(57) Abstract:The invention relates to medical equipment, namely to devices used in surgery, and is intended for infusion or drainage of hollow organs and narrow cavities. The technical result of the invention is to provide x-ray contrast infusion and drainage device is rigidly fixed inner end, with an atraumatic needle and surgical thread with atraumatic deleting it at the right time, and this excludes complications after removal of similar products. The device is equipped with a fixing device on the inner end of the housing and solid branch of a body, which, as well as through the entire body, inside it, is flexible monoactive electrode in direct contact with the wick hydrophobic or hydrophilic thread with an atraumatic needle on the active end of the thread and rigidly connected with the monolithic branch housing the passive end of the locking thread. 2 Il. The invention relates to medical equipment, namely to devices used in surgery, and is intended for infusion and drainage of hollow organs and narrow cavities.Known truscello USSR N 543401, m CL 61 M 27/00, 25.01.77 - 2 C.) have the following disadvantages:
1. The inner end of such device does not have a fixation device and therefore able to migrate drained from the hollow body or inside it, making it difficult or completely disrupts the process of infusion or drainage.2. When rigid fixation of the inner end of the infusion and drainage device within a hollow organ, such as the thoracic lymphatic duct, surgical suture or ligature, closed the removal of infusion and drainage device becomes traumatic and leads to a number of complications (bleeding, pain, tearing of the wall of a hollow organ, adhesions and others)
3. When removing such infusion and drainage devices in tissues remains suture material, which supports an inflammatory response.4. Existing infusion-drain devices x-ray lack contrast and the contrast in the wall of the latter must be incorporated x-ray contrast chord.5. After removing the usual infusion and drainage devices, which were recorded by ligature, a narrowing of the lumen of a hollow organ in the place of standing ligatures, which reduces the functionality of the hollow body.The invention consists in that in the wall of the tubular housing infusion and drainage device is placed flexible monoactive electrode, the inner end of which is allocated out of the total housing in the form of a monolithic junction of the casing and parallel to the infusion and drainage housing and is in direct contact with the wick hydrophobic or hydrophilic thread (for example made of silk, woven nylon or Dacron) with atraumatic needle on the end. Body infusion and drainage device is inserted through the incision or through a stump in the lumen of a hollow organ, and a monolithic offshoot of the housing electrode is located outside the walls of the hollow body, the fixation device is a thread with an atraumatic needle on the end. The outer end of infusion and drainage device is displayed on the surface of the skin through a separate hole. The ligature contact the disorder so, that being briefly cut off after tying surgical knots, can be extracted from the tissues with the current time together with the electrode and the housing infusion and drainage device after burnout her discharge high-frequency current in the solid branch of the corps infusion and drainage devices, which is an insulating sheath for the electrode, and the electrode x-ray contrasting chord for infusion and drainage devices.The invention is illustrated in Fig. 1 and 2. In Fig. 1 shows an infusion and drainage device of Fig. 2 - the same, in the working position. The device is prepared in advance for disposable and pre-sterilized in any way. The device consists of a tubular infusion and drainage of the housing 1, made for example of silicone rubber, the inner end of the housing has a fixing device, such as fixing groove 2, and monolithic offshoot of the housing 3 containing the inner end 4 of the electrode 10, which is held in the housing infusion-drain devices. Monolithic branch separated from the overall body and is parallel infusion-drainage body 1, the wall of which is placed a flexible monoactive is rpose infusion-drain device and inside the solid branch of the housing is in direct contact with the wick hydrophobic or hydrophilic thread 5, 7, which has an active end 5, provided with an atraumatic needle 6 and the passive end 7, which is rigidly fixed to the bifurcated end 3 of the housing 1 infusion and drainage device at the point 8, for example, soldered to the body, the lumen of the infusion and drainage device 9.The device is used as follows (Fig. 2). After surgical exposure required of a hollow organ (duct, vessel, intestine) into the lumen of the body 14 is inserted body infusion and drainage device 1 and the monolithic branch 3 of the housing with the inner end 4 of the electrode 10 is located outside of the hollow body 11. The device is fixed in the lumen of a hollow organ using an atraumatic needle and thread, knotted at the fixation device 2 of the housing 1. The ends of the threads 5 and 7 are fixed conventional surgical site 6, located as close as possible to the monolithic branch 3 of the housing. The ends of the thread briefly cut off, and the skin surface 12 through a separate hole deduce the outer end of infusion and drainage device in the housing 1 which is flexible monoactive electrode 10, and the wound is sutured on tightly. Through the infusion lumen drainage device 9 is infusion or drainage of substances into the lumen or lumen of Porogaramu for high-frequency surgery, for example of the type EN-n, and to the outer end of the flexible monoactive electrode 10, a pre-released from the insulating sheath, attached monoactive electrode device for high frequency surgery and miss the high-frequency discharge. In the wet strands of tissue fluid and electric discharge on the inner end 4 monoactive electrode 10 instantly blows the active end of the ligature 5 is in close contact with the inner end monoactive electrode 10. Burnout happens inside a monolithic junction 3 of the housing 1 infusion and drainage devices, and the burnout so small that it is not possible to damage the hull of a monolithic branch 3, the surrounding tissues 11 and the hollow body 14, and the device together with a ligature 5, 7, which is fixed on a monolithic branch 3 of the housing 1 infusion and drainage device at the point 8, atraumatic is retrieved to the surface.The thickness monoactive electrode is chosen empirically and is approximately equal to the thickness of the applied ligatures. Chosen experimentally and corresponds to division 6 of the rheostat device for high frequency surgery, the voltage of high-frequency current, it is necessary what is the inner end of the infusion and drainage device is rigidly fixed on the fixing device in the lumen of a hollow organ, and the available atraumatic needle allows not only ligation and circular seam, which will record not only the infusion and drainage device, but the hollow body, which further facilitates the process of infusion or drainage.Infusion-drain device may noninvasive and completely removed from the cavity or hollow organ in the estimated time, not leaving in the tissue suture material, infusion and drainage device has a rent contrasting chord.Conducted bench tests proposed infusion-drain devices (200 pieces). Dummy foam was placed on the passive electrode device for high frequency surgery, type EN-n. The model was attached a rubber tube into the lumen of which is inserted the inner end of the housing infusion and drainage devices, and monolithic branch housing infusion and drainage devices were placed on the outside of the rubber tube. Infusion-drain device is recorded in a rubber tube ligature with an atraumatic needle. Fixation was carried out simple surgical usli second layer of foam, through the opening in which the surface whenever the outer end of the housing infusion-drain devices. The top layer of foam podshivalsya to the bottom layer of foam. All the foam was soaked 9% solution of sodium chloride, and to the outer end of the electrode infusion-drain devices connected monoactive the electrode device for high frequency surgery. In the wet filaments solution of sodium chloride and high-frequency discharge thread locking infusion-drain device burned out, and the device is removed from the foam and microscopically under a magnifying glass MBS-9.In all cases, infusion-drainage device is removed completely, the body infusion and drainage device and the rubber tube is not damaged, and fixing the ligature was left on the device.Conducted experiments in 15 rabbits, which through the middle section of the neck was exposed external jugular vein, which was catheterizable proposed devices after heparinisation. Surgical wounds were usuals tightly, and the device is displayed on the surface of the skin. After exposure of the device from 1 to 5 days device of the animals were extracted by connecting to the outer end of the guy who kind of device for high frequency surgery, and on the skin of the rabbit, after her rich wetting tap water was connected to the passive electrode device for high frequency surgery. Passing through rabbit discharge of high-frequency current after burn-out locking ligatures, all devices were extracted atraumatic at exactly the specified time. The animals were killed for collection of tissues with the aim of histological research.Device microscopically under a magnifying glass MBS-9. In all cases, the devices were intact. Histological studies have identified low degree of inflammation and the absence of suture material in the tissue. Infusion-drainage device containing tubular body, characterized in that the inner tubular end of the housing has a monolithic branch, rigidly United with matchlock hydrophobic or hydrophilic ligature with an atraumatic needle on the end directly contacting the inside of the solid branch housing with flexible monoactive electrode held in the case of infusion-drain devices.
SUBSTANCE: method involves conducting bougie through the liver. Flexible tube is attached to its end and set in bile ducts. Flexible radio-opaque conductor is introduced through the flexible tube. The tube is removed. Draining tube is introduced along the conductor from porta hepatis to its diaphragmatic surface into the ducts to be drained.
EFFECT: reduced risk of traumatic complications.
SUBSTANCE: method involves puncturing pyogenic abscess cavity under ultrasonic control with draining tube left therein. Laparoscope connected to monitor unit is introduced into abscess cavity. One of introduced drains is set in upper point of the cavity and the other one in lower point. The abscess cavity is filled with ozonized solution to 2/3 of its volume and bubbled with ozone-oxygen mixture during 2-3 min changing the solution until it becomes transparent. The emptied cavity walls are treated from distance of 3-4 cm with laminar airflow heated to 38-40°C under pressure of 1-1.5 atm during 2-3 min. Next to it, the cavity walls are irradiated from distance of 2-3 cm with non-coherent red light during 2-3 min per each area.
EFFECT: improved safety conditions and healing quality.
FIELD: medical engineering.
SUBSTANCE: device has suction tube having lateral openings and irrigation tube. The irrigation tube is connected to jet-action atomizer. The atomizer is hollow collapsible cylinder with holes. Ultrasonic radiator having conductor to ultrasonic frequency oscillator is available in the cylinder. The radiator and conductor enable one to introduce ultrasonic oscillations into antiseptic solution.
EFFECT: enhanced effectiveness of treatment.
SUBSTANCE: method involves puncturing pyogenic cavity with trocar having blunt obturator via skin incision made outside of abscess boundary having length equal to arthroscope diameter. Then, arthroscope is introduced and the cavity is filled with physiologic saline. Pyogenic cavity revision is carried out under arthroscope control, irrigation cannula is set, constant water medium is created. Arthroscopic mill on shaver handle is introduced via another skin incision. Non-viable tissues are removed with stage-by-stage hemostasis using endocoagulator. The cavity is healed. Perforated draining tube is set under arthroscope control. Tube ends are brought out through pierces outside of the cavity and sutured to skin. Active suction of wound exudates is carried out using closed vacuum drain system in postoperative period. The drainage is removed when cleaning the wound from wound microflora and single sutures are placed.
EFFECT: enhanced effectiveness of treatment.
FIELD: medicine, abdominal surgery.
SUBSTANCE: the present innovation deals with treating patients in case of destructive forms of pancreatitis. One should lance a gastro-colic ligament, mobilize splenic and hepatic angles of large intestine, tighten a middle colic artery, descend mesenteric root cross-sectionally against a colon, dissect parietal peritoneum along the upper and lower edges of pancreas to withdraw it into abdominal cavity, remove necrotized tissues. Then one should apply a rubber balloon with drainage tubes along its upper and lower edges into omental cavity: one balloon's end should be withdrawn through median wound, another one - through contra-aperture being 5 cm below a costal arch along median axillary line. The method suggested enables to form adequate access to patient's pancreas.
EFFECT: higher efficiency of drainage.
6 dwg, 1 ex
FIELD: medical engineering.
SUBSTANCE: device has liquid-permeable porous lining that is to be placed on or in a wound, flexible plastic film having a set of holes distributed over its surface, liquid-impermeable film napkin and connection means. The porous lining has foamed polymer material having interconnecting cells. The plastic film makes contact with porous lining surface and is between wound surface and the lining when used. The film napkin is placed above the porous lining and is sticky along its perimeter to provide sealing in skin area surrounding the wound. The connection means passes through the film napkin and communicates to porous lining via liquid flow for making connection to negative pressure source for stimulating fluid flow discharged from the wound. Another embodiment has removable wound bandage usable in particular for treating large wounds requiring draining fluids. It has the first porous lining, the second porous lining, elastomer envelope, film napkin and tubular connection means. The first liquid-permeable porous lining contacts the wound and has foamed lining having foamed material based on polymer built of interconnecting cells and isolated transverse holes. The elastomer envelope has the first and the second sheets of elastomer film soldered along their periphery and enveloping said foamed lining. Each of the first and the second elastomer film sheets has spaced-apart holes. The holes in the second sheet are justified with said spaced-apart holes in the first sheet. The second liquid-permeable porous lining is to be placed under the first porous lining. It has foamed polymer material having interconnecting cells. The liquid-impermeable film napkin is placed above the second porous lining. The first porous lining is placed above the wound. The film napkin is sticky along its perimeter to glue the napkin to skin area surrounding the wound. The tubular connection means passes through said film napkin and communicates to porous lining via liquid flow for making connection to negative pressure source for stimulating fluid flow discharged from the wound. The third embodiment has the first elastomer film sheet having spaced-apart holes deviated from spaced-apart holes in the foamed lining. The second elastomer film sheet has spaced-apart holes adjusted to the spaced-apart holes in the foamed lining.
EFFECT: simplified usage; accelerated wound healing.
15 cl, 3 dwg
FIELD: medicine, surgery.
SUBSTANCE: one should perform decompression of Wirsung's duct with the help of silicone instrument or catheter in case of pancreatogastrostomy in the course of pancreatoduodenal resection. Moreover, the above-mentioned instruments should be fixed in anastomosis with one of the sutures in internal row, their free ends should be loosely located in the stomach and tightened to caprone ligature to be then withdrawn through patient's nose. In 7-10 d either silicone instrument or catheter should be removed due to pulling by caprone ligature. The innovation enables to decrease the risk in the failure of pancreatogastroanastomoses and post-operational pancreatitis.
EFFECT: higher efficiency of draining.
FIELD: medicine, surgery.
SUBSTANCE: at the end of the main stage of operation conducted one should perform paravertebral Novocain blockade by puncturing the sheath of m.erector trunci, the drainage should be introduced towards lateral edge of m.ilipsoas through paracentesis of lumbar area being about 1-2 cm above ilium's ala at the line made via the end of the 12th rib vertically up to ilium's ala. Retroperitoneal space should be, also, drained. The innovation enables to prevent purulent-septic complications and decrease the pain.
EFFECT: higher efficiency.
1 dwg, 2 tbl
FIELD: medicine, obstetrics, gynecology.
SUBSTANCE: uterine cavity should be drained in the course of operation, moreover, irrigator's distal end should be withdrawn through operation wound at anterior abdominal wall, and 2 h after the end of operation uterine cavity should be washed through irrigator with 400 ml of cooled 0.06%-sodium hypochlorite solution at perfusion rate being 200 ml/h, 6 times every 12 h up to 3-4 d; after each perfusion one should introduce 1 g kanamycin directly into uterine cavity, moreover, in case of availability of bacterioid and/or anaerobic flora in uterine cavity according to the results obtained due to pre-operational antibioticogram one should add 100 ml 3%-hydrogen peroxide solution into perfusion solution. The present innovation enables to efficiently sanitize uterine cavity due to intrauterine injection of antibiotics by taking into account antibioticogram performed at all stages of operative treatment.
EFFECT: higher efficiency of prophylaxis.
1 cl, 2 ex
FIELD: medical engineering.
SUBSTANCE: device has lateral holes and is manufactured from absorbable material like polydioxanon. The holes are diametrically arranged in two rows along the whole tube length in chessboard order in the first embodiment of the invention. The absorbable material of polydioxanon is manufactured as threads arranged as reticular mesh grid structure of 12-20 u/cm in building tube walls.
EFFECT: eliminated occurrence of pyo-inflammatory complications.
2 cl, 2 dwg