RU2161931C2 - Method and device for performing simultaneous dissection and coagulation of tissues - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves maintaining direct supply of high temperature narrow- jet damp flow produced from liquid preheated in reaction chamber. The device has reservoir for keeping substratum connected to the reaction chamber in the casing having outlet opening. The substratum in liquid state is kept in the reaction chamber of device for producing damp that has a heating member. EFFECT: low traumatic injuries in performing tissue dissection. 6 cl, 3 dwg

Description

 The invention relates to medical equipment, in particular to surgical instruments, for dissection and coagulation of tissues when performing surgical interventions.

 Known coagulator of cold plasma (EP 0787465, 08/06/97), considered as a prototype of the method and device, in which the tissue is exposed to a high-temperature gas stream of cold plasma. The coagulator consists of a gas-dynamic tank, which is a reservoir for the substrate, connected by a gas pipeline to a chamber inside a hollow body, in which a gas-plasma flow is formed. The exit from the chamber is made in the form of a small hole for the formation of a narrow flow. The gas stream is heated by high frequency currents.

 As a result of using the known method and device, a dense scab is formed on the tissue, coagulation of the tissues is carried out, but tissue cannot be welded, moist necrosis is formed, which is available for stratification when small anatomical structures are preserved.

 The aim of the invention is to develop a less traumatic method of tissue dissection, providing for the simultaneous isolation and coagulation of thin anatomical structures and the creation of a device that allows the use of other factors on tissue for dissection.

 This goal is achieved in that the dissection of tissues and their subsequent coagulation is carried out by applying to the fabric a high-temperature narrowly directed flow of the substrate at a speed sufficient to rupture and stratify the tissues from a special device, while the substrate in the form of a liquid is preheated to form steam in the reaction chamber of the device, containing a reservoir for the substrate associated with the reaction chamber in the housing and provided with an outlet. The steam generator chamber is equipped with a heating element.

 The heating element can be made in the form of an electric thermal element, and the reaction chamber is connected to the reservoir by a valve mechanism.

 Water or an alcohol-water solution or an aqueous solution of ether are used as a substrate.

 In FIG. 1 shows a section through a steam generator with a heating element.

 In FIG. 2 shows a device in section with a steam generator, a reservoir for a liquid and a heating element.

 In FIG. 3 shows the operation of the device.

 The device consists (Fig. 1) of a hollow body 1, one end of which (outlet) is made in the form of a small hole or nozzle 2, designed for narrow exit of the substrate in the form of a steam stream and representing a steam generator 3, in the reaction chamber 4 of which from the substrate 5 high-temperature steam is formed, or where the substrate is transferred from one state of aggregation to another - a high-temperature gaseous state of aggregation, of a rapidly heating electric thermal element 6 included in an electric circuit and representing a heating element in the form of a spiral located inside or outside the housing 1, as well as the housing itself, and a fluid reservoir 10 (Fig. 2) connected to the reaction chamber 4 with a filling hole 11 and a valve 12. The substance 5 is used as a substrate in a liquid state, easily turning into another aggregate state - high-temperature vaporization, including in the case of using a mixture of liquids. As a substrate, water, alcohol, a water-alcohol solution are used that easily turn into hot steam, as well as ether and other similar liquids that easily form steam when heated. When heating the thermal element 6, the substrate 5 located in the reaction chamber 4, when heated, quickly passes into a gaseous state or steam. Thus, the electric coil or the casing of the device acts as a heating element of the device. For heating, non-contact heating of substrate 5 can be used in a steam generator 3, which is used in instruments for electrocoagulation of tissues, namely, electric current or a high-frequency current that passes through substrate 5 introduced into the reaction chamber 4 in an electric circuit 7 connected directly to the device body 1, or an insulated contact located inside the housing 8. When these contacts are closed by a substrate / water, electrolyte, etc. / the electric circuit closes, a liquid closed in the ele trotsep heated and passes into the gaseous state of aggregation. In this case, the housing itself acts only as an electric current conductor or one of the contacts, but not a heating element.

 The operation of the device is carried out (Fig. 3) as follows. When an electric current or a high-frequency current is supplied to a thermal element 6 closed in circuit 7 directly to the device body or, closing the electric circuit 7 by feeding a substrate to the device in the initial liquid aggregate state, the substrate 5, when heated, passes into a high-temperature gaseous aggregate state 8. From - due to the difference in the volumes of the two aggregate states of the substrate in the device 1 or, more precisely, in the reaction chamber 4 with a narrow outlet in the form of a nozzle 2, the steam cloud 8 is under pressure and at a high speed starts to exit the nozzle in the form of a narrowly directed high-temperature steam stream 9. A reservoir 10 with a filling hole 11 connected to the reaction chamber 4 by means of a valve 12 that feeds the substrate into the reaction chamber and ensures a continuous process in continuous or pulsed dissection mode without recharging the device .

 When performing the operation, the device is brought (Fig. 3) directly to the fabric 13 or is installed at a certain distance and a highly focused high-temperature steam stream 9 is used for mechanical separation of the tissues and simultaneous coagulation. In this case, structures with weak mechanical strength, for example, fatty tissue, serous membranes, i.e. those structures that are usually disconnected during the operation and at the same time eliminates damage to important anatomical structures, for example large vessels with greater mechanical strength. In addition, only very small blood vessels are coagulated, since large vessels are practically not damaged by the steam flow due to its low heat capacity. The directed steam flow also exfoliates the tissues, acting on the principle of hydraulic preparation, while bleeding from small tissue ruptures from mechanical stress is excluded. When connected to an electrical circuit of the device’s body, made in the form of an isolated electrical contact, the output of which is connected to a conventional tissue coagulation apparatus, this device can perform the functions of tissue electrocoagulation.

 Depending on the flow rate, nozzle shape, temperature, substrate selection, etc. You can adjust the degree of mechanical and thermal effects on the tissue. The advantage of this device is the simultaneity of the processes of mechanical destruction of tissues and coagulation of small, inaccessible to visual control, anatomical structures, sparing regime of mechanical and thermal effects. This device will be widely used in endoscopic surgery to perform dissection in the excretion of organs and blood vessels and in oncology for lymphatic dissection.

Claims (6)

 1. The method of dissection and coagulation of tissues by exposing the tissue to a high-temperature narrowly directed substrate flow, characterized in that the substrate in the form of a liquid is preheated in the reaction chamber until steam is formed.  2. A device for dissection and coagulation, containing a reservoir for the substrate, connected to the reaction chamber in a housing provided with an outlet for supplying a high-temperature narrowly directed flow, characterized in that the substrate is in a liquid state in the reaction chamber of a steam generator equipped with a heating element.  3. The device according to claim 2, characterized in that the heating element is made in the form of an electric thermal element, and the reaction chamber is connected to the substrate reservoir by a valve mechanism.  4. The device according to claim 1, characterized in that water is used as a substrate.  5. The device according to claim 1, characterized in that an alcohol-water solution is used as a substrate.  6. The device according to claim 1, characterized in that an aqueous solution of ether is used as a substrate.

Images