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CN-121971144-A - Switchable negative pressure leading-in sheath for soft lens operation

CN121971144ACN 121971144 ACN121971144 ACN 121971144ACN-121971144-A

Abstract

The application provides a switchable negative pressure leading-in sheath for soft mirror operation, which relates to the technical field of medical appliances and comprises a sheath body, a side arm negative pressure interface and a plugging cap component. The sheath body comprises a straight sheath section and a head end bendable section, a tail end side arm negative pressure interface is communicated with the main channel and is connected with a negative pressure source, the plugging cap component is arranged at the tail end straight arm, a through hole communicated with the main channel is formed in the plugging cap component and is used for adjusting the effective negative pressure of the main channel, and the negative pressure adjusting position is transferred from the tail end side arm to the tail end straight arm. The through hole can be switched among three states of low-resistance passing, sealing pressurization and ventilation and pressure relief, wherein the low-resistance passing state is a main operation state of an operation. In addition, a side through pipe is arranged in the side wall of the straight sheath section and used for introducing external media into the main channel under the action of negative pressure so as to form passive circulation reflux and improve the discharge condition of broken stone chips.

Inventors

  • WU ZHONGHUA
  • LIU TONGZU

Assignees

  • 武汉大学中南医院

Dates

Publication Date
20260505
Application Date
20260323

Claims (10)

  1. 1. A switchable negative pressure introducer sheath for soft-endoscopic surgery, comprising: A sheath body, wherein a main channel for a soft lens to pass through and a medium to be discharged is defined in the sheath body, and the sheath body comprises a straight sheath section and a bendable section positioned at the head end of the straight sheath section; The side arm negative pressure interface is arranged on the side wall of the sheath body close to the tail end and communicated with the main channel and is used for being connected with a negative pressure source to apply negative pressure to the main channel; the plugging cap assembly is arranged at the straight arm at the tail end of the sheath body, a through hole communicated with the main channel is formed in the plugging cap assembly, and the plugging cap assembly can at least switch between the following three states by adjusting the opening degree of the through hole: The effective passing inner diameter of the through hole is not smaller than the outer diameter of the soft lens, so that the soft lens passes through the through hole in a clearance fit mode, and the first state is a preset common state so as to maintain basic negative pressure of the main channel when a negative pressure source works; The effective passing inner diameter of the through hole is reduced compared with that of the through hole in the first state, so that the through hole and the periphery of the soft lens form sealed sliding fit, and the effective negative pressure of the main channel is improved, wherein the sealed sliding fit allows the soft lens to axially slide through relative to the through hole; And in a third state, the effective passing inner diameter of the through hole is increased compared with that in the first state, so that the distance between the soft mirror and the inner wall of the through hole is increased, and an enlarged ventilation passage is formed between the through hole and the outside, so that the effective negative pressure of the main channel is reduced.
  2. 2. The switchable negative pressure introducer sheath of claim 1, wherein the occlusion cap assembly includes a base, an adjustment member, and an elastic seal member, the through hole is disposed on the elastic seal member, the base is connected to a tail end of the sheath, the adjustment member is disposed on the base so as to be movable relative to the base in an axial direction, the elastic seal member is interposed between the base and the adjustment member, and axial displacement of the adjustment member relative to the base is used to change a degree of compression of the elastic seal member so as to change an opening degree of the through hole, thereby achieving switching among the first state, the second state, and the third state.
  3. 3. The switchable negative pressure introducer sheath of claim 2, wherein, The elastic sealing element is of an annular structure, an inner convex section protruding radially towards the annular center is formed in the axial middle of the inner wall of the elastic sealing element, an outer concave section corresponding to the inner convex section and recessed radially towards the annular center is formed in the axial middle of the outer wall of the elastic sealing element, and therefore the effective passing inner diameter of the through hole is changed through elastic deformation when the elastic sealing element is axially pressed.
  4. 4. A switchable negative pressure introducer sheath according to claim 2 or 3, wherein, The adjusting piece comprises an adjusting cylinder and an extrusion piece, the adjusting cylinder is in threaded connection with the base, the extrusion piece is arranged at one end, far away from the base, of the adjusting cylinder, the elastic sealing piece is clamped between the base and the extrusion piece, and when the adjusting cylinder rotates relative to the base, rotary motion is converted into axial displacement through a threaded pair, so that the compression degree of the extrusion piece on the elastic sealing piece is changed.
  5. 5. The switchable negative pressure introducer sheath of claim 4, wherein, Annular grooves are formed in two ends of the elastic sealing piece, the height of the outer side wall of each annular groove in the axial direction is larger than that of the inner side wall of each annular groove, and the extrusion piece is annular and can be inserted into the annular grooves, so that the axial fit stability between the extrusion piece and the elastic sealing piece is improved.
  6. 6. The switchable negative pressure introducer sheath of claim 4, wherein, The base comprises a base body, a mounting screw cylinder and a locking screw cylinder, wherein an avoidance hole which is coaxially arranged with the main channel is formed in the base body, an annular first shoulder is arranged in the avoidance hole, the mounting screw cylinder is positioned at one side of the first shoulder, which is close to the elastic sealing element, and the locking screw cylinder is positioned at one side of the first shoulder, which is far away from the elastic sealing element; The locking screw cylinder comprises a first threaded part and a first limiting part, the first limiting part is annular, the outer diameter of the first limiting part is larger than the inner diameter of the first shoulder, one end of the first threaded part is connected with the first limiting part, and the other end of the first threaded part penetrates through and protrudes out of the first shoulder; The installation screw cylinder comprises a second threaded part, a second limiting part and a third threaded part which are distributed along the axial direction of the through hole in sequence, wherein the second threaded part is in threaded connection with the first threaded part, the second limiting part is annular, the inner diameter of the second limiting part is smaller than that of the second threaded part, and the third threaded part is in threaded connection with the adjusting cylinder.
  7. 7. The switchable negative pressure introducer sheath of claim 6, wherein, The seat body is provided with spacing shoulder in dodging the downthehole, spacing shoulder is located first spacing portion is kept away from one side of first shoulder, the internal diameter of spacing shoulder is less than the external diameter of first spacing portion, in order to restrict locking spiral shell barrel axial deviate from.
  8. 8. The switchable negative pressure introducing sheath of claim 6, wherein the sidewall of the adjustment barrel is provided with knurled patterns and an adjustment handle is provided on the sidewall thereof in a radial direction thereof for the operator to rotationally adjust the adjustment barrel.
  9. 9. The switchable negative pressure introducing sheath according to claim 1, wherein the side tube is disposed in a side wall of the straight sheath segment, the bendable segment is not provided with an independent channel, a head end of the side tube is communicated with the main channel, a tail end of the side tube passes out of the side wall of the straight sheath segment and forms an auxiliary interface, and the auxiliary interface is used for communicating with the outside so that an external medium enters the main channel through the side tube under the action of negative pressure.
  10. 10. The switchable negative pressure introducer sheath of claim 9, wherein, The auxiliary interface is provided with a one-way valve which allows external medium to enter the side through pipe from the auxiliary interface and flow to the main channel, and limits liquid in the main channel to flow back to the auxiliary interface through the side through pipe, and the external medium at least comprises gas and optionally liquid.

Description

Switchable negative pressure leading-in sheath for soft lens operation Technical Field The application relates to the technical field of medical instruments, in particular to a switchable negative pressure introducing sheath for soft mirror operation. Background The ureteroscope lithotripsy stone clearing operation is a minimally invasive operation commonly used in kidney stone treatment, a stable working channel from a transurethral canal to renal pelvis and renal calyx is usually required to be established through an introducing sheath in the operation, on one hand, the operation of lithotripsy stone clearing and exploration is completed by repeatedly entering and exiting an operation area through a soft lens, on the other hand, a reflux path is provided for a medium poured through the working channel of the soft lens, and a special passage is provided for stone fragment discharge. In the prior art, a negative pressure suction guide sheath (hereinafter referred to as a negative pressure guide sheath) with a bendable head end is connected with a negative pressure source through a tail end side arm so as to apply negative pressure to a main channel of the guide sheath to realize suction and discharge of a medium, and meanwhile, in order to conveniently adjust the effective negative pressure of the main channel, the side arm can be provided with a negative pressure adjusting hole, and the amount of gas entering a negative pressure loop is changed by opening and closing the negative pressure adjusting hole, so that the adjustment of the magnitude of the negative pressure is realized. The negative pressure regulating hole is in an open state in normal operation to reduce the effective negative pressure in the main channel, and is closed to increase the effective negative pressure in the main channel when the suction capacity needs to be enhanced. To maintain the tightness of the negative pressure loop, the straight arm at the tail end of the leading-in sheath is usually provided with a sealing cap structure so as to form a seal on the periphery of the soft lens. Because the gap between the introducer sheath and the soft lens is smaller, the removal of stone fragments often requires that the soft lens be retracted or withdrawn and then the suction be completed in the introducer sheath channel by means of negative pressure. However, the structure still has the following defects that firstly, a soft lens always needs to go in and out of an introducing sheath for tens or hundreds of times in the process of stone breaking and removing, a tail end straight arm sealing cap is easy to generate larger friction resistance to continuously wrap the periphery of the soft lens, smoothness of in and out is influenced, operation burden of operators and abrasion of the soft lens are increased, secondly, a negative pressure regulating hole is formed in a tail end side arm, a main operation area of the soft lens is positioned in the tail end straight arm, negative pressure regulation in operation needs to be switched between the straight arm and the side arm, operation is not intuitive and convenient enough, and assistance is possibly relied on in the process of rapid regulation, thirdly, the existing negative pressure introducing sheath adopts a single-channel structure, perfusion medium can only be input through a working channel of the soft lens, and when the soft lens is retracted or withdrawn for negative pressure stone suction, medium supply at the upstream of stone fragments is insufficient, stable continuous medium circulation and stone carrying liquid flow cannot be formed, and thus sucking efficiency of stone fragments is influenced. Although there is an improvement scheme of adding a main side channel, for example, injecting liquid into the operation area through the side channel and sucking the main channel under negative pressure to form effective circulation reflux of the medium, the scheme often needs to add an independent channel in the whole process of the introducing sheath, the structural thickness of the bendable section of the head end can be increased and the maximum bending degree of the bendable section of the head end can be reduced, so that the introducing sheath is limited to enter the complex parts such as the subrenal cup and the like, and the active injection of liquid into the operation area through the side channel can cause the pressure rise of renal pelvis to increase the infection risk, and the matching cost of operation steps and manpower in operation is additionally increased. In summary, there is a need for a negative pressure introducing sheath structure, which can reduce the high-frequency in-out resistance of the soft lens, facilitate negative pressure adjustment and switching, and improve the debris discharging efficiency, thereby improving the comprehensive performance of the soft lens operation on the premise of ensuring the negative pressure suction core function and the use safety. D