RU2452522C2 - Colon cleansing device - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly abdominal surgery and coloproctology. The device comprises supply and suction pumps with a control unit coupled with a washing solution and sucked liquid container connected with a probe presented in the form of a hollow flexible tube ended with a smooth oval surface with irrigating and suction holes which integrates a supply canal connected with the washing solution container and a catheter connecting a pressure manometer with a colon cavity. The supply canal is connected with a washing solution source through a pipeline and the catheter to generate a pulsating flow, located in the middle of the probe, projects therefrom by 5-10 mm and has at least 3-4 holes on an end face. The pressure manometer catheter also projects from the probe by 5-10 mm. A probe surface comprises 6-8 suction holes. The supply and suction pumps can vary productivity. The probe is additionally supplied with a conductor clamp representing a metal tube whereon an inflated and blown-off soft elastic cylinder is fixed. An internal diameter of the tube matches wit an external diameter of the probe.

EFFECT: more effective colon preparation to colonoscopy and provided tightness of the procedure.

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Description

The invention relates to medicine, in particular to abdominal surgery and coloproctology, and can be used for emergency colonoscopy with obstructive colonic obstruction, preparing the colon for surgery, etc.

Known catheter for monitor cleaning of the colon (RF patent No. 20144095, 1994), which contains a housing made in the form of a hollow flexible tube, and a supply channel connected to a source of flushing fluid. The inlet channel and the centrally located outlet channel are separated. An endoscope is placed in the outlet channel, the working part of which protrudes from the body and has an inflatable transparent bubble. The pear-shaped inflatable balloon is hermetically mounted at the end of the hollow tube from its outer surface and has irrigation holes at the end. The cylinder is connected by a supply channel to a source of flushing fluid. The catheter is equipped with an electric manometer connected to the intestinal cavity with a tube.

The disadvantage of this catheter is the difficulty of its implementation, due to the constant dissolving and inflating of the balloon, the inability to control the pressure in the cylinders, and the duration of its use. In addition, during the operation of the device, only a certain part of the colon is cleaned, all this leads to inconvenience of the procedure.

A known device for monitor cleaning of the colon (ed. St. USSR No. 1463307, 1989), taken by us as a prototype, containing a tank for washing solution, a pump for supplying a washing solution, a suction pump, pipelines and a probe with a silicone plate inside, forming the suction and irrigation channels, in the ratio of the areas 3: 1, the holes of the irrigation and suction channels are made on the working end of the probe. The device is equipped with a catheter passing through the irrigation canal to measure intracavitary pressure in the lumen of the colon using an electronic pressure gauge.

The disadvantage of this device is the lack of tightness, which leads to free flow of fluid from the rectum to the outside, especially in patients with weakness of the external sphincter, and this creates inconvenience during the procedure. In addition, the device does not provide free suction of feces from the intestine from different sides, because suction holes are made on only one side of the probe.

The objective of the invention is to increase the efficiency of preparing the colon for emergency colonoscopy, ensuring integrity during the procedure.

The objective is achieved in that a device for cleaning the colon, containing tanks for washing solution and suction liquid, forcing and suctioning pumps with a control unit, a probe made in the form of a hollow flexible tube ending with a smooth oval surface, with irrigation and suction holes, inside of which there is a supply channel connected to the source of the washing fluid, and a catheter connecting the pressure gauge to the intestinal cavity, the supply channel is located in the center of the probe, protrudes from the housing 5-10 mm and having at least 3-4 end openings manometer tubing also extends from the housing 10 mm on a side surface of the probe is provided with holes for the sucked fluid. The device is additionally equipped with a block of a fixing unit - a conductor, which is a metal tube on which a soft elastic balloon is fixed with the possibility of inflation and deflating, the inner diameter of the tube corresponds to the outer diameter of the probe.

The invention is illustrated by drawings where:

Figure 1 presents a General view of the device;

figure 2 - probe;

figure 3 - fixing node is a conductor.

A device for cleaning the colon (Fig. 1) consists of a reservoir 1 for washing solution and a reservoir 2 for collecting suction fluid, forcing and suctioning pumps with a control unit 3 connected to the tanks 1 and 2 by pipelines 4.

The probe (figure 2) is made in the form of a hollow flexible tube 5. The length of the tube is 850 mm. Inside the tube 5, in the center, there is a supply channel 6 connected to a source of flushing fluid through a conduit 7, and a catheter 8 connecting the pressure gauge 9 to the colon cavity. The final section of the tube ends with a smooth oval surface 10, on which there are two holes 11, for the inlet channel 6 and the catheter 8, which protrude above the surface of 10 and 5 mm, respectively. The supply channel 6 also ends with a smooth oval surface and has 3-4 holes 12.

The catheter 8 at a distance of 80 cm from the end of the probe through a special separate lateral hole 13 is brought out and connected to the electronic pressure gauge 14. The tube 5 can be made with a diameter of 16 mm, the inlet channel is 6-4 mm, and the catheter 8, connecting the manometer 8-2 mm , trunk tubes from 4 to 8 mm. On the side surface of the tube 5, suction holes 15 are made for draining fluid from the colon. The number of holes is 6-8.

The fixing node - the conductor 16 (Figure 3) is a metal tube 17 (for example, stainless steel, 150 mm long and 17 mm in diameter). A soft elastic balloon 18, for example of silicone material, is fixed to the tube 17. The cavity of the container 18 is connected to the gas supply sources through the tube 19, for example, sterile air with a syringe. At the end of the tube there is a cuff 20 for regulating the pressure in the cylinder and a tip 21, arranged according to the type of valve. The operation of the device is as follows. A metal tube 16 is inserted into the colon under visual control, with the balloon located inside the intestine. Sterile air is supplied through the tip 21 into the cavity of the container 18, increasing its volume. The pressure is regulated by a cuff 20 at the end of the tube 19. Increasing in volume, the balloon 18 closes and fixes the rectum hermetically and securely.

Then, probe 5 is inserted through the metal tube 17, upon reaching the sacrum cape, the inner end of the probe is turned to the right, corresponding to the direction of the distal part of the sigmoid colon, after which the probe is passed through the bend of the sigmoid colon. If necessary and depending on the obstruction of the colon, the probe can be injected up to 50-60 cm.The solution is introduced into the colon through the internal supply channel of the probe 6, with the simultaneous elimination through special lateral openings 15 of the external channel 5 under the control of the volume of injected and aspirated liquid. The control is carried out by calibrating the tanks 1 and 2, which are connected by pipelines 4, to the discharge and suction pumps with the control unit 3. At the same time, the intra-intestinal pressure is monitored through a separate catheter 8, which is connected through a special separate lateral opening 13 with an electronic pressure gauge 14.

The controllability of the processes of fluid supply and elimination creates the conditions for the formation of a pulsating flow, which also stimulates the elimination of toxic metabolites from the colon. The resulting hydromechanical irritation of the intestinal wall improves the processes of blood and lymph flow, thereby moderately stimulating intestinal motility.

When the probe 5 is in the colon, the capacity of the delivery and elimination pumps 16 should be 1000 and 1200 ml / min, respectively. In this case, feces are well eroded. When the probe is advanced into the sigmoid colon and above, the performance of the feed and elimination pumps 16 should be 600-700 ml / min. The main criterion for the adequacy of intestinal perfusion is the level of intestinal pressure, which is measured through a separate internal catheter in probe 8, depending on the suitability of supply and elimination of the solution. This mode of operation allows for elimination of the contents of the colon in 8-10 minutes. The optimization of the colon cleaning procedure is achieved by changing the position of the patient's body in space during the procedure.

The total procedure time is 5-20 minutes, depending on the level of obstruction. The amount of fluid used to clean wash water, approximately 6-10 liters. In the mode of introduction and removal of fluid, it is necessary to strive to ensure that the amount of contents removed from the intestine is greater than or equal to the amount introduced. Control is provided by weighing the patient before and after the procedure.

The preparation of the colon for emergency colonoscopy according to our method using a metal tube with a soft elastic balloon leads to a decrease in trauma to the rectal mucosa, adequate tightness in the rectum during the procedure, which prevents fluid from escaping outward. A prototype of the proposed device was tested in the city clinical hospital No. 7 of Kazan and showed high efficiency of its use for emergency cleaning of the colon.

Claims (1)

A device for cleaning the colon, containing injection and suction pumps with a control unit connected to a reservoir for washing solution and suction liquid, communicating with a probe made in the form of a hollow flexible tube ending with a smooth oval surface, with irrigation and suction holes, inside which are located a supply channel connected to the reservoir for the washing solution and a catheter connecting the pressure gauge to the intestinal cavity, characterized in that the supply channel connected to the source a flushing solution through the pipeline and the catheter with the possibility of creating a pulsating flow, is located in the center of the probe, protrudes from it by 5-10 mm and has at least 3-4 holes at the end, the pressure gauge catheter also protrudes from 5 to 10 mm from the probe, the probe surface has 6-8 suction openings, while the discharge and suction pumps have the ability to change performance, the probe is additionally equipped with a fixing unit - a conductor, which is a metal tube on which a soft elastic balloon with the ability to inflate and deflate, the inner diameter of the tube corresponds to the outer diameter of the probe.

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