RU45927U1 - EXTERNAL DRAINING DEVICE Pseudocyst of the pancreas - Google Patents

Abstract

The proposed utility model relates to surgery, in particular, to drainage devices and can be used for external drainage of complicated pseudocysts of the pancreas. The purpose of the utility model is to increase the effectiveness of prolonged flow-washing drainage of the pancreatic pseudocyst. The drainage device comprises an external tube 1 with a T-shaped working end and a micro-irrigator 2 located in the T-shaped tube and protruding through the end hole 4 in the center of the horizontal part 6 of the T-shaped tube, the protrusion length of the micro-irrigator is adjustable. The microirrigator is located near the wall and is discharged through an additional perforation hole of the corresponding diameter in the distal part of the T-shaped tube 5 with fixation to the last ligature 7. The protruding working part of the microirrigator and each elbow of the horizontal part of the T-shaped tube carry at least two perforations 3 offset along the axis not exceeding the diameter of the inner diameter of the respective tubes. Perhaps the removal of microirrigator.

Description

The utility model relates to surgery, in particular, to drainage devices and can be used for external drainage of complicated pancreatic pseudocysts.

Known devices for drainage of the pseudocyst of the pancreas, consisting of various numbers and shapes of tubes (Danilov M.V., Fedorov V.D. Pancreatic surgery: A guide for doctors. -M .: Medicine, 1995. - 512 pp., Ill. ) Proven advantage of tubular drainage. However, the used drainage does not provide a timely outflow of discharge and detritus. Single-lumen tubular drainage does not meet the increasing requirements of modern surgeons. The two- and multi-lumen tubes used for drainage with poor fixation or long-term use easily fall out in the postoperative period, and the use of single-lumen T-shaped drains, if necessary, flow-washing drainage involves the use of two or more drains removed through additional sections of the abdominal wall, which increases tissue trauma and the risk of post-drainage complications.

It is known to use a drainage tube made of a T-shaped with vertical and horizontal parts, where along the contour of the vertical and horizontal parts and on both sides of the tube, in the thickness of its wall, there are micro-irrigators having open end ends [3]. However, in this device there are no perforations at the working end of the suction tube and microirrigator, which complicates flow-washing drainage (RU 2045284 C1, 10.10.1995).

Closest to the proposed in its technical essence is a drainage device for the implementation of drainage bed

pancreas (RU 2183477 C2, 04/04/2000), consisting of an aspiration tube with a T-shaped working end with perforations on it, a microirrigator with perforations protruding from the aspiration tube, an air tube also protruding from the suction tube placed in it. However, this device also has drawbacks, namely, the presence of an air tube that is not required during passive-flush drainage drainage narrows the working channel of the T-shaped tube. The drainage device requires the use of an additional design (collector) for sealing the distal end of the drainage and separation of fluid flows. The collector, inserted into the main tube, reduces the diameter of the working channel at the outlet, obturates with detritus and clots. When using this device, the authors propose to use active vacuuming of the intervention zone, which significantly increases the risk of bleeding during drainage of complicated pancreatic pseudocysts even when using an air duct.

The essence of the utility model is that the drainage device is arranged on the principle of "pipe in pipe", with a T-shaped tube being used as the external one, and a micro-irrigator located near the wall as the internal one. The working end of the microirrigator protrudes through the end hole of the horizontal part of the T-shaped tube to the required length. The distal end of the micro-irrigator is brought out through an additional perforation hole of the corresponding diameter in the distal part of the T-shaped tube with fixation to the last ligature to prevent displacement. Perforated openings are applied to the working ends of the tubes, the size of which does not exceed the inner diameter of the corresponding tubes and is offset along the axis. Perhaps the removal of microirrigator.

New is that the microirrigator is located near the wall, is discharged through an additional perforation hole

the corresponding diameter in the distal part of the T-shaped tube with fixation to the last ligature, the holes on the working part of the T-shaped tube and microirrigator are displaced along the axis, their diameter does not exceed the inner diameter of the corresponding tubes. The working end of the micro-irrigator protrudes through the end hole of the horizontal part of the T-shaped tube with an adjustable long protrusion, the size of this hole does not exceed the inner diameter of the T-shaped tube. The design of the drainage does not require the use of additional devices to seal its distal end and to separate multidirectional fluid flows. It is possible to remove the microirrigator if it is necessary to conduct further long-term passive drainage without irrigation without moving the drainage.

The figure shows a drainage device, general view. The drainage device includes a drainage tube 1 with a T-shaped working end and a micro-irrigator 2 located in the T-shaped tube and protruding from it through the end hole 4 in the center of the horizontal part 6 of the T-shaped tube not exceeding its inner diameter, the protrusion length of the micro-irrigator is adjustable. The microirrigator is located near the wall and is discharged through an additional perforation hole of the corresponding diameter in the distal part of the T-shaped tube 5 with fixation to the last ligature 7, with the possibility of removing the microirrigator. The protruding part of the microirrigator and each knee of the horizontal part of the T-shaped tube carry at least two perforations 3 displaced along the axis, not exceeding the diameter of the inner diameter of the corresponding tubes. The device is made of a transparent, elastic, inert material.

The device operates as follows. After the end of the main stage of the operation, a drainage device is sealed in the cyst cavity, the distal ends of the tubes are placed outside. Excretion of the distal part of the microirrigator through an additional perforation

the hole in the distal part of the T-shaped tube does not complicate the removal of drainage through the abdominal wall when it is placed and avoids additional tissue trauma. A microirrigator is connected to a flushing fluid supply device, a continuous flow-washing flushing of the cyst cavity is carried out without aspiration. After flow-washing drainage is completed, the device is removed. If further passive drainage is required without irrigation, the microirrigator is removed, the T-shaped tube is cut proximal to the hole for the removal of the microirrigator, and further drainage is carried out for the necessary period of time.

The implementation of the working end of the device with a T-shaped ensures reliable fixation of drainage in the cavity of the cyst, prevents its displacement. The use of at least two perforation holes displaced along the axis on each elbow of the horizontal part of the T-shaped tube and the protruding part of the microirrigator, with a diameter not exceeding the inner diameter of the corresponding tubes with a step equal to the outer diameter of the tubes, provides optimal conditions for flow-washing drainage and prevents occlusion of the drainage device. Placing the microirrigator inside the T-shaped tube wall will preserve a sufficient clearance of the working channel of the drainage, reduces tissue trauma, ensures the location of the working end of the microirrigator in the drainage zone, eliminating the displacement of perforations in the free abdominal cavity, ensuring optimal delivery of irrigation solutions to the working zone in the postoperative period. Fixation of the microirrigator to the T-shaped tube by the ligature excludes the possibility of its displacement. The ability to remove the micro-irrigator allows the use of drainage in a passive mode after the termination of the stage of flow-washing drainage without changing the drainage. The use of a transparent, flexible, inert material for

manufacturing of drainage allows visual monitoring of its work in the postoperative period.

The practical use of the device has shown its efficiency and effectiveness. Literature:

1. Danilov M.V., Fedorov V.D. Pancreatic Surgery:

A guide for doctors. -M.: Medicine, 1995 .-- 512 p .: ill.

2. RU 2045284 C1, 10.10.1995

3. RU 2183477 C2, 04.12.2000

Claims (2)

1. Device for external drainage of the pseudocyst of the pancreas, containing an external tube with a T-shaped working end and a micro-irrigator located in a T-shaped tube, characterized in that the micro-irrigator is located parietally and removed through an additional perforation hole of the corresponding diameter in the distal part of the T-shaped tube with fixation to the last ligature, with the possibility of removing the microirrigator, the working part of the microirrigator protrudes from the T-shaped tube through the end hole in its horizontally part with an adjustable long protrusion, and the protruding part of the micro-irrigator and each elbow of the horizontal part of the T-shaped tube carry at least 2 perforations that are offset along the axis and not exceeding the size of the inner diameter of the corresponding tubes. 2. The device according to claim 1, characterized in that it is made of a transparent, elastic, inert material.