RU2086265C1 - Bouginage appliance for treatment of stenoses of tubular organs, for instance, of tracheostenosis - Google Patents

Abstract

FIELD: medicine, in particular, appliances for bouginage in bronchoendoscopy. SUBSTANCE: appliance is a cone-shaped tip with longitudinal recesses over its entire length and with internal channel whose proximal end has thread for connection of holder, which, on proximal bent end, has branch for electrosuction of mucopurulent contents of trachea and bronchi, and holder end has sealing valve for introduction of radiopaque catheter. Tip longitudinal recesses allows bouginage without disturbance of lungs ventilation. EFFECT: reduced injury in condition of bronchoscope tube below stenosis. 3 dwg

Description

 The invention relates to medical equipment, namely to a bronchoscopic instrument.

 A known tool for bougienage of stenosis of tubular organs, which is a tip (bougie) connected to the holder. The disadvantage is that when it is inserted into a narrow opening of a hollow organ, the passage of air to the departments of the trachea and bronchi through the stenosis is stopped. This leads to a violation of gas exchange and complicates the conduct of endoscopic surgery. In addition, such an instrument does not allow removal of liquid contents from the trachea and bronchi to improve the visibility of the stenosis area during surgery, as well as catheterize and control the departments located below the stenosis. This increases the likelihood of organ wall perforation.

 In order to reduce trauma to the walls of the trachea and bronchi during stenosis bougienage without disturbing gas exchange in them and the possibility of removing the mucopurulent contents of the trachea and bronchi, the tip of the bougie is made in the form of a cylinder turning into a cone at both ends with an internal channel, longitudinal grooves are made along the entire length of the tip, a thread is made at the proximal end of the internal channel for connection with a hollow holder having an outlet for an electric suction at the proximal bent end, and in the end part of the hollow holder there is a sealing valve for conducting a radiopaque catheter.

 In FIG. 1 shows a general view of a tool for bougieurage. In FIG. 2 is a section along aa of figure 1. Figure 3 presents the diagram of the tool.

 The tool consists of a tip 1 of a cylindrical shape, passing at the ends into a cone. Along the entire length of the tip, longitudinal grooves 2 are made, occupying at least half of the cross-sectional area for the possibility of maintaining normal gas exchange in the lungs and an internal channel 3 having a thread 4 at the proximal end, which the tip is connected to the hollow holder 5. There is a tap at the proximal bent end of the holder 6 for attaching an electric suction device for aspirating the contents of the trachea and bronchi, and at the end there is a replaceable sealing valve 7 for conducting a radiopaque catheter.

 The tool for bougieurage works as follows.

 Depending on the anatomy of the trachea, the corresponding tube of the bronchoscope is selected. Under the inner diameter of the tube of the bronchoscope choose a tip of a certain external diameter and length in accordance with the diameter and location of the stenosis. The selected tip 1 is connected via a thread 4 to the hollow holder 5. A bronchoscope tube is inserted into the trachea under anesthesia and placed over the stenosis (Fig. 3a). The illumination mirror is removed from the illumination head of the bronchoscope, a tool for bougienage is inserted into the tube, and it is forced through the stenosis region (Fig. 3b). If cicatricial changes are not amenable to bougienage, choose the bougie of the smallest diameter. Such an operation is performed several times. Then through the bougie through a stenosis, a bronchoscope tube is passed and the instrument is removed (Fig. 3c). Due to the presence of slots 2 (Fig. 1) in the tip, gas exchange is maintained in the trachea and bronchi, which allows to increase the duration of the instrument in the stenosis and thereby perform all necessary operations. In the case of tortuous stenosis in tumors, when the direction of the canal is unknown, the contents of the stenosis are aspirated through a bougienage tool by attaching an electric pump to the outlet 6, thereby clearing the stenosis canal. An X-ray contrast catheter is inserted through valve 7 and through the internal channel of the instrument into the stenosis section, a narrow stenosis channel is contrasted through the catheter to obtain information on the diameter, extent and direction of the stenosis channel. This avoids perforation of the walls of the organ.

 Using the instrument for bougieurage allows without excessive trauma and especially in extreme situations (impaired ventilation) to quickly hold the tube of the bronchoscope below stenosis, remove mucopurulent contents from the trachea and bronchi and thereby restore gas exchange.

 The bougieurage tool can also be used to straighten a silicone prosthesis inserted into stenosis.

 Prototypes of the proposed tool have successfully passed clinical testing in X-ray MNIIDiH (F.A. Astrakhantsev). Test materials may be submitted for examination.

Claims (1)

 A bougie tool for the treatment of narrowing of tubular organs, for example, the trachea, in the form of a tip with a holder, characterized in that the tip is made in the form of a cylinder turning into a cone at both its ends, with an internal channel, and along the entire length of the tip there are longitudinal grooves, and a thread is made at the proximal end of the inner channel for connection with a hollow holder having an outlet for an electric suction at the proximal bent end, a sealing valve is made in the end part of the hollow holder.

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