RU98117U1 - INTRAOPERATIVE COLUMN CLEANING KIT - Google Patents

Abstract

 A set for intraoperative cleaning of the colon, including a tube, a trocar, a cannula and a collection bag, characterized in that the tube with a diameter of 5-10 mm is equipped with a roller control of the fluid flow rate, the cannula has notches at one end and is equipped with a limiter in the form of a disk with two slots The self-opening vacuum collecting bag is made of flexible plastic material, the kit additionally includes a metal fitting with a trihedral sharpening.

Description

The utility model relates to medicine, namely colorectal surgery, and can be used for intra-operative colon cleansing.

Known kit for intraoperative cleaning of the colon, which consists of four parts: a trocar, cannula, tube and collection bag [Sitzler P.J., Stephenson B.R., Nicholls R.J. "On-table colonic lavage: an alternative", J.R. Coll. Surg. Edinb., 43, August 1998, p.276-277]. The kit was manufactured under the trademark "Coloclean" by B. Braun, Germany. Using the kit during surgery in a certain group of patients with colorectal cancer complicated by intestinal obstruction allows the colon to be cleansed of feces and gases, preparing the latter for the formation of the primary anastomosis. The described set is accepted by the authors as a prototype.

The disadvantages of the prototype are;

1. The small diameter (5 mm) of the tube, designed to supply a cleaning solution to the intestine. This circumstance increases the procedure time to 50 minutes or more.

2. Inadequately tight connection of the cannula with the canopy of the colon in some cases can lead to the ingress of fluid from the transport system into the free abdominal cavity, which is unacceptable due to the sterility of the surgical field.

3. The dosage of fluid in the intestine is not provided.

4. The fixed shape of the collection bag creates certain inconveniences during the procedure.

The technical result of the utility model is the development of a kit for intraoperative cleaning of the colon, which allows to reduce the time of the procedure to 20-30 minutes, to control the rate of fluid flow through the tube into the intestine, to ensure the tightness of the installed transport system in order to prevent purulent-inflammatory complications, and to expand Arsenal of means for intraoperative colon cleansing.

The specified technical result is achieved by the fact that in the known set for intraoperative cleaning of the colon, including a tube, a trocar, a cannula, and a collection bag, according to a utility model, the tube with a diameter of 5-10 mm is equipped with a roller control of the fluid flow rate, the cannula has notches on one of the ends and is equipped with a limiter in the form of a disk with two slots, a self-opening vacuum collecting bag made of flexible plastic material, the kit also includes a metal fitting with a trihedral sharpening.

Reducing the time for colon cleansing to 20-30 minutes is achieved by increasing the diameter of the polymer tube to 10 mm.

A roller regulator of the fluid flow rate allows you to control the procedure and dosed to supply fluid to the intestine.

A disk-shaped limiter with two slots allows for tight connections between the transport system and the colon.

The use of flexible plastic material provides a variable geometric shape of the collection bag, which is more convenient for the procedure.

The essence of the utility model is illustrated by the drawings in figures 1-6.

Figure 1 shows a tube with a roller control of the fluid flow rate.

Figure 2 shows the fitting with a trihedral sharpening.

Figure 3 shows a trocar.

Figure 4 shows a cannula with a limiter.

Figure 5 shows the collection bag.

Figure 6 shows the set in working condition.

The kit consists of a polymer tube 1 having a diameter of 10 mm, made of polyvinyl chloride, equipped with a fluoroplastic roller regulator 2 of the fluid flow rate. The fitting 3 is a hollow sleeve with a trihedral pointed 4, designed to puncture the rubber stopper of a glass medical bottle 5, and has an external thread 6 for connection with a polymer tube 1. The cannula 7 is a hollow tube made of fluoroplastic with a limiter 8 in the form of a disk with two slots 9. One end of the cannula 7 has a notch 10 for fixing with a purse string suture of the polymer tube 1 to the wall of the cecum 11. Trocar 12 is a pointed hard pin made of stainless steel eyuschey steel. A self-opening vacuum collecting bag 13 with a capacity of 11 l is made of flexible plastic material that takes a variable geometric shape.

The kit is used as follows.

After ligation and intersection of the blood supplying the affected area of the 14 vessels and mobilization of the affected area of the cecum 11 in accordance with the principles of oncological radicalism, a precast self-opening bag 13 is fixed proximal to the tumor, which is a circuit completely isolated from the external environment. The cannula 7 is inserted into the cecum 11 through the appendicotomy opening 15 and tightly fixed to the wall of the intestine 11 with a purse string suture using notches 10. The filament of the purse string suture is passed through the slots 9 and knotted. In the case when the appendix (appendicotomy opening 15) is absent due to a previously performed appendectomy, a trocar 12 is used to insert the cannula 7. Then, a polymer tube 1 with a speed regulator 2 is connected to the cannula 7. Saline solution (0.9% NaCl) via the nozzle 3 comes from a medical glass bottle 5 through a polymer tube 1 into the gut 11.

During the cleaning procedure, the gut 11 is gently massaged so that the large feces are washed away and can pass into the collection bag 13. The time required for successful irrigation depends on the consistency and amount of gut contents, as well as the anatomical features of the colon (high and acute hepatic and splenic bends), and averages 20-30 minutes. The volume of flushing fluid in this case is from 3 to 11 liters (an average of 4.5 liters). After washing the colon 11, a resection of the mobilized section of the intestine 14 with the tumor is performed, the adequacy of blood supply to the anastomosed sections of the colon 11 and the subsequent formation of the anastomosis are evaluated.

Using the claimed kit, 76 patients were operated on. There were no mortality in this group of patients. In all patients of this group, surgery ended with the formation of a primary anastomosis. In all cases, the formed anastomoses were consistent.

Using the kit reduces the time of the procedure of intraoperative cleaning of the colon to 20-30 minutes, allows you to control the procedure and dosed to supply fluid to the intestine, ensures a tight connection of the transport system with the colon.

Claims (1)

A set for intraoperative cleaning of the colon, including a tube, a trocar, a cannula and a collection bag, characterized in that the tube with a diameter of 5-10 mm is equipped with a roller regulator of the fluid flow rate, the cannula has notches at one end and is equipped with a limiter in the form of a disk with two slots The self-opening vacuum collecting bag is made of flexible plastic material. Additionally, the kit includes a metal fitting with a trihedral sharpening.