阅读说明：本技术 一种牵引装置 (traction device ) 是由 冀明 双建军 沈正华 李常青 冷德嵘 刘春俊 胡洁 于 2018-07-20 设计创作，主要内容包括：一种牵引装置,包括夹持部和牵引部,牵引部含有封闭牵引结构,封闭牵引结构由弹性材料制成,夹持部包括夹持主体和夹臂,夹持主体能够穿过内镜的活检通道,夹臂可以夹住封闭牵引结构。(traction device, including clamping part and traction portion, traction portion contains seals and draws the structure, seals and draws the structure and make by elastic material, and clamping part includes centre gripping main part and arm lock, and the centre gripping main part can pass the biopsy passageway of scope, and the arm lock can clip seals and draws the structure.)

The traction device is characterized in that the traction device comprises a clamping part and a traction part, the traction part comprises a closed traction structure, the closed traction structure is made of elastic materials, the clamping part comprises a clamping main body and clamping arms, the clamping main body can penetrate through a biopsy channel of an endoscope, and the clamping arms can clamp the closed traction structure.

2. The towing attachment in accordance with claim 1, wherein the enclosed tow structure is made of silicone rubber or a thermoplastic elastomer.

3. The towing attachment in accordance with claim 1 wherein the enclosed tow structure is , two or more.

4. A towing attachment in accordance with claim 3, characterised in that a resilient structure can be connected between two or more closed towing structures.

5. The towing attachment in accordance with claim 4 wherein the resilient structure is a resilient wire-like structure.

6. The towing attachment in accordance with claim 4 wherein the resilient structure is an elastic loop.

7. A towing attachment in accordance with claims 1 to 6, characterised in that the closed towing construction is circular, triangular, diamond-shaped, square.

8. Traction device according to claim 1, characterized in that the closed traction structure is elastically deformable by moving the clamping body of the clamping portion.

9, traction rings, characterized in that, the traction ring is formed by connecting closed traction structures or a plurality of closed traction structures, and the traction ring is made of elastic material.

10. The traction loop of claim 9, wherein a resilient structure is connected between the closed traction structures.

11. The traction loop of claim 10, wherein the resilient structure is a resilient wire-like structure.

12. The traction loop of claim 10, wherein the resilient structure is an elastic loop.

13. The traction loop of claim 9, wherein the closed traction structure is circular, triangular, diamond shaped, square shaped.

Technical Field

The invention relates to traction devices in the field of medical instruments, in particular to traction devices which have good elasticity, do not need external force, can realize traction on a cutting focus only by the elasticity of a traction part, fully expose the visual field of operation, and can draw and shrink a large wound surface, thereby facilitating the wound surface to be clamped in steps.

Technical Field

EMR (Endoconpic mucosal resection, EMR) for treating early gastric cancer is used clinically in Japan at the earliest time, before the EMR is introduced into Japan, gastrectomy is a treatment method of early gastric cancer , and currently, the treatment method is widely applied in .

ESD and EMR realize that ordinary single-channel endoscopes are used for excising lesions, and the pain of laparotomy and organ excision are avoided, the defect of EMR is that the technology can not excise large lesions in a whole block, taken broken block specimens are difficult to carry out detailed pathological analysis, the stage of tumors is indefinite, and the risk of tumor recurrence is high.

However, EMR is about 20 minutes longer than EMR, and has great risks and difficult operation, most of the ESD has operation time of 60-90min, and complications such as bleeding, perforation, stenosis and postoperative infection exist, which is not good for large-scale pushing and application, EMR rarely bleeds, but the visual field is covered by blood during ESD operation with little attention, and continuous hemostasis and visual field flushing are required.

Inspired by surgical traction technology, various endoscope auxiliary traction technologies are developed at the same time. The traction can be roughly divided into internal traction and external traction according to the position of the traction source; the structure of the traction device can be divided into dental floss traction, metal wire clamping and wire combining traction technology, metal clip elastic ring combining traction technology, S-O metal clip traction technology, magnetic anchor technology and the like.

Recent digestive endoscopy articles in the discussion section point out that although dental floss is a good auxiliary ESD, there is a possibility of tissue damage, which requires attention to point during use, and in addition, the dental floss is pulled to fix the direction, and the pulling end is outside the body, so that the dental floss must be parallel to the endoscope, and the pulling direction is limited.

The metal wire clamping and wire drawing combined technology has no elasticity, and after partial focuses are cut, the silk may lose effect, the focuses cannot be drawn continuously, and the cutting process cannot be carried out smoothly.

The metal clip elastic ring combined traction technology has the limitation on the size of the elastic ring, needs a silk thread to tie the O-shaped ring on the clip, and needs a special sheath, so that the operation is complex, and inconvenience is brought to a user.

The S-O metal clip traction technology is developed by combining a metal clip elastic ring with a traction method, replaces the elastic ring with a spring, strives to obtain greater flexibility to adapt to ESD excision of large and superficial colon early tumors, but the spring has no tension after cutting, occupies large space and volume and cannot enter an endoscope biopsy channel, so that an endoscope needs to be taken out during an operation, the endoscope is clamped by a metal clip extending out of the endoscope biopsy channel in vitro and then is sent into a body to reach a target position, and the method is easy to cause injury to the human body due to the fact that the spring is exposed at the far end of the biopsy channel, and is limited in use.

The magnetic anchor traction technology needs special equipment, such as a standard telescopic arm, and the traction is continuously changed in direction outside the body, so that the operation is complicated, and the visual field of the operation is obstructed if the number of magnets is large in the operation process.

Disclosure of Invention

The traction device comprises a clamping part and a traction part, wherein the traction part is elastically deformed and extended by the elasticity of the traction part, so that traction acting force can be provided in a body to draw a focus, and the visual field of operation is fully exposed. Because external force is not needed to be provided, the traction device is not limited by the size of an anatomical position and a digestive tract lumen, can be used for drawing mucous membranes, tissues and organs, and is particularly suitable for positions with difficult operation in an ESD (electro-static discharge) operation, so that doctors can perform mucous membrane stripping operation under the more intuitive and visible conditions, the operation can be safer and more convenient, the operation time can be greatly shortened, the pain of patients can be reduced, and the traction device is suitable for large-area focus stripping.

The common digestive endoscope comprises a biopsy channel, an objective lens, an LED light source, a water inlet channel, a water outlet channel and the like, wherein the biopsy channel is used for being fed into a clamping part and a traction part.

traction device, the traction device includes a clamping part and a traction part, the traction part contains a closed traction structure, the closed traction structure is made of elastic material, the clamping part includes a clamping main body and a clamping arm, the clamping main body can pass through the biopsy channel of the endoscope, the clamping arm can clamp the closed traction structure.

Preferably, the closed traction structure is made of silicone rubber or a thermoplastic elastomer.

Preferably, the number of closed traction structures is , two or more.

Preferably, the closed traction structure may be circular, triangular, diamond-shaped, square, or the like.

An elastic structure may be connected between two or more closed traction structures, preferably an elastic thread structure, an elastic ring, etc.

The clamping main body is moved, so that the closed traction structure can be elastically deformed.

traction rings, wherein the traction rings are formed by connecting closed traction structures or a plurality of closed traction structures, the traction rings are made of elastic materials, and the elastic structures are connected between the closed traction structures.

Preferably, the elastic structure is an elastic thread structure, an elastic ring or the like.

Preferably, the closed traction structure may be circular, triangular, diamond-shaped or square, etc.

After the pre-separation of the mucous membrane is completed in vivo, the electrotome is withdrawn, a second large-area clamping part of the traction device is opened, the clamping arms of the clamping part clamp the 0 end of the closed traction structure, the th clamping part and the closed traction structure are placed into a biopsy channel of an endoscope, after the biopsy channel reaches the distal end of the biopsy channel, the clamping arms of the th clamping part are opened under the observation of an eyepiece of the endoscope, the end of the pre-separated tissue clamping part and the end of the closed traction structure clamp the everted end of the tissue and the closed traction structure 634 end of the endoscope, the clamping body of the th clamping part and the proximal end of the closed traction structure are separated from each other, so that the closed endoscopic tissue cutting structure can be completely cut by the closed endoscopic cutting endoscope, and the closed endoscopic cutting structure can be cut by the closed endoscopic cutting endoscope, and the endoscopic surgical incision device can be used for a long time, and the endoscopic surgical operation can be performed by a long time, and the endoscopic surgical operation is facilitated.

Has the advantages that:

the traction device combines the clamping part and the traction part into bodies, the traction part has elasticity, and can provide acting force in the body by means of self extension, and the traction device is particularly suitable for the position with difficult operation of the ESD operation because external force is not required to be provided and is not limited by the size of an anatomical position and a digestive tract lumen.

In the actual use process of the product, if the condition of traction looseness is found, a plurality of clamping parts can be added to clamp and close the traction structure, the traction structure is pulled towards other directions and then clamped and closed to form a polygonal structure, the traction force can be continuously provided, the operation visual field is widened until tissues are completely separated, and the separation process is smoothly carried out.

Drawings

FIG. 1A is a cross-sectional view and a front view of a traction portion in two annular closed traction structures

FIG. 1B is a schematic view of a three-ring-shaped closed traction structure of a traction part

FIG. 1C is a schematic view of a four-ring-shaped closed traction structure of the traction part

FIG. 1D is a cross-sectional and front view of a triangular closed draft configuration

FIG. 2 is a schematic view of the interaction of the clamping portion and the pulling portion

FIG. 3 is a schematic view of the insertion of the grasping portion and the pulling portion into the biopsy channel of the endoscope

FIG. 4 is a schematic view of the th clamping part and the annular closed traction structure clamping a lesion under the guidance of an endoscope

FIG. 5 is a schematic view of the endoscope guiding the second clamping portion and the annular closed traction structure clamping the lesion

FIG. 6 is a schematic view of the separation of the lesion by the cooperation of the clamping portion and the annular closed traction structure

FIG. 7 is a schematic view of a traction device separating a lesion in a narrow space

FIG. 8 is a schematic view of the elastic thread structure connected between the ring-shaped closed traction structures

FIGS. 9A-9C are schematic views of a traction device reducing a lesion wound surface when the lesion wound surface is large

1. Traction part, 11, closed traction structure, 2, clamping part, 21, th clamping part, 22, second clamping part, 23, clamping main body, 24, clamping arm, 25, clamping main body, 26, clamping arm, 3, endoscope, 4, biopsy channel, 5, focus, 6, mucosa layer, 7, muscle layer, 8, lumen contralateral mucosa layer

Detailed Description

For purposes of making the objects, aspects and advantages of the present invention more apparent, the present invention will be described in detail below with reference to the accompanying drawings and examples.

Hereinafter, the end of the endoscope proximal to the operator is defined as the proximal end and the end distal from the operator is defined as the distal end.

Fig. 1A-1D and 8 are schematic diagrams of different types of closed traction structures, fig. 1A is a schematic diagram of a traction part 1 comprising two annular closed traction structures, the two annular structures are connected in a closed manner to form the traction part 1 of the closed traction structure, fig. 1B and 1C are schematic diagrams of a traction part 1 comprising three annular closed traction structures and four annular closed traction structures, fig. 1D is a sectional view and a front view of a triangular closed traction structure, fig. 8 shows that the traction part 1 can also be provided with an elastic thread structure in the closed traction structure, and the closed traction structure and the elastic thread structure can be elastically deformed to completely separate a lesion 5 from an mucosa layer 6, which is particularly suitable for a larger lesion 5.

The use process of the traction device for mucosal traction separation is described below by taking a case that the traction portion is composed of only a closed traction structure as an example, the traction portion is used for a closed traction structure, the use process of the traction device for mucosal traction separation is described, in the actual operation process, an electric knife can be inserted into the vicinity of lesion tissues through an endoscope biopsy channel, marking is performed around the lesion position, after marking is completed, liquid is injected through the electric knife or an external injector, the lesion tissues are bulged, and a liquid buffer layer, namely a 'water cushion', is formed under mucosa, as shown in fig. 2-6, fig. 2 is a schematic diagram of the mutual matching of the clamping portion 2 and the traction portion 1, the clamping portion 2 comprises clamping bodies 23 and 25 and clamping arms 24 and 26, after the endoscopic tissue is completely separated from mucosa in vivo, as shown in fig. 2-6, fig. 2 is a clamping arm 24 of the clamping device clamping portion 2 and the traction portion 1, the closed traction structure 11 is opened, the clamping end of the traction portion 1, as shown in fig. 3 and fig. 4, the clamping portion 21 and the closed traction structure 11 is opened, the clamping portion 21 and the closed traction portion is placed into the biopsy channel 4 of the endoscope 3, after the endoscopic tissue is completely separated from the endoscope biopsy channel, the endoscope biopsy channel is completely pulled, the endoscope, the closed end of the endoscope biopsy channel is completely separated, the endoscope, the endoscopic tissue is completely, the endoscopic tissue is pulled, the endoscopic tissue is completely, the clamping structure is pulled, the clamping portion is pulled, the clamping structure is pulled out, the clamping structure is completely, the clamping structure is pulled out, the closed end of the clamping structure is pulled out, the closed endoscope biopsy channel is completely, the endoscopic tissue, the closed end of the endoscopic tissue, the closed endoscope biopsy channel is pulled out, the endoscopic tissue, the closed end of the endoscopic tissue, the clamping portion is pulled out, the endoscopic tissue is completely, the clamping structure is pulled out, the endoscopic tissue is completely, the clamping structure is completely.

As shown in fig. 4 and 7, when the lesion 5 is relatively large and the space is relatively small, for example, during an ESD operation in the intestinal tract, side of the lesion 5 may be cut first, as shown in fig. 4, the cut lesion 5 is clamped by the clamping arm 24 of the -th clamping portion 21, at this time, the second clamping portion 22 is fed through the endoscope 3, the clamping arm 26 of the second clamping portion 22 is clamped on the mucosa layer 8 on the opposite side of the intestinal tract lumen under the observation of the eyepiece of the endoscope 3, the clamping arm 26 of the second clamping portion 22 is closed, and the cut lesion 5 is continuously pulled along with the operation of the operation cutting operation under the elastic force of the closed traction structure 11, so as to maintain the operation field of view and facilitate the operation.

As shown in fig. 9A-9C, when the wound surface of the lesion 5 is relatively large, with the aid of the endoscope 3, the clamping arm 24 of the th clamping portion is used to clamp the side of the wound surface of the lesion 5 and the end of the closed traction structure 11, and then with the aid of the endoscope 3, the clamping arm 26 of the second clamping portion is used to clamp the other side of the wound surface of the lesion 5 and the other end of the closed traction structure 11, so that the two sides of the wound surface of the lesion 5 are pulled inward by the elastic force of the closed traction structure 11, and the wound surface of the lesion 5 is shrunk, thereby facilitating the wound surface of the lesion 5 to be further clamped.

Various modifications and combinations of these embodiments will be readily apparent to those skilled in the art, and the -generic principles defined herein may be implemented in other embodiments without departing from the spirit or scope of the disclosure.