RU132994U1 - DEVICE FOR DECOMPRESSION OF THE COLUM - Google Patents

Abstract

A device for decompression of the colon, made in the form of a tube, characterized in that the tube has 4 channels that are not interconnected: the main channel with a diameter of at least 16 mm, made with the possibility of aspiration of intestinal contents and measurement of intestinal pressure, and having side holes with a diameter of 2 mm located 20 cm from the distal end of the tube; the second channel - with a diameter of at least 3 mm, made with the possibility of washing feces and irrigation of the anastomosis zone; and two channels for inflating cuffs of 1.5 mm each, two cuffs are sequentially installed 10 cm from the proximal end of the probe, cuffs are placed at a distance of 5-7 cm from each other, additional openings of the main channel are located between the cuffs at an equal distance; individual PVC pipes are located in the channels for inflating the cuffs; the channels on the proximal part of the probe are connected to cannulas with anti-return cuffs and valves.

Description

The utility model relates to medical equipment, namely to devices designed to perform decompression of the colon.

An analogue of the proposed device is a probe for decompression of the intestine R.V. Senyutovich (Surgery, 1997. No. 9. P.53). However, the known device has several disadvantages: it is used for decompression of the colon after removal of the tumor and the formation of colonic anastomosis and does not allow lavage and delimit the zone of anastomosis from feces; the design of the probe also does not allow a selective study of intraluminal pressure in the area of intestinal sutures, as well as x-ray examination of the anastomosis; the use of a probe can lead to infection of the lumen of the small intestine with an ascending infection from the colon due to iatrogenic failure of the bauginium damper.

Achievable when using the proposed device, the technical result is the ability to carry out simultaneous - decompression, lavage and drainage of the anastomotic zone, regardless of nasointestinal drainage. This, in turn, helps to reduce intraluminal hypertension of the colon, which reduces the risk of developing interintestinal anastomosis.

A silicon-organic thermolabile radiopaque probe (Figs. 1a and 1b), designed as an elastic thermolabile and radiopaque polyvinyl chloride tube, was developed. The average length of the probe is 200 cm. The probe has 4 channels of different diameters - the main channel (1) with a diameter of at least 16 mm, the second channel (7) - at least 3 mm and two channels (4, 5) of 1.5 mm each.

The main channel through the hole located at the distal end (2) of the tube communicates with the lumen of the colon. In addition, the main channel has side holes (3) with a diameter of 2 mm, which are located from the hole (2) to the distal cuff. The distal cuff is located 40 cm from the hole (2).

The main channel (1), communicating with the intestinal lumen through the lateral openings (3), serves for aspiration of intestinal contents, decompression, and measurement of intra-intestinal pressure.

At 10 cm from the proximal end of the probe, 2 cuffs (6) are installed in series, the location of which allows you to delimit the chyme from the intestinal anastomosis, fix the probe in a predetermined position.

Cuffs are placed at a distance of 5-7 cm from each other. The cuffs are inflated using separate PVC tubes passing inside the probe in channels 4 and 5. On the proximal part of the probe, the PVC tubes are connected to cannulas with control cuffs and anti-return valves.

On figa, the positions 8 and 9 indicate: control cuff, anti-return valve and cannula (not shown separately in FIG.). After the tube is inserted into the intestine, fluid is introduced into the channels 4 and 5 (for example, through a syringe), then cannulas with control cuffs and anti-return valves are connected to the channels. This design performs the controlling function of fluid movement in the cuffs.

Between the cuffs at an equal distance there are additional openings of the main channel (10) for irrigation and aspiration between the cuffs.

The second channel (7) has an internal diameter of 3 mm, and serves to rinse feces and irrigate the anastomosis zone with drugs.

Using the developed device.

The probe is installed intraoperatively after the formation of an intestinal anastomosis. During the operation, cuffs (6) are inflated through channels 8 and 9. In the postoperative period, a fluid is introduced into channel 7, which enters the intestine through opening 2 and into the intestinal anastomosis between the cuffs through additional openings (10), then through the channel 1, through the side openings (3) and additional openings (10), the contents are aspirated.

Through the main channel (1), the intestinal contents are aspirated and the intestinal anastomosis is irrigated with drugs. In addition, decompression is ensured, which is performed due to the fact that at one moment all openings cannot be in the liquid, i.e. part is simply in the lumen of the intestine, evacuating gas from it.

The probe is removed for 3-4 days as motor-evacuation function of the intestine is restored, and the general condition of the patient improves.

Example 1. Patient N., 54 years old, was admitted with a clinic of intestinal bleeding. With fibrocolonoscopy, the diagnosis is established - Cancer of the sigmoid colon with decay. Performed surgical intervention - resection of the sigmoid colon. The formation of a bell anastomosis end to end. The institution of the developed probe is proximal to the anastomosis. Abdominal drainage.

The postoperative period was uneventful. Motor evacuation function was restored on the 3rd day. The probe was removed on day 4. Drainage tubes removed on the 5th and 6th day. Sutures were removed on the 15th day. The patient in satisfactory condition was discharged from the department.

The structural features of the probe, which consist in the fact that the probe, in addition to the main washing and aspiration channel, has two separate channels - for inflating the proximal and distal cuffs (to protect the anastomosis) and for irrigation-aspiration (for decompression, drainage and lavage of the anastomosis suture line medicines). These features provide:

- protection of the anastomosis from passage of intestinal contents;

- decompression of the anastomosis zone, regardless of the intraluminal pressure in the small intestine;

- conducting antibacterial therapy of the area of the intestinal anastomosis;

- measurement in the dynamics of intraluminal pressure in the anastomotic zone;

- X-ray contrast studies of the anastomosis to diagnose anastomositis and the failure of the intestinal intestinal sutures;

- timely diagnosis of suture failure, visualization of this complication,

- the creation of aseptic conditions for healing;

- the possibility of introducing into the intestinal wound zone solutions of drugs that accelerate healing and epithelization;

- localization of the process in the abdominal cavity (with the failure of intestinal sutures), preventing the development of general peritonitis.

All these factors together reduce the number of postoperative complications, reduce the time of inpatient treatment of patients and contribute to their early social and labor rehabilitation.

Claims (1)

A device for decompression of the colon, made in the form of a tube, characterized in that the tube has 4 channels that are not interconnected: the main channel with a diameter of at least 16 mm, made with the possibility of aspiration of intestinal contents and measurement of intestinal pressure, and having side holes with a diameter of 2 mm located 20 cm from the distal end of the tube; the second channel - with a diameter of at least 3 mm, made with the possibility of washing feces and irrigation of the anastomosis zone; and two channels for inflating cuffs of 1.5 mm each, two cuffs are sequentially installed 10 cm from the proximal end of the probe, cuffs are placed at a distance of 5-7 cm from each other, additional openings of the main channel are located between the cuffs at an equal distance; Separate PVC tubes are located in the channels for inflating the cuffs; the channels on the proximal part of the probe are connected to cannulas with anti-return cuffs and valves.

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