CN101889885A - Renal artery blockage and cold infusion device for laparoscopic surgeries - Google Patents
Renal artery blockage and cold infusion device for laparoscopic surgeries Download PDFInfo
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- CN101889885A CN101889885A CN2010102399554A CN201010239955A CN101889885A CN 101889885 A CN101889885 A CN 101889885A CN 2010102399554 A CN2010102399554 A CN 2010102399554A CN 201010239955 A CN201010239955 A CN 201010239955A CN 101889885 A CN101889885 A CN 101889885A
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Abstract
The invention discloses a renal artery blockage and cold infusion device for laparoscopic surgeries, which comprises a renal artery blockage clip, wherein the renal artery blockage clip is integrated with a renal artery puncture needle, is connected with an infusion tube capable of simultaneously and continuously infusing normal saline or kidney protection fluid of 0 to 4 DEG C to the kidney, and is an ordinary 4cm bent vascular clamp which is widely used for blocking renal arteries in partial nephrectomy at present; the renal artery puncture needle is similar to a vascular sclerosis needle, and consists of a needle core and a sheath; the renal artery blockage clip and the renal artery puncture needle are fixedly connected with each other to be integrated; and the renal artery puncture needle is fixed to the middle part of the front half of the renal artery blockage clip vertically and at 60 degrees to a horizontal direction. The renal artery blockage and cold infusion device has the characteristics of rational design, simple structure, material cost saving, simple operation, capability of effectively reducing haemorrhage in the surgeries, protecting renal function, remarkably prolonging renal blockage time (longer than 1 hour) in the surgeries without damaging the renal function, greatly reducing the risk of laparoscopic partial nephrectomy, extensively developing the laparoscopic partial nephrectomy, and the like.
Description
Technical field
What the present invention relates to is that a kind of peritoneoscope is blocked and cold-penetration injection system and the application in the peritoneoscope partial nephrectomy thereof with kidney, belongs to clinical medicine surgery technical field.
Background technology
Kidney part resection operation is very fast at developed recently; the main application and the renal carcinoma of diameter of tumor less than 3cm; the solitary kidney tumor; the bilateral tumor of kidney; benign tumors such as renal hamartoma; segmental kidney vascular malformation; duplex kidney deformity companion inadequate drainage; hemorrhage and the urinary extravasation of limitation injury of kidney companion; be confined on the kidney or the diseases such as multiple calculus of the following utmost point; operating difficulty is bigger; hemorrhage control and the processing of kidney otch and the protection of renal function when its main difficulty is to perform the operation; but its theory that keeps renal function obtains affirming of urinary system circle both at home and abroad, so this operation has good prospect.Traditional open surgery is through the long otch of waist, under the situation of blocking or do not block the kidney base of a fruit, lesion portion is excised, and means hemostasis such as stitching, hemostatic gauze filling, still have amount of bleeding big, sew up difficult, not attractive in appearance, labour force and influence shortcomings such as big, perform the operation and mainly carry out in some big medical institutions.
Laparoscopicallyly occur making various Urology Surgery operations to obtain minimally-invasive treatment, particularly some destructive operations.In recent years, the Urology Surgery plastic operation is carried out in the progress of suturing skill under the peritoneoscope clinically gradually, comparative maturity be the renal pelvis plastic operation.The technological progress of laparoscopic surgery also makes kidney part resection operation obtain new development, and increasing urological surgeon utilizes peritoneoscope to carry out this operation, but the requirements of operation height not only will excise pathological changes, also will sew up kidney operation tangent plane in the limited time.In the art as do not block the kidney base of a fruit, though avoided the influence of the hot ischemia of excess of the kidney matter, intraoperative blood loss can increase, and exposes not goodly, and give removal lesion tissue and recognize that relevant structure brings difficulty, even because of hemorrhage threat to life.If the temporary interruption kidney base of a fruit in the art, amount of bleeding will reduce, it is very clean that the art open country can become, and can accurately recognize pathological tissues, helps accurate cutting, particularly when sewing up aggregation system, seem more favourable, but because the influence of hot ischemia, operating time will limit to some extent, and renal function can damage inevitably to some extent in the art, especially for solitary kidney or functional solitary kidney tumor patient, the postoperative renal function can descend to some extent even can cause renal insufficiency.In view of this, the whole bag of tricks of renal function protecting when many scholars begin to explore the blocking-up kidney base of a fruit, main cooling of still concentrating the Rhizoma Atractylodis Macrocephalae open country comprises the kidney surface cooling, excess of the kidney matter frozen water perfusion etc.There is experiment to show that 20～25 ℃ can guarantee that excess of the kidney matter is without prejudice in 90min.To ice bits underwent operative operation duct behind application such as the Gill blocking-up kidney base of a fruit and insert renal cortex is lowered the temperature, thereby reach the purpose of renal function protecting.Report such as Landman reduces the kidney temperature internally through ureteral catheter retroperfusion kidney.And row LPN when femoral arteriography to renal artery brine ice pours into kidney such as Janetschek.Though certain effect is all arranged, the above two cooling-down effects are poor, latter's complicated operation and costliness.
Summary of the invention
The objective of the invention is to overcome the deficiency that prior art exists, and provide a kind of can be under condition strict, the effectively control of the kidney base of a fruit and low temperature depletion of blood calm excision pathological changes, safety finish completely that the kidney otch is handled and effectively the laparoscopic surgery of renal function protecting with renal artery blocking-up and cold-penetration dispensing device.
The objective of the invention is to finish by following technical solution; it includes renal artery blocking-up folder; described renal artery blocking-up folder is integrated with a renal artery puncture needle, and is connected to and can continues the normal saline of 0～4 ℃ of perfusion or the tube for transfusion of kidney protection liquid to kidney simultaneously.
Described renal artery blocking-up folder is blocked arteriorenal common 4cm when being widely used in partial nephrectomy now and is bent vascular clamp; Described renal artery puncture needle is similar to the sclerosis of blood vessels pin, is made up of nook closing member and epitheca two parts.
Described renal artery blocking-up folder is integrated by being mutually permanently connected with renal artery puncture needle, and renal artery puncture needle is vertically vertical, 60 ° of centres of being fixed in renal artery blocking-up folder first half of level.
The present invention improves existing kidney base of a fruit control and kidney cooling way, does not disturb surgical field of view, does not influence operation technique, guarantees that the safety of peritoneoscope kidney part resection operation is carried out, and guarantees effective protection of renal function.It can be under the situation of making reliable control of the kidney base of a fruit and cold ischemia safe handling kidney otch, can reduce amount of bleeding again, make this operation reach even be better than the effect of open surgery.
Description of drawings
Fig. 1 is a structural representation of the present invention.
The specific embodiment
The present invention will be described in detail below in conjunction with accompanying drawing: shown in Figure 1; the present invention includes renal artery blocking-up folder 1; described renal artery blocking-up folder 1 and one renal artery puncture needle 2 is integrated, and is connected to and can continues the normal saline of 0～4 ℃ of perfusion or the transfusion device 3 of kidney protection liquid to kidney simultaneously.This transfusion device 3 links to each other with renal artery puncture needle 2 by tube for transfusion 4.
Described renal artery blocking-up folder 1 is blocked arteriorenal common 4cm when being widely used in partial nephrectomy now and is bent vascular clamp; Described renal artery puncture needle 2 is similar to the sclerosis of blood vessels pin, is made up of nook closing member and epitheca two parts.Described nook closing member has the mobility of 1cm in sheath, head puncture part is stainless steel hollow needle, external diameter is 0.2mm, can puncture and enter the intra-arterial partial-length is 0.5cm, and what be attached thereto is the hollow nook closing member, and external diameter is 0.5mm, the nook closing member total length is 30cm, after can meet general infusion set or blood exchange transfusion set, the sheath of diameter 1.0mm is arranged, but nook closing member and sheath end screw thread are fixed outward.
Described renal artery blocking-up folder is integrated by being mutually permanently connected with renal artery puncture needle, and renal artery puncture needle is vertically vertical, 60 ° of centres of being fixed in renal artery blocking-up folder first half of level.
The present invention increases renal artery puncture needle in one on the basis of renal artery blocking-up folder (common vascular clamp), link to each other with external by tube for transfusion, carry out the blocking-up of kidney blood confession, and lasting cold-penetration is annotated.
Embodiment
1) by illustrating the fixed part of making renal artery puncture needle and epitheca head both sides and vascular clamp;
2) renal artery puncture needle is fixed in the central authorities of curved vascular clamp one arm of 4cm, concave surface forward, after meet transfusion device or blood exchange transfusion set, promptly finish the making of renal artery blocking-up and cold-penetration injection system.
Embodiment 1: renal artery blocking-up and cold-penetration injection system are used for zoopery
After the experiment pig general anesthesia, dorsal position, by umbilicus, peritoneoscope is placed as Trocar A by about 2～3cm place on the umbilicus level.Select Trocar B above the about 7～10cm in the outside of Trocar A place, the B hole is with blocking renal artery in the Rhizoma Atractylodis Macrocephalae.Trocar C then is positioned on the same vertical line of Trocar B, and the three constitutes an equilateral triangle.After puncturing successfully, under pneumoperitoneum pressure 13～15mmHg, carry out renal artery blocking-up cold-penetration and annotate experiment.Find kidney, vertically cut peritoneum and perirenal fascia outside slightly, separate, promptly see the kidney arteriovenous, separate that to be about to renal artery behind the little fat fully free to kidney base of a fruit place at the hilus renalis.Extract Trocar A, renal artery blocking-up and cold-penetration injection system are inserted intraperitoneal by the A hole, again insert Trocar A again, clamping the renal artery blocking-up with elastic separating plier or needle holder is clipped near ventral aorta root blocking-up renal artery, make puncture needle aim at renal artery, release puncture needle forward and promptly finished arteriorenal puncture, after connect tube for transfusion and continue 0～4 ℃ of normal saline of perfusion, the about 100cmH of perfusion pressure
2O, metanephros bleached gradually in about 3 minutes, saw through wall of vein and saw that the blood in the renal veins is also thin out gradually, cut excess of the kidney matter after about 10 minutes, saw that it is water but not blood that tangent plane flows out, and puncture is poured into successfully.Sew up the kidney otch, extract puncture needle, open renal artery sees that kidney recovers the preceding normal color and luster of blocking-up immediately, and arterypuncture place pulsation is hemorrhage, oppresses 3min with dry gauze, and promptly blood ends.Looking into kidney myometrial suture place does not have movable hemorrhagely, takes out renal artery blocking-up and cold-penetration injection system, extracts Trocar, and experiment is finished.Renal artery blocking-up, puncture, filling process are operated smoothly, the about 45min of experimental period, and renal artery blocking-up and puncture time spent be 2min only.
Embodiment 2: renal artery blocking-up and cold-penetration injection system are used for people's partial nephrectomy
After the general anesthesia, get left lateral position (90 degree), sterile drape, the other right side of umbilicus is inserted Trocar A and is placed peritoneoscope, abdominal cavity inflation, pneumoperitoneum pressure 13～15mmHg.Insert Trocar B below right costal margin in the anterior axillary line, Trocar C is placed on 2cm place, top in the anterior superior iliac spine, and Trocar D is positioned at Trocar A posterior axillary line place, top slightly.Find kidney, vertically cut peritoneum and perirenal fascia at the hilus renalis outside slightly, separate to kidney base of a fruit place, ultrasound knife separates the renal artery surrounding tissue, and fully free renal artery is seen the about 3mm of renal artery diameter, the about 3cm of trunk length.Find tumor, fully free tumor surrounding tissue.Extract Trocar A, renal artery blocking-up and cold-penetration injection system are inserted intraperitoneal by the A hole, again insert Trocar A again, clamping the renal artery blocking-up with elastic separating plier or needle holder is clipped near ventral aorta root blocking-up renal artery, make puncture needle aim at renal artery, release the about 4mm of puncture needle forward and promptly finished arteriorenal puncture, after connect tube for transfusion and continue 0～4 ℃ of normal saline of perfusion, the about 100cmH of perfusion pressure
2O, about 5min metanephros bleaches gradually, behind about 10min with shears apart from the complete tumor of digging out of the about 0.5cm of tumor, see that tangent plane flows out light bloody fluid, seam is pricked blood vessel, sew up the kidney otch continuously, extract puncture needle, open renal artery, see that kidney recovers the preceding normal color and luster of blocking-up immediately, arterypuncture place pulsation is hemorrhage, oppresses 3min with dry gauze, and promptly blood ends.Looking into kidney myometrial suture place does not have movable hemorrhagely, and kidney placed around drainage tube takes out renal artery blocking-up and cold-penetration injection system, extracts Trocar, sews up incision of abdominal wall, and art finishes.Operation process is smooth, hemorrhage about 50ml, and operation about 1.5h of time spent, about 1h of kidney blocking-up time finishes blocking-up about 5min of puncture time.
Keep the nephron operation and accepted by international, domestic more and more scholars, along with constantly improving of laparoscopic device and improving constantly of technology, the peritoneoscope partial nephrectomy is used to more and more treatment of diseases.But so far, this technology only is confined to the minority large hospital carries out, and its main cause one is to cause renal ischaemia after the renal artery blocking-up, the infringement renal function, and the renal artery blocking-up time can not surpass 30min, otherwise will cause the irreversible lesion of renal function.The 2nd, as not blocking renal artery, then intraoperative hemorrhage is many.At present, the most effectual way of renal function protecting is a low temperature, and the heating ischemia is cold ischemia, thereby can prolong the kidney blocking-up time (greater than 1h) greatly, and the most effective method is the renal artery hypothermia perfusion.The successful exploitation of renal artery blocking-up and cold-penetration injection system; solved above-mentioned two large problems; when reducing intraoperative hemorrhage; protected renal function effectively; chien shih peritoneoscope partial nephrectomy can generally be carried out when competent kidney was blocked; and easy to use, need not special equipment, therefore have good application prospects.This system design is reasonable, and is simple in structure, uses material economy, is convenient to produce in enormous quantities, has good economical, societal benefits.
Claims (3)
1. a laparoscopic surgery is blocked and the cold-penetration dispensing device with renal artery; it includes renal artery blocking-up folder; it is characterized in that described renal artery blocking-up folder is integrated with a renal artery puncture needle, and be connected to and continue the normal saline of 0～4 ℃ of perfusion or the tube for transfusion of kidney protection liquid to kidney simultaneously.
2. laparoscopic surgery according to claim 1 is with renal artery blocking-up and cold-penetration dispensing device, it is characterized in that described renal artery blocking-up folder blocks arteriorenal common 4cm when being widely used in partial nephrectomy now and bend vascular clamp; Described renal artery puncture needle is similar to the sclerosis of blood vessels pin, is made up of nook closing member and epitheca two parts.
3. laparoscopic surgery according to claim 1 and 2 is blocked and the cold-penetration dispensing device with renal artery, it is characterized in that described renal artery blocking-up folder is integrated by being mutually permanently connected with renal artery puncture needle, renal artery puncture needle is vertically vertical, 60 ° of centres of being fixed in renal artery blocking-up folder first half of level.
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| Application Number | Priority Date | Filing Date | Title |
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| CN 201010239955 CN101889885B (en) | 2010-07-26 | 2010-07-26 | Renal artery blockage and cold infusion device for laparoscopic surgeries |
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| CN 201010239955 CN101889885B (en) | 2010-07-26 | 2010-07-26 | Renal artery blockage and cold infusion device for laparoscopic surgeries |
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| CN101889885A true CN101889885A (en) | 2010-11-24 |
| CN101889885B CN101889885B (en) | 2013-02-06 |
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| CN 201010239955 Expired - Fee Related CN101889885B (en) | 2010-07-26 | 2010-07-26 | Renal artery blockage and cold infusion device for laparoscopic surgeries |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107693079A (en) * | 2017-10-31 | 2018-02-16 | 中国人民解放军第二军医大学 | Laparoscopic surgical instruments and laparoscopic surgery equipment |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5928253A (en) * | 1998-03-13 | 1999-07-27 | Cardiothoracic Systems, Inc. | Integrated cannula and vascular clamp assembly |
| CN1745722A (en) * | 2004-09-06 | 2006-03-15 | 佛山特种医用导管有限责任公司 | Sleeving puncture of laparoscope |
| CN201147344Y (en) * | 2007-08-01 | 2008-11-12 | 浙江大学 | Device for preventing rupture of renal pedicle |
| CN201189206Y (en) * | 2008-01-25 | 2009-02-04 | 天津市第一中心医院 | Liver and kidney combination cutting and taking priming line |
| CN201394041Y (en) * | 2009-05-26 | 2010-02-03 | 中山大学附属第一医院 | Novel vascular clamp used for blocking blood stream at small blood vessels with anastomosis method |
-
2010
- 2010-07-26 CN CN 201010239955 patent/CN101889885B/en not_active Expired - Fee Related
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5928253A (en) * | 1998-03-13 | 1999-07-27 | Cardiothoracic Systems, Inc. | Integrated cannula and vascular clamp assembly |
| CN1745722A (en) * | 2004-09-06 | 2006-03-15 | 佛山特种医用导管有限责任公司 | Sleeving puncture of laparoscope |
| CN201147344Y (en) * | 2007-08-01 | 2008-11-12 | 浙江大学 | Device for preventing rupture of renal pedicle |
| CN201189206Y (en) * | 2008-01-25 | 2009-02-04 | 天津市第一中心医院 | Liver and kidney combination cutting and taking priming line |
| CN201394041Y (en) * | 2009-05-26 | 2010-02-03 | 中山大学附属第一医院 | Novel vascular clamp used for blocking blood stream at small blood vessels with anastomosis method |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107693079A (en) * | 2017-10-31 | 2018-02-16 | 中国人民解放军第二军医大学 | Laparoscopic surgical instruments and laparoscopic surgery equipment |
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| CN101889885B (en) | 2013-02-06 |
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Granted publication date: 20130206 Termination date: 20180726 |