RU201167U1 - THORACAL PORT - Google Patents

Abstract

The utility model relates to the field of medicine, and more specifically to medical technology, namely to devices designed to access the cavity of the human body for performing a surgical thoracic intervention. The thoracic port consists of a stationary part 1 having the shape of a ring, rotatable 2 and movable parts 3 having the shape of rings, while the stationary part 1 of the device and the first ring 4 of the movable part 3 are connected by a threaded connection, and grooves 7 are made on the rotatable part 2 of the device, having a wedge-shaped shape, the first ring 4 of the movable part and the actual movable part 3, consisting of a number of rings, are made of medical metal; all rings of the movable part 3 are provided with through holes 9 through which the cables 8 pass, which connect all the elements of the device and provide the ability to change the geometry of the movable part 3 of the device, while some ends of the cables are rigidly fixed in the blind holes of the distal ring 6, which has a conical narrowing 10, and the other ends are rigidly fixed in the first ring 4 of the movable part 3; in the internal channel of the device, assembled and ready for operation, the removable part 5 of the device, called the "stylet", is installed. This design of the thoracic port makes it possible to increase the efficiency of the surgical intervention by increasing the range of motion of the surgical instrument, the possibility of introducing a curved instrument, and reducing tissue trauma. 10 ill.

Description

The utility model relates to the field of medicine, and more specifically to devices of medical technology designed to provide access to the cavity of the human body for performing a surgical thoracic intervention.

A domestically produced valveless thoracic port is known (https://endo.ru/product/laparoskopiya/troakary-laparoskopicheskie/troakar-torakalnyy-12-5-mm/), which consists of a sleeve and a stylet made of medical metal. The outer side of the sleeve has a screw thread in order to improve fixation in the patient's tissues.

The disadvantage is the rigidity of the sleeve design, the impossibility of introducing a curved surgical instrument into the patient's cavity, and tissue trauma during manipulation of instruments inserted into the patient's cavity.

A well-known foreign-made thoracic port (http://en.unimicromed.com/product-item-4.html), which consists of a sleeve and a stylet made of synthetic transparent material. The trocar sleeve contains a valve to exclude the escape of gas from the body cavity. The stylet, depending on the version, contains blades to facilitate implantation.

The disadvantage is the rigidity of the sleeve design, the impossibility of introducing a curved surgical instrument into the patient's cavity, traumatizing the tissues during manipulation of instruments inserted into the patient's cavity, as well as the impossibility of disinfection and sterilization - the manufacturer declares one-time use.

Known domestically produced valveless thoracic port https://aksioma.com/catalog/instrumenty/troakary_i_prochie_instrumenty_dostupa/troakar_besklapannyj_gibkij_torakoport_diam_10_6_mm_dlina_60_mm sleeve) outside and the stylet are made of medical metal. The outer side of the sleeve has a screw thread in order to improve fixation in the patient's tissues.

This design allows you to combine the rigidity of the structure during implantation and mobility during instrument insertion and manipulation.

The disadvantage of this design is the complexity of disinfection and sterilization - the device uses synthetic materials that are potentially not resistant to aggressive disinfecting chemical environments and high temperatures. In addition, the combination of materials of different physical properties - medical metal and synthetic material - reduces the reliability and durability of the device.

The technical result of the utility model is to provide satisfactory access to the patient's cavity, mainly the pleural one, for flexible or bulky surgical instruments by increasing freedom of movement and eliminating obstacles in insertion and manipulation.

The delivered technical result is achieved by the fact that the thoracic port consists of a fixed part having the shape of a ring, rotating and moving parts having the shape of rings, while the fixed part of the device and the first ring of the moving part are connected by a threaded connection, and grooves are made on the rotating part of the device, which have a wedge-shaped shape, and the first ring of the movable part and the actual movable part, consisting of a number of rings, are made of medical metal; all rings of the movable part are provided with through holes through which the cables pass, which connect all the elements of the device and provide the ability to change the geometry of the movable part of the device, while some ends of the cables are rigidly fixed in the blind holes of the distal ring, which has a conical narrowing, and the other ends are fixed in the rotatable parts with spherical extensions; In the internal channel of the device, assembled and ready for operation, a removable part of the device, called the "stylet", is installed.

The utility model is illustrated by graphic material, where in FIG. 1 shows an assembly model of the device, frontal view in the initial position; in fig. 2 shows the internal removable part of the device, referred to as the "stylet"; in fig. 3 shows a view of the rotated part of the device; in fig. 4 shows a relaxed view of the movable part of the device; in fig. 5 shows two rings of the movable part of the device in close-up in a relaxed position, where you can see the fixing cables of the device; in fig. 6 shows one ring of the moving part of the device; in fig. 7 shows the first ring of a threaded movable part; in fig. 8 shows the stationary part of the device with a threaded connection; in fig. 9 shows the distal ring of the movable part, FIG. 10 shows the internal cable of the device.

In the figures, the following designations are adopted: 1 - fixed part of the thoracic port, having the shape of a ring, 2 - rotating part of the device, made in the form of a ring, 3 - moving part of the device, consisting of separate rings, 4 - first ring of the moving part of the device, 5 - inner a removable part of a device called a stylet; 6 - distal ring of the movable part of the device; 7 - wedge-shaped groove in the rotating part of the device; 8 - internal cables of the device; 9 - holes for the passage of cables; 10 - cone-shaped narrowing of the distal ring 6 of the movable part; 11 - thread, 12 - spherical expansion of the cable 8 of the device.

The thoracic port consists of a stationary part 1 in the form of a ring, on which the rotatable part 2 is movably located, while the stationary part of the device 1 and the first ring of the movable part 4 of the thoracic port are fixedly connected relative to each other by a threaded connection 11. On the rotatable part of the device 2 there are grooves 7 wedge-shaped, which are designed to fix the movable part 3 due to the tension of the cables 8 by pulling them by the spherical expansion 12 passing through all the rings of the movable part and rigidly fixed in the distal ring of the movable part. The first ring of the movable part 4 and the actual movable part 3, consisting of a row of rings with an inner diameter of 12.2 mm and an outer diameter of 13 mm, are made of medical metal. All rings of the moving part (pos. 4 and 3) are equipped with through holes 9 through which cables 8 with a diameter of 0.5 mm pass, while their ends are rigidly fixed by pressing in the blind holes 9 of the distal ring 6, which has a tapered taper 10. Inside the device In the assembled and ready-to-use form, the internal removable part of the device 5, called the "stylet", with a diameter of 12 mm is installed.

A part of the proposed design of the thoracic port, directly implanted into the patient's body, has the ability to relatively freely change its geometry due to the mobility of the rings 3, thereby it is possible to introduce a curved surgical instrument into the patient's body through a channel that changes its geometry created by movable rings and freely manipulate it in the patient's body, minimizing tissue trauma in the access area, increasing the safety and speed of the surgical procedure. In addition, the device is made of medical metal, which implies ease of disinfection and sterilization.

The device works as follows.

The surgical field, namely the patient's chest, is processed three times according to the generally accepted technique. The operating field is covered with sterile linen, the patient is placed on the operating table. Further, the assembled sterile device is installed through the skin and tissue incision into the patient's body in the required position, while, due to the conical shape of the inner extractable part of the device 5 and the conical narrowing 10 of the distal ring 6 of the movable part 3, a smooth non-traumatic expansion of soft tissues occurs. After installing the device into the human cavity, the inner extractable part of the device 5 is removed, thereby freeing the channel of the device through which the surgical instrument is inserted. If it is necessary to introduce a curved tool, one hand makes a clockwise rotation of the rotated part of the device 2, while the other hand holds the device by the stationary part of the device 1. In this case, the spherical expansion 12 of the cable 8 slides along the wedge-shaped grooves 7, thereby weakening the internal cables 8, passing through special through holes 9 inside all rings of the movable part of the device 3, starting from the first ring 4 of the movable part of the device to the distal ring 6. Thus, the movable part of the device 3 gains relative flexibility, allowing a curved surgical instrument to be inserted through the internal channel of the device into the human cavity and freely manipulate it. In this case, the movable part of the device 3 repeats the movements of the tool, thereby minimizing the trauma to the tissues of the stationary 1 and the rotated parts of the device 2. The device is removed from the human body in the following order: first, the rotated part 2 is turned counterclockwise, thereby, due to the tension of the cables 8, reduction occurs rings of the movable part of the device 3 and then the device is removed without damaging the tissues along the channel. During the antiseptic treatment of the device, the inner part of the device 5 is removed, the threaded connection 11 between the stationary part of the device 1 and the first ring of the movable part 4 is disconnected.

Clinical example.

Patient G., 21 years old, history number 8221, was admitted to the Department of Thoracic and Vascular Surgery of the UOCB on 07.10.2019 with a diagnosis of J43.9 Bullous pulmonary disease. Multiple bullae of the upper lobe of the right lung. Right-sided spontaneous pneumothorax. On 10/08/2019, surgical intervention was performed - videothoracoscopy on the right, ligation and clipping of bullae of the upper lobe of the right lung. Electromechanical pleurodesis. Partial pleurectomy. Due to the need to introduce curved instruments for pleurectomy, namely the Bebcock forceps, this thoracic port was used. The course of the operation: Treatment of the operating field with betadine solution and 70% alcohol three times. TVA + IVL one-lung. The proposed device was used to access the pleural cavity. Surgical intervention was performed without intraoperative complications. The general condition of the patient is satisfactory. Examined on 1, 2, 5, 7 and 9 days. Healing wounds by primary intention. On control radiographs of the chest, the lungs are fully extended. She was discharged for outpatient treatment on 11/18/2019.

The thoracic port will find wide application in surgical departments of medical institutions.

Claims (1)

A thoracic port, characterized in that it consists of a fixed part having the shape of a ring, rotatable and movable parts having the shape of rings, while the fixed part of the device and the first ring of the moving part are connected by a threaded connection, and grooves are made on the rotating part of the device, which have a wedge-shaped shape, and the first ring of the movable part and the actual movable part, consisting of a number of rings, are made of metal; all rings of the moving part are equipped with through holes through which the cables pass, which connect all the elements of the device and provide the ability to change the geometry of the moving part of the device, while some ends of the cables are rigidly fixed in the blind holes of the distal ring, which has a conical narrowing, and the other ends are rigidly fixed in the first ring of the movable part; In the internal channel of the device, assembled and ready for operation, a removable part of the device, called the "stylet", is installed.

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