RU124550U1 - LARGE GAS LAVAGE PROBE - Google Patents

Abstract

A probe for performing lavage of a thick pick, containing a tube, characterized in that the tube is made with holes: a hole in the tip (1) for withdrawing a metal rod, holes for decompression (2), holes for supplying water (3); balloon dilator (4), located proximal from the holes; at the proximal end of the tube there is a port with an anti-return valve (5), communicating with the channel for inflating the balloon (6); inside the tube there is a metal rod (9), the tube consists of three channels that are not interconnected - a channel for inflating the balloon (6), a drainage channel (7), a channel for supplying water (8).

Description

The utility model relates to medical equipment, namely to devices designed to perform lavage of the colon. An analogue of the proposed device is a single-lumen plastic tube with a tip (Wilson-Cook splinting device, 180 cm long and 8 mm in diameter, with lateral holes at the distal end) [Kondratenko PG, Stukalo AA, Radenko E.E . Gastrointestinal endoscopy. A practical guide. - Donetsk, 2007. - 374 s]. However, the known device has several disadvantages. One of the disadvantages is the inability to fix the tube in the lumen of the colon, because the Wilson-Cook device is intended for single colon lavage during colonoscopy. For adequate colon sanitation, repeated colonoscopy is necessary. The presence of a single lumen in the Wilson-Cook device makes it difficult to hold the tube itself beyond the level of the tumor, and adequate lavage of the intestinal contents due to the lack of a channel for irrigation, which is necessary in the presence of dense feces. Thus, it is relevant to develop a probe for performing lavage of the colon, which does not have these drawbacks.

Achievable technical result is the decompression of the colon during its narrowing (obstruction), due to the constant lavage of feces from the intestinal lumen proximal to the obstruction. This allows you to delay the emergency operation, and prepare the patient for radical surgical treatment.

A useful model is the developed silicon-organic tube in the modification of the N.V. Sklifosovsky research institute of joint ventures - length 180 cm, diameter 8 mm. The probe (FIGS. 1, 2) contains a tube with holes: a hole in the tip (1), holes for decompression (2), holes for supplying water (3); balloon dilator (4) located proximal from the holes. At the proximal end of the tube there is a port with an anti-return valve (5). Inside the tube has three channels - a channel for inflating the balloon (6), a drainage channel (7), a channel for supplying water (8). In addition, a metal rod (9) extends inside the tube, which exits the tube through an opening in the tip (1).

Holes for decompression (2) located in the distal part in channel 7 are designed for decompression and aspiration of the contents of the intestine. Water supply openings (3) in the distal part of channel 8 are intended for irrigation with aqueous solutions of the intestinal lumen. Channel 6 contains a balloon dilator (4) and a port with an anti-return valve (5). Channel 6, 7 and 8 are not communicating with each other. Channel 6 only communicates with a port with an anti-return valve, and serves to inflate the cuff.

The use of a utility model is possible in patients with colon cancer complicated by large bowel obstruction.

Patients with the above pathology after performing lavage of the colon and setting indications for surgery, laparoscopy is performed after 2-3 days. If, according to the results of fibrocolonoscopy, the intestinal lumen in the area of tumor stricture reaches 3 mm or more, then this is more likely to indicate an unexpanded tumor stenosis with an undeveloped tumor channel. In this case, the probe developed at the N.V. Sklifosovsky research institute is used.

The probe is inserted proximal to the level of obstruction and is fixed proximal to the narrowing. Fixation is carried out by inflating the balloon dilator (4) through the port (5) at the distal end of the probe. To confirm the localization of the proximal end of the tube above the stricture, a water-soluble contrast medium (for example, Omnipack) is introduced through its lumen, followed by x-ray control. After performing recanalization of the lumen of the intestine, it is repeatedly washed. After the probe is inserted proximal to the tumor narrowing, an additional port (5) is used to fix the probe through the channel for inflating the balloon (6), liquid (water) that enters the balloon dilator (4) and inflates it. Through the water supply channel (8), water is brought under pressure, which enters through the water supply openings (3) into the intestinal lumen. Through holes for decompression (2), water from the intestinal cavity enters the drainage channel (7) and, together with feces, flows out.

After resolving obstructive intestinal obstruction, after 2-3 days in a delayed order, a radical operation is performed by the video laparoscopic method, which includes removing the tumor with the formation of a primary intestinal anastomosis. The operation is performed according to the standard technique, which includes the video laparoscopic stage of tumor mobilization using the Ultracision ultrasound generator and the LigaSure electrolytic apparatus and subsequent resection of the intestinal site affected by the tumor, with the formation of the primary intestinal anastomosis in an extra- or intra-abdominal way.

Clinical example No. 1.

Patient: C, 72 years old. Clinical diagnosis: Stenosing rectosigmoid tumor. T3NxMx. Obstructive colonic obstruction. He entered the institute with a clinical and instrumental picture of acute intestinal obstruction. Rg of the abdominal cavity: colonic obstruction. Under intravenous anesthesia, a sigmoidoscopy, tumor stricture stricture, colon intubation were performed. The study revealed decompensated tumor stenosis of the distal sigmoid colon and rectosigmoid junction zone up to 10 cm in length. Roughening and intubation of the rectum and sigmoid colon with a probe proximal to the tumor level were performed. With x-ray control: low obstructive colonic obstruction with pronounced positive dynamics. After 3 days from the moment of endoscopic resolution of acute colonic obstruction, an operation was performed: laparoscopic anterior resection of the rectum with the formation of a sigmorectal anastomosis in a hardware way. The postoperative period is smooth. In satisfactory condition, the patient was discharged from the hospital.

Clinical example No. 2.

Patient: N, 59 years old. Clinical diagnosis: Cancer of the sigmoid colon. T3NxMx. Obstructive colonic obstruction. He entered the institute with a clinical and instrumental picture of acute colonic obstruction. Under intravenous anesthesia, a sigmoidoscopy, tumor stricture stricture, colon intubation were performed. The study revealed extended to 6 cm decompensated tumor stenosis of the distal sigmoid colon. When x-ray control study: low obstructive colonic obstruction with pronounced positive dynamics. After 2 days from the moment of retrograde intubation of the colon, a laparoscopic resection of the sigmoid colon was performed with the formation of rectosigmanastomosis with an end-to-end circular apparatus. The postoperative period was uneventful. In satisfactory condition, the patient was discharged from the hospital.

Claims (1)

A probe for performing lavage of a thick pick, containing a tube, characterized in that the tube is made with holes: a hole in the tip (1) for withdrawing a metal rod, holes for decompression (2), holes for supplying water (3); balloon dilator (4), located proximal from the holes; at the proximal end of the tube there is a port with an anti-return valve (5), communicating with the channel for inflating the balloon (6); inside the tube there is a metal rod (9), the tube consists of three channels that are not interconnected - a channel for inflating the balloon (6), a drainage channel (7), a channel for supplying water (8).

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