RU2279258C2 - Conductor for guiding catheters and probes - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: device has rod the anterior working end of which is stiletto-like. Tube is fixed on posterior rod end. Rod-like fixing member is available in the tube. The rod has flexible conic working end. The fixing member is rigidly mounted on rod end. The tube is removable. It is fixed coaxially with the rod and thrusts against conic bead available on the rod.

EFFECT: improved reliability properties; reduced risk of traumatic complications.

3 cl, 3 dwg

Description

The invention relates to medical equipment, namely to surgical instruments.

One of the stages of surgical operations associated with the installation of catheters and probes is to conduct them through the formed subcutaneous tunnel. This procedure has to be performed both in experimental studies on animals and in patients, in particular during catheterization of central blood vessels.

Known conductor for drainage, containing a rod with a removable pointed tip and handle, as well as a removable fitting with the ability to install it at both the distal and proximal ends of the conductor [1]. It is possible to increase the length of the conductor due to the rod-shaped insert. The conductor is made collapsible and all five of its parts are connected to each other by threaded connections. The procedure associated with conducting drainage through soft tissues, in particular, the pelvic region, involves disassembling and assembling the conductor with a change in the sequence of connection of all parts to each other. Circular grooves are made on the fitting and the drainage tube put on it is held by a snug fit.

The disadvantage of this conductor is that it consists of a relatively large number of parts and some of them have blind threaded holes that make it difficult to clean the instrument, in particular when preparing it for sterilization. The fastening of the drainage tube on the conductor is not reliable enough. It would be possible to additionally fix the tube on the fitting with the help of a ligature, but then the threads and the ligature assembly located on the outer surface of the drainage tube would make it difficult to move the drainage through the tissues, making the corresponding procedure more traumatic.

Known conductor for the drainage tube, made in the form of a rod, which at one end has a trihedral sharpening with cutting edges, and at the end of the other end, a tube is fixed coaxially with the rod [2]. A hole is made in the end of the rod into which a removable rod-shaped retainer is screwed. For fastening the drainage tube, it is put on the latch, when screwing it into the threaded hole in the end of the rod, a small end section of the drainage tube is pinched between the end of the rod and the shoulders of the latch.

The disadvantage of this conductor is the unreliable fastening of the drainage tube in it, which in a certain situation can easily disconnect. Such a situation can occur, in particular, in operations on laboratory animals, when it is necessary to remove a catheter or probe (drainage analogs) from the abdominal cavity to a place inaccessible to the animal on its body, for example, to the interscapular or occipital region. (In the following, for convenience of presentation, we will use only the term “probe”, bearing in mind that the described relevant situations equally apply to catheters and to drainage tubes, since all three devices are small in technical essence The fundamental differences are mainly related to the functional purpose of each of these devices.) In the subcutaneous canal of great length, the probe is tightly compressed by the surrounding tissues and, as a result, its progress is inhibited. This makes possible the unauthorized release of the clamped end of the probe and the disconnection of the latter from the conductor. The slightest rotation (rotation) of the conductor relative to the probe can contribute to this, which will be accompanied by a partial unscrewing of the clamp and, accordingly, the release of the clamped end of the tube. Another disadvantage of the known conductor is due to the fact that its free end is pointed and there are several cutting edges on its lateral surface. This embodiment of the conductor can only be justified if it is used to conduct a drainage tube, for example, through the abdominal wall, the thickness of which, as a rule, does not exceed 3 cm. In a section of this length, the probability of damage to blood vessels with the pointed end and cutting edges of the conductor is relatively small. However, when a probe is passed through a subcutaneous tunnel several tens of centimeters long, a pointed conductor inevitably injures the blood vessels encountered in its path with subsequent bleeding.

Guide for catheters and probes according to the copyright certificate SU 214024, 06/12/1968 is considered by us as a prototype.

The technical result of the invention is to increase the reliability and reduce the invasiveness of the conductor.

The specified technical result is achieved due to the fact that in the known conductor for catheters and probes containing a rod, the front working end of which is made in the form of a stylet, and at the rear end coaxially with the rod, a tube with a rod-shaped retainer located inside is fixed, the rod has a working end in the form cone and made flexible, while the latch is rigidly mounted on the end of the rod, and the tube is removable and has the ability to abut the conical shoulder located on the rod. Behind the cone, a groove is made or two parallel flats for gripping and holding the conductor. The top of the cone is blunt, and the tube is screwed onto the rear end of the rod.

The invention is illustrated by drawings, where:

figure 1 presents a General view of the conductor with a local incision;

figure 2 is a section in the plane aa in figure 1;

figure 3 is the same, an embodiment of the device.

The conductor for catheters and probes consists of a rod 1 (figure 1), the front working end of which is made in the shape of a cone 2. The top of the cone may be slightly dulled. The rod itself has a relatively small diameter and has a certain flexibility, which makes it easy to give it the degree and shape of curvature congruent to the bends of the corresponding section of the body surface when laying the subcutaneous tunnel. At the end of the rear end of the rod, a non-removable rod-shaped retainer 3 is coaxially mounted (Fig. 1), on the surface of which several ring-shaped protrusions are made for better fixation of the probe 4. The tube (sleeve) 5 (Fig. 1) is screwed onto the rear end of the rod 1, which abuts into a cone-shaped collar made on the rod 6. At the front end of the rod, behind the cone 2, a circular groove 7 or two parallel flats 8 (Fig. 3) is made for gripping and holding the conductor reliably with a clamp.

As applied, for example, to a situation related to the installation of a probe in the small intestine of a dog being prepared for experiments, the corresponding manipulations using a guide are performed as follows. After installing the probe 4 in the small intestine, a tube (sleeve) is put on it 5. Then the free end of the probe is pulled over the rod-shaped clamp 3. For reliable fastening, the probe is additionally fixed using a ligature, individual turns of which are located between the ring-shaped protrusions on the surface of the clamp 3. Next, the rear end of the rod is screwed onto the tube 5, which covers the end portion of the probe 4, acting as a fairing.

Then the parietal peritoneum with the adjacent muscle layer is pierced with the free end of the conductor and the conductor is brought into the subcutaneous space. Under the skin, the conductor with the probe is advanced in the direction of the interscapular region, where the skin is cut with a scalpel at a given point and the front end of the conductor is brought out through the hole formed. With some rigid surgical clamp, the conductor is grasped in the area of the groove 7 and with it, the conductor with the probe is pulled out. After that, the tube 5 is screwed from the conductor, the ligature that fixes the probe is cut off, and then the latter is removed from the latch 3. This completes the work with the conductor.

The manufacture of the front end of the conductor in the shape of a cone and the absence of cutting elements (edges) on it allows avoiding injury to blood vessels that inevitably occur in the area of the formed tunnel. The used means of fixing the probe on the conductor guarantee a more reliable connection with each other than in the prototype device. The presence of a cowling tube at the end of the conductor facilitates the process of dragging the probe through the formed subcutaneous tunnel and makes the corresponding procedure less traumatic. Making the guide rod for catheters and probes moderately flexible allows you to lay long subcutaneous tunnels under the curved surface of the body. In the proposed conductor, in contrast to the prototype, there are no blind holes, which facilitates its cleaning.

Information sources

3. Goldberg VV Copyright certificate SU 322195, 11/08/1972.

4. Tsybarne K.A., Yakobzon I.A. Copyright certificate SU 214024, 06/12/1968.

Claims (3)

1. A guide for catheters and probes, containing a rod, the front working end of which is made in the form of a stylet, and at the rear end coaxially with the rod, a tube with a rod-shaped retainer located inside is fastened, characterized in that the rod has a cone-shaped working end and is flexible, while the latch is rigidly mounted on the end of the rod, and the tube is removable and has the ability to abut the cone-shaped collar, which is placed on the rod. 2. The conductor according to claim 1, characterized in that a groove or two parallel flats are made behind the cone for gripping and holding. 3. The conductor according to claim 1, characterized in that the top of the cone is blunt, and the tube is screwed onto the rear end of the rod.

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