Endoscopic minimally invasive transmural interventional operation incision device with step-by-step expansion function

Abstract

The utility model relates to an endoscopic minimally invasive transmural interventional operation incision device with a step-by-step expansion function, which comprises a handle part, a step-by-step expansion part, a cutter head and a guide wire, one end of the step-by-step expansion part is connected with the handle part, the other end of the step-by-step expansion part is connected with the cutter head, and the cutter head is conical; the guide wire penetrates in from the handle part and penetrates out from the scalpel head through the step-by-step expansion part. The utility model has the advantages that due to the design of the short and small conical cutter head, a transmural incision is small, the electric cautery range is small, the trauma of an endoscopic minimally invasive intervention transmural operation is obviously reduced, the accuracy of approach incision is improved, the risks of bleeding, infection and other serious diseases are greatly reduced, and the success rate of the operation is improved; the step-by-step, segmented and step-by-step expansion design is adopted, it is ensured that step-by-step expansion is implemented while incision is conducted, instruments do not need to be replaced, the operation process and steps are greatly simplified, the operation risk is reduced, and the operation cost is saved; due to the sectional fusiform expansion design, expansion propelling is smooth, expansion resistance is reduced, and operation difficulty is lowered.

Description

Technical Field

[0001] The utility model relates to the technical field of medical devices, and more specifically to an endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function. Background Art

[0002] In recent years, as traditional surgical operations have gradually developed towards minimally invasive procedures, minimally invasive interventional techniques such as digestive endoscopy have become increasingly the preferred method for the treatment of certain complex diseases, especially lesions of organs around the digestive tract. Minimally invasive transmural surgery through the digestive tract has gradually become the mainstream method for completing disease treatment. These technologies break through the barriers of the digestive tract wall and create minimally invasive access or connecting channels for adjacent digestive tract luminal structures, thereby providing a safe and feasible minimally invasive treatment approach for these special lesions.

[0003] However, in the implementation of minimally invasive transmural interventional surgery through digestive endoscopy, the most important step is the establishment of the interventional approach. The common steps are to select a suitable position under the guidance of the endoscope, puncture the target lesion under direct endoscopy or EUS guidance, use a cutter to establish the digestive tract-target organ cavity channel, and then expand along the guide wire to expand the puncture point cavity of the digestive tract wall, and then complete the next step, such as entering the abdominal cavity for lesion resection, placement of drainage, abdominal cavity necrotic tissue debridement and lavage, etc. Therefore, this step is the most critical step for the safe implementation of the operation.

[0004] At present, in the process of establishing minimally invasive transmural interventional surgical approaches through digestive endoscopy, the existing technical methods have serious deficiencies and need to be improved urgently:

[0005] 1. There are deficiencies in the incision technique at the transmural entrance;

[0006] The first step in implementing minimally invasive transmural interventional surgery with digestive endoscopy is the transmural incision of the entry port, which is also the most critical step and the step with the most complications, directly affecting the success or failure of the interventional surgery. Selecting the right incision knife for reasonable incision is the key to preventing serious complications. When implementing this step, the most serious complication is bleeding, because there are abundant blood vessels (some are arterial blood vessels) around the wall of the digestive tract and its abdominal cavity, which can cause massive bleeding if not handled with care, and in severe cases can lead to the death of the patient. Therefore, moderate and precise incision is the key to reducing complications. The incision requires that the incision be as small as possible, and the incision path must strictly follow the preset guide wire path to reduce or avoid the occurrence of complications.

[0007] However, the existing transmural surgical incision knives have shortcomings: (1) Needle knife or Lassie knife incision: These two types of knives are tools for ERCP papillary incision. They have long blades and the axis of incision deviates from the axis of the preset guide wire. Therefore, it is difficult to control accurately and it is very easy to damage blood vessels and cause heavy bleeding or excessive incision leading to serious complications such as gastrointestinal leakage; (2) Annular cyst incision: This type of knife is designed for pancreatic cyst drainage and consists of a catheter with a circular knife at the tip. Compared with the needle knife or Lasker knife, the removal of the long lateral blade wire improves the axial incision accuracy, but the blade head is too thick (10F) and too round and blunt, with low incision efficiency and large incision resistance. In addition, the blade head has a large outer diameter, the tube diameter is too thick, and the electrocuting area is too large, which can easily lead to accidental injury to surrounding blood vessels during surgery and cause massive bleeding. The incision diameter is too large and can easily cause abdominal leakage and lead to serious infection. The large contact surface requires a larger electrocuting power, the resistance is too high, and the tube diameter is too thick and hard, which increases the difficulty of operation. In addition, it is a single-cavity design, and it is impossible to achieve synchronous angiography during surgery, so it cannot be combined with X-ray guidance, and it is difficult to ensure accuracy and safety.

[0008] 2. The transmural approach expansion technique has shortcomings;

[0009] After the transmural incision, the second step is the precise dilation of the transmural channel. The current implementation method is to leave the scalpel wire after the incision, withdraw the incision knife, and then use the dilation bougie or columnar water balloon for dilation. Step-by-step dilation requires repeated replacement of instruments, 5F, 6F, 7F, 8.5F... and other step-by-step dilations. The steps are cumbersome, and repeated replacement of instruments can easily lead to serious complications such as guide wire detachment or abdominal fistula, and even cause surgical failure.

[0010] In summary, minimally invasive transmural interventional surgery under digestive endoscopy urgently needs to develop an incision knife with a short blade, precise and safe incision, and a step-by-step expansion function (integrating incision and expansion into one), so as to simplify the operation steps and improve the safety of the operation.

[0011] The preceding description is intended to provide general background information and does not necessarily constitute prior art. Utility Model Content

[0012] The utility model aims to provide an endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function, which improves the accuracy and safety of digestive endoscopic minimally invasive transmural interventional surgery and simplifies the surgical operation steps.

[0013] The utility model provides an endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function, comprising a handle portion, a step-by-step expansion portion, a knife head and a guide wire, wherein one end of the step-by-step expansion portion is connected to the handle portion, and the other end of the step-by-step expansion portion is connected to the knife head, and the knife head is tapered; the guide wire penetrates from the handle portion, passes through the step-by-step expansion portion, and exits from the knife head.

[0014] By adopting the above technical solution, the blade head is designed to be conical, which is smaller and shorter than the traditional blade head; at the same time, the diameter of the blade head is 4Fr, and the diameter of the widest part of the bottom surface is 6Fr (F), which is significantly smaller than the various cutting knives currently on the market, so that the electric cutting opening trauma is small and safe, and can ensure the smooth passage of various types of guide wires currently available; at the same time, the conical blade head is designed to be 2mm long, and the conical design of the blade head controls the thermal burning range of the cutting knife within a very small range, avoiding accidental injury to surrounding blood vessels and reducing the occurrence of complications such as bleeding.

[0015] Furthermore, the handle portion includes a handle body, an electrode interface, a handle body, an injection cavity and a guidewire cavity screw cap, one end of the handle body is connected to the step-by-step expansion portion, the sides of the handle body are respectively connected to the electrode interface and the injection cavity, the other end of the handle body is connected to the handle body, and the other end of the handle body is connected to the guidewire cavity screw cap; a guidewire cavity is provided in the guidewire cavity screw cap, the handle body, the handle body and the step-by-step expansion portion, the guidewire passes through the guidewire cavity and is fixed and tightened by the guidewire cavity screw cap.

[0016] By adopting the above technical solution, the guidewire cavity can be smoothly compatible with the guidewire for operation. The spiral cap design of the guidewire cavity at the top can not only prevent the sliding of the guidewire during operation, but also prevent the overflow of contrast agent when injecting; the electrode interface on the side of the handle body is used to connect the electrode, and the injection cavity is used for injection / withdrawal drainage cavity to ensure that contrast agent can be injected or flushed and drained at any time during the operation, reducing frequent instrument replacement.

[0017] Further, the step-by-step expansion portion includes a first catheter platform portion, a first expansion portion, a second catheter platform portion, a second expansion portion and a third catheter platform portion; the first catheter platform portion, the first expansion portion, the second catheter platform portion, the second expansion portion and the third catheter platform portion are sequentially connected to form the step-by-step expansion portion; the first catheter platform portion, the second catheter platform portion and the third catheter platform portion are all in the shape of a circular tube, and the outer diameters of the first expansion portion and the second expansion portion gradually increase in the direction from the blade head to the handle portion.

[0018] By adopting the above technical solution, the traditional design of the existing incision knife with a constant diameter is changed, and the knife body material is selected from the same material as the expansion bougie, and the outer diameter of the knife body is changed to a step-by-step segmented expansion design. Each section of the expansion catheter with different outer diameters is composed of a shuttle-shaped expansion part (a first expansion part and a second expansion part) and a constant diameter platform part (a first catheter platform part, a second catheter platform part and a third catheter platform part). This can ensure that the incision is immediately expanded step by step at the same time, without the need to replace the instrument, simplifying the operation steps, and the segmented shuttle-shaped expansion design makes the expansion proceed smoothly and reduces the expansion resistance.

[0019] Furthermore, the outer diameter of the first catheter platform portion is the same as the minimum outer diameter of the first expansion portion, the outer diameter of the second catheter platform portion is the same as the maximum outer diameter of the first expansion portion, the minimum outer diameter of the second expansion portion is the same as the outer diameter of the second catheter platform portion, and the maximum outer diameter of the second expansion portion is the same as the outer diameter of the third catheter platform portion.

[0020] Furthermore, the outer diameter of the first catheter platform portion is 6F, the maximum outer diameter of the first expansion portion is 7F, the outer diameter of the second catheter platform portion is 7F, the maximum outer diameter of the second expansion portion is 8.5F, and the outer diameter of the third catheter platform portion is 8.5F.

[0021] Furthermore, the lengths of the first expansion portion and the second expansion portion are both 3 cm, the length of the first catheter platform portion is 5 cm, and the length of the second catheter platform portion is 2 cm.

[0022] Furthermore, a metal identification ring is provided at a position on the second catheter platform close to the first expansion part and at a position on the third catheter platform close to the second expansion part, so as to accurately determine the expansion position during the operation and ensure the accuracy, smoothness and safety of the operation.

[0023] The utility model discloses an endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function. The short and small conical blade head design makes the transmural incision small and the electric heat burning range small, which significantly reduces the trauma of endoscopic minimally invasive interventional transmural surgery, improves the accuracy of the approach incision, greatly reduces the risk of bleeding, infection and other serious complications, and improves the success rate of the operation; adopts a step-by-step segmented expansion design, which ensures that step-by-step expansion is implemented at the same time as the incision, without the need to replace the instrument, greatly simplifies the operation process and steps, reduces the operation risk, and saves the operation cost; the segmented shuttle-shaped expansion design makes the expansion advance smoothly, reduces the expansion resistance, and reduces the difficulty of operation; the design of the metal identification ring ensures accurate positioning during the operation and ensures that the operation is carried out accurately and smoothly; the double-lumen design of the guide wire cavity is added to ensure that the contrast agent is injected and developed at the same time as the incision, provides more guidance information for the transmural interventional surgery, and improves the operation accuracy; at the same time, the injection channel can also be used to perform aspiration decompression, flushing and drainage, etc., to give full play to the rich interventional surgery functions of the patent. BRIEF DESCRIPTION OF THE DRAWINGS

[0024] Figure 1 A schematic plan view of the structure of an endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function provided in an embodiment of the utility model.

[0025] Figure 2 for Figure 1 Another schematic diagram of the planar structure of the incision device for minimally invasive transmural interventional surgery under endoscopy.

[0026] Figure 3 for Figure 2 Enlarged view of part B in the middle.

[0027] Figure 4 for Figure 2 Enlarged view of part A in the middle.

[0028] The reference numerals and components involved in the drawings are as follows:

[0029] 1. Handle 11, handle body 12, electrode interface

[0030] 13. Handle body 14. Injection cavity 15. Guidewire cavity screw cap

[0031] 2. Step-by-step expansion section 21, first catheter platform section 22, first expansion section

[0032] 23. Second catheter platform portion 24. Second expansion portion 25. Third catheter platform portion

[0033] 3. Blade head 4. Guide wire DETAILED DESCRIPTION

[0034] The following is a further detailed description of the specific implementation of the present invention in conjunction with the accompanying drawings and examples. The following examples are used to illustrate the present invention, but are not intended to limit the scope of the present invention.

[0035] The terms "first", "second", "third", "fourth" and the like in the specification and claims of the present utility model are used to distinguish similar objects and are not necessarily used to describe a specific order or sequence.

[0036] Example 1

[0037] Figure 1 This is a schematic diagram of the planar structure of an endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function provided by an embodiment of the utility model. Figure 1The endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function provided by an embodiment of the utility model comprises a handle portion 1, a step-by-step expansion portion 2, a blade head 3 and a guide wire 4, one end of the step-by-step expansion portion 2 is connected to the handle portion 1, and the other end of the step-by-step expansion portion 2 is connected to the blade head 3, and the blade head 3 is tapered; the guide wire 4 penetrates from the handle portion 1, passes through the step-by-step expansion portion 2, and exits from the blade head 3.

[0038] It should be noted that the blade head 3 of the present invention is conical, which is smaller and shorter than the traditional blade head 3; specifically, the head diameter of the blade head 3 is 4Fr, and the widest diameter of the bottom surface is 6Fr (F), which is significantly smaller than the various cutting knives currently on the market, so that the electric incision opening is small and safe, and can ensure the smooth passage of various types of guide wires currently available; at the same time, the length of the conical blade head 3 is designed to be 2mm, and the conical design of the blade head 3 controls the thermal burning range of the cutting knife within a very small range, avoiding accidental injury to surrounding blood vessels and reducing the occurrence of complications such as bleeding; the working principle of the present invention is the same as the endoscopic minimally invasive transmural interventional surgical incision device in the prior art, so it will not be elaborated here.

[0039] Figure 2 for Figure 1 Another schematic diagram of the planar structure of the incision device for minimally invasive transmural interventional surgery under endoscopy. Figure 3 for Figure 2 Enlarged view of middle part B. Please refer to Figure 2 , Figure 3 The handle portion 1 provided in the embodiment of the utility model includes a handle body 11, an electrode interface 12, a handle body 13, an injection cavity 14 and a guide wire cavity screw cap 15, one end of the handle body 11 is connected to the step-by-step expansion portion 2, the sides of the handle body 11 are respectively connected to the electrode interface 12 and the injection cavity 14, the other end of the handle body 11 is connected to the handle body 13, and the other end of the handle body 13 is connected to the guide wire cavity screw cap 15; a guide wire cavity (not shown in the figure) is provided in the guide wire cavity screw cap 15, the handle body 13, the handle body 11 and the step-by-step expansion portion 2, and the guide wire 4 passes through the guide wire cavity and is fixed and tightened by the guide wire cavity screw cap 15.

[0040] It should be noted that the guidewire cavity can be smoothly compatible with the guidewire 4 for operation, and the guidewire cavity screw cap 15 design at the top can not only prevent the guidewire 4 from sliding during operation, but also prevent overflow when injecting contrast agent; the electrode interface 12 on the side of the handle body 11 is used to connect the electrode, and the injection cavity 14 is used for injection / withdrawal drainage cavity to ensure that contrast agent can be injected or flushed and drained at any time during the operation, reducing frequent instrument replacement.

[0041] Figure 4 for Figure 2 Enlarged view of center A. Please refer to Figure 4The step-by-step expansion portion 2 provided in the embodiment of the utility model includes a first catheter platform portion 21, a first expansion portion 22, a second catheter platform portion 23, a second expansion portion 24 and a third catheter platform portion 25; the first catheter platform portion 21, the first expansion portion 22, the second catheter platform portion 23, the second expansion portion 24 and the third catheter platform portion 25 are sequentially connected to form the step-by-step expansion portion 2; the first catheter platform portion 21, the second catheter platform portion 23 and the third catheter platform portion 25 are all in the shape of a circular tube, and the outer diameters of the first expansion portion 22 and the second expansion portion 24 gradually increase along the direction from the blade head 3 to the handle portion 1.

[0042] Specifically, the outer diameter of the first catheter platform portion 21 is the same as the minimum outer diameter of the first expansion portion 22, the outer diameter of the second catheter platform portion 23 is the same as the maximum outer diameter of the first expansion portion 22, the minimum outer diameter of the second expansion portion 24 is the same as the outer diameter of the second catheter platform portion 23, and the maximum outer diameter of the second expansion portion 24 is the same as the outer diameter of the third catheter platform portion 25; the outer diameter of the first catheter platform portion 21 is 6F, the maximum outer diameter of the first expansion portion 22 is 7F, the outer diameter of the second catheter platform portion 23 is 7F, the maximum outer diameter of the second expansion portion 24 is 8.5F, and the outer diameter of the third catheter platform portion 25 is 8.5F; the lengths of the first expansion portion 22 and the second expansion portion 24 are both 3cm, the length of the first catheter platform portion 21 is 5cm, and the length of the second catheter platform portion 23 is 2cm.

[0043] It should be noted that the utility model changes the traditional design of the existing incision knife with a constant diameter, and uses the same material as the expansion bougie as the knife body material, and changes the outer diameter of the knife body to a step-by-step segmented expansion design (6F-7F-8.5F). Each segment of the expansion catheter with different outer diameters is composed of a 3 cm long fusiform expansion portion (a first expansion portion 22 and a second expansion portion 24) and a constant diameter platform portion (a first catheter platform portion 21, a second catheter platform portion 23 and a third catheter platform portion 25). This can ensure that the incision is immediately expanded step by step without the need to replace the instrument, simplifying the operating steps, and the segmented fusiform expansion design makes the expansion proceed smoothly and reduces the expansion resistance.

[0044] Further references Figure 4 In the present invention, a metal identification ring is provided on the second catheter platform portion 23 at a position close to the first expansion portion 22 and on the third catheter platform portion 25 at a position close to the second expansion portion 24 .

[0045] It should be noted that the metal identification ring is designed to accurately determine the expansion position during surgery, ensuring that the surgery is accurate, smooth and safe.

[0046] Based on the above description, it can be seen that the advantages of the utility model are:

[0047] 1. The utility model has a step-by-step expansion function for the endoscopic minimally invasive transmural interventional surgery incision device. The short and small conical blade head design makes the transmural incision small and the electric heat cauterization range small, which significantly reduces the trauma of endoscopic minimally invasive transmural interventional surgery, improves the accuracy of the approach incision, greatly reduces the risk of bleeding, infection and other serious complications, and improves the success rate of the operation;

[0048] 2. The endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function of the utility model adopts a step-by-step segmented and step-by-step expansion design. This design ensures that step-by-step expansion is implemented simultaneously during incision without the need to replace instruments, greatly simplifying the operation process and steps, reducing operation risks, and saving surgical costs;

[0049] 3. The utility model has a step-by-step expansion function for minimally invasive transmural interventional surgery under endoscopy. The segmented fusiform expansion design makes the expansion smooth, reduces the expansion resistance, and reduces the difficulty of operation;

[0050] 4. The utility model has a step-by-step expansion function for minimally invasive transmural interventional surgery under endoscopy. The design of the metal identification ring ensures accurate positioning during surgery and ensures accurate and smooth surgery.

[0051] 5. The endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function of the utility model adds a double-lumen design of the guide wire lumen to ensure that contrast agent injection and development are performed simultaneously during incision, providing more guiding information for transmural interventional surgery and improving operational accuracy; at the same time, the injection channel can also be used to perform back suction decompression, flushing and drainage, etc., giving full play to the rich interventional surgical functions of the patent.

[0052] The above is only a specific implementation of the utility model, but the protection scope of the utility model is not limited thereto. Any technician familiar with the technical field can easily think of changes or substitutions within the technical scope disclosed by the utility model, which should be included in the protection scope of the utility model. Therefore, the protection scope of the utility model should be based on the protection scope of the claims.

Claims

1. An endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function, characterized in that: The invention comprises a handle portion (1), a stepwise expansion portion (2), a blade head (3) and a guide wire (4); one end of the stepwise expansion portion (2) is connected to the handle portion (1), and the other end of the stepwise expansion portion (2) is connected to the blade head (3); the blade head (3) is tapered; the guide wire (4) passes through the handle portion (1), passes through the stepwise expansion portion (2), and exits from the blade head (3).

2. The endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function according to claim 1, characterized in that: The handle portion (1) comprises a handle body (11), an electrode interface (12), a handle body (13), an injection cavity (14) and a guide wire cavity screw cap (15); one end of the handle body (11) is connected to the stepwise expansion portion (2); the side surfaces of the handle body (11) are respectively connected to the electrode interface (12) and the injection cavity (14); the other end of the handle body (11) is connected to the handle body (13); and the other end of the handle body (13) is connected to the guide wire cavity screw cap (15); The guidewire cavity screw cap (15), the handle body (13), the handle main body (11) and the step-by-step expansion portion (2) are all provided with a guidewire cavity, and the guidewire (4) passes through the guidewire cavity and is fixed and tightened by the guidewire cavity screw cap (15).

3. The endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function according to claim 1, characterized in that: The step-by-step expansion portion (2) comprises a first catheter platform portion (21), a first expansion portion (22), a second catheter platform portion (23), a second expansion portion (24) and a third catheter platform portion (25); The first conduit platform portion (21), the first expansion portion (22), the second conduit platform portion (23), the second expansion portion (24) and the third conduit platform portion (25) are sequentially connected to form the step-by-step expansion portion (2); The first catheter platform portion (21), the second catheter platform portion (23) and the third catheter platform portion (25) are all in the shape of a circular tube, and the outer diameters of the first expansion portion (22) and the second expansion portion (24) gradually increase in a direction from the blade head (3) to the handle portion (1).

4. The endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function according to claim 3, characterized in that: The outer diameter of the first catheter platform portion (21) is the same as the minimum outer diameter of the first expansion portion (22), the outer diameter of the second catheter platform portion (23) is the same as the maximum outer diameter of the first expansion portion (22), the minimum outer diameter of the second expansion portion (24) is the same as the outer diameter of the second catheter platform portion (23), and the maximum outer diameter of the second expansion portion (24) is the same as the outer diameter of the third catheter platform portion (25).

5. The endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function according to claim 4, characterized in that: The outer diameter of the first catheter platform portion (21) is 6F, the maximum outer diameter of the first expansion portion (22) is 7F, the outer diameter of the second catheter platform portion (23) is 7F, the maximum outer diameter of the second expansion portion (24) is 8.5F, and the outer diameter of the third catheter platform portion (25) is 8.5F.

6. The endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function according to claim 4, characterized in that: The lengths of the first expansion portion (22) and the second expansion portion (24) are both 3 cm, the length of the first catheter platform portion (21) is 5 cm, and the length of the second catheter platform portion (23) is 2 cm.

7. The endoscopic minimally invasive transmural interventional surgical incision device with a step-by-step expansion function according to claim 4, characterized in that: A metal identification ring is provided at a position on the second catheter platform portion (23) close to the first expansion portion (22) and at a position on the third catheter platform portion (25) close to the second expansion portion (24).

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