CN110898317A

CN110898317A - Uterine neck sheath tube for oviduct interventional embolization

Info

Publication number: CN110898317A
Application number: CN201911258917.0A
Authority: CN
Inventors: 金文韬; 张国福; 李文涛
Original assignee: Obstetrics and Gynecology Hospital of Fudan University
Current assignee: Obstetrics and Gynecology Hospital of Fudan University
Priority date: 2019-12-10
Filing date: 2019-12-10
Publication date: 2020-03-24

Abstract

The invention provides a cervix uteri sheath tube for oviduct interventional embolization, which comprises a cervix uteri plug, a sheath tube and a sheath tube seat, wherein the cervix uteri plug is of a conical hollow structure and is provided with a first tubular cavity along the axial direction, the cervix uteri plug is movably sleeved at the head end of the sheath tube, the sheath tube is provided with a second tubular cavity and a fourth tubular cavity along the axial direction, the sheath tube seat is provided with a third tubular cavity along the axial direction, the tail end of the sheath tube seat is provided with a first through hole, the lateral surface of the sheath tube seat is provided with a second injection through hole, the second injection through hole is connected with a lateral tube, the tail end of the lateral tube is provided with a three-way device and a pressure gauge, the first through hole is. The device can lead the oviduct catheter to pass through and directly enter the uterine cavity, thereby reducing the damage to the cervical canal; the sheath tube is provided with a double-cavity structure, when the oviduct catheter is inserted into an oviduct, contrast agent is injected through the side tube, uterine cavity radiography is carried out, pressure is monitored, the step of repeatedly withdrawing the oviduct catheter is omitted, damage to a cervical canal and an endometrium of the uterine cavity is reduced, and operation time and infection risk are reduced.

Description

Uterine neck sheath tube for oviduct interventional embolization

Technical Field

The invention relates to the technical field of medical instruments, in particular to a cervical sheath for an oviduct interventional embolization.

Background

For patients with more severe tubal infertility, in vitro fertilization-embryo transfer is often used clinically. However, if the patient is accompanied by hydrosalpinx, the hydrosalpinx flows back into the uterine cavity to cause the pregnancy rate to be greatly reduced. DSA guided tubal interventional embolization is an alternative method for preventing hydrops reflux at present, and embolization materials are usually platinum microcoils, so that the major advantages of the embolization materials are that the risks of operation and general anesthesia are avoided, the blood supply of ovaries is not influenced, and more patients begin to select the technology to treat the hydrops tubal.

In the process of a fallopian tube interventional embolization operation, when a fallopian tube catheter is inserted into a uterine cavity, a contrast medium is injected from a cervix to clearly determine the shape of the uterine cavity and the position of a uterine horn, and meanwhile, when a spring ring is placed, the position of the uterine horn is also clearly determined, but the position of the uterus is not fixed, a reference provided by a contrast film is reserved in advance and is not reliable, and the risk of infection is increased by repeatedly withdrawing the inserted catheter.

The Chinese patent CN203425355U discloses an outer sheath tube and a sealing ring, the outer sheath tube is formed by sequentially connecting a uterine plug, a first tube body and a connector, the uterine plug is an arc cone, the uterine plug is provided with a first cavity along the axial direction, and the big end of the uterine plug is spliced with one end of the first tube body; the sealing ring is composed of a first cylinder with a second cavity, a second cylinder body and a third cylinder body, wherein a through hole is formed in the axis part of the third cylinder body, the shape of the second cavity of the first cylinder body is matched with that of the joint suspension end, an open slot is formed in the end part of the first cylinder body, and the open slot is communicated with the second cavity. The device is more reasonable as uterus oviduct radiography device, can not get into the palace chamber and carry out uterus oviduct radiography, and circular arc cone type uterine plug can seal the outer mouth of cervix completely when injecting the contrast medium, prevents that the contrast medium is excessive, but circular arc cone type uterine plug can't reach the inner mouth of cervical canal when as the sheath pipe, is unfavorable for oviduct catheter to insert. As can be seen from the structural schematic diagram of the sheath tube of the fig. 1, the uterine plug is inserted at one end of the first tube body, and the first tube body can not completely penetrate the uterine plug, so that the structure can play a good role in blocking gas (liquid) in the uterus from overflowing at the external opening of the uterus, but because a slender cervical tube channel is arranged between the external opening of the uterus and the internal opening, the fallopian tube catheter can only be guided to the external opening during insertion, can not be guided to enter the internal opening, can not smoothly enter the uterine cavity, and can easily cause damage to the cervical tube. In addition, the sealing ring is only provided with a through hole matched with the outer diameter of the oviduct catheter, and is not provided with an injection through hole or a pipeline, so that uterine cavity radiography can not be carried out when the oviduct catheter and the microcatheter are inserted in an operation, the oviduct catheter must be withdrawn first to inject a contrast medium for radiography, the risk of operation infection can be improved, the injury of the cervical canal is increased, and the placing accuracy of the embolism spring ring is influenced. Meanwhile, when the uterine cavity radiography is carried out at the end of the operation to check whether the oviduct embolism is successful, operators determine the injection pressure of the contrast agent according to hand feeling at present, the standards of different operators have larger difference, and uniform quantitative standards do not exist, so that the oviduct embolism operation success rates of different centers/hospitals have larger difference. In summary, it is not possible to completely guide the fallopian tube into the uterine opening during the tubal embolization, and it is not possible to simultaneously perform the radiography to show the uterine angle while the tubal catheter is inserted, so it is desirable to provide a cervical sheath for tubal embolization to solve the above-mentioned problems.

Disclosure of Invention

The invention aims to provide a cervix sheath tube for a fallopian tube interventional embolization, which can guide a fallopian tube into an internal uterine opening during the fallopian tube embolization, inject a contrast medium into the uterine cavity while inserting a fallopian tube catheter to display uterine horn by radiography, and simultaneously prompt injection pressure.

In order to achieve the purpose, the invention provides a cervix sheath tube for a tubal interventional embolization, which comprises a cervix plug, a sheath tube and a sheath tube seat, and is characterized in that the cervix plug is of a conical hollow structure, a first tubular cavity is arranged along the axial direction, the inner diameter of the first tubular cavity is matched with the outer diameter of the sheath tube, the cervix plug is movably sleeved at the head end of the sheath tube, the sheath tube can be inserted from the large head end of the cervix plug and extends out from the small head end of the cervix plug, a second tubular cavity and a fourth tubular cavity are arranged along the axial direction of the sheath tube, a third tubular cavity is arranged along the axial direction of the sheath tube seat, the connecting end of the sheath tube seat is connected with the tail end of the sheath tube, a first through hole is arranged at the tail end of the sheath tube seat, a second injection through hole is arranged on the side surface of the sheath tube seat, the second injection through hole is connected with a side tube, a tee joint, the injection through hole II is communicated with the cavity IV.

As a preferable scheme, the cavity four is an interlayer formed between the tubular cavity two and the outer wall of the sheath tube. The injection through hole II is communicated with the interlayer, contrast agent is injected from the side tube and directly reaches the head end of the sheath tube through the interlayer, and the head end of the sheath tube is provided with a plurality of small holes or is open, so that the contrast agent enters the uterus to carry out uterine cavity radiography.

As a preferable scheme, the head end of the sheath tube is of a round blunt structure. The sheath tube can be inserted from the large head end of the cervical plug and extends out from the small head end of the cervical plug, and passes through the cervical canal to enter the uterus, and the round and blunt structure reduces the damage to the inner wall of the cervical canal.

Preferably, the through hole has a diameter matched with the outer diameter of the oviduct catheter.

Preferably, the inner diameter of the tubular cavity II is larger than the outer diameter of the oviduct catheter.

Preferably, the end of the sheath tube seat is provided with an anti-reflux valve. The valve is generally made of silica gel, and can be inserted into the oviduct catheter from the tail end of the sheath seat and can also be used for blocking the tail end of the sheath seat to prevent the contrast agent and the like from flowing backwards.

Preferably, the outer wall of the sheath tube is provided with guide scale marks. The sheath needs to enter the inner opening from the external uterine opening, and the scale lines can remind an operator of intuitively knowing the entering depth, so that the operation is more convenient, and the oviduct catheter is guided to enter a proper position.

The through hole arranged at the tail end of the sheath tube seat is used for introducing an oviduct catheter and a microcatheter, the catheter passes through the second tubular cavity of the sheath tube and enters the uterus, the second injection through hole arranged on the side surface of the sheath tube seat is connected with an injector through a side tube to inject a contrast medium, and the contrast medium enters the uterus through the fourth independent cavity to carry out uterine cavity radiography. The sheath dual lumen structure allows the contrast agent to enter the uterus through a separate lumen. In the oviduct embolism operation step, finally, after the bilateral oviduct embolism is finished, contrast agent is injected from a lateral tube to carry out uterine cavity radiography to check whether the oviduct is completely embolism, an operator must give certain injection pressure when carrying out radiography to ensure that the oviduct is completely blocked, the contrast agent enters the uterus through an independent cavity, the situation that the pressure is slightly high is avoided, the contrast agent possibly seeps out from a reverse flow prevention valve at the tail end of a sheath tube seat to influence the judgment of the oviduct blockage degree, the independent cavity can avoid the occurrence of the situation, the oviduct blockage degree can be more accurately evaluated, and the success rate of the oviduct embolism operation is improved.

The pressure gauge can display the pressure in the uterine cavity quantitatively when the side tube is used for hysterosalpingography. In the oviduct embolism operation, after the bilateral oviduct embolism is finished, contrast agent is injected from a lateral tube to carry out uterine cavity radiography so as to check whether the oviduct is completely embolized. The pressure required to inject the contrast media, if too great, may cause the contrast media to cross the intimal-media layer into the interstitium and blood vessels, causing severe pain to the patient and also increasing the risk of surgical infection. If the injection pressure is too low, incomplete embolism of the fallopian tube can be missed, so that the operation fails, the problem of water accumulation cannot be solved, and the embryo of the patient is wasted. The injection pressure is determined by the hand feeling of the operator in the previous operation, different operators are greatly distinguished without uniform quantitative standards, the injection pressure can be standardized by using the quantitative counting pressure gauge to carry out the operation, the risk of the oviduct embolism operation failure is reduced, the operation effect is improved, and the occurrence of operation complications is reduced.

The invention has the advantages that the device can lead the oviduct catheter to pass through and directly enter the uterine cavity, reduce the damage to the cervical canal, and lead the cervical plug to completely seal the external opening of the cervix; the sheath tube double-cavity structural design enables the oviduct catheter to be inserted into an oviduct, meanwhile, contrast agent is injected through the independent cavity, uterine cavity radiography is carried out under the pressure of the pressure gauge for prompting injection pressure, the step of repeatedly withdrawing the oviduct catheter is omitted, the damage to a cervical canal and an endometrium of the uterine cavity is reduced, the operation time and the infection risk are reduced, and the success rate of oviduct embolization is improved.

Drawings

Fig. 1 is a schematic structural view of a cervical sheath for embolization for intervention of fallopian tube in example 1.

Description of reference numerals:

1-cervical plug; 11-tubular cavity one; 12-big head end; 13-small head end; 2-sheath; 21-tubular cavity II; 22-Cavity four; 23-sheath head end; 3-sheath base; 31-tubular cavity III; 32-sheath tube seat connecting end; 33-sheath seat end; 34-through hole one; 35-injection through hole two; 37-side tube; 38-three-way device; 39-pressure gauge.

Detailed Description

Hereinafter, the technique of the present invention will be described in detail with reference to specific embodiments. It should be understood that the following detailed description is only for the purpose of assisting those skilled in the art in understanding the present invention, and is not intended to limit the present invention.

Example 1.

Referring to fig. 1, the cervical sheath for tubal interventional embolization comprises a cervical plug 1, a sheath tube 2 and a sheath tube seat 3, wherein the cervical plug 1 is a conical hollow structure, and is provided with a first tubular cavity 11 along an axial direction, an inner diameter of the first tubular cavity 11 is matched with an outer diameter of the sheath tube 2, the cervical plug 1 is movably sleeved at a head end of the sheath tube 2, the sheath tube 2 can be inserted from a big head end 12 of the cervical plug and extends out from a small head end 13 of the cervical plug, the sheath tube is provided with a second tubular cavity 21 and a fourth cavity 22 along the axial direction, the sheath tube seat 3 is provided with a third tubular cavity 31 along the axial direction, a connecting end 32 of the sheath tube seat is connected with a tail end of the sheath tube 2, a tail end 33 of the sheath tube seat is provided with a first through hole 34, a side surface of the sheath tube seat is provided with a second injection through hole 35, the second injection through hole 35 is connected with a side tube 37, a tail end of the side tube 37 is, the second injection through hole 35 is communicated with the fourth cavity 22.

In fig. 1, the cavity four 22 is an interlayer formed between the tubular cavity two 21 and the outer wall of the sheath tube 2. The second injection through hole 35 is communicated with the interlayer, contrast agent is injected from the side tube 37 and directly reaches the head end of the sheath tube through the interlayer, and the head end of the sheath tube is provided with a plurality of small holes or is open, so that the contrast agent enters the uterus to carry out uterine cavity radiography.

The cavity IV can also be an independent cavity which is not an interlayer, and the injection through hole II is communicated with the cavity IV.

The bore of the tubular cavity three 31 matches the outer diameter of the sheath 2 so that the sheath 2 is just inserted into the tubular cavity three 31. The inner diameter of the tubular cavity II 21 is larger than the outer diameter of the oviduct catheter, so that the oviduct catheter can freely pass through the tubular cavity II 21.

The head end 23 of the sheath tube is a round blunt structure, the aperture of a first through hole 34 arranged at the tail end 33 of the sheath tube seat is matched with the outer diameter of the oviduct catheter, the oviduct catheter and the microcatheter are introduced, and the catheter passes through a second tubular cavity 21 of the sheath tube and enters the uterus. The second injection through hole 35 arranged on the side surface of the sheath tube seat is connected with a side tube 37, and the tail end of the side tube 37 is provided with a three-way device 38 and a pressure gauge 39. Contrast media is injected through the extended side tube 37 to increase the operating space, facilitate the operation during surgery, and monitor pressure while injecting contrast media.

The sheath hub end 33 is provided with an anti-reflux valve (not shown). The valve is generally composed of silica gel, and can be inserted into the oviduct catheter from the tail end 33 of the sheath seat, and can also be used for blocking the tail end of the sheath seat to prevent the contrast agent and the like from flowing backwards.

For the operation during the operation, the outer wall of the sheath is provided with a guiding scale mark (not shown). The sheath needs to enter the inner opening from the external uterine opening, and the scale lines can remind an operator of intuitively knowing the entering depth, so that the operation is more convenient, and the oviduct is guided to enter a proper position.

The using method of the cervical sheath for the oviduct embolism comprises the following steps: firstly, the sheath tube is inserted from the large head end of the cervical plug and extends out from the small head end of the cervical plug, passes through the cervical plug and is placed into the cervical canal through the external cervical orifice, the cervical plug is pushed to the external cervical orifice, and the external cervical orifice is completely sealed. The assistant connects the injector with the three-way device, opens the drainage direction switch, and carries out hysterosalpingography. After the uterus oviduct radiography is finished, the three-way switch is closed, and an oviduct catheter and a micro catheter are introduced through the sheath tube seat to carry out the superselective intubation of the oviduct. After the microcatheter is placed in the isthmus of the fallopian tube, uterine cavity radiography is carried out through the three-way device again, the position of the uterine horn and the isthmus is observed, the placing position of the spring ring is determined, after the spring ring is placed in the microcatheter, the microcatheter is withdrawn, uterine cavity radiography is carried out through the side tube, the injection pressure is monitored, whether the contrast agent leakage exists at the far end of the fallopian tube or not is observed, if no leakage performance exists, the operation is ended, if leakage performance exists, the microcatheter needs to be inserted into the fallopian tube again to supplement embolism until no leakage performance exists at the far end of the fallo.

The foregoing is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and decorations can be made without departing from the principle of the present invention, and these modifications and decorations should also be regarded as the protection scope of the present invention.

Claims

1. The cervical sheath tube for the oviduct interventional embolization comprises a cervical plug, a sheath tube and a sheath tube seat, and is characterized in that the cervical plug is of a conical hollow structure, a first tubular cavity is arranged along the axial direction, the inner diameter of the first tubular cavity is matched with the outer diameter of the sheath tube, the cervical plug is movably sleeved at the head end of the sheath tube, and the sheath tube can be inserted from the large head end of the cervical plug, and extends out from the small head end of the cervical plug, the sheath tube is provided with a tubular cavity II and a tubular cavity IV along the axial direction, the sheath tube seat is provided with a tubular cavity III along the axis direction, the connecting end of the sheath tube seat is connected with the tail end of the sheath tube, the tail end of the sheath tube seat is provided with a through hole I, the side surface of the sheath tube seat is provided with an injection through hole II, the injection through hole II is connected with a side pipe, the tail end of the side pipe is provided with a three-way device and a pressure gauge, the through hole I is communicated with the tubular cavity II, and the injection through hole II is communicated with the cavity IV.

2. The cervical sheath for interventional embolization of fallopian tube according to claim 1, wherein said lumen four is an interlayer formed between the tubular lumen two and the outer wall of the sheath.

3. The uterine neck sheath for interventional embolization of uterine tube according to claim 1, wherein the sheath tip is a round blunt structure.

4. The cervical sheath for embolization of claim 1, wherein the through hole has a diameter matching the outer diameter of the fallopian tube catheter.

5. The uterine neck sheath for interventional embolization of fallopian tube of claim 1, wherein the inner diameter of the tubular cavity two is larger than the outer diameter of the fallopian tube catheter.

6. The cervical sheath for interventional embolization of fallopian tube according to claim 1, wherein the end of the sheath base is provided with a reverse flow prevention valve.

7. The cervical sheath for interventional embolization of fallopian tube according to claim 1, wherein the outer wall of the sheath is provided with guide scale lines.