Exploration of common bile duct sheathTechnical field
The present invention relates to a kind of exploration of common bile duct sheath, the exploration of common bile duct sheath of specifically a kind of choledochoscope.
Background technique
Liver inside and outside bile duct stone is the common disease and frequently-occurring disease in China, and it is treat the disease main that exploration of common bile duct, which takes stone,Modus operandi, traditional operation scheme are to open abdomen exploration of common bile duct, have the shortcomings that wound is big, it is slow to restore.With laparoscope and gallbladderThe development of road mirror technology takes laparoscopic exploration of common bile duct, choledochoscope to take the treatment of liver inside and outside bile duct stone more at presentStone therapeutic scheme has many advantages, such as that wound is small, restores fast, few intercurrent disease compared with Tradtional laparotomy.
Currently, being placed in choledochoscope from abdominal cavity puncture outfit casing, when carrying out exploration of common bile duct and taking stone, there are all for whichMore disadvantages: being both needed to establish pneumoperitoneum in 1. entire surgical procedures, and prolonged pneumoperitoneum is easy to influence the swing of diaphram, influences to breatheAnd acid poisoning and ion imbalances can occur for circulation, the absorption of great amount of carbon dioxide, the carbon dioxide of high pressure is through venous return, evenGas embolism occurs, jeopardizes patient vitals；2. in choledochoscope probe procedure, a large amount of infectivity bile, rubble, gallbladder mud and choledochoscopeFlushing liquor flows into intraperitoneal through notch, is easy to cause abdominal cavity infection, peritoneal abscess, and after rubble and gallbladder mud enter abdominal cavity, it is difficult toIt removes completely, leads to the complication such as abdominal cavity adhesion, intestinal obstruction, internal fistula, peritoneal abscess；3. post-choledochotomy, common bile duct pressureIt reduces and collapses, increase the difficulty that choledochoscope enters choledochus；4. stamp card outer tube is rigid plastics, head end tube wall is easyDamage choledochoscope.
Summary of the invention
According to technical problem set forth above, and provide a kind of exploration of common bile duct sheath.The technological means that the present invention usesIt is as follows:
A kind of exploration of common bile duct sheath, horizontal tube and vertical pipe including being located at the sheath tube head；
It is connected between the horizontal tube and the vertical pipe by bend pipe, i.e., the described sheath head end is L-shaped；
The horizontal tube has opening far from one end of the bend pipe；
The outer tube wall of the bend pipe is equipped with through-hole；
The outer wall of the vertical pipe is equipped with water outlet connector；
The vertical pipe is equipped with pedestal far from one end of the bend pipe；
The channel being connected to the vertical pipe is equipped in the pedestal；
The vias inner walls are equipped with antireflux pad；
The material of the antireflux pad is silica gel；
The antireflux pad is equipped with the springhole passed through for choledochoscope, after the choledochoscope passes through the springhole,The springhole is bonded the choledochoscope, constitutes sealing, antireflux.
The shape of the through-hole and the opening around the upper end tilt 15 ° to the bend pipe after positive throwing on the bend pipeShadow (projecting along the axis direction of the horizontal tube) is consistent；
The angle of plane and the vertical pipe axis where the through-hole is greater than 45 ° and is less than or equal to 60 °.
After the setting of the through-hole makes the horizontal tube be placed to choledochus, the through-hole close to the vertical tube portion notIt can expose to outside choledochus, and the through-hole is less than the internal diameter of the vertical pipe along the projection of the vertical tube axis direction.
The material of the horizontal tube, the bend pipe and the vertical pipe is silica gel, therefore has certain elasticity, described curvedPipe has certain curvature, and since the outer tube wall of the bend pipe is equipped with through-hole, the sheath is basic in the pipe bent positionIt can be bent and be in line, be then placed to through stamp card intraperitoneal.
The outer diameter of the vertical pipe is 0.9cm, because the internal diameter of stamp card is essentially 1cm, the outer diameter of the vertical pipeIt is more smaller than 1cm；
The outer diameter of the horizontal tube is 6mm, 8mm or consistent with the outer diameter of the vertical pipe.
Pipeline section a length of 1cm of the sheath tube head beyond cylindrical surface where the vertical pipe.
The wall thickness of the horizontal tube, the bend pipe and the vertical pipe is 1mm, has preferable support.
A length of 30~60cm of the vertical pipe, can go directly choledochus through stomach wall.
Compared with prior art, the invention has the following advantages that
1. sheath head end is L-shaped, the outer tube wall of bend pipe is equipped with through-hole, and stamp card outer tube can be placed to after appropriate bendingIt is interior；
2. sheath head end is L-shaped, it is placed in choledochus through choledochus notch, there is good fixed function；
3. horizontal tube, bend pipe and vertical pipe are silica gel material, avoid during choledochoscope takes stone and stab card housing tube wall pairThe damage of choledochoscope；
4. sheath head end is L-shaped, the outer tube wall of bend pipe is equipped with through-hole, and choledochoscope can be through the opening and bend pipe on horizontal tubeThrough-hole on the tube wall of outer detects lower common bile duct and upper section；
5. after sheath enters choledochus, pneumoperitoneum and laparoscope video can be closed, the concurrent of long-term pneumoperitoneum generation is avoidedThe loss of disease and laparoscope system；
6. choledochoscope can be directly entered in choledochus along sheath, and by opening on horizontal tube and bend pipe outer tube wallThrough-hole identification lower common bile duct and upper section direction；
7. water outlet connector connects negative-pressure suction pipe, infectious bile, flushing liquor, muddy stone and gallbladder mud etc. can be dischargedIn vitro, it reduces above-mentioned substance and enters complication caused by abdominal cavity.
The present invention can be widely popularized in fields such as medical apparatus based on the above reasons.
Detailed description of the invention
In order to more clearly explain the embodiment of the invention or the technical proposal in the existing technology, to embodiment or will show belowThere is attached drawing needed in technical description to do simply to introduce, it should be apparent that, the accompanying drawings in the following description is this hairBright some embodiments for those of ordinary skill in the art without any creative labor, can be withIt obtains other drawings based on these drawings.
Fig. 1 is the schematic diagram under exploration of common bile duct sheath is in running order in a specific embodiment of the invention.
Fig. 2 is the schematic diagram (insertion under exploration of common bile duct sheath is in running order in a specific embodiment of the inventionCholedochoscope).
Specific embodiment
In order to make the object, technical scheme and advantages of the embodiment of the invention clearer, below in conjunction with the embodiment of the present inventionIn attached drawing, technical scheme in the embodiment of the invention is clearly and completely described, it is clear that described embodiment isA part of the embodiment of the present invention, instead of all the embodiments.Based on the embodiments of the present invention, those of ordinary skill in the artEvery other embodiment obtained without making creative work, shall fall within the protection scope of the present invention.
As depicted in figs. 1 and 2, a kind of exploration of common bile duct sheath, including being located at the horizontal tube 1 of the sheath tube head and erectingStraight tube 2；
It is connected between the horizontal tube 1 and the vertical pipe 2 by bend pipe 3；
The horizontal tube 1 has opening 4 far from one end of the bend pipe 3；
The outer tube wall of the bend pipe 3 is equipped with through-hole 5；
The outer wall of the vertical pipe 2 is equipped with water outlet connector 6；
The vertical pipe 2 is equipped with pedestal 7 far from one end of the bend pipe 3；
The channel 8 being connected to the vertical pipe 2 is equipped in the pedestal 7；
8 inner wall of channel is equipped with antireflux pad 9；
The antireflux pad 9 is equipped with the springhole 11 passed through for choledochoscope 10.
The shape of the through-hole 5 and it is described opening 4 around the upper end to the bend pipe 3 tilt 15 ° after on the bend pipe 3Orthographic projection is consistent；
The angle of the 5 place plane of through-hole and 2 axis of vertical pipe is greater than 45 ° and is less than or equal to 60 °.
The material of the horizontal tube 1, the bend pipe 3 and the vertical pipe 2 is silica gel.
The outer diameter of the vertical pipe 2 is 0.9cm；
The outer diameter of the horizontal tube 1 is 6mm, 8mm or consistent with the outer diameter of the vertical pipe 2.
The sheath tube head exceeds a length of 1cm of pipeline section on the 2 place cylindrical surface of vertical pipe.
The wall thickness of the horizontal tube 1, the bend pipe 3 and the vertical pipe 2 is 1mm.
A length of 30~60cm of the vertical pipe 2.
It establishes pneumoperitoneum and is placed in stamp card through stomach wall, take out stamp card pushing ram, water outlet connector 6 connects negative-pressure suction pipe, makes instituteHorizontal tube 1, the bend pipe 3 and the vertical pipe 2 is stated to be connected to negative-pressure suction pipe.
Through the stamp card outer tube merging sheath and gradually close to 12 notch of choledochus, the sheath is entered through notchIn choledochus 12, the vertical pipe 2 with choledochus 12 in obtuse angle when, it is remote that the sheath tube head is upwardly into 12 notch of choledochusEnd, when the vertical pipe 2 is at an acute angle with choledochus 12, the sheath tube head is upwardly into 12 notch proximal end of choledochus.
The vacuum suction pressure for adjusting negative-pressure suction pipe, makes negative pressure water yield and 10 inflow of choledochoscope and Amount of Bile phaseTogether, avoid choledochus 12 collapse or choledochus 12 in liquid it is excessive through notch.
Pneumoperitoneum is closed, stops laparoscope video system, injects atoleine in the sheath, is placed in gallbladder from springhole 11Road mirror 10, choledochoscope 10 are visited through the through-hole 5 on the 3 outer tube wall of opening 4 and bend pipe on horizontal tube 1 into extrahepatic ductLook into and take stone.
After taking net liver inside and outside bile duct stone, pneumoperitoneum is established again and opens laparoscope system, take out the sheath and suture12 notch of choledochus.
Finally, it should be noted that the above embodiments are only used to illustrate the technical solution of the present invention., rather than its limitations；To the greatest extentPipe present invention has been described in detail with reference to the aforementioned embodiments, those skilled in the art should understand that: its according toSo be possible to modify the technical solutions described in the foregoing embodiments, or to some or all of the technical features intoRow equivalent replacement；And these are modified or replaceed, various embodiments of the present invention technology that it does not separate the essence of the corresponding technical solutionThe range of scheme.