RU193065U1 - Laparoscopic device for the expansion of bile ducts - Google Patents

Abstract

The utility model relates to medical devices for performing surgical laparoscopic operations, namely to expand the bile ducts. The device consists of a housing, a pusher and a handle; four jaws are attached to the housing using axes, which are opened or closed to each other by means of the pusher head, and a pin is attached to the pusher that transmits movement from the handle attached to the housing by an axis, while the pusher can be fixed with a locking screw. The use of this device in clinical practice allows you to clearly visualize all the walls of the bile duct during laparoscopic surgery and flush the duct without the threat of critical narrowing due to the involvement of adjacent duct walls in the suture material. The proposed device is industrially applicable, easy to manufacture and use, does not require large expenses. 2 ill.

Description

The utility model relates to medical devices for performing surgical laparoscopic operations, namely to expand the bile ducts.

In particular, the claimed utility model can be used to form a bileodigestive anastomosis with precision suturing of choledoch into the mucous membrane of the jejunum intracorporeally, i.e. in the abdominal cavity.

The level of technology.

Known catheter containing coaxially located on it the working sleeve with a balloon and a channel for inflating it, and an additional locking element (AS USSR 1662579).

A disadvantage of the known device is the leakage of the walls of the wound channel, which may be accompanied by leakage of pathological fluid beyond its boundaries. In addition, a balloon catheter involves monofunctional use: external drainage of the cavity in the absence of combinations of the possibility of manipulation in it.

A device for cystostomy of parenchymal organs is known. The device is equipped with a working sleeve with a balloon balloon through an additional channel in the working sleeve, which is coaxially located on the balloon catheter with the possibility of reciprocating movement, as well as an additional locking sleeve coaxially located on the working sleeve (RU 2093200 C1).

However, this device has disadvantages associated with a large initial diameter of the sleeve, which does not allow the introduction of the blades of the device into the ducts, in view of the smaller diameter of the latter.

Closest to the claimed solution is a device for expanding the bile ducts (RU 187551 U1), consisting of a sleeve, inside of which there is an axis with a button head, a drum and four blades, and inside the axis there is a spring Kerner mechanism that drives the blades and fixes them in a certain position.

However, this device has disadvantages in the aspect of laparoscopic interventions and the application of pancreatojejunoanastomosis intracorporeally. Namely: the dimensions of the device, the expansion mechanism of the blades, the mechanism of fixation of the blades do not allow the device to pass through a trocar with a diameter of 12 mm into the abdominal cavity.

The technical result of the claimed utility model is the creation of a laparoscopic device for the expansion of the bile ducts and the formation of an intracorporeal bileodigestive anastomosis with precision suturing of the bile duct into the mucous membrane of the jejunum during laparoscopic procedures.

The indication for applying biliodigestive anastomoses is:

- impaired patency of the terminal section of the common bile duct with benign pathology (for example, with stenosis and strictures of the common bile duct);

- tumors of the large duodenal papilla, cancer of the terminal part of the common bile duct, cancer of the head of the pancreas, cancer of the extrahepatic bile ducts.

The specified technical result is achieved by the fact that a pin is attached to the pusher, transmitting movement from the handle connected to the housing with an axis, while the pusher can be fixed with a locking screw.

The utility model is illustrated by a detailed description and illustrations, which depict:

FIG. 1 is a general view of a laparoscopic device for expanding the bile ducts with closed lips; 1 - body, 2 - axis, 3 - jaws, 4 - head, 5 - pusher, 6 - locking screw, 7 - pin, 8 - handle, 9 - axis.

FIG. 2 - laparoscopic device for the expansion of the bile duct with open lips.

The laparoscopic device for expanding the bile ducts (Fig. 1) consists of a body 1, a pusher 5 and a handle 8, four jaws 3 are attached to the body 1 with the help of axes 2, opened or closed together by means of the head 4 of the pusher 5, and to the pusher 5 a pin 7 is attached, transmitting movement from the handle 8, attached to the housing 1 using the axis 9, while the pusher 5 can be fixed with a locking screw 6.

The device (Fig. 1) operates as follows. After installing the closed jaws 3 of the device in the lumen of the stump of the bile duct, the surgeon turns the handle 8. The handle 8 acts on the pin 7 and moves the pusher 5. The head 4 rotates the jaws 3, spreading their free ends and making a slow dilation of the bile duct (Fig. 2). After visualizing all the walls of the bile duct, the jaw 3 is fixed in a certain position, which is determined by the size of the duct, using the locking screw 6.

Further, under the control of vision, all walls of the bile duct are flashed. The injection is carried out from the duct between the fixed jaws 3 of the device. The injection is made through the mucosa of the small intestine into the lumen of the latter. After applying the required number of sutures, proceed to the formation of a bileodigestive anastomosis. To remove the device from the lumen of the bile duct and abdominal cavity, the handle 8 is rotated in the opposite direction, closing the jaws 3. After that, the device is removed from the lumen of the bile duct and abdominal cavity.

The proposed device allows to achieve optimal tightness of the formed anastomosis and thereby significantly reduce the frequency of early postoperative pancreatic fistulas.

The use of this device in clinical practice allows you to clearly visualize all the walls of the bile duct during laparoscopic operations and flush the duct without the threat of critical narrowing, due to the involvement of adjacent duct walls in the suture material. The proposed device is industrially applicable, easy to manufacture and use, does not require large expenses.

Claims (1)

A laparoscopic device for expanding the bile ducts consists of a body, a pusher and a handle; four jaws are attached to the body with the help of axes; they can be opened or closed to each other by means of the pusher head, characterized in that a pin is transmitted to the pusher that transfers movement from the handle attached to the body using the axis, while the pusher can be fixed with a locking screw.

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