WO1993022979A1 - Dispositif destine a des systemes de liquide de rinçage utilises dans des operations medicales ou chirurgicales - Google Patents

Dispositif destine a des systemes de liquide de rinçage utilises dans des operations medicales ou chirurgicales Download PDF

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Publication number
WO1993022979A1
WO1993022979A1 PCT/SE1993/000371 SE9300371W WO9322979A1 WO 1993022979 A1 WO1993022979 A1 WO 1993022979A1 SE 9300371 W SE9300371 W SE 9300371W WO 9322979 A1 WO9322979 A1 WO 9322979A1
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WO
WIPO (PCT)
Prior art keywords
container
flushing liquid
carrier
liquid
force transmitting
Prior art date
Application number
PCT/SE1993/000371
Other languages
English (en)
Inventor
Torbjörn FRYKLUND
Original Assignee
Fryklund Torbjoern
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Fryklund Torbjoern filed Critical Fryklund Torbjoern
Publication of WO1993022979A1 publication Critical patent/WO1993022979A1/fr

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Classifications

    • 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
    • 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
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3379—Masses, volumes, levels of fluids in reservoirs, flow rates
    • A61M2205/3393—Masses, volumes, levels of fluids in reservoirs, flow rates by weighing the reservoir

Definitions

  • This invention relates to a device in flushing liquid systems for use in medical or surgical operations.
  • certain gynecological and urological operations such as transcervical endometrium resection (TCER), transurethral prostatec ⁇ tomy (TUR-P) and transurethral bladder tumour resection (TUR-T).
  • transcervical endometry resection As a complement to uterine operation through the abdomen (hysterectomy) transcervical endometry resection (TCER) was intro ⁇ quizd about 10 years ago. This means operative removing of the endometrium and its rudiments by means of a resectoscope that is in ⁇ troduced through the vagina and the uterine neck.
  • the TUR-P and TUR-T operations have been used as a matter of routine for more than 40 years.
  • the resectoscope that, by way of example, has been used in the TCER operation is a tubular instrument, originally developed for urological use. It consists of an optical part (optics) which is equipped with fibre light and an outer light source, which permits inspection of the ute e cavity. This can be done by the eye or by means of a camera -..at is fastened to the optics and gives a picture on a monitor or a video equipment.
  • the second part of the resectoscope is formed by a work channel that consists of a double sheathed flushing channel with in- and outflow tubes for the flushing liquid and a diathermical loop (electrical) shaped as a half circle that cuts out the mucous membrane and tissues in chip-like structures. The method is medically established since a number of years.
  • Flushing liquid is used for widening the usually shrunken uterine cavity and for keeping free sight during the operation that is otherwise disturbed by blood products and tissue pieces.
  • the type of flushing liquid that is used varies between different clinics and countries.
  • the requirements of the flushing liquid are however that it must not be electrically conducting, must have good optical properties, must not be harmful in contact with human tissues or operation instruments, and be isosmotic together with the blood to cause the least possible damage when it unintentionally gets into the circulation of the blood (resorption) of the patient, which always occurs to a varying extent through the endometrium, the blood vessels of the uterus or the peritoneum.
  • the liquid that best corresponds to the requirements and is most often used is 1.5% glycine solution.
  • a large and rapid resorption of glycine solution is a known and feared complication to the TCER, TUR-P and TUR-T operations. This is usually called the TUR syn ⁇ drome and means among other things electrolyte changes in the blood, disturbances of consciousness and influence on the circulation.
  • the amount of liquid that is required for this to happen depends among other things on the size and speed of the resorption, the age and general condition of the patient etc.
  • the existing way of measuring the resorption to the circulation of the patient is done by means of volumetric technique.
  • the current volumetric method is unsatisfying as it is:
  • the object of the invention is to produce a device that makes it possible to superintend the resorption of flushing liquids rationally, ac- curately and continuously, especially at TCER, TUR-P and TUR-T.
  • the device forms a closed system where the total weight of the included flushing liquids and returning liquids is continuously mea ⁇ sured and the amount of liquid that leaves the system corresponds to the resorption to the circulation of the patient.
  • the device comprising a carrying arrangement designed to simulta- neously carry the first container for unused flushing liquid and the other container for used flushing liquid and that a weighing means is arranged for the weighing of the carrying arrangement and the con ⁇ tainers carried by the latter.
  • Fig 1 is a perspective, partially cut and schematic view illustrating the device according to the invention.
  • Fig 2 is a partially cut view of a frame, that according to the invention is included in the device, and the weighing means intended for co ⁇ operation therewith.
  • the device in flushing liquid systems for use in medical and surgical operations comprises at least one first container 1 for unused flushing liquid, first means 2 for supply of the flushing liquid from the first container to the place of the operation, at least one second container 3 for used flushing liquid and second means 4 for the returning of flushing liquid from the place of the opera ⁇ tion to the second container 3.
  • the means 2 for supply of the flushing liquid from the first container 1 to the place of the operation comprises the operation instrument 5 itself. Accordingly, the flushing liquid is supplied to the place of the operation through the operation instrument since the latter has an inlet 6 to an internal flushing liquid channel.
  • the instruments include an optical device for examination of the place of the operation and light, for instance through fibre optics, is provided at a connection indicated at 7.
  • the operation instrument 5 can also be said to be part of the second means for the returning of flushing liquid from the place of the opera ⁇ tion to the container 3, as the instrument in this case has an internal return channel, from which the returning liquid goes out from the instrument through an outlet 8 to be forwarded to the container 3 via a flexible conduit 9.
  • the operation instrument is formed by the resec ⁇ toscope described initially.
  • the means 4 for the returning of flushing liquid also includes a device 10 for gathering of liquid, arranged to be located in the vicinity of the place of the operation to gather flushing liquid that is supplied there.
  • the device 10 has the character of a funnel or the like, from which liquid is sent to the container 3 through a conduit 11.
  • the conduits 9 and 11 from the resectoscope and the device 10 for gathering go together to one conduit 12, which in its turn is connected to an inlet 13 in the container 3.
  • the provision of flushing liquid to the instrument 5 is executed by means of a pump 13 that receives flushing liquid from the container 1 via a conduit 14 and sends this liquid under pressure to the instrument 5 via the conduit 15.
  • a pressure limiting de ⁇ vice 16 might suitably be incorporated.
  • a conduit 17 is connected to the conduit 15 upstream the pressure limiting device 16, which cond " t 17 is connected to a pressure control input 18 of the pump devie * 13, i.e. an input that is possible to throttle depending on the wished feed pressure.
  • the device further comprises a suction arrangement 19 which is ar ⁇ ranged to bring the inside of the container 3 to an underpressure condition via a conduit 20 connected to said inside, for the establish ⁇ ment of a suction effect in the conduit 12 for returning of liquid.
  • This suction effect means that a suction is established in the operation in ⁇ strument 5 as well as in the device 10 for gathering.
  • the pump arrangement 13 and the suction arrangement 19 might be co-ordinated into one single apparatus indicated with 21.
  • the device according to the invention comprises a carrying arrange ⁇ ment generally indicated with 22 and designed to simultaneously carry the first container 1 for unused flushing liquid and the other container 3 for used flushing liquid.
  • a weighing means 23 is arranged for the weighing of the carrying arrangement 22 and the containers 1 , 3 carried thereby.
  • the weighing means 23 is carried by a frame 24 and the carrying arrangement 22 is carried by the frame 24 via the weighing means 23.
  • the carrying arrangement 22 comprises a first carrier 25 meant for the first container 1 and a second carrier 26 meant for the second con ⁇ tainer 3. It is preferred that the first carrier 25 is located on a higher level than the second carrier 26. Furthermore, it is preferred that the weighing means 23 is arranged on a higher level than the first carrier 25.
  • the first and second carriers 25, 26 are mutually connected by means of force transmitting elements 27.
  • These force transmitting elements are preferred to be of the traction force transmitting type and they are suitably flexible, for example in the shape of lines, chains or the like 27.
  • the carrying arrangement 22 comprises a third carrier 28 which is load transmittingly associated with the weighing means 23 and which is ar ⁇ ranged to carry the first and second carriers 25, 26.
  • the third carrier 28 and the first carrier 25 are mutually associated by means of force transmitting elements 29 which similarly to the elements 27 also, ad- vantageously, are of the traction force transmitting type, for example flexible elements in the shape of lines, chains or the like.
  • the force transmitting elements 27, 29 extends within uprights 30 of the frame.
  • the frame comprises four uprights and in every one of those the elements 27, 29 run.
  • the elements 27 and 29, extending in a single upright 30 form part of one and the same line, chain or the like, which at one place 31 is connected to the first carrier 25, at one place 32 to the second carrier 26 and at one place 33 to the third carrier 28.
  • every carrier 25, 26 and 28 can exhibit sections that protrude into the interiors of each of the uprights 30 respectively through slots 34. Inside the uprights, these sections are fastened to the elements 27, 29 in a force transmitting way. These sections 35 could for example have the character of pieces that would be detachably connected to the carriers 25, 26 and 28 respectively via any suitable type of fastening, for example screw fastening for disassembling and assembling respectively.
  • the frame 24 might exhibit rolls 36 for the facilitation of the moving of the frame.
  • the uprights 30 of the frame are mutually connected through fixed transverse means 37.
  • the frame 24 further exhibits means 38 to carry the weighing means 23.
  • this means 38 has the character of a relatively firm shelf comprising a plate 39 and transverse pieces
  • the framework of the weighing means 23 rests on said shelf 38.
  • the already mentioned carrier 28 rests, which in the example comprises two rods
  • the first carrier 25 is located just beneath the shelf 38 carrying the weighing means 23 and suitably exhibits two rods 43, the end sections of which protrude into the interiors of the uprights 30 through the slots 34 and there are associated with the elements 27, 29.
  • the two rods 43 are mutually connected by means of one or more transverse pieces 44 arranged to carry a plurality of the first containers 1 , for instance via hooks 45.
  • the first containers 1 have the character of bags.
  • the second carrier 26 has the character of a shelf on which the container 3 for returning liquid is arranged.
  • the number of con- tainers might of course be two or more.
  • the second carrier 26 exhibits sections protruding into the interior of the uprights 30 through the slots 34 in a way that has already been described.
  • the frame In the area between the first and second carriers 25, 26, the frame exhibits carrying means 46 fixed to the frame. These carrying means 46 serve to carry required extra equipment, in the example, the pump and suction arrangements 13, 19 described earlier.
  • the carrying means 46 have the character of a shelf.
  • the carrying arrangement 22 including the three carriers 25, 26 and 28 and the elements 27, 29 is vertically mobile in relation to the frame 24 and is carried by the weighing means 23.
  • This one suitably exhibits a display 47 that might be mounted somewhere on the frame 24 or otherwise in the vicinity of the place of the operation, and might, furthermore, be connected to a computer 48 so that the resorption of flushing liquid can be shown graphically and be computerized in a suitable way.
  • the described device is used in the following way. Before the opera ⁇ tion, a requisite number of containers 1 with flushing liquid are hung up on the carrier 25.
  • the conduits in question 9, 11 , 12 and 14, 15, 17 are connected to the instrument 5, the containers 1 , 3 and the apparatus 21.
  • the funnel 10 for gathering is applied on the patient.
  • the suction arrangement 19 might be left out, in which case the returning of liquid from the gathering arrange ⁇ ment 10 and/or the instrument 5 becomes dependent only on the container 3 being located beneath the arrangement 10 and the instru- ment 5 so that the return flow occurs under the influence of the gravity.
  • the carrier 25 of the container with unused liquid is located relatively high on the frame 24 while, on the other hand, the container 3 for used flushing liquid ought to be located low on the frame.
  • each carrier respectively shall be vertically freely mobile in relation to the frame and that the force transmitting elements 27, 29 also shall run freely within the uprights.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biomedical Technology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Pulmonology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgery (AREA)
  • External Artificial Organs (AREA)

Abstract

Dispositif destiné à des systèmes de liquide de rinçage utilisés en médecine ou en chirurgie, comprenant au moins un premier récipient (1) qui contient le liquide de rinçage non utilisé, un premier système (2) qui véhicule le liquide de rinçage depuis le premier récipient jusqu'à l'endroit de l'opération, au moins un deuxième récipient (3) destiné au liquide de rinçage utilisé et un deuxième système (4) qui renvoie le liquide de rinçage de l'endroit de l'opération jusque dans le deuxième récipient (3). Ledit dispositif comprend un chariot (22) conçu pour porter simultanément le premier récipient (1) destiné au liquide de rinçage non utilisé, le deuxième récipient (3) destiné au liquide de rinçage utilisé, ainsi qu'un système de pesage servant à peser le chariot (22) et les récipients qu'il porte afin de calculer la diminution du poids du liquide, cette réduction de poids correspondant à la résorption du liquide dans le corps du patient opéré.
PCT/SE1993/000371 1992-05-08 1993-04-28 Dispositif destine a des systemes de liquide de rinçage utilises dans des operations medicales ou chirurgicales WO1993022979A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE9201449A SE500960C2 (sv) 1992-05-08 1992-05-08 Anordning vid spolvätskesystem för användning vid medicinska eller kirurgiska operationer
SE9201449-7 1992-05-08

Publications (1)

Publication Number Publication Date
WO1993022979A1 true WO1993022979A1 (fr) 1993-11-25

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Application Number Title Priority Date Filing Date
PCT/SE1993/000371 WO1993022979A1 (fr) 1992-05-08 1993-04-28 Dispositif destine a des systemes de liquide de rinçage utilises dans des operations medicales ou chirurgicales

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SE (1) SE500960C2 (fr)
WO (1) WO1993022979A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0755282A1 (fr) * 1994-04-14 1997-01-29 Bei Medical Systems Systeme d'alimentation en liquide utilise en chirurgie hysteroscopique
EP0755283A1 (fr) * 1994-04-14 1997-01-29 Bei Medical Systems Systeme d'alimentation en liquide utilise dans l'ablation de l'endometre par hysteroscopie
WO1997017093A2 (fr) * 1995-11-08 1997-05-15 Storz Endoskop Gmbh Dispositif pour rincer des cavites organiques
US6059782A (en) * 1995-11-20 2000-05-09 Storz Endoskop Gmbh Bipolar high-frequency surgical instrument
CN107796497A (zh) * 2017-11-22 2018-03-13 戴向东 体液流失称重系统
US11850396B2 (en) 2019-10-30 2023-12-26 Boston Scientific Scimed, Inc. System and method for monitoring fluid deficit
US11883626B2 (en) 2019-06-27 2024-01-30 Boston Scientific Scimed, Inc. Detection of an endoscope to a fluid management system

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1404134A (en) * 1971-07-22 1975-08-28 Glevum Ind Designers Ltd Apparatus for controlling the flow of liquids
DE3136318C2 (de) * 1981-09-12 1984-05-03 Gerhard 6200 Wiesbaden Kratzsch Vorrichtung zum Spülen des Magens von Menschen
US4770187A (en) * 1987-06-29 1988-09-13 Md Engineering Surgical aspirator and monitor
WO1991002227A1 (fr) * 1989-08-10 1991-02-21 University College London Methode et appareil pour mesurer l'equilibre hydrique d'un patient pendant une intervention chirurgicale

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1404134A (en) * 1971-07-22 1975-08-28 Glevum Ind Designers Ltd Apparatus for controlling the flow of liquids
DE3136318C2 (de) * 1981-09-12 1984-05-03 Gerhard 6200 Wiesbaden Kratzsch Vorrichtung zum Spülen des Magens von Menschen
US4770187A (en) * 1987-06-29 1988-09-13 Md Engineering Surgical aspirator and monitor
WO1991002227A1 (fr) * 1989-08-10 1991-02-21 University College London Methode et appareil pour mesurer l'equilibre hydrique d'un patient pendant une intervention chirurgicale

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0755282A1 (fr) * 1994-04-14 1997-01-29 Bei Medical Systems Systeme d'alimentation en liquide utilise en chirurgie hysteroscopique
EP0755283A1 (fr) * 1994-04-14 1997-01-29 Bei Medical Systems Systeme d'alimentation en liquide utilise dans l'ablation de l'endometre par hysteroscopie
EP0755283A4 (fr) * 1994-04-14 1998-04-22 Bei Medical Systems Systeme d'alimentation en liquide utilise dans l'ablation de l'endometre par hysteroscopie
EP0755282A4 (fr) * 1994-04-14 1998-04-22 Bei Medical Systems Systeme d'alimentation en liquide utilise en chirurgie hysteroscopique
WO1997017093A2 (fr) * 1995-11-08 1997-05-15 Storz Endoskop Gmbh Dispositif pour rincer des cavites organiques
WO1997017093A3 (fr) * 1995-11-08 1997-06-26 Storz Endoskop Gmbh Dispositif pour rincer des cavites organiques
US5921953A (en) * 1995-11-08 1999-07-13 Storz Endoskop Gmbh Device for the rinsing of body cavities
US6059782A (en) * 1995-11-20 2000-05-09 Storz Endoskop Gmbh Bipolar high-frequency surgical instrument
CN107796497A (zh) * 2017-11-22 2018-03-13 戴向东 体液流失称重系统
US11883626B2 (en) 2019-06-27 2024-01-30 Boston Scientific Scimed, Inc. Detection of an endoscope to a fluid management system
US11850396B2 (en) 2019-10-30 2023-12-26 Boston Scientific Scimed, Inc. System and method for monitoring fluid deficit

Also Published As

Publication number Publication date
SE9201449D0 (sv) 1992-05-08
SE500960C2 (sv) 1994-10-10
SE9201449L (sv) 1993-11-09

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