Traction and opening device for ESD (Electro-Static Discharge)

Abstract

The invention relates to the technical field of medical instruments, and discloses an ESD operation exfoliated tissue traction opening device. The device comprises a ground anchor, an external channel pipe, a traction rope and a tension spring assembly. The anchors are respectively fixed on the edge of the tissue to be stripped and the wall of the alimentary canal on the opposite side; the external channel tube is arranged outside the endoscope, is used for conducting the traction rope and is detachably connected with the endoscope through a fixing structure; the tension spring assembly comprises a fixing plate, a sliding block, a sliding rod, a tension spring, a circular ring and a hanging ring, wherein the circular ring and the hanging ring are used for connection. Continuous traction force is applied to the traction rope through elastic deformation of the tension spring. Through automatic continuous traction, the edge of the stripped tissue is kept in an open state, the surgical field is effectively improved, and the operation convenience and safety of an ESD surgery are improved.

Description

Technical Field

[0001] The present application relates to the field of medical device technology, and in particular to endoscopic surgery auxiliary equipment technology. Background Art

[0002] ESD (endoscopic submucosal dissection) is a minimally invasive surgical method for the treatment of early gastrointestinal tumors. During the operation, the surgeon needs to use special instruments to peel off the submucosal layer of the disease and remove it completely. In order to ensure a clear surgical field of view and the convenience of subsequent operations, the peeled mucosal tissue needs to be continuously pulled to one side during the operation to prevent it from blocking the area that has not yet been peeled off.

[0003] At present, there are some ESD surgical auxiliary traction devices on the market, such as the ENDoLifter ESD surgical stripping forceps from OLYMPUS. This device also uses an external channel design, but it has several obvious limitations:

[0004] The ENDoLifter device is installed at the front end of the endoscope, occupying the position originally used to install the transparent cap. In ESD surgery, the use of the transparent cap is essential to maintain the surgical field of view. The installation method of the ENDoLifter device makes it impossible to use the transparent cap at the same time, which limits its clinical application to a certain extent.

[0005] The ENDoLifter device has permanent holding jaws at the front end of the endoscope, forming sharp spikes. When the endoscope is inserted into the patient's esophagus, cardia and other organs, these sharp spikes may cause damage to the mucosa, increase surgical risks, and affect the safety of patients.

[0006] The ENDoLifter device is fixedly connected to the front end of the endoscope, and the two are linked in motion. During ESD surgery, the endoscope needs to be frequently adjusted in angle and moved in position, and the ENDoLifter device will move the separated tissue as the endoscope moves, causing an unstable field of view, interfering with the doctor's delicate operation, and increasing the difficulty of the surgery.

[0007] In view of the above-mentioned deficiencies in the prior art, there is an urgent need for a new ESD surgical traction device that can achieve continuous and stable traction of the stripped tissue without affecting the use of the transparent cap of the endoscope, and isolate the influence of the movement of the endoscope on the traction state to the greatest extent, thereby providing a clear field of view and a stable operating environment for ESD surgery, and improving surgical efficiency and safety. Summary of the invention

[0008] The purpose of the present application is to provide a tissue traction and lifting device for ESD surgery to solve the problems raised in the above-mentioned background technology.

[0009] The present application discloses an ESD surgical tissue stripping traction and lifting device, comprising:

[0010] Anchors, used to fix on the edge of the tissue to be stripped and the opposite digestive tract wall respectively;

[0011] An external channel tube is arranged outside the endoscope and is used to conduct the traction wire. The external channel tube is detachably connected to the endoscope through a fixed structure.

[0012] A traction rope is used to connect the anchor and the tension spring assembly;

[0013] The tension spring assembly comprises a fixed plate, a sliding block, a sliding rod, a tension spring, and a connecting ring and a hanging ring, wherein: the fixed plate is a horizontal concave structure, one side of which is provided with a hanging ring for connecting an endoscope, and the other side of which is provided with a first ring for connecting a tension spring; the sliding block is slidably arranged on the fixed plate, and the sliding block is provided with a second ring for connecting a tension spring and a third ring for connecting a traction rope; the sliding rod is used to guide the sliding block to slide on the fixed plate; one end of the tension spring is connected to the first ring of the fixed plate, and the other end is connected to the second ring of the sliding block;

[0014] The anchor is connected to the third ring of the tension spring assembly through a traction cord, and the tension spring assembly applies a continuous traction force to the traction cord through elastic deformation of the tension spring, so as to keep the edge of the peeled tissue in an open state.

[0015] In a preferred example, the fixing structure includes: an ultra-thin tape for fixing the front end of the external channel tube to the front end of the endoscope; and a fixing hoop for fixing the rear end of the external channel tube to the endoscope handle or the root of the endoscope insertion tube, and the fixing hoop is a horizontal H-shaped structure with inverted Ω-shaped openings at both ends, one of which is used to connect the rear end of the external channel tube, and the other opening is used to connect the endoscope handle or the root of the insertion tube.

[0016] In a preferred example, the tension spring assembly also includes: a latch, which is detachably arranged on the fixed plate and is used to limit the movement range of the sliding block; wherein the fixed plate is provided with a positioning slot that cooperates with the latch, and the position of the sliding block is locked when the latch is inserted into the positioning slot, and the sliding block is released when the latch is pulled out.

[0017] In a preferred embodiment, it also includes: an anchor soft rotating rod, used to rotate the anchor into the edge of the tissue to be stripped and the opposite digestive tract wall; a wire rope pulling soft rod, used to pull the traction wire from the endoscope working channel to the external channel tube.

[0018] In a preferred example, it is characterized in that: the wire rope pulling soft rod includes a flexible rod body and a hook-shaped structure arranged at the front end of the rod body, the hook-shaped structure is in an inwardly bent shape, and is used to hook and prevent the traction wire from falling off; the rod body of the wire rope pulling soft rod is formed by spirally winding stainless steel wire, and its surface is coated with a Teflon paint layer.

[0019] In a preferred example, it is characterized in that: the external channel tube is made of PTFE material, with an outer diameter of 2.0 mm and a wall thickness of 0.3 mm; the tail end of the external channel tube is an H-shaped structure, which cooperates with the inverted Ω-shaped opening of the fixing hoop, wherein the groove in contact with the fixing hoop is 5 mm in length and 2.5 mm in diameter.

[0020] In a preferred example, it is characterized in that: the bottom plate of the fixed plate is used for the sliding of the sliding block, the length of the bottom plate is 68mm to 72mm, the width is 5mm to 7mm, and the thickness is 2.8mm to 3.2mm; the thickness of the short side and the long side of the fixed plate are both 4.8mm to 5.2mm; the thickness of the sliding block is 2.8mm to 3.2mm, and it is made of 304 stainless steel.

[0021] In a preferred example, it is characterized in that: the diameter range of the tension spring is 2.8mm to 3.2mm, the retracted length is 20mm to 27mm, and the maximum elongated deformation is 25mm to 32mm; the hanging ring of the tension spring assembly is made of stainless steel wire with a diameter of 1.3mm to 1.7mm, and its inner diameter is 20mm to 40mm.

[0022] Compared with the prior art, the embodiments of the present application have at least the following differences and effects:

[0023] The problem of insufficient traction on the peeled tissue in existing ESD surgery is effectively solved. The device uses anchors and wires to achieve continuous and stable traction on the peeled tissue, so that its edge always maintains sufficient tension, thereby significantly improving the surgical field of view and providing favorable conditions for the doctor's delicate operation.

[0024] The device adopts a unique external channel design, placing the traction cord outside the endoscope, effectively avoiding the influence of endoscope movement on the traction effect. Compared with the existing technology, the device realizes the relative independence of tissue stripping traction and endoscope operation, greatly improving the stability and controllability of traction.

[0025] The introduction of the tension spring assembly realizes the automatic control of traction force. The tension spring uses its own elastic deformation to provide a continuous and constant traction force at the edge of the peeled tissue, without the need for manual adjustment by the operator, which not only improves the convenience of operation, but also ensures the uniformity and repeatability of the traction effect.

[0026] The main components of the device, such as anchors, are of universal design and can be used for postoperative wound closure and other surgeries such as gastric volume reduction surgery in addition to ESD surgery, and have wide applicability. The components have simple structure, low manufacturing cost, and are easy to promote and apply.

[0027] The system is easy to operate, and uses external channels and special tools to achieve quick installation and removal, shortening the preoperative preparation time. The main operation steps are completed by non-operators, reducing the doctor's labor intensity and improving surgical efficiency.

[0028] Overall, this application is significantly superior to existing technologies in terms of ensuring surgical field of view, improving traction stability, simplifying operation procedures, etc. Its solution to the problem of continuous traction of dissected tissue during ESD surgery not only shortens the operation time and improves the success rate of the operation, but also reduces the risk of complications, reflecting significant technological progress and clinical application value.

[0029] To sum up, the ESD surgical tissue traction and lifting device provided in this application not only effectively improves the surgical field of view, makes the installation and disassembly of the device more convenient, reduces the surgical preparation time, reduces the operating burden of medical staff, and improves surgical efficiency and safety, but also has low manufacturing costs and is easy to promote and apply. It has a very broad application prospect in the field of minimally invasive treatment of early gastrointestinal tumors.

[0030] A large number of technical features are recorded in the specification of this application, which are distributed in various technical solutions. If all possible combinations of technical features of this application (i.e., technical solutions) are to be listed, the specification will be too long. In order to avoid this problem, the various technical features disclosed in the above invention content, the various technical features disclosed in the various embodiments and examples below, and the various technical features disclosed in the accompanying drawings can be freely combined with each other to form various new technical solutions (these technical solutions are all deemed to have been recorded in this specification), unless such a combination of technical features is technically infeasible. For example, in one example, feature A+B+C is disclosed, and in another example, feature A+B+D+E is disclosed, and features C and D are equivalent technical means that play the same role. Technically, only one can be used, and it is impossible to use them at the same time. Feature E can be combined with feature C technically. Then, the solution of A+B+C+D should not be deemed to have been recorded because it is technically infeasible, and the solution of A+B+C+E should be deemed to have been recorded. BRIEF DESCRIPTION OF THE DRAWINGS

[0031] Figure 1 It is a schematic structural diagram of an external channel tube of an ESD surgical tissue stripping and traction and lifting device according to the first embodiment of the present application.

[0032] Figure 2 It is a schematic structural diagram of an external channel tube endoscope fixing hoop of an ESD surgical tissue stripping traction and lifting device according to the first embodiment of the present application.

[0033] Figure 3It is a schematic structural diagram of a cord pulling soft rod of an ESD surgical tissue stripping traction and lifting device according to the first embodiment of the present application.

[0034] Figure 4 It is a schematic structural diagram of a tension spring assembly of an ESD surgical tissue stripping and traction and lifting device according to the first embodiment of the present application.

[0035] Throughout the drawings, the same reference numerals are used to denote the same elements or structures, wherein:

[0036] 111: Groove

[0037] 400: Extension spring assembly

[0038] 410: Fixed plate

[0039] 420: Slider

[0040] 430: Sliding block retaining slide bar

[0041] 440: Sliding block positioning pin

[0042] 450: Extension spring

[0043] 460: small ring a

[0044] 470: small ring b

[0045] 480: small ring c

[0046] 490: Connecting rod and small ring

[0047] 500: hanging loop

[0048] 510: Short side

[0049] 520: Long side DETAILED DESCRIPTION

[0050] In the following description, many technical details are provided to help readers better understand the present application. However, those skilled in the art can understand that the technical solution claimed in the present application can be implemented even without these technical details and various changes and modifications based on the following embodiments.

[0051] The following is a brief description of some of the innovative features of this application:

[0052] After extensive and in-depth research, the inventors of this application have proposed a tissue traction and lifting device for ESD surgery in response to the technical problems mentioned above, aiming to solve the problem that the peeled tissue blocks the field of view and affects subsequent operations during the operation. The device continuously pulls the edge of the peeled tissue to keep it open and away from the wound, thereby ensuring a clear surgical field of view and facilitating the doctor's continuous operation. The ESD surgical tissue traction and lifting device of the present invention can automatically maintain the opening angle of the peeled tissue edge throughout the operation and keep the peeled tissue away from the wound. This not only continuously ensures the clarity of the surgical field of view, but also significantly reduces the impact of the movement of the endoscope on the state of the peeled tissue. The device effectively improves the convenience and safety of ESD surgery and has broad clinical application prospects.

[0053] Furthermore, the ESD surgical tissue stripping traction and lifting device of the present application is intended to solve the following technical problems:

[0054] In ESD surgery, if the peeled and cut mucosal tissue cannot be kept open continuously, it is easy to cover the area that has not been peeled, affecting the doctor's judgment of the lesion boundary and the subsequent peeling operation. The present application continuously pulls the peeled tissue edge to maintain it at an appropriate opening angle, thereby ensuring that the surgical field is always clearly visible.

[0055] Traditional ESD surgical tissue traction devices are mostly installed at the front end of the endoscope. The device is large in size and may increase the patient's discomfort when the endoscope is inserted through the mouth. This application adopts the design of an external channel and a tension spring component to separate the traction device from the endoscope body, effectively reducing the patient's pain.

[0056] Most existing traction devices are fixedly connected to the front end of the endoscope, and when the endoscope moves, it will pull the peeled tissue synchronously, causing instability in the surgical field and interfering with the doctor's operation. The traction device of the present application is relatively independent of the endoscope through an external channel, which isolates the influence of the movement of the endoscope on the traction state of the peeled tissue to the greatest extent, and provides a relatively stable operating environment for the doctor.

[0057] An ideal ESD surgical traction device should be able to automatically maintain the suspension state of the peeled tissue throughout the operation, so that its edges continue to open and gradually separate from the wound surface as the peeling range expands. This application uses a tension spring assembly to provide continuous constant force traction, combined with the ingenious design of the anchor and slider mechanism, to achieve follow-up automatic traction, without the need for additional manual adjustment throughout the entire process, greatly reducing the difficulty of surgical operation.

[0058] In summary, this application proposes a new design concept and implementation plan for the many technical problems existing in the existing ESD surgical traction device. Through the reasonable layout and sophisticated coordination of key structures such as external channels and tension spring components, the problems of insufficient surgical field exposure, obvious endoscopic interference, and inconvenient operation are effectively solved, creating a clear, stable, and efficient surgical environment for ESD surgery, improving the quality and safety of surgery, and representing a major technological advancement in the field of ESD.

[0059] In the following description, many technical details are provided to help readers better understand the present application. However, those skilled in the art can understand that even without these technical details and various changes and modifications based on the following embodiments, the technical solutions claimed in the claims of the present application can be implemented. In addition, the technical features involved in the various embodiments of the present application described below can be combined with each other as long as they do not conflict with each other.

[0060] Description of some concepts:

[0061] ESD: The abbreviation of endoscopic submucosal dissection, refers to a minimally invasive surgical method for the treatment of early gastrointestinal tumors. The surgeon uses special instruments to peel off the submucosal layer of the disease and completely remove it.

[0062] Tissue traction: The pulling force applied to the separated tissue during surgery. By applying tension to the tissue, the surgical field of view is expanded, making it easier for the doctor to perform subsequent operations.

[0063] ESD surgical tissue traction refers to the process of maintaining continuous traction on the separated tissue during ESD surgery. The traction force is used to keep the edges of the separated tissue open to ensure a clear surgical field of view.

[0064] Automatic maintenance of traction force: refers to the mechanism of using a tension spring or other devices to automatically maintain the traction force of the traction rope. As the surgical incision proceeds, the degree of opening of the traction tissue is automatically maintained without manual adjustment.

[0065] In the present application, the external channel tube refers to a pipe arranged outside the endoscope for conducting the traction wire. By separating it from the endoscope, the influence of the movement of the endoscope on the traction effect is reduced.

[0066] An anchor refers to a device used to fix the traction rope, which is fixed on the edge of the tissue to be peeled off and the opposite wall of the digestive tract as the traction point.

[0067] The tension spring assembly, in the present application, refers to a core component that provides continuous traction force. Through the elastic deformation of the tension spring, continuous traction force is applied to the traction rope to achieve automatic traction of the peeled tissue.

[0068] In order to make the objectives, technical solutions and advantages of the present application clearer, the implementation methods of the present application will be further described in detail below in conjunction with the accompanying drawings.

[0069] First embodiment

[0070] In general, the ESD surgical tissue stripping traction and lifting device of this embodiment is mainly composed of the following parts: an anchor, an anchor soft rotating rod, an external channel tube, a wire rope pulling soft rod and a tension spring assembly, wherein the tension spring assembly is a key component for realizing automated wire rope traction.

[0071] In clinical applications, the working principle of the device is as follows: First, the external channel tube is firmly installed on the endoscope through ultra-thin tape and a fixing hoop, the former is fixed to the front end of the endoscope, and the latter is fixed to the handle of the endoscope. Next, the first anchor with a pre-tied wire rope is screwed into a position close to the edge of the tissue to be stripped using the anchor soft rotating rod, and then the anchor soft rotating rod is withdrawn. Then, the second anchor is installed at the front end of the anchor soft rotating rod, and the other end of the first anchor wire rope is passed through the wire hole of the second anchor, and sent to the surgical site along the working channel. The second anchor is screwed into the digestive tract wall on the opposite side of the lesion to form an "anchor-wire-anchor" traction structure, and the anchor soft rotating rod is withdrawn. At this time, the wire rope is retained at least 2 meters outside the working channel.

[0072] After fixing the second anchor, the nurse uses the wire pulling rod to hook the wire from the entrance of the external channel tube, and pulls it out along the external channel tube for 150-200mm before cutting it off. At the same time, the other end of the wire in the endoscope clamp channel is pulled out. Next, the nurse inserts the upper ring of the tension spring assembly into the exit of the endoscope clamp channel, tightens the wire through endoscopic image monitoring, and fastens it to the small ring at the lower end of the tension spring assembly.

[0073] When the doctor starts the ESD operation, the operating nurse pulls out the retaining pin of the tension spring assembly and generates continuous traction using the elastic deformation of the tension spring 450. As the operation progresses and the stripping range expands, the tension spring assembly automatically maintains the opening of the stripped tissue edge, which not only ensures the clarity of the endoscopic field of view, but also provides sufficient operating space for the operator.

[0074] After the operation, the excised tissue was suspended under the traction of the 450° spring, which made it easier for the surgeon to observe and treat the wound surface. It also prevented the risk of cancer cell spread caused by the excised tissue rolling off. Finally, the surgeon removed the two anchors, and the excised tissue was removed from the body along with the endoscope, completing the entire operation.

[0075] In conclusion, the ESD surgical tissue stripping traction and lifting device successfully achieved the automated continuous traction of the stripped tissue through the clever coordination of anchors, wire ropes and tension spring components, solving the problems of insufficient surgical field exposure and limited operating space. The device has a simple structure and is easy to operate. It can significantly improve the quality and efficiency of ESD surgery and has broad clinical application prospects.

[0076] More specifically, the ESD surgical tissue traction and lifting device of this embodiment ensures that the peeled tissue always maintains an appropriate opening degree during the operation, thereby improving the surgical field of view and enhancing the operation accuracy. Through the ingenious design and synergy of multiple components, the device not only achieves precise traction control of the tissue, but also greatly simplifies the operation process.

[0077] The core components of the device include anchors, external channel tubes and tension spring assemblies. The anchors are fixed to the stripped tissue and the contralateral digestive tract wall, providing connection points for the traction rope, which is the basis for achieving traction. The external channel tube is located outside the endoscope, used to conduct the traction rope, and is firmly connected to the endoscope through ultra-thin tape and a fixing hoop. The tension spring assembly provides automatic and continuous traction, the core of which is the elastic deformation of the tension spring 450, which achieves precise control of the traction force through cooperation with the sliding block 420, the fixing plate 410 and other components.

[0078] During the operation, the anchor soft rotating rod and the wire pulling soft rod play an important role as auxiliary tools. The former is used to rotate the anchor into the tissue to form an anchor point for traction; the latter is used to pull the wire from the endoscope working channel to the external channel tube to establish a traction path.

[0079] The tension spring assembly is exquisitely designed and consists of a fixed plate 410, a sliding block 420, a sliding rod 430, a latch 440, a tension spring 450 and a plurality of small rings. Each component closely cooperates and works together. The fixed plate 410 provides basic support for other components; the sliding block 420 and the sliding rod 430 form a sliding mechanism to ensure accurate traction adjustment; the latch 440 is used to limit the movement range of the sliding block 420; and the plurality of small rings connect the tension spring 450 and the traction rope. The connecting rod and the hanging ring 500 ensure that the tension spring assembly is detachably connected to the endoscope, ensuring that the traction direction is consistent with the movement of the endoscope.

[0080] In summary, the ESD surgical stripping and cutting post-tissue traction and lifting device effectively meets the demand for continuous traction of stripped tissue in clinical surgery through the precise design and close cooperation of various components. It has a compact and reasonable structure, is easy to operate, significantly improves the surgical field of view, improves surgical efficiency and success rate, and reduces the cooperation requirements for operating nurses, and has significant clinical application value.

[0081] The key components of this embodiment are further explained below.

[0082] External channel tube

[0083] The external channel tube is one of the key components of the device, and its main function is to provide a conductive path for the traction rope. Figure 1 As shown in the figure, the external channel tube is made of PTFE material, which has good heat resistance, chemical resistance and lubricity. The outer diameter of the channel tube is 2.0mm, the wall thickness is 0.3mm, and the total length is provided in various specifications from 1150mm to 1600mm according to different models of digestive endoscopes to meet different clinical needs.

[0084] In order to ensure a stable connection with the endoscope handle fixing hoop, the tail end of the external channel tube is designed as an H-shaped structure. The length of the groove 111 is 5mm and the diameter is 2.5mm. This special design makes the external channel tube and the fixing hoop fit tightly, effectively preventing the connection from falling off or loosening.

[0085] The stability of the connection between the external channel tube and the endoscope is crucial to the clinical application effect of the entire device. By adopting a special H-shaped tail design and using it with a dedicated fixing hoop, the external channel tube can be firmly attached to the endoscope. This not only improves the convenience and stability of clinical operation, but also provides reliable support for the smooth conduction of the traction rope.

[0086] External channel tube endoscope fixing hoop

[0087] The external channel tube endoscope fixing hoop is a key component to ensure that the external channel tube is firmly connected to the endoscope. Figure 2 As shown, the fixing hoop adopts a unique horizontal H-shaped design, with inverted Ω-shaped openings of different sizes at both ends.

[0088] The smaller inverted Ω-shaped opening is used to connect the tail end of the external channel tube, and its inner circle diameter ranges from 2.5mm to 2.7mm, matching the diameter of the groove 111 at the tail end of the external channel tube. The minimum diameter of the inverted Ω opening ranges from 2.2mm to 2.4mm, slightly smaller than the inner circle diameter, to ensure a tight and stable connection.

[0089] The larger inverted Ω-shaped opening is used to connect the endoscope handle to the joint of the insertion tube (or the root of the insertion tube). For different models of endoscopes, the inner circle diameter D of the opening ranges from 9.5mm to 13.0mm to achieve a wide range of compatibility. Accordingly, the minimum diameter of the inverted Ω opening is about 2mm to 3mm smaller than the inner circle diameter D to ensure a tight fit with the endoscope.

[0090] The thickness of the fixing hoop ranges from 4.0mm to 5.0mm. It is made of PC material with excellent strength and toughness. It can withstand greater stress during clinical use and improve the durability of the device.

[0091] Through the horizontal H-shaped design and the inverted Ω-shaped opening structure, the fixing hoop realizes a reliable connection between the external channel tube and the endoscope, and provides customized connection dimensions for different models of external channel tubes and endoscopes. This design not only ensures the stability of the device in clinical applications and provides reliable support for doctors' operations, but also improves the overall performance and service life of the device.

[0092] Tools-Rope pulling soft rod

[0093] Tool - The soft rod for pulling the wire is an indispensable auxiliary tool in the device. Its main function is to pull the wire of the second anchor column from the working channel of the endoscope to the external channel tube and extend the end of the wire to an appropriate length.

[0094] like Figure 3 As shown, the soft rod is specially designed to meet the needs of different types of endoscopes. Its total length is available in various specifications from 1200mm to 1800mm, and its outer diameter is uniformly 1.2mm to ensure that it can pass through the working channel of the endoscope smoothly.

[0095] The flexible part of the soft rod is made of spirally wound stainless steel wire, which has good flexibility and can adapt to the bending of the endoscope tube. The surface of the rod is coated with Teflon paint, which not only improves the wear resistance and corrosion resistance, but also reduces the friction with the pipe wall, making the wire rope traction smoother.

[0096] The head of the soft rod is designed as a special hook, made of the same stainless steel as the rod body and processed by a special process. The lower part of the hook is inward curved, which is convenient for hooking the rope and preventing the rope from falling off during traction.

[0097] The root is connected to a handle made of PC material, which is convenient for the nurse to hold and apply force. When in use, the nurse inserts the soft rod from the external channel tube, hooks the wire rope at its head end and pulls it to the end of the external channel tube, leaving 100mm to 150mm of the wire rope length before cutting it off. Then, the nurse pulls the end of the wire rope out of the endoscope working channel to complete the laying of the wire rope.

[0098] The design of the soft rod for wire pulling fully considers the characteristics of the endoscope channel and the clinical operation requirements. Its flexible structure and special hook-shaped head ensure the smooth progress of the wire pulling process, while the design of the hand-held handle improves the convenience of operation. By using this tool, the operating nurse can efficiently complete the laying of the wire, providing a reliable foundation for subsequent tissue traction.

[0099] Extension spring assembly

[0100] The tension spring assembly is the core component of the device to achieve automatic and continuous traction. Figure 4As shown, it is mainly composed of a fixed plate 410, a sliding block 420, a sliding block 420 retaining slide rod 430, a sliding block 420 positioning pin 440, a tension spring 450, a hanging ring 500 and several small circular rings for connection.

[0101] The fixing plate 410 adopts a horizontal concave structure design, with a total length of 70mm to 80mm. A connecting rod with a small ring 460 at the head end is installed on the thick plate of the right long side 520. The connecting rod has a diameter range of 1.8mm to 2.2mm and a length of 13mm to 17mm; the small ring 460 on the connecting rod has an inner diameter of 2.8mm to 3.2mm and an outer diameter of 4.8mm to 5.2mm.

[0102] The small circular ring 460 is used to connect a hanging ring 500 made of stainless steel wire with a diameter of 1.3mm to 1.7mm. The inner diameter of the hanging ring 500 is 20mm to 40mm. It is used to hang on the biopsy channel of the endoscope to detachably connect the tension spring assembly to the endoscope. A small circular ring 470 is also installed on the thick plate of the left long side 520 of the fixed plate 410, which is used to connect the upper end of the tension spring 450. Its inner diameter is 0.8mm to 1.2mm. The concave bottom plate of the fixed plate 410 is used for the sliding of the sliding block 420.

[0103] Small pull rings b and c are installed on both sides of the upper part of the sliding block 420, with an inner diameter ranging from 0.8mm to 1.2mm. The small pull ring b is connected to the lower end of the tension spring 450, and the small pull ring c is used to tie the traction rope. There is a hole with a diameter of 1.3mm to 1.7mm on both sides of the lower part of the sliding block 420, which is used to connect two sliding rods 430 to ensure the free sliding of the sliding block 420 on the bottom plate of the fixed plate 410. The sliding rod 430 is made of a stainless steel round rod with a diameter of 1.3mm to 1.5mm and a length of 75mm to 80mm. One end is fixed to the short side 510 of the fixed plate 410 with bolts, and the other end passes through the sliding block 420 and the long side 520 of the fixed plate 410 and is fixed with a retaining spring.

[0104] The bottom plate of the fixed plate 410 has a length ranging from 68mm to 72mm, a width ranging from 5mm to 7mm, and a thickness ranging from 2.8mm to 3.2mm; the thickness of the short side 510 and the long side 520 are both 4.8mm to 5.2mm. The sliding block 420 has a thickness ranging from 2.8mm to 3.2mm and is made of 304 stainless steel.

[0105] The diameter of the tension spring 450 ranges from 2.8mm to 3.2mm, the retracted length is 20mm to 27mm, and the maximum elongated deformation is 25mm to 32mm, corresponding to the travel range of the sliding block 420. When the tension spring 450 reaches the maximum elongated deformation, a positioning slot parallel to the surface of the sliding block 420 is provided on the fixed plate 410, which is 2.8mm to 3.2mm long and 1.3mm to 1.7mm wide, for placing the positioning pin 440. The thickness of the positioning pin 440 is 1.0mm to 1.4mm, the width of the inserted part is 2.5mm to 2.9mm, the length of the exposed part is 1.8mm to 2.2mm, and the maximum width of the handheld part is 6mm to 8mm. After the tension spring assembly is installed and the traction rope is tightened, the positioning pin 440 is pulled out, and the tension spring 450 generates continuous traction on the traction rope.

[0106] During ESD surgery, as the doctor cuts the mucosal tissue along the markings, the tension spring assembly automatically maintains traction, gradually increasing the opening angle of the peeled tissue edge until the diseased tissue is completely removed. At the same time, the traction force separates the peeled tissue from the wound surface, which not only provides a good field of vision for the doctor's subsequent operations, but also prevents the risk of cancer cell implantation and metastasis caused by the peeled tissue rolling off to a certain extent. The entire process does not require the doctor or nurse to make additional adjustments to the cord, greatly simplifying the surgical operation.

[0107] The tension spring assembly is a key component of the device. It uses elastic elements to achieve continuous and stable traction through sophisticated design and meticulous structural processing. Its automation characteristics and constant force traction function significantly enhance the clinical demand for continuous exposure of stripped tissue in ESD surgery, and improve surgical efficiency and safety.

[0108] Working principle:

[0109] The main working principle of the ESD surgical tissue traction and lifting device is to keep the peeled tissue open during the operation through automatic traction control, ensure a clear surgical field of view, and provide enough space for the doctor's operation. Its working steps and principles are as follows:

[0110] Installation of the external channel tube: First, the external channel tube is firmly installed on the endoscope through ultra-thin tape and fixing hoop. The external channel tube is separated from the endoscope to avoid the interference of the movement of the endoscope on the traction state, and provides a conductive path for the traction rope.

[0111] Anchor setting: Use the anchor soft rotating rod to screw the first anchor with the pre-tied wire into the digestive tract wall near the edge of the stripped tissue, and then pass the wire through the second anchor. The second anchor is screwed into the opposite digestive tract wall to form an "anchor-wire-anchor" traction structure, providing a stable traction point.

[0112] Operation of the tension spring assembly: The tension spring assembly is composed of a fixing plate 410, a sliding block 420, and a tension spring 450. When the device is activated, the tension spring assembly applies a continuous traction force to the traction cord through the elastic deformation of the tension spring 450. As the operation proceeds, the tension spring assembly automatically adjusts the traction force to ensure that the edges of the peeled tissue remain open.

[0113] Automatic adjustment of traction force: As the doctor gradually performs the peeling operation, the area of ​​peeled tissue gradually increases. The tension spring assembly uses its automatic adjustment function to maintain a constant traction force, ensuring that the peeled tissue is always in a suspended and open state during the operation, avoiding blocking the unpeeled area and ensuring a clear surgical field.

[0114] Postoperative treatment: After the operation, the stripped tissue remains suspended under the traction of the tension spring assembly, which is convenient for the surgeon to further treat the wound surface. Finally, the doctor removes the two anchors and removes the stripped tissue from the body through the endoscope to complete the operation.

[0115] The device forms an automated traction mechanism through the coordination of anchors, external channel tubes and tension spring components, which not only provides a stable surgical field but also simplifies the operation process. The entire process does not require additional adjustments by doctors or nurses, greatly improving the efficiency and safety of the operation.

[0116] The ESD surgical tissue stripping and traction device of the present application has the following technical effects:

[0117] The problem of insufficient traction on the peeled tissue in existing ESD surgery is effectively solved. The device uses anchors and wires to achieve continuous and stable traction on the peeled tissue, so that its edge always maintains sufficient tension, thereby significantly improving the surgical field of view and providing favorable conditions for the doctor's delicate operation.

[0118] The device adopts a unique external channel design, placing the traction cord outside the endoscope, effectively avoiding the influence of endoscope movement on the traction effect. Compared with the existing technology, the device realizes the relative independence of tissue stripping traction and endoscope operation, greatly improving the stability and controllability of traction.

[0119] The introduction of the tension spring assembly realizes the automatic control of traction force. The tension spring 450 uses its own elastic deformation to provide a continuous and constant traction force at the edge of the peeled tissue without the need for manual adjustment by the operator, which not only improves the convenience of operation but also ensures the uniformity and repeatability of the traction effect.

[0120] The main components of the device, such as anchors, are of universal design and can be used for postoperative wound closure and other surgeries such as gastric volume reduction surgery in addition to ESD surgery, and have wide applicability. The components have simple structure, low manufacturing cost, and are easy to promote and apply.

[0121] The system is easy to operate, and uses external channels and special tools to achieve quick installation and removal, shortening the preoperative preparation time. The main operation steps are completed by non-operators, reducing the doctor's labor intensity and improving surgical efficiency.

[0122] Overall, this application is significantly superior to existing technologies in terms of ensuring surgical field of view, improving traction stability, simplifying operation procedures, etc. Its solution to the problem of continuous traction of dissected tissue during ESD surgery not only shortens the operation time and improves the success rate of the operation, but also reduces the risk of complications, reflecting significant technological progress and clinical application value.

[0123] In order to better understand the technical solution of the present application, a specific example is provided below for illustration. The details listed in the example are mainly for ease of understanding and are not intended to limit the scope of protection of the present application.

[0124] In this example, the components and structures used in the system include: an anchor, a tool-anchor soft rotating rod, an external channel tube pre-tied to the distal end of the endoscope and fixed to the endoscope handle using an endoscope fixing hoop, a tool-wire pulling soft rod that transfers the wire pull rope through the external channel tube and passes through the external channel tube, and a tension spring assembly that can pre-control the wire pull rope.

[0125] When the system is working, the traction control device of the tension spring assembly pulls the wire rope through the external channel tube of the endoscope, the second anchor and the first anchor, generating automatic traction, so that the edge of the stripped and cut tissue maintains the opening degree as the operation progresses, until the stripped tissue leaves the surgical wound as a whole.

[0126] During the operation, first use the anchor column soft rotating rod device to screw an anchor column with a pre-tied rope near the edge of the tissue to be completely peeled and cut (near the starting point of the electric knife cutting). After withdrawing the soft rotating rod device along the endoscope working channel, another anchor column is installed at the front end of the anchor column soft rotating rod. The rope of the first anchor column is passed through the rope threading hole of the anchor column and then sent into the surgical site along the working channel. The anchor column is screwed and fixed on the wall of the digestive tract opposite the surgical site, and then the anchor column soft rotating rod device is withdrawn. At this time, the rope remains outside the working channel opening and is at least 2 meters long.

[0127] In this example, the external channel tube is pre-fixed on the endoscope used. The front end of the external channel tube is fixed to the position 7-9mm behind the front end of the endoscope using "ultra-thin tape", and the end of the external channel tube is fixed to the lower part of the endoscope handle (or the root of the endoscope insertion tube) using "external channel tube endoscope fixing hoop". After the second anchor is screwed in, the operating nurse holds the tool "wire traction soft rod" and goes deep into the surgical site along the entrance of the "endoscope external channel tube", operates the hook at the front end of the "wire traction soft rod" to put the wire rope, and then pulls the "wire traction soft rod" out along the entrance of the "endoscope external channel tube", leaving a length of 150-200mm beyond the entrance of the "endoscope external channel tube" and then cuts it off, and then pulls out the wire rope still remaining in the endoscope clamp channel tube. Next, the operating nurse inserts the upper ring of the "tension spring assembly" into the position of the clamp channel outlet on the endoscope handle, observes the endoscopic image, tightens the rope and fastens it to the ring at the lower end of the "tension spring assembly". When the doctor starts the ESD operation, the operating nurse pulls out the retaining pin on the "tension spring assembly". At this time, the tension spring on the "tension spring assembly" will generate traction. As the doctor removes the tissue to a certain extent, the edge of the peeled off tissue will automatically maintain the mouth opening, thereby ensuring the field of view of the endoscope camera and the space for the doctor to operate the ESD equipment. After the operation, due to the traction force of the 450 tension spring of the "tension spring assembly", the cut tissue will remain suspended. After the operating doctor removes the second anchor, the cut tissue and anchor will be removed from the human body with the withdrawal of the endoscope.

[0128] External channel tube

[0129] The appearance and structure of the external channel tube are as follows Figure 2 As shown, its material is PTFE and its outer diameter is The wall thickness is 0.3mm, and the total length is divided into different specifications of 1150mm-1600mm to adapt to different types of digestive endoscopes. The tail end of the external channel tube is designed to be H-shaped to adapt to the endoscope handle fixing hoop. The length of the groove 111 in contact with the fixing hoop is 5mm and the diameter is 2.5mm.

[0130] External channel tube endoscope fixing hoop

[0131] The external channel tube endoscope fixing hoop is used to fix the external channel tube to the endoscope handle (or the root of the endoscope insertion tube). Its appearance is as follows Figure 2As shown. The fixing hoop adopts a horizontal H-shaped design with inverted Ω-shaped openings at both ends. The inverted Ω-shaped opening at one end is smaller in size and suitable for insertion into the groove 111 at the tail end of the external channel tube; the inverted Ω-shaped opening at the other end is larger in size and suitable for insertion into the connection between the endoscope handle and the insertion tube (or the root of the insertion tube). The thickness B of the fixing hoop is 4.5mm, the diameter C of the inverted Ω-shaped inner ring for inserting one side of the external channel tube is 2.6mm, and the minimum diameter of the inverted Ω opening is 2.2-2.3mm. The inverted Ω-shaped inner ring diameter D for inserting one end of the endoscope handle is divided into various specifications such as 9.8mm, 11.6mm, and 12.7mm according to different endoscope types. The corresponding inverted Ω opening minimum diameter is 2-3mm smaller than the inner ring diameter D. The fixing hoop is made of PC.

[0132] Rope pulling soft rod

[0133] The wire pulling rod is used to pull the wire of the second anchor into the external channel tube and extend it out of the end of the tube, leaving a length of 100 to 150 mm before cutting it off. The operating nurse then pulls the wire that originally passed through the working channel of the endoscope out along the working channel. Figure 4 As shown in the figure, the tool is suitable for different types of endoscopes. The total length of the tool is divided into different specifications of 1200mm-1800mm, and the outer diameter is 1.2mm. The soft part of the soft rod is made of spirally wound stainless steel wire, and the head end is a hook-shaped stainless steel of the same material bent by a specific process. The lower part of the hook is bent inward to prevent the rope from detaching. The soft part is coated with Teflon paint to retain a certain toughness. The root of the rope traction rod is a hand-held handle made of PC material.

[0134] Extension spring assembly

[0135] The tension spring assembly is used to maintain the automatic traction force of the pull rope between the first anchor and the second anchor. As the surgeon cuts the diseased tissue along the mark, the cut and peeled tissue edge automatically maintains a gradually increasing opening angle under the traction of the tension spring 450 until the diseased tissue is completely removed. The peeled tissue is separated from the ESD wound surface under the traction force of the rope, providing a good field of view for the doctor's subsequent operations, and the rope traction makes the peeled tissue suspended in the air, reducing the risk of cancer cell implantation and metastasis. Figure 4As shown, the tension spring assembly consists of a fixed plate 410, a sliding block 420, a sliding rod 430, a latch 440, a tension spring 450, and several connecting rings. The fixed plate 410 adopts a horizontal concave structure with a total length of 70 mm. A connecting rod with a small ring 460 with a diameter of 2.0 mm and a length of 15 mm is installed on the thick plate of the long side 520 on the right side; the small ring 460 has an inner diameter of 3.0 mm and an outer diameter of 5.0 mm, and is used to connect a hanging ring 500 made of a stainless steel wire with a diameter of 1.5 mm. The hanging ring 500 has an inner diameter of 20-40 mm and is used to hang on the endoscope biopsy channel. A small ring 470 with a diameter of 1.0 mm is installed on the thick plate of the long side 520 on the left side of the fixed plate 410, and is used to connect the upper end of the tension spring 450. The concave bottom plate of the fixed plate 410 is used for the sliding of the sliding block 420. The bottom plate is 70mm long, 6mm wide and 3.0mm thick. The short side 510 and the long side 520 are 5.0mm thick. The sliding block 420 is 3.0mm thick and made of 304 stainless steel. Small pull rings b and c are installed on both sides of the upper part, both with a diameter of 1.0mm. B is used to connect the lower end of the tension spring 450, and c is used to tie the traction rope. There is a hole with a diameter of 1.5mm on each side of the lower part of the sliding block 420, which is used to connect two stainless steel round sliding rods 430 with a diameter of 1.4mm and a length of 78mm. One end is fixed to the short side 510 of the fixed plate 410 with bolts, and the other end passes through the sliding block 420 and the long side 520 of the fixed plate 410 and is fixed with a retaining ring. The tension spring 450 has a diameter of 3.0mm, a retracted length of 20-27mm, and a maximum elongated deformation of 25-32mm (i.e., the travel of the sliding block 420). When the tension spring 450 reaches the maximum elongation deformation, a positioning slot with a length of 3 mm and a width of 1.5 mm is provided on the fixing plate 410 above the sliding block 420, which is used to place a positioning pin 440 with a thickness of 1.2 mm. The portion of the pin 440 inserted into the fixing plate 410 is 2.7 mm wide, the exposed portion is 2 mm long, and the maximum width of the handheld portion is 7 mm. After the tension spring assembly is installed with a traction cord and tightened, the positioning pin 440 is pulled out, and the tension spring 450 generates a continuous traction force on the cord, so that the tissue being stripped during the ESD operation is automatically pulled without manual adjustment.

[0136] It should be noted that all documents mentioned in this application are cited as references in this application, just as each document is cited as reference separately. In addition, it should be understood that after reading the above teaching content of this application, those skilled in the art can make various changes or modifications to this application, and these equivalent forms also fall within the scope defined by the claims attached to this application.

[0137] Furthermore, in the claims and specification of this patent, relational terms such as first and second, etc., are used only to distinguish one entity or operation from another entity or operation, and do not necessarily require or imply any such actual relationship or order between these entities or operations. Moreover, the terms "include", "comprise" or any other variants thereof are intended to cover non-exclusive inclusion, so that a process, method, article or device including a series of elements includes not only those elements, but also other elements not explicitly listed, or also includes elements inherent to such process, method, article or device. In the absence of further restrictions, the elements defined by the sentence "including one" do not exclude the existence of other identical elements in the process, method, article or device including the elements. In the claims and specification of this patent, if it is mentioned that an action is performed according to an element, it means that the action is performed at least according to the element, which includes two situations: performing the action only according to the element, and performing the action according to the element and other elements.

[0138] Although the present application has been illustrated and described with reference to certain preferred embodiments thereof, it will be apparent to those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the present application.

Claims

1. An ESD surgical tissue stripping traction and lifting device, characterized in that: include: Anchors, used to fix on the edge of the tissue to be stripped and the opposite digestive tract wall respectively; An external channel tube is arranged outside the endoscope and is used to conduct the traction wire. The external channel tube is detachably connected to the endoscope through a fixed structure. A traction rope is used to connect the anchor and the tension spring assembly; The tension spring assembly comprises a fixed plate, a sliding block, a sliding rod, a tension spring, and a connecting ring and a hanging ring, wherein: the fixed plate is a horizontal concave structure, one side of which is provided with a hanging ring for connecting an endoscope, and the other side of which is provided with a first ring for connecting a tension spring; the sliding block is slidably arranged on the fixed plate, and the sliding block is provided with a second ring for connecting a tension spring and a third ring for connecting a traction rope; the sliding rod is used to guide the sliding block to slide on the fixed plate; one end of the tension spring is connected to the first ring of the fixed plate, and the other end is connected to the second ring of the sliding block; The anchor is connected to the third ring of the tension spring assembly through a traction cord, and the tension spring assembly applies a continuous traction force to the traction cord through elastic deformation of the tension spring, so as to keep the edge of the peeled tissue in an open state.

2. The ESD surgical tissue stripping traction and lifting device according to claim 1, characterized in that: The fixing structure includes: an ultra-thin tape, which is used to fix the front end of the external channel tube to the front end of the endoscope; and a fixing hoop, which is used to fix the rear end of the external channel tube to the endoscope handle or the root of the endoscope insertion tube. The fixing hoop is a horizontal H-shaped structure, and both ends are inverted Ω-shaped openings, one of which is used to connect the rear end of the external channel tube, and the other opening is used to connect the endoscope handle or the root of the insertion tube.

3. The ESD surgical tissue stripping and traction device according to claim 1, characterized in that: The tension spring assembly also includes: a latch, which is detachably arranged on the fixed plate and is used to limit the movement range of the sliding block; wherein the fixed plate is provided with a positioning slot that cooperates with the latch, and when the latch is inserted into the positioning slot, the sliding block is locked in position, and when the latch is pulled out, the sliding block is released.

4. The ESD surgical tissue stripping traction and lifting device according to claim 1, characterized in that: Also includes: Anchor soft rotating rod, used to rotate the anchor into the edge of the tissue to be stripped and the opposite digestive tract wall; The wire pulling soft rod is used to pull the traction wire from the endoscope working channel to the external channel tube.

5. The ESD surgical tissue stripping and pulling device according to claim 4, characterized in that: The wire rope pulling soft rod includes a flexible rod body and a hook-shaped structure arranged at the front end of the rod body. The hook-shaped structure is in an inwardly curved shape and is used to hook and prevent the traction wire rope from falling off. The rod body of the wire rope pulling soft rod is formed by spirally winding stainless steel wire, and its surface is coated with a Teflon paint layer.

6. The ESD surgical tissue stripping traction and lifting device according to claim 1, characterized in that: The external channel tube is made of PTFE material, with an outer diameter of 2.0 mm and a wall thickness of 0.3 mm; the tail end of the external channel tube is an H-shaped structure, which matches the inverted Ω-shaped opening of the fixing hoop, wherein the groove in contact with the fixing hoop is 5 mm long and 2.5 mm in diameter.

7. The ESD surgical tissue stripping and pulling device according to claim 1, characterized in that: The bottom plate of the fixed plate is used for the sliding of the sliding block. The length of the bottom plate is 68mm to 72mm, the width is 5mm to 7mm, and the thickness is 2.8mm to 3.2mm. The thickness of the short side and the long side of the fixed plate are both 4.8mm to 5.2mm. The thickness of the sliding block is 2.8mm to 3.2mm and is made of 304 stainless steel.

8. The ESD surgical tissue stripping and pulling device according to claim 1, characterized in that: The diameter range of the tension spring is 2.8mm to 3.2mm, the retracted length is 20mm to 27mm, and the maximum elongated deformation is 25mm to 32mm; the hanging ring of the tension spring assembly is made of stainless steel wire with a diameter of 1.3mm to 1.7mm, and its inner diameter is 20mm to 40mm.

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