RU58922U1 - PROBE FOR NASOINSTINAL INTUBATION - Google Patents

Abstract

The utility model relates to medicine, in particular to abdominal surgery, namely, probe designs for intubation of the small intestine in patients with acute intestinal obstruction and diffuse peritonitis. The probe performs frame and decompression-detoxification functions, can be used to prevent intestinal paresis and for enteral tube feeding in the postoperative period, as well as for laboratory monitoring of the intestinal microflora of different sections of the small intestine and probe correction of dysbiosis. The inventive probe design is made of silicone with an olive-shaped conductor at the distal end of at least 3 m in length, provided with a main channel and three additional channels located in its wall, the length of the first additional channel being 1/3 of the length of the main channel, the length of the second one / 2 the length of the main channel, the length of the third is 2/3 of the length of the main channel, in the distal part of each channel there are side holes, and in the main channel the holes are made in a section not exceeding 2/3 of its length, and in additional channels lah - in areas not exceeding 1/10 of the length of each channel, respectively, and the distal end of each additional channel is indicated by a radiopaque mark. In contrast to the prototype, a probe design was developed that allows laboratory monitoring of the state of the enteric environment and its probe correction in patients with acute intestinal obstruction and diffuse peritonitis, which allows for effective correction of intestinal dysbiosis in patients operated on the gastrointestinal tract in the early postoperative period.

Description

The utility model relates to medicine, in particular to abdominal surgery, namely, probe designs for intubation of the small intestine in patients with acute intestinal obstruction and diffuse peritonitis. The probe performs frame and decompression-detoxification functions, can be used to prevent intestinal paresis and for enteral tube feeding in the postoperative period, as well as for laboratory monitoring of the intestinal microflora of different sections of the small intestine and probe correction of dysbiosis.

Probe designs are known: single-channel probes of the Abbot-Muller, Cantor type, standard single-channel intestinal, manufactured by MEDSIL CJSC and an experimental enterprise of the Research Institute of Traumatology and Orthopedics of Nizhny Novgorod. Devices

The probes listed are a hollow tube with a length of at least 3 m with perforated holes and various devices for moving in the lumen of the small intestine during surgery (Nechaev E.A., Kurygin A.A., Kanevich M.D. Drainage of the small intestine and intestinal therapy for peritonitis and intestinal obstruction. - St. Petersburg: "Rosmedpolis", 1993, p. 240, p. 70).

The disadvantage of existing designs of probes for intubation of the intestine is the impossibility of laboratory monitoring of the contents of different departments of the small intestine in order to assess the microbiocenosis of the latter and probe correction of dysbiosis due to the lack of description of the design of the probe for these purposes (Trusov A.L., Papandopulo N.S. Transnasal intubation of thin intestines with intestinal paresis // Surgery. - 1983. - No. 2. - P.90-92.)

Based on the closest technical essence, as a prototype, we chose the design of a silicone single-channel probe for transnasal intubation of the small intestine with an olive tip at the end and lateral openings (Nechaev E.A., Kurygin A.A., Kanevich M.D. Drainage of the small intestine and intestinal therapy for peritonitis and intestinal obstruction. - St. Petersburg: Rosmedpolis, 1993, p. 240, p. 70; Lyubenko L.A. et al. Prolonged intestinal decompression in acute peritonitis and intestinal obstruction // Clinical Surgery. - 1987. - No. 4. - S.30-32.)

The disadvantage of the probe selected as a prototype is the inability to determine the state of the intestinal environment in different parts of the small intestine due to the presence of only one channel, which serves to empty and decompress overgrown loops of the intestine from liquid contents and gases (Kurygin A.A., Stoyko Yu. M., Bagnenko S.F. Emergency Surgical Gastroenterology .-- SPb .: Peter, 2001. - p. 480; Androsov N.S. On Drainage of the Small Intestine with

surgical treatment of intestinal obstruction // Herald of surgery. I.I. Grekova. - 1971. - No. 5. - S.40-43.)

The objective of the utility model is to develop a more advanced probe design that, while maintaining the physiological dimensions of the product, would allow laboratory monitoring of the state of the enteric environment and its probe correction in patients with acute intestinal obstruction and diffuse peritonitis.

The problem is solved in that the proposed design of the probe for nasointestinal intubation is a silicone probe with a conductor in the form of an olive at the distal end with a length of at least 3 m; the probe is equipped with a main channel and three additional channels located in its wall, the length of the first additional channel being 1/3 of the length of the main channel, the length of the second 1/2 length of the main channel, the length of the third 2/3 of the length of the main channel; in the distal part of each channel there are side holes, and in the main channel, the holes are made in a section not exceeding 2/3 of its length, and in the additional channels in areas not exceeding 1/10 of the length of each channel, respectively, and the distal end of each additional channel indicated by a radiopaque mark.

Distinctive essential features of a utility model are:

- additional equipment of the probe with three channels located in the wall of the main channel;

- the length of the first additional channel is 1/3 of the length of the main channel, the length of the second additional channel is 1/2 the length of the main channel, and the length of the third additional channel is 2/3 of the length of the main channel;

- the distal parts of the additional channels are perforated and

perforation is performed in each channel in a section not exceeding a length corresponding to 1/10 of the channel length;

- at the distal end of each channel there are radiopaque labels.

A causal relationship between symptoms and outcome:

Using additional channels located in the wall of the probe, it becomes possible, while maintaining the physiological dimensions of the probe, to take the intestinal contents in order to study the microbiocenosis of the small intestine.

Given the different lengths of the additional channels, laboratory monitoring of intestinal status is carried out in different parts of the small intestine:

- the length of the first additional channel is 1/3 of the length of the main channel, since the duodenum is located at this level;

- the length of the second additional channel is 1/2 the length of the main channel, since the jejunum is located at this level;

- the length of the third additional channel is 2/3 of the length of the main channel, since the ileum is located at this level;

The presence of perforated holes in the distal sections of each additional canal in the area not exceeding a length corresponding to 1/10 of the channel length allows the intestinal contents to be effectively evacuated from the studied sections of the small intestine and the correction of microbiocenosis, respectively.

The presence of radiopaque markers at the distal end of each additional channel prevents the dislocation of the probe along the gastrointestinal tract and the regurgitation of intestinal contents into the stomach in view of the possibility of controlling the location of the probe.

Distinctive essential features are new and allow laboratory monitoring of the state of the enteric environment and its probe correction in patients with acute intestinal obstruction and diffuse peritonitis.

Figure 1 presents a schematic representation of a probe.

The probe consists of:

- the main channel - 1,

- olives - 2,

- additional channels - 3,

- perforations - 4.

The total length of the probe is 3 m. The outer diameter of the probe is not more than 8-10 mm, the inner 6-8 mm. The internal diameter of the additional channels is not more than 1.5 mm.

At the end of each additional channel there are radiopaque tags.

The distal end of the probe is equipped with a conductor in the form of olive, which is made of the same material - silicone, has the same diameter and is dumbbell-shaped connected to the main part of the probe.

Intubation of the intestine with a probe is performed as follows: before starting the probe, the anesthesiologist monitors the extension of the cuff of the endotracheal tube and empties the stomach to prevent aspiration of the contents into the airways; then, the probe is coordinated and synchronously moved along the gastrointestinal tract in the distal direction due to pressure along its axis in the usual way using olive (2). Decompression-detoxification, skeleton functions and enteral nutrition are carried out using the main channel (1). Laboratory monitoring of the microflora of different departments of the small intestine is carried out using additional channels (3) located in the probe wall; perforations (4)

at the proximal end of each channel allows you to evacuate the contents of different departments of the small intestine by actively aspirating intestinal exudate with subsequent evaluation of the small intestine contents for dysbiosis. Probe correction of dysbiosis is carried out through additional channels (3) by the gravitational method with the connection of infusion systems and a dosing dropper.

In contrast to the prototype, a probe design was developed that allows laboratory monitoring of the state of the enteric environment and its probe correction in patients with acute intestinal obstruction and diffuse peritonitis, which allows for effective correction of intestinal dysbiosis in patients operated on the gastrointestinal tract in the early postoperative period.

Claims (1)

Silicone probe for nasointestinal intubation with a conductor in the form of an olive at the distal end, at least 3 m long, equipped with a main channel and three additional channels located in its wall, the length of the first additional channel being 1/3 of the length of the main channel, the length of the second one / 2 of the length of the main channel, the length of the third is 2/3 of the length of the main channel, in the distal part of each channel there are side holes, and in the main channel the holes are made in the distal section, not exceeding 2/3 of its length, and in addition curing channels - in distal sections not exceeding 1/10 of the length of each channel, respectively, and the distal end of each additional channel is indicated by a radiopaque mark.