A tool for removing prostate coagulated tissue in prostatectomy surgery

Abstract

A prostate excavation surgery tool for excavating prostate coagulated tissue, the technical solution adopted is to set an insulating hollow catheter that can penetrate into the prostate through the urethra, install a rotatable rotary knife tube at the front end of the catheter, set a knife hole on the rotary knife tube, and set a needle knife mechanism that can extend and retract along the knife hole in the rotary knife tube, and configure a power shaft that can move and rotate along the catheter along the hollow catheter, and control the needle knife mechanism through the front end of the power shaft to make the needle knife extend from the knife hole of the rotary knife tube, and at the same time, the front end of the power shaft drives the rotary knife tube to rotate, so as to drive the extended needle knife to quickly remove the coagulated necrotic prostate tissue. The beneficial effect is that the prostate excavation surgery can be realized as an equipment operation, thereby improving the accuracy of the excavation surgery, reducing the difficulty of the surgery, shortening the operation time, making the excavation surgery simple, and reducing the surgical risk and cost of prostate hyperplasia excavation.

Description

Technical Field

[0001] The invention belongs to the technical field of surgical equipment, and in particular relates to a prostate coagulation tissue excavation tool used in prostate excavation surgery. Background Art

[0002] Prostatic hyperplasia is a common disease among middle-aged and elderly men. Its harm lies in the fact that the hyperplastic gland is located at the bladder neck, which will narrow the urinary tract and in severe cases, cause urinary tract obstruction, resulting in frequent urination and dysuria in patients. For patients with prostatic hyperplasia who are in a more serious condition and cannot urinate normally, the more common treatment method is transurethral resection of the prostate. Transurethral resection of the prostate is a minimally invasive surgery that requires general anesthesia of the patient and the use of a prostate resectoscope inserted through the urethra to remove the blocked part of the prostate. However, the thickness of the removal cannot be controlled, the operation is difficult and requires high requirements. It requires a high level of experience of the surgeon to perform the operation, and the operation time is long, there is a lot of bleeding during the operation, and it is easy to have persistent bleeding after the removal. It requires continuous flushing for a week, and the bleeding is long and the amount of bleeding is large, which is more harmful to the patient. Since most of these patients are high-collar patients, most of them are elderly and have serious underlying diseases, and some patients cannot tolerate this operation, so the operation risk is high, and they can only rely on a catheter for a long time, which is a burden on the quality of life.

[0003] In view of the surgical risks and complications of transurethral resection of the prostate, doctors in this field have proposed a new surgical method, which is to introduce a coagulation device that can be accurately positioned in the center of the prostate urethra through the urethra, and use the coagulation device to make the prostate coagulate, liquefy and necrotize within a certain range within the safety range centered on the prostate, and then use the resection device to resect the coagulated necrotic part along the center position within a certain safety range to ensure that the urethra is unobstructed. The coagulated necrotic part of a certain thickness remaining along the periphery of the coagulated necrotic part does not need to be excised, so that it gradually falls off and is discharged through its own metabolic necrosis. The advantage of this method is that the operation does not require general anesthesia and can be completed within half an hour, which greatly reduces the difficulty of the operation and the risk of surgical complications. In addition, there will be no bleeding problems during the excavation of the coagulated necrotic prostate part, and there is no obvious discomfort after the operation. Only infusion anti-inflammatory treatment is required, and continuous bladder urethral flushing is not required. The postoperative recovery is fast, which reduces the difficulty of subsequent treatment. The above improvements to the prostate excavation surgery are significantly better than the existing transurethral resection of the prostate, but the existing technology lacks the corresponding tools for implementing the above surgery. Summary of the invention

[0004] The purpose of the present invention is to solve the above-mentioned problem of excavating the prostate after the coagulation operation in the central part of the prostate, and to provide a prostate coagulated tissue excavating tool for quickly excavating the coagulated tissue in the central part of the prostate along the urethra.

[0005] In order to achieve the above purpose, the technical solution adopted by the present invention is to set an insulating hollow catheter that can penetrate into the prostate through the urethra, install a rotatable rotary knife tube at the front end of the catheter, set a knife hole on the rotary knife tube, and set a needle knife mechanism that can extend and retract along the knife hole in the rotary knife tube, and configure a power shaft that can move and rotate along the hollow catheter. The needle knife mechanism is controlled by the front end head of the power shaft to make the needle knife extend from the knife hole of the rotary knife tube. At the same time, the front end head of the power shaft drives the rotary knife tube to rotate, so as to drive the extended needle knife to quickly remove the coagulated necrotic prostate tissue. The specific technical solution is as follows.

[0006] The present invention discloses a tool for removing coagulated prostate tissue during prostate excavation surgery, comprising a catheter, a rotating knife tube, a knife rod, a reset spring and a power shaft; the catheter is an insulating hollow tube structure capable of penetrating into the coagulated prostate tissue site through the urethra, a knife tube sleeve interface is arranged along the outer wall of the front end of the catheter, and a power shaft limiting shaft hole is arranged along the inner part of the front end of the catheter 1; the rotating knife tube is a shaft cylinder structure, provided with a wall thickness, knife holes are evenly arranged along the cylinder wall, and an inclined knife groove is opened below the knife holes on the inner side of the cylinder wall, a cover is fixedly installed on the upper end of the shaft cylinder, a movable mounting sleeve is arranged at the lower end of the shaft cylinder, and a transmission shaft hole is arranged on the upper side of the movable mounting sleeve; the rotating knife tube is connected to the shaft cylinder through the movable mounting sleeve at the lower end The opening is axially positioned and fitted on the knife tube set interface at the front end of the catheter; the knife rod is axially fitted in the rotating knife tube, and the knife rod is provided with needle knives of corresponding positions and numbers according to the positions and numbers of the knife holes of the rotating knife tube. The root of the needle knife is hingedly mounted on the knife rod, and the tip and the blade of the needle knife are installed in the knife holes and knife grooves at corresponding positions on the rotating knife tube; the reset spring is installed between the top of the knife rod and the cover of the rotating knife tube, and the reset spring enables the knife rod to always move axially toward the lower end of the rotating knife tube; the power shaft is axially fitted in the catheter, and a transmission shaft head is provided at the front end of the power shaft, and the transmission shaft head is transmission-fittedly installed with the transmission shaft hole of the rotating knife tube.

[0007] The knife holes on the rotating knife tube are evenly staggered along the axial direction and radial direction of the rotating knife tube, and the distribution length along the axial direction of the rotating knife tube is less than 2 mm.

[0008] The knife hole on the rotating knife tube is respectively provided with chamfers on the upper side and the lower side of the mouth along one side of the outer wall of the rotating knife tube.

[0009] The knife hole on the rotating knife tube is arranged perpendicularly to the tube wall along the upper hole wall penetrating the wall thickness of the rotating knife tube.

[0010] A spring installation groove is arranged on the cover of the rotary knife tube, and one end of the return spring is fixedly installed in the spring installation groove of the cover.

[0011] A connecting key is arranged on the transmission shaft hole of the rotating knife tube, and a keyway matched with the connecting key of the transmission shaft hole is arranged on the transmission shaft head of the power shaft, and the rotating knife tube and the power shaft are matched through the keyway structure.

[0012] The movable installation sleeve of the rotating knife tube and the knife tube sleeve interface of the catheter are installed in a bearing-matched manner.

[0013] The knife rod is coaxially positioned and matched with the rotating knife tube through an upper end rod body and a lower end rod body.

[0014] An axial positioning shoulder is arranged at the rear end of the transmission shaft head of the power shaft.

[0015] The transmission shaft head of the power shaft is provided with an inclined guide opening along the upper end surface of the keyway.

[0016] The beneficial effect of the present invention is that it enables prostatectomy surgery to be performed in an equipment-based manner, thereby improving the accuracy of the surgery, reducing the difficulty of the surgery, shortening the surgery time, making the surgery simpler, and reducing the surgical risks and costs of prostatectomy for prostate hyperplasia. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] Attached Figure 1 It is a schematic diagram of the appearance structure of the present invention;

[0018] Attached Figure 2 It is a schematic diagram of the internal structure of the present invention;

[0019] Attached Figure 3 It is a schematic diagram of the internal structure of the present invention (working state);

[0020] Attached Figure 4 It is a schematic diagram of the cross-sectional structure of the rotary knife tube of the present invention;

[0021] Attached Figure 5 It is a schematic diagram of the cross section of the internal structure of the present invention (the location of the knife hole);

[0022] Attached Figure 6 It is a schematic cross-sectional view of the internal structure of the present invention (transmission position);

[0023] Attached Figure 7 It is a schematic diagram of the cross-section of the internal structure of the present invention (the end position of the transmission shaft head);

[0024] In the accompanying drawings: catheter 1, knife tube set interface 11, power shaft limiting shaft hole 12, rotating knife tube 2, knife hole 21, chamfer 211, upper hole wall 212, knife groove 22, cover 23, spring mounting groove 231, movable mounting sleeve 24, transmission shaft hole 25, connecting key 251, knife rod 3, needle knife 31, upper end rod body 32, lower end rod body 33, reset spring 4, power shaft 5, transmission shaft head 51, keyway 511, guide mouth 512, axial positioning shaft shoulder 52, bearing 6. DETAILED DESCRIPTION

[0025] In order to make the purpose, technical solution and advantages of the present invention more clear, the technical solution of the present invention will be described in detail below in conjunction with embodiments.

[0026] As attached Figure 1-7 As shown, the prostate coagulation tissue excavation tool for prostate excavation surgery of the present invention comprises a catheter 1, a rotating knife tube 2, a knife rod 3, a reset spring 4 and a power shaft 5; the catheter 1 is an insulating hollow tube structure that can penetrate into the prostate coagulation tissue site through the urethra, a knife tube sleeve interface 11 is arranged along the outer wall of the front end of the catheter 1, and a power shaft limiting shaft hole 12 is arranged along the inside of the front end of the catheter 1; the rotating knife tube 2 is a shaft tube structure, with a wall thickness, knife holes 21 are evenly distributed along the tube wall, and an inclined knife groove 22 is opened below the knife holes 21 on the inner side of the tube wall, a cover 23 is fixedly installed on the upper end of the shaft tube, a movable mounting sleeve 24 is arranged at the lower end of the shaft tube, and a transmission shaft hole 25 is arranged on the upper side of the movable mounting sleeve 24; the rotating knife tube 2 is axially positioned by the movable mounting sleeve 24 at the lower end It is mounted on the knife tube sleeve interface 11 at the front end of the catheter 1; the knife rod 3 is mounted in the rotating knife tube 2 along the axial direction of the rotating knife tube 2, and the knife rod 3 is provided with needle knives 31 of corresponding positions and numbers according to the positions and numbers of the knife holes 21 of the rotating knife tube 2. The root of the needle knife 31 is hingedly mounted on the knife rod 3, and the tip and the blade of the needle knife 31 are mounted in the knife holes 21 and knife grooves 22 at corresponding positions on the rotating knife tube 2; the reset spring 4 is mounted between the top of the knife rod 3 and the cover 23 of the rotating knife tube 2, and the reset spring 4 enables the knife rod 3 to always move axially toward the lower end of the rotating knife tube 2; the power shaft 5 is mounted in the catheter 1 along the axial direction of the catheter 1, and a transmission shaft head 51 is arranged at the front end of the power shaft 5, and the transmission shaft head 51 is mounted in transmission cooperation with the transmission shaft hole 25 of the rotating knife tube 2.

[0027] The knife holes 21 on the rotating knife tube 2 are evenly staggered along the axial direction and radial direction of the rotating knife tube 2, and the distribution length along the axial direction of the rotating knife tube 2 is less than 2 mm.

[0028] The knife hole 21 on the rotating knife tube 2 is provided with chamfers 211 at the upper and lower sides of the opening along one side of the outer wall of the rotating knife tube 2 .

[0029] The knife hole 21 on the rotating knife tube 2 is arranged perpendicular to the tube wall along the upper hole wall 212 that penetrates the wall thickness of the rotating knife tube 2 .

[0030] The cover 23 of the rotary knife tube 2 is provided with a spring installation groove 231 , and one end of the return spring 4 is fixedly installed in the spring installation groove 231 of the cover 23 .

[0031] A connecting key 251 is provided on the transmission shaft hole 25 of the rotating knife tube 2, and a keyway 511 matching with the connecting key 251 of the transmission shaft hole 25 is provided on the transmission shaft head 51 of the power shaft 5. The rotating knife tube 2 and the power shaft 5 are matched through the keyway structure.

[0032] The movable installation sleeve 24 of the rotating knife tube 2 and the knife tube sleeve interface 11 of the catheter 1 are installed in cooperation with each other by means of a bearing 6 .

[0033] The knife rod 3 is coaxially positioned and mounted with the rotating knife tube 2 through an upper rod body 32 and a lower rod body 33 .

[0034] An axial positioning shoulder 52 is provided at the rear end of the transmission shaft head 51 of the power shaft 5 .

[0035] The transmission shaft head 51 of the power shaft 5 is provided with an inclined guide opening 512 along the upper end surface of the keyway 511 . Example

[0036] The invention discloses an operation process and method of a prostate coagulation tissue excavation tool for prostate excavation surgery.

[0037] 1) As attached Figure 1 The figure shows a schematic diagram of the appearance structure of the present invention. The tool is inserted from the patient's genital urethra through the top round head cover 23, and the rotary knife tube 2 is made to penetrate into the center of the coagulated part of the prostate urethra with the help of ultrasound guidance to ensure that the knife hole 21 of the rotary knife tube 2 is located at the prostate coagulated tissue part. According to the requirements of the surgical design, a certain thickness of prostate coagulated tissue must be retained along the edge of the coagulated tissue during the excavation process to ensure that there will be no bleeding during the excavation process. Therefore, the knife hole 21 of the rotary knife tube 2 must be completely located at the prostate coagulated tissue part. The axial distribution length of the knife hole 21 on the rotary knife tube 2 is at least less than 2 mm. The excavation range can be controlled by moving the position of the rotary knife tube 2 during the excavation process.

[0038] 2) When the rotary knife tube 2 reaches the designated position under ultrasound guidance, the internal structure diagram of the present invention is as shown in the attached figure. Figure 2As shown, the knife rod 3 is located at the lower part of the rotating knife tube 2 under the pressure of the reset spring 4, and one end of the needle knife 31 on the knife rod 3 is hinged to the knife rod 3. The needle knife 31 is driven by the knife rod 3 to always shrink downward along the knife groove 22, ensuring that the other end of the needle knife 31 shrinks in the knife hole 21 and does not leak out of the outer wall of the rotating knife tube 2. During the insertion process of the entire catheter 1, the safety of the knife rod 3 and the needle knife 31 is ensured in the rotating knife tube 2 under the action of the reset spring 4. The advantage of this structure is that it can increase the length of the needle knife 31, facilitate the storage and extension of the needle knife 31, and ensure that the needle knife 31 can reach the length required by the operation after being extended. Since the diameter of the ureter is 6-7mm, and the extension length of the needle knife 31 during the excavation process must reach about 1cm, the setting length of the needle knife 31 is much larger than the diameter of the rotating knife tube 2. The inclined knife groove 22 can not only limit the activity space and path of the needle knife 31, so that it can perform telescopic operations along the knife hole 21 through the axial movement of the knife rod 3, but also the inclined knife groove 22 provides storage space for the needle knife 31.

[0039] 3) As attached Figure 2 In the state shown, fix the position of the catheter 1 and the urethra, insert the power shaft 5 along the center of the catheter 1 under ultrasound guidance until the transmission shaft head 51 at the front end extends into the power shaft limit shaft hole 12 at the front end of the catheter 1, then manually rotate the power shaft 5 appropriately and push it forward, so that the keyway 511 of the transmission shaft head 51 and the connecting key 251 of the transmission shaft hole 25 are matched and installed, as shown in the attached Figure 6 As shown, the transmission shaft head 51 and the transmission shaft hole 25 of the rotating knife tube 2 complete the transmission cooperation. At the same time, when the power shaft 5 continues to push, the transmission shaft head 51 passes through the transmission shaft hole 25 and begins to press on the bottom of the knife rod 3 to compress the reset spring 4, so that the knife rod 3 moves upward along the axial direction of the rotating knife tube 2. At the same time, the knife rod 3 drives the needle knife 31 to slide outward along the knife groove 22 so that the front end slides out of the knife hole 21. When the axial positioning shoulder 52 of the power shaft 5 reaches the power shaft limiting shaft hole 12 at the front end of the catheter 1 and cannot move forward any further, the transmission shaft head 51 presses the knife rod 3 into place, as shown in the attached figure. Figure 3 And attached Figure 5 As shown in the structure, at this time, the needle knife 31 on the knife rod 3 is in a vertical state with the knife rod 3, and the needle knife 31 vertically extends from the knife hole 21 of the rotating knife tube 2 to the maximum length and is inserted into the coagulated necrotic prostate tissue. Under the guidance of ultrasound, observe whether the extension length of the needle knife 31 is in place and whether the extended needle knife 31 exceeds the range of the coagulated prostate tissue. Only after ensuring that there is no error, can the excavation operation be carried out.

[0040] 4) Control and start the power output mechanism to make the power shaft 5 rotate in the catheter 1, and the transmission shaft head 51 and the transmission shaft hole 25 cooperate to drive the rotating knife tube 2 to rotate. As the rotating knife tube 2 rotates, the needle knife 31 is driven to excavate and crush the surrounding necrotic and coagulated prostate tissue with the extended length as the radius. This crushing process can be completed instantly. At the same time, under the guidance of ultrasound, the operating position of the rotating knife tube 2 is changed by pulling the catheter 1 to control the excavation range of the necrotic and coagulated prostate tissue.

[0041] 5) After the excavation and crushing operation is completed, the rotation of the power shaft 5 is stopped, and the power shaft 5 is pulled out along the catheter 1 under the guidance of ultrasound; as the transmission shaft head 51 withdraws from the transmission shaft hole 25, the knife rod 3 moves downward along the rotating knife tube 2 to the lower end of the rotating knife tube 2 under the action of the return spring 4, and at the same time drives the needle knife 31 from the knife hole 21 of the rotating knife tube 2 into the knife groove 22, the excavation operation state is released, and the overall structure is restored to the state as shown in the attached figure. Figure 2 Under ultrasound guidance, observe whether the needle knife 31 is restored to its original position, and ensure that the needle knife 31 is completely retracted from the outer wall of the rotating knife tube 2.

[0042] 6) Under ultrasound guidance, catheter 1 is pulled out along the urethra and the excavation operation is completed.

[0043] 7) Insert a catheter along the urethra to the excavated area, clean the excavated area, and discharge the excavated and broken prostate tissue. The operation is now completed and the patient will receive subsequent rehabilitation treatment.

[0044] As attached Figure 1 As shown, the knife holes 21 on the rotating knife tube 2 are staggered one by one in the same row along the axial direction during the setting process. The reason is that if they are all set in the same axial direction, the internal space is not enough to set the knife groove 22. The knife groove 22 of the upper knife hole 21 of the two adjacent knife holes 21 will overlap with the lower knife hole 21, which will not only damage the limiting structure, but also affect the setting length of the knife groove 22, thereby affecting the setting length of the needle knife 31. The positions of the knife holes 21 in the two adjacent rows arranged radially along the rotating knife tube 2 are evenly staggered, and the density of the axial knife holes 21 can be increased or decreased by this arrangement, thereby improving the density of the excavation operation.

[0045] Attached Figure 7 During the transmission cooperation between the transmission shaft head 51 of the present invention and the transmission shaft hole 25 of the rotary knife tube 2, an inclined guide opening 512 is provided on the upper end surface of the key slot 511 of the transmission shaft head 51, so that the key slot 511 and the connecting key 251 can be easily and quickly cooperated during the installation cooperation process.

Claims

1. A tool for removing prostate coagulated tissue during prostatectomy, characterized in that: The invention comprises a catheter (1), a rotating knife tube (2), a knife rod (3), a reset spring (4) and a power shaft (5); the catheter (1) is an insulating hollow tube structure capable of penetrating into the prostate coagulation tissue through the urethra, a knife tube sleeve interface (11) is arranged along the outer wall of the front end of the catheter (1), and a power shaft limiting shaft hole (12) is arranged along the inner part of the front end of the catheter (1); the rotating knife tube (2) is a shaft tube structure, provided with a wall thickness, knife holes (21) are evenly arranged along the tube wall, and an inclined knife groove (22) is opened below the knife holes (21) on the inner side of the tube wall; a sealing cover (23) is fixedly installed at the upper end of the shaft tube, and a movable installation sleeve (24) is arranged at the lower end of the shaft tube, and a transmission shaft hole (25) is arranged on the upper side of the movable installation sleeve (24); the rotating knife tube (2) is axially positioned and matched with the knife tube sleeve interface (11) installed at the front end of the catheter (1) through the movable installation sleeve (24) at the lower end. ); the knife rod (3) is mounted in the rotating knife tube (2) along the axial direction of the rotating knife tube (2); the knife rod (3) is provided with needle knives (31) of corresponding positions and numbers according to the positions and numbers of the knife holes (21) of the rotating knife tube (2); the root of the needle knives (31) is hingedly mounted on the knife rod (3); the tip and the blade of the needle knives (31) are mounted in the knife holes (21) and knife grooves (22) of corresponding positions on the rotating knife tube (2); the return spring (4) is mounted between the top of the knife rod (3) and the cover (23) of the rotating knife tube (2); the return spring (4) enables the knife rod (3) to always move axially toward the lower end of the rotating knife tube (2); the power shaft (5) is mounted in the conduit (1) along the axial direction of the conduit (1); a transmission shaft head (51) is provided at the front end of the power shaft (5); the transmission shaft head (51) is transmission-matchedly mounted with the transmission shaft hole (25) of the rotating knife tube (2).

2. The prostate coagulation tissue excavation tool for prostate excavation surgery as claimed in claim 1, characterized in that: The knife holes (21) on the rotating knife tube (2) are evenly staggered along the axial direction and radial direction of the rotating knife tube (2), and the distribution length along the axial direction of the rotating knife tube (2) is less than 2 mm.

3. The prostate coagulation tissue excavation tool for prostate excavation surgery as claimed in claim 1, characterized in that: The knife hole (21) on the rotating knife tube (2) is provided with chamfers (211) respectively on the upper side and the lower side of the mouth along one side of the outer wall of the rotating knife tube (2).

4. The prostate coagulation tissue excavation tool for prostate excavation surgery as claimed in claim 1, characterized in that: The knife hole (21) on the rotating knife tube (2) is arranged perpendicular to the tube wall along an upper hole wall (212) that penetrates the wall thickness of the rotating knife tube (2).

5. The prostate coagulation tissue excavation tool for prostate excavation surgery as claimed in claim 1, characterized in that: A spring installation groove (231) is provided on the cover (23) of the rotary knife tube (2), and one end of the return spring (4) is fixedly installed in the spring installation groove (231) of the cover (23).

6. The prostate coagulation tissue excavation tool for prostate excavation surgery as claimed in claim 1, characterized in that: A connecting key (251) is arranged on the transmission shaft hole (25) of the rotating knife tube (2), and a keyway (511) matching with the connecting key (251) of the transmission shaft hole (25) is arranged on the transmission shaft head (51) of the power shaft (5), and the rotating knife tube (2) and the power shaft (5) are matched in transmission through the keyway structure.

7. The prostate coagulation tissue excavation tool for prostate excavation surgery as claimed in claim 1, characterized in that: The movable installation sleeve (24) of the rotating knife tube (2) and the knife tube sleeve interface (11) of the catheter (1) are installed in cooperation with each other using a bearing (6).

8. The prostate coagulation tissue excavation tool for prostate excavation surgery as claimed in claim 1, characterized in that: The knife rod (3) is coaxially positioned and mounted with the rotating knife tube (2) through an upper rod body (32) and a lower rod body (33).

9. The prostate coagulation tissue excavation tool for prostate excavation surgery as claimed in claim 1, characterized in that: An axial positioning shoulder (52) is provided at the rear end of the transmission shaft head (51) of the power shaft (5).

10. The prostate coagulation tissue excavation tool for prostate excavation surgery according to claim 1, characterized in that: The transmission shaft head (51) of the power shaft (5) is provided with an inclined guide opening (512) along the upper end surface of the keyway (511).

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