RU201910U1 - Device for percutaneous puncture and drainage of cavities - Google Patents

Abstract

The utility model relates to surgical instruments, in particular to a device for percutaneous puncture and drainage of cavity formations, namely to surgery, and can be used in minimally invasive surgery. The proposed device for percutaneous puncture and drainage of cavity formations allows safe passage of parenchymal organs, due to the expansion tissues and moving the vessels in them, as well as improved visualization of the distal end of the needle during puncture under ultrasound control.

Description

The utility model relates to surgical instruments, in particular to a device for percutaneous puncture and drainage of cavities, namely to surgery, and can be used in minimally invasive surgery.

Known device for puncture and subsequent drainage of intrahepatic bile ducts and cavity formations under ultrasound control, consisting of coaxially coupled two needles, and the outer needle is made in the form of a pointed casing and is equipped with a retainer for the inner needle at the proximal end, and the inner needle is hollow with a mandrel and coaxially placed in the lumen of the external needle with the ability to move along the lumen of the external needle for puncture of the intrahepatic bile ducts and subsequent conduction of a commensurate conductor into the punctured flow system, (see RF patent No. 78059 according to class A61B 17/34, 2008)

The disadvantages of the known design are:

- the absence of ultrasound marks on the mandrel and the trunks of the external and internal needles, therefore, insufficient visualization during puncture under the control of ultrasound;

- an accidental puncture of the opposite wall of the cavity (for example, the bile duct) is possible, because outer and inner needles have a sharp obliquely sharpened working end;

- the presence of a large number of both basic (two needles, etc.) and auxiliary tools (conductors of various diameters and rigidity);

- subsequent drainage when using this device is possible only according to the Seldinger technique, while a large number of reciprocating movements with various instruments (needle, bougie, guide wire) are required and, therefore, there is a high risk of infection of the puncture canal and leakage of contents into the abdominal cavity.

The closest in technical essence to the proposed technical solution is a device for percutaneous puncture and drainage, containing a needle with a holder, a mandrel located inside the needle and freely moving in it, and an outer tube with a holder, inside which the needle is installed, while the needle is made with a sharpened a cut of the working end and ultrasonic marks are made on the outer tube of the needle (see RF patent No. 98111, according to class A61B 17/34, 2010). The known device has a number of disadvantages, namely:

- the impossibility of performing a number of operations by the puncture method (puncture pancreaticogastrostomy, hepaticoduodenostomy, hepaticohepaticostomy, etc.);

- an accidental puncture of the opposite wall of the cavity (for example, the bile duct) is possible, because the inner needle has a sharp sharpened working end;

- the difficulty of the synchronous action of both pushers;

- the complexity of the design;

- insufficient visualization of the needle end under ultrasound control when passing through dense tissues.

The technical result, solved by the proposed utility model, is the creation of a device for percutaneous puncture and drainage, which allows safe passage of parenchymal organs by expanding the tissues and moving the vessels in them, as well as improving the visualization of the distal end of the needle during puncture under ultrasound control.

The technical result in the proposed utility model is achieved by creating a device for percutaneous puncture and drainage of cavity formations containing a needle with a holder, a mandrel located inside the needle and freely moving in it, while the needle is made with a sharpened working end, has a bevel to the axis of the needle, and the mandrel has a pusher, in which, according to the utility model, the mandrel is made in the form of a whole rod with a distal rounded end, and its pusher is made in the form of a spring located at the proximal end of the mandrel. at the same time, ultrasonic marks are made at the distal ends of the needle and mandrel at the same level.

The proposed useful model prevents injury to the vessels of the parenchymal organs, the organs themselves, including the urinary tract, bile ducts, etc., significantly reduces the risk of bleeding, trauma to intraorgan structures and, as a consequence, the risk of deterioration in visualization of the puncture site.

There is no need to use fascial needles and scalpels to dissect the aponeurosis, which reduces trauma during percutaneous interventions.

The application of laser ultrasound marks on the distal ends of the needle and at the same level on the mandrel significantly improves the visualization of the needle end during punctures under ultrasound guidance.

The conducted patent studies have shown that there are no known technical solutions with the specified set of essential features in similar devices for percutaneous puncture and drainage of cavities, i.e. the proposed solution meets the "novelty" criterion.

We believe that the information contained in the application materials is sufficient for the practical implementation of the utility model.

The essence of the proposed utility model is illustrated by the following description and drawings, where:

in fig. 1 shows the proposed device assembled;

in fig. 2 shows a view of the distal end of a needle with a sharpened beveled working end and a mandrel installed in it;

in fig. 3 shows the mandrel pusher in the body and its connection with the needle holder.

A device for percutaneous puncture and drainage of cavity formations contains a needle 1 fixed in a holder 2, a spring-loaded mandrel 3 located inside the needle 1 and freely moving in it together with the body 4

The sharpened working end of the needle 1 has a bevel to the axis of the needle. The choice of the value of the bevel angle is chosen depending on the technical problems.

Mandrin 3 is made in the form of a whole rod with a distal rounded end 5, and protrudes beyond the edge of the needle 1.

The proximal end of the mandrel 3 is fixed in the bushing 6, which is connected to the pusher 7 and is located inside the housing 4.

The pusher 7 of the mandrel 3 is made in the form of a spring (depending on technical capabilities) or a screw or disk located at the proximal end of the mandrel 3

At the distal end of the needle 1, ultrasonic marks 8 are made and in the same area, ultrasonic marks are made on the mandrel (in the picture, not shown)

The operation of the device for percutaneous puncture and drainage of cavity formations is as follows.

Under the control of ultrasound, a percutaneous puncture of the cavity is performed. At the same time, when passing through dense tissues (skin, fascia, membranes of the kidneys or liver), the protruding rounded end 5 of the mandrel 3, overcoming the force of the spring 7, goes inside the end of the needle and releases the end of the needle 1 sharpened at an angle, which cuts the dense structures.

With further movement of the needle in soft tissues and parenchymal structures, the spring-pusher 7 returns the mandrel 3 to its original position, and it pushes the tissues and vessels on the way to the cavity formation, without causing injury and without causing bleeding and excluding the formation of hematomas.

Upon reaching the distal end of the needle of the cavity formation, which is visualized by ultrasound, the body 4 with the mandrel 3 is removed.

Through the lumen of the needle with the holder, a conductor is inserted into the cavity formation and a drainage is installed through it to drain the fluid formations.

The proposed device for percutaneous puncture and drainage of cavities was tested at the Praxi-Medik training center of the First Moscow State Medical University named after I.M. Sechenov on pigs during drainage of the renal calyces under ultrasound control. The results obtained confirmed the reliability, simplicity, safety and atraumaticity of the kidney puncture, as well as high visualization of the needle tip under ultrasound control.

Claims (1)

A device for percutaneous puncture and drainage of cavity formations, containing a needle with a holder, a mandrel located inside the needle and freely moving in it, while the needle is made with a working end sharpened at an angle to the axis of the needle, and the mandrel has a pusher, characterized in that the mandrel is made in the form of a whole rod with a distal rounded end, and its pusher is made in the form of a spring located at the proximal end of the mandrel, while ultrasonic marks are made on the distal ends of the mandrel and the needle and at the same level.

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