Duodenal papilla incision knife tube structure and incision knife

Abstract

The utility model relates to the technical field of medical instruments, and discloses a duodenal papilla incision knife tube structure and an incision knife, the knife tube structure comprises a sheath tube assembly and a head assembly which are fixedly connected; the sheathing canal assembly comprises a sheathing canal body, an injection cavity, a shredding cavity and at least two guide wire cavities which axially penetrate through the sheathing canal body are formed in the sheathing canal body, and an injection inlet communicated with the injection cavity and a guide wire inlet communicated with each guide wire cavity are formed in the sheathing canal body; the head assembly comprises a bendable head tube, and the head tube is provided with an injection outlet communicated with the injection cavity, a shredding outlet communicated with the shredding cavity and a wire guide outlet communicated with each wire guide cavity. According to the utility model, while the injection function and the cutting function are realized, the simultaneous intubation of the bile duct and the pancreatic duct can be realized during the first intubation, or the simultaneous guide wire guiding of the right hepatic duct and the left hepatic duct can be realized, so that the operation time is shortened, and the occurrence rate of ERCP complications is reduced.

Description

Technical Field

[0001] The utility model relates to the technical field of medical instruments, in particular to a knife tube structure of a duodenal papilla cutter and a cutter. Background Art

[0002] The steps of ERCP (endoscopic retrograde pancreaticocholangiopancreatography) include inserting a duodenoscope into the patient's mouth, passing through the esophagus and stomach into the descending part of the duodenum, finding the duodenal papilla (hereinafter referred to as the papilla), and inserting a contrast catheter through the biopsy tube to the opening of the papilla. Contrast agent is then injected, and the structure of the pancreatic and bile ducts is displayed by X-ray film. Since its birth in the late 1960s, this technology has become an important treatment for pancreatic and biliary diseases. It can not only diagnose diseases such as common bile duct stones, benign and malignant biliary obstruction, and pancreatic mass, but also perform some minimally invasive treatment operations. ERCP is popular with patients because of its advantages of no surgery, less trauma, short operation time, fewer complications, and short hospitalization time. In addition, ERCP is currently recognized as the gold standard for diagnosing pancreatic and biliary diseases, and has important clinical application value for the diagnosis and treatment of unexplained obstructive jaundice, congenital biliary abnormalities, and pancreatic and biliary diseases.

[0003] Although ERCP has the above advantages in treating hepatobiliary and pancreatic diseases, its operation difficulty coefficient is relatively high. The key to the success of ERCP surgery lies in the successful selective cannulation of the pancreaticobiliary duct and sphincterotomy. Some patients directly fail the ERCP surgery due to cannulation failure. Repeated cannulation of the duodenal papilla not only prolongs the operation time and increases the surgical risk, but also easily induces acute pancreatitis, thereby increasing the cost of treatment, prolonging the hospitalization time, causing great pain to the patient, and there is a certain mortality rate. Clinically, in order to improve the success rate of papillary cannulation in ERCP surgery, guidewire-assisted papillary sphincterotomy is often used for bile duct cannulation or pancreatic duct occupation method is often used for bile duct cannulation.

[0004] At present, most of the high-frequency papillotomies used in clinical practice are equipped with a single guide wire. The channels of the high-frequency papillotomies are generally double-lumen or triple-lumen. The double-lumen is a guide wire cavity and a cutting wire cavity, and the three-lumen is a guide wire cavity, a cutting wire cavity and an injection cavity. When using this type of high-frequency papillotomy for auxiliary intubation, since only one guide wire can be placed, the direction of the guide wire cannot be controlled during auxiliary intubation, resulting in the guide wire entering the pancreatic duct during bile duct intubation, and the guide wire entering the bile duct during pancreatic duct intubation, which not only reduces the risk of invasive surgery, but also reduces the risk of invasive surgery. The success rate of selective bile and pancreatic duct cannulation increases, the operation time is prolonged, and it is easy to cause duodenal papillary edema, increasing the incidence of complications such as intraoperative bleeding and postoperative pancreatitis; it is also used in the treatment of right and left hepatic ducts. For example, when the guide wire is located in the right hepatic duct and the pathological location is in the left hepatic duct, an additional guide wire needs to be inserted. This step will repeat the auxiliary cannulation of the high-frequency papillotomy knife, and the bile duct already has a guide wire, making it even more impossible to efficiently insert the second guide wire into the left hepatic duct, thereby prolonging the operation time and increasing the incidence of ERCP complications. Utility Model Content

[0005] In view of this, the purpose of the utility model is to provide a duodenal papillotomy knife tube structure and a duodenal papillotomy knife, which has injection and cutting functions and can simultaneously cannulate the bile duct and pancreatic duct during the first cannulation, or simultaneously guide the right and left hepatic ducts with guidewires, thereby reducing the operation time and reducing the incidence of ERCP complications.

[0006] The utility model solves the above technical problems through the following technical means:

[0007] In a first aspect, the present invention discloses a blade tube structure of a duodenal papillomatomy knife, comprising a sheath assembly and a head assembly that are fixedly connected; the sheath assembly comprises a sheath body, the sheath body is provided with an injection cavity, a wire cutting cavity and at least two guide wire cavities axially penetrating the sheath body, the sheath body is provided with an injection inlet connected to the injection cavity, and a guide wire inlet connected to each guide wire cavity; the head assembly comprises a flexible head tube, the head tube is provided with an injection outlet connected to the injection cavity, a wire cutting outlet connected to the wire cutting cavity and a guide wire outlet respectively connected to each guide wire cavity.

[0008] Furthermore, the number of the guidewire cavities is two, namely the first guidewire cavity and the second guidewire cavity; the guidewire outlets include the first guidewire outlet and the second guidewire outlet, the first guidewire outlet is arranged at the end of the head tube away from the sheath body, the second guidewire outlet is arranged at the side of the head tube, and the distance between the first guidewire outlet and the second guidewire outlet is 3-5mm. With such a setting, when one of the guidewires passes through the first guidewire outlet, its direction can be consistent with the overall incision knife, and can be inserted into, for example, the pancreatic duct; the other guidewire passes through the second guidewire outlet on the side, and its direction of passing through can be at a certain angle with the incision knife, so that it can be more easily inserted into, for example, the bile duct outside the pancreatic duct, so that the guidewire is inserted more quickly and accurately.

[0009] Furthermore, the guide wire inlet includes a first guide wire connector and a second guide wire connector, and the distance from the first guide wire connector connected to the first guide wire outlet to the end of the head tube is greater than the distance from the second guide wire connector to the end of the head tube. With such an arrangement, the first guide wire connector is located near the handle assembly, and the guide wire inserted from the first guide wire connector always passes through the end of the head tube, and the other guide wire passes through the side of the head tube, which is less likely to make mistakes when the doctor performs the operation.

[0010] Further, the injection inlet is an injection connector arranged on the sheath body, and a heat shrink tube is arranged at the connection between the injection connector, the first guide wire connector, and the second guide wire connector and the sheath body. Such an arrangement enables the injection connector, the first guide wire connector, and the second guide wire connector to be sealed and firmly fixed on the sheath body. The injection connector, the first guide wire connector, and the second guide wire connector can all be Luer connectors.

[0011] Furthermore, the sheath body is a circular structure, and the sheath body has a first symmetry axis and a second symmetry axis that are perpendicular to each other, the first guidewire cavity and the second guidewire cavity are symmetrically arranged on both sides of the first symmetry axis, and the injection cavity and the wire cutting cavity are symmetrically arranged on both sides of the second symmetry axis. In this way, the first guidewire cavity and the second guidewire cavity are located on both sides of the second symmetry axis, which facilitates the two guidewires to pass through from different angles, and the success rate of intubation in surgery is higher.

[0012] Furthermore, an arc-shaped incision is provided at the outlet of the second guide wire, so that the subsequent guide wire can form a certain bevel after passing through, and the operation is more convenient.

[0013] Furthermore, the outer diameter of the head tube gradually decreases from the sheath tube assembly to the end, and the end of the head tube away from the sheath tube body is hemispherical. Such a configuration facilitates the insertion of the head assembly into the patient's body, and the hemispherical end can be inserted more smoothly into the patient's body to avoid scratching the patient's flesh.

[0014] Furthermore, the inner diameter of the injection cavity is 0.65-0.75 mm, the inner diameter of the wire cutting cavity is 0.55-0.65 mm, and the inner diameters of the first guide wire cavity and the second guide wire cavity are both 0.7-0.8 mm.

[0015] Furthermore, the head tube is also provided with a first color ink scale line and a second color ink scale line, so that medical personnel can understand the depth of the head tube inserted into the body.

[0016] In a second aspect, the present invention further discloses a duodenal papilla cutter, comprising the above-mentioned duodenal papilla cutter tube structure and a handle, wherein the handle is provided with a cutting wire and an electrode, one end of the cutting wire is electrically connected to the electrode, and the other end of the cutting wire passes through a cutting cavity and is fixedly connected to a head tube after passing through a cutting outlet.

[0017] Beneficial effects of the utility model:

[0018] When the utility model is used, it is matched with the handle, and the medical staff can use the cutting wire on the handle to bend the head tube into a certain arc, and cooperate with the rotation of the colonoscope to insert one end of the head tube into the patient's body. Because the sheath tube body has two guide wire cavities, the first guide wire cavity and the second guide wire cavity, two guide wires can be inserted, and the guide wires are inserted through the first guide wire Luer connector and the second guide wire Luer connector. If one of the guide wires has been placed in the pancreatic duct through the first guide wire outlet, the other guide wire can be directly inserted obliquely into the bile duct through the second guide wire outlet located on the side; or when one of the guide wires has been placed in the right hepatic duct through the first guide wire outlet, the other guide wire can be directly inserted obliquely into the left hepatic duct through the second guide wire outlet, thereby reducing the operation time, greatly improving the success rate of intubation, and reducing the incidence of ERCP complications. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] Figure 1 It is a structural schematic diagram of a knife tube structure of a duodenal papillomatomy knife of the present invention;

[0020] Figure 2 yes Figure 1 Schematic diagram of the structure of the middle sheath tube body;

[0021] Figure 3 yes Figure 2 Schematic diagram of the cross-sectional structure of the middle four-lumen tube;

[0022] Figure 4 yes Figure 1 A schematic diagram of the structure of the head assembly when the second guide wire outlet is on the left side;

[0023] Figure 5 yes Figure 1 A schematic diagram of the structure of the head assembly when the second guide wire outlet is on the right side;

[0024] Figure 6 yes Figure 5 A schematic diagram of the top view of the head assembly;

[0025] Figure 7 It is a schematic diagram of the duodenal papillotomy knife tube structure of the present invention when it is applied to the bile duct and pancreatic duct;

[0026] Figure 8 It is a schematic diagram of the blade tube structure of the duodenal papillotomy knife of the present invention when it is applied to the left hepatic duct and the right hepatic duct.

[0027] Among them, the sheath assembly 1, the head assembly 2, the handle 3, the first guide wire 4, the second guide wire 5,

[0028] Sheath body 11, first guide wire connector 12, injection connector 13, second guide wire connector 14, heat shrink tube 15, injection cavity 111, first guide wire cavity 112, second guide wire cavity 113, wire cutting cavity 114, first symmetry axis 115, second symmetry axis 116,

[0029] Head tube 21 , first color ink scale line 22 , shredded wire outlet 23 , second color ink scale line 24 , first guide wire outlet 25 , second guide wire outlet 26 , injection outlet 27 , shredded wire 28 . DETAILED DESCRIPTION

[0030] The utility model will be described in detail below with reference to the accompanying drawings:

[0031] Embodiment 1,

[0032] like Figure 1-Figure 6As shown, a duodenal papillomatomy knife tube structure of the present embodiment includes a sheath assembly 1 and a head assembly 2 that are fixedly connected; the sheath assembly 1 includes a sheath body 11, and the sheath body 11 is provided with an injection cavity 111, a wire cutting cavity 114 and two guide wire cavities axially penetrating the sheath body 11, the injection cavity 111, the wire cutting cavity 114 and the guide wire cavity are not interconnected, and the two guide wire cavities are respectively a first guide wire cavity 112 and a second guide wire cavity 113; the sheath body 11 is a circular structure, and the sheath body 11 has a first symmetry axis 115 and a second symmetry axis 116 that are perpendicular to each other, and the first guide wire cavity 112 and the second guide wire cavity 113 are respectively provided. 113 are symmetrically arranged on both sides of the first symmetry axis 115, and the injection cavity 111 and the wire cutting cavity 114 are symmetrically arranged on both sides of the second symmetry axis 116; wherein the inner diameter of the injection cavity 111 can be 0.65-0.75mm, the inner diameter of the wire cutting cavity 114 can be 0.55-0.65m, and the inner diameters of the first guide wire cavity 112 and the second guide wire cavity 113 can both be 0.7-0.8mm; in the present embodiment, the inner diameter of the injection cavity 111 is 0.7mm, the inner diameter of the wire cutting cavity 114 is 0.6m, and the inner diameters of the first guide wire cavity 112 and the second guide wire cavity 113 are both 0.75mm.

[0033] The sheath body 11 is provided with an injection connector 13 connected to the injection cavity 111, a first guide wire connector 12 connected to the first guide wire cavity 112, and a second guide wire connector 14 connected to the second guide wire cavity 113. The distance from the first guide wire connector 12 to the end of the head tube 21 is greater than the distance from the second guide wire connector 14 to the end of the head tube 21. A heat shrink tube 15 is sleeved at the connection between the injection connector 13, the first guide wire connector 12, the second guide wire connector 14 and the sheath body 11. The injection connector 13, the first guide wire connector 12, and the second guide wire connector 14 of this embodiment are all Luer connectors.

[0034] The head assembly 2 includes a flexible head tube 21, which may be made of medical rubber, for example. In the present embodiment, the head tube 21 and the sheath body 11 are integrally formed. To facilitate insertion of the head assembly 2 into the patient's body and avoid scratching the patient's flesh, the outer diameter of the head tube 21 gradually decreases from the sheath assembly 1 to the end, and the end of the head tube 21 away from the sheath body 11 is hemispherical. The head tube 21 is provided with an injection outlet 27 connected to the injection cavity 111, a wire cutting outlet 23 connected to the wire cutting cavity 114, and a guide wire outlet respectively connected to each guide wire cavity. To facilitate medical personnel to understand the insertion depth of the head tube 21 into the body, the head tube 21 is also provided with a first color ink scale line 22 and a second color ink scale line 24. For example, the first color ink scale line 22 may be blue, and the second color ink scale line 24 may be green.

[0035] The guide wire outlet includes a first guide wire outlet 25 and a second guide wire outlet 26. The first guide wire outlet 25 is arranged at the end of the head tube 21, and the second guide wire outlet 26 is arranged at the side of the head tube 21. Figure 4 and 5 As shown, the side here can be either the left side or the right side; in order to facilitate the subsequent guide wire to form a certain angle after passing through, an arc-shaped incision is provided at the second guide wire outlet 26, and the distance between the first guide wire outlet 25 and the second guide wire outlet 26 is 3-5mm, and 4mm in this embodiment.

[0036] The method of using the utility model is as follows:

[0037] When the utility model is used, medical personnel can match it with the handle 3, and use the wire cutter 28 on the handle 3 to bend the head tube 21 into a certain arc to match the rotation of the colonoscope. Insert one end of the head tube 21 into the patient's body through the duodenoscope, and the medical personnel can see the depth of the head tube 21 inserted into the body through the first color ink scale line 22 and the second color ink scale line 24. Because the high-frequency papillotomy knife of this embodiment has two guide wire cavities, the first guide wire cavity 112 and the second guide wire cavity 113, two guide wires can be inserted, such as Figure 7 and 8 The first guide wire 4 and the second guide wire 5 are inserted through the first guide wire connector 12 and the second guide wire Luer connector 14, as shown in FIG. Figure 7 As shown, if the first guide wire 4 has been placed in the pancreatic duct through the first guide wire outlet 25, the second guide wire 5 can be directly inserted obliquely into the bile duct through the second guide wire outlet 26 located at the side; or Figure 8 As shown, when the first guide wire 4 has been placed in the right hepatic duct through the first guide wire outlet 25, the second guide wire 5 can be directly inserted obliquely into the left hepatic duct through the second guide wire outlet 26, which can reduce the operation time and the incidence of ERCP complications.

[0038] Embodiment 2,

[0039] This embodiment is a duodenal papillotomy knife, comprising the duodenal papillotomy knife tube structure of the above-mentioned embodiment 1 and a handle 3, wherein the handle 3 is provided with a shredder 28 and an electrode, one end of the shredder 28 is electrically connected to the electrode, the other end of the shredder 28 passes through the shredder cavity 114, and is fixedly connected to the head tube 21 after passing through the shredder outlet 23. The handle 3 comprises a core rod, one end of the core rod is snap-connected with a thumb ring, the other end of the core rod is bonded with an end cap, and the sheath body 11 is fixedly connected to the end cap; a sliding handle is provided on the core rod, the sliding handle is threadedly connected with an electrode holder, and the electrode is threadedly mounted on the electrode holder. When in use, the index finger and middle finger of the medical staff can be inserted into the sliding handle, and the thumb is inserted into the thumb ring, and the head tube is bent into a certain arc by sliding the sliding handle and using the shredder.

[0040] The above embodiments are only used to illustrate the technical solution of the utility model and are not intended to limit it. Although the utility model is described in detail with reference to the preferred embodiments, those skilled in the art should understand that the technical solution of the utility model can be modified or replaced by equivalents without departing from the purpose and scope of the technical solution of the utility model, which should be included in the scope of the claims of the utility model. The technology, shape, and structure that are not described in detail in the utility model are all well-known technologies.

Claims

1. A duodenal papillomatomy knife tube structure, comprising a sheath assembly and a head assembly fixedly connected; characterized in that: The sheath assembly includes a sheath body, in which an injection cavity, a wire cutting cavity and at least two guide wire cavities are axially penetrated through the sheath body; the sheath body is provided with an injection inlet connected to the injection cavity, and a guide wire inlet connected to each guide wire cavity; the head assembly includes a bendable head tube, on which an injection outlet connected to the injection cavity, a wire cutting outlet connected to the wire cutting cavity and a guide wire outlet respectively connected to each guide wire cavity are provided.

2. The blade tube structure of the duodenal papilla cutter according to claim 1, characterized in that: The number of the guidewire cavities is two, namely the first guidewire cavity and the second guidewire cavity; the guidewire outlet includes a first guidewire outlet and a second guidewire outlet, the first guidewire outlet is arranged at the end of the head tube away from the sheath tube body, and the second guidewire outlet is arranged on the side of the head tube, and the distance between the first guidewire outlet and the second guidewire outlet is 3-5mm.

3. The blade tube structure of the duodenal papilla cutter according to claim 2, characterized in that: The guide wire inlet includes a first guide wire connector and a second guide wire connector, and the distance from the first guide wire connector connected to the first guide wire outlet to the end of the head tube is greater than the distance from the second guide wire connector to the end of the head tube.

4. The blade tube structure of the duodenal papilla cutter according to claim 3, characterized in that: The injection inlet is an injection connector arranged on the sheath body, and a heat shrink tube is arranged at the connection between the injection connector, the first guide wire connector, the second guide wire connector and the sheath body.

5. The blade tube structure of the duodenal papilla cutter according to claim 2, characterized in that: The sheath body is a circular structure, and has a first symmetry axis and a second symmetry axis perpendicular to each other. The first guidewire cavity and the second guidewire cavity are symmetrically arranged on both sides of the first symmetry axis, and the injection cavity and the wire cutting cavity are symmetrically arranged on both sides of the second symmetry axis.

6. The blade tube structure of the duodenal papilla cutter according to claim 2, characterized in that: An arc-shaped incision is arranged at the outlet of the second guide wire.

7. The blade tube structure of the duodenal papilla cutter according to claim 1, characterized in that: The outer diameter of the head tube gradually decreases from the sheath tube assembly to the end portion, and one end of the head tube away from the sheath tube body is hemispherical.

8. The blade tube structure of the duodenal papilla cutter according to claim 2, characterized in that: The inner diameter of the injection cavity is 0.65-0.75 mm, the inner diameter of the wire cutting cavity is 0.55-0.65 mm, and the inner diameters of the first guide wire cavity and the second guide wire cavity are both 0.7-0.8 mm.

9. The blade tube structure of the duodenal papilla cutter according to claim 1, characterized in that: The head tube is also provided with first color ink scale lines and second color ink scale lines.

10. A duodenal papillomatomy knife, characterized in that: It comprises a duodenal papilla cutter tube structure and a handle as described in any one of claims 1-9, wherein the handle is provided with a cutting wire and an electrode, one end of the cutting wire is electrically connected to the electrode, and the other end of the cutting wire passes through a cutting cavity and is fixedly connected to a head tube after passing through a cutting outlet.

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