Medical water jet cutter system

Abstract

A medical water jet cutter system. The medical water jet cutter system is provided with an insertion portion (12) and a handle portion (11) connected to the near end of the insertion portion (12), and the medical water jet cutter system comprises a water jet cutter assembly, a laser assembly, and a suction control assembly. The water jet cutter assembly comprises a water jet cutter channel (101) penetrating through the insertion portion (12) and the handle portion (11) and is configured to output a jet. The laser assembly comprises a laser channel (201) penetrating through the insertion portion (12) and the handle portion (11) and is configured to output laser energy. The suction control assembly comprises a suction channel (401) penetrating through the insertion portion (12) and the handle portion (11) and is configured to suck a fluid. The medical water jet cutter instrument combines water jet cutter technology and laser technology and enables the resection of prostate tissue without thermal damage while achieving hemostasis. In addition, the medical water jet cutter instrument enables the use of one instrument to complete an entire operation; during the operation, there is no need to replace the surgical instrument. The medical water jet cutter instrument is simple to operate and has a short learning curve.

Description

Medical water jet system

[0001] This application claims priority to Chinese Patent Application No. 202410980599.3, filed on July 19, 2024, the disclosure of which is incorporated herein in its entirety by this reference as part of the present application. TECHNICAL FIELD

[0002] Embodiments of the present disclosure relate to a medical water jet system. BACKGROUND

[0003] Benign prostatic hyperplasia is the most common benign disease causing urinary dysfunction in middle-aged and elderly men. About 50% of men over 50 years old have prostatic hyperplasia, and the prevalence rate of men over 80 years old is as high as 90%. Currently, the treatment of prostatic hyperplasia mainly includes lifestyle guidance, drug treatment, and surgical treatment. Among them, surgical treatment is the most radical treatment.

[0004] Surgical treatment of prostatic hyperplasia mainly includes open prostatectomy, laparoscopic prostatectomy, transurethral resection of the prostate (TURP), laser vaporization, and laser enucleation. During the resection of prostatic hyperplasia tissue, the capsule interface needs to be separated. The depth of thermal injury in TURP is about 5 mm, and the thickness of the surgical capsule is 2 mm. Therefore, during the resection of prostatic hyperplasia tissue, the tissue behind the surgical capsule is easily thermally injured, leading to complications such as bleeding, infection, and sexual dysfunction. With the development of instrument technology, the thermal injury generated during the cutting process of the instrument is gradually reduced. For example, the thermal injury of TURP is about 5 mm, the thermal injury of plasma instrument is about 2 mm to 4 mm, the thermal injury of holmium laser is about 0.4 mm, and the thermal injury of thulium laser is about 0.1 mm. Reducing thermal injury is of great significance for avoiding complications and postoperative rehabilitation. SUMMARY

[0005] At least one embodiment of the present disclosure provides a medical water jet system having an insertion portion and a handle portion connected to the proximal end of the insertion portion, and the medical water jet system comprises a water jet assembly, a laser assembly, and a suction control assembly; the water jet assembly comprises a water jet channel passing through the insertion portion and the handle portion and is configured to output a jet flow; the laser assembly comprises a laser channel passing through the insertion portion and the handle portion and is configured to output laser energy; and the suction control assembly comprises a suction channel passing through the insertion portion and the handle portion and is configured to suck fluid.

[0006] For example, the medical water jet system provided by at least one of the embodiments of the present disclosure further comprises a pressure control assembly, comprising a pressure sensor and a pressure control module in communication connection with the pressure sensor, wherein the pressure sensor is located at the distal end of the insertion part and is configured to detect the pressure value of the fluid in the environment at the distal end of the insertion part and feed back to the pressure control module; the pressure control module is configured to receive the pressure value detected by the pressure sensor and control the suction speed of the suction control assembly and / or control the shutdown of the medical water jet system according to the pressure value.

[0007] For example, in the medical water jet system provided by at least one of the embodiments of the present disclosure, the pressure control module controlling the suction speed of the suction control assembly according to the pressure value comprises: when the pressure value is greater than a first upper threshold value and less than or equal to a second upper threshold value, controlling the suction control assembly to increase the suction speed; when the pressure value is less than a first lower threshold value and greater than or equal to a second lower threshold value, controlling the suction control assembly to decrease the suction speed; wherein the first upper threshold value is greater than the first lower threshold value.

[0008] For example, in the medical water jet system provided by at least one of the embodiments of the present disclosure, the pressure control module controlling the suction speed of the suction control assembly according to the pressure value further comprises: when the pressure value is less than or equal to the first upper threshold value and greater than or equal to the first lower threshold value, controlling the suction control assembly to maintain the current suction speed.

[0009] For example, in the medical water jet system provided by at least one of the embodiments of the present disclosure, the pressure control module controlling the shutdown of the medical water jet system according to the pressure value comprises:

[0010] When the pressure value is greater than the second upper threshold value or the pressure value is less than the second lower threshold value, the pressure control module outputs a shutdown signal to control the medical water jet system to stop outputting the jet flow.

[0011] For example, in the medical water jet system provided by at least one of the embodiments of the present disclosure, the water jet channel and / or the laser channel are located inside the suction channel.

[0012] For example, in the medical water jet system provided by at least one of the embodiments of the present disclosure, the axes of the water jet channel and the laser channel are parallel, and the water jet channel and the laser channel are respectively located on opposite sides of the suction channel along the radial direction.

[0013] For example, in the medical water jet system provided by at least one of the embodiments of the present disclosure, the water jet channel or the laser channel is located on the central axis of the insertion part.

[0014] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the outer diameter of the insertion part is R1, and the outer diameter of the suction channel is R2, and 0.4R1≤R2≤0.6R1.

[0015] For example, the medical water jet system provided by at least one embodiment of the present disclosure further comprises an image control assembly comprising a lens located at the distal end of the insertion part, and the image control assembly is configured to acquire images through the lens; wherein, on the cross section of the distal end of the insertion part, the center of the lens, the center of the water jet channel and the center of the laser channel are located on the same radial line.

[0016] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the suction control assembly further comprises a water inlet channel penetrating through the insertion part and the handle part, and the water inlet channel is configured to output fluid, and on the cross section of the distal end of the insertion part, the water inlet channel and the pressure sensor are located on opposite sides of the center line of the water jet channel and the laser channel respectively, and the water inlet channel is away from the pressure sensor.

[0017] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the laser energy adopts at least one of green laser, holmium laser, thulium laser and semiconductor laser.

[0018] For example, the medical water jet system provided by at least one embodiment of the present disclosure further comprises a host part, and the host part comprises a main control module, and the main control module is in communication connection with at least one of the laser assembly, the water jet assembly, the pressure control assembly, the image control assembly and the suction control assembly.

[0019] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the water jet assembly further comprises a nozzle connected to the distal end of the water jet channel, and the nozzle comprises an oscillation cavity, and the oscillation cavity comprises a throat hole and a cavity located distally to the throat hole, the ratio of the diameter of the cavity to the diameter of the throat hole is between 10:1 and 1:1, and the diameter of the throat hole is smaller than the diameter of the distal end of the water jet channel.

[0020] For example, in the medical water jet system provided by at least one embodiment of the present disclosure, the nozzle comprises a plurality of oscillation cavities connected in sequence from the proximal end to the distal end.

[0021] The medical water jet system provided by the present disclosure has the following beneficial effects: the medical water jet system provided by the embodiments of the present disclosure has a water jet assembly, a laser assembly and a suction control assembly, can simultaneously realize cutting and separation of tissues and hemostasis, and on this basis, improves the cutting and hemostasis efficiency, improves the operation effect, significantly reduces the heat damage to the tissues, reduces the complications and postoperative recovery time. Further, the medical water jet system provided by some embodiments of the present disclosure is more conducive to the observation and operation of doctors by cleverly arranging the water jet channel and the laser channel; the pressure control module controls the suction speed of the suction control assembly according to the pressure value, keeps the medical water jet system in a safe and stable working state, further reduces the secondary damage and complications of the patient, and improves the operation and operation safety. BRIEF DESCRIPTION OF DRAWINGS

[0022] In order to more clearly illustrate the technical solutions of the embodiments of the present disclosure, the drawings of the embodiments will be briefly introduced below. Obviously, the drawings described below only relate to some embodiments of the present disclosure, but not limit the present disclosure.

[0023] Fig. 1 is a structural schematic diagram of a medical water jet instrument provided by at least one embodiment of the present disclosure;

[0024] Fig. 2 is a cross-sectional schematic diagram of the distal end of the insertion part of the medical water jet instrument provided by at least one embodiment of the present disclosure;

[0025] Fig. 3 is a whole framework diagram of the medical water jet instrument provided by at least one embodiment of the present disclosure;

[0026] Fig. 4 is a control logic diagram of the pressure control module of the medical water jet instrument provided by at least one embodiment of the present disclosure;

[0027] Fig. 5 is another whole framework diagram of the medical water jet instrument provided by at least one embodiment of the present disclosure;

[0028] Fig. 6 is a schematic diagram of the arrangement of the water jet channel, the laser channel and the suction channel on the cross section of the distal end of the insertion part of the medical water jet instrument provided by at least one embodiment of the present disclosure;

[0029] Fig. 7 is another schematic diagram of the arrangement of the water jet channel, the laser channel and the suction channel on the cross section of the distal end of the insertion part of the medical water jet instrument provided by at least one embodiment of the present disclosure;

[0030] Fig. 8 and Fig. 9 are structural schematic diagrams of two kinds of cavitation nozzles of the medical water jet instrument provided by at least one embodiment of the present disclosure, respectively;

[0031] Fig. 10 is an experimental detection result of the cavitation nozzle of the medical water jet instrument provided by at least one embodiment of the present disclosure;

[0032] FIG. 11 is a structural schematic view of another cavitation nozzle of a medical water jet instrument according to at least one embodiment of the present disclosure;

[0033] FIG. 12 is a structural schematic view of another medical water jet instrument according to at least one embodiment of the present disclosure; and

[0034] FIG. 13 is an enlarged view of the medical water jet instrument of FIG. 1 circled by a dashed line. DETAILED DESCRIPTION

[0035] In order to make the objects, technical solutions and advantages of the embodiments of the present disclosure clearer, the technical solutions of the embodiments of the present disclosure will be described clearly and completely below with reference to the drawings of the embodiments of the present disclosure. Obviously, the described embodiments are only some of the embodiments of the present disclosure, but not all the embodiments of the present disclosure. Based on the described embodiments of the present disclosure, all other embodiments obtained by those of ordinary skill in the art without creative effort belong to the scope of protection of the present disclosure.

[0036] Unless otherwise defined, technical terms or scientific terms used in the present disclosure should be understood as having the same meaning as commonly understood by those of ordinary skill in the art to which the present disclosure belongs. The terms "first", "second" and similar terms used in the present disclosure do not denote any order, quantity or importance, but are used to distinguish different components. The terms "include" or "contain" and similar terms mean that the elements or objects before the terms encompass the elements or objects listed after the terms and their equivalents, and do not exclude other elements or objects. The terms "connect" or "connected" and similar terms are not limited to physical or mechanical connections, but can include electrical connections, whether direct or indirect. The terms "upper", "lower", "left", "right" and the like are only used to represent relative positional relationships, and when the absolute positions of the described objects change, the relative positional relationships may also change accordingly.

[0037] In the embodiments of the present disclosure, the term "proximal" refers to a part of the component or structure involved close to the clinician, and the term "distal" refers to a part of the component or structure involved away from the clinician. The term "a plurality of" means two or more.

[0038] For the surgical treatment of benign prostatic hyperplasia, after the resection of the prostatic hyperplasia tissue, the stem cells in the surgical capsule will regenerate and transform into transitional epithelial cells to cover the new surgical capsule surface to form new epithelial tissue, so the protection of the surgical capsule surface in the operation is of great significance to the postoperative recovery of the patient.

[0039] However, the current clinical resection of prostate hyperplasia tissue is often hot damage, which is easy to cause tissue burning and carbonization, and can cause a certain degree of damage to the surgical capsule, causing postoperative complications. At the same time, the learning curve of laser surgery is long, and doctors are not easy to master.

[0040] To this end, the surgical procedure using water cavitation ablation technology has no risk of thermal damage, which can protect the surgical capsule to some extent. Specifically, the water cavitation ablation technology uses water jet to generate cavitation in the submerged flow state, and uses the energy generated by the cavitation bubbles to effectively ablate the glandular tissue, while preserving structures such as blood vessels and surgical capsules. Water ablation technology does not generate heat, and is a non-thermal damage tissue cutting and separation technology, but this technology is difficult to ablate while stopping bleeding.

[0041] In addition, the existing prostate enucleation / resection surgery has many components, and often needs to change different surgical instruments during the operation, which is complicated and easy to cause damage to the urethra.

[0042] The medical water jet system provided by at least one embodiment of the present disclosure has an insertion part and a handle part connected to the proximal end of the insertion part, and includes a water jet assembly, a laser assembly, and a suction control assembly; the water jet assembly includes a water jet channel through the insertion part and the handle part, and is configured to output a jet; the laser assembly includes a laser channel through the insertion part and the handle part, and is configured to output laser energy; the suction control assembly includes a suction channel through the insertion part and the handle part, and is configured to suction fluid.

[0043] The medical water jet system provided by the embodiment of the present disclosure combines water jet technology and laser technology, which can achieve prostate tissue resection without thermal damage and at the same time achieve hemostasis, which is of great significance to the protection of stem cells in the surgical capsule. In addition, the medical water jet instrument has the functions of water jet resection, laser hemostasis, waste liquid collection, etc., and can complete the entire operation with one instrument, so the operator does not need to change the surgical instrument during the operation, which is simple to operate and has a short learning curve.

[0044] The medical water jet instrument provided by the embodiment of the present disclosure will be described below through several specific embodiments.

[0045] The medical water jet device according to at least one embodiment of the present disclosure is shown in FIG. 1, the cross-sectional view of the distal end of the insertion part of the medical water jet device is shown in FIG. 2, and the overall structure of the medical water jet device is shown in FIG. 3. As shown in FIG. 3, the medical water jet device includes an operation part and a main machine part. The operation part includes, for example, an insertion part 12 as shown in FIG. 1 and a handle part 11 connected to the proximal end of the insertion part 12. The insertion part 12 can enter the target area of the human body, for example, to perform corresponding operations. The handle part 11 can be held by the operator to control the insertion part 12. For example, the medical water jet device further includes a water jet assembly, a laser assembly, an image control assembly, a suction control assembly, and the like. At least part of these assemblies includes structures located in the operation part and control modules located in the main machine part, respectively.

[0046] For example, the water jet assembly includes a water jet channel 101 passing through the insertion part 12 and the handle part 11, for conveying fluid to form a jet. The water jet assembly further includes, for example, a jet output module and a nozzle. The nozzle is arranged at the distal end of the insertion part 12. The water jet assembly is configured to output a jet with a certain pressure through the cooperation of various structures of the water jet assembly, which can be used to crush, cut, and the like, the treatment site of the prostate tissue and the like.

[0047] For example, the jet output module is configured to regulate the output pressure or output flow rate of the nozzle. For example, the jet is conveyed to the nozzle through a high-pressure pipe arranged in the water jet channel 101 to form a cavitation jet. For example, through control, the nozzle can produce cavitation effect under the submerged flow in the surgical environment (to be described in detail later). The generated pressure ranges from 1 MPa to 15 MPa, for example, 4 MPa to 6 MPa, for example, 4 MPa, 4.5 MPa, 5 MPa, 5.5 MPa, or 6 MPa, and the like.

[0048] For example, the laser assembly includes a laser channel 201 passing through the insertion part 12 and the handle part 11, and further includes, for example, a laser generating device (such as a laser), a laser output module, and a laser fiber arranged in the laser channel 201. The laser assembly is configured to output laser energy through the cooperation of the above-mentioned various structures, which can be used to perform vaporization, cutting, hemostasis, and the like, on the treatment site of the prostate tissue and the like.

[0049] For example, the laser output module is configured to regulate the output power or pulse energy or pulse frequency or indicate spot size or indicate optical power of the laser, and output laser energy through the laser fiber in the laser channel 201. For example, the laser fiber is a direct laser fiber.

[0050] For example, in some examples, the laser fiber has a core diameter of 50 microns to 1000 microns, such as 50 microns, 100 microns, 200 microns, 300 microns, 400 microns, 500 microns, 550 microns, 600 microns, 700 microns, 800 microns, 900 microns, or 1000 microns, etc. The laser fiber can be in various forms such as round fiber, square fiber, ring fiber, etc. For example, the laser energy can be at least one of green laser, holmium laser, thulium laser, and semiconductor laser, etc. For example, in one example, the laser type used is thulium laser with a central wavelength of 1940 nm ± 10 nm. Thulium laser can cause less thermal damage, reduce damage to the surgical capsule, and facilitate differentiation of basal cells into urothelial cells in the surgical capsule after surgery, accelerating wound repair.

[0051] For example, the image control assembly includes a lens 301, and further includes an image control module, the proximal end of the insertion portion 12 is connected to the handle portion 11, the lens 301 is located at the distal end of the insertion portion 12, and the image control assembly is configured to obtain images.

[0052] For example, the image control module is configured to process the images collected by the lens 301 and output the processed information to a display for viewing by an operator, such as a doctor.

[0053] For example, in some embodiments, the lens 301 can include an image sensor (such as a CMOS image sensor) and a light source, which are connected to an interface 302 through a connecting line, and the interface 302 of the lens 301 is connected to the image control module through a connecting line, for outputting the images taken by the lens 301 in real time or the processed images on a display, for example, to facilitate the operator to perform the corresponding surgical operation. For example, as shown in FIG. 2, the lens 301 is located at the 12 o'clock direction on the end face of the cross section or the distal end of the insertion portion 12, and the lens view angle (i.e., the angle relative to the axial direction of the insertion portion 12) can be 12°, 30°, or 45°, etc. For example, in some examples, the lens 301 and the connecting line and the interface 302 can be an independent component, which can be detachably installed in the insertion portion 12 and the handle portion 11, and can be detached after use, and can be reused after sterilization and other treatments.

[0054] For example, the suction control assembly includes a suction passage 401 that penetrates through the insertion portion 12 and the handle portion 11, and further includes a suction control module, and the suction control assembly is configured to suck fluid, such as waste liquid in the environment at the distal end of the insertion portion 12.

[0055] As shown in FIG. 2, for example, in some embodiments, the suction control assembly can further include a water inlet channel 601 passing through the insertion portion 12 and the handle portion 11, configured to output fluid, for example, to output fluid to the distal end of the insertion portion 12, for example, for washing the treatment site of the prostate tissue and the lens 301 and other structures.

[0056] As shown in FIG. 2, for example, the suction control module is configured to control the on-off and flow rate of the fluid in the suction channel 401 or the water inlet channel 601, thereby achieving safer and more timely flushing operations.

[0057] For example, the proximal end of the handle portion 11 provides an interface for each component. As shown in FIG. 1, the handle portion 11 includes a housing portion 111 and a holding portion 112, and the interface 202 corresponding to the laser channel 201 and the interface 102 corresponding to the water jet channel 101 extend from the housing portion 111 of the handle portion 11, respectively used for connecting the laser source and the fluid source.

[0058] For example, the interface 302 corresponding to the lens 301, the interface 402 corresponding to the suction channel 401, and the interface 602 corresponding to the water inlet channel 601 extend from the holding portion 112 of the handle portion 11. For example, a pipe body, for example, a high-pressure pipe, can be provided in the water inlet channel 601, which is connected to a water source, for example, physiological saline, through the interface 602. For example, the water inlet channel 601 can be provided with one or more, for example, two, of which one is shown in FIG. 2 as an example. For example, a pipe body, for example, a negative pressure pipe, can be provided in the suction channel 401, which is connected to a waste liquid tank through the interface 402 of the suction pump, used for collecting tissue, waste liquid, etc. For example, as shown in FIGS. 3 and 5, the collection device can be used to collect the excised prostate tissue in vitro, which can be used for postoperative tissue inspection.

[0059] For example, in some embodiments, in combination with FIGS. 2 and 3, the medical water jet instrument can further include a pressure control assembly, the pressure control assembly including a pressure sensor 501 and a pressure control module in communication connection with the pressure sensor 501, the pressure sensor 501 being located at the distal end of the insertion portion 12, configured to detect the pressure value of the fluid in the environment where the distal end of the insertion portion 12 is located, for example, for real-time monitoring, and feedback to the pressure control module; the pressure control module is configured to receive the pressure value detected by the pressure sensor 501, and control the suction speed of the suction control assembly according to the pressure value.

[0060] For example, as shown in FIG. 2, the pressure sensor 501 is arranged on the end face of the distal end of the insertion portion 12, so as to better measure the fluid pressure in the environment where the distal end of the insertion portion 12 is located. For example, in other embodiments, the pressure sensor 501 can also be arranged on the side of the distal end of the insertion portion 12, and the embodiments of the present disclosure are not limited thereto.

[0061] For example, FIG. 4 shows a control logic diagram of a pressure control module in a medical water jet instrument according to at least one embodiment of the present disclosure. In some embodiments, as shown in FIG. 4, the pressure control module controls the suction speed of the suction control assembly according to the pressure value includes: when the pressure value is greater than a first upper threshold value and less than or equal to a second upper threshold value, controlling the suction control assembly to increase the suction speed; when the pressure value is less than a first lower threshold value and greater than or equal to a second lower threshold value, controlling the suction control assembly to decrease the suction speed.

[0062] For example, in some embodiments, as shown in FIG. 4, the pressure control module controls the suction speed of the suction control assembly and / or the jet of the water jet assembly according to the pressure value can further include: when the pressure value is greater than the second upper threshold value, or the pressure value is less than the second lower threshold value, the pressure control module outputs a stop signal to control the medical water jet system to stop, for example, the pressure control module (for example, through the main control module) outputs a stop signal to the water jet assembly, and the water jet assembly stops outputting the jet. In another embodiment, the pressure control module can also output a stop signal to the suction control assembly to control the water inlet channel 601 of the suction control assembly to stop outputting the fluid. When the pressure value is less than or equal to the first upper threshold value, and the pressure value is greater than or equal to the first lower threshold value, the suction control assembly maintains the current suction speed.

[0063] For example, the first upper threshold is greater than the first lower threshold. The first upper threshold is an upper warning value, for example, 13 mmHg, and the pressure value greater than the value can cause damage to the human body, so the pressure value needs to be controlled within the value. The second upper threshold is an upper limit value, for example, 30 mmHg, and the pressure value greater than the value can cause safety risks, so the pressure value cannot exceed the value. For example, the first lower threshold is a lower warning value, for example, 0-13 mmHg, and the pressure value less than the value can cause damage to the human body, so the pressure value needs to be controlled above the value; the second lower threshold is a lower limit value, for example, 0 mmHg, and the pressure value less than the value can cause safety risks, so the pressure value cannot be lower than the value. Thus, by the above control method, for example, by the PID control method, the medical water jet instrument can be kept in a safe and stable working state, and the operation safety can be improved. For example, in the specific control process, the control logic of the PID is that the pressure sensor 501 measures once every certain period of time (for example, every 1 s, 1 ms, etc.), compares the pressure value detected by the current pressure sensor 501 with the pressure value detected by the last pressure sensor 501, obtains a pressure difference value, calculates the negative pressure change value of the suction pump (for example, the negative pressure pump) corresponding to the pressure difference value by the PID, and then adjusts the suction negative pressure of the suction pump (for example, the negative pressure pump) according to the negative pressure change value, so as to adjust the suction speed. In the specific control, the above process can be repeated until the pressure value detected by the pressure sensor 501 returns to the safe value interval, that is, the interval between the first upper threshold and the first lower threshold.

[0064] For example, the pressure control module can receive pressure data from the pressure sensor 501 in real time, and realize feedback, regulation and control under the control logic as shown in FIG. 4, and provide alarm or prompt information.

[0065] For example, the pressure control module can control the suction flow rate by directly controlling the negative pressure value of the suction pump of the suction assembly, thereby realizing different suction speeds, and the embodiments of the present disclosure do not make specific limitations thereto as long as the effect of controlling the suction speed can be realized.

[0066] The medical water jet system realizes different suction speeds, which can control the pressure of the fluid in the environment (patient treatment site, for example, bladder and urethra) where the distal end of the insertion part is located in real time, thereby reducing the side damage and complications of the patient. For example, if the pressure value is too high, it exceeds the pressure threshold of the bladder-ureter valve anti-reflux, and the liquid will enter the kidney along the ureter, causing pressure damage to the kidney. In addition, the working environment where the distal end of the insertion part is located has some open venous vessels, and high pressure can easily cause venous reflux and cause complications. Therefore, the suction speed is controlled in real time according to the pressure value of the fluid in the environment where the distal end of the insertion part is located, which can keep the urethra in a relatively constant liquid environment and ensure the safety of the operation.

[0067] For example, in some embodiments, as shown in FIG. 3, the host part can also include a main control module, which is in communication connection with at least one of the laser assembly, the water jet assembly, the pressure control assembly, the image control assembly and the suction control assembly, for example, the main control module is in communication connection with the laser output module, the jet output module, the pressure control module, the image control module and the suction control module, etc., for example, various control instructions of the operator, such as the doctor, such as control buttons, foot pedals, etc. Control information input, such as on-off control or parameter adjustment of each module, or feedback control according to the feedback information of the module, etc.

[0068] For example, in some embodiments, as shown in FIG. 5, the host part can also not contain the laser output module. At this time, the host part can be compatible with and connected to the existing laser treatment equipment in the hospital, which can be connected through the laser channel 201 provided by the medical water jet instrument, at this time, the control of the laser equipment can be controlled by its own foot pedal and control button or key. Thus, the function of the laser assembly can also be realized.

[0069] For example, the water jet channel 101 and / or the laser channel 201 are located inside the suction channel 401; in some embodiments, as shown in FIG. 2, the water jet channel 101 is located inside the suction channel 401. For example, in some embodiments, the laser channel 201 is located inside the suction channel 401. For example, in some embodiments, the water jet channel 101 and the laser channel 201 are both located inside the suction channel 401. Thus, the suction force of the suction channel 401 can be used to form a certain traction force on the tissue to suck the tissue and prevent the water jet cavitation jet from blowing the tissue away; on the other hand, this setting can make the suction channel 401 occupy a larger space to achieve better suction effect.

[0070] For example, the water jet channel 101 or the laser channel 201 is located on the central axis of the insertion part 12. For example, in the embodiment of FIG. 2, the water jet channel 101 is located on the central axis of the insertion part 12, and the position of the laser channel 201 is at the 6 o'clock direction in the cross section of the insertion part 12. The water jet channel 101 is arranged at the middle position of the insertion part 12, which can facilitate the balance during the operation of the water jet nozzle, and the laser channel 201 is located beside the water jet channel 101 to facilitate the realization of the auxiliary function of hemostasis; for example, in other examples, the positions of the water jet channel 101 and the laser channel 201 can also be interchanged. If the positions are arranged at will, the water jet channel 101 or the laser channel 201 needs to stretch out a long length from the distal end surface of the insertion part 12 to be exposed in the field of vision of the doctor, which affects the operation of the doctor. In addition, if the water jet channel 101 or the laser channel 201 is at the edge of the field of vision, it is also not conducive to the doctor to observe the state of the tissue during ablation.

[0071] For example, in some embodiments, as shown in FIG. 2, the axes of the waterjet channel 101 and the laser channel 201 are parallel, and the waterjet channel 101 and the laser channel 201 are respectively located on opposite sides of the suction channel 401 in the radial direction. Thus, when switching between cutting and coagulation, i.e., switching between waterjet jet operation and laser operation, since the energy of each operation needs to be placed in the center of the field of view, by the above arrangement, the movement of the insertion portion 12 of the operating handle during switching between cutting and coagulation can be minimized, while avoiding rotation of the insertion portion 12.

[0072] For example, FIG. 6 shows a schematic view of the arrangement of the waterjet channel 101, the laser channel 201, and the suction channel 401 on the cross section / end surface of the distal end of the insertion portion 12. In some embodiments, in combination with FIG. 2 and FIG. 6, on the cross section / end surface of the distal end of the insertion portion 12, the center O1 of the lens 301, the center O2 of the waterjet channel 101, and the center O3 of the laser channel 201 are located on the same line in the radial direction, as shown by the dashed line in FIG. 6. Thus, the lens 301 can face the waterjet channel 101 and the laser channel 201, so that the operator can fully see and control the working state of the waterjet assembly and the laser assembly.

[0073] For example, in some embodiments, in combination with FIG. 2 and FIG. 6, on the cross section / end surface of the distal end of the insertion portion 12, the water inlet channel 601 and the pressure sensor 501 are located on opposite sides of the above-mentioned same line (e.g., the dashed line in FIG. 6), i.e., on opposite sides of the connecting line of the centers of the waterjet channel 101 and the laser channel 201, and the water inlet channel 601 is away from the pressure sensor 501. Thus, the pressure sensor 501 is spaced apart from the water inlet channel 601, so that the fluid pressure of the water inlet channel 601 can not affect the detection of the pressure sensor 501.

[0074] For example, FIG. 7 shows another schematic view of the arrangement of the waterjet channel 101, the laser channel 201, and the suction channel 401 on the cross section / end surface of the distal end of the insertion portion 12. As shown in FIG. 7, in other embodiments, the waterjet channel 101 is located inside the suction channel 401, and the laser channel 201 is located outside the suction channel 401. At this time, the waterjet channel 101 and the laser channel 201 are respectively located on opposite sides of the suction channel 401 in the radial direction. At this time, the suction force of the suction channel 401 can also be used to form a certain traction force on the tissue, so as to suck the tissue and prevent the waterjet cavitation jet from blowing away the tissue.

[0075] For example, in some embodiments, referring to FIG. 7, the outer diameter of the insertion portion 12 is R1, the outer diameter of the suction channel 401 is R2, 0.4R1≤R2≤0.6R1, for example, R2=0.5R1. In this way, the suction channel 401 occupies more space in the insertion portion 12, and a better suction effect can be achieved. For example, in some examples, the outer diameter R2 of the insertion portion 12 is 20F-26F (French, 1 French=1 / 3mm), for example, 20F, 21F, 22F, 23F, 24F, 25F, or 26F, etc., and R1 is, for example, 7mm-9mm.

[0076] For example, in some embodiments, the nozzle 103 of the water jet assembly can be assembled or disassembled as a separate component on the water jet channel 101 at the distal end of the insertion portion 12.

[0077] For example, in some embodiments, the nozzle 103 adopts a cavitation nozzle, which has a shock cavity, for example, a single-stage or multi-stage shock cavity design can be adopted, and the multi-stage shock cavity design can produce a better cavitation effect than the single-stage shock cavity.

[0078] For example, FIGS. 8 and 9 respectively show the structural schematic diagrams of two kinds of cavitation nozzles, and the shock cavities of the cavitation nozzles in FIGS. 8 and 9 adopt different structures. In FIG. 8, the shock cavity includes a throat hole Q1 and a cavity Q2’ located distally to the throat hole Q1. The cavity structures on both sides of the throat hole Q1 are different, the cavity Q2 located on the upper side (i.e., the proximal end) is columnar, and the cavity Q2’ located on the lower side (i.e., the distal end) is conical; in FIG. 9, the cavity Q2’ distal to the throat hole Q1 and the distal end cavity Q2 of the water jet channel 101 have the same structure, which is columnar. For example, shown in FIGS. 8 and 9 are single-stage shock cavities, and in use, a plurality of shock cavities can be connected in sequence from proximal to distal, i.e., in series, to form a multi-stage shock cavity, thereby achieving a better cavitation effect.

[0079] For example, after the high-pressure water flow passes through the throat hole Q1 from the cavity Q2 at the distal end of the water jet channel 101 to the cavity Q2’ of the shock cavity, the space expands sharply and the pressure decreases instantaneously, the dissolved gas in the water flow releases small bubbles from the fluid and continues to grow, forming a cavitation bubble group (appearing as many cavitation bubbles), until it falls off and breaks, i.e., cavitation effect is produced. These bubbles can have an ablation effect on the tissue.

[0080] For example, in some embodiments, as shown in FIGS. 8 and 9, the diameter of the cavity Q2’ of the oscillation cavity is b (in FIG. 8, the value of the diameter b gradually increases along the axial direction from the proximal end to the distal end), and the diameter of the throat Q1 is d, and the value of b:d can be between 10:1 and 1:1, for example, 10:1, 8:1, 7:1, 6:1, 5:1, 4:1, 3:1, or 1:1, etc. For example, the diameter d of the throat Q1 is smaller than the diameter of the distal cavity Q2 of the water jet channel 101.

[0081] The jet ejected from the nozzle produces cavitation in the liquid environment, and the part of the jet with cavitation bubbles is referred to as a plume, which has the effect of cutting tissue. Through experimental detection of water jet nozzles with different b:d values, FIG. 10 shows the results of the experimental detection. As shown in FIG. 10, under the same test conditions, i.e., the water pressure generated by the nozzle is 5 MPa and the flow rate is 3.3 mL / min, only the value of b:d is changed, for example, the value of d is selected as 0.25 mm, and only the value of b is changed. When b is 0.75 mm, the b / d ratio is 3:1, and the obtained plume length is 14 mm; when b is 1.6 mm, the b / d ratio is 6.4:1, and the obtained plume length is 13 mm; when b is 1.25 mm, the b / d ratio is 5:1, and the obtained plume length is 17 mm. That is, when the b / d ratio is 5:1, the obtained plume length is the longest, and better cavitation effect can be achieved.

[0082] For example, in actual operation, the plume length generated by the cavitation nozzle under submerged flow can reach 2 mm to 20 mm, for example, 2 mm to 10 mm, for example, 2 mm to 5 mm. At this time, the plume generated by the cavitation nozzle is less likely to cause secondary damage, and the ablation area is larger.

[0083] For example, in some embodiments, the ejection direction of the water jet nozzle cavitation jet is parallel to the axial direction of the insertion part 12; for example, in other embodiments, as shown in FIG. 11, the ejection direction of the water jet nozzle cavitation jet has an angle a with the axial direction of the insertion part 12, and the angle a is, for example, 10°, 12°, 20°, 30°, 45°, 90°, 12°, 180°, etc. For example, the ejection direction of the nozzle cavitation jet is the same as the extension direction of the throat Q1 of the oscillation cavity, so the ejection direction of the nozzle cavitation jet can be adjusted by designing the throat Q1.

[0084] For example, FIG. 13 shows the medical water jet instrument in FIG. 1 in an enlarged schematic view circled by a dashed line. In some embodiments, as shown in FIG. 13, the end face of the distal end of the insertion portion 12 is arranged at an angle to the axial direction of the insertion portion 12. The angle between the perpendicular of the end face of the distal end of the insertion portion 12 and the axial direction of the insertion portion 12 is β. β can be 12°-45°, for example, 12°, 30°, or 45°, etc. This angle is more convenient for the operator to view and operate the surgical area.

[0085] For example, FIG. 12 shows a structural schematic view of another medical water jet instrument according to at least one embodiment of the present disclosure. As shown in FIG. 12, in some embodiments, the proximal end of the laser channel 201 or the water jet channel 101 has a water stop valve A. The water stop valve A can allow the laser fiber or the water jet nozzle connected pipe in the laser channel 201 to pass through the corresponding channel, while preventing the liquid or broken tissue in the surgical area from flowing out through this channel. For example, the insertion portion 12 can pass through the handle portion 11. The portion of the insertion portion 12 located in the handle portion 11 is labeled as B.

[0086] For example, the medical water jet instrument according to the embodiments of the present disclosure can be used for surgical treatment of prostatic hyperplasia, bladder stones, bladder tumors, uterine fibroids, etc. During the treatment, the jet of the water jet can be used to break and selectively remove the tissue. This process is fast and efficient, and can remove the hyperplastic tissue without heat damage, protect the surgical capsule, and reduce surgical complications. At the same time, the laser energy can be used to cut, coagulate, and vaporize the tissue to ensure hemostasis. On the other hand, by designing the laser and water jet technology in the same instrument, hemostasis is achieved while the tissue is broken and ablated by laser energy, and the heat damage caused by the laser is reduced by the water jet. The two achieve a synergistic effect, reducing complications and postoperative recovery time, and significantly improving treatment effect. On the other hand, the doctor does not need to change the instrument during the operation, reducing the number of surgical steps and avoiding damage to the urethra caused by instrument replacement. On the other hand, the lens provides a real-time visual image for the operation, which can facilitate precise operation. The pressure sensor can control the pressure in the bladder and urethra, which can reduce the side damage and complications of the patient. In addition, the medical water jet instrument also has the function of flushing the lens, the surgical area, etc. It also has the function of aspirating the flushing waste liquid, tissue debris, and ex vivo tissue generated during the operation. The medical water jet instrument integrates multiple functions in one, avoiding the replacement of the instrument during the operation, thereby improving the efficiency of the operation.

[0087] The following points need to be explained:

[0088] (1) The drawings of the embodiments of the present disclosure only involve the structures involved in the embodiments of the present disclosure, and other structures can be referred to the general design.

[0089] (2) For clarity, the thickness of layers or regions in the drawings used to describe embodiments of the present disclosure is exaggerated or reduced, i.e., the drawings are not drawn to scale.

[0090] (3) In the case of no conflict, the embodiments of the present disclosure and the features in the embodiments can be combined with each other to obtain new embodiments.

[0091] The above is only a specific implementation of the present disclosure, but the protection scope of the present disclosure is not limited thereto, and the protection scope of the present disclosure should be subject to the protection scope of the claims.

Claims

1. A medical water jet system, characterized in that The medical water jet system comprises: a water jet assembly comprising a water jet channel penetrating through the insertion part and the handle part, configured to output a jet flow; a laser assembly comprising a laser channel penetrating through the insertion part and the handle part, configured to output laser energy; and a suction control assembly comprising a suction channel penetrating through the insertion part and the handle part, configured to suck fluid.

2. The medical water jet system according to claim 1, further comprising: a pressure control assembly comprising a pressure sensor and a pressure control module in communication connection with the pressure sensor, wherein the pressure sensor is located at a distal end of the insertion part, configured to detect a pressure value of fluid in an environment where the distal end of the insertion part is located, and feed back to the pressure control module; the pressure control module is configured to receive the pressure value detected by the pressure sensor, and control a suction speed of the suction control assembly and / or control the medical water jet system to stop according to the pressure value.

3. The medical water jet system according to claim 2, wherein the pressure control module controls the suction speed of the suction control assembly according to the pressure value comprises: when the pressure value is greater than a first upper threshold value and less than or equal to a second upper threshold value, control the suction control assembly to increase the suction speed; when the pressure value is less than a first lower threshold value and greater than or equal to a second lower threshold value, control the suction control assembly to decrease the suction speed; wherein the first upper threshold value is greater than the first lower threshold value.

4. The medical water jet system according to claim 3, wherein the pressure control module controls the suction speed of the suction control assembly according to the pressure value further comprises: when the pressure value is less than or equal to the first upper threshold value, and the pressure value is greater than or equal to the first lower threshold value, control the suction control assembly to maintain the current suction speed.

5. The medical water jet system according to any of claims 2-4, wherein the pressure control module controls the medical water jet system to stop according to the pressure value comprises: when the pressure value is greater than the second upper threshold value, or the pressure value is less than the second lower threshold value, the pressure control module outputs a stop signal to control the medical water jet system to stop outputting the jet flow.

6. The medical water jet system according to any of claims 1-5, wherein the water jet channel and / or the laser channel are located inside the suction channel.

7. The medical water jet system according to claim 6, wherein the axes of the water jet channel and the laser channel are parallel, and the water jet channel and the laser channel are respectively located on opposite sides of the suction channel along the radial direction.

8. The medical water jet system according to claim 6, wherein the water jet channel or the laser channel is located on the central axis of the insertion part.

9. The medical water jet system according to any of claims 1-8, wherein an outer diameter of the insertion part is R1, and an outer diameter of the suction channel is R2, 0.4R1≤R2≤0.6R1.

10. The medical water jet system according to any one of claims 1-9, further comprising: an image control assembly comprising a lens located at a distal end of the insertion part, the image control assembly being configured to acquire an image through the lens; wherein, on a cross section of the distal end of the insertion part, a center of the lens, a center of the water jet channel and a center of the laser channel are located on the same straight line along the radial direction.

11. The medical water jet system according to any of claims 2-5, wherein the suction control assembly further comprises a water inlet channel penetrating through the insertion part and the handle part, the water inlet channel being configured to output fluid, On a cross section of a distal end of the insertion part, the water inlet channel and the pressure sensor are respectively located on opposite sides of a center line of the water jet channel and the laser channel, and the water inlet channel is away from the pressure sensor.

12. The medical water jet system according to any of claims 1-11, wherein The laser energy adopts at least one of green laser, holmium laser, thulium laser and semiconductor laser. 13.The medical water jet system of claim 10, further comprising a main machine part, the main machine part comprising a main control module, the main control module being communicatively connected with at least one of the laser assembly, the water jet assembly, the pressure control assembly, the image control assembly and the suction control assembly.

14. The medical water jet system according to any of claims 1-13, wherein The water jet assembly further comprises a nozzle connected to a distal end of the water jet channel, The nozzle comprises an oscillation cavity, the oscillation cavity comprising a throat and a cavity located distally to the throat, a ratio of a diameter of the cavity to a diameter of the throat being between 10:1 and 1:1, and the diameter of the throat being smaller than a diameter of the distal end of the water jet channel. 15.The medical water jet system of claim 14, wherein, The nozzle comprises a plurality of the oscillation cavities connected in sequence from proximal end to distal end.

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