RU117795U1 - DEVICE FOR DISEASING THE INTESTINAL STOMA - Google Patents

Abstract

A device for removing an intestinal stoma, containing a ratchet and two removable convex working blades, characterized in that the blades are 7 cm long and 3 cm wide, have a bulge at the working end, are attached to the branches of the device at an angle of 75 °, and on the rack a centimeter scale is made, corresponding to the diastasis between the blades.

Description

The utility model relates to medicine, namely to surgery, and can be applied during operations on hollow organs to expand the surgical wound during the formation of the intestinal stoma.

In surgery, a large number of retractors are known to be used to expand an operative wound.

The prototype of the utility model is the Collin retractor (http://www.nworld.spb.ru/medinss_003v.htm), which is a bicuspid tool with a cremallera, used to expand the surgical wound. However, the prototype has drawbacks: the tool cannot be used to remove the intestinal stoma, since the working part has wide blades and shallow depth, and also does not allow to measure the diameter of the surgical wound, which is very important for determining the correspondence of the surgical wound to the diameter of the intestinal stoma.

The objective of the utility model is to create convenience and safety when performing the expansion of the surgical wound when removing the intestinal stoma.

The technical result is the expansion of the surgical wound in the form of an oval in accordance with the size of the intestine.

The specified technical result is achieved by the fact that in the device for removing the intestinal stoma, containing the cremallera and two removable convex working blades, according to the utility model, the blades are made 7 cm long and 3 cm wide, have a thickening at the working end in the form of a protrusion, attached to the device branches under angle of 75 degrees, and a centimeter scale corresponding to diastasis between the blades was made on the rack.

The essence of the utility model is illustrated by the following figures: figure 1 shows the proposed device, General view; figure 2 - removable blades of the device.

The proposed device contains a cremallera 1, on which a centimeter scale 2 is made, corresponding to the diastasis between the blades, two removable convex blades 3 of the expander with a length of 7 cm and a width of 3 cm, having at the end a bulge 4 in the form of a protrusion, attached to the branches 5 of the device at an angle of 6 75 degrees.

This device is used in operations on the small and large intestines, in the removal of intestinal stoma, for example, with acute intestinal obstruction. With this device, the surgeon expands the surgical wound to the required size in accordance with the size of the output intestine, removes the intestine through this wound.

The above device, in contrast to the prototype, allows you to expand the surgical wound of a small size to a predetermined diameter to remove the intestinal stoma through it.

This device was used in 5 patients with diseases of the colon and small intestine with acute intestinal obstruction.

Clinical example:

Patient D. 65 years old was admitted on an emergency basis with a diagnosis of acute colonic obstruction. The patient started conservative antispasmodic therapy. 6 hours after the treatment, given the lack of a positive effect, the patient was operated on. With a laparotomy in the abdominal cavity, a stricturing tumor of the lower third of the sigmoid colon is revealed, above which the intestinal loops are inflated to 7 cm in diameter. During the audit, tumor operability was established; distant metastases were not detected. A resection of the sigmoid colon was performed according to the Hartmann type. In the left iliac region, in the middle of the distance between the umbilicus and the anterior superior iliac spine, the skin was excised 7 cm in diameter, subcutaneous fatty tissue was removed, the aponeurosis of the external oblique muscle of the abdomen was dissected crosswise, the internal oblique muscle of the abdomen was stratified along the fibers, the peritoneum was dissected, and the working blades were installed retractor, metered dilation of the surgical wound with additional dissection of tissues to a size of 7 cm on the centimeter scale of the instrument's rack was performed. The convex blades of the retractor allow you to expand the wound in the form of an oval, which is convenient when removing the intestine, attaching the blades to the branches at an angle of 75 degrees, as well as a thickened protrusion at the end of the blade allows the device not to slip out of the wound. A sigmoid colon inflated to 7 cm is removed through the resulting wound, after which the retractor is removed from the wound, and the intestine is fixed with interrupted vicryl sutures to the skin. The course of the postoperative period without complications, wound healing by primary intention, the patient was discharged after 10 days in satisfactory condition.

Claims (1)

A device for removing an intestinal stoma containing a cremallera and two removable convex working blades, characterized in that the blades are 7 cm long and 3 cm wide, have a bulge at the working end in the form of a protrusion, are attached to the device branches at an angle of 75 °, and on the cremallera made centimeter scale corresponding to the diastasis between the blades.