Multifunctional resection mirror for prostate surgery

Abstract

A multifunctional resection mirror for prostate surgery comprises an endoscope electric resection ring assembly and a liquid inlet and outlet assembly, and the endoscope electric resection ring assembly comprises an endoscope body and a high-frequency electronic resection ring. An operating handle part for driving the high-frequency electronic excision ring to linearly move along the probe part of the endoscope body is arranged between the eyepiece part and the probe part of the endoscope body, the liquid inlet and outlet assembly comprises an inner shell tube rotationally arranged on the probe part of the endoscope body in a sleeving mode, and an outer shell tube is arranged outside the inner shell tube in a sleeving mode; the mounting base is provided with a first locking mechanism connected with the inner shell tube and a first locking mechanism used for rotating by 180 degrees, and through rotation of the inner shell tube, the enucleation surface of the sheath tip and the visual angle surface of the end part of the probe of the endoscope body are oppositely arranged so as to facilitate observation, so that when the prostate is enucleated, the whole process of an operation is performed under direct vision, and damage or perforation is prevented. The enucleation is completed by pushing and stripping the sheath tip, so that the pushing and cutting level and depth are easy to control, and bladder perforation is prevented.

Description

Technical Field

[0001] This utility model relates to a surgical instrument for prostate surgery, and more particularly to a multifunctional resection endoscope for prostate surgery. Background Technology

[0002] Prostatectomy endoscopy is mainly used for the removal of prostate and bladder lesions.

[0003] During prostate enucleation, the external urethral sphincter is used as a fulcrum, and the procedure is performed blindly by rotating and pushing the inner sheath outward (away from the longitudinal axis of the urethra) from the front end. Especially when searching for the capsule plane, damage to the urethral sphincter and capsule is easily caused.

[0004] This increases the outward tension (pressure) on the membrane.

[0005] It can cause capsule damage or perforation. ① Capsule perforation leads to outflow of perfusion fluid, increased absorption by the body, and endangers the patient's life; ② Capsule damage or perforation leads to increased bleeding.

[0006] The external urethral sphincter was subjected to compression and tearing.

[0007] External forces can easily damage the muscles and mucous membranes. ① Postoperative urethral sphincter closure disorder may occur, leading to temporary urinary incontinence, and in severe cases, permanent urinary incontinence; ② Edema of the external urethral sphincter may cause urinary retention; damage to the sphincter mucosa may lead to urethral stricture.

[0008] The learning curve is too long. (When searching for the capsule plane...)

[0009] Blindfolded operation requires a considerable amount of time to explore, train, and experience in terms of the direction, force, and feel of pushing and peeling outwards, resulting in a long learning curve.

[0010] Delayed hemostasis. When separating the prostate from its capsule, hemostasis can only be performed after the prostate and capsule have been separated and the bleeding point has been located.

[0011] The limitations of simulating finger dissection of the prostate. Prostate enucleation, similar to finger dissection of the prostate, separates the prostate from its capsule and removes the enlarged prostate. Using the tip of the inner sheath to dissect the prostate involves pushing the capsule away from the longitudinal axis of the urethra, the opposite of dissecting the prostate towards the longitudinal axis of the urethra with the fingertip.

[0012] When removing tumors from the base of a bladder tumor, the anterior end of the inner sheath is far from the tumor pedicle, making it impossible to compress and fix the local mucosal tissue. When performing electroresection of the resection ring, pushing and dissecting the tumor, and electrocoagulation, it is not easy to control the depth and level of the resection, which can easily cause bladder perforation. Summary of the Invention

[0013] The technical problem to be solved by this invention is to address the shortcomings of existing technologies by proposing a multifunctional resection endoscope for prostate surgery that is easy to operate.

[0014] The technical problem to be solved by this utility model is achieved through the following technical solution: a multifunctional resection endoscope for prostate surgery, comprising an endoscopic electroresection ring assembly and a fluid inlet / outlet assembly. The endoscopic electroresection ring assembly includes an endoscope body and a high-frequency electronic resection ring. The endoscope body includes an eyepiece portion and a probe portion. An operating handle portion for driving the high-frequency electronic resection ring to move linearly along the probe portion of the endoscope body is provided between the eyepiece portion and the probe portion of the endoscope body. The fluid inlet / outlet assembly includes an inner shell tube rotatably fitted onto the probe portion of the endoscope body, and an outer shell tube fitted onto the outer shell tube. The inner shell tube is provided with a fluid inlet connector communicating with the inner cavity of the inner shell tube. An outlet is provided between the inner shell tube and the outer shell tube. The endoscope has a fluid channel and an outer shell tube with a fluid outlet connector communicating with the fluid outlet channel. Several fluid inlet holes communicating with the fluid outlet channel are located on the tube wall at the front end of the outer shell tube. An inner shell tube mounting base is located on the endoscope body. A locking ring that mates with the mounting base is located at the end of the inner shell tube. The locking ring has a first locking mechanism that mates with the mounting base. The inner shell tube is characterized by having a sheath tip for excision surgery at the front end of the inner shell tube and a second locking mechanism at the end of the inner shell tube. The inner shell tube is initially locked by the first locking mechanism. When the second locking mechanism is engaged, the inner shell tube rotates 180° from its initial state, and the excision surface of the sheath tip faces the viewing angle of the endoscope probe end in a direction that facilitates observation.

[0015] The technical problem to be solved by this utility model can also be further achieved through the following technical solution: the sheath tip used for enucleation surgery is a curved slope sheath tip, that is, its enucleation surface is set as a spoon-shaped curved surface with a downward arc.

[0016] Compared with existing technologies, this invention, through the rotation of the inner sheath, positions the resection surface of the sheath tip and the viewing angle of the endoscope probe tip in a direction that facilitates observation. This allows the entire surgical procedure to be performed under direct vision during prostate resection, without increasing capsular tension, thus protecting the capsule and preventing damage or perforation. Resection is accomplished through sheath tip dissection, eliminating the need for applying pressure or tearing force to the external urethral sphincter, thereby avoiding damage to the external urethral sphincter. During the resection of bladder tumors at their base, the protruding inner sheath tip is close to the tumor pedicle, compressing and fixing the local bladder wall and mucosa. This facilitates control of the resection layer and depth during resection ring electrocautery, tumor dissection, and electrocoagulation, preventing bladder perforation. Attached Figure Description

[0017] Figure 1 This is a simplified structural diagram of the present invention;

[0018] Figure 2 Diagram showing the locking mechanism after a 180° rotation of the inner shell tube;

[0019] Figure 3 This is a structural diagram of the endoscopic electrosurgical resection ring assembly;

[0020] Figure 4 This is a diagram of the inner shell tube structure;

[0021] Figure 5 This is a structural diagram of the outer casing tube;

[0022] Figure 6 This is a schematic diagram of the locking ring structure. Detailed Implementation

[0023] The specific technical solutions of the present invention are further described below. To make the objectives, technical solutions, and advantages of the embodiments of the present invention clearer, and to facilitate a better understanding of the present invention by those skilled in the art, the technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the embodiments of the present invention. Obviously, the described embodiments are only some embodiments of the present invention, not all embodiments, and do not constitute a limitation on its rights. All other embodiments obtained by those skilled in the art based on the embodiments of the present invention without creative effort are within the scope of protection of the present invention.

[0024] A multifunctional resection endoscope for prostate surgery includes an endoscopic electroresection ring assembly 1 and a fluid inlet / outlet assembly 4. The endoscopic electroresection ring assembly includes an endoscope body and a high-frequency electronic resection ring 8. The endoscope body includes an eyepiece portion 5 and a probe portion 6. An operating handle portion 7 is provided between the eyepiece portion 5 and the probe portion of the endoscope body to drive the high-frequency electronic resection ring to move linearly along the probe portion of the endoscope body. The fluid inlet / outlet assembly includes an inner shell tube 11 rotatably fitted onto the probe portion of the endoscope body, and an outer shell tube 14 fitted outside the inner shell tube. The inner shell tube has a fluid inlet connector 12 communicating with the inner lumen of the inner shell tube. A fluid outlet channel is provided between the inner shell tube and the outer shell tube. The outer shell tube has a... The fluid outlet connector 15 communicates with the fluid outlet channel. Several fluid inlet holes 16 communicating with the fluid outlet channel are provided on the wall of the outer shell tube at its front end. A mounting base 9 for the inner shell tube is provided on the endoscope body. A locking ring 18 that mates with the mounting base is provided at the end of the inner shell tube. A first locking mechanism 2 that mates with the mounting base is provided on the locking ring. A sheath tip 13 for excision surgery is provided at the front end of the inner shell tube. A second locking mechanism 3 is provided at the end of the inner shell tube. The inner shell tube is locked in its initial state by the first locking mechanism. When the second locking mechanism is engaged, the inner shell tube rotates 180° from its initial state, and the excision surface of the sheath tip faces the viewing angle of the endoscope probe end in a direction that facilitates observation. The sheath tip for excision surgery is a curved, sloping sheath tip, meaning its excision surface is a downward-curving, spoon-shaped curved surface to facilitate the excision surgery.

[0025] The mounting base 9 is provided with a V-shaped locking port 10, and the locking ring 18 is provided with a stop pin 19 that cooperates with the V-shaped locking port. A locking elastic element 17 is provided between the locking ring and the mounting base. The first locking mechanism 2 includes a pressing head, a V-shaped locking port, a stop pin and a locking elastic element, and the locking elastic element 17 is installed in the guide tube of the pressing head.

[0026] The second locking mechanism is a rotating pressure arm 3 that is rotatably mounted on the inlet connector tube. When the inner shell tube rotates 180° from the initial state, the locking ring, under the action of the locking elastic element, will not have its stop pin inserted into the root of the V-shaped locking port to form a lock. At this time, the rotating pressure arm turns over and presses against the pressing head, pressing out the locking elastic element and in the opposite direction pressing the stop pin on the locking ring into the root of the V-shaped locking port.

[0027] This structure is an improvement on the original locking structure. Without making major changes to the original structure, a rotating pressure arm is used to lock the inner shell tube when it is rotated 180° from its initial state.

[0028] Of course, the first and second locking mechanisms can also adopt other structural forms, as long as they can achieve 180° rotation of the inner shell tube of this application and achieve locking in both states, they are all within the protection scope of this application.

[0029] The sheath tip used for enucleation surgery is a curved slope sheath tip, that is, its enucleation surface is set as a spoon-shaped curved surface with a downward curvature.

[0030] During prostate enucleation, starting from the urethral sphincter, under direct vision, the protruding part of the ceramic tip of the inner sheath is pressed closely against the enlarged prostate and pushed inward (towards the longitudinal axis of the urethra) to separate the prostate from the surgical capsule, exposing the capsule plane; always within this plane, the capsule is rotated clockwise and counterclockwise to separate the complete enlarged prostate tumor.

[0031] (1) Protect the integrity of the film and prevent damage to the coating.

[0032] The entire process is performed under direct vision, and the prostate is pushed inward without increasing the tension of the capsule, thus protecting the capsule and preventing damage or perforation.

[0033] (2) It reduces the external force applied to the external urethral sphincter, thus avoiding damage to the external urethral sphincter. Since the excision is completed by pushing and peeling with the tip of the sheath, there is no need to apply external force of squeezing or tearing to the external sphincter, thus avoiding damage to the external urethral sphincter.

[0034] (3) It is easy to teach and promote. When locating the capsule plane, it is easy to find by operating under direct vision and gently pushing and peeling away. The learning curve segment is easy for students to master.

[0035] (4) Rapid hemostasis. During the removal process, the bleeding point is quickly identified and the bleeding is stopped immediately by peeling and separating the capsule plane close to the prostate.

[0036] (5) When pushing and peeling the prostate along the longitudinal axis of the urethra while keeping it close to the prostate, the curved slope sheath tip applies a combined force to the prostate along the longitudinal axis of the urethra, which is completely consistent with the method of separating the prostate with fingers.

[0037] When removing bladder tumors at their base, the protruding tip of the inner sheath is close to the pedicle of the tumor and compresses and fixes the local bladder wall and mucosa. This makes it easier to control the cutting layers and depth during resection, dissection of the tumor, and electrocoagulation, thus preventing bladder perforation.

Claims

1. A multifunctional resection endoscope for prostate surgery, comprising an endoscopic electroresection ring assembly and a fluid inlet / outlet assembly. The endoscopic electroresection ring assembly includes an endoscope body and a high-frequency electronic resection ring. The endoscope body includes an eyepiece portion and a probe portion. An operating handle portion for driving the high-frequency electronic resection ring to move linearly along the probe portion of the endoscope body is provided between the eyepiece portion and the probe portion of the endoscope body. The fluid inlet / outlet assembly includes an inner shell tube rotatably fitted onto the probe portion of the endoscope body, an outer shell tube fitted onto the inner shell tube, a fluid inlet connector communicating with the inner cavity of the inner shell tube on the inner shell tube, a fluid outlet channel between the inner shell tube and the outer shell tube, a fluid outlet connector communicating with the fluid outlet channel on the outer shell tube, and a plurality of fluid inlet holes communicating with the fluid outlet channel on the wall of the front end of the outer shell tube. A mounting base for the inner shell tube is provided on the endoscope body, and a locking ring cooperating with the mounting base is provided at the end of the inner shell tube. The locking ring is provided with a first locking mechanism cooperating with the mounting base. The feature is that: The inner shell tube has a sheath tip for excision surgery at the front end and a second locking mechanism at the end of the inner shell tube. The inner shell tube is locked in the initial state by the first locking mechanism. When the second locking mechanism is locked, the inner shell tube rotates 180° from the initial state, and the excision surface of the sheath tip is set opposite to the viewing angle surface of the endoscope probe end in a way that facilitates observation.

2. The multifunctional resection endoscope for prostate surgery according to claim 1, characterized in that: The sheath tip used for enucleation surgery is a curved slope sheath tip, that is, its enucleation surface is set as a spoon-shaped curved surface with a downward curvature.

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