CN204468356U - Stomach wall urine stream Efferent tube man-made support - Google Patents

Abstract

The utility model discloses an artificial support for the abdominal wall urinary outlet tract, which is characterized in that it comprises a tubular support, the tubular support is composed of a spiral metal wire ring covered with a superfine fiber porous membrane, and the two ends of the tubular support extend into bell mouths Shaped ports, microfiber porous membranes have built-in elastic rings at the port positions. The utility model has the advantages of simple structure and reasonable design, and is different from the existing ileum-substituting-bladder operation in that it does not use intestines to replace the bladder, but adopts an improved cortical drainage. The artificial stent of the utility model can effectively solve the problem of ostomy stenosis, and has good toughness and biocompatibility, high strength and high compliance. On the oblique aponeurosis and skin, it can effectively prevent ureterostomy stenosis. This operation is simple and easy to operate, and can effectively reduce many intraoperative and postoperative complications.

Description

Artificial stent for abdominal wall urinary output tract

technical field

The utility model belongs to the technical field of medical devices, in particular to an artificial support for the abdominal wall urine flow outlet tract used in urology surgery for urinary diversion and ureteral cortex drainage.

Background technique

Many bladder diseases in the Department of Urology, such as invasive bladder cancer, advanced neurogenic bladder, severe bladder tuberculosis and severe bladder fibrosis, require urinary diversion to improve the patient's voiding symptoms. Urinary diversion is most commonly used in patients with invasive bladder cancer. Bladder cancer is a common malignant tumor in genitourinary tumors. Urinary diversion is a common problem after radical cystectomy. According to the 2011 Chinese guidelines for the diagnosis and treatment of urological diseases, the basic surgical indications for radical cystectomy are T2-T4a, N0-X, M0 invasive bladder cancer, high-risk non-muscle-invasive bladder cancer T1G3 tumors, and BCG treatment ineffective Tis, recurrent non-muscle-invasive bladder cancer, extensive papillary lesions that cannot be controlled by TUR or endovascular surgery alone, etc. There are many ways of urinary diversion clinically, such as ileal bladder replacement, colon bladder replacement, sigmoid colon bladder replacement and rectal bladder replacement, etc., all of which replace the original bladder with a section of intestinal tube. The ileal bladder replacement is commonly used in clinical practice. This operation was first reported by Bricker in 1950. The operation is relatively simple, the complications are few, and it is widely used. The ileal bladder has only the function of storing urine but not the function of urination, and urinates mainly by abdominal pressure. Some elderly patients with poor physical condition or patients with short survival period can choose simple cortical drainage to solve the urination problem in a short time.

At present, all urinary diversion methods have certain problems, such as high surgical complexity, large surgical trauma, more surgical complications, more intraoperative blood loss, longer postoperative recovery, and longer hospital stay There is no doubt about other aspects, and it is necessary to carry the urine collection bag for life. Radical cystectomy plus urinary diversion is the most complicated operation in urology. It not only requires complete resection of bladder tumors but also pelvic lymph node dissection. For men, the prostate and seminal vesicles should be included, for women, the uterus and accessories should be included, and finally the urine should be restored. Lu Tong smoothly performed urinary diversion. Intestinal replacement of bladder needs to intercept a section of intestinal tract about 20-50cm long, so the chance of postoperative intestinal obstruction is relatively high. After the ureter is anastomosed with the "new bladder", anastomotic stenosis is prone to occur, resulting in repeated urinary tract infections and hydronephrosis , Outflow tract stenosis is the most common complication of urinary diversion, and early complications include mucus blocking the urethra, urine leakage, diarrhea, and lung infection.

The simplest urinary diversion procedure is ureteral cortical drainage, but stenosis of the stoma is a clinical problem. Although the operation of ileal outflow tract abdominal wall stoma is simple, there are some factors that affect the patency of the outflow tract, such as the compression of the new bladder by muscles such as the rectus abdominis, external oblique muscle, and internal oblique muscle at the stoma, and the surrounding Extrusion of fat, adhesion of surrounding tissues, etc. Although some technical improvements have been made in recent years, such as changing the rectus abdominis muscle from longitudinal incision to transverse incision, the incidence of incisional hernia in the abdominal wall after surgery will increase, and there are more and more obese patients, and it is difficult for the new bladder to be squeezed by fat. avoid. These factors lead to an increase in the chance of urinary tract infection caused by postoperative stenosis and stoma stenosis. Such infection is not easy to control and often further damages renal function, so it needs to be paid attention to clinically. Even after the routine use of antibiotics after surgery, yeast colonization still occurs in the intestinal mucus and urine, and a mixed flora of yeast and Gram-positive bacteria appears in the outflow tract immediately, and Gram-negative bacteria also appear after the withdrawal of antibiotics , if the outflow tract is not smooth, the asymptomatic bacteriuria in it can easily evolve into a symptomatic urinary tract infection.

Utility model content

Aiming at the problems existing in the prior art, the purpose of this utility model is to design and provide an artificial support for the abdominal wall urinary outlet tract.

The artificial stent for the abdominal wall urinary output tract is characterized in that it includes a tubular stent, the tubular stent is composed of a spiral metal wire ring coated with a microfiber porous membrane, and the two ends of the tubular stent extend into bell-shaped Port, the microfiber porous membrane has an elastic ring built in at the port position.

The artificial stent for the abdominal wall urinary output tract is characterized in that a fixed anchor is co-located at one of the ports.

The artificial stent for the abdominal wall urinary output tract is characterized in that there are four fixing anchors, which are symmetrically arranged on the edge of the port. the

The artificial stent for the abdominal wall urinary outlet tract is characterized in that the diameter of the tubular stent is 0.8-1.0 cm.

The artificial stent for the abdominal wall urinary outlet tract is characterized in that the microfiber porous membrane is woven in a crossing pattern, and the microporous structure is formed by the crossing pattern.

The utility model has the advantages of simple structure and reasonable design, and is different from the existing ileum-substituting-bladder operation in that it does not use intestines to replace the bladder, but adopts an improved cortical drainage. The artificial stent of the utility model can effectively solve the problem of ostomy stenosis, and has good toughness and biocompatibility, high strength and high compliance, and the ureters on both sides can be directly fixed to the peritoneum and the outside On the oblique aponeurosis and skin, it can effectively prevent ureterostomy stenosis. This operation is simple and easy to operate, safe and reliable to use, can effectively reduce many intraoperative and postoperative complications, and has great social and economic value.

Description of drawings

Fig. 1 is a structural representation of the utility model;

In the figure: 1-tubular support, 2-wire ring, 3-porous membrane, 4-port, 5-elastic ring, 6-fixed anchor.

Detailed ways

The utility model will be further described below in conjunction with the accompanying drawings.

As shown in Figure 1, the utility model is an artificial support for the abdominal wall urinary outlet tract, which belongs to a medical device that can be implanted into the human body, and is a support for the abdominal wall urinary outlet tract that is suitable for urethral diversion and ureteral cortical drainage in urology. . It includes a tubular stent 1, which is generally a straight tubular mesh stent with a diameter of 0.8-1.0 cm, consisting of a helical wire ring 2 coated with a microfiber porous membrane 3, and the two ends of the tubular stent 1 extend It is a trumpet-shaped port 4, and the superfine fiber porous membrane 3 has an elastic ring 5 built in the position of the port 4, and the ports are respectively placed inside and outside the abdominal wall, and the bell-shaped port is buckled outside the abdominal wall, which can effectively prevent The stent is retracted into the abdominal wall. Among them, the metal wire ring 2 is a shape memory alloy material, which can resist abdominal wall pressure; the ultrafine fiber porous membrane 3 is made of organic high molecular polymer, which is woven in a cross shape and has a microporous structure, which is conducive to the movement of cells into the material. The ureter migrates and regenerates the structure of the tissue, so as to integrate into one body and maintain the blood supply; in order to prevent the artificial stent from displacing at the application site, a fixed anchor 6 is provided at the port that goes deep into the inner side of the abdominal wall, and there are 4 fixed anchors 6, And symmetrically arranged on the edge of the port 4, the anchor 4 is used for fixing on the inner side of the abdominal wall during the operation.

In the process of use, the artificial stent of the utility model is used in urinary diversion and ureteral cortex drainage operations in urology, such as radical cystectomy, ureteral cortex stoma, and after the stoma site is selected, the skin with a diameter of about 1.0 cm is removed and inserted into the puncture The cannula penetrates the abdominal wall and enters the patient's abdominal cavity to expand the channel. The tubular stent 1 is inserted into the cannula. After the cannula is withdrawn, the tubular stent 1 rebounds to a functional predetermined tubular configuration and is embedded in the abdominal wall channel. The anchor 6 Fixed with peritoneum. The ureter is led out of the abdominal wall from the tubular stent 1, and is sutured with the skin of the outer opening of the abdominal wall to form a papillary shape, and is externally connected with the stoma chassis and the stoma bag. The new artificial stent can play an effective supporting role, prevent ureterostomy stenosis and drain urine, simplify the operation, reduce medical expenses, effectively reduce ileal bladder and other surgery-related complications, and significantly improve the quality of life of patients.

Claims (5)

1. stomach wall urine stream Efferent tube man-made support, it is characterized in that comprising tubular bracket (1), described tubular bracket is made up of the coating superfine fiber porous membrane (3) of spiral helicine wire rings (2), the two ends of described tubular bracket (1) extend to the port (4) of bell mouth shape, and superfine fiber porous membrane (3) is built-in with elastic ring (5) in port (4) position.

2. stomach wall urine stream Efferent tube man-made support as claimed in claim 1, is characterized in that port (4) place is equipped with mooring anchor (6) wherein.

3. stomach wall urine stream Efferent tube man-made support as claimed in claim 2, is characterized in that described mooring anchor (6) is provided with 4, and is symmetricly set on the edge of port (4).

4. stomach wall urine stream Efferent tube man-made support as claimed in claim 1, is characterized in that the caliber of described tubular bracket (1) is 0.8-1.0cm.

5. stomach wall urine stream Efferent tube man-made support as claimed in claim 1, it is characterized in that described superfine fiber porous membrane (3) is in intersecting walking braiding, the walking braiding that intersects forms microcellular structure.