ULTRASONIC SURGICAL METHOD FOR TREATING AXILLARY HYPERHYDROSIS CASES Russian patent published in 2007 - IPC A61N7/00 

FIELD: medicine.

SUBSTANCE: method involves carrying out preoperative patient examination, taking X-ray pictures of thorax or performing photoroentgenographic examination, electrocardiographic examination and studying external breathing function. Zones of forthcoming destruction of subcutaneous fat tissue with auxiliary sudoriferous glands are determined by means of iodineo-starch test. Necessary volume of anesthesia aid is carried out depending on deleted subcutaneous fat tissue. Transcutaneous incisions are carried out on auxiliary sudoriferous glands zone boundary or skin punctures of 5-8 mm in length are done. Infiltration cannula of 2 mm diameter is introduced through them. The cannula has end openings. Infiltration of uniform subcutaneous fat tissue of auxiliary sudoriferous glands zone is carried out under manual control to 5-15 mm depth by introducing tumescent solution heated to 37-38°С into it through infiltration cannula openings under pressure of 0.4-0.6 bar at a rate of 80-100 ml/min. Infiltration cannula is reciprocally moved in selected subcutaneous fat tissue thickness in each separately generated tunnel with the subsequent formation in subcutaneous fat tissue volume infiltration tunnels network arranged fanlike close to each other, piercing thus all volume of subcutaneous fat tissue and saturating it with tumescent solution to create local endocellular lipocyte hyperhydration conditions. Places of puncture or cut are dilated with blunt dilator in 10-15 mines after beginning infiltration of subcutaneous fat cellular tissue of auxiliary sudoriferous glands zone with tumescent solution. Trocar having protective silicon lining is place in it. Hollow ultrasonic device titanium probe is introduced through the trocar into the infiltrated subcutaneous fat cellular tissue of auxiliary sudoriferous glands zone. Ultrasonic destruction fatty cells is carried out in moving the probe in continuous linear motion mode through the subcutaneous fat cellular tissue layer having thickness of 5-15 mm with simultaneous alternating probe movement at a speed of 30-50 movements per minute in each separately generated tunnel. Suction of fatty detrite from emulgated adipocytes of auxiliary sudoriferous glands zone is simultaneously carried out through ultrasonic probe canal apertures having diameter of 3-4 mm using negative pressure of 0.2-0.3 bar. Ultrasonic influence upon subcutaneous fat cellular tissue begins in each created tunnel first in bottom layers of subcutaneous fat cellular tissue of auxiliary sudoriferous glands zone and then with subsequent transition to above lying subcutaneous fat cellular tissue layers after having sucked the obtained fatty detrite. The ultrasonic probe is deleted from the trocar. Final small-tunnel-type suction of remaining fatty detrite quantity is carried out via cannula of 2-3.5 mm large diameter preliminarily introduced through trocar. The operation being finished, aseptic and compression bandages are applied. Wounds are bandaged in postoperative period with antiseptic solutions and water-soluble ointments being used. Not narcotic analgesic, sedative preparations are simultaneously given, and antibacterial therapy with antibiotics of wide spectrum of action is carried out within 4-7 days after operation.

EFFECT: enhanced effectiveness of treatment.

12 cl