating tube, the two loop electrode tubes are connected to the front end of the insulating tube, one of the double-core wires is electrically connected to one of the loop electrode tubes, the other of the double-core wires passes through the other loop electrode tube and is electrically connected to the cutting electrode, and the cutting electrode and the two loop electrode tubes are connected by an insulating sleeve to maintain a gap; the guide column is wrapped around the three insulating tubes and slidably engaged in the outer tube.

[0009] Furthermore, the insulating sleeve is composed of a main insulating sleeve and a secondary insulating sleeve arranged in parallel, and the main insulating sleeve and the secondary insulating sleeve are respectively inserted into the two loop electrode tubes; the cutting electrode includes a cutting rod and a cutting head, one end of the cutting rod is inserted in the secondary insulating sleeve, and the cutting head is arranged on the cutting rod and away from the side wall of the secondary insulating sleeve.

[0010] Furthermore, in order to increase the one-time resection range, the main insulating sleeve is made of ceramic material, the secondary insulating sleeve is made of soft rubber material, and a retaining spring is connected between the cutting rod and the side wall away from the secondary insulating sleeve and the side wall of the main insulating sleeve, and the retaining spring is used to bias the cutting head radially outward along the guide column; the three star-shaped cutting heads expand radially outward under the action of their respective retaining springs, and the surgical circumferential range of the three expanded cutting heads is expanded, thereby increasing the relative position of the three initial cutting points. After the secondary insulating sleeve is bent, it does not affect the double-core wire passing through it and being electrically connected to the cutting electrode.

[0011] Furthermore, the outer wall of the main insulating sleeve and the outer wall of the secondary insulating sleeve are connected by a welding block, and the welding block is arranged on a side close to the loop electrode tube; the advantage of this arrangement is that when the retaining spring pushes the cutting rod outward, the lower end of the cutting rod is connected to the secondary insulating sleeve. Since the secondary insulating sleeve is made of soft rubber material, the secondary insulating sleeve bends, and the bending force will be transmitted to one of the loop electrode tubes. Since the overall diameter is small, the tube diameter and wall thickness of the loop electrode tube are extremely small, and continuous force will cause the loop electrode tube to bend or even break, seriously reducing the reliability of the operation. In the present invention, the secondary insulating tube is welded to the main insulating sleeve by a welding block, and the fixed ends of the two retaining springs are also fixedly connected to the main insulating sleeve. According to the force action principle, the retaining spring force is balanced between the cutting electrode and the insulating sleeve, and will not affect the two loop electrode tubes, thereby improving the reliability of the instrument.

[0012] The multi-dimensional endo-cutting knife used in urinary tract repair provided by the present invention has the following advantages over the prior art: on the one hand, the present invention adopts a three-claw multi-dimensional cutting knife: it can synchronously cut the lumen at multiple angles, and the three transmitting ends work at the same time, and can cut the directions of three dimensions at the same time, and the cutting process is fast and efficient; on the other hand, if the resection caliber requirement is still not met after the three-point synchronous cutting, the present invention adds a spring structure, and uses the spring to expand the cutting electrode radially outward to ensure a wider range of resection. The present invention is based on low-temperature plasma technology and adopts a multi-dimensional bipolar cutting knife to evenly cut ureteral stenosis scars. The surgical system established in this project brings a new treatment method and new concept to clinicians. The present invention adopts a dual-electrode structure (the distance between the transmitting end electrode and the loop electrode is less than 5mm), removes the requirement of an external negative plate for the traditional monopolar energy platform, and also reduces the thermal damage to the tissue caused by the penetration and diffusion of electrical energy, thereby greatly reducing the product of complications and the recurrence rate of postoperative restenosis of the ureter. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1 Figure a is a schematic diagram of ureteral stenosis; Figure b is a traditional single-direction cold knife incision;

[0014] Figure 2 A is a real picture of ureteral stenosis; B is a picture of the cutting effect of a traditional endo-cutting knife; C is a picture of the cutting effect of a multi-dimensional endo-cutting knife used in urinary tract repair surgery of the present invention;

[0015] Figure 3 This is a schematic diagram of the structure of a multi-dimensional endo-cutting knife used in urinary tract repair surgery according to the present invention;

[0016] Figure 4 A schematic diagram of a multi-dimensional endo-cutting knife used in urinary tract repair surgery to remove an outer tube structure of the present invention;

[0017] Figure 5 for Figure 4 Schematic diagram of the change position structure;

[0018] Figure 6 for Figure 5 Schematic diagram of local structure;

[0019] Figure 7 for Figure 2 Schematic diagram of the transformation state structure;

[0020] Figure 8 for Figure 7 Schematic diagram of the structure without the outer tube.

[0021] Among them: 1. Outer tube; 2. Guide column; 3. Insulating tube; 4. Loop electrode tube; 5. Cutting electrode; 6. Double-core wire; 7. Main insulating sleeve; 8. Auxiliary insulating sleeve; 9. Cutting rod; 10. Cutting blade; 11. Retaining spring; 12. Welding block. DETAILED DESCRIPTION

[0022] The technical solution of the present invention will be clearly and completely described below in combination with the embodiments and drawings of the present invention. Obviously, the described embodiments are only 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.

[0023] In the description of the present invention, it should be noted that the terms "upper", "lower", "inner", "outer", "top", "bottom", "two ends", "one end", "the other end" and the like indicate positions or positional relationships based on the positions or positional relationships shown in the drawings, and are only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the device or element referred to must have a specific position, be constructed and operated in a specific position, and therefore cannot be understood as limiting the present invention; it should be noted that, unless otherwise clearly specified and limited, the terms "installed", "provided with", "connected" and the like should be understood in a broad sense, for example, "connected" can be a fixed connection, a detachable connection, or an integral connection; it can be a mechanical connection or an electrical connection; it can be a direct connection, or it can be an indirect connection through an intermediate medium, or it can be a communication between the two elements. For those of ordinary skill in the art, the specific meanings of the above terms in the present invention can be understood according to specific circumstances.

[0024] See also Figures 3 to 8 , This embodiment provides a multi-dimensional internal cutting knife used in urinary tract repair surgery, which includes an outer tube 1, a guide column 2 and three groups of cutting knife units distributed in a star shape;

[0025] Each group of the cutter units comprises an insulating tube 3, two return electrode tubes 4 and a cutting electrode 5; a double-core wire 6 is passed through the insulating tube 3, two return electrode tubes 4 are connected to the front end of the insulating tube 3, one of the double-core wires 6 is electrically connected to one of the return electrode tubes 4, the other of the double-core wires 6 passes through the other return electrode tube 4 and is electrically connected to the cutting electrode 5, the cutting electrode 5 and the two return electrode tubes 4 are connected by an insulating sleeve to maintain a gap; the insulating sleeve is composed of a main insulating sleeve 7 and a secondary insulating sleeve 8 arranged in parallel, the main insulating sleeve 7 and the secondary insulating sleeve 8 are respectively inserted into the two return electrode tubes 4; The cutting electrode 5 comprises a cutting rod 9 and a cutting blade 10, one end of the cutting rod 9 is inserted into the secondary insulating sleeve 8, and the cutting blade 10 is arranged on the cutting rod 9 and away from the side wall of the secondary insulating sleeve 8; the main insulating sleeve 7 is made of ceramic material, and the secondary insulating sleeve 8 is made of soft rubber material. A retaining spring 11 is connected between the side wall of the cutting rod 9 and away from the secondary insulating sleeve 8 and the side wall of the main insulating sleeve 7, and the retaining spring 11 is used to bias the cutting blade 10 radially outward along the guide column 2; the outer wall of the main insulating sleeve 7 and the outer wall of the secondary insulating sleeve 8 are connected by a welding block 12, and the welding block 12 is arranged on a side close to the return electrode tube 4;

[0026] The guide column 2 is wrapped around the three insulating tubes 3 and slidably engaged in the outer tube 1;

[0027] During the operation, the entire guide column 2 and the three groups of cutting knife units distributed in a star shape are pushed out of the outer tube 1. Under the spring force of the retaining spring 11, the cutting rod 9 is deflected outward around the auxiliary insulating sleeve 8 made of soft rubber material, thereby expanding the area surrounded by the first contact points of the three cutting points, making it easier to cut in place at one time, and significantly improving the operating convenience.

[0028] Figure 2 A is a real picture of ureteral stenosis; B is a picture of the cutting effect of a traditional endo-cutting knife; C is a picture of the cutting effect of the multi-dimensional endo-cutting knife used in urinary tract repair surgery of the present invention.

[0029] The matters not described in detail in the present invention are all known technologies to those skilled in the art.

[0030] It will be apparent to those skilled in the art that the invention is not limited to the details of the exemplary embodiments described above and that the invention can be implemented in other specific forms without departing from the spirit or essential features of the invention. Therefore, the embodiments should be considered exemplary and non-limiting in all respects, and the scope of the invention is defined by the appended claims rather than the foregoing description, and it is intended that all variations falling within the meaning and scope of the equivalent elements of the claims be included in the invention. Any reference numeral in a claim should not be considered as limiting the claim to which it relates.

Claims

1. A multi-dimensional endoscopic cutter used in urinary tract repair surgery, based on low-temperature plasma technology, characterized in that: It comprises an outer tube (1), a guide column (2) and three groups of cutting units distributed in a star shape; Each group of the cutter units comprises an insulating tube (3), two return electrode tubes (4) and a cutting electrode (5); a double-core wire (6) is passed through the insulating tube (3), the two return electrode tubes (4) are connected to the front end of the insulating tube (3), one of the double-core wires (6) is electrically connected to one of the return electrode tubes (4), the other of the double-core wires (6) passes through the other return electrode tube (4) and is electrically connected to the cutting electrode (5), and the cutting electrode (5) and the two return electrode tubes (4) are connected by an insulating sleeve to maintain a gap; The guide column (2) is wrapped around the three insulating tubes (3) and slidably engaged in the outer tube (1); the insulating sleeve is composed of a main insulating sleeve (7) and a secondary insulating sleeve (8) arranged in parallel, and the main insulating sleeve (7) and the secondary insulating sleeve (8) are respectively inserted into the two loop electrode tubes (4); the cutting electrode (5) includes a cutting rod (9) and a cutting head (10), one end of the cutting rod (9) is inserted into the secondary insulating sleeve (8), and the cutting head (10) is arranged on the cutting rod (9) and away from the side wall of the secondary insulating sleeve (8), and a retaining spring (11) is connected between the side wall of the cutting rod (9) away from the secondary insulating sleeve (8) and the side wall of the main insulating sleeve (7), and the retaining spring (11) is used to bias the cutting head (10) radially outward along the guide column (2).

2. The multi-dimensional endoscopic cutter used in urinary tract repair according to claim 1, characterized in that: The main insulating sleeve (7) is made of ceramic material, and the secondary insulating sleeve (8) is made of soft rubber material.

3. The multi-dimensional endoscopic cutter used in urinary tract repair according to claim 1, characterized in that: The outer wall of the main insulating sleeve (7) and the outer wall of the auxiliary insulating sleeve (8) are connected via a welding block (12), and the welding block (12) is arranged on a side close to the return electrode tube (4).

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