CN102166127B - Renal artery directional blocking device - Google Patents
Renal artery directional blocking device Download PDFInfo
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- CN102166127B CN102166127B CN 201110123234 CN201110123234A CN102166127B CN 102166127 B CN102166127 B CN 102166127B CN 201110123234 CN201110123234 CN 201110123234 CN 201110123234 A CN201110123234 A CN 201110123234A CN 102166127 B CN102166127 B CN 102166127B
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- renal artery
- blocking
- sacculus
- kidney
- groove
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B2017/12004—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding
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Abstract
The invention discloses a renal artery directional blocking device comprising a clamping slot, wherein one side in the clamping slot is provided with a saccule which is connected with a gas filled tube, and a gas valve is arranged on the gas filled tube. An opening structure at the front end of the renal artery directional blocking device greatly facilitates the fixing of the blocking device around renal artery without surrounding, and the saccule can be quickly removed after the saccule is deflated, namely the blocking can be stopped in midway to temporarily restore the infusion of kidney, so as to be more beneficial to the protection for renal function. The renal artery directional blocking device is reliable in fixing after the device is fixed around the renal artery, can achieve the effect of truly blocking the renal artery, and can quickly and precisely adjust the blocking pressure on the renal artery at any time according to anatomical variations of different individuals, requirements of an operator and changes in the operation, with really reliable blocking effect. Under the condition of incomplete blocking, a patient can also take a medicine for protecting the kidney, the medicine can be directly involved in the metabolism of the kidney at the side, so as to protect the renal function according to actual situation in the operation to the greatest extent.
Description
Technical field
The invention belongs to clinical medicine surgery technical field, relate to a kind of renal artery orientation blocking device, be particularly useful for laparoscopic surgery.
Background technology
The partial nephrectomy developed recently is very fast, is mainly used in renal carcinoma, solitary kidney tumor, two renal carcinoma, kidney benign tumor, segmental kidney vascular malformation less than 4cm, is confined to the diseases such as calculus of upper pole of kidney or the lower utmost point.Operative Puzzle mainly is control that the kidney wound surface is hemorrhage and the protection of renal function, needs to block renal artery in the art, in addition, and in the excess of the kidney matter Lithotomy as need to cut more excess of the kidney matter and need to block renal artery equally.Conventional therapy is very difficult, and wound is larger, and the in recent years progress of laparoscopic surgery has been so that partial nephrectomy has been obtained improvement, patient's wound is obviously reduced, but difficulty is higher, but doctor's operation technique is had higher requirement.
The blood flow of kidney is very abundant, and the normal adult per minute has 1200ml blood to flow to bilateral renal.For the suitable patient who implements the kidney Partial Resection of part, when carrying out the kidney Partial Resection, because the blood flow of kidney is very abundant, in order to reduce hemorrhage and to obtain clearly that the visual area often needs renal artery is blocked to shorten operating time and accurately to finish operation.But because that excess of the kidney is verified is very responsive in hot postischemic reperfusion damage, surpasses halfhour hot ischemia and often the renal function of Ipsilateral is brought irreversible infringement, and along with the prolongation of renal artery Xining, the extent of damage increases the weight of gradually.In order to reduce hemorrhage and to obtain clearly visual area, shorten operating time, traditional partial nephrectomy is often blocked renal artery fully.Operation should be blocked in rear 30 minutes at renal artery as far as possible and finish, at present under the peritoneoscope partial nephrectomy to carry out this operation easier larger, renal artery does not block then that amount of bleeding significantly increases, and often is difficult to finish partial nephrectomy under the peritoneoscope, even is forced to row radical-ability nephrectomy.But the blood vessel blocking folder is blocked renal artery and is fully blocking-up, and the blood flow of this side kidney stops fully, can't give easily the medicine of renal function protecting to this side kidney.Can't the fine adjustment occluding pressure, can not the Halfway Stopping blocking-up, must cause irreversible lesion to kidney, make the matter worse especially for solitary kidney or functional isolation tumor of kidney patient, be unfavorable for patient's long term survival.Use the blood vessel blocking folder that renal artery is blocked, blood vessel itself had certain damage, particularly have atheromatous plaque in atherosclerotic patient's the renal artery, blood vessel blocking folder or other modes are blocked and may be caused that all the renal artery atheromatous plaque breaks even comes off more.Existing blocking way operates under peritoneoscope has certain difficulty, expend time in, and easily slippage, even cause secondary damage.Also someone peritoneoscope advance an idea with renal artery blocking-up and cold-penetration dispensing device, operation technique is extremely impracticable, namely enables kidney poured into still obviously to have prolonged operating time, has increased arteriorenal damage, to be difficult to control in case injury of renal artery is hemorrhage, even be forced to the row nephrectomy.In addition, between renal artery, the renal veins and the anatomic space around this two very narrow and small, anatomical variation such as renal artery branch are too early or two renal artery, need during operation two renal artery or arteriorenal two branches are all blocked, also might only need block a tremulous pulse, even there is the patient need block simultaneously renal artery and renal veins, use other blocking way occluding pressure excursions little, and be difficult to realize the meticulous adjusting to the renal artery blocking-up, carry out the laparoscopic procedure difficulty larger, can't farthest satisfy the requirement of operation technique.The Peritoneoscope forceps for blocking blood vessel construction process is complicated at present, has increased the operation consumptive material, need increase simultaneously the operation technique passage, has increased the weight of the wound to the patient, has increased patient's financial burden.In order to protect patient's renal function, patient's renal artery is carried out the part blocking-up and the fine adjustment occluding pressure is best selection, but up to the present still do not have partly to block and to carry out renal artery the device of fine adjustment.
Summary of the invention
The present invention is intended to address the above problem; a kind of renal artery orientation blocking device is provided, can makes by operation himself to be fixed on around the renal artery, and can be ideal renal artery is partly blocked; reduce ischemical reperfusion injury, farthest protect patient's renal function.The present invention is simple in structure, easy to operate.
Technical solution of the present invention is:
A kind of renal artery orientation blocking device comprises: draw-in groove, a side is provided with sacculus in the groove of draw-in groove, is connected with gas tube at sacculus, is provided with air valve at gas tube.
Useful result of the present invention is: the structure great convenience of this device front opening is fixed on this device around the renal artery; need not around, but rapid moving removes behind the air bag deflation, namely can Halfway Stopping blocking-up; the perfusion of of short duration recovery kidney is conducive to renal function protecting more.It is fixing reliable on every side that this device is fixed in renal artery; and can reach the arteriorenal effect of certain blocking-up; and can also accurately regulate arteriorenal occluding pressure is rapid at any time according to the anatomical variation of Different Individual and patient's requirement and the situation of change in the operation; barrier effect is infallible; not exclusively can give simultaneously the medicine of protection kidney in the situation of blocking-up to the patient; medicine can be participated in the metabolism of this side kidney directly, farthest according to practical situation renal function protecting in the art.This device takes up room little, arteriorenal branch capable of blocking, or only block renal artery and do not affect renal veins, or block respectively simultaneously the requirement of kidney artery and vein, can not cause because of the outside dilatancy of self structure the damage to the target blood surrounding structure, and can be because of taking more spacial influence operation technique.The utilization of this blocking vessel had both reduced intraoperative hemorrhage, had guaranteed again the clear of visual area, had particularly importantly also protected to greatest extent the function of kidney, was very easy to operation technique.In addition, this device can be placed in laparoscopically operation sheath card around the renal artery, latter half can place external in the sheath card or by the sheath card, need not additionally to increase the quantity of laparoscopic procedure sheath card, made things convenient for operation technique, reduced the wound to the patient, above-described various useful results will better be realized in laparoscopic surgery, and concrete advantage is as follows:
1, simple in structure.The present invention directly finishes arteriorenal blocking-up by the balloon compression in the notch, and manufacturing process is relatively simple, can block renal artery rapidly after the inflated.
2, convenient fixing, the structure great convenience of front opening is fixed on this device around the renal artery, renal artery after only needing to dissociate places groove surfaces, expansion along with sacculus, just effectively reached the purpose that blocking vessel is fixing, need not around, having reduced increases the probability that operating procedure causes the mistake damage, surgical operation step and operating time have been greatly reduced, shortened anesthesia duration, and then having reduced the risk that the prolongation anesthesia duration brings, the Financial cost of having saved anesthesia surgery has reduced the wound to the patient.The structure of front opening is very convenient to need various situations that this device is removed, finishes such as operation, need not to continue blocking-up, or renal artery is atherosis need stop to block at once the time,, only need this moment with air bag deflation can rapid moving except this device, saved operating time.
3, to arteriorenal fixing reliable, the matching structure of sacculus and groove can be fixed renal artery reliably, and the external hard plastic framework of notch and the groove structure relative with sacculus can effectively limit the dilatating and deformable space of sacculus, inside directed expansion along with sacculus, further renal artery is fixed in the groove, blocking effect disappears after preventing the renal artery slippage, causes massive hemorrhage in the art.
4, reliable to arteriorenal blocking-up, owing to oppressing to interior orientation of sacculus, its broader contact surface can become flat with the renal artery compressing, reduces intraluminal blood flow, guarantees the requirement of performing the operation renal artery being blocked.
5, occluding pressure fine adjustment at any time; aeration quantity in the sacculus is accurate adjustment at any time; the variation of the occluding pressure that brings with the increase and decrease of aeration quantity in the sacculus can be on the pressure detecting table Real-Time Monitoring; Different Individual is owing to arteriorenal caliber, elasticity are all different; different patients also are huge to the difference that requires of blocking-up; ultrafine occluding pressure difference all may be brought different impacts to this side renal function, satisfy operation technique to the blocking-up of renal blood flow with the protection renal function.According to the visual area operational circumstances, the fine adjustment occluding pressure, the blood flow of control kidney is guaranteeing that the blood that the visual area farthest keeps kidney clearly under the prerequisite supplies.Both obviously reduce intraoperative hemorrhage, and can guarantee again the basic perfusion of kidney, farthest avoided the ischemical reperfusion injury of kidney.
6, balloon compression is to arteriorenal incomplete blocking-up characteristics, protects the medicine of kidney in can art, improves the metabolism situation in this side kidney, the function of a side kidney of the protection implement operation in operation.
7, the occluding pressure adjustable extent is wide, because the outside of the draw-in groove spline structure of the first half of this device is hard structure, not yielding, can bear the active force of larger balloon expandable, so that sacculus occluding pressure adjustable extent is very big, Different Individual is because arteriorenal caliber, elasticity are all different, and different patients also are huge to the difference that requires of blocking-up, and the structure of this device can satisfy Different Individual, occluding pressure requirement that different patient is different to renal artery.
8, to arteriorenal double protection.Can not be out of shape in the notch art of this device first half, often in the operation technique use various sharp property or with the operating apparatus of energy, notch all can reduce various operations to the probability of sacculus infringement to the protection of sacculus, the inside directional expansion of semi-cylindrical structure of blocking-up sacculus, thereby the renal artery disappearance of blocking of avoiding sacculus to break causing, the visual area massive hemorrhage, draw-in groove all can increase arteriorenal protective effect arteriorenal direct protection; The hemispherical utricule is oppressed rear renal artery to renal artery and is become flat; there is atherosclerosis in some patients were; the renal artery quality is more crisp; renal artery easily broken around the medicated porridge template of compressing metanephros Wall of Artery come off; easily cause aneurysm of renal artery behind the plaque rupture; after coming off, the medicated porridge template causes renal infarction; will cause to patient's renal function irreversible infringement; and hemispherical utricule and groove structure are not easy to induce the medicated porridge template of renal artery inwall to break or come off to the variation that renal artery compressing metanephros tremulous pulse shape occurs, thereby increase arteriorenal protective effect.
9, this device takes up room littlely, very is fit to the requirements of operation of laparoscopic partial nephrectomy, certainly also can satisfy the requirement of open surgery.Because of renal artery, between the renal veins and the anatomic space around this two very narrow and small, anatomical variation such as renal artery branch are too early or two renal artery, need during operation two renal artery or arteriorenal two branches are all blocked, also might only need block a tremulous pulse, even there is the patient need block simultaneously renal artery and renal veins, this device is because sacculus is only indeformable to intramedullary expansion and notch, take up room little, arteriorenal branch capable of blocking, or only block renal artery and do not affect renal veins, or it is moving to block respectively simultaneously kidney, the requirement of vein, can not cause because of the outside dilatancy of self structure the damage to the target blood surrounding structure, and can be because of taking more spacial influence operation technique.
10, easy to operate.The first half of this device can be placed in laparoscopically operation sheath card around the renal artery, latter half can place external in the sheath card or by the sheath card, need not additionally to increase the quantity of laparoscopic procedure sheath card, made things convenient for operation technique, reduced the wound to the patient, it can be easily to sacculus gas injection and monitoring pressure at external latter half.
11, the sacculus quality is soft, and without dissection, and roomy contact surface has increased arteriorenal protective effect between the renal artery to renal artery.By sacculus renal artery compressing is blocked among the present invention, substituted the blood vessel blocking folder that tradition is used, avoided the damage of metal clip to renal artery adventitia and inner membrance, provide safer protective measure for the patient who merges blood vessel scleratheroma.
Description of drawings
Fig. 1 is the structural representation of one embodiment of the present of invention.
Fig. 2 is the present invention implements blocking-up to renal artery work process schematic diagram.
Fig. 3 is the structural representation of an alternative embodiment of the invention.
Fig. 4 is the again structural representation of an embodiment of the present invention.
The specific embodiment
A kind of renal artery orientation blocking device comprises: draw-in groove 7, a side is provided with sacculus 1 in the groove of draw-in groove 7, is connected with gas tube 2 at sacculus 1, is provided with air valve 5 at gas tube 2.In the present embodiment, opposite side is provided with groove 4 in the groove of draw-in groove 7, be connected with pressure monitoring table 6 at sacculus 1, an end that is connected with pressure-measuring pipe 3 and pressure-measuring pipe 3 at sacculus 1 is connected with sacculus 1, is connected with pressure monitoring table 6 at the other end of described pressure-measuring pipe 3.
With reference to the accompanying drawings, the present invention is made more detailed explanation:
Referring to Fig. 1, sacculus 1 and groove 4 are arranged in this device front end notch.Referring to Fig. 2, the draw-in groove opening part of renal artery through this blocking vessel is placed in the groove, through air valve 5 to sacculus 1 slightly gas injection can prevent its slippage with self being fixed in around the renal artery.Pressure measurement tube core 3 connects the pressure monitoring table through side joint 6, on the side branch joint 6 switch is arranged, and can exit and reduce the sacculus internal pressure.
Referring to Fig. 1 and Fig. 2, in partial nephrectomy or excess of the kidney matter Lithotomy, free good renal artery is placed in the groove through the draw-in groove opening part of this blocking vessel, through air valve 5 progressively after the gas injection, sacculus 1 is progressively partly blocked renal artery purpose, pressure monitoring table 6 synchronous detecting sacculus 1 internal pressure to reach with the renal artery compressing in groove.According to the visual area operational circumstances, regulate kidney perfusion by regulating the blocking-up balloon pressure, farthest reduce arteriorenal blocking-up under the prerequisite clearly in the assurance visual area, the blood that keeps kidney supplies, hemorrhage more such as the visual area, obviously affect operation technique, can continue slow gas injection through air valve 5, increase occluding pressure, until hemorrhage the reducing to of wound surface satisfied requirements of operation just, such as the visual area without obviously hemorrhage, but the kidney surface obviously bleaches, and the prompting renal ischemic is serious, a small amount of slowly venting this moment, monitoring sacculus internal pressure guarantees to perform the operation and still keeps to a certain extent the blood flow of kidney when carrying out smoothly.Can give the medicine of patient's renal function protecting with fashion; these medicines can enter in the kidney by the renal artery through not blocking fully; improve the metabolism of this side kidney; reduce the generation of harmful metabolite or know harmful substance; thereby realize that at utmost the requirement of renal function protecting is too much as finding inflation; embodiment is in laparoscopic partial nephrectomy; after kidney and renal artery is free; with elastic separating plier the first half of this device is entered the visual area through the holding of laparoscopically operation sheath; renal artery is placed the groove of this blocking vessel; air valve 5 progressively after the gas injection sacculus 1 expand, RAP is prevented slippage in groove 4.After air valve 5 gas injections, sacculus 1 is also progressively oppressed renal artery, the kidney surface that is blocked begins to bleach, the pressure of pressure monitoring table 6 simultaneous display sacculus 1, be arteriorenal occluding pressure, beginning cut-out kidney, the requirement of and operation technique hemorrhage according to wound surface, regulate the gas injection rate of sacculus 1 by gas injection and aerofluxus and regulate occluding pressure, strive for guaranteeing that the blood that the visual area farthest keeps kidney clearly under the prerequisite supplies.After the excision of part kidney, the otch of excess of the kidney matter is sewed up again, at this moment, the gas in the sacculus is slowly emitted gradually, observe the wound surface bleeding, without obviously hemorrhage, with gas emptying in the sacculus, remove this device such as wound surface.Find that wound surface is hemorrhage more in the process such as gas in discharge finding sacculus, again increase on a small quantity gas flow in the sacculus, the thorough Suture hemostasis of wound surface is satisfied after with gas emptying in the sacculus, remove this device.
In laparoscopic renal parenchyma incision lithotomy, kidney and renal artery is free after, renal artery is placed the groove of this blocking vessel, progressively after the gas injection, sacculus 1 expands, and RAP is prevented slippage in groove 4 through air valve 5.After air valve 5 gas injections, sacculus 1 is also progressively oppressed renal artery, the kidney surface that is blocked begins to bleach, the pressure of pressure monitoring table 6 simultaneous display sacculus 1, be arteriorenal occluding pressure, begin to cut kidney, the requirement of and operation technique hemorrhage according to wound surface, regulate the gas injection rate of sacculus 1 by gas injection and aerofluxus and regulate occluding pressure, strive for guaranteeing that the blood that the visual area farthest keeps kidney clearly under the prerequisite supplies.After kidney cuts, take out calculus, the otch of excess of the kidney matter is sewed up again, at this moment, the gas in the sacculus is slowly emitted gradually, observe the wound surface bleeding, without obviously hemorrhage, with gas emptying in the sacculus, remove this device such as wound surface.Find that wound surface is hemorrhage more in the process such as gas in discharge finding sacculus, again increase on a small quantity gas flow in the sacculus, the thorough Suture hemostasis of wound surface is satisfied after with gas emptying in the sacculus, remove this device.Therefore, this device had both reduced intraoperative hemorrhage, again the at utmost low renal function of having protected the patient.
Although the present invention is described with respect to preliminary election embodiment, the present invention is not limited to this embodiment, but can implement with various forms.
For example, such as Fig. 3 and Fig. 4, another embodiment of the present invention, namely lead to the tube core of blocking sacculus and only be one, the tube core end is divided into two tube cores, and the side joint connects the pressure monitoring table, and end fitting connects gas injection valve, exit to regulate occluding pressure through air valve gas injection or side branch joint in the blocking-up sacculus, the pressure of pressure monitoring table in can synchronous detecting blocking-up sacculus.Such as Fig. 4, an again embodiment of the present invention, replace groove with sacculus, two tube cores that lead to two sacculus are merged into one in the centre of draw-in groove, and two sacculus are expanded synchronously, the compressing renal artery, the tube core end meets the three way cock, and the side joint connects the pressure monitoring table, and another joint of threeway connects gas injection valve, to blocking gas injection in the sacculus, the pressure monitoring table can the interior pressure of synchronous detecting blocking-up sacculus through gas injection valve.
Claims (2)
1. renal artery orientation blocking device, it is characterized in that, comprise: draw-in groove (7), a side is provided with sacculus (1) in the groove of draw-in groove (7), opposite side is provided with groove (4) in the groove of draw-in groove (7), be connected with pressure monitoring table (6) at sacculus (1), be connected with gas tube (2) at described sacculus (1), be provided with air valve (5) at described gas tube (2), through described air valve (5) progressively after the gas injection, described sacculus (1) is progressively partly blocked renal artery purpose to reach with the renal artery compressing in described groove, the described sacculus of described pressure monitoring table (6) synchronous detecting (1) internal pressure according to the visual area operational circumstances, is regulated kidney perfusion by regulating the blocking-up balloon pressure, farthest reduce arteriorenal blocking-up under the prerequisite clearly in the assurance visual area, the blood that keeps kidney supplies.
2. renal artery orientation blocking device according to claim 1, it is characterized in that, an end that is connected with pressure-measuring pipe (3) and described pressure-measuring pipe (3) at described sacculus (1) is connected with described sacculus (1), is connected with described pressure monitoring table (6) at the other end of described pressure-measuring pipe (3).
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| Application Number | Priority Date | Filing Date | Title |
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| CN 201110123234 CN102166127B (en) | 2011-05-13 | 2011-05-13 | Renal artery directional blocking device |
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| Application Number | Priority Date | Filing Date | Title |
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| CN 201110123234 CN102166127B (en) | 2011-05-13 | 2011-05-13 | Renal artery directional blocking device |
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| CN102166127A CN102166127A (en) | 2011-08-31 |
| CN102166127B true CN102166127B (en) | 2013-02-06 |
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| CN 201110123234 Expired - Fee Related CN102166127B (en) | 2011-05-13 | 2011-05-13 | Renal artery directional blocking device |
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Families Citing this family (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103417256B (en) * | 2013-08-09 | 2015-04-08 | 浙江大学 | Inflatable type zero-damage blood vessel occlusion tractor |
| CN104622532B (en) * | 2014-12-30 | 2017-01-04 | 陈世伟 | A kind of gasbag-type kidney part blocks device |
| CN105105813A (en) * | 2015-09-24 | 2015-12-02 | 中国人民解放军第三军医大学第三附属医院 | Blood vessel blocker capable of controlling blood flow volume |
| CN109036062A (en) * | 2018-09-07 | 2018-12-18 | 合肥安尔瑞科学仪器制造有限公司 | A kind of vasopressors simulation system |
| CN109758198B (en) * | 2018-11-22 | 2021-07-13 | 中国人民解放军第二军医大学 | Zero ischemia renal artery blocking mechanism |
| CN113892991B (en) * | 2021-10-20 | 2023-05-16 | 安徽医科大学第二附属医院 | Pressure-adjustable renal artery blocking forceps |
| CN114521934A (en) * | 2022-02-10 | 2022-05-24 | 中国人民解放军总医院第一医学中心 | Blood flow blocking device |
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| US6616624B1 (en) * | 2000-10-30 | 2003-09-09 | Cvrx, Inc. | Systems and method for controlling renovascular perfusion |
| EP1390093B1 (en) * | 2001-05-01 | 2006-11-22 | St. Jude Medical, Cardiology Division, Inc. | Emboli protection devices |
| CN101902988A (en) * | 2008-04-25 | 2010-12-01 | 耐利克斯股份有限公司 | The induction system of stent graft |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6086527A (en) * | 1998-04-02 | 2000-07-11 | Scimed Life Systems, Inc. | System for treating congestive heart failure |
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Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6616624B1 (en) * | 2000-10-30 | 2003-09-09 | Cvrx, Inc. | Systems and method for controlling renovascular perfusion |
| EP1390093B1 (en) * | 2001-05-01 | 2006-11-22 | St. Jude Medical, Cardiology Division, Inc. | Emboli protection devices |
| CN101902988A (en) * | 2008-04-25 | 2010-12-01 | 耐利克斯股份有限公司 | The induction system of stent graft |
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