Concealed closed-type bronchoscope and artificial airway breathing circuit combination system

Abstract

Disclosed is a concealed closed-type bronchoscope and artificial airway breathing circuit combination system. The combination system comprises an artificial airway breathing pipeline (1) and a bronchoscope (2). The artificial airway breathing pipeline (1) comprises an inspiratory limb (4) and an expiratory limb (5) which are connected by a connecting tube (3). The bronchoscope (2) comprises a handle portion (2-1) and an insertion portion (2-2) connected to the handle portion (2-1). The bronchoscope handle portion (2-1) is wrapped around a section of the expiratory limb (5). In the structural modification on the basis of the existing breathing circuit and disposable bronchoscope (2), the bronchoscope insertion portion (2-2) is concealed in a telescopic section of breathing circuit, such that the bronchoscope insertion portion (2-2) is moved forward or backward in a closed manner under a telescopic action; functional components of the bronchoscope handle are ingeniously wrapped around the tube surface of the breathing circuit, such that the functions of the bronchoscope handle and the breathing circuit are organically combined together; and the tube connector can be cleaned to keep the bronchoscope (2) clean and unobstructed. In this way, the service life of the bronchoscope (2) can be extended from a single use to about 1-2 weeks.

Description

Hidden closed bronchoscope and artificial airway breathing circuit combination system Technical Field

[0001] The invention relates to a concealed and sealed bronchoscope and an artificial airway breathing circuit combined system, belonging to the technical field of medical equipment. Background Art

[0002] Generally, patients with artificial airways are divided into two categories: those with respiratory diseases and those without. The former may have more airway secretions, while the latter may also have more airway secretions due to factors such as limited coughing, secretions on the airway cuff, and reflux aspiration. Both require suctioning to prevent ventilator-associated pneumonia. These patients undergo 10-20 airway suctioning sessions daily and regular bronchoscopic suctioning to effectively clear the airway, reduce the incidence of ventilator-associated pneumonia, and assist in treatment. Existing airway suctioning methods use both conventional and closed suction tubes, both of which utilize a blind suctioning method. Closed suction tubes utilize a closed operation to reduce the risk of infection, but they have a short service life and complex components. Because both of these blind suctioning methods prevent direct visualization of the airway, suction is limited to the trachea and artificial airway, avoiding the main bronchi and their branches. Therefore, both methods are inefficient and can easily damage the airway mucosa, inducing a series of adverse physiological reactions and, in severe cases, even worsening the condition.

[0003] Airway management is crucial for patients with artificial airways, and the most effective method is based on visual manipulation. Regular bronchoscopic examinations, alveolar lavage, suctioning, and even interventional treatment are the most effective and reliable methods. Bronchoscopes are divided into two types: reusable and disposable. Reusable bronchoscopes offer superior performance, require no consumables, can be sterilized repeatedly, and have a low single-use cost. However, they carry the risk of sterilization contamination and the high cost of the main unit, leading to a decreasing trend in their use in the ICU. The increasing use of disposable bronchoscopes overcomes the contamination risk and high cost of the reusable bronchoscopes. However, their high single-use cost significantly limits their widespread use. Some patients with excessive airway secretions may require multiple bronchoscope uses within 24 hours, significantly increasing the daily cost and limiting their use, impacting airway management and increasing the incidence of ventilator-associated pneumonia. Therefore, the main contradiction in airway management in the ICU at present is that the cost and convenience of disposable bronchoscopes restrict their dynamic monitoring and on-demand use. As a result, many hospitals at home and abroad have repeatedly disinfected disposable bronchoscopes for use, which not only violates medical routines but also poses a greater risk of infection.

[0004] Therefore, the cost and convenience of single-use bronchoscopy procedures are currently the key constraints to the rational dynamic and on-demand use of disposable bronchoscopes, and are also the core factors for airway visualization management. These issues currently plague clinicians, and therefore, there is a need to develop a product and solution to address these issues.

[0005] Summary of the Invention

[0006] The purpose of the present invention is to solve the technical problem of converting artificial airway management from an inefficient method based on blind suction to a continuous, convenient, visual and low-cost efficient mode, comprehensively popularize and improve the level of airway management, and improve the prognosis of critically ill patients. The present invention provides a hidden closed bronchoscope and artificial airway breathing circuit combination system.

[0007] In order to achieve the purpose of solving the above technical problems, the present invention provides a hidden closed bronchoscope and artificial airway breathing circuit combination system, the combination system includes an artificial airway breathing circuit and a bronchoscope, the artificial airway breathing circuit includes an inhalation circuit and an exhalation circuit connected by a connecting tube;

[0008] The exhalation circuit includes a front telescopic bellows, a standard breathing circuit tube provided with a bronchoscope handle, and a rear telescopic bellows connected in series, wherein the front telescopic bellows is connected to a connecting tube; the front telescopic bellows is provided with an upward water injection channel and a downward drainage channel;

[0009] The bronchoscope includes a handle portion and an insertion portion connected to the handle portion, one end of the insertion portion is connected to the handle portion, and the other end is a bending portion, and the head end of the bending portion is provided with a camera lens, an LED light source and a working channel;

[0010] The insertion portion is inserted into the front telescopic bellows and passes through the connecting tube. The insertion portion is configured so that the bending portion extends out of the connecting tube after the insertion portion moves forward by contraction of the front telescopic bellows.

[0011] The handle part includes an outer shell, a bronchoscope bending part direction control component, a bronchoscope bending part direction control handle and a handle part functional component. The diameter of the outer shell is larger than that of the standard breathing circuit tube and is wrapped around the outside of the standard breathing circuit tube. The bronchoscope bending part direction control component is arranged in the outer shell, and the bronchoscope bending part direction control handle is connected to the outer shell through a handle sleeve and its operating end is exposed.

[0012] Preferably, the front-end telescopic bellows and the connecting tube, the front-end telescopic bellows and the standard breathing circuit tube, and the standard breathing circuit tube and the rear-end telescopic bellows are all detachably connected.

[0013] More preferably, the detachable connection is via a rotatable coupling joint.

[0014] Preferably, both the water injection channel and the drainage channel are provided with regulating valves and blocking caps for closing the channel openings.

[0015] Preferably, the housing comprises an upper handle housing and a lower handle housing that can be opened and mounted on the box, and the bronchoscope bending portion direction control handle is connected to the upper handle housing through a handle sleeve and its operating end is exposed.

[0016] Preferably, a head-end pipe separating connector is provided between the front-end telescopic bellows and the standard breathing circuit tube, and a limiting hole is provided on the head-end pipe separating connector, and the inserting portion is inserted into the limiting hole.

[0017] Preferably, an electronic control module is further provided inside the handle housing and outside the standard breathing circuit tube, and the electronic control module includes electrically connected power / video signal lines and a power conversion / video processing chip;

[0018] The handle is also provided with a negative pressure suction line, a negative pressure control button connected to the negative pressure suction line and electrically connected to the electronic control module, and a power supply / video signal connector integrated with an electrical connection line (the connector is used to connect to an external host);

[0019] One end of the negative pressure suction pipeline is connected to the insertion part, and the other end is provided with a negative pressure suction connector. The negative pressure suction pipeline runs through the inside of the handle part, and the negative pressure suction connector is exposed outside the handle part shell.

[0020] Preferably, a working channel is further provided at the connection between the insertion portion and the negative pressure suction pipeline, and the working channel is connected to the insertion portion and the negative pressure suction pipeline respectively through connecting tubes.

[0021] Preferably, a tail end pipe dividing connector is provided between the standard breathing circuit tube and the tail end retractable bellows, and the tail end pipe dividing connector is provided with limiting holes for inserting the negative pressure suction pipeline and the power supply / video signal connector respectively. The negative pressure suction pipeline and the power supply / video signal connector are respectively inserted into the limiting holes of the tail end pipe dividing connector so that their connectors are exposed.

[0022] Preferably, the negative pressure control button is connected to the lower housing of the handle through a button sleeve and its operating end is exposed, and the working channel is connected to the lower housing of the handle through a pipe sleeve, and the pipe sleeve is provided with a pipe cap for closing the working channel opening.

[0023] Preferably, the standard breathing circuit tube is a non-retractable tube;

[0024] And / or, the front end telescopic bellows includes at least one section of telescopic bellows.

[0025] Preferably, the front-end telescopic bellows comprises two sections of telescopic bellows that are fixedly connected or detachably connected.

[0026] More preferably, the front end telescopic bellows comprises two sections of telescopic bellows connected by a rotatable coupling joint.

[0027] Compared with the prior art, the present invention has the following beneficial effects:

[0028] (1) The present invention provides a concealed, sealed bronchoscope and breathing circuit combination system, which is based on the structural modification of the existing breathing circuit and disposable bronchoscope. The bronchoscope insertion part is hidden in a retractable breathing circuit, and the bronchoscope insertion part is moved forward or backward in a sealed state by retracting. In addition, the components of the bronchoscope handle are cleverly wrapped around the surface of the breathing circuit pipe, organically combining the functions of the bronchoscope handle and the breathing circuit. At the same time, the pipe interface can be cleaned to keep the bronchoscope clean and unobstructed. In this way, the service life of the bronchoscope can be extended from a single use to about 1-2 weeks.

[0029] (2) The present invention organically integrates the breathing circuit and the bronchoscope into one, making the operation of the bronchoscope extremely convenient. The operation mode is closed, and dynamic visual management of the artificial airway can be achieved throughout the process. The system pipeline is provided with an external interface to clean the bronchoscope insertion part and can be connected to negative pressure suction, thereby keeping the bronchoscope clean and unobstructed, maintaining the normal function of the bronchoscope, extending the service life of the bronchoscope, and significantly reducing the cost of a single bronchoscope operation.

[0030] (3) The system of the present invention can transform artificial airway management from an inefficient method based on blind suction to a continuous, convenient, efficient, visual and low-cost mode, comprehensively improving the level of airway management, thereby avoiding cross infection, reducing the occurrence of ventilator-associated pneumonia, and ultimately improving the prognosis of critically ill patients. BRIEF DESCRIPTION OF THE DRAWINGS

[0031] FIG1 is a schematic diagram of the overall structure of a concealed, sealed bronchoscope and artificial airway breathing circuit combination system provided by an embodiment of the present invention;

[0032] FIG2 is a schematic diagram of the structure of the combined system of the present invention in a normal non-use state (A) and a use state (B);

[0033] Figure 3 is a schematic diagram of the bronchoscope and connector connection structure;

[0034] Figure 4 is a schematic diagram of the structure of a bronchoscope;

[0035] Figure 5 is a schematic structural diagram of the connecting pipe;

[0036] FIG6 is a schematic structural diagram of a rotatable coupling joint;

[0037] FIG7 is a schematic diagram of the connection structure between the handle and the exhalation circuit;

[0038] Figure 8 is a schematic diagram of the handle structure;

[0039] Figure 9 is a partial schematic diagram of the handle;

[0040] Reference numerals: 1. Artificial airway tube; 2. Bronchoscope; 3. Connecting tube; 4. Inspiratory circuit; 5. Expiratory circuit; 2-1. Handle; 2-2. Insertion portion; 2-3. Bending portion; 2-4. Bronchoscope bending portion direction control handle; 2-5. Handle upper housing; 2-6. Handle lower housing; 2-7. Power / video signal cable; 2-8. Power conversion / video processing chip; 2-9. Negative pressure suction line; 2-10. Negative pressure control button; 2-11. Working channel; 2-12. Power / video signal connector; 2-13. Negative pressure suction connector; 2-14. Bronchoscope bending direction control rope fixing part; 2-15. Bronchoscope bending direction control rope; 2-16. Bronchoscope bending direction control wheel; 2-17. Bronchoscope insertion part fixing part; 2-18. Handle cover; 2-19. Button cover; 2-20. Tube cover; 2-21. Tube cap; 3-1. Threaded tube; 3-2. Bend tube; 3-3. Straight-in Y-type tube; 3-4. Artificial airway interface; 3 -5. Rotatable coupling joint A; 3-6. Rotatable coupling joint B; 3-7. Rotatable coupling joint C; 3-8. Socket; 5-1. Front end telescopic bellows; 5-2. Standard breathing circuit tube; 5-3. Tail end telescopic bellows; 5-4. First rotatable coupling joint; 5-5. Second rotatable coupling joint; 5-6. Head end pipe dividing connector; 5-7. Water injection channel; 5-8. Drainage channel; 5-9. Tail end pipe dividing connector; 5-10. Seal; A. Forward rotatable coupling joint; B. Reverse rotatable coupling joint; C. Outer sleeve; D. Inner sleeve. DETAILED DESCRIPTION

[0041] To make the present invention more clearly understood, preferred embodiments are described in detail below with reference to the accompanying drawings.

[0042] Example

[0043] The present embodiment provides a hidden closed bronchoscope and artificial airway breathing circuit combination system, as shown in Figures 1 to 9, the combination system includes an artificial airway tube 1 and a bronchoscope 2, the artificial airway tube 1 includes an inhalation circuit 4 and an exhalation circuit 5 connected by a connecting tube 3; the bronchoscope includes a handle portion 2-1 and an insertion portion 2-2 connected to the handle portion, one end of the insertion portion 2-2 is connected to the handle portion 2-1, and the other end is a bending portion 2-3, the direction of the bending portion is adjustable, specifically a section of a curved snake bone, which is inserted into the human trachea for tracheal detection and visual sputum suction operations, and the head end of the bending portion 2-3 is provided with a The invention has a camera lens, an LED light source and a working channel (the structure and composition of the bending part are not modified in the present invention, and the structure and composition of the bending part of the existing bronchoscope are referred to); the exhalation circuit 5 includes a front-end telescopic bellows 5-1 connected in series, a standard breathing circuit tube 5-2 (the standard breathing circuit tube is a non-retractable tube designed according to the existing standard breathing circuit) provided with a bronchoscope handle and located in the middle, and a tail-end telescopic bellows 5-3, wherein the first telescopic bellows 5-1 is connected to the connecting tube 3, and the connection method is a detachable connection. The handle part 2-1 of the bronchoscope includes a shell, a bronchoscope, and a bronchoscope. The bending direction control component (including the bronchoscope bending direction control rope fixing part 2-14, the bronchoscope bending direction control rope 2-15 and the bronchoscope bending direction control wheel 2-16), the bronchoscope bending direction control handle 2-4 and the handle function component, the shell is set outside the standard breathing circuit tube 5-2 (that is, the diameter of the shell is larger than the standard breathing circuit tube and is wrapped around the standard breathing circuit tube 5-2), the bronchoscope bending direction control component is set inside the shell, the bronchoscope bending direction control handle 2-4 is connected to the shell through the handle sleeve 2-18, that is, the bronchoscope bending direction control The handle 2-4 is inserted into the housing through a handle sleeve 2-18, and its operating end is exposed, so as to facilitate adjustment of the direction of the bending portion 2-3 of the bronchoscope by sliding operation (bending portion angle adjustment). The housing may specifically include an upper handle housing 2-5 and a lower handle housing 2-6 that can be opened and mounted on the box. The bronchoscope bending portion direction control handle 2-4 is inserted into the upper handle housing 2-5 for easy operation. The insertion portion 2-2 of the bronchoscope is inserted into the front telescopic bellows 5-1 and extends into the connecting tube 3. By contracting the front telescopic bellows 5-1, it is moved toward the trachea and inserted into the trachea for operation. The functional components of the handle portion include an electronic control module, a power / video signal line 2-7, a power conversion / video processing chip 2-8, a negative pressure suction line 2-9, a negative pressure control button 2-10, a working channel 2-11, and other functional components inherent to the handle portion of the bronchoscope.

[0044] In this embodiment, the front-end telescopic bellows 5-1, the standard breathing circuit tube 5-2, and the rear-end telescopic bellows 5-3 are detachably connected. Specifically, in this embodiment, the front-end telescopic bellows 5-1 and the standard breathing circuit tube 5-2 are connected by a first rotatable coupling joint 5-4, and the standard breathing circuit tube 5-2 and the rear-end telescopic bellows 5-3 are connected by a second rotatable coupling joint 5-5. The rotatable coupling joint allows the direction of the handle to be rotatably adjusted, thereby adjusting the direction of the bronchoscope bending portion 2-3. In combination with the bending portion direction control handle 2-4, not only can the angle be adjusted by the bending portion direction control handle 2-4, but the circumferential adjustment can also be achieved by rotating the handle portion, so that the bending portion can be adjusted in different directions and angles, thereby facilitating the suction operation at the tip of the bending portion. See Figures 3-4.

[0045] In this embodiment, the standard breathing circuit tube is further provided with a bronchoscope insert portion fixing member 2-17 to facilitate the fixing of the bronchoscope insert portion 2-2. The bronchoscope insert portion fixing member 2-17 can be a fixing ring into which the bronchoscope insert portion 2-2 is inserted to limit the position of the bronchoscope insert portion. See Figure 3.

[0046] Furthermore, a head-end pipe separating connector 5-6 is provided between the front-end telescopic bellows 5-1 and the standard breathing circuit tube 5-2. The head-end pipe separating connector 5-6 is provided with a limiting hole, and the inserting portion 2-2 is inserted into the limiting hole to further limit the insertion portion of the bronchoscope (see Figure 3).

[0047] In this embodiment, the front telescopic bellows 5-1 is provided with an upward-facing water injection channel 5-7 and a downward-facing water drainage channel 5-8, each of which is equipped with a regulating valve and a sealing cap at the opening of each channel. Water can be injected through the water injection channel 5-7 to clean the exterior of the bronchoscope insertion portion, and then drained through the water drainage channel 5-8. The water drainage channel can also be connected to a negative pressure suction device to facilitate suctioning of small amounts of sputum adhering to the tip of the insertion portion. See Figures 1-2.

[0048] Furthermore, in order to ensure the airtightness of the breathing circuit, seals (which may be sealing rings) are provided at the joints of adjacent pipes, such as the seal 5-10 provided at the joint of the front telescopic bellows 5-1 and the standard breathing circuit tube 5-2, see Figure 3.

[0049] In this embodiment, an electronic control module is also provided outside the standard breathing circuit tube 5-2 in the shell of the handle part 2-1, and the electronic control module includes a power supply / video signal line 2-7 and a power conversion / video processing chip 2-8 that are electrically connected. The functional components provided in the handle part also include a negative pressure suction line 2-9, a negative pressure control button 2-10 connected to the negative pressure suction line 2-9 and electrically connected to the electronic control module, a working channel 2-11 provided on the negative pressure suction line 2-9 and forming a branch of the negative pressure suction line 2-9, and the electrical connection wires of the power supply / video signal line 2-7 and the remaining components (including the negative pressure control button and the bronchoscope bending direction control handle) are integrated into the power supply / video signal connector after being collected. 2-12; A tail-end pipe split connector 5-9 is also provided between the standard breathing circuit tube 5-2 and the tail-end telescopic bellows 3 (at the connection point). The negative pressure control button 2-10 is sleeved on the lower housing 2-6 of the handle. One end of the negative pressure suction line 2-9 is connected to the insertion portion 2-2, and the other end is provided with a negative pressure suction connector 2-13. The negative pressure suction line 2-9 runs horizontally through the interior of the handle, passes through the tail-end pipe split connector 5-9, and extends from the tail-end pipe split connector 5-9, thereby exposing the negative pressure suction connector 2-13 to facilitate external connection to a negative pressure suction device. Similarly, the power / video signal connector 2-12 is exposed after passing through the tail-end pipe split connector 5-9 to facilitate external connection to a host. See Figures 3-4.

[0050] Furthermore, the negative pressure control button 2-10 is connected to the handle lower housing 2-6 via a button cover 2-19, with its operating end exposed from the handle lower housing. Similarly, the working channel 2-11 is connected to the handle lower housing 2-6 via a tube cover 2-20, and the tube cover 2-20 is further connected to a tube cap 2-21 for sealing the working channel 2-11. See Figures 3-4.

[0051] Furthermore, as shown in FIG5 , the connecting tube specifically comprises: a threaded tube 3-1, a curved tube 3-2, a straight-in Y-type tube 3-3, an artificial airway interface 3-4, a rotatable coupling joint A 3-5, a rotatable coupling joint B 3-6, a rotatable coupling joint C 3-7, and a socket 3-8.

[0052] In this embodiment, the composition of the rotatable coupling joint is shown in FIG6 . To ensure the consistency of the rotation direction, the rotatable coupling joints connected at both ends of the same pipe are in opposite directions, i.e., a pair of forward rotatable coupling joints and a reverse rotatable coupling joint.

[0053] The working principle and process are as follows:

[0054] The bronchoscope insertion section, hidden within the circuit, is advanced or retracted by adjusting the length of the retractable breathing circuit catheter (the front-end retractable bellows 5-1). The bronchoscope is operated via the bronchoscope handle, which is integrated into the breathing circuit. Four rotatable couplings allow for rotational adjustment of the handle and breathing circuit, making bronchoscopic examinations extremely convenient and rapid. Water injection and negative pressure suction through the water channel keep the bronchoscope clean and unobstructed, maintaining its normal function.

[0055] The above-mentioned implementation cases are only preferred implementation cases of the present invention and are not any formal or substantial limitations of the present invention. It should be pointed out that ordinary technicians in this technical field can make several improvements and supplements without departing from the present invention, and these improvements and supplements should also be regarded as the scope of protection of the present invention.

Claims

1. A concealed, sealed bronchoscope and artificial airway breathing circuit combination system, characterized in that: The combined system comprises an artificial airway breathing circuit and a bronchoscope, wherein the artificial airway breathing circuit comprises an inhalation circuit and an exhalation circuit connected by a connecting tube; The exhalation circuit includes a front telescopic bellows, a standard breathing circuit tube provided with a bronchoscope handle, and a rear telescopic bellows connected in series, wherein the front telescopic bellows is connected to a connecting tube; the front telescopic bellows is provided with an upward water injection channel and a downward drainage channel; The bronchoscope includes a handle portion and an insertion portion connected to the handle portion, one end of the insertion portion is connected to the handle portion, and the other end is a bending portion, and the head end of the bending portion is provided with a camera lens, an LED light source and a working channel; The insertion portion is inserted into the front telescopic bellows and passes through the connecting tube. The insertion portion is configured so that the bending portion extends out of the connecting tube after the insertion portion moves forward by contraction of the front telescopic bellows. The handle part includes an outer shell, a bronchoscope bending part direction control component and a bronchoscope bending part direction control handle. The diameter of the outer shell is larger than the standard breathing circuit tube and is wrapped around the outside of the standard breathing circuit tube. The bronchoscope bending part direction control component is arranged in the outer shell. The bronchoscope bending part direction control handle is connected to the outer shell through a handle sleeve and its operating end is exposed.

2. The combined system according to claim 1, characterized in that The front-end telescopic bellows and the connecting tube, the front-end telescopic bellows and the standard breathing circuit tube, and the standard breathing circuit tube and the rear-end telescopic bellows are all detachably connected.

3. The combined system according to claim 2, characterized in that The detachable connection is connected via a rotatable coupling joint.

4. The combined system according to claim 1, characterized in that The shell comprises an upper handle shell and a lower handle shell which can be opened and mounted on the box. The bronchoscope bending portion direction control handle is connected to the upper handle shell through a handle sleeve and the operating end thereof is exposed.

5. The combined system according to claim 1, characterized in that: A head-end pipe separating connector is provided between the front-end telescopic bellows and the standard breathing circuit tube. A limiting hole is provided on the head-end pipe separating connector, and the inserting portion is inserted into the limiting hole.

6. The combined system according to claim 1, characterized in that: An electronic control module is also provided inside the handle housing and outside the standard breathing circuit tube. The electronic control module includes an electrically connected power / video signal line and a power conversion / video processing chip. The handle is further provided with a negative pressure suction line, a negative pressure control button connected to the negative pressure suction line and electrically connected to the electronic control module, and a power supply / video signal connector integrated with an electrical connection line; One end of the negative pressure suction pipeline is connected to the insertion part, and the other end is provided with a negative pressure suction connector. The negative pressure suction pipeline runs through the inside of the handle part, and the negative pressure suction connector is exposed outside the handle part shell.

7. The combined system according to claim 6, characterized in that A working channel is further provided at the connection between the insertion portion and the negative pressure suction pipeline. The working channel is connected to the insertion portion and the negative pressure suction pipeline respectively through connecting pipes.

8. The combined system according to claim 6, characterized in that: A tail end pipe dividing connector is provided between the standard breathing circuit tube and the tail end retractable bellows. The tail end pipe dividing connector is provided with limiting holes for inserting the negative pressure suction pipeline and the power supply / video signal connector respectively. The negative pressure suction pipeline and the power supply / video signal connector are respectively inserted into the limiting holes of the tail end pipe dividing connector and their connectors are exposed.

9. The combined system according to claim 6, characterized in that: The negative pressure control button is connected to the lower shell of the handle through a button sleeve and its operating end is exposed. The working channel is connected to the lower shell of the handle through a pipe sleeve, and the pipe sleeve is provided with a pipe cap for closing the working channel opening.

10. The combined system according to any one of claims 1 to 9, characterized in that: The standard breathing circuit tube is a non-retractable tube; And / or, the front end telescopic bellows includes two connected sections of telescopic bellows.

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