Source: https://patents.google.com/patent/CN106535779A/en
Timestamp: 2020-02-24 16:26:31
Document Index: 91456340

Matched Legal Cases: ['art 114', 'art 114', 'art 114', 'art 114', 'art 114', 'art 126', 'art 126', 'art 126', 'art 126', 'art 126', 'art 126', 'art 126', 'art 126']

CN106535779A - Eus guided access device - Google Patents
CN106535779A
CN106535779A CN201580038430.5A CN201580038430A CN106535779A CN 106535779 A CN106535779 A CN 106535779A CN 201580038430 A CN201580038430 A CN 201580038430A CN 106535779 A CN106535779 A CN 106535779A
CN106535779B (en
230000000916 dilatatory Effects 0 abstract 3
238000009558 endoscopic ultrasound Methods 0 abstract 1
The entrance device of endoscopic ultrasonic guiding
This application claims the U.S. Provisional Application of the Serial No. 62/024,747 submitted on July 15th, 2014 is preferential Power, the disclosure of which are herein incorporated by reference.
Pancreas and biliary system form the pith of digestive system together.Pancreas and liver produce digestive juice (pancreatic juice and Bile), this contributes to digestion process (that is, food is resolved into the part that can easily absorb and be used by body).These Digestive juice passed through the pipeline of ductus pancreaticus and biliary system before enteron aisle is exited into.By for example, cancer, gall stone or cicatrization And blocking of any one of caused these pipelines may make pipeline become to block and full of fluid, this needs to carry out drainage.
The present invention relates to a kind of system for guiding drainage for endoscopic ultrasonic, which includes current sheath, its proximally to Distal end Longitudinal extending including its current chamber is proximally extended through to distal end；Stylet, slidably holds in current chamber Stylet is put, proximally to distal end Longitudinal extending and including its passage is extended through, passage is configured to accommodating logical stylet Cross its fluid；And expansion sheath, which is proximally to distal end Longitudinal extending and including extending through its expansion cavity, expansion cavity It is sized and shaped to slidably house the current sheath.
In one embodiment, current sheath may include to bending shape the distal part for deviateing.
In one embodiment, current sheath can be moved when stylet is housed wherein by the distal part for allowing bending Make to the flexible polymeric materials for stretching form.
In one embodiment, bending shape can be the one kind in pigtail ring, J-shaped and sheephook stock-raising commune.
In one embodiment, stylet may include distal part, and which has more logical than what distally part proximad extended The bigger diameter of the residue length of pipe pin.
In one embodiment, the part in the passage of the distal part for extending through stylet can be by around stylet Longitudinal axis extend annular space limit.
In one embodiment, the system may also include and be attached to stylet, current sheath and expand every in sheath The Handleset of the near-end of.
In one embodiment, Handleset is may include for the actuating for expanding sheath is vertically moved relative to current sheath Device.
In one embodiment, expanding sheath may include the electrode for being configured to burning tissue positioned at its distal end.
In one embodiment, the distal part of stylet can be with the remainder of the stylet than extending from its proximad The bigger diameter for dividing, the diameter of the distal part of stylet correspond to the diameter in current chamber to pierce through target tissue.
The invention further relates to a kind of method for guiding drainage for endoscopic ultrasonic, which includes logical by the work of endoscope By in the target pipeline in current sheath and stylet insertion body, stylet extends through the inner chamber of current sheath in road, so that Target pipeline is pierced through so as to distal tip in the distally extending distal end by sheath of passing through of distal tip of stylet；By stylet Passage contrast preparation is injected in target pipeline visually verifying target pipe full fluid；And distad push away in current sheath P-adic extension p sheath simultaneously enters in target pipeline to expand target pipeline.
Fig. 1 illustrates the longitudinal sectional view of the system of an exemplary embodiment of the invention；
Fig. 2 illustrates the longitudinal sectional view of the distal part of the stylet of the component of Fig. 1；
Fig. 3 illustrates the side view of the current sheath of the system according to Fig. 1；
Fig. 4 illustrates the side view of the current sheath of another exemplary embodiment of the invention；
Fig. 5 illustrates the side view of the current sheath of another exemplary embodiment of the invention；And
Fig. 6 illustrates the stereogram of the Handleset of the system of Fig. 1.
Refer to description below and accompanying drawing further understands the present invention, wherein being given the same reference numerals identical unit Part.The present invention relates to endoprosthesis medical device, and more particularly to endoscopic ultrasonic (EUS) guiding drainage.Exemplary embodiment is retouched The drainage system of EUS guiding has been stated, and which is included for stylet being inserted by the stylet in fluid injection hydrops pipeline, by which Current sheath and for expanding hydrops pipeline to carry out the expansion sheath of drainage.It will be apparent to one skilled in the art that The system and method for the present invention can be used for drainage, for example, bile duct, ductus pancreaticus, tumour, gall-bladder etc..It should be noted that as used in this article Term " nearside " and " distally " be intended to indicate that the direction towards (nearside) and the user away from (distally) device.
As shown in figs. 1-6, a kind of system 100 of an exemplary embodiment of the invention is included for piercing through Fluid (for example, contrast preparation) is simultaneously injected stylet therein 102 and for providing the path into hydrops by hydrops pipeline Current sheath 104.System 100 is also included for expanding channel to carry out the expansion sheath 106 of drainage.The size of system 100 With shape selected with by the service aisle of endoscope to be visualized under ultrasound guidance.System 100 may also include Handleset 108, which is in stylet 102 and the insertion live body of current sheath 104 (for example, along the naturally occurring body orifices of Jing Into bodily lumen) when be maintained at the outside of live body.When current sheath 104 is retained in target pipeline, Handleset 108 Permission removes stylet 102 from which.Handleset 108 is also included for going forward side by side along the propulsion expansion sheath 106 of current sheath 104 Enter the actuator in target pipeline.
As shown in FIG. 2, proximally 109 to distal end 110 longitudinally extends and including extending through which stylet 102 Passage 112.Stylet 102 can be fabricated from a flexible material, so that stylet 102 can be along zigzag path, for example, along natural body Chamber passes through.In one exemplary embodiment, stylet 102 can be made up of Nitinol with flexible and super-elasticity.However, this The technical staff in field will be understood that stylet 102 can be made up of any one in various flexible materials.Distal end 110 include for Pierce through the conical distal tip 122 of target pipeline.The distal part 114 of stylet 102 can be with more logical than what is extended from its proximad The bigger diameter of the portions of proximal 116 of pipe pin 102.The scope of the length of the distal part 114 of stylet 102 can be 0.3cm And 5.0cm between, and especially can be about 1cm.Line extends through stylet to the portions of proximal 118 of passage 112 along its longitudinal axis 102 portions of proximal 116, and the distal part of the passage 112 of the distal part 114 of stylet 102 is extended through by siphunculus The annular space extended around the longitudinal axis of pin 102 is limited.Can Jing passages 112 by fluid, such as, such as contrast preparation injects target With checking target pipeline by hydrops (for example, digestive juice) in pipeline.
As shown in FIG. 1, sheath 104 of passing through proximally 123 to distal end, 124 Longitudinal extending including extending through which Inner chamber 134.Inner chamber 134 is sized and shaped to house stylet 102 slidably therein.Especially, in the present embodiment In inner chamber 134 internal diameter correspond essentially to stylet 102 distal part 114 external diameter, so as to wherein house stylet When 102, distal part 114 is filled up completely with the inner chamber 134 of current sheath 104, to be wherein equipped with the logical of stylet 102 Target pipeline is pierced through when in the insertion target pipeline of row sheath 104.As shown in FIG. 3, sheath 104 of passing through can deflect with remote along which Side part 126 is presented desired bend.In one exemplary embodiment, the distal part 126 of sheath 104 of passing through is deflected into Pigtail form, this especially fits makes current sheath 104 stable in target pipeline.In another exemplary embodiment, such as in Fig. 4 Shown in, the distal part 126 ' of current sheath 104 ' is with being particularly suitable for guiding herding for seal wire in target pipeline in the desired direction Sheep cane form (that is, the bending distal end of sheath 104 ' turned back to which closer to the part of side).In another exemplary embodiment In, as shown in FIG. 5, pass through sheath 104 " distal part 126 " to J-shaped form deflection (that is, distal part 126 " along 90 ° Or less arc deviates sheath 104 " more portions of proximal axis and form bending) with target pipeline as another needed for Seal wire is guided in direction.
Current sheath 104 can be by making with sufficiently flexible polymeric material, to house stylet 102 wherein When, stretch the distal part 126 of current sheath 104.Once however, stylet 102 is removed from which, then allow current sheath 104 distal part 126 returns back to the form of its bending.In one exemplary embodiment, sheath 104 of passing through is strengthened by braiding Polyamide make.In another embodiment, sheath 104 of passing through is formed by multilayer, such as PTFE, braid, for antitorque Bent polyether block amide.
Similarly, expand proximally 128 to distal end, 130 Longitudinal extending including extending through its inner chamber of sheath 104 132.Inner chamber 132 is sized and shaped to house current sheath 104 slidably therein, with can be along current sheath 104 are advanced into target pipeline to expand blocked pipeline, consequently facilitating its drainage.Expansion sheath 106 can be cold expansion device, all Such as Sohendra types expander and/or balloon dilatation catheter.Alternately, it can be thermal expansion prop to expand sheath 106, such as cut capsule Knife or pin knife, which includes electrosurgery ability.For example, expanding sheath 106 may include the electricity along its distal end 130 for burning tissue Pole.Especially, expand sheath 106 can be configured to will expansion sheath 106 insert in target pipeline using electrosurgery dissect with Just expanded or burnt damage stove.In the embodiment that expansion sheath 106 includes electrode, sheath 106 is may include for by electricity Power is delivered to the second inner chamber (not shown) for extending through which of electrode.However, the distal end of expansion sheath 106 can have to be easy to insert Enter any one in the variform in target pipeline.In another example, distal end 130 can be taper.Once current Propulsion in sheath 104 is expanded sheath 106 and is inserted in target pipeline, then expansion sheath 106 may be actuated to expand or open target Pipeline.For example, expand sheath 106 can with positioned at the more than one stepped change diameter with distal end at the discrete distance, Or can have can independent actuation being flared to the more than one extra sheath in the path of target pipeline.
As shown in FIG. 6, Handleset 108 includes grip portions 136 that proximally 138 to distal end 140 extends, is joined It is connected to the distal end 140 of grip portions 136, and the extension 142 that the near-end 128 of expansion sheath 106 can be attached to.It is current Sheath 104 can be contained in grip portions 136 and be attached to grip portions 136, so that current sheath 104 extends through expansion Open the inner chamber 132 of sheath 106.Stylet 102 extends through grip portions 136 and extension 142, wherein stylet 102 Near-end extends from 138 proximad of near-end of grip portions, and the length of stylet 102 extends through the inner chamber of current sheath 104 134.As the near-end 109 of stylet 102 extends from grip portions proximad, therefore can pass through simply relative to Handleset 108 proximads pull stylet 102 and remove stylet 102 from current sheath 104.Distad prolong the distal end 110 of stylet 102 The distal end 124 of current sheath 104 is extended through, once so that system 100 is inserted in body, cone point 122 can then be pierced Wear target pipeline.Handleset 108 also includes actuator 144, and which vertically moves expansion sheath 106 relative to current sheath 104.It is special , actuator 144 not may include lug, its relative to Handleset 108 grip portions 136 distad with proximad movement with Advance in current sheath 104 and retract expansion sheath 106 respectively.
According to a kind of a kind of method of the system 100 of the exemplary embodiment using the present invention, Jing ultrasonic guidances are by interior System 100 is inserted internal target pipeline by the service aisle of sight glass.In insertion form, current sheath 104 can be fully accommodated in The sharp distal tip 122 of stylet 102 is avoided in expansion sheath 106 with the interspersed endoscope for passing through of protection system 100. After insert endoscope, regracting expansion sheath 106, so that the expansion current sheath not in target pipeline is inserted into of sheath 106 Extend on 104 part.Now, the distally extending distal end 124 by sheath 104 of passing through in the distal end 110 of stylet 102.With Afterwards, the distal tip 122 of stylet 102 is distally advanced to pierce through target pipeline.Once by stylet 102 and current sheath In 104 insertion target pipelines, contrast preparation (for example, radiopaque dyestuff) is inserted by target pipeline by the passage 112 of stylet 102 In, so that the user of system 100 can visually verify that pipeline has been filled with fluid and need to carry out drainage.Subsequently, can pass through Stylet 102 is pulled relative to 104 proximad of current sheath and stylet 102 is removed from current sheath 104, so that only logical Row sheath 104 is retained in target pipeline.After stylet 102 is removed, the distal part 126 of the current sheath 104 of release is with reply Form to bending is being anchored at current sheath 104 in target pipeline or guide seal wire by required direction by which.If not Current sheath 104 is anchored in target pipeline, seal wire can be inserted and be entered in target pipeline by the inner chamber 134 of sheath 104 of passing through.With The tip of seal wire is guided to contact the inner surface of target pipeline in direction corresponding with the bend of the distal part of current sheath 104, So that current sheath 104 is anchored at which.Can be by a part of rotating current sheath 104 of control crank component 108, will Bending shape is directed to desired direction.
Once current sheath is anchored in target pipeline, then expansion sheath 106 can be advanced in current sheath 104 Into target pipeline.As described above, being distally moved actuator 144 to push away by the grip portions 136 relative to Handleset 108 P-adic extension p sheath 106.The distal end 130 of expansion sheath 106 is configured to facilitate inserts expansion sheath 106 in target pipeline.One In individual embodiment, start the electrode positioned at distal end 130 and the surface texture of target pipeline is cut and/or burnt with electrosurgery to insert Enter wherein.Expansion sheath 106 can be started to expand target pipeline, make target pipeline expand beyond its obturator to allow to carry out target pipe The drainage in road.It will be apparent to one skilled in the art that expansion sheath 106 can in many ways in any one expansion target pipeline. In an example, expand the expandable balloon that sheath 106 may include to be activated for expanding target pipeline.Those skilled in the art Member will be understood that user can also implement the further process to blocking pipeline.Especially, support can be inserted in target pipeline, will Pipeline be maintained at amplification form in guarantee which proceeds drainage.
It will be evident to one skilled in the art that can exist without departing from the scope of the present invention Various modifications are carried out in the present invention.Therefore, it is contemplated that covering modification and the modification of the present invention, its condition is which will fall in institute In the range of attached claim and its equivalent.
1. it is a kind of for endoscopic ultrasonic guide drainage system, which includes：
Current sheath, which is proximally to distal end Longitudinal extending and current including what is extended through from the near-end to the distal end Chamber；
Stylet, which is slidably received in the current chamber, and the stylet is from its near-end to distal end Longitudinal extending, and wraps The passage for extending through the stylet is included, the passage is configured to accommodating through its fluid；And
Expansion sheath, its from its near-end to distal end Longitudinal extending, and including extend through it is described expansion sheath expansion cavity, to institute The size and dimension for stating expansion cavity is configured slidably to house the current sheath.
2. system according to claim 1, wherein the current sheath includes the distal part to bending shape deflection.
3. system according to claim 2, wherein the current sheath is made up of flexible polymeric materials, the flexible polymer Thing material allows the distal part of the bending to be moved into when being equipped with the stylet wherein and stretches form.
4. the system according to Claims 2 or 3, wherein the bending shape is in pigtail ring, J-shaped and sheephook stock-raising commune Kind.
5. system according to any one of claim 1 to 4, wherein the stylet includes distal part, it with than From the bigger diameter of the residue length of the stylet of its proximad extension.
6. system according to any one of claim 1 to 5, wherein the remote of the stylet is extended through in the passage This part of side part is limited by the annular space that the longitudinal axis around the stylet extends.
7. system according to any one of claim 1 to 6, which also includes being attached to the stylet, current sheath With the Handleset of the near-end of each in expansion sheath.
8. system according to claim 7, wherein the Handleset is included for making the expansion sheath relative to institute State the actuator that current sheath is vertically moved.
9. system according to any one of claim 1 to 8, the expansion sheath include its distal end for burning tissue Electrode.
10. system according to any one of claim 1 to 9, the distal part of the stylet is with than from which near The bigger diameter of the remainder of the stylet that side extends, the diameter of the distal part of the stylet is corresponding to described The diameter in current chamber is to pierce through target tissue.
11. systems according to any one of claim 1 to 10, which also includes being attached to the stylet, current sheath The Handleset of the near-end of each in pipe and expansion sheath.
12. systems according to claim 11, wherein the Handleset include for make it is described expansion sheath relative to The actuator that the current sheath is vertically moved.
A kind of 13. systems for endoscope drainage, which includes：
Stylet, which is slidably received in the current chamber, the stylet from its near-end to distal tip Longitudinal extending, And including the passage of the stylet is extended through, the passage is configured to house through its fluid, the stylet The bigger diameter of remainder of the distal part with the stylet than extending from its proximad, the institute of the stylet The diameter for stating distal part corresponds to the diameter in the current chamber to pierce through target tissue；And
14. systems according to claim 13, wherein the current sheath includes the distal part to bending shape deflection.
15. systems according to claim 14, wherein the current sheath is made up of flexible polymeric materials, the flexibility is gathered Compound material allows the distal part of the bending to be moved into when being equipped with the stylet wherein and stretches form.
CN106535779A true CN106535779A (en) 2017-03-22
CN106535779B CN106535779B (en) 2019-02-12
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