RU193186U1 - DEVICE FOR CARRYING A BLOOD VESSEL - Google Patents

Abstract

The utility model relates to the field of medicine, and more specifically to medical equipment, namely, devices designed to constrict blood vessels in open surgical operations on the main arteries. The device comprises a housing (1), which is a rectangle with an internal rectangular hollow cavity (2) with a slot (3) on the front end surface and grooves (4) with a slope along the lateral internal surfaces where the pins (5) of the wheel (6) are inserted with the possibility of its movement, moreover, when the wheel is moved in the proximal direction, a gap (7) appears between the wheel and the body, and when the wheel is moved in the distal direction, it fits snugly against the inner wall of the body. The upper surface of the housing is made in the form of teeth (8), and in the end part of the pins of the wheel is a V-shaped structure (9), and its proximal part (10) is made in the form of a spatula (11) with the possibility of gripping the grooves of the teeth (8), the distal part (12) of the V-shaped design is made in the form of a thrust pad (13) for the possibility of lifting the spatula (11) from the groove of the tooth (8), in the grooves of which a constant elastic traction (14) is fixed, fixed on one side to the proximal parts (10) of the V-shaped structure (9) of the spatula (11), and on the other hand rons - to the median bracket (15) of the V-shaped structure (9). The device allows to increase the effectiveness of surgical intervention on the main arteries due to reliable temporary clamping of blood vessels. 5 ill.

Description

The utility model relates to the field of medicine, and more specifically to medical equipment, namely, devices designed for temporary clamping of blood vessels during open surgical operations on the main arteries.

A device for local pressure of a blood vessel, designed to stop blood flow through the main vessel for the period of open surgery on it (RF patent No. 2158109, A61B 17/12, 10.27.2000).

The disadvantage of this device is the inability to use it when performing eversion carotid endarterectomy using a temporary shunt.

A device is known for dosed temporary occlusion of a cerebral vessel, which contains constantly diluted branches and is made of metal or a biologically inert solid material. An elastic balloon is immersed in one of the jaws, which is fixed on a flexible tube. The tube exits the jaw and serves to supply liquids or gases through it into the cylinder under pressure (RF patent No. 2163470, АВВ 17/12, 02/27/2001).

The disadvantage of this device is the inability to use it for temporary clamping of the main vessel when performing eversion carotid endarterectomy using a temporary shunt.

Known vascular clamp, which contains a thrust base with double thrust surfaces and vascular retainers, and a thrust pad, which is equipped with a receiving cylinder made with a spring retainer for the removed segment of the vessel. The thrust base is made in the form of jaws with a spring clip for fixing the position of the jaws relative to each other. The thrust surfaces and the receiving cylinder are mounted on one branch, and the vascular retainers are located on the other branch (RF patent No. 2313298, АВВ 17/12, 12/12/2005).

The disadvantage of this vascular clamp is the inconvenience of its use in operations on the carotid arteries.

A device for narrowing a blood vessel is known, which comprises a metal plate provided with a V-neck and side guides. A working element is inserted into the guides, which is made in the form of a curly wire loop made of an alloy with memory. The ends of the loop are insulated and made to supply current to them (RF patent No. 2152178, АВВ 17/12, 10.07.2000).

The disadvantage of this device is the increased complexity and inconvenience when performing eversion carotid endarterectomy.

A known method of reducing the lumen of a blood vessel using a special device comprising retracting the area subjected to narrowing of the vessel into a single polyvinyl chloride tube (RF patent No. 2213377, A61B 17/12, 09/27/2003).

The disadvantage of this method and device is the complexity and the need to attract additional medical personnel for the manipulation.

The technical result of the utility model is to increase the efficiency of surgical intervention on the main arteries due to reliable temporary clamping of blood vessels.

The technical result is achieved by the fact that the device for clamping a blood vessel contains a body, which is a rectangle with an internal rectangular hollow cavity with a slot on the front end surface and grooves with a slope on the side inner surfaces where the wheel pins are inserted with the possibility of its movement, and when when moving the wheel in the proximal direction, a gap appears between the wheel and the housing, and when moving the wheel in the distal direction, it rafts but adjacent to the inner wall of the housing, while the upper surface of the housing is made in the form of teeth, and in the end part of the pins of the wheel is a V-shaped design, and its proximal part is made in the form of a spatula with the possibility of gripping the grooves of the teeth, and the distal part is V-shaped the structure is made in the form of a thrust pad for the possibility of lifting the spatula from the teeth, in the grooves of which a constant elastic traction is provided, fixed on one side to the proximal V-shaped design of the spatula, and on the other Orons - to the middle bracket of the V-shaped design. Comparison of the proposed device with others known in the field of medicine, showed its compliance with the criteria of a utility model.

The utility model is illustrated by graphic material. In FIG. 1 shows an assembly model of the device, side view in the initial position; in FIG. 2 shows an assembly model of the device, a top view in the initial position; in FIG. 3 shows an assembly model of the device, a side view in the working position; in FIG. 4 shows an assembly model of the device, end view; in FIG. 5 shows an assembly model of the device, a top view in the initial operating position; in FIG. 6 shows an assembly model of the device, a top view in the final operating position.

The device comprises a housing 1 which is a rectangle with an internal rectangular hollow cavity 2 with a slot 3 on the front end surface. On the lateral inner surfaces of the rectangular cavity 2 of the housing 1, grooves 4 are made with a slope in the front to back direction, where the pins 5 of the wheel 6 are inserted with the possibility of moving it along the inclined grooves 4, and when the wheel 6 is moved in the distal direction, a gap 7 appears between the wheel 6 and the body 1, and when the wheel 6 is moved in the proximal direction, it fits snugly against the inner wall of the housing 1. The upper surface of the housing 1 is made in the form of teeth 8, and in the end part of the pins 5 there is a V-shaped design 9, and the proximal part 10 of the V-shaped structure 9 is made in the form of a spatula 11 with the possibility of gripping the grooves of the teeth 8, and the distal part 12 of the V-shaped structure 9 is made in the form of a thrust pad 13 for the possibility of lifting the spatula 11 from the groove of the teeth 8. For reliable fixation of the spatula 11 in the grooves of the teeth 8, a constant elastic rod 14 is provided, fixed on one side to the proximal part 10 of the V-shaped structure 9 of the scapula 11, and on the other hand to the middle bracket 15 of the V-shaped structure 9. In addition, on graphicaterialah depicted: PVC tube 18 for performing intravascular bypass the internal carotid artery (ICA) 16 and common carotid artery (CCA) 17, as well as gum glove 19 and flexible liner 20.

The device operates as follows.

The operation is performed under general anesthesia. From a conventional incision, carotid arteries are exposed along the lateral surface of the neck. To prevent blood from entering the arteriotomy hole after cutting off the common carotid artery (CCA) from the internal carotid artery (ICA), a temporary intravascular bypass through ICA 16 is performed by introducing a polyvinyl chloride tube 18 into the lumen of the OCA 17 and the ICA 16. To prevent bleeding between the OCA 17 , ICA 16 and the wall of the polyvinyl chloride tube 18. A device for clamping a blood vessel between the vessel walls and the polyvinyl chloride tube is applied to the OCA 17 and the ICA 16. The glove gum 19 is wrapped in a round around the main vessels of the BCA 16 and the OCA 17, containing a silicone tube 18. Next, the glove gum 19 is threaded through the rubber elastic strip 20 and carried out on the back surface of the body 1 under the wheel 6 and held by the fingers of the surgeon. The glove gum 19 is pulled so that the blood flow between the inner walls of the main vessels of the ICA 16 and the OSA 17 and the silicone tube 18 is stopped. By pressing on the thrust pad 13, the spatula 11 of the proximal part 10 of the V-shaped structure 9 is lifted from the groove of the toothed angle rail 8, move the wheel 6 in the distal direction until it fits snugly against the inner wall of the housing 1, while securely fixing the glove rubber 19 in a predetermined position. Having achieved reliable clamping of the blood vessel, release the thrust pad 13, while the scapula 11 of the proximal part 10 of the V-shaped structure 9 is fixed in the grooves of the teeth 8 of the housing 1.

Surgical intervention on the ICA 16 is completed by eversion carotid endarterectomy, that is, the removal of an atherosclerotic plaque. Then remove the polyvinyl chloride tube 18 serving as a temporary intravascular shunt. Restore the integrity of extracranial arteries by applying a vascular suture. Removing the device for temporary clamping of the main vessel is carried out in the reverse order.

Clinical example.

Patient A., 70 years old, was admitted to the department of vascular surgery SOKB them. V.D. Seredavina 02/14/19 with a diagnosis of Atherosclerosis of extracranial arteries. ICA stenosis on the right 70%, ICA stenosis on the right 54%. After preoperative preparation, the patient performed surgery on February 15, 1919 - eversion carotid endaterectomy on the right. Progress of the operation: Along the inner edge of the sternocleidomastoid muscle, the skin and fiber were dissected for 11 cm to the right. OSA, ICA, and HCA were isolated — the arteries were passable and pulsating. In the area of the OSA bifurcation with the transition to the ICA, an atherosclerotic plaque with a length of 2.2 cm is determined, a stenotic clearance of 70%. OCA, ICA are pressed. Cut off from the mouth of the ICA. A temporary intravascular shunt is installed in the OSA and ICA. To prevent blood flow between the walls of the great vessels and the PVC tube, devices are installed for clamping the blood vessel, (three). There is no blood flow between the walls of the main arteries and the shunt. The shunt is functioning, cerebral oximetry is normal. An eversion endarterectomy from the ICA was performed, and a good retro-blood flow was obtained. ICA is implanted in the OCA. Shunt removed. Removed a device for clamping a blood vessel. The arteriotomy suture is tight. All arteries in the wound pulsate distinctly. Hemostasis. Stitches on the wound. In the postoperative period, the patient was in the intensive care unit for 2 hours. Transferred to the vascular surgery department in satisfactory condition. In the postoperative period, conservative treatment was carried out (anticoagulants, cerebroprotectors, analgesia). General condition is satisfactory. Examined by a neurologist - there is no neurological deficit. Healing by first intention. Discharged for outpatient treatment at the clinic at the place of residence 03/15/19. Examined by a vascular surgeon at the polyclinic SOKB im. V.D. Seredavina 04/11/19 - the general condition is satisfactory, there is no neurological deficit, wound healing by primary intention.

A device for dosed temporary narrowing of the main blood vessel will find wide application in the surgical units of medical institutions.

Claims (1)

A device for clamping a blood vessel, comprising a body, a polyvinyl chloride tube for performing intravascular shunting, elastic gaskets, characterized in that the body is a rectangle with an internal rectangular hollow cavity with a slot on the front end surface and grooves with a slope along the side inner surfaces where the pins are inserted the wheel with the possibility of its movement, and when moving the wheel in the proximal direction, a gap appears between the wheel and the housing while moving the wheel in the distal direction, it fits snugly against the inner wall of the housing, while the upper surface of the housing is made in the form of teeth, and in the end part of the pins of the wheel there is a V-shaped structure, and its proximal part is made in the form of a spatula with the possibility of gripping grooves of the teeth, and the distal part of the V-shaped design is made in the form of a thrust pad for the possibility of lifting the spatula from the teeth, in the grooves of which a constant elastic traction is fixed, fixed on one side to the proximal V-shaped design of the scapula, and on the other hand, to the middle bracket of the V-shaped design.

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