RU2217034C2 - Surgical tubus device - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has body, handle for manipulating with the device, video camera, light guide member, connector assembly and adapter. The video camera is built in into an additional olive canal. Camera lens is integrated into light guide outlet. Instrumental tube canal is combined with the external additional canal having sealed connection to the video camera. Cable coming from the video camera connected to the connector assembly for connecting monitor control unit, mounted on the device body, and the light guide member connected to illumination source adapter attached to the device body is arranged in the external additional canal. The olive is removable and replaceable and has fixing screw. The handle is removable and fixable by turning with grooves available on tubus body and fixing screw. The device body is closed with sealing loading. EFFECT: wide range of functional applications; reduced risk of traumatic complications. 2 cl, 4 dwg

Description

 The invention relates to surgical instruments and is intended for endoscopic subfascial dissection of perforated veins, and can also be used in other cases of endosurgery, for example, during operations on the rectum.

 Treatment of patients with varicose veins is an urgent problem of modern phlebology. Therapeutic results are achieved by performing a direct, open Linton-Felder operation that eliminates venous hypertension in the affected tissue area (Phlebology, 5/97. Moscow, p. 13-15).

 But during these operations, tissue dissection is required, providing wide access to perforating veins, which is performed by a well-known surgical instrument, which makes the operation traumatic and increases the time of postoperative rehabilitation of patients, and performing an incision in the immediate vicinity of the area of trophically altered tissues causes a high incidence of purulent-necrotic complications .

 The surgeons' desire to achieve better functional results and avoid complications led to the use of a well-known endoscopic instrument. To visualize the surgical field, we tried to use children's rectoscopes, mediastinoscopes and instruments from the set for laparoscopic operations (see Appendix 1, p. 13).

 But their use could not be widely used and only the development of special endoscopic instruments ensured the active use of these instruments in endoscopic dissection of perforants. 3a, a prototype tube was taken according to the patent DE 4445599 A1, A 61 B 1/00, 09/21/1995 with olive for the preparation of subfascial space.

 In the prototype instrument, the tube body consists of a tube with preparation olive forming a channel, which is used to place a video optical system in it, and already it has an instrumental channel through which the surgical tool is operated. In addition, the known tube contains a control knob, a light guide, a connector and an adapter.

 However, such a constructive implementation requires the use of the maximum allowable diameters (20-22 mm) of the olive and tube forming the channel, since a significant part of its space is occupied by the video optical system, and the rest of it is occupied by the working instrumental channel of this system, which is limited and cannot have diameters. This increases the invasiveness of the tube and at the same time limits the operational capabilities of the tool used, and also affects the reliability of its operation. Thus, the operational limitations of using 5 mm surgical instruments simply will not allow to cut or clip on veins whose diameter is greater than the working capabilities of the instrument, for example, whose diameter is 8 mm.

 At the same time, the well-known operating tube and the video-optical system located in its channel with the working instrumental channel, used together to provide operational actions, are difficult to characterize as a single tool, since an endoscope with ring video optics and a working channel is known.

 The proposed operating tube is devoid of all the above disadvantages, fundamentally expands operational capabilities, combines a tube and a video camera with image output on a monitor, and, if necessary, for recording a VCR, provides the surgeon with maximum observation and greater freedom of choice of posture and movements, has a separate instrumental channel and a much larger - 9-11 mm - diameter, with an olive diameter of 20-22 mm, which allows you to use a wider set of surgical instruments, more monthly and with great operational capabilities, for example, allows you to provide radical assistance to patients with operations on veins with a diameter of 8 mm or more, and when using a 5 mm instrument, the diameter of the tube with removable olive can be a minimum of 15-16 mm, which also extends the operational capabilities , but now the tube itself, and reduces the injuries of the operation. A removable, replaceable tube olive allows you to quickly, if necessary, switch from one diameter or a corner of a cut of olive to an olive of a different diameter or a corner of a cut, and a removable, rotatable-fixed handle of the tube provides the surgeon with the convenience of using the tool.

 The essence of the invention is characterized by the following set of essential features.

 The operating tube contains a housing consisting of a tube with a preparation olive, which form a channel, a tube control handle, a video camera, a light guide, a connector, and an adapter, while the video camera is placed in an additional olive channel, the lens of which is aligned with the fiber exit, and the instrument channel of the tube is aligned with an external auxiliary channel hermetically connected to the video camera, and in the external auxiliary channel there is a cable coming from the video camera connected to the connector for connecting the monitor control unit a ditch mounted on the housing, and a light guide connected to an adapter for connecting a light source mounted on the housing, while the olive is removable and replaceable with a fixing screw, and the handle is removable, rotatably fixed with slots on the housing of the tube and the fixing screw of the handle, while the housing at the inlet is closed with a sealing plug.

 Figure 1 shows a General view of the tube operating room Assembly.

 Figure 2 shows a view of "B" from the end of the olive.

On fig.3 shows a section of olive according to "AA"
Figure 4 shows a section of the tube on "bb" in a 2: 1 scale.

 The tube of FIGS. 1, 2, 3 and 4 has a housing 1, a tube 2, an instrument channel 3, which is combined with an external (auxiliary) channel 5, which is hermetically connected to the video camera 4, in which the fiber-optic fiber 6 and the video camera cable 7 pass (pass) 4, the tube 2 is connected to a removable olive 8, removable and fixed by a screw 8, in which a video camera 4 with a lens 10 and the output of the optical fiber 6 is placed, and the output of the instrumental channel 3 of the olive 9 is aligned with the instrumental channel 3 of the tube 2 and the housing 1 closed on seal inlet Lushka 11.

 In this case, the cable 7 of the video camera 4 is connected to the connector 12, mounted on the housing 1 for connection to the monitor control unit, not shown), and the optical fiber 6 is connected to the adapter 13, also mounted on the housing 1 (for connection to the light source. a tube on the slots 14 of the housing 1 has a removable, rotary-fixed screw 15 handle 16.

 Work tube operating as follows. A tube with olive 9, the diameter of which corresponds to this operation, and the tube control handle 16 is mounted on the housing 1 in the required position and is in the surgeon's hand, the adapter 13 of the optical fiber 6 is connected to the light source, and the connector 12 of the video camera 4 is connected to the monitor control unit, by preparation olive 9 into the operating space, observing the insertion process on the monitor, and then, removing the sealing plug 11, the required surgical instrument is introduced through the instrument channel 3 and the necessary surgical operations are performed, observing and implementation of the monitor and recording on the VCR if necessary, which is very important in complex operational cases. Olive 9, if necessary, can be quickly replaced with olive of a different diameter or cutting angle. After the operation, the tube is disassembled, sterilized and collected for the next operation.

Claims (2)

1. The operating tube containing a housing consisting of a tube with preparation olive, which form a channel, a tube control handle, a video camera, a light guide, a connector and an adapter, characterized in that the video camera is placed in an additional olive channel, the lens of which is aligned with the light guide output, and the instrument channel of the tube is combined with an external auxiliary channel hermetically connected to the video camera, and in the external auxiliary channel there is a cable coming from the video camera connected to the connector for connecting the unit control of the monitor mounted on the housing and the light guide connected to the adapter for connecting the light source mounted on the housing, while the olive is removable and replaceable with a fixing screw, and the handle is removable, rotatably fixed with slots on the housing of the tube and the fixing screw of the handle. 2. The tube according to claim 1, characterized in that the housing at the inlet is closed with a sealing plug.

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