RU194185U1 - A catheter for trapping and conducting an endoscopic string for laparoendoscopic treatment of complicated gallstone disease - Google Patents

Abstract

The utility model relates to special medical equipment, namely to the construction of a medical catheter, which can be used in laparoendoscopic treatment of complicated gallstone disease, in particular, in the presence of stones in the gallbladder and common bile duct, mainly with simultaneous intervention with cholecystectomy and assisted endoscopic retrograde papillosphincterotomy (EPST) in the so-called rendezvous technique, which is carried out using an endoscopic string under the control of wodenoscope. The catheter contains a hollow rod with a diameter of 3.0 mm, the distal end of the catheter is cut at an angle of 45 °, and a hole 5 mm long and 1.5 mm wide is made on it along the lateral surface to visually monitor the movement of the string in the lumen of the catheter. A new technical result achieved by the utility model is to increase the reliability of the fact that the endoscopic string is trapped by a medical catheter and passes through the catheter lumen under conditions of simultaneous intervention with cholecystectomy and assisted EPST.

Description

The utility model relates to special medical equipment, namely to the construction of a medical catheter, which can be used in laparoendoscopic treatment of complicated gallstone disease, in particular, in the presence of stones in the gallbladder and common bile duct, mainly with simultaneous intervention with cholecystectomy and assisted endoscopic retrograde papillosphincterotomy (EPST) in the so-called rendezvous technique, which is carried out using an endoscopic string under the control of wodenoscope.

One of the techniques of rendezvous technique with simultaneous intervention with cholecystectomy and EPST is the insertion of an endoscopic string into the lumen of the duodenum through the trocar after the incision of the cystic duct. From the lumen of the duodenum, the string is first caught by a hollow endoscopic catheter, and then passed through the same catheter to the external opening of the working channel of the duodenoscope. Given the negative consequences of x-ray monitoring of the operation, there was a need for a special endoscopic instrument such as a catheter that could be used to trap and conduct an endoscopic string under the conditions of an intervention without x-ray control. No such tools have been found in the prior art.

The objective of this utility model is to create a design for a hollow endoscopic catheter, which, under the conditions of an intervention without x-ray control, could provide the possibility of monitoring the reliability of the fact that the endoscopic string was caught by the catheter and its passage through the catheter’s lumen from the lumen of the duodenum to the external opening of the duodenoscope working channel.

The prototype of the claimed utility model is the well-known biliary dilatation catheter Endo-Flex (Germany), an electronic resource http://endo-stars.ru/shop/dilation/single/biliary_catheter1.

This medical instrument is a hollow rod with a thinned distal end, little adapted for trapping an endoscopic string by a catheter and passing it through the lumen of the catheter.

The claimed catheter is a hollow rod with a diameter of 3.0 mm, the distal end of which is cut at an angle of 45 degrees and a hole is cut out on it along the side surface for visual control of the movement of the string in the lumen of the catheter.

The cut of the distal end increases its area, which facilitates the capture of the string, and the hole made on it along the lateral surface with a length of 5 mm, a width of 1.5 mm allows the surgeon to control the reliability of the fact of catching the string by the catheter and its passage through the lumen of the catheter under the control of a duodenoscope without radiological patient control.

A new technical result achieved by the utility model is to increase the reliability of the fact that the endoscopic string is trapped by a medical catheter and passes through the catheter lumen under conditions of simultaneous intervention with cholecystectomy and assisted EPST.

The utility model is illustrated in the figure, which shows a fragment of a catheter with the distal end of the claimed design.

The claimed catheter contains a hollow rod 1, the distal end 2 of which is 3.0 mm in diameter, cut off at an angle of 45 degrees, a hole 3 is cut out on its side surface 5 mm long, 1.5 mm wide for visual control of the movement of the string 4 in the lumen of the catheter.

The catheter is made from a biliary dilatation catheter Endo-Flex (Germany) for a guide wire of 0.89 mm, a diameter of 1.67-3.0 mm, a length of 1800 mm. The thinned distal end of the Endo-Flex catheter is cut, the end of the remaining portion having a diameter of 3.0 mm is cut at an angle of 45 degrees, and a hole 5 mm long, 1.5 mm wide, is cut out on the obtained distal end along the lateral surface, in this example a rectangular one.

The intervention, which used a catheter of the claimed design, conditionally contains four sequentially conducted steps:

1. first laparoscopic,

2. rendezvous stage,

3. endoscopic,

4. second laparoscopic.

During the first laparoscopic stage, after application of pneumoperitoneum, optical and instrumental trocars were installed, then anatomical structures were isolated in the neck of the gallbladder to achieve maximum mobility of the cystic duct. At the rendezvous stage, after cutting the cystic duct through a trocar with a diameter of 3 mm, an endoscopic string of 0.89 mm was inserted, 450 cm long, and passed into the duodenal lumen. From the lumen of the duodenum, the string was first caught with a new catheter, and then passed through it to the external opening of the working channel of the duodenoscope. After that, the third and fourth stages of the intervention were carried out.

Visual control through hole 3 for the reliability of the fact that the endoscopic string is trapped by the distal end of the catheter and its passage through the lumen of the catheter allows for simultaneous intervention without performing x-ray control with cholecystectomy and EPST.

Claims (1)

A catheter for trapping and conducting an endoscopic string during laparoendoscopic treatment of complicated gallstone disease, comprising a hollow shaft 3.0 mm in diameter, characterized in that the distal end of the catheter is cut at an angle of 45 °, and a hole 5 mm long, 1 wide , 5 mm for visual control of the movement of the string in the lumen of the catheter.

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