RU2705236C1 - Vibroacoustic device for implementing coronary endarterectomy - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention refers to medical equipment, namely to a vibroacoustic device for coronary endarterectomy. Device comprises a surgical instrument in form of a bar with a working tip, which is installed in a tube, made with possibility of communication through holes to central channel, equipped with branch pipe for vacuum generation, handle and electromechanical vibroacoustic generator, connected to rod by flexible drive with possibility of rod vibration in axial direction, at that, said working tip is made up of spoon or spatula. Tube is corrugated with ribs of equal height. Recesses of said ribs have holes for connection with central channel while handle is faceted.EFFECT: use of the invention widens the range of products for coronary endarterectomy.1 cl, 1 dwg

Description

Vibroacoustic device for the implementation of coronary endarterectomy belongs to the field of medicine, namely to vascular surgery.

The purpose of the device is to expand the range of surgical devices that provide the optimal choice for the appointment of endarterectomy.

The present invention is characterized in that the vibroacoustic device for the implementation of endarterectomy includes a surgical instrument, in the form of a rod with a working tip, spoons / spatulas for mechanical removal of blood clots and plaques, controlled through a thin long corrugated tube with ribs of equal height and holes located in the recesses between the ribs connected to the central channel, a faceted handle, an electromechanical vibroacoustic generator connected to a surgical bending tool providing drive and its vibration in the axial direction, and connected with the central channel connection for creating underpressure in the central channel, the ribs intima pressing tool and leaving together with the plaques when retrieving the tool from the operated vessel.

Known endarterectomy instrument for restoring patency of an arterial vessel (RF Patent No. 2026018, 1985), containing a handle with a rigidly fixed inside the lead, connected end to the working part in the form of an open ring with a surface under the variable inner diameter of the vessel, characterized in that the lead is made in in the form of an elastic tube with end pipes diluted in the form of an asymmetric fork, fixed at the end located in the plane of the ring oriented at an angle of 45-70 ° to the longitudinal driving axis, the ring is made in the form of a wire rope with a diameter of 0.5-1.0 mm, rigidly fixed in the first pipe and installed with the ability to move in the second pipe, in a leash and handle. The device is difficult to perform and operate.

A device for endarterectomy is known (RF Patent No. 2110225, 1997), containing a rod, a handle is fixed on one end and a working element on the other, and elastic elements with longitudinal stiffness are made on the rod, and the working element is a spiral turning into a scraper . However, the use of the device is fraught with unplanned ruptures by a scraper of the vessel walls.

A known endarterectomy instrument (EP0337918A1, 1988), comprising a flexible catheter with a proximal end and an open distal end, with a flexible guide conductor freely passing through the catheter and protruding from the distal end, as well as a plaque removing element in the form of a flexible wire loop connected to the conductor. The tool is unreliable in use, since it can leave rags of ragged intimacy in the vessel.

Known vibration catheter (US5498236A, 1992), intended, however, to remove blood clots and unsuitable for removal of intravascular plaques and damaged intima.

A known apparatus for endarterectomy (GB, 1313730, 1973), in the form of a rod, to the proximal end of which is attached a vibration generator, and to the distal end - a working element in the form of a loop. The working element is moved along the artery with the simultaneous imposition of vibrational movements on it. An apparatus for operations on arteries is also known (GB, 2195542, 1988), which is a rigid rod with a handle fixed at one end and a working element in the form of a pointed hook at the other end of the rod. The working element is inserted into the artery and moved, turning around the axis of the rod and stripping plaques from the inner surface of the artery. A device for operations on hollow vessels (Jesse E. Thompson The Evolution of Surgery for the Treatment and Prevention of Stroke. Stroke. 1996; 27: 1427-1434), containing a rod, one end of which is fixed to the handle, and the other - cutting work item in the form of a ring. The disadvantages of these devices are the rigidity of the structures, leading to possible rupture of the walls of the artery, and not guaranteeing the successful cleaning of their inner surface.

A device for operations on blood vessels is known (US 5152777, 1992), which is a flexible rod, with a handle at one end and a working element in the form of a set of a bunch of diverging incisors in the form of pointed rods on the other. A apparatus for operations on blood vessels is also known (Fr. 2163580, 1973), comprising a flexible rod, on one end of which a handle is fixed, and on the other end, a working element in the form of a carriage. Despite the relative elasticity of these tools, when using them, there is a high risk of perforation of the vessel walls.

A device for endarterectomy with a working element in the form of a spiral located on the middle part of a tubular tensile rod (WO 91/16005, 1991), designed to clean hollow vessels. The spiral, when moving along the vessel, cleans its inner surface, making translational-reverse movements, accompanied by alternately compression of the turns with an increase in their diameter to the walls of the vessel and subsequent extension of the spiral with a decrease in diameter, to allow further movement along the vessel. The disadvantage of the tool is the low longitudinal rigidity and the resulting low efficiency.

The claimed invention is a vibro-acoustic device for the implementation of coronary endarterectomy, includes a surgical instrument, in the form of a rod with a working tip - spoons / spatulas for mechanical removal of blood clots and plaques, controlled through a thin long corrugated tube with ribs of equal height, and holes located in the recesses between the ribs, connected to the central channel, faceted handle, electromechanical vibroacoustic generator connected to the surgical instrument by a flexible drive and about providing its vibration in the axial direction, as well as a pipe connected to the central channel to create a vacuum in the central channel, pressing the intima to the edges of the instrument and removed together with plaques when removing the instrument from the operated vessel.

The device (drawing) includes:

- a bar with a working tip in the form of a spoon / spatula (1) for the mechanical removal of blood clots and plaques;

- flexible corrugated tube (2), with holes (3) between the corrugations of equal height;

- a pipe for creating low pressure (4);

- faceted handle (5);

- on / off button for acoustic vibrations (6);

- a protective plastic tubular cover (7);

- metal guide tube (8)

- acoustic vibration generator (9)

The device operates as follows:

- turn on the acoustic oscillation generator (9), use the on / off button of the acoustic vibration (6) and set the amplitude required for this particular case using the controller (not shown);

- a bar with a working tip in the form of a spoon / spatula (1) for mechanical removal of blood clots and plaques is introduced into the artery through a pre-formed incision;

- after removing by means of a spoon / spatula (1) from the vessel walls of undesirable formations, reduce the air pressure through the pipe to create a reduced pressure (4) in the working part of the inventive device, which provides rarefaction and pressing of the vessel intima to the corrugations of the corrugated tube (2), s holes (3) between the corrugations;

- remove the corrugated tube (2) from the vessel with the intima pressed against the corrugations with the unwanted formations formed on it.

As a result of the functioning of the device during endarterectomy, a smooth inner surface of the walls of the arteries is formed, the operation time is reduced, the likelihood of leaving unrepaired flaps of intima and plaques in the vessel is reduced, and the risk of repeated thrombosis is reduced.

As follows from the above, the combination of distinctive features of the claimed device provides the implementation of effective deobliteration of arteries.

As a result of the analysis of the prior art, a source characterized by features identical to all the essential features of the claimed device was not found.

An additional search for known solutions showed that the claimed device does not follow explicitly from the prior art for the specialist, since the proposed device has properties that ensure effective arterial disobliteration due to the use of the corrugated tube and the negative pressure of the intima with unwanted structures to be removed from the tube edges.

For the claimed device in the form as described in the claims, there are no obstacles to its implementation with the above result.

The proposed device creates the necessary variety of functioning structures that provide the optimal choice for the appointment of endarterectomy.

Claims (1)

 A vibroacoustic device for the implementation of coronary endarterectomy, containing a surgical instrument in the form of a rod with a working tip, mounted in a tube configured to communicate through openings with a central channel equipped with a nozzle for creating a vacuum, a handle and an electromechanical vibroacoustic generator connected to the rod with a flexible drive with the possibility of vibration of the rod in the axial direction, characterized in that the working tip is made in the form of a spoon or spatula, the tube is made corrugated with ribs of equal height, in the recesses of which there are holes for communication with the Central channel, and the handle is faceted.

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