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CN209952029U - 一种可变向的输尿管软镜导入鞘 - Google Patents

一种可变向的输尿管软镜导入鞘 Download PDF

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CN209952029U
CN209952029U CN201920466208.0U CN201920466208U CN209952029U CN 209952029 U CN209952029 U CN 209952029U CN 201920466208 U CN201920466208 U CN 201920466208U CN 209952029 U CN209952029 U CN 209952029U
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sheath
section
pipe
flexible ureteroscope
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程继文
李天宇
莫曾南
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Guangxi Medical Association
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/307—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the urinary organs, e.g. urethroscopes, cystoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
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    • A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147—Holding or positioning arrangements
    • A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M25/005—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
    • A61M25/0052—Localized reinforcement, e.g. where only a specific part of the catheter is reinforced, for rapid exchange guidewire port
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A61B1/0057—Constructional details of force transmission elements, e.g. control wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M25/0045—Catheters; Hollow probes characterised by structural features multi-layered, e.g. coated
    • A61M2025/0046—Coatings for improving slidability
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M2025/0059—Catheters; Hollow probes characterised by structural features having means for preventing the catheter, sheath or lumens from collapsing due to outer forces, e.g. compressing forces, or caused by twisting or kinking
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M2025/006—Catheters; Hollow probes characterised by structural features having a special surface topography or special surface properties, e.g. roughened or knurled surface
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M2025/0062—Catheters; Hollow probes characterised by structural features having features to improve the sliding of one part within another by using lubricants or surfaces with low friction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
    • A61M2025/0681—Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/10—Trunk
    • A61M2210/1078—Urinary tract

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Abstract

本实用新型提供一种可变向的输尿管软镜导入鞘，包括鞘管、内芯和鞘管接头，鞘管套设于内芯外侧，鞘管接头与鞘管尾端连接，所述鞘管包括依次连接的第一直管段、弯曲段、第二直管段，所述第一直管段、第二直管段管壁中内置加强钢丝为不可弯曲段，弯曲段为可弯曲结构。本实用新型提出一种可变向的输尿管软镜导入鞘，可克服传统输尿管导引鞘不能弯曲使输尿管损伤的问题，同时可避免因放鞘位置不到位导致术中灌洗液引流不通畅的问题，可提高输尿管软镜手术的效率和安全性。

Description

一种可变向的输尿管软镜导入鞘
技术领域
本实用新型涉及泌尿系统医疗器械技术领域，特别涉及一种可变向的输尿管软镜导入鞘。
背景技术
在临床医学上，在进行逆行输尿管软镜手术前，需在输尿管内置入输尿管导引鞘，实现输尿管软镜的导引和灌洗液体的实时导流，保持视野清晰和降低肾盂内压。传统的输尿管鞘呈不能弯曲的直线结构，导致手术中导引鞘上行至弯曲处(尤其是肾盂输尿管交界处时)容易损伤，导致输尿管穿孔和尿外渗。经过多次输尿管、邻近器官手术的病人或肾盂输尿管交界处弯曲度大的病人，容易出现输尿管穿孔或导引鞘放置不到位的情况，进而引起术中灌洗液引流不通畅、肾盂内压过高和尿源性脓毒血症等问题。因此，设计可自行弯曲变向的输尿管导引鞘具有重要的临床意义。
实用新型内容
本实用新型提出一种可变向的输尿管软镜导入鞘，可克服传统输尿管导引鞘不能弯曲使输尿管损伤的问题，同时可避免因放鞘位置不到位导致术中灌洗液引流不通畅的问题，可提高输尿管软镜手术的效率和安全性。
为实现上述技术目的，达到上述技术效果，本实用新型通过以下技术方案解决上述问题：
一种可变向的输尿管软镜导入鞘，包括鞘管、内芯和鞘管接头，鞘管套设于内芯外侧，鞘管接头与鞘管尾端连接，所述鞘管包括依次连接的第一直管段、弯曲段、第二直管段，所述第一直管段、第二直管段管壁中内置加强钢丝为不可弯曲段，弯曲段为可弯曲结构。
上述方案中，输尿管鞘管中的弯曲段可自由弯曲，在输尿管安置了斑马导丝之后，鞘管可沿着斑马导丝向内运动。当遇到生理弯曲或病理性弯曲时，弯曲段可以变向和适度的弯曲保证鞘体的推送，不会直接划伤、穿透输尿管粘膜层、肌层或输尿管壁，可有效保护输尿管。
为达到较好的弯曲效果，所述弯曲段为可弯曲折叠的波纹管结构。
进一步的，所述弯曲段中波纹管结构内置环形加强钢圈。
进一步的，所述加强钢丝纵向等间隙设置于第一直管段、第二直管段的管壁内。
进一步的，所述鞘管采用塑料材料注塑成型，其内、外壁上均涂布有亲水涂层。
进一步的，所述内芯采用具有一定弯曲性能的特氟隆制作。
优选的，所述弯曲段的长度为1～2cm，第一直管段的长度为2～3cm。
本实用新型的优点与效果是：
1、本装置中于鞘管中设置适宜长度的弯曲段，并在直管段内设置加强钢丝，可在保证鞘管在斑马导丝和内芯推送过程中保证其内推强度的情况下，使导引鞘具有一定的弯曲性能，容易越过输尿管生理性或病理性弯曲段，实现导引鞘的顺利上行，可避免原有的导引鞘直线结构和简单的单向运动对输尿管粘膜和输尿管壁肌层的直接创伤。
2、第一直管段、第二直管段均设置内藏式加强钢丝，在手术操作的过程中，可以通过术中X线进行显影、定位，同时起到良好的输尿管腔内良好的支撑作用。
3、具有弯曲段的鞘管末端更容易到达肾盂输尿管交界处，实时引流术中的浑浊的灌洗液、尿液和粉末样碎石，避免肾盂内高压反流造成的尿源性脓毒血症、感染性休克甚至死亡等严重并发症。同时，通过改善手术视野，可有效提高软镜下激光碎石的手术效率，减少肾盂和肾盏的粘膜损伤和出血。
附图说明
图1为一种可变向的输尿管软镜导入鞘结构示意图。
图号标识：1、鞘管，11、第一直管段，12、弯曲段，13、第二直管段，14、加强钢丝，15、环形加强钢圈，2、内芯，3、鞘管接头，4、斑马导丝。
具体实施方式
以下结合实施例对本实用新型作进一步说明，但本实用新型并不局限于这些实施例。
本实施例所述的一种可变向的输尿管软镜导入鞘，如附图1所示，其主体由鞘管1、内芯2和鞘管接头3构成，鞘管1套设于内芯2外侧，鞘管接头3与鞘管1尾端连接。内芯2具有可供斑马导丝4穿过的通孔，内芯2前端长于鞘管1并从其端部露出。
鞘管1由第一直管段11、弯曲段12、第二直管段13依次连接构，第二直管段13长于第一直管段11。其中第一直管段11、第二直管段13管壁内纵向等间隙设置有加强钢丝14，加强钢丝14可提高鞘体强度对输尿管腔进行良好的支撑，而且可以通过X线进行显影、定位，提高手术效率。
弯曲段12为可自由弯曲折叠的波纹管结构，波纹管结构内置环形加强圈15，环形加强圈15可保证弯曲段12中部的液体通道，避免弯曲段12被输尿管腔挤压封堵，影响液体的引流，如附图1所示。
第一直管段11的长度优选为3cm，弯曲段12的长度优选为2cm，弯曲段12和第一直管段11设置于该长度位置可更好的适用于肾盂输尿管交界处输尿管导引鞘的安置和引流。
本实用新型的工作原理为：
斑马导丝4在输尿管硬镜直视下安置与输尿管内，输尿管导引鞘环套斑马导丝4并沿着斑马导丝4向输尿管内推送，在推送过程中第一直管段11、弯曲段12、第二直管段13均依靠输尿管软镜导引鞘的内芯2支撑和前行。
当遇到生理弯曲或病理性弯曲时，第一直管段11沿着预先留置的斑马导丝4上行，弯曲段12可适度的弯曲变向并随着第一直管段11前进，在置入过程中不会直接划伤、穿透输尿管粘膜层、肌层或输尿管壁，有效地保护输尿管结构。
以上结合附图对本实用新型的实施方式详细说明，但本实用新型不局限于所描述的实施方式。在不脱离本实用新型的原理和精神的情况下对这些实施方式进行多种变化、修改、替换和变型仍落入本实用新型的保护范围内。

Claims (7)

1.一种可变向的输尿管软镜导入鞘，包括鞘管(1)、内芯(2)和鞘管接头(3)，鞘管(1)套设于内芯(2)外侧，鞘管接头(3)与鞘管(1)尾端连接，其特征在于：所述鞘管包括依次连接的第一直管段(11)、弯曲段(12)、第二直管段(13)，所述第一直管段(11)、第二直管段(13)管壁中内置加强钢丝(14)为不可弯曲段，弯曲段(12)为可弯曲结构。
2.根据权利要求1所述的一种可变向的输尿管软镜导入鞘，其特征在于：所述弯曲段(12)为可弯曲折叠的波纹管结构。
3.根据权利要求2所述的一种可变向的输尿管软镜导入鞘，其特征在于：所述弯曲段(12)中波纹管结构内置环形加强钢圈(15)。
4.根据权利要求1所述的一种可变向的输尿管软镜导入鞘，其特征在于：所述加强钢丝(14)纵向等间隙设置于第一直管段(11)、第二直管段(13)的管壁内。
5.根据权利要求1～4任何一项所述的一种可变向的输尿管软镜导入鞘，其特征在于：所述鞘管(1)采用塑料材料注塑成型，其内、外壁上均涂布有亲水涂层。
6.根据权利要求1～4任何一项所述的一种可变向的输尿管软镜导入鞘，其特征在于：所述内芯(2)采用具有一定弯曲性能的特氟隆制作。
7.根据权利要求1～4任何一项所述的一种可变向的输尿管软镜导入鞘，其特征在于：所述弯曲段(12)的长度为1～2cm，第一直管段(11)的长度为2～3cm。
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EP20167438.9A EP3721933B1 (en) 2019-04-03 2020-03-31 Bendable ureteral access sheath
US16/839,036 US20200315445A1 (en) 2019-04-03 2020-04-02 Bendable ureteral access sheath

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CN113143346A (zh) * 2020-07-08 2021-07-23 郑州大学第一附属医院 人体腔道多功能抗折活检鞘套装
USD942621S1 (en) 2020-04-02 2022-02-01 The First Affiliated Hospital Of Guangxi Medical University Bendable ureteral access sheath

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