RU24102U1 - DEVICE FOR TREATMENT OF CHOLANGITIS - Google Patents

Description

The device relates to medical equipment, namely to devices for conducting intraductal laser irradiation of bile in the postoperative period.

In practical medicine, a fiber-optic instrument for laser therapy is used (patent No. 2056875, 1996). It includes a fiber-optic cable, a tip made of a transparent material, a forming element, a grip, a means for connecting and securing them. It is used for external physiotherapeutic procedures using optical radiation, but cannot be used for intracavitary irradiation of organs and tissues.

The light guide tool we took for the prototype for intracavitary therapeutic treatment of the body (patent No. 20111387, 1994) contains a catheter with a closed rounded distal end made of optically transparent material, a connecting node located on the open proximal end of the catheter, an optical fiber in a protective sheath, the first end of which is the inlet, and the second end is fixed in the connecting node and placed inside the catheter.

The prototype has some disadvantages for irradiating the walls of the common bile duct through external drainage in the postoperative period:

1) the impossibility of precise control over the depth of insertion of the light guide tool into the drainage tube, which on the one hand, when insufficiently administered, makes laser therapy ineffective (the wall of the drainage tube is irradiated), and on the other hand, if it is introduced too much, it can damage the walls of the bile ducts;

2) treatment using the prototype requires repeated administration and removal of the fiber-optic instrument through stationary drainage of the common bile duct, which increases the risk of infection of the bile ducts in the postoperative period;

3) with repeated use of the prototype, sterilization is required after each use, which is inconvenient, since the sterilization process lasts at least two days, while laser therapy sessions must be carried out daily;

To eliminate these shortcomings, we offer a device for the treatment of cholangitis, presented in the form of two modifications:

1) Drainage tube with a quartz monofilament fiber mounted in the lumen (modified Holsted-Pikovsky drainage)

2) T-shaped drainage tube with a quartz monofilament fiber mounted in the lumen (modified Kera drainage)

The device consists of a connector, a plug, a tube for blood collection and transfusion systems, a heat shrink tube and a light guide. One end of the fiber is fixed in the plug, and the other is connected to the connector. The latter is connected to the main light guide coming from a helium-neon laser.

Figure 1 shows a device for treating cholangitis (modification 1). The device contains a connector - 1, a plug - 2, a tube for blood collection and transfusion systems - 3, a heat shrink tube - 4, a light guide - 5.

Figure 2 shows a device for treating cholangitis (modification 2). The device contains a connector -1, a plug -2, a tube for blood collection and targeting systems -3, a T-shaped tube from HBX -4, a heat-shrink tube -5, a light guide -6 .

Work with the device as follows.

A device for treating cholangitis in a sterile form is installed intraoceratively instead of external drainage of the common bile duct in patients with cholangitis. In this case, a device for treating cholangitis is fixed either in the cult of the cystic duct (modification 1) or in the choledochotomy opening (modification 2). A tube for blood collection and transfusion systems (Fig. 1 c) and a T-shaped tube (Fig. 2a, TU6-05-1533-85 PVC 1,5x0,2 transparent PM-1- / 142) function as external choledoch drainage: bile is absorbed along them with bile hypertension concomitant with acute cholangitis. The fiber is proximally fixed in the plug, and distally mounted in the connector, which serves to connect to the main fiber. The proximal 2/3 of the fiber is in the lumen of the drainage tube, and the distal third is located outside. In the area of perforation of the drain tube with a light guide, there is a heat shrink tube (VW-1 SUMI-PAC CSA HSXPO mm). The latter is attached to the drainage tube using glue Elastosil-137 sealant. The radiation of a helium-neon laser through the main fiber enters the connector, which is connected to the fiber of the device for treating cholangitis. The connector is shown in FIG. 1 a, consists of polypropylene 21060 (GOST 26996-86), its length is 24 mm, the diameter of the distal end is 3 mm, the diameter of the proximal end is 4.5 mm. According to the PWF 200T fiber 10/05 / 00/09 mm radiation reaches the plug shown in fig.1b.3 the plug consists of PVC polyvinyl chloride (GOST 9639), the length is 5 mm, the outer end is presented in the form of a sphere, 9 mm, freely transmitting laser radiation. Through the plug, which is located in the common bile duct, the walls of the common bile duct are irradiated, which contributes to an earlier relief of inflammation of the biliary tract.

A device for treating cholangitis has been successfully tested at the 51GB hospital on the basis of surgical departments for 4 years. So, patient B., 84 years old (medical history No. 8698), was operated on for chronic calculous cholecystitis, choledocholithiasis, purulent-fibrinous cholangitis. During the operation, a device for the treatment of cholangitis (modified Kera drainage) was installed. In the postoperative period, laser therapy sessions were carried out, which allowed earlier to stop inflammation of the bile ducts, to reduce the length of hospital stay. Patient D, 46 years old (case history No. 16200) was operated on for chronic calculous cholecystitis, catarrhal cholangitis. A device for the treatment of cholangitis (modified Holsted-Pikovsky drainage) was installed at the operation. In the postoperative period, laser therapy sessions were performed, which made it possible to quickly stop the inflammation of the bile ducts according to clinical, biochemical and bacteriological parameters.

A distinctive feature of the proposed device is that the monofilament quartz fiber is mounted and fixed in the lumen of the drainage tube.

The device we offer for conducting intracurrent laser therapy allows us to overcome the above disadvantages. A single-use sterile system consisting of a drainage tube with an integrated monofilament quartz optical fiber is installed once during the operation and does not require subsequent sterilization of the optical fiber after each laser therapy session.

A device for treating cholangitis during surgery is established but using the generally accepted method of installing the drains of Kera and Halsted-Pikovsky and does not require special navps and special equipment.

Claims (2)

1. A device for treating cholangitis, consisting of a connector, a plug, a tube for blood collection and transfusion systems, a heat shrink tube, a monofilament quartz fiber, and characterized in that the fiber is mounted in the lumen of the drainage tube. 2. The device according to p. 1, characterized in that the drainage tube made of PVC has a T-shape.