RU85324U1 - DEVICE FOR OPERATIONS BY THE METHOD OF TROACAR CYSTOSTOMY UNDER ULTRASONIC CONTROL - Google Patents

Abstract

A device for operations by the method of trocar cystostomy under ultrasound control, characterized in that it consists of a collapsible tube with a scale of marks on it, a pointed stylet, and brackets.

Description

The invention relates to medicine, namely to urology and surgery, and can be used to install a cystostomy catheter for patients with acute urinary retention.

A close solution is trocar drainage (Emergency care in urology. F.A. Klepikov, Kiev “Health” 1988, p. 63), which allows you to install a drainage tube in the bladder cavity. This method is taken as a prototype.

The disadvantages of the known trocar stylet are the presence of a one-piece, non-separable tube, with which it is impossible to use Foley catheters. There is a risk of damage to the transitional fold and organs of the abdominal cavity (since the bladder is punctured “blindly”), it is impossible to control and evaluate the depth of the trocar placement and the cystostomy catheter into the bladder cavity (there may be cases when the trocar and cystostomy catheter only partially penetrate the bladder cavity bubble and subsequently with the reduction of the latter easily departs). A complication of this method is also the flow of urine into the paravesical tissue.

The technical result - the ability to install Foley catheters and control the depth of their installation during operations by the method of trocar cystostomy under ultrasound control.

The technical result is ensured by the fact that the tube of the proposed device is collapsible, allowing unhindered installation of Foley catheters No. 18-24 according to Ch.

The task is achieved by the use of a trocar (Figure 1), consisting of:

- collapsible tube with a scale of labels (Fig.2, 3);

-o string stylet (Figure 4);

- two brackets-retainers (Figure 5). The invention is illustrated by the figures:

- Figure 1 device for drainage of the bladder assembly (side view);

- Figure 2, 3 collapsible tube with a scale of labels (side view from the outside and from the inside);

- Figure 4 pointed stylet (side view);

- Figure 5 brackets-retainers (top view).

The device works as follows: during the operation by the method of trocar cystostomy under ultrasound guidance using a collapsible trocar with a mark scale on its tube, the bladder is punctured, a Foley catheter No. 18-24 by Ch is installed on the trocar, the balloon of the catheter is inflated. The brackets are removed, the collapsible tube is removed.

Thus, the proposed device compares favorably with its prototype, its technical solution allows to achieve a technical result due to the fact that the design features of the invention, namely the presence of a collapsible tube and a scale of marks on it, allows you to install Foley catheters No. 18-24 by Ch in the bladder and control the installation depth of the latter.

Using the proposed device helps to solve a number of problems:

1. To improve the quality of the technique of staging trocar cystostomy.

2. The ability to use Foley catheters No. 18-24 according to Ch and thereby exclude the flow of urine into the paravesical tissue and make the bladder fistula more direct and short, which significantly improves the subsequent change of cystostomy drainage.

3. The ability to control the depth of installation of the cystostomy catheter.

An example of a specific application: Example No. 1 Patient V., 76 years old, was admitted to the urology department on an emergency basis with a diagnosis of Benign prostatic hyperplasia. Acute urinary retention. Two days ago, the patient turned to the emergency room with the same diagnosis, refused the proposed epicystostomy, the urine was removed by an elastic catheter, and treatment was prescribed. Upon repeated admission complains about the inability to urinate, pain over the bosom. In a general blood test without pathology. Rectal digital and ultrasound examination of the prostate indicate an increase in it. The volume of the bladder according to ultrasound is 650 ml. After further examination: a biochemical blood test, a consultation with a physician, the patient underwent a trocar epicystostomy under ultrasound control. A Foley catheter No. 20 by Ch was attached to the bladder cavity, fixed to the skin. 600 ml of urine was released by drainage. The postoperative period without complications: normal body temperature, general blood count unchanged, general urine analysis: density 1014, acidic reaction, protein 0.03, white blood cells 6-8, red blood cells 10-12. The patient was discharged after 24 hours in satisfactory condition under the supervision of a polyclinic urologist, followed by the second stage of an adenomectomy.

Example No. 2 Patient N., 79 years old, was admitted to the urology department on an emergency basis with a diagnosis of Benign prostatic hyperplasia. Acute urinary retention. Complains about the inability to urinate independently, pain over the bosom, general weakness. From the anamnesis: is under the supervision of a urologist at a clinic for BPH for a long time. An additional examination revealed decompensated somatic pathology: ischemic heart disease, angina of exertion III FC, HIIA. Hypertension 3 tbsp., Risk 4. In the general analysis of blood without pathology. Rectal digital and ultrasound examination of the prostate indicate an increase in it. The volume of the bladder according to ultrasound 500 ml. The patient underwent a trocar epicystostomy under ultrasound control. A Foley catheter No. 22 by Ch was attached to the bladder cavity, fixed to the skin. 400 ml of light pink urine was allocated for drainage. The postoperative period without complications: normal body temperature, complete blood count unchanged, general urine analysis: density 1012, acid reaction, protein 0.03, white blood cells 8-10, red blood cells 14-16. The patient was discharged on the second day in satisfactory condition under the supervision of a urologist and cardiologist at the clinic.

Claims (1)

A device for operations by the method of trocar cystostomy under ultrasound control, characterized in that it consists of a collapsible tube with a scale of marks on it, a pointed stylet, and brackets.