RU2465849C2 - Shaver - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to surgical cutting instruments, and may be used in otorhinolaryngology. A shaver comprises an Archimedean screw rigidly connected with a piston rod for coupling with a motor and integrated inside a tube. The tube has diametrical slots in a side wall of an open working end and an extension socket for connecting with a vacuum aspirator on the opposite end. The slots in the side wall of the tube are provided for introducing a bony frame. A working end of the Archimedean screw is provided with a flat slotted rectangular plate. The slot width of the plate is equal to the slot width in the side wall of the tube.

EFFECT: effective nasal breathing management by removal of greater massifs of bony tissue of inferior nasal concha and adjoining soft tissues with no mucosal damages.

2 dwg

Description

The invention relates to medicine and can be used in otorhinolaryngology.

Known devices for removing soft tissues (polyps, hypertrophied parts of the nasal concha) - various designs of scissors, polyp loops. A variant of a polyp loop is a galvanic loop. For the destruction of soft tissues, various types of physical effects are used - laser radiation, cryotherapy, galvanocaustic [Magomedov MM, Palchun VT, Luchikhin LA Otorhinolaryngology: Textbook for medical schools. - Medicine, 2002; Mueller V. The Surgical Armamentarium for Oto-Rhino-Larynology // Div. of American Hospital Supply Corp .. - 1974]. All of the above devices remove soft tissue, which leads to an expansion of the lumen of the cavity, however, the mucous membrane is inevitably removed. The mucosal defect is often of considerable size (for example, after conchotomy) is replaced by scar tissue, which ultimately leads to atrophic processes in the nasal cavity. The atrophic process is accompanied by the appearance of a large number of crusts, viscous mucus, a feeling of dryness in the nasal cavity. The presence of crusts complicates nasal breathing and worsens the sense of smell. Radiofrequency and ultrasound effects produced by submucosa allow avoiding excessive trauma to the mucous membrane, however, the volume of tissues exposed to the above-mentioned effect is reduced slightly, which does not lead to a significant improvement in nasal breathing [Piskunov G.Z., Piskunov S.Z. Clinical rhinology. - Medical News Agency, 2006].

Closest to the proposed device is a shaver or microdebrider [The Next Generation is Here-Introducing Hummer 2 ENT Micro Debrider // ENT Ear Nose & Throat Journal. - 1996. - vol. 75, pages 1-2], which is a device consisting of two tubes with blind ends, one of which is located concentrically inside the other tube and is driven by an electric motor. Both tubes at the working end on each side have windows equipped with cutting edges, and the inner tube is connected to a source of negative pressure. When the device is operating, the tissue to be removed is cut off by an internal rotating tube and aspirated from the inner tube using a negative pressure source. A shaver can be inserted submucosally into the thickness of the nasal concha and it is possible to remove a certain volume of tissue without violating the integrity of the mucous membrane. The disadvantage of the described device is the inability to remove bone tissue, for example, part of the bone skeleton of the lower nasal concha with its bone hyperplasia. In such cases, the said shaver is ineffective, and the removal of a small amount of soft tissue does not lead to a noticeable improvement in nasal breathing.

For the first time, the authors propose a shaver consisting of a tube with an open working end and diametrically opposite slots on the working end, equipped with a handle for holding and a pipe for attaching a vacuum aspirator, inside which there is an Archimedean screw, equipped on the working end with a flat plate with a slot equal in width slots in the outer tube; and at the other end, a smooth stem for connecting to an external motor. A shaver of this design is devoid of these drawbacks and is intended to remove the bony skeleton of the nasal concha, mainly the lower and adjacent soft tissues of the concha.

Shaver is shown in figures 1 and 2, where

1 - outer tube

2 - archimedean screw

3 - plate

4 - slot in the plate

5 - slots on the working end of the tube

6 - an epiploon

7 - rod of the Archimedean screw for connecting the engine

8 - pipe for vacuum aspirator

9 - shaver handle

The shaver consists of a tube 1, inside which the Archimedean screw 2 rotates. The working end of the tube 1 is open and has diametrically opposite slots 5. The working end of the Archimedean screw has a flat plate 3 provided with a slot, the width of which is equal to the width of the slot 5 on the tube, located from each other at a distance of 4 equal to the width of the slot 5 on the tube 1, on the opposite side of the Archimedes screw 2 has a smooth rod 7, which connects to the engine of the Archimedes screw. The engine of the Archimedean screw can have an electric or muscular drive. A pipe 8 is attached to the tube 1 at the end opposite the worker, which serves to connect to a negative pressure source (vacuum aspirator). Maintaining negative pressure is provided by the gland 6 or the exact fit of the corresponding node. The shaver has a handle 9 for holding in the hand when working with a tool.

The device is used as follows. Under local anesthesia or under anesthesia, an incision is made in the mucous membrane and submucosal layer in the region of the anterior end of the lower nasal concha to its bony skeleton. The working end of the shaver (tube 1) is inserted into the formed incision in such a way that the front end of the bone skeleton is inserted into the slots 4 and 5, and then the engine is turned on. Rotating Archimedean screw 2 by plate 3 destroys the bone skeleton of the lower nasal concha and adjacent soft tissues that fall into the slot 5 and into the slot 4 in the plate 3. The rotation of the Archimedean screw leads the removed tissues to the opposite working end of the tube 1, then they are removed through the pipe 8 due to the negative pressure created by a vacuum aspirator attached to the pipe 8.

The proposed design of the shaver allows you to remove large arrays of bone tissue, for example, the base of the lower nasal concha, as well as to remove adjacent soft tissues without significant damage to the mucous membrane, which allows more effective surgical interventions on the nasal cavity.

Claims (1)

A shaver containing an Archimedean screw, which is rigidly connected to the rod for attachment to the driving motor and located inside a tube having diametrically opposite slots in the side wall of the open working end and a pipe for connecting to a vacuum aspirator at the opposite end, characterized in that it is diametrically opposite slots are made to enter the bone skeleton, and the working end of the Archimedean screw is provided with a flat rectangular plate with a slot, the width of which is equal to the width of the slots in b the shackle of the tube.

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