Method for introducing transhepatic drainage for intrahepatic bile ducts
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.
The invention relates to medicine, namely to liver surgery, and ways of conducting transretinoic drains.
A known method lies in the fact that for transperceneige drainage use clamp-type collets, which together with the drainage tube put on the end of the uterine probe wire after tunnelling liver (1).
The disadvantages of this method of conducting drainage through the liver is high traumatism due to the risk of serious complications, especially wound large vascular trunks liver, rupture of its parenchyma.
There is a method of conducting transretinoic drainage through the use of bogey of different diameters having the form paladugu with olive on the end. Conducting bougie is carried out in the course of intrahepatic duct up to his end of the division with the subsequent release of the diaphragmatic surface of the liver. The olive tree onto a PVC drain with side holes, retrograde movement extends into the lumen of the common hepatic duct with subsequent reduction of the end of the drainage lumen of the intestine (2).
The disadvantage of this type of drainage through the liver is high trauma (damage to the liver parenchyma), because the bougie with drainage are carried out from the surface of the liver to its goal, which is more than the op is sny option rather than holding them in the opposite direction.
The aim of the invention is to reduce the trauma of holding transretinoic drains.
This goal is achieved by the fact that through the elastic tube passes a flexible radiopaque guidewire, remove the tube and the conductor from the hilus of the liver to its diaphragmatic surface is performed in the bile ducts drain tube.
The method is implemented as follows.
Through discovered the proximal end of the common hepatic duct in equity ducts is thin pugachy bougie of soft metal, with a diameter of not more than 2 mm At its distal end, which has a conical thickening and ring grinding, firmly attached thin (2-2 .5 mm) plastic tube. Metal bougie is modeled in the form of a semicircle, is conducted through the tissue of the liver on its diaphragmatic surface. Behind him stretches a thin plastic tube. Then through its lumen spend a flexible radiopaque wire. The tube removed. Pick transitory drainage - plastic tube of the required diameter (usually 5-6 mm) with multiple side holes for drainage of bile. Models its proximal end in the form of a cone, which is placed on flexible metallic conduit located in the bile ducts of the liver. Gradually using Windows Explorer as a marker, not what we spend transitory drainage through the intrahepatic bile ducts.
The positive effect from the use of the proposed method is that it decreases the invasiveness of holding respecting drains through the liver parenchyma.
The proposed method is feasible and appropriate to use in operations concerning injuries and scar strictures of extrahepatic bile ducts.
Sources of information:
1. Eigenpair, Umetered “non-standard situations during operations on liver and biliary tract”. - M., 1987.
2. VNIIM, POS, Vfetaa. Bulletin of surgery №7. - 1992. - P.36-39.
Method of making drainage for intrahepatic bile duct by passing through the liver of bougie, fastening on his distal end of the drainage tube and install it in the bile ducts, characterized in that, to reduce the morbidity, through the elastic tube passes radiopaque guidewire, remove the tube and the conductor from the hilus of the liver to its diaphragmatic surface is performed in the bile ducts drain tube.
FIELD: medicine; medical engineering.
SUBSTANCE: method involves simultaneously introducing one bougie into the urethra in retrograde way and the other one via the urinary bladder in antegrade way to bring them in contact at the urethra rupture place. Then, the bougie introduced via the urinary bladder is brought outside. Foley catheter is attached to it and introduced into the urinary bladder cavity. Balloon is pumped. A thread is tied to the catheter start segment and stretching is carried out with a load of 200 g at an angle of during 15 days. Device has two bougies. The first bougie head is conic. Recess is available in the second bougie head for making engagement with the first bougie head. The recess is shaped to receive the first bougie head. The second bougie head is used for tying Foley catheter to it.
EFFECT: enhanced effectiveness of treatment.
2 cl, 5 dwg
FIELD: medicine; medical engineering.
SUBSTANCE: device is rectangular and has four or more slits for fixing means to pass through each of them. Two slits have exit to lateral side of plate to enable one to set the plate at required position and fix it without preliminarily removing the instrument for correcting orientation relative to vertebral column. Lateral plate surface runs from edge pointing the same direction with longitudinal plate direction. The latter exactly coincides with the vertebral column direction. The system comprises several vertebral column osteosynthesis plates to keep orientation correction relative to the vertebral column unchanged. Correction is carried out by means of the instrument for correcting orientation.
EFFECT: less number of holes to be drilled for mounting the device.
11 cl, 10 dwg