WO2021063024A1 - Anse pour résection de tissu - Google Patents

Anse pour résection de tissu Download PDF

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Publication number
WO2021063024A1
WO2021063024A1 PCT/CN2020/095273 CN2020095273W WO2021063024A1 WO 2021063024 A1 WO2021063024 A1 WO 2021063024A1 CN 2020095273 W CN2020095273 W CN 2020095273W WO 2021063024 A1 WO2021063024 A1 WO 2021063024A1
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Prior art keywords
ferrule
snare
flat wire
wire structure
longitudinal axis
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Ceased
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PCT/CN2020/095273
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English (en)
Chinese (zh)
Inventor
韦建宇
沈正华
李常青
金鸿雁
汤小伟
冯明浩
奚杰峰
唐志
李宁
刘春俊
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Micro Tech Nanjing Co Ltd
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Micro Tech Nanjing Co Ltd
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Publication of WO2021063024A1 publication Critical patent/WO2021063024A1/fr
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/32056—Surgical snare instruments

Definitions

  • This application relates to the field of medical devices, and in particular to a snare for tissue resection.
  • Endoscopic mucosal resection refers to the injection of drugs into the submucosal layer of the lesion (such as sessile polyps, flat or shallow concave polyps, leiomyomas, early cancers of the esophagus, stomach and colon, etc.) to form a liquid cushion and then cut out Techniques for large pieces of mucosal tissue.
  • drugs such as sessile polyps, flat or shallow concave polyps, leiomyomas, early cancers of the esophagus, stomach and colon, etc.
  • polyps can be divided into three types according to their shape: Guangji sessile polyps, Yati polyps and pedicle polyps.
  • the pedicle means the root.
  • Polyps with pedicles are relatively slender polyps. Polyps with pedicles are generally benign; sessile is without obvious roots, and the shape is relatively flat. Generally speaking, malignant polyps are more common; polyps with pedicles are more common. Between the two, it is raised but the root is relatively inconspicuous.
  • the traditional snare ferrule material is woven from multiple strands of stainless steel round wire. The ferrule material is soft and has poor resistance to deformation.
  • snare specifications include seven models including 40mm, 35mm, 30mm, 25mm, 20mm, 15mm and 10mm. Due to the limitation of traditional snare ferrule structure, the diameter of the ferrule (the maximum distance between the two sides of the axial symmetry of the ferrule) rapidly becomes smaller during the process of shrinking the ferrule to the outer tube, and loses the original shape and cannot maintain the original shape under different diameters. The shape of the ferrule is used to trap polyps, which can only be trapped in the original size.
  • the doctor usually needs to predict the size of the patient's lesion first, and then use different sizes of snares to perform EMR surgery under the endoscope. However, during the actual operation, the doctor may misjudge the size of the lesion. It is also possible that after the first polyp (or other lesions) is removed, new polyps are found when the examination is continued, and the diameter is quite different from the previous one. , There is a defect that the same snare cannot be used for polyps or lesions of different diameters, so that doctors have to replace the snare with a new specification, which increases the operation time and the economic burden of the patient is also greatly increased.
  • the purpose of this application is to: in view of the low stiffness of the ferrule in the prior art, the sessile or pedicle polyp cannot be effectively inserted into the snare, and its edge cannot be completely grasped, so that the lesion cannot be completely removed at one time.
  • the performance of taking sessile or yati polyps is poor, and the same snare cannot meet the defects of removing polyps or lesions of different diameters. It provides a snare that has good tissue grasping performance and can continuously reduce diameters and snare lesions of different diameters. Snare.
  • a hollow outer tube with a proximal end and a distal end a cable located in the outer tube and capable of reciprocating along its longitudinal axis; a ferrule arranged at the distal end of the cable, passing along the Move the cable in the longitudinal direction to pull the ferrule into or out of the outer tube, thereby changing the inner snare area of the ferrule; configured to fix the proximal end of the ferrule and the distal end of the cable
  • the fixed portion of the connection; the ferrule is a single-strand flat wire structure, the cross-sectional thickness P of the flat wire structure and the height Q ratio are 1:4 to 1:1.5, wherein the ferrule is axially along the longitudinal axis Symmetrical, and strong bending parts are axially opposite to each other on both sides of the ferrule axial direction, and the strong bending parts are preferably symmetrically arranged.
  • the invention adopts the special design of single-strand flat wire structure and the ratio of thickness P to height Q in the ferrule flat wire structure is controlled in the range of 1:4 ⁇ 1:1.5, which is easier than traditional multi-strand winding wire ferrule.
  • the defect of deformation, the single-strand flat wire structure has stronger resistance to deformation, and can withstand greater force in the height direction of the flat wire without deforming, so that it is easier to press the edge of the polyp tissue and effectively invade the tissue completely into the snare , Improve the efficiency of crawling organization.
  • the strong bending portion is formed by pre-bending the ferrule flat wire structure, and the flat wire structure at the strong bending portion has a strength enhancement structure.
  • the strong bending portion is formed by bending the ferrule flat wire structure to a certain angle in the same plane in opposite directions and then strengthening the bending part to form a strength-enhancing structure.
  • the strength-enhancing structure includes a reinforced coating and a reinforced coating.
  • the material can be reinforced solder and/or reinforced coating.
  • the strength-reinforcing structure in this application may not contain reinforced coating and is formed only by reinforced bending treatment, but by using reinforced coating, such as reinforced solder, reinforced coating , Can improve the deformation resistance of the strong bending part, and improve the technical effect of the overall diameter reduction of the snare without deformation.
  • the ferrule in the present application is based on the bending characteristics of the strong bending part during the recovery process, which slows down the shape of the ferrule in the recovery process and quickly considers the central axis Therefore, the effect of reducing diameter and not deforming is basically realized.
  • the strong bending structure obtained by bending the flat wire in the same plane in opposite directions in the present application guarantees the maximum guarantee in the process of recycling the ferrule
  • the middle bending position and shape are relatively stable, and the overall shape of the ferrule basically maintains the shape of the racket.
  • the ratio of the axial distance d1 of the strong bending part from the distal end to the length L2 of the ferrule along the longitudinal axis is less than 1/2, wherein the axial distance d1 of the strong bending part from the distal end is the strong bending part
  • the length between the axial projection position of the ferrule and the farthest end of the ferrule, the length of the ferrule extending along the longitudinal axis, the value L2 is the distance between the farthest end of the ferrule and the farthest end of the outer tube.
  • the strong bending part When the axial distance d1 of the strong bending part from the distal end is equal to the length of the ferrule extending along the longitudinal axis L2 When the ratio is less than 1/2, or even smaller, the effect of diameter reduction without deformation is the best, and the ability to grasp polyps is the strongest. When 1/6 ⁇ d1/L2 ⁇ 1/2, the strong bending part has the strongest ability to slow down the deformation of the ferrule.
  • the ratio of the ferrule diameter L1 of the snare to the length L2 of the ferrule along the longitudinal axis is 1:4 to 1:1.5, wherein the ferrule diameter L1 of the snare is equal to that of the ferrule.
  • the maximum distance between the two sides of the ring is axially symmetric, and the extension distance of the ring along the longitudinal axis L2 is the distance between the farthest end of the ring and the farthest end of the outer tube.
  • the ferrule When the snare cuts the tissue, the ferrule is pulled into the outer tube from the distal end to the proximal end. When the ferrule continuously enters the outer tube, the diameter of the snare gradually becomes smaller, and the ratio of L1 to L2 gradually changes. Before the middle and ferrule entraps the tissue, based on the bending characteristics of the strong bending part in the ferrule, it can be realized that the shape of the ferrule is basically maintained as a racket-like shape during the continuous change of the diameter of the ferrule, so that the diameter of the ferrule is not deformed. the goal of.
  • the ferrule does not have a bendable and strong bending part, when the ferrule is recovered to the outer tube, when the symmetrical two sides of the ferrule are compressed by the outer tube, the two sides of the ferrule are integrated toward the longitudinal axis. The direction is folded and closed quickly, resulting in the ferrule not having enough time to fully adjust and grasp the polyp tissue, resulting in poor tissue grasping ability of the ferrule.
  • the ratio of L1 to L2 is 1:3 to 1:2.34, and the numerical range of L1 is 10 mm to 40 mm.
  • the flat wire structures on both sides of the ferrule that are axially symmetric have at least an arc-shaped flat wire structure and a straight-line flat wire structure, respectively, and the strong bending portion is located at the flat wire structure of the arc-shaped section flattened toward the straight line. The transition position of the silk structure.
  • the ratio of the cross-sectional thickness P and the height Q of the ferrule flat wire structure is 1:3 to 1:2.
  • cross section of the flat wire structure is rectangular or a fan ring with an opening facing the longitudinal axis of the ferrule.
  • the overall structure of the ferrule is similar to the I-steel structure, which can withstand greater force in the vertical direction of the ferrule plane and is not easy to deform, thereby providing greater holding force for better It is easy to compress the polyp tissue and effectively nest the tissue into the ferrule.
  • the cross-sectional shape of the flat wire structure is a fan ring with an opening facing the longitudinal axis of the ferrule (similar to a C-shape)
  • the arc-shaped opening facing the inner side of the ferrule is easier to fasten and grasp the polyp tissue in the ferrule, and due to the height of the flat wire
  • the upper and lower ends of the direction are curved surfaces, so that the ferrule is adapted to the curvature of the inner wall of the outer tube.
  • the fixing part is a riveting pipe arranged outside the fixed connection end of the ferrule and the cable and located inside the outer pipe.
  • the ferrule is shaped by medical stainless steel, nickel-titanium alloy and cobalt-chromium alloy.
  • This application optimizes the structure of the ferrule wire material to make it easier for doctors to press the polyp through this structure in the clinic, and to completely lift the polyp, especially for flat pedicle or pedicle polyps, it is easier to complete the lesion and Thoroughly nest in the snare, so as to ensure that the polyp is removed more thoroughly.
  • the racquet-like snare for tissue removal realizes the technical effect of adjustable ring diameter gear by providing a strong bending part structure on the ring.
  • the supporting function of the strong bending part in the ferrule is better, and the shape change is flexible.
  • the shape of the ferrule will not change due to the change of the diameter of the ferrule during the tissue removal process.
  • the shape of the ferrule is always similar to the shape of a racket, so it is suitable for lesions of different diameters.
  • the position of the two ends of the flat wire structure of the ferrule in the height direction is basically the same as the relative position outside the outer tube, and the two sides of the ferrule are placed in parallel.
  • the sum of the thickness of the flat wires on both sides is less than the diameter of the outer tube.
  • Figure 1 shows a schematic diagram of the structure of the ferrule in different gears
  • Figure 2 shows a schematic diagram of the distal end of a snare with a tail silver solder joint and a riveted tube on the ferrule;
  • FIG. 3 shows a schematic diagram of the structure of the strong bending part 5 in the ferrule
  • Figure 4 shows a schematic diagram of the ferrule marked with positions L1 and L2;
  • Figure 5 shows a three-dimensional schematic diagram of a flat wire structure with a rectangular cross-section
  • Figure 6 shows the thickness and height markings in the flat wire structure with a rectangular cross-section
  • Figure 7 shows a three-dimensional schematic diagram of a flat wire structure with a fan ring in cross section
  • Figure 8 shows the thickness and height markings in the flat wire structure with an arc-shaped cross-section
  • Figure 9 shows a schematic diagram of the maximum stroke of the handle
  • Figure 10 shows the tooling diagram of the pressure test of the snare ferrule
  • Figure 11 shows a cross-sectional view of a 3*3 multi-strand braided wire in the prior art
  • Fig. 12 shows a cross-sectional view of a 1*7 multi-strand braided wire in the prior art.
  • the working process of the snare in this application as shown in Figure 1, Figure 2 and Figure 9, first select a snare with an appropriate length of the outer tube according to the patient’s lesion site, and then place the snare into the working channel of the endoscope and make the snare
  • the distal end of the outer tube (the distal end refers to the end opposite to the external operating end and located inside the human body) is placed on the lesion site.
  • the control slider 8 on the snare handle 7 is adjusted ( Figure 9) Show) Adjust the diameter of the ferrule 1 of the snare to be slightly larger than the diameter of the polyp, then put the ferrule 1 of the snare on the pedicle of the lesion, and ensure that the lateral plane of the ferrule 1 is approximately parallel to the lateral plane of the lesion.
  • the control slider 8 fixedly connected to the cable 4 on the sliding handle 7 is used to pull the cable 4 toward the proximal end, and the cable 4 drives the ferrule 1 to retract into the outer tube 6.
  • the diameter of the ferrule 1 becomes smaller, but the shape of the racket of the ferrule 1 remains basically unchanged.
  • the polyp is tightened, and the polyp protrudes on the ferrule 1.
  • the high-frequency current of the active device (not shown in the figure) connected to the snare is turned on, and the polyp is cut off under the action of the high-frequency current. If the patient needs to continue to remove polyps or lesions of other diameters, slide the slider 8 on the handle 7 to drive the cable to change the diameter of the snare loop, place the loop 1 on the new lesion to be cut, and continue. Tissue cutting without having to replace new snares of other specifications.
  • the strong bending portion 5 is formed by bending a flat wire structure of the ferrule 1 to a certain angle in the same plane, and then strengthening the bending part to form a strengthening structure, and the strength strengthening structure is reinforced solder and/ Or reinforced coating layer, the flat wire structures on both sides of the axial symmetry of the ferrule 1 respectively have at least an arc-shaped flat wire structure and a straight-line flat wire structure, and the strong bending portion 5 is located in the arc-shaped flat wire structure. The transition position of the wire structure to the straight-line flat wire structure.
  • the preferred structure of the present application is that the straight section at the proximal end of the ferrule, the arc section at the distal end of the ferrule, the proximal end of the straight section and the distal end of the arc section are fixedly connected And form a strong bending part that can be bent.
  • the snare configured for tissue resection includes at least the following structure: a hollow outer tube 6 having a proximal end and a distal end; Pull cord 4; a ferrule 1 arranged at the distal end of the pull cord 4, by moving the pull cord 4 along the longitudinal axis to pull the ferrule 1 into or out of the outer tube 6, thereby changing the
  • the inner snare area of the ferrule 1 is provided at the distal end of the cable with a fixing portion configured to fixedly connect the proximal end of the ferrule 1 and the distal end of the cable 4, and the fixing portion is preferably arranged on the ferrule 1
  • the riveting pipe 3 outside the joint end of the cable 4 and located inside the outer tube 6, can also adopt other existing conventional fixed connection means such as welding.
  • a ferrule is provided at the distal end of the fixed part formed by the ferrule 1 and the cable 4
  • the tail silver solder joint 2 is configured to pre-fix the flat wire structure on both sides of the ferrule axially symmetrical.
  • other conventional fixed connection methods in the prior art can also be used.
  • the flat wires on both sides of the end are pre-fixed, and then the flat wires on both sides of the ferrule 1 are fixedly connected to the cable 4, which improves the deformation resistance of the proximal end of the ferrule and can provide the bending process of the strong bending part on the ferrule. Sufficient supporting force to better realize the technical effect of diameter reduction and non-deformation of the ferrule.
  • the ferrule 1 is a single-strand flat wire structure, the ratio of the thickness P to the height Q of the flat wire structure is 1:1.5 to 1:4, and the ferrule 1 is axially symmetrical along the longitudinal axis, and The two sides of the ferrule that are axially symmetric are respectively provided with strong bending parts.
  • the ferrule 1 is preferably shaped by one or more of stainless steel, nickel-titanium alloy, or cobalt-chromium alloy. Of course, other materials that can be used in the body in the prior art can be used.
  • the overall rigidity of the ferrule of the single-strand flat wire structure is far greater than that of the traditional ferrule structure composed of multiple round wires.
  • the traditional ferrule is usually woven from multiple round wires and adopts 3*3 (It is woven from three silk threads woven by three filaments respectively, see Figure 11 for details) or 1*7 (a silk thread woven from a central filament and six filaments surrounding the central filament, specifically See Figure 12) Braiding specifications, the total outer diameter is controlled within 0.4mm, for example, a 1*7 specification multi-strand ferrule is woven from 7 round wires, and the diameter of each round wire is about 0.16mm. The diameter is small, and the corresponding deformation resistance is relatively small.
  • the cross-sectional height of the single-stranded flat wire ferrule wire is 0.18-0.48mm, and the thickness of the flat wire section is about 0.12-0.2mm.
  • the cross-section of the ferrule wire is preferred.
  • the thickness is about 0.2mm, and when the height is about 0.381mm, the thickness is about 0.127mm.
  • the single-strand flat wire structure adopted in this application has better resistance to deformation and can provide stronger gripping power to the lesion tissue.
  • the cross-section of the flat wire structure can be rectangular.
  • the overall structure of the ferrule is similar to the I-steel structure, which can withstand more in the vertical direction of the ferrule plane.
  • the large force is not easy to deform, which can provide a greater holding force, so that it is easier to press the polyp tissue, and the tissue is effectively inserted into the snare.
  • the cross section of the flat wire structure may be a fan ring with an opening facing the longitudinal axis of the ferrule.
  • the cross section of the flat wire structure is a fan ring with an opening facing the longitudinal axis of the ferrule (similar to C )
  • the arc-shaped opening facing the inner side of the ferrule makes it easier to clasp the polyp tissue in the ferrule, and because the upper and lower ends of the flat wire in the height direction are arc-shaped curved surfaces, the ferrule is adapted to the curvature of the inner wall of the outer tube , When the ferrule slides back and forth in the outer tube, the smoothness is greatly improved.
  • FIG. 10 it is a schematic diagram of the tooling for pressure test of the snare ferrule wire.
  • One end of the ferrule wire structure to be tested is fixed to the fixed tooling structure, and the other free end is used as the test point.
  • the distance between the test point and the fixed point of the tooling It is 20mm.
  • the free end of the ferrule wire deformed to reach a certain pressure distance is recorded, and the pressure required to be applied to the free end is recorded.
  • Table 1 is a list of the different parameters of the flat wire structure ferrule and the existing 1*7 specification ferrule, and the parameter comparison table of the corresponding strength percentage of the different specification ferrule.
  • the abscissa values in the first 6 rows and 5 columns in Table 1 represent the ratio of the thickness P to the height Q of the flat wire section, which are 1:1.5, 1:2, 1:3, and 1:4 (the corresponding specific size examples are 0.12mm/0.18mm, 0.20mm/0.40mm, 0.127mm/0.381mm and 0.12mm/0.48mm), the ordinate value represents the compression distance of the free end of the ferrule when the pressure is tested (the ferrule is perpendicular to the thickness direction) Back deflection distance), the two-dimensional value of the intersection area between the abscissa and the ordinate refers to the pressure (in N) required for the free end of the ferrule corresponding to the PQ value to deviate from 2mm, 4mm... and 10mm, the same pressure Distance, the larger the pressure value, the better the holding performance of the snare made of ferrule wire of this size.
  • the sixth column in the table is the finished product of 1*7 specification ferrule (the part where the end of the snare covers the polyp) which is woven with 7 round wires in the prior art.
  • the total outer diameter of the ferrule wire section is about 0.4mm;
  • the specific meaning of the 6 columns is that when the pressure test of the existing multi-strand round wire ferrule is performed, when the compression distance of the ferrule wire (the deflection distance perpendicular to the length direction) is 2mm, 4mm, 6mm, 8mm and 10mm respectively, the free end deviates
  • the pressure required for 2mm, 4mm... and 10mm is respectively 0.04N, 0.07N, 0.10N, 0.12N and 0.17N.
  • the pressure applied is 0.17N as the reference force value, and the strength percentage is set to 100%, and the same free end deviates by 10mm, and the different PQ size is flat.
  • the pressure to be applied to the wire is 0.15N, 1.05N, 0.30N and 1.10N.
  • the strength percentage of the flat wire ferrule of different specifications is 88%. , 618%, 176% and 647%. It can be seen from this:
  • the P/Q value range of the flat wire cross-section is preferably greater than 1:4 and less than 1:1.5, and P and Q should satisfy 0.1mm ⁇ P ⁇ Q ⁇ 0.48mm.
  • the ferrule structure further includes a strong bending portion 5 arranged symmetrically along the longitudinal axis of the ferrule.
  • the maximum distance between the two sides of the axial symmetry of the ferrule is defined as the ferrule diameter L1 of the snare, and the distance between the most distal end of the ferrule and the most distal end of the outer tube is defined as the extension distance of the ferrule along the longitudinal axis.
  • the value L2 the ratio of L1 to L2 is preferably 1:1.5 to 1:4.
  • Table 2 and Table 3 are comparison tables of different parameters of L1 and L2 and L1/L2 in this application.
  • the abscissa in Table 2 is the ratio of L1 to L2, which are four specifications of 1:1.5, 1:2.34, 1:3 and 1:4 respectively.
  • the ordinate represents the value of the snare ferrule diameter L1; the cross area in the table
  • the two-dimensional data represents the value of L2 (in mm).
  • the abscissa represents the ratio of L1 to L2; the ordinate represents the value of the snare ferrule diameter L1; the intersecting two-dimensional value represents L3 (in mm), where L3 represents the maximum movable movement of the control slider 8 on the handle 7 Stroke (see Figure 9), L3 usually corresponds to the limit of the controllable size of a human finger.
  • the maximum stroke L3 that the slider can move is 240mm, which is relatively large (generally the longest does not exceed 120mm in actual use), which is not conducive to manual operation.
  • L1/L2 is preferably between 1:1.5 and 1:2.34.
  • L1/L2 should be between 1:2.34 and 1:4; snares with L1/L2 greater than 1:4 are not applicable in clinical practice.
  • the strong bending part 5 in the first embodiment or the second embodiment has an enhanced bending structure, which can basically maintain the bending inflection point during the deformation of the ferrule, thereby ensuring that the shape of the ferrule basically maintains the shape of the racket during the process of grasping the tissue. No change, to achieve the technical effect of reducing the diameter without deformation.
  • the strong bending portion 5 is formed by bending the ferrule flat wire structure to a certain angle in the same plane, and then strengthening the bending part to form a strength enhancement structure, wherein the strength enhancement structure is preferably reinforced solder or reinforced coating
  • the solder is preferably a non-breakable and flexible metal material, such as silver, to form a silver solder layer, so as to ensure that the strong bending portion 5 has sufficient bending stability and is not easy to break during the deformation process.
  • the existing conventional flat wire ferrule products without strong bending parts, a certain symmetrical flat wire ferrule product with torsion angle and the flat wire ferrules with strong bending parts in this application have been tested.
  • the change in the diameter of the ferrule during the retraction of the loop further proves that the ferrule in the present application basically realizes the beneficial effect of reducing the diameter and not deforming.
  • the slider on the handle moves to the proximal end to retract the ferrule.
  • the diameter of the ferrule in the three products is measured.
  • the comparison shows that the diameter of the ferrule in this application Compared with the other two products, the decreasing trend is significantly slower, especially when the slider moves a distance of 5-20mm, and this moving distance is an important node in the process of grasping the tissue by the corresponding ring.
  • the reduction of the speed of the ferrule diameter reduction can provide enough time and space for the ferrule to fully adjust and grasp the polyp tissue, which greatly improves the tissue grasping ability of the ferrule.
  • the ferrule in the present application is based on the bending characteristics of the strong bending part during the recovery process, which slows down the shape of the ferrule quickly to the center during the recovery process The tendency of the shafts to move closer, which basically realizes the effect of reducing the diameter and not deforming.
  • the strong bending structure obtained by bending the flat wire in the same plane in opposite directions in the present application guarantees the maximum guarantee in the process of recycling the ferrule
  • the middle bending position and shape are relatively stable, and the overall shape of the ring basically maintains the shape of the racket, which effectively improves the gripping ability of the ring.
  • the two sides of the ferrule that are axially symmetric include at least an arc-shaped flat wire structure and a straight-line flat wire structure, respectively, and the strong bending portion 5 is configured to form the two-segment flat wire structure.
  • the ends are fixedly connected and form a bendable structure, wherein any one of the two flat wire structures is a straight or arc-shaped section extending along the length of the flat wire.
  • the position of the strong bending part 5 is preferably It is the transition position from the straight section to the arc section.
  • the bending feature of the strong bending part can be used to ensure that when the ferrule enters the outer tube, the distance between the flat wires on the two sides of the axial symmetry of the ferrule does not quickly close, and the overall shape of the ferrule Basically maintain stability.
  • the distal end of the ferrule is a straight section and the proximal end is an arc section.
  • the transition area between the proximal end of the straight section and the distal end of the arc section constitutes a strong bending part. 5.
  • the ferrule structure is relatively simple, stable and reliable, and can realize that the ferrule shape is basically a racket shape during the process of grasping the tissue, achieving the technical effect of changing the diameter and not deforming during the process of grasping the tissue.
  • the ratio of the axial distance d1 (as shown in FIG. 4) between the strong bending portion from the distal end and the extension distance L2 of the ferrule along the longitudinal axis is less than 1/2.
  • the distal axial distance d1 is the length between the strong bending part in the axial projection position of the ferrule and the farthest end of the ferrule, and the length of the ferrule extending along the longitudinal axis is the distance L2 is the distance between the farthest end of the ferrule and the outer tube.
  • the axial distance d1 from the distal end of the strong bending part to the ferrule extends along the longitudinal axis.
  • the ratio of the distance value L2 is less than 1/2, or even smaller, the effect of changing the diameter without deformation is the best, and then the ability to grasp the polyp is the strongest.
  • This embodiment illustrates the difference in the effect of reducing the diameter of the ferrule without deforming under different d1/L2.
  • the anti-deformation performance is correspondingly weakened.
  • the strong bending part has the strongest ability to slow down the deformation of the ferrule.
  • the ferrule is provided with a scale, and a laser is used to mark the side of the flat wire as a measurement scale, so that the doctor can better compare the size of the polyp or lesion under the endoscope and accurately estimate The size of the lesion, using a video screenshot to accurately save the size of the polyp, provide original and accurate data for future precise treatment.
  • the scale on the snare can help the doctor estimate the size of the lesion, so that the doctor can accurately determine the volume of the lesion and avoid judgment errors.
  • the height of the ferrule flat wire structure is 0.38mm and the thickness is 0.13mm.
  • the total thickness of the flat wire is 0.26mm
  • the cable diameter is 0.8mm
  • the inner diameter of the outer tube is 1.5mm. According to this parameter, the ferrule is easy to be pulled in the outer tube for reciprocating motion after being folded.
  • the positions of the two ends in the height direction of the ferrule flat wire structure are basically the same as the relative position outside the outer tube.
  • the two sides of the ferrule are placed in parallel, and the two sides of the ferrule are flat.
  • the sum of the thickness of the wire is smaller than the diameter of the outer tube.
  • the present application realizes snares with a ferrule diameter L1 ranging from 10mm to 40mm by providing a strong bending part.
  • the minimum scale of each size of snare is 5mm or 10mm. It can completely meet the requirement of the same specification snare to excise polyps of different diameters.
  • the ferrule diameter L1 of the ferrule refers to the maximum distance between the two sides of the axial symmetry of the ferrule.
  • the size of the snare provided is 40mm.
  • the snare can be adjusted before the polyp is trapped. Perform pre-operation and change its ferrule diameter L1 to 30mm. At this time, the snare still maintains the original racket shape. Then, the snare loop in this state is placed around the polyp, and then the diameter of the loop is reduced at this time to complete the process of grasping the polyp tissue.

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  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne une anse pour résection de tissu, comprenant un tube externe creux (6) pourvu d'une extrémité proximale et d'une extrémité distale, un élément de traction (4) placé dans le tube externe (6) et pouvant effectuer un mouvement de va-et-vient dans une direction axiale longitudinal, et une boucle (1) disposée au niveau de l'extrémité distale de l'élément de traction (4) ; la boucle (1) présente une structure de fil plat à simple brin, le rapport de l'épaisseur P à la hauteur Q de la section transversale de la structure de fil plat est de 1:4 - 1:1.5, la boucle (1) est axialement symétrique dans la direction axiale longitudinale, et des parties de flexion de renforcement (5) sont disposées sur deux côtés axiaux de la boucle (1) et axialement opposées l'une à l'autre. La présente invention peut renfermer efficacement, complètement dans la boucle (1), un polype sessile ou semi-pédonculé et obtenir essentiellement l'effet technique de ne pas se déformer tout en changeant le diamètre, ce qui améliore considérablement l'effet de capture d'un polype relativement plat par la boucle (1).
PCT/CN2020/095273 2019-09-30 2020-06-10 Anse pour résection de tissu Ceased WO2021063024A1 (fr)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN117281588A (zh) * 2023-09-20 2023-12-26 杭州安杰思医学科技股份有限公司 一种圈套器

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110584749B (zh) * 2019-09-30 2024-04-30 南微医学科技股份有限公司 一种用于组织切除的圈套器
CN112451053A (zh) * 2020-12-15 2021-03-09 南微医学科技股份有限公司 一种冷圈套器

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2001252280A (ja) * 2000-03-14 2001-09-18 Asahi Optical Co Ltd 内視鏡用スネア
US20150066045A1 (en) * 2013-09-03 2015-03-05 United States Endoscopy Group, Inc. Endoscopic snare device
CN105530875A (zh) * 2013-03-15 2016-04-27 波士顿科学国际有限公司 组织切除圈套器
CN107920824A (zh) * 2015-05-15 2018-04-17 维兰德.K.沙马 可变柔性的勒除器
CN208769982U (zh) * 2018-04-09 2019-04-23 扬州发特利医疗器械科技有限公司 一种高分子涂层圈套器
US10299858B2 (en) * 2014-12-23 2019-05-28 Cook Medical Technologies Llc Variable thickness electrosurgical snare
CN110584749A (zh) * 2019-09-30 2019-12-20 南微医学科技股份有限公司 一种用于组织切除的圈套器
CN210962216U (zh) * 2019-09-30 2020-07-10 南微医学科技股份有限公司 一种用于组织切除的圈套器

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2000083963A (ja) * 1998-09-14 2000-03-28 Asahi Optical Co Ltd 内視鏡用スネア
JP4420523B2 (ja) * 2000-04-12 2010-02-24 Ｈｏｙａ株式会社 内視鏡用スネア
WO2015054410A1 (fr) * 2013-10-10 2015-04-16 Boston Scientific Scimed, Inc. Dispositif de résection de tissu
CN103750881B (zh) * 2014-02-14 2016-01-20 胡兵 一种冷热一体的圈套器
JP2017136188A (ja) * 2016-02-03 2017-08-10 株式会社八光 内視鏡用スネア
CN106983539B (zh) * 2017-05-08 2020-05-19 南微医学科技股份有限公司 一种医用可旋转圈套器
JP6761378B2 (ja) * 2017-06-13 2020-09-23 オリンパス株式会社 内視鏡用処置具
WO2019104355A1 (fr) * 2017-11-27 2019-05-31 Rafic Saleh Anse endoscopique
JP2021065244A (ja) * 2018-01-19 2021-04-30 オリンパス株式会社 内視鏡用処置具

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2001252280A (ja) * 2000-03-14 2001-09-18 Asahi Optical Co Ltd 内視鏡用スネア
CN105530875A (zh) * 2013-03-15 2016-04-27 波士顿科学国际有限公司 组织切除圈套器
US20150066045A1 (en) * 2013-09-03 2015-03-05 United States Endoscopy Group, Inc. Endoscopic snare device
US10299858B2 (en) * 2014-12-23 2019-05-28 Cook Medical Technologies Llc Variable thickness electrosurgical snare
CN107920824A (zh) * 2015-05-15 2018-04-17 维兰德.K.沙马 可变柔性的勒除器
CN208769982U (zh) * 2018-04-09 2019-04-23 扬州发特利医疗器械科技有限公司 一种高分子涂层圈套器
CN110584749A (zh) * 2019-09-30 2019-12-20 南微医学科技股份有限公司 一种用于组织切除的圈套器
CN210962216U (zh) * 2019-09-30 2020-07-10 南微医学科技股份有限公司 一种用于组织切除的圈套器

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN117281588A (zh) * 2023-09-20 2023-12-26 杭州安杰思医学科技股份有限公司 一种圈套器

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