RU1817689C - Method of sutureless connection of resected urethra ends - Google Patents

Abstract

The invention relates to the field of healthcare and will find application in the treatment of patients who have suffered damage to the urethra. The goal is to reduce the number of postoperative complications by reducing the invasiveness of the compound. The ends of the crossed urethra are fixed intraluminally with a bundle of needles equipped with a cable to the fluoropolymer catheters, through which the conductor is guided and catheters are aligned with the crossed ends of the urethra, after which the catheters are fixed with collet clamps. To implement the method, a device consisting of two halves is used, containing each sleeve with a needle socket, a tubular sheath with a pull for moving the needles. Each of these halves is inserted into the ends of the resected urethra and, under visual control, the edge of the urethra is aligned with the end of the sleeve. By mixing the rods, the needles are withdrawn from the holes of the sleeve, while they are inserted into the urethral tissue 5-8 mm from the edge and fix it in a predetermined position. Using a guide conductor, both halves of the device, together with the ends of the urethra fixed on them, are tightly joined, and the edges of the resected urethra are precisely connected. By means of collet clamps fixed on the conductor, the displacement of the joined sleeves and the ends of the urethra is prevented, and they are held in this position until the wound of the urethra heals. The method prevents necrosis of the edges of the urethra by suture threads, because they do not disturb blood circulation in them, ensure the integrity of the anastomosis, and reduce the time of the operation. 1 ill. SO 00

Description

The invention relates to the field of healthcare and will find application in the treatment of patients with urethral strictures.

The aim of the invention is to reduce the number of postoperative complications by reducing the invasiveness of the compound, preventing necrotization of the edges of the urethra, and reducing the time for surgery.

This goal is achieved by the fact that the ends of the crossed urethra are fixed intraluminally with a bundle of needles equipped with

with a cable to the fluoroplastic catheters, through the cavities of which a conductor is passed and catheters are aligned with the crossed ends of the urethra, after which the catheters are fixed to each other with scurvy clamps.

The method of joining (joining) the ends of the resected urethra without suturing is carried out as follows. The urethra in the stricture area is secreted by midline perineal access, it is crossed at the level of scars, and excised

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cicatricial section of the urethra and surrounding scar tissue, oriented to the bougie, inserted into the internal opening of the urethra after cystotomy. One of the halves of the device is inserted into the central segment of the urethra or the neck of the bladder, the tubular membrane of which is led out through the wound of the bladder. Under the control of vision, the edge of the urethra is combined with the end of the sleeve. With offset m, the needle outlet is moved inside the separator sleeve.

In this case, the radially bent ends of the outlet needles slide along the edges of the hexagonal inner surface of the sleeve, fall into the holes, extend beyond the outer surface of the sleeve, penetrate the urethral tissue at a distance of 5-8 mm from its resected end and fix the edge of the urethra in a predetermined position ,

In a similar manner, the peripheral end of the urethra is fixed on the second half of the device, the rod and shell of which are brought out through the distal urethra. A flexible conductor (cable) is passed through the through channels t of both halves of the device. Half of the device is moved together with the peripheral edge of the urethra fixed on it along the guide cable until it is in full contact with the end surface of the second part of the device inserted into the central segment of the urethra (see drawing). The fixed position of the joined ends of the urethra fixed on the sleeves 1 with the needles 3 on the cable 4 is carried out by collet clips 5. The collet clips 5 are fixed on the cable 4 and they prevent the half of the device from being fixed with the fixed urethra. After healing of the urethral wound, the fixing collet clamps 5 are removed, the cable (flexible conductor) 4 is removed. Tig with needle rosettes 3 and 4 are removed from the sleeve 1 and the shells 2. Both halves of the device are freely removed from the urethra. The suprapubic urinary fistula heals and restores urination.

The advantages of the proposed method for connecting the ends of the resected urethra

and devices for its implementation are as follows.

Eliminates the need to flash the hard-to-reach central end of the posterior urethra or bladder neck;

eliminating the need for suture material, which creates the conditions for the development of an inflammatory reaction of tissues around the threads; needle fixation of the wall of the urethral canal is carried out in

5-8 mm from the edges of the wound surfaces, which does not interrupt the blood supply to the tissues and creates the best conditions for the healing (regeneration) processes in the urethral anastomosis zone; ideal matching of the ends of the resected urethra, tightness of the anastomosis and stable retention of the connected ends of the urethra are ensured. The simplicity of the operation of the device contributes to a significant reduction in the duration of the operation, a decrease in the operating trauma, and allows the operation to be performed in the inaccessible zone of intervention for surgeons of any skill.

Claims (1)

The claims A method for seamlessly connecting the ends of the resected urethra, including fixing, matching and holding the crossed ends of the urethra until regeneration, which consists in the fact that, in order to reduce the number of postoperative complications by reducing the invasiveness of the joint, the ends of the crossed urethra are fixed intraluminally with a bundle of non-wound needles equipped with a cable to fluoroplastic catheters, through the cavities of which a conductor is passed and catheters are compared with the crossed ends of the urethra, after which the catheters are fixed between each other with collet clamps.