Method for rear retroperitoneal adrenalectomy perfomance
SUBSTANCE: rear retroperitoneoscopic adrenalectomy is performed through an incision to 30 mm under the 12th rib end. The workspace is created using an endoscope tube. Along the wound edges two punctures for the endoscope and working tool are made. Detection of adrenal gland tumours is performed. First, the lower part of the adrenal gland, then the side surfaces are subjected to mobilization, then the adrenal gland central vein is suppressed, and the rear surface is mobilized. The upper part is the last to be suppressed.
EFFECT: method eliminates the costly special equipment, reduces pain in the postoperative period and provides a good cosmetic effect due to operation according to a specially developed algorithm of adrenal gland selection from the surrounding tissues.
4 cl, 1 tbl, 2 ex
SUBSTANCE: system comprises a guide assembly, an extendible support unit and a working element. The support device is connected to the distal end of the guide assembly. The working element is mounted on the extendible support unit. The extendible support device can be transformed between the compressed and extendible configurations. The extendible support device can rest on one or more flexible supports in parallel with the axis, about which the extendible support device is compressed and/or on a number of ribs. The ribs are arranged as a structure configured to maintain the transformation of the extendible support device between the compressed and extendible configurations. The guide assembly can be configured to provide torsion transmission to the extendible support device. The working element can comprise a number of electrodes in parallel with the axis about which the extendible support device compresses.
EFFECT: improving operational characteristics.
121 cl, 35 dwg
SUBSTANCE: puncture device for diagnostics and treatment of traumas and diseases of abdominal organs represents universal trocar. Trocar contains casing in form of two semi-tubes and circle dissected by diameter. Circle has opening for stilet in the centre and is divided into two halves. Halves are connected in mobile way by means of lock. Tags of side are made to open casing when pressed. Triangular segment, equal to circle radius in height, is excised from circle. Semi-tubes are 100 mm long and are welded to edges on lower surface of circle. Circle is made of metal.
EFFECT: reduction of intervention trauma.
SUBSTANCE: invention relates to medicine. Set of telescopic cannula with blocking contains multitude of telescopic tubes, made, all together, with such shape and dimensions as to reach specified place relative to anatomical area. Each tube has preliminarily installed blocking shape. Construction of internal tube, inserted into external tube, contains clearance between tubes, which are blocked with each other inside clearance to limit turn of tubes relative to clearance. Blocking shapes of tubes can be similar or different. Examples of blocking with each other shapes are as follows: polygonal blocking shape, blocking shape in form of non-circular closed curve, combined blocking shape in form of polygonal curve and blocking shape in form of spline.
EFFECT: orientation to tubes, set by planning device, is provided.
14 cl, 22 dwg
SUBSTANCE: invention refers to medical interventions, namely to percutaneous interventions by means of a needle for diagnosing a wide spectrum of diseases. A system for the tissue inspection and use in various inspections comprises a console comprising a number of data processing algorithms from a number of various types of needle configuration with each type used for specific intervention in certain anatomical area, and the coupled needle configuration of certain type from a number of various types of the needle configurations. The algorithms comprise a tissue analysis and classification algorithm for each differing intervention and are specified depending on the specific type of the needle configuration. The console is used with the needle configuration presented to display optical data, and adapted for executing a number of optical data processing algorithms obtained from the needle configuration.
EFFECT: using invention enables providing higher-accuracy optical characterisation of the tissue.
12 cl, 5 dwg
SUBSTANCE: invention refers to disposable surgical instruments and can be used as a trocar. A disposable device consists of a kit (a port, a mandrin, a T-connector, a drain tube and sealing covers), which is assembled in specific combinations to perform various manipulations for monitoring a pathological process in the abdominal cavity through the presented device without a repeated laparocentesis. The kit parts are hermetically coupled. An inner surface of a port nozzle has fittings to shape the inner surface of the nozzle wavily to reduce friction. The port is made of an elastic polymer material, while the mandrin is made of a polymer material. The T-connector is made of a rigid polymer and has a branch pipe to form a pneumoperitoneum. A laparoscope or an elastic drain tube can be inserted through the T-connector and port to monitor the pathological process in the abdominal cavity and to perform low-invasive interventions without the repeated laparocentesis.
EFFECT: dynamic monitoring of the abdominal cavity, excluding the negative effect on the body tissues and combining the principles of a searching catheter, laparoscopy, dynamic laparoscopy and passive drainage.
SUBSTANCE: laparoscopic gastrofundoplication is performed. The gastric fundus is mobilised. A tunnel is formed behind the oesophagus. The gastric fundus around the oesophagus is closed with two lines of interrupted sutures in the form of a fundoplication cuff. The first line of sutures is applied with underruning the gastric walls through all the layers with involving the muscular layer of the oesophageal wall. The second line of sutures is applied with involving the seromuscular layer only of the gastric walls immersing the first line of sutures.
EFFECT: reducing a rate of migration, opening and rupture of the fundoplication cuff by its reliable fixation within the oesophagus.
5 dwg, 1 ex
SUBSTANCE: invention refers to medicine, namely to surgery. A biopsy is performed, and a bipolar drain tube is inserted into the bile ducts. A terminal end of the X-ray contrast drain tube is preliminarily notched along the long axis. A recurrent biopsy is performed on the 10-14th day. The external drain tube is removed. The biopsy forceps 3.5 cm is inserted along a fistulous passage. The bile ducts are contrasted by inserting a thin X-ray contrast catheter guide. A histological material is sampled under X-ray control.
EFFECT: method for the direct punch biopsy of the tumour along the fistulous passage reduces injuries and provides the higher diagnostic accuracy.
2 ex, 9 dwg
SUBSTANCE: invention refers to medicine, specifically to surgery. An abdominal paracentesis is performed. A puncture is made with a trocar with a 25-cm tube in the McBurney point. The tube is arranged at an angle of 23-30°. The tube is advanced in parallel with the inguinal ligament along the lateral abdominal cavity to the small pelvic cavity. A trocar cuff is fixed to the skin of the abdominal wall. A 100-175-cm drain tube is put on a proximal end of the trocar tube and fixed. An aspiration is adjusted by a clamp for 1-2 days. The method enables removing ascites by external fraction adjustable aspiration drainage in ascites.
EFFECT: provided integrity of the liquid removal and prevented complications.
2 dwg, 1 ex
SUBSTANCE: invention can be used for emergency actions in penetrating wounds and closed chest injuries with the pulmonary injury accompanied by a developing pressure pneumothorax followed by intrapleural haemorrhages both in time of peace, and in time of war on the battlefield. A kit for the pleural cavity drainage and pneumo- and hemopneumothorax elimination contains a drainage unit, a disposable package and an anaesthetic bottle. As the drainage unit, the kit contains a syringe-trocar comprising a drain tube with a side hole at the working end. Inside the drain tube, there is a piston cylinder having a hollow intermediate portion at the end with a blade with sharp outer edges passing a hollow injection needle of the syringe.
EFFECT: invention provides the fast, painless, effective pneumo- and hemopneumothorax elimination in injured people with chest cases or closed chest injuries with the pulmonary injury followed by intrapleural haemorrhages in the field, in sites of crash, in ambulance cars, at medical evacuation or in hospitals.
5 cl, 2 dwg
SUBSTANCE: patient's constitution is typed to localise trocar ports. A dolichomorphic constitution requires localising a trocar port 5 cm above the navel; the second port is found on a line between the superior anterior iliac spine 2 cm in the medial direction from the left superior anterior iliac spine; the third trocar port is located on the right anterior axillary line 2 cm above the navel. If the patient has a mesomorphic constitution, the first trocar port is situated 2 cm above the navel along the mid-line; the second trocar port is found on a concurrence of a line passing along an external edge of the left abdominal rectus muscle and a line between the superior anterior iliac spines; the third trocar is inserted on the right anterior axillary line at the level of the navel. For the patients having a brachymorphic constitution, the first trocar point is localised 2 cm below the navel along the mid-line; the second trocar is inserted on a concurrence of the mid-line and the line between the superior anterior iliac spines; the third trocar port is found on the right anterior axillary line 2 cm below the navel.
EFFECT: method provides finding the ports for laparoscopic appendectomy taking into account the patient's constitution.
SUBSTANCE: pre-operative fasting venous blood 1 ml is sampled at room temperature 20-24°C into an anticoagulant-free vacuum system (test tube). The test tubes are delivered in a sealed container at temperature 2-8°C for 2 hours to a laboratory for immunoenzyme assay and analysed to determine anti-thyroid stimulating hormone receptor antibodies. If the antibody level is 1.5 units/l or more, a thyroidectomy is performed, whereas the antibody level of less than 1.5 units/l requires performing a subtotal thyroid resection according to standard techniques.
EFFECT: invention enables reducing a probability of recurrent thyrotoxicosis in the patients after subtotal thyroid resection.
SUBSTANCE: group of inventions relates to medicine. A laparoscopic surgical device contains a detachable instrument. The instrument contains an external rod and an internal drive plunger, which can be connected to each other in a detachable or a non-detachable way. The handle of the device contains a two-button mechanism for the engagement and release of a detachable, tool-containing rod. The two-button mechanism is made with a possibility of engagement with matching holes of the external rod and the internal plunger, which extends through the external rod.
EFFECT: handle contains a convenient in operation locking device, which provides the reliable fixation and convenient detachment of the tool end unit.
20 cl, 5 dwg
SUBSTANCE: left total nephrectomy is performed. A kidney is approached by forming an oval window into a mesocolon of a descending colon. The window area is limited by: v. mesenterica inf, arcus Riolani, a. colicae sin and a tail of pancreas. A ligament of Treitz, a peritoneum and mesocolon tissues are incised. A free oval area of the mesocolon and peritoneum are left on the kidney. The kidney is evacuated through the mesocolon window. The mesocolon is left open. A strand of a greater omentum is placed into a retroperitoneal cavity formed after the kidney has been removed. In specific case, the kidney is mobilised together with an adrenal gland.
EFFECT: method enables optimising the surgical procedure by eliminating the stage of intestinal mobilisation, leads to the fastest postoperative intestinal functional recovery.
3 cl, 2 ex
SUBSTANCE: peritoneum and mesocolon tissues of a descending colon are incised above an involved region and above a vascular renal pedicle to perform a left partial nephrectomy. Through the local mesocolon incision above the vessels, a renal artery is filopressed and compressed for thermal ischemia. A new growth is incised and evacuated through the mesocolon incision made above the involved region of the kidney.
EFFECT: method provides the ergonomic approach through a minimum thickness of the mesocolon tissues, minimises the risk of intestinal and splenic injuries and development of complications, ensures the fast postoperative intestinal functional recovery.
2 cl, 2 ex
SUBSTANCE: planned skin incision is first configured on an anteriolateral neck surface by projection zoning of a clavisternomastoid and a neck median line to be marked with colour graphic lines. A first line extends along a medial border of the clavisternomastoid. A second line extends from a suprasternal notch to the middle of a hyoid shaft. Both of the lines are then combined by drawing a perpendicular third line from a lower border of the middle of a hyoid shaft to the medial border of the clavisternomastoid, thereby forming a projection triangle. Cutaneofascial layers, platysma and subcutaneous fat are incised along the first and third lines to cut out a musculocutaneous flap, which is brought outwards. Underlying soft tissues are dissected to an anterior surface of cervical spinal bodies by splitting subcutaneous fat between a neurovascular bundle and a pharynx, detaching an intracervical fascia, splitting perioesophageal subcutaneous fat and displacing midline organs of the neck in the medial direction, and the neurovascular bundle - in the lateral direction.
EFFECT: method enables reducing a risk of treatment-induced traumatic injuries of the midline organs of the neck, an upper laryngeal nerve, upper and lower thyroid arteries, as well as a parenchyma and an excretory duct of a submandibular salivary gland with optimising topographo-anatomical relations of the incision wound structures, thus providing a surgical angle approaching 90 degrees.
SUBSTANCE: muscle of the neophallus is mobilised. A corset is formed intra-operatively according to the diameter and length of a mobilised muscle from a mesh with non-absorbable polypropylene 0.5-0.6 mm thick monofilaments, with the porosity of 85-90%, with run-proof edges in case of resection. The muscle is circularly wrapped up with the formed corset.
EFFECT: provision of the sufficient rigidity of the neophallus and elimination of its deformation due to the application of the corset, formed from the mesh with non-absorbable polypropylene monofilaments.
SUBSTANCE: invention relates to medical equipment, namely to sealing device for reparation of heart defect and vessel diseases in the process of performing surgical operations for treating such diseases as patent foramen ovale (PFO) or heart stunt, vascular system diseases, etc. Sealing device contain stretchable frame ad sealing element. Frame contains multitude of wires, each of which passes from proximal end to distal end of frame. First and second segments from multitude of wires form wound proximal loop and distal loop respectively. Multitude of wires form proximal disc and distal disc when sealing devise is extended. Proximal disc and distal disc are located between proximal and distal loops. Each wire from multitude of wires forms respective petal of proximal disc and respective petal of distal disc. Respective petals form zones of overlapping and unsupported sections. Sealing element, at least, partially encapsulates extending wire frame.
EFFECT: invention has improved compatibility with heart anatomy, it is easier to extend, reposition and return into initial condition in the place of opening.
25 cl, 16 dwg
SUBSTANCE: invention refers to medicine, namely surgery, and can be used for treating aseptic pancreonecrosis. Intra-organic pulseless pancreatic segments are localised and removed. To cover the pancreas, a greater omentum is incised into two portions - 1/3 from the left and 2/3 from the right up to a base of the greater omentum. Segments with pulse oscillation amplitude not less than 3.0 mm in the left 1/3 of the greater omentum and not less than 2.0 mm in the right 2/3 of the greater omentum are localised. The left portion in the distal segment is anchored with U-sutures to peripancreatic subcutaneous fat, whereas the right portion in the distal segment is anchored to a right hepatic lobe.
EFFECT: method enables arresting the disease progression and preventing infected pancreatic necrosis, improving pancreatic tissue blood supply by detecting the intra-organic pulse, removing all necrotic portions of the pancreas and using the greater omentum to cover the pancreas.
3 dwg, 2 ex
SUBSTANCE: distal pancreas resection is performed. That involves transecting a parenchyma to the right from a superior mesenteric vein. That is followed by a resection of an anterior surface of the pseudocysts of the head of pancreas. A Roux pancreatocystojejunoanastomosis with isolated enteric loop is created.
EFFECT: reduced intraoperative injuries and risk of postoperative complications, lower extent of the operation, preserved portion of the pancreatic parenchyma and physiological passage of food and bile in the gastrointestinal tract by the distal pancreas resection and created pancreatocystojejunoanastomosis with the cyst walls and the anterior surface of the head of pancreas.
SUBSTANCE: invention refers to systems for applying a filling material onto a working surface and can be used for applying a multicomponent compound, such as a surgical filling material for a tissue mass. A mixture feed device comprises a Luer mandrel sub-assembly, a cannula and a nozzle atomiser sub-assembly. The Luer mandrel sub-assembly is formed to contact at least two containers and forms the first and second fluid pipes of the mandrel for facilitating the flow of the first and second components. The cannula comprises the first and second cavities carrying the fluid. Each cavity is fluid connected to one of the first or second fluid pipes of the mandrel. The nozzle atomiser sub-assembly is arranged at the end of the cannula and involves at least a part of a nozzle insert placed into a nozzle cap. The nozzle cap has an end wall with an outlet therein. The nozzle insert and nozzle cap form at least three feed channels and are configured to limit at least three fluid passages in three respective feed channels. Each of the three feed channels is fluid connected to the fluid passage.
EFFECT: more effective mixing of the components, prevented cross-contamination of the components and facilitated fluid feed.
12 cl, 25 dwg
SUBSTANCE: method involves applying one or two parallel through draining tubes having lateral perforations. Flow lavage of the retroperitoneal space with antiseptic solutions is carried out via the perforations at room temperature and cooled solutions are administered concurrently with vacuum suction. Omental bursa is concurrently drained using the two parallel through draining tubes. Flow lavage of the omental bursa is carried out using these tubes.
EFFECT: enhanced effectiveness of treatment in healing pyo-inflammation foci.
5 cl, 1 dwg