DE102009043472B4 - Insertion system for a sponge drainage for vacuum sponge therapy - Google Patents

Abstract

Delivery system for positioning a sponge drainage in an intestinal lumen, a hollow organ, a body cavity or a tissue abscess, the system comprising: - a guide wire (5), - a drainage tube (1) connected to a polyurethane sponge (4) which can be fitted with a positioning sleeve (2) are located in a guide sleeve (3), the polyurethane sponge having an X-ray marking.

Description

General state of the art

Internal wounds in the event of a postoperative anastomotic insufficiency in the rectum can be treated with the insert and drainage connected to an open-pored polyurethane sponge. The drainage is put under suction, it removes the wound secretion, leads to wound adhesion and healing.

The insertion system available to date can only treat wounds close to the body opening.

The advantages to be achieved with the invention lie in the deeper positioning of a sponge drainage and the resulting expanded indication for vacuum sponge therapy. With the invention, the sponge system can also be placed in the esophagus, stomach, duodenum, large intestine and in all body cavities or wound cavities that can be reached with an endoscope.

By positioning in an intestinal lumen, a complete closure of the same can be achieved. Drainage and internal closure of internal wounds can also take place at the same time, thereby allowing them to heal.

An esophageal perforation can be performed endoscopically with a covered self-expanding stent. This is introduced with an insertion system over a previously endoscopically inserted guide wire over the defect and is intended to seal it from the inside. A wound drainage inserted from the outside is also necessary for this.

With the invention, the insertion system is also positioned via an endoscopically inserted guide wire and an open-pored polyurethane sponge, which is connected to a drain, is inserted over the perforation defect in the esophagus.
The drainage is placed under negative pressure with a vacuum pump. As a result, the esophageal lumen collapses over the sponge, the defect is closed and wound secretion is drained at the same time.
The advantage of this procedure compared to the stent system is that the wound secretion is drained inwards and discharged via the drainage by the suction effect in the direction of the intestinal lumen.
This is particularly effective on organs that are naturally under negative pressure (organs in the chest cavity) or wounds and wound cavities that are in contact with the chest cavity and are physiologically under negative pressure here.
Due to the vacuum suction applied to the open-pored polyurethane sponge via the drainage, the wound exudate can be emptied via the drainage and is not drawn along the physiologically existing pressure gradient and in the direction of the chest during breathing movements.

• 1 ist eine Darstellung, die die Anordnung des kompletten Einführsystems zeigt. Am distalen Ende der Führungshülse (3) ist der komprimierte Schwamm (4), der mit der Drainage (1) verbunden ist, aufgenommen. Über die Drainage (1) ist eine Positionierungshülse (2) ebenfalls in die Führungshülse eingeschoben, sie ist sowohl gegenüber der Führungshülse als auch der Drainage verschieblich. In der Drainage liegt der Führungsdraht (5) ein. Dieser Führungsdraht wird zunächst endoskopisch über einen Defekt platziert, dann kann das ganze Einführungssystem über den Draht in die Position geschoben werden. Der Schwamm besitzt eine Röngtenstrahlen dichte Markierung, so dass unter Röntenkontrolle die Positionierung vorgenommen und kontrolliert werden kann.
• 2 zeigt das beginnende Freisetzen des Schwammes (4), die Positionierunghülse (2) und Die Führunshülse (3) werden gegeneinander verschoben, so dass der Schwamm aus dem Distalende der Führungshülse austritt.
• Fig .3 zeigt ein fortschreitendes Freisetzen des Schwammes.
• 4 zeigt eine vollständige Schwammfreisetzung.
• 5 zeigt den freigesetzen Schwamm nach Enferung der Führunghülse, Positionierungshülse und des Führungsdrahtes.
• 6 zeigt einen Querschnitt durch das Einführungssystem mit freigesetzem Schwamm, 6 bezeichnet die Perforationsöffnungen der Drainage im Schwamm.
• 7 zeigt einen Querschnitt durch das Einführungssystem mit in dem Distalende der Führungshülse (3) komprimiertem Schwamm (4).

The invention is explained with reference to the drawings after construction and handling.

• 1 Figure 12 is an illustration showing the layout of the complete delivery system. The compressed sponge (4), which is connected to the drain (1), is accommodated at the distal end of the guide sleeve (3). A positioning sleeve (2) is also pushed into the guide sleeve via the drain (1) and can be moved relative to both the guide sleeve and the drain. The guide wire (5) lies in the drainage. This guide wire is first placed endoscopically over a defect, then the entire delivery system can be slid into position over the wire. The sponge has an X-ray-tight marking so that the positioning can be carried out and checked under X-ray control.
• 2 shows the beginning of the release of the sponge (4), the positioning sleeve (2) and the guide sleeve (3) are pushed against each other so that the sponge emerges from the distal end of the guide sleeve.
• 3 shows a progressive release of the sponge.
• 4 shows complete sponge release.
• 5 shows the released sponge after removal of the guide sleeve, positioning sleeve and guide wire.
• 6 shows a cross section through the insertion system with released sponge, 6 designates the perforation openings of the drainage in the sponge.
• 7 shows a cross section through the insertion system with the sponge (4) compressed in the distal end of the guide sleeve (3).

Claims (1)

Delivery system for positioning a sponge drain in an intestinal lumen, a hollow organ, a body cavity or a tissue abscess, the system comprising: - a guide wire (5), - A polyurethane sponge (4) connected to a drainage tube (1), which is located with a - Positioning sleeve (2) in a - Guide sleeve (3), the polyurethane sponge having an X-ray marking.

Images