Surgical instrument yakunin for percutaneous drainage of abdominal formations

 

(57) Abstract:

The surgical instrument is designed for drainage of cavity formations and can be used in medicine when implementing the various methods of treatment and diagnosis, the security of its use and reduce the risk of postoperative complications. The technical result in the use of the invention is to enhance the technological capabilities of a surgical instrument. The tool includes coaxially arranged with the possibility of relative longitudinal movement of the rod, a hollow needle with a pavilion, an outer tube with adapter, the drainage tube and the control device is moved. Pavilion hollow needle is made removable in the form of coaxially connected with the connector housing and a collet clamp. Between them is the seal. A hollow needle is supplied adapter replacement of drainage pipes and extension. 4 C.p. f-crystals, 10 ill.

The invention relates to medical equipment, namely to surgical instruments that are designed for drainage of cavity formations.

A device for percutaneous drainage of abdominal formations needle with pavilion outer tube with adapter and the drainage tube, and a device control movement associated with the pavilion and the adapter and made in the form of two pivotally connected branches [1].

A disadvantage of the known device is affecting the procedure drainage limited technological capabilities.

In the known device cannot replace the drainage tube (catheter) on the outside of the tube without removing the needle from the abdominal education that is required if you want to use catheters greater length, with a different, compared with the initial configuration of the end or, if necessary, removal of the damaged catheter. In these cases, using the procedure of use of Windows Explorer or repeated puncturing abdominal education. This increases the risk of postoperative complications due to the possibility of leakage of the contents of cavity formation, blood in the needle channel or the abdominal cavity, and is complicated by the carrying out of drainage in the drained cavity.

Also known device does not provide a reliable fixing of the blades of the catheter "baskets" on the outside of the tube in the expanded form, which is confirmed by the device spatial branched, i.e. not enough comfortable at work.

The purpose of the invention is to enhance the technical capabilities of the surgical instrument.

The technical result will be the creation of a surgical instrument with advanced technical capabilities, characterized by versatility and with sufficient reliability that will allow you to use it in various techniques of percutaneous drainage of cavity formation, and reducing morbidity and improving the safety of the procedure drainage.

To achieve this goal in the known device, comprising coaxially arranged with the possibility of relative longitudinal movement of the rod, a hollow needle with a pavilion, outer tube with adapter and the drainage tube, and the control device moves, the pavilion hollow needle is made removable in the form of coaxially connected with the connector housing and a collet clamp between which is located a seal, with the needle supplied adapter replacement of drainage pipes and extension.

In addition:

the adapter is made in the form of a pointed tip with the installation ledge, and the extension is in the form of art is olony sahastranam the end of the hollow needle includes a threaded connection with the threaded extension;

the end of the outer tube is made with faceted thickening, interacting with the inner surface of the working end of the drainage tube;

drainage pipe is mounted on the outer tube at full length and mechanically connected with the adapter;

the device control move is made in the form of a gauge that is installed with the possibility of free longitudinal movement relative to the pavilion, and the end of which is fixedly mounted on the adapter.

In Fig. 1 shows a surgical instrument for percutaneous drainage of abdominal formations - option; Fig. 2, 3 and 4, respectively, the positions a, B and C In Fig. 1; Fig. 5 - section G-G of Fig. 3; Fig. 6 - supply hollow needle adapter replacement of drainage tubes; Fig. 7 - supply hollow needle extension; Fig. 8 is a tool equipped with a measuring ruler - view from the side line of Fig. 9 - section D-D in Fig. 8; Fig. 10 - section E-E in Fig. 8.

The surgical instrument includes a coaxially located with the possibility of relative longitudinal movement of the rod 1, the hollow needle 2 with interchangeable pavilion 3, the outer tube 4 with the adapter 5 and the drainage tube (catheter) 6 and the control device moves, done detachable pavilion 3, the end 8 which is fixedly mounted on the adapter 5 by means of a removable bracket 9. Removable pavilion 3 of the hollow needle 2 comprises coaxially connected, for example, by means of the thread of the housing 10 and a collet clamp, representing, in fact, the collet 11 with jaws 12 and threaded coupling 13 with the inner conical surface that interacts with navorachivaya on the collet 11 with jaws 12. Between the housing 10 and the collet 11 is elastic seal 14.

Hollow needle 2 tool offset adapter 5 replacement of the drainage tube and the extension tube 16. The adapter 15 is made in the form of a pointed tip 17 with the installation ledge 18 and the extension 16 is in the form of a rod, one end 19 of which has the form of a pointed tip 17 of the adapter 15 and the other end 20 is an external thread, while the opposite sahastranam the end 21 of the hollow needle 2 has an internal thread for connection with the threaded extension 16.

The end of outer tube 14 is made with faceted thickening 22 that interacts with the inner surface of the working end 23 of the drainage tube 6, which is installed on the outer tube 4 at full length and mechanically connected with the adapter 5 by means of a cap nut 24, navorachivaya on the threaded section is s internal organs - ultrasound scanning has greatly expanded the diagnostic capabilities of modern medicine. Thanks to high resolution ultrasound scanning has become possible to carry out under its control sighting invasive surgery performed with both diagnostic and therapeutic purposes, including percutaneous drainage, which is used in the treatment of various diseases of the abdominal organs, anatomical cavities and diseases, accompanied by the formation of closed cavities filled with liquid [2].

Example 1. After diagnosis of the disease produce a complete set of surgical tools - choose the type of drainage tube 6, for example, the catheter "basket", working length elements and collect device - coaxial system with the free working end of the hollow needle 2. Given the "shape memory" material of the catheter is installed on the outer tube 4 at full length to the blade baskets straightened up. The construction of the outer tube 4 allows you to put on catheters of various sizes, and the presence of faces in the thickening of 22 passes in the space between the inner surface of the kata is of the skin is chosen place for optimum puncture abdominal education. Is local anesthesia tissue along the intended puncture channel and a small skin incision. Through an incision in the skin, using a needle sensor ultrasonic inspection, free working end of the hollow needle 2 is held by the puncture of the abdominal education. When worn on the hollow needle 2, the outer tube 4 with a thickening 22 and the catheter (drainage tube 6) remain outside of the skin of the patient. Removed the rod 1 and is held aspiration of a small amount of the contents of cavity formation. In the cavity introduces a water-soluble contrast agent, and flexible metallic conduit (not shown). Fix the position of the hollow needle 2 and perform the translational motion of the outer tube 4 to slippage of the working end of the catheter to a metallic conductor. Then produce a further reduction of drainage into the lumen of the abdominal education. After fluoroscopic control provisions of the drainage of the outer tube 4, a hollow needle 2 and the conductor are removed. Drainage is fixed to the skin, for example, by filing and making threads on the adhesive tape around the skin incision.

Example 2. Obviously, to carry out percutaneous puncture easier short needle 2. In this case the process; 2 coaxial system. To do this, with the hollow needle 2 is removed pavilion 3, which is slightly Unscrew the collet 11 on the housing 10 and the rotation of the threaded bushing 13 loosen the jaws 12 of the collet 11. In the hole of the hollow needle 2 insert the adapter 15 or screw the extension tube 16. After these manipulations mounting on the hollow needle 2 coaxial system of a surgical instrument is not difficult. If necessary, wear pavilion 3, and further work is well-established technique (e.g., described in example 1 or the source of information [2]).

Example 3. When the hollow needle 2 in the abdominal education sometimes requires replacement of the damaged tube 6, the installation of the needle 2 drainage of greater length or installation (replacement) of the drainage with a different configuration of the working end 23 (for example, "direct" to "loop", or other). To do this, hold the manipulation tool, the procedure for which is set out in examples 1 and / or 2.

Example 4. To control the insertion depth of drainage on needle 2, you can use the gauge 7, which allows you to increase the security of intervention, namely to carry out drainage without additional ultrasonic or x-ray control. In this case, the tool offset measuring line 7 through the installation of a removable bracket is mounted on a removable pavilion 3 and containing the guide groove, which gauges 7 glides effortlessly. The zero mark is set by moving and fixed by the screw 28, the end 8 of the measuring line 7 in the bracket 9. If the gauge 7 will interfere with the connection of the pavilion 3 of the hollow needle 2 with canula syringe (or other tool), it's simple enough to bend to the side, and after the necessary manipulations it will occupy its original position.

Surgical tool for percutaneous drainage of abdominal formations, made according to the invention, allows to implement various techniques of diagnostic and therapeutic drainage procedures, while ensuring the safety of its use and significantly reducing the risk of postoperative complications.

Sources of information:

1. Description of the invention to the patent of Russian Federation N 2019200, A 61 M 25/08, 27/00, BI N 17, 1994 (prototype).

2. Invasive interventions under the control of ultrasound scanning. (Briskin B. S., Karpov, I. B., Fuchs, M. A., Teodorovich O. Century Overview. Medicine and healthcare. Series - surgery, vol. 3. - M.: Sojuzmedtorg, 1989, 73 S.

1. Surgical instrument for percutaneous drainage of palmenia rod, a hollow needle with a pavilion, an outer tube with adapter and the drainage tube and the control device moves, characterized in that the pavilion hollow needle is made removable in the form of coaxially connected with the connector housing and a collet clamp between which is located a seal, with a hollow needle provided with adapter replacement of drainage pipes and extension.

2. The instrument under item 1, characterized in that the adapter is made in the form of a pointed tip with the installation ledge, and the extension is in the form of a rod, one end of which has the form of a pointed tip adapter, and the other thread, while the opposite sahastranam the end of the hollow needle includes a threaded connection with the threaded extension.

3. The instrument under item 1, characterized in that the end of the outer tube is made with faceted thickening, interacting with the inner surface of the working end of the drainage tube.

4. The instrument under item 1 or 3, characterized in that the drain pipe is mounted on the outer tube at full length and mechanically connected with the adapter.

5. The instrument under item 1, characterized in that the control device movement is made in the form of a gauge that is installed with who is and adapter.

 

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