RU209755U1 - Trocar surgical - Google Patents

Abstract

The utility model relates to medicine, namely to surgery. A surgical trocar with a detachable sleeve was used in 7 patients with purulent diseases of the lungs and pleura, and in 23 patients with benign prostatic hyperplasia and acute urinary retention. The technical result of using the utility model is to create a new version a handle, a support platform for a collapsible trocar sleeve, which provides greater convenience when draining various organs of the chest and abdominal cavities with drains of a complex configuration, which makes it possible to seal the puncture sites of organs and more effectively sanitize purulent foci and cavities, as well as hollow organs. The device has become less metal-intensive , more easy to use. The number of inflammatory complications after the use of drains of a complex design has decreased. The surgical trocar consists of an elongated teardrop-shaped handle, 85.0 mm long, a support platform 1.5 mm thick, 22.0 mm in diameter, connected to a stylet 8.0 mm in diameter, 120.0 mm long, having a tip with a tip of a triangular configuration; detachable trocar sleeve, consisting of two halves of the tube, which in the distal part have plates of the connection unit on each half of the sleeve, 7.0 mm wide, 20.0 mm long, 1.0 mm thick; the left side of the lower plate is a groove for 225° of a circle, the right side is a plate with dimensions: 7.0 mm wide, 20.0 mm long, on which there are two holes for a fixing wire U-shaped bracket 20.0 mm long, 3 in diameter, 0 mm and curvature under the radius of 5.0 mm; the upper plate of the junction of the second half of the trocar sleeve 1.0 mm thick, the left side of the edge of the upper plate is represented by a rod with a diameter of 3.0 mm, the right side is a plate with dimensions of 7.0 mm wide and 20.0 mm long, with similar holes for a wire clip . 3 ill.

Description

The utility model relates to medicine, namely to surgery, urology, thoracic surgery, and can be used to introduce complex drains into different cavities.

Trocars, commonly used in surgery and urology, are designed to introduce cylindrical drains into body cavities.

The prototype of the trocar for inserting into the human body cavities of complex configuration drains, having several channels in the distal part, is a device for operations by the method of trocar cystostomy under ultrasound control (utility model patent RU 85324 U1 dated 2008) having a collapsible tube, a stylet and two brackets - clamps. The tube-sleeve of the trocar consists of two longitudinal halves of the tube, which have two massive half-rings in the distal part. The connection of the halves of the sleeve occurs due to the introduction of U-shaped wire staples into two pairs of holes on the half-rings of the sleeve in mutually perpendicular directions.

The disadvantage of the prototype is the configuration of the handle of the trocar, which allows you to conveniently perform the progressive introduction of the trocar, and it is difficult to control the limitation of the force during puncture and the depth of insertion. The liner connection assembly is metal-intensive by design and, with the staples inserted, is not very convenient to use.

EFFECT: creation of a device with a detachable trocar sleeve and a stylet with a handle, convenient for introducing a trocar into the body cavities with a dosed force.

The technical result is achieved due to the presence in the device of a stylet with a diameter of 8.0 mm, a length of 12.0 mm, a support platform, a thickness of 1.5 mm, a diameter of 22.0 mm, connected to a handle of an elongated teardrop-shaped configuration 85.0 mm long, comfortable for fixation in the hand and allowing progressive insertion, control of puncture force and depth of trocar insertion; split sleeve consisting of two halves, which in the distal part have plates of the sleeve connection unit, 7.0 mm wide, 20.0 mm long, 1.0 mm thick, the left side of the bottom plate is a groove on a 225⁰ circle, the right half of the plate is wide 7.0 mm, 20.0 mm long, has two holes for a fixing wire U-shaped bracket 20.0 mm long, 3.0 mm in diameter and curvature for a radius of 5.0 mm; the upper plate of the connection unit of the second half of the trocar sleeve 1.0 mm thick, the left side - the edge of the upper plate is represented by a rod with a diameter of 3.0 mm, the plate width is 7.0 mm, the length is 20.0 mm, the right side is represented by a plate 7.0 mm wide , 20.0 mm long, on which there are two holes for a wire U-shaped bracket.

UTILITY MODEL IS EXPLAINED WITH FIGURES (Fig. 1-3)

Fig. 1 – Surgical trocar assembled.

Fig. 2 – Trocar handle with stylet and support platform.

Fig. 3 - Collapsible sleeve with a connection unit and a fixing bracket.

The device consists of a handle (1) of an elongated teardrop configuration, 85.0 mm long, a support platform (2), 1.5 mm thick, 22.0 mm in diameter, connected to a stylet (3) 8.0 mm in diameter, 120 mm long. .0 mm, having a tip (4) with a tip of a triangular configuration; detachable trocar sleeve, consisting of two halves of the tube, which in the distal part have plates of the connection unit on each half of the sleeve, 7.0 mm wide, 20.0 mm long, 1.0 mm thick; the left side of the bottom plate (5) is a groove for 225° of the circumference, the right side (6) is a plate with dimensions: 7.0 mm wide, 20.0 mm long, on which there are two holes for a wire U-shaped bracket 20.0 long mm, diameter 3.0 mm and curvature under a radius of 5.0 mm; the upper plate of the junction of the second half of the trocar sleeve 1.0 mm thick, the left side of the edge of the upper plate is represented by a rod with a diameter of 3.0 mm, the right side is a plate measuring 7.0 mm wide and 20.0 mm long, on which there are two holes for wire U-shaped bracket with a diameter of 3.0. (Fig. 3).

THE DEVICE WORKS AS FOLLOWS

Depending on the planned surgical intervention (thoracocentesis, epicystostomy), anesthesia and fixation of the anterior abdominal wall using a ligature method are performed in order to prevent damage to internal organs during puncture. The two halves of the sleeve are connected in the left part of the fixation unit, the rod of the upper part is inserted into the groove of the lower part of the sleeve, and finally fixed with a bracket in the right part of the connection unit. Once assembled, the sleeve is mounted on the stylet support pad, after which this instrument allows you to safely puncture the soft tissues of the chest or abdominal wall. After the introduction of the trocar into a certain cavity to the required depth, the stylet is removed from the sleeve, providing the possibility of separation of the two halves of the sleeve after removing the fixing clip.

EXAMPLES OF CLINICAL APPLICATIONS OF THE DEVICE

A surgical trocar with a detachable sleeve was used in clinical practice in 7 patients with purulent diseases of the lungs and pleura, and in 23 patients with benign prostatic hyperplasia and acute urinary retention.

Patient K., 65 years old, was hospitalized in the obstructive care unit of the KGKB SMP, purulent department, Kursk from 04/06/21 to 04/21/2021. Diagnosis - right-sided post-traumatic clotted infected median hemothorax. He was transferred from the surgical department of the Fatezhskaya Central District Hospital, where he was treated for a right-sided closed fracture of the V, VI, VII ribs, right-sided hemothorax from 04/02/2021. On April 6, 2021, a general clinical examination was carried out. The radiograph revealed fractures of the V-VII ribs and a middle right-sided hemothorax, which could not be evacuated by puncture. Under local anesthesia on April 6, 2021, after standard treatment of the surgical field with iodopyrone, thoracocentesis was performed in the 7th intercostal space along the posterior axillary line using a trocar with a split sleeve. A N22 Fogarty catheter was inserted into the pleural cavity and sutured to the skin. 300.0 ml was evacuated from the pleural cavity. hemolyzed blood with clots. In the postoperative period, antibacterial, detoxification therapy, laundering of the pleural cavity with solutions of furacilin and trypsin were carried out. Breathing exercises were performed. Plain fluoroscopy on April 19, 2021 showed no inflammatory changes, good lung excursion. The consolidation of the ribs is noted.

The use of a trocar of a new design with a split sleeve made it possible to use drainage of a complex design, which ensured the tightness of the drainage channel and excluded the possibility of infection.

Patient S., 58 years old, was hospitalized in the obstructive care unit of the KGKB SMP, purulent department of Kursk from 04/22/2021 to 05/25/2021. Diagnosis - right-sided destructive pneumonia, abscess of the lower lobe of the right lung. He was transferred from the Central District Hospital for inpatient treatment due to the detection of an abscess in the lower lobe of the right lung. On April 23, 2021, under local anesthesia, after standard treatment of the surgical field with iodopyrone, thoracocentesis was performed along the midaxillary line using a trocar with a split sleeve. After removing the stylet, a N22 Fogarty catheter was inserted into the abscess cavity. The bracket of the fixing unit of the sleeve parts has been removed. Sleeve removed from the wound channel in parts. The Fogarty catheter is sutured to the skin with two interrupted sutures. Removed 100.0 ml of thick pus. The cavity of the abscess is washed with a solution of furacilin. In the postoperative period, antibiotic therapy was carried out, taking into account the sensitivity of the microflora, infusion detoxification therapy. received mucolytics. Abscess cavity sanitized. The control roentgenoscopy showed positive dynamics. The cavity of the abscess is not defined. In a satisfactory condition, he was discharged under the supervision of a local therapist at the place of residence. Dispensary supervision is recommended.

Patient I., 75 years old, was hospitalized at the Regional Clinical Hospital for Emergency Medical Services, Urology Department of Kursk from 05/12/2021 to 05/17/2021. Diagnosis - benign prostatic hyperplasia, stage 3, acute urinary retention, chronic pyelonephritis in remission, CRF 1. A standard clinical examination, ultrasound of the kidneys, bladder with determination of the volume of residual urine was performed. On May 13, 2021, trocar epicystostomy was performed under local anesthesia using a trocar with a split sleeve. A Foley catheter was inserted into the bladder and sutured to the skin. In the postoperative period, antibiotic therapy (fluoroquinolones), infusion, detoxification (Filtrum-STI) therapy was performed. Sanitation of the bladder with a solution of furacilin. The natural passage of urine has been restored. Suppuration of the postoperative channel is not marked. In a satisfactory condition, he was discharged under the supervision of a urologist at the place of residence.

Thus, a surgical trocar with a split sleeve is more convenient for draining various organs of the chest and abdominal cavities with drains of a complex configuration, which allows sealing the puncture sites of organs and more effectively sanitizing purulent foci and cavities, as well as hollow organs.

The device has become less metal-intensive, easier to use. The number of inflammatory complications along the wound channel decreased after the use of complex drains.

Claims (1)

The surgical trocar consists of a handle, a stylet and a detachable sleeve, differing in that the handle has an elongated teardrop-shaped configuration 85.0 mm long, a support platform 1.5 mm thick, 22.0 mm in diameter, connected to a stylet 8.0 mm in diameter, 120.0 mm long, having a tip with a tip of a triangular configuration; detachable trocar sleeve, consisting of two halves of the tube, which in the distal part have plates of the connection unit on each half of the sleeve, 7.0 mm wide, 20.0 mm long, 1.0 mm thick; the left side of the lower plate is a groove for 225° of the circumference, the right side is a plate with dimensions: 7.0 mm wide and 20.0 mm long, on which there are two holes with a diameter of 3.0 mm for a fixing wire U-shaped bracket with a length of 20.0 mm, diameter 3.0 mm and curvature under a radius of 5.0 mm; the upper plate of the junction of the second half of the trocar sleeve 1.0 mm thick, the left side of the edge of the upper plate is represented by a rod with a diameter of 3.0 mm, the right side is a plate measuring 7.0 mm wide and 20.0 mm long, on which there are two holes for wire U-shaped bracket with a diameter of 3.0.

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