RU2233182C1 - Device for temporal fixing the drainage of cystic duct at laparoscopic cholecystectomy - Google Patents

Abstract

FIELD: medicine, surgery.

SUBSTANCE: the present innovation deals with intraoperational diagnostics of benign lesions in extrahepatic biliary ducts. The suggested device has got a hollow chlorovinyl tube with a fixing ligature applied through tube's lumen. Fixing ligature is designed to be a metal one: its one end is in the form of a hook the external diameter of which corresponds to internal tube's diameter. The device suggested enables to loosely fix and remove the drainage of cystic duct in case of laparoscopic cholecystectomy by not applying conventional operational accesses.

EFFECT: higher efficiency of diagnostics.

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Description

The invention relates to medicine, and specifically to surgery, and can be used for intraoperative diagnosis of benign lesions of extrahepatic bile ducts.

Known locking device for intraoperative cholangiography, including a vinyl chloride tube and a locking thread [1].

However, this device is used in traditional cholecystectomy and its use in laparoscopic surgery is of great technical complexity.

A device for removing the fixative drainage of the cystic duct in the postoperative period, containing a tube with two hollow needles inserted one into the other, and the fixing thread [2].

The disadvantage of this device is the great technical complexity of the intraoperative installation and its removal with laparoscopic cholecystectomy.

A device for temporary fixation of the drainage of the cystic duct during laparoscopic cholecystectomy, including a hollow vinyl chloride tube with a metal fixing thread held through the lumen of the tube, is proposed. In the proposed device, one of the ends of the fixing thread has a hook shape, while the outer diameter of the hook corresponds to the inner diameter of the tube.

The proposed device allows you to freely fix and remove the drainage of the cystic duct during laparoscopic cholecystectomy, without resorting to traditional surgical approaches.

The device (see drawing) contains a hollow vinyl-chloride tube 230 mm long with an inner diameter of 4 mm 1, a metal fixing thread 2, one of the ends of which has the shape of a hook 3 with an outer diameter of 4 mm.

The device operates as follows.

The device is inserted into the abdominal cavity, hook 3 captures the cystic duct 4 in combination with the drainage of the Holsted-Pikovsky 5 and the method of lowering the vinyl tube 1 along the metal fixing thread 2 to the cystic duct 4, it is sealed with fixing the drainage of the Holsted-Pikovsky 5.

An example of a specific implementation.

Patient V., 50 years old, was admitted to the surgical department of the 3rd mountains. Clinical Hospital of Blagoveshchensk January 20, 2003, and / b No. 830, with a diagnosis of chronic calculous cholecystitis, was operated on as planned 2 days after receipt. Performed laparoscopic cholecystectomy. Given the history of obstructive jaundice, the operation was supplemented by the study of the main bile ducts. Under the control of a laparoscope, a Holstead-Pikovsky drainage was installed in the stump of the cystic duct, which is fixed by a device for temporary fixation of the cystic duct drainage during laparoscopic cholecystectomy. During intraoperative cholangiography, it was diagnosed: there are no shadows suspicious of calculus in the common bile duct, extrahepatic bile ducts are not dilated, contrast freely enters the duodenum. The device and drainage of Halstead-Pikovsky removed, the stump of the cystic duct is sealed with 2 metal clips.

The postoperative period was satisfactory, there were no complications. The patient was discharged 3 days after surgery.

Sources of information

1. I.N. Grishin, Cholecystectomy: prakt. allowance, 1989, p. 99.

2. RU 2192181 C1, 11/10/2002. Device for removing the fixation of the cystic duct drainage in the postoperative period.

Claims (1)

A device for temporary fixation of the cystic duct drainage during laparoscopic cholecystectomy, including a hollow vinyl tube with a fixing thread drawn through the lumen of the tube, characterized in that the fixing thread is made of metal, and one of its ends has a hook shape, the outer diameter of which corresponds to the inner diameter of the tube .