RU2589616C1 - Device for endoscopy - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: device for endoscopy, including housing with proximal and distal parts and control stick. Endoscope is equipped with thermoplastic jacket, which length of corresponds to length of endoscope input part. Distal end of cover has ring from thermoplastic. Inner diameter of ring is equal to diameter of endoscope housing. Width and height of rings are equal to, respectively, width and depth of U-shaped recess made on distal end of endoscope housing. Distance from ledge and recess form, respectively, distal end of cover and distal end of housing are equal. Cover has metal-coated thread on inner surface extending beyond proximal end of cover and provided with clamp on proximal end of thread.

EFFECT: using given invention allows to save time for cleaning of endoscope, and reducing consumption of toxic disinfectant, to protect endoscope working surface against action of corrosive medium and disinfectant action.

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Description

The invention relates to medicine, namely to gastroenterology, and can be used as a device for conducting endoscopy.

A known endoscope containing flexible proximal and working parts interconnected by a rigid part (1 - RF application No. 2006143516, 2006). This device is taken as an analog.

A known endoscope having a proximal and distal parts connected by a flexible tube with fiberglass, and a control handle; the distal end section of the endoscope is placed in the cavity of the internal organ and moved along the inner wall to the test site (2 - RF patent No. 93002331, 1995). This device is taken as a prototype.

Traditionally, the use of an endoscope includes its cleaning (functional sterilization of the endoscope), which takes considerable time, time-consuming and entails material costs. The aggressive effect of disinfectants on the working surface of the endoscope leads to premature failure of expensive equipment.

The aim of the invention is to increase operational reliability.

The technical result is achieved by the fact that the endoscope is equipped with a thermoplastic cover, the length of which corresponds to the length of the input part of the endoscope, the distal end of the cover has a thermoplastic ring, the inner diameter of the ring is equal to the diameter of the endoscope body, and the width and height of the ring are, respectively, the width and depth of the U-shaped the recesses made at the distal end of the endoscope body, the protrusion distance and the recesses from, respectively, the distal end of the cover and the distal end of the body are equal, the cover has an inner surface A metallic thread protruding beyond the proximal end of the sheath and provided with a grip at the proximal end of the thread.

For treatment, an endoscopy device is used.

The device contains an endoscope with a body 1, placed in a plastic case 2, equipped with a metallized thread 3 located inside the case. Moreover, there is a ring 5 at the distal end 4 of the case 2, and a ring-shaped recess 7 of a U-shape is made at the distal end 6 of the case 1. The inner diameter of the ring 5 is equal to the diameter of the housing 1 of the endoscope, and the width and height of the protrusion 5 are equal, respectively, to the width and depth of the U-shaped recess 7 made at the distal end 6 of the housing 1, the distance of the ring 5 and the recess 7 from, respectively, the distal end 4 cover and the distal end 6 of the housing 1 are equal. The metallized thread 3 by 3-5 cm protrudes beyond the proximal end 8 of the cover 2 and is equipped with a gripper 9. located on the proximal end 9 of the thread 3.

The device is assembled as follows. The endoscope body 1 is placed in a cover 2, which is equipped with a thread 3 fixed to the distal end 4 of the cover 2. A ring 5 is put on the cover 2, moving it to the distal end 4 of the housing 1 to the level of the recess 7 of the housing 1. The housing 1 is heat treated with a cover 2 and a ring 8, achieving heat shrinkage of the cover 2 on the housing 1 of the endoscope. In this case, thermoplastic deformation also occurs of the ring 5 of the case 2, the ring 5 crushes the case 2, filling the annular recess 7 of the body 1 of the endoscope and fixing the case 2 on the body 1 of the endoscope. Picking up the proximal end 8 of the cover 2, achieving its tightness.

Apply the device for endoscopy as follows. After assembly and heat treatment, an endoscope assembly with a cover is inserted into the stomach cavity for visual inspection of the gastric mucosa and the distal duodenum.

The device operates as follows.

The patient was admitted for an in-depth study about a polyposis of the stomach detected during gastroduodenoscopy. Pallor of the skin, sometimes a change in the color of feces, is noted.

Apply a device for endoscopy. After assembly and heat treatment of the device, an endoscope assembly with a cover is inserted into the stomach cavity for visual inspection of the gastric mucosa and the distal duodenum.

The patient is preliminarily treated with the root of the tongue and pharynx with a solution of lidocaine. An endoscope is passed through the esophagus into the pyloric stomach. An endoscopic examination of the stomach reveals a large 1.5 cm single polyp in the pyloric stomach. Through the optical channel, the endoscope is accurately brought to the polyp. The loop for electrocoagulation is brought to the leg of the polyp. Carry out an electroexcision of a polyp. The separated polyp body is removed, thorough hemostasis is performed.

Remove the endoscope from the body. After an endoscopic examination, fragments of mucus and biological fluids are removed mechanically from the surface of the cover 2 of the endoscope. After that, using the gripper 9, the thread 3 is pulled and an inside cut is made along the length of the cover 2 and the ring 5. The cut cover 2 is removed from the body 1. The working surface of the endoscope remains biologically sterile. Used case 2 with thread 3 disposing of.

1 hour after the endoscopy, the patient is prescribed an anti-inflammatory drug in a standard dosage; therapy is carried out for 5 days.

Control endoscopic examination after 10 days does not reveal ulceration after electroexcision of the polyp.

Example 1

Patient K., 26 years old, was admitted with complaints of heartburn, periodic pain behind the sternum, tendency to constipation.

From the anamnesis it is known that about 4 years ago, erosive esophagitis and a hiatal hernia were revealed.

Upon receipt, the condition is satisfactory. The physique is normosthenic. The skin is of normal color. Peripheral lymph nodes are not enlarged. The vesicular breathing, no wheezing. Heart sounds are sonorous, rhythmic, blood pressure 130/80 mm Hg Heart rate - 70. The tongue is covered with a white coating, the abdomen is soft, symmetrical, pain on palpation in the epigastrium.

An X-ray examination confirmed the presence of a hiatal hernia.

A device for endoscopy is used, and the ratio is: 1.1-1.15 (D + h) = 0.5-0.75 N, where D is the diameter of the thread without coating, h is the height of the coating, N is the thickness of the cover. After assembly and heat treatment of the device, an endoscope assembly with a cover is inserted into the stomach cavity for visual inspection of the gastric mucosa and the distal duodenum. The patient is preliminarily treated with the root of the tongue and pharynx with a solution of lidocaine.

An endoscopic examination reveals edema and hyperemia of the mucosa of the lower third of the esophagus; the cardia gapes. The mucous membrane of the stomach is pink, swollen, sometimes hyperemic, sometimes thinned. The folds are medium sized, elastic. Active peristalsis. The angle of the stomach is not changed. Conclusion - erosive esophagitis, cardia failure, chronic gastritis, hiatal hernia. A morphological study of a biopsy of the mucous membrane of the esophagus reveals the presence of mature granulation and necrotic tissue, infiltrated by decaying white blood cells.

Remove the endoscope from the body. After an endoscopic examination, fragments of mucus and biological fluids are removed mechanically from the surface of the cover 2 of the endoscope. After that, using the gripper 9, the thread 3 is pulled and an inside cut is made along the length of the cover 2 and the ring 5. The cut cover 2 is removed from the body 1. The working surface of the endoscope remains biologically sterile. Used case 2 with thread 3 is disposed of.

1 hour after the endoscopy, the patient is prescribed an anti-inflammatory drug in a standard dosage; therapy is carried out for 5 days.

Daily monitoring of pH in the esophagus reveals the presence of acid reflux in an amount of 60 per day.

In the study of the electromotor activity of the stomach, the frequency of slow waves of EMA is 12.5 per min, which is twice the norm and the amplitude is 0.35 mV, which is 94% higher than the norm.

Treatment was carried out, including diet therapy, the exclusion of fatty, fried foods, hot and cold foods, carbonated drinks and alcohol, coffee, chocolate. It is recommended to sleep with a raised head end, to exclude taking medications that inhibit the motility of the esophagus (anticholinergics, theophylline, nitrates) and drugs that have a damaging effect on the mucous membrane of the esophagus.

The treatment was carried out: prokinetics (motilium) and proton pump inhibitors (soars) for 12 weeks.

Based on a control study, a patient with gastroesophageal reflux disease is diagnosed with esophagitis, the presence of acid reflux 52 per day, and an increase in the electromotor activity of the stomach.

Example 2

Patient B-za, 42 years old, was admitted with complaints of constant heartburn, epigastric pain that occurs after eating, flatulence.

From the anamnesis it is known that for 15 years he suffers from peptic ulcer of the duodenum. The real deterioration for several months, when constant heartburn began to bother.

Upon receipt, the condition is satisfactory. The physique is normosthenic. The skin of normal color, clean. Peripheral lymph nodes are not enlarged. No peripheral edema. Vesicular breathing. Heart sounds are sonorous, rhythmic, blood pressure 140/90 mm Hg Heart rate - 63. Tongue coated in white, moist; the abdomen is involved in the act of breathing, symmetrical, with palpation soft, sensitive in the epigastrium.

An X-ray examination revealed the presence of a hiatal hernia.

A device for endoscopy is used, and the ratio is: 1.1-1.15 (D + h) = 0.5-0.75 N, where D is the diameter of the thread without coating, h is the height of the coating, N is the thickness of the cover. After assembly and heat treatment, the device is inserted into the endoscope assembly with a cover in the stomach cavity for visual inspection of the mucous membrane of the esophagus, stomach and duodenum.

The patient is preliminarily treated with the root of the tongue and pharynx with a solution of lidocaine.

An endoscopic examination: the mucous membrane of the esophagus is pale pink, the cardia periodically gapes. The mucous membrane of the terminal esophagus is whitish, with erosion. In the duodenum, a single ulcer is 0.8 × 1.2 cm in size. The cavity of the stomach is an admixture of bile. The mucous membrane of the stomach is pink, swollen, sometimes hyperemic. The folds are medium sized, elastic. Peristalsis is active, can be traced in all departments. The angle of the stomach is not changed. Conclusion - erosive and ulcerative esophagitis, cardia failure, chronic gastritis, hiatal hernia. Duodenal ulcer. A morphological study of a biopsy sample of the duodenal mucosa reveals the presence of necrotic tissue infiltrated by decaying white blood cells.

Remove the endoscope from the body. After an endoscopic examination, fragments of mucus and biological fluids are removed mechanically from the surface of the cover 2 of the endoscope. After that, using the gripper 9, the thread 3 is pulled and an inside cut is made along the length of the cover 2 and the ring 5. The cut cover 2 is removed from the body 1. The working surface of the endoscope remains biologically sterile. Used case 2 with thread 3 is disposed of.

Daily monitoring of pH in the esophagus reveals the presence of acid reflux in an amount of 85 per day.

When studying the electromotor activity of the stomach, the frequency of slow waves of EMA is 13.5 per min, which is 1.8 times higher than the norm, and the amplitude is 1.05 mV, which is 300% higher than the norm.

Based on the findings of a clinical diagnostic study, an adverse course of gastroesophageal reflux disease is predicted.

Treatment was carried out, including diet therapy, the exclusion of fatty, fried foods, hot and cold foods, carbonated drinks and alcohol, coffee, chocolate. It is recommended to sleep with a raised head end, to exclude taking medications that inhibit the motility of the esophagus (anticholinergics, theophylline, nitrates) and drugs that have a damaging effect on the mucous membrane of the esophagus.

The treatment was carried out: prokinetics (coordinates) and proton pump inhibitors (rabeprazole) for 12 weeks; the effectiveness of the treatment was insufficient, and therefore a course of maintenance therapy was carried out for 12 months, after which a control endoscopic examination, pH-metry and electromyography were performed.

On the basis of a control study in a patient with gastroesophageal reflux disease with concomitant constipation, esophagitis, the presence of acid reflux 55 per day, an increase in the electromotor activity of the stomach are detected, which confirms the preliminary prediction about the adverse course of gastroesophageal reflux disease.

This device can significantly save time on cleaning the endoscope, reduce the cost of toxic disinfectant, protect the working surface of the endoscope from the effects of aggressive environment and disinfectant, which ultimately extends the life of the endoscope.

Claims (1)

A device for conducting endoscopy, comprising a housing having a proximal and distal parts and a control handle, characterized in that the endoscope is equipped with a thermoplastic cover, the length of which corresponds to the length of the input part of the endoscope, the distal end of the cover has a thermoplastic ring, the inner diameter of the ring is equal to the diameter of the endoscope body moreover, the width and height of the ring are equal, respectively, to the width and depth of the U-shaped recess made at the distal end of the endoscope body, the distance of the protrusion and the recess from, respectively enno, the distal end cover and the distal end of the housing equal, a cover has on the inner surface of the metallized thread protruding beyond the proximal end of the cover and provided with a gripper at the proximal end of the filament.

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