RU2223694C1 - Device for taking cytological material in cholangitis cases - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has protection casing and working part as flexible pusher. The flexible pusher has elastic metal strings, ending in fleecy loop and surrounded with spiral. The spiral is attached to the strings on both ends by means of rings. Initial ring has handles for rotating loop. EFFECT: enabled cytological material sampling via external draining system or fibrogastroduodenoscope. 4 dwg

Description

 The invention relates to medicine, namely to surgery, and can be used in endoscopy.

 Currently, a device for producing cytological material is known, consisting of protective drainage, a hollow pusher with a hollow cylinder with foam rubber fixed at its end and a flexible wire pusher passing inside it with a brush fixed on its end (A. Myasnikov, O. Okhotnikov I. ., Bondarev G.A., Istomin S.R., Ivanov I.S. - Patent 2175853 dated 12.07.2000).

 However, this device has significant disadvantages: a large diameter in the cross section, the lack of plasticity of the working part, its insufficient length, which does not allow the production of cytological material from the common bile duct through the external drainage system of the biliary tract and through a fibrogastroduodenoscope.

 The technical result of the invention is the capture of cytological material from the common bile duct in case of cholangitis through an external drainage system and through a fibrogastroduodenoscope.

 The technical result is achieved by the fact that the device is made of a protective casing and a flexible pusher extending inside it, consisting of two elastic plastic metal strings ending in a loop with a pile and surrounded by a spiral fixed to the strings at both ends by rings, while the initial ring has handles for rotation.

 The invention is illustrated by the following figures.

 In FIG. 1 shows a diagram of the device in assembled form.

 In FIG. 2 shows a diagram of the device in working condition.

 In FIG. 3 shows a diagram of the device at the time of sampling.

 In FIG. 4 shows a diagram of the device at the time of material intake during fibrogastroduodenoscopy.

 The device consists of a protective casing (1) and a flexible pusher (2) passing inside it, consisting of two elastic and plastic metal strings (3) ending with a loop with a pile (4) and surrounded by a spiral (5) fixed to the strings from both ends with rings (6) and (7), while the initial ring (6) has handles for rotation (8).

 The device operates as follows.

 After preliminary sanitation with a physiological solution of the external drainage system, the proposed device, through the patient’s drainage (9), is introduced into the common bile duct (10). Using a flexible wire pusher (2) we translate a loop with a pile (4) from the protective casing (1). Then, using the ring (6) with handles (8), we rotate the loop (4), touching the inner wall of the common bile duct (10). After taking the material with the flexible pusher (2), in a return movement we remove the loop with the pile (4) in the protective casing (1) and remove the device from the drainage system (9).

 During endoscopic examination, in particular during fibrogastroduodenoscopy with examination of the large papilla of the duodenum and its cannulation, the proposed device is inserted through the biopsy channel of the endoscope (11) into the common bile duct (10). Using a flexible wire pusher (2) we translate a loop with a pile (4) from the protective casing (1). Then, using the ring (6) with handles (8), we rotate the loop (4), touching the inner wall of the common bile duct (10). After taking the material with the flexible pusher (2), in a return movement we remove the loop with the pile (4) in the protective casing (1) and remove the device from the endoscope (11).

 Thus, the technical result is achieved by the fact that the device for obtaining cytological material is made of a protective casing and a flexible pusher extending inside it, consisting of two elastic and plastic metal strings ending in a loop with a pile and surrounded by a spiral fixed to the strings at both ends of the rings while the initial ring has handles for rotation.

 An example of a specific application 1. Patient G., 72 years old, (case history 454367) was treated in the purulent surgery department of the Kursk Design Bureau with a diagnosis of cholelithiasis. Chronic calculous cholecystitis, stage of exacerbation. Choledocholithiasis. Obstructive jaundice. Acute purulent cholangitis.

 The patient underwent surgery, which ended with drainage of the biliary tract according to Keru.

 The device was inserted through a pre-washed saline drain of Kera into the common bile duct. To prevent infection, the device is enclosed in a protective casing. Using a flexible pusher, a loop with a pile was taken out of the protective casing by translational movement. Then, using a ring with handles, a loop was rotated, touching the inner wall of the choledochus. After the material was taken using a flexible pusher, the loop with a pile was removed in a protective casing in a return movement and the device was removed from the Kera drainage.

 The conclusion of the cytological study: purulent inflammatory process, degenerative-inflammatory type.

 An example of a specific application 2. Patient F., 65 years old, (medical history 546723) was treated at the purulent surgery department of the Kursk Design Bureau with a diagnosis of cholelithiasis. Acute cholecystitis. Choledocholithiasis. Acute purulent cholangitis.

 The patient underwent endoscopic lithoextraction, followed by taking cytological material from the common bile duct through the channel of the endoscope. The device was inserted through the biopsy channel of the endoscope into the common bile duct. To prevent infection, the device is enclosed in a protective casing. Using a flexible pusher, a loop with a pile was taken out of the protective casing by translational movement. Then, using a ring with handles, a loop was rotated, touching the inner wall of the choledochus. After the material was taken using a flexible pusher, the loop with a pile in the protective casing was removed by a return movement and the device was removed from the endoscope.

 The conclusion of the cytological study: purulent inflammatory process, degenerative-inflammatory type.

 The proposed device in the clinic of surgical diseases was performed 13 cytological studies in patients with acute purulent cholangitis. There were no complications from using this device.

Claims (1)

A device for producing cytological material for cholangitis, consisting of a protective casing and a working part, characterized in that it is made for insertion through the drainage and the channel of the endoscope, while its working part is made of a flexible pusher consisting of two elastic metal strings ending in a loop with a pile and surrounded by a spiral fixed to the strings at both ends of the rings, and the initial ring has handles for rotating the loop.

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