Method for improving postoperational disease flow in case of operations upon the upper urinary tract

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

 

The invention relates to medicine, in particular to surgery, and can be used after operations on the upper urinary tract, especially when conserving surgery about Staghorn calculi stone.

Studies on patent and scientific and medical literature revealed the way in which in the postoperative period regarding pathologies of the upper urinary tract drainage is carried out through the lumbar region and set directly to the venue operations [1].

The method has the following disadvantages.

In the first place. Patients by the end of the second hour post-operative period there was a strong pain that makes use of narcotic analgesics.

Secondly. Patients wound on drainage continues until 5-6 days, with the first day of the postoperative period, the number of wound least, and the transition gemorragticheskogo content in serous starts with 4-5 days.

In third. In the postoperative period in a larger number of patients are septic and bronchopulmonary complications.

Above mentioned disadvantages can be eliminated in the proposed solution.

The objective of the invention is to improve the efficiency and reduction of post-operative disease in the pathology of the upper urinary what's ways.

This object is achieved by a combination of paravertebral procaine blockade through the vagina m.erector.trunci with subsequent drainage of the retroperitoneal space through the projection Petitou triangle in relation to the 12th rib.

A practical method is as follows.

At the end of key stage operations on the upper urinary tract, focusing on the lower edge 12 of the ribs, palpation define the edge m.erector.trunci and transverse process I of the lumbar vertebrae. Then the dotted line in the vagina m.erector.trunci needle with a syringe with anesthetic 0.25% solution of novocaine, this weight is distributed on the vagina muscles to level 12 of the rib to the transverse process II lumbar vertebra with capture nerves of the lumbar plexus by penetration to intervertebrale the outlet of the nerves. Further, by setting the projection Petitou triangle in relation to the 12th rib, and the end of the 12th rib is as a reference to a line drawn vertically to the wing of the Ilium at 1-2 cm above the wing of the Ilium, peelable lumbar region and we get to a lateral edge of m.iliopsoas that forms in this area of the lower edge of pojasnichno-iliac fossa. This site retroperitoneal space is the boundary between the lumbar region and the cavity of the pelvis, in this area due to the physiology m is chiyogami ways and the position of the patient expires postoperative bleed and have exudate wounds of the injured area of the kidneys and urine, also in this plot accumulate retroperitoneal hematoma. Put drainage with subsequent holding it up in the course of the wound to the initial parts of the urinary tract allows for active aspiration, for example an electric or mechanical pump, remove the contents of wound exudate, with an increase in intraperitoneal pressure to reduce the size of the retroperitoneal space by squeezing exudate in this area.

The method is illustrated by the following examples.

Among the 53 patients studied" the group claimed method was conducted on 28 patients, while 25 patients ablative surgery conducted without paravertebral procaine blockade and without active selective drainage of the retroperitoneal space through Petitou triangle. Two "researched" group approximately matched in equal proportions by age from 35 to 55 years of age and sex composition: in the first group of men in 53.6%of women of 46.4%, and in the second group to 53.1% and 46.9%, respectively.

Clinical results of the applied method can be assessed as good, which is supported also by the results of observations, reflecting the improvement in the postoperative course of the disease in patients in tables 1, 2 and graph.

table 1

The intensity of the pain felt is the third in the immediate postoperative period in patients "researched" groups
Patient groupThe presence of pain in the wound in the postoperative period
2 hours after surgery4 hours after surgery6 hours after surgery
1st group of patients with held interoperational paravertebral procaine blockade and drainage of the retroperitoneal space through Petitou trianglenomoderate intensity of painIntense
2nd group patients carried out without interoperational paravertebral procaine blockade and drainage of the retroperitoneal space through Petitou triangleintenseintenseIntense
table 2

Comparative table of purulent-septic and bronchopulmonary complications of the patients in two groups
Patient groupPurulent-septic complicationsBronchopulmonary complications
abs. number% abs. number%
1st group of patients with held interoperational paravertebral procaine blockade and drainage of the retroperitoneal space through Petitou triangle13,500
2nd group patients carried out without interoperational paravertebral procaine blockade and drainage of the retroperitoneal space through Petitou triangle412,539,3
Statistical significance P<0,05

The proposed method improve the postoperative course of the disease with surgery of the upper urinary tract, namely Staghorn calculi stone, does not require special technical and medical supply, is easily observed in the surgical hospital at any level and improve the results of the postoperative treatment of disease.

Sources of information

1. Manual of urology. Under the editorship of Academician Lopatkin N.A., 2000.

The way to improve the postoperative course of the disease with operations in the upper urinary tract, including drainage, characterized in that the end of the main phase of the operation do paravertebrally blockade, puncture vagina m.erector trunci, and the subsequent drainage of the retroperitoneal space is done by entering the drainage to the lateral edge of the m.ilipsoas through the puncture lumbar region of 1-2 cm above the wing of the Ilium on the line drawn through the end of the 12 ribs vertically to the wing of the Ilium.



 

Same patents:

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.

1 dwg

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, 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: medicine.

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.

3 cl

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.

1 dwg

FIELD: medicine.

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: medicine.

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 surgery, and can be used for sanitation of the abdominal cavity with generalized peritonitis
The invention relates to medicine, namely to surgery, and may be applicable for the surgical treatment of pancreatic necrosis

The invention relates to medicine, namely to devices and devices for the treatment of abdominal diseases, namely anal (hemorrhoids, proctitis, fissures), gynecological (erosion, obesity, vulvovaginitis), as well as for active drainage surgery

FIELD: medicine.

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.

FIELD: medicine.

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.

1 dwg

FIELD: medicine.

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.

3 cl

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.

1 dwg

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

Draining tube // 2269365

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

Up!