RU2005495C1 - Device for extraction of intracranial hematoma - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: device has an aspirating tube with two openings and spatula, detachable flexible ring-shaped metallic hose with silicone catheter mounted within the tube. The aspirating tube is in communication with irrigating tube with cock and with silicone catheter for periodically feeding washing solution. EFFECT: reduced traumatism of brain. 1 dwg

Description

 The invention relates to medicine and can be used in neurosurgery.

 There are various devices for removing intracranial hematomas, for example, suction tubes, spatulas, spoon-shaped brain, tips for suction. However, their use is traumatic, since trauma of the brain substance and blood vessels of the brain can occur simultaneously with hematoma aspiration. In addition, these devices do not simultaneously flush the surgical field.

 As a prototype, a device for removing intracranial hematomas, including a tube for aspiration of blood and a tube for washing the hematoma, was selected. However, it is known that the device does not create brain protection at the same time as removing the hematoma. It does not allow penetration into the basal and parasagittal parts of the brain, where hematomas accumulate to a greater extent and foci of brain crushing are formed.

 The problem to which the invention is directed, is to provide the ability to remove intracranial hemorrhage while protecting the brain, including from inaccessible parts of the skull. The device allows to reduce the operation time and reduce its invasiveness.

 The task is achieved in that the suction tube is made with a spatula at the end and a catheter placed inside the annular hose mounted on the tube with the possibility of removal, and the irrigation tube is equipped with a crane and a removable flexible catheter. The suction tube is made with holes for uniform suction of blood. The drawing shows a General view of the device.

 A device for removing intracranial hematomas contains a handle 1 with an opening for adjusting the suction speed of the hematoma, an aspiration tube 2 with an inlet. Two holes 3 are made on the tube 2 for uniform suction of blood and a spatula 4 for protecting the brain during surgery. A removable flexible ring-shaped metal hose is installed in the tube 2, in which the removable silicone catheter 6 passes. The hose 5 with the catheter 6 is fixed to the suction tube 2 with nuts 7. An irrigation tube 8 with a valve 9 for periodic supply of the washing solution and a removable silicone catheter are soldered to the tube 2 10, fixed to the tube 8 by means of nuts 11.

 A device for removing intracranial hematomas works as follows.

 A spatula 4 with an aspirator 2 during a neurosurgical operation is applied to the brain and brought to the intracranial hematoma. They turn on the motor and begin to suck the hematoma; through the holes 3 of the tube 2, the liquid part of the hematoma and detritus is evenly emptied. After that, the remaining part of the hematoma is washed: open the valve 9 and through the tube 8 and catheter 10 by the reverse fluid flow through the tube 2, the surgical field is irrigated with sterile solutions, the blood clots are washed out. Then the valve 9 is closed and the hematoma is continued to be sucked through the tube 2. As the blood is aspirated from the cranial cavity to access the basal parts of the brain, the metal hose 5 together with the silicone catheter 6 are bent according to the curvature of the cerebral hemisphere: the ring-shaped structure of the hose 5 allows you to maintain the necessary bend of the tube 2 in depending on the stage of the operation. To enhance the suction effect, the hole in the handle 1 is periodically closed by the surgeon's finger.

 PRI me R. Patient G. (54 years old), medical history N 7696. He received a head injury on November 1, 1991. On the same day he was hospitalized at the Nizhny Novgorod Interregional Neurosurgical Center. The state at the time of hospitalization: consciousness - deep stunning, tonic-clonic seizures in the left arm and leg, positive reflexes of oral automatism, left-side hemiparesis, severe miningeal symptoms. Breathing 20 rpm, pulse 72 rpm, BP = 130/80 mmHg. Art. ECHO-EG: M-ECHO offset from right to left by 11 mm. An urgent operation was performed: osteoplastic trepanation in the right frontotemporal temporal region. During surgery in the fronto-parietal-temporal region, a subdural hematoma of 80 cl was detected. The hematoma consisted of a liquid part represented by dark blood and blood clots. The hematoma is removed by a device to remove intracranial hematomas. Blood was aspirated through an aspiration tube with subdural space flushing using an irrigation system while protecting the brain with a spatula. When approaching the basal sections, the tube was bent due to a ring-shaped metal hose corresponding to the curvature of the cerebral hemisphere, and the protruding part of the spatula after removal of blood clots protected the basal veins of the brain from rupture. After removal of the hematoma, a crush center of the temporal lobe pole with dimensions of 4x3x1 cm with detritus was revealed. Detritus is aspirated by this device; at the same time, thanks to the protection with a spatula, only crushed, non-viable areas of the brain substance are removed. November 30, 1991 the patient was discharged for outpatient treatment in satisfactory condition.

 The proposed device for the removal of intracranial hematomas makes it possible to remove the hematoma and the crush site with the protection of the brain substance and blood vessels of the brain from surgical aggression, facilitates access to the basal structures of the brain, is convenient in operation, and frees the assistant's hands during surgery for other purposes. (56) Neurosurgery, Yurger I.M., M., 1971, p. 64.

 Vasaelas - Surgery, 1987 - 195- c. N 8, s. 81.

Claims (2)

 1. A device for removing intracranial hematoma, containing an aspiration and irrigation tube, characterized in that the suction tube is made with a spatula at the end and a catheter located inside the flexible metal hose mounted on the tube with the possibility of removal, and the irrigation tube is equipped with a crane and a removable flexible .  2. The device according to p. 1, characterized in that the suction tube is made with holes for uniform suction of blood.

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