Device for dewatering arachnoidal liquor cysts
(57) Abstract:The invention relates to medicine, namely to neurosurgery. The technical result of the invention is to provide non-traumatic surgical intervention in the field of cysts, providing a reliable drainage of the contents of the cyst in the direction of healthy the subarachnoid spaces of the brain and in podporujici space over the area of the cyst, which also happens resorption of CSF. The catheter is made in the form of a U-shaped bracket made of metal with shape memory, the parallel legs of which are bent opposite inside without clamping, with the bracket in cross section has the shape of a trough, open side facing outwards. 3 Il. The invention relates to medicine, namely to neurosurgery.Post-traumatic cyst of the brain are formed in different periods of time (months-years) after suffering a traumatic brain injury. Localization distinguish subarachnoid and intracerebral. First observed in children, second in adults. Post-traumatic subarachnoid CSF cysts are the result of subarachnoid haemorrhage, adhesive leptomeningitis; intracerebral develop PR="ptx2">Despite the progress made in neuropathology, radiology and neurosurgery problem remains up to date. Regardless of the cause of occurrence of cysts in the brain (congenital or acquired) in patients suffering from this pathology, there are persistent paresis, paralysis, epilepsy, disorders of psycho-emotional sphere.A brain cyst, available as a kind of volumetric education in the skull cavity, leads to disruption of liquorices in the field of cysts, and in case of increase in size creates additional compression and disruption of blood supply to the surrounding areas of the brain, which in turn leads to disruption and progression of lost functions.In neurosurgical practice at the present time there are many different methods and their modifications in the treatment of cysts of the brain, but they are not always universal and highly effective.A device for the production of cerebral spinal fluid.Device that communicates with the catheter includes an elongated sleeve having a through hole lines up with the valve of the catheter. The sleeve is attached to the check valve and the attached loop, which serves as a support hinge stabilizing valve when the change of pressure and contributing to the opening of the exhaust valve at a certain level of fluid pressure in the valve and closing the valve when the fluid pressure falls below this level /USA. Patent N 4215695, publ. August 5, 1980, M CL A 61 M 1/00, 27/00/.The disadvantage of this device is that the commitment of the cerebrospinal fluid there is need for additional surgical intervention diversion of fluid in the abdominal cavity or into the right atrium of the heart.A device for treatment of hydrocephalus with improved catheter.The device is intended for the treatment of hydrocephalus, in particular, caused by the block of liquor-conducting paths, using intracranial catheter attached to a tube that allows you to divert cerebrospinal fluid from the ventricles of the brain into the abdominal cavity or into the right atrium of the heart. At a certain distance from the free end of the catheter has a flange that allows you to set it at the level of the Dura. Near the flange from the side of the free end is provided by numerous intermediate holes, prednaznachennnoj, oblong slots with rounded edges /France, application N 2539298, publ. 20.07.84,, M CL A 61 M 1/00/.The disadvantage of this device is that the lead and holding the distal end of the drainage involves opening the abdominal cavity, or the carrying out of drainage through the facial vein into the right atrium of the heart.Closest to the claimed is a device containing a curved catheter, clamp, needle and rod.When catheterization of the ventricles in the clip pre-attached catheter in the desired position, followed by the introduction into the cavity of the ventricle of the brain (A. S. N 1398877, M. CL. A 61 M 27/00 "Method of introducing a catheter into the cavity", B. I. N 20, 1988).The disadvantage of this device is that when the puncture of the ventricle of the brain will still be possible trauma of the brain indicated by the needle with mandrin.The objective of the invention is to create a device for dewatering arachnoidal liquor cysts of the brain, which would retraumatize conduct surgery in the field of cysts, providing a reliable drainage of the contents of the cyst in the direction of healthy the subarachnoid spaces Golo isThis object is achieved in that the catheter is made in the form of a U-shaped bracket made of metal with shape memory, the parallel legs of which are bent opposite inside without clamping, with the bracket in cross section has the shape of a trough, open side facing outwards.The novelty of device:
1. The device is made in the form of a U-shaped staples with parallel legs, promotes surgical intervention directly and only in the area of the cyst.2. The bracket has a cross section the shape of a trench, facing outwards, helps to create an outflow of cerebrospinal fluid from the cavity of the cyst in the direction of healthy the subarachnoid spaces of the brain and in podporujici space.3. Performing a bracket made of metal with shape memory with the tabs-the tabs on the ends of the parallel legs helps to fix all staples in the bone between the two holes in the bones made directly above the cyst.The invention is illustrated by drawings, where Fig. 1 shows a General view of the bracket of Fig. 2 shows a cross-section of the bracket; Fig. 3 shows a diagram of the installation brackets.Device for dewatering arachnoidal liquor cysts of the legs (2) brackets have a size of 20 mm, at the ends are not closed and have the tabs-the tabs (3) the type of hooks over the edge of the bone, the size of 2 mm, which closed opposite, inside not being closed. Device around the perimeter has a thickness of 1 mm and made in the form of troughs with the tabs on the edges of a width of 1 mm and a height of the edge of the trench 3 mm Width of the entire bracket 5 mm, and the width of the inner part of the trench 3 mm Bracket all the way to the projections of the tabs has the shape of a trough, open side facing outwards.The device operates as follows.In operating to produce a linear incision over the area of the cyst. Impose Presevo hole on the bottom edge of the cyst. Then make the opening, emptying and ventriculoscopy cavity of the cyst by conducting ventriculomegaly perforation of the cyst wall in a radial direction towards a healthy subarachnoid spaces of the brain. Along the created message in the radial direction, some distance 2 cm from the edge trepanation holes, using a drill with a diameter of 5 mm is applied an extra hole. To prevent possible damage to brain drill last recorded clip-limiter used to cranioplastic. U-shaped bracket (1) in the form of a gutter outside the op what oterom possible extension brackets for legs with clamps. In a state where the legs of the bracket divorced, hook one leg is put in the cavity of the cyst under the subarachnoid space and the tab-holder (3) is put in an extra hole of a bone.The temperature of human tissue and the environment, the reverse bending of a U-shaped bracket (1) to its original condition, with parallel leg bracket (2) falls into the cavity of the cyst inside of the formed bone between the holes in the bone, and the second parallel leg bracket (2) with the tab-holder (3) sets and fixed in the hole of the bone on the outside, while Galabova part of the bone facing outwards.Bracket (1) is firmly fixed between the two holes in the bone.The arrows show the direction of the outflow of cerebrospinal fluid from the cyst.Installation of the fixed bracket, made of metal with shape memory, creates an outflow of cerebrospinal fluid from the cavity of the cyst in the direction of healthy unchanged subarachnoid spaces of the brain and in the direction in podporujici space, where is the absorption of cerebrospinal fluid. Device for dewatering arachnoidal liquor cysts, made in the form of a curved cut the legs of which are bent opposite inside without clamping, when this bracket in cross section has the shape of a trough, open side facing outwards.
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