RU2138998C1 - Device for passing of drainage and paracentetic instruments into abdominal cavity - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device is intended for directed introduction of drains of paracentetic needles into abdominal cavity under control of computer tomography. Device has case consisting of two detachable plates which are provided with recesses made symmetrically at their ends. Plates are secured to each other by means of pins and holes coaxial with them, as well as through U-shaped clamps positioned in recesses. Through holes of different axial orientation are made in case along joint line. Transverse slots are provided at end faces for fixing members, for example belts. EFFECT: enhanced accuracy. 2 cl, 3 dwg

Description

 The invention relates to the field of medical technology and can be used for targeted introduction into the abdominal cavity of medical instruments - drainage or puncture needles under the control of computed tomography.

 In recent years, there has been a pronounced trend towards minimally invasive methods of treatment and diagnosis of a number of diseases of the abdominal organs. The introduction of such an accurate and informative research method as computed tomography (CT) and ultrasound (ultrasound) into practice has greatly expanded the possibilities of using puncture-drainage methods in clinical practice. To ensure accurate entry into the pathological focus, special devices are needed to facilitate these manipulations.

 A device for conducting targeted punctures and drainage of fluid formations under the control of ultrasound, for example, linear-puncture sensor PLF - 308P of the Japanese company "TOSHIBA" (V.Yu. Mishin et al. // Ultrasound diagnosis, - 1995 -, N 3, s . 41 - 46). The sensor has a groove in which a special triangular insert is installed with the channels of various directions in it for holding puncture needles.

 A device for the directed introduction of drainage and puncture devices into the abdominal cavity under the control of ultrasound, made in the form of a special nozzle on the convex sensor UAGV - 009A of the Japanese company "TOSHIBA" (A. F. Chernousov et al. / Annals of surgery, - 1997-, N 2, p. 42-47). The device consists of a metal bracket for fixing to the ultrasound probe and the actual guiding device into which the puncture needle or drainage is inserted. The guide channel has a device that allows you to change its diameter, or completely disconnect its walls to release the introduced drainage. The angle of inclination is adjusted by moving the guide channel in a special slot with a fixing screw.

 However, the known devices suggest the presence of constant visual control during the manipulation, because cannot be reliably fixed to the patient’s body and the slightest movement of the operator’s hand causes a significant change in the direction of insertion of the needle or drainage device. These devices can be successfully applied only during manipulations under the control of ultrasound and are not suitable for manipulations under the control of CT.

 CT allows you to outline the point of implementation, determine its direction and the required depth of penetration into the pathological focus, but the manipulation itself is performed "blindly" with subsequent computer control. To date, there is no device that can reliably maintain the direction of movement of the needle or trocar - catheter during diagnostic and therapeutic procedures using CT.

 The objective of the invention is to provide a device for accurately conducting into the abdominal cavity drainage and puncture instruments under the control of computed tomography.

 The essence of the invention lies in the fact that the device for conducting drainage and puncture instruments into the abdominal cavity comprises a housing consisting of two detachable plates that have symmetrically made grooves at the ends and are fastened together by means of pins and holes aligned therewith, as well as by P -shaped brackets installed in the grooves, and through-holes with multidirectional axial orientation are made in the housing along the connector line, and transverse slots for fixing elements, for example, belts, are made at the ends.

 The device is made of plastic, for example, caprolon.

 Using the invention allows to obtain the following technical result. The device ensures the precise penetration of the puncture needle into the pathological focus to obtain biopsy material or puncture sanitation of purulent cavities in the organs and tissues of the abdominal cavity. With its help, it is also possible to conduct drainage tools for drainage of intra-abdominal abscesses, cysts and abscesses of the liver and pancreas, and sclerotherapy of pancreatic pseudocysts. For the first time, a device has been proposed for performing diagnostic and therapeutic manipulations on the abdominal organs using drainage and puncture instruments under CT control. The low invasiveness and high efficacy of these interventions are now widely recognized. They are priority in comparison with traditional surgical methods in this category of patients. The device is made of plastic, for example, caprolon. This material does not interfere with the visualization of pathological lesions during the study, lends itself to any type of sanitization and is easily sterilized. The simplicity of the device does not require special skills when performing a doctor these interventions.

 The technical result is achieved due to the fact that the device has the ability to be securely fixed on the patient’s body. The presence of holes multidirectional along the axis allows you to choose the optimal point and direction of the puncture or drainage tool. There is no likelihood of the device moving during manipulation. The detachable nature of the device along the vertical axis along which the holes are made, allows you to remove it, leaving the inserted tools in a predetermined position, and also allows the use of drains of any design of their distal part (devices for fixing to the skin, the presence of additional channels for washing pathological cavities, etc. d.).

 In FIG. 1 shows a device for conducting drainage and puncture instruments into the abdominal cavity, general view; in FIG. 2 - section aa; in FIG. 3 is a view of the plate from the side of the surface of the connector.

 The device comprises a housing consisting of two detachable plates 1, 2 having grooves symmetrically made at the ends 3. The plates 1, 2 are fastened to each other by means of pins 4 located on the inner side of the plate 1 and holes 5 aligned therewith, made on the inner side of the plate 2 , as well as U-shaped brackets 6, which are installed in the grooves 3. In the housing, through holes 7 are made with axially oriented axially bifurcated along the connector line of plates 1, 2. The diameter of the holes may be different. At the ends of the plates 1, 2 there are transverse slots 8 for fixing the device on the patient’s body, for example, using belts.

 The device is used as follows.

 For installation on the patient’s body, the device is assembled. The plates 1, 2 are fastened to each other using the pins 4 located on the plate 1 and the holes 5 coaxial with them, made on the plate 2. For reliability of fastening, U-shaped brackets are installed in the grooves 3. 6. On a Somatom DR - 2 computer tomograph on the body of the patient lying on his back, fix the line of the optimal cut, on which the pathological focus is visualized. When the device is turned off, the device is mounted on the body in such a way that the computer cut line coincides with the line of perforations, the device is fixed on the patient’s body, for which a fixing element, for example, belts, is inserted into slot 8. The computer apparatus is turned on again and one of the holes is selected that provides the optimal direction for holding the draining or puncture instrument, and the penetration depth is also determined. When the device is turned off, focusing on the available marks on the input instrument, it is introduced to the required depth through the selected hole 7. The computer tomograph is turned on again and the accuracy of the instrument getting into the pathological focus is controlled, the device is turned off and diagnostic or therapeutic manipulation is performed. After receiving the biopsy material, the puncture needle is removed, the device is assembled removed from the patient. In the case of installing the drainage, the removal of the device is as follows: U-shaped staples 6 are removed from the grooves 3, the plates 1, 2 are disconnected. In this case, the locking belts spontaneously released. Drainages carried into the abdominal cavity are fixed to the skin of the abdominal wall.

Claims (2)

 1. Device for conducting drainage and puncture instruments into the abdominal cavity, characterized in that it comprises a housing consisting of two detachable plates that have symmetrically made grooves at the ends and are fastened together by means of pins and holes aligned therewith, as well as by means of P -shaped brackets installed in the grooves, and through-holes with multidirectional axial orientation are made in the housing along the connector line, and transverse slots for fixing elements, for example belts, are made at the ends.  2. The device according to claim 1, characterized in that it is made of plastic, for example caprolon.

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