Bronchial occlusion device and method of push placement

Abstract

This invention discloses a bronchial occlusion device, comprising an occluder and a pusher inserter. The occluder includes an occluder base tube, an occluder insertion head, a deep bronchus insertion tube, a fixed end, a retrieval wire, a connecting tube, an adjustment end, and a guidewire through-hole. The pusher inserter includes a pusher catheter and a pusher guidewire, the pusher guidewire extending from the front end of the deep bronchus insertion tube to the outside of the pusher catheter, and the front end of the pusher guidewire is arc-shaped. This occluder device is designed in a dumbbell-like shape, with a scientifically and rationally designed structure that greatly increases friction with the bronchial wall, improves stability, and prevents dislodgement due to factors such as coughing. Furthermore, the pusher inserter, including the pusher guidewire and pusher catheter, allows for precise insertion of the occluder into the responsible bronchus. It is easy to operate, highly practical, and worthy of widespread application. This invention also discloses a method for inserting the device, which is scientifically designed to achieve precise insertion of the device.

Description

Technical Field

[0001] This invention relates to a bronchial occlusion technique, specifically a bronchial occlusion device, and also discloses a method for pushing and inserting the occlusion device. Background Technology

[0002] Clinically, bronchial occluders are indicated for conditions such as bronchopleural fistula, refractory active bronchial bleeding, refractory pneumothorax, lung volume reduction in heterogeneous emphysema, and lung volume reduction in giant bullae. However, currently used bronchial occluders have smooth outer surfaces and are relatively hard, resulting in low friction with the bronchial wall and poor stability. They are prone to dislodgement due to coughing or other factors. Furthermore, the responsible bronchus below the lobe or segment is relatively narrow, making it difficult to locate the responsible bronchus after the biopsy forceps clamp the silicone occluder, hindering precise insertion and limiting its widespread application. Summary of the Invention

[0003] To address the shortcomings of existing technologies, this invention provides a bronchial occlusion device. This device features a dumbbell-shaped occluder with a scientifically designed structure that significantly increases friction with the bronchial wall, enhancing stability and preventing dislodgement due to coughing or other factors. It also includes a pusher device comprising a guidewire and a catheter, allowing for precise insertion into the responsible bronchus. The device is easy to operate, highly practical, and worthy of widespread adoption. Furthermore, this invention discloses a method for inserting the device, tailored to the device's scientifically designed structure, ensuring accurate placement.

[0004] To achieve the above objectives, the technical solution adopted by the present invention is as follows:

[0005] A bronchial occlusion device includes an occluder and an inserter connected to each other. The occluder includes a cylindrical occluder base tube, with a conical occluder insertion head at its front end. The diameter of the bottom surface of the occluder insertion head is larger than the diameter of the occluder base tube. A deep bronchial insertion tube is located at the front end of the occluder base tube. A fixed end is fitted at the rear end of the occluder base tube to stabilize it within the bronchus and prevent displacement. The fixed end is cylindrical and its diameter is larger than the diameter of the occluder base tube. A retrieval line is wound around the occluder base tube at the front end of the fixed end. One end of the retrieval line is attached to the occluder base tube, and the other end is left free. A retrieval line is located on the rear side of the fixed end. The device includes an adjusting block that covers its outer circumference. The rear end of the fixed end is provided with a connecting tube that connects to the pusher. The connecting tube is also cylindrical. The center of the sealing base tube, sealing embedding head, deep branch embedding tube, fixed end, and connecting tube are all provided with interconnected guide wire through holes. The pusher includes a push guide tube sleeved outside the connecting tube. The push guide tube is cylindrical and also has a guide wire through hole at its center. The pusher also includes a push guide wire that can pass through the guide wire through holes of the sealing device and the push guide tube. The push guide wire can extend from the front end of the deep branch embedding tube to the outside of the push guide tube, and the front end of the push guide wire is arc-shaped.

[0006] As a preferred technical solution, in order to make the occluder fit into the responsible bronchus in a ring shape and lock onto the bronchus wall, greatly increasing the friction between the occluder insertion head and the bronchus, ensuring that the occluder can be tightly embedded in the bronchus, and further preventing the occluder from falling off due to coughing, the occluder insertion head is uniformly provided with friction grooves along its outer conical surface.

[0007] As a preferred technical solution, in order to allow the occluder to be guided into the endotracheal tube without using a push guide wire, the method of pushing and inserting the occluder is increased, which greatly improves the practicality of the occluder. The front end of the deep branch insertion tube is bent forward.

[0008] The methods for pushing and inserting bronchial occlusion devices include the following two:

[0009] First, the guidewire is inserted into the responsible bronchus through the bronchoscope. After the bronchoscope is withdrawn, the guidewire is retained. Then, the rear end of the guidewire is sequentially inserted into the guidewire through-hole of the occluder and the push catheter, so that the guidewire, occluder and push device are connected into a single occlusion device. Under the supervision of the bronchoscope (if the push channel is narrow and cannot be simultaneously inserted into the bronchoscope, the length from the entrance to the opening of the responsible bronchus can be measured preoperatively to determine the depth of insertion of the push catheter to push the occluder), the occlusion device is slowly pushed forward until the occluder is pushed into the responsible bronchus and locked in place. The push catheter holds the occluder, and the guidewire is slowly withdrawn. Then, the push catheter is slowly withdrawn and detached from the occluder and withdrawn from the body. The bronchoscope is then inserted to confirm that the occluder is fixed and blocks the responsible bronchus before the bronchoscope is withdrawn.

[0010] Secondly, first, pass the guidewire through the occluder and the guide tube, leaving 2-4 cm of the guidewire at the front end of the deep bronchus insertion tube to facilitate the insertion of the occluder into the responsible bronchus. Then, insert the guidewire and the guide tube together from the lower end of the bronchoscope and push them out of the bronchoscope's working channel entrance. After confirming that the front end of the guidewire and the position of the occluder are in a suitable position at the front end of the bronchoscope, enter through the nasal cavity, laryngeal mask, endotracheal tube, rigid endoscope, etc., and slowly advance until the occluder is pushed into the responsible bronchus and locked in place. The guide tube presses against the occluder, and the guidewire is slowly withdrawn. Then, the front end of the bronchoscope presses against the occluder, and the guide tube is slowly withdrawn from the occluder. After confirming that the occluder is fixedly blocking the responsible bronchus, the bronchoscope is withdrawn.

[0011] Compared with the prior art, the present invention has the following beneficial effects:

[0012] 1. This occlusion device features a dumbbell-shaped occluder with a scientifically designed structure that significantly increases friction with the bronchial wall, enhancing stability and preventing dislodgement due to factors such as coughing. It also includes a pusher device with a guidewire and a catheter, allowing for precise insertion into the responsible bronchus. The device is easy to operate, highly practical, and worthy of widespread use.

[0013] 2. The occlusion insert head has friction grooves evenly distributed along its outer conical surface, so that the occluder enters the responsible bronchus and locks into the tube wall in a ring shape, which greatly increases the friction between the occlusion insert head and the bronchus, ensuring that the occluder can be tightly embedded in the bronchus, and further preventing the occluder from falling off due to coughing.

[0014] 3. The front end of the deep branch embedding tube is bent forward, so that the occluder can be pushed into the responsible airway without using a push guide wire, which increases the pushing and insertion method of the occluder and greatly improves the practicality of the occluder.

[0015] 4. The present invention also discloses a method for pushing and inserting the tracheal occlusion device. This method is scientifically designed for the structure of the device and can accurately push the occlusion device into the responsible trachea, which greatly shortens the operation time and improves the occlusion effect. Attached Figure Description

[0016] The present invention will now be described in further detail with reference to the accompanying drawings and specific embodiments.

[0017] Figure 1 This is a schematic diagram of the structure of the present invention;

[0018] Figure 2 This is a schematic diagram of the plugging device.

[0019] Reference numerals: 1. Occluder; 1-1. Occluder base tube; 1-2. Occluder insert head; 1-3. Deep branch insert tube; 1-4. Fixed end; 1-5. Retrieval line; 1-6. Adjusting block; 1-7. Connecting tube; 1-8. Guide wire through hole; 2. Pusher inserter; 2-1. Pushing catheter; 2-2. Pushing guide wire. Detailed Implementation

[0020] like Figure 1The present invention provides a specific embodiment of a bronchial occlusion device, comprising an occluder 1 and a pusher inserter 2 connected to each other. The occluder 1 includes a cylindrical occlusion base tube 1-1, the diameter of which can be set to four specifications: 5mm, 6mm, 7mm, and 10mm. The front end of the occlusion base tube 1-1 is provided with a conical occlusion insert head 1-2, and the bottom diameter of the occlusion insert head 1-2 is larger than the diameter of the occlusion base tube 1-1. This is to facilitate the occlusion insert head 1-2 entering a deeper branch of the responsible trachea, generating greater friction, and simultaneously reducing obstruction of the occlusion insert head 1-2 by the front bronchial branch. The front end of the occlusion insert head 1-2 is provided with a deep branch insertion tube 1-3. While ensuring easy access for the deep branch insertion tube 1-3, the overall size of the bronchial occlusion device is controlled. In this embodiment, the length of the deep branch insertion tube 1-3 is set to 20-30 mm. The rear end of the occlusion base tube 1-1 is provided with a fixed end 1-4 for stabilizing the bronchus and preventing displacement. The fixed end 1-4 is cylindrical, and its diameter is larger than the diameter of the occlusion base tube 1-1. In this embodiment, the diameter of the fixed end 1-1 is equal to the bottom diameter of the occlusion insert head 1-2. Thus, the occlusion base tube 1-1, the occlusion insert head 1-2, and the fixed end 1-4 form a dumbbell shape. In this embodiment, a retrieval line 1-5 is wound around the sealing base tube 1-1 and at the front end of the fixed end 1-4. One end of the retrieval line 1-5 is attached to the sealing base tube 1-1, and the other end is left free. This ensures that the retrieval line 1-5 can be fixed to the sealing base tube 1-1 while also being easily grasped by biopsy forceps to remove the occluder 1. In this embodiment, the length of the retrieval line 1-5 is set to 4-5 cm. To facilitate observation and adjustment of the position of the occluder 1 within the responsible bronchus, an adjusting block 1-6 is provided on the rear side of the fixed end 1-4 to cover its outer circumference. Therefore, after the occluder 1 is inserted into the responsible bronchus, the adjusting block 1-6 is positioned within the responsible bronchus. To increase the friction between the adjusting block 1-6 and the biopsy forceps, facilitating precise positioning and fixed contact, this embodiment features evenly distributed raised ridges along the outer circumference of the adjusting block 1-6. The rear end of the fixed end 1-4 is provided with a connecting tube 1-7 that connects to the pusher 2. To ensure a stable connection between the connecting tube 1-7 and the pusher 2, this embodiment sets the length of the connecting tube 1-7 to 5mm. The connecting tube 1-7 is cylindrical. The center of the sealing base tube 1-1, the sealing embedding head 1-2, the deep branch embedding tube 1-3, the fixed end 1-4, and the connecting tube 1-6 are all provided with interconnected guide wire through holes 1-8. Figure 2As shown, to ensure easy access via the guidewire 2-2 and to prevent external gases from entering the occluder 1 and affecting it, this embodiment sets the diameter of the guidewire through-hole 1-8 to 1mm. To ensure a stable connection between the occlusion base tube 1-1, the occlusion insert head 1-2, the deep branch insert tube 1-3, the fixed end 1-4, the connecting tube 1-6, and the adjusting end 1-7, this embodiment uses a single-piece manufacturing process for the occlusion base tube 1-1, the occlusion insert head 1-2, the deep branch insert tube 1-3, the fixed end 1-4, the adjusting block 1-6, and the connecting tube 1-7. Therefore, the occluder 1 is made of medical-grade silicone. To effectively prevent the occluder 1 from being coughed out by the patient, the deep branch insert tube 1-3 is made more flexible than the occlusion insert head 1-2, which can be achieved through material selection or manufacturing process. To increase friction and prevent the occluder 1 from shifting after being inserted into the bronchus, this embodiment... In this embodiment, the outer surface of the occlusion base tube 1-1 is coated with a layer of antibacterial and water-absorbing medical fiber material that increases friction. The medical fiber material is bound to the occlusion base tube 1 with non-absorbable surgical sutures. To further ensure that the occluder 1 can be securely embedded in the responsible trachea, the diameter of the occlusion base tube 1 after being bound with the medical fiber material is equal to the diameter of the fixed end 1-4. The pusher inserter 2 includes a pusher catheter 2-1 sleeved outside the connecting tube 1-7. The pusher catheter 2-1 is cylindrical and has a guide wire through hole 1-8 at its center. The pusher inserter 2 also includes a pusher guide wire 2-2. The pusher guide wire 2-2 can pass through the guide wire through hole 1-8 of the occluder 1 and the pusher catheter 2-1. The pusher guide wire 2-2 can extend from the front end of the deep branch insertion tube 1-3 to the outside of the pusher catheter 2-1, and the front end of the pusher guide wire 2-2 is arc-shaped.

[0021] The occlusion insert 1-2 is provided with friction grooves evenly distributed along its outer conical surface, which effectively increases the friction between the occlusion insert 2-2 and the bronchus, ensuring that the occluder 1 can be tightly embedded in the bronchus, and further preventing the occluder from falling off due to coughing or other factors.

[0022] The front end of the deep branch embedding tube 1-3 is bent forward, and the deep branch embedding tube 1-3 with the front end bent forward has a guiding function. Without using the push guide wire 2-2, the occluder 1 can be guided into the responsible airway with the help of the deep branch embedding tube 1-3, which increases the pushing and insertion method of the occlusion device and greatly improves the practicality of the occlusion device.

[0023] When using this invention:

[0024] 1. For patients with persistent hemoptysis, chest CT scans suggest the bleeding lesion is located below the peripheral bronchus. Bronchoscopy ultimately identifies the active bleeding location as approximately in a specific lobe and segment of the bronchus. After confirming the diameter of the responsible bronchus, a suitable occluder (1) is selected. After adequately preparing the bronchial plug kit, the bronchoscope is removed after sufficient suction of the bleeding. Alternatively, if suctioning is ongoing, a spare bronchoscope with a working channel of 2.0mm or larger is used. First, the guidewire 2-2 is inserted into the guide tube 2-1, extending the guidewire 2-2 slightly beyond the tip of the guide tube 2-1 by approximately 4 cm. Then, both are inserted through the bronchoscope's working channel until the guidewire 2-2 is completely extended from the tip of the bronchoscope, with a small portion of the guide tube 2-1 exposed. At the tip of the bronchoscope, the guide wire 2-2 is passed through the connecting tube 1-7 until it extends about 2 cm beyond the deep bronchial insertion tube 1-2. The connecting tube 1-7 is then inserted into the front hole of the push tube 2-1 along the guide wire 2-2. The push tube 2-2 is then advanced to the opening of the target bronchus through the nasal cavity, laryngeal mask, endotracheal tube, or rigid endoscope. After successfully guiding the guide wire 2-2 into the responsible bronchus, the push tube 2-1 is pushed forward along the guide wire 2-2. The occluder 1 is pushed into the responsible bronchus and secured. The tip of the bronchoscope is then pressed against the rear of the occluder 1. The guide wire 2-2 is pulled out first, and then the push tube 2-1 is detached from the connecting tube 1-7 and pulled out of the bronchoscope's working channel. The operation is now complete.

[0025] 2. For patients with refractory pneumothorax, a closed chest tube continuously drains air. A chest CT scan is used to carefully locate the visceral pleural tear. After identifying the responsible bronchus where the tear is located, bronchoscopic airway exploration is performed. A occlusion balloon is inserted into the responsible bronchoscope, and the overflow of air bubbles from the drainage tube is observed. Once the overflow of air bubbles is confirmed to have decreased or even disappeared, the diameter of the responsible bronchus is determined, and an appropriate occluder 1 is selected. The bronchoscope can then be withdrawn. First, the guidewire 2-2 is inserted into the guide tube 2-1, extending the guidewire 2-2 slightly beyond the tip of the guide tube 2-1 by about 4 cm. Both are then inserted through the bronchial working channel until the guidewire 2-2 is completely extended out of the bronchoscope tip, with a small portion of the guide tube 2-1 protruding from the bronchoscope tip. Next, pass the guidewire 2-2 through the connecting tube 1-7 until it extends approximately 2 cm beyond the deep bronchus insertion tube 1-2. Insert the connecting tube 1-7 into the front hole of the push tube 2-1 along the guidewire 2-2. Then, enter the responsible bronchus for active lower airway bleeding through the nasal cavity, mouthpiece, laryngeal mask, endotracheal tube, or rigid endoscope. After successfully guiding the guidewire 2-2 into the responsible bronchus, push the push tube 2-1 forward along the guidewire 2-2. Push the occluder 1 into the responsible bronchus and confirm its fixation. Place the front end of the bronchoscope against the rear end of the occluder 1, pull out the guidewire 2-2 first, and finally detach the push tube 2-1 from the connecting tube 1-7 before pulling it out of the bronchoscope's working channel. If the air bubbles decrease but do not completely stop overflowing, consider the possibility of communication with adjacent bronchial segments. Use the same method to insert the occluder 1 to block the adjacent bronchus until the air bubbles disappear. The operation is then complete.

[0026] 3. For patients with heterogeneous emphysema, locate the target lobe segment of heterogeneous emphysema using chest CT, perform bronchoscopic airway exploration to confirm the diameter of the responsible bronchus, select an appropriate occluder 1, first insert the guidewire 2-2 into the guide tube 2-1, extending the guidewire 2-2 slightly beyond the tip of the guide tube 2-1 by about 4 cm, then insert both through the bronchial working channel until the guidewire 2-2 is completely extended out of the bronchoscope tip, with a small portion of the guide tube 2-1 protruding from the bronchoscope tip. Then pass the guidewire 2-2 through the connecting tube 1-7 until the guidewire 2-2 extends about 2 cm beyond the deep bronchial insertion tube 1-2, and insert the connecting tube 1-7 into the tip hole of the guide tube 2-1 along the guidewire 2-2. Then, the responsible bronchus for active bleeding in the lower airway is entered through channels such as the nostril, mouthpiece, laryngeal mask, endotracheal tube, and rigid endoscope. After successfully guiding the bronchus into the responsible bronchus using guide wire 2-2, the push tube 2-1 is pushed forward along the guide wire 2-2. The bronchial plug is pushed into the responsible bronchus and confirmed to be fixed. The front end of the bronchoscope is pressed against the rear of the occluder 1. The guide wire 2-2 is pulled out first, and then the push tube 2-1 is disconnected from the connecting tube 1-7 and pulled out of the working channel of the bronchoscope until the responsible bronchus for heterogeneous emphysema is completely blocked, so that the area of ​​heterogeneous emphysema innervated by the responsible bronchus gradually develops atelectasis.

[0027] Of course, the above description of preferred embodiments of the present invention is only in conjunction with the accompanying drawings and is not intended to limit the scope of the present invention. All equivalent changes made in accordance with the principles, construction and structure of the present invention should be covered within the protection scope of the present invention.

Claims

1. A bronchial occlusion device, characterized in that: The device includes an interconnected plug (1) and a pusher inserter (2); the plug (1) includes a cylindrical plug base tube (1-1), the front end of which is provided with a conical plug insertion head (1-2), and the bottom diameter of the plug insertion head (1-2) is larger than the diameter of the plug base tube (1-1); the front end of the plug insertion head (1-2) is provided with a deep branch insertion tube (1-3); and the rear end of the plug base tube (1-1) is provided with a device for stabilizing the plug. A fixed end cap (1-4) that is not easily displaced inside the bronchus is provided. The fixed end cap (1-4) is cylindrical and its diameter is larger than that of the sealing base tube (1-1). A recovery line (1-5) is wound around the sealing base tube (1-1) and located at the front end of the fixed end cap (1-4). One end of the recovery line (1-5) is tied to the sealing base tube (1-1), and the other end is left free. An adjusting block (1-6) is provided on the rear side of the fixed end cap (1-4) to cover its outer circumference. The rear end of the fixed end (1-4) is fitted with a connecting tube (1-7) that is connected to the pusher (2). The connecting tube (1-7) is cylindrical. The center of the sealing base tube (1-1), the sealing embedding head (1-2), the deep branch embedding tube (1-3), the fixed end (1-4), and the connecting tube (1-7) are all provided with interconnected guide wire through holes (1-8). The pusher (2) includes a pusher conduit (2-1) fitted outside the connecting tube (1-7). The push catheter (2-1) is cylindrical and has a guide wire through hole (1-8) at its center. The push inserter (2) also includes a push guide wire (2-2). The push guide wire (2-2) can pass through the guide wire through hole (1-8) of the occluder (1) and the push catheter (2-1). The push guide wire (2-2) can extend from the front end of the deep branch embedding tube (1-3) to the outside of the push catheter (2-1), and the front end of the push guide wire (2-2) is arc-shaped.

2. The bronchial occlusion device according to claim 1, characterized in that: The sealing insert head (1-2) has friction grooves uniformly provided along its outer conical surface.

3. The bronchial occlusion device according to claim 1, characterized in that: The front end of the deep branch embedded tube (1-3) is bent forward.

Images