Summary of the invention
The problem that the present invention solves is to provide a kind of tissue pulverizer cutter head and device for laser therapy, to simplify operation, fallThe low possibility causing postoperative complication.
For solving the problems referred to above, the present invention provides a kind of tissue pulverizer cutter head, including:
Fixing seat；Interior cutter, is arranged on described fixing seat, and described interior cutter is shaft-like；Optical-fibre channel pipe, in describedCutter be arranged in parallel；The epitheca of tubular structure, be arranged in parallel with described interior cutter and described optical-fibre channel pipe and is set in describedOutside interior cutter and described optical-fibre channel pipe, described epitheca is fixedly linked with described optical-fibre channel pipe by inwall, and described epitheca hasThere is the first end and second end relative with described first end being connected with described fixing seat, the tube wall of described second end has cutterMouthful, the described edge of a knife exposes a part for described interior cutter, and the end face of described second end is to intersect with described epitheca bearing of trendInclined-plane.
Optionally, the end face of described second end and the angle of described epitheca bearing of trend are in the range of 30 ° to 45 °.
Optionally, the internal diameter of described epitheca tube chamber is in the range of 5.75mm to 6.00mm.
Optionally, the material of described optical-fibre channel pipe and described epitheca is metal.
Optionally, described epitheca is connected with described optical-fibre channel sealing of tube, or described epitheca and described optical-fibre channel pipeIt is structure as a whole.
Optionally, described optical-fibre channel pipe is arranged at epitheca inwall and described edge of a knife relative position.
Optionally, described optical-fibre channel pipe has the external part away from described fixing seat；Described epitheca is provided with the edge of a knifeOne end is operating side；Along bearing of trend, described external part is between described operating side and described fixing seat.
Optionally, along bearing of trend, the distance between described external part and described operating side is in 0.5mm to 3.0mm scopeIn.
Optionally, described fixing seat has the first end face and the second end face being oppositely arranged, and described second end face is arrangedThere is fiber entrance；The side that described interior cutter points to the second end face along the first end face extends upward through described fixing seat；Described optical fiber leads toDeferent is connected with the first end face of described fixing seat, and the tube chamber of described optical-fibre channel pipe connects with described fiber entrance；DescribedFirst end of epitheca is connected with the first end face of described fixing seat.
Optionally, described interior cutter rotation in real presently described epitheca under the control of motor；Set on described interior cutterIt is equipped with motor connector, for realizing the connection of described interior cutter and motor.
Optionally, described interior cutter includes being provided with breaking-edge away from the side face of described fixing seat one end operating space and notIt is provided with the enclosed area of breaking-edge.
Accordingly, the present invention also provides for a kind of device for laser therapy, including:
Laser fiber, is connected with described laser instrument；The tissue pulverizer cutter head of the present invention, described optical fiber slidably overlapsIt is loaded in described optical-fibre channel pipe.
Optionally, described laser instrument is holmium laser, and described optical fiber is the optical fiber of conduction Bladder stone.
Compared with prior art, technical scheme has the advantage that
In technical solution of the present invention, described outer sheath is loaded on outside described interior cutter and described optical-fibre channel pipe, and describedThe end face of the second end is the inclined-plane intersected with described epitheca bearing of trend, so the second end of described epitheca forms wedge structure.When performing the operation, it is possible to use described epitheca pushes tissue, epitheca second end of wedge structure and the contact area of tissueLess, described epitheca is relatively big to needing the pressure pushing tissue, thus is conducive to the epitheca strengthening wedge structure to push tissueEffect；The epitheca of wedge structure pushes the enhancing of tissue effect, beneficially reduces the thrust applied, and reduces health tissueImpaired possibility, thus advantageously reduce the possibility that postoperative complication occurs.
Detailed description of the invention
From background technology, when using operation handle of the prior art to carry out surgical operation, there is operation complexity, holdThe problem easily causing postoperative complication.In conjunction with a kind of prostatic hyperplasia cut out the laser surgery procedures removed analyze its operation complexity askThe reason of topic:
Cut out except, in the laser surgery of prostatic hyperplasia, first by the laser operations handle with endoscope, utilizing laserHyperplastic prostate tissue is cut；Afterwards according to patient, or the hyperplastic tissue cut is cut into further little brokenSheet is to clean and discharging, or the hyperplastic tissue cut is cut into bigger bulk and is pushed to intravesical.
During excision hyperplastic prostate tissue, scope sheath may be used, with sphincter as fulcrum, from prostateThe prostata tissue of hypertrophy is pushed on peplos.But owing to the end face of scope sheath is straight with the angle of the axis of described scope sheathAngle, so when pushing the prostata tissue of hypertrophy, the end face of scope sheath and the contact area of tissue are relatively big, cause scope sheath pairThe pressure of the hyperplastic tissue that needs push is less, so when pushing the prostata tissue of hypertrophy, needing to apply scope sheath relativelyBig thrust.Apply the increase of thrust, the possibility that capsula prostatica is impaired can be increased, also can increase the possibility of sphincter injury,The possibility that the postoperative complications such as postoperative urinary incontinence occur can be increased.
For solving described technical problem, the present invention provides a kind of tissue pulverizer cutter head, including:
Fixing seat；Interior cutter, is arranged on described fixing seat, and described interior cutter is shaft-like；Optical-fibre channel pipe, in describedCutter be arranged in parallel and contacts with described interior tool bar wall；The epitheca of tubular structure, leads to described interior cutter and described optical fiberDeferent be arranged in parallel and is set in outside described interior cutter and described optical-fibre channel pipe, and described epitheca is led to described optical fiber by inwallDeferent is fixedly linked, and described epitheca has the first end and second end relative with described first end being connected with described fixing seat,Having the edge of a knife on the tube wall of described second end, the described edge of a knife exposes a part for described interior cutter, and the end face of described second end isThe inclined-plane intersected with described epitheca bearing of trend.
In technical solution of the present invention, described outer sheath is loaded on outside described interior cutter and described optical-fibre channel pipe, and describedThe end face of the second end is the inclined-plane intersected with described epitheca bearing of trend, so the second end of described epitheca forms wedge structure.When performing the operation, it is possible to use described epitheca pushes tissue, epitheca second end of wedge structure and the contact area of tissueLess, described epitheca is relatively big to needing the pressure pushing tissue, thus is conducive to the epitheca strengthening wedge structure to push tissueEffect；The epitheca of wedge structure pushes the enhancing of tissue effect, beneficially reduces the thrust applied, and reduces health tissueImpaired possibility, thus advantageously reduce the possibility that postoperative complication occurs.
Understandable, below in conjunction with the accompanying drawings to the present invention for enabling the above-mentioned purpose of the present invention, feature and advantage to become apparent fromSpecific embodiment be described in detail.
With reference to Fig. 1, it is shown that the structural representation of tissue pulverizer cutter head one embodiment of the present invention.
Described tissue pulverizer cutter head includes:
Fixing seat 100；Interior cutter 120, is arranged on described fixing seat 100, and described interior cutter 120 is shaft-like；Optical fiber leads toDeferent 130, be arranged in parallel with described interior cutter 120 and contacts with described interior cutter 120 bar wall；The epitheca 110 of tubular structure,It is arranged in parallel with described interior cutter 120 and described optical-fibre channel pipe 130 and be set in described interior cutter 120 and described optical-fibre channelOutside pipe 130, described epitheca 110 is fixedly linked with described optical-fibre channel pipe 130 by inwall, and described epitheca 110 has with describedFixing seat 100 the first connected end and second end (as shown in Fig. 1 centre circle 121 in) relative with described first end, described secondHaving the edge of a knife 111 on the tube wall of end, the described edge of a knife 111 exposes a part for described interior cutter 120, and the end face of described second end isThe inclined-plane intersected with described epitheca 110 bearing of trend.
Concrete, in conjunction with referring to figs. 2 to Fig. 4, wherein Fig. 2 is the close-up schematic view of Fig. 1 centre circle 121 inner structure；Fig. 3It it is the plan structure schematic diagram along A direction in Fig. 2；Fig. 4 is the cross-sectional view in Fig. 1 along BB line.
Described fixing seat 100, is used for fixing described tissue pulverizer cutter head.
In the present embodiment, described fixing seat 100 can be the epitheca seat of fixation, the material of described fixing seat 100For metal, such as medical stainless steel.
Concrete, described fixing seat 100 is cylinder.Described fixing seat 100 includes the first end face being oppositely arranged along axis101 and second end face 102, described second end face 102 has fiber entrance 103, for stretching into for optical fiber.
It should be noted that in the present embodiment, described fixing seat 100 is hollow housing structure, described fiber entrance 103 withCavity in described fixing seat 100 is connected.But in other embodiments of the invention, described fixing seat can also be entity knotStructure.
Interior cutter 120 is used for carrying out crushing operation.
The side that described interior cutter 120 points to the second end face 102 along the first end face 101 extends upward through described fixing seat 100；InstituteState interior cutter 120 include being provided with the operating space 122 of breaking-edge away from the side face of described fixing seat 100 one end and be not provided with powderThe enclosed area of broken sword.
Described operating space 122 is for pulverizing tissue in operation process.
In the present embodiment, described tissue pulverizer for cutting out except in the operation of hyperplastic prostate tissue, described interior cutter 120For planing cutter head.So as shown in Figures 2 and 3, the operating space 122 of described interior cutter 120 is provided with the pulverizing of broached-tooth designSword.But in other embodiments of the invention, described interior cutter can also be for being suitable for being sleeved on the interior cutter of epitheca other structures interiorTool, the most described operating space can also arrange the breaking-edge of other structures.
Described enclosed area is used for closing the edge of a knife.
In the present embodiment, the side face of described enclosed area is smooth surface.
The material of described interior cutter 120 is also metal, such as medical stainless steel.It should be noted that described interior cutter 120For hollow structure.During conducting powder is broken, described interior cutter 120 is connected with drainage bottle, and drainage bottle passes through described interior cutterSubnormal ambient is formed, so that the hyperplastic tissue cut down is adsorbed onto described interior cutter at described tissue pulverizer cutter head adnexaOperating space 122 adnexa of 120, to realize pulverizing.
It should be noted that described interior cutter 120 is circular rod-like structure for cross section, so described interior cutter 120Can be rotatable around its axis.In the present embodiment, described interior cutter 120 realizes rotating under the control of motor；So described interior cutterIt is provided with motor connector 123, for realizing the connection of described interior cutter 120 and motor on tool 120.
Optical-fibre channel pipe 130, for providing optical fiber to enter the path spacing of human body, is additionally operable to using laser to cutDuring fix optical fiber, it is to avoid optical fiber rocks excessive in cutting process.
The setting of described optical-fibre channel pipe 130, it is possible to make optical fiber and described interior cutter 120 can simultaneously enter human body.?Carry out in surgical operation, utilize the fiber optic conduction laser being set in optical-fibre channel pipe 130, to carry out tissue cutting；Lead to afterwardsCross described interior cutter 120 to pulverize the tissue of excision to excrete, it is achieved thereby that a cutter head carries out cutting and tissue powderTwo broken functions.
So in operation process, it is only necessary to rotate described tissue pulverizer cutter head and can realize cutting function and tissue powderSwitching between broken function, it is to avoid change endoscopic system in operation process, thus simplify operation technique, is conducive to improvingProcedure efficiency, shortens operating time.
It should be noted that owing to described optical-fibre channel pipe 130 not only needs jacketed fiber, in addition it is also necessary to optical fiber is carried out oneFixed control action, so the internal diameter of described optical-fibre channel pipe 130 and the fiber size being set with need to cooperate, thus carriesHigh operation precision, reduces operation risk.
In the present embodiment, the material of described optical-fibre channel pipe 130 is metal, such as medical metal.
Described optical-fibre channel pipe 130 is connected with the first end face 101 of described fixing seat 100, and described optical-fibre channel pipe 130Tube chamber connect with described fiber entrance 103.In the present embodiment, described fixing seat 100 is hollow housing structure, so described lightThe tube chamber of fine channel 130 realizes connecting by the cavity in described fixing seat 100 with described fiber entrance 103.Carrying out handsDuring art, optical fiber enters in described optical-fibre channel pipe 130 by the described fiber entrance 103 cavity in described fixing seat 100, logicalThe tube chamber crossing optical-fibre channel pipe 130 enters human body to perform the operation.
Described epitheca 110 is used for providing operation pathway space, is additionally operable to carry out crushing operation.
Described epitheca 110 is the tubular structure of hollow, with described interior cutter 120 and described optical-fibre channel pipe 130 is parallel setsPut and be set in outside described interior cutter 120 and described optical-fibre channel pipe 130.Carrying out operating room, the tube chamber of described epitheca 110 is i.e.Enter through the tube chamber of described epitheca 110 for operating path spacing, described interior cutter 120 and described optical-fibre channel pipe 130Human body.In the present embodiment, the material of described epitheca 110 is metal, such as medical stainless steel.
First end of described epitheca 110 is connected with the first end face 101 of described fixing seat 110.In the present embodiment, described solidReservation 100 is hollow housing structure, and the tube chamber of described epitheca 110 is connected with the inner chamber of described fixing seat 100 conducting.The present invention itsIn his embodiment, when described fixing seat is entity structure, point on the direction of the second end face 102 along the first end face 101, described outsideSheath 110 runs through described fixing seat 100, forms through hole in described fixing seat 100.
The end face 112 of described epitheca 110 second end is the inclined-plane intersected with described epitheca bearing of trend.So described epithecaSecond end of 110 forms wedge structure.So utilizing described tissue pulverizer cutter head to perform the operation, it is possible to use described epitheca110 push tissue, and epitheca 110 second end of wedge structure is less with the contact area of tissue, and described epitheca 110 is to needsThe pressure pushing tissue is relatively big, thus is conducive to the epitheca 110 improving wedge structure to push the effect of tissue.Outside wedge structureSheath 110 pushes the raising of tissue effect, beneficially reduces the thrust applied, and reduces the possibility of health tissue damaged, fromAnd advantageously reduce the possibility that postoperative complication occurs.
It should be noted that the angle between the end face 112 of described second end and described epitheca 110 bearing of trend should not be tooLittle also should not be the biggest.
If the angle between the end face 112 of described second end and described epitheca 110 bearing of trend is too big, then wedge structureThe contact area of epitheca the second end and tissue too big, described epitheca is the least to needing the pressure pushing tissue, is unfavorable forImprove epitheca and push the effect of tissue, reduce the thrust applied；The end face 112 of described second end extends with described epitheca 110If the angle between direction is the least, then epitheca second end of wedge structure is the least with the contact area of tissue, described outsideSheath is big to needing the pressure Mrs pushing tissue, then may increase operation risk.So in the present embodiment, described second endThe angle of end face 112 and described epitheca 110 bearing of trend is in the range of 30 ° to 45 °.
Additionally, the edge of a knife 111 on described epitheca 110 second end tube wall runs through tube wall connects the tube chamber of described epitheca 110.InstituteState the position of the edge of a knife 111 with described interior cutter 120 away from position, operating space 122 phase on the side face of described fixing seat 100 one endCorrespondence, the described edge of a knife 111 can expose described operating space 122.
During the broken tissue of conducting powder, described interior cutter 120 can make described tissue pulverizer cutter head be formed about negative pressure ringBorder, so that the tissue adsorptions cut down is on the described edge of a knife 111；Described interior cutter 120 realizes under the control of motorThe rotation of 110 in described epitheca, so interacting between the described edge of a knife 111 and described operating space 122, described breaking-edgeCooperate with the described edge of a knife 111 and the tissue adsorbed on the described edge of a knife 111 is sheared, thus reach to pulverize the mesh of tissue's.
Additionally, during described tissue pulverizer cutter head enters human body, by rotating described interior cutter 120, make instituteState enclosed area to expose from the described edge of a knife 111, utilize epitheca 110 to cover described operating space 122, reduce described tissue pulverizer cutter headThe probability of incised wound tissue when entering human body.
Described epitheca 110 is fixedly linked with described optical-fibre channel pipe 130 by inwall.In the present embodiment, described epitheca 110It is metal with the material of described optical-fibre channel pipe 130.So described epitheca 110 and described optical-fibre channel pipe 130 can pass throughThe mode of welding is fixedly linked.But in other embodiments of the invention, described epitheca 110 can also be with described optical-fibre channel pipe130 are structure as a whole, thus reduce the gap in described tissue pulverizer cutter head structure, reduce sterilization difficulty, reduce and use windDanger.
Described optical-fibre channel pipe 130 is arranged at epitheca 110 inwall and the described edge of a knife 111 relative position.Due to described groupThe edge of a knife 111 knitting destructor cutter head is operationally in subnormal ambient, is cut so that the described edge of a knife 111 can adsorbThe tissue cut off is to realize pulverizing.But the existence of subnormal ambient is it is also possible that the described edge of a knife 111 is adsorbed onto normal tissue.In the present embodiment, described tissue pulverizer cutter head is for cutting out except, in the operation of prostatic hyperplasia, the described edge of a knife 111 may be adsorbed ontoIn wall of urinary bladder.In the presence of subnormal ambient, even if what the described edge of a knife 111 exposed is the enclosed area of described interior cutter 120, described cutterMouth 111 is adsorbed onto normal structure it is also possible that normal structure is impaired, increases operation risk.
So the way that described optical-fibre channel pipe 130 is oppositely arranged with the described edge of a knife 111, it is possible to carry out using laserDuring cutting function, make the edge of a knife 111 away from normal structure, thus reduce the edge of a knife 111 and damage the probability of normal structure, increase operation peaceQuan Xing.
It should be noted that owing to described epitheca 110 needs to be set with described optical-fibre channel pipe 130 and described interior cutter 120,So the internal diameter of described epitheca 110 tube chamber should not too big also should not be the least.
If the internal diameter of described epitheca 110 tube chamber is the least, then cannot be sleeved on described interior cutter 120 and described optical-fibre channelOutside pipe 130, or the rotation in described epitheca 110 of the interior cutter 120 of suit can be affected, affect crushing function, it is also possible to meetingThe size making interior the cutter 120 and described optical-fibre channel pipe 130 being set with is the least；Owing to described epitheca 110 is to described interior cutter120 and the operation in human body of the described optical-fibre channel pipe 130 operation pathway space, the size of described epitheca 110 and operation are providedThe size of wound is correlated with, if so the internal diameter of described epitheca 110 tube chamber is too big, then can affect described interior cutter 120 and instituteState the control accuracy of optical-fibre channel pipe 130, also can increase surgical wound, thus increase operation risk.So in the present embodiment, instituteState the internal diameter of epitheca 110 tube chamber in the range of 5.75mm to 6.00mm.
It should be noted that in the present embodiment, described optical-fibre channel pipe 130 contacts with described interior cutter 120 bar wall, andIt is fixedly linked with described epitheca 110 inwall, so the diameter of described epitheca 110 tube chamber and described interior cutter 120 external diameter and describedOptical-fibre channel pipe 130 external diameter needs to cooperate, and is ensureing that described epitheca 110 can be set in described interior cutter 120 and describedOutside optical-fibre channel pipe 130, and described interior cutter 120 is in described epitheca 110 on the premise of smooth rotation, reduce as far as possible described outsideThe size of sheath 110, to reach to reduce the purpose of surgical wound.
Additionally, described optical-fibre channel pipe 130 has the external part away from described fixing seat 100；Described epitheca 110 is provided withOne end of the edge of a knife 111 is operating side；In the present embodiment, along bearing of trend, described external part is positioned at described operating side and described solidBetween reservation 100.When performing the operation, optical fiber stretches out to perform the operation in described optical-fibre channel pipe 130.This way canReduce described optical-fibre channel pipe 130 enter during human body and carry out in the operation process that cuts and pulverize with tissueDirectly contact, thus reduce the damage to human normal tissue of the described optical-fibre channel pipe 130, reduce operation risk.
Along bearing of trend, the distance between described external part and described operating side should not too big also should not be the least.
If the distance between described external part and described operating side is too big, when operation, optical fiber needs to stretch out optical-fibre channelThe length of pipe 130 is longer, is unfavorable for the control to optical fiber, is likely to result in the problem that operation risk increases；Described external part withIf the distance between described operating side is the least, described optical-fibre channel pipe 130 end is too near to described epitheca 110 end, is enteringDuring entering human body and carry out optical-fibre channel pipe 130 described in the operation process that cuts and pulverize and may connect with normal structureTouch, the possibility that normal structure is impaired can be increased, also can increase operation risk.So in the present embodiment, along bearing of trend, described in stretchGo out the distance between end and described operating side in the range of 0.5mm to 3.0mm.
Accordingly, the present invention also provides for a kind of device for laser therapy, including:
Laser fiber, is connected with described laser instrument；Tissue pulverizer cutter head provided by the present invention, described optical fiber can be slidedDynamic is set in described optical-fibre channel pipe.
Described laser instrument is for producing the laser carrying out treating.
In the present embodiment, described device for laser therapy is for section office's operations such as Urology Surgery, department of eye, department of dermatologry, gynecologicalIn treatment, described laser instrument is with yttrium-aluminium-garnet as active medium, and doped with sensitized ion chromium, biography can ion thulium, active ions holmiumsThe pulsed solidstate holmium laser made of laser crystal.The Bladder stone that described laser instrument produces is to the penetration depth of tissue veryShallow, only 0.38mm, therefore can accomplish damaging surrounding tissue less when operation, safety is higher.
Described optical fiber is used for transmitting laser to treat.
Described laser instrument is holmium laser, so the optical fiber that described optical fiber is conduction Bladder stone.Concrete, described optical fiber isThe optical fiber of a length of 2.1 μm pulse type lasers of keying wave.
Described tissue pulverizer cutter head is tissue pulverizer cutter head provided by the present invention, and concrete technical scheme is with reference to aforementionedThe embodiment of tissue pulverizer cutter head, the present invention does not repeats them here.
Described optical fiber is set in described optical-fibre channel pipe, and when carrying out operative treatment, described optical fiber passes through optical-fibre channelThe tube chamber of pipe enters human body to perform the operation.Laser for carrying out treating enters human body arrival affected part through the conduction of described optical fiberTo treat.
Described optical fiber can realize sliding in described optical-fibre channel pipe, therefore when utilizing laser to cut, and optical fiberStretch out to perform the operation from described optical-fibre channel pipe；When not using laser, optical fiber is regained from described optical-fibre channel pipe, reduces and swashsThe probability of photic damage normal structure, improves operation safety.
Optical fiber can be introduced human body to carry out cut by described optical-fibre channel pipe by described device for laser therapy；AlsoCan realize the tissue cut down is pulverized by interior cutter；Therefore described device for laser therapy is used to perform the operationTime, it is not necessary in operation process, change endoscopic system, thus simplify operation technique, be conducive to improving procedure efficiency, shortenOperating time, is also beneficial to reduce the probability of secondary damage.
It is sleeved on the epitheca outside described interior cutter and described optical-fibre channel pipe, has at an acute angle with described epitheca bearing of trendEnd face.So the second end of described epitheca forms wedge structure.When performing the operation, it is possible to use described epitheca pushes tissue,The effect that epitheca second end of wedge structure pushes tissue is preferable, pushes the thrust of required applying during tissue less, is conducive toReduce the possibility of health tissue damaged, thus advantageously reduce the possibility that postoperative complication occurs.
To sum up, in technical solution of the present invention, described outer sheath is loaded on outside described interior cutter and described optical-fibre channel pipe, andThe end face of described epitheca the second end and the angle of described epitheca bearing of trend are acute angle, so the second end of described epitheca forms wedgeShape structure.When performing the operation, it is possible to use described epitheca pushes tissue, epitheca second end of wedge structure and connecing of tissueContacting surface is long-pending less, and described epitheca is relatively big to needing the pressure pushing tissue, thus is conducive to the epitheca strengthening wedge structure to pushThe effect of tissue.The epitheca of wedge structure pushes the enhancing of tissue effect, beneficially reduces the thrust applied, and reduces human body and is good forThe possibility of health tissue damaged, thus advantageously reduce the possibility that postoperative complication occurs.
Although present disclosure is as above, but the present invention is not limited to this.Any those skilled in the art, without departing from thisIn the spirit and scope of invention, all can make various changes or modifications, therefore protection scope of the present invention should be with claim instituteLimit in the range of standard.