RU37312U1 - CRYOGENIC DEVICE - Google Patents

Description

Utility model Cryogenic apparatus

The utility model relates to the field of medicine, namely to cryogenic devices of active action, and can be used in cryosurgery for cryodestruction of any superficial pathological tissues, tumors and in cryotherapy for the treatment of inflammatory foci, mycoses, for regenerative effects in various fields of clinical medicine (otorhinolaryngology, small oncology, dentistry, gynecologist, surgery).

Currently, the cryogenic method of treatment is widespread in the everyday practice of doctors of many specialties, therefore, in the field of development of cryogenic devices, the most interesting are the simplest in design and use, and at the same time quite reliable cryogenic devices that can be used in real ambulatory cryosurgery and cryotherapy.

A well-known autonomous cryogenic apparatus containing a thermally insulated container for cold halogen with a sealing plug, channels for supplying and discharging a coolant, an emergency pressure relief valve, a channel for raising pressure, an evaporator, an applicator (Bozhenkov Yu.G., Afanasyev V.A. - A.S. USSR No. 1242142, publ. 07.07.86, bull. No. 25).

The device has a rather complex design, it is not universal: it cannot be used for cryoapplication and at the same time cryo-spraying, cryomassage, etc. The refrigerating capacity of the apparatus is limited, since the refrigerant supply pipe is not constantly in the vapor of liquid nitrogen. The emergency relief valve is a separate part, which complicates the design. The refrigerant from the flask is not fully used, as

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The construction of the end of the supply tube does not allow nitrogen to be taken from the very bottom of the flask.

A device is known - a medical portable cryogenic apparatus “Ledok - containing a container for a refrigerant with a sealing conical plug, channels for supplying a refrigerant and raising pressure in a tank passing through a plug, draining a refrigerant, augf-pressure relief valve (in the book: Laser, cryogenic methods of surgical treatment and their combination in cancer of the larynx. - Kochenov V.I. - Diss.doct.med.med.nas., N. Novgorod, 1992., pp. 60-61). The device assumes for use as a container for liquid nitrogen a 200-250-gram thermos, the sealing plug is made of frost-resistant rubber, the channels for raising pressure, supply and removal of the refrigerant are made of stainless steel. The emergency pressure relief valve is spring-loaded, for it there is an additional channel in the plug.

The device operates as follows. 2/3 liquid nitrogen is poured into the container. The vessel is sealed with a stopper, on which refrigerant supply valves, pressure boost valves and an emergency valve are mounted. The pressure is raised using a pear with a check valve due to the injection of air into the puffed up bubble of the vessel. The refrigerant under pressure rushes along the nitrogen supply channel to the working end of the applicator, brings it into working condition, lowering the temperature. Next, the refrigerant spontaneously discharged through the channel of the outflow of refrigerant through the channel to the evaporator, open at the end of the channel. Thus, deep cooling of the working tip is ensured and it is maintained in working condition during very long cryotherapy and cryodestruction of tissues of various localization.

However, the plug hardens when working with the device and is fixed in the neck of the thermos. With a sharp rise in refrigerant pressure in a thermos, time is required for the emergency valve to operate, the thermos flask may burst with a sharp emergency pressure rise. When the cryotherapy is stopped, the air is pumped into the flask. However, a rather long time is required for the pressure in the flask to fully approach atmospheric pressure. This continues the flow of refrigerant to the tip, and the applicator continues to cool. It is not possible to quickly stop cryotherapy in the presence of adhesion of the applicator and tissue. In emergency and emergency situations that may occur during the work of the otorhinolaryngologist, oncologist (gag reflex, loss of consciousness), complications may occur. It requires the complete consumption of the refrigerant and the complete thawing of the plug in order to refuel the device with the refrigerant. The presence of a special emergency pressure relief valve complicates the design and use of the apparatus, and provides additional weight.

For the prototype of the proposed utility model, the well-known cryosurgical unit “CryoIney” was selected, containing a capacity for a refrigerant with a capacity of 400 ml, a pressurized roof, on which an emergency pressure relief valve, channels for supplying and discharging a refrigerant located coaxially inside the cannula, an applicator (Erganokov Kh.Kh., Shtanchaev MI - Cryosurgical apparatus. - RF Patent No. 2034517, publ. Bulletin No. 13, 1985).

The apparatus contains a specially made insulated container for a refrigerant, in the neck of which a cartridge with a vertical part of the refrigerant supply channel is hermetically mounted, a cylindrical body with a horizontal portion of the supply channel and a discharge channel equipped with a refrigerant discharge cavity is mounted on the cartridge, and

also an emergency relief valve. A set of operational tips was made to the device.

The apparatus is used as follows. 2/3 liquid nitrogen is poured into the container, closed with a lid, and the container is sealed. Expect a passive increase in pressure. They press the handle of the refrigerant supply valve, wait for the liquid refrigerant to exit the cannula, while the applicator cools, it is pressed against the pathological tissue without stopping the supply of refrigerant. At the end of the application, the applicator is removed from the fabric and the supply of refrigerant is suppressed.

However, the apparatus is too bulky, has a large weight (900-950 g), requires the manufacture of a special container, which increases its cost, has a rather complicated construction; the emergency pressure relief valve and the handle of the refrigerant supply valve are separate parts. During operation, the pressure inside the vessel is constantly increased (200 mmHg), which reduces the safety of the device, since the emergency pressure relief valve can freeze from the inside, and this will lead to an explosion of the device. The device goes to operating mode too slowly - within 20-30 seconds. There is no possibility to regulate the air supply to the tank and control the pressure in it. In a passive state, that is, when the application effect is stopped, the air supply and the flow of liquid nitrogen continue, there is no opportunity to save it. In addition, a constant supply does not allow nitrogen to stop in one place inside the cannula at the applicator, it is constantly blown away by a new portion of liquid gas, but heat transfer is possible only when nitrogen droplets stop motionless. The outer surface of the cannula is completely thermally insulated, which does not allow to control the temperature of the refrigerant, since you can only monitor the cooling of the applicator itself. The device is not always convenient for the surgeon at work, since during

the application time in the general static position does not allow sliding along the cannula for the hirug's hand. In addition, the spent LIQUID nitrogen flows during operation from the emergency pressure relief valve to the surgeon and patient. The cryo-tips offered in the kit limit the use of the instrument, since they have too large diameters for working in narrow cavities (nose, urethra).

The objective of the proposed utility model is the design, ensuring safety, simplicity and convenience when working with a cryosurgical apparatus.

A complete task is achieved by the fact that in a known cryosurgical apparatus containing a refrigerant container, a sealing cap, on which an emergency pressure relief valve, supply and removal channels of a refrigerant coaxially located inside the cannula are placed, an applicator, the outer part of the channel is fixed on the side surface of the sealing cap pressure relief, made in the form of a bell and coaxially inserted inside a conical plug of an elastic tube for connection to a source of pressure air, and the plug is placed in the socket with the possibility of sliding along the axis of the channel and sealing the channel, on the opposite side of the surface of the sealing cover are rigidly fixed on top of the cover - cannula, and on the bottom of the cover is a coolant supply channel with the possibility of reaching the near-bottom part of the tank with the cap fully secured to the tank, moreover, the cannula is made longer than the vertical part of the coolant supply channel, the distal portion of the cannula, the length of which is 5-10 diameters of the cannula, is made non-heat insulated, a cavity is made in the middle of the sealing cover, into which the refrigerant removal channel is led out, and the cavity is provided with an opening with a discharge tube directed upward and

away from the cannula, the device is located on the base of the sealing cap of a household metal thermos with a capacity of 100-1000 ml, the source of pressure increase in the container is the respiratory p) human (surgeon), the proximal and middle sections of the cannula are equipped with an insulating tube made of low or non-conductive material, with the possibility of displacement along the cannula, the coolant supply and exhaust channels are made telescopic, while the distal part of the supply channel is fixed by jumpers inside the exhaust channel, the cannula is made in one of Vuh options.

A proposed utility model is depicted in FIG. 1.

The device contains: 1 - a container for a refrigerant, 2 sealing krypps, 3 - a channel for increasing pressure, 4 - a channel for supplying a refrigerant, 5 - a channel for removing a refrigerant, 6 - a cannula, 7 - an applicator, 8 socket, 9 - a cone-shaped plug, 10 - elastic a tube for connecting to a source of pressure rise, 11 - a cavity in the sealing cover, 12 - a hole in the cover, 13 - a discharge tube, 14 - an insulating tube, 15 - jumpers.

On the side of the surface of the sealing cover 2 is fixed the outer part of the pressure lifting channel 3, made in the form of a socket 8 and coaxially inserted inside the conical plug 9 of the elastic tube 10 for connection to a source of pressure lifting air, and the plug 9 is placed in the socket 8 with the possibility of sliding along the axis channel and pressurization channel 3, On the opposite side of the surface of the sealing cover 2 are rigidly fixed on top of the lid - cannula 6, and from the bottom of the lid - the coolant supply channel 4 with the possibility of reaching eniya okolodoshyuy of the container 1 when fully fixing the lid 2 on the container 1, the cannula 6 is made longer than the vertical portion of the channel 4 supplying coolant. The distal section of the cannula 6, the length of which

it is equal to 5-10 diameters of the cannula 6, it is filled with non-heat insulated. In the middle of the sealing cover 2, a cavity 11 is made, into which the refrigerant exhaust channel 5 is led out, and the cavity 11 is provided with an opening 12 with a discharge tube 13 directed upward and away from the outer part of the cannula 6. As a source of pressure increase in the container 1, airways of a person (surgeon). The proximal and middle sections of the cannula 6 can be equipped with an insulating tube 14 of low or non-conductive material, with the possibility of displacement along the cannula 6. The supply channels 4 and the refrigerant outlet 5 can be made telescopic, while the distal part of the supply channel 4 is fixed by jumpers 15 inside channel 5. The cannula 6 is made in one of two ways. The whole device is placed on the basis of a sealed cover 2 of a household metal thermos 1 with a capacity of 100-1000 ml.

The cone-shaped sealing plug 9 located in the socket 8 of the pressure-lifting channel 3 acts as an emergency pressure-relief valve: when it increases excessively in the tank 1, the tube 9 slides in the socket 8 along the axis of the pressure-lifting channel 3, flies out of the socket 8 and depressurizes the container 1, refrigerant supply to the applicator 7 is terminated.

For the convenience of using the apparatus, the pressure lifting channel 3 with the possibility of emergency discharge through it of excess pressure and the working cannula 6 are placed on opposite sides of the surface of the cover 2, and the hole 12 with the exhaust pipe 13 can be located on either side of the axis connecting the channel 3 and cannula 6 , the choice of layout option depends on the individual working skills of the surgeon (right-handed or left-handed).

screwed sealed cover 2, channel 4 feed reaches the lower, near-bottom part of the tank 1, but does not touch its bottom, and the length is taken out of the onyte and is determined by the size of the thermos.

The need to turn the length of the cannula 6 relative to the height of the vertical part of the refrigerant supply channel 4 is also determined experimentally: this ratio facilitates the supply of the refrigerant to the applicator 7, makes it possible to quickly deliver liquid nitrogen to the tip of the distal part of the cannula 6 when supplying one portion of air and the smallest increase in pressure. and stop it at the applicator 7, providing its bubble boiling and evaporation not on the walls of the cannula 6, namely on the applicator 7, and cooling the applicator 7 to ultra-low temperatures ry. The distal portion of the cannula 6 is made non-insulated for constant visual control of the temperature of the applicator 7. On this side, when the liquid nitrogen stops and the heat exchange starts, oxygen from the surrounding air is liquefied and when the lowest temperature reaches -182 ° С with the formation of a wet film on the visible surface cannula 6 and applicator 7. The presence of a film is the simplest criterion for operability of applicator 7. The length of the area where oxygen is liquefied is 5-10 diameters of cannula 6, which determines Leno experimentally, as further implementation of liquefaction of the applicator causes transfusion liquid nitrogen outlet channel 5 and ejection of liquid nitrogen outwards and sokrashenie length neteploizolirovashyugo distal j iacTKa requires frequent air supply portions and does not implement the passively draining liquefied oxygen in the freezing zone.

To supply air to the container and increase pressure, an electric compressor, an air blower, a blower with a check valve, and a foot mechanical pump can serve. The proposed utility model uses

airway of a person, Henoq) eflCTBeHHO performing cryotherapy: the surgeon himself, with the possibility of visual control of the sufficiency of a portion of the nitrogen supplied, determines the dose and time of the next supply by simply blowing air into the elastic tube, that is, regulates and controls the pressure.

For a number of cases, when performing cryosurgical operations with adhesion, when the applicator 7 must be brought uncooled to the pathological tissue, for short-term therapeutic applications for some external lesions, as well as when working through tubular endoscopes of different lengths at different depths, for example, with bronchoscopy, laryngoscopy, esophagoscopy, colonoscopy, supply channels 4 and coolant removal 5 are made telescopic, while the distal part of the supply channel 4 is fixed by jumpers 15 inside the removal channel 5.

To more accurately bring the applicator 7 to the pathological focus, the proximal and middle parts of the cannula 6 are equipped with an insulating tube 14 of low or non-conductive material, with the possibility of displacement along the cannula 6. At the same time, the tube 14 serves as a support, for example, on the edge of the endoscope, on the lip , the patient’s teeth while promoting the cannula 6 inside it.

Cannula 6 of the device is made in one of two options: with a diameter of 3-4 mm (most convenient for deep procedures - in the larynx, pharynx, urethra, cervical canal) or with a diameter of 8-10 mm (for treating external

defeats). Sizes are determined from the experience of using the proposed

utility model.

The proposed utility model works as follows.

Before starting work, choose a device with a cannula of 6 suitable, depending on the object of treatment, diameter: 3-4 mm or 8-10 mm. in a container 1 is poured into 2/3 of liquid nitrogen. Close and screw the container 1 with a sealing buckle 2. At the first moment after that, the pressure inside the container 1 rises slightly, and the liquid nitrogen boils slightly and evaporates. To ensure the safety of further work, as well as the prevention of untimely depressurization of the tank 1, the pressure rising channel 3 is not closed for 1-1.5 minutes to relieve refrigerant vapor and overpressure. Then, a cone-shaped plug 9 is tightly inserted into the socket 8 of the pressure lifting channel 3 to ensure sealing. To increase the pressure in the tank 1 and ensure the supply of liquid nitrogen to the applicator 7, the elastic tube 10 is connected to a source of pressure increase. B, when the surgeon’s respiratory tract is the source of pressure increase, the surgeon takes an elastic tube 10 inserted into the sealing plug 9 into his mouth and blows it into it, forcing warm air into the container 1. When performing any type of pressure lifting, the cone-shaped sealing plug 9 works like a valve emergency pressure relief: if it is excessively increased in the tank 1, the plug 9 slides in the socket 8 along the axis of the pressure rising channel 3, flies out of the socket 8 and depressurizes the container 1, the flow of refrigerant to the applicator 7 stops i. The air supply to the container 1 is carried out portionwise. In any variant of supplying air to the container 1 (for example, in the case when the surgeon blows into the elastic tube 10), the liquid nitrogen in the gas bubble of the container 1 partially evaporates, an increase in pressure occurs in the container 1, due to excess pressure, the liquid nitrogen rushes through the supply channel 4 to the applicator 7 and stops in the distal part of the cannula 6 at the applicator 7. When the liquid nitrogen stops in the feed channel in the distal part of the cannula 6 at the applicator 7 begins

heat transfer between liquid nitrogen and applicator 7: liquid nitrogen evaporates, and applicator 7 begins to cool. Appearance after 2-5 seconds. on the surface of the non-heat-insulated distal part of the cannula 6 and the applicator 7 of the film naccimno oxygen liquefied from the ambient air is a criterion that the applicator 7 is brought into working condition. The submission fee is stopped. Further produce

cryotherapy of the applicator 7, moreover, with a therapeutic effect (for example, on the inflammatory focus), first supply air and cool the dry applicator 7, and then produce short-term applications, and during surgical application, apply the moistened applicator 7 to the focus () warm and begin to supply air and lift pressure. In this case, the cannula 6 during operation is facing the distal part with the applicator 7 down. In some cases, when performing cryosurgical operations with adhesion, as well as when working through tubular endoscopes of different lengths at different depths, telescopically made supply channels 4 and 5 of coolant are used, and for a more accurate lead of applicator 7 to the pathological focus, the insulating slide along the cannula 6 the tube 14, which also serves as a support, for example, on the edge of the endoscope, lip or teeth of the patient while moving the cannula 6 inside it.

The operation of the applicator 7 at an extremely low temperature of -182 ° C is supported for a long time by portioned air supply during visual monitoring by the surgeon of the degree of cooling of the applicator 7 by the presence of a film on the surface of the distal part of the cannula 6 and applicator 7.

The pressure in the tank 1 is also increased by simply swaying the thermos or rotating it lightly, provided that the pressure rise channel 3 is completely sealed by bending and clamping the tube 10.

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applicator 7 comes into working condition, super-cold (-182 ° C) for short-term therapeutic applications without adhesion.

During operation, the refrigerant spontaneously is discharged along the exhaust channel 5 into the cavity 11 made in the middle of the sealing cover 2, evaporates inside the cavity 11 and through the hole 12 with the discharge tube 13 enters the atmosphere up and to the side of the cannula 6 in the form of steam.

Clinical practice using cryogenic annarat in the cryology laboratory of NGMA revealed that the proposed utility model, in comparison with known technical solutions, provides:

- safety in the non-working state: the pressure lifting channel is simply open to the atmosphere - there is no pressure inside the vessel;

-safe during operation: the plug acts as an emergency valve in the channel for raising pressure and flies out when the pressure inside the thermos is exceeded;

-tightness: liquid nitrogen during operation does not leak out, but evaporates inside the lid, only a small amount of steam leaves the hole;

-simplicity in work: the surgeon can carry out air supply and pressure rise by mouth, and if the pressure lifting channel is sealed (the tube is bent and clamped), then just shake the thermos to bring the applicator into working condition;

-convenience in the work through the use of a) a suitable layout option for the surgeon (opposite location on the lid of the working cannula and the pressure-lifting channel); b) directivity upward and away from the cannula of the gas discharge opening and its variable performance; c) a light thermos of small capacity;

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- variety of varivgggs of air supply;

-possibility of portioned supply of refrigerant;

-the ability to visually control the temperature of the applicator by the presence of a film of passively liquefying oxygen on the cannula and applicator;

-multifunctionality; the device allows you to work both therapeutically - without adhesion, and surgically with adhesion, both during short-term exposure, and through tubular endoscopes of different lengths, with a telescopic cannula and an insulating sliding tube;

-efficiency: dosed, portioned supply of refrigerant and the absence of emission of liquid nitrogen

-convenience of sterilization, since the thermos is metallic from the outside;

-the possibility of outpatient use, in field conditions, in major surgery (during operations under general anesthesia);

-cheap cost: the entire device is aligned on the basis of the cover of a household metal thermos.

Examples confirming the possibility of using a utility model.

Example 1. Patient E-va L.G., 25 years old, an extract from an outpatient card K 345. I applied on 12.04.2002. about the presence of warts on the hands, of which two - with a diameter of 7 and 8 mm and 6 warts - with a diameter of 1-2 mm.

Before starting cryotherapy, a soap solution was prepared. We chose 2 devices: with a cannula with a diameter of 8 mm for large warts and a diameter of 8 mm for small ones. Poured into 2/3 of liquid nitrogen into the container capacity with an 8 mm cannula, closed and screwed the container with a sealing cap. The pressure inside the vessel increased slightly, the liquid nitrogen boiled slightly and began to evaporate. The pressure raising channel was not closed for 1-1.5 minutes to relieve refrigerant vapor and overpressure.

Then, a cone-shaped plug was tightly inserted into the socket of the pressure lifting channel and the container was sealed. They moistened the surfaces of large warts with soapy water, dipped the tip of the applicator into the solution for a short time, slowly removed it, made sure that there was a hanging drop of liquid at the tip of the applicator. They applied a moistened warm applicator to the surface of the wart (7 mm), pressed a drop with the applicator to the surface so that it spread slightly around the tip of the applicator to the boundaries of the formation. To increase the pressure in the container and ensure the supply of liquid nitrogen to the applicator, the surgeon took an elastic tube inserted into the sealing plug into his mouth and blew it into it, pumping warm air into the container. In this case, the liquid nitrogen in the container’s gas bubble partially evaporated, the pressure increased in the container, due to overpressure, the liquid nitrogen rushed through the supply channel to the applicator and stopped in the distal part of the cannula at the applicator, heat transfer between the liquid nitrogen and the applicator began, the applicator began to cool. After 2-5 seconds On the surface of the non-heat-insulated distal part of the cannula and on the applicator, a film of oxygen passively liquefied from the surrounding air appeared, after which the air supply was stopped. In this case, the cannula during operation was facing the distal part with the applicator down at an angle of 35-40 °. The instant freezing of the drop and the onset of adhesion between the applicator and the drop, as well as between the drop and the wart, were noted. The applicator continued to be cooled while maintaining tight contact between them, portionwise supplying air to the container and observing the growth of the freezing zone with an exit by 2-3 mm beyond its limits. Immediately, without waiting for the applicator to warm up, with a sharp rotational movement, holding the frozen wart with his hand, the applicator was torn from the drop, breaking it; moreover, a piece of ice remained on the applicator. Applicator operation u) and ultra-low temperature of -182 ° С

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It was maintained for a long time by portioned air supplies during visual monitoring by the surgeon over the degree of cooling of the applicator by the presence of a film on the surface of the distal part of the cannula and the applicator. During operation, the refrigerant was spontaneously discharged through the discharge channel into the cavity made in the middle of the sealing cover, evaporated inside the cavity and through the hole with the discharge tube went into the atmosphere up and to the side of the cannula in the form of steam, without interfering with the surgeon's work.

Immediately, without waiting for the wart to thaw, the applicator was warmed up with a piece of ice thawed on it and hung in the form of a drop over the flame of an alcohol lamp until the drop boils, slowly moved the applicator to another wart (8 mm) and made a freezing in the same sequence of actions as for first. Repeated freezing of large warts 3 times. Further, a device with a cannula with a diameter of 4 mm likewise acted on small warts.

Example 2. Patient M-in K.L., 45 years old, extract from outpatient card No. 233. I applied on 05.05.2002. about fibroids of the skin of the forehead with a diameter of 5 mm.

Before starting cryotherapy, a soap solution was prepared. We chose a cryogenic apparatus with a cannula with a diameter of 8 mm. Poured into the container 2/3 of liquid nitrogen, closed and screwed the container with a sealing cap. The pressure inside the tank increased slightly, liquid nitrogen boiled slightly and began to evaporate. The pressure raising channel was not closed for 1-1.5 minutes to relieve refrigerant vapor and overpressure. Then, a cone-shaped plug was tightly inserted into the socket of the pressure lifting channel and the container was sealed. They moistened the surface of the fibroma with a soap solution, briefly dipped the tip of the applicator into the solution, slowly ejected it, made sure that there was a hanging drop of liquid at the tip of the applicator. The cannula was set for work

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the distal part with the applicator down at an angle of 35-40 °. They applied a moistened warm applicator to the surface of the fibroma, and a drop was pressed with the applicator to the surface of the fibroma so that it spread slightly around the tip of the applicator to the boundaries of the formation. To increase the pressure in the container and ensure the supply of liquid nitrogen to the applicator, the surgeon injected warm air into the container with a pear with a check valve. In this case, the liquid nitrogen in the container’s gas bubble partially evaporated, the pressure increased in the container, due to overpressure, the liquid nitrogen rushed through the supply channel to the applicator and stopped in the distal part of the cannula at the applicator, heat transfer between the liquid nitrogen and the applicator began, the applicator began to cool. After 2-5 seconds On the surface of the non-insulated distal part of the cannula and on the applicator, a film of oxygen passively liquefied from the ambient air appeared, after which the supply of air was stopped and the layer of liquefied oxygen was waiting to drip to the tip of the applicator. We observed instant freezing of the drop and the onset of adhesion between the applicator and the drop, as well as between the drop and the fibroma. The applicator continued to be cooled while maintaining tight contact between them, portionwise supplying air to the container with a decrease in the layer of liquefied oxygen and observing the growth of the freezing zone with a step outside of it by 1-2 mm. Without waiting for the applicator to warm up, with a sharp, dreadful twitch, holding the frozen flower pot by hand, the applicator was torn from the drop, breaking it. After natural thawing of the pathological tissue, the freezing and thawing of fibroma was repeated 4 times. During operation, the refrigerant spontaneously was discharged through the drain channel into the cavity made in the middle of the seal cover, evaporated inside the cavity and through the hole with the discharge tube went into the atmosphere up and to the side of the cannula in the form of steam, without interfering with the surgeon's work.

Claims (4)

1. A cryogenic apparatus containing a refrigerant container, a sealing cap, on which an emergency pressure relief valve is located, supply and removal channels of the refrigerant coaxially located inside the cannula, an applicator, characterized in that the outer part of the pressure lifting channel is fixed on the side of the surface of the sealing cap made in the form of a bell and coaxially inserted inside a conical tube of an elastic tube for connection to a source of increasing air pressure, and the tube is placed in a a pipe with the possibility of sliding along the axis of the channel and sealing the channel, on the opposite side of the surface of the sealing cover are rigidly fixed on top of the cover - the cannula, and on the bottom of the cover - the refrigerant supply channel with the possibility of reaching the near-bottom part of the tank with the cap fully fixed on the tank, the cannula being made longer than the vertical part of the refrigerant supply channel, the distal part of the cannula, the length of which is 5-10 diameters of the cannula, is made non-heat-insulated, in the middle of the sealing cover in A cavity has been made into which a refrigerant removal channel is led out, and the cavity is provided with an opening with a discharge tube directed up and away from the cannula, the device is placed on the base of the sealing cap of a household metal thermos with a capacity of 100-1000 ml. 2. The cryogenic apparatus according to claim 1, characterized in that the respiratory tract of a person (surgeon) is a source of increasing pressure in the container. 3. The cryogenic apparatus according to claim 1, characterized in that the proximal and middle portions of the cannula are equipped with an insulating tube of low or non-conductive material, with the possibility of displacement along the cannula. 4. The cryogenic apparatus according to claim 1, characterized in that the supply and exhaust channels of the refrigerant are telescopic, while the distal part of the supply channel is fixed by jumpers inside the exhaust channel.