CN2120592U - Catheter for esophagus operation - Google Patents

Abstract

The utility model relates to an esophagus operation catheter used for the anastomosis of the esophagus, the stomach and the enteron. The utility model comprises a main catheter which can be inserted into the oesophagus from the nasal cavity; four mutually isolated through cavities are arranged in the main catheter, and the four mutually isolated through cavities are respectively communicated with a flushing head at the top end of the main catheter, an attracting hole near the top end, and a front and a back air sacs; four branch pipes are respectively led out from the tail ends of the through cavities, and the four branch pipes are used for flushing, attracting and gas injection. When the operation catheter is used for the operations, the contamination can be reduced, and the inflated air sacs can also support and expand the oesophagus in the operation in order to clearly expose the operating field; therefore, the operation effect is improved.

Description

Catheter for esophagus operation

This utility model relates to a kind of surgical operating instrument, promptly a kind of can be for implementing the operating theater instruments that esophageal-gastric or esophagus-intestinal anastomosis are provided convenience and improved surgical effect.

The surgical intervention of illness such as the esophageal carcinoma, carcinoma of gastric cardia need be excised diseased region usually and be implemented esophageal-gastric or esophagus-intestinal anastomosis.Operating theater instruments commonly used is an esophageal forceps, and promptly operative doctor is lived the anastomotic part of esophagus and lifted esophagus with the esophageal forceps clamp, implements esophageal-gastric or esophagus-intestinal anastomosis near mouthful of end of esophageal forceps.Usually do not excise pathological changes section esophagus before coincideing earlier.The exposure of art open country is poor, and is subject to the pollution of esophageal lumen content.At this moment the incidence rate that causes anastomotic stenosis after surgery and fistula is one of main reason of high still so far.According to statistics, this use esophageal forceps is implemented esophageal-gastric or esophagus-intestinal anastomosis, and the incidence rate of anastomotic stenosis after surgery and fistula is about 2～10%, and the generation in a single day of intrathoracic fistula of operative incision, and mortality rate is 25～50%.

This utility model is intended to provide a kind of ideal operating theater instruments for implementing esophageal-gastric or esophagus-intestinal anastomosis, it can not only strut esophageal lumen at Shi Shushi, fully expose the art open country, and esophagus that can also adversary's art zone washes, guarantee that field of operation is aseptic substantially, thereby both the operation technique of implementing esophagus and stomach or intestinal anastomosis for the doctor was provided convenience, and can also improve therapeutic effect so as to reducing the incidence rate of anastomotic stenosis after surgery, fistula of operative incision and postoperative empyema.

This utility model is to finish by a bag catheter of being made by macromolecular material, that is to say, it comprises that one is suitable for inserting the main pipe that the macromolecular material of esophagus is made by nasal cavity, it is characterized in that, be provided with four mutual isolated cavities in this main pipe, promptly attract the chamber, preceding balloon inflation lumen, flushing chamber and rear gasbag inflatable chamber, the top of main pipe is provided with syringe pipe, air bag and rear gasbag before on the main pipe of syringe pipe caudal directions, being equipped with, leading tube wall between the place ahead of pro-air bag and preceding air bag and the rear gasbag is provided with and attracts the hole, attract the top in chamber and flushing chamber to be connected with attracting hole and syringe pipe respectively, the tail end of this two cavity is connected with suction manifold and flushing arm respectively, the top of preceding balloon inflation lumen and rear gasbag inflatable chamber is connected with preceding air bag and rear gasbag respectively, and the tail end of this two cavity is connected with preceding airbag aeration arm and rear gasbag inflation arm respectively.Can pass through these arms like this, implement operations such as flushing, attraction and inflation air bag.

Unique texture design of the present utility model guarantees that it has following two kinds of major functions:

(1) before implementing anastomosis, can wash esophageal lumen with antibiotics solution by conduit, and the liquid in attracting hole exhaustion esophageal lumen, esophageal lumen is polluted significantly reduce.

(2) after pathological changes section esophagus excision, the air bag of inflation can support and expand esophagus, and again by to the lifting of the catheter tip of performing the operation, mucous membrane of esophagus is unfolded and turned up, so the art open country is clear, ten minutes is convenient to implement esophageal-gastric or esophagus-intestinal anastomosis.

Also promptly, the doctor at first inserts esophagus with the surgical catheters of this utility model by nasal cavity when performing a surgical operation, and adjusts pipe end, makes to be positioned at esophagus incisxal edge near-end.Put pincers blocking-up esophagus at esophagus incisxal edge place.By rear gasbag inflation arm gas injection inflation rear gasbag, blocking-up esophagus.Inject antibiotics solution by the flushing arm, the esophageal lumen flushing is partly clamped to blocking-up by the rear gasbag inflation, and exhaust liquid in this section esophageal lumen by suction manifold, make this section esophageal lumen be in basic aseptic condition.The cross-section esophagus of nearly peristoma at esophagus anastomotic part blocking-up pincers cuts pathological changes section esophagus stomach function regulating, and the surgical catheters top of this utility model is exposed.By the gas injection of preceding airbag aeration arm, air bag before the inflation, and traction catheter tip lift air bag, at this moment esophageal wall is lax naturally, thickens, and high resilience is along with air bag lifts, esophageal lumen struts, and mucosa is unfolded and turned up, and art is wild to be exposed clearly, very is convenient to implement esophageal-gastric or esophagus-intestinal anastomosis.

For ease of the traction catheter tip, lift air bag, also syringe pipe has been done special design, promptly on syringe pipe, be provided with the radially flushing hole that is connected with flushing chamber in the main pipe, and be provided with shackle, in operation, both be convenient to like this esophageal lumen is rinsed well equably on the top of syringe pipe, can utilize suspension hook tractive shackle again, finish the traction catheter tip, lift the action of air bag, make the equal exposure of being satisfied with in each orientation of peristoma of esophagus.

Before and after behind the airbag aeration diameter can be extended to 20～30mm, rear gasbag generally is slightly larger than preceding air bag, can fully block esophagus like this, be convenient to wash, but again behind the pro-airbag aeration, the esophagus upset of being convenient to cut off lifts, for anastomosis is provided convenience.Because in executing the art process, conduit is inserted in the esophagus, so forward and backward air bag all is positioned at esophageal lumen, its inflating condition can't visualization.For this reason, the tail end of pro-rear gasbag inflation arm is equipped with the detection capsule, at the afterbody of surveying capsule check valve is housed.Check valve can not backflow the gas of injection, thus the gas institute inflation that air bag is injected into before and after guaranteeing.Survey capsule and be connected with the front and back air bag respectively,, just know the front and back air bag by the situation of inflation, very intuition, safety so maintenance and the equal inflation pressure of front and back air bag are observed and surveyed capsule by the situation of inflation.Postoperative unclamps check valve, can discharge the gas that charges in the capsule, and it is flat that capsule is collapsed, and is convenient to take out conduit.

For can be in executing the art process fixing this utility model, the bridge of the nose fixed mount that can move forward and backward along main pipe is equipped with in anti-sliding stop on main pipe.When conduit is inserted esophagus to the appropriate location by nasal cavity, can be on the bridge of the nose with this bridge of the nose fixed mount retaining, be right after the bridge of the nose fixed mount tail end direction position limiting clamp that can move forward and backward along main pipe is housed, be used at bridge of the nose fixed mount retaining after on the bridge of the nose, withstand this bridge of the nose fixed mount, do not allow it move again.In addition, for the conduit that prevents to insert skids off from esophageal lumen, between bridge of the nose fixed mount and rear gasbag, be provided with the external diameter insurance bulge loop more bigger along the aperture that main pipe moves forward and backward than bridge of the nose fixed mount apart from 15～25cm place, main pipe top, when main pipe generation slippage, the insurance bulge loop can be blocked by bridge of the nose fixed mount, thereby the 5cm main pipe that can guarantee still to have an appointment is stayed in the esophageal lumen.

Each critical piece in this utility model comprises that main pipe, each arm, front and back air bag etc. should make with macromolecular material, particularly has the physiology inertia, can not cause that tissue inflammation is convenient to disinfectant silicone rubber or polyurethane material again.The pipe fitting softness of so making and high resilience and property very, thus not only convenient but also safety of intubate operation guaranteed.Syringe pipe, bridge of the nose fixed mount, position limiting clamp etc. can be formed by metal and/or rigid plastics car system or mold pressing.The insurance bulge loop can be made by the macromolecular material identical with main pipe or rigid plastics, metal.

Once implement esophageal-gastric anastomosis 34 examples with the operation on esophagus conduit of this utility model, male's 28 examples wherein, women's 6 examples, 61 years old mean age, postoperative does not have fistula of operative incision, and no anastomotic stricture does not have surgical death yet.Compare with the traditional operation that uses esophageal forceps the same period, it is as shown in the table for the result.

As seen, use operation on esophagus conduit support expansion esophageal lumen described in the utility model to implement esophageal-gastric or esophagus-intestinal anastomosis, excised pathological changes section esophagus before coincideing, the wild exposure of art is clear.Esophageal lumen has been eliminated the polluter in the esophageal lumen basically through antibiotics solution continual rinsing and attraction before coincideing, and the postoperative patient exothermic reaction is little.More owing to support expansion esophageal lumen anastomotic part with air bag, make the esophagus anastomotic part appear good, and esophageal wall is lax naturally, thickening, mucous membrane of esophagus is unfolded and is turned up, the mucous layer that can guarantee mucous membrane of esophagus stomach function regulating when coincideing or intestinal is satisfied involutory, these all be to use esophageal forceps traditional anastomosis was difficult to accomplish.Effect of the present utility model is conspicuous.

Further specify this utility model below in conjunction with accompanying drawing with embodiment.

Fig. 1 is a structural representation of the present utility model, and Fig. 2 is the profile of A-A part among Fig. 1.Number in the figure is: airbag aeration arm before the 1-; 2,7-surveys capsule, 3,6-check valve, the 4-suction manifold, 5-washes arm, 8-rear gasbag inflation arm, 9-arm bunch block, the 10-main pipe, the 11-position limiting clamp, 12-bridge of the nose fixed mount, 13-insures bulge loop, air bag before the 14-rear gasbag, 15-, 16-syringe pipe, 17-flushing hole, the 18-shackle, 19-attracts the hole, and 20-attracts the chamber, balloon inflation lumen before the 21-, 22-washes the chamber, 23-rear gasbag inflatable chamber.

Embodiment one

Referring to Fig. 1 and Fig. 2, in making with extrusion moulding, the use silastic material have four to isolate cavities mutually, promptly attract chamber 20, preceding balloon inflation lumen 21, flushing chamber 22, the main pipe 10 of rear gasbag inflatable chamber 23, this pipe range 500mm after the sulfuration, external diameter 5.2mm.With bonding construction from part two rubber pneumatic bags made from infusion process are installed respectively at distance main pipe 10 top 30mm and 68mm place, be that length is the preceding air bag 15 of 30mm and the rear gasbag 14 that length is 60mm, the leading tube wall in the capsule is provided with aperture and is connected with preceding balloon inflation lumen 21 and rear gasbag inflatable chamber 23 in the main pipe respectively.This two cavity sticks with glue agent respectively in the aperture leading edge and stops up.Have on the leading tube wall between the place ahead of pro-air bag 15 and preceding air bag 15 and the rear gasbag 14 three with the attraction holes 19 that attract chamber 20 to be connected.Attract the front end in chamber 20 also to stick with glue the agent obstruction, in case it is communicated with syringe pipe 16.For air bag before and after guaranteeing expands when the gas injection equably, and be convenient to intubate, tube drawing operation, this two air bag is made Fructus Citri tangerinae pleat shape.

At the top of main pipe 10 bonding assembling syringe pipe 16, this syringe pipe 16 is formed by rustless steel car system, it is blunt coniform that the top is, and perforation arranged, form shackle 18, waist is the cylinder of φ 7mm, six flushing holes 17 of radial equipartition, and these Kong Jun are connected by the flushing chamber 22 in the intravital overall channel of cylinder and the main pipe 10.

Apart from the bonding insurance bulge loop 13 that usefulness silicone rubber of the same race is made in 21cm place, syringe pipe 16 top, one with the ring-type bridge of the nose fixed mount 12 that has the hook loop of nylon manufacturing and the position limiting clamp 11 of interior toothing shape spring arch clasp at this bulge loop rear suit successively on main pipe 10.The external diameter of the annular aperture of bridge of the nose fixed mount 12 and position limiting clamp 11 and main pipe 10 is suitable, to guarantee that they can move forward and backward along main pipe 10, the spring arch clasp of position limiting clamp 11 can be positioned on the main pipe after clamping, no longer movable, but can not block four interior cavities of flat main pipe yet.

Four cavities in the main pipe 10, promptly attracting the tail end of chamber 20, preceding balloon inflation lumen 21, flushing chamber 22, rear gasbag inflatable chamber 23 is 4mm with four external diameters respectively by the bonding construction from part, the silicone rubber tube that is about 80mm is connected, and these four silicone rubber tubes are followed successively by suction manifold 4, preceding airbag aeration arm 1, flushing arm 5 and rear gasbag inflation arm 8.Come off for preventing that these arms from twisting, and be convenient to operations such as gas injection, flushing, attraction, these arms are inlaid in the arm bunch block of being made by real core silicon rubber piece 9.Detection capsule 2 and 7 of being made by plastic membrane of polyvinyl chloride of the bonding respectively assembling of tail end of pro-airbag aeration arm 1 and rear gasbag inflation arm 8 is equipped with check valve 3 and 6 at the afterbody of surveying capsule 2 and 7.To 8 gas injections of preceding airbag aeration arm 1 or rear gasbag inflation arm the time, because the effect of check valve 3 or 6, gas can not backflow like this, and survey capsule 2 or 7 can along with preceding air bag 15 or rear gasbag 14 together by inflation.In case the gas injection path has leakage, observe the inflation situation of surveying capsule and can find out, if gas injection pressure is too high, surveys capsule and promptly can break, to guarantee safety.

Embodiment two

Also see also Fig. 1 and Fig. 2, wherein main pipe 10 and each arm 1,4,5,8 and insurance bulge loop 13 usefulness thermoplastic polyurethane materials are that main body is made, all the other each parts and assembling are identical with embodiment one, and the operation on esophagus conduit hardness that obtains is higher, and very property is good.

Claims (6)

1, a kind of operation on esophagus conduit that is used for esophagus and stomach or intestinal anastomosis: comprise that one is suitable for inserting the main pipe 10 that the macromolecular material of esophagus is made by nasal cavity, it is characterized in that, be provided with four mutual isolated cavities in this main pipe 10, promptly attract chamber 20, preceding balloon inflation lumen 21, flushing chamber 22, rear gasbag inflatable chamber 23, the top of main pipe 10 is provided with syringe pipe 16, air bag 15 and rear gasbag 14 before on the main pipe of syringe pipe caudal directions, being equipped with, leading tube wall between the place ahead of pro-air bag 15 and preceding air bag 15 and the rear gasbag 14 is provided with and attracts hole 19, attract the top in chamber 20 and flushing chamber 22 to be connected with attracting hole 19 and syringe pipe 16 respectively, the tail end of this two cavity is connected with suction manifold 4 and flushing arm 5 respectively, the top of preceding balloon inflation lumen 21 and rear gasbag inflatable chamber 23 is connected with preceding air bag 15 and rear gasbag 14 respectively, and the tail end of this two cavity is connected with preceding airbag aeration arm 1 and rear gasbag inflation arm 8 respectively.

2, operation on esophagus conduit according to claim 1 is characterized in that syringe pipe 16 is provided with the radially flushing hole 17 that is connected with flushing chamber 22 in the main pipe 10, and there is the shackle 18 of being convenient to tractive on the top of syringe pipe 16.

According to claim 1 and 2 described operation on esophagus conduits, it is characterized in that 3, the tail end of preceding airbag aeration arm 1 and rear gasbag inflation arm 8 is provided with surveys capsule 2 and 7, at the afterbody of surveying capsule 2 and 7 check valve 3 and 6 is housed.

4, operation on esophagus conduit according to claim 1 is characterized in that being equipped with on main pipe 10 and can make the bridge of the nose fixed mount 12 that moves forward and backward along main pipe 10.

5, operation on esophagus conduit according to claim 4 is characterized in that tail end direction at bridge of the nose fixed mount 12 is equipped with one and can makes the position limiting clamp 11 that moves forward and backward along main pipe 10.

6, operation on esophagus conduit according to claim 4 is characterized in that between bridge of the nose fixed mount 12 and rear gasbag 14, is provided with an insurance bulge loop 13 apart from 15～25cm place, main pipe 10 tops.

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