LV14475B - Needle for infiltration a couch of bilious bladder - Google Patents

Abstract

Invention relates to medical devices, particularly to puncturing and rinsing needles for hollow organs and vessels. The invention provides for a needle having bushing (1) with neck (2), main (3), intermediate (4) and working (5) tubes. The working tube (5) has blunt end (6) which is joined under acute angle to intermediate (4) tube. The blunt end (6) has a height (8) distance from axle (7) no more than 2.5 mm.

Description

DESCRIPTION OF THE INVENTION

BACKGROUND OF THE INVENTION The invention relates to medical techniques, including instruments for puncture and lavage of hollow organs and blood vessels, in particular injection needles, and to the development of a gallbladder infiltration needle.

TECHNICAL LEVEL

Surgery with gallbladder removal (cholecystectomy) has been a widespread phenomenon in recent years. Cholecystectomy is performed either by laparotomy or by laparoscopy [3, 4, 5], during the cholecystectomy, the peritoneum and ligaments that connect the gallbladder to the liver are removed from the liver surface. The gallbladder is densely fused to the surface of the liver, which makes it difficult to remove, especially in the case of a marked infiltration-fusion process. In this case, the process of removing the gallbladder can take up to 3 hours, bleeding is possible, traumatic injury is caused by leaving behind fragments of the gallbladder, and so on. complications.

There is a known needle aspiration of the gallbladder and aspiration of the gallbladder contents by decompression method of recovery by videolaparoscopic manipulation [6]. The gallbladder puncture is performed using a puncture needle: outer diameter 1-1.2 mm, length 15-20 cm. The needle should be very sharp (pointed).

Needles of various designs are known for hollow organ lavage and vascular puncture [7-10]. Puncture tissue biopsy needles of various designs are known [11-15].

All known needle structures have very pointed ends [6-15]. Using such needles with pointed ends it is not possible to infiltrate the gallbladder because the pointed needle tip can puncture the gallbladder wall, which can cause iatrogenic complications due to bile flow into the abdomen.

The information provided is well known to surgeons and clinicians performing cholecystectomy for gallbladder removal.

DISCLOSURE OF THE INVENTION

Objective and technical result of the invention:

• developing a new design needle with a blunt tip - for safe target infiltration of the gallbladder; • providing a new design needle penetration through a trocar internal cross-section through videolaparoscopic cholecystectomy; .

RECOMMENDED EXAMPLES OF THE INVENTION

In the process of developing a needle of a new design, various pipe connections were used: basic (3), intermediate (4) and working (5). Optimal connections were determined by: coaxial (7) joint between the base (3) and intermediate (4) tubes; the working tube (5) must be connected to the intermediate tube (4) at a wide angle with respect to the axis (7) of the intermediate tube (4), the untapered end (6) of the working tube (5) being at height (8), not exceeding 2,5 mm.

The relationship between the lengths of the various base (3), intermediate (4) and working (5) tubes was investigated and experimentally investigated. The optimal tubing sizes found were as follows: 400-200 mm - length of base (3) tube; 15-10 mm length of intermediate tube (4); 7-5 mm - length of working tube (5). The ratio between the optimum lengths of the base (3), intermediate (4) and working (5) tubes was as follows: 40,020,0: 1,5-1,0: 0,7-0,5, where 1 equals 10 mm.

Changes in tube length and their relationship adversely affected the rigidity and sharpness of the new design needle and prevented the blunt end (6) of the targeted working tube from penetrating between the gallbladder and liver, separating the peritoneum and ligaments that connect the gallbladder to the liver. Experimentally, the outer diameter of the tubes, which were supposed to perform their function of infiltration of the gallbladder bed and at the same time pass through an internal trachar cross-section through endoscopic videolaparoscopy, was found experimentally.

The following outer diameter dimensions were found: 5-4 mm - outer diameter of the base (3) tube; 1.0-0.5 mm - outer diameter of intermediate pipe (4); 1.0-0.5 mm - Outer diameter of working pipe (5).

The ratio of the optimum diameter of the outer diameter of the base (3), intermediate (4) and working (5) tubes: 0.5-0.4: 0.1-0.05: 0.1-0.05, where 1 equals 10 mm.

The objective is achieved on the basis that the infiltration needle consists of a sleeve (1) with an opening (2), a base (3), an intermediate (4) and a working (5) tube with a blunt proximal (patient) tube. end (6); a sleeve (1) with an opening (2), a base (3) and an intermediate tube (4) coaxially connected with respect to the axis (7); a base tube (3) tapered to the intermediate tube (4); the working tube (5), at a wide angle to the axis (7), is connected to the intermediate tube (4), whereby the unshaped end (6) of the working tube (5) is at a height (8) not exceeding 2.5 mm; the length ratio of the base (3), intermediate (4) and working (5) tubes is 40.0-20.0: 1.5-1.0: 0.7-0.5, where 1 equals 10 mm; the ratio of the outer diameter of the base (3), intermediate (4) and working (5) tubes is 0.5-0.4: 0.1-0.05: 0.1-0.05, where 1 equals 10 mm.

The invention is explained by a drawing, in which Fig. 1 is a schematic representation of a new design needle for gallbladder infiltration.

Needle description in static

The needle consists of a sleeve (1) with an opening (2), a base (3), an intermediate (4) and a working tube (5) with a blunt proximal (patient) end of the working tube (5). Coupling (1) with aperture (2), base (3) and intermediate tube (4) firmly connected along axis (7), base tube (3) tapered to intermediate tube (4). The working tube (5) is at a wide angle relative to the axis (7) connected to the intermediate tube (4), whereby the unshaped end (6) of the working tube (5) is at a height (8) not exceeding 2 from the shaft (7). , 5 mm. The dimensions of the tubes are as follows: length of base tube (3) 400-200 mm; the length of the intermediate tube (4) is 15-10 mm; length of working tube (5) 7-5 mm. The ratio of the length of the main (3), intermediate (4) and working (5) tubes is 40.0-20.0: 1.5-1.0: 0.7-0.5, where 1 equals 10 mm. The outer diameter of the main (3), intermediate (4) and working (5) tubes is as follows: the outer diameter of the basic (3) tube is 5-4 mm; the outer diameter of the intermediate tube (4) is 1.0-0.5 mm; the working tube (5) has an outer diameter of 1.0-0.5 mm. The ratio of the outer diameter of the main (3), intermediate (4) and working (5) tubes is: 0.50.4: 0.1-0.05: 0.1-0.05, where 1 equals 10 mm.

The new design needle works as follows:

Cholecystectomy is performed under general anesthesia (endotracheal). A 10 mm long incision is made at the skin 2 cm above the navel (midline of the navel). A first 10 mm diameter trocar is introduced through the skin incision, which penetrates the abdominal wall and injects gas into the abdominal cavity until a pressure of 4 mm of mercury is applied (pneumoperitoneum). This allows the doctor to safely insert the camcorder between the internal organs. A camcorder is introduced through the first trocar and a careful examination of the liver and gallbladder. Under visual control, 3 additional abdominal stitches are performed through which 3 additional 10 mm, 5 mm, 5 mm trocars are introduced. Surgical instruments are introduced through these three additional trocars: an electrocoagulator, a clipper, and two clamps. Clamps the bottom and neck of the gallbladder. Clips are used to clip: 1) duets cysticus 2) arteria cystica. An electrocoagulant is used to initiate the gallbladder removal procedure. A gallbladder infiltration needle is inserted through the second trocar (diameter 10 mm) before electrocoagulation begins. The needle from the outside is connected to the disposable syringe with 20 ml of 1% lidocaine solution through the cap (1) with the opening (2). The blind end (6) of the working tube (5) is guided to the gallbladder bed by visual inspection. The blunt end (6) of the working tube (5) performs perforation of the peritoneum in the ligament area between the gallbladder and the liver. With the help of a spray, the gallbladder bed is slowly infiltrated with 20 ml of 1% lidocaine solution through the main (3), intermediate (4) and working (5) tubes. There is additional analgesia and gentle removal of the gallbladder from the surface of the liver. Through the electrocoagulant, the gall bladder is removed from the bed. During the process of removing the gallbladder from the liver surface, the peritoneum and the ligaments that connect the gallbladder to the liver are removed. The gallbladder is removed through the clamps through the first incision. Surgical instruments are removed from the incisions and the wound is sutured.

The use of a new design needle for gallbladder infiltration in the process of videolaparoscopic cholecystectomy enables: 1) to pass through the internal tracheal cross-section by videolaparoscopic cholecystectomy; 2) realize safe targeted infiltration of the gallbladder bed during the process of detaching the peritoneum and ligaments (which closely connect the gallbladder to the liver); 3) to ensure gentle gentle detachment of the gallbladder from the liver surface by cholecystectomy; 4) to prevent damage to the walls of the gallbladder, including during the pronounced infiltration-adhesion process; 5) to reduce and prevent the occurrence of traumatic bleeding during cholecystectomy; 6) to shorten the time for performing a cholecystectomy.

INDUSTRIAL USE

A new-design gallbladder infiltration needle may be used in clinics involved in abdominal surgery for cholecystectomy using videolaparoscopy or laparoscopy.

Sources of information

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4. F.Charles Brunicardi, MD, FACS. Schwartz's principles of surgey. 9 ¹¹¹ Ed. The McGraw-Hill Companies. 2010, pp. 142-1154.

5. Robert M.Zollinger, Jr. and E.Christopher Ellison. Zollinger's Atlas of Surgical Operations 9 ^Λ Ed. The McGraw-Hill Companies. 2003, p. 1182-1190.

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Claims (1)

THE CLAIM The gallbladder infiltration needle is characterized in that it consists of a sleeve (1) with an opening (2), a base (3), an intermediate (4) and a working (5) tube with a blunt proximal (patient) end of the working tube (5). (6); a sleeve (1) with an opening (2), a base (3) and an intermediate tube (4) coaxially connected with respect to the axis (7); a base tube (3) tapered to the intermediate tube (4); the working tube (5), at a wide angle to the axis (7), is connected to the intermediate tube (4), whereby the unshaped end (6) of the working tube (5) is at a height (8) not exceeding 2.5 mm; the length ratio of the base (3), intermediate (4) and working (5) tubes is 40.0-20.0; 1.5-1.0: 0.7-0.5, where 1 equals 10 mm; the ratio of the outer diameter of the base (3), intermediate (4) and working (5) tubes is 0.5-0.4: 0.1-0.05: 0.1-0.05, where 1 equals 10 mm.