阅读说明：本技术 一种治疗性ercp胆总管结石用扩张取石装置 (Therapeutic ERCP common bile duct calculus expanding and fetching device ) 是由 和泽源 木春姬 杨瑞芬 赵振黎 史四妹 李晓宇 和丽书 和凤 和秀华 于 2019-09-30 设计创作，主要内容包括：本发明公开一种治疗性ERCP胆总管结石用扩张取石装置,涉及医疗器械技术领域。治疗性ERCP胆总管结石用扩张取石装置包括球囊导管和辅助充气泵,所述球囊导管后端与辅助充气泵连接,通过辅助充气泵对球囊导管上的扩张球囊和取石球囊充气,由十二指肠与胆管连接部的乳头扩张出天然通道并由此取出结石。本发明通过扩张取石装置能实现快速经自然通道清除结石、除梗阻。(The invention discloses a therapeutic expansion calculus removing device for ERCP common bile duct calculus, and relates to the technical field of medical instruments. The dilatation and calculus removal device for the therapeutic ERCP common bile duct calculi comprises a balloon catheter and an auxiliary inflator pump, wherein the rear end of the balloon catheter is connected with the auxiliary inflator pump, the dilatation balloon and the calculus removal balloon on the balloon catheter are inflated through the auxiliary inflator pump, and a natural channel is expanded from a nipple at the connecting part of a duodenum and a bile duct to remove calculi. The invention can realize quick removal of calculus and obstruction through a natural channel by expanding the calculus removing device.)

1. A therapeutic ERCP common bile duct calculus is with expansion calculus removal device which characterized in that: the device comprises a balloon catheter and an auxiliary inflator pump, wherein the rear end of the balloon catheter is connected with the auxiliary inflator pump, an expansion balloon and a calculus removing balloon on the balloon catheter are inflated through the auxiliary inflator pump, and a natural channel is expanded from a nipple at the connecting part of a duodenum and a bile duct to remove calculus;

The auxiliary inflator pump comprises a pressurizing part, a pressure measuring part, a catheter and a balloon catheter linking part, wherein the pressurizing part comprises a pressurizing cylinder and a pushing piston, the rear end of the pressurizing cylinder is provided with a locking device for locking the relative position of the pushing piston, the front end of the pressurizing part is connected with the pressure measuring part, the pressure measuring part is a mechanical or digital display pressure gauge, the front end of the pressure measuring part is connected with the balloon catheter linking part through the catheter, and the balloon catheter linking part is a cock three-way valve;

The balloon catheter comprises a catheter main body, an expansion balloon, a stone removal balloon, a developing balloon and a joining seat at the rear end, the catheter main body is a multi-cavity hollow tube, an independent guide wire channel and an inflation channel are designed inside, the columnar expansion balloon is installed at the front end of the catheter main body, the developing balloon is installed on the catheter main body at the front end and the rear end of the expansion balloon, the stone removal balloon is installed on the catheter main body at the rear end of the expansion balloon, the joining seat is installed at the rear end of the catheter main body, an expansion balloon joint, a stone removal balloon joint and a developing balloon joint are installed on the joining seat respectively, and the expansion balloon joint, the stone removal balloon joint and the two joints of the cock three-way.

2. The expandable lithotomy device for therapeutic ERCP choledocholithiasis as claimed in claim 1, wherein: the calculus removing balloon is positioned between the expansion balloon and the connecting seat on the catheter main body or close to the expansion balloon.

3. The expandable lithotomy device for therapeutic ERCP choledocholithiasis as claimed in claim 1, wherein: the expansion balloon is a three-stage columnar expansion balloon expanded by inflation, the expansion balloon is connected with a cock three-way valve through an expansion balloon joint for inflation, and the cock three-way valve selectively conducts an auxiliary inflator pump and the expansion balloon or the auxiliary inflator pump and the stone removal balloon.

4. the expandable lithotomy device for therapeutic ERCP choledocholithiasis as claimed in claim 1, wherein: the expansion balloon joint, the calculus removing balloon joint and the developing balloon joint are provided with marks.

5. The expandable lithotomy device for therapeutic ERCP choledocholithiasis as claimed in claim 1, wherein: the catheter is a high-pressure catheter, and the expansion balloon is divided into different specifications.

6. Use of the expandable lithotomy device of any of claims 1-5 for the removal of therapeutic ERCP common bile duct stones.

7. use of the expandable lithotomy device of any of claims 1-5 for the retrieval of therapeutic ERCP choledocholithiasis through a potentially expandable natural passageway.

Technical Field

The invention relates to the technical field of medical instrument combination, in particular to a therapeutic expansion calculus removing device for ERCP common bile duct calculus.

Background

Bile duct calculus is a common digestive disease with the clinical manifestations caused by long-term cholestasis and calculus, particularly large calculus which has no daily effect and is finally blocked and bile duct drainage is not smooth. Endoscopic therapeutic ERCP has been experienced in the weather for 51 years in China and has become an important means for the clinical treatment of common bile duct stones.

however, the excellent treatment method is difficult to popularize and apply in national primary hospitals, and has two main influence factors:

One is as follows: (1) the existing therapeutic ERCP method is originated from foreign countries, the rules of the existing therapeutic ERCP method are formulated by foreign experts, and the domestic rule guide still refers to the suggestions and opinions of the foreign experts and never changes the framework of the existing therapeutic ERCP method; the method and details thereof have never been questioned and broken through. (2) According to the existing guidelines and methods, there are complications and risks, some of which are even fatal, which are objective to operate and skilled and still experience to avoid. (3) All of the research in the past has been essentially directed to precise guidelines and the use of, and improvements associated with, electrotomes. The prior many literature concerns and research directions are: (1) how to control the direction of the incision of the nipple is to maintain the incision or to slightly dilate the nipple after the incision, and the purpose of the incision is to control the direction of the incision and to prevent perforation and bleeding caused by the incision. (2) The large, medium and small papilla are cut according to the size of the calculus, how to control the large, medium and small papilla and roughly measure the cut size of the papilla to evaluate whether the instrument is favorable for entering and exiting and calculus removing, the papilla is passively expanded only when the papilla is cut into a linear shape or a slit shape, and bleeding and perforation are difficult to prevent and some even fatal bleeding and perforation are difficult to prevent by care during the calculus removing process. Particularly nipple openings that open into or alongside a diverticulum, straddling the edge of the diverticulum. Objectively, clinically, the nipple is opened in a diverticulum or is positioned beside the diverticulum and straddles the nipple at the edge of the diverticulum, so that more surgeons who are engaged in the therapeutic ERCP feel great pressure, are deeply anxious and difficult to grasp the incision size, and the application of the diverticulum is influenced. (3) Edema caused by heat radiation of incised nipples and the functional problems of the future fibrosis and stiffness of nipples affecting the function are paid attention to surgeons who advocate the nipple plasty, so that doctors in many hospitals become a promising and inaccessible technology and are difficult to popularize;

the second step is as follows: with the development of science and technology, surgical instruments and the progress of technology are fused and cooperated with the field of surgery, new ideas and new stone removing means are continuously appeared and still performed under the old framework, the choledochus side wall is opened through a laparoscope for first-stage stone removing suture, two-lens combined treatment, or stone removing after holmium laser lithotripsy, the application of primary and secondary lenses and the like. So now, basically, such a pattern is formed: the calculi with the size of more than or equal to 1.5cm, the nipple opening in the diverticulum or the nipple straddling the edge of the diverticulum beside the diverticulum are multiplied because of the worry of complication and are all listed as an endoscopic treatment forbidden area, thus reminding practitioners to take precautions. Handed over to surgical treatment. In case of emergency, the drainage tube is placed under the endoscope, and the drainage tube is periodically treated after the emergency is changed. In the past, the ERCP technology is usually defaulted and only used as one of transition means of other diagnosis and treatment processes rather than a preferred and optimal scheme of treatment, so that the patients cannot completely and truly benefit from minimally invasive therapeutic ERCP to the maximum extent, and the application and development of treating ERCP are limited. Varying degrees affect the dividend brought by the development of therapeutic ERCP. The confidence of the patients, family members and doctors in treatment is influenced, and the situation is reduced greatly. Can be forbidden by many hospitals and doctors. The clinical problem that is still unavoidable in the end is how to treat patients with critical conditions. If possible, the quick and disposable calculus removing and obstruction removing device is certainly minimally invasive and preferable. At present, clinical practice calls for simplification, and a living RECP technology is used, and the method comprises minimally invasive rapid one-time obstruction removal treatment of critical patients suffering from choledocholithiasis with 1.5cm or more, or without a nipple opening in a diverticulum or a nipple opening straddling the edge of the diverticulum beside the diverticulum.

In view of the foregoing, the prior art is deficient in the absence of minimally invasive surgical instruments for the true therapeutic removal of ERCP common bile duct stones, all of which require removal of the stone through an incision.

Disclosure of Invention

aiming at the problems in the prior art, the invention provides the expansion calculus removing device for the therapeutic ERCP common bile duct calculus, and the expansion calculus removing device can be used for rapidly removing the calculus and removing the obstruction through a natural channel.

in order to achieve the technical purpose and achieve the technical effect, the invention is realized by the following technical scheme:

A therapeutic ERCP common bile duct calculus dilating and calculus removing device comprises a balloon catheter and an auxiliary inflator pump, wherein the rear end of the balloon catheter is connected with the auxiliary inflator pump, the dilating balloon and the calculus removing balloon on the balloon catheter are inflated through the auxiliary inflator pump, and a natural channel is dilated from a nipple at the connecting part of duodenum and bile duct to remove calculus;

The auxiliary inflator pump comprises a pressurizing part, a pressure measuring part, a catheter and a balloon catheter linking part, wherein the pressurizing part comprises a pressurizing cylinder and a pushing piston, the rear end of the pressurizing cylinder is provided with a locking device for locking the relative position of the pushing piston, the front end of the pressurizing part is connected with the pressure measuring part, the pressure measuring part is a mechanical or digital display pressure gauge, the front end of the pressure measuring part is connected with the balloon catheter linking part through the catheter, and the balloon catheter linking part is a cock three-way valve;

the balloon catheter comprises a catheter main body, an expansion balloon, a stone removal balloon, a developing balloon and a joining seat at the rear end, the catheter main body is a multi-cavity hollow tube, an independent guide wire channel and an inflation channel are designed inside, the columnar expansion balloon is installed at the front end of the catheter main body, the developing balloon is installed on the catheter main body at the front end and the rear end of the expansion balloon, the stone removal balloon is installed on the catheter main body at the rear end of the expansion balloon, the joining seat is installed at the rear end of the catheter main body, an expansion balloon joint, a stone removal balloon joint and a developing balloon joint are installed on the joining seat respectively, and the expansion balloon joint, the stone removal balloon joint and the two joints of the cock three-way.

Further, the calculus removing balloon is positioned on the catheter main body and is positioned between the expansion balloon and the connecting seat or close to the expansion balloon.

furthermore, the expansion balloon is an inflated and expanded three-stage columnar expansion balloon, the expansion balloon is connected with a cock three-way valve through an expansion balloon joint for inflation, and the cock three-way valve selectively conducts the auxiliary inflator pump and the expansion balloon or the auxiliary inflator pump and the lithotomy balloon.

further, the expansion balloon joint, the lithotomy balloon joint and the development balloon joint are provided with marks.

Further, the conduit is a high pressure conduit.

It is another object of the present invention to provide a use of an expandable lithotomy device for therapeutic ERCP common bile duct stones in the retrieval of therapeutic ERCP common bile duct stones.

The invention has the beneficial effects that: the invention relates to a therapeutic ERCP common bile duct calculus dilating and calculus removing device, which comprises a balloon catheter and an auxiliary inflator pump, wherein the rear end of the balloon catheter is connected with the auxiliary inflator pump, the dilating balloon and the calculus removing balloon on the balloon catheter are inflated by the auxiliary inflator pump, and a natural channel is dilated from a nipple at the connecting part of a duodenum and a bile duct to remove calculus; by the design of the expansion calculus removing device, the special anatomical substrate with a safe area suitable for saccule expansion from the nipple at the joint of the duodenum and the biliary tract is fully utilized, and a potential natural passage capable of expanding through the nipple is inoculated from the occurrence date of calculus,

After the device is adopted for expansion, the crack direction of the saccule-expanded nipple is completely consistent with the direction of the classical nipple incision, the crack size and direction do not need to be worried about, the device is superior to the electric incision of the nipple or the expansion of the nipple after the incision, the electric incision can be completely replaced, and the technical operation related to the electric incision of the electric incision or the expansion after the incision can be avoided; can avoid edema and postoperative local fibrosis stiffness dysfunction caused by thermal radiation during incision; the gall mud adhered to the surface of the calculus and the surface of the balloon is effectively coated on the new wound surface for hemostasis through the balloon and the calculus, and a treatment concept of 'quickly removing the calculus and removing obstruction through a natural channel' is introduced through the effective combination of the instrument balloon combination and the pathophysiological change of the common bile duct calculus; finding that a safe area is arranged on the nipple of the connecting part of the duodenum and the biliary tract, and the safe area can be used for special dissection by cylindrical saccule expansion; the cracking direction of the papilla of the column-shaped saccule expansion is found to be completely consistent with the classical direction of papilla incision; meanwhile, the balloon has a developing function, so that the position of the expanded balloon can be observed conveniently under an imaging device, and the safety is improved; fundamentally solves the problem of how to solve the critical states of large calculus obstruction, suppurative obstructive cholangitis, severe cholegenic pancreatitis and the like which always puzzles the clinic from the birth of the therapeutic ERCP in time. Breaks through multiple restricted areas of the therapeutic ERCP for the diseases related to the common bile duct stone. Is the key to therapeutic RECP in the treatment of choledocholithiasis-related diseases. Promotes and consolidates the status of the medicine in treating the diseases related to the choledocholithiasis. Has milestone significance.

Of course, it is not necessary for any product in which the invention is practiced to achieve all of the above-described advantages at the same time.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings used in the description of the embodiments will be briefly introduced below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art that other drawings can be obtained according to the drawings without creative efforts.

FIG. 1 is a schematic structural view of an expandable lithotomy device for therapeutic ERCP common bile duct stones, according to an embodiment of the invention;

FIG. 2 is a schematic diagram of an auxiliary inflator according to an embodiment of the present invention;

FIG. 3 is a schematic structural diagram of a pressing portion according to an embodiment of the present invention;

FIG. 4 is a schematic structural view of a balloon catheter according to an embodiment of the present invention;

FIG. 5 is a schematic structural diagram of an adapter according to an embodiment of the present invention;

FIG. 6 is a schematic view of a balloon catheter according to an embodiment of the present invention in use;

In the drawings, the components represented by the respective reference numerals are listed below:

1-auxiliary inflator pump, 101-pressurizing part, 1011-pressurizing cylinder, 1012-pushing piston, 102-pressure measuring part, 103-catheter, 104-balloon catheter joint, 2-balloon catheter, 201-catheter main body, 202-expanding balloon, 203-developing balloon, 204-stone removing balloon, 205-joint seat, 2051-balloon joint, 2052-stone removing balloon joint and 2053-developing balloon joint.

Detailed Description

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

as shown in fig. 1-6

A therapeutic ERCP common bile duct calculus dilating and calculus removing device comprises a balloon catheter 2 and an auxiliary inflator 1, wherein the rear end of the balloon catheter 2 is connected with the auxiliary inflator 1, the dilating balloon 202 and the calculus removing balloon 204 on the balloon catheter 2 are inflated through the auxiliary inflator 1, and a natural channel is dilated from a nipple at the connecting part of duodenum and bile duct to remove calculus;

The auxiliary inflator pump 1 comprises a pressurizing part 101, a pressure measuring part 102, a catheter 103 and a balloon catheter joint part 104, wherein the pressurizing part 101 comprises a pressurizing cylinder 1011 and a pushing piston 1012, a locking device for locking the relative position of the pushing piston 1012 is arranged at the rear end of the pressurizing cylinder 1011, the front end of the pressurizing part 101 is connected with the pressure measuring part 102, the pressure measuring part 102 is a mechanical or digital display pressure gauge, the front end of the pressure measuring part 102 is connected with the balloon catheter joint part 104 through the catheter 103, and the balloon catheter joint part 104 is a cock three-way valve;

The auxiliary inflator pump 1 is pressurized by the pressurization part 101, the pressure measuring part measures the pressure of a related saccule of the pressurizer, the cock three-way valve of the front saccule conduit joint part 104 controls the conduction of the corresponding saccule to inflate, namely, during operation, the saccule conduit joint part 104 is connected with the joint of the corresponding saccule conduit 2 to inflate, and due to the design of the cock three-way valve and the arrangement of a locking device for locking the relative position of the pushing and injecting piston 1012 at the rear end of the pressurization cylinder 1011, the saccule can be inflated and the pressure of the saccule can be maintained conveniently;

the balloon catheter 2 comprises a catheter main body 201, an expansion balloon 202, a calculus removing balloon 204, a developing balloon 203 and a joining seat 205 at the rear end, wherein the catheter main body 201 is a multi-cavity hollow tube, independent guide wire channels and inflation channels are designed inside the multi-cavity hollow tube, the front end of the catheter main body 201 is provided with the columnar expansion balloon 202, the developing balloon 203 is arranged on the catheter main body 201 at the front end and the rear end of the expansion balloon 202, the calculus removing balloon 204 is arranged on the catheter main body 201 at the rear end of the expansion balloon 202, the joining seat 205 is arranged at the rear end of the catheter main body 201, an expansion balloon joint 2051, a calculus removing balloon joint 2052 and a developing balloon joint 2053 are respectively arranged on the joining seat 205, and the expansion balloon joint 2051 and the calculus removing balloon joint 2052 are connected with two joints.

The lithotomy balloon 204 is positioned on the catheter main body 201 between the expansion balloon 202 and the joint seat 205 or close to the expansion balloon 202.

The inflatable balloon 202 is an inflated and expanded three-stage columnar inflatable balloon, the inflatable balloon 202 is connected with a cock three-way valve through an inflatable balloon joint 2051 for inflation, and the cock three-way valve selectively conducts the auxiliary inflator 1 and the inflatable balloon 202 or the auxiliary inflator 1 and the lithotomy balloon 204.

The dilatation balloon joint 2051, the lithotomy balloon joint 2052 and the visualization balloon joint 2053 are marked.

The conduit 103 is a high pressure conduit.

The balloon catheter is provided with an expansion balloon, a calculus removing balloon and a developing balloon through integration, three joints are arranged at a connecting end at the rear end respectively, the expansion balloon is connected with a cock three-way valve through the expansion balloon joint for inflation, the cock three-way valve selectively switches on an auxiliary inflator pump and the expansion balloon or the auxiliary inflator pump and the calculus removing balloon, the position of the expansion balloon is convenient to identify through the design of the development balloon at the front end and the rear end of the expansion balloon, the pressure of the expansion balloon is measured by a pressure measuring part, the pressure is accurately controlled according to the pressure required by each level of pressure measurement, a natural channel is expanded from a nipple of a connecting part of duodenum and bile duct by the expansion balloon, calculi are taken out through the calculus removing balloon, and the developing balloon can be identified.

the technical scheme of the invention is explained by combining the specific embodiment as follows: