Method for predicting potential efficacy of endoscopic treatment of vesicoureteral reflux
SUBSTANCE: invention relates to medicine, surgery. Predict the effectiveness of endoscopic treatment of vesicoureteral reflux in children. At the mouth of the ureter, a ureteral catheter with a measuring scale is inserted through the working channel of the cystoscope. Cystoscope is deflected axially upwards relative to plane of operating table by no more than 20°. Model the endoscopic correction of the shortening of the submucosal ureter. Deformation of ureteral anterior wall is visually determined when end of catheter is moved from intramural to submucosa. Determine the length of the submucosa of the ureter. Length of no more than 2 mm is regarded as adverse predictor of the effectiveness of endoscopic treatment.
EFFECT: method for predicting the potential efficacy of endoscopic treatment of vesicoureteral reflux is proposed.
1 cl, 2 dwg, 3 tbl
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: invention relates to medical equipment, namely to instruments for measuring length of cervix of uterus in vaginal vault and cervix of uterus dilation. Device for measuring cervix of uterus length contains elongated measuring unit, hollow unit, flange, handle and lock mechanism. Elongated measuring unit extends along longitudinal axis and includes measuring scale located on it. Hollow unit is coaxial with elongated measuring unit and is located above it. Flange is displaced from longitudinal axis and is fixed to distal end of hollow unit. Handle is fixed to proximal end of measuring unit. Lock mechanism is made on handle. Lock mechanism is made with possibility to fix hollow unit relative to measuring unit in case of blocking, and in case of de-blocking to provide possibility for hollow unit to slide along measuring unit and to rotate around longitudinal axis in such a way as to place flange in required position of rotation without moving measuring scale. Proximal end of hollow unit is made with possibility of sliding in handle.
EFFECT: invention provides simplicity, ease and accuracy of performing measurements.
11 cl, 8 dwg
SUBSTANCE: animal is placed on the movable thermostated preparation microscope stage. Median laparotomy is carried out. Bleeding is stopped by thermocoagulation, fixing the wound edges using ligatures. Paramedial incision is made in the right at the level of lower third of abdomen, through which the removable hollow light guide of cylindrical shape is inserted into the abdominal cavity and it is filled with indifferent oils or normal saline. The mesentery of small intestine is thrown on the upper end of the light guide and biomicroscopy is carried out using a fixed camera for a microscope, connected to the personal computer, the results are recorded at various stages of research, followed by treatment of the data obtained, using a computer program.
EFFECT: method eliminates drying and adhesion of the area under study, as well as bending the vessels, which enables to perform long-term studies.
SUBSTANCE: method of detecting pathology of respiratory organs includes the visual examination of the tracheobronchial tree with the application of an optic system of a bronchoscope. The bronchoscope is introduced into the tracheobronchial system, with the control of the introduction depth, position of the bronchoscope is changed and listening to acoustic phenomena in real time at different levels of the tracheobronchial tree is realised. For this purpose used is an acoustic sensor, installed in a detachable way in the instrumental channel of the bronchoscope and made in the form of a microphone and connected to means for registration, recording and analysis. Zones of the tracheobronchial tree are simultaneously subjected to visual examination. A zone of the tracheobronchial tree affection is determined by data of visual examination and the form and intensity of the acoustic phenomena. The bronchoscope includes an elongated tube with the instrumental channel for the installation of detachable surgical instruments and an optic channel for the detachable optic system and the acoustic sensor, installed in a detachable way in the instrumental channel.
EFFECT: increased accuracy of pathology detection in real time.
2 cl, 1 dwg
SUBSTANCE: invention relates to medicine and can be applied for the fixation of an external endoscope catheter. Fastening elements are made in the form of two mechanically conjugated semi-rings, facing opposite sides, the internal diameter of which corresponds to the external diameter of the catheter and the external diameter of the endoscope, the width of the smaller ring constitutes 2-6 catheter diameters, and the width of the larger ring constitutes 1-4 endoscope diameter(s).
EFFECT: device makes it possible to increase exploitation reliability.
2 dwg, 3 ex
SUBSTANCE: invention relates to medicine, namely to neurosurgery, neurooncology, and can be used for the treatment of glial brain tumours of a supratentorial localisation. For this purpose photodithazine in a dose of 1 mg/kg of body weight is introduced to a patient 2 hours before the tumour ablation. After that, surgical access to the tumour is performed. The operation wound is illuminated by blue colour with a wavelength of 400 nm, and the tumour boundaries are determined by means of fluorescence of photodithazine, selectively accumulated in the tumour tissue. The tumour is ablated under control of the tumour luminescence in blue colour with the application of an operation microscope. After that, a flexible light guide from a radiation source with a wavelength of 662 nm and power of 2.0 W with a light dispersing nozzle is placed into the tumour bed and the perifocal zone of the tumour is irradiated. The dose of irradiation is determined by the disappearance of fluorescence.
EFFECT: method provides an increase of the treatment efficiency due to the reliable clear determination of the tumour tissue boundaries with the normal brain substance independent on the malignancy degree and character of the tumour growth, with an increase of its ablation radicality, as well as due to the destruction of cells, located in the perifocal zone.
2 cl, 1 ex
SUBSTANCE: duodenoscopy is performed with the use of an endoscope with its inspection window on the side. The greater duodenal papilla is visualised. It is cannulated with a Teflon catheter with a working end having an aperture in the middle. An end face of the working end of the catheter is inclined at an angle of 45°. Two apertures of 0.2 cm in diameter are arranged oppositely diametrically on its sides. The first aperture is arranged at 0.4 cm from the end face. The second is found at 0.8 cm. A metal lift is actuated to advance the catheter into a lumen of the common bile duct. A sterile syringe is attached to a connector of the catheter; the syringe is pulled out to draw the bile into the catheter. The syringe piston is pulled out to a 8 ml mark and then released. The manipulation is repeated until the bile penetrates into the syringe. After the bile ingress into the syringe is visualised, the piston is pulled out to a 5 ml mark. A 2-second pause is made. The piston is released. In the course of bile aspiration, the catheter is advanced along the common bile duct 1-2 cm above.
EFFECT: method enables fast and effective bile aspiration from the lumen of the common bile duct, preparation of the material free from the intestinal discharge and pancreatic fluid, as well as reduces a risk of the catheter suction to a wall of the common bile duct ensured by the catheter structure and a certain sequence of the syringe piston motions.
4 dwg, 1 ex
SUBSTANCE: group of inventions refers to medicine. An optical probe comprises: an optic guide with a distal end; a drive body and system with driven coils displacing the distal end by a displacement force. The optic guide is integrated inside the body so that the distal end can be displaced in relation to the body. Exciting current is corrected by a drive train with a feedback circuit. The feedback circuit determines an adjustment member and comprises: a unit for current feed to the driven coils; a unit for temporary exciting current cut-off and a unit for comparing a specified position and measured speed. The unit for temporary exciting current cut-off comprises a switch; a measuring chain configured to measure a speed of the distal end. The unit for comparing is configured to: measure the specified speed from the specified position and to compare the specified speed and the measured speed to derive a difference; or to determine the measured position from the measured speed and to compare the specified position and the measured position to derive the difference, thereby correcting the exciting current, if the difference exceeds the specified level. An optical visualisation system comprises: an optical probe, an emitting source and an emission sensor optically connected to the optical probe.
EFFECT: using the given group of inventions enables eliminating the onset of artefacts in image construction from the probe travel.
10 cl, 6 dwg
SUBSTANCE: invention can be used for the purpose of the early prediction of a risk of peripheral vitreochorioretinal dystrophies (PVCRD) on a paired eye after regmatogenous retinal detachment (RRD) surgeries. The IL18 content in the sub-retinal fluid (SRF) taken intraoperatively from an RRD eye is measured; if the measured value makes 550 pcg/ml, the PVCRD is predicted on the paired eye.
EFFECT: invention enables the preventive treatment of the paired eye in case of the risk of the developing PVCRD before the clinical manifestations of the developing PVCRD in the individual with operated retinal detachment on the other eye.
SUBSTANCE: invention refers to medicine, to surgery. A patient is fixed on a surgical table. An anaesthesia care is provided. That is followed by approaching from a superior-median laparotomy. Wound retractor hooks have an effect on the ribcage and breast bone. That is combined with forming a surgical approach, first by separating the incision wound edges with two rib hooks for normosthenic, asthenic and hypersthenic types.
EFFECT: method provides the adequate wound opening with the low number of patient's injuries, improves the objective control when performing the surgical approach.
2 dwg, 2 tbl
SUBSTANCE: endoscope with a variable scan direction configured so that to insert the device into a human or animal cranial cavity; it comprises an extended body having a proximal end, a distal end and an outer diameter equal to no more than approximately 5mm, an inspection window along the body on the distal end or thereby, an in-built rotary prism integrated into the body close to the distal end, designed for varying the endoscope scan direction, and built into a case functionally mated with a rotating axis directed proximally; a distal portion of the axis is threaded to engage with teeth on the case; there are also provided a self-focusing lens inside the body and automatically focusing an image displayed in the inspection window as the prism rotates, and a handle connected to the proximal end of the extended body. The handle comprises a first rotating dial to adjust a viewing angle of the endoscope by turning the prism, and the first dial rotates about a long axis of the body.
EFFECT: device enables avoiding the intraoperative removal of a lesser pancreas.
10 cl, 31 dwg
FIELD: medicine, pulmonology.
SUBSTANCE: one should perform lovage in three stages:during the 1st stage one should carry out lovage of tracheoalveolar tree for 3-4 min with 60-80 ml 0.08%-sodium hypochlorite solution, at the 2nd stage one should introduce 5-7 ml 10%-fluimucyl solution into tracheobronchial tree for 4-6 min, and at the 3d stage one should perform lovage of tracheobronchial tree for 3-4 min with 60-80 ml 0.11%-sodium hypochlorite solution. The present innovation favors secreta release of decreased viscosity into large bronchi that simplifies its evacuation and this, in its turn, simplifies the access of antiphlogistic and antibacterial preparations towards tracheobronchial tree's mucosa that leads to interrupting inflammatory process in more shortened terms.
EFFECT: more prolonged period of remission.