RU72856U1 - DEVICE FOR EMERGENCY DRAINING OF THE CUP AND PULPOUS SYSTEM - Google Patents

Abstract

A device for percutaneous drainage of the pyelocaliceal system, which is a needle on the end of which ultrasound markers are applied, a mandrin mounted in the lumen of the needle, an external cannula movably mounted on the needle, and drainage in the form of a pig-tail flexible tube ») With holes on the inner surface of the ring. The device is equipped with a device for moving the external cannula and drainage along the needle, made in the form of thrust plates with a restrictive cable, the length of which is equal to the length of the free section of the needle.

Description

The utility model relates to medical equipment and can be used for percutaneous drainage of the pyelocaliceal system (hereinafter - HLS).

In clinical practice, for the implementation of percutaneous nephrostomy, a flexible drainage catheter with an internal fixation mechanism in the form of an end folded into a ring (pig-tail type) equipped with holes on the inner surface of the ring is widely used (Figure 1) (Percutaneous puncture X-ray endourological interventions on the upper urinary tract in cancer patients, “Medical imaging”, No. 1, 2002, p. 94). However, the known catheter is included in a set of expensive disposable devices for nephrostomy and has the following disadvantages:

- the need for 2-4-fold bougienage in order to create a channel for installing a nephrostomy tube;

- the need for X-ray television control over the location of the conductor string).

Also known device for percutaneous drainage of the biliary system, presented in figure 2. (Ivshin V.G., Yakunin A.Yu., Lukichev O.D. Transcutaneous diagnostic and biliary interventions in patients with obstructive jaundice. Tula 2000. P.78-79).

The device is a needle (1) with the outer cannula (2) movably mounted on it and a drainage tube (3). The device is equipped with a device for moving the external cannula and drainage along the needle, made in the form of thrust plates (4) with a restrictive cable (5). The dimensions of the external cannula and drainage are selected such that the assembled form remains a free area of the needle. The length of the restrictive cable (5) is equal to the length of the free area of the needle (1). Special markers are applied to the end of the needle to improve its visualization using ultrasound. A mandrin is installed in the lumen of the needle.

The known device is intended for percutaneous drainage of the biliary system and cannot be used for percutaneous nephrostomy due to the fact that the direct cholangistomic drainage does not have an internal fixation mechanism and, therefore, cannot be reliably fixed in the expanded CLS.

The design of the inventive utility model allows to overcome the above disadvantages and has the following advantages:

- the draining of the CLS can be performed under the control of ultrasonic scanning in rooms without protection from ionizing radiation. This eliminates the need for the use of X-ray television equipment and, as a result, significantly reduces the cost of equipment, eliminates radiation exposure to the patient and staff;

- the device is made of stainless steel and after appropriate processing can be used repeatedly, only the drainage tube is disposable;

- the presence in the device of a conductor string designed to fix the drainage tube can reduce the risk of injury to the opposite wall of the cup and large (segmental, arc) vessels of the kidney in conditions of insufficiently reliable visualization of the needle in the lumen of the CLS (isolated pyelectasia, grade 1 hydronephrosis, reduced acoustic availability) .

The indicated technical and economic results when using the claimed utility model in medical practice are achieved due to the fact that the device for percutaneous draining of the CLS includes a needle, ultrasound markers are applied to its end, a mandrin mounted in the needle’s lumen, an external cannula and drainage are movably mounted on the needle, provision of a device for moving the external cannula and drainage along the needle, made in the form of thrust plates with a restrictive cable, the length of which is equal to the length of the free section needle.

A feature of the utility model is that the drainage is made in the form of a flexible tube of the pig-tail type with holes on the inner surface of the ring.

When preparing the device for operation, the rolled end of the nephrostomy tube is straightened and put on the cannula in a straightened form.

The distal end (in section) of the inventive device prepared for operation is presented in FIG. 3, where (1) is a needle with a mandrin (2) and an external cannula (3) movably mounted on it and an extended pig-tail flexible drainage tube - “Pork tail” (4).

The draining of the HF using the inventive device is as follows. Under the control of ultrasound scanning on the skin choose

the place of the optimal puncture of the most accessible area of the kidney line. Through the skin incision, puncture is carried out with the free part of the needle (Figure 4), while the external cannula and the drainage tube placed on it remain outside the skin of the patient.

Using 3D reconstruction of the ultrasound scanner, the position of the tip of the needle in the lumen of the cup is determined. An additional confirmation of the needle getting into the right part of the enlarged HRS kidney is the appearance of urine in the lumen of the needle.

Using the thrust plates fix the position of the needle and carry out the translational movement of the external cannula and drainage along the needle (Figure 5) at a distance equal to the length of the restrictive cable.

In this case, the distal end of the drainage appears in the lumen of the expanded part of the pyelocaliceal system, exactly at the location of the end of the needle. Then, a deeper introduction of drainage into the lumen of the calyx or pelvis and removal of the needle with mandrin and cannula are performed. In this case, the drainage tube takes its original shape in the form of a curved loop (Fig.6).

After ultrasound testing (3D reconstruction and antegrade administration of the pyelocaliceal system of a sterile saline solution or novocaine with visualization of its “movement” in the pelvis), the drainage is fixed to the skin and an extension tube is connected.

Claims (1)

A device for transdermal drainage of the pyelocaliceal system, including a needle, ultrasound markers are applied to its end, a mandrin mounted in the lumen of the needle, an external cannula and drainage movably mounted on the needle, equipped with a device for moving the external cannula and drainage along the needle, made in the form of persistent plates with a restrictive cable, the length of which is equal to the length of the free portion of the needle, characterized in that the drainage is made in the form of a flexible tube of the "pig-tail" type ("pig tail") with holes on the inside surface of the ring.