RU183470U1 - Device for holding fixed urethral catheters into the bladder with trocar cystostomy - Google Patents

Abstract

The utility model relates to medicine, namely to urology and surgery, and can be used to install a cystostomy catheter for patients with acute urinary retention. The technical result is the ability to install Foley catheters from No. 18-24 on Ch, safety and simplicity, eliminating the possibility of additional surgical urinary tract interventions; reusable use of the device for installation during operations by the method of trocar cystostomy. This technical result is achieved by the fact that the collapsible tube consists of two conical half-tubes having grooves around the circumference in its wide part, a fastening lock-clutch consisting of two parts, one of which has a fastening screw with nut, and the second - groove for fastening with a screw.

Description

The utility model relates to medicine, namely to urology and surgery, and can be used to install a cystostomy catheter for patients with acute and chronic urinary retention.

Trocar cystostomy is a vital minimally invasive operation performed under local anesthesia. An indication for its conduct is acute urinary retention, which developed against a background of various diseases. It consists in the installation of a cystostomy - a medical instrument in the form of a catheter. An established cystostomy temporarily assumes the functions of the urinary canal. The actual operation of the trocar cystostomy is a reusable trocar with the possibility of installing a Foley catheter up to No. 20 ch.

A device is known (trocar-cystofix) for trocar cystostomy (Vahlensieck W. Jr et al. Z. Urol. Nephrolog. 1990 Jun; 83 (6): 309-12). This is a disposable hollow trocar with a pointed end, through the cavity of which, after a bladder puncture, a Foley catheter is passed over the pubis. After installation of the Foley catheter, the balloon of the catheter is inflated, the trocar is carefully removed from the bladder, while avoiding damage to the balloon with the tip of the trocar. Having completely removed the trocar from the wound channel (bladder, prebubble fatty tissue, muscle-aponeurotic layer of the anterior abdominal wall, subcutaneous fatty tissue and skin), the cystofix trocar is broken along the axis in half to remove the Foley catheter from its cavity.

The main disadvantages of this device (trocar) are: 1) when breaking along the axis of the trocar, which is partially located in the wound channel, the drainage tube (catheter) can cross the tip of the trocar. In this case, the proximal end of the drainage tube (catheter) remains in the wound, which requires surgical intervention - revision of the wound canal (Dogra P.N., Goel R Int. Urol. Nephrol. 2004; 36 (3): 343-4); 2) when removing the trocar, there is a danger of damage to the Foley catheter balloon with the sharp end of the trocar, which will lead to the catheter falling out of the bladder cavity; 3) the impossibility of assessing the depth of penetration of the device (trocar) through the wound channel (skin, subcutaneous fat, muscle-aponeurotic layer of the anterior abdominal wall and prevesical tissue) into the bladder; 4) the one-time use of the trocar-cystofix; 5) the high cost of the trocar set itself is cystofix.

A device for installing fixed urethral catheters into the bladder during trocar cystostomy is known, characterized in that it contains a tube and stylet, and the tube is a tube that is not closed along its axis, with a groove width of 5 mm, the tube has oval on the opposite wall from the groove holes and risks applied at intervals of 1 cm, while the stylet is made with a groove and a retainer located between the rod and the handle, and the beginning and end of the stylet groove are made with the possibility of alignment with the holes on the tube ce (RF patent №2408311, publ. 10.01.2011).

The disadvantage of this device is that it allows you to install only a Foley catheter no more than No. 16 on Ch, which does not allow to exclude the flow of urine into the paravesical tissue and make the urinary fistula more direct and short, which makes it difficult to subsequently change the cystostomy drainage.

From the existing level of technology, a puncture device for diagnosing and treating injuries and diseases of the abdominal organs is a universal trocar containing a casing in the form of two half-tubes and a circle dissected in diameter, having a stylet opening in the center and two halves connected movably by means of a lock, characterized the fact that it additionally contains the ears of the side, made to open the casing when pressed, while the triangle segment is cut out of the circle, equal in height to the radius of the circle, and the width of the base is up to 20 mm, and the half-tubes have a length of 100 mm and are welded along the edges on the lower surface of a circle made of metal (RF patent No. 2551188, publ. 05.20.2015).

This technical solution relates to medical instruments for the diagnosis and treatment of injuries of the chest, abdominal cavity and bladder with the possibility of stopping bleeding or removing stones.

A device for operations using the method of trocar cystostomy under ultrasound control, characterized in that it consists of a collapsible tube with a scale of marks on it, a pointed stylet, brackets and brackets (patent for utility model of the Russian Federation No. 85324, publ. 10.08.2009). This device is taken by us as a prototype.

The disadvantages of this technical solution are, like in other models, damage to the peritoneum adjacent to the bladder.

The objective of the claimed utility model is to ensure the safe installation of fixed in the bladder urethral catheters of Foley No. 18 or more using the proposed reusable device after trocar cystostomy.

This problem is solved due to the fact that the claimed device for conducting fixed urethral catheters into the bladder during trocar cystostomy consists of two cone-shaped half-tubes with grooves around the circumference in a wide part, connected by a lock-clutch consisting of two half-couplings, fixed by a screw. The device without difficulty, after installing the Foley catheter, is evacuated from the bladder.

The technical result - the ability to install Foley catheters from No. 18-24 on Ch, safety and simplicity, eliminating the possibility of additional surgery on the urinary tract; reusable use of the device for installation during operations by the method of trocar cystostomy.

The technical result is ensured by the fact that the tube of the proposed device is cone-shaped and collapsible, which facilitates its insertion into the bladder and allows the unhindered installation of Foley catheters No. 18-24 by Ch. The reusability of the device is ensured by the fact that it consists of 2 cone-shaped half-tubes having grooves around the circumference in its wide part, as well as the fact that the device contains a simple reliable lock-clutch that fastens both detachable parts of the trocar tube and is easily removable.

The essence of the utility model is illustrated by drawings:

FIG. 1 - a device for conducting fixed urethral catheters into the bladder with trocar cystostomy.

FIG. 2 - a coupling consisting of 2 connected coupling halves, one of which (1) has a fastening nut with a screw (3, 4), and the second (2) - groove 8 for fastening with a screw. (photo 1)

FIG. 3 - collapsible tube of 2 cone-shaped half tubes 5 having grooves around the circumference in its wide part. (Photo 2)

Figure 4 - spiky stylet 6. (photo 2)

A device for holding fixed urethral catheters in the bladder during trocar cystostomy contains a sleeve consisting of 2 half-couplings interconnected, one of which (1) has a fixing nut 3 with screw 4, and the second (2) has a groove 8 for fastening with screw 4. The device contains a collapsible tube of 2 cone-shaped half tubes 5 having grooves around the circumference in its wide part; and also a pointed stylet 6. The coupling half 1 and the coupling half 2 are connected by screws 7.

Before using the device, both cone-shaped half tubes 5 are folded together and inserted into the open coupling, so that the coupling halves 1 and 2 fit into the grooves located on the circumference of the wide part of the half tubes 5. The coupling half 2 is closed so that its groove 8 is on the screw 4 The screw 4 with the pre-wound nut 3 is tightened, and its leg passes into the groove 8 of the coupling half 2, until it stops. Thus, the entire structure is reliably combined, a stylet 6 is inserted into it. Dismantling of the device occurs in the reverse order. All parts of the device are made of stainless steel, approved for use in medicine.

The device works as follows: during the operation by the method of a trocar cystostomy using a collapsible trocar, the bladder is punctured, stylet 6 is removed, the Foley catheter No. 18-24 by Ch is inserted into the trocar, the balloon of the catheter is inflated. The fixing screw 4 is untwisted, the halves of the coupling 1 and 2 are opened, the coupling is removed from the top of the tube 5, it is disconnected and removed from the cavity of the bladder.

Thus, the proposed device compares favorably with the prototype, because allows you to provide a technical result due to the design features of the utility model, namely the presence of a collapsible cone-shaped tube and a simple reliable lock-clutch on it allows you to install Foley catheters No. 18-24 by Ch in the bladder and repeatedly use the device.

The performance of the claimed device is confirmed by the following clinical example:

Example. Patient S. s.V. 79 years old, was admitted to the urology department on an emergency basis with a diagnosis of :. Acute urinary retention.

The urethral catheter could not be inserted due to an insurmountable obstruction in the prostatic urethra. Performed a trocar cystostomy of the proposed device. The postoperative period without complications. On the ultrasound control of the flow in the small pelvis are not determined. The patient was discharged after a day in satisfactory condition under the supervision of a urologist at the clinic and further examination.

Using the proposed device helps to solve a number of problems:

1. To improve the quality of the technique of staging trocar cystostomy.

2. The ability to use Foley catheters No. 18-24 by Ch and thereby exclude the flow of urine into the paravesical tissue and make the bladder fistula more direct and short, which significantly improves the subsequent change of cystostomy drainage.

The proposed device is effective and safe when installing fixed Foley urethral catheters in the bladder during trocar cystostomy and is intended for reusable use, economically and available for use in hospitals and outpatient clinics.

Claims (1)

A device for holding fixed urethral catheters into the bladder during trocar cystostomy characterized in that the collapsible tube consists of two cone-shaped half tubes with circumferential grooves in its wide part, a fastening lock-clutch consisting of two half couplings, one of which has a fixing screw with nut, and the second - a groove for fastening with a screw.

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