METHOD FOR PUNCTURE-DRAINAGE TREATMENT OF NECROTIZING PANCREATITIS, PARAPANCREATIC DESTRUCTION CHANGES, TROCAR CATHETER AND ENDOSCOPIC CLAMP FOR ITS IMPLEMENTATION Russian patent published in 2023 - IPC A61B17/34 A61B17/29 A61M25/08 A61M27/00 

FIELD: medical equipment.

SUBSTANCE: used in the complex treatment of necrotizing pancreatitis and parapancreatic destructive changes. A method of puncture-drainage treatment of necrotizing pancreatitis, parapancreatic destructive changes, including puncture under ultrasound control with a needle with a mandrel located in it, insertion of a metal conductor after the needle enters the cavity and removal of the mandrin, under ultrasonographic control, a puncture of the anterior abdominal wall with a trocar is performed on one side of the drained cavity, made in the form of a trocar sleeve, into which an endoscopic clamp with tetrahedral sharpening of the jaws is inserted to a depth set by a limiter in the form of a tape clamp with a screw bolt, and on the other side of the drained cavity a puncture is made with a needle with a mandrel, which is then removed and a flexible metal conductor is inserted, which is passed through the longitudinal through hole of the stylet with a screw in its distal part, then the stylet is advanced together with the polyvinyl chloride catheter put on it forward and by rotating the screw, using a disk-shaped handle, the stylet with the polyvinyl chloride catheter put on it is inserted into the cavity of the omental bursa, then removed stylet, fix the flexible metal conductor with a previously inserted endoscopic clamp and withdraw the conductor through the trocar sleeve, after which the trocar sleeve is removed, the polyvinyl chloride catheter is moved forward along the flexible metal conductor and withdrawn at the access point of the removed trocar, and to replace the catheter with a drain of a larger diameter, a drain is inserted into the expanded part of the catheter, is fixed by stitching and pulled through the wound tract into the omental bursa and then removed through the second hole. The trocar-catheter for insertion into the cavity of the omental bag in the implementation of the above method includes a hollow PVC catheter having drainage holes, and a conducting stylet made with a through hole along the longitudinal axis, an auger in its distal part and a disk-shaped handle for auger rotation. An endoscopic clamp for fixing a flexible metal conductor in the implementation of the above method includes a tube-body with a wing nut, a rod with a working part with a diameter of 5 mm, a handle, movable jaws having a transverse notch on their inner surface and a tetrahedral sharpening, and a limiter in the form of a tape clamp with a screw bolt.

EFFECT: providing instantaneous through drainage of the pathological focus without an initial reduction in the volume of the cavity, maintaining ultrasonographic control during the drainage process and obtaining the possibility of subsequent replacement of drains with drains of larger diameter without additional surgical trauma.

4 cl, 4 dwg