Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B5/00—Measuring for diagnostic purposes; Identification of persons
  • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
  • A61B5/02042—Determining blood loss or bleeding, e.g. during a surgical procedure
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/12—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/71—Suction drainage systems
  • A61M1/77—Suction-irrigation systems
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/71—Suction drainage systems
  • A61M1/77—Suction-irrigation systems
  • A61M1/777—Determination of loss or gain of body fluids due to suction-irrigation, e.g. during surgery
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M3/00—Medical syringes, e.g. enemata; Irrigators
  • A61M3/02—Enemata; Irrigators
  • A61M3/0204—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity
  • A61M3/0208—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity before use
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M3/00—Medical syringes, e.g. enemata; Irrigators
  • A61M3/02—Enemata; Irrigators
  • A61M3/0204—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity
  • A61M3/0212—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity after use
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M3/00—Medical syringes, e.g. enemata; Irrigators
  • A61M3/02—Enemata; Irrigators
  • A61M3/0204—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity
  • A61M3/0216—Pressure
• • G—PHYSICS
  • G05—CONTROLLING; REGULATING
  • G05D—SYSTEMS FOR CONTROLLING OR REGULATING NON-ELECTRIC VARIABLES
  • G05D16/00—Control of fluid pressure
  • G05D16/20—Control of fluid pressure characterised by the use of electric means
  • G05D16/2006—Control of fluid pressure characterised by the use of electric means with direct action of electric energy on controlling means
  • G05D16/2066—Control of fluid pressure characterised by the use of electric means with direct action of electric energy on controlling means using controlling means acting on the pressure source
  • G05D16/2073—Control of fluid pressure characterised by the use of electric means with direct action of electric energy on controlling means using controlling means acting on the pressure source with a plurality of pressure sources
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/33—Controlling, regulating or measuring
  • A61M2205/3317—Electromagnetic, inductive or dielectric measuring means
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M3/00—Medical syringes, e.g. enemata; Irrigators
  • A61M3/02—Enemata; Irrigators
  • A61M3/0202—Enemata; Irrigators with electronic control means or interfaces
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M3/00—Medical syringes, e.g. enemata; Irrigators
  • A61M3/02—Enemata; Irrigators
  • A61M3/0233—Enemata; Irrigators characterised by liquid supply means, e.g. from pressurised reservoirs
  • A61M3/0254—Enemata; Irrigators characterised by liquid supply means, e.g. from pressurised reservoirs the liquid being pumped
  • A61M3/0258—Enemata; Irrigators characterised by liquid supply means, e.g. from pressurised reservoirs the liquid being pumped by means of electric pumps

Definitions

• the present invention relates to an apparatus for controlled irrigation of natural cavities of the human body, in particular for endoscopes and in particular for urological, gynecological and arthroscopic endoscopes, comprising at least two channels respectively for continuously injecting a liquid of irrigation in one of these cavities and for continuously evacuating this irrigation liquid from this cavity, this apparatus comprising an irrigation circuit coupled to one of said channels and a suction circuit coupled to the other of the channels.
• the present invention proposes to complete this embodiment to improve the safety of use of the device by permanently controlling the various parameters such as the volume of irrigation liquid and its pressure in the inlet and outlet circuits. outlet, when operating in continuous irrigation.
• the irrigation device is characterized in that the irrigation circuit and the suction circuit each comprise a pump, a pressure sensor and means for comparing the pressures measured by each of these sensors and to control the pumps according to the pressure differences observed.
• each of the two circuits is equipped with a weighing device, and these two weighing devices are associated with means for comparing the results of the measurements of each of these devices.
• the suction circuit includes a conductive sensor to determine the blood losses contained in the irrigation liquid at the outlet of the cavity.
• the device comprises a reference pressure sensor which is coupled to said means for comparing the pressures measured by the sensors disposed respectively on the irrigation circuit and the suction circuit.
• the suction circuit of the device can be equipped with a solid particle filter.
• FIG. 1 represents a schematic view of an irrigation device according to the invention
• FIG. 2 represents a diagram illustrating the pressure / volume curve during an intervention by means of the controlled irrigation device according to the invention
• FIG. 3 represents a diagram illustrating the curves of irrigation flow and aspiration as a function of time during an intervention by means of the irrigation apparatus according to the invention.
• the controlled irrigation apparatus 10 schematically represented by this figure, comprises an irrigation circuit 11 connected to one of the channels 12 of an endoscope 13 to two channels and a suction circuit 14- connected to the other channel 15 of this endoscope.
• the irrigation circuit 11 essentially comprises a first pump 16 and a first pressure sensor 17 and the suction circuit 14 essentially comprises a second pump 18 and a second pressure sensor 19.
• These pumps and these 'pressure sensors are connected to a central management unit 20 whose function consists in managing the operating parameters of the device, namely in particular the volume and the flow rate of liquid to be injected into the cavity where the intervention takes place and of the one which is sucked out of this cavity, taking into account in particular the values of the pressures measured by said sensors.
• the two irrigation and suction circuits also include, respecti ⁇ vely a first weighing device 21 and a second weighing device 22.
• the suction circuit 14 is equipped with a conductive measuring instrument 23 whose role will be defined later.
• a third pressure sensor 24, called the reference sensor, is also connected to the central management unit 20.
• irrigation circuit 11 is directly connected to the corresponding channel 12 of the endoscope 13 while on the suction circuit 14, a solid particle filter 25 is interposed between the corresponding channel 15 of the endoscope 13 and the other components of this circuit, in particular the pump 18.
• the central management unit 20 which contains an internal clock, can determine in real time, the weight, the volume and the pressure of the irrigation liquid as well as the flow rate of the pump 16. This unit is also designed to memorize the reference pressure supplied by the sensor 24 and the duration of operation of the device.
• the same measurements of weight are carried out by means of the weighing device 22, and of pressure by means of the pressure sensor 19 and the corresponding values are transmitted to the central unit of management.
• a measurement additional conductimetry calculates blood loss, that is to say the quantity of red blood cells contained in the liquid aspirated from the cavity in which the intervention is performed. Knowing the weight of injected liquid and aspirated liquid and the conductimetry of the liquid which has been modified at suction due to the presence of red blood cells, we can determine the hemodilution, i.e. the volume of water that has entered the bloodstream.
• the central management unit is controlled by software that allows automatic global management of the device. It is especially designed for. store pressure drop characteristics corresponding to different types of endoscopes, which considerably reduces the calibration time. The value of the pressures measured by the sensors 17 and 19 is corrected by the central management unit, taking into account in particular the pressure drops corresponding to each endoscope used.
• the central management unit is designed to activate the device in three modes which correspond respectively to the purge program, the calibration program and the use program.
• the irrigation and suction pipes are connected together and a purge liquid passes through the pipes to clean them.
• the irrigation and suction pipes are connected to the endoscope, the endoscope is purged and the pressure drops of the two circuits are corrected, these pressure losses can be from 0 to 700 ml / min.
• the data corresponding to two calibration curves are stored and, if necessary, these calibration curves are printed using an appropriate printer.
• the endoscope coupled to the pumps is ready for use.
• the third pressure sensor 24 is necessary to measure a reference pressure which, in urological or gynecological use, could for example be the pressure corresponding to the height of the table on which the patient is lying, or abdominal pressure.
• a reference pressure which, in urological or gynecological use, could for example be the pressure corresponding to the height of the table on which the patient is lying, or abdominal pressure.
• the differential pressure which is in fact the bladder pressure minus the abdominal pressure is called Detrusor pressure and makes it possible to get rid of any changes in table position or abdominal contractions during surgery. .
• the sensors are zeroed after putting the endoscope and the reference sensor at the height of the organ where the intervention is located.
• the operator introduces the endoscope and the organ is filled either by manual control or by automatic control.
• a screen 26 coupled to the central management unit 20 or by means of a printer (not shown), the pressure / volume curve which provides precise indications on the state of "swelling" of the organ. This curve is shown by way of example in FIG. 2. It shows that during the filling of the member, which is generally a pocket, the internal pressure is either constant or slightly increasing until the pocket is full and the injection of an additional volume of liquid causes the pocket to expand. At this time, the expansion of the walls generates a rapid and noticeable increase in pressure.
• the operator can determine his working area, that is to say the maximum and minimum values of the volumes of physiological liquid to be injected into the cavity where the intervention takes place as a function of the maximum and minimum pressures not to be exceeded. To stay in this work area, vacuum the excess volume by means of the suction circuit.
• Figure 3 illustrates the curves representing the suction flow (in dashed lines) and the irrigation flow (in solid lines,) as a function of time.
• This flow regulation can be carried out either by providing an irrigation flow which is equal to the suction flow at constant volume, or by regulating around the volume.
• the direction of rotation of the pump is reversed d suction 18 for injecting for a period of a few 5 seconds liquid into the suction circuit in order to evacuate the solid particle which obstructs the suction circuit and which is probably at the origin of this pressure difference. If the fault persists, the pumps are stopped to avoid excessive overpressure inside the organ.
• the two pumps which are arranged to be able to operate automatically or in manual control, can be either independent or replaced by a double pump.
• the irrigation circuit is continuously checked by measurements which are carried out continuously (volume, pressure, flow). These same measurements are made on the suction circuit and in addition, a comparative verification is carried out on the two circuits.
• the surgeon When the device is equipped with a printer, the surgeon has a working pressure / duration of the intervention curve printed on a document which constitutes, where appropriate, forensic evidence, also indicating the volume of the minimum work and maximum volume, hemodilution rate and a specific indication of blood loss during the procedure.
• a manual key empties the organ.
• the suction circuit is closed on the endoscope.
• the end of the suction tube is connected to the main end of the endoscope.
• the solid particles or shavings generated by the intervention inside the organ can be recovered for later analysis.

Landscapes

• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Heart & Thoracic Surgery (AREA)
• Engineering & Computer Science (AREA)
• Public Health (AREA)
• Biomedical Technology (AREA)
• Veterinary Medicine (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Hematology (AREA)
• Anesthesiology (AREA)
• Surgery (AREA)
• Physics & Mathematics (AREA)
• Pulmonology (AREA)
• Vascular Medicine (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Biophysics (AREA)
• Pathology (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Physiology (AREA)
• Cardiology (AREA)
• General Physics & Mathematics (AREA)
• Automation & Control Theory (AREA)
• Optics & Photonics (AREA)
• Radiology & Medical Imaging (AREA)
• Fluid Mechanics (AREA)
• Endoscopes (AREA)

Priority Applications (2)

Applications Claiming Priority (2)

Publications (1)

Family

ID=9412144

Family Applications (1)

Country Status (5)

Cited By (12)

Families Citing this family (1)

Citations (5)

• 1991
  • 1991-04-22 FR FR9104969A patent/FR2675367A1/fr not_active Withdrawn
• 1992
  • 1992-04-22 EP EP92910533A patent/EP0535209A1/fr not_active Withdrawn
  • 1992-04-22 WO PCT/FR1992/000362 patent/WO1992018049A1/fr not_active Application Discontinuation
  • 1992-04-22 JP JP4510448A patent/JPH06504221A/ja active Pending
  • 1992-04-22 CA CA002085990A patent/CA2085990A1/fr not_active Abandoned

Patent Citations (5)

Also Published As

Similar Documents

Legal Events