An auxiliary traction device for endoscopic submucosal dissection

Abstract

The present application relates to mucosal stripping traction device technical field, especially to a kind of auxiliary traction device for endoscopic submucosal dissection, including at least partially elastic main body, the elastic part of main body is in the state of winding bending in natural state, main body has curved shape outer side camber surface for and inner mucosa tissue is attached, main body is also provided with the shaping device for keeping main body in the state of storage elastic potential energy, when the shaping device is separated from the main body, main body releases the stored elastic potential energy, it is realized to the mucosa tissue of pathological change by at least partially elastic main body to be pulled, reach when cutting without additional personnel operation traction, over shaping device to limit main body in the state of storage elastic potential energy, main body can be placed into passageway into human body by endoscope when being close to straight line state, while straight line state also facilitates the position of main body in human body fixed, further, also facilitate the time of controlling elastic potential energy release.

Description

Technical Field

[0001] This invention relates to the field of mucosal dissection traction device technology, and in particular to an auxiliary traction device for endoscopic submucosal dissection. Background Technology

[0002] Endoscopic submucosal dissection involves inserting an endoscope into the body to locate and mark the lesion area. After marking, an injection is made below the lesion tissue to elevate it, causing it to expand and form a tent-like shape. Then, an ultrasonic high-frequency mucosal incision knife is used to remove the lesion. The mucosa consists of three layers from the outside in: the muscularis propria, the submucosa, and the mucosa. The lesion is located in the innermost mucosa. During the removal of the lesion, the submucosa needs to be cut, taking care not to damage the muscularis propria. Dividing the submucosa allows the lesion to detach from the mucosa. However, to avoid damaging the muscularis propria during the cutting process, a traction device is used to pull the submucosa to ensure adequate exposure.

[0003] Existing traction devices employ a combination of titanium clips and a traction rope to lift the tissue on the cutting side. However, this method requires one person to control the traction operation while another performs the cutting. Another method uses titanium clips with springs for traction, but this involves the difficulty of installing and fixing the clips and springs inside the body. Still other methods utilize external traction, such as cannula traction and magnetic traction, all of which require additional personnel to perform the traction operation. Furthermore, cannula traction can cause significant damage to the human body. Therefore, an auxiliary traction device for endoscopic submucosal dissection is needed to address these issues. Summary of the Invention

[0004] This invention provides an auxiliary traction device for endoscopic submucosal dissection, which uses at least partially elastic main body to achieve traction of internal mucosal tissue during the cutting process, achieving automatic traction without the need for additional personnel and with minimal damage to the human body.

[0005] The technical problem solved by this invention is achieved by the following technical solution: This invention provides an auxiliary traction device for endoscopic submucosal dissection, comprising at least a partially elastic body, wherein the elastic portion of the body is in a coiled and bent state in its natural state, and the body has a curved outer arc surface for adhering to the internal mucosal tissue. The body is also provided with a shaping device for maintaining the body in a state of stored elastic potential energy. When the shaping device is released from its action on the body, the body releases the stored elastic potential energy.

[0006] Preferably, the main body is adhered to the internal mucosal tissue via titanium clips.

[0007] Preferably, the main body is adhered to the internal mucosal tissue by means of medical tissue adhesive.

[0008] Preferably, the shaping device is a rigid rod-shaped body, and the main body has at least an elastic portion with a channel inside for accommodating the rod-shaped body. When the rod-shaped body is in the channel, the elastic portion of the main body maintains a state of storing elastic potential energy, and when the rod-shaped body leaves the channel, the elastic portion of the main body releases the elastic potential energy.

[0009] Preferably, the rod-shaped body and the channel are at least partially threaded.

[0010] Preferably, the shaping device is a rope, and the two ends of the elastic part of the main body are provided with through holes. After the two ends of the rope pass through the through holes, they form knots to bind the elastic part of the main body and keep it in a state of storing elastic potential energy. The rope extends on the outer arc surface of the main body with a curved shape, and the knots are formed on the inner arc surface of the main body with a curved shape.

[0011] Preferably, the shaping device is a rope, and the two ends of the elastic part of the main body are provided with countersunk holes. After the two ends of the rope pass through the countersunk holes, they form knots to bind the elastic part of the main body and keep it in a state of storing elastic potential energy. The interior of the main body is provided with a receiving channel for placing the rope.

[0012] Preferably, the rope is a rigid or elastic rope.

[0013] Preferably, the main body has a groove, which exposes the rope-forming part inside the main body that is attached to the internal mucosal tissue.

[0014] The beneficial effect of the present invention is that it achieves traction of diseased mucosal tissue by having at least a partially elastic main body, so that no additional personnel are required to perform traction during cutting.

[0015] By using a shaping device to restrict the subject's state of storing elastic potential energy, it is possible to allow the subject to enter the human body through the endoscopic insertion channel when it is in a near-linear state. At the same time, the straight state also facilitates the fixation of the subject's position inside the human body, and further, it also makes it easier to control the timing of the release of elastic potential energy.

[0016] The main body design is at least partially flexible, and the overall structure is relatively simple, making it easier to operate compared to other traction methods. Attached Figure Description

[0017] To more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the drawings used in the description of the embodiments or the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained from these drawings without creative effort.

[0018] Figure 1 This is a schematic diagram of the structure of the first prior art of the present invention; Figure 2 This is a schematic diagram of the first state structure of the second prior art of the present invention; Figure 3 This is a schematic diagram of the second state structure of the second prior art of the present invention; Figure 4 This is a schematic diagram of the structure of the third prior art of the present invention; Figure 5 This is a schematic diagram of the fourth prior art of the present invention; Figure 6 This is a schematic diagram of the structure of the fifth prior art of the present invention; Figure 7 This is a schematic diagram of the structure of the present invention. Figure 1 ; Figure 8 This is a schematic diagram of the structure of the present invention. Figure 2 ; Figure 9 This is a schematic diagram of the structure in the second state of the present invention; Figure 10 This is a schematic diagram of the structure of the present invention, which is fixed using titanium clips; Figure 11 This is a schematic diagram of the main structure of the present invention; Figure 12 The diagram shows the structure of various embodiments of the main body of the present invention; Figure 13 For the present invention Figure 12 A cross-sectional view; Figure 14 Corresponding to the present invention Figure 13 Enlarged structural diagrams of points A, B, C, and D in the diagram.

[0019] In the diagram, 1. Muscularis propria; 2. Submucosa; 3. Mucosa; 4. Diseased tissue; 5. Titanium clip; 6. Traction rope; 7. Magnetic bead; 8. Magnet; 9. Abdomen; 10. Spring; 11. Rope; 12. Sleeve; 13. Main body; 14. Joint; 15. Rope body; 16. End; 17. Ultrasonic scalpel; 18. Thread; 19. Groove. Detailed Implementation

[0020] To make the technical means, creative features, objectives and effects of this invention easier to understand, the invention will be further described below with reference to specific illustrations.

[0021] refer to Figures 1-6 To enable those skilled in the art to understand the innovative points of this invention, the prior art involved in this invention is first described. Firstly, the internal mucosal tissue, from the outside in, includes the muscularis propria 1, the submucosa 2, and the mucosa 3. A typical lesion area is a lesion in the mucosa 3, forming lesion tissue 4. In the process of peeling off lesion tissue 4, the method used is to perform the peeling by cutting through the submucosa 2, achieving the peeling of lesion tissue 4 without damaging the muscularis propria 1. (Refer to...) Figure 1 This is the first prior art involved in the present invention. It uses a titanium clip 5 to hold the lesion tissue 4 at its front end, and a traction rope 6 fixed to the titanium clip 5 to achieve traction of the lesion tissue 4 during the ultrasonic scalpel 17 resection. The traction rope 6 extends out of the body through the endoscopic channel. Personnel pull the traction rope 6 from outside the body to achieve traction. Because the traction direction is inclined upwards (upper right in the attached figure), this method is only suitable for traction of small areas of lesion tissue 4, and the traction effect is limited. However, structurally, it only requires one titanium clip 5 and one traction rope 6, making it relatively simple and easy to operate. (Reference) Figure 2 and Figure 3 The improvement on the first existing technology uses two titanium clips 5 and a traction rope 6 to achieve traction. One titanium clip 5 is fixed to the front end of the lesion tissue 4, and the other titanium clip 5 is fixed to the opposite side of the lesion tissue 4, slightly behind. The traction rope 6 is fixed to the titanium clip 5 at the front end of the lesion tissue 4 and slidably coupled to the titanium clip 5 on the opposite side of the lesion tissue 4. Thus, during the cutting process, by pulling the traction rope 6 externally, the front end of the lesion tissue 4 can be tilted backward and upward (upper left of the attached diagram), forming a shape like... Figure 3 The shown configuration facilitates full exposure of the submucosal layer 2. When using the ultrasonic scalpel 17 to remove the submucosal layer 2, the field of vision is clearer, reducing the risk of damage to the muscularis propria 1. Because its traction direction is posterosuperior, it is suitable for traction of larger lesions. However, it requires the placement of two titanium clips 5, which takes a relatively long time, and additional personnel are needed externally to pull the traction rope 6. (See reference...) Figure 4The third existing technology uses two titanium clips 5 and a spring 10 to traction the lesion tissue 4. Specifically, one titanium clip 5 is fixed to the front end of the lesion tissue 4, and the other titanium clip 5 is fixed to the opposite side and slightly posterior to the lesion tissue 4. The two titanium clips 5 are connected by the spring 10. After the two titanium clips 5 are fixed, the spring 10 is in a stretched state. This ensures that the front end of the lesion tissue 4 is always pulled up during the cutting process, fully exposing the submucosal layer 2, which is convenient for the ultrasonic scalpel 17 to cut. The advantage of this method is that no additional personnel are needed to perform the traction operation. The disadvantage is that the setup is relatively complicated, especially the secure fixation between the titanium clips 5 and the spring 10. (Reference) Figure 5 This is the fourth prior art of the present invention, which involves implanting magnetic beads 7 into the interior of the diseased tissue 4, and then using a magnet 8 to attract the magnetic beads 7 externally during the cutting process, causing the front end of the diseased tissue 4 to move upward. The drawback of this method is that, for obese individuals, the magnetic attraction is limited due to the greater distance between the magnet 8 and the magnetic beads 7, and the direction and strength of the attraction are not stable enough. (Reference) Figure 6 This is the fifth prior art involved in the present invention, which achieves traction by inserting a cannula 12 from outside the body into the body (the cannula 12 penetrates the abdomen 9, causing significant damage). Specifically, the bottom end of the cannula 12 has a rope 11, which is fixed to the titanium clip 5 at the front end of the lesion tissue 4. Traction is achieved by controlling the direction of the cannula 12 from outside the body. This traction method causes significant damage to the human body and is generally only used for traction in specific areas. It also requires additional personnel to perform the traction operation.

[0022] Based on the above, the present invention provides an auxiliary traction device for endoscopic submucosal dissection to overcome the shortcomings of the aforementioned traction devices. Specifically, refer to... Figures 7-11 The traction device provided by this invention includes a main body 13 parts, which can be plate-shaped or column-shaped. The accompanying drawings show a rectangular plate as an example, but in specific implementations, the plate shape can also be designed with other cross-sectional shapes. The main body 13 parts can be configured as a combination of elastic and inelastic parts, or they can be entirely elastic. Figure 11 In the example of elastic and inelastic parts, the elastic part in its natural state is as follows: Figure 11 As shown in Figure a, the body 13 is in a curved state, while the inelastic portion is in a straight state. When the body 13 is attached to the mucosal tissue for use, it is necessary to constrain the body 13 portion as follows: Figure 11 As shown in b, this is a straight line, which facilitates the placement of the main body 13 through the endoscope's placement channel near the lesion tissue 4 inside the human body. Simultaneously, when fixing the main body 13 to the lesion tissue 4, it is also necessary to maintain the main body 13 in a straight line or nearly straight line, with the curved outer arc surface of the main body 13 (in...) Figure 11In 'a', it refers to the outer surface. Figure 11 (b refers to the bottom surface) used for attachment and fixation to the internal mucosal tissue; the fixed state is as follows... Figure 7 , Figure 8 and Figure 9 As shown, where Figure 7 It is a single main body 13 fixed to the mucosal layer 3, while Figure 8 Multiple main bodies 13 are fixed to the mucosal layer 3 (when the lesion tissue area 4 is large, the number of main bodies 13 is increased to achieve a better traction effect). Figure 9 The process involves the body 13 releasing elastic potential energy, causing the front end of the diseased tissue 4 to move upwards. The fixation between the body 13 and the mucosal tissue can be achieved using medical adhesives, such as cyanoacrylate medical adhesives (also known as tissue adhesives or skin adhesives). These adhesives adhere and fix the mucosal tissue to the body 13 without causing damage to the human body and are commonly used for wound closure. Of course, other methods of fixation can also be used, such as... Figure 10 The figure shows the use of titanium clips 5 to clamp the main body 13 to the mucosal tissue for fixation. The fixation position of the main body 13 is referenced. Figure 7 and Figure 8 One end is fixed to the healthy mucosal layer 3 region at the rear end of the lesion tissue 4 (if the main body 13 is composed of elastic and inelastic parts, one end of the inelastic part is fixed to this region), and the other end is fixed to the lesion tissue 4 near the front end.

[0023] refer to Figures 12-14 The main body 13 maintains a near-straight line state from its insertion into the human body until fixation is complete. Before accurate cutting, its straight-line constraint needs to be released to allow it to release elastic potential energy, enabling traction on the front end of the diseased tissue 4. Therefore, a shaping device is also provided on the main body 13 to maintain its straight-line state, ensuring stability during insertion into the human body and fixation to the mucosal layer 3. Specifically, this shaping device can be designed using the following scheme: Figure 12 a, Figure 13 a and Figure 14 As shown in Figure a, a shaping device is implemented by using a rod-shaped body for shaping. Specifically, the rod-shaped body is rigid and has a channel inside the main body 13 to accommodate the rod-shaped body (the channel extension length is not less than the length of the elastic part and is set corresponding to the elastic part). When the rod-shaped body is inside the channel, the elastic part of the main body 13 remains in a straight line under the restriction of the rod-shaped body. After the main body 13 is fixed to the mucosal tissue, the rod-shaped body inside the channel is removed, and the main body 13 releases elastic potential energy, causing the front end of the lesion tissue 4 to move upward.

[0024] To ensure that the rod-shaped body can be stably placed in the channel, such as Figure 14As shown in a, the rod-shaped body and the channel are connected by at least a threaded 18 connection (the thread 18 should not be too long to facilitate removal; the end 16 of the rod-shaped body can be clamped through the endoscope channel by the operating forceps and rotated to remove it).

[0025] Furthermore, such as Figures 12-14 The shaping device can also be rope 15; for details, please refer to [reference needed]. Figure 12 b、 Figure 13 b and Figure 14 b. Perforations are made at both ends of the elastic part of the main body 13. The rope 15 extends along the curved outer arc surface of the main body 13. After the two ends of the rope 15 pass through the perforations, knots 14 are formed on the other side (inner arc surface). This keeps the elastic part of the main body 13 in a state of storing elastic potential energy. When the main body 13 is attached to the target area, before the diseased tissue 4 is peeled off, the knots 14 are melted by the ultrasonic scalpel 17 or cut off by pliers. This allows the rope 15 to be released from the elastic part of the main body 13. Thus, during the process of peeling off the diseased tissue 4 by the ultrasonic scalpel 17, the peeled part is pulled.

[0026] Further reference Figure 12 c. Figure 13 c and Figure 14 c. When the shaping device is a rope 15, the rope 15 can also be set inside the main body 13 to ensure that the main body 13 can be fixed to the mucosa layer 3 smoothly. Specifically, a receiving channel for placing the rope 15 is opened inside the main body 13, and a countersunk hole is opened on the main body 13 and connected to both ends of the receiving channel. The rope 15 extends inside the receiving channel, and after the two ends of the rope 15 pass through the countersunk hole, they form a knot 14 on the outside to bind the main body 13. This solution, compared to setting the rope 15 on the outside, can make the main body 13 adhere to the mucosa layer 3 more smoothly.

[0027] Furthermore, to prevent the ends of the rope 15 from becoming stuck in the channel when the knots 14 of the rope 15 are melted using the ultrasonic scalpel 17, such as... Figure 12 d and Figure 14 As shown in d, a slot 19 is opened on the main body 13, which exposes part of the rope 15 on the main body 13. Thus, the exposed part of the rope 15 is melted by the ultrasonic scalpel 17, making it easier for the rope 15 to be removed from the receiving channel. Of course, for the scheme where the rope 15 is placed on the outside to keep the main body 13 in a straight state, a slot 19 can also be set through the main body 13 to expose part of the rope 15, so that the ultrasonic scalpel 17 can pass through the slot 19 to act on the exposed rope 15 area.

[0028] The aforementioned rope 15 can be a rigid rope 15 (non-stretchable but flexible), which overcomes the bending tendency of the main body 13 because it is non-stretchable. Alternatively, it can be an elastic rope 15, which is in a stretched state when binding the main body 13 to maintain it in a straight state. The elastic potential energy stored in the stretched rope 15 is equal to the elastic potential energy stored in the straight state of the main body 13, thereby maintaining the straight state of the main body 13. It should be further noted that the material of the main body 13 can be a metal material that is harmless to the human body and has elasticity (such as titanium-nickel alloy), and the surface edges are all designed with rounded corners so as not to scratch human tissue. The rope 15 can be made of the same material as the suture thread to ensure that it is non-toxic and does not irritate the human body.

[0029] The foregoing has shown and described the basic principles, main features, and advantages of the present invention. Those skilled in the art should understand that the present invention is not limited to the above-described embodiments. The embodiments and descriptions in the specification are merely illustrative of the principles of the invention. Various changes and modifications can be made to the invention without departing from its spirit and scope, and all such changes and modifications fall within the scope of the present invention as claimed. The scope of protection of this invention is defined by the appended claims and their equivalents.

Claims

1. An auxiliary traction device for endoscopic submucosal dissection, characterized in that, The body (13) includes at least a partially elastic body. The elastic part of the body (13) is in a curled-up state in its natural state. The body (13) has an outer arc surface with a curved shape for attaching to the internal mucosal tissue. The body (13) is also provided with a shaping device for keeping the body (13) in a state of storing elastic potential energy. When the shaping device is removed from the action on the body (13), the body (13) releases the stored elastic potential energy.

2. The auxiliary traction device for endoscopic submucosal dissection according to claim 1, characterized in that, The main body (13) is adhered to the internal mucosal tissue by means of titanium clips (5).

3. The auxiliary traction device for endoscopic submucosal dissection according to claim 1, characterized in that, The main body (13) is adhered to the internal mucosal tissue by medical tissue adhesive.

4. The auxiliary traction device for endoscopic submucosal dissection according to claim 1, characterized in that, The shaping device is a rigid rod-shaped body. The main body (13) has at least an elastic part with a channel inside for accommodating the rod-shaped body. When the rod-shaped body is in the channel, the elastic part of the main body (13) maintains a state of storing elastic potential energy. When the rod-shaped body leaves the channel, the elastic part of the main body (13) releases the elastic potential energy.

5. The auxiliary traction device for endoscopic submucosal dissection according to claim 4, characterized in that, The rod-shaped body and the channel are at least partially threaded (18).

6. The auxiliary traction device for endoscopic submucosal dissection according to claim 1, characterized in that, The shaping device is a rope (15). The two ends of the elastic part of the main body (13) are provided with through holes. After the two ends of the rope (15) pass through the through holes, they form knots (14) to bind the elastic part of the main body (13) and keep it in a state of storing elastic potential energy. The rope (15) extends on the outer arc surface of the main body (13) with a curved shape, and the knots (14) are formed on the inner arc surface of the main body (13) with a curved shape.

7. The auxiliary traction device for endoscopic submucosal dissection according to claim 1, characterized in that, The shaping device is a rope (15). The main body (13) has sink holes at both ends of the elastic part. After the two ends of the rope (15) pass through the sink holes, they form knots (14) to keep the elastic part of the main body (13) in a state of storing elastic potential energy. The main body (13) has a receiving channel inside for placing the rope (15).

8. An auxiliary traction device for endoscopic submucosal dissection according to claim 6 or 7, characterized in that, The rope (15) is either a rigid or elastic rope (15).

9. An auxiliary traction device for endoscopic submucosal dissection according to claim 6 or 7, characterized in that, The main body (13) has a slot (19) that exposes part of the rope (15) inside the main body (13) which is attached to the internal mucosal tissue.

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