EA017899B1 - Device for aspiration method of detecting variants of intravenous position of mouth of large lymphatic collectors - Google Patents

Abstract

The invention relates to medicine, in particular to devices for detecting position of the mouth of large lymphatic collectors inside the left and right venous angle and sampling lymph from their lumen. The device comprises a hollow elastic cylinder-transformer, provided with hydraulic and aspiration catheters. In the initial position the device is cylindrical, its lateral (comb-shaped) sides are folded (closed), since the inner wall of the elastic cylinder has a greater tension rate compared to that of the outer wall. In the working position the device takes a sheet shape, its lateral (comb-shaped) parts are developed (opened), since physiologic saline is injected into the elastic cylinder cavity via the hydraulic catheter. For lymph sampling there must be provided a close contact of the vessel drainage plate with the mouth of the lymphatic basins in the zone of the venous angles, this achieved by increasing the vessel volume by adding physiological solution into its cavity via the hydraulic catheter. Then the aspiration catheter creates a negative pressure (aspiration) on the surface of the vessel drainage plate - the aspiration provides an active the lymph outflow from the mouth of the lymphatic basins.

Description

The invention relates to medical equipment, in particular to devices for determining the mouth of large lymphatic collectors inside the left and right and venous corners and taking lymph from their lumen (thoracic duct, right lymphatic duct, bronchial mediastinal trunk, jugular trunk, subclavian trunk).

A device for collecting lymph from the mouth of large lymphatic collectors flowing into the left and right venous corners made of elastic material in the form of a double-walled elastic T-shaped balloon (1). However, the large individual variability of the place where the final section (mouth) of the lymphatic collectors flows into the venous angle (2, 3) limits the use of this device (1).

The disadvantages of this device: the design features of the device (T-shaped) do not allow selective installation of it in the lumen of the venous angle, thereby providing a search for the mouth of the lymphatic collectors with various topography options for these anatomical formations.

The purpose of the invention: determining the position of the mouth of large lymphatic collectors inside the left and right venous angle and providing an aspiration procedure for collecting lymph from their lumen with various topography options for these anatomical formations (thoracic duct, right lymphatic duct, bronchial mediastinal trunk, jugular trunk, subclavian trunk).

This goal is achieved by using a device of a special design made of a polymeric material in the form of an elastic balloon with two catheters: hydraulic and suction (Fig. 1). The lateral parts of the cylinder have a comb configuration (the comb part of the cylinder is 1). The central part of the cylinder has a longitudinal drainage plate of a cellular structure (the drainage part of the cylinder is 2), which communicates with an aspiration catheter (3). The cavity of the elastic balloon is closed (4), its volume is regulated by a hydraulic catheter (5). In the initial state, the device has a cylindrical shape, since the inner wall (6) of the elastic balloon has a higher degree of tension compared to the outer wall (7) and the cavity between them is empty, the comb part of the balloon is in a folded (closed) position (Fig. 2a ) In the working state, the device takes on a leaf-like shape, since saline is introduced into the cavity of the elastic balloon through a hydraulic catheter, and the crested portion of the balloon is brought into an extended (open) position (Fig. 2b).

The device works as follows: in the shoulder region, in its lower third (in the internal brachial groove - 8 and 1 8 Νοίρίΐαΐίδ sheLaib), the brachial vein is exposed and the above-described device is rolled up into its lumen. The device is carried out to the level of the left or right venous angle, then a physiological solution is introduced into the cavity of the elastic balloon through a hydraulic catheter, which increases the volume of the balloon and brings it into the working (deployed) position in the lumen of the venous angle. In the working (deployed) position of the device, the inner (concave) surface of the elastic balloon faces the lumen of the venous angle, and the outer (convex) surface faces the endothelium of the venous angle. The curved configuration of the elastic balloon corresponds to the configuration of the inner semicircle of the subclavian or internal jugular vein and does not interfere with free blood flow in the venous corner. (Fig. 3). In the working (deployed) position, the comb part of the balloon fixes the device in the lumen of the venous angle and ensures close contact of the drainage part of the balloon with the mouth of the adjacent lymphatic collector. After installation (fixation) of the device in the lumen of the venous angle with an aspiration catheter, negative pressure (aspiration) is created on the surface of the drainage part of the balloon, which contributes to the active (forced) outflow of lymph from the mouth of the detected lymphatic collector. In the absence of lymph in the lumen of the aspiration catheter, the mouth of the lymphatic collector is searched. For this, it is necessary to selectively change the position of the device in the lumen of the venous angle through a hydraulic catheter. So, to displace the device in the lumen of the venous angle with a hydraulic catheter, the volume of the elastic balloon is reduced, and to fix the device in the lumen of the venous angle, the volume of the elastic balloon is increased. Thus, by sequentially reducing and increasing the volume of the elastic balloon with a hydraulic catheter, the mouth of the lymphatic collectors is searched throughout the entire inner wall of the venous angle. After finding the mouth of the lymphatic collector and completing the procedure for taking lymph from its lumen with a hydraulic catheter, the volume of the elastic balloon decreases to the initial (collapsed) position, which will allow you to freely remove (extend) the device from the lumen of the venous angle.

Information sources

1. Patent EAPO No. 007758 Asanov B.U., Sapin M.R., Omurbaev A.S. A device for the aspiration method of opening the mouth of large lymphatic collectors.

2. Zhdanov D.A. Surgical anatomy of the thoracic duct and major lymphatic collectors and trunk nodes. - Gorky, 1945.

3. Urtaev B.M. Combined transverse-longitudinal access to the terminal part of the thoracic duct. Sat .: Clinical lymphology. - M., 1986, p. 76-80.

Claims (1)

A device for the aspiration method for determining the intravenous position of the mouth of large lymphatic collectors, which is a hollow elastic balloon, part of the outer wall of which is facing the endothelium of the venous angle, made in the form of a drainage plate equipped with an aspiration catheter for collecting lymph, and the lateral parts of the balloon have a comb configuration and serve to fix the device into the lumen of the venous angle, while the volume of the balloon is regulated by a hydraulic catheter.