A single rotary electric cutter

Abstract

The present invention discloses a single-body rotary electrosurgical resection device, which includes a cutting electrode, an electrode rod, an electrode sleeve, a rotating sleeve, a support sleeve, a handle and a hydraulic drive system. The electrode rod and the electrode sleeve can rotate relative to the support sleeve through the rotating sleeve, and the trigger on the operating handle can enable the hydraulic drive system to control the extension and retraction of the cutting electrode through the electrode rod. After the cutting electrode is extended during treatment, the cutting direction can be flexibly and accurately adjusted, resulting in better treatment effects and safer operation. As a single-body electrosurgical resection device, the present invention provides more convenient conditions for surgical operations.

Description

Technical Field

[0001] The invention relates to an electric cutting instrument used in hysteroscopic surgery and urological surgery, and in particular to a single rotary electric cutting device. Background Art

[0002] In a hysteroscopic resectoscope, the resection ring, resection needle and other resection instruments are usually wrapped together with the endoscope. During the intrauterine treatment, in order to avoid damage to the cutting electrode and other parts of the resection instrument (for example, when entering and exiting the external cervical os, cervical canal and internal os), the resection ring and resection needle need to be retracted into the resection instrument. Therefore, the resection instrument itself has a relatively large caliber, and the uterus needs to be dilated to 8-11mm during use, which can easily cause damage to the cervix, thereby causing cervical insufficiency after surgery. At the same time, during the operation, the resection instrument can only be driven to rotate by rotating the resection instrument as a whole, resulting in poor operational flexibility of the resection instrument, and the movement of the resection instrument and the adjustment of the endoscope observation field cannot be performed independently. As the observation field expands, the resection instrument also moves away from the treatment site along with the endoscope, which is not conducive to the treatment of intrauterine adhesions and uterine malformations. Since it is impossible to adjust the angle of the electrosurgical instrument independently during electrosurgical treatment, when polyps, intrauterine adhesions, and submucosal fibroids are found in the uterine cavity during hysteroscopy, not only is the electrosurgical operation complicated, but the time required for electrosurgical resection also increases with the size of the lesion (such as larger submucosal fibroids), which significantly increases the probability of complications such as hyponatremia and water intoxication, and increases the difficulty of performing hysteroscopic surgery in outpatient clinics.

[0003] With the introduction of single-body electrosurgical resection instruments, by using a method in which a hysteroscope and such electrosurgical resection instruments are separately introduced into the uterine cavity, the cross-sectional area of ​​the internal cervical os can be more effectively utilized, thereby reducing uterine dilatation, and taking into account the surgical field of view during treatment and the need for overall observation of the uterine cavity. For single-body electrosurgical resection instruments, in order to better perform clinical applications in hysteroscopic surgery, higher requirements are placed on the flexibility and safety of the instruments. For example, in Chinese patent CN111904472A (a single-body hysteroscopic electrosurgical resection instrument), a traction wire and a tension wire are used to retract and release the cutting electrode, but the cutting electrode is still in an exposed state, and it is difficult to completely avoid rubbing against normal tissue when entering and exiting the uterine cavity. In Chinese patent CN212788680U (a needle-shaped ablation electrode), a slider on the outside of the syringe and a needle clamp at the end are used to fix the retracted position of the cutting electrode (tungsten needle), but the retracted and released operation of the electrode needle can only be performed in vitro, and the ablation entry direction of the electrode needle cannot be flexibly adjusted. Chinese patent CN105125282A (a kind of irrigation and suction device with electric hook) uses a turntable, a limit ring, a constraint convex, and a stepped positioning slot to realize the structural integrated design of the sliding and rotating insulating sleeve, but the flexibility of the retracting and releasing operation of the cutting electrode (electric hook) is insufficient and it is not suitable for one-handed operation. At present, the single-body electric cutting instrument has not fully exerted its advantages in treatment effect.

[0004] For urological surgical resectoscopes, there are also higher requirements for the safety, flexibility and treatment efficiency of the instrument. Summary of the invention

[0005] The object of the present invention is to provide a single-body rotary electric cutter.

[0006] To achieve the above object, the present invention adopts the following technical solutions:

[0007] The electric cutter includes a cutting electrode, a hydraulic drive system, a supporting sleeve, a rotating sleeve arranged on the supporting sleeve, and an electrode sleeve and an electrode rod (the electrode sleeve is located outside the electrode rod) that can rotate synchronously with the rotating sleeve. One end of the electrode rod is connected to the cutting electrode, and the other end is connected to the hydraulic drive system.

[0008] Preferably, the electrode sleeve includes a detachable tube section (serving as a front section of the electrode sleeve) and a fixed tube section (serving as a rear section of the electrode sleeve) connected to the tube section (for example, by a threaded connection), and the fixed tube section is connected to the rotating sleeve. By manually operating the hydraulic drive system, the cutting electrode is extended from the detachable tube section or retracted into the electrode sleeve, thereby further improving the operational safety of the electrosurgical cutter in hysteroscopic surgery and urological surgery (especially the latter).

[0009] Preferably, the hydraulic drive system comprises a hydraulic axial linkage mechanism and a hydraulic sleeve led out from the inside of the support sleeve, a hydraulic medium is arranged in the hydraulic sleeve, and the hydraulic axial linkage mechanism cooperates with the electrode rod and the hydraulic medium in the hydraulic sleeve respectively.

[0010] Preferably, the hydraulic axial linkage mechanism includes a connecting rod, a sliding plate arranged on one end of the electrode rod (the cutting electrode is connected to the other end of the electrode rod), and a piston arranged at one end of the hydraulic casing. The piston is connected to the sliding plate through the connecting rod, and the piston is in contact with the hydraulic medium in the hydraulic casing.

[0011] Preferably, a sliding block is provided on the sliding sheet, and the sliding block cooperates with an axial sliding groove provided on the inner wall of the electrode sleeve (specifically, the fixed tube section thereof) (ie, the sliding block is connected to the axial sliding groove and can slide relatively thereto).

[0012] Preferably, a clamping groove is provided in the rotating sleeve, and the electrode sleeve (specifically, the fixed tube section thereof) is fixed together with the rotating sleeve through the clamping groove.

[0013] Preferably, the hydraulic drive system further comprises a pressure regulating trigger, the pressure regulating trigger comprises a pressure cap, a pressure rod and a pressure block, the pressure block is arranged at the other end of the hydraulic casing, the pressure cap is respectively connected to one end of the pressure rod and a spring arranged outside the corresponding end of the hydraulic casing, and the other end of the pressure rod is connected to the pressure block; or the pressure regulating trigger comprises a pressure cap and a pressure block, the pressure block is arranged at the other end of the hydraulic casing, the top of the pressure cap is opposite to the pressure block, and the inner side of the pressure cap is tightly fitted with the hydraulic casing. The pressure block contacts the hydraulic medium in the hydraulic casing.

[0014] Preferably, the hydraulic drive system also includes a handle, the support sleeve is connected to the handle, the hydraulic sleeve extends from the inside of the support sleeve to the handle and the rotating sleeve respectively, one end of the hydraulic sleeve is fixed in the rotating sleeve, and the other end is fixed to the handle.

[0015] Preferably, the rotating sleeve comprises a front sleeve body and a rear sleeve body which are connected to each other, the front sleeve body is provided with a threading hole which is connected to the electrode sleeve (specifically, its fixed tube section), a wire hole plug is provided in the threading hole (the functions include: fixing the lead wire and the rotating sleeve together to avoid entanglement and breakage; sealing the position where the lead wire is connected to the electrode rod), and the rear sleeve body is provided with a dial (for adjusting the rotation angle of the rotating sleeve under finger operation, so as to conveniently, quickly and accurately switch the cutting direction of the cutting electrode in the treatment site, so as to obtain a greater treatment effect in a single electrocute).

[0016] Preferably, a bearing is provided on the supporting sleeve, and the rotating sleeve (specifically the rear sleeve body) is connected to the supporting sleeve via the bearing.

[0017] Preferably, the cutting electrode is needle-shaped, ring-shaped or hook-shaped, and its size is sufficient to extend out or retract into the electrode sleeve as the electrode rod moves under the action of the hydraulic drive system.

[0018] The beneficial effects of the present invention are embodied in:

[0019] The electrosurgical resectoscope of the present invention introduces a hydraulic drive system and a rotating sleeve, so that the cutting direction of the cutting electrode can be flexibly adjusted under single-handed operation, thereby improving the treatment effect; at the same time, the cutting electrode can be flexibly extended and retracted when the front end of the electrosurgical resectoscope is located inside the human body cavity space such as the uterine cavity, which not only improves the efficiency and accuracy of single-handed operation of the electrosurgical resectoscope during surgery (the other hand holds a separate hysteroscope during hysteroscopic surgery), but also effectively ensures the safety of electrosurgical treatment (especially when inserting and removing the electrosurgical resectoscope), avoiding damage to normal tissue. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] Figure 1 Schematic diagram of the external structure of the single-body rotary intrauterine electrosurgical resectoscope in Example 1 (the cutting electrode is retracted);

[0021] Figure 2Schematic diagram of the internal structure of the single-body rotary hysterectomy device in Example 1 (cutting electrode extended);

[0022] Figure 3 for Figure 2 A schematic diagram of a local area (area I);

[0023] Figure 4 for Figure 3 The assembly diagram of the slot, electrode rod and electrode sleeve shown (end face);

[0024] Figure 5 It is a structural schematic diagram of the trigger in Example 1;

[0025] Figure 6 This is a schematic diagram of the external structure of the single-body rotary urinary electrosurgical resectoscope in Example 3 (the front and rear sections of the electrode sleeve are separated, and the internal electrode rod is omitted);

[0026] Figure 7 for Figure 6 The schematic diagram of the assembly of the front section of the electrode sleeve and the closer shown;

[0027] In the figure: 1-cutting electrode, 2-electrode rod, 3-electrode sleeve, 4-front sleeve, 5-lead, 6-rear sleeve, 7-hydraulic medium, 8-hydraulic sleeve, 9-support sleeve, 10-handle, 11-trigger, 1101-pressure cap, 1102-pressure rod, 1103-pressure block, 12-slot, 13-bearing, 14-hydraulic axial linkage mechanism, 141-connecting rod, 142-slide, 15-wire hole plug, 16-threaded interface, 17-closer. DETAILED DESCRIPTION

[0028] The present invention is further described in detail below in conjunction with the accompanying drawings and embodiments. The embodiments are only used to explain the present invention, but not to limit the scope of protection of the present invention.

[0029] Example 1

[0030] By separating the uterine cavity inspection system of the resectoscope from the electrosurgical system and improving the structure of the electrosurgical system, a single-body electrosurgical system (such as a single-body rotary hysterotomy device) is formed. The cutting electrode can effectively avoid rubbing against tissue when entering and exiting the uterine cavity. At the same time, with the cooperation of the inspection scope, it can play a therapeutic role in a larger range, thereby better utilizing the physiological structure of women themselves for treatment, reducing the difficulty and cost of treatment, and alleviating the patient's pain.

[0031] See also Figure 1 as well as Figure 2The single-body rotary hysterectomy device comprises a cutting electrode 1 (e.g., a needle electrode), an electrode rod 2, an electrode sleeve 3, a rotating sleeve, a lead wire 5, a support sleeve 9, and a handheld hydraulic drive system. The electrode rod 2 and the electrode sleeve 3 can rotate relative to the support sleeve 9 through the rotating sleeve. The main body of the electrode rod 2 is located in the electrode sleeve 3, the front end is connected to the cutting electrode 1, and the rear end and the electrode sleeve 3 extend into the rotating sleeve together; the rotating sleeve has a dial (referred to as the dial) for finger movement. One end of the lead wire 5 is introduced into the rotating sleeve to provide power (energy source for electroresection treatment) for the cutting electrode 1. The handheld hydraulic drive system comprises a hydraulic sleeve 8, a handle 10, and a trigger 11; a hydraulic medium 7 is injected into the hydraulic sleeve 8, the front horizontal straight pipe section of the hydraulic sleeve 8 is fixed in the support sleeve 9, the rear part is bent downward and then extends into the handle 10, the lower end of the hydraulic sleeve 8 is fixed at the position where the trigger 11 is installed on the handle 10, and the upper end extends into the rotating sleeve and remains fixed.

[0032] See also Figure 3 The rotating sleeve is composed of a front sleeve body 4 (columnar) and a rear sleeve body 6 (conical, convenient for turning the turntable thereon) connected to each other as one body, and a slot 12 is formed inside, and the rear part of the electrode sleeve 3 is fixed in the slot 12. A radial through hole (i.e., a threading hole) is opened on the front sleeve body 4, which passes through the slot 12 and the upper side of the electrode sleeve 3, and a wire hole plug 15 is installed in the through hole to facilitate the installation and fixing of the lead wire 5 and take into account the sealing. The rear sleeve body 6 is coaxially connected to the bearing 13 installed on the support sleeve 9, and the hydraulic sleeve 8 passes through the center of the bearing 13.

[0033] Combination Figure 4 As shown, the handheld hydraulic drive system also includes a hydraulic axial linkage mechanism 14, which includes a connecting rod 141, a slide 142 and a piston body. The piston body is installed in the upper end of the hydraulic sleeve 8 (with an end cover to prevent the piston body from falling out) and forms a piston structure. The rear end of the connecting rod 141 is connected to the piston body (the connecting rod connection position and the hydraulic medium action position are respectively located on both sides of the piston body). The piston body adopts end seals to take into account the hydraulic action and the flexibility of relative rotation between the piston body and the hydraulic sleeve 8, and the front end of the connecting rod 141 is connected to the center of the slide 142.

[0034] Combination Figure 4As shown, sliders are fixed at the upper and lower ends of the slide 142, and the sliders are embedded in the axial slide grooves at the corresponding circumferential positions of the rear inner wall of the electrode sleeve 3, ensuring that the electrode rod 2 connected to the slide 142 only translates but does not rotate relative to the electrode sleeve 3, while the piston body can rotate on its own. In this way, the synchronous rotation of the electrode rod 2 and the electrode sleeve 3 and the linear movement of the electrode rod 2 are structurally taken into account, so that the role of the hydraulic drive system (driving the electrode rod to drive the cutting electrode to extend or retract at the front end of the electrode sleeve) and the role of the rotating sleeve (especially the flexible adjustment of the rotation angle when the cutting electrode is extended) are integrated.

[0035] Combination Figure 4 As shown, a strip-shaped convex strip is fixed on the outer wall of the rear portion of the electrode sleeve 3 in a direction 90 degrees apart from the above-mentioned axial sliding groove, so as to facilitate the alignment, assembly and fixation of the electrode sleeve 3 in the slot 12.

[0036] See also Figure 5 The trigger 11 includes a pressure cap 1101, a pressure rod 1102 and a pressure block 1103. The pressure block 1103 is loaded in the lower end of the hydraulic sleeve 8. The center of the top of the pressure cap 1101 is fixed to one end of the pressure rod 1102. The bottom of the pressure cap 1101 (i.e. Figure 5 The edge of the side overlapping with the hydraulic sleeve 8 in the middle is butted with the spring, the spring is fixed on the handle 10 and is sleeved on the outside of the part of the hydraulic sleeve 8 extending out of the handle 10 (including the above-mentioned lower end), and the other end of the pressure rod 1102 is fixed together with the pressure block 1103. When the pressure cap 1101 pushes the pressure block 1103 to move the hydraulic medium 7 to the right, the above-mentioned piston structure exhausts air from the end cover, and the piston body pushes the electrode rod 2 to move outward (so that the cutting electrode 1 extends out of the electrode sleeve 3). Once the pressure cap 1101 is released, the pressure cap 1101 drives the pressure block 1103 to reset under the action of the spring restoring force, the external atmosphere fills into the piston structure, and the piston body pulls the electrode rod 2 to move inward (so that the cutting electrode 1 is retracted into the electrode sleeve 3).

[0037] Example 2

[0038] Different from the first embodiment, the trigger 11 does not have a pressure rod 1102, but mainly utilizes the air tightness of the overlapping part of the pressure cap 1101 and the hydraulic sleeve 8 (i.e., the gas in the space surrounded by the pressure cap 1101 outside the sealed pressure block 1103). The action (push, pull) of the piston body is realized by the pressure difference of the gas at both ends of the hydraulic medium 7.

[0039] The treatment process of the above-mentioned single-body rotary hysterectomy device is as follows:

[0040] When intrauterine polyps, intrauterine adhesions, submucosal myomas and other lesions that need to be electrocuted are checked, the electrosurgical resectoscope is operated for treatment under the hysteroscope. Hold the handle 10 tightly, adjust the front end position of the electrode sleeve 3 according to the required incision site and depth, and when electrical treatment is required, first press the trigger 11, wait for the cutting electrode 1 to extend, adjust the cutting direction of the cutting electrode 1 by rotating the sleeve, step on the electrode plate, and let the current pass into the cutting electrode 1 through the lead 5. In the process of electrocuting, in addition to using the handle 10 and trigger 11 to pull back or push forward, the cutting direction of the cutting electrode 1 can also be repeatedly adjusted by rotating the sleeve, so that the lesion can be electrocuted and treated with the cutting electrode 1 in the energized state, so as to quickly achieve the treatment effect.

[0041] When used in conjunction with a hysteroscope, a hysteroscope with a diameter of about 5 mm has a cross-sectional area of ​​6.25πmm. 2 , and a single-body electrosurgical system (specifically the electrosurgical cutter in the above embodiment) with an electrode structure diameter of about 4 mm has a cross-sectional area of ​​4πmm 2 For most patients, the cervix is ​​about 6mm, so there is basically no need for cervical dilation (the cervix is ​​pulled into an oval shape), and the smaller the cervical dilation or even no cervical dilation, the less damage to the patient's cervix can be reduced accordingly. In addition, the hysteroscope and the single-body electrosurgical resection system can complete electrosurgical resection treatment without the limitation of the speculum and cylindrical metal package, with a wider field of view and a larger range of motion.

[0042] The single-body rotary transhysterectomy device proposed in the above embodiment has the following characteristics:

[0043] The electrosurgical resectoscope does not need to dilate the uterus or reduce the size of the dilated uterus when entering and exiting the uterine cavity, and the electrosurgical resectoscope can still be easily entered and exited from the uterine cavity, with little damage to the cervix, and the cutting electrode is not easily damaged. In hysteroscopic treatment, the hysteroscope and the electrosurgical resectoscope can be held separately, and the operation can be completed in cooperation with each other (the electrosurgical resectoscope can be sent in separately), and the doctor can not only continuously complete the surgical operation of resection of lesions (polyps, intrauterine adhesions, and submucosal myomas in the uterine cavity) at different angles and depths within a certain field of view (after the cutting electrode is extended during treatment, the cutting direction can also be flexibly and accurately adjusted), so that the treatment process is simple to operate and achieves good treatment effects, and the operation process is safer (for example, when the electrosurgical resectoscope is taken out, the cutting electrode can be completely retracted into the electrode sleeve by releasing the trigger, so that the electrosurgical resectoscope is easy to take out from the uterine cavity and is not easy to cause normal tissue damage). At the same time, the promotion and application of the above-mentioned electrosurgical resectoscope can also reduce the cost of the instrument (the price of the existing integrated electrosurgical resectoscope is much higher than that of the single-body electrosurgical resectoscope), treatment costs and time, alleviate the pain of treatment, and reduce the risk of complications, so that the corresponding surgical operations can be completed in outpatient clinics.

[0044] Example 3

[0045] Because the male urethra is relatively thin and has three narrow areas in the cavity structure, if the electrosurgical cutter in the above embodiment is directly inserted, the front end opening of the electrode sleeve 3 is easy to enter the cavity tissue, thereby increasing the difficulty of the electrosurgical cutter to enter and easily damaging normal tissue. Therefore, when the electrosurgical cutter is inserted, it is necessary to use Figure 7 The closure device 17 shown in the figure is used, and the electrode sleeve 3 of the electrosurgical cutter proposed in the above embodiment is split from a tube structure into two assembleable front and rear tube structures (wherein the rear tube structure is slightly longer than the length of the rear portion of the electrode sleeve, so as to split and connect the front and rear tube structures of the electrode sleeve outside the rotating sleeve, and at the same time ensure that the front tube structure has enough length to manually separate the closure device outside the cavity structure), thereby forming a tube structure as shown in the figure. Figure 6 The single-body rotary urinary electrosurgical resector shown.

[0046] In the single-body rotary urinary electrosurgical resectoscope, the front and rear sections of the electrode sleeve 3 are provided with threaded interfaces 16 at their respective butt ends. When the electrosurgical resection operation needs to be started, the front section of the electrode sleeve 3 is unscrewed, the closure 17 is inserted from the butt end of the front section of the electrode sleeve 3, and the bullet-shaped cap of the closure 17 is partially or completely extended from the other end of the front section of the electrode sleeve 3 (i.e., the front end of the electrode sleeve 3), so that the front end of the electrode sleeve 3 is sealed by the cap. At this time, the front section of the electrode sleeve 3 is sent into the urethra and reaches the prostate, bladder and other parts, and then the closure 17 is separated, and the cutting electrode 1, the electrode rod 2 (connected to the rotating sleeve through the rear section of the electrode sleeve) and the observation mirror attached to the electrode rod 2 are inserted along the front section of the electrode sleeve 3 until the front and rear sections of the electrode sleeve 3 can be tightened. After that, the electrosurgical resection treatment can be performed with reference to the above embodiment.

Claims

1. A single rotary electric cutter, characterized in that: The electric cutter comprises a cutting electrode (1), a hydraulic drive system, a support sleeve (9), a rotating sleeve arranged on the support sleeve (9), an electrode sleeve (3) and an electrode rod (2) which can rotate synchronously with the rotating sleeve, wherein one end of the electrode rod (2) is connected to the cutting electrode (1), and the other end is connected to the hydraulic drive system; A clamping groove (12) is provided in the rotating sleeve, and the rear end of the electrode sleeve (3) is fixedly connected to the clamping groove (12); The electrode sleeve (3) comprises a detachable tube section and a fixed tube section connected to the section, the fixed tube section is connected to the rotating sleeve, and the cutting electrode (1) extends out of or retracts into the electrode sleeve (3) from the detachable tube section; The hydraulic drive system comprises a hydraulic axial linkage mechanism (14) and a hydraulic sleeve (8), a hydraulic medium (7) is arranged in the hydraulic sleeve (8), and the hydraulic axial linkage mechanism (14) cooperates with the electrode rod (2) and the hydraulic medium (7) respectively; The hydraulic axial linkage mechanism (14) comprises a connecting rod (141), a sliding plate (142) arranged on the electrode rod (2), and a piston arranged at one end of the hydraulic sleeve (8), wherein the piston is connected to the sliding plate (142) via the connecting rod (141); The sliding piece (142) is provided with a sliding block, and the sliding block matches with an axial sliding groove provided in the electrode sleeve (3); The hydraulic drive system further comprises a pressure regulating trigger (11), the pressure regulating trigger (11) comprising a pressure cap (1101), a pressure rod (1102) and a pressure block (1103), the pressure block (1103) being arranged at the other end of the hydraulic sleeve (8), the pressure cap (1101) being respectively connected to one end of the pressure rod (1102) and a spring arranged at the outer side of the corresponding end of the hydraulic sleeve (8), and the other end of the pressure rod (1102) being connected to the pressure block (1103); or the pressure regulating trigger (111) comprising a pressure cap (1101) and a pressure block (1103), the pressure block (1103) being arranged at the other end of the hydraulic sleeve (8), and the inner side surface of the pressure cap (1101) being in contact with the hydraulic sleeve (8); The hydraulic drive system further comprises a handle (10), a support sleeve (9) connected to the handle (10), a hydraulic sleeve (8) extending from the inside of the support sleeve (9) to the handle (10) and the rotating sleeve respectively, one end of the hydraulic sleeve (8) being fixed in the rotating sleeve, and the other end being fixed on the handle (10); The rotating sleeve comprises a front sleeve body (4) and a rear sleeve body (6) which are connected to each other, the front sleeve body (4) is provided with a threading hole which is connected to the electrode sleeve (3), a threading hole plug (15) is provided in the threading hole, and the rear sleeve body (6) is provided with a dial; The support sleeve (9) is provided with a bearing (13), and the rotating sleeve is connected to the support sleeve (9) via the bearing (13); It also includes a closer (17), which has a bullet-shaped cap body. When in use, the closer (17) is used to seal the front end of the detachable tube section of the electrode sleeve (3), thereby effectively preventing the front end of the electrode sleeve (3) from damaging normal tissue.

Images