RU2542370C2 - Abdominal monitor - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to disposable surgical instruments and can be used as a trocar. A disposable device consists of a kit (a port, a mandrin, a T-connector, a drain tube and sealing covers), which is assembled in specific combinations to perform various manipulations for monitoring a pathological process in the abdominal cavity through the presented device without a repeated laparocentesis. The kit parts are hermetically coupled. An inner surface of a port nozzle has fittings to shape the inner surface of the nozzle wavily to reduce friction. The port is made of an elastic polymer material, while the mandrin is made of a polymer material. The T-connector is made of a rigid polymer and has a branch pipe to form a pneumoperitoneum. A laparoscope or an elastic drain tube can be inserted through the T-connector and port to monitor the pathological process in the abdominal cavity and to perform low-invasive interventions without the repeated laparocentesis.

EFFECT: dynamic monitoring of the abdominal cavity, excluding the negative effect on the body tissues and combining the principles of a searching catheter, laparoscopy, dynamic laparoscopy and passive drainage.

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Description

The invention relates to medical equipment, namely to surgical instruments, the so-called disposable trocars.

Known designs of metal trocars used in hospitals.

Known trocar (patent RU 2187266 C2, class A61B 17/34, 2002), which is a metal port, inside of which is a removable valve mechanism with the original seal. The main disadvantage of this trocar is a complex and rigid design, the need for multiple sterilization.

A sleeve trocar (US Pat. No. 6,945,983 B2, class A61B 17/34, 2005) with a variable insulated passage is a device that relates to sleeve trocars that seal the opening of an endoscopic instrument into the sleeve. The disadvantage of this trocar design is its complexity and rigidity, the need for multiple sterilization.

The trocar (patent RU 2212198 C1, class A61B 17/34, 2003) has a port with a tube and a hinged lid. The joint arrangement of the tube and the cover make up the flap type valve device. The main disadvantage of this trocar design is the large number of parts and the presence of a metal port, as well as the need to perform additional manipulations by the surgeon during the operation.

The trocar (patent RU 2212199 C1, class A61B 17/34, 2006) has a metal port with a plastic tube and a cover made of elastic rubber with a flap valve. The valve petal is located at an angle of 45 ° to the central tube. After removing the instrument from the trocar, the valve should return to its original position and press firmly against the end of the tube under the influence of excess pressure in the abdominal cavity. This is a fairly simple and convenient design. However, a small excess pressure in the abdominal cavity is not enough to press the petal to the tube due to the large inertia of the rubber when returning to its original position. In addition, the metal part of the port does not exclude the risk of injury to internal organs, and repeated use of it can lead to accidental transmission of infection.

Disposable trocar drainage (patent RU 2310407 C1, class A61B 17/34, 2006) can be adopted as a prototype.

On the wall of the outer part of the port pipe, a local ring thinning is made in the form of a belt, the length of which approximately corresponds to the anatomical size of the surgeons' fingers or 2-3 calibers of the pipe, which ensures reliable tightness by pinching this belt with fingers or a tool.

The port is made of elastic polymer material, which allows the trocar to stay in the abdominal cavity for a long time without the risk of developing pressure sores of organs, monitor the pathological process in the abdominal cavity through the trocar without repeated laparocentesis.

The stylet is made of rigid polymeric material, and the diameter of the stylet shaft is approximately equal to the diameter of the pipe channel. A stopper is movably fixed on the flange of the endoscopic port, which closes the internal hole, thereby ensuring the tightness of the cavity between surgical procedures.

Replacing the plug with a fitting allows for dynamic endoscopy and sanitation of the abdominal cavity.

The objective of the proposed device is to create a disposable device for monitoring the abdominal cavity, which will allow you to combine the principles of "scaffolding catheter", laparoscopy, dynamic laparoscopy, drainage of the abdominal cavity. The device uses materials that exclude the negative effects of exposure to patient tissue (the formation of pressure sores and intestinal fistulas) of rigid devices that are not available in the proposed product.

The solution of the tasks is provided by the fact that:

- the device consists of a set of parts (port, stylet, fitting, drainage tube and sealing covers), which in certain combinations allow you to perform various types of manipulations monitoring the pathological process in the abdominal cavity through the proposed device without repeated laparocentesis;

- the port is made in the form of a pipe with a channel for introducing a tool divided by a flange into the intracavitary part and the handle;

- the inner surface of the port pipe has metal or plastic reinforcement in the form of a spiral spring to maintain the size of the inner diameter and its concentricity while maintaining the flexibility of the pipe, as well as to form a wavy surface of the pipe of the intracavitary part of the device to reduce friction;

- the stylet is made of hard polymer material;

- on the flange of the endoscopic port, a plug is movably fixed, which closes the internal hole, thereby ensuring the tightness of the cavity between surgical procedures;

- replacing the cork with a tee with a cylindrical outer surface and a lateral branch allows you to create pneumoperitoneum in the abdominal cavity and carry out not only laparoscopy, but also dynamic laparoscopy, and sanitation of the abdominal cavity;

- there is a drainage tube;

- there are sealing rings.

The proposed trocar retains the advantages of the prototype and has the following differences:

- the device consists of a set of parts (port, stylet, tee, drainage tube and sealing rings), which in certain combinations allow various types of manipulations to monitor the pathological process in the abdominal cavity through the proposed device without repeated laparocentesis and are connected tightly by an annular groove on the outer surface and the corresponding flange on the inner surface of the parts.

These differences allow you to:

- monitor the pathological process in the abdominal cavity by introducing a drainage tube through the tee and port using the “catheter catheter” technique, or by introducing a laparoscope to perform laparoscopy or dynamic laparoscopy, as well as performing surgical operations without repeated laparocentesis.

- to carry out a long stay of the laparoscopic port in the abdominal cavity;

- simplify the use of trocars;

- use the device once.

The invention is illustrated by drawings.

Figure 1 presents the main view of the trocar assembly with the details: "Port", "Stiletto", "Sealing cover" and "Cork".

Figure 2 presents a detail of the device "Port" in diametrical section with the detail "Cork".

Figure 3 presents the detail "Stylet".

Figure 4 presents the diametrical section of the "Port", explaining the use of "Tee", "O-ring" and "Drain pipe".

The device consists of port 2, stylet 10, tee 14, drain pipe 17, sealing ring 15 and plug 7.

Port 2, made in the form of an elastic polymer pipe with a channel 3, for holding a tool divided by a flange 5 into an intracavitary 4 and an external (handle) 6 part. The inner surface of the port pipe has a metal or plastic reinforcement 1 in the form of a spiral spring. On the wall of the outer part of the pipe, a local ring thinning is made in the form of a belt 13, the length of which approximately corresponds to the anatomical sizes of the surgeons' fingers or 2-3 calibers of the pipe. The belt 13 is clamped by hand or tool to ensure tightness. At the end of the outer part (or handle) there is an annular groove 22 for tight and detachable connection with the flange 21 of the cover 20. A plug 7 is movably fixed on port 2, which is installed in the inner hole of port 2 to ensure long tightness between manipulations.

The stylet 10 is made in the form of a rod 11, bounded at one end by a tip 9 with a tip 8, and from the other end by a handle 12. The diameter of the rod 11 of the stylet 10 is approximately equal to the diameter of the channel 3 of the pipe.

The trocar is used as follows.

During laparoscopy, port 2 with a sealing cap 20 is installed on the stylet 10 and fixed on it. At the injection site of the trocar, a small incision is made on the skin. After insertion of the tube into the abdominal cavity, the stylet is removed. Before the final removal of the stylet 10, port 2 is pinched by the belt 13. After removing the stylet 10, the plug 7 is inserted and the clamped belt 13 is released. Port 2 is fixed to the skin with a ligature thread behind flange 5 and is left in the abdominal cavity.

Through the port, you can enter a laparoscope or other necessary instrument. First, the girdle 13 is pinched, the plug 7 is removed, a tee 14 is installed, having a cylindrical outer surface, with a clamped elastic tube 19 on the lateral branch 18. A sealing ring 15 with a collar 24 is installed on the tee 14 for a tight and detachable connection with the cavity 23 of the tee 14, is inserted the laparoscope and the clamped girdle 13 are released. The tube 19 is squeezed out and pneumopiretoneum is applied. After laparoscopic surgery, port 2 is not removed if necessary. Tee 14 is removed and port 2 is closed by plug 7, thereby creating a seal.

To perform the “catheter catheter” or drainage technique, the girdle 13 is pinched, the plug 7 is removed, a tee 14 is installed with an o-ring 15 installed on it, through which the drainage tube 17 is passed. The girdle 13 is squeezed out and the drainage tube 17 is carried out to the required length. The removal of the drainage tube 17 and the tee 14 occurs in the reverse order with pinch and release of the girdle 13 to ensure tightness.

Claims (1)

A device for monitoring the abdominal cavity, containing a port in the form of a nozzle with a channel for introducing an instrument divided by a flange into the intracavitary part and the handle, characterized in that it is equipped with a tee with a cylindrical outer surface having a central circular hole with a side outlet and a lid having a central hole with a sealing cuff, while on the handle there is a landing hole for a tight and detachable connection with a tee, moreover, on the outer surface of the tee and handle rotating arm groove for sealing releasable connection with flange lid, and the inner part of the port is provided with a metal or plastic reinforcement in the form of a helical spring which generates undulating inner surface intracavitary nozzle of the device.

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