Device for treatment of gastrointestinal bleeding
(57) Abstract:The invention relates to the field of medical equipment, namely to endoscopy. Goal: increase the effectiveness of endoscopic methods of hemostasis in the treatment of gastrointestinal bleeding. For the implementation of the chilled water at the source of bleeding in the endoscope introduced insulated vessel with water in contact with the cold surface of thermoelectric Converter, a hot surface which is in contact with the radiator, blown air; a temperature sensor located in the water container; a control unit including a power source and temperature controller, configured to communicate with a temperature sensor and a thermoelectric Converter to maintain a predetermined temperature of the water in the vessel; a pump supplying water from the pressure vessel into a tube connected with the endoscope with water at the source of bleeding; a toggle button, connecting the pump to the power source. Through laundering the site of bleeding and reduce bleeding caused by vascular spasm at their local cooling, improve visibility of the source of bleeding, allowing for greater dostov what relates to the field of medical technology, namely endoscopy.Known devices for local hypothermia of the stomach  gastric bleeding.In these devices double barreled through the tube or gastric tube) directly into the stomach or into the stomach elastic container from the refrigerator and served chilled water. The resulting vascular spasm slows the blood flow and the formation of a blood clot at the site of erosion of the vessel, which leads in some cases to spontaneous hemostasis. These devices are not widely used due to the inherent disadvantages:
for hypothermia stomach takes a long time;
- exposure to cold is non-localized and uncontrolled;
long and massive cooling of the walls of the stomach itself can be accompanied by the formation of acute ulcers;
- hypothermia may not be used as an independent method of hemostasis, as the results are not predictable, and is shown only in combination with other treatments.At the present time to stop bleeding widely used endoscopic methods: bi - and monopolar electrocautery, laser photocoagulation, medikamente should be able to achieve a stable hemostasis without surgical intervention [2, 3, 4].Known endoscopes [5, 6] for the implementation of endoscopic methods of hemostasis.Their disadvantage is that the field operations, especially in cases of emergency, closed the contents of the stomach, and blood clots of the bleeding vessel. Available in the endoscope channel water is used for washing the lens monitoring channel, the water is served in small doses and with a small head that does not clear the source of bleeding.For treatment and diagnostic endoscopy is first necessary to provide a good overview of the source of bleeding. For this conduct:
any preliminary lavage chilled (ice) water, which as a secondary effect reduces bleeding due to vascular spasm;
any sighting irrigation-laundering through a tube connected to the syringe with water and put into the instrument channel of the endoscope.Both of these methods have significant drawbacks:
in the first case requires a lot of time for preparation of the patient, and to begin the source of bleeding can be re-closed by a blood clot;
in the second case, a small volume and a small head of water from a syringe require the enta (using endoscopes with one working channel) significantly complicates the work.The present invention is providing a good view of the source of bleeding with a simultaneous decrease bleeding.This task is solved in that additionally introduced a device for cold (ice) water under considerable (about 1 ATM) pressure to the source of bleeding.The applicant considered during patent search sources of information not found, similar to the declared that allows to conclude that the proposed solution should not be explicitly studied the prior art, i.e., meets the criterion of "novelty" and "inventive step".The present invention can be used in medicine during endoscopic hemostasis gastrointestinal bleeding, i.e., meets the criterion of "industrial applicability".The device consists of a thermally insulated from the environment of the vessel with water in contact with the cold surface of thermoelectric Converter. Hot surface of thermoelectric Converter is in contact with the heat sink, which is blown by the fan. In a vessel with water has a temperature sensor, connection of the population are also the source of the power button connection to the power source of the pump, through which water from the vessel at the required pressure is applied in a thin tube attached to the endoscope so that the exiting water fell on the source of bleeding.During operation, the temperature controller connects thermoelectric converters to the power source. Thermoelectric converters are cooled by the water in the vessel to a predetermined temperature, 32oC. the Emitted heat is dissipated into the environment via the heat sink and fan. If you lower the water temperature to a predetermined temperature controller according to the signals of the temperature sensor changes the current through thermoelectric converters so that the amount of heat coming from the environment in the vessel was equal to the quantity of heat removed thermoelectric converters of the vessel with water. When connected to a power source, the pump delivers water from a vessel under pressure of 1 ATM in a thin tube attached to the endoscope so that the water from the tube fell on the source of bleeding. Thus, in the process, the physician may, at any time to quickly clear the source of bleeding, and submission to the place of bleeding chilled (ice) water reduces the ing pump may be in the form of a foot switch, that frees the hands of a doctor.To reduce the size of the endoscope water supply in the operating field can be done through free passage in the tool channel of the endoscope when introduced into the channel of the instrument.Thus, the device allows you to:
- perform emergency endoscopic treatment of acute gastrointestinal bleeding, excluding the preliminary preparation of the patient (lavage);
to improve treatment efficiency by improving the visibility of the field of erosion of vessels using endoscopic methods of hemostasis;
- check the condition of the place of erosion of the vessel after endoscopic hemostasis.Sources of information
1. Bratus C. D. Acute gastrointestinal bleeding Kiev: Health, 19712. Panzeri Y. M., Fedorov, E. D. current level and prospects for the development of therapeutic endoscopy in ulcerative gastroduodenal bleeding. New technologies in clinical practice, surgery and Oncology, the Materials of the Russian-German Symposium - Moscow, 1999, S. 45-48.3. Gallinger Y. I., Godzilla E. A., M. Khrustaleva Century Therapeutic endoscopy at the gastroduodenal bleeding in patients operated n the salary. Moscow, 2000, S. 60.4. Panzeri Y. M., Mikhalev A. I. and other Treatment of gastroduodenal ulcer bleeding. Surgery, 2000, 3, S. 23.5. OLYMPUS ENDOSCOPY SYSTEM. Sinjuku-ku, Tokyo, Japan, 19846. The OLYMPUS. Service manual of medical endoscopes. Moscow, 2000, S. 27, 29. 1. Device for treatment of gastrointestinal bleeding, made in the form of an endoscope, characterized in that it introduced thermally insulated from the environment of the vessel with water in contact with the cold surface of thermoelectric Converter, a hot surface which is in contact with the radiator, blown air temperature sensor, located in the vessel with water, the control unit including a power source and temperature controller, configured to communicate with a temperature sensor and a thermoelectric Converter to maintain a predetermined temperature of the water in the vessel, a pump for supplying water from the pressure vessel into the tube, connected with the endoscope with water at the source of bleeding, and click switch to connect the pump to the power source.2. The device under item 1, characterized in that the button switch made in Vyborny the lumen of the instrument channel of the endoscope.
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