RU2284771C1 - Instrument for extracting concrements out of tubular organs - Google Patents

Abstract

FIELD: endoscope surgical instruments.

SUBSTANCE: instrument can be used for extracting concrements of gall-bladder duct. Conductor has radial rectangular curve. Instrument has tubular case inside which case the conductor is disposed. Conductor has handle at one end and gripping basket at the other one. Conductor is made in form of spring, lamellar and it is connected with basket, made of ropes, through connector. Basket is made in form of spoon, front part of basket is provided with tip. Ropes are made for extension and for formation of bag. Instrument is under full control of surgeon and it does not cause any trauma.

EFFECT: improved reliability; reduced time for concrement extraction.

2 cl, 2 dwg

Description

The invention relates to medicine, namely to endosurgical instruments, and is intended for the extraction of stones (calculi) from tubular organs, and in this case from choledochus (common bile duct).

Various exciting tongs are known, both rigid and flexible with two, as well as three and four branches, however, they are not suitable for grabbing and removing stones from tubular organs and cannot provide a grip for stone to be extracted from the bile duct due to the impossibility of holding jaws under a stone in a tubular organ.

A well-known tool for extracting stones with a basket grip, which we took as a prototype according to the Catalog of 2004, "Medfarmservis" equipment, Equipment for minimally invasive surgery. Page 46, and also according to the catalog of 2001, “Axiom” forms, pages 22-23.

The basket of this tool is formed by three or more cables, and has the shape of a "flashlight", and its movement is carried out by a flexible cable or plastic conductor.

The disadvantage of this tool is the lack of oriented control of the basket grip, since the cable cannot provide this, while the input and promotion of the basket along the duct, which has the form of a "flashlight", occupying the entire cross section of the duct, in this case does not provide guaranteed capture of the stone and does not exclude instead of capturing, it is stragging and pushing along the duct, which is extremely dangerous and can lead to serious complications. This is two interrelated shortcomings of the tool, the cable-conductor cannot provide oriented control of the basket, and for this reason it can only have a circular “flashlight” shape, which does not provide guaranteed grip of the stone, makes this procedure time-consuming and can be carried out only through the flexible channel of the endoscope .

The proposed tool does not have these drawbacks. Work with him can be carried out both with an endoscope and without it. The basket of the spoon-shaped form due to the semi-rigid plate conductor is absolutely controllable, and the shape of its front part-tip simplifies its confident submission under the stone to grab it, and more importantly, when removing the stone, the cables of the spoon-like basket are stretched and form a "bag", since the upper the lateral cables of the spoon-shaped basket, stretching, overlap the stone from above, and it is in the “bag” and is reliably removed, since the greater the pulling force, the greater the force of its grip around the spoon baskets.

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

A tool comprising a tubular body and a rod with a handle located therein is equipped with a plate spring conductor with a radial rectangular bend connected via an adapter to a basket of cables having a spoon-shaped shape with a front part-tip located below the axis of the tool. The presence of a plate spring conductor with a radial rectangular bend ensures its retraction and extension from the tubular body, allowing you to quickly and confidently enter the spoon-shaped basket connected to it through the adapter into the choledochus, bringing it with a tip under the stone and then removing it from the choledochus.

Such a tool is completely controllable by the surgeon, atraumatic, reliable in operation and simplifies and shortens the procedure for stone extraction as much as possible.

Figure 1 shows a General view of the tool and the shape of the tip in the form of "A".

Figure 2 shows a view of a basket of a spoon-shaped form for stone extraction with a section view along AA.

The tool of FIG. 1 consists of a tubular body 1, 325 mm long and 5 mm in diameter, at one end of which there is a nut 2 with a sealing washer 3, and the other end is open. Inside the tubular housing 1 there is a rod 4 with a handle 5 at one end, its other end is connected to a spring plate conductor 6 having a radial, rectangular bend and through an adapter 7 connected to a basket of spoon-shaped form 8, formed by seven cables with a front part-tip 9.

Work tool is as follows. A spoon-shaped basket 8 with a handle 5 and a rod 4 with a conductor 6 and an adapter 7 is retracted into the tubular body 1 and in this position is inserted into the patient’s abdominal cavity through a trocar, after which the basket 8 is pulled out of the tubular body 1 and introduced into the choledoch through the prepared incision. Then the basket 8 with the tip 9 is held under the stone so that the stone is in the basket 8 of a spoon-like shape, after which by pulling the rod 4 with the conductor 6, the adapter 7, the basket 8 with the stone is removed from the common bile duct, and then through the trocar and from the abdomen.

After performing all surgical operations, the instruments are removed and the wounds sutured.

Claims (2)

1. A tool for extracting stones from tubular organs, consisting of a tubular body, inside which there is a conductor with a handle at one end and an exciting basket at the other, characterized in that the conductor is spring, plate with a radius, rectangular bend and connected through an adapter to the basket of cables having a spoon-shaped shape with the front part - the tip, while the cables are made with the possibility of tension and the formation of a bag. 2. The tool according to claim 1, characterized in that the tubular body has a length of 325 mm and a diameter of 5 mm, with a nut with a sealing washer installed at one end of the case, and the other end open.

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