Implantable shunt for treatment of hydrocephalus
The invention relates to medicine, in particular to neurosurgery, and can be used as a device for the controlled drainage of cerebral spinal fluid (CSF) from the cavities of the ventricles of the brain into the abdominal cavity or directly into the bloodstream. Implantable shunt includes a flexible pump chamber, and ventricular cardiac catheters, United respectively with the inlet and outlet fittings of the pump. The shield is made from the second chamber communicated with the first pump chamber and containing a flexible diaphragm with a hole in its middle part, dividing the second chamber into two parts. The flexible membrane is configured to fit to the annular projection, made in the lower part of the body of the second chamber, for periodic overlap the holes in the membrane. The invention provides a more effective drainage of CSF by eliminating clogging of the device by the formation therein of blood clots. 3 Il. The invention relates to medicine, in particular to neurosurgery, and can be used as a device for the controlled drainage of cerebral spinal fluid (CSF) from the cavities of the ventricles of the brain into the abdominal cavity or reportnow hemispherical pump, ventricular cardiac catheters (see Acta Neu-rochirurgia, 1959, 7, S. 483).The main problem when using a shunt in the bloodstream was that the blood flowed in the opposite direction and accumulated in the pump.Closest to the technical nature of the proposed solution is implantable shunt, consisting of an elastic hemispherical pump, a ventricular catheter and the cardiac catheter with Kosheleva valve on the end (see U.S. patent 3595240), which prevents the reflux of blood into the pump.One of the complications when using a shunt to treat hydrocephalus, is a blockage of the slotted valve due to the formation of blood clots on the valve face.The problem solved by the invention is to increase the efficiency of drainage of CSF by eliminating clogging of the device by the formation therein of blood clots.The technical result is an effective drainage without clogging of channels is achieved by the invention due to the fact that: firstly, the output channel is removed from immersed in blood cavity of the proximal end of the cardiac catheter that reduces the likelihood of blood clots; second, the lower surface is its low tendency to precipitation of the protein.This reduces the number of postoperative complications requiring surgical intervention.The problem is solved due to the fact that the implantable shunt for treatment of hydrocephalus, including flexible pump chamber, and ventricular cardiac catheters, United respectively with the inlet and outlet fittings pump, made with the second chamber communicated with the first pump chamber and containing a flexible diaphragm with a hole in its middle part, dividing the second chamber into two parts, while the flexible membrane is configured to fit to the annular projection, made in the lower part of the body of the second chamber, for periodic overlap the holes in the membrane.The invention is illustrated by drawings, where: Fig.1 shows an implantable shunt of Fig.2 shows the pumping elastic pump shunt of Fig.3 shows the passage of fluid through the shunt.The shunt consists of a flexible pump, inside the housing 1 which has a camera 5. In the chamber 5 with the deflection of the attached flexible membrane 2 with holes 3 along the periphery. Flexible membrane 2 of the housing 1 of the pump is designed so that in a static position tight to the annular projection 4, made the s may flow into the cavity of the housing 1 of the pump.In addition, the shunt contains inlet port 6 connected to the ventricular catheter 7, the second chamber 11 is communicated through the channel 10 camera 5 elastic pump. Inlet port 6 of the pump is connected with the ventricular catheter 7 through the adapter 9.The chamber 5 of the housing 1 of the pump is connected through the channel 10 with the second chamber 11, which is fixed inside the second flexible membrane 12 with an aperture 13 in the middle. The output fitting 16 of the pump is located at the outlet of the second chamber 11 and is connected via the adapter 17 with cardiac catheter 18.The second flexible membrane 12 with a Central hole 13 is fixed in the chamber 11 with the deflection and rests on the annular ledge 14 made in the lower part of the chamber 11. The membrane 12 is designed and located such that in a static position, the hole 13 is blocked by the protrusion 14. CSF in this case is not able to enroll in a part of the second chamber 11 connected with cardiac catheter, through which CSF is diverted into the abdominal cavity or directly into the bloodstream.The operation of the device is as follows. When pumping elastic pump 1 you must click on the casing 1 of the pump and to let him go. When first clicking on the casing 1 of the pump by increasing d is on, on the contrary, will be pressed against the annular ledge 14 with the release holes 13 for the passage of CSF from one side of the camera 11 in another. If on the first membrane 2 in the chamber 5 there was CSF, she pushed through the output fitting and cardiac catheter outside of the device. Then, when the force is removed from the body 1 of the pump, under the action of forces of elasticity will restore its shape, while in the chamber 5 will experience depression. As a result, due to the pressure differential CSF will flow through the holes 8 of the ventricular catheter 7 in the inlet fitting 6, the membrane 2 is pressed against the annular protrusion 4 and the CSF will go through the holes 3 of the membrane 2 in the part of the chamber 5 is communicated with the second chamber 11.In the chamber 11 at this point under the action of pressure difference of the second membrane 12 (vacuum-side annular protrusion 14) it will be tightly pressed against the annular projection, so as to avoid back flow of CSF.These needs to be done once or repeated several times.
ClaimsImplantable shunt for treatment of hydrocephalus, including flexible pump chamber, and ventricular cardiac catheters, United respectively with the input Aderasa flexible membrane with a hole in its middle part, dividing the second chamber into two parts, while the flexible membrane is configured to fit in the static state to the annular projection, made in the lower part of the housing second chamber for periodic overlap the holes in the membrane, and in the chamber of the pump with the deflection of the attached flexible membrane with holes on the periphery, with the possibility of a snug fit to the annular projection, made from the housing and covering the opening of the input nozzle.
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