CN113995508A - A kind of medical optical fiber guiding structure and guiding method - Google Patents

Abstract

Translated fromChinese

本发明涉及一种医用光纤导向结构及导向方法，属于医疗器械技术领域，解决了现有技术中光纤在消融导管所建立的直行消融通道内仅能对其所贯穿周围有限区域内的病灶组织进行消融的问题。本发明包括光纤导向管，所述光纤导向管包含第一管段和第二管段；所述第一管段具有沿轴向方向延伸设置的管腔，所述第二管段具有一与所述管腔连通的开口；所述开口与所述管腔连通的延伸方向和所述管腔的延伸方向之间呈一设定夹角，所述设定夹角为钝角。本发明既增加了避开重要组织的路径方案选择的灵活性和多样性，又提供了从单一通道就可实现大病灶组织的消融方案，不仅提高了手术的效率，还提高了手术的安全性和有效性，实现了“弯道超车”的微创有效治疗。

The invention relates to a medical optical fiber guiding structure and a guiding method, which belong to the technical field of medical equipment, and solve the problem that in the prior art, the optical fiber can only carry out the optical fiber in the straight ablation channel established by the ablation catheter in the surrounding limited area. ablation problem. The present invention includes an optical fiber guide tube, the optical fiber guide tube includes a first tube section and a second tube section; the first tube section has a lumen extending along the axial direction, and the second tube section has a tube communicating with the lumen There is a set angle between the extending direction of the opening communicating with the lumen and the extending direction of the lumen, and the set angle is an obtuse angle. The present invention not only increases the flexibility and diversity of the path scheme selection for avoiding important tissues, but also provides an ablation scheme that can realize large lesion tissue from a single channel, which not only improves the efficiency of the operation, but also improves the safety of the operation and effectiveness, realizing the minimally invasive and effective treatment of "overtaking on a curve".

Description

Medical optical fiber guiding structure and guiding method

Technical Field

The invention relates to the technical field of medical instruments, in particular to a medical optical fiber guiding structure and a guiding method.

Background

As a new technology, compared with the traditional treatment means, the laser ablation has the advantages of precise and controllable ablation range, almost no damage to normal structures around the pathological changes, small operation wound, short operation time, quick postoperative recovery and the like, and particularly brings the eosin for patients with pathological changes in deep parts of the brain and intolerance to the conventional craniotomy treatment. At present, an ablation catheter used for transmitting laser energy to realize tissue damage limits that an optical fiber inside the ablation catheter can only go through a linear type operation channel, but in an actual ablation operation, due to the influence of the position, the shape and the size of a tumor and the influence of other tumor microenvironments such as blood vessels, the scheme of the nonlinear type operation channel is expected by an operation operator. In particular, when a tumor is located at a deep brain site and is located in close proximity to critical tissues, it is advantageous to adopt a "curve salvage" treatment strategy in order to avoid the critical brain tissues for better conformal and global ablation.

It is not easy to establish a nonlinear surgical channel in the cranium, and the operation time and the puncture difficulty are correspondingly increased. The medical optical fiber arranged in the existing ablation catheter can only realize tissue ablation of a linear channel and a limited area, namely only lesion tissues of the linear channel and the limited area nearby the linear channel can be ablated, and a plurality of linear ablation channels need to be considered for ablation of larger lesions.

In addition, in the existing laser ablation surgical scheme, if sampling is performed before ablation, sampling needs to be performed before an ablation catheter is not inserted, and if sampling is performed after ablation, sampling needs to be performed after the ablation catheter is pulled out, so that the operation difficulty of the surgery is high, and the risk that a patient is damaged and infected is extremely high.

Disclosure of Invention

In view of the above analysis, the embodiments of the present invention are directed to providing a medical optical fiber guiding structure and a guiding method, so as to solve the problem that the existing optical fiber can only ablate lesion tissues in a limited region around a straight ablation channel established by an ablation catheter, thereby achieving the therapeutic purpose of curve rescue.

In one aspect, the invention provides a medical optical fiber guide structure, which comprises an optical fiber guide tube, wherein the optical fiber guide tube comprises a first tube section and a second tube section;

the first pipe section is provided with a pipe cavity extending along the axial direction,

the second pipe section is provided with an opening communicated with the pipe cavity;

the opening with be a set for contained angle between the extending direction of lumen intercommunication with the extending direction of official tube chamber, set for the contained angle and be the obtuse angle.

Furthermore, a medical optical fiber is detachably connected in the optical fiber guide tube;

the medical optical fiber can be threaded out of the opening to achieve guided bending.

Further, the first pipe section is a straight pipe part of the optical fiber guide pipe, and the second pipe section is a bent part of the optical fiber guide pipe; the medical optical fiber penetrates out of the bending part to realize guiding bending.

Furthermore, the skull nail device also comprises a guide tube base, a fixing cover and a skull nail, wherein one end of the guide tube base is arranged in the end part of the skull nail, and the other end of the guide tube base is in threaded connection with the fixing cover.

Furthermore, the sealing device also comprises a sealing plug which is arranged in the through hole of the guide pipe base connected with the fixed cover.

Further, the guide tube base comprises a first thread portion and an optical axis portion, the first thread portion and the optical axis portion are located at two ends of the guide tube base respectively, and the first thread portion is provided with an external thread.

Furthermore, the center of the guide tube base is provided with a first through hole, a second through hole and a third through hole which are coaxial and communicated, the first through hole and the second through hole are respectively located at two ends of the guide tube base, and the rear end of the optical fiber guide tube is arranged in the second through hole.

Further, the diameter of the second through hole is smaller than that of the first through hole and larger than that of the third through hole; the diameter of the third through hole is larger than that of the medical optical fiber, and the diameter of the second through hole is equal to the outer diameter of the optical fiber guide tube.

Furthermore, a threaded hole and a fourth through hole which are coaxial and communicated are formed in the center of the fixing cover, the diameter of the fourth through hole is larger than or equal to that of the medical optical fiber, and the first threaded portion is arranged in the threaded hole.

Further, the sealing plug is arranged in the first through hole, the outer wall of the sealing plug is attached to the inner wall of the first through hole, and the medical optical fiber is sleeved in the center hole of the sealing plug and attached to the outer wall of the medical optical fiber.

Furthermore, the skull nail comprises a first connecting part, a second connecting part and a second thread part which are sequentially connected, the first connecting part is connected with the optical axis part, and the second thread part is provided with an external thread and is connected with the skull.

On the other hand, the invention provides a medical optical fiber guiding method, which adopts the medical optical fiber guiding structure and comprises the following steps:

step 1: fixedly connecting the skull nail with the skull;

step 2: inserting the medical optical fiber into the optical fiber guide tube, wherein the front end of the medical optical fiber does not exceed the bending part of the optical fiber guide tube; one end of the guide tube base is connected with the optical fiber guide tube, and the other end of the guide tube base is provided with a sealing plug and is screwed with the fixing cover;

and step 3: inserting the optical fiber guide tube into a designated position through a skull nail;

unscrewing the fixing cover, applying a pushing force to the outside, and moving the medical optical fiber to the front end of the optical fiber guide tube to enable the medical optical fiber to penetrate out of the bent part and change the direction by means of the bent part; then screwing down the fixing cover;

and 4, step 4: unscrewing the fixing cover to pull the medical optical fiber backwards, so that the front end of the medical optical fiber does not exceed the bending part, rotating the guide tube base to adjust the orientation of the bending part, extending the medical optical fiber out of the optical fiber guide tube, and melting another region.

Compared with the prior art, the invention can realize at least one of the following beneficial effects:

(1) the front end of the optical fiber guide tube is a bending part, the front end of the bending part is provided with the arc-shaped incision, when the medical optical fiber penetrates out of the optical fiber guide tube, the medical optical fiber can be bent under the action of the bending part, important tissues on a channel can be avoided, the target focus area can be subjected to conformal ablation, a new channel does not need to be planned again, and the operation efficiency is improved.

(2) The most front end of the optical fiber guide tube is provided with a sharp arc edge, so that the brain tissue can be easily punctured and penetrated, and meanwhile, the projection of the whole bending part towards the straight tube part is positioned in the cross section of the straight tube part, so that the guide tube can extend into the brain only by opening a round small hole on the skull and guiding and positioning through a skull nail, and meanwhile, only a cylindrical channel is established in the brain, so that the tissue cannot be hooked and damaged during exiting, and minimally invasive treatment is realized.

(3) According to the invention, the self-bending deformation of the medical optical fiber is realized through the optical fiber guide tube, and an important area which is not suitable for puncture can be avoided; the range of an ablation area can be further enlarged by adjusting the opening direction of the optical fiber guide tube, ablation which can be completed only by opening two or more channels originally is realized, and the efficiency is improved.

(4) The invention is matched with different medical optical fibers, such as side-emitting optical fibers, and can more conveniently match focuses of different shapes by changing the opening direction of the optical fiber guide tube, complete conformal ablation and realize multi-region ablation in the same channel.

(5) According to the invention, the scale marks are arranged on the limiting part, the marking lines are arranged on the skull nail, the rotation angle of the optical fiber guide tube can be quantitatively changed by rotating the guide tube base, other regions are ablated, the ablation area is expanded, the operation path does not need to be re-planned, and the operation efficiency is improved; meanwhile, the medical optical fiber can be pushed or retreated along the axial direction of the optical fiber guide tube by loosening the fixing cover, and the ablation area can be expanded.

(6) The optical fiber guide tube not only can be suitable for the ablation operation of optical fibers, but also can be matched with a hose sampling needle to realize bending sampling or suction of damaged tissues after ablation.

(7) The parts of the invention are made of nuclear Magnetic compatible materials, such as glass, polytetrafluoroethylene or PC (Polycarbonate), etc., and can be operated in MR (Magnetic Resonance), and the operation can be performed under MR scanning regardless of ablation operation or residual sampling, so that the operation process can be monitored in real time, and the operation process is safer.

(8) The guide structure of the invention can realize laser ablation operation and sampling operation according to different internal instruments (such as medical optical fibers, sampling needles or samplers); the sampling and laser ablation sequence can be reasonably arranged according to actual needs, a sampling appliance is used, a sampling channel does not need to be additionally established in the brain, a guide structure does not need to be replaced by other auxiliary devices, the application range of the device is enlarged, the operation efficiency is improved, and the injury and infection risks to a patient are reduced.

(9) The front end of the optical fiber guide tube is provided with a bending part with a lateral opening, and the medical optical fiber can penetrate out from the lateral opening of the bending part, so that the medical optical fiber guide tube is more flexible in puncture angle and puncture direction. On one hand, the flexibility and the diversity of the selection of the path scheme avoiding important tissues are increased, on the other hand, the ablation scheme which can realize large focal tissues from a single channel is also provided, the efficiency of the operation is improved, the safety and the effectiveness of the operation are also greatly improved, and the minimally invasive effective treatment of 'curve overtaking' can be realized.

In the invention, the technical schemes can be combined with each other to realize more preferable combination schemes. Additional features and advantages of the invention will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The objectives and other advantages of the invention will be realized and attained by the structure particularly pointed out in the written description and drawings.

Drawings

The drawings are only for purposes of illustrating particular embodiments and are not to be construed as limiting the invention, wherein like reference numerals are used to designate like parts throughout.

FIG. 1 is a schematic diagram of an exemplary embodiment of a fiber guide tube configuration;

FIG. 2 is a cross-sectional view of an exemplary embodiment of a fiber guide tube;

FIG. 3 is a diagram illustrating a state in which a medical optical fiber is threaded out of a bending portion according to an embodiment;

FIG. 4 is a schematic structural diagram of a medical fiber guide structure according to an embodiment;

fig. 5 is a schematic structural diagram (two) of a medical optical fiber guide structure according to an embodiment;

FIG. 6 is a schematic diagram of a guide tube base structure according to an embodiment;

FIG. 7 is a schematic view of a retaining cap according to an embodiment;

FIG. 8 is a schematic view of a skull nail structure according to an exemplary embodiment;

FIG. 9 is a schematic view of multiple ablation zones obtained by varying the protrusion length of a medical optical fiber according to an exemplary embodiment;

fig. 10 is a schematic structural diagram (three) of a medical optical fiber guide structure according to an embodiment;

FIG. 11 is a schematic structural view of a guide tube base according to an embodiment;

fig. 12 is a schematic structural view (iv) of a medical optical fiber guide structure according to an embodiment;

FIG. 13 is a cross-sectional view (one) of a medical fiber guide structure according to an embodiment;

FIG. 14 is an exploded view of a portion of a medical fiber guide structure according to an embodiment;

FIG. 15 is a schematic view of the alignment of the guide tube base 0 scale with the marking line of the cranial nail according to an embodiment;

FIG. 16 is a schematic view of the alignment of the guide tube base 60 scale with the marking line of the cranial nail according to an exemplary embodiment;

fig. 17 is an ablation schematic view of the medical optical fiber according to the embodiment in a state where the light-emitting side mark corresponds to the 0 scale;

fig. 18 is an ablation schematic view of the medical optical fiber according to the embodiment in a state where the light-emitting side mark does not correspond to the 0 scale;

FIG. 19 is a cross-sectional view of an exemplary embodiment of a fiber guide tube;

FIG. 20 is a schematic cross-sectional view of an exemplary embodiment of a fiber guide tube;

FIG. 21 is a schematic cross-sectional view of an exemplary embodiment of a fiber guide tube;

FIG. 22 is a schematic cross-sectional view of an exemplary embodiment of a fiber guide tube;

FIG. 23 is a schematic cross-sectional view of an exemplary embodiment of a fiber guide tube;

FIG. 24 is a schematic cross-sectional view of a fiber guide tube according to an exemplary embodiment (VI);

FIG. 25 is a schematic cross-sectional View (VII) of a fiber guide tube according to an exemplary embodiment;

FIG. 26 is a schematic cross-sectional view of an exemplary embodiment of a fiber guide tube (eighth);

FIG. 27 is a cross-sectional view of a medical fiber guide structure according to an embodiment;

fig. 28 is a schematic view (ii) illustrating a state in which the medical optical fiber is threaded out of the bending portion according to the embodiment;

FIG. 29 is a schematic view of a lateral sampling pin according to an embodiment;

FIG. 30 is a schematic view of an embodiment of a lateral sampling needle positioned within a fiber guide tube;

FIG. 31 is a schematic side-view of a sampling probe according to one embodiment;

FIG. 32 is a schematic view of an embodiment of an end face sampling needle extended from a fiber guide tube;

fig. 33 is a schematic diagram of a sampler according to an embodiment.

Reference numerals:

1-optical fiber guide tube; 11-a bend; 111-arc incision; 12-a straight tube portion; 13-a light return film; 14-a lens structure; 15-opening; 16-a curved channel; 17-a puncture head; 2-a guide tube base; 21-a first threaded portion; 211 — a first via; 22-an optical axis part; 221-a second via; 23-a limiting part; 231-third via holes; 3-fixing the cover; 31-a threaded hole; 32-fourth via; 4-cranial bone screws; 41-a first connection; 411-fifth via; 412-mark line; 42-a second connection; 421-sixth via; 43-a second threaded portion; 5-sealing plug; 6-sheath locking screw;

100-medical optical fiber; 101-light emitting side mark; 200-skull bone; 300-target lesion area; 301-a first ablation zone; 302-a second ablation zone; 400-an obstruction; 500-lateral sampling needle; 501-side sampling port; 502-inclined plane; 600-tissue to be cleared; 700-end face notch sampling needle; 701-end face sampling port; 800-sampler.

Detailed Description

The preferred embodiments of the present invention will now be described in detail with reference to the accompanying drawings, which form a part hereof, and which together with the embodiments of the invention serve to explain the principles of the invention and not to limit its scope.

In the description of the embodiments of the present invention, it should be noted that the term "connected" is to be understood broadly, and may be, for example, fixed, detachable, or integrally connected, and may be mechanically or electrically connected, and may be directly or indirectly connected through an intermediate medium, unless otherwise specifically stated or limited. The specific meanings of the above terms in the present invention can be understood by those skilled in the art according to specific situations.

The terms "top," "bottom," "above … …," "below," and "on … …" as used throughout the description are relative positions with respect to components of the device, such as the relative positions of the top and bottom substrates inside the device. It will be appreciated that the devices are multifunctional, regardless of their orientation in space.

Example 1

A specific embodiment of the present invention, as shown in fig. 1-2, discloses a medical optical fiber guiding structure, which includes an opticalfiber guiding tube 1, a medicaloptical fiber 100 is disposed in the opticalfiber guiding tube 1, the opticalfiber guiding tube 1 includes a bendingportion 11 and astraight tube portion 12, the bendingportion 11 is located at a front end of thestraight tube portion 12, a notch is disposed at a front end of the bendingportion 11, preferably, the notch is an arc-shapednotch 111, and the medicaloptical fiber 100 can sequentially pass through thestraight tube portion 12 and the bendingportion 11 and pass through the arc-shapednotch 111, so as to achieve guiding bending of the medicaloptical fiber 100.

The opticalfiber guide tube 1 is made of transparent material, preferably optical transparent material. The medicaloptical fiber 100 can realize laser ablation in thestraight tube portion 12, and can also realize laser ablation after penetrating out of the bendingportion 11. That is, during ablation, the laser path may only penetrate through the medicaloptical fiber 100 to destroy the lesion, or may penetrate through the medicaloptical fiber 100 and thestraight tube portion 12 to achieve laser ablation.

Compared with the prior art, the medical optical fiber guiding structure that this embodiment provided, the front end of optic fibre stand pipe is the flexion, and the front end of flexion is equipped with the arc incision, can realize the bending under the effect of flexion when medical optic fibre wears out from the optic fibre stand pipe, can avoid the important tissue on the passageway, and then can suitably melttarget focus area 300, and need not plan new passageway again, has improved the efficiency of operation.

Due to the use of existing ablation catheters for ablation, surgical path planning and ablation channel establishment is best along the mesial axis of the lesion tissue if a greater ablation field is to be achieved or conformal ablation is to be achieved or ablation completion is to be achieved. However, such mesial access is not desirable or desirable every time, given the influence of the tumor microenvironment. In this embodiment, the front end of the opticalfiber guide tube 1 is abent portion 11 having a lateral opening, and the medicaloptical fiber 100 can pass through the lateral opening of thebent portion 11, so as to provide more flexibility in the puncture angle and puncture direction. On one hand, the flexibility and the diversity of the selection of the path scheme avoiding important tissues are increased, on the other hand, the ablation scheme which can realize large focal tissues from a single channel is also provided, the efficiency of the operation is improved, the safety and the effectiveness of the operation are also greatly improved, and the minimally invasive effective treatment of 'curve overtaking' can be realized.

The projection of thecurved portion 11 towards thestraight tube portion 12 is located within the cross section (interface perpendicular to the axis of the fiber guide tube 1) of thestraight tube portion 12, i.e. the outer contour of thecurved portion 11 in the axial direction of thestraight tube portion 12 does not exceed the axial outer contour of thestraight tube portion 12.

In this embodiment, the most front end of the opticalfiber guide tube 1 presents a sharp arc edge, so that the brain tissue can be easily punctured and penetrated, and meanwhile, the whole bending part is also in a circle limited by the outer contour of thestraight tube part 12, so that only a round small hole needs to be formed in the skull, the opticalfiber guide tube 1 can be inserted into the brain through the guiding and positioning of the skull nail, meanwhile, only a cylindrical channel is formed in the brain, other tissues cannot be damaged, the tissues cannot be hooked and pulled to cause damage when the optical fiber guide tube is withdrawn, and the minimally invasive treatment is realized.

The opticalfiber guide tube 1 is bent at the head end, and the structure can penetrate into the brain through a through hole on askull nail 4 for guiding. And at the same time, the medicaloptical fiber 100 can be guided by the bending structure of the front end.

It should be noted that the included angle between the axis of the bendingportion 11 and the axis of thestraight tube portion 12 is not too small to avoid breaking the medicaloptical fiber 100, and preferably, as shown in fig. 3, the bendingportion 11 and thestraight tube portion 12 are preferably arranged in such a manner that the included angle a between the axis of the unbent portion of the medicaloptical fiber 100 and the axis of the bent portion of the medicaloptical fiber 100 is between 140 ° and 170 ° when the medicaloptical fiber 100 extends out of the bendingportion 11 for a certain distance.

As shown in fig. 4-5, the medical optical fiber guiding structure further includes a guidingtube base 2, a fixingcover 3, askull nail 4 and a sealingplug 5, wherein one end of the guidingtube base 2 is disposed in a through hole of theskull nail 4, the other end of the guiding tube base is in threaded connection with the fixingcover 3, and the sealingplug 5 is disposed in an end portion of the guidingtube base 2.

As shown in fig. 6, theguide tube base 2 is a revolving structure, and includes afirst thread portion 21 and anoptical axis portion 22, and thefirst thread portion 21 and theoptical axis portion 22 are respectively located at two ends of theguide tube base 2. The first threadedportion 21 is provided with an external thread.

The center of thefirst thread part 21 is provided with a first throughhole 211, the center of theoptical axis part 22 is provided with a second throughhole 221, the first throughhole 211 is communicated with the second throughhole 221, the diameter of the first throughhole 211 is larger than that of the second throughhole 221, and the diameter of the second throughhole 221 is equal to the outer diameter of the opticalfiber guide tube 1. The end of thestraight tube portion 12 of the opticalfiber guide tube 1 is disposed in the second throughhole 221. The first throughhole 211 is coaxial with the second throughhole 221.

In order to limit the end of the opticalfiber guide tube 1, theguide tube base 2 is further provided with a third throughhole 231 located between the first throughhole 211 and the second throughhole 221, the third throughhole 231 is communicated with the first throughhole 211 and the second throughhole 221, the diameter of the third throughhole 231 is smaller than that of the second throughhole 221, and the diameter of the third throughhole 231 is slightly larger than that of the medicaloptical fiber 100, so that the medicaloptical fiber 100 can pass through smoothly. The third throughhole 231 and the second throughhole 221 are coaxial.

As shown in fig. 7, the fixingcover 3 is a rotary structure, and is provided with ascrew hole 31 and a fourth throughhole 32, and thescrew hole 31 and the fourth throughhole 32 are coaxially communicated with each other. The diameter of the fourth throughhole 32 is larger than the diameter of the medicaloptical fiber 100 and smaller than the diameter of the threadedhole 31. The first threadedportion 21 is provided in the threadedhole 31.

The sealingplug 5 is of a cylindrical structure, the sealingplug 5 is arranged in the first throughhole 211, the outer diameter of the sealingplug 5 is the same as the diameter of the first throughhole 211, and the diameter of the central hole of the sealingplug 5 is equal to the diameter of the medicaloptical fiber 100. The length of the sealingplug 5 is greater than that of the first throughhole 211, and preferably, the length of the sealingplug 5 is 1.3 to 1.4 times that of the first throughhole 211.

In this embodiment, the medicaloptical fiber 100 sequentially passes through the fourth throughhole 32, the center hole of the sealingplug 5 disposed in the first throughhole 211, and the third throughhole 231, enters the opticalfiber guide tube 1 disposed in the second throughhole 221, and passes out from the front end of the opticalfiber guide tube 1.

The sealingplug 5 is arranged in the first throughhole 211 and used for guiding and limiting the medicaloptical fiber 100, after the fixingcover 3 is screwed down, a center hole of the sealingplug 5 is in interference fit with the medicaloptical fiber 100, and the outer diameter of the sealingplug 5 is in interference fit with the first throughhole 211, so that the medicaloptical fiber 100 can be stably arranged in theguide tube base 2. After the fixingcover 3 is screwed to thefirst thread part 21, the medicaloptical fiber 100 is stably connected with theguide tube base 2, and the medicaloptical fiber 100 is limited to move along the axial direction and rotate around the axis of the medicaloptical fiber 100.

As shown in fig. 8, theskull nail 4 is a revolving body structure, and includes a first connectingportion 41, a second connectingportion 42, and asecond thread portion 43, and the first connectingportion 41, the second connectingportion 42, and thesecond thread portion 43 are connected in sequence. The first connectingportion 41 is connected with theoptical axis portion 22 of theguide tube base 2, and the second threadedportion 43 is provided with external threads and connected with theskull bone 200.

A fifth throughhole 411 is formed in the first connectingportion 41, the diameter of the fifth throughhole 411 is equal to the outer diameter of theoptical axis portion 22, and the length of the fifth throughhole 411 is greater than the length of theoptical axis portion 22, so that theguide tube base 2 has a sufficient moving distance in the axial direction of the fifth throughhole 411.

The second connectingportion 42 is provided with a sixth throughhole 421, the sixth throughhole 421 is communicated with the fifth throughhole 411 and is coaxial, and the sixth throughhole 421 penetrates thesecond thread portion 43 and has a diameter equal to the outer diameter of the opticalfiber guiding tube 1.

In this embodiment, the opticalfiber guide tube 1 is installed on theguide tube base 2, theguide tube base 2 is used for fixing the opticalfiber guide tube 1 and the medicaloptical fiber 100, and the medicaloptical fiber 100 is fixed relatively by the cooperation of the sealingplug 5 and the fixingcover 3. Meanwhile, theguide tube base 2 and theskull nail 4 are matched with each other to fix the opticalfiber guide tube 1. Wherein theskull nail 4 is fixed on theskull 200 and plays a role in establishing a guide channel and fixing the opticalfiber guide tube 1.

The medicaloptical fiber 100 may be a bare optical fiber, or may be an optical fiber conduit structure with a cooling system or an optical fiber conduit structure with a non-cooling system, and the optical fiber conduit structure with a cooling system and the optical fiber conduit structure with a non-cooling system are both in the prior art and are not described herein again.

Understandably, as shown in fig. 9, by changing the extending length of the medicaloptical fiber 100 along the opticalfiber guiding tube 1 and/or the orientation of the arc-shapedincision 111, and/or the relative position of the medicaloptical fiber 100 in thestraight tube part 12, multi-zone ablation in the same channel can be realized to treat a larger zone of a lesion, and exemplarily, afirst ablation zone 301 and asecond ablation zone 302 are obtained by changing the extending length of the medicaloptical fiber 100 along the opticalfiber guiding tube 1. Of course, as shown in fig. 4 and 10, the medicaloptical fiber 100 may also be laser ablated in thestraight tube portion 12.

Example 2

Another specific embodiment of the present invention, as shown in fig. 1-2, discloses a medical optical fiber guiding structure, which includes an opticalfiber guiding tube 1, wherein the opticalfiber guiding tube 1 is an elongated tube, a medicaloptical fiber 100 is disposed in the opticalfiber guiding tube 1, acurved portion 11 is disposed at a front end of the opticalfiber guiding tube 1, and the medicaloptical fiber 100 penetrates through thecurved portion 11 to achieve guiding and bending of the medicaloptical fiber 100.

Compared with the prior art, the medical optical fiber guide structure that this embodiment provided, the front end of optic fibre stand pipe is the flexion, can realize the bending under the effect of flexion when medical optic fibre wears out from the optic fibre stand pipe, can avoid the important tissue on the passageway, and then can be to the regional 300 conformal ablation of target focus, improved the efficiency of operation.

The opticalfiber guide tube 1 is bent at the front end, and can penetrate into the brain through the center hole of theskull nail 4 for guiding. And the medicaloptical fiber 100 can be guided by the bending structure of the front end.

The front end of the bendingpart 11 is provided with an arc-shapedcut 111, and the medicaloptical fiber 100 penetrates out of the arc-shapedcut 111 of the bendingpart 11, so that the medicaloptical fiber 100 is guided and bent.

As shown in fig. 10, the medical optical fiber guiding structure further includes a guidingtube base 2, a fixingcover 3, askull nail 4 and a sealingplug 5, one end of the guidingtube base 2 is connected with one end of theskull nail 4, the other end of theskull nail 4 is connected with theskull 200, the sealingplug 5 is arranged in the other end of the guidingtube base 2, and the fixingcover 3 is connected to the outer side of the other end of the guidingtube base 2.

As shown in fig. 11, theguide tube base 2 is a revolving structure, and includes afirst thread portion 21, anoptical axis portion 22, and a stopper portion 23, thefirst thread portion 21 and theoptical axis portion 22 are respectively located at two ends of theguide tube base 2, and the stopper portion 23 is located between thefirst thread portion 21 and theoptical axis portion 22. Thefirst thread part 21 is provided with an external thread, and the outer diameters of thefirst thread part 21 and theoptical axis part 22 are smaller than the outer diameter of the limiting part 23.

The outer cylindrical surface of the limiting portion 23 is provided with scale marks, the scale marks equally divide a circumferential angle, and the scale marks are arranged close to thelight shaft portion 22.

The center ofstand pipe base 2 is equipped with first through-hole 211, second through-hole 221 and third through-hole 231, first through-hole 211 and second through-hole 221 are located the both ends ofstand pipe base 2 respectively, first through-hole 211, second through-hole 221 and third through-hole 231 intercommunication and coaxial.

The diameter of the second throughhole 221 is smaller than the diameter of the first throughhole 211 and larger than the diameter of the third throughhole 231, and the diameter of the second throughhole 221 is equal to the outer diameter of thefiber guide tube 1. The rear end of the opticalfiber guide tube 1 is disposed in the second throughhole 221. The diameter of the third throughhole 231 is slightly larger than that of the medicaloptical fiber 100, so that the medicaloptical fiber 100 can pass through smoothly.

As shown in fig. 7, the fixingcover 3 is provided with a threadedhole 31 and a fourth throughhole 32, and the threadedhole 31 and the fourth throughhole 32 are communicated and coaxial. The diameter of the fourth throughhole 32 is equal to the diameter of the medicaloptical fiber 100 and smaller than the diameter of the threadedhole 31. The first threadedportion 21 is provided in the threadedhole 31.

The sealingplug 5 is an elastic member having a cylindrical structure, and is disposed in the first throughhole 211. The outer diameter of the sealingplug 5 is slightly larger than the diameter of the first throughhole 211, and the diameter of the central hole of the sealingplug 5 is slightly smaller than the diameter of the medicaloptical fiber 100, so that the medicaloptical fiber 100 and theguide tube base 2 connected through the sealingplug 5 are stable and reliable. The length of the sealingplug 5 is greater than that of the first throughhole 211, and preferably, the length of the sealingplug 5 is 1.3 to 1.4 times that of the first throughhole 211.

The sealingplug 5 is arranged in the first throughhole 211 and used for guiding and limiting the medicaloptical fiber 100, and the sealingplug 5 has elasticity, the outer diameter of the sealing plug is slightly larger than that of the first throughhole 211, and the inner diameter of the sealing plug is slightly smaller than that of the medicaloptical fiber 100, so that the medicaloptical fiber 100 can be stably arranged in theguide tube base 2. In addition, after the fixingcap 3 is screwed to thefirst screw portion 21, the medicaloptical fiber 100 is firmly connected to theguide tube base 2, and the medicaloptical fiber 100 is restricted from moving in the axial direction and rotating around its own axis.

As shown in fig. 8, theskull nail 4 comprises a first connectingpart 41, a second connectingpart 42 and a second threadedpart 43 which are connected in sequence. The first connectingportion 41 is connected with theoptical axis portion 22 of theguide tube base 2, and the second threadedportion 43 is provided with external threads and connected with theskull bone 200.

Theskull nail 4 is provided with a fifth throughhole 411 and a sixth throughhole 421 which are coaxial and communicated with each other in the center, the fifth throughhole 411 is arranged at the end of the first connectingpart 41, the diameter of the fifth throughhole 411 is equal to the outer diameter of thelight shaft part 22, and the length of the fifth throughhole 411 is greater than the length of thelight shaft part 22, so that theguide tube base 2 has a sufficient moving distance in the axial direction of the fifth throughhole 411. The sixth throughhole 421 penetrates thesecond screw portion 43, and has a diameter equal to the outer diameter of the opticalfiber guide tube 1.

In this embodiment, the medicaloptical fiber 100 sequentially passes through the fourth throughhole 32, the center hole of the sealingplug 5, and the third throughhole 231, and then enters the opticalfiber guide tube 1 disposed in the second throughhole 221. The opticalfiber guide tube 1 passes through the fifth throughhole 411 and the sixth throughhole 421, and then passes through the end of the second threadedportion 43 to penetrate into the brain, and the medicaloptical fiber 100 can pass through thebent portion 11 of the opticalfiber guide tube 1 to perform laser ablation operation.

In order to further limit the opticalfiber guide tube 1, as shown in fig. 12, 13, and 14, the medical optical fiber guide structure further includes asheath locking screw 6, an axis of thesheath locking screw 6 is perpendicular to an axis of the opticalfiber guide tube 1, and thesheath locking screw 6 can penetrate through a through hole radially disposed along the first connectingportion 41 and press against an outer wall of theoptical axis portion 22.

It is noted that the cylindrical surface of the first connectingportion 41 is provided with a markingline 412, and the markingline 412 is parallel to the axis of theskull nail 4 and is arranged near the end of the first connectingportion 41 so as to determine the rotation angle of theguide tube base 2 relative to theskull nail 4. Because theskull nail 4 is fixedly connected with theskull 200 through threads, the medicaloptical fiber 100 is tightly matched and connected with one end of theguide tube base 2 through the sealingplug 5, and the opticalfiber guide tube 1 is tightly matched with the other end of theguide tube base 2, the orientation of the arc-shapedincision 111 of the medicaloptical fiber 100 can be changed by rotating theguide tube base 2, and accordingly, the conformal ablation of thetarget focus area 300 can be realized.

Understandably, in order to facilitate better operation of the medical optical fiber guiding structure, the graduation line of the limiting part 23 is provided with a 0 marking point (i.e. 0 graduation), and the graduation line corresponding to the 0 marking point is aligned with the markingline 412, which is the initial position of the medical optical fiber guiding structure.

In this embodiment, the opticalfiber guide tube 1 is installed on theguide tube base 2, theguide tube base 2 is used for fixing the opticalfiber guide tube 1 and the medicaloptical fiber 100, and the medicaloptical fiber 100 is fixed relatively by the cooperation of the sealingplug 5 and the fixingcover 3. Meanwhile, theguide tube base 2 is matched with theskull nail 4 and thesheath locking screw 6 to complete the fixing and guiding structure of the medicaloptical fiber 100. Wherein theskull nail 4 is fixed on theskull 200 and plays a role in establishing a guide channel and fixing the opticalfiber guide tube 1. The position direction of the opticalfiber guide tube 1 is judged through the markingline 412 on theskull nail 4 and the angle scale mark on theguide tube base 2.

In the actual operation process, the first region is ablated at the 0 ° scale in the above description, at this time, the fixingcover 3 is unscrewed to pull the medicaloptical fiber 100 backward so that the front end of the medicaloptical fiber 100 does not exceed the bendingpart 11, thesheath locking screw 6 is unscrewed, the guidingtube base 2 is rotated to adjust the orientation of the arc-shapedincision 111, thesheath locking screw 6 is screwed, at this time, the bending position of the outlet of the opticalfiber guiding tube 1 is changed, so that the medicaloptical fiber 100 is extended out of the opticalfiber guiding tube 1, and the second region can be ablated. The ablation area can be expanded not only in the axial direction in which the medicaloptical fiber 100 protrudes but also in the radial direction of theguide tube 1.

Illustratively, as shown in fig. 15 and 16, the first region is ablated at 0 scale, the optical fiber is retracted by unscrewing the fixingcover 3, thesheath locking screw 6 is unscrewed, thebase 2 of the guide tube is rotated to 60 scales, and then thesheath locking screw 6 is tightened, the bending orientation of the outlet of the opticalfiber guide tube 1 is changed, so that the medicaloptical fiber 100 extends out of the opticalfiber guide tube 1, and the second region can be ablated. Or keeping the medicaloptical fiber 100 still and directly rotating theguide tube base 2 to 60 scales after unscrewing thesheath locking screw 6.

Example 3

In another embodiment of the present invention, a medical optical fiber guiding structure is disclosed, where the medicaloptical fiber 100 is a medical optical fiber (i.e., a side-emitting optical fiber) capable of emitting light from a side, and on the basis ofembodiment 2, as shown in fig. 17 and fig. 18, a light-emittingside mark 101 is provided on the medicaloptical fiber 100 to mark a direction of a light outlet, and at this time, the position and size of an ablation region can be further controlled by loosening the fixingcover 3 and then adjusting the direction of the light outlet of the medicaloptical fiber 100, so as to more easily perform conformal ablation. Other structures and advantageous effects are the same as those ofembodiment 2, and are not described in detail herein.

Example 4

The invention discloses a medical optical fiber guide structure, which has certain light transmittance and can transmit light paths. Further, the front end of the opticalfiber guide tube 1 is provided with a light path adjusting component, the light path adjusting component is arranged on the front end side wall of the straight tube portion of the opticalfiber guide tube 1, and when the front end of the medicaloptical fiber 100 is located in the straight tube portion, the light path adjusting component can change the light path of laser emitted by the medicaloptical fiber 100 located in the opticalfiber guide tube 1 so as to ablate thetarget focus area 300.

The light path adjusting component comprises areflective membrane 13 and alens structure 14, wherein thereflective membrane 13 is used for guiding the light rays emitted by the medicaloptical fiber 100 to the direction of thetarget lesion area 300 so as to realize unidirectional emission; thereflective membrane 13 and thelens structure 14 cooperate to accommodate tumors of more diverse shapes.

Thelens structure 14 may vary the size and/or shape of the ablation volume. Due to the addition of thelens structure 14, the ablation region which is originally in a circular ring shape is converted into an ablation region with a specific shape (as shown in fig. 22 and 26), so that the lens structure can be adapted to more irregular tumors.

Thelens structure 14 is located on thefiber guide tube 1. understandably, thelens structure 14 can be provided on the inner wall of thefiber guide tube 1 as a separate component, for example, thelens structure 14 is adhered to the inner wall of thefiber guide tube 1, or can be a part of thefiber guide tube 1.

In this embodiment, in order to reduce the volume of the sheath structure, thelens structure 14 and the opticalfiber guiding tube 1 are an integral structure. Of course, thelens structure 14 can also be made on the side wall of the opticalfiber guiding tube 1, and thelens structure 14 is embedded in the groove provided on the side wall of the opticalfiber guiding tube 1.

Thelens structure 14 may be a condenser, preferably a convex lens, or a diverging mirror, preferably a concave lens.

When thelens structure 14 is a convex lens, the laser emitted by the medicaloptical fiber 100 is circumferentially dispersed and changed into parallel light to be emitted after passing through the convex lens, so that the ablation of thetarget lesion area 300 of the position where thelens structure 14 is located can be locally protruded and/or deepened.

When thelens structure 14 is a concave lens, the laser emitted by the medicaloptical fiber 100 is circumferentially dispersed and becomes more dispersed after passing through the concave lens, so that the coverage of the light emitted from the position of thelens structure 14 is enlarged, and the ablation effect is enhanced.

In the sheath structure provided by this embodiment, thelens structure 14 is disposed on the opticalfiber guiding tube 1, and when the medicaloptical fiber 100 is used in an ablation operation, the path of the laser emitted from the medicaloptical fiber 100 is changed by thelens structure 14 disposed on the opticalfiber guiding tube 1, so that ablation of tumors with irregular shapes becomes more flexible and easier to operate.

Thereflective film 13 and thelens structure 14 are disposed opposite to each other and located on two sides of the medicaloptical fiber 100. As shown in fig. 19 to 22, thelens structure 14 is a convex lens, the laser light emitted from the circumferential direction of the medicaloptical fiber 100 is focused after being parallel and returned to the convex lens when encountering thereflective film 13, and the medicaloptical fiber 100 directly transmits the parallel light beam formed by the convex lens, so that ablation on a certain region of thetarget lesion area 300 can be enhanced.

As shown in fig. 23-26, thelens structure 14 is a concave lens, and the laser emitted from the medicaloptical fiber 100 in the circumferential direction is parallel and returns to the concave lens after encountering thereflective film 13, and is refracted by the concave lens and then emitted at a larger refraction angle, and the medicaloptical fiber 100 directly penetrates through the light beam refracted by the concave lens, so that the ablation of thetarget lesion area 300 in a specific range can be enhanced.

Understandably, in this embodiment, different light emitting ranges can also be obtained by changing the radial coverage area of thereflective film 13 along the opticalfiber guide tube 1 and/or changing the structure of the arc-shaped surface where thereflective film 13 is disposed, which is not described herein again.

Compared withembodiments 1 to 4, the optical path adjusting component is provided at the front end of the opticalfiber guide tube 1, so that the type of the medicaloptical fiber 100 can be enlarged. In thisembodiment 4, the medicaloptical fiber 100 may be any one of a side-emitting optical fiber, a dispersion optical fiber, or a ring optical fiber.

Example 5

The invention also discloses a medical optical fiber guiding method, which adopts the medical optical fiber guiding structure and comprises the following steps:

step 1: theskull nail 4 is fixed on the planned path according to the operation plan and keeps a fixed state with theskull 200.

Step 2: the medicaloptical fiber 100 is inserted into the opticalfiber guide tube 1, and the front end of the medicaloptical fiber 100 does not exceed the bendingpart 11 of the opticalfiber guide tube 1. One end of theguide tube base 2 is connected with the opticalfiber guide tube 1, and the other end is provided with the sealingplug 5 and the fixingcover 3 in a screwing mode.

The medicaloptical fiber 100 is kept in a straight state so that no other substance enters the opticalfiber guide tube 1 to cause subsequent blockage when the opticalfiber guide tube 1 is inserted into the brain. The medicaloptical fiber 100 can also realize laser ablation in thestraight tube portion 12, that is, the front end of the medicaloptical fiber 100 is located in thestraight tube portion 12 and does not enter thebent portion 11 or extend out of thebent portion 11.

Understandably, the medicaloptical fiber 100 may also be afterloaded.

And step 3: according to the operation plan, the opticalfiber guide tube 1 is inserted into a designated position through theskull nail 4, an area needing to be avoided is avoided, corresponding scale marks are arranged on the opticalfiber guide tube 1, and the insertion depth can be visually confirmed.

At this time, the fixingcover 3 is unscrewed to enable the medicaloptical fiber 100 and the opticalfiber guide tube 1 to be capable of moving in a single axial direction, thrust is applied to the medicaloptical fiber 100 through the outside, the medicaloptical fiber 100 can be slowly moved inwards continuously, and due to the bending structure of the front end of the opticalfiber guide tube 1, the medicaloptical fiber 100 can be bent along with the bending surface. The curved surface is preferably smooth, since otherwise a jamming situation may occur. The medicaloptical fiber 100 passing through the bendingportion 11 is straightened due to the influence of its own characteristics, and at this time, the light-emitting portion at the front end of the medicaloptical fiber 100 reaches thetarget lesion area 300, and skillfully avoids the area with theobstacle 400, and the fixingcover 3 is screwed, so that the ablation treatment can be further completed.

And 4, step 4: unscrewing the fixingcover 3 to pull the medicaloptical fiber 100 backwards so that the front end of the medicaloptical fiber 100 does not exceed the bendingpart 11, unscrewing thesheath locking screw 6, rotating theguide tube base 2 to adjust the orientation of the arc-shapedincision 111, and screwing thesheath locking screw 6, wherein the bending position of the outlet of the opticalfiber guide tube 1 is changed, so that the medicaloptical fiber 100 extends out of the opticalfiber guide tube 1, and the second region can be ablated. The ablation area can be expanded not only in the axial direction in which the medicaloptical fiber 100 protrudes but also in the radial direction of theguide tube 1.

According to the invention, the self-bending deformation of the medical optical fiber is realized through the optical fiber guide tube, and an important area which is not suitable for puncture can be avoided; by adjusting the direction of the optical fiber guide tube, the range of an ablation area can be further expanded, ablation which can be completed only by opening two channels originally is realized, and the efficiency is improved; matching with different medical optical fibers, the utility model can more conveniently match with the focuses of different shapes to complete conformal ablation.

It should be noted that the front end of the existing ablation catheter (i.e. the end contacting with the focal tissue for ablation) is closed and is only a linear ablation channel, and the medical optical fiber can only move within the axial range of the ablation catheter, so that the ablation range of the focal tissue is limited to a limited area around the ablation catheter. In the medical optical fiber guide structure provided by the invention, the front end of the opticalfiber guide tube 1 is a bendingpart 11 with a lateral opening (namely, the arc-shaped incision 111), and the medicaloptical fiber 100 can be guided and bent by penetrating out of the lateral opening of the bendingpart 11. This feature expands the range of motion of the medicaloptical fiber 100, which can move both in the axial direction and in the radial direction, and thus can ablate large focal tissues in a single channel. Meanwhile, under the condition that the tumor microenvironment is not ideal, for example, the tumor is positioned in the deep part of the brain, and a plurality of important tissues, blood vessels and the like are arranged around the tumor, the medical optical fiber guide structure also increases the flexibility and the diversity of the selection of the path scheme avoiding the important tissues.

Example 6

One embodiment of the present invention, as shown in fig. 27-28, discloses a medical optical fiber guiding structure, which comprises an opticalfiber guiding tube 1. The front end of the opticalfiber guide tube 1 in the above embodiment is formed in a curved shape to realize bending when the medicaloptical fiber 100 is passed out. In thisembodiment 6, the opticalfiber guiding tube 1 is a tubular body with a tubular structure, and in order to realize bending of the medicaloptical fiber 100 when it is threaded out, anopening 15 needs to be formed on the side wall of the front end of the opticalfiber guiding tube 1.

Specifically, the opticalfiber guiding tube 1 comprises a first tube section and a second tube section, the first tube section has a lumen extending along the axial direction, and the side wall of the second tube section has anopening 15 communicating with the lumen, so that the passage of theopening 15 communicating with the lumen is acurved passage 16. Preferably, the lumen is smoothly connected with theopening 15, and a set included angle α is formed between the extending direction of thecurved channel 16 and the extending direction of the lumen, and the set included angle α is an obtuse angle.

Notably, the front end of the second tube section is a piercinghead 17.

The medicaloptical fiber 100 or other sampling devices (such as a sampling needle, a sampler, etc.) can penetrate through the opening to realize the guided bending, and the set included angle a is preferably set to be between 140 ° and 170 ° between the axis of the unbent part of the medicaloptical fiber 100 and the axis of the bent part of the medicaloptical fiber 100 when the medicaloptical fiber 100 realizes the guided bending.

Further, the first pipe section is astraight pipe portion 12 of the opticalfiber guide pipe 1, and the second pipe section is abent portion 11 of the opticalfiber guide pipe 1; the medicaloptical fiber 100 passes out of the bendingportion 11 to realize guided bending.

Example 7

Edema and other problems may arise after ablation surgery, and the risk may be reduced by removing a portion of the damaged tissue. Meanwhile, the target tissue can be sampled and detected before and after the ablation operation is finished, so that pathological analysis can be conveniently carried out on the target tissue.

In another embodiment of the present invention, as shown in fig. 29 to fig. 31, the medical optical fiber guide structure is adopted, the medicaloptical fiber 100 is replaced by alateral sampling needle 500, and a connection relationship between thelateral sampling needle 500 and the medical optical fiber guide structure is the same as a connection relationship between the medicaloptical fiber 100 and the medical optical fiber guide structure, which is not described herein again.

The sidedirection sampling needle 500 is arranged in the opticalfiber guide tube 1, theside sampling port 501 is arranged on the front end side wall of the sidedirection sampling needle 500, the front end side wall of theside sampling port 501 is aninclined surface 502, preferably, theinclined surface 502 inclines towards the rear end of the sidedirection sampling needle 500, so that when the sidedirection sampling needle 500 is taken out, a sample can be cut off from thetissue 600 to be cleaned by utilizing theinclined surface 502, and the front end of the sidedirection sampling needle 500 is conical.

In this embodiment, the lateral sampling needle is a hollow hose, the hose has a certain strength to ensure its own straightness, but can be bent by the structural influence of the bending portion, the basic characteristics are consistent with those of the optical fiber, and a polytetrafluoroethylene tube is preferably used. The head end of the lateral sampling needle is made into a cone shape to facilitate puncture, an opening is arranged on one side of the lateral sampling needle for sampling, and the foremost end of the opening is made into a sharp incision shape to cut off the sample from the tissue. The rear end of the hose can be connected with a negative pressure pump, and the pressure difference in the hollow pipe can be adjusted to suck a fluid sample and the like.

When thelateral sampling needle 500 is used together with the medical optical fiber guide structure, firstly, theskull nail 4 and the opticalfiber guide tube 1 are fixed, the path is confirmed, after the ablation operation is completed, the medicaloptical fiber 100 is taken out, then, thelateral sampling needle 500 is inserted from one end of the opticalfiber guide tube 1, the tip end of the lateral sampling needle is inserted into the brain to reach the indication position, and at the moment, the tissue to be sampled can be adsorbed to the hollow part of thelateral sampling needle 500 through the work of a negative pressure pump at the tail end of thelateral sampling needle 500. If some cerebrospinal fluid, blood, etc. is fluid, it can be sucked slowly for this purpose, and if some hard tissue is sucked, the tissue is cut away by theinclined surface 502 by pulling back thelateral sampling needle 500 after the suction to complete the sampling or removal.

Understandably, the rear end side wall of theside sampling port 501 is an inclined surface, the inclined surface is inclined towards the front end of theside sampling needle 500, when theside sampling needle 500 enters, a sample can be cut off from thetissue 600 to be cleared, the sample can be stored in the hollow part at the front end of theside sampling needle 500, and a negative pressure pump is not needed when theside sampling needle 500 is pulled out.

Further, as the medicaloptical fiber 100 according to the above-mentioned embodiment, thelateral sampling needle 500 can also be adjusted in the radial direction and the axial direction, and can complete sampling operations in different areas by adjusting and sampling for a plurality of times, thereby removing excessive damaged tissues after ablation, and facilitating pathological analysis of the sampled tissues by medical staff. The specific adjustment method is not described in detail.

Still further, the development coating is coated on theside sampling port 501 of the sidedirection sampling needle 500, and when an operation is performed in an MR environment, the position of the sampling needle can be monitored through an MR scanning image, so that the sampling is more accurate and safer, and other substances in the brain cannot be damaged.

It should be noted that thelateral sampling needle 500 can be used in combination with themedical fiber 100 described above, i.e., thelateral sampling needle 500 can be used to perform a sampling operation before or after ablation using themedical fiber 100.

Example 8

In another specific embodiment of the present invention, as shown in fig. 32, by using the medical optical fiber guide structure, if the position to be sampled is closer to the opticalfiber guide tube 1 or the position to be sampled is larger, the medicaloptical fiber 100 is replaced by an end faceincision sampling needle 700, and the connection relationship between the end faceincision sampling needle 700 and the medical optical fiber guide structure is the same as the connection relationship between the medicaloptical fiber 100 and the medical optical fiber guide structure, which is not described herein again.

The end face sampling port 701 (cut) of the end faceincision sampling needle 700 is arranged at the foremost end, and in the inserting process, the cut can cut off tissues and store the tissues in the hollow tube of the end faceincision sampling needle 700, and when the tissue is drawn out, the tissues in the hollow tube can not be separated through a negative pressure pump connected with the rear end of the end faceincision sampling needle 700 and leave together with the end faceincision sampling needle 700.

Understandably, thelateral sampling needle 500 of the embodiment 7, in combination with the medical optical fiber guide structure, can also be adjusted in the radial and axial directions, can sample or remove damaged tissues in a large range, and has high efficiency and convenient sampling.

It should be noted that the end-face-cut sampling needle 700 may be used in conjunction with themedical fiber 100 described above, i.e., the end-face-cut sampling needle 700 may be used to perform a sampling operation before or after ablation using themedical fiber 100.

Example 9

In another embodiment of the present invention, as shown in fig. 33, by using the above medical optical fiber guiding structure, understandably, the medical optical fiber guiding structure can also be matched with asampler 800 capable of meeting the requirement for sampling, thesampler 800 is a prior art and is commonly used in an endoscope tube, the specific structure is not described in detail, the silk thread on thesampler 800 can control the closing and opening of the front end sampler, after thesampler 800 extends out of the opticalfiber guiding tube 1, thefront end sampler 800 is opened, and after reaching the position, thefront end sampler 800 is pulled to close through the structure, and then exits along the opticalfiber guiding tube 1.

It is noted that thesampler 800 may be used in conjunction with themedical fiber 100 described above, i.e., thesampler 800 may be used to perform a sampling operation before or after ablation using themedical fiber 100.

It should be noted that thelateral sampling needle 500 in example 7, the end-face-notchedsampling needle 700 in example 8, and thesampler 800 in example 9 may be integrally formed as a flexible tube having a certain strength to ensure its linearity, but being bent by the structure of the bent portion, the basic characteristics being consistent with those of the optical fiber, and a teflon tube is preferably used.

The opticalfiber guide tube 1 not only can be an operation channel of laser ablation, but also can be a sampling channel of thelateral sampling needle 500 or the end faceincision sampling needle 700 or thesampler 800 when the ablation is finished, so that the lesion can be damaged in the same operation, and the lesion after the damage can be sampled. In addition, the hardness of the opticalfiber guide tube 1 is much greater than the hardness of the medicaloptical fiber 100, thelateral sampling needle 500, the end-faceincision sampling needle 700, and thesampler 800. Thelateral sampling needle 500, the end-facecut sampling needle 700 and thesampler 800 can be implemented by the prior art, and are not described in detail herein.

The above description is only for the preferred embodiment of the present invention, but the scope of the present invention is not limited thereto, and any changes or substitutions that can be easily conceived by those skilled in the art within the technical scope of the present invention are included in the scope of the present invention.

Claims (10)

1. The medical optical fiber guide structure is characterized by comprising an optical fiber guide tube (1), wherein the optical fiber guide tube (1) comprises a first tube section and a second tube section;

the first pipe section is provided with a pipe cavity extending along the axial direction,

the second pipe section is provided with an opening communicated with the pipe cavity;

the opening with the extending direction of lumen intercommunication with be one between the extending direction of lumen and set for the contained angle, set for the contained angle and be the obtuse angle.

2. The medical optical fiber guide structure according to claim 1, wherein a medical optical fiber (100) is detachably connected in the optical fiber guide tube (1);

the medical optical fiber (100) can be threaded out of the opening to effect guided bending.

3. The medical optical fiber guide structure according to claim 1 or 2, wherein the first tube section is a straight tube portion (12) of the optical fiber guide tube (1) and the second tube section is a bent portion of the optical fiber guide tube (1); the medical optical fiber (100) penetrates out of the bending part (11) to realize guide bending.

4. The medical optical fiber guide structure according to claim 1, further comprising a guide tube base (2), a fixing cover (3) and a skull nail (4), wherein one end of the guide tube base (2) is arranged in the end part of the skull nail (4), and the other end is in threaded connection with the fixing cover (3).

5. The medical optical fiber guide structure according to claim 4, further comprising a sealing plug (5), wherein the sealing plug (5) is disposed in the through hole of the guide tube base (2) connected with the fixing cover (3).

6. The medical optical fiber guide structure according to claim 4, wherein the guide tube base (2) comprises a first threaded portion (21) and an optical axis portion (22), the first threaded portion (21) and the optical axis portion (22) are respectively located at both ends of the guide tube base (2), and the first threaded portion (21) is provided with an external thread.

7. The medical optical fiber guide structure according to claim 5, wherein a first through hole (211), a second through hole (221) and a third through hole (231) are coaxially and communicated with each other at the center of the guide tube base (2), the first through hole (211) and the second through hole (221) are respectively located at two ends of the guide tube base (2), and the rear end of the optical fiber guide tube (1) is arranged in the second through hole (221).

8. The medical optical fiber guide structure according to claim 7, wherein the sealing plug (5) is disposed in the first through hole (211), an outer wall of the sealing plug (5) is attached to an inner wall of the first through hole (211), and a central hole of the sealing plug (5) is sleeved with the medical optical fiber (100) and is attached to an outer wall of the medical optical fiber (100).

9. The medical optical fiber guide structure according to claim 6, wherein the skull nail (4) comprises a first connecting part (41), a second connecting part (42) and a second threaded part (43) which are connected in sequence, the first connecting part (41) is connected with the optical axis part (22), and the second threaded part (43) is provided with external threads and is connected with the skull (200).

10. A method for guiding a medical optical fiber, comprising the steps of using the medical optical fiber guide structure according to any one of claims 1 to 9, comprising:

step 1: fixedly connecting the skull nail (4) with the skull (200);

step 2: inserting the medical optical fiber (100) into the optical fiber guide tube (1), wherein the front end of the medical optical fiber (100) does not exceed the bending part (11) of the optical fiber guide tube (1); one end of the guide tube base (2) is connected with the optical fiber guide tube (1), and the other end is provided with a sealing plug (5) and is screwed with the fixing cover (3);

and step 3: the optical fiber guide tube (1) is inserted to a designated position through a skull nail (4);

unscrewing the fixing cover (3), applying a pushing force to the outside, moving the medical optical fiber (100) to the front end of the optical fiber guide tube (1), and enabling the medical optical fiber (100) to penetrate out of the bending part (11) and change the direction by means of the bending part (11); then screwing down the fixed cover (3);

and 4, step 4: unscrewing the fixing cover (3) to pull the medical optical fiber (100) backwards to enable the front end of the medical optical fiber (100) not to exceed the bending part (11), rotating the guide tube base (2) to adjust the orientation of the bending part (11), extending the medical optical fiber (100) out of the optical fiber guide tube (1), and melting another region.

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