RU2429792C1 - Uterine cavity vacuum aspiration tip - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: uterine cavity vacuum aspiration tip comprises the following components sequentially coupled from a working end: an aspiration tube with annular holes in a side wall and a limiter with a nozzle connected to an aspirate discharge tube. A working distal end of the aspiration tube is rounded smoothly in the form of a projecting portion of a hollow ball-shaped body. The lengths of the aspiration tube and the limiter are related as:

at d_lim. = 20 mm, where L_tub. is the length of the aspiration tube, L_lim. is the length of the limiter; d_lim. is the diameter of the limiter.

EFFECT: invention enables postpartum uterus vacuum aspiration if observing any inflammatory disease in a puerperant.

4 cl, 3 dwg, 1 ex

Description

The invention relates to medical equipment, namely to obstetric and gynecological instruments. It can be used in medicine, more specifically in gynecology, for vacuum aspiration of the uterine cavity with postpartum complications: postpartum endometritis, uterine subinvolution, the presence of residues of placental tissue.

Known suction gynecological tips [copyright certificate SU for the invention No. 1643007, patent RU for utility model No. 23376]. They are made in the form of tubes with side holes and perforation of the wall of the working end.

However, these tips are used to terminate early pregnancy and for endometrial biopsy.

Also known as "Aspiration gynecological tip" [RU patent for invention No. 2020890]. It contains a tubular body with an axial channel, an end hole, a window in the working part. The tip has additional holes made on the working part. Outside the working part, additional holes are made coaxially with each other and diametrically opposite. A movable sleeve is installed on the tip for overlapping holes made in the inactive part.

Also known is the "Gynecological tip for vacuum aspiration of the uterine cavity" [RU patent for invention No. 2053720]. It contains an aspiration tube with aspiration holes located at a narrowed working end mutually perpendicular to each other. A restrictive ring is made on the outer surface of the tube to which an additional outer tube is rigidly attached at one end, enclosing the suction and fixed to it by the other end. In the internal channel of the suction tube there are hollow protrusions forming air ducts for communicating the working end with the atmosphere, as well as a flexible nozzle with a peripheral mustache connected to a flat rod and a ramrod for moving the nozzle when it is installed in a working position.

However, all of the above analogues are designed either to terminate early pregnancy by vacuum aspiration, or to endometrial biopsy and cannot be used effectively to remove the contents of the uterine cavity in women in the postpartum period for several reasons, one of which is a structural increase in the size of the uterus and her neck.

The closest analogue to the claimed invention is the “Cervical electrode tip” [RU patent for utility model No. 65380] and a technical solution with the participation of the author of the above utility model A. Churakov [RU patent for utility model No. 21345]. It includes a cervical tip with a length of 45-50 mm, made cylindrical with a smoothly rounded distal end. The tip has four sizes for the diameter of the cylindrical part inserted into the cervical canal: 3 mm; 4 mm; 5 mm and 6 mm. The central channel is located along the axis of the cervical tip. Holes with a diameter of 1 mm are made on the lateral surface of the cylindrical part of the tip, communicating with the central channel. A circularly located protrusion stop is placed in the middle part of the tip. The cervical tip is connected by a tube made of a dielectric flexible material with a fitting. The latter is connected to the cervical tip inside the tube by a wire of conductive material for the implementation of vibration massage of the cervix.

The disadvantage of the closest analogue and all other analogues is the impossibility of their use in women in the postpartum period, since during childbirth it changes significantly towards an increase in the architectonics of the cervix, as indicated above. Even within a few days, architectonics does not return to its former size. In case of postpartum inflammatory complications, it is necessary to treat the uterine cavity. However, suitable modern tips and other tools for treating patients in the postpartum period have been extremely insufficiently developed, and there is no gynecological postpartum uterine tip at all.

Slowing down the processes of reverse development of the uterus is one of the main pathogenetic mechanisms for the occurrence of postpartum septic diseases, primarily endomyometritis [Nikonov AP, Asstaturova OR Postpartum Infectious Diseases // Gynecology. 2007.V.9. Number 3].

The inner surface of the uterus after separation of the placenta is an extensive wound surface, which gives reason to consider the course of puerperia from the point of view of the doctrine of the wound. The basis of this teaching is the principle of the speediest and, if possible, radical surgical treatment of an infected wound in combination with its adequate drainage and rational antibacterial therapy.

Recently, in connection with the expansion of diagnostic and therapeutic capabilities, there has been an interest in active surgical tactics for the management of the postpartum period.

Manual vacuum aspiration is included in the complex of therapy for postpartum subinvolution of the uterus and acute postpartum endometritis. The features of the postpartum uterus during the development of these complications are an increase and insufficiently dense consistency of the uterus with a reduced rate of formation of the internal pharynx and cervical canal, which necessitates the choice of the most optimal effect on the uterus in order to prevent possible complications.

Sonographic studies show that in the uterine cavity with postpartum inflammatory diseases there are a large number of pathological inclusions (delayed secretions, residues of decidual tissue, amniotic membranes, etc.). In these cases, the surgical removal of the morphological substrate, as a rule, contributes to the relief of the inflammatory process that occurs in the uterine cavity when its drainage function is impaired. In most puerperas, the very day after the surgical treatment of the endometrium, the nature of the discharge from the genital tract is normalized, the processes of uterine involution are significantly accelerated.

Vacuum aspiration of the contents of the uterine cavity can be regarded as a partial surgical treatment of an infected wound performed on an internal organ. Vacuum aspiration can significantly reduce bacterial contamination of the contents of the uterine cavity. The inclusion of vacuum aspiration of the contents of the uterine cavity into a set of methods for the prevention and treatment of postpartum endomyometritis is fully justified. The earlier the surgical treatment of the endometrium is performed, the higher its effectiveness and, obviously, the risk of spreading the infection to the myometrium with the subsequent generalization of the process is less.

The tip for vacuum aspiration of the uterine cavity is an independent part of the system from which it is removed after operation for one patient in accordance with the modern international standard for one-time use of removable replaceable instruments (see the text on the page under the picture on the website http: //www.din.kai .ru / catalog /? pid = 47). The limiter, with the help of which the exploited tip is emphasized in the vacuum aspirator system, located in front of the cervix of the puerpera in the postpartum period during the treatment with vacuum aspiration in case of postpartum inflammatory complications in the form of, for example, postpartum endometritis, is also a one-time element of the operation system. To accomplish this, replace one-time tools, there are modern materials and technologies that manufacture products from polyethylene medical compounds. The requirements for such gynecological tips are tens and hundreds of times higher than the requirements for vacuum aspiration devices, which have been used for several years, unlike the working part of the tip. This makes the tip with the limiter a multi-run independent medical device, if necessary, once operated. The aspiration system into which it can be integrated is different. However, the output sizes of the diameters of the tubes 1, 2 are always standard and possible for different sizes.

The task of the invention is the ability to vacuum aspirate directly the contents of the uterine cavity with postpartum complications: subinvolution of the uterus, the presence of residues of placental tissue, postpartum endometritis.

The essence of the claimed invention lies in the fact that in the tip for vacuum aspiration of the uterine cavity, containing in series connected from the side of the working end: an aspiration tube with round holes in the side wall and a limiter with a fitting placed inside it, brought to the tube to remove aspirate, while working the distal end of the suction tube is smoothly rounded in the form of the protruding outward part of the hollow spherically shaped body, the length of the suction tube and the limiter are associated with elations:

where L _tr. - the length of the suction tube;

L _ogre. - length of the limiter;

d _ogre - diameter of the limiter.

In addition, a tip is claimed for vacuum aspiration of the uterine cavity with the above features, in which the diameter of the round holes in the side wall of the suction tube is 2-4 mm.

A tip for vacuum aspiration of the uterine cavity with the aforementioned features is also disclosed, in which the surface of the restrictor is made of rounded step-shaped in the form of three distinct zones: the central one with a diameter in the form of a ring of regular shape, the distal zone towards the aspiration tube in the form of a circularly protruding surface protruding to it , proximal area in the form of a truncated cone in the direction of the tube to remove aspirate.

The tip for vacuum aspiration of the uterine cavity, the dimensions of the elements of which are subject to the ratio:

where d _rings are the diameter of the ring;

d _output - diameter of the outlet.

The technical result of the claimed invention is to develop a technical embodiment of the possibility of adapting uterine gynecological tips for vacuum aspiration in the treatment of inflammatory diseases of puerperas. Especially for this period, there are no uterine gynecological tips, and other equipment is conditionally suitable, since the architectonics of the uterus undergoes significant changes during childbirth, which does not allow using it effectively. Calculated on a large number of examples and empirically worked out relationships led to modified forms and geometry of the nodes and parts of the claimed gynecological tip. It became justifiably different: with a different profile of the restrictor on the distal and proximal sides, with large holes in the suction tube, with their other number several times (5-6) exceeding the length of the suction tube. The named improvements are of a technical nature in bringing medical instruments to the possibility of use for a group of patients for whom all existing uterine tips did not fit, at best some conditionally.

The invention is illustrated using Fig.1-3, which depicts a General view of the tip for vacuum aspiration of the uterine cavity. 1-3, the positions 1-5 indicate:

1 - suction tube;

2 - round holes;

3 - limiter;

4 - tube for removing aspirate;

5 - fitting.

The inventive tip for vacuum aspiration of the uterine cavity is a combination of parts connected in series from the working end, providing a solution to the problem: an aspiration tube 1 with a length of 90-120 mm with round holes 2 in the side wall, a stopper 3 with a fitting 5 placed inside it, connected to tube for removing aspirate 4. The total number of holes in the suction tube 1 depends on their number in a row along the suction tube 1 and the number of their rows parallel elongated along it. In the claimed case, their optimal number is 40. The working distal end of the suction tube 1 is made smoothly rounded in the form of the protruding outward part of the hollow spherical body. The limiter 3 is made in the form of a horizontally oriented body of a complex step-like smooth rounded shape with a smaller diameter from the side of the suction tube 1 and a larger one from the output end of the nozzle 5. The lengths of the suction tube 1 and the limiter 3 are connected by the ratio:

where L _tr. - the length of the suction tube 1;

L _ogre. - the length of the limiter 3;

d _ogre - diameter of the limiter 3.

This ratio is obtained using calculated statistically and empirically worked out data and is optimal.

In addition, the round holes 2 in the side wall of the suction tube 1 have a diameter of 2-4 mm.

The surface of the restrictor 3 is made of a smooth rounded step-like shape in the form of three distinct zones: a central central one with a diameter in the form of a ring of regular shape, a distal zone in the direction of the suction tube 1 in the form of a circularly protruding surface protruding to it, a proximal zone in the form of a truncated cone in the direction of the tube for removal of aspirate 4. The dimensions of the limiter 3 are subject to the ratio:

where d _rings = 20 mm is the diameter of the ring in the center of the stop 3;

d _output - diameter of the outlet of the limiter 3.

The tip for vacuum aspiration of the uterine cavity works as follows.

A patient in the postpartum period with an inflammatory complication, for example, with postpartum endometritis, is placed on a gynecological chair. The tip is removed from the sterile packaging, attached to a vacuum source. The external genitalia and cervix, removed using a Cuzco mirror, are treated with a sterile swab moistened with a disinfectant solution. Fix the cervix to bullet forceps. Gently introduce the working end of the suction tube 1 of the tip into the uterine cavity. Its large length and small diameter make it possible. The limiter 3 with transverse dimensions exceeding the size of the analog limiters for fixation, allows you to place it "without failing" in the enlarged cervix after birth, which changed its architectonics. Then, the vacuum source is turned on and the contents of the uterine cavity are aspirated through the suction openings 2. The perfectly smooth streamlined tip surface both along the length and across, which does not have parts transversely located on its surface, spacer elements, as in a number of analogues, facilitates manipulation procedures.

Example

The claimed invention has been implemented so far in experimental samples of two standard sizes manufactured at one of the enterprises of the military-industrial complex with a high-precision level of the machine park. The product is being prepared for practical testing in medical conditions.

Claims (4)

1. A tip for vacuum aspiration of the uterine cavity, containing serially connected from the side of the working end: an aspiration tube with round holes in the side wall and a stopper with a fitting placed inside it and brought out to the tube to remove aspirate, while the working distal end of the suction tube is smoothly rounded in the form of a protruding outward part of a hollow spherically shaped body, characterized in that the lengths of the suction tube and restrictor are connected by the ratio

where L _tp. - the length of the suction tube, L _ogre. - length of the limiter; d _ogre - diameter of the limiter. 2. The tip according to claim 1, characterized in that the diameter of the round holes in the side wall of the suction tube is 2-4 mm. 3. The tip according to claim 1, characterized in that the surface of the limiter is made of rounded step-shaped in the form of three distinct zones: a central central one with a diameter in the form of a limited ring of regular shape, a distal zone in the direction of the suction tube in the form of a circularly protruding surface protruding towards it, proximal zone - in the form of a truncated cone in the direction of the tube to remove aspirate. 4. The tip according to claim 3, characterized in that in it the dimensions of the limiter are subject to the ratio

where d _rings - the diameter of the ring limiter;
d _ex. - diameter of the outlet of the limiter.

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