A magnetic traction surgical device specially used for endoscopic mucosal dissection

Abstract

The invention discloses a magnetic traction surgical device specially used for endoscopic mucosal stripping, which belongs to the technical field of medical devices. The device comprises a high-frequency electric knife for cutting mucosa and a metal clip for clamping mucosa. A first magnet and a second magnet that repel each other are respectively arranged on the working end of the high-frequency electric knife and the metal clip. By utilizing the mutual repulsion property of the magnetic poles of the first magnet and the second magnet, the metal clip is clamped at the mucosal incision as an auxiliary device. During the operation, the high-frequency electric knife is operated to perform the operation, and the metal clip is automatically repelled by the magnet on the high-frequency electric knife, and then the mucosa is lifted up to achieve a traction effect, thereby improving the surgical field of view. There is no need to expend extra effort to manipulate the metal clip separately. Moreover, since the magnetic repulsion force is constant, the metal clip will gradually lift up the diseased mucosa as the high-frequency electric knife is operated, which not only avoids excessive traction force, but also can flexibly change the lifting direction as the direction of the high-frequency electric knife changes, thereby meeting the needs of high-precision surgery.

Description

Technical Field

[0001] The invention relates to the technical field of medical devices, and in particular to a magnetic traction surgical device dedicated to endoscopic mucosal dissection. Background Art

[0002] In recent years, with the rapid development of digestive endoscopy equipment and related instruments, various endoscopic minimally invasive surgeries have also achieved unprecedented development, especially the concept of "super minimally invasive", which has realized many treatments that could only be achieved through surgery and interventional surgery before. Compared with traditional surgical operations, endoscopic treatment can preserve the original organs and the integrity of the organ structure under the premise of complete removal of the lesion, without incision on the body surface, shorter operation time, and better postoperative recovery effect for patients. Endoscopic submucosal dissection (ESD) is currently widely used in endoscopic treatment of early tumors and precancerous lesions of the esophagus, stomach, and colon. The classic ESD technology is to inject physiological saline into the submucosa to make the tumor bulge and separate from the submucosa, and then use various incisors to cut the periphery of the lesion, and gradually extend the submucosal layer to completely dissect the entire lesion. During endoscopic submucosal dissection, auxiliary devices are usually required to lift the lesion mucosa to obtain a better surgical field of view. Currently, the commonly used auxiliary device is a transparent cap with a transparent plastic tubular structure. When in use, the transparent cap is placed at the end of the endoscope. The transparent cap can be used to lift the lesion that has been removed, playing a "support" role, thereby better exposing the lesion mucosa for subsequent submucosal dissection (cutting, coagulation, and blunt separation). However, in actual use, medical personnel found that after adding the transparent cap, not only was the exposure of the submucosal layer of some lesions unsatisfactory, but also due to the obstruction of the transparent cap, it was difficult for instruments such as the incision knife to approach the submucosal layer. For example, for large lesions in the esophagus, only using the transparent cap to "lift and divide" to separate the submucosal layer cannot achieve the clear submucosal surgical field of view required for ESD, especially in the part with wrinkles or the distal end of the corner of the mucosal tissue. The field of view is difficult to meet the requirements. Blind dissection and cutting will increase the risk of perforation or bleeding, and will also lead to serious complications in the later stage.

[0003] Therefore, in order to ensure a good visual field during surgery, a dental floss traction-assisted method has been proposed in recent years, that is, after the lesion is cut at the edge and part of the submucosal tissue is peeled off, a metal clip is inserted into the endoscopic biopsy channel in vitro to expose it, the metal clip is opened, the dental floss is tied to one arm of the clip, and then the two arms of the clip are gently closed, and the metal clip is pulled back into the transparent cap, and then the endoscope is inserted into the lesion again, and a metal clip with dental floss is placed on the mucosal tissue cut on the anal side of the lesion. The submucosal cut surface is exposed by pulling the dental floss on the metal clip, so that the peeling operation can be performed efficiently. However, the dental floss traction method has high requirements, the traction force is relatively small, and excessive pulling may cause it to fall off the specimen, causing the pulling of the muscularis propria. In addition, the medical staff is required to control the traction of the traction dental floss during traction, and because the traction of the traction dental floss is coordinated with the high-frequency electric knife, the medical staff needs to concentrate their attention to achieve high-precision coordination between the two. However, long-term high concentration of attention has instead caused a burden on the medical staff, and performing surgery in a tired state is also prone to safety hazards.

[0004] Therefore, in order to reduce the workload of medical personnel, the utility model with patent number "201620536535.5" and patent name "A device for auxiliary mucosal lifting of diseased mucosa in endoscopic surgery" proposes a mucosal lifting device that does not require medical personnel to spend extra energy to control. By setting a number of metal clips on the rubber band, and then clamping the metal clips around the diseased mucosa, by adjusting the length of the rubber band, the edge of the lesion can be flipped toward the center of the lesion, thereby improving the surgical field of view. However, once the rubber band of the above-mentioned auxiliary device is tightened, it cannot be adjusted in position as the operation progresses. Therefore, it is difficult to meet the needs of some areas with more wrinkles or the distal end of the corners of mucosal tissue with higher surgical precision. Summary of the invention

[0005] The purpose of the present invention is to solve the above-mentioned technical problems and provide a magnetic traction surgical device dedicated to endoscopic mucosal dissection. A metal clip with a built-in magnet is clamped at the mucosal incision as an auxiliary device, and then a high-frequency electric knife with a built-in magnet is used in conjunction with it. During the operation, it is only necessary to operate the high-frequency electric knife normally for the operation. The metal clip will automatically be repelled by the magnet on the high-frequency electric knife, and then the mucosa will be lifted up to improve the surgical field of view. There is no need to spend extra energy to operate the auxiliary device. Moreover, since the magnetic repulsion force is constant, the metal clip will gradually lift up the diseased mucosa as the high-frequency electric knife is operated. Not only can excessive traction force be avoided, but also the lifting direction can be flexibly changed as the direction of the high-frequency electric knife changes.

[0006] To achieve the above-mentioned purpose, the present invention provides the following solution: The present invention provides a magnetic traction surgical device dedicated to endoscopic mucosal dissection, comprising a high-frequency electric knife for cutting the mucosa and a metal clip for clamping the mucosa, wherein the working end of the high-frequency electric knife and the metal clip are respectively provided with a first magnet and a second magnet that repel each other.

[0007] Preferably, the high-frequency electric knife includes a dual blade head and a hollow plastic tube matching the size of the endoscopic biopsy hole, the first magnet is an annular magnet coaxially fixed in the working end of the hollow plastic tube, an insulating conduit is fixed in the ring of the first magnet, the insulating conduit extends to the working end of the hollow plastic tube, the dual blade head is sleeved in the insulating conduit and the head extends out of the working end of the hollow plastic tube, the tail of the dual blade head is connected to a conductive wire connected to a power supply system, and the tail of the hollow plastic tube is provided with a traction handle for controlling the axial movement of the dual blade head along the hollow plastic tube.

[0008] Preferably, the traction handle includes a pull handle with a pull ring at the tail and a traction tube with grip rings on both sides. The traction tube is sleeved on the pull handle, and a limit ring is coaxially fixed to the head of the pull handle to prevent the traction tube from detaching. The head of the pull handle is provided with a pull cable fixedly connected to the tail of the Dual blade head.

[0009] Preferably, an annular fixing frame is coaxially fixed to the working end of the hollow plastic tube, and the insulating conduit is fixed in the ring of the annular fixing frame.

[0010] Preferably, the length of the hollow plastic tube is 160 mm, the length of the first magnet is 0.5 mm, the length of the annular fixing frame is 0.2 mm, the distance between the first magnet and the annular fixing frame is 1 mm, and the length of the insulating conduit is 20 mm.

[0011] Preferably, the metal clip includes a clip assembly and a connecting seat for detachably connecting to the metal clip releaser, and the second magnet is fixedly connected between the clip assembly and the connecting seat, and the second magnet is an annular magnet.

[0012] Preferably, the clamp assembly comprises a clamp seat fixedly connected to the second magnet, and a clamping piece arranged on the clamp seat, and an end of the clamping piece is bent inward.

[0013] Preferably, the ends of the two clips are respectively provided with a V-shaped engaging groove and a triangular engaging tooth.

[0014] Preferably, the maximum opening and closing angle of the clip is 160°.

[0015] Preferably, the metal clip is a titanium clip.

[0016] Compared with the prior art, the present invention has achieved the following technical effects:

[0017] 1. The magnetic traction surgical device includes a metal clip with a built-in second magnet and a high-frequency electric knife with a built-in first magnet. The doctor's operation realizes mutual cooperation. During the stripping process, the metal clip clamps the mucosa next to the lesion, and the high-frequency electric knife performs the surgical operation normally. The magnetic poles of the first magnet and the second magnet repel each other. The metal clip will lift the mucosa to improve the surgical field of view as the high-frequency electric knife goes deeper, thereby achieving traction on the lesion. There is no need to spend extra energy to operate the metal clip. Since the magnetic repulsive force is constant, the metal clip will not be over-traction, but will be gradually lifted up as the high-frequency electric knife goes deeper, thereby avoiding strain on the muscularis propria and tissue damage caused by improper surgery. At the same time, changing the direction of the high-frequency electric knife can also change the moving position of the metal clip and flexibly change the lifting direction.

[0018] 2. The high-frequency electric knife uses a cutting knife with a dual blade head. The dual blade head has the advantages of being safe, effective and reducing the use of accessories. The dual blade head can freely change its length in the hollow plastic tube under the action of the traction handle and remain fixed after changing the length, thus being able to adapt to different cutting needs.

[0019] 3. The working end of the hollow plastic tube is coaxially fixed with an annular fixing frame, which fixes the end of the insulating catheter in one step, thereby improving the stability of the insulating catheter in the hollow plastic tube, and then ensuring the stability of the Dual blade in the insulating catheter to meet the needs of high-precision surgery.

[0020] 4. The second magnet is fixedly connected between the clip assembly and the connecting seat. The second magnet is repelled by the first magnet and can push the metal clip from the tail of the metal clip, which is conducive to the tail of the metal clip rotating outward to push open the mucosal incision.

[0021] 5. The ends of the clips are provided with V-shaped bite grooves and triangular bite teeth that can bite each other. When the ends of the two clips 20 are put together, the triangular bite teeth 22 are just embedded in the V-shaped bite groove 21, which is conducive to firmly clamping the mucosal tissue without causing displacement after clamping. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] 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 will be briefly introduced below. Obviously, the drawings described below are only 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.

[0023] Figure 1 It is a schematic diagram of the structure of the high-frequency electric knife and the traction handle;

[0024] Figure 2 It is a structural schematic diagram of a high-frequency electric knife;

[0025] Figure 3 This is a partial enlarged picture of the high-frequency electric knife;

[0026] Figure 4 It is a schematic diagram of the structure of a metal clip and a metal clip releaser;

[0027] Figure 5 is a schematic diagram of the structure of the metal clip;

[0028] Figure 6 Schematic diagram of the clip end of the metal clip.

[0029] Explanation of the reference numerals: 1. high-frequency electric knife; 2. metal clip; 3. first magnet; 4. second magnet; 5. dual blade head; 6. hollow plastic tube; 7. insulating conduit; 8. conductive wire; 9. traction handle; 10. pull ring; 11. pull handle; 12. grip ring; 13. traction tube; 14. limiting ring; 15. pull rope; 16. annular fixing frame; 17. connecting seat; 18. metal clip releaser; 19. clamp seat; 20. clip; 21. V-shaped bite groove; 22. triangular bite teeth. DETAILED DESCRIPTION

[0030] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments 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.

[0031] This embodiment provides a magnetic traction surgical device for endoscopic mucosal dissection, such as Figures 1 to 6As shown, it includes a high-frequency electric knife 1 for cutting mucosa, and a metal clip 2 for clamping the diseased mucosa. A first magnet 3 is provided on the working end of the high-frequency electric knife 1, and a second magnet 4 is provided on the metal clip 2. The outer surface magnetic poles of the first magnet 3 and the second magnet 4 are the same. When in use, firstly, physiological saline is injected under the mucosa where the tumor is located to make the tumor bulge and separate from the normal mucosa, and then the high-frequency electric knife 1 is extended from the endoscopic biopsy hole of the endoscope into the vicinity of the mucosa where the tumor is located, and the edge of the lesion is cut with the high-frequency electric knife 1. Then, the high-frequency electric knife 1 is pulled out, and the metal clip releaser 18 with the metal clip 2 is extended from the endoscopic biopsy hole of the endoscope to the lesion, and the metal clip 2 is released so that the metal clip 2 is clamped on the edge of the lesion. The number of metal clips 2 is selected according to actual needs. After the metal clip 2 is released, the metal clip releaser 18 is pulled out, and the high-frequency electric knife 1 is extended to the lesion again to perform the stripping operation. Under the repulsion of the first magnet 3 on the high-frequency electric knife 1, the metal clip 2 with the second magnet 4 will move away from the high-frequency electric knife 1. By controlling the position of the high-frequency electric knife 1, the metal clip 2 can lift the edge of the lesion, thereby exposing more fields of view. Then, as the high-frequency electric knife 1 is extended, the metal clip 2 can further lift the lesion mucosa until the endoscopic mucosal glass surgery is completed, and the lesion mucosa together with the lesion and the metal clip 2 are stripped off. The magnetic force of the first magnet 3 and the second magnet 4 should not be too large, and the metal clip 2 should not be pushed too far, causing excessive pulling, tearing the muscular layer, and causing damage to the muscular layer. A magnet with an appropriate magnetic force can be selected to achieve the purpose of gradually opening the mucosa at the lesion. At the same time, by changing the position of the high-frequency electric knife 1, the direction of opening the metal clip 2 can also be changed to achieve a precise and controllable purpose, so that it can deal with wrinkles or the distal end of the corner of the mucosal tissue, etc., which requires high precision. The metal clip releaser 18 is a commonly used medical device available on the market. The connection method between it and the metal clip 2 is currently available and will not be described in detail here.

[0032] In this embodiment, Figures 1 to 3As shown, the high-frequency electric knife 1 is a high-frequency electric knife 1 with a dual blade head 5. The high-frequency electric knife 1 is composed of a hollow plastic tube 6, an insulating conduit 7, a first magnet 3, and a conductive wire 8. The size of the hollow plastic tube 6 matches the size of the endoscopic biopsy hole to ensure that the hollow plastic tube 6 can be freely extended and retracted in the endoscopic biopsy hole. The first magnet 3 is an annular magnet. Preferably, the outer ring of the first magnet 3 is an N pole and the inner ring is an S pole. The first magnet 3 is coaxially fixed in the working section of the hollow plastic tube 6. The insulating conduit 7 is coaxially fixed in the ring of the first magnet 3, and the end of the insulating conduit 7 is flush with the working end of the hollow plastic tube 6. The dual blade head 5 is sleeved in the insulating conduit 7 and can be freely extended and retracted in the insulating conduit 7. The head of the dual blade head 5 extends out of the working end of the hollow plastic tube 6 for operation. The tail of the dual blade head 5 is electrically connected to the conductive wire 8. The conductive wire 8 extends outward along the insulating conduit 7 and extends out of the tail of the hollow plastic tube 6 to connect with the power supply system. A traction handle 9 is provided at the rear end of the hollow plastic tube 6 for controlling the axial movement of the dual blade head 5 along the hollow plastic tube 6 and for controlling the length of the dual blade head 5 extending out of the hollow plastic tube 6. The traction handle 9 is a commonly used control handle in medical treatment and is available on the market.

[0033] Further, in this embodiment, the traction handle 9 includes a pull handle 11, the tail of the pull handle 11 is fixedly connected with a pull ring 10, a traction tube 13 is sleeved in the middle of the pull handle 11, and grip rings 12 are provided on both sides of the traction tube 13. At the same time, a limit ring 14 is provided at the head of the pull handle 11 to prevent the traction tube 13 from detaching from the head, and a pull cable 15 is provided at the head of the pull handle 11 for fixed connection with the tail of the Dual blade 5. By pushing the pull handle 11 to move relatively in the traction tube 13, the extension length of the Dual blade 5 in the hollow plastic tube 6 can be controlled. It should be pointed out that the pull handle 11 is also provided with a fixing auxiliary device for fixing the relative position of the pull handle 11 and the traction tube 13. The device is a structure that is provided on the existing traction handle 9 and will not be described in detail here. At the same time, in order to ensure accurate control of the extension length of the Dual blade 5, a scale can be set on the pull handle 11 to determine the telescopic distance of the Dual blade 5 to meet the surgical requirements.

[0034] In this embodiment, the hollow plastic tube 6 is also provided with an annular fixing frame 16, which is made of plastic and is coaxially fixed to the end of the hollow plastic tube 6. The end of the insulating conduit 7 is fixed to the center of the inner ring of the annular fixing frame 16 to improve the stability of the insulating conduit 7 and prevent the Dual blade 5 from shaking during surgery.

[0035] In this embodiment, Figures 1 to 3 As shown, the length of the hollow plastic tube 6 is 160 mm, the length of the first magnet 3 is 0.5 mm, the length of the annular fixing frame 16 is 0.2 mm, the distance between the first magnet 3 and the annular fixing frame 16 is 1 mm, and the length of the insulating conduit 7 is 20 mm.

[0036] In this embodiment, Figures 4 to 6 As shown, the metal clip 2 includes a clip assembly and a connecting seat 17. The metal clip 2 is detachably connected to the metal clip releaser 18 through the connecting seat 17. The connection method between the connecting seat 17 and the metal clip releaser 18 is existing and will not be described in detail here. Figure 4 As shown, the metal clip releaser 18 is controlled by the traction handle 9. The second magnet 4 is arranged between the clip assembly and the connecting seat 17, and the three are fixedly connected. The second magnet 4 is an annular magnet. Preferably, the outer circle of the second magnet 4 is an N pole, the inner circle is an S pole, the length of the second magnet 4 is 5 mm, and the length of the second magnet 4 is longer than the first magnet 3, which increases the magnetic area of ​​the second magnet 4, is more conducive to the outward rotation and lifting of the metal clip 2, and can prevent the metal clip 2 from escaping from the repulsion range of the first magnet 3 due to the insufficient length of the second magnet 4 after the tail of the metal clip 2 is lifted.

[0037] Further, in this embodiment, if Figures 4 to 6 As shown, the clamp assembly includes a clamp 20 and a clamp seat 19. The end of the clamp 20 is bent inward to facilitate clamping of the mucosal tissue. The clamp 20 is arranged on the clamp seat 19. The specific arrangement is a common arrangement of medical clamps and is not described in detail here. The clamp assembly is fixedly connected to the second magnet 4 through the clamp seat 19.

[0038] Further, in this embodiment, reference Figure 5 and Figure 6 The end of one of the clips 20 is a sawtooth structure, and a V-shaped bite groove 21 is formed between the saw teeth. The end of the other clip 20 is provided with a triangular bite tooth 22, and the shape and size of the triangular bite tooth 22 just match the V-shaped bite groove 21. When the ends of the two clips 20 are put together, the triangular bite tooth 22 is just embedded in the V-shaped bite groove 21, which is conducive to firmly clamping the mucosal tissue and will not cause displacement after clamping. Figure 6 As shown, the maximum width of the V-shaped engaging groove 21 is 3 mm.

[0039] Furthermore, in this embodiment, the maximum opening and closing angle of the clip 20 is 160° to meet the needs of various situations. Generally speaking, the hooking force of the metal clip 2 at a 90° angle is greater and is more suitable for clamping the mucosa next to the lesion, while the hooking force of the metal clip 2 at a 135° angle is slightly weaker and is more suitable for hemostasis. However, in actual applications, the opening and closing angle of the metal clip 2 can be flexibly adjusted.

[0040] In this embodiment, the metal clip 2 is a titanium clip. Titanium and titanium alloys have good corrosion resistance. Titanium is non-toxic and non-magnetic, and is a good material for medical devices. At the same time, the metal clip 2 is relatively small and will not cause any harm to the body if it remains in the body. Even if the titanium clip remains in the body, it will fall off on its own and be discharged with the feces after the wound heals. It takes about 10-15 days, depending on personal circumstances.

[0041] The present invention uses specific examples to illustrate the principles and implementation methods of the present invention. The above examples are only used to help understand the method and core ideas of the present invention. At the same time, for those skilled in the art, according to the ideas of the present invention, there will be changes in the specific implementation methods and application scope. In summary, the content of this specification should not be understood as limiting the present invention.

Claims

1. A magnetic traction surgical device for endoscopic mucosal dissection, characterized in that: It comprises a high-frequency electric knife for cutting the mucosa and a metal clip for clamping the mucosa, wherein the working end of the high-frequency electric knife and the metal clip are respectively provided with a first magnet and a second magnet that repel each other, the high-frequency electric knife comprises a dual blade head and a hollow plastic tube that matches the size of the endoscopic biopsy hole, the first magnet is an annular magnet coaxially fixed in the working end of the hollow plastic tube, an insulating catheter is fixed in the ring of the first magnet, the insulating catheter extends to the working end of the hollow plastic tube, the dual blade head is sleeved in the insulating catheter and the head extends out of the working end of the hollow plastic tube, the tail of the dual blade head is connected to a conductive wire connected to a power supply system, the tail of the hollow plastic tube is provided with a traction handle for controlling the axial movement of the dual blade head along the hollow plastic tube, the metal clip comprises a clip assembly and a connecting seat for detachably connecting to a metal clip releaser, the second magnet is fixedly connected between the clip assembly and the connecting seat, and the second magnet is an annular magnet.

2. The magnetic traction surgical device for endoscopic mucosal dissection according to claim 1, characterized in that: The traction handle includes a pull handle with a pull ring at the tail and a traction tube with grip rings on both sides. The traction tube is sleeved on the pull handle. A limiting ring is coaxially fixed to the head of the pull handle to prevent the traction tube from detaching. The head of the pull handle is provided with a pull rope fixedly connected to the tail of the Dual blade head.

3. The magnetic traction surgical device for endoscopic mucosal dissection according to claim 1, characterized in that: The working end of the hollow plastic tube is coaxially fixed with an annular fixing frame, and the insulating conduit is fixed in the ring of the annular fixing frame.

4. The magnetic traction surgical device for endoscopic mucosal dissection according to claim 3, characterized in that: The length of the hollow plastic tube is 160 mm, the length of the first magnet is 0.5 mm, the length of the annular fixing frame is 0.2 mm, the distance between the first magnet and the annular fixing frame is 1 mm, and the length of the insulating conduit is 20 mm.

5. The magnetic traction surgical device for endoscopic mucosal dissection according to claim 4, characterized in that: The clamp assembly comprises a clamp seat fixedly connected to the second magnet, and a clamping piece arranged on the clamp seat, wherein the end of the clamping piece is bent inwardly.

6. The magnetic traction surgical device for endoscopic mucosal dissection according to claim 5, characterized in that: The ends of the two clips are respectively provided with a V-shaped bite groove and a triangular bite tooth.

7. The magnetic traction surgical device for endoscopic mucosal dissection according to claim 6, characterized in that: The maximum opening and closing angle of the clip is 160°.

8. The magnetic traction surgical device for endoscopic mucosal dissection according to claim 7, characterized in that: The metal clip is a titanium clip.

Images