RU204655U1 - DEVICE FOR TEMPORARY BLOOD VESSEL COMPRESSION - Google Patents

Abstract

The utility model relates to the field of medicine, and more specifically to medical technology, namely to devices designed to narrow blood vessels during open surgical operations on the great arteries. The technical result is a complete and reliable narrowing of a blood vessel in an operating wound, a decrease in labor intensity and an increase in ease of use, providing a good access and view of the surgical field by preventing the flow of blood between the vascular shunt and the vessel wall, freedom of manipulation of the instrument when working on the main arteries. The device contains a body 1, which is made in the form of a hollow structure having the shape of a rectangle and can be made of any durable material. Inside the body there is a rubber cylinder 3, in the end part of which there is a fitting 6. In the lower part of the body there is a through hole 4, in which a rubber strip 5 passes, which with its middle part bends around the polyvinyl chloride tube 10, and its ends are rigidly connected to the fitting 6, which in turn has the ability to tightly connect, for example, with a syringe 7. The body of the device is pressed against the walls of the vessels by means of an elastic gasket 11.1 z.p. f-ly, 2 dwg.

Description

The utility model relates to the field of medicine, and more specifically to medical technology, and more specifically to devices designed to narrow blood vessels during open surgical operations on the great arteries.

A device for local pressing of a blood vessel is known, designed to stop blood flow through a major vessel during the period of an open operation on it. The device consists of a clamping device with a harness. The hold-down device is made in the form of a hold-down pad. The platform is attached in a parallel plane to two longitudinal rods at a distance of at least 20 mm from them. The rods are interconnected by jumpers, and the jumpers are located symmetrically on both sides of the clamping area and form windows for threading the bundle (RF patent No. 2158109, А61В 17/12, 10/27/2000).

The disadvantage of this device is the impossibility of using it when performing eversional carotid endarterectomy using a temporary shunt.

There is a known method of reducing the lumen of a blood vessel, in which the vessel is narrowed by pulling a section of the vessel in the form of a loop into a one-piece plastic tube (RF patent No. 2213377, A61B 17/12, 09/27/2003).

The disadvantage of this method and device is that the process of its implementation is more laborious, and it is necessary to attract additional medical personnel to carry out the manipulation.

A device for clamping a blood vessel is known (RF patent No. 193186, A61B 17/12, 10/16/2019), containing a body that is a rectangle with an inner rectangular hollow cavity with a slot on the front end surface and sloped grooves along the lateral inner surfaces, where the pins of the wheel are inserted with the possibility of its movement. The upper surface of the body 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 ability to grip the grooves of the teeth, while the distal part of the V-shaped structure is made in the form of a thrust platform for the possibility lifting the scapula from the groove of the tooth, in the grooves of which a constant elastic rod is provided, fixed on one side to the proximal part of the V-shaped structure of the scapula, and on the other side to the middle bracket of the V-shaped structure.

The disadvantage of this device is the impossibility of using it when performing eversional carotid endarterectomy using a temporary shunt.

A device for temporary clamping of a blood vessel is known (RF patent No. 193671, A61B 17/12, 11.11.2019) selected by the authors as a prototype. The device contains a body, which is a rectangle with an inner rectangular hollow cavity with a slot on the front end surface, while U-shaped protrusions are made on the edge of the slot, and in the rectangular hollow cavity of the body there is a ring made of durable material with the ability to move it inside the rectangular hollow cavity of the body, while V-shaped rods are fixed to the surface of the ring, which come out to the surface of the body through the slot, while on the end surfaces of the V-shaped rods there are "spatulas" for their compression and exit from the slot of the U-shaped protrusions for movement rings inside the case. The internal carotid artery 8 and the common carotid artery are tightened with a PVC tube using a glove band and a rubber elastic pad.

The disadvantage of this method and device is that the process of its implementation is more laborious, and it is necessary to attract additional medical personnel to carry out the manipulation.

The purpose of the device for temporary clamping of a blood vessel, developed by the authors, is to increase the efficiency of surgical intervention on the main arteries due to a reliable temporary narrowing of blood vessels.

The technical result is a complete and reliable narrowing of a blood vessel in an operating wound, a decrease in labor intensity and an increase in ease of use, providing good access and a view of the operating field by preventing the flow of blood between the vascular shunt and the vessel wall, freedom of manipulation of the instrument when working on the main arteries.

The delivered technical result is achieved by the fact that a device for temporary clamping of a blood vessel, containing a body, a PVC tube, a rubber strip, an elastic gasket, while the body is made in the form of a hollow structure in the shape of a rectangle, inside which is placed a rubber balloon, in the end part of which is located fitting, a through hole is made in the lower part of the body, in which a rubber strip passes, which with its middle part bends around the blood vessels and a polyvinyl chloride tube, and its ends are rigidly connected to the fitting, which in turn has the ability to hermetically connect, for example, with a syringe, the body of the device is pressed against the walls of the vessel by means of an elastic gasket.

Comparison of the proposed device with others known in the field of medicine has shown that it meets the criteria of a utility model.

A device for temporarily clamping a blood vessel is illustrated by graphic images. FIG. 1 shows the device in isometric view in the initial period of the working position; in FIG. 2 - shows the device in isometric view in the working position of the device.

The device contains a body 1, which is made in the form of a hollow structure in the form of a rectangle with a slot 2 along the entire length and can be made of any durable material. Inside the body there is a rubber balloon 3, in the end part of which there is a fitting 6. In the lower part of the body there is a through hole 4, in which a rubber strip 5 passes, which with its middle part bends around the polyvinyl chloride tube 10, and its ends are rigidly connected to the fitting 6, which in turn, it has the ability to be tightly connected, for example, with a syringe 7. The body of the device is pressed against the walls of the vessels by means of an elastic gasket 11 In FIG. 1 and FIG. 2 also shows the internal carotid artery (ICA) 8 and the main carotid artery (CCA) 9.

A device for temporary clamping of a blood vessel works as follows.

From a conventional incision along the lateral surface of the neck, the carotid arteries are exposed. The operation is performed under general anesthesia. In these patients, temporary intravascular shunting is performed through the ICA 8, by introducing a PVC tube 10 into the lumen of the CCA 9 and ICA 8. To prevent bleeding between CCA 9, ICA 8 and the wall of the PVC tube 10, a device is applied to the CCA 9 of the ICA 8 for temporary clamping of the blood vessels. To do this, rubber strips 5 are cut out of the glove gum, which are carried out in the form of a ring around the main vessels OCA 9 and BCA 8, the ends of the rubber strips 5 are drawn inside the housing 1, through the through hole 4 and fixed to the fitting 6 located in the end part of the rubber cylinder 4. The fitting 6 has the ability to tightly connect, for example, to the syringe 7. Air is pumped with the syringe 7 through the fitting 6 into the rubber balloon 4, which increases in size creates a traction for the rubber strip 5, thereby temporarily squeezing the blood vessels. An elastic lining 11 is located between the body 1 and the walls of the vessels of the ICA CCA. Surgical intervention on the ICA 8 is completed with eversion carotid endarterectomy, that is, the atherosclerotic plaque is removed. After that, a temporary intravascular shunt is removed - a PVC tube 10. The integrity of the extracranial arteries is restored by applying a vascular suture. Removal of the device for temporary clamping of a blood vessel is carried out in the reverse order.

The use of the proposed device reduces labor intensity and increases ease of use, provides a complete and reliable narrowing of the blood vessel in the operating wound, good access and view of the operating field by preventing blood flow between the vascular shunt and the vessel wall, freedom of manipulation of the instrument when working on the great arteries. The reliability of the narrowing of the blood vessel improves the working conditions of the surgeon, which, in turn, allows to improve the quality and speed up the course of the surgical intervention.

The device for narrowing a blood vessel will find wide application in the surgical departments of medical institutions.

Clinical example.

Patient A, 68 years old, history no. 546581, entered the department of vascular surgery of the S. V.D. Seredavina 03.17.19 g with a diagnosis of Atherosclerosis of the extracranial arteries. ICA stenosis on the right 74%, ICA stenosis on the right 54%. After preoperative preparation, the patient underwent surgery on March 18, 19 - eversion carotid endaterectomy on the right. The course of the operation: Along the inner edge of the sternocleidomastoid muscle on the right, the skin and fiber were dissected for 10 cm. The CCA, ICA, ECA were isolated - the arteries were passable, pulsated. In the area of the CCA fork with the transition to the ICA, an atherosclerotic plaque with a length of 2.2 cm is determined, stenosing the lumen by 75%. The OCA, ICA are pinched. Cut off from the ICA mouth. A device for temporary clamping of a blood vessel is installed in the CCA and ICA (in the same sequence as described earlier). There is no blood flow between the walls of the main arteries and the shunt. The shunt in the form of a PVC pad is functioning, cerebral oximetry indicators are normal. An eversional endarterectomy from the ICA was performed, and a good retrocirculation was obtained. The ICA is implanted in the CCA. Devices for temporary clamping of a blood vessel were removed. The intravascular shunt (PVC tube) was removed. The arteriotomy suture is hermetically sealed. 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. He was transferred to the Department of Vascular Surgery in satisfactory condition. In the postoperative period, conservative treatment was carried out (anticoagulants, cerebroprotectors, pain relief). The general condition is satisfactory. Examined by a neurologist - no neurological deficit. Healing by first intention. Discharged for outpatient treatment at the polyclinic at the place of residence on 03/29/19. Examined by the vascular surgeon of the polyclinic of the S. V.D. Seredavina 04/08/19 - satisfactory general condition, no neurological deficit, wound healing by primary intention.

Claims (2)

1. A device for temporary clamping of a blood vessel, containing a body, a PVC tube, a rubber strip, an elastic gasket, characterized in that the body is made in the form of a hollow structure having the shape of a rectangle, inside which is placed a rubber balloon, in the end part of which there is a fitting, in a through hole is made in the lower part of the body, in which a rubber strip passes, which with its middle part bends around the blood vessels and a polyvinyl chloride tube, and its ends are rigidly connected to the fitting, while the body of the device is pressed against the vessel walls by means of an elastic gasket. 2. A device for temporary clamping of a blood vessel according to claim 1, characterized in that the fitting is configured to be hermetically connected to the syringe.

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