RU2310407C1 - Single-use troacar-drainage - Google Patents

Abstract

FIELD: surgical instruments.

SUBSTANCE: single-use troacar-drainage has stiletto in form of rod and endoscopic port in form of branch-pipe provided with channel for placing instrument. Additional channel is disposed in wall of endoscopic port. Additional channel begins at front part of port inside it and it goes outside behind flange in form of tube. Channel is oriented at angle to external surface of port. Ring-shaped tapering in form of belt is made on wall of external part of branch-pipe. Belt has length, which corresponds to anatomical sizes of fingers of surgeon or to 2-3 gauges of branch-pipe. Branch-pipe is made of elastic polymer material. Stiletto is made of hard polymer material and it has ring-shaped protrusion and tip with diameter in area of where branch-pipe adjoins tip; diameter of tip is bigger than diameter of branch-pipe. Ring-shaped protrusion is disposed onto rod in area of conjugation with tip. Corresponding hollow is made onto wall of channel of branch-pipe. Single-use silicon troacar-drainage provides access when doing diagnostic testing of serous cavities followed by irrigation of antiseptic preparations through additional channel.

EFFECT: improved efficiency of operation.

3 cl, 4 dwg

Description

The invention relates to medical equipment, namely to surgical instruments, the so-called disposable trocars, combined with drainage.

Known trocar (1), the provision of sealing in which during surgical procedures is carried out by compressing the elastic element with half couplings.

The trocar (2) is a metal port, inside of which there is a removable valve mechanism with an original seal.

A sleeve trocar (3) with a variable insulated passage is a device that relates to sleeve trocars that seal the opening of the input of an endoscopic instrument into the sleeve.

Troakar (4) has a port with a tube and a rotatable lid. The joint arrangement of the tube and the cover makes up the flap type valve device.

The disadvantages of these trocars can be attributed to the many details, the complexity of the design and the lack of a channel for summing antiseptics to the pathological focus.

Trocar (5) can be adopted as a prototype. It has a metal port with a plastic tube and an elastic rubber cap with a flap valve. The valve petal is located at an angle of 45 ° to the central tube. After removing the instrument from the trocar, the valve should return to its original position and press firmly against the end of the tube under the influence of excess pressure in the abdominal cavity. This is a fairly simple and convenient design. However, a small excess pressure in the abdominal cavity is not enough to press the petal to the tube due to the large inertia of the rubber when returning to its original position. In addition, the metal part of the port does not exclude the risk of injury to internal organs, and repeated use of it can lead to accidental transmission of infection. This design also lacks a channel for bringing antiseptics and other drugs to the focus.

There are also well-known drainage designs (6, 7, 8, and 9), which serve for drainage of cavities, suction of liquids from the surgical field during surgical interventions, and also for ensuring irrigation.

The described drainage (10) can be adopted as a prototype. It has an elastic tube with a diametrical longitudinal partition forming a channel sucking in with the side openings, and an aspiration channel and a tip on the working distal part of the tube. The longitudinal partition is not brought to the base of the tip by the amount of clearance equal to at least half the diameter of the tube. The tip is made hollow of soft material. The design allows you to use it for long-term aspiration from the body cavities, helping to reduce the treatment time for purulent diseases.

But this and the other drainages presented above were created for narrow directions and do not allow performing endoscopic examinations of the serous cavity.

The objective of the invention is the creation of a disposable silicone trocar drainage both to provide access when performing diagnostic studies of serous cavities, to monitor the pathological process in the serous cavity (dynamic endoscopy) through trocar drainage without repeated damage to tissues, and to actively aspirate the contents of serous cavities with irrigation of antiseptics through an additional channel of the trocar-drainage. Moreover, the described trocar drainage can be used for endoscopic surgery.

The proposed trocar drainage retains the advantages of the described prototypes and has the following differences:

- on the wall of the outer part of the nozzle, a local annular thinning is made in the form of a girdle, the length of which approximately corresponds to the anatomical sizes of the surgeons' fingers or 2-3 calibers of the nozzle;

- the nozzle is made of flexible polymeric material, and the stylet is made of rigid polymeric material, and the diameter of the stylet rod is approximately equal to the diameter of the nozzle channel, and the diameter of the tip is made somewhat larger than the diameter of the nozzle in the area adjacent to the tip, and on the stylet rod, in the mating zone with a tip, an annular protrusion is made, and a corresponding cavity is made on the wall of the pipe channel;

- the end surface of the protrusion on the rod is made in the form of a truncated cone with a vertex facing the tip, and the corresponding end surface of the cavity on the wall of the pipe channel is made in the form of a truncated cone with a vertex facing the port flange;

- at the end of the endoscopic port, a plug replaced by a fitting is movably fixed;

- in the wall of the endoscopic port passes an additional channel, starting in the front of the port from the inside and going out at an angle to the outer surface of the port behind the pipe flange;

- on the flange of the endoscopic port, a plug is movably fixed to close the additional channel.

The listed differences allow

- increase the reliability of port sealing;

- reduce the risk of nosocomial infection;

- monitor the pathological process in the serous cavity through the trocar without repeated laparocentesis;

- to carry out for active aspiration of the contents of the serous cavities through the large channel of the trocar with the irrigation of antiseptics through the additional channel of the trocar-drainage;

- spend a long stay of the endoscopic port in the serous cavity;

- simplify the technology of manufacturing trocars-drains;

- simplify the use of trocars-drains.

The invention is illustrated by drawings.

Figure 1 presents the main view of the trocar-drainage assembly with an explanatory diametrical section in the form of a tear.

Figure 2 presents a diametrical section in the form of a breakout, explaining the use of the fitting.

Figure 3 presents the detail of the trocar-drainage "Port" in the diametric section with clarifying sections AA, GG and view B.

Figure 4 presents the detail "stylet" with explanatory section BB and view A.

Troakar drainage is a device consisting of an endoscopic port 1 made in the form of an elastic polymer pipe with a channel 2 for holding a tool divided by a flange 3 into an intracavitary 4 and an external 5 part, and a stylet 6 made in the form of a rod 7, limited from one end with a tip 8 with a tip 9 and from the other end by a handle 10. On the wall of the outer part of the pipe, a local ring thinning is made in the form of a belt 11, the length of which approximately corresponds to the anatomical sizes of the fingers of surgeons and and 2-3 caliber pipe. The belt 11 is clamped by hand or tool to ensure tightness. The diameter of the stylet rod 7 is approximately equal to the diameter of the nozzle channel. The diameter of the tip 8 is made somewhat larger than the diameter of the pipe in the area of its adjacency to the tip. An annular protrusion 12 is made on the stylet rod 7, in the interface zone with the tip, and there is a corresponding cavity 13 on the pipe channel wall. The end surface 14 of the protrusion 12 on the rod is made in the form of a truncated cone with the vertex facing the tip, and the corresponding end surface 15 depressions 13 on the wall of the pipe channel is made in the form of a truncated cone with a vertex facing the port flange. On the flange of the endoscopic port, a plug 16 is movably fixed, which is inserted into the inner hole to ensure continuous tightness. For drainage, plug 16 can be replaced by fitting 17. An additional channel 18 passes through the endoscopic port wall, starting from the inside of the port and going outward at an angle to the port outer surface behind the pipe flange, and plug 19 is movably fixed on the endoscopic port flange to close the additional channel.

Trocar drainage is used as follows.

During endoscopy, port 1 is put on stylet 6 and fixed on the protrusion 12 of the stylet with its cavity 13. A small incision is made on the skin at the site of introduction of the trocar-drainage. After the introduction of the tube into the serous cavity, the stylet is removed. Through an additional hole 18 in the serous cavity, gas can be insufflated according to indications. Before the final removal of the stylet, the port is pinched by the belt 11, and after the stylet is removed, the plug 16 is inserted and the clamped belt is pressed. Through the port, you can enter an endoscope or the necessary instrument. First, the band 11 is pinched, the plug 16 is removed, the endoscope is inserted and the clamped band is released. After performing endoscopic operations, if necessary, port 1 is not removed, but closed with a stopper 16 and, thereby creating a tightness, is fixed to the skin with a ligature thread over flange 3 and left in the serous cavity. The use of the fitting 17 instead of the plug 16 allows drainage of the serous cavity. To conduct active drainage of the serous cavity, a vacuum aspirator is attached to channel 2, and through the additional channel 18, antiseptics are added dropwise.

Information sources

1. Patent RU 3043076 C1, cl. A61B 17/34, 1995

2. Patent RU 2187266 C2, cl. A61B 17/34, 2002

3. Patent US 6945983 B2, cl. A61B 17/34, 2005

4. Patent RU 2212198 C1, cl. A61 17/34, 2003

5. Patent RU 2212199 C1, cl. A61 17/34, 2003

6. Patent RU No. 2052999 C1, cl. A61 M 27/00, 1970

7. Patent RU No. 2148419 C1, cl. A61 M 27/00, 1998

8. AS of the USSR No. 1066608, cl. A 61 M25 / 00, 1982

9. AS of the USSR No. 1532056, class A 61 M27 / 00, 1987

10. USSR AS No. 880432, class A 61 M25 / 00, 1981

Claims (3)

1. Disposable trocar-drainage, including an endoscopic port, made in the form of a pipe with a channel for holding the instrument, and having a stylet, in the form of a rod, characterized in that an additional channel is placed in the wall of the endoscopic port, which starts from the inside of the port and exits behind a flange in the form of a tube oriented at an angle to the outer surface of the port, and on the wall of the outer part of the nozzle made local ring thinning in the form of a belt having a length corresponding to the anatomical dimensions of surgeons or 2-3 calibers of the nozzle, the nozzle is made of flexible polymeric material, and the stylet is made of rigid polymeric material and has an annular protrusion and a tip with a diameter in the area where the nozzle adjoins the tip to a larger diameter of the nozzle, while the annular protrusion is placed on the rod in the zone mating with the tip, and on the wall of the pipe channel the corresponding cavity is made. 2. The trocar drainage according to claim 1, characterized in that a plug for closing the additional channel is movably fixed on the flange of the endoscopic port. 3. The trocar drainage according to claim 1, characterized in that the end surface of the protrusion on the rod is made in the form of a truncated cone with the vertex facing the tip, and the corresponding end surface of the cavity on the wall of the pipe channel is made in the form of a truncated cone with the vertex facing flange.

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