Device for changing the lumen of a hollow organ
(57) Abstract:Usage: medicine for the experimental reproduction of the reverse of stenoses and occlusions of hollow internal organs. The inventive device includes a flexible locking element in the form of plates with elastic reservoir that is connected by a tube with a self-sealed chamber for the working environment. The camera is made in the form of a rigid inner frame, the outer thick-walled rubber cap and disk-base. In disk-based internal channel, informing the cavity of the camera tube. This plate has at least one through hole at one of its ends and return the ledge at the other end for fastening. Disk-based equipped with locking rings. 2 Il. The invention relates to medicine, in particular, to surgery, and is intended to implement reversible narrowing of the lumen of hollow internal organs.A device for change of a lumen of a hollow organ, in particular a blood vessel, a fully implantable in the body of the object, based on the influence of fluid introduced into the container through the injection needle and coming through trojstvo prototype contains a flexible locking element in the form of a plate element for fastening its ends and an elastic reservoir, connected by a tube with a self-sealed camera for a production environment.The disadvantage of the prototype is unsuitable for implementation reversible non-invasive stenosis hollow internal organs.In the invention a self-Luggage made in the form of a rigid inner hemispherical dome-shaped frame, the outer thick-walled rubber cap and the disc base with the internal channel, informing the cavity of the camera tube, and also introduced the locking rings, and the element for fastening the plates are made in the form of at least one through hole at one of its ends and response protrusion in the form of buttons on the other.In Fig. 1 and 2 shows the proposed device for changing the lumen of hollow organs in the assembled condition.The device provides a flexible rubber plate cuff 1 with 2 holes on its free part 3 and with a protruding hook 4 fixed 5, and closer to the last record of the cuff has an additional through hole 6, through which is tightly threaded end of the flexible tube 7 connected to inflatable elastic reservoir 8, coming inside mA is 10, consisting of a disk base 11, provided with a fixing ring 12 and the inner channel 13 in the disk that tells the flexible tube 9 with the cavity of the camera 10, and the carrier dome lattice frame 14 and is tightly fixed to the base 11 on top of the dome frame 14 dense thick-walled rubber cap 15.The cuff 1 through hole 2 and Pugacheva hook 4 is shrouded hollow tubular body 16 so that the gleam in his original state is not davlen and adjacent to the wall of the rubber elastic reservoir 8 with the hollow body 16 inside the circumference of the cuff. The cavity of the chamber at the opposite end of the tube proportiona through thick-walled rubber cap 15 cameras needle 17 filled with fluid medium sealed syringe 18, pressing the piston of which is the discharge contained in the syringe of the environment in the cavity of the chamber 10 and further through the channel 13 in the base 11 to the discharge tube 9 to inflatable elastic balloon 8 inside circumference of the cuff, resulting in an inflated elastic reservoir of compressed hollow body 16 and thus is called dosed (depending on the amount pumped into the system of air or liquid) stricture formation in its diameter up to 8 is extracted from the cavity of the chamber 10 through her thick cap 15. Leak pumped and the pressure medium is eliminated, allowing the compression of the hollow body 16 inflated rubber balloon 8 continues to stay in tight spaces. To resolve created narrowing of the lumen of the hollow body 16 again the dotted line in the cavity of the chamber 10 through a thick-walled rubber cap 15 of the injection needle 17 and released or pumped by the syringe 18 is pumped into the system environment, resulting in an inflatable reservoir 8 elastic in the cuff is reduced, thereby stopping the compression of the walls of the body, and the latter extends to its initial state.The device is used as follows.Disassembled sterilized by any known method. Under conditions of anesthesia expose the hollow organ of interest, cuff wrap it with narzuty tank without compression of the walls and lumen of the body. The discharge tube cuff with a hemispherical chamber, hermetically United with the elastic reservoir cuff, conduct and placed into a soft surface tissue of the object, without compromising the integrity of the skin over the location prifessional at the camera place. After this surgical wound, poured creation of stenosis or occlusion of the hollow tubular body in any informative way will verify complete patency of its lumen, making sure in the absence of the original compression of the body. Propylparaben subcutaneously located hemispherical camera system, the dotted line through the skin with a needle on the syringe and pushing the plunger of the latter, pump air or liquid through the connecting tube into the balloon cuff adjacent to the wall of a hollow organ, thereby causing stricture formation in its lumen to the desired degree. Depending on the number inspirowana under pressure piston air or fluid in the bottle, to achieve the desired degree of contraction of the internal body without surgical intervention, up to the complete overlap of its lumen, and then remove the needle of the syringe from the camera. The leak is pumped into the system environment when this is excluded, and the compression of the hollow body continues to hold a sealed system under pressure. Non-invasive removal of the generated re-stenosis by percutaneous puncture of surface-located camera and releasing the previously pumped into the system environment. In the elastic reservoir cuff subsided, and the hollow body extends from the compression and restores the lumen to its original status.P R I m e R 1. The experiment was modeled posto is strong membranous during the day sterilized in proformative the camera. Then the animal under General anesthesia was performed a median laparotomy and shifting to the right from the mesentery of the intestine, mobilized the middle third of the left ureter for 3-4 see Modelsavannah plot of the ureter gently wrapped plate cuff pre-assembled device so that the elastic tank-canister inside the cuff when the original naraguta his condition adjoined to the wall of the ureter without compression of the lumen. Hemispherical camera connected through a thin tube with a balloon cuff, through an incision in the back parietales the peritoneum and the muscle layer of the lumbar implanted from the side of the abdomen under the skin of the back of the animal convex part of it to the skin. Disk-based cameras were sewn for the fixation ring in the thickness of the lumbar muscles nylon sutures and after layer deaf to the suturing of the surgical approach in the abdominal wall, vestigal coat formed over back bulge from the implanted camera to denote the localization of implanted reservoir and facilitate its subsequent sighting percutaneous functions. On day 7 after complete healing of the wound, was executed control excretory urography, and protopalatial model unwanted operative trauma and anesthesia.Collecting control portion normal urine, skin loin with shorn wool was treated with iodine, watered by a stream of chloroethyl for surface anesthesia. Then with a needle connected to the syringe, shot through the skin awake animal was punctilobula pre profilirovannyj implanted in thickness lumbar dome camera and inspirowane in its cavity a portion of the air to feel the elastic resistance of the piston. After that the needle from the skin of the back was removed. To control the reproducibility of obstruction of the left ureter animal performed x-rays of both kidneys after intravenous injection of urografin at the rate of 30 mg/kgOn the 7th and 15th minute programma said full block passage of contrast from the left ureter below the third lumbar vertebra at the site of implantation of the cuff, while the right ureter was contrastively all over. Last testified full and persistent stenosis of the left ureter, i.e. its obstruction. Verifying re programme and collection of experimental samples of urine from the urethra was made after 24 and 48 h of obstruction. In the last period implantirovannoi back camera re punctilobula Hoeksema urography, performed after non-invasive Troubleshooting block the passage of urine from the left kidney revealed the passage of contrast from the left ureter at its normal level throughout. In the study in the dynamics postobstructive period markers of proliteracy content in the urine of diene conjugates, prostaglandin E-2, hexosaminidase and neutral glucosidase investigated the pathogenetic mechanisms and the timing of a full recovery functions postobstructive kidney experimentally in pure form, i.e. without direct layering on the model of the operative trauma and anesthesia.P R I m m e R 2. In the experiment simulated a reversible obstruction of the common bile duct for the study of liver functions in icteric and postreturn period.Presterilized before surgical intervention device to be implanted dog under anesthesia produced laparotomy and were covered with a flexible sheath of the common bile duct near the duodenum without compression of the walls of the choledochus. The camera on the discharge tube implanted through Zadneprovsky incision on the side of the abdominal cavity, where recorded seams disk camera for the correct holes. Kamali seams disk camera for the correct holes. The operating frame sutured tightly and waited for her complete healing. 10 day percutaneous was punctilobula implantirovannoi the camera and under the pressure of the plunger of the syringe filled the system with saline solution to the elastic resistance of the piston when fluid injection.Through the day the animal has noted the signs of obstructive jaundice interesest sclera and mucous membranes, symptoms polemically intoxication. In the blood plasma during the three days studied the content of bilirubin, urea, ALT, AST, factors hemocoagulation. Then puncture implanted under the skin of the camera, the syringe is completely drained from the system previously pumped liquid. Regression of the symptoms of obstructive jaundice was observed within 8 days of non-invasive eliminate obstruction of the choledochus, during which also investigated the dynamics of restoration of hepatic functions on the indicated markers in repeated blood tests.P R I m e R 3. In the experiment simulated a coarctation of the aorta, and investigated the dynamics of changes in the wall of the left ventricle myocardium in poststenoticescuu period.Under endotracheal anesthesia with artificial ventilation of the lungs through a thoracotomy in the 4th intercostal space to the left flexible cuff subscheme prior to implant it under the skin of the back of the syringe through introduced into the chamber needle escalate saline solution before formation of the narrow clearance 2/3 of the diameter of the aorta, that was checked visually and intraoperative aortography.By registering on the calibration syringe injectate volume, leading to the development needed in the study of the degree of aortic stenosis, the saline solution is completely drained from the system before full spadine in the initial state of the reservoir cuff and extending the walls of the vessel. After that, the camera system implanted from the side of the mediastinum under the skin of the back of the animal. Thoracotomy sutured tightly peoplevalue seams when straightened on the breath of the lungs.After healing wounds on the 11th day in the system percutaneous introduced previously defined volume of liquid under pressure, and according to ortografia confirmed the reproducibility of the desired degree of coarctation. Within 120 days in the dynamics observed the development of left ventricular hypertrophy on EKG and ultrasound examination with measurement of the thickness of the left ventricular myocardium. After 3 months of the implanted system transcutaneous its puncture was previously pumped pumped liquid, non-invasive, thereby eliminating aortic stenosis. The involution of hypertrophic myocardium and normalization of hemodynamic parameters was noted within 2 months after non-invasive elimination of coarctation on the possibility of non-invasive reproduce dosed stenosis and occlusion of hollow internal organs, as well as "pure" poststenotic-postocclusion changes in the body without layering operative trauma and anesthesia.The design of the invention is simple and affordable to manufacture and use, being a universal solution for nontraumatic playback dosed or complete stenosis of hollow internal organs with reversible effect. DEVICE FOR CHANGING the LUMEN of a HOLLOW ORGAN, containing a flexible locking element in the form of plate elements for fastening its ends and an elastic reservoir that is connected by a tube with a self-sealed chamber for the working medium, characterized in that the chamber is in the form of a rigid inner hemispherical dome-shaped frame, the outer thick-walled rubber cap and the disc base with the internal channel, informing the cavity of the camera tube, and additionally retaining rings, when this element for fastening the plates are made in the form of at least one through hole at one of its ends and response protrusion in the form of buttons on the other.
FIELD: medical engineering.
SUBSTANCE: device has elongated body having operation end engageable with ligature loop, lateral slit for ligature to exit and movable rod, mounted in the device body, having operation end for holding the ligature. The elongated body has special purpose design to match endosurgical port or trocar lumen. The rod is spring-loaded and has nonworking end projecting from the device body as handle. The rod operation end is hook arranged in front of the lateral slit for ligature to exit and making displacement at a distance minimum equal to distance from operation body end to end face of slit for ligature to exit, oriented towards the handle.
EFFECT: improved tissue and organ engagement conditions; simplified maintenance procedure; accelerated operation process.
3 cl, 2 dwg