Resectoscope

By designing an electroconv mirror that can control the degree of freedom between the grip and the connection through external force, it drives the bending of the flexible continuous body, and realizes the posture change of the electroconv ring assembly and the lens assembly, the problems of blind spots and difficulty of the operation of the lesions around the bladder neck are solved, and the visibility and operability of the surgery are improved.

CN119867911AActive Publication Date: 2025-04-25BEIJING HOSPITAL +1

Patent Information

Application Number
CN202510060638.2
Authority / Receiving Office
CN · China
Patent Type
Applications(China)
Current Assignee / Owner
Filing Date
2025-01-15
Publication Date
2025-04-25
Estimated Expiration
2045-01-15

AI Technical Summary

Technical Problem

The lesions in the 2-3 cm area around the bladder neck are in the visual field and operating blind spots, making it difficult to effectively apply transurethral bladder tumor resection (TURBT) in this area. Due to limited operating space, it is easy to cause hand shaking, causing bleeding, tissue perforation and other problems.

Method used

An electrocutting mirror is designed to control the freedom between the grip and the connecting part through external force, and to drive the pulling structure to bending the flexible continuum, so as to realize the posture change of the distal electric incision ring assembly and the lens assembly of the flexible continuum, thereby enlarging the visible area and the operable area in the surgical operation.

Benefits of technology

Through the design of this electrorecision mirror, the position and posture of the electrorecision ring assembly can be more intuitively controlled, the difficulty of surgery can be reduced, the treatment effect of lesions around the bladder neck is improved, and the risks of operating blind spots and bleeding, perforation, etc. can be reduced.

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Abstract

The invention belongs to the technical field of medical instruments, and provides a resectoscope which comprises an outer sheath tube and an inner sheath tube which are arranged in a sleeving mode. The guiding assembly is movably arranged in the inner sheath tube in a penetrating mode, and a flexible continuous body is arranged at the far end of the guiding assembly; the electric cutting ring assembly is detachably arranged at the far end of the flexible continuous body; the lens assembly is arranged at the far end of the flexible continuous body and is exposed out of the electric cutting ring assembly; the handle assembly comprises a holding part and a connecting part which are rotationally connected with each other, the far end of the connecting part is connected with the near end of the guiding assembly, and the holding part is connected with the flexible continuum through a traction structure. The degree of freedom between the holding part and the connecting part is controlled through external force, so that the traction structure is driven to pull the flexible continuum to be bent, the posture change of the flexible continuum far-end electric cutting ring assembly and the posture change of the lens assembly are achieved, the visual area and the operable area in surgical operation are increased, and the surgical difficulty is reduced.
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Description

Technical Field

[0001] The present application relates to the technical field of medical devices, and in particular to an electroresectoscope. Background Art

[0002] Bladder cancer is a common malignant tumor in the urinary system, with high morbidity and mortality, which seriously threatens the health and quality of life of patients. Transurethral resection of bladder tumor (TURBT) is currently the preferred method for treating bladder tumors. It is a surgical intervention in which a rigid resectoscope is inserted into the patient's body through the urethra. Under the guidance of the endoscopic imaging system, the energy platform electric cutter is turned on and off to physically remove the diseased tissue. Moreover, the electric cutting ring has become a common instrument in the field of bladder cancer treatment due to its regular shape, fast operation and low cost.

[0003] However, since the soft endoscope used for diagnosis lacks support and the field of view of the hard endoscope used for treatment cannot be bent, lesions in the 2-3 cm area around the bladder neck are within the field of view and there is an operational blind spot, which makes it difficult to effectively apply TURBT in this area, and thus makes it difficult to treat lesions in this area; and because TURBT is very strong, under the influence of limited operating space, it is very easy for the operator's hands to shake, causing bleeding, tissue perforation and other problems, which is not conducive to surgical treatment. Summary of the invention

[0004] An embodiment of the present application provides an electrosurgical resectoscope that can control the degree of freedom between the gripping portion and the connecting portion through external force to drive the pulling structure to pull the flexible continuum to bend, thereby changing the posture of the distal electrosurgical resection ring assembly and the lens assembly of the flexible continuum, so as to increase the visible area and the operable area during surgical operations.

[0005] The embodiment of the present application provides a resectoscope for resecting a target tissue, wherein the resectoscope comprises an outer sheath tube and an inner sheath tube which are mutually sleeved; and

[0006] A guide component is movably arranged in the inner sheath tube, and a flexible continuum is arranged at the distal end of the guide component;

[0007] An electric cutting ring assembly is detachably arranged at the distal end of the flexible continuum;

[0008] A lens assembly, disposed at the distal end of the flexible continuum and exposed from the electrocuting ring assembly;

[0009] The handle assembly comprises a gripping portion and a connecting portion which are rotatably connected to each other, wherein the distal end of the connecting portion is connected to the proximal end of the guide assembly, and the gripping portion is connected to the flexible continuum via a pulling structure; the handle assembly is configured to change the degree of freedom of the gripping portion relative to the connecting portion under the action of an external force, so as to drive the pulling structure to pull the flexible continuum, so as to adjust the degree of freedom of the distal end of the flexible continuum.

[0010] In a feasible implementation, the flexible continuum includes at least two rotational joints that are rotationally connected to each other, and the pulling structure is sequentially connected to at least two of the rotational joints, so that the flexible continuum is bent under the drive of the gripping portion.

[0011] In a feasible implementation, the flexible continuum also includes a first joint and a second joint, the first joint and the second joint are respectively connected to the two ends of at least two of the rotating joints, the proximal end of the first joint is fixedly connected to the end of the guide assembly, and the distal end of the second joint is used to set the lens assembly and the electric cutting ring assembly.

[0012] In a feasible implementation, one end of each of the revolving joints is configured with a joint ball socket, and the other end is configured with a joint ball head, and the joint ball head is used for ball-jointed connection with the joint ball socket of an adjacent revolving joint;

[0013] The end of the first joint is configured with a joint ball socket / joint ball head for ball-jointed connection with an adjacent rotary joint, and the end of the second joint is correspondingly configured with a joint ball head / joint ball socket.

[0014] In a feasible implementation, each of the rotational joints is constructed with a plurality of through holes, the axis of the through holes is consistent with the extension direction of the flexible continuum, and the plurality of through holes are evenly distributed on the periphery of the rotational joint;

[0015] The pulling structure comprises a plurality of pulling ropes, one end of each of which is fixed to the holding portion, and the other end of each of which passes through the through holes of each of the rotating joints in sequence and is fixed.

[0016] In a feasible implementation, the first joint and the second joint are hollow cylinders, and the side walls of the first joint and the second joint are constructed with multiple through holes corresponding to the through holes, and the end of the pulling rope passes through the through hole of the first joint, the through holes of the multiple rotating joints, and the through hole of the second joint in sequence, and is fixed at the second joint.

[0017] In a feasible implementation, an annular boss is provided on the outer periphery of the rotary joint, the annular boss is located on the joint ball socket side, and the plurality of through holes are evenly distributed on the annular boss.

[0018] In a feasible implementation, the annular boss is further configured with a plurality of wire passing holes, at least one of the plurality of wire passing holes is disposed between two adjacent through holes, and the wire passing holes are used for the electric cutting ring cable to pass through.

[0019] In a feasible implementation, along the extension direction of the flexible continuum, a central channel is formed through the first joint, the plurality of rotational joints and the second joint, and the central channel is used for the lens cable to pass through.

[0020] In a feasible implementation, the lens assembly includes a lens fixing seat, a accommodating shell and a lens device, the lens fixing seat is fixedly connected to the second joint, the lens fixing seat is installed with the lens cable, the accommodating shell is arranged on the outer end surface of the lens fixing seat, and the accommodating shell is used to install the lens device.

[0021] In a feasible implementation, the electric cutting ring assembly includes a fixed base and a cutting electrode, the cutting electrode is fixed on one side of the fixed base and is used to cut the target tissue, and a first mounting portion is configured on a side of the fixed base facing away from the cutting electrode;

[0022] The outer end surface of the lens fixing seat is configured with a second mounting portion, and the second mounting portion is adapted to be plugged with the first mounting portion.

[0023] In a feasible implementation, the first mounting portion includes at least two plugs, and the second mounting portion includes at least two sockets corresponding to the plugs one by one, and metal contacts are fixed in the two sockets, and the metal contacts are used to connect the electric cutting ring cable and the plug.

[0024] In a feasible implementation, the fixed base is configured with an avoidance channel, so that the accommodating shell passes through the avoidance channel, so that the lens assembly is exposed from the fixed base;

[0025] Wherein, the depth of the avoidance channel is less than or equal to the height of the accommodating shell.

[0026] In a feasible implementation, the lens fixing seat is cylindrical, and the lens fixing seat is adapted to be embedded in the second joint and fixedly connected to the second joint;

[0027] An annular groove is configured along the circumference of the lens fixing seat, and the annular groove is used to install a sealing ring to seal the lens fixing seat and the second joint.

[0028] In a feasible implementation, the guide assembly includes a guide tube, a distal end of the guide tube is fixedly connected to the first joint, a proximal end of the guide tube is fixedly connected to the connecting portion, and the guide tube is used for the traction structure to pass through.

[0029] In a feasible implementation, a steering portion is provided between the gripping portion and the connecting portion, and the steering portion is configured to enable the gripping portion to tilt relative to the connecting portion under the action of an external force, and / or to enable the connecting portion to rotate synchronously with the gripping portion.

[0030] In a feasible implementation, the connecting portion includes a connecting shell, one end of the connecting shell is connected to the guide assembly, and the other end is connected to the steering portion;

[0031] The side wall of the connecting shell is configured with a plurality of threading grooves, which are evenly distributed around the circumference of the connecting shell. The threading grooves are used for pulling ropes to enter the guide assembly from the outside.

[0032] In a feasible implementation, a plurality of guide wheel groups are provided on the connection shell, and the plurality of guide wheel groups correspond one-to-one to the plurality of threading grooves to guide the pulling rope.

[0033] In a feasible implementation, the holding portion includes a fixed plate and a handle rod that are connected to each other. The fixed plate is connected to the steering portion and is used to fix the ends of multiple pulling ropes. The fixed plate moves with the handle rod to enable the multiple pulling ropes connected to the fixed plate to move different distances.

[0034] In a feasible implementation, the steering part includes an active fork, an intermediate connecting block and a driven fork, one end of the active fork is fixed to the fixed plate, and the other end is hinged to the intermediate connecting block through a first rotating shaft, and one end of the driven fork is fixed to the connecting housing, and the other end is hinged to the intermediate connecting block through a second rotating shaft;

[0035] Wherein, the axis of the first rotating shaft is perpendicular to the axis of the second rotating shaft.

[0036] In a feasible implementation, the pulling structure includes four pulling ropes, two of which are located at two opposite ends of the first rotating shaft, and the other two pulling ropes are located at two opposite ends of the second rotating shaft.

[0037] In a feasible implementation, the intermediate connecting block is constructed with a plurality of threading holes, so that the electric cutting ring cable connected to the electric cutting ring assembly and the lens cable connected to the lens assembly pass through the threading holes and the connecting shell to reach the guide assembly.

[0038] In a feasible implementation, the handle assembly also includes a handle shell, which is constructed with a accommodating cavity and a limit opening that are interconnected. The limit opening is formed at the proximal end of the handle shell, and the hand grip rod is inserted through the limit opening. The fixed plate, the connecting shell and part of the guide tube are placed in the accommodating cavity.

[0039] In a feasible implementation, the accommodating cavity includes a supporting cavity and a spherical cavity;

[0040] The gripping portion further comprises a handle ball head, the handle ball head is arranged between the fixing plate and the hand grip rod, and the handle ball head is arranged in the spherical cavity;

[0041] The supporting cavity is used to support the connecting shell and the guiding tube.

[0042] In a feasible implementation, a limit member is provided on the outer side of the distal end of the handle shell, and the limit member is used to engage with the slot at the end of the inner sheath tube to fix the inner sheath tube, the outer sheath tube and the handle shell in connection.

[0043] The electrosurgical resectoscope provided in the embodiment of the present application is designed to have a holding part, a connecting part, a guiding assembly, a flexible continuum and a lens assembly, and an electrosurgical cutting ring assembly connected in sequence from the proximal end to the distal end, and a pulling structure is connected between the holding part and the flexible continuum. The freedom between the holding part and the connecting part is controlled by an external force to drive the pulling structure to pull the flexible continuum to bend, thereby changing the posture of the electrosurgical cutting ring assembly and the lens assembly at the distal end of the flexible continuum, so as to increase the visible area and the operable area during the surgical operation. The operator controls the freedom of the flexible continuum through the holding part, and can more intuitively control the position and posture of the electrosurgical cutting ring assembly, thereby reducing the difficulty of the operation. BRIEF DESCRIPTION OF THE DRAWINGS

[0044] In order to more clearly illustrate the technical solutions in the embodiments of the present application or the related technologies, the drawings required for use in the embodiments or the related technical descriptions are briefly introduced below. Obviously, the drawings described below are only some embodiments of the present application. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative work.

[0045] Figure 1 is a schematic diagram of the overall structure of a resectoscope provided according to an embodiment of the present application;

[0046] Figure 2 is a schematic diagram of the exploded structure of a resectoscope provided according to an embodiment of the present application;

[0047] Figure 3This is a schematic diagram of the use status of the resectoscope (without the handle housing) provided according to an embodiment of the present application;

[0048] Figure 4 It is a schematic diagram of the connection structure between the flexible continuum and the electric cutting ring assembly provided in an embodiment of the present application;

[0049] Figure 5 It is a schematic diagram of the disassembled structure of the flexible continuum, the electric cutting ring assembly, and the lens assembly provided according to an embodiment of the present application;

[0050] Figure 6 is a schematic diagram of the structure of a rotary joint provided according to an embodiment of the present application;

[0051] Figure 7 is a schematic cross-sectional structural diagram of a rotary joint provided according to an embodiment of the present application;

[0052] Figure 8 is a structural schematic diagram of a first joint provided according to an embodiment of the present application;

[0053] Fig. 9 is a schematic structural diagram of a second joint provided according to an embodiment of the present application;

[0054] Fig.10 is a structural schematic diagram of a lens assembly provided according to an embodiment of the present application;

[0055] Fig.11 is a schematic structural diagram of an electric cutting ring assembly provided according to an embodiment of the present application;

[0056] Fig.12 is a schematic cross-sectional structural diagram of a guide assembly provided according to an embodiment of the present application;

[0057] Fig.13 is a schematic diagram of the connection structure of the gripping portion and the connecting portion provided according to an embodiment of the present application;

[0058] Fig.14 is a schematic diagram of the structure of the intermediate connection block provided according to an embodiment of the present application;

[0059] Fig.15 It is a schematic diagram of the structure of a handle assembly provided according to an embodiment of the present application.

[0060] Reference numerals:

[0061] 10. Outer sheath tube; 20. Inner sheath tube; 30. Foot pedal; 40. Video output interface; 60. Signal cable harness;

[0062] 100. guide assembly; 110. protective sleeve;

[0063] 200, flexible continuum; 210, rotating joint; 213, annular boss; 2131, through hole; 220, first joint; 230, second joint; 231, through hole; 232, threaded connection structure; 211, joint ball socket; 212, joint ball head; 214, central channel;

[0064] 300, electric cutting ring assembly; 310, fixed base; 320, cutting electrode; 350, plug; 340, avoidance channel; 330, electric cutting ring cable;

[0065] 400, lens assembly; 410, lens fixing seat; 420, housing; 430, lens device; 411, jack; 412, annular groove; 450, lens cable;

[0066] 500, handle assembly; 510, gripping portion; 512, fixing plate; 511, hand grip rod; 513, handle ball head; 520, connecting portion; 521, connecting shell; 5211, threading groove; 530, handle shell; 533, supporting cavity; 532, spherical cavity; 531, limiting opening; 535, limiting member; 534, bearing; 536, screw assembly hole;

[0067] 514, connecting rod; 515, stopper;

[0068] 700, guide wheel assembly; 710, fixed bracket; 720, guide wheel;

[0069] 600, pulling structure; 610, pulling rope; 611, crimping joint 1; 612, crimping joint 2;

[0070] 800, steering part; 810, active fork; 820, middle connecting block; 821, threading hole; 830, driven fork. DETAILED DESCRIPTION

[0071] The following is a further detailed description of the implementation of the present application in conjunction with the accompanying drawings and examples. The following examples are used to illustrate the present application but cannot be used to limit the scope of the present application.

[0072] In the description of the embodiments of the present application, it should be noted that the terms "center", "longitudinal", "lateral", "up", "down", "front", "back", "left", "right", "vertical", "horizontal", "top", "bottom", "inside", "outside" and the like indicate positions or positional relationships based on the positions or positional relationships shown in the accompanying drawings, which are only for the convenience of describing the embodiments of the present application and simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as limiting the embodiments of the present application. In addition, the terms "first", "second", and "third" are used for descriptive purposes only and cannot be understood as indicating or implying relative importance.

[0073] In the description of the embodiments of the present application, it should be noted that, unless otherwise clearly specified and limited, the terms "connected" and "connection" should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integral connection; it can be a mechanical connection or an electrical connection; it can be directly connected or indirectly connected through an intermediate medium. For ordinary technicians in this field, the specific meanings of the above terms in the embodiments of the present application can be understood according to specific circumstances.

[0074] In the embodiments of the present application, unless otherwise clearly specified and limited, a first feature being "above" or "below" a second feature may mean that the first and second features are in direct contact, or the first and second features are in indirect contact through an intermediate medium. Moreover, a first feature being "above", "above" or "above" a second feature may mean that the first feature is directly above or obliquely above the second feature, or simply means that the first feature is higher in level than the second feature. A first feature being "below", "below" or "below" a second feature may mean that the first feature is directly below or obliquely below the second feature, or simply means that the first feature is lower in level than the second feature.

[0075] In the description of this specification, the description with reference to the terms "one embodiment", "some embodiments", "example", "specific example", or "some examples" etc. means that the specific features, structures, materials or characteristics described in conjunction with the embodiment or example are included in at least one embodiment or example of the embodiments of the present application. In this specification, the schematic representations of the above terms do not necessarily refer to the same embodiment or example. Moreover, the specific features, structures, materials or characteristics described may be combined in any one or more embodiments or examples in a suitable manner. In addition, those skilled in the art may combine and combine the different embodiments or examples described in this specification and the features of the different embodiments or examples, without contradiction.

[0076] Before introducing the structure of the resectoscope of the embodiment of the present application, its application scenario is first explained. The resectoscope of the present application can be used for resection surgery in the bladder cavity, but there is no specific limitation.

[0077] In the technical solution provided in this application, for the convenience of description, the end of the entire device placed in the human body is called the distal end, which is mainly used to perform surgical operations on tissues; the end located outside the body is called the proximal end, which is mainly used by the operator to perform operations. Unless otherwise specified in this application, the distal end of each component refers to the end close to the human body, and the proximal end of each component refers to the end close to the outside of the body.

[0078] Figure 1 is a schematic diagram of the overall structure of a resectoscope provided according to an embodiment of the present application; Figure 2 is a schematic diagram of the exploded structure of a resectoscope provided according to an embodiment of the present application; Figure 3 Schematic diagram of the use state of the resectoscope (without the handle housing) provided in accordance with an embodiment of the present application. The present application provides an electric resectoscope, which is used to resect target tissues, such as Figure 1-Figure 3 As shown, the resectoscope may include an outer sheath tube 10, an inner sheath tube 20, a guide assembly 100, an electric cutting ring assembly 300, a lens assembly 400 and a handle assembly 500, wherein the outer sheath tube 10 and the inner sheath tube 20 are coaxially sleeved. Figure 1 , 2 Only the state in which the inner sheath tube 20 is sleeved in the outer sheath tube 10 is shown, wherein the proximal end diameter of the inner sheath tube 20 is larger than the outer diameter of the outer sheath tube 10 , so the proximal end of the inner sheath tube 20 is exposed outside the outer sheath tube 10 .

[0079] The guide assembly 100 is movably inserted into the inner sheath tube 20, and a flexible continuum 200 is arranged at the distal end of the guide assembly 100; the electrosurgical cutting ring assembly 300 is detachably arranged at the distal end of the flexible continuum 200; the lens assembly 400 is arranged at the distal end of the flexible continuum 200 and is exposed from the electrosurgical cutting ring assembly 300; the handle assembly 500 includes a gripping portion 510 and a connecting portion 520 which are rotatably connected to each other, the distal end of the connecting portion 520 is connected to the proximal end of the guide assembly 100, and the gripping portion 510 is connected to the flexible continuum 200 through a pulling structure 600; the handle assembly 500 is configured to change the degree of freedom of the gripping portion 510 relative to the connecting portion 520 under the action of an external force, so as to drive the pulling structure 600 to pull the flexible continuum 200, so as to adjust the degree of freedom of the distal end of the flexible continuum 200.

[0080] It is understandable that, considering the complexity and compatibility of the resectoscope, based on the existing matching design of the resectoscope in the relevant technology, the outer sheath 10, inner sheath 20 and the mirror core (obturator) used in this application can be used for surgical operations with conventional instruments.

[0081] This example is explained by taking the removal of a tumor in the bladder as an example. After completing the conventional surgical preparation steps for transurethral bladder tumor electroresection, the outer sheath 10, the inner sheath 20 and the mirror core are first inserted into the bladder, and the mirror core is pulled out after it is in place. An electric cutting ring assembly 300 and a lens assembly 400 are arranged at the distal end of the flexible continuum 200, and the flexible continuum 200 is arranged at the distal end of the guide assembly 100, so that the flexible continuum 200, the electric cutting ring assembly 300 and the lens assembly 400 are sent to the inside of the bladder through the inner sheath 20 through the guide assembly 100.

[0082] To facilitate the operator's operation, the guide assembly 100 and the holding portion 510 are connected through the connecting portion 520, and the pulling structure 600 is connected between the holding portion 510 and the flexible continuum 200, so that a linkage structure is formed between the holding portion 510 and the flexible continuum 200. When the operator applies force to the holding portion 510 to change the degree of freedom of the holding portion 510, the flexible continuum 200 will be instantly driven to bend under the linkage of the pulling structure 600, thereby reducing or avoiding the situation where the lesion in the bladder is in the field of vision and operation blind spot. This setting can also more intuitively control the position and posture of the electric cutting ring assembly 300 to reduce the difficulty of surgical operation.

[0083] In addition, the electric cutting ring assembly 300 in this example can be detachably arranged at the end of the flexible continuum 200, for example, it can be arranged at the end of the flexible continuum 200 by plugging, unplugging, snapping, etc., which is conducive to selecting replacement of the electric cutting ring assembly 300 according to the preoperative situation, thereby improving the diversity and convenience of using the electric cutting mirror.

[0084] In order to make the structure of the flexible continuum 200 provided in this embodiment simple, easy to manufacture and assemble, and able to effectively reduce costs. The flexible continuum 200 in this example can be formed by rotating and connecting / articulating multiple joints, and multiple holes for the pull rope 610 to pass through are set on the outer ring of the multiple joints, so that the pull rope 610 can achieve the purpose of adjusting the multiple degrees of freedom of the distal end of the flexible continuum 200. The specific structure of the flexible continuum 200 can be understood by referring to the following content.

[0085] It should be noted that, in order to achieve effective communication among the gripping portion 510, the pulling structure 600 and the flexible continuum 200, the connecting portion 520 and the guiding assembly 100 as well as the outer sheath tube 10 and the inner sheath tube 20 are static by default when the posture of the flexible continuum 200 is changed. In other words, the gripping portion 510, which is rotationally connected to the connecting portion 520, can be deflected relative to the axis of the connecting portion 520, the outer sheath tube 10, the inner sheath tube 20, etc. under the external force applied by the operator, that is, the degree of freedom of the gripping portion 510 is changed. The pulling structure 600 (multiple pulling ropes 610) will be displaced by different distances under the drive of the gripping portion 510 to pull the flexible continuum 200 to change its posture, so as to facilitate the observation of the lesion point in the bladder from various angles and adjust the posture of the electrosurgical ring assembly 300 to remove the lesion.

[0086] In order to facilitate the transmission of force to the connecting part 520, the guide assembly 100, and the flexible continuum 200 in sequence through the holding part 510, and realize the rotation of the electric cutting ring assembly 300 and the lens assembly 400, that is, to realize the rotation of the guide assembly 100, the flexible continuum 200, the electric cutting ring assembly 300 and the lens assembly 400 relative to the inner sheath tube 20, the rotational connection between the holding part 510 and the connecting part 520 needs to maintain the transmission of torque. The specific connection between the holding part 510 and the connecting part 520 can be understood by referring to the following content.

[0087] In the present application, a holding portion 510, a connecting portion 520, a guiding assembly 100, a flexible continuum 200, a lens assembly 400, and an electric cutting ring assembly 300 are designed to be connected in sequence from the proximal end to the distal end, and a pulling structure 600 is connected between the holding portion 510 and the flexible continuum 200. The freedom between the holding portion 510 and the connecting portion 520 is controlled by an external force to drive the pulling structure 600 to pull the flexible continuum 200 to bend, thereby changing the posture of the electric cutting ring assembly 300 and the lens assembly 400 at the distal end of the flexible continuum 200, so as to increase the visible area and the operable area during the surgical operation. The operator controls the freedom of the flexible continuum 200 through the holding portion 510, and can more intuitively control the position and posture of the electric cutting ring assembly 300, thereby reducing the difficulty of the operation.

[0088] Next, we will combine the attached Figure 1 -Attached Fig.15 The specific structure of the electroresectomoscope in the embodiment of the present application is introduced in detail.

[0089] Figure 4 Schematic diagram of the connection structure between the flexible continuum and the electric cutting ring assembly provided in the embodiment of the present application; Figure 4 As shown, in some embodiments, the flexible continuum 200 includes at least two rotational joints 210 rotatably connected to each other, and the pulling structure 600 is sequentially connected to the at least two rotational joints 210 to bend the flexible continuum 200 driven by the gripping portion 510 .

[0090] Specifically, the flexible continuum 200 may be provided with at least two mutually rotatably connected rotating joints 210, and the connection method of the two rotating joints 210 may be a ball joint, and there is no specific limitation. The pulling structure 600 may be a plurality of pulling ropes 610, such as 4, 6, 8 or more, and the plurality of pulling ropes 610 are used to sequentially connect all the rotating joints 210, and the ends of the pulling ropes 610 are fixed to a rotating joint 210 at the farthest end. Through the deflection of the gripping portion 510, at least one of the pulling ropes 610 will be pulled, and the pulling ropes 610 at the corresponding position will drive the rotating joint 210 to deflect in the direction toward the gripping portion 510, thereby realizing the bending of the flexible continuum 200.

[0091] Of course, in order to achieve large-angle bending of the flexible continuum 200, the flexible continuum 200 is usually formed by multiple rotational joints 210; and in order to achieve multi-degree-of-freedom bending of the flexible continuum 200, the connection mode of two adjacent rotational joints 210 is usually set to ball joint.

[0092] In order to facilitate the connection between the flexible continuum 200 and the guide assembly 100, and to facilitate the arrangement of the electric cutting ring assembly 300 and the lens assembly 400 at the distal end of the flexible continuum 200, as shown in FIG. Figure 4 As shown, in some embodiments, the flexible continuum 200 also includes a first joint 220 and a second joint 230, and the first joint 220 and the second joint 230 are respectively connected to the two ends of at least two rotating joints 210, the proximal end of the first joint 220 is fixedly connected to the end of the guide assembly 100, and the distal end of the second joint 230 is used to set the lens assembly 400 and the electric cutting ring assembly 300.

[0093] Specifically, the flexible continuum 200 includes a first joint 220, a plurality of rotating joints 210 and a second joint 230 from the proximal end to the distal end. The first joint 220 is fixedly connected to the distal end of the guide assembly 100, and the distal end of the second joint 230 is provided with a lens assembly 400 and an electric cutting ring assembly 300. The first joint 220 and the adjacent rotating joint 210 are connected in an active manner, such as a ball joint. Similarly, the second joint 230 and the adjacent rotating joint 210 are connected in an active manner, such as a ball joint, so that the flexible continuum 200 can be bent in its entirety.

[0094] The specific structure of the above joints can be, Figure 6 is a schematic diagram of the structure of a rotary joint provided according to an embodiment of the present application; Figure 7 is a schematic cross-sectional view of a rotary joint according to an embodiment of the present application; Figure 6 and Figure 7 As shown, in some embodiments, one end of each rotating joint 210 is constructed with a joint ball socket 211, and the other end is constructed with a joint ball head 212, and the joint ball head 212 is used for ball-jointed connection with the joint ball socket 211 of the adjacent rotating joint 210; the end of the first joint 220 is constructed with a joint ball socket 211 / joint ball head 212 for ball-jointed connection with the adjacent rotating joint 210, and the end of the second joint 230 is correspondingly constructed with a joint ball head 212 / joint ball socket 211.

[0095] Specifically, one end of the revolute joint 210, for example, the distal end, may be configured with a joint ball socket 211, and the other proximal end may be configured with a joint ball head 212. By placing the joint ball head 212 in the joint ball socket 211, the articulation and rotation connection of multiple revolute joints 210 can be realized, and a multi-degree-of-freedom kinematic pair between each revolute joint 210 can be realized, thereby achieving high flexibility of the flexible continuum 200. Of course, the structure of the joint ball socket 211 can be adjusted so that the joint ball heads 212 of adjacent revolute joints 210 can be clamped in the joint ball socket 211, which ensures that the adjacent revolute joints 210 can rotate while also ensuring effective connection between multiple revolute joints 210.

[0096] Correspondingly, the end of the first joint 220 can be set as a joint ball socket 211 to effectively engage with the joint ball head 212 in the adjacent rotating joint 210, and the end of the second joint 230 can be set as a joint ball head 212 to effectively engage with the joint ball socket 211 in the adjacent rotating joint 210.

[0097] In order to achieve the change of the degree of freedom of the above joints by the pulling structure 600, Figure 6 As shown, in some embodiments, each rotating joint 210 is constructed with a plurality of through holes 2131, the axis of the through hole 2131 is consistent with the extension direction of the flexible continuum 200, and the plurality of through holes 2131 are evenly distributed on the periphery of the rotating joint 210; the pulling structure 600 includes a plurality of pulling ropes 610, one end of the plurality of pulling ropes 610 is fixed to the gripping portion 510, and the other end passes through the through holes 2131 of the plurality of rotating joints 210 in sequence and is fixed.

[0098] Specifically, multiple through holes 2131 may be constructed on the end surface of each rotating joint 210, and multiple rotating joints 210 may be connected in series by sequentially passing the pulling rope 610 through the multiple through holes 2131. However, since a joint ball head 212 is constructed at one end of the rotating joint 210, multiple through holes 2131 may be provided on the outer edge of the end surface of the rotating joint 210 to ensure effective articulation between the joint ball head 212 and the joint ball socket 211 without excessively increasing the volume of the rotating joint 210.

[0099] For example, four perforations 2131 can be evenly arranged along the circumference of the rotating joint 210, so that four corresponding pulling ropes 610 pass through the corresponding perforations 2131, and the distal end of the pulling rope 610 can be fixed to the second joint 230. In the initial state, the axes of the multiple rotating joints 210 and the holding portion 510 coincide, and the four pulling ropes 610 are parallel to each other and in a tensioned state. When the holding portion 510 rotates relative to the connecting portion 520, part of the pulling rope 610 will be pulled to move, and the pulling rope 610 will drive the rotating joint 210 to rotate in turn, thereby realizing multi-directional bending of the flexible continuum 200. It should be noted that in this embodiment, the movement of the pulling rope 610 driven by the holding portion 510 can at least realize the four-way bending of the flexible continuum 200, and the four-way bending can be understood as the forward and reverse movement of the flexible continuum 200 in two degrees of freedom. This setting combined with the rotation of the holding portion 510 can realize the bending of the electric cutting ring assembly 300 in any direction and posture adjustment.

[0100] The pulling rope 610 may only pass through the through holes 2131 in the plurality of rotating joints 210 to drive the plurality of rotating joints 210 to bend. Of course, the first joint 220 and the second joint 230 may also be connected in series. Figure 8 is a structural schematic diagram of a first joint provided according to an embodiment of the present application; Fig. 9 is a schematic diagram of the structure of the second joint provided according to an embodiment of the present application; Figure 8 and Fig. 9 As shown, in some embodiments, the first joint 220 and the second joint 230 are hollow cylinders, and the axial directions of the first joint 220 and the second joint 230 are both constructed with multiple through holes 231 corresponding to the through holes 2131, and the end of the pulling rope 610 passes through the through hole 231 of the first joint 220, the through holes 2131 of the multiple rotating joints 210, and the through hole 231 of the second joint 230 in sequence, and is fixed at the second joint 230.

[0101] Specifically, in order to facilitate the connection between the first joint 220 and the guide assembly 100, and to set the electric cutting ring assembly 300 and the lens assembly 400 at the distal end of the second joint 230, the first joint 220 and the second joint 230 are designed as a hollow cylinder with a certain wall thickness, and a plurality of through holes 231 corresponding to the position and number of the through holes 2131 are constructed on the end faces of the first joint 220 and the second joint 230. When connected, the end of the pulling rope 610 first passes through the through hole 231 of the first joint 220, then passes through the through holes 2131 of the plurality of rotating joints 210, and the through hole 231 of the second joint 230, and is fixed at the second joint 230. For example, a crimping joint 611 can be set at the end of the pulling rope 610, so that the pulling rope 610 is crimped to the through hole 231 at the second joint 230, but this is not limited.

[0102] To increase the firmness of the perforation 2131, Figure 6 and Figure 7 As shown, in some embodiments, an annular boss 213 is disposed on the outer periphery of the rotary joint 210 . The annular boss 213 is located on the side of the joint ball socket 211 , and a plurality of through holes 2131 are evenly distributed on the annular boss 213 .

[0103] Specifically, an annular boss 213 is provided near the joint socket 211, which can increase the bending degree of the adjacent rotating joint 210, thereby increasing the bending degree of the flexible continuum 200. In order to facilitate the control of the degree of freedom of the flexible continuum 200, a plurality of perforations 2131 are evenly distributed on the annular boss 213, so that the pulling rope 610 can be evenly passed through the flexible continuum 200.

[0104] It should be noted that a plurality of through-holes 2131 may be constructed on the annular boss 213, but not all of the plurality of through-holes 2131 are used for the pulling rope 610 to pass through, and may be arranged according to actual requirements. For example, eight through-holes 2131 are evenly constructed on the annular boss 213, and eight pulling ropes 610 may be used to pass through. Of course, four pulling ropes 610 may also be used to pass through four evenly distributed through-holes 2131, and there is no limitation here.

[0105] In some embodiments, the annular boss 213 is further configured with a plurality of wire passing holes, at least one of which is disposed between two adjacent through holes 2131 , and the wire passing holes are used for the electrosurgical cutting ring cable 330 to pass through.

[0106] Specifically, the wire holes can be evenly distributed between the through holes 2131. The setting of the wire holes is mainly used for the electric cutting ring cable 330 electrically connected to the electric cutting ring assembly 300 to pass through. Of course, the lens cable 450 electrically connected to the lens assembly 400 can also pass through. There is no limitation here.

[0107] It should be noted that, for the convenience of describing this embodiment, the holes formed on the annular boss 213 are described as through holes 2131 and wire holes respectively. However, in actual manufacturing, a plurality of evenly distributed holes can be formed on the annular boss 213 at one time, some of which are used as through holes 2131, and some are used as wire holes. If there are remaining holes, elastic ropes such as nickel-titanium alloy wires can be passed through the remaining holes as an elastic skeleton to increase the stiffness of the flexible continuum 200 and improve its flexibility during bending.

[0108] like Figure 7 As shown, in some embodiments, along the extension direction of the flexible continuum 200 , a central channel 214 is formed through the first joint 220 , the plurality of rotating joints 210 , and the second joint 230 , and the central channel 214 is used for the lens cable 450 to pass through.

[0109] Specifically, the joint ball heads 212 and joint ball sockets 211 in the multiple rotating joints 210 can be connected, and combined with the hollow first joint 220 and the second joint 230 to form a central channel 214. The central channel 214 can be used for the lens cable 450 electrically connected to the lens assembly 400 to pass through. Of course, it can also allow the electric cutting ring cable 330 electrically connected to the electric cutting ring assembly 300 to pass through, and there is no limitation here.

[0110] It should be noted that, whether it is the through hole 2131 and the wire hole formed on the annular boss 213, or the central channel 214 formed in the first joint 220, the multiple rotating joints 210, and the second joint 230, the end surface edges of the holes can be chamfered to reduce the collision and wear on the pulling rope 610, the electrosurgical cutting ring cable 330, and the lens cable 450.

[0111] In one example, the end of the second joint 230 can be simultaneously provided with the electric cutting ring assembly 300 and the lens assembly 400, that is, half is provided with the electric cutting ring assembly 300 and the other half is designed with the lens assembly 400. However, due to the large size of the two, the above-mentioned setting method will inevitably increase the volume of the end of the second joint 230 and is not conducive to the operation.

[0112] Based on this, the electric cutting ring assembly 300 and the lens assembly 400 can be arranged front and back, that is, the lens assembly 400 is connected to the second joint 230, and the electric cutting ring assembly 300 is arranged on the lens assembly 400, in order to improve the integration. Figure 5 It is a schematic diagram of the disassembled structure of the flexible continuum, the electric cutting ring assembly, and the lens assembly provided according to an embodiment of the present application; Fig.10 is a schematic diagram of the structure of a lens assembly provided according to an embodiment of the present application; Figure 5 and Fig.10 As shown, in some embodiments, the lens assembly 400 includes a lens fixing seat 410, a containing shell 420 and a lens device 430. The lens fixing seat 410 is fixedly connected to the second joint 230. The lens fixing seat 410 is installed with a lens cable 450. The containing shell 420 is arranged on the outer end surface of the lens fixing seat 410, and the containing shell 420 is used to install the lens device 430.

[0113] It is understandable that the lens device 430 in this example may include an illumination port and an imaging port, and existing packaging products may be directly used. To avoid blocking the lens device 430, this part needs to be exposed to the electric cutting ring assembly 300. Therefore, the lens assembly 400 in this example includes a lens fixing seat 410 and a housing shell 420. The lens fixing seat 410 is mainly used for fixed connection with the second joint 230, and the cross-section of the housing shell 420 is smaller than the outer end face of the lens fixing seat 410, and is protruding from the outer end face of the lens fixing seat 410. Without affecting the installation and use of the lens device 430, it can also leave space on the outer end face of the lens fixing seat 410 for the subsequent setting of the electric cutting ring assembly 300.

[0114] Fig.11 is a schematic diagram of the structure of an electric cutting ring assembly provided according to an embodiment of the present application; Fig.11 As shown, in some embodiments, the electric cutting ring assembly 300 includes a fixed base 310 and a cutting electrode 320. The cutting electrode 320 is fixed on one side of the fixed base 310 for removing target tissue. A first mounting portion is configured on the side of the fixed base 310 facing away from the cutting electrode 320. A second mounting portion is configured on the outer end face of the lens fixing seat 410, and the second mounting portion is adapted to be plugged into the first mounting portion.

[0115] Specifically, the electric cutting ring assembly 300 can be detachably arranged at the far end of the lens assembly 400. In order to realize the rapid replacement of various types of electric cutting ring assemblies 300, the electric cutting ring assembly 300 can be designed to be quickly plugged in and out of the lens assembly 400. For example, the first mounting portion can be a socket 411 formed on the surface of the fixed base 310, and the second mounting portion corresponds to a plug 350 formed on the outer end surface of the lens fixing seat 410. The plug 350 is connected to the electric cutting ring cable 330, and a metal contact is arranged in the plug 350, so as to realize the electrical connection between the cutting electrode 320 and the electric cutting ring cable 330 after the plug 350 is plugged into the socket 411.

[0116] Of course, in addition to the above settings, you can also Fig.10 and Fig.11 As shown, in some embodiments, the first mounting portion includes at least two plugs 350, and the second mounting portion includes at least two sockets 411 corresponding one to the plugs 350, and metal contacts are fixed in the two sockets 411, and the metal contacts are used to connect the electrosurgical cutting ring cable 330 and the plug 350.

[0117] Specifically, the first mounting part may be three plugs 350 formed on the surface of the fixed base 310, and the second mounting part may be three sockets 411 formed on the lens fixing seat 410 and corresponding to the plugs 350. Two of the three sockets 411 are plug-in interfaces for the electric cutting ring, and metal contacts are fixed therein. The metal contacts are electrically connected to the electric cutting ring cable 330, so that after the plug 350 and the socket 411 are plugged in, a high-frequency signal closed loop between the electric cutting ring cable 330 and the cutting electrode 320 is realized. The other socket 411 is an asymmetric socket, and the diameter of the socket is slightly smaller than the diameter of the corresponding plug 350, so as to form an interference connection, so as to ensure the firmness of the electric cutting ring assembly 300 connected to the lens assembly 400.

[0118] In this example, the metal contact can be fixed in the cutting ring insertion interface by injection molding or sintering, but there is no specific limitation.

[0119] It should be noted that the three sockets 411 are asymmetrically designed, that is, a triangular plug 350 is formed on the surface of the fixed base 310, so as to form a straight-plug structure with the asymmetrical socket 411 on the lens fixing seat 410, so as to ensure the firmness of the connection between the electric cutting ring assembly 300 and the lens assembly 400. In addition, the openings of all or part of the sockets 411 can be chamfered to increase the smoothness and accuracy of the plug 350 being inserted into the socket 411.

[0120] like Fig.10 and Fig.11 As shown, in some embodiments, the fixed base 310 is constructed with an avoidance channel 340 to allow the accommodating shell 420 to pass through the avoidance channel 340 so that the lens assembly 400 is exposed from the fixed base 310; wherein the depth of the avoidance channel 340 is less than or equal to the height of the accommodating shell 420 body.

[0121] Specifically, the avoidance channel 340 of the fixed base 310 is adapted to the shape of the housing shell 420. When the plug 350 is plugged into the jack 411, the housing shell 420 will pass through the avoidance channel 340 and be exposed to the fixed base 310. The cutting electrode 320 arranged on the outer end surface of the fixed base 310 adopts a conventional design. Due to its small size and arc-shaped arrangement, it is difficult to block the lens device 430 in the housing shell 420 body. It is only necessary to ensure that the outer end surface of the housing shell 420 body is flush with the outer end surface of the fixed base 310, or the outer end surface of the housing shell 420 body protrudes from the fixed base 310, that is, the depth of the avoidance channel 340 needs to be less than or equal to the height of the housing shell 420 body to ensure that the field of view of the lens device 430 is not blocked.

[0122] like Fig.10As shown, in some embodiments, the lens fixing seat 410 is cylindrical, and the lens fixing seat 410 is adapted to be embedded in the second joint 230 and fixedly connected to the second joint 230; an annular groove 412 is constructed along the circumference of the lens fixing seat 410, and the annular groove 412 is used to install a sealing ring to seal the lens fixing seat 410 and the second joint 230.

[0123] Specifically, the lens fixing seat 410 is configured as a cylindrical structure that can be adapted to be embedded in the second joint 230, and corresponding threaded connection structures 232 (threaded connection holes, threaded connection grooves) are provided on the side walls of the second joint 230 and the lens fixing seat 410, so that after the two are properly embedded, fasteners are passed through the threaded connection structures 232 for connection and fixation. The annular groove 412 of the lens fixing seat 410 along the circumferential structure is used to install a sealing ring, which can achieve sealing between the second joint 230 and the lens fixing seat 410, thereby ensuring the waterproofness of the flexible continuum 200.

[0124] In this example, the lens fixing seat 410 can be made of insulating ceramics or medical high-temperature resistant plastics, which is not limited here.

[0125] Fig.12 is a schematic cross-sectional view of a guide assembly according to an embodiment of the present application; Fig.12 As shown, in some embodiments, the guide assembly 100 includes a guide tube, the distal end of the guide tube is fixedly connected to the first joint 220, the proximal end of the guide tube is fixedly connected to the connecting portion 520, and the guide tube is used for the pulling structure 600 to pass through.

[0126] Specifically, the guide tube is a hollow structure, which can not only deliver the flexible continuum 200 to the distal end, but also pass the external traction rope 610, the electrosurgical cutting ring cable 330, and the lens cable 450. In order to prevent the traction ropes 610 and cables from being entangled with each other in the guide tube, in one example, a plurality of protective sleeves 110 are provided in the guide tube, and the protective sleeves 110 are used to wrap and isolate the traction ropes 610, the electrosurgical cutting ring cable 330, and the lens cable 450, so as to reduce or avoid entanglement between the traction ropes 610, or between the electrosurgical cutting ring cable 330 and the lens cable 450, and also reduce the friction of the traction rope 610 during the traction movement.

[0127] It should be noted that the protective sleeve 110 can be a stainless steel spring tube or a polytetrafluoroethylene tube, etc., which is not limited here.

[0128] Fig.13 is a schematic diagram of the connection structure of the holding portion and the connecting portion provided according to an embodiment of the present application; Fig.13As shown, in some embodiments, a steering portion 800 is provided between the holding portion 510 and the connecting portion 520, and the steering portion 800 is configured to enable the holding portion 510 to tilt relative to the connecting portion 520 under the action of an external force, and / or to enable the connecting portion 520 to rotate synchronously with the holding portion 510.

[0129] It is understandable that the gripping portion 510 in this example not only needs to drive the pulling rope 610 to bend the flexible continuum 200, thereby changing the degree of freedom of the electric cutting ring assembly 300, but also can transmit its own rotation to the electric cutting ring assembly 300, so that the electric cutting ring assembly 300 follows the gripping portion 510 to twist, so as to adjust the electric cutting ring assembly 300 to a suitable position. In order to achieve the above two purposes (control the bending and twisting of the electric cutting ring assembly 300) so that the cutting electrode 320 in the electric cutting ring assembly 300 can reach the lesion point, the steering portion 800 in this example can be designed as a universal joint structure, or other structures that can achieve the above two purposes are adopted, and no specific restrictions are made here.

[0130] like Fig.13 As shown, in some embodiments, the connecting portion 520 includes a connecting shell 521, one end of the connecting shell 521 is through-connected to the guide assembly 100, and the other end is connected to the steering portion 800; the side wall of the connecting shell 521 is constructed with a plurality of threading grooves 5211, and the plurality of threading grooves 5211 are evenly distributed around the circumference of the connecting shell 521, and the threading grooves 5211 are used for the pulling rope 610 to enter the guide assembly 100 from the outside.

[0131] Specifically, the connection housing 521 can be set as a prismatic housing or a cylindrical housing, which can be set specifically according to the number of the pulling ropes 610. Taking the number of pulling ropes 610 as an example, the connection housing 521 is a hollow rectangular structure, one end of which is connected to the guide tube, and each of the four side walls of the side of the connection housing 521 is provided with a threading groove 5211, which can be U-shaped, so that the external pulling rope 610 can enter the connection housing 521 through the threading groove 5211 until it enters the guide tube and connects with the flexible continuum 200 at the far end. This setting is convenient for setting the steering portion 800 between the connection portion 520 and the grip portion 510 on the one hand, and is also convenient for the installation and connection of the pulling rope 610 and the grip portion 510 on the other hand.

[0132] In addition, the end portion of the connecting shell 521 connected to the guide tube can be configured as a hollow tube adapted to the guide tube, and the hollow tube and the guide tube can be fixed by, for example, a plurality of set screws.

[0133] In order to change the extension direction of the traction rope and reduce the friction of the traction rope 610 moving at the connecting shell 521, in some embodiments, a plurality of guide wheel groups 700 are provided on the connecting shell 521, and the plurality of guide wheel groups 700 correspond one by one to the plurality of threading grooves 5211 to guide the traction rope 610.

[0134] Specifically, the guide wheel assembly 700 includes a fixing bracket 710 and a guide wheel, one end of the fixing bracket 710 is fixed to the connection housing 521, and the other end is used to fix the guide wheel, one end of the traction rope 610 is fixed to the gripping portion 510, and the other end passes through the guide wheel and enters the connection housing 521 through the threading groove 5211. Of course, in order to prevent the traction rope 610 from slipping off the guide wheel during movement, the guide wheel can be designed as an anti-jumping guide wheel 720, or other guide wheels 720 with anti-jumping functions, which are not listed here one by one.

[0135] like Fig.13 As shown, in some embodiments, the holding portion 510 includes a fixed plate 512 and a hand grip rod 511 that are interconnected. The fixed plate 512 is used to fix the ends of multiple pulling ropes 610. The fixed plate 512 moves with the hand grip rod 511 to enable the multiple pulling ropes 610 connected to the fixed plate 512 to move different distances.

[0136] Specifically, the fixed disk 512 is not only used to connect with the steering portion 800, but also used to fix the end of the traction rope 610. Specifically, a crimping joint 612 can be set at the end of the traction rope 610 and crimped onto the fixed disk 512. In this example, the diameter of the fixed disk 512 can be designed to adjust the bending movement amplification ratio from the hand grip rod 511 to the far end of the flexible continuum 200. For example, the ends of multiple traction ropes 610 can be evenly fixed on the edge of the fixed disk 512. If the diameter of the fixed disk 512 is larger, the deviation of the hand grip rod 511 by a small distance will drive the traction rope 610 to move a longer distance, and the longer the moving distance of the traction rope 610 is, the greater the bending angle of the flexible continuum 200 will tend to be.

[0137] like Fig.13 As shown, in some embodiments, the steering portion 800 includes an active fork 810, an intermediate connecting block 820 and a driven fork 830, wherein one end of the active fork 810 is fixed to the fixed plate 512, and the other end is hinged to the intermediate connecting block 820 through a first rotating shaft, and one end of the driven fork 830 is fixed to the connecting shell 521, and the other end is hinged to the intermediate connecting block 820 through a second rotating shaft; wherein the axis of the first rotating shaft is perpendicular to the axis of the second rotating shaft.

[0138] Specifically, the steering portion 800 may adopt a cross universal joint type structural design, which may include an active fork 810, an intermediate connecting block 820 and a driven fork 830. The first rotating shaft connecting the active fork 810 and the intermediate connecting block 820, and the second rotating shaft connecting the driven fork 830 and the intermediate connecting block 820 may be an integrally designed cross shaft. Of course, the first rotating shaft may also be separated from the second rotating shaft and staggered, and no specific limitation is made here. During use, the connecting portion 520 (inner sheath 20, outer sheath 10) side is stationary relative to the human body, and the operator holds the gripping portion 510 and applies force, which can cause the gripping portion 510 to rotate around the first rotating shaft and / or the second rotating shaft, that is, the gripping portion 510 is deflected relative to the connecting portion 520 side. More specifically, Fig.13 Taking the direction shown as an example, the gripping portion 510 can be deflected up / down around the first rotation axis, or can be deflected forward / backward around the second rotation axis, or can be deflected in corresponding directions around the first rotation axis and the second rotation axis at the same time, so that the gripping portion 510 has two degrees of freedom relative to the connecting portion 520. In addition, the steering portion 800 can transmit the rotation torque of the gripping portion 510 to the connecting portion 520, and then to the guide tube, the flexible continuum 200 and the electric cutting ring assembly 300, so as to control the position and posture of the electric cutting ring assembly 300.

[0139] In some embodiments, the pulling structure 600 includes four pulling ropes 610 , wherein two pulling ropes 610 are respectively located at two opposite ends of a first rotating shaft, and the other two pulling ropes 610 are respectively located at two opposite ends of a second rotating shaft.

[0140] Specifically, this example is explained by taking the setting of four pulling ropes 610 as an example. The four pulling ropes 610 are evenly distributed on the outside of the steering part 800, so that the deflection direction of the fixed plate 512 driven by the hand handle 511 relative to the connecting part 520 is positively correlated with the moving direction and distance of the four pulling ropes 610. Therefore, two of the relative pulling ropes 610 are respectively located at the two end positions of the first rotating shaft, and the other two relative pulling ropes 610 are respectively located at the two end positions of the second rotating shaft.

[0141] More specifically, the steering portion 800 is observed from the perspective of the grip portion 510, assuming that the first rotating shaft extends in the left-right direction, the pulling ropes 610 located at both ends of the first rotating shaft are respectively the first pulling rope 610 (left side) and the second pulling rope 610 (right side), and the second rotating shaft extends in the up-down direction, and the pulling ropes 610 located at both ends of the second rotating shaft are respectively the third pulling rope 610 (upper) and the fourth pulling rope 610 (lower). When the grip portion 510 deflects downward around the first rotating shaft, the displacement of the third pulling rope 610 and the fourth pulling rope 610 is the largest, and the movement directions are opposite. The third pulling rope 610 is pulled toward the proximal end by the grip portion 510, thereby driving the distal end of the flexible continuum 200 to bend upward. At the same time, the first pulling rope 610 and the second pulling rope 610 have a slight change, that is, they move in the same direction and have the same displacement.

[0142] When the gripping portion 510 deflects to the left around the second rotation axis, the displacement of the first traction rope 610 and the second traction rope 610 increases, and the movement directions are opposite. The second traction rope 610 is pulled toward the proximal end by the gripping portion 510, thereby driving the distal end of the flexible continuum 200 to bend to the right. At the same time, the third traction rope 610 and the fourth traction rope 610 have a slight change, that is, they move in the same direction and have the same displacement. Of course, the gripping portion 510 can also be offset upward, leftward, or in other combined directions at the same time. The distal end of the flexible continuum 200 is positively correlated with the movement amplitude of the gripping portion 510, and will also follow the gripping portion 510 to perform bending movement.

[0143] It should be noted that the four pulling ropes 610 should maintain the same or similar tension when assembled, that is, in the initial position, to ensure that the flexible continuum 200 is straight or almost unbent in the initial position.

[0144] Fig.14 is a schematic diagram of the structure of the intermediate connection block provided according to an embodiment of the present application; Fig.14 As shown, in some embodiments, the middle connecting block 820 is constructed with a plurality of threading holes 821 so that the electric cutting ring cable 330 connected to the electric cutting ring assembly 300 and the lens cable 450 connected to the lens assembly 400 pass through the threading holes 821 and the connecting shell 521 to reach the guide assembly 100.

[0145] Specifically, the electric cutting ring cable 330 and the lens cable 450 in this example need to enter the guide tube from the outside through the connection housing 521 until they are electrically connected to the electric cutting ring assembly 300 and the lens assembly 400 at the far end. To prevent the electric cutting ring cable 330 and the lens cable 450 from affecting the relative deviation of the gripping portion 510 and the connecting portion 520, and to be able to rotate synchronously with the gripping portion 510. In this example, a signal cable bundle 60 can be set at the end of the handle rod 511, and the electric cutting ring cable 330 and the lens cable 450 are inserted into the handle rod 511 and connected to the signal cable bundle 60. The electric cutting ring cable 330 and the lens cable 450 pass through the fixed plate 512 and then come out. In order to reach the connecting shell 521 arranged opposite to the fixed plate 512, a plurality of threading holes 821 can be set at the middle connecting block 820 of the steering part 800, so that the electric cutting ring cable 330 and the lens cable 450 passing through the fixed plate 512 can enter the interior of the connecting shell 521 after passing through the threading holes 821.

[0146] It should be noted that the signal cable bundle 60 is respectively connected to the foot pedal 30 and the video output interface 40 to respectively control the switch of the electric cutting ring assembly 300 and obtain the surgical field image, wherein the video output interface 40 can be designed as an interface such as USB Type-A, USB Type-C or HDMI, which is not limited here. The signal cable bundle 60 is made of medical rubber material.

[0147] Fig.15 is a schematic diagram of the structure of a handle assembly provided according to an embodiment of the present application, such as Fig.15 As shown, in some embodiments, the handle assembly 500 also includes a handle shell 530, which is constructed with a accommodating cavity and a limiting opening 531 that are interconnected. The limiting opening 531 is formed at the proximal end of the handle shell 530, and the grip rod 511 is inserted through the limiting opening 531, and the fixing plate 512, the connecting shell 521 and part of the guide tube are placed in the accommodating cavity.

[0148] Specifically, in order to facilitate the fixing of the connecting part 520 (inner sheath tube 20, outer sheath tube 10 and guide tube), this example also provides a handle shell 530 that is easy to hold. The handle shell 530 is internally configured with a receiving cavity to accommodate the fixing plate 512, the connecting shell 521 and part of the guide tube. The hand grip rod 511 is inserted into the limit opening 531, and the exposed part is used for hand holding.

[0149] When in use, one hand holds the handle housing 530 to remain relatively still, and the other hand holds the hand grip 511 to perform an offset or rotation operation relative to the handle housing 530 to control the position and posture of the distal end of the electric cutting ring assembly 300 of the flexible continuum 200. Of course, the handle housing 530 and the hand grip 511 can also be driven by both hands to move together, so that the entire electric resectoscope enters or exits the bladder to further adjust the position of the electric cutting ring assembly 300.

[0150] It should be noted that the setting of the limit opening 531 can effectively limit the deviation angle of the handle bar 511 to avoid the pulling rope 610 being torn or broken due to the excessive deviation angle of the handle bar 511.

[0151] In addition, the handle housing 530 can be disassembled into two parts, namely, a first housing and a second housing. The first housing and the second housing are assembled to form a receiving cavity, which is convenient for manufacturing the handle housing 530 on the one hand, and convenient for placing the fixing plate 512, the connecting housing 521, and part of the guide tube in the receiving cavity on the other hand. The connection between the first housing and the second housing can be a threaded assembly hole connection, or a snap connection, etc., which is not limited here.

[0152] In some embodiments, the accommodating cavity includes a supporting cavity 533 and a spherical cavity 532; the gripping portion 510 also includes a handle ball head 513, the handle ball head 513 is arranged between the fixing plate 512 and the handle rod 511, and the handle ball head 513 is arranged in the spherical cavity 532; the supporting cavity 533 is used to support the connecting shell 521 and the guide tube.

[0153] Specifically, the supporting cavity 533 is connected to the spherical cavity 532. The spherical cavity 532 is mainly used to place the handle ball head 513 located between the fixed plate 512 and the handle rod 511. The handle ball head 513 is adapted to be installed in the spherical cavity 532, and can support the handle rod 511 passing through the limit opening 531, so as to facilitate the displacement of the handle rod 511 relative to the handle housing 530.

[0154] At least two bearings are arranged in the supporting cavity 533, one of which can be arranged at the distal end of the connecting shell 521 to support the connecting shell 521 suspended in the accommodating cavity, and the other bearing 534 can support the guide tube. The arrangement of the bearing 534 is conducive to the rotation of the connecting shell 521 and the guide tube along with the rotation of the hand handle 511, thereby reducing the force applied by the hand handle 511.

[0155] It should be noted that a connecting rod 514 is further connected between the handle ball head 513 and the fixing plate 512, and a stopper 515 is provided at the outer end of the grip rod 511. The connecting rod 514 and the grip rod 511 can be made of biocompatible plastic such as medical grade PEEK material. In addition, the connecting rod 514 and the grip rod 511 can be formed into a single part by integrated molding, or connected by rivets, screws, bonding, etc.

[0156] In some embodiments, a limit member 535 is provided on the outer side of the distal end of the handle housing 530 , and the limit member 535 is used to engage with the slot at the end of the inner sheath tube 20 to fix the inner sheath tube 20 , the outer sheath tube 10 and the handle housing 530 in connection.

[0157] It is understandable that the inner sheath tube 20 is sleeved inside the outer sheath tube 10, and the end of the inner sheath tube 20 is exposed to the outer sheath tube 10, in order to achieve the relative stillness of the handle shell 530 and the inner sheath tube 20 and the outer sheath tube 10, that is, when the connecting shell 521, the guide tube, and the flexible continuum 200 rotate with the gripping portion 510, the handle shell 530, the inner sheath tube 20, and the outer sheath tube 10 will not rotate. Based on this, in this example, a limiting member 535 is provided on the side wall at the distal end of the handle shell 530, for example, it can be a limiting block, and the limiting block can be clamped with the clamping groove at the end of the conventionally used inner sheath tube 20. The specific clamping method can be understood with reference to the prior art, and will not be repeated here.

[0158] The specific operation process of the resectoscope provided in the present application can be that after completing the conventional surgical preparation steps of transurethral bladder tumor electroresection, the outer sheath tube 10, the inner sheath tube 20 and the mirror core (obturator) of the resectoscope are inserted into the bladder. Then select a suitable replaceable resection ring assembly 300 to insert the resection ring insertion interface, the video output interface 40 of the resectoscope is connected to the video display device, the mirror core is removed, and the guide tube with a flexible continuum 200 is inserted through the inner sheath tube 20. Together with the handle assembly 500 and the connecting part 520, the guide tube is pushed toward the bladder, and the image output and the handle shell 530 are observed at the same time, until the limiter 535 of the handle shell 530 is matched with the end of the inner sheath tube 20. Then, the operator operates the bending movement of the hand grip 511, and adjusts the flexible continuum 200 to move to the position near the lesion point through the image visual feedback, and then adjusts the posture of the resection ring assembly 300 by rotating the hand grip 511, so as to observe and be familiar with the characteristics of the tumor from all angles. Finally, the electrosurgical cutting ring assembly 300 is continuously adjusted to a suitable position for electrosurgical cutting by adjusting the bending and rotation of the hand grip 511 and the advance and retreat of the handle housing 530, and the cutting electrode 320 is controlled by the foot pedal 30 to gradually remove the tumor until the operation is completed.

[0159] In the embodiment of the present application, the rotational movement of the electric cutting ring assembly 300 and the lens assembly 400 can be achieved by rotating the hand handle 511 while the flexible continuum 200 maintains a bent posture, thereby achieving decoupling operation of the rotation of the electric cutting ring assembly 300 and the bending movement of the flexible continuum 200, allowing the operator to more intuitively control the position and posture of the electric cutting ring assembly 300, thereby reducing the difficulty of surgical operation.

[0160] Finally, it should be noted that the above implementation modes are only used to illustrate the present application, rather than to limit the present application. Although the present application is described in detail with reference to the embodiments, a person skilled in the art should understand that various combinations, modifications or equivalent substitutions of the technical solutions of the present application do not depart from the spirit and scope of the technical solutions of the present application, and should be included in the scope of the claims of the present application.

Claims

1. A resectoscope, characterized in that: Used to resect target tissue, the resectoscope comprises an outer sheath tube and an inner sheath tube which are mutually sleeved; and, A guide component is movably arranged in the inner sheath tube, and a flexible continuum is arranged at the distal end of the guide component; An electric cutting ring assembly is detachably arranged at the distal end of the flexible continuum; A lens assembly, disposed at the distal end of the flexible continuum and exposed from the electrocuting ring assembly; The handle assembly comprises a gripping portion and a connecting portion which are rotatably connected to each other, wherein the distal end of the connecting portion is connected to the proximal end of the guide assembly, and the gripping portion is connected to the flexible continuum via a pulling structure; the handle assembly is configured to change the degree of freedom of the gripping portion relative to the connecting portion under the action of an external force, so as to drive the pulling structure to pull the flexible continuum, so as to adjust the degree of freedom of the distal end of the flexible continuum.

2. The resectoscope according to claim 1, characterized in that: The flexible continuum includes at least two rotational joints that are rotationally connected to each other, and the pulling structure is sequentially connected to at least two of the rotational joints so that the flexible continuum is bent under the drive of the gripping portion.

3. The resectoscope according to claim 2, characterized in that: The flexible continuum also includes a first joint and a second joint, and the first joint and the second joint are respectively connected to the two ends of at least two of the rotating joints. The proximal end of the first joint is fixedly connected to the end of the guide assembly, and the distal end of the second joint is used to set the lens assembly and the electric cutting ring assembly.

4. The resectoscope according to claim 3, characterized in that: One end of each of the rotating joints is configured with a joint ball socket, and the other end is configured with a joint ball head, and the joint ball head is used for ball-jointed connection with the joint ball socket of the adjacent rotating joint; The end of the first joint is configured with a joint ball socket / joint ball head for ball-jointed connection with an adjacent rotary joint, and the end of the second joint is correspondingly configured with a joint ball head / joint ball socket.

5. The resectoscope according to claim 4, characterized in that: Each of the rotational joints is structured with a plurality of through holes, the axes of the through holes are consistent with the extension direction of the flexible continuum, and the plurality of through holes are evenly distributed on the periphery of the rotational joint; The pulling structure comprises a plurality of pulling ropes, one end of each of which is fixed to the holding portion, and the other end of each of which passes through the through holes of each of the rotating joints in sequence and is fixed.

6. The resectoscope according to claim 5, characterized in that: The first joint and the second joint are hollow cylinders, and the side walls of the first joint and the second joint are both constructed with multiple through holes corresponding to the through holes, and the end of the pulling rope passes through the through hole of the first joint, the through holes of the multiple rotating joints, and the through hole of the second joint in sequence, and is fixed at the second joint.

7. The resectoscope according to claim 5, characterized in that: An annular boss is arranged on the outer periphery of the rotary joint, the annular boss is located on the side of the joint ball socket, and a plurality of through holes are evenly distributed on the annular boss.

8. The resectoscope according to claim 7, characterized in that: The annular boss is also configured with a plurality of wire-passing holes, at least one of which is disposed between two adjacent through holes, and the wire-passing holes are used for the electric cutting ring cable to pass through.

9. The resectoscope according to claim 7, characterized in that: Along the extension direction of the flexible continuum, a central channel is formed through the first joint, the plurality of rotating joints and the second joint, and the central channel is used for the lens cable to pass through.

10. The resectoscope according to any one of claims 3 to 9, characterized in that: The lens assembly includes a lens fixing seat, a accommodating shell and a lens device. The lens fixing seat is fixedly connected to the second joint, the lens fixing seat is installed with a lens cable, and the accommodating shell is arranged on the outer end surface of the lens fixing seat, and the accommodating shell is used to install the lens device.

11. The resectoscope according to claim 10, characterized in that: The electric cutting ring assembly comprises a fixed base and a cutting electrode, wherein the cutting electrode is fixed to one side of the fixed base and is used to cut the target tissue, and a first mounting portion is configured on a side of the fixed base facing away from the cutting electrode; The outer end surface of the lens fixing seat is configured with a second mounting portion, and the second mounting portion is adapted to be plugged with the first mounting portion.

12. The resectoscope according to claim 11, characterized in that: The first mounting portion includes at least two plugs, and the second mounting portion includes at least two sockets corresponding to the plugs one by one. Metal contacts are fixed in the two sockets, and the metal contacts are used to connect the electric cutting ring cable and the plug.

13. The resectoscope according to claim 11, characterized in that: The fixed base is configured with an escape passage, so that the accommodating shell passes through the escape passage, so that the lens assembly is exposed from the fixed base; Wherein, the depth of the avoidance channel is less than or equal to the height of the accommodating shell.

14. The resectoscope according to claim 10, characterized in that: The lens fixing seat is cylindrical, and the lens fixing seat is adapted to be embedded in the second joint and fixedly connected to the second joint; An annular groove is configured along the circumference of the lens fixing seat, and the annular groove is used to install a sealing ring to seal the lens fixing seat and the second joint.

15. The resectoscope according to any one of claims 3 to 9 and 11 to 14, characterized in that: The guide assembly includes a guide tube, a distal end of the guide tube is fixedly connected to the first joint, a proximal end of the guide tube is fixedly connected to the connecting portion, and the guide tube is used for the pulling structure to pass through.

16. The resectoscope according to any one of claims 5 to 9 and 11 to 14, characterized in that: A steering portion is provided between the gripping portion and the connecting portion, and the steering portion is configured to, under the action of an external force, enable the gripping portion to tilt relative to the connecting portion, and / or enable the connecting portion to rotate synchronously with the gripping portion.

17. The resectoscope according to claim 16, characterized in that: The connecting portion comprises a connecting shell, one end of which is connected to the guide assembly through the connecting shell, and the other end of which is connected to the steering portion; The side wall of the connecting shell is configured with a plurality of threading grooves, which are evenly distributed around the circumference of the connecting shell. The threading grooves are used for pulling ropes to enter the guide assembly from the outside.

18. The resectoscope according to claim 17, characterized in that: The connecting shell is provided with a plurality of guide wheel groups, and the plurality of guide wheel groups correspond to the plurality of threading grooves one by one to guide the pulling rope.

19. The resectoscope according to claim 17, characterized in that: The holding portion includes a fixed plate and a hand grip rod connected to each other. The fixed plate is connected to the steering portion and is used to fix the ends of multiple pulling ropes. The fixed plate moves with the hand grip rod to enable the multiple pulling ropes connected to the fixed plate to move different distances.

20. The resectoscope according to claim 19, characterized in that: The steering part comprises an active fork, an intermediate connecting block and a driven fork, wherein one end of the active fork is fixed to the fixed plate, and the other end is hinged to the intermediate connecting block via a first rotating shaft, and one end of the driven fork is fixed to the connecting housing, and the other end is hinged to the intermediate connecting block via a second rotating shaft; Wherein, the axis of the first rotating shaft is perpendicular to the axis of the second rotating shaft.

21. The resectoscope according to claim 20, characterized in that: The pulling structure includes four pulling ropes, two of which are located at two opposite ends of the first rotating shaft, and the other two pulling ropes are located at two opposite ends of the second rotating shaft.

22. The resectoscope according to claim 20, characterized in that: The middle connecting block is constructed with a plurality of threading holes, so that the electric cutting ring cable connected to the electric cutting ring assembly and the lens cable connected to the lens assembly pass through the threading holes and the connecting shell to reach the guide assembly.

23. The resectoscope according to claim 19, characterized in that: The handle assembly also includes a handle shell, which is constructed with a accommodating cavity and a limiting opening that are interconnected. The limiting opening is formed at the proximal end of the handle shell, and the hand grip rod is inserted through the limiting opening. The fixing plate, the connecting shell and part of the guide tube are placed in the accommodating cavity.

24. The resectoscope according to claim 23, characterized in that: The accommodating cavity comprises a supporting cavity and a spherical cavity; The gripping portion further comprises a handle ball head, the handle ball head is arranged between the fixing plate and the hand grip rod, and the handle ball head is arranged in the spherical cavity; The supporting cavity is used to support the connecting shell and the guide tube.

25. The resectoscope according to claim 23, characterized in that: A limiting member is arranged on the outer side of the distal end of the handle shell, and the limiting member is used to engage with the clamping groove at the end of the inner sheath tube so that the inner sheath tube, the outer sheath tube and the handle shell are fixedly connected.

Citation Information

Patent Citations

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    CN104490467A

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