Novel incision knife facilitating ERCP (endoscopic retrograde cholangiopancreatography) intubation

Abstract

The utility model relates to a novel incision knife convenient for ERCP (endoscopic retrograde cholangiopancreatography) intubation, which comprises an operating machine body, an integrated sleeve, an elastic sheet and a guide wire component, the integrated sleeve is connected with the operating machine body and comprises a first sleeve and a flexible sleeve, the end part of the first sleeve is connected with the flexible sleeve, the end surface of the flexible sleeve is arc-shaped, the peripheral surface of the first sleeve is provided with a guide wire port, and the elastic sheet is arranged on the guide wire port. The guide wire assembly comprises a guide wire and an electric cutting assembly, the guide wire extends into the first sleeve from the guide wire opening, the guide wire extends out of the peripheral face, close to the first sleeve, of the flexible sleeve and is fixedly connected to the peripheral face, close to the end, of the flexible sleeve, the electric cutting assembly is used for supplying power to the guide wire, and a transverse groove extending in the axis direction of the flexible sleeve is formed in the flexible sleeve. The inlet is formed between the bottom of the transverse groove and the flexible sleeve, the elastic piece stretches into the transverse groove from the inlet to be fixed, and during operation, the flexible sleeve can advance along the cavity only through proper force, and mucosa of the cavity cannot be damaged.

Description

Technical Field

[0001] The utility model belongs to the technical field of medical equipment, and in particular relates to a novel incision knife which is convenient for ERCP intubation. Background Art

[0002] Endoscopic retrograde cholangiopancreatography is an advanced endoscopic minimally invasive technique that is commonly used for the examination, diagnosis, and treatment of biliary and pancreatic diseases. Successful selective bile duct cannulation is the starting step of all ERCP operations, and it is also the most difficult, most critical, and most prone to complications. The duodenal papilla varies greatly. When intubation is difficult during ERCP, the duodenal papilla is mostly: long nose papilla, flabby papilla, paradiverticular papilla, papilla displacement, and intestinal deformation. Different intubation strategies may be adopted for different papilla morphologies. A good intubation knife is the key to the success of ERCP surgery. The incision knife commonly used in clinical practice is the bow knife, which has a thin and hard head. Direct intubation is likely to create a false passage, which is not conducive to direct deep intubation. Currently, ERCP surgeons use two methods for endoscopic intubation: the first involves slightly inserting the endoscopic blade into the papilla, adjusting its direction by pulling the endoscopic bowel and manipulating the guidewire for deep intubation. The second method involves slightly inserting the endoscopic blade into the papilla, performing an angiography, and then guiding the intubation using fluoroscopic guidance based on the angiography. However, this method is less commonly used due to the risk of pancreatitis. Intubation over a guidewire can improve intubation success rates and reduce pancreatitis complications. However, this method places high demands on the assistant handling the guidewire. Because the endoscopic blade is placed too shallowly into the papilla, the guidewire can easily push the blade out of the papilla. Furthermore, repeated insertion and withdrawal of the guidewire can cause papillary edema, leading to pancreatitis and intubation failure. If the surgeon can advance the endoscopic blade deeper into the biliary tract during intubation, or even achieve successful intubation directly without damaging the biliary mucosa, the success rate of intubation can be greatly improved and the incidence of pancreatitis can be reduced. Utility Model Content

[0003] In view of the deficiencies in the prior art, the technical problem to be solved by the present invention is to provide a new type of incision knife that is convenient for ERCP intubation, has good cavity compliance, and appropriate force will not cause bile duct wall damage.

[0004] In order to solve the above technical problems, the technical solution adopted by the utility model is: a new type of incision knife for facilitating ERCP intubation, including an operating body, a collection sleeve, a spring and a guide wire assembly, the collection sleeve is connected to the operating body, the collection sleeve includes a first sleeve and a flexible sleeve, the end of the first sleeve is connected to the flexible sleeve, the end face of the flexible sleeve is arc-shaped, the circumferential surface of the first sleeve has a guide wire port, the guide wire assembly includes a guide wire and an electric cutting assembly, the guide wire extends into the first sleeve from the guide wire port, the guide wire extends from the circumferential surface of the flexible sleeve close to the first sleeve and is fixedly connected to the circumferential surface of the flexible sleeve close to the end, the electric cutting assembly is used to power the guide wire, a transverse groove extending along the axial direction of the flexible sleeve is formed in the flexible sleeve, an inlet is provided between the bottom of the transverse groove and the flexible sleeve, and the spring extends from the inlet into the transverse groove for fixation.

[0005] Furthermore, the novel cutting knife also includes a Teflon ring, the flexible sleeve has an annular groove formed on its circumference, the inlet is located in the annular groove, the Teflon ring has an inclined notch formed on its circumference, and the Teflon ring is sleeved in the annular groove.

[0006] Furthermore, the guide wire assembly also includes a mounting seat and a pull handle, the mounting seat is connected to the circumference of the operating body, the mounting seat has a mounting hole, the pull handle is installed in the mounting hole, and the other end of the guide wire is fixedly connected to the pull handle.

[0007] Furthermore, a hose is provided on the outer peripheral surface of the guide wire located outside the first sleeve.

[0008] Furthermore, the electrosurgical cutting assembly includes a conductive wire, which is located in the first sleeve and extends to the guide wire port to be electrically connected to the guide wire. The operating body has an electrical connector on its periphery, which is electrically connected to the conductive wire.

[0009] Furthermore, a movable knife assembly is provided in the collective sleeve, and the movable knife assembly includes a plurality of connecting joints, a needle knife, a connecting line, a spring and a driving body, and the plurality of connecting joints are connected in sequence;

[0010] The connecting joint includes an upper cylinder and a lower cylinder, the upper cylinder is connected to the upper surface of the lower cylinder, the diameter of the upper cylinder is smaller than the diameter of the lower cylinder, a chamber is formed in the connecting joint, the lower opening diameter of the chamber is larger than the diameter of the upper cylinder, the circumference of the upper cylinder is formed with a rotating shaft on both sides near the upper end, sliding channels are formed on both sides of the chamber, the rotating shaft is located in the sliding channel and is slidably connected, the rotating shaft can rotate in the sliding channel, the upper surface of the chamber has a through hole, a spring is arranged between adjacent connecting joints, the spring is located in the chamber, one end of the spring is against the surface of the chamber of one of its connecting joints, and the other end of the spring is against the upper surface of the other connecting joint, the needle knife is fixedly arranged on the upper surface of the uppermost connecting joint, one end of the connecting line is fixedly connected to the uppermost connecting joint and passes through the through holes of multiple connecting joints in sequence and is fixedly connected to the output end of the driving body, and the lower surface of the connecting joint at the bottom is against the surface of the operating fuselage.

[0011] Furthermore, a slit is formed on the upper surface of the flexible sleeve, and the needle knife extends out of or retracts from the slit.

[0012] Compared with the prior art, the present invention has the following beneficial effects:

[0013] In the utility model, a commonly used PTFE collective sleeve is changed into a combination of a first sleeve (PTFE material) and a flexible sleeve (rubber material). The end face of the flexible sleeve is arc-shaped. During operation, only appropriate force is needed to advance along the cavity without damaging the cavity mucosa. When the surgical site has fewer bends, shrapnel can also be filled in the transverse groove of the flexible sleeve to make it have a certain hardness, so that it can better adapt to the needs of the current environment. BRIEF DESCRIPTION OF THE DRAWINGS

[0014] Figure 1 It is a schematic diagram of the three-dimensional structure of the utility model;

[0015] Figure 2 This is a side structural diagram of the present utility model;

[0016] Figure 3 This is a side view of the structure of the flexible sleeve bent to form a knife bow in the utility model;

[0017] Figure 4 This is a schematic cross-sectional view of the flexible sleeve in Example 1 of the present utility model;

[0018] Figure 5 This is a schematic cross-sectional view of the flexible sleeve in Example 2 of the present utility model;

[0019] Figure 6 This is a schematic cross-sectional structural diagram of multiple connection joints in Example 2 of the present utility model.

[0020] Markings in the figure: 1. Operating body; 11. Mounting seat; 12. Electrical connector; 2. Collective sleeve; 21. First sleeve; 211. Guide wire port; 212. Liquid injection port; 22. Flexible sleeve; 3. Shrapnel; 4. Teflon ring; 5. Guide wire assembly; 51. Guide wire; 52. Pull handle; 6. Moving knife assembly; 61. Connecting section; 611. Upper cylinder; 612. Lower cylinder; 613. Chamber; 614. Sliding channel; 615. Rotating shaft; 616. Spring; 62. Needle knife; 63. Connecting line. DETAILED DESCRIPTION

[0021] In order to make the above features and advantages of the present invention more obvious and easy to understand, embodiments are given below with reference to the accompanying drawings for detailed description. Example

[0022] like Figures 1-4 As shown, this embodiment provides a new type of incision knife that facilitates ERCP intubation, including an operating body 1, a collection sleeve 2, a spring 3, a Teflon ring 4 and a guide wire assembly 5.

[0023] The operating body 1 has three grip rings, and the integrated sleeve 2 is connected to the operating body 1. The integrated sleeve 2 comprises a first sleeve 21 and a flexible sleeve 22. The first sleeve 21 is made of PTFE, while the flexible sleeve 22 is made of rubber, resin, or other materials. The end of the first sleeve 21 is connected to the flexible sleeve 22. The flexible sleeve 22 is made of a material similar to rubber tubing, which makes it highly elastic and flexible, allowing it to better adapt to physiological changes and transmit force to the incision tip through the cavity. This excellent elasticity and flexibility allows the incision tip to have a wider angle of extension and rotation, making it more adaptable to nipple variations.

[0024] The end surface of the flexible sleeve 22 is arc-shaped, which has good cavity compliance and will not cause bile duct wall damage when applied with appropriate force. The first sleeve 21 has a guide wire port 211 and a liquid injection port 212 on its circumference.

[0025] The guide wire assembly 5 includes a guide wire 51, a mounting seat 11, a pull handle 52 and an electric cutting assembly. The guide wire 51 extends from the guide wire port 211 into the first sleeve 21. The guide wire 51 extends from the circumference of the flexible sleeve 22 near the first sleeve 21 and is fixedly connected to the circumference of the flexible sleeve 22 near the end. Under normal conditions, the guide wire 51 is attached to the surface of the flexible sleeve 22. The mounting seat 11 is connected to the circumference of the operating body 1. The mounting seat 11 has a mounting hole. The pull handle 52 is installed in the mounting hole. The other end of the guide wire 51 is fixedly connected to the pull handle 52. Specifically, the outer circumference of the guide wire 51 located outside the first sleeve 21 is covered with a hose. By pulling the pull handle 52, the flexible sleeve 22 is bent to form a bow-shaped knife.

[0026] The electric cutting assembly is used to power the guide wire 51. The electric cutting assembly includes a conductive wire, which is located in the first sleeve 21 and extends to the guide wire port 211 to be electrically connected to the guide wire 51. The operating body 1 has an electrical connector 12 on its periphery, which is electrically connected to the conductive wire. The electric cutting assembly and the guide wire 51 are the high-frequency electric knife in the prior art, which is an electrosurgical instrument that replaces a mechanical scalpel for tissue cutting. It heats the tissue when the high-frequency high-voltage current generated by the effective electrode tip contacts the body, achieving separation and coagulation of the body tissue, thereby achieving the purpose of cutting and stopping bleeding.

[0027] A transverse groove extending along the axial direction of the flexible sleeve 22 is formed in the flexible sleeve 22, and an inlet is provided between the bottom of the transverse groove and the flexible sleeve 22. The shrapnel 3 extends from the inlet into the transverse groove for fixation. Specifically, an annular groove is formed on the peripheral surface of the flexible sleeve 22, and the inlet is located in the annular groove. An inclined notch is formed on the peripheral surface of the Teflon ring 4, and the Teflon ring 4 is sleeved in the annular groove. When the surgical site has fewer bends, the shrapnel 3 can also be filled in the transverse groove of the flexible sleeve 22 to give it a certain hardness, so that it can better adapt to the needs of the current environment. The setting of the Teflon ring can ensure that the shrapnel 3 will not slip out from the inlet of the annular groove during operation.

[0028] In this embodiment, the commonly used PTFE collective cannula 2 is modified into a combination of a first cannula 21 (PTFE) and a flexible cannula 22 (rubber). The end surface of the flexible cannula 22 is arc-shaped. During operation, only moderate force is required to advance along the cavity without damaging the luminal mucosa. The flexible cannula 22 also reduces the risk of false passages. Compared with a rigid blade, the flexible cannula 22 reduces the risk of false passages. The probability of deep intubation is increased, and combined with the guidewire 51 for intubation, false passages caused by force can be reduced.

[0029] In this embodiment, after the handle 52 is pulled, the flexible sleeve 22 bends to form a knife bow. Since the operating body 1, the collection sleeve 2 and the guide wire 51 are fixedly connected together, during the operation, the operating body 1 can be rotated to achieve the function of rotating the knife bow direction, thereby increasing the success rate of nipple selective intubation and facilitating superselection of the intrahepatic bile duct. Example

[0030] like Figure 1-Figure 3 、 Figure 5 and Figure 6 As shown, the difference between this embodiment and embodiment 1 is that a movable knife assembly 6 is provided in the collecting sleeve 2.

[0031] The movable knife assembly 6 includes a plurality of connecting joints 61, a needle knife 62, a connecting line 63, a spring 616 and a driving body, and the plurality of connecting joints 61 are connected in sequence; the connecting joint 61 includes an upper cylinder 611 and a lower cylinder 612, the upper cylinder 611 is connected to the upper surface of the lower cylinder 612, the diameter of the upper cylinder 611 is smaller than the diameter of the lower cylinder 612, a chamber 613 is formed in the connecting joint 61, the lower opening diameter of the chamber 613 is larger than the diameter of the upper cylinder 611, a rotating shaft 615 is formed on both sides of the circumference of the upper cylinder 611 near the upper end, a sliding path 614 is formed on both sides of the chamber 613, the rotating shaft 615 is located in the sliding path 614 and is slidably connected, the rotating shaft 615 can rotate in the sliding path 614, the upper surface of the chamber 613 has a through hole, and a spring 616 is provided between adjacent connecting joints 61. 16. The spring 616 is located in the chamber 613. One end of the spring 616 is pressed against the surface of the chamber 613 of one of its connecting nodes 61, and the other end of the spring 616 is pressed against the upper surface of the other connecting node 61. The needle knife 62 is fixedly arranged on the upper surface of the uppermost connecting node 61. The needle knife 62 is electrically connected to the heating wire through the conductive wire passing through each connecting node 61. A gap is formed on the upper surface of the flexible sleeve 22. The needle knife 62 extends or retracts from the gap. One end of the connecting wire is fixedly connected to the uppermost connecting node 61 and passes through the through holes of multiple connecting nodes 61 in sequence and is fixedly connected to the output end of the driving body. The driving body is a driving motor. A winding wheel is provided at the output end of the driving motor. The connecting wire is connected to the winding wheel. The lower surface of the connecting node 61 at the bottom is pressed against the surface of the operating body 1.

[0032] When the movable knife assembly 6 is not in use, the drive motor rotates, the winding wheel winds the wire, and the multiple connecting sections 61 move and retract under the pull of the connecting line until the needle knife 62 retracts into the first sleeve 21. Due to the existence of the rotating shaft 615 and the sliding path 614, the retraction and sliding of adjacent connecting sections 61 will not be misaligned. When the movable knife assembly 6 is in use, the drive motor rotates, the winding wheel unwinds the wire, and the springs 616 between adjacent connecting sections 61 are reset, and the distance between the connecting sections 61 is pushed open, from to making the distance between adjacent connecting sections 61 longer. When the distance between each group of adjacent connecting sections 61 reaches the maximum, the needle knife 62 extends from the gap of the flexible sleeve 22. By setting the needle knife 62 and the bow knife together, the new incision knife of this solution can adapt to more different surgical situations and can cope with various different scenarios. Moreover, when the needle knife 62 is not in use, it will extend into the harder first sleeve 21 of the knife, which will not affect the advancement and use of the knife flexible sleeve 22.

[0033] The above shows and describes the basic principles and main features of the invention and the advantages of the utility model. Those skilled in the art should understand that the utility model is not limited to the above embodiments. The above embodiments and descriptions only illustrate the principles of the utility model. Without departing from the spirit and scope of the invention, the utility model will have various changes and improvements, and these changes and improvements will fall within the scope of the utility model to be protected. The scope of protection of the utility model is defined by the attached claims and their equivalents.

Claims

1. A novel incision knife for facilitating ERCP intubation, characterized by: It includes an operating body, a collection sleeve, a spring and a guide wire assembly, the collection sleeve is connected to the operating body, the collection sleeve includes a first sleeve and a flexible sleeve, the end of the first sleeve is connected to the flexible sleeve, the end face of the flexible sleeve is arc-shaped, the circumference of the first sleeve has a guide wire opening, the guide wire assembly includes a guide wire and an electric cutting assembly, the guide wire extends into the first sleeve from the guide wire opening, the guide wire extends from the circumference of the flexible sleeve close to the first sleeve and is fixedly connected to the circumference of the flexible sleeve close to the end, the electric cutting assembly is used to power the guide wire, a transverse groove extending along the axial direction of the flexible sleeve is formed in the flexible sleeve, an inlet is provided between the bottom of the transverse groove and the flexible sleeve, and the spring extends from the inlet into the transverse groove for fixation.

2. A novel incision knife for facilitating ERCP intubation according to claim 1, characterized in that: The novel cutting knife further comprises a Teflon sleeve, an annular groove is formed on the peripheral surface of the flexible sleeve, the inlet is located in the annular groove, an inclined notch is formed on the peripheral surface of the Teflon sleeve, and the Teflon sleeve is sleeved in the annular groove.

3. The novel incision knife for facilitating ERCP intubation according to claim 1, characterized in that: The guide wire assembly also includes a mounting seat and a pull handle. The mounting seat is connected to the circumference of the operating body. The mounting seat has a mounting hole. The pull handle is installed in the mounting hole. The other end of the guide wire is fixedly connected to the pull handle.

4. The novel incision knife for facilitating ERCP intubation according to claim 3, characterized in that: A hose is sleeved on the outer peripheral surface of the guide wire located outside the first sleeve.

5. The novel incision knife for facilitating ERCP intubation according to claim 1, characterized in that: The electric cutting assembly includes a conductive wire, which is located in the first sleeve and extends to the guide wire port and is electrically connected to the guide wire. The operating body has an electrical connector on its periphery, which is electrically connected to the conductive wire.

6. The novel incision knife for facilitating ERCP intubation according to claim 1, characterized in that: A movable knife assembly is provided in the collective sleeve, and the movable knife assembly includes a plurality of connecting joints, a needle knife, a connecting line, a spring and a driving body, and the plurality of connecting joints are connected in sequence; The connecting joint includes an upper cylinder and a lower cylinder, the upper cylinder is connected to the upper surface of the lower cylinder, the diameter of the upper cylinder is smaller than the diameter of the lower cylinder, a chamber is formed in the connecting joint, the lower opening diameter of the chamber is larger than the diameter of the upper cylinder, the circumference of the upper cylinder is formed with a rotating shaft on both sides near the upper end, sliding channels are formed on both sides of the chamber, the rotating shaft is located in the sliding channel and is slidably connected, the rotating shaft can rotate in the sliding channel, the upper surface of the chamber has a through hole, a spring is arranged between adjacent connecting joints, the spring is located in the chamber, one end of the spring is against the surface of the chamber of one of its connecting joints, and the other end of the spring is against the upper surface of the other connecting joint, the needle knife is fixedly arranged on the upper surface of the uppermost connecting joint, one end of the connecting line is fixedly connected to the uppermost connecting joint and passes through the through holes of multiple connecting joints in sequence and is fixedly connected to the output end of the driving body, and the lower surface of the connecting joint at the bottom is against the surface of the operating fuselage.

7. The novel incision knife for facilitating ERCP intubation according to claim 6, characterized in that: A slit is formed on the upper surface of the flexible sleeve, and the needle knife extends out of or retracts from the slit.

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