RU183188U1 - Device for draining the ductal system of the liver - Google Patents

Abstract

The utility model relates to the field of medicine and medical equipment, namely to surgery, and is aimed at ensuring the most optimal and long-term removal of bile from the hepatic ducts with their complete and large incomplete high intersection. This is achieved by the fact that the device is represented by washing channels that open in the total lumen of an elastic hollow tube containing a V-shaped working part with a narrowed collective surface and holes. A useful model can be used in surgical practice, in particular stomatology during operations for hepaticostomy at a high intersection of the bile ducts, to ensure a long and optimal outflow of bile.

Description

The utility model relates to the field of medicine and medical equipment, namely to surgery, and is intended to provide the most optimal and long-term removal of bile from the hepatic ducts with their complete and large incomplete high intersection.

As is known, various types of drains are used in biliary tract surgery for prophylactic, diagnostic and therapeutic purposes, which allow X-ray monitoring of the ductus biliferi state, various drugs (litholytic, antibacterial drugs) are administered, as well as the prevention of biliary hypertension. However, the latter function is not always performed in full, since the perforated part of the drainage is tightly pressed against the walls of the duct and is not able to collect bile, due to its aggregate properties (sufficient viscosity, tendency to crystallization). It should be noted that the choice of a discharge tube of a smaller diameter is not correct, because drainage requires careful sealing of the surgical wound (otherwise, operational complications such as biliary hemorrhage, abscess formation, biliary peritonitis, etc. are possible). A separate problem remains the drainage of the hepatic ducts at their full high intersection, when it becomes necessary to use either two bile-removing systems or a specially bent T-shaped drainage, which carries certain difficulties and disadvantages, which will be discussed below.

Today, for the purpose of decompression of the bile ducts, various drainage tubes produced by the medical industry are used.

Known drainage tube with a cuff [RU No. 151515, publ. 04/10/2015], containing an elastic tube, the distal end of which has lateral openings for collecting biological fluid and its further outflow through the proximal end; a soft thin-walled cuff that can stretch due to the air entering it through a supercharger adapted to attach a syringe to it.

The disadvantage of the tube is its stiffness, which can cause traumatic effects on the tissue in the area of its location, the formation of pressure sores and fistulas of the ductal system of the liver, and the cuff located at the proximal end does not provide complete obstruction of the wound channel.

Also known polyvinyl chloride drainage pipe [RU No. 32395, publ. September 20, 2003], 40 cm long and with an outer diameter of 5 mm, at the working end of which there are three side holes with a diameter of 2 mm at a distance of 3 cm from one another, the end end is open, characterized in that at a distance of 10 cm from the working end to it a 4 cm wide cuff is put on from a sterile red tubular rubber dissected on one side.

The disadvantage of this drainage is a small number of collecting side holes that can be closed by bile crystals with a long stay of the tube in the bile duct.

Known surgical drainage [RU No. 123670, publ. 01/10/2013], including a flexible longitudinal housing connected to a device for creating negative pressure and having openings on the working part of the housing for drainage, characterized in that the holes for drainage are provided with valves.

The disadvantage of this drainage is the presence of valves that become unusable under the crystallizing action of bile during prolonged stay of the working part in the bile duct.

Also known drainage tube [RU No. 2045284, publ. 10.10.1995], which is a T-shaped tube, on two sides of which in the thickness of the wall microchannels pass, moving from the vertical to the horizontal part of the drainage and freely opening at the ends.

When using this T-shaped drainage for drainage of the hepatic ducts at their complete intersection, there is a significant drawback, which is the difficulty of its installation, especially when it is made from coarse tubes and large diameter tubes, which, in turn, can create additional trauma to ductus biliferi.

A common drawback of these drainages is that when the perforated discharge part is located in the bile duct, a relative obstruction of the drainage tube occurs due to the intimate fit to the walls of the duct and the inability to fully take bile, since the diameter of the drainage is constant throughout. A high complete intersection of the main lobar ducts allows the use of either separate drainage with separate tubes, which increases the invasiveness of the intervention as a whole, or T-shaped drains, which, in addition to the deficiencies inherent to other bile-removing systems, create a negative effect on the ducts themselves, since they constantly tend to taking their original shape and thereby either injuring them, creating excessive pressure on the duct walls in a certain vector direction, which contributes to the image mations bedsores and early fistula and strictures in the late postoperative period, either spontaneously migrate from the duct into the free peritoneal cavity, creating prerequisites serious complications (bile peritonitis, sepsis, etc.).

The purpose of the technical solution is to create easy-to-use, easy-to-use drainage, which ensures a long and optimal outflow of bile from the ductal system of the liver with its complete and large incomplete high intersection.

The technical result of the goal is achieved by the fact that the device is represented by channels 4 for washing, opening into the general lumen of an elastic hollow tube 1 containing a working part 5 of a V-shape with a narrowed collective surface 2 and holes 3.

Figure 1 shows a general view of a utility model.

Figure 2 shows the position of the working part 5 with the collecting surface 2 in the drained duct system with a large incomplete high intersection of the hepatic ducts while maintaining the upper wall of the confluence.

Figure 3 shows an example of the installation of the working part 5 with a collective surface 2 in the main lobar ducts with their complete separate intersection.

The utility model is used as follows.

When performing a hepaticostomy, the device with its working part 5 is installed in such a way that the narrowed collective surfaces 2 with holes 3 are immersed in the stump of the hepatic ducts, and through a separate puncture of the skin in the right hypochondrium, an elastic hollow tube 1 containing channels 4 for washing is output to the anterior abdominal the wall with its laying in the bed of the gallbladder (or in another way, ensuring the outflow of bile, and eliminating the kink of the tube) and is fixed to the skin.

The positive effect of the claimed technical solution consists not only in ease of use, but also in ensuring a long and optimal outflow of bile from the hepatic ducts with their complete and large incomplete high intersection due to the presence of a V-shaped working part with a narrowed collective surface and washing channels.

Claims (1)

A device for draining the ductal system of the liver, including a hollow elastic tube with channels for washing, characterized in that its working part has a V-shape with a narrowed collective surface and holes.

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