RU213945U1 - Device for microphlebectomy - Google Patents

Abstract

The utility model relates to medicine, namely to vascular surgery, and can be used in surgical operations on patients with varicose veins.

A device for microphlebectomy, consisting of a scalpel and a phleb extractor, fixedly mounted at different ends of a metal rod, the length of which is at least 14 cm, and in the middle of which a handle in the form of a rectangular parallelepiped is fixed to put the scalpel or phleb extractor into working condition.

A simple and easy-to-use device has been created that allows performing the functions of a phlebextractor and a scalpel during surgical intervention, which reduces the time of the operation, improves the cosmetic effect, reduces the amount of blood loss and the invasiveness of the operation during elective and emergency vein surgery.

Description

The utility model relates to medicine, namely to vascular surgery, and can be used in surgical operations on patients with varicose veins.

In developed countries, the frequency of varicose veins is 25-33% among women and 10-20% among men. In Russia, more than 38 million people are officially registered as suffering from various forms of varicose veins, including trophic disorders in 15% of cases. The number of people with venous diseases is increasing by 2.5% annually [http:travma-net.ru>Articles.aspx…].

For the surgical treatment of varicose veins, various instruments are used: medical scalpels, phleb extractors, hemostatic clamps and in various modifications.

Described is a medical scalpel having a handle and a cutting element [Patent RU No. 121726 dated 11/10/2012. Bull. No. 31]. The tool allows, due to the inclusion of a stabilizer-catalyst in the composition of the material, to increase the wear resistance of the device. However, this tool is not designed for phlebactration.

A similar drawback was noted when using the scalpel proposed by A.L. Rogozin et al. [Patent RU No. 95993 dated 20.07.2010. Bull. No. 20].

A scalpel is known that allows dissection of the wall of blood vessels with a diameter of 10-14 mm at a precisely fixed depth from any surgical accesses and in any anatomical regions of the body [Patent RU No. 169319 dated 15.03.2017. Bull. No. 8]. However, this device allows you to perform only one action, namely, tissue incision.

Proposed phlebactor for removal of trunks of saphenous varicose veins [Patent RU No. 89945 dated 27.12.2009. Bull. No. 36]. With this device, you can perform only one action - phlebectomy. The advantage is the possibility of turning the perforating end of the phlebextractor rod towards the skin without significant efforts of the surgeon and the help of an additional instrument, as well as reducing the risk of rupture of the venous trunk during stripping by increasing the reliability of fixing the vein trunk to the phlebextractor rod. The technical result is achieved by the fact that the opposite end of the phlebextractor rod, made in the form of a plate, is bent at the same angle, 45 degrees, as its perforating end. A through hole at the opposite end of the rod is made along its entire length. The disadvantage of the device is to perform only one action - phlebextraction.

Phlebextractor is known (Patent RU No. 167672 dated 10.01.2017. Bull. No. 1). A low-traumatic device for the treatment of varicose veins of the lower extremities, which makes it easier to perform interventions in emergency and elective vein surgery. However, this device is intended only for performing phlebextraction.

The use of several instruments during the operation increases the duration of the operation, which is accompanied by increased traumatism during the surgical intervention, the cosmetic effect decreases, the rehabilitation period increases, and an increased risk of disease recurrence is created.

The objective of this utility model is to create a simple, easy-to-use device for microphlebectomy, which allows using one tool to perform the actions of two tools: a scalpel and a phlebextractor.

There is no prototype of the proposed device, since the scalpel and phlebextractor have a different purpose. The device for microphlebectomy is designed to perform operations on patients with varicose veins.

The technical result is achieved by the fact that a scalpel is mounted on one rod at one end, and a phlebextractor is mounted on the other end of this rod. In the middle of the rod is a handle that facilitates its fixation in the hand.

According to the technical solution, a device for microphlebectomy, consisting of a scalpel and a phleb extractor, fixedly mounted at different ends of a metal rod, the length of which is at least 14 cm, and in the middle of which a handle in the form of a rectangular parallelepiped is fixed to put the scalpel or phleb extractor into working condition.

The proposed utility model is illustrated by graphic material.

The figure 1 shows a General view of the device for microphlebectomy,

where 1 is a metal rod, 2 is the working part of the scalpel, 3 is the working part of the phleb extractor, 4 is the handle.

The proposed device is used as follows

When performing an operation using a microphlebectomy device, the working part of the scalpel is in motion, and the working part of the phlebextractor is in the opposite direction. When the phlebextractor is working, the working part of the scalpel is set in the opposite direction.

An example of practical use.

Patient V., 47 years old. Diagnosis: Chronic disease of the veins of the left lower limb C2,3S,Ep,As,Pr; 07/13/2016; L.I. Chronic venous insufficiency II degree. The operation was performed on July 14, 2016. Phlebectomy of the great saphenous vein (GSV) on the left thigh, microphlebectomy of the tributaries from the mini-access.

Under intravenous anesthesia, after processing the surgical field using a device for microphlebectomy, a linear access was made on the left along the inguinal fold to the saphenofemoral anastomosis 1.5 cm long, the great saphenous vein was isolated using the phlebextractor of the device for microphlebectomy. Using a hemostatic clamp, the blood flow through the great saphenous vein was stopped. Departing from the saphenofemoral fistula by 0.5 cm, the vein was crossed with a scalpel device for microphlebectomy. The stump of the great saphenous vein was sutured and tied. The stump was left up to 0.5 cm.

A guidewire probe was inserted retrogradely into the distal end of the vein to the lower third of the thigh, after which GSV phlebectomy on the thigh was performed by traction.

Varicose-transformed tributaries of the left great saphenous vein were removed from individual mini-accesses 0.5 cm long using a microphlebectomy device. Separate interrupted sutures, aseptic dressing and compression stockings of class II compression were applied to the wounds.

The postoperative period was uneventful. The patient was discharged in a satisfactory condition on the 2nd day after the operation.

This example indicates the possibility of using the proposed device for microphlebectomy during surgical operations in patients with varicose veins.

The use of a device for microphlebectomy, which allows using one tool to perform the actions of two tools: a scalpel and a phlebextractor, can reduce the time of the operation, improve the cosmetic effect, reduce the amount of blood loss and the invasiveness of surgical intervention during elective and emergency vein surgery. The proposed device for microphlebectomy is inexpensive and allows microphlebectomy to be performed using local anesthesia. There is a decrease in the incidence of recurrence of the disease, the rehabilitation period is reduced by an average of 2.5 times.

The proposed utility model was implemented on the basis of the "CHUZ" KB "Russian Railways - Medicine". 14 operations were performed using a microphlebectomy device for varicose veins of the lower extremities.

Claims (1)

A device for microphlebectomy, consisting of a scalpel and a phlebextractor, fixedly mounted at different ends of a metal rod, the length of which is at least 14 cm, and in the middle of which a handle in the form of a rectangular parallelepiped is fixedly fixed.

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