RU2410135C1 - Method of preventing contact of fluid contents of intraocular neoplasm with surrounding tissues in case of transscleral introduction and removal of electrodes - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: electrodes are introduced into tumour and are removed from tumour in transscleral way through reservoir for fluid collection.

EFFECT: method allows to exclude contact of fluid contents of intraocular neoplasm with surrounding tissues through wound canal in case of transscleral introduction and removal of electrodes.

Description

The invention relates to medicine and can be used in ophthalmology and ophthalmic oncology to prevent contact of the liquid contents of the intraocular neoplasm with surrounding tissues during transscleral insertion and removal of electrodes.

At the present stage of development of ophthalmic oncology, preference is given to organ-preserving methods of treatment of intraocular neoplasms.

In this regard, the method of electrochemical lysis (ECL) (destruction) is of interest. The principle of ECL is based on the direct effect of direct current on the tumor (electrodes (anode, cathode) are injected directly into the tumor) with the occurrence of aseptic necrosis and delayed chemical exposure to the tumor by electrolysis products in the form of alkali and acid. Alkali and hydrogen are formed at the cathode, hydrochloric acid, oxygen, and chlorine are formed at the anode. This leads to a shift in pH. The ECL process is not accompanied by an increase in temperature, which fundamentally distinguishes this method from radiofrequency, plasma and laser ablation.

Electrochemical lysis is quite successfully used to treat breast cancer, with malignant neoplasms of the liver and liver metastases from various primary tumors, with benign prostatic hyperplasia, with cancer of the esophagus, lung, pancreas, and skin.

Needle electrodes are used for ECL of intraocular neoplasms (patent for invention No. 2336059), however, when they are introduced and removed, it is impossible to exclude contact of the liquid contents of the intraocular neoplasm with surrounding tissues through the wound channel, which is a violation of ablasticity.

The authors in available sources have not been able to find a way to prevent contact of the liquid contents of the intraocular neoplasm with surrounding tissues during transscleral administration and removal of the electrodes.

The objective of the invention is to develop a method for preventing contact of the liquid contents of the intraocular neoplasm with surrounding tissues during transscleral insertion and removal of electrodes.

The technical result is the exclusion of contact of the liquid contents of the intraocular neoplasm with surrounding tissues through the wound channel during transscleral insertion and removal of the electrodes.

The technical result is achieved due to the fact that the electrodes are introduced into the tumor and removed from the tumor transsclerally through a container for collecting fluid.

The liquid collection tank is made of elastic bioinert translucent material, for example, silicone, 0.25-0.3 mm thick, has a cylindrical shape, base diameter 4.0-6.0 mm, height 10.0-30.0 mm.

The method is as follows.

At the preparatory stage for ECL, if necessary, rectus muscles are cut off to provide access. Transsclerally diaphanoscopically clarify the location and size of the tumor, determine the boundaries of the projection of the base of the tumor on the sclera, as well as the points of transscleral insertion of the electrodes and outline them with a coloring matter, for example, 1% aqueous-alcoholic solution of brilliant green.

For the introduction of the electrodes, a spear with screw length control and a cannula for instruments of 25 G are used. The necessary spear length is established (the length of the extrascleral part of the cannula is 25 G + the thickness of the bottom of the reservoir for collecting fluid + the thickness of the sclera (according to preliminary ultrasound) + the depth to which the electrode injected into the tumor (according to preliminary ultrasound)). Then, a container for collecting fluid is installed on the sclera so that the center of its base coincides with the point of introduction of the electrode into the tumor. Using a spear mounted in the cannula canal, a sclerotomy is performed through a fluid collection container, introducing a full-length spear into the tumor structure. The spear is removed from the cannula canal and an electrode is introduced into it (into the canal) of a pre-selected length (defined as the length of the spear).

After the introduction of the electrodes, ECL of the tumor is carried out with a charge of 27-50 C. At the end of the ECL, the electrodes and 25 G cannulas are removed, and the liquid collection tank is removed. Sclerotomy is not sutured. When the muscles are cut off, they are hemmed into place.

The invention is illustrated by the following data.

ECL using the proposed method for preventing contact of the liquid contents of the intraocular neoplasm with surrounding tissues during transscleral insertion and removal of the electrodes was performed on 4 eyes with large choroid melanomas: prominence - more than 9 mm, base width - from 13 to 19 mm.

We used containers for collecting liquid from elastic bioinert translucent silicone with a thickness of 0.25-0.3 mm, a cylindrical shape, the diameter of the base was from 4.0 to 6.0 mm, and the height was from 10.0 to 30.0 mm.

During the introduction and removal of the electrodes, the liquid contents of the tumor accumulated in the container. No fluid outflow from the reservoir and its contact with surrounding tissues was noted.

Thus, the claimed invention ensures the exclusion of contact of the liquid contents of the intraocular neoplasm with surrounding tissues through the wound channel during transscleral insertion and removal of the electrodes.

Claims (2)

1. A method for preventing contact of the liquid contents of an intraocular neoplasm with surrounding tissues during transscleral insertion and removal of the electrodes, the method being that the electrodes are introduced into the tumor and removed from the tumor transsclerally through a fluid collection container. 2. The method according to claim 1, characterized in that the container for collecting liquid is made of elastic bioinert translucent material with a thickness of 0.25-0.3 mm, has a cylindrical shape, the diameter of the base is 4.0-6.0 mm, height 10, 0-30.0 mm.