Appendix broken stone extractor for endoscope

Abstract

The appendix lithotripsy and lithotripsy extractor comprises an outer tube, an inner core tube is axially and movably arranged in the outer tube in a penetrating mode, a guide ball is arranged at the end of the inner core tube, a lithotripsy brush assembly is arranged on the outer side of the position, close to the guide ball, of the inner core tube, a through hole is formed in the guide ball, and a guide wire is arranged in the through hole in a penetrating mode. The stone breaking brush assembly comprises a plurality of rows of brush sets arranged in the axial direction of the inner core pipe, and each row of brush set comprises a plurality of brush rotating heads which are evenly arranged in the circumferential direction of the inner core pipe and can rotate front and back and brush bundles which are installed on the brush rotating heads and extend outwards. When the inner core pipe is pulled to enable the stone breaking brush assembly to enter the outer pipe, the brush set rotates and topples towards the direction of the guide ball, and when the inner core pipe moves to enable the stone breaking brush assembly to be separated from the outer pipe, the brush set rotates towards the direction of the outer pipe and is kept in the state of inclining towards the outer pipe. The problems that in the existing endoscopic retrograde appendicitis treatment, calculus cannot be accurately removed, the front end is difficult to reach and fit the tail end of the appendix cavity, and a calculus removing blind area exists can be solved.

Description

Technical Field

[0001] This invention relates to the field of medical device technology, specifically to an endoscopic appendiceal lithotripter. Background Technology

[0002] The most common causes of appendicitis are generally two. The first is that inflammation of the appendix itself causes narrowing and blockage of the lumen. When the lumen is blocked, the fluid cannot flow out, which easily leads to appendicitis. The other common cause is fecalith getting stuck in the appendix. Fecalith is often a relatively loose fecal residue-like material, or it can be a foreign object such as hair or fruit, which can induce appendicitis.

[0003] Currently, the main treatment for appendicitis remains surgery, including laparoscopic appendectomy and open appendectomy. However, surgery is inherently invasive, and children, pregnant women, and the elderly are generally reluctant to undergo surgical removal. Furthermore, the appendix is ​​not superfluous; it participates in the body's autoimmune function. Removing it is detrimental to the immune system, for example, increasing the risk of chronic inflammatory bowel disease and colon cancer. In response to these issues, international medical experts have proposed endoscopic retrograde appendectomy (ERAT) in the last decade. This technique is generally performed under anesthesia with a colonoscope. Instruments for stone removal and flushing are inserted through the colonoscope's opening. Under X-ray guidance, the appendix is ​​accessed for flushing, stone removal, and stent placement. Post-operatively, appendicitis is generally relieved quickly, with faster recovery than medication alone and a significantly lower recurrence rate. It also preserves appendiceal function, potentially sparing patients from surgery.

[0004] ERAT (Extended Endoscopic Removal of Stones) technology primarily uses a basket or balloon to remove stones under X-ray guidance. While baskets and balloons are mainly used within the bile duct, there are currently no dedicated instruments for appendiceal stone removal. This results in relatively low efficiency for two main reasons: First, the appendix opening is often large, making it difficult to store contrast agents effectively under X-ray, leading to poor visualization of the appendiceal lumen and hindering precise stone removal. Second, existing stone-removing baskets and balloons have guide sections of considerable length, making it difficult for the tip to reach and conform to the distal appendiceal lumen, creating blind spots in stone removal. Furthermore, inserting the instrument too deeply could cause perforation of the distal appendix, posing a certain risk. Therefore, there is an urgent need in the market for a highly efficient, safe, and inexpensive appendiceal stone removal device to address these issues. Summary of the Invention

[0005] This invention provides an endoscopic appendiceal lithotripter that can solve the problems of current endoscopic retrograde appendicitis treatment, such as the inability to accurately remove stones, difficulty in reaching and fitting the end of the appendiceal lumen, and the existence of blind spots in stone removal.

[0006] To achieve the above objectives, the present invention provides the following technical solution: an endoscopic appendix lithotripter, comprising an outer tube, an inner core tube axially movably inserted inside the outer tube, a guide ball at the end of the inner core tube, a lithotripsy brush assembly disposed on the outer side of the inner core tube near the guide ball, a through hole on the guide ball, a guide wire passing through the through hole, an injection port connected to the outer tube, and the lithotripsy brush assembly comprising multiple rows of brush groups arranged axially along the inner core tube, each row of brush groups comprising multiple rotatable brush rotating heads evenly arranged around the circumference of the inner core tube, and brush rotating heads extending outward from the brush rotating heads. The brush assembly, when the inner core tube is pulled to allow the lithotripsy brush assembly to enter the outer tube, rotates and tilts towards the guide ball. When the inner core tube moves and the lithotripsy brush assembly disengages from the outer tube, the brush assembly rotates towards the outer tube and remains tilted towards the outer tube. By setting a rotatable lithotripsy brush assembly, it can be hidden in the outer tube and enter the end of the appendix's lumen. At the same time, under the guidance of the guide wire, the outer tube and guide ball can be accurately moved to the location of the fecal stones in the appendix. After the lithotripsy brush assembly disengages from the outer tube, it automatically unfolds and can maintain a tilted state to crush the fecal stones and pull them along. In conjunction with the liquid injected through the injection port, the fecal stones can be effectively discharged.

[0007] Preferably, a groove is provided on the outer side of the inner core tube at the position where the brush rotating head is installed. The bottom surface of the groove is a first inclined surface. One end of the first inclined surface is connected to the outer wall of the inner core tube, and the other end of the first inclined surface is provided with a second inclined surface. The brush rotating head is installed in the groove near the end of the second inclined surface via a rotating shaft. A coil spring is installed on the rotating shaft. The coil spring keeps the brush rotating head in contact with the second inclined surface. Through the structural design of the groove, the rotation angle of the brush rotating head can be limited. The first inclined surface can limit the tilting angle of the brush bundle, and the second inclined surface can limit the angle of the brush bundle when it is in the state of cleaning gravel.

[0008] Preferably, when the brush rotating head is close to the second inclined surface, the brush bundle and the radial plane of the inner core tube form an angle of 15-20°. The back-and-forth tilting of the brush bristles, combined with water rinsing, can improve the stone crushing effect and effectively drive the stone crushing to move.

[0009] Preferably, the material of the brush bundle is one of nylon, PBT tapered filaments, PP brush, PET brush, natural pig bristles, or bamboo charcoal brush, which can be selected as needed.

[0010] Preferably, a handle is provided on the outer side of the outer tube. The handle facilitates the operation of the position of the outer tube, such as the synchronous rotation and axial movement of the outer tube and the inner core tube.

[0011] Preferably, the guidewire has a soft end (hydrophilic section) to prevent the end of the guidewire from damaging the lumen of the appendix.

[0012] Preferably, the width of the brush bundle is 6-8mm, which can improve the stone crushing effect.

[0013] Preferably, the spacing between the brush groups is 10-15mm, which allows the fecal matter to be removed from its original position by the gravel brush assembly after entering.

[0014] Compared with the prior art, the beneficial effects of the present invention are: By incorporating a rotatable lithotripsy brush assembly, which can be concealed within the outer tube and inserted into the end of the appendix lumen, the outer tube and guide ball, guided by the guide wire, can precisely move to the location of the fecalith within the appendix. After detaching from the outer tube, the lithotripsy brush assembly automatically unfolds, maintaining an inclined position to crush the fecalith and pull it along. Combined with the fluid injected through the infusion port, it can effectively crush and remove the fecalith. The guide wire, acting as a guide component, works in conjunction with the guide ball to achieve precise guidance, solving the problem of the current endoscopic retrograde appendectomy's difficulty in reaching and adhering to the end of the appendix lumen. The rotatable lithotripsy brush assembly, on the other hand, solves the problem of precise stone retrieval and crushing. Attached Figure Description

[0015] Figure 1 This is a front view structural diagram according to the present invention; Figure 2 yes Figure 1 Enlarged structural diagram at point A; Figure 3 This is a structural diagram of the brush assembly according to the present invention; Figure 4 This is a schematic diagram of the tilted state of the stone crushing brush assembly located inside the outer tube according to the present invention; Figure 5 This is an axial schematic diagram of the unfolded state of the brush assembly according to the present invention.

[0016] Figure label: 1. Outer tube, 2. Handle, 3. Injection port, 4. Inner core tube, 41. Groove, 42. First inclined surface, 43. Second inclined surface, 5. Guide wire, 51. Flexible end, 6. Guide ball, 61. Through hole, 7. Stone brush assembly, 70. Brush group, 71. Brush bundle, 72. Brush rotating head, 73. Second inclined surface, 74. Shaft. Detailed Implementation

[0017] The technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention.

[0018] This invention addresses the problems of current endoscopic retrograde appendectomy, such as the inability to precisely remove stones, difficulty in reaching and adhering to the distal end of the appendix lumen, and the existence of blind spots in stone removal. Figure 1-5 As shown, the following technical solution is provided: An endoscopic appendix lithotripter includes an outer tube 1, an inner core tube 4 axially movably inserted inside the outer tube 1, a guide ball 6 at the end of the inner core tube 4, a lithotripsy brush assembly 7 disposed on the outer side of the inner core tube 4 near the guide ball 6, a through hole 61 disposed on the guide ball 61, a guide wire 5 passing through the through hole 61, and an injection port 3 connected to the outer tube 1. The lithotripsy brush assembly 7 includes multiple rows of brush groups 70 arranged axially along the inner core tube 4. Each row of brush groups 70 includes multiple rotatable brush rotating heads 72 evenly arranged around the inner core tube 4 and bristles extending outward from the brush rotating heads 72. When the inner core tube 4 is pulled to allow the lithotripsy brush assembly 7 to enter the outer tube 1, the brush assembly 70 rotates and tilts towards the guide ball 6. When the inner core tube 4 moves to allow the lithotripsy brush assembly 7 to disengage from the outer tube 1, the brush assembly 70 rotates towards the outer tube 1 and remains tilted towards the outer tube 1. By setting the rotatable lithotripsy brush assembly 7, it can be hidden in the outer tube 1 and enter the end of the appendix lumen. At the same time, under the guidance of the guide wire 5, the outer tube 1 and the guide ball 6 can be accurately moved to the location of the fecal stones in the appendix. After the lithotripsy brush assembly 7 disengages from the outer tube 1, it automatically unfolds and can maintain the tilted state to crush the fecal stones and pull them away. In conjunction with the liquid injected into the injection port 3, the fecal stones can be effectively discharged.

[0019] The technical solution in this embodiment employs a rotatable lithotripsy brush assembly 7, a guide wire 5, and a guide ball 6 for precise guidance, along with a coordinated design for the outer tube 1. This solves various technical problems associated with existing endoscopic retrograde appendectomy (ERAT) procedures. Specifically, in this embodiment, the guide ball 6, in conjunction with the guide wire 5, provides flexible guidance, accurately reaching the distal end of the appendix. Furthermore, the guide ball 6 exhibits clear X-ray imaging, minimal positioning deviation, and significantly reduced perforation risk. In this embodiment, the lithotripsy brush assembly 7 automatically tilts outward after detaching from the outer tube, 360° surrounding the inner core tube 4 to cover the lumen wall, resulting in a relatively small blind zone and a significantly reduced residual lithotripsy rate. Simultaneously, when the lithotripsy brush assembly 7 enters the outer tube 1, it automatically tilts towards the guide ball and adheres to the inner core tube 4, thus drastically reducing mucosal damage during the movement of the outer tube 1 within the body. Combined with the flushing and drainage at the injection port 3, this significantly increases the rate of fecal impaction.

[0020] Specifically, the inner core tube 4 can be made of medical-grade nickel-titanium alloy, with a length of 2300mm and a 100mm extension beyond the outer tube, meeting the requirement of an average appendix depth of 80-120mm in adults. The guide ball 6 is made of 316L stainless steel, with a through hole 61 diameter of 1-2mm, adapting to the diameter of the guide wire 5, with a gap of 0.2mm, and is laser-welded to the inner core tube 4, with a tensile strength ≥400MPa after welding. The guidewire 5 has a total length of 2500mm and is made of 304 stainless steel wire. The end of the guidewire 5 is provided with a flexible end 51 to prevent the end of the guidewire 5 from damaging the lumen of the appendix. The flexible end 51 at the front end is 8mm long and is wrapped with medical silicone. The flexible end 51 can conform to the inner wall of the curved section of the appendix and bend it, avoiding the bend caused by excessive hardness. At the same time, the flexible end 51 can be filled with barium sulfate contrast agent, which can be clearly visualized under X-ray and the position of the front end can be observed in real time, avoiding blind perforation caused by blind advancement. The injection port 3 is made of medical PVC and the interface is a Luer conical connector, which is compatible with clinical syringes.

[0021] Specifically, the width of the brush bundle 71 is 6-8mm, and the spacing between the brush groups 70 is 10-15mm. This spacing facilitates the removal of fecal matter from its original position by the crushing brush assembly 7 after it enters, thus improving the crushing effect. When the spacing between the brush groups 70 is 10-15mm, the space between adjacent brush groups can accommodate fecal matter with a diameter of 5-8mm. If the spacing is <10mm, the space is insufficient, and fecal matter is prone to getting stuck; while if the spacing is >15mm, the space is too large, and fecal matter is prone to falling off. In addition, the spacing of 10-15mm between the brush groups 70 provides sufficient flow channels for the flushing fluid, and the flow rate of the flushing fluid can reach 5cm / s, ensuring that the crushed stone is discharged in time without secondary blockage.

[0022] During use, guidewire 5 is inserted through the biopsy port of the colonoscope. Under X-ray fluoroscopy, the soft tip of guidewire 5 is guided into the appendix opening and slowly advanced to the blind end of the appendix. X-ray imaging confirms that guidewire 5 remains in the intestinal lumen as a support. Next, guideball 6 is inserted along guidewire 5 through the through-hole 61. The outer tube 1 is pushed so that the lithotripsy brush assembly 7 is fully inserted into the outer tube. At this time, the brush assembly is squeezed by the inner wall of the outer tube and tilts towards the guideball, adhering to the inner core tube 4, until the guideball gently touches the blind end of the appendix, avoiding excessive pushing. Next, fix the outer tube 1 and pull the inner core tube 4 outwards, so that the three rows of brushes 70 are completely separated from the outer tube 1. The brushes 70 automatically tilt towards the outer tube under the action of the coil spring. Hold the handle 2 and rotate it clockwise at an angular velocity of 60° / s, driving the outer tube and the inner core tube to rotate synchronously. At the same time, pull the inner core tube back and forth at a speed of 50mm / s. Inject 37°C physiological saline through the injection port every 30 seconds. Use the shearing force of the brush bundles 71 to break up the fecal stones. The flushing fluid carries the stones into the intestinal lumen. After breaking up the fecal stones, stop rotating and slowly push the inner core tube 4 back, so that the brushes 70 enter the outer tube 1 and automatically tilt towards the guide ball. Switch the injection port 3 to the negative pressure suction device, withdraw the entire instrument, and remove the stones embedded in the gaps of the brushes 70 by negative pressure suction of the outer tube 1 and negative pressure suction of the colonoscope. After X-ray confirmation that there are no residues in the appendix lumen, the operation is ended.

[0023] In this embodiment, a groove 41 is provided on the outer side of the inner core tube 4 at the position where the brush rotating head 72 is installed. The bottom surface of the groove 41 is a first inclined surface 42. One end of the first inclined surface 42 is connected to the outer wall of the inner core tube 4, and the other end of the first inclined surface 42 is provided with a second inclined surface 43. The brush rotating head 72 is installed in the groove 41 near the end of the second inclined surface 43 via a rotating shaft 74. A coil spring 73 is installed on the rotating shaft 74. The coil spring 73 keeps the brush rotating head 72 in contact with the second inclined surface 43. Through the structural design of the groove 41, the rotation angle of the brush rotating head 72 can be limited. The first inclined surface 42 can support the brush bundle 71. The tilting angle is limited. The second inclined surface 43 restricts the angle of the brush bundle 71 when it is in the gravel-cleaning state. Specifically, the first inclined surface 42 limits the maximum tilting angle of the brush when it is stored to ≤30° to avoid excessive bending of the brush and breakage of the bristles. When the brush rotating head 72 is close to the second inclined surface 43, the brush bundle 71 and the radial plane of the inner core tube 4 form an angle of 15-20°, which provides good gravel crushing effect and can effectively move the gravel. The second inclined surface 43 limits the tilting angle of the brush when it is working to 15-20° to ensure that the contact pressure between the brush bundle and the cavity wall is stable at 0.3-0.5N, which ensures the gravel crushing force and can crush fecal stones with a diameter ≤5mm, while avoiding excessive pressure that scrapes the mucous membrane. This 15-20° angle makes the brush bundle form a hook-shaped gripping space, and each row of brushes 70 can stably carry 0.5-2mm³ gravel, effectively increasing the amount of gravel carried in a single pull-back compared to existing technologies.

[0024] The coil spring 73 provides a continuous restoring force of 0.2-0.3N, ensuring that the brush bundle 71 immediately engages with the second inclined surface 43 after detaching from the outer tube 1. During storage, the force exerted by the inner wall of the outer tube on the brush rotating head only needs to be 0.8N to overcome the coil spring force, preventing jamming. Specifically, the groove 41 is formed on the outer side of the inner core tube, with a depth of 2mm and a width of 3mm, matching the size of the brush rotating head. One groove is formed every 45° along the circumference of the inner core tube, corresponding to 8 brush rotating heads. The connection angle between the first inclined surface 42 and the outer wall of the inner core tube is 150°. When the brush tip tilts towards the guide ball, the bottom surface of the brush rotating head engages with the first inclined surface, limiting the tilting angle to ≤30°. The angle between the second inclined surface 43 and the first inclined surface 42 is 90-100°. The rotating shaft 74 is made of medical-grade 304 stainless steel and is interference-fitted with the shaft hole of the brush rotating head 72. Both ends are embedded in the shaft holes of the inner core tube 4. After assembly, the rotating shaft can rotate flexibly. The shaft is made of piano wire with a diameter of 0.1mm, 3 effective turns, and a free length of 2mm. It is pre-compressed by 0.5mm during assembly to provide a 0.25N restoring force. During assembly, first, the coil spring 73 is fitted onto the rotating shaft 74, then the rotating shaft 74 is embedded into the shaft hole of the inner core tube 4, and finally the brush rotating head 72 is fitted onto the rotating shaft. This ensures that one end of the coil spring abuts against the bottom surface of the groove and the other end abuts against the inner wall of the brush rotating head, so that the brush rotating head 72 is in contact with the second inclined surface 43 in a natural state and rotates towards the first inclined surface 42 when subjected to external pressure.

[0025] In this embodiment, the material of the brush bundle 71 is one of nylon, PBT tapered filaments, PP brush, PET brush, natural pig bristles, or bamboo charcoal brush. The choice can be made according to needs. Specifically, nylon has excellent wear resistance and flexibility, making it suitable for loose fecal matter, such as fecal sludge, avoiding excessive crushing that could lead to flying debris. PBT tapered filaments have high sharpness and moderate hardness, making them suitable for harder fecal matter, such as calcified fecal matter, with improved crushing efficiency compared to nylon and a higher crushing rate for calcified fecal matter. Natural pig bristles have excellent biocompatibility and a smooth surface, making them suitable for patients with sensitive mucous membranes, such as children and pregnant women, with a low mucous membrane irritation rate. Bamboo charcoal brushes have excellent antibacterial properties, making them suitable for patients with appendicitis with suppuration, avoiding postoperative infection and significantly reducing the postoperative infection rate.

[0026] In this embodiment, a handle 2 is sleeved on the outer side of the outer tube 1. The handle facilitates the operation of the position of the outer tube 1, such as synchronous rotation and axial movement of the outer tube 1 and the inner core tube 4. The handle 2 solves the problems of low operating accuracy, easy slippage, and the need for multiple people to cooperate in the existing instruments.

[0027] As a specific implementation plan for clinical operation in this embodiment: (1) Preoperative preparation Patient preparation: The patient was given general anesthesia via intravenous injection, placed in the left lateral decubitus position, and underwent routine bowel preparation. Equipment preparation: Stone crusher of this invention, colonoscope with transparent cap, guide wire 5, cutting knife (for backup), 37℃ physiological saline, negative pressure suction device, X-ray fluoroscopy equipment; Instrument inspection: The soft end 51 of the guidewire 5 is undamaged, the brush bundle 71 is not detached, the injection port 3 is well sealed, and the handle 2 operates smoothly.

[0028] (2) Intraoperative procedures Guidewire placement: Guide wire 5 is inserted through the biopsy port of the colonoscope and slowly advanced under X-ray fluoroscopy, allowing the soft end 51 to enter the appendiceal opening. Continue advancing to the blind end of the appendix, fixing the position of guide wire 5 to prevent displacement. If it is difficult for the guide wire to enter the appendiceal opening, the incision scalpel with the guide wire can be opened. By rotating the scalpel at the bow angle, the guide wire can be superselectively entered into the appendix. After this, the incision scalpel is withdrawn, leaving the guide wire in place.

[0029] Machine propulsion: Insert the guide ball 6 through the through hole 61 along the guide wire, hold the handle part 2 and push the outer tube 1 so that the stone crushing brush assembly 7 is fully inserted into the outer tube. The brush assembly 70 is squeezed by the inner wall of the outer tube and tilts around the guide ball to fit the inner core tube 4 until the guide ball gently touches the blind end of the appendix. Rotate the handle part fixing knob clockwise to lock the outer tube.

[0030] Brush spread and gravel: Push the handle to pull the slider outward, pulling the inner core tube 415mm outward. The 5 rows of brush groups 70, spaced 12mm apart and 7mm wide, are completely separated from the outer tube 1. Under the action of the coil spring 73, the brush rotating head 72 is in contact with the second inclined surface 42, and the brush bundle 71 forms an angle of 18° with the radial plane. Hold the handle 2 and rotate it at an angular velocity of 60° / s, driving the outer tube and inner core tube to rotate synchronously. At the same time, pull the slider back and forth at a speed of 50mm / s. The inner core tube 4 travels 30mm. Every 30 seconds, inject 5ml of 37℃ physiological saline through the injection port 3. The brush bundle 71 shears and breaks up the fecal stones. The flushing fluid carries the stones and flows into the intestinal lumen with the help of the colonoscope.

[0031] Stone Acquisition and Storage: Stop rotating, slowly push and pull the slider back to allow the brush assembly 70 to enter the outer tube 1 and automatically tilt towards the guide ball. Switch the injection port 3 to the negative pressure suction device, withdraw the entire instrument, and use negative pressure to suction out the stones embedded in the gaps between the brushes. After confirming by X-ray that there are no residual fecal stones in the appendix lumen, withdraw the colonoscope and guide wire.

[0032] Postoperative observation After the patient regained consciousness, their body temperature and abdominal pain were monitored. An abdominal CT scan was performed again within 24 hours to confirm that there was no appendiceal perforation or effusion.

[0033] It should be noted that all directional indications (such as up, down, left, right, front, back, etc.) in the embodiments of the present invention are only used to explain the relative positional relationship and movement of each component in a certain specific posture (as shown in the figure). If the specific posture changes, the directional indication will also change accordingly.

[0034] Furthermore, in this invention, descriptions involving terms such as "primary," "secondary," etc., are for descriptive purposes only and should not be construed as indicating or implying their relative importance or implicitly specifying the number of technical features indicated. Therefore, a feature defined as "primary" or "secondary" may explicitly or implicitly include at least one of that feature. In the description of this invention, "multiple" means at least two, such as two, three, etc., unless otherwise explicitly specified.

[0035] In this invention, unless otherwise explicitly specified and limited, the terms "connection," "fixed," etc., should be interpreted broadly. For example, "fixed" can mean a fixed connection, a detachable connection, or an integral part; it can mean a mechanical connection or an electrical connection; it can mean a direct connection or an indirect connection through an intermediate medium; it can mean the internal communication of two components or the interaction between two components, unless otherwise explicitly limited. Those skilled in the art can understand the specific meaning of the above terms in this invention according to the specific circumstances.

[0036] Furthermore, the technical solutions of the various embodiments of the present invention can be combined with each other, but only if they are feasible for those skilled in the art. If the combination of technical solutions is contradictory or cannot be implemented, it should be considered that such combination of technical solutions does not exist and is not within the scope of protection claimed by the present invention.

Claims

1. An endoscopic appendiceal lithotripter, characterized in that, include: An outer tube (1) is provided with an inner core tube (4) that moves axially through the inner core tube (4). A guide ball (6) is provided at the end of the inner core tube (4). A stone crushing brush assembly (7) is provided on the outer side of the inner core tube (4) near the guide ball (6). A through hole (61) is provided on the guide ball (6). A guide wire (5) passes through the through hole (61). An injection port (3) is connected to the outer tube (1). The stone crushing brush assembly (7) includes multiple rows of brush groups (70) arranged axially along the inner core tube (4). Each brush group (70) includes multiple brush rotating heads (72) that can rotate back and forth evenly arranged around the inner core tube (4) and brush bundles (71) that extend outward on the brush rotating heads (72). When the inner core tube (4) is pulled to allow the stone crushing brush assembly (7) to enter the outer tube (1), the brush group (70) rotates and tilts in the direction of the guide ball (6). When the inner core tube (4) moves to allow the stone crushing brush assembly (7) to disengage from the outer tube (1), the brush group (70) rotates in the direction of the outer tube (1) and remains in a state of tilting towards the outer tube (1).

2. The endoscopic appendiceal lithotripter according to claim 1, characterized in that: A groove (41) is provided on the outer side of the inner core tube (4) at the position where the brush rotating head (72) is installed. The bottom surface of the groove (41) is a first inclined surface (42). One end of the first inclined surface (42) is connected to the outer wall of the inner core tube (4). The other end of the first inclined surface (42) is provided with a second inclined surface (43). The brush rotating head (72) is installed in the groove (41) near the end of the second inclined surface (43) via a rotating shaft (74). A coil spring (73) is installed on the rotating shaft (74). The coil spring (73) keeps the brush rotating head (72) in contact with the second inclined surface (43).

3. The endoscopic appendiceal lithotripter according to claim 2, characterized in that: When the brush rotating head (72) comes into contact with the second inclined plane (43), the brush bundle (71) and the radial plane of the inner core tube (4) form an angle of 15-20°.

4. The endoscopic appendiceal lithotripter according to claim 1, characterized in that: The material of the brush bundle (71) is one of nylon, PBT tapered filament, PP brush, PET brush, natural pig bristles, and bamboo charcoal brush.

5. The endoscopic appendiceal lithotripter according to claim 1, characterized in that: The outer tube (1) is fitted with a handle part (2) on its outer side.

6. The endoscopic appendiceal lithotripter according to claim 5, characterized in that: The guide wire (5) is provided with a flexible end (51) at its end.

7. The endoscopic appendiceal lithotripter according to any one of claims 1-6, characterized in that: The width of the brush bundle (71) is 6-8 mm.

8. The endoscopic appendiceal lithotripter according to claim 7, characterized in that: The spacing between the brush groups (70) is 10-15 mm.

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