CN101433469A - Attaching observation type puncture endoscope for percutaneous nephrolithotomy - Google Patents
Attaching observation type puncture endoscope for percutaneous nephrolithotomyDownload PDFInfo
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- CN101433469A CN101433469ACNA2008101706666ACN200810170666ACN101433469ACN 101433469 ACN101433469 ACN 101433469ACN A2008101706666 ACNA2008101706666 ACN A2008101706666ACN 200810170666 ACN200810170666 ACN 200810170666ACN 101433469 ACN101433469 ACN 101433469A
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Abstract
Translated fromChinese
Description
Technical field
The present invention relates to a kind of medical surgical operation and use endoscope, relate in particular to a kind of percutaneous nephrolithotomy puncture endoscope.
Background technology
Percutaneous nephrolithotomy is a kind of new technique for the treatment of urinary system calculus that rises in recent years, and it utilizes special endoscope and intracavity rubble, get stone equipment finishes treatment by percutaneous kidney fistulation.Just there is the tradition of getting renal calculus through the skin puncture in Arab as far back as 10th century of Christian era, but success rate is lower due to limited conditions, fails to apply always.After mid-term 1940's, PCN came out, this technology was just fairly perfect, is applied.China then initial stage 1980's from this technology and equipment of external introduction, at first achieve success on Beijing, Guangzhou and other places, then push the whole nation to, domestic most big-and-middle-sized hospital has all carried out this operation at present, but the equipment that percutaneous nephrolithotomy needs is comparatively expensive, and specification requirement is also than higher.Also can carry out external stone crushing in the place that the external stone crushing condition is arranged and add the method that auxiliary lithagogue is treated, but the calculus time is long, and not necessarily thorough, effect can not be got instant result, therefore at present not as main Therapeutic Method.
Percutaneous nephrolithotomy generally is to need to carry out under the anesthesia, renal pelvis at first punctures under X line or ultrasonic guidance, but consider equipment manufacturing cost and to patient and doctor's radiation injury, the doctor is reluctant to adopt the mode of X line more, then puncture channel is expanded to and needs size, put into PCN through this passage, spy on down the calculus taking-up or calculus is smashed the back and take out with special rock crushing plant.
When operation is carried out, the first step: under cystoscopic guiding, particularly to the inapparent patient of hydronephrosis, soft conduit per urethra with F5, bladder, again through ureter, deliver to renal pelvis, so that in puncture, can fetch water to renal pelvis from the outside, such first can help developing under the B ultrasonic, second can be in puncture presses to renal pelvis and fetches water whether observe puncture tube fluid situation correct to judge that puncture arrives the position by adding, and the 3rd is to squeeze into liquid continuously after puncturing successfully, prevents the renal pelvis wound clot that condenses, the 4th is to form hydrops hollow in the renal pelvis, is beneficial to the use of PCN.Second step was operation success or failure keys: set up the passage from skin to the renal pelvis, it is fistulation, generally under B ultrasonic or X-ray machine guiding, carry out the kidney puncture fistula-building, one in puncture needle overcoat is put and is stayed pipe during puncture, the about 1.4mm of external diameter, puncture to renal pelvis, behind the renal calices, extract puncture needle out, put stay pipe to put to stay in through skin to renal pelvis, between renal calices, stay pipe slowly to be lowered to renal pelvis by putting on one soft rustless steel steel wire, in between renal calices and coil two or three circles, extract out to put then and stay pipe, put and stay steel wire, use diameter more than three kinds at last, the tapered convergent divergent channel of head is enclosed within to put and stays on the steel wire, has passage from thin to slightly expanding repeatedly, need diameter up to being expanded to, promptly finished the fistulation process.Puncture fistula-building generally carries out also can shifting to an earlier date puncture fistula-building at lithotomy simultaneously, when shifting to an earlier date puncture fistula-building, treats to carry out percutaneous nephrolithotomy again after sinus tract forms, and sinus tract forms common needs about 2 weeks.The advantage of carrying out is to perform the operation once to finish simultaneously, and the hospital stays is short; Shortcoming is to increase the chance of failure because of the hemorrhage cause influence operation technique that waits.In advance fistulation again the shortcoming of second operation be that the hospital stays is long, need the two operations operation, but sinus tract forms that afterwards intraoperative hemorrhage is less, gets a clear view the success rate of operation height.The 3rd step: use PCN by the fistulation passage, under line-of-sighting observation, carry out the searching and the taking-up of renal pelvis, renal calices and ureter epimere calculus or smash the back taking out, and finish operation.
Percutaneous nephrolithotomy just can be treated kidney and ureter epimere calculus by diameter less than 1 centimetre passage, than the operative treatment of routine little to patient trauma, strike is little, post-operative recovery is fast, and can repeat to treat residual through stone by the kidney fistulation pipe of keeping somewhere, advantage is conspicuous.
But this lithotomy also exists following The key factor and restricts its utilization in clinical:
Because being dendroid, the blood vessel in the kidney distributes, use the F5 fine needle aspiration progressively to expand the purpose of opening again during fistulation and be to avoid blood vessel, enter from the vascular branch gap, when expansion, can arrange blood vessel like this, hemorrhage during fistulation will be less, but can not judge whether to have pushed open blood vessel when having lithotomy now and still wear out blood vessel owing to puncture, the probability that causes not wearing out blood vessel is very low, often run into hemorrhage in the art, and hemorrhage sometimes can not at once the discovery, may outside renal tissue, form hematocele, certain risk is arranged, and directly have influence on the success or failure of operation.
If can design a kind of endoscope visual in puncture, just the restriction point of this operation clinical application of above-mentioned restriction can be readily solved.
But, four significant components of classical endoscope should comprise object lens, biography is as the unit, lighting unit and eyepiece, clinical practice based on this operation, if use the design concept of classical endoscope, then need an object distance, if before puncture needle, arrange a big unobstructed space, then can't satisfy the tiny more constraints that is difficult for injured blood vessel more, if in tiny puncture needle, arrange certain object distance, then pin hole place (visual place) will account for ultrafine part in the visual field, the interior pipe that the overwhelming majority around the visual field can be punctured pin occupies, but if puncture tube is processed into transparent material, present stage does not have to satisfy and can puncture, and rigidity and brittleness are again so good plastic materials.Like this, narrow and small impression can be given in the visual field of observing, simultaneously, the sealing of the transparent material that before needle tubing, carries out, no matter transparent material is installed and is processed into which kind of angle, all can't thoroughly eliminate the flare that brings by lighting source, thereby the definition of image can reduce significantly, therefore, puncture needle tiny determined to form the observation interval (as modes such as method by bath, qi of chong channel ascending adversely, mechanical expansion and transparent material sealings) of a hollow.
Technology on the multifilament image transmission optical fibre makes us might realize the visual of perforator, but its difficult point is that the head of ultra-fine sight glass can be finished puncture can carry out the structurally difficult realization of clear observation again, and the visual field also is subject to certain restrictions simultaneously; Simultaneously, because piercing process is hemorrhage, if introduce flushing function, then water flushing channel can increase again the space requirement of puncture instrument at diametrically, also can increase technical difficulty, therefore will consider the visual difficult problem under not washing by water.
Summary of the invention
For solving hemorrhage many, the operative failure rate is higher, safety is the not high technical problem of institute's use apparatus in the existing percutaneous nephrolithotomy, the invention provides a kind of visuality of performing the operation good, go out the percutaneous nephrolithotomy attaching observation type puncture endoscope that insufficiency of blood, success rate of operation are higher, safe, need not to wash by water.
Technical solution of the present invention is:
1, a kind of percutaneous nephrolithotomy attaching observation type puncture endoscope comprisesmain mirror 7, passes as unit, lighting unit and ocular unit, and it is characterized in that: it also comprises puncture body, and described puncture body comprisespuncture needle 10, puts and staypipe 8; Describedpuncture needle 10 comprises hollowouter pipe 9, and its leading section is the spininess on band inclined-plane; Described ocular unit compriseseyepiece hood 2, imagerotation camera lens 15,eyepiece camera lens 3 and eyepiece glass 1, described imagerotation camera lens 15,eyepiece camera lens 3 and eyepiece glass 1 are successively set in theeyepiece hood 2, described imagerotation camera lens 15 can with chamfer map as blur-free imaging to the image planes ofeyepiece camera lens 3; Described biography comprises that as the unit multifilament of hollowouter pipe 9 inside that are arranged onpuncture needle 10passes picture rod 6, and theimaging surface 18 that described multifilament passespicture rod 6 constitutes solid spine for the inclined-plane and with the leading section of hollowouter pipe 9, and theimage planes 5 that go out that described multifilament passespicture rod 6 are the inclined-plane; Described lighting unit comprises thelight beam chuck 11 that can be connected withmain mirror 7, be arranged on thelight beam chuck 11 and thelight beam interface 12 that can be connected with external light source, be arranged onlight cone 13 in thelight beam interface 12, pass the biographylight fibre bundle 14 thatimage planes 5 are connected that goes out as excellent 6 with multifilament; The imaging surface outer circumferential sides that described multifilament passespicture rod 6 is filled withblack epoxy glue 17; Described puncture body is fixedly installed onmain mirror 7 front ends; The rear end and the ocular unit of describedmain mirror 7 are connected.
2, percutaneous nephrolithotomy attaching observation type puncture endoscope according to claim 1, it is characterized in that: described biographylight fibre bundle 14 with the connected mode that goes outimage planes 5 of multifilamentbiography picture rod 6 is: the front end and the multifilament biography that passlight fibre bundle 14 are glued together near the cylindrical side that goes outimage planes 5 one ends mutually asrod 6, and its gummed angle is consistent with respect to the optical reflection line direction that goes outimage planes 5 as excellent 6 axis with the multifilament biography;
3, percutaneous nephrolithotomy attaching observation type puncture endoscope according toclaim 1 and 2, it is characterized in that: the solid spine that described multifilament passes as the end formation of theimaging surface 18 ofrod 6 and hollowouter pipe 9 comprises theforward puncture face 41 that is arranged on the spine forefront and theface 42 that punctures dorsad, be separately positioned on the sidedirection puncture face 44 offorward puncture face 41 left and right sides, be arranged on theauxiliary puncture face 43 atforward puncture face 41 rears, the scope of the puncture angle α of describedforward puncture face 41 is: 9 °～11 °, the scope of the angle β that punctures dorsad of the describedface 42 that punctures dorsad is: 17 °～5 °, the side direction puncture angle δ 1 of described sidedirection puncture face 44 and the scope ofδ 2 are: 9 °～11 °, and the lateral deflection angle
With
Scope be: 18 °～10 °, the scope of the auxiliary puncture angle γ of describedauxiliary puncture face 43 is: 40 °～10 °.
4, percutaneous nephrolithotomy attaching observation type puncture endoscope according toclaim 3 is characterized in that: theimage planes 5 that go out that described multifilament passespicture rod 6 are 45 ° of inclined-planes.
5, a kind of percutaneous nephrolithotomy attaching observation type puncture endoscope comprisesmain mirror 7, passes as unit, lighting unit and ocular unit, and it is characterized in that: it also comprises puncture body, and described puncture body comprisespuncture needle 10, puts and staypipe 8; Describedpuncture needle 10 comprises hollowouter pipe 9, and its leading section is the spininess on band inclined-plane; Described ocular unit compriseseyepiece hood 2,eyepiece camera lens 3 and eyepiece glass 1, and describedeyepiece camera lens 3 and eyepiece glass 1 are successively set in theeyepiece hood 2; Described biography comprises half-reflection and half-transmissionsquare glass prism 16 as the unit and the multifilament that are arranged in the hollowouter pipe 9 ofpuncture needle 10pass picture rod 6, and described multifilament passes theimage planes 5 that ofpicture rod 6 and glues together mutually with the upper surface of half-reflection and half-transmissionsquare glass prism 16; Theimaging surface 18 that described multifilament passespicture rod 6 constitutes solid spine for the inclined-plane and with the leading section of hollowouter pipe 9; The outer circumferential sides that described multifilament passespicture rod 6close imaging surfaces 18 is filled withblack epoxy glue 17; Described lighting unit comprises thelight beam chuck 11 that can be connected withmain mirror 7, be arranged on thelight beam chuck 11 and thelight beam interface 12 that can be connected with external light source, be arranged onlight cone 13 in thelight beam interface 12, be sent to half-reflection and half-transmissionsquare glass prism 16 lateral biographylight fibre bundles 14 after can external light source passing throughlight cone 13; The rear end of described biographylight fibre bundle 14 is connected with the end face oflight cone 13, and its front end glues together mutually with the side end face of half-reflection and half-transmissionsquare glass prism 16; Described puncture body is fixedly installed onmain mirror 7 front ends; The rear end and the ocular unit of describedmain mirror 7 are connected.
6, percutaneous nephrolithotomy attaching observation type puncture endoscope according toclaim 5, it is characterized in that: the solid spine that described multifilament passes as the end formation of theimaging surface 18 ofrod 6 and hollowouter pipe 9 comprises theforward puncture face 41 that is arranged on the spine forefront and theface 42 that punctures dorsad, be separately positioned on the sidedirection puncture face 44 offorward puncture face 41 left and right sides, be arranged on theauxiliary puncture face 43 atforward puncture face 41 rears, the scope of the puncture angle α of describedforward puncture face 41 is: 9 °～11 °, the scope of the angle β that punctures dorsad of the describedface 42 that punctures dorsad is: 17 °～5 °, the side direction puncture angle δ 1 of described sidedirection puncture face 44 and the scope ofδ 2 are: 9 °～11 °, and the lateral deflection angle
With
Scope be: 18 °～10 °, the scope of the auxiliary puncture angle γ of describedauxiliary puncture face 43 is: 40 °～10 °.
The invention has the advantages that:
1, the present invention is provided with the biography of endoscope as unit and lighting unit in the puncture needle of operation puncturing fistulation, realized in operation the purpose of Real Time Observation while puncturing, simultaneously can judge accurately in piercing process whether position that puncture needle arrives exists blood vessel, thereby can avoid the blood vessel in the kidney effectively, wear out blood vessel in avoiding then performing the operation and cause the hemorrhage situation of unexpected unexpected volume, reduced the blind potential risk that exists in the operation process of wearing; Have insufficiency of blood, higher, the safe advantage of success rate of operation.
The imaging surface that multifilament passed as rod when 2, the present invention punctured well contacts owing to the existence of puncture force with tissue, can push effectively Real Time Observation to tissue surface (what promptly puncture caused organizes cleaved facet), squeeze blood and slime and hemostasis by compression, thereby cleared up the blood of sightingpiston, solved the visual difficult problem of the hemorrhage pollution in visual field under the situation of not washing by water.
3, after multifilament of the present invention passes the excellent imaging surface of picture and treats that tissues observed well contacts, no matter whether imaging surface passes vertical as excellent axis with multifilament, no matter whether imaging surface is polished to optical mirror plane, as long as satisfy good contact, just can imaging, therefore, the present invention can pass an end multifilament of puncture and be processed into the inclined-plane as rod, form puncture angle α, as shown in Figure 4, this profile has just in time kept consistent well with present puncture needle profile (forming sharp-pointed puncturing head thereby a hollow stainless steel tube is worn into the inclined-plane), the angle β that punctures is dorsad in addition making puncture break the edge that just in time is in the visual field into interlacing point, the blind area that the interlacing point of avoiding puncturing brokenly is not in the visual field occurs, and the side direction puncture angle δ 1 and theδ 2 of auxiliary puncture angle γ and left and right directions make endoscope obtain sharper puncture ability.
4, good illumination effect of the present invention does not influence the veiling glare of observing effect.The present invention adopts special lighting system, and the light component that has guaranteed the directive visual field can evenly enter multifilament and pass as each monofilament in the rod with illumination field of view, and remainder is fixed with opaque black epoxy glue and hollow outer pipe.
Description of drawings
Fig. 1 is the structural representation of first kind of puncture endoscope of the present invention;
Fig. 2 is the structural representation of second kind of puncture endoscope of the present invention;
Fig. 3 is a product design sketch map of the present invention;
Fig. 4 is the end construction sketch map of puncture needle of the present invention;
Fig. 5 is the structural representation of puncture needle of the present invention;
Wherein: 1-eyepiece glass; 2-eyepiece hood; 3-eyepiece camera lens; 5-go out image planes; 6-multifilament passes the picture rod; 7-main mirror; 8-put and stay pipe; 9-hollow outer pipe; 10-puncture needle; 11-light beam chuck; 12-light beam interface; 13-light cone; 14-biography light fibre bundle; 15-image rotation camera lens; 16-half-reflection and half-transmission square glass prism; 17-black epoxy glue; 18-imaging surface; 41-forward puncture face; 42-dorsad faces that puncture; 43-auxiliary puncture face; 44-side direction puncture face.
Specific embodiment
Classical endoscope is owing to exist observation space before object lens, allow lighting fiber illumination field of view well, and after multifilament passes the picture rod and the needs sightingpiston well contacts, if use classical endoscope illumination mode, illumination light can't enter the sightingpiston that has attached multifilament biography picture rod, so the present invention adopts following two kinds of frame modes.
As Fig. 1, Fig. 3 and shown in Figure 5, first kind of percutaneous nephrolithotomy of the present invention comprisesmain mirror 7, puncture body, biography as unit, lighting unit and ocular unit with the structure of attaching observation type puncture endoscope, and puncture body comprisespuncture needle 10, puts andstay pipe 8;Puncture needle 10 comprises hollowouter pipe 9, and its leading section is the spininess on band inclined-plane; Ocular unit compriseseyepiece hood 2, imagerotation camera lens 15,eyepiece camera lens 3 and eyepiece glass 1, and imagerotation camera lens 15,eyepiece camera lens 3 and eyepiece glass 1 are successively set in theeyepiece hood 2; Imagerotation camera lens 15 can with chamfer map as blur-free imaging to the image planes ofeyepiece camera lens 3; Biography comprises that as the unit multifilament of hollowouter pipe 9 inside that are arranged onpuncture needle 10 passespicture rod 6, and theimaging surface 18 that multifilament passespicture rod 6 constitutes solid spine for the inclined-plane and with the leading section of hollowouter pipe 9; Theimage planes 5 that go out that multifilament passespicture rod 6 are the inclined-plane; Lighting unit comprises thelight beam chuck 11 that can be connected withmain mirror 7, be arranged on thelight beam chuck 11 and thelight beam interface 12 that can be connected with external light source, be arranged onlight cone 13 in thelight beam interface 12, can external light source pass the biographylight fibre bundle 14 of theimaging surface 18 of picture excellent 6 through being sent to multifilament behind thelight cone 13; The imaging surface outer circumferential sides that multifilament passespicture rod 6 is filled withblack epoxy glue 17; The rear end that passeslight fibre bundle 14 is connected with the end face oflight cone 13, and its front end passes asrod 6 with multifilament and glues together mutually near the cylindrical side that goes outimage planes 5 one ends, and its gummed angle passes consistent with respect to the optical reflection line direction that goes outimage planes 5 as excellent 6 axis with multifilament; Puncture body is fixedly installed onmain mirror 7 front ends; The rear end and the ocular unit ofmain mirror 7 are connected.
In Fig. 1, with multifilamentpass picture rod 6 go outimage planes 5 mill miter angles and essence is thrown to optical mirror plane, multifilament pass as excellent 6 axis therewith the angle of reflection direction bonding that forms of inclined-plane passlight fibre bundle 14, no longer enter hollowouter pipe 9, introduce illumination light this moment, the interior inclined-plane that multifilament passespicture rod 6 forms one along its axially downward reflection, thereby illuminate the surface ofpuncture needle 10 head contact surfaces, another part of illumination light can see through multifilament and pass as excellent 6 inclined-planes along former direction outgoing, therefore the associated part of endoscope'sprimary mirror body 7 and assembling thereof should be reserved the emergent light breach, and be processed into black, enter the subsequent optical system to avoid reflecting veiling glare.But what this kind application need was noted is: go outimage planes 5 and be the inclined-plane because multifilament passespicture rod 6, but it goes out as direction and do not change,eyepiece hood 2 still need be seated on the axis, can't place and the vertical direction in inclined-plane.The depth of field ofeyepiece hood 2 is shorter, can't be with the clear picture ground imaging of inclined-plane in whole axial range, therefore the imagerotation camera lens 15 that a depth of field and amplification are enough mated need be set between multifilament passes asrod 6 andeyepiece hood 2, thereby guarantee that the chamfer map picture can be byeyepiece hood 2 blur-free imagings.Owing to introduced this imagerotation camera lens 15, the more preceding a kind of application example of the synthetic resolution of system is low, but owing to do not introduce biographylight fibre bundle 14, under the identical situation of hollowouter pipe 9 external diameters, its field range can relatively be enlarged.
As Fig. 2, Fig. 3 and shown in Figure 5, second kind of percutaneous nephrolithotomy attaching observation type puncture endoscope of the present invention, it passes as the unit and comprises half-reflection and half-transmissionsquare glass prism 16 and the multifilament that are arranged in the hollowouter pipe 9 ofpuncture needle 10pass picture rod 6, and multifilament passes theimage planes 5 that ofpicture rod 6 and glues together mutually with the upper surface of half-reflection and half-transmissionsquare glass prism 16; Theimaging surface 18 that multifilament passespicture rod 6 constitutes solid spine for the inclined-plane and with the leading section of hollowouter pipe 9; The outer circumferential sides that multifilament passespicture rod 6close imaging surfaces 18 is filled withblack epoxy glue 17; Its ocular unit compriseseyepiece hood 2,eyepiece camera lens 3 and eyepiece glass 1, andeyepiece camera lens 3 and eyepiece glass 1 are successively set in theeyepiece hood 2; Its lighting unit comprises thelight beam chuck 11 that can be connected withmain mirror 7, be arranged on thelight beam chuck 11 and thelight beam interface 12 that can be connected with external light source, be arranged onlight cone 13 in thelight beam interface 12, be sent to half-reflection and half-transmissionsquare glass prism 16 lateral biographylight fibre bundles 14 after can external light source passing throughlight cone 13; The open rearward end that passeslight fibre bundle 14 is in the end face oflight cone 13, and its front end glues together mutually with the side end face of half-reflection and half-transmissionsquare glass prism 16; Puncture body is fixedly installed onmain mirror 7 front ends; The rear end and the ocular unit of describedmain mirror 7 are connected.
In Fig. 2, multifilamentpass picture rod 6 go out image planes bonding one by two half-reflection and half-transmissionsquare glass prisms 16 that corner cube prism is glued together, the inclined-plane of one of them corner cube prism is coated with transflective film (allowing the rete of light portion transmissive portions sub reflector), multifilament pass as excellent 6 axis therewith the angle of reflection direction bonding that forms of inclined-plane passlight fibre bundle 14, no longer enter hollowouter pipe 9, introduce illumination light this moment, half-reflection and half-transmissionsquare glass prism 16 inclined-planes form one along its axially downward reflection, thereby illuminate the surface ofpuncture needle 10 head contact surfaces, another part of illumination light can see through half-reflection and half-transmissionsquare glass prism 16 inclined-planes along former direction outgoing, therefore the associated part of endoscope'sprimary mirror body 7 and assembling thereof should be reserved the emergent light breach, and be processed into black, enter the subsequent optical system to avoid reflecting veiling glare, the appropriate section of half-reflection and half-transmissionsquare glass prism 16 should use the black epoxy glue well to seal, to avoid the interference of veiling glare to picture element.Adopt the main problem of this structure be multifilamentpass picture rod 6 cemented surfaces that go out image planes and half-reflection and half-transmissionsquare glass prism 16 can produce one reflective consumingly, thereby effective image is fallen into oblivion, naked eyes can't observe directly image, because this is reflective to be a noise source that is directly proportional with the light intensity of lighting source, as long as each endoscope that assembles is measured in advance and proofreads, generally be in the treatment circuit of ccd image detector, to adopt noise cancellation technique, thereby significantly improve signal to noise ratio, extract effective picture signal, be presented in the monitor.Use this technology, owing to there is the reflecting background source, and part reflective semitransparent film can fall the effective reflection image signal of a part, therefore the brightness of image is relative with acutance can be low, noise is eliminated the resolution that thoroughly can not reduce system, but do not passlight fibre bundle 14 owing to do not introduce, under the identical situation of hollowouter pipe 9 external diameters, its field range can relatively be enlarged.
Referring to Fig. 4, more than the solid spine that constitutes of the end of the puncture endoscope multifilament of the two kinds ofstructures imaging surface 18 that passespicture rod 6 and hollowouter pipe 9 comprise theforward puncture face 41 that is arranged on the spine forefront and theface 42 that punctures dorsad, be separately positioned on the sidedirection puncture face 44 offorward puncture face 41 left and right sides, be arranged on theauxiliary puncture face 43 atforward puncture face 41 rears, the scope of the puncture angle α offorward puncture face 41 is: 9 °～11 °, the scope of the angle β that punctures dorsad offace 42 of puncturing dorsad is: 17 °～5 °, the side direction puncture angle δ 1 of sidedirection puncture face 44 and the scope ofδ 2 are: 9 °～11 °, and the lateral deflection angle
With
Scope be: 18 °～10., the scope of the auxiliary puncture angle γ ofauxiliary puncture face 43 is: 40 °～10 °.
The parameter of part-structure of the present invention is as follows: multifilament passes as excellent filament diameter: 4～12 μ m; When filament diameter hour, the resolution height, cost is more expensive, hollowouter pipe 9 diameter d:0.5～4.0mm; Hollowouter pipe 9 is used higher, the anti abrasive stainless steel material of hardness (as 4Cr13 or 3Cr13 etc.), can guarantee the use repeatedly of endoscope like this, but this also there is certain time limit, when the needle point passivation, can carry out suitable grinding and polishing to needle tip by the professional, thereby recover its acutance.Hollowouter pipe 9 length L: 80～220mm; Put and staypipe 8 diameter D:0.8～4.2mm; Put and staypipe 8 length l: 40～210mm.
The principle of the invention: the present invention does not use object lens to carry out imaging, but has utilized a key property of multifilament biography picture rod 6: will be delivered to the end face imaging and the principle that passes picture that the other end is an image transmission optical fibre well with information such as good object surfaces form that attaches of its end face and colors).Multifilament passes the operation principle of picture rod: light can pass to the other end from an end of thin Glass rod and not run out of excellent outside, even when thin rod was crooked, light also can be followed " bending " and propagate.In fact, light is not crooked, and it just ceaselessly reflects in the inboard of Glass rod and advances, and optically this is called total reflection.It is that, diameter certain by tens thousand of length is the optical fiber (elongated Glass rod or silk) about 4～12 microns that multifilament passes picture rod (also claiming optical fiber image transmission beam), and the optical fiber image device with the transitive graph picture of can directly receiving of assembling for one is arranged at two ends according to close relation one to one.Multifilament passes the optical signal that enters as an excellent end can be transferred to the other end, can can regard each root monofilament as a pixel element, monofilament is because by order arrangement one to one, several pixels of bright dipping end just can be formed the piece image identical with the light inputting end image information.This is the equal of in the other end imaging, can be handled the present invention just so-called " adherent observation type " by the subsequent optical system smoothly.Simultaneously, because the needle point of puncture position own is the surface that is attached at renal tissue, the operating position that this is also realistic, puncture needle head and multifilament can be passed the other end that is passed to multifilament biography picture rod as the good tissue image that attaches in rod surface fully, and not consider whether the puncture tube inwall takies the visual field.Certainly, leaving behind the end face this endoscope can not imaging, thereby the working substance of endoscope is apart from for being zero, and the depth of field also is zero, but this can not have influence under this specific occasion the use to this endoscope.
Endoscope shown in the present is the new instrument that substitutes the fistulation puncture needle, and this gets with operation is follow-up that employed PCN is not same instrument in the stone process, and PCN is an indispensable intrinsic instrument in this operation, has nothing to do with the present invention.PCN has two types in rigid kidney mirror and soft kidney mirror.Soft kidney mirror is thin, front end can turn to as required, enter renal calices easily, but handle hole is less, only be used for the treatment of keep somewhere the kidney fistulation can complete taking-up microlith.Rigid kidney mirror is thick, handle hole is big, can put into various intracavity rubbles and dislodger tool by its handle hole, is the most frequently used apparatus of PCN lithotrity.
Claims (6)
Translated fromChinese
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| CN2008101706666ACN101433469B (en) | 2008-10-09 | 2008-10-21 | Attaching observation type puncture endoscope for percutaneous nephrolithotomy |
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| CN2008101706666ACN101433469B (en) | 2008-10-09 | 2008-10-21 | Attaching observation type puncture endoscope for percutaneous nephrolithotomy |
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| CN112023130A (en)* | 2020-08-25 | 2020-12-04 | 宁波市医疗中心李惠利医院 | Guiding device for first aid under endoscope |
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| CN101711663B (en)* | 2009-10-30 | 2011-06-15 | 飞秒光电科技(西安)有限公司 | Endoscope axially provided with lighting fiber |
| CN102178503A (en)* | 2011-05-06 | 2011-09-14 | 杭州桐庐尖端内窥镜有限公司 | Cervical intervertebral disc scope |
| CN102178503B (en)* | 2011-05-06 | 2013-02-27 | 浙江天松医疗器械股份有限公司 | Cervical intervertebral disc scope |
| CN103505267A (en)* | 2012-06-27 | 2014-01-15 | 成爱军 | Puncture pressure reducing needle in cholecystitis operation and puncture pressure reducing method thereof |
| US12090285B2 (en) | 2012-11-10 | 2024-09-17 | Agile Devices, Inc. | Coaxial bi-directional catheter |
| US10029072B2 (en) | 2012-11-10 | 2018-07-24 | Curvo Medical, Inc. | Coaxial bi-directional catheter |
| US10071224B2 (en) | 2012-11-10 | 2018-09-11 | Curvo Medical, Inc. | Coaxial bi-directional catheter |
| US10071225B2 (en) | 2012-11-10 | 2018-09-11 | Curvo Medical, Inc. | Coaxial bi-directional catheter |
| US10582837B2 (en) | 2012-11-10 | 2020-03-10 | Curvo Medical, Inc. | Coaxial micro-endoscope |
| US11083873B2 (en) | 2012-11-10 | 2021-08-10 | Agile Devices, Inc. | Coaxial bi-directional catheter |
| US12097338B2 (en) | 2012-11-10 | 2024-09-24 | Agile Devices, Inc. | Coaxial bi-directional catheter |
| US11700994B2 (en) | 2012-11-10 | 2023-07-18 | Agile Devices, Inc. | Coaxial micro-endoscope |
| CN112023130A (en)* | 2020-08-25 | 2020-12-04 | 宁波市医疗中心李惠利医院 | Guiding device for first aid under endoscope |
| CN112023130B (en)* | 2020-08-25 | 2023-05-12 | 宁波市医疗中心李惠利医院 | A guiding device for endoscopic first aid |
| US11872357B2 (en) | 2020-11-09 | 2024-01-16 | Agile Devices, Inc. | Devices for steering catheters |
| WO2024044131A1 (en)* | 2022-08-22 | 2024-02-29 | Thomas Jefferson University | Device for periurethral bulking and methods incorporating the same |
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| CN101433469B (en) | 2010-12-22 |
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