RU2518139C2 - Device for endoscopic sanitation of bile ducts - Google Patents

Device for endoscopic sanitation of bile ducts Download PDF

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Publication number
RU2518139C2
RU2518139C2 RU2012114141/14A RU2012114141A RU2518139C2 RU 2518139 C2 RU2518139 C2 RU 2518139C2 RU 2012114141/14 A RU2012114141/14 A RU 2012114141/14A RU 2012114141 A RU2012114141 A RU 2012114141A RU 2518139 C2 RU2518139 C2 RU 2518139C2
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Russia
Prior art keywords
cylinder
aspiration
bile
bile ducts
endoscopic
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RU2012114141/14A
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Russian (ru)
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RU2012114141A (en
Inventor
Сергей Александрович Габриэль
Валентин Иванович Закусило
Виктор Юрьевич Дынько
Виктор Викторович Гольфанд
Владимир Станиславович Крушельницкий
Original Assignee
Сергей Александрович Габриэль
Валентин Иванович Закусило
Виктор Юрьевич Дынько
Виктор Викторович Гольфанд
Владимир Станиславович Крушельницкий
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Application filed by Сергей Александрович Габриэль, Валентин Иванович Закусило, Виктор Юрьевич Дынько, Виктор Викторович Гольфанд, Владимир Станиславович Крушельницкий filed Critical Сергей Александрович Габриэль
Priority to RU2012114141/14A priority Critical patent/RU2518139C2/en
Publication of RU2012114141A publication Critical patent/RU2012114141A/en
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Abstract

FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to endoscopic surgery, and may be used for endoscopic sanitation of bile ducts. A device for endoscopic sanitation of bile ducts comprises a catheter inserted into an endoscope for exudate (E) aspiration. The above catheter encloses a catheter for drug preparation (DP) delivery into a bile duct lumen. The catheters are connected to control handles. What is also provided is a cylinder used for DP delivery from a container into the bile duct lumen and coupled with a bracket arm regularly loaded for ensuring the DP pressure. There is also provided an aspiration cylinder coupled with a drive cylinder attached to a ruler with adjustable stops which impact a flatted valve lever and automatically switch the drug preparation delivery and aspiration. One flat connects pressurised water supply to the drive cylinder. The second one connects water drainage and releases the load on the DP cylinder and the ruler when the valve lever is in the other position. The drive cylinder, DP cylinder, E aspiration cylinder travel speeds are regulated by the valves. There are also provided valves for E delivery from the bile duct lumen and E delivery to the container.
EFFECT: invention provides automated endoscopic sanitation of the bile ducts by dispensing the drug preparations and exudate aspiration from the bile duct lumen; reduces the labour costs in treating patients with suppurative cholangitis by avoiding the medical personnel assistance of the sanitation procedure; controlled administration of the drug preparations enables avoiding a potential pressure increase in the biliary system followed by penetration of purulent bile elements into the circulatory bed (a biliovenous shunt) and as a consequence, developing common septic complications.
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Description

The invention relates to medicine, namely to endoscopic surgery, and can be used for debridement of the bile ducts in an endoscopic manner.

All diseases accompanied by a violation of the outflow of bile from the liver to the duodenum (duodenum) (calculus of the common bile duct, cicatricial narrowing, compression from the outside, tumor lesions, etc.) cause inflammatory changes in the wall of the bile ducts (cholangitis). Marked inflammatory changes in the wall of the bile ducts (purulent cholangitis) significantly aggravate the general condition of patients, causing a septic state in patients with the possible development and progression of multiple organ failure phenomena. At the same time, surgical interventions against the background of severe cholangitis significantly increase the percentage of complications, such as the failure of biliary anastomoses, the development of liver failure, septic conditions and associated fatal outcomes.

Currently, endoscopic interventions through the large duodenal nipple (BDS) of the duodenum (duodenum) are actively used in biliary surgery, and endoscopic decompression and debridement of the gall tree plays an important role in the treatment and preoperative preparation of patients.

As an analogue, you can take nazobiliary drainage (NDB) of COOK-medical company, presented in the catalog of the company on page 91 (or www.cookmedical.com). This device is a drainage tube 250 cm long, at the distal end of which there are side holes (5 or 9). This drainage tube using an endoscope is installed in the bile ducts above the site of obstruction. Due to the increased pressure in the bile ducts through the drainage tube, outflow of bile occurs. In addition, medications (antibiotics) can be periodically administered through the proximal end of the tube into the lumen of the bile ducts for local therapy of the inflammatory process. The introduction of these drugs is carried out manually, using a syringe. Moreover, this procedure takes some time from the medical staff, and most importantly, the doctor cannot control the pressure that is created in the bile ducts. Uncontrolled introduction of solutions into the lumen of the common bile duct increases the pressure in the biliary system and promotes the penetration of purulent bile into the bloodstream (biliary-venous shunt).

The task is to create a device that is installed using the endoscope into the bile ducts, and in an automated mode, without spending a lot of time on the medical staff, controlling the pressure in the bile ducts, reorganizes the bile ducts through dosed administration of drugs (LP) and excretion (E ) from the lumen of the bile ducts.

The essence of the proposed device consists in the following: a catheter installed in an endoscope designed to aspirate exudate (E), which contains a catheter for delivering drugs (PL) into the lumen of the bile ducts, catheters are connected to the control handles, and a cylinder for supplying PL from the reservoir to lumen of the bile ducts associated with an arm equipped with an adjustable weight, to ensure LP pressure, an aspiration cylinder is connected to the drive cylinder, connected to a ruler equipped with a reg adjustable stops, which, acting on the lever of the tap with flats, carry out automatic switching of the supply of drugs and aspiration, for which one flat connecting the supply of pressurized water to the drive cylinder, and the second with a different position of the tap lever connecting the water drain, freeing the load on the LP cylinder and the ruler, and the movement speeds of the drive cylinder, LP cylinder, aspiration cylinder E are regulated by cranes, valves for the intake of E from the lumen of the bile ducts and the supply of E to the container are provided.

The device will provide:

- endoscopic automated debridement of the bile ducts by dosing of drugs into the lumen of the bile ducts at a controlled stable pressure and aspiration of exudate from the bile ducts,

- reduce labor costs in the treatment of patients with purulent cholangitis by eliminating the need for medical personnel to participate in the rehabilitation of the bile ducts,

- due to the controlled administration of drugs, the possibility of increasing pressure in the biliary system is excluded, which causes the penetration of purulent bile elements into the bloodstream (biliary-venous shunt) and, as a result, the development of general purulent-septic complications.

The design of the device shown in figure 1, figure 2.

Figure 1 - General view of the device

Figure 2 - lock position of the crane automatically switch the supply of LR and outlet E.

Capacity for LP - 1, cylinder - 2 LP feeds, adjustable load - 3 bracket - 4 drive cylinders - 5, exudate drain cylinder - 6, pressurized water tap - 7, adjustable stops - 8 and 9, cylinder stroke - 2 and the volume of the delivered medicinal product in one move, the line - 10 with adjustable stops 8 and 9, the capacity - 11 for E, the tap for regulating the supply speed of the medicinal product - 12, the valve for supplying the medicinal product - 13 from the tank 11, the supply valve for the medicinal product - 14 to the catheter - 18 from cylinder - 2, valve for regulating the speed of aspiration E - 15, cylinder - 6 from the lumen of the common bile duct - 21 with the place of obstruction - 35, valve - 16 of the intake of E in the tank t - 11, valve - 17 of the intake of E into the cylinder - 6, catheter - 19, performing the reorganization of the lumen of the common bile duct - 21, endoscope - 20, stem - 22, connected to the catheter - 18, having a handle - 23, the body - 24 securing the catheter - 19 with a catheter control handle - 25, a duodenum - 26, a place for supplying water with pressure - 27, a place for water discharge - 28, a crane - 29 for controlling the operation of the drive cylinder - 5, a lever - 36 cranes - 29, a flat - 30 cranes 29 for supply water to the cylinder - 5 flats - 31 draining water from the cylinder - 5, lock - 32 positions of the crane - 29, recesses 33 and 34 for fixing the position of the crane - 29 fix rum - 32, water draining place - 28, the handle - 37 for turning on and off supply water under pressure through the tap - 29 to the drive cylinder - 5, area obstruction - 35 in the lumen of bile duct - 21.

The operation of the device is as follows.

A catheter - 19 with a catheter located inside it - 18 is inserted into the endoscope - 20. By means of an endoscope, a catheter - 19, attached to the body - 24 with a control handle - 25, is inserted through the duodenum - 26 into the lumen of the bile ducts - 21 above the level of obstruction - 35 Inside, located in the catheter - 19, the catheter - 18, fixed to the rod - 22 with a handle - 23, is installed in the lumen of the bile ducts - 21. With the handle - 37, the crane - 29 is installed in the flat position - 30 and with the lock - 32 recesses - 33 on the tap - 29. Turns on by the tap - 7 water supply s, under pressure, from the point of supply - 27 through the flats - 30 to the drive cylinder - 5. Cylinder - 5 moves up the ruler - 10 with stops - 8 and 9, together with the bracket - 4 and adjustable for pressure in the cylinder - 2 load - 3. At the same time, by moving the cylinder - 2, the drug solution from the container - 1 through the valve - 13 enters the cylinder - 2. At the same time moving the cylinder - 5 by means of the cylinder - 6, the exudate is removed from the site of the disease - 21 through the catheter - 19 valve - 17 and the valve - 15, regulating the speed of removal of exudate. When moving the cylinder - 5 rulers - 10 adjustable emphasis - 8, acting on the lever - 36 of the crane - 29, turns the valve - 29 to the flat position - 31. Water from the cylinder - 5 flows through the outlet - 28. The load - 3 moves the bracket - 4 down, cylinder - 2 delivers drugs into the lumen of the bile ducts - 21 through the valve - 14, valve - 12 and catheter - 18. Simultaneously by moving the ruler - 10, the adjustable stop - 9, acting on the lever - 36, switches the valve - 29 to position risks - 30. The latch - 32 secures the tap - 29 recess - 33. Water from the point of supply - 27 through the flats - 30 is supplied to the drive cylinder - 5, automatic work is performed on aspiration of exudate from the bile ducts - 21. The operation of the device is repeated. The operation of the device is turned off by a crane - 7.

Claims (1)

  1. A device for endoscopic debridement of the bile ducts contains a catheter installed in an endoscope designed to aspirate exudate (E), which contains a catheter for delivering drugs (PL) into the lumen of the bile ducts, catheters are connected to the control handles, a cylinder for supplying PL from the reservoir to lumen of the bile ducts associated with an arm equipped with an adjustable weight to provide for LP pressure; an aspiration cylinder is connected to the drive cylinder, connected to the ruler, It is equipped with adjustable stops, which, acting on the lever of the tap with flats, carry out automatic switching of the drug supply and aspiration, while one flat connects the supply of pressurized water to the drive cylinder, and the second, with a different position of the tap lever, connects the water drain, releasing the action load on the LP cylinder and the ruler, and the movement speeds of the drive cylinder, LP cylinder, aspiration cylinder E are regulated by cranes, valves for the entry of E from the bile duct lumen and supply of E to the container are provided.
RU2012114141/14A 2012-04-10 2012-04-10 Device for endoscopic sanitation of bile ducts RU2518139C2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
RU2012114141/14A RU2518139C2 (en) 2012-04-10 2012-04-10 Device for endoscopic sanitation of bile ducts

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Application Number Priority Date Filing Date Title
RU2012114141/14A RU2518139C2 (en) 2012-04-10 2012-04-10 Device for endoscopic sanitation of bile ducts

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RU2012114141A RU2012114141A (en) 2013-10-20
RU2518139C2 true RU2518139C2 (en) 2014-06-10

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5273534A (en) * 1992-02-27 1993-12-28 Knoepfler Dennis J Laparoscopic T-tube, drain and securing instrument and method therefor
RU32394U1 (en) * 2003-01-14 2003-09-20 Юрченко Владимир Владимирович Nazobiliarny drainage
US6770066B1 (en) * 1992-05-11 2004-08-03 Ballard Medical Products Multi-lumen endoscopic catheter
RU60864U1 (en) * 2006-06-13 2007-02-10 Государственное образовательное учреждение высшего профессионального образования "Санкт-Петербургская государственная медицинская академия им. И.И. Мечникова Федерального агентства по здравоохранению и социальному развитию" Catheter externally-internal drainage biliary tracts
RU84711U1 (en) * 2008-10-30 2009-07-20 Государственное образовательное учреждение высшего профессионального образования "Белгородский государственный университет" Nazobiliarny catheter drainage
RU2408308C1 (en) * 2009-04-13 2011-01-10 Николай Николаевич Карякин Device for endoscopic catheterisation of deformed duct structures

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5273534A (en) * 1992-02-27 1993-12-28 Knoepfler Dennis J Laparoscopic T-tube, drain and securing instrument and method therefor
US6770066B1 (en) * 1992-05-11 2004-08-03 Ballard Medical Products Multi-lumen endoscopic catheter
RU32394U1 (en) * 2003-01-14 2003-09-20 Юрченко Владимир Владимирович Nazobiliarny drainage
RU60864U1 (en) * 2006-06-13 2007-02-10 Государственное образовательное учреждение высшего профессионального образования "Санкт-Петербургская государственная медицинская академия им. И.И. Мечникова Федерального агентства по здравоохранению и социальному развитию" Catheter externally-internal drainage biliary tracts
RU84711U1 (en) * 2008-10-30 2009-07-20 Государственное образовательное учреждение высшего профессионального образования "Белгородский государственный университет" Nazobiliarny catheter drainage
RU2408308C1 (en) * 2009-04-13 2011-01-10 Николай Николаевич Карякин Device for endoscopic catheterisation of deformed duct structures

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HE9A Changing address for correspondence with an applicant
FZ9A Application not withdrawn (correction of the notice of withdrawal)

Effective date: 20140123

MM4A The patent is invalid due to non-payment of fees

Effective date: 20140628