RU2116802C1 - Device for washing abdominal cavity - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has two reservoirs provided with draining tubes. Automatic unit for switching liquid supply and discharge has lever-type draining tubes switch and electromagnet with core. Automatic liquid supply and discharge unit is additionally provided with electric pump, time relay and syringe. Time relay is connected to piston rod micro-contact member and to electric pump and electromagnet through trigger unit. The electromagnet is connected to the lever-type draining tubes switch. Syringe cavity is connected to manometer. Thrust washer with internal thread and spring are fixed on syringe piston rod. One end of the spring is attached to the thrust washer and the second one to the piston. EFFECT: washing the whole space in the abdominal cavity; reduced number of complications. 4 dwg

Description

 The invention relates to medical equipment, is used in surgery and is used to rinse the abdominal cavity.

 A device for washing the abdominal cavity, made in the form of a perforated tube, a suction bulb and a reservoir for collecting washing water [2].

A device for washing the abdominal cavity by local washing with a directed fluid flow is known. The irrigo-aspirator contains an irrigation distributor in the form of a tubular closed loop, concave in the longitudinal direction with rows of holes located at an angle of 60 ^° to each other, a suction tip made in the form of a hollow volume cylinder with holes in the walls and with a rounded end part. When suctioning the contents of the abdominal cavity to the walls of the irrigo-aspirator, a nozzle is opened for dilution [3].

 However, this device allows you to flush only the local area of the abdominal cavity: for washing another area of the abdominal cavity, intraoperative rearrangement of the device is necessary, which causes additional surgical trauma to the patient, requires additional anesthesia; the device requires constant monitoring of its functioning, otherwise, when suction occurs, further injection of fluid into the abdominal cavity, filling of non-draining areas, deposition of fluid in these areas will occur, which will serve as an additional factor for the spread of infection from the focus and contamination of the abdominal cavity.

 Closest to the proposed technical solution is the installation for continuous washing of the bladder [1]. The installation contains two glass tanks located at different levels in height, drainage tubes, clamps, a dropper, an automatic switching device for inflow and outflow. The automatic switching device comprises an electric motor, a gearbox, a cam mechanism, a lever system, an electromagnet with a core. Under the influence of excessive pressure, fluid from a vessel with an antiseptic through the inflow pipe, through an automatic switching device and a single-channel drainage, fills the bladder. Then the automatic switching device closes the inflow pipe and opens the outflow pipe. The washing liquid through a single-channel drainage and tee is drained into another glass vessel. The frequency of operation of the system is achieved due to the inclusion in the electric network of an automatic switching device by means of an actuating lever. The duration of the switching period of the tubes is achieved by changing the gear ratio of the gearbox and the selection of the cam profile. In order to avoid clogging with blood clots of a catheter or outflow tube, the duration of fluid flow is less than the time of normal blood coagulation.

 However, the installation provides for washing only the local area of the closed cavity, washing the other area of the abdominal cavity is possible only after intraoperative rearrangement of the drainage, which is associated with the application of additional surgical trauma and additional anesthesia. Using the installation provides for the presence of a cavity that does not have areas of possible deposition - when placed in the abdominal cavity, the supplied liquid will not immediately come back, but only after the injection period. The liquid remaining in the abdominal cavity will be excreted only in the immediate vicinity of the tube. The fluid flowed into the place of possible deposition and already in contact with the site of infection will not be excreted by this drainage and will be a source of additional infection of the abdominal cavity. The volume of the rinsed cavity can be different, so the volume of inflowed liquid for washing the entire volume of the cavity must be selected individually and can only be achieved by selecting the gear ratio of the gearbox, which causes additional inconvenience to the surgeon. When a single-channel drainage is blocked by a valve clot, i.e., a clot that allows liquids to enter the cavity, but not to flow out of it during the operation of the system, excessive pressure may be created in the cavity, which may lead to additional trauma and additional inconvenience to the surgeon . The design does not provide for adjusting the pressure of the injected fluid in the cavity. The functioning of the system is only possible with patency of single-channel drainage.

 The purpose of the invention is the simultaneous washing of the entire abdominal cavity and reducing the number of complications.

 This goal is achieved in that the device for washing the abdominal cavity, containing two tanks, drainage tubes, switching the automatic device of the inflow and outflow of liquid, including a lever switch of the inflow and outflow tubes, an electromagnet with a core, includes a thrust washer with an internal thread located on the piston rod of the syringe, a spring, one end of which abuts against the piston and the other against the thrust nut, an adjusting threaded sleeve with a thrust nut, a manometer connected to the syringe cavity, rel e time, consisting of a coil, core and microcontact time relay, microcontact, roller electric pump, electromagnetic starter. In addition, the duration of the pause in the operation of the automatic circuit is longer than the time the fluid was squeezed out of the syringe cavity by the piston spring, the tube switching period is achieved by adjusting the air valve of the time relay, elimination of the suction effect is achieved by alternately connecting the drains to the device and pumping it with a roller pump after the procedure of washing into the abdominal cavity of the air.

Distinctive features of the prototype features of the proposed technical solutions are the following:
thrust washer with internal thread;
the presence of a spring syringe on the piston rod;
the presence of an adjusting threaded sleeve with a thrust nut;
a manometer connected to the cavity of the syringe chamber;
use of a time relay, microcontact, roller electric pump, electromagnetic starter in an automatic switching device.

 Only through the introduction of distinctive features from the prototype, in combination with the known ones, the proposed technical solution allows simultaneous washing of the entire volume of the abdominal cavity and regardless of its volume, regulating the pressure created by the pumped fluid in the rinsed cavity, eliminating the effect of suction of the abdominal organs and blockage of the drains, thereby improving the convenience of the surgeon. In addition, excludes additional tissue trauma, additional anesthesia. Increases the effectiveness of treatment of the patient. The syringe is connected to the drainage of the abdominal cavity. Due to the pressure exerted by the spring on the piston rod of the syringe, one end of which abuts against the piston, and the other into the thrust nut of the adjusting threaded sleeve, on the piston, the fluid pumped into the abdominal cavity by the roller pump and flowing out of it through the perforated drains enters the drainage inflow, meets an obstacle on the piston of the syringe and is forced to occupy all the free space in the abdominal cavity, thereby washing the entire volume of the abdominal cavity, regardless of the volume. The threaded adjusting sleeve with the thrust nut is screwed into the thrust washer with an internal thread. With a constant distance between the microcontact lever and the end of the syringe piston rod, using the threaded sleeve with the thrust nut fixed on it through the thrust washer with internal thread, you can change the pressure exerted by the spring on the piston and the piston on the outflowing fluid, respectively changing the pressure created by the pumped fluid in the abdominal cavity, which will avoid the constriction of the vessels of the abdominal cavity and ischemic abdominal organs. The syringe cavity is connected to a hollow tube with a pressure gauge. Therefore, the change in fluid pressure in the cavity of the syringe and, accordingly, in the abdominal cavity can be recorded, and by rotating the adjusting sleeve to adjust. Alternating connection of drains to the device (table of provisions for connecting drains to a washing device) provides for periodic pumping of liquid into each drain, which eliminates the effect of suction and blockage of drains. The duration of the pause in the operation of the automatic circuit, set by the time relay, should be longer than the time the fluid was squeezed from the syringe cavity by the syringe piston spring, otherwise the fluid will be pumped into the abdominal cavity without outflow from the abdominal cavity, which will lead to the absence of fluid flow in abdominal cavity and its active washing. The duration of the tube switching period is achieved by adjusting the air valve of the time relay, so that for an equal period of time a different amount of liquid can be passed through the abdominal cavity, thereby changing the intensity of the washing of the cavity. After the abdominal flushing procedure is completed, instead of the fluid, a roller electric pump injects air into the abdominal cavity, which displaces the remaining fluid from the abdominal cavity, thereby eliminating the potential source of infection of the abdominal cavity. Drainages, once placed in the abdominal cavity during the washing procedure, are not reinstalled, but only connected alternately to the device, which eliminates additional tissue trauma, eliminates additional anesthesia, facilitates the work of the surgeon and increases the efficiency of patient treatment.

It was known in science
the use of perforated drains of the suction bulb and a reservoir for collecting washing water [2];
the use of several perforated drains, some of which work for the inflow, some for the outflow of the washing liquid [3];
the use of a spring on the piston rod of the syringe, which allows one-handed injection and the necessary preparation (ed. St. 1130350, class A 61 M 5/178);
the use of a washing device with automatic switching of the inflow and outflow of the injected liquid [1], made differently and having a lot of disadvantages.

 In the proposed technical solution, the distinguishing features of the device form a new set of known features. In addition, it is not known to use a spring, one end of which abuts against the piston, and the other end into the thrust nut of the adjusting threaded sleeve, the use of an adjusting threaded sleeve with a thrust nut, and the use of a thrust washer with an internal thread of the pressure gauge connected to the chamber cavity. The new device allows by turning the adjusting sleeve to change the pressure of the washing fluid in the abdominal cavity, while washing the entire volume of the abdominal cavity, regardless of its volume. By registering the pressure of the washing fluid in the abdominal cavity on the manometer, screwing or unscrewing the adjusting threaded sleeve, you can adjust it. The duration of a pause in the operation of the automatic circuit should be longer than the time when the fluid was squeezed out of the syringe cavity. Elimination of the effect of suction is achieved by alternately connecting the drains to the device.

 Thus, the new device provides a positive effect, meets the criteria of the invention "significant differences".

 In FIG. 1 shows a schematic diagram of the connection of the device and the piston system of the syringe; in FIG. 2 is a table for connecting drainages to an automatic device; in FIG. 3 is a circuit diagram of an automatic circuit; in FIG. 4 is a kinematic diagram of a locking device.

 The device includes a syringe 1, a piston 2 with a rod 3, a rod spring 4, abutting one end against the piston, and the other into the thrust nut 5 of the adjusting threaded sleeve 6, which is screwed into the thrust washer with an internal thread 7, tee 8, inflow drainage Drp, drainage of the outflow of DrOT, four perforated drains A, B, C, D, reservoir 9 with an antiseptic solution, reservoir 10 for draining the washing liquid, connected by a hollow tube to the syringe cavity of pressure gauge M. The automatic circuit consists of a time switch, which includes relay coil included webbings PB time relay coil core microcontact timers MKRV with a lever rod microcontact UGS, magnetic starter MP syringe with contacts located in the normally closed position NC and the normally open position NO, the electromagnet core MAG electric E. M. The locking device includes MAG, the core spring P connected at one end to the core of the electromagnet C, and the other to the thrust plate UP of the support struts of the US, lever P connecting the core to the diamond-shaped clamp РЗ.

 The device operates as follows.

 After connecting to the drains intraoperatively delivered in the field of possible liquid deposition (device connection diagram), the ABVG device is connected to the electric network. Electric pump M. pumps liquid from the reservoir 9 with an antiseptic into the abdominal cavity. Drainage outflow drainage during this period of time is closed by a locking device. The piston 2 of syringe 1 is located at the outlet of the drainage of the DRP inflow. The pressure exerted by the spring 4 on the piston 2 of the syringe 1 prevents the penetration of fluid from the abdominal cavity into the cavity of the syringe 1, so the fluid is forced to occupy all the free space in the abdominal cavity, regardless of its size. As soon as the pressure of the injected fluid in the abdominal cavity and, accordingly, in the drainage of the DRP inflow is higher than the pressure exerted by the spring 4 on the piston 2, the cavity of the syringe 1 begins to fill. The piston 2 with the rod 3 will come into motion and after a certain period of time as filling the cavity of the syringe 1, the rod 3 of the piston 2 will switch the microcontact rod Mksh. An automatic circuit will work, the drainage of the DRP inflow will close, the drainage of the DROT outflow will open, and the liquid, under the pressure exerted by the spring 4 on the piston 2 and piston 2 on the liquid, will be discharged from the syringe cavity through the outflow drainage into the washing liquid reservoir 10. As soon as the time relay RV trips, the cycle will repeat. During the procedure, rotating the adjusting threaded sleeve 6 with the thrust nut 5 located on it through the thrust washer with internal thread 7, you can change the pressure created by the pumped fluid in the drainage of the DRP inflow and, accordingly, in the abdominal cavity. The presence of a pressure gauge M connected to the syringe cavity allows this pressure to be recorded. By turning the adjusting threaded sleeve, this pressure can be adjusted. Alternating connection of drains (ABVG) to the device (table of the position of connecting drains to an automatic device) provides a forced fluid flow in each drain, which avoids clogging of the drains and the effect of suction. After the washing procedure is completed, instead of the fluid pumped into the abdominal cavity, air is supplied, which gradually displaces the fluid remaining in the abdominal cavity after washing, thereby eliminating the source of possible infection of the abdominal cavity.

 When the automatic circuit is connected to the electric network, the electric current passes through the microcontact of the rod (MkSh), which is at the moment of switching on in the normally closed position (NC position), through the microcontact of the time relay (MkRV), which is in the NZ position before being turned on. The electric circuit is closed on the coil of the magnetic starter (MP). The MP contacts, which are in the normally open position (BUT position) before switching on, go into the NZ position, thereby including the pump electric motor (El. M.) and the core electromagnet (MAG) in the electric current circuit. As soon as the syringe rod, as it moves forward, transfers the MCS to the reverse position, the MP coil is turned off. MP contacts that close when the coil is on, when it is disconnected, open and disconnect. M. and MAG. At the same time, the MP contact, which is located when the MP coil is switched on in the NOS position, when the coil is disconnected from the electric current, closes, closing the time relay coil (RV) circuit through the MCS. Mkrv core of the coil RV is transferred from the NZ position to the NOS position. Thus, at the time specified by the air valve RV, the circuit is broken, ending on the MP coil. As the syringe rod advances downward, the MCh switches to its initial state upon inclusion. As soon as the specified RV time ends, the MkRV will switch to the NC position, close the circuit ending on the MP coil, and the contacts including El. M. and MAG. When switching the MCS lever, the cycling of the chain will resume, thereby ensuring the automatism of the chain.

 The spring of the core P pulls the diamond-shaped clamp RZ to the far right position, which presses the drainage of the inflow of DRP between the thrust posts and opens the drainage of the outflow of DROT. When the unit is turned on in the electric network, the core of the MAG electromagnet through the lever P transfers the diamond-shaped clamp to the extreme left position, squeezing the DROT drain between the DC and opening the DRP. The fluid pumped by the electric pump through the abdominal cavity by means of DGP enters the cavity of the syringe, driving the piston of the syringe with the rod. When the automatic circuit is switched, the MAG turns off, the spring returns the diamond-shaped clamp through the core lever to the extreme right position, squeezing the DRP between the DC and opening the DROT. Fluid is squeezed out of the cavity of the syringe by the spring of the syringe rod into the reservoir for draining the flushing fluid. The duration of the pause in the operation of the automatic circuit, set by the air valve RV, is longer than the time when the fluid is squeezed out of the syringe cavity by a spring. When the time relay is activated, the cycle repeats, which ensures the automatic operation of the locking device.

 Thus, the use of the proposed device will allow you to flush the entire volume of the abdominal cavity, regardless of the size of the volume due to the obstacle created by the piston with the rod spring at the outlet of the drainage of the fluid flow periodically occurring in the abdominal cavity; to regulate the pressure exerted by the injected fluid in the abdominal cavity, which will prevent the compression of the vessels of the internal organs of the abdominal cavity and the subsequent ischemia of the organs; will eliminate the effect of suction and blockage of the drainage due to the alternate connection of the drainage to the device and create a fluid flow in each drainage. Once delivered intraoperative drains are used throughout the procedure, only alternately connected to the device, and do not require re-arrangement, which avoids additional tissue trauma and additional anesthesia, facilitates the work of the surgeon, and increases the efficiency of patient treatment.

Claims (1)

 A device for washing the abdominal cavity, containing two tanks equipped with drainage tubes, switching an automatic device for inflowing and outflow of liquid, including a lever switch for drainage tubes and an electromagnet with a core, characterized in that the automatic device for inflowing and outflowing of liquid is additionally equipped with a roller electric pump, a time switch, and with a syringe, while the time relay is connected to the piston rod microcontact and, through the starter, with an electric pump and an electromagnet connected to the lever vym switch drainage tubes and the cavity of the syringe connected to the manometer, to the piston rod of the syringe is fixed thrust washer with an inner thread and a spring, one end of which is fixed to the thrust washer and the other - on the piston.

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