Detailed Description
The following description of the embodiments of the present application will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that some, but not all embodiments of the application are described. All other embodiments, which can be made by those skilled in the art based on the embodiments of the application without making any inventive effort, are intended to be within the scope of the application.
The terms first, second and the like in the description and in the claims, are used for distinguishing between similar elements and not necessarily for describing a particular sequential or chronological order. It is to be understood that the data so used may be interchanged, as appropriate, such that embodiments of the present application may be implemented in sequences other than those illustrated or described herein, and that the objects identified by "first," "second," etc. are generally of a type, and are not limited to the number of objects, such as the first object may be one or more. Furthermore, in the description and claims, "and/or" means at least one of the connected objects, and the character "/", generally means that the associated object is an "or" relationship.
The negative pressure suction sheath provided by the embodiment of the application is described in detail below through specific embodiments and application scenes thereof with reference to the accompanying drawings.
In various embodiments of the present application, "proximal" and "distal" refer to the negative pressure suction sheath and its components in the environment of use, relative to the user's proximal-distal position, wherein the end closer to the user is designated as "proximal" and the end farther from the user is designated as "distal".
As shown in fig. 9, during the operation of taking out stones and waiting for suction when the insertion portion 300 is used in combination with the sheath 100, there is a suction gap between the endoscope insertion portion 300 and the inner wall of the sheath 100, so that stones are discharged from the suction gap, and of course, in order to facilitate the doctor to obtain the positions of stones, especially during the operation of removing stones from kidney stones, it is necessary to enter the endoscope into the kidney through a natural orifice or through the skin kidney to remove stones in each region of the kidney, so that the endoscope has a controllable bending function to avoid causing great trauma to the kidney of the patient, so that the distal end of the sheath 100 adapted thereto in the prior art has a passive bending capability, that is, the active bending section 310 of the endoscope can drive the distal end of the sheath 100 to bend during the bending.
The inventor found that, in the actual operation, when the active bending section 310 drives the sheath 100 to be in the bending state, different portions of the active bending section 310 may abut against specific positions of the sheath 100, so that in the extending direction of the active bending section 310, the maximum distances between each portion of the bent active bending section 310 in the extending direction and the inner wall of the bent sheath 100 are unevenly distributed, that is, the maximum distances between each portion of the bent active bending section 310 in the extending direction and the inner wall of the bent sheath 100 are constantly changed, and therefore, stones with a size equal to or slightly larger than the minimum value of each maximum distances may be blocked between the bent sheath 100 and the bent active bending section 310 during the stone aspiration, resulting in uneven stone removal.
Here, as explained with respect to the maximum distances between the respective portions of the curved active bending section 310 in the self-extending direction and the inner wall of the curved sheath tube 100, referring to fig. 9 a to g, since the pipe diameter of the active bending section 310 is smaller than that of the sheath tube 100, there is necessarily a gap between the curved active bending section 310 and the curved sheath tube 100, which surrounds the curved active bending section 310, so that the distances between the respective regions of a portion of the curved active bending section 310 in the self-extending direction in the circumferential direction and the inner wall of the sheath tube 100 are not equal, respectively, and the maximum value of the distances between the respective regions of the portion of the curved active bending section 310 in the circumferential direction and the sheath tube 100 is the maximum distance between the portion of the curved active bending section 310 and the curved sheath tube 100, respectively.
As shown in fig. 1 to 8, the embodiment of the present application discloses a negative pressure suction sheath, which includes a sheath tube 100 and a blocking structure 200, wherein the sheath tube 100 is disposed at a distal end of the negative pressure suction sheath, and the distal end of the sheath tube 100 has a passive bending section 110 capable of bending following an active bending section 310 of an endoscope. By way of example, the endoscope may be a bronchoscope, a pyeloscope, a esophagoscope, a gastroscope, a enteroscope, an otoscope, a nasoscope, a stomatoscope, a laryngoscope, a colposcope, a laparoscope, an arthroscope, etc., and the type of the endoscope is not particularly limited in the embodiments of the present application.
The sidewall of the passive bending section 110 is provided with a through hole 111, wherein the through hole 111 penetrates from the outer circumferential surface of the passive bending section 110 to the inner circumferential surface of the passive bending section 110, the through hole 111 extends along the extending direction of the passive bending section 110, the maximum depth of the through hole 111 is smaller than one half of the outer diameter of the passive bending section 110, and the blocking structure 200 is connected with the sheath 100 and seals the through hole 111. Specifically, the occluding structure 200 covers and seals the through-hole 111, thereby preventing the aspiration object between the active bending section 310 and the sheath 100 from leaking out of the sheath 100 from the through-hole 111.
The passive bending section 110 includes an expandable portion 112 radially opposite to the through hole 111, and the expandable portion 112 is formed after the through hole 111 is opened in the passive bending section 110, as shown in fig. 1, and the expandable portion 112 is located below the through hole 111, and when the passive bending section 110 is bent and a side of the expandable portion 112 facing away from the through hole 111 is a tensile side, the expandable portion 112 expands outwards in a direction perpendicular to a plane in which the bending direction of the passive bending section 110 is located. Specifically, the bending direction of the passive bending section 110 is the direction indicated by the y arrow line in fig. 2, and the direction perpendicular to the plane in which the y arrow line lies is the direction indicated by the x arrow line, that is, the expandable portion 112 expands radially outward in the direction indicated by the x arrow line in fig. 2.
When the passive bending section 110 is bent, one side of the passive bending section 110 is a stretching side, the other side is a pressing side, and the lower side of the passive bending section 110 is a stretching side, taking the view shown in fig. 2 as an example.
In the present application, the passive bending section 110 is provided with the through hole 111, the through hole 111 breaks the continuity of the passive bending section 110, so that stress concentration occurs near the through hole 111 during bending of the passive bending section 110, and the stress concentration region is easier to deform due to overlarge local stress, so that the expandable portion 112 opposite to the through hole 111 in the radial direction expands outwards along the direction perpendicular to the plane in which the bending direction of the passive bending section 110 is located, and the stress accumulated during bending of the passive bending section 110 is released. After the expandable portion 112 radially expands outwards, the distance between the inner wall of the expandable portion 112 and the active bending section 310 is increased, so as to increase the overflow area and the minimum value among the maximum distances, so that the target object (the stone stuck in the related art) can smoothly pass through the gap between the curved active bending section 310 and the curved passive bending section 110, and the problem that the stone waiting for suction is not smooth when being discharged is solved.
After the expandable portion 112 is radially expanded, the flow path of the target is such that, as illustrated in the orientation of view a in fig. 9, the target passes over the active curved section 310 first, and as the target flows to the stricture (view c in fig. 9), the target flows circumferentially to the side of the active curved section 310, thereby entering the expanded expandable portion 112, and then the target flows again circumferentially to flow under the active curved section 310 (view e in fig. 9) to pass through the stricture.
In addition, when the passive bending section 110 of the present application is not bent following the active bending section 310, the portion of the blocking structure 200 located at the through-hole 111 is not pressed, and thus the blocking structure 200 is not bulged toward the outside of the through-hole 111, that is, the outer diameter of each portion of the passive bending section 110 in the self-extending direction is small when the passive bending section 110 is in the straight state, which is advantageous for inserting the sheath 100 into the human body.
The operation method for solving the problem that the suction object waiting for discharging the calculus is not smooth by utilizing the negative pressure suction sheath comprises the following two steps:
1. After the insertion portion 300 of the endoscope is inserted into the sheath 100 and the active bending section 310 drives the sheath 100 to bend, the expanded expandable portion 112 corresponds to the minimum value of the maximum distances of the sheath 100 in the prior art, that is, the minimum value of the maximum distances is larger than the size of the target object after the active bending section 310 is inserted into the sheath 100 and drives the sheath 100 to bend, so that the target object can smoothly pass through the gap between the bent active bending section 310 and the inner wall of the tube section of the sheath 100 bent by the active bending section 310, thereby solving the problem that the waiting for sucking of the discharged stone is not smooth.
2. After the insertion portion 300 of the endoscope is inserted into the sheath 100 and the active bending section 310 bends the sheath 100, the raised expandable portion 112 does not correspond to the minimum value of the maximum distances of the sheath 100 in the prior art, for example, the expanded expandable portion 112 is located near the minimum value of the maximum distances of the sheath 100, at which time only the active bending section 310 needs to be drawn to move the active bending section 310 proximally until a portion of the curved active bending section 310 enters the raised expandable portion 112, so that the minimum value of the maximum distances is greater than the size of the target object by the raised expandable portion 112, thereby introducing the target object jammed between the curved sheath 100 and the curved active bending section 310 into the raised expandable portion 112 to solve the problem that the target object is jammed between the curved sheath 100 and the curved active bending section 310.
Referring to fig. 3-5, in an alternative embodiment, the depth of the central portion of the through-hole 111 in the direction of extension of the passive curved section 110 is smaller than the depth of the other portions of the through-hole 111.
In this embodiment, the height dimension of the expandable portion 112 is related to the depth of the through hole 111, and the sum of the height dimension and the depth dimension of the through hole 111 is equal to the outer diameter of the through hole 111, whereas in this embodiment, the depth of the middle portion of the through hole 111 is shallower, the height of the middle portion of the expandable portion 112 is greater, and the greater the height of the middle portion of the expandable portion 112 is, the greater the dimension of the middle portion which can radially expand in the direction indicated by the x arrow line is, so after the structure of this embodiment is adopted, the distance between the inner wall of the expandable portion 112 and the active bending section 310 can be further increased, so that the greater stone waiting suction object can pass through the gap between the expandable portion 112 and the active bending section 310, thereby improving the trafficability of the sheath tube 100. Further, since the depth of the through-hole 111 is large on both sides in the self-extending direction, the height of both sides of the expandable portion 112 is also small, which obviously gives the expandable portion 112 a relatively low structural strength, and thus the expandable portion 112 is more easily deformed.
Referring to fig. 4, in an alternative embodiment, the bottom wall of the through-hole 111 includes an arc 1111, and the arc 1111 is located at a middle of the through-hole 111 along the extending direction of the passive bending section 110.
In this embodiment, the arc-shaped portion 1111 protrudes away from the expandable portion 112, the bottom wall of the through hole 111 forms the arc-shaped portion 1111, the arc-shaped portion 1111 is located in the middle of the through hole 111, and the arc-shaped portion 1111 itself is characterized by a small middle depth at both sides of the middle of the through hole 111, i.e. a large middle depth at both sides of the middle, which can further increase the height of the middle of the expandable portion 112, thereby further improving the trafficability of the sheath 100. At the same time, the depth of both sides of the middle of the through-hole 111 is large, which makes the height of both sides of the expandable portion 112 smaller, thereby making it easier to deform the expandable portion 112.
With continued reference to fig. 4, in an alternative embodiment, the bottom wall of the through hole 111 further includes two engaging portions 1112, where the two engaging portions 1112 are located on two sides of the arc-shaped portion 1111 and are connected to the arc-shaped portion 1111, and each engaging portion 1112 is planar. In this embodiment, the height of the engagement portion 1112 is kept uniform compared to the curved surface, so the engagement portion 1112 is flat, which can make the two sides of the through hole 111 have a larger depth, and the depth is not reduced in the extending direction of the through hole 111, thereby facilitating the bending of the passive bending section 110.
Referring to fig. 1 and 2, in alternative embodiments, the depth of the through opening 111 may be constant along the extension of the passive bend section 110.
To prevent the blocking structure 200 from deforming inwardly during bending of the passive bending section 110, referring to fig. 6-8, in an alternative embodiment, the inner wall of the through opening 111 has a profile that forms a support tongue 113 on the side wall of the passive bending section 110, the support tongue 113 being located at one end of the through opening 111.
In this embodiment, the through hole 111 is formed on the passive bending section 110, and the supporting tongue 113 is formed at the same time, when the passive bending section 110 is bent, the two sides of the through hole 111 are close to each other, so that the supporting tongue 113 is also close to the other end of the through hole 111, and the supporting tongue 113 can provide support for a part of the plugging structure 200, so that the plugging structure 200 is prevented from collapsing into the passive bending section 110, the distance between the plugging structure 200 and the active bending section 310 is increased, and the stone waiting suction object is prevented from being stuck between the active bending section 310 and the plugging structure 200, thereby further improving the trafficability of the sheath 100.
Referring to fig. 6, in an alternative embodiment, the direction in which the end of the supporting tongue 113 connected to the other portion of the passive bending section 110 extends from the other end is the first direction (the direction indicated by the arrow line m in fig. 6), and the first direction is parallel to the extending direction of the passive bending section 110, so that the supporting performance of the supporting tongue 113 on the blocking structure 200 can be further improved, so as to further improve the trafficability of the sheath 100. Of course, the first direction may also be parallel to the direction shown by the x arrow line in fig. 2.
With continued reference to fig. 6, in an alternative embodiment, a first section 101 and a second section 102 are formed on a sidewall of the passive bending section 110, the first section 101 and the second section 102 intersect, an inner wall of the through hole 111 includes the first section 101 and the second section 102, the first section 101 and the second section 102 are disposed obliquely with respect to an axial direction of the passive bending section 110, an included angle between the first section 101 and the second section 102 is an acute angle, an oblique direction of the first section 101 and the second section 102 is opposite, and a plane where an inner wall of the supporting tongue 113 is located coincides with the second section 102.
In this embodiment, the inclination directions of the first tangential plane 101 and the second tangential plane 102 are opposite, and the included angle between the two is acute, that is, the groove depth of the through hole 111 at the intersection between the first tangential plane 101 and the second tangential plane 102 is the greatest, so when the passive bending section 110 is bent, the passive bending section 110 will bend, that is, the bending position of the passive bending section 110 is adjacent to the supporting tongue 113, and the collapse degree of the portion of the plugging structure 200 located at the bending position is the greatest, so the supporting tongue 113 can support the portion of the plugging structure 200 with the greatest collapse degree, which can further promote the trafficability of the sheath tube 100.
In an alternative embodiment, the number of the through holes 111 includes two through holes 111, and the two through holes 111 are respectively disposed on two opposite sides of the passive bending section 110, and the two through holes 111 are spaced apart along the extending direction of the passive bending section 110.
In general, the active bending section 310 of the endoscope has a bi-directional bending function, if only one through hole 111 is provided, and if the through hole 111 is just located at the extrusion side of the passive bending section 110 when the passive bending section 110 is bent following the active bending section 310, the expandable portion 112 is not radially expanded outwards, whereas in order to enable the negative pressure suction sheath of the present application to adapt to the bi-directional bending of the active bending section 310, the through holes 111 are provided at opposite sides of the passive bending section 110, and the blocking structure 200 seals each through hole 111, so that no matter in which direction the active bending section 310 is bent, one through hole 111 is always located at the stretching side of the passive bending section 110, thereby radially expanding the corresponding expandable portion 112 outwards. It can be seen that, with the structure of this embodiment, no matter in which direction the active bending section 310 is bent, the expandable portion 112 expands radially outwards, that is, no matter in which direction the active bending section 310 is bent, the stones are trapped between the active bending section 310 and the passive bending section 110 when the stones are sucked by the negative pressure suction sheath.
In an alternative embodiment, where the passive bending section 110 bends and presses the portion of the occluding structure 200 sealing the through-hole 111, the pressed portion of the occluding structure 200 bulges towards the outside of the through-hole 111.
When the negative pressure suction sheath of the present application is applied, the insertion part 300 of the endoscope can be inserted into the sheath tube 100, and when the active bending section 310 drives the passive bending section 110 to bend, the passive bending section 110 can press the portion of the blocking structure 200 for blocking the through hole 111, so that the two ends of the portion of the blocking structure 200 are close to each other, and the portion of the blocking structure 200 bulges towards the outer side of the through hole 111, which can increase the cross-sectional area of the passive bending section 110 at the through hole 111, thereby increasing the overflow area at the position and increasing the minimum value of the maximum distances, so that the object can smoothly pass through the gap between the bent active bending section 310 and the bent passive bending section 110, and the problem that the suction waiting for discharging stones is not smooth is solved.
The state of the plugging structure 200 after bulging outside the through-hole 111 is not shown, and the direction in which the portion of the plugging structure 200 is crushed bulges is explained here, but the portion of the plugging structure 200 bulges radially outward in the direction away from the through-hole 111 (the direction indicated by the z arrow line in fig. 2).
In an alternative embodiment, the blocking structure 200 comprises a blocking film and a braid (not shown in the figures), the blocking film being connected to the braid, the portion of the braid being pressed bulging towards the outside of the through opening 111 in case the passive bending section 110 bends and presses the portion of the blocking structure 200 sealing the through opening 111. Further, the blocking structure 200 is an annular structural member.
In an alternative embodiment, the portion of the plugging structure 200 sealing the through-opening 111 is pre-bulging towards the outside of the through-opening 111 in case the passive bending section 110 is in a straightened state, and the pre-bulging portion of the plugging structure 200 bulges towards the outside of the through-opening 111 in case the passive bending section 110 bends and presses the pre-bulging portion of the plugging structure 200.
In this embodiment, the plugging structure 200 is pre-bulging outwards in the initial situation, that is, the plugging structure 200 has a certain tendency to expand outwards when not subjected to an external force, which results in a higher initial curvature on the outer side of the plugging structure 200, so that when the plugging structure 200 is subjected to a compressive force, the pre-bulging structure can better adapt to the bending deformation of the passive bending section 110, thereby making it easier for the plugging structure 200 to expand outwards.
The foregoing embodiments of the present application mainly describe differences between the embodiments, and as long as there is no contradiction between different optimization features of the embodiments, the embodiments may be combined to form a better embodiment, and in view of brevity of line text, no further description is provided herein. The embodiments of the present application have been described above with reference to the accompanying drawings, but the present application is not limited to the above-described embodiments, which are merely illustrative and not restrictive, and many forms may be made by those having ordinary skill in the art without departing from the spirit of the present application and the scope of the claims, which are to be protected by the present application.