CN116899036A

CN116899036A - Drainage device

Info

Publication number: CN116899036A
Application number: CN202310996819.7A
Authority: CN
Inventors: 王帆; 李娟�; 陈杰; 申英末; 李晓霞; 朱万骥
Original assignee: Beijing Chaoyang Hospital
Current assignee: Beijing Chaoyang Hospital
Priority date: 2023-08-08
Filing date: 2023-08-08
Publication date: 2023-10-20

Abstract

The present invention provides a drainage device comprising: drainage tubes, ostomy bags and balloon mechanisms; the air bag mechanism comprises an air bag and an air inlet and outlet device, the air bag is arranged at the head end of the drainage tube, and the air inlet and outlet device is connected with the air bag and is used for inflating or deflating the air bag; the ostomy bag is detachably connected with the drainage tube, and the technical problem that auxiliary damage is easy to cause, complications related to ostomy occur and the tightness of patch stitching is difficult to control in a ostomy hernia repair is solved.

Description

Drainage device

Technical Field

The invention relates to the technical field of medical instruments, in particular to a drainage device.

Background

Ostomy hernia (Parastomal hernia, PSH) is the most common complication after enterostomy, and can cause complications such as chronic pain, peripheral skin tearing, and ostomy prolapse as the condition progresses. In addition, further aggravated PSH is prone to severe consequences such as stomal necrosis, ileus, anastomotic fistula, etc., and thus parastomal hernias require surgical treatment.

Currently, parastomal hernia repair includes laparoscopic and open repair, as well as hybrid of both. The complexity of the ostomy hernia operation is far superior to that of the first operation, and the following problems mainly exist: firstly, the small intestine is herniated by the side of the stoma, the intestine is adhered to each other, and a doctor is difficult to distinguish the stomal intestine from the herniated intestine in the separation process, so that side injury is easy to occur; secondly, taking the laparoscopic surgery with the lowest postoperative recurrence rate as an example, because the ostomy intestinal canal needs a certain submerging distance between the patch and the abdominal wall, the tightness of patch stitching is difficult to control, the intestinal canal can be herniated again due to over loosening, and the intestinal canal can be stenosed due to over tightening, so that mechanical obstruction is formed; thirdly, due to scar hyperplasia of abdominal wall tissues caused by previous operation, abdominal wall compliance is reduced, and contracture of the patch also aggravates the occurrence of the condition, and finally intestinal obstruction is caused; fourthly, the postoperative artificial anus is difficult to dilate, the body position of the postoperative patient is changed, most of the patients with the parastomal hernia belong to obese people, the direction of intestinal canal is changed, the intestinal canal at the stomal part is bent, and the fingers of most people are difficult to touch the narrow part, so that the anus is difficult to dilate; fifth, if the stoma is reshaped, the stoma-related complications, such as infection of the stoma caused by faeces, and the like, are again faced, and the healing of the stoma is difficult; sixth: if the stoma is remodeled, in general, redundant skin needs to be excised, an incision is formed beside the stoma, and the risk of fecal pollution is also faced, and the seventh is: the ostomy bag is replaced just after the operation, and because the operation wound is not sterile, the additional pain is caused to the patient. In summary, at present, the parastomal hernia repair has the technical problems that side injury is easy to cause, complications related to the stoma occur, and the tightness of patch nailing is difficult to control.

Disclosure of Invention

The invention aims to provide a drainage device to solve the technical problems that side injury is easy to cause, complications related to the stoma occur, and the tightness of patch stitching is difficult to control in a parastomal hernia repair.

The above object of the present invention can be achieved by the following technical solutions:

the present invention provides a drainage device comprising: drainage tubes, ostomy bags and balloon mechanisms; the air bag mechanism comprises an air bag and an air inlet and outlet device, the air bag is arranged at the head end of the drainage tube, and the air inlet and outlet device is connected with the air bag and is used for inflating or deflating the air bag; the ostomy bag is detachably connected with the drainage tube.

In a preferred embodiment, the number of the balloon mechanisms is plural, and plural balloons are arranged at intervals in the longitudinal direction of the drainage tube.

In a preferred embodiment, at least one of the balloons is a cylindrical balloon extending in the longitudinal direction of the drainage tube.

In a preferred embodiment, at least one of the balloons is an inner-bracing balloon which is curved outwardly in the direction from the trailing end to the leading end of the drainage tube.

In a preferred embodiment, the air bag is sleeved outside the drainage tube.

In a preferred embodiment, the plurality of balloons include an inner-stay balloon and a plurality of columnar balloons, the columnar balloons extending in the longitudinal direction of the drainage tube, the inner-stay balloon being bent outward in the direction from the trailing end to the leading end of the drainage tube; at least one internal supporting air bag and at least two columnar air bags are distributed along the direction from the head end to the tail end of the drainage tube.

In a preferred embodiment, the air inlet and outlet device comprises an air inlet and outlet pipeline and a cache air bag, wherein the cache air bag is connected with the air bag through the air inlet and outlet pipeline, and the cache air bag is provided with an air inlet and outlet.

In a preferred embodiment, the ostomy bag comprises a bag body, wherein an access channel and an outlet channel are connected to the bag body, the drainage tube is detachably connected to the access channel, and a closure plug is detachably connected to the outlet channel.

In a preferred embodiment, the closure plug comprises a conical plug body and an injection channel provided to the conical plug body.

In a preferred embodiment, the drainage device comprises a spring-loaded drift comprising a drift-head end, a drift-tail end and a drift-body, the spring-loaded drift being insertable into the drainage tube.

The invention has the characteristics and advantages that:

the drainage tube is inserted into the intestinal cavity through the artificial stoma to drain the excrement to the outside of the body, and the air bag on the drainage tube has the functions of fixing the drainage tube, closing the intestinal cavity, supporting the intestinal wall and expanding the stoma. Considering that a plurality of intestinal tubes are adhered to each other in the parastomal hernia, sometimes indistinguishable, the air inlet and outlet device can repeatedly inflate and deflate the air bag, and the position of the intestinal tube is referred to as the position of the ostomy; considering that if the intestinal canal is wrinkled, the intestinal canal is easy to break in the separation process, the air bag can prop up the intestinal canal to form a cylinder, so that the surface of the intestinal canal is ensured to be in a surface shape during separation, and the damage to the intestinal canal is reduced; moreover, when the patch is stapled, the intestinal canal is supported by the air bag, so that the patch can be better attached to the intestinal canal, and over-loosening or over-tightening is avoided. The drainage device can reduce complications after the ostomy hernia operation, avoid intestinal obstruction and ostomy pollution caused by the ostomy stenosis, and solve the technical problems that the ostomy hernia repair operation is easy to cause side injury, the complications related to the ostomy occur and the tightness of patch nailing is difficult to control.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings required for the description of the embodiments will be briefly described below, and it is apparent that the drawings in the following description are only some embodiments of the present invention, and other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.

FIG. 1 is a schematic diagram of a drainage device according to the present invention;

FIG. 2 is a schematic structural view of a drainage tube and an air bag mechanism in the drainage device provided by the invention;

FIG. 3 is an enlarged view of a portion of FIG. 2 at A;

FIG. 4 is a schematic structural view of a drainage tube and a spring through strip in the drainage device provided by the invention;

FIG. 5 is a schematic diagram of the structure of a spring vent in the drainage device according to the present invention;

FIGS. 6-7 are schematic views of the structure of an ostomy bag in a drainage device according to the present invention;

figure 8 is a schematic view of the structure of the chassis in the ostomy bag of figure 6;

fig. 9 is a schematic structural view of a sealing plug in the drainage device provided by the invention.

Reference numerals illustrate:

100. a longitudinal direction of the drainage tube;

20. a drainage tube; 21. a side hole;

30. an air bag mechanism;

40. an air bag; 41. a columnar balloon; 42. an inner support airbag;

50. an air inlet and outlet device; 51. a cache air bag; 511. an air inlet and outlet; 52. an air inlet and outlet pipeline;

60. an ostomy bag; 61. a bag body; 611. an access passage; 612. an outlet channel;

62. a chassis; 621. A chassis hole;

70. closing the plug; 71. A conical plug body; 72. An injection channel;

80. a spring drift; 81. a pass bar body; 821. a drift tube head end; 822. tail end of the pass-through strip.

Detailed Description

The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.

The present invention provides a drainage device, as shown in fig. 1-2, comprising: a drainage tube 20, an ostomy bag 60 and an air bag mechanism 30; the air bag mechanism 30 comprises an air bag 40 and an air inlet and outlet device 50, wherein the air bag 40 is arranged at the head end of the drainage tube 20, and the air inlet and outlet device 50 is connected with the air bag 40 and is used for inflating or deflating the air bag 40; ostomy bag 60 is removably attached to drain tube 20.

The drainage tube 20 is inserted into the intestinal cavity through the artificial stoma to drain the excrement to the outside of the body, and the air bag 40 on the drainage tube 20 plays the roles of fixing the drainage tube 20, closing the intestinal cavity, supporting the intestinal wall and expanding the stoma. Considering that there are many intestinal tubes in the parastomal hernia that adhere to each other, sometimes indistinguishable, the access device 50 may repeatedly inflate and deflate the balloon 40, intraoperatively referring to the site of the stoma intestinal tube; considering that if the intestinal canal is wrinkled, the intestinal canal is easy to break in the separation process, the air bag 40 can prop up the intestinal canal to be cylindrical, so that the surface of the intestinal canal is ensured to be in a surface shape during separation, and the damage to the intestinal canal is reduced; in addition, when the patch is stapled, the balloon 40 is used for supporting the intestinal canal, so that the patch can be better attached to the intestinal canal, and over-loosening or over-tightening can be avoided. The drainage device can reduce complications after the ostomy hernia operation, avoid intestinal obstruction and ostomy pollution caused by the ostomy stenosis, and solve the technical problems that the ostomy hernia repair operation is easy to cause side injury, the complications related to the ostomy occur and the tightness of patch nailing is difficult to control.

The tail of the drain tube 20 may be connected to an external drainage bag to drain fecal matter to the external drainage bag for smooth drainage and storage of fecal matter through the drain tube 20, minimizing fecal water entering the ostomy bag 60.

The head end of the draft tube 20 is provided with a side hole 21 for the intestinal contents to enter the draft tube 20. Further, the number of the balloon mechanisms 30 is plural, a plurality of balloons 40 are distributed at intervals along the longitudinal direction of the drainage tube, and each balloon 40 supports a different position of the intestinal canal. Preferably, each bladder 40 may be independently inflated or deflated by a respective air inlet and outlet device 50. Further, the balloon 40 has a complete ring shape, i.e., as shown in fig. 1 and 2, the balloon 40 is sleeved outside the drainage tube 20.

In one embodiment, at least one balloon 40 is a cylindrical balloon 41, the cylindrical balloon 41 extending longitudinally of the drain tube. The columnar air bag 41 is 1-shaped when fully inflated, and when in use, the inflated columnar air bag 41 can seal the intestinal canal to prevent intestinal contents from flowing out of the stoma; the drainage tube 20 can be fixed, and the drainage tube 20 is prevented from falling off; when the patch is stapled, the inflated columnar air bag 41 can prevent the patch from being stapled too tightly to cause stenosis and can prevent the patch from being stapled too loose to cause hernia recurrence; when in use after operation, the utility model has the advantages of manual anus dilating function, convenient and flexible anus dilating, convenient use and simple operation.

In one embodiment, at least one of the air bags 40 is an inner supporting air bag 42, as shown in fig. 2 and 3, the inner supporting air bag 42 is bent outwards along the direction from the tail end to the head end of the drainage tube 20, and when a larger pressure is applied, the inner supporting air bag 42 can be buckled and deformed to be more fit with the intestinal tract; when the drainage tube 20 is pulled out carelessly, the inner supporting air bag 42 is buckled and deformed, so that the intestinal canal can be prevented from being torn. The inner supporting air bag 42 can be in a complete ring shape, and the inner supporting air bag 42 is bowl-shaped when inflated, so that the fecaluria is led out through the drainage tube 20 to the greatest extent in the process of sealing the intestinal cavity. The inner support balloon 42 has the characteristic of strong plasticity. Further, as shown in fig. 3, in the area surrounded by the bowl-shaped inner support airbag 42, side holes 21 are provided on the side wall of the draft tube 20 to prevent the accumulation of fecal sewage in the area.

To better function as the airbag 40, the present inventors have further improved the arrangement of the airbag 40: the plurality of balloons 40 includes an inner-stay balloon 42 and a plurality of columnar balloons 41, and at least one inner-stay balloon 42 and at least two columnar balloons 41 are distributed along the direction from the head end to the tail end of the drainage tube 20. For example: as shown in fig. 1 and 2, 1 inner supporting air bag 42 and 2 columnar air bags 41 are distributed in sequence, and the columnar air bags 41 at the middle position are in a shape of 1 when fully inflated, so that the intestinal canal can be assisted to intercept fecal water, be assisted to close the intestinal canal, support the intestinal canal to prevent the occurrence of secondary injury in operation, prevent the nailing patch from being too loose or too narrow, and prevent the intestinal canal from being narrow due to excessive contracture of the patch.

Further, the air bags 40 are made of micro-elastic materials, when not inflated, the walls of the air bags shrink, so that the air bags can be inflated at a place with low pressure in the inflation process, the stress of intestinal tracts is uniform, and the pressure of a narrow section cannot be too high; the balloon 40 is in a deflated configuration when not inflated and does not adhere to the vessel wall.

Preferably, the drainage tube 20 is connected with 1 inner supporting air bag 42 and 2 columnar air bags 41, the total length of the drainage tube 20 is 40cm, the inner diameter is 8mm, the drainage tube 20 can penetrate through the abdominal wall of an obese patient, and a sufficient length of the drainage tube 20 is reserved in the intestinal tract; can ensure the smooth extraction of intestinal contents. The head end of the drainage tube 20 is provided with an opening and 4 side holes 21, and along the longitudinal direction 100 of the drainage tube, the length of the head end is recorded as L1, l1=4cm, so that faeces can be ensured to enter the drainage tube 20. When fully inflated, the inner strut balloon 42 has a diameter of 4cm and a length of 2cm along the longitudinal direction 100 of the drain tube; when fully inflated, the cylindrical balloon 41 in the intermediate position has a maximum diameter of 2.5cm and a length of 4cm in the longitudinal direction 100 of the drainage tube; when fully inflated, the cylindrical balloon 41 closest to the trailing end has a maximum diameter of 2.5cm and a length in the longitudinal direction 100 of the drain tube of 10cm. Further, the draft tube 20 is marked with a scale every 1cm for recording.

In one embodiment, the air inlet and outlet device 50 comprises an air inlet and outlet pipeline 52 and a buffer air bag 51, the buffer air bag 51 is connected with the air bag 40 through the air inlet and outlet pipeline 52, the buffer air bag 51 is provided with an air inlet and outlet port 511, air enters the buffer air bag 51 through the air inlet and outlet port 511, and enters the air bag 40 through the buffer air bag 51, the buffer air bag 51 and the air bag 40 ensure the same pressure, the air bag 40 is prevented from being excessively pressurized during blind inflation to cause the rupture of the air bag 40, and the air bag 40 is prevented from being excessively inflated to cause tearing of intestinal tracts in abdominal cavity or cause ischemia necrosis of intestinal tracts in narrow sections in abdominal wall. Preferably, the cushion air cells 51 are in one-to-one correspondence with the air cells 40.

In one embodiment, ostomy bag 60 comprises a pouch body 61, and pouch body 61 is connected with an access channel 611 and an outlet channel 612, drain tube 20 is detachably connected with access channel 611, and outlet channel 612 is detachably connected with closure plug 70. The outlet channel 612 is connected with the sealing plug 70 to seal when a small amount of fecal sewage is discharged at any time when needed; after removing the closure plug 70, the outlet passage 612 may be connected to a drain bag for use when more fecal water is available, preventing accumulation of fecal water, in response to the drain tube 20 not closing the bowel, and a large amount of fecal water entering the ostomy bag 60. Further, as shown in fig. 6 and 7, the bottom surface of the bag 61 is planar, and the outlet channel 612 is located below and near the bottom surface of the bag 61, so as to facilitate the extraction of the fecal sewage. The access channel 611 comprises a silica gel hose, and the access channel 611 is arranged above the silica gel hose, so that the silica gel hose is conveniently led out. The drainage tube 20 can be inserted into the access channel 611, and the access channel 611 and the drainage tube 20 can be sealed by rubber bands. As shown in fig. 1, 6 and 8, the bottom surface of the bag 61 is connected with a chassis 62, the chassis 62 is in a ring shape, the chassis 62 is provided with a chassis hole 621, and the drainage tube 20 can sequentially pass through the chassis hole 621, the bag 61 and the access channel 611.

Further, as shown in fig. 9, the closure plug 70 includes a tapered plug body 71 and an injection channel 72 provided to the tapered plug body 71. The closure plug 70 may close the outlet passage 612 of the ostomy bag 60, and the closure plug 70 may also be connected to the tail end of the drain tube 20 to close the drain tube 20. Through the injection channel 72, irrigation of the drain tube 20, the ostomy bag 60 can be performed, preventing clogging of the drain tube 20 and irrigation of the intestine. The closure plug 70 may be attached to a syringe with the needle removed, and the syringe may be inserted into the injection passage 72 to inject saline flush to facilitate flushing of the ostomy bag 60 when flushing is desired. Specifically, the closure plug 70 is used intraoperatively to close the drain tube 20; after surgery, the closure plug 70 prevents the accumulation of fecal water in the stoma bag from contaminating the stoma and incision, and the intestinal tract may be flushed through the closure plug 70 to prevent the accumulation of fecal matter in the intestinal tract.

In one embodiment, the drainage device includes a spring pass 80, the spring pass 80 including a pass head 821, a pass tail 822, and a pass body 81, the spring pass 80 being insertable into the drain 20. As shown in fig. 4 and 5, the drain rod head 821 may reach the head of the drain tube 20, and the drain rod body 81 may support the drain tube 20 to be more elastic and to open a pipe when the drain tube 20 is blocked. The tail 822 of the pass-bar is for holding. The drift tube head 821 is provided with a rounded head to prevent damage to the intestinal canal when entering the intestinal canal.

The reasonable use of the drainage device can reduce related complications after the ostomy hernia operation; the use method is simple, the practical function is multiple, the medical staff is easy to get on hand, and the family members after simple training can be used.

The drainage device can be applied to laparoscopic surgery, and is described by taking a Sugarbaker surgery as an example:

(1) Before performing the ostomy hernia operation, after the patient is anesthetized, the original ostomy bag 60 is removed, the tail end of the drainage tube 20 is plugged by a sealing plug 70, then the drainage tube is inserted into the intestinal tract as deeply as possible, and the columnar air bag 41 closest to the tail end is inflated to be fixed so as to prevent the drainage tube 20 from falling off;

(2) If the access is difficult, the spring through strip 80 can be inserted into the drainage tube 20, so that the drainage tube 20 is more elastic;

(3) The conventional sterilization, the drainage tube 20 is sterilized, the stoma is sealed, and the sealing patch is used for fixing the drainage tube 20 again;

(4) The balloon 40 can be inflated and deflated according to the situation in the operation, if the ostomy tube is not clear, the balloon can be inflated, and the position of the tube is clear;

(5) The air bag 40 inflated in the intestinal tract can support the intestinal wall, so that the intestinal wall is not shrunken any more in the process of separating adhesion, and the risk of damage to the intestinal wall is reduced;

(6) When the patch is fixed by the nailing gun, the columnar air bags 41 positioned at the middle position and the columnar air bag 41 closest to the tail end can be inflated, and the nailing gun is tightly attached to the inflated intestinal wall for fixation under the guidance of the air bag 40, so that the excessive tightening and the excessive loosening of the nailing gun can be prevented;

(7) Meanwhile, the positions of the air bags 40 can be clarified through repeated inflation and deflation of the air bags 40;

(8) After the operation is finished, the inner supporting air bag 42 is inflated, part of air of the columnar air bag 41 positioned at the middle position and the columnar air bag 41 closest to the tail end is discharged, the inner supporting air bag 42 is placed at the edge of the abdominal cavity patch under the direct view of a cavity mirror, the columnar air bag 41 closest to the tail end is inflated again, and the stoma outlet of the abdominal wall is closed;

(9) After the operation is finished, covering the bottom plate 62 of the ostomy bag 60 on the edge of the stoma, enabling the drainage tube 20 to pass through a bottom plate hole 621 on the bottom plate 62 and pass out of the access channel 611, connecting an external drainage bag at the tail part of the drainage tube 20, and draining fecal sewage in the intestinal cavity;

(10) The bag body 61 of the ostomy bag 60 is attached to the chassis 62 and the outlet channel 612 is closed with the closing plug 70.

Besides being used in endoscopic surgery, the drainage device can also be used after the ostomy hernia repair of the endoscope and the open knife:

(1) Inserting the spring pass 80 into the drain tube 20;

(2) Inserting the drainage tube 20 into the intestinal canal through the stoma, and evaluating the position of each balloon 40;

(3) If the operation is laparoscopic operation, and the intestinal canal has a submerging distance from the patch, and the position of the internal supporting air bag 42 is difficult to evaluate, the internal supporting air bag is inserted as far as possible, and finally, the columnar air bag 41 closest to the tail end in the cavity is simply used;

(4) If the operation is performed or no obvious long section of submerged intestinal canal exists, the inner supporting air bag 42 can be inflated first, the drainage tube 20 is lifted lightly, and the proper position is reached;

(5) Then the columnar air sac 41 positioned at the middle position or the columnar air sac 41 closest to the tail end is inflated, and the intestinal canal of the rest abdominal wall section is sealed;

(6) The pressure applied to each balloon 40 is evaluated by the buffer balloon 51 on the air inlet and outlet device 50, so that excessive pressure is avoided and the ischemia necrosis of the stoma is avoided.

The foregoing is merely a few embodiments of the present invention and those skilled in the art may make various modifications or alterations to the embodiments of the present invention in light of the disclosure herein without departing from the spirit and scope of the invention.

Claims

1. A drainage device, comprising: drainage tubes, ostomy bags and balloon mechanisms;

the air bag mechanism comprises an air bag and an air inlet and outlet device, the air bag is arranged at the head end of the drainage tube, and the air inlet and outlet device is connected with the air bag and is used for inflating or deflating the air bag;

the ostomy bag is detachably connected with the drainage tube.

2. The drainage device of claim 1, wherein the number of balloon mechanisms is plural, and a plurality of the balloons are spaced apart along the longitudinal direction of the drainage tube.

3. The drainage device of claim 2, wherein at least one of said balloons is a cylindrical balloon extending longitudinally of said drainage tube.

4. The drainage device of claim 2, wherein at least one of said balloons is an inner-strut balloon which is curved outwardly in the direction from the trailing end to the leading end of said drainage tube.

5. The drainage device of claim 3 or 4, wherein the balloon is sleeved outside the drainage tube.

6. The drainage device of claim 5, wherein the plurality of balloons include an inner-stay balloon and a plurality of columnar balloons, the columnar balloons extending longitudinally of the drainage tube, the inner-stay balloon being curved outwardly in a direction from a trailing end to a leading end of the drainage tube; at least one internal supporting air bag and at least two columnar air bags are distributed along the direction from the head end to the tail end of the drainage tube.

7. The drainage device according to claim 1, wherein the air inlet and outlet device comprises an air inlet and outlet pipe and a buffer air bag, the buffer air bag is connected with the air bag through the air inlet and outlet pipe, and the buffer air bag is provided with an air inlet and outlet.

8. The drainage device of claim 1, wherein the ostomy bag comprises a bag body, the bag body is connected with an access channel and an outlet channel, the drainage tube is detachably connected with the access channel, and the outlet channel is detachably connected with a sealing plug.

9. The drainage device of claim 8, wherein the closure plug comprises a tapered plug body and an injection channel disposed in the tapered plug body.

10. The drainage device of claim 1, comprising a spring pass bar comprising a pass bar head end, a pass bar tail end, and a pass bar body, the spring pass bar being insertable into the drainage tube.