RU2488364C2 - Cryomedical apparatus - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment, namely to cryomedicine. Apparatus contains microcryogenic system, which consists of gas cryogenic Split-Stirling machine with linear drive, compressor with two opposite pistons and with cryoagent. Split-Stirling machine is placed in cavity of bearing case, has connected to its edges ventilators and is connected from one side with cannula, and from the other - with control block of micro cryogenic system with buttons of switching on and switching off. Cannula has replacable cryotip, and on its working part placed with possibility of movement on it is power magnet in form of cylindrical bushing with ring-shaped projection, which comes into contact with respective ring-shaped groove of replaceable cryotip for fixation of its position relative to cooling head. Profile groove of replaceable cryotip is matched with profile projection of cooling head, and in zone of matching is thermoconductive paste is placed.

EFFECT: application of invention makes it possible to optimise construction and composition of cryomedical apparatuses.

2 cl, 6 dwg, 1 ex

Description

The invention relates to cryomedicine and medical equipment and is intended for use in medical technology for the treatment of diseases using cryosurgery and cryotherapy in various branches of clinical medicine, cosmetology, sporting, etc.

Cryosurgery as a branch of cryomedicine, used since the 1960s (Cooper J. et al., 1961, Kandel E.I., 1962), provides for the use of cryogenic (“freezing”) temperatures to affect living biological tissues by removing heat from them from the purpose of their destruction by gaseous, liquid and solid coolants (hereinafter referred to as cryoagents) to achieve surgical or therapeutic results or to solve other problems facing the attending physician.

The cryo-damaging effect on biological systems in the process of “freezing-thawing” is due to the main components of the mechanism [1, 2, 3]:

- direct damage to cells - a violation of water-electrolyte and biochemical processes in them due to extracellular and intracellular crystallization of water, dehydration of cell membranes and denaturation of protein components of cells upon contact freezing of biological tissues with a cryoapplicator cooled to cryogenic temperature. Extracellular crystallization takes place along the periphery of the frozen zone and in the cryovirus zone, which contributes to the preservation of their integrity by these cells. At the same time, the cooled cells die faster with a high cooling rate than with a slow one, and during heating, they die faster with a slow thaw than with a fast one;

- indirect (secondary) damage to cells - the development of aseptic inflammation due to vascular reactions that cause edema, thrombosis, ischemia, hypoxia, etc., which destroy biological tissues after cryotherapy.

The effect of cryogenic temperatures, mainly up to -196 ° С on warm-blooded biological tissues and organs, implements three main clinical phases of cold treatment - edema, ischemia, necrosis, healing, initiating the following main pathological effects:

- adhesion (cryoadhesion);

- tissue destruction - cryostasis or cryonecrosis, varying in severity of the dynamics of changes in the phase state of extra- and intracellular water;

- hemostatic effect;

- analgesic effect;

- immunostimulating effect;

- Penting effect (the course of the reparative process without the formation of rough scars), etc.

The aforementioned serves as the basis for the use of cryogenic temperatures in cryosurgical surgical interventions for painless and bloodless removal of degenerative, inflammatory, vascular or tumor pathological foci, as well as in cryotherapy during rehabilitation treatment and rehabilitation, cryoanalgesia, cryoreflexotherapy, etc.

In the field of cryogenics, cryogenic devices and devices based on various principles of cooling-Joule-Thomson, Peltier, Ettinghausen, Gifford-McMahon, etc., have been created and, more or less successfully, introduced into clinical practice. In this case, different types of liquid and solid cryoagents are used to cool the applicator tip [3, 4]: neon-up to -250 ° С, helium - up to -198 ° С, nitrogen - up to -196 ° С, nitrous oxide - up to -85 ° C, carbon dioxide - up to -70 ° C, freon - up to -65 ° C, etc., used in cryogenic equipment for local freezing of biological tissues for medicinal purposes.

In clinical practice, different types of cryogenic devices are used, which make up two main groups. The first group includes devices providing freezing of biological tissues with an open stream of cryoagent in a liquid or gaseous state, and the second group includes devices providing freezing by applying biological tissues with a cryoprobe cryo-tip. Among the latter group, close in technical essence to the claimed invention, there are:

- passive cryoprobes that accumulate cold when immersed in a cryoagent;

- cryoprobes with the supply of cryoagent from individual tanks;

- autonomous cryoprobe (the first autonomous cryosurgical apparatus on liquid nitrogen was proposed by Langer et al. in 1967).

The proposed cryomedical apparatus belongs to the group of devices of the class of constant readiness for work, not requiring refueling with a cryoagent, which most fully meets the modern requirements of cryomedicine - clinical and experimental cryosurgery and therapy.

Known cryomedical apparatus [4, p. 32, 33], containing a thermally insulated load-bearing housing, an inner container periodically filled with a cryoagent (liquid nitrogen), a cryoprobe with a circulating cryoagent, a set of interchangeable cryo-tips.

However, this cryomedical apparatus does not belong to the group of devices of the class of constant readiness for work, since it requires periodic refueling with a cryoagent from an additional Dewar vessel (every 10 minutes of operation due to the high consumption of cryoagent in the active phase of operations associated with cryodestruction of pathological tissues, and also during breaks). This device is difficult to use for many hours of extensive surgical interventions, for example, in oncology and general surgery, practicing the stages associated with cryodestruction, cryoadhesion and cryostasis of pathologically altered tissues, as well as providing cryo-hemostasis of the surgical field, etc. The use of this device is impossible due to difficulties in providing liquid nitrogen to clinics remote from its production centers. In addition, the lack of thermal insulation of the surfaces of interchangeable cryo-tips that do not come into contact with frozen sections of biological tissues during cryodestruction reduces the efficiency of cryo-cooling of biological tissues. At the same time, screwing the cryoprobe onto the cryoprobe and tightening it does not preclude the destruction of the cryoprobe made of a thin-walled tube.

Known cryomedical apparatus [4, p. 42, 43], containing a microcryogenic system consisting of a gas cryogenic machine operating on the principle of cooling Gifford-Mac-Magon, having a separate cylinder or compressor, a cooler associated with a displacer associated with a cannula, having a cooling head, a set of cryo-tips and a control unit for cooling or heating of the cryo-tips.

However, this cryomedical apparatus also does not belong to the group of apparatuses of the class of constant readiness for work, as it requires additional connection to a separate cylinder or compressor filled with a cryoagent, for example, air, nitrogen or helium. At the same time, it is problematic to use such a highly effective, but expensive and superfluid cryoagent as helium due to the fact that the design of the apparatus is not leakproof and relates to expendable devices. The above limits its use for many hours of extensive operations, for example, in oncology, general surgery, etc., requiring the implementation of cryosurgical stages associated with cryodestruction, cryoadhesion, cryostasis, cryo-hemostasis of tumor and pathological tissues. In addition, the lack of thermal insulation of the surfaces of cryo-tips (from the existing set), which do not come into contact with frozen sections of biological tissues during cryodestruction, reduces the efficiency of cryo-cooling of biological tissues.

The closest in technical essence and the achieved result is a cryomedical apparatus in the form of a microcryogenic system [5], containing a microcryogenic system consisting of a split-Stirling gas cryogenic machine with a linear drive, including a compressor with two opposed pistons, hermetically charged with a cryoagent - helium associated with capillary nozzle cooler, the cooler is associated with a displacer associated with a cannula having a cooling head, and the control unit of the microcryogenic system.

However, despite the fact that this device can be attributed to a group of devices of the class of constant readiness for work with the ability to control cooling modes or subsequent heating of the cooling head of the cannula, it is not intended for use in cryomedicine due to the implementation of the device in the form of a spatial block-wise construction large-sized versions that make it impossible to use it in the clinical setting of a limited surgical field and create inconvenience when working with it. In addition, the lack of a system for removing excess heat fluxes during overheating of the compressor and cooler, as well as the lack of thermal insulation of the surfaces of the cooling head and cryo-tips from a known set of interchangeable cryo-tips that do not come into contact with frozen sections of biological tissues during cryodestruction, make their use ineffective in cryo-cooling of biological tissues of various organs and cavities organism and limits the use of this device design in cryosurgery and cryotherapy.

The objective of the invention is the optimization of the design and composition of the cryomedical apparatus.

The objective of the invention is achieved in that a cryomedical apparatus containing a microcryogenic system consisting of a split-Stirling gas cryogenic machine with a linear drive, including a compressor with two opposed pistons, hermetically filled with a cryoagent, connected to a cooler by a capillary tube, the cooler is connected with a displacer associated with the cannula having a cooling head and a control unit for a microcryogenic system, characterized in that the gas split-Stirling cryogenic machine has a torus attached to it fans, located in the cavity of the supporting body, and connected on one side with a cooler mounted on the same axis as a cannula, the cooling head of which has a replaceable cryo-tip, and on the other, with a microcryogenic system control unit associated with the on and off buttons of the gas cryogenic machine , a speed regulator for opposing compressor pistons, a two-position switch for reversing the electric drive of a microcryogenic system located on a bearing body, installed on the working part of the cannula with the power magnet can be moved along it in the form of a cylindrical sleeve with an annular protrusion that comes into contact with the corresponding annular groove of the replaceable cryo-tip to fix its position relative to the cooling head, while the profile groove of the replaceable cryo-tip is aligned with the profile protrusion of the cooling head, and a heat-conducting one is placed in the interface area paste. At the same time, the surface of interchangeable tips is thermally insulated with a Teflon coating, except for areas that come into contact during cryotherapy with frozen biological tissues, as well as with the cooling head and the inner surface of the annular protrusion of the cylindrical sleeve of the power magnet made, for example, of a samarium-cobalt alloy.

Analysis of patent information showed that at the filing date of the application for an invention, the design of the cryomedical apparatus with the indicated distinguishing features is not known.

The invention is illustrated by drawings, which depict:

- figure 1 - isometric illustration of a cryomedical apparatus containing a microcryogenic system consisting of a gas cryogenic Split-Stirling machine with linear drive;

- figure 2 - isometric shows a cryomedical apparatus (detachable load-bearing housing - not shown);

- figure 3 - shows a section aa of the cryomedical apparatus (figure 2);

- figure 4 - shows a section bB of the cryomedical apparatus (Figure 3);

- figure 5 - shows a set of cryo-tips of various configurations and sizes, the surface of which is thermally insulated with a Teflon coating, except for areas in contact with the frozen areas of biological tissues, as well as with the cooling head and the inner surface of the annular protrusion of the cylindrical sleeve of the power magnet;

- figure 6 - shows a cryomedical apparatus in the process of implementing the stage of cryodestruction of the cervical ectopy region.

The cryomedical apparatus (Fig. 1 - Fig. 5) contains: a bearing body 1, consisting of a cone-shaped part 1.1 and a perforated cylindrical part 1.2, in the cavity of which a microcryogenic system 2, consisting of a split-Stirling gas cryogenic machine 3 with linear drive, which includes a compressor 3.1 with two opposed pistons (not shown in the figure), hermetically charged with a cryoagent - helium (cooling temperature to -198 ° C) or neon (cooling temperature to -250 ° C). The Split-Stirling gas cryogenic machine 3 is connected through a capillary pipe 4 to a cooler 5. The cooler 5 communicates with a displacer 6, is screwed to the lower flange 7 of the pre-assembled sleeve-holder 8. They are mounted on the same axis with a cannula 9, which has its terminal working parts of the cooling head 10. The upper cone-shaped flange 11 of the pre-assembled sleeve-holder 8 is the support of the cone-shaped part 1.1 of the bearing housing 1, fixed to it by screws 12. Associated with the cooler 5, the displacer 6, placed in the cannula 9 with capillary the nitrogen that ensures the circulation of the refrigerant is paired with a cooling head 10 having a profile protrusion 10.1. In contact with the cooling head 10 and in conjunction with the outer generatrix of the working part of the cannula 9, a power magnet 13 is installed, with the possibility of movement along it, made, for example, of a samarium-cobalt alloy. The power magnet 13 in the form of a cylindrical sleeve with an annular protrusion comes into contact with the corresponding annular groove of the replaceable cryo-tip 14 (hereinafter referred to as the cryo-tip 14) from the set of cryo-tips (Figure 5) and provides reliable power fixation of its position relative to the working end of the cooling head 10 due to the significant the attractive force developed by the power magnet 13. This eliminates the longitudinal or transverse displacement of the cryo-tip 14 relative to the axis of the cooling head 10 in contact with it through a thin layer of heat rovodyaschey paste 15 that improves heat transfer along their mating surface. In this case, the lateral displacements of the cryo-tip 14 relative to the cooling head 10 are limited by the annular flange of the magnet 13 in contact with the corresponding annular groove made near the plane of contact with the cooling head 10. In addition, the cryo-tip 14, equipped with a profile groove 14.1, is mated with the corresponding profile protrusion 10.1 of the cooling head 10 with the formation of their profile connection, preventing the circular turn of the cryo-tip 14 relative to the cooling head 10 and the axis of the working part cannula 9. This option of quickly connecting the cryo-tip 14 to the cooling head 10 or disconnecting it eliminates damage to the thin-walled working part of the cannula 9 and displacer 6, which in turn causes depressurization and destruction of the microcryogenic system 2. It allows you to eliminate a high level of bending and tangential stresses, often arising with known methods for connecting cryotips by screwing. To reduce the level of heat loss, the surface of the cryo-tip 14 is thermally insulated with Teflon coating 16, except for the areas that come into contact with the frozen sections of biological tissues, as well as with the cooling head 10 and the annular protrusion of the cylindrical sleeve of the power magnet 13. The set of cryo-tips 14 shown in Fig. 5 contains a typical series of cryo-tips for example, “disk-shaped”, “mushroom-shaped”, “secateurs”, “button-shaped”, “hemispherical”, “beveled peak”, “conical”, “olive-shaped cone”, etc., used in various branches of surgery and therapy, having different sizes and configurations of work endings designed for the implementation of certain technological stages of cryodestruction, cryoadhesion, cryostasis, hemostasis of pathologically altered biological tissues. During operation of the microcryogenic system 2, excess heat from the surfaces of the compressor 3.1 and cooler 5 is removed by the fans 17 through perforations of the cylindrical part 1.2 of the bearing housing 1. The split-Stirling 3 gas cryogenic machine and the fans 17 installed at its ends are powered from a 12 V DC network and are electrically connected to the control unit 18 of the microcryogenic system 2, which, in turn, is powered by an adapter 19 (12 V) from an alternating current network of 220 V. The control unit 18, which controls the cooling modes and heating of the cooling head 10, is equipped with a speed regulator 20 located on the cylindrical part 1.2 of the bearing housing 1, which controls the speed of movement of the opposing pistons of the compressor 3.1 and the on / off switch 21 of the electric drive reverse of the microcryogenic system 2, providing control of the cooling modes of the cooling head 10 (position I “Cooling” on-off switch 21) and heating the cooling head 10 (position II "Heating" on-off switch 21), as well as adjusting its temperature cooling or heating and, accordingly, the cryo-tip 14 in contact with it (its “Cooling” or “Thawing”), button 22 on and off the microcryogenic system 2 of the split-Stirling gas 3 cryogenic machine.

Cryomedical apparatus works as follows. Initially: the speed regulator 20 sets the average value of the speed of movement of the opposing pistons of the compressor 3.1, by switching the on-off switch 21 to position I (“Cooling”) and pressing the button 22, the microcryogenic system 2 is put into operation with its output, for 2-3 minutes, to active the "Cooling" mode of the cooling head 10, due to the expansion of the cryoagent in it. Cold is produced only in the expansion zone of the cryoagent - in the cooling head 10, therefore, thermal insulation of the cannula 9 is not required. After that, the speed controller 20 sets the maximum value of the speed of movement of the opposing pistons of the compressor 3.1. From the available set of cryo-tips (Figure 5), a cryo-tip 14 of the necessary configuration and size is selected taking into account the shape and size of the pathological formation to be cooled and frozen to a particular depth, and a thin layer of heat-conducting paste is applied 15. The cryo-tip 14 with the profile groove 14.1 is brought to the working end of the cooling head 10 with the profile protrusion 10.1 and mate with providing a profile connection, eliminating their circular displacement. A power magnet 13 is moved along the working part of the cannula 9, its bounding annular flange is mounted flush with the working end of the cooling head 10. The annular protrusion of the cylindrical sleeve of the power magnet 13 is brought into contact with the corresponding annular groove of the cryo-tip 14 with transverse fixation relative to the cooling head 10. The apparatus ready for work. After the appearance of crystalline ice in the form of hoarfrost on the non-heat-insulated working part of the cryo-tip 14 of the crystalline ice, the cryo-tip 14 is applied with a slight effort to the pathologically modified biological tissue surface prepared for cryotherapy (Figure 6). Upon contact with the frozen biological tissue pre-cooled to -180-198 ° C by the cryo-tip 14, the intensity of its cooling, the depth and volume of cryodestruction gradually decrease. Upon reaching the required freezing depth, which is visually determined by the formation, near the cryo-tip generatrix 14, the cryogenic rim of the “white” color with a width characteristic of one kind or another modified by the biological tissue process, the cryo-tip is heated 14. Heating is carried out by reversing the electric drive of the microcryogenic system 2 by switching the on-off switch 21 to position II (“Heating”), leading to a reverse cycle of the microcryogenic system 2, resulting in an expansion cavity of the cooling head 10, the cryoagent is heated, transmitted through the heat-conducting paste 15 to the cryo-tip 14, leading to its “thawing”, which improves the conditions for its removal from the cryodestruction area. The speed controller 20 reduces the speed of movement of the opposing pistons of the compressor 3.1, turns off the microcryogenic system 2 with the button 22, and removes the cryo-tip 14 from the cryodestruction zone of biological tissues. The cryomedical device is removed from the operating area, the adapter 19 is disconnected from the mains.

The possibilities of using this cryomedical apparatus in gynecology are indicative of cryodestruction of eroded tissues (e.g. epithelial dysplasia, leukoplakia), polyps of the cervix and cervical canal, cryocoagulation and cryostasis in cases of dysfunctional and climacteric bleeding, etc.

At the clinical base of the Department of Obstetrics and Gynecology No. 1 of the Omsk State Medical Academy in 2011-12. limited testing of the prototype of the proposed cryomedical apparatus.

Example. Patient L., 23 years old. Examined for cervical pathology. On examination, revealed cervical ectopia of the cervix, with a size in the range of 1.5-2.0 cm around the cervical canal. Diagnosed with Cervical ectopy. Urogenital chlamydia. According to the results of the examination, cryodestruction of the cervix is recommended.

Against the background of etiopathogenetic treatment, cryodestruction of the altered cervical epithelium was performed. Before the cryodestruction stage of the cervical ectopia is carried out, the vagina and vaginal part of the cervix are sanitized by sounding with low-frequency ultrasound through an intermediate ozone / NO-containing saline solution, which is a means of stopping chlamydial infection.

Then the second stage carry out cryodestruction of the cervix. For this, the speed controller 20 sets the average value of the speed of movement of the opposing pistons of the compressor, switches the on-off switch 21 to position I (“Cooling”) and by pressing the button 22 turn on the microcryogenic system 2 with its output for 2-3 minutes to the active mode “Cooling” "The cooling head 10. Then, the speed controller 20 sets the maximum value of the speed of movement of the opposing pistons of the compressor, filled with cryoagent - helium (cooling temperature to -198 ° C). From the set of cryo-tips (Figure 5), a cryo-tip 14 of the "fungus" type is selected, taking into account the shape and size of the ectopic region (1.5-2.0 cm around the cervical canal), which is subject to cryodestruction. A thin layer of heat-conducting paste 15 is applied to the profile groove of the cryo-tip 14 and mate it with the profile protrusion of the working end of the cooling head 10, which excludes their circular displacement. A power magnet 13 is moved along the working part of the cannula 9, its bounding annular flange is installed flush with the working end of the cooling head 10. The annular protrusion of the cylindrical sleeve of the power magnet 13 is brought into contact with the corresponding annular groove of the cryo-tip 14, performing its transverse fixation relative to the cooling head 10. After the appearance on the working part of the cryo-tip 14 of hoarfrost it is applied to the ectopic region (Fig.6). Upon contact with a frozen tissue (within 20-30 seconds) of a pre-cooled cryo-tip 14 (up to -180-190 ° С), its cooling intensity, depth and volume of cryodestruction are visually manifested by the appearance (near the generatrix of the cryo-tip 14) of a cryogenic rim of a ring-shaped “white” »Colors up to 2-3 mm wide. Upon reaching the required level of freezing of the ectopic region, the cryotip 14 is heated by reversing the electric drive of the microcryogenic system 2 by switching the on-off switch 21 to position II (“Heating”), which changes the cycle of operation of the microcryogenic system 2 to the opposite, as a result of which the cryoagent transmitted through heat-conducting paste 15 to the cryo-tip 14, leading to its "Thawing" and improving the conditions for its removal from the field of cryodestruction. Button 22 turns off the microcryogenic system 2, removes the cryo-tip 14 from the cryodestruction zone of biological tissues and removes the cryomedical apparatus from the operating area. At the subsequent control colposcopic examination, conducted after 1 and 2 months, the original epithelium was revealed, indicating a recovery. In the future, the patient did not show complaints.

The proposed technical solution allows the creation of a cryomedical apparatus of the class of constant readiness for work with practically non-expendable cryoagent and cold recovery, as well as with the ability to control the cooling regimes and subsequent heating of the cooling cryo-tip, which in general ensure its highly efficient use in cryomedicine. Optimization of its design and composition is provided by:

- coaxial placement of the main elements of the cryomedical apparatus in one load-bearing housing (Figs. 1-3 and 6), namely, a gas split-Stirling cryogenic machine with a linear drive with fans connected to it at the ends, connected to it by a microcryogenic system control unit and a cooler as well as those removed outside the bearing body: a cannula with a displacer, a cooling head and a cryo-tip, which allows to sharply minimize the overall size of the device, including taking into account the location of the controls on it: buttons on reading and turning off the gas cryogenic machine, the speed regulator for opposing compressor pistons, the on-off switch for reversing the electric drive of the microcryogenic system;

- the exception of periodic refueling of the cryomedical apparatus with a cryoagent during interventions in cryosurgery and cryotherapy (shelf life of at least 7 years; MTBF of 10,000 hours [5]), which allows it to be assigned to the class of devices of constant readiness for work;

- the convenience of working with the cryomedical apparatus with the achieved technical solution of its small linear and diametrical dimensions of the “manual” execution of the apparatus (see Figure 6), regardless of the external source of the cryoagent. In the case of using the built-in rechargeable power source, the device becomes autonomous;

- the use of a power magnet, for example, from a samarium-cobalt alloy, fixing the position of the replaceable cryo-tip relative to the cooling head, eliminating the longitudinal or lateral displacement of the cryo-tip relative to the cooling head with ease of installation, fixation and removal from the cooling head;

- the implementation of the profile of the interchangeable cryo-tip with the cooling head, excluding its circular displacement relative to it when placing heat-conducting paste between them to improve heat transfer at the interface;

- the presence of a set of interchangeable cryo-tips (Figs. 3, 5) thermally insulated with a Teflon coating, except for areas that come into contact with cryotherapy with frozen biological tissues, as well as with the cooling head and the inner surface of the annular protrusion of the cylindrical sleeve of the power magnet.

The proposed cryomedical device is a universal and multifunctional cryogenic medical device intended for use in various branches of clinical medicine (general surgery, oncology, gynecology, proctology and urology, otorhinolaryngology, dermatology, cosmetology, sporting, etc.).

The claimed invention will accelerate the introduction into clinical practice of highly efficient cryomedical devices of a class of constant readiness for work with the ability to control the cooling regimes of biological tissues and the subsequent heating of a cooling interchangeable cryo-tip, the rate of change of which during cryosurgery is decided by the use of mechano-magnetic fixation with a power magnet. The cryomedical device is operable in any spatial position, is not limited by the complexity of the surgical field, performs the functions of more complex devices of this purpose, and manipulations with it do not require effort.

Currently, a prototype of the proposed cryomedical apparatus "Cryodest-MM" is undergoing a set of preliminary technical and technological tests at the "Research and Production Enterprise" Metromed "(Omsk).

In accordance with the procedure established by the Ministry of Health of the Russian Federation for the organization of production of the cryomedical apparatus "Cryodest-MM" and its introduction into the practice of cryosurgery and cryotherapy of various branches of clinical medicine, the following documents have been developed: design documentation, TU project, Passport, Methodical recommendations for use. The program and methods of acceptance and clinical trials of the product.

Information sources

1. Lozina-Lozinsky L.K. Essays on cryobiology. L., 1972. - 288 p.

2. Kirpatovsky V.I. Et al., Frolova E.V. Organizational and biological problems of the functioning of the bank of organs / Medicine and healthcare. Series. Surgery, issue 4. - M .: VNIIMI, 1988 .-- 72 p.

3. Datsenko B.M. and others. Cryosurgery in proctology. - Chisinau: Cartya Moldoveniasca, 1990, pp. 4-29.

4. Verkin B.I. and others. Cryosurgery in dentistry, - Kiev: Sciences. Dumka, 1984. - 160 p.

5. The prospectus. A microcryogenic system based on a Split-Stirling gas cryogenic machine with a linear actuator MSMG-0.7A-0.5 / 80 KVO.0743.000. - Omsk: NTK “Cryogenic Technique”, 2011. - 1 p.

Claims (2)

1. Cryomedical apparatus containing a microcryogenic system consisting of a split-Stirling gas cryogenic machine with a linear drive, including a compressor with two opposed pistons, hermetically filled with a cryoagent, connected to a cooler by a capillary pipe, the cooler is connected to a displacer paired with a cannula having a cooling head , and the control unit of the microcryogenic system, characterized in that the gas split-Stirling cryogenic machine has fans connected to its ends and is not located in the cavity of the existing housing and is connected on one side with a cooler mounted on the same axis as a cannula, the cooling head of which has a replaceable cryo-tip, and on the other, with a microcryogenic system control unit associated with the on and off buttons of the gas cryogenic machine, a speed controller for opposing compressor pistons , a two-position switch for reversing the electric drive of the microcryogenic system located on the supporting body, on the working part of the cannula is installed with the possibility of moving forces on it a magnet in the form of a cylindrical sleeve with an annular protrusion that comes into contact with the corresponding annular groove of the replaceable cryo-tip to fix its position relative to the cooling head, while the profile groove of the replaceable cryo-tip is aligned with the profile protrusion of the cooling head, and a heat-conducting paste is placed in the interface zone. 2. The apparatus according to claim 1, characterized in that the surface of the interchangeable tips is thermally insulated with a Teflon coating, except for areas contacting during cryotherapy with frozen biological tissues, as well as with the cooling head and the inner surface of the annular protrusion of the cylindrical sleeve of the power magnet made, for example, of samarium cobalt alloy.

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