Method for implanting slipknot silicone airway stent

Abstract

The invention relates to a method for placing a silicone stent in an airway, and belongs to the field of respiratory endoscope interventional therapy. In order to overcome the defect that the Y-shaped silicone airway stent is difficult to implant in complex airway lesions, the implanting mode of the Y-shaped silicone airway stent is improved, the implanting difficulty can be reduced, complications are reduced, and the Y-shaped silicone airway stent is simple, easy to operate and high in clinical feasibility. According to the specific scheme, a small hole is formed in the far end, 1 cm away from the lower edge of the stent, of a longer branch under the branch of the Y-shaped silicone airway stent; then the far end is folded; a surgical suture line is used for suturing a needle, a slipknot is made outside the body, and the thread end of the slipknot is guided into the support through the hole; normally loading the sewed bracket into a metal pusher; the sewn support is placed in the air channel according to the normal pushing process, and the placing position is well adjusted; when the stent is placed in place, bendable biopsy forceps are applied to enter and clamp the suture line in the stent through a bendable bronchoscope biopsy duct, the slipknot is removed, the suture line is taken out, and the stent is placed successfully after the suture line is taken out.

Description

Technical Field

[0001] The invention relates to a method for inserting a silicone stent into an airway, and belongs to the field of respiratory endoscopic interventional treatment. Background Art

[0002] Currently, silicone stents are durable and can resist external compression from tumors, enlarged lymph nodes, and annular fibrous scars. They are less prone to stress fractures and have less granulation tissue and tumor infiltration. This property, coupled with durability, makes silicone stents suitable for long-term (e.g., >500 days) or indefinite use. Silicone stents are easier to reposition and remove with rigid grasping forceps. This property of silicone stents is ideal when repositioning or removal is required due to adverse reactions, and when the airway is too narrow to expand before stent placement and a series of increasingly larger stents need to be placed. Silicone stents have been widely used as an important treatment for airway stenosis and airway-digestive and airway-pleural fistulas. The method of inserting the silicone airway stent is to load the silicone stent into a metal hollow hard pusher, and then push it into the airway through a hard bronchoscope. When placing the Y-shaped stent, both the hard mirror and the pusher are in the main airway, and the stent needs to be pushed below the bifurcation to the left and right main airways. However, since the silicone stent is relatively hard and the silicone stent opens quickly after being pushed out of the pusher, it is difficult to push the stent into place when the carina is deformed or the left and right main airways are narrowed, resulting in difficulty or even failure in stent placement. During the pushing process, friction with the bronchial mucosa can easily cause damage to the tracheal wall and even massive bleeding, bronchial tearing, and even bronchial fistula. Due to the difficulty in pushing, clinicians often give up placing the Y-shaped silicone airway stent according to the shape of the carina and the degree of stenosis of the left and right main airways during clinical application, resulting in many patients being unable to place the Y-shaped silicone airway stent. In the past, surgeons first dilated the narrowed airway with a balloon, pushed the stent into the airway, and then guided the balloon or used hard endoscope forceps to twist and push it in. The above methods often required high-value consumables such as dilation balloons and were prone to damage the bronchial arm. In order to reduce the difficulty of Y-shaped silicone airway stent placement and reduce the use of high-value consumables, the Y-shaped silicone airway stent placement method was improved and the slipknot silicone airway stent placement method was invented, which greatly improved the indications of the Y-shaped silicone airway stent and ensured the safety of the operation. Summary of the invention

[0003] The technical problem to be solved by the present invention is as follows: In order to overcome the difficulty in implanting a Y-shaped silicone airway stent in complex airway lesions, the implantation method of the Y-shaped silicone airway stent is improved into the implantation method of the present invention. The present invention can reduce the difficulty of implantation, reduce complications, is simple and easy to operate, and has high clinical feasibility. The technical solution adopted by the present invention to solve its technical problems is: additional material preparation: one medical braided suture (non-absorbable), one 1 / 2 arc double-angle needle, one endoscopic biopsy forceps, and one puncher; preparation before stent installation: a small hole is punched at a distance of 1 cm from the lower edge of the stent at the distal end of the longer branch of the Y-shaped silicone airway stent; then the distal end is folded in half; a stitch is sutured with surgical suture, a slipknot is tied outside the body, and the thread end of the slipknot is introduced into the stent through the opening; stent installation: the sutured stent is normally loaded into the metal pusher; stent pushing: the sutured stent is placed into the airway according to the normal pushing process, and the position is adjusted; suture removal: when the stent is in place, a flexible biopsy forceps is used to enter through the flexible bronchoscope biopsy channel, clamp the suture in the stent, remove the slipknot, and take out the suture. After taking out, the stent is successfully placed. The beneficial effects of the present invention are as follows: this slipknot silicone stent implantation method reduces the resistance to stent pushing because the distal end of the stent is folded in half and sutured, and the distal end of the stent is temporarily reduced in diameter, thereby avoiding the difficulty of pushing and reducing damage to the bronchial arm. Because it is a slipknot suture, it is easy to remove the slipknot in the bronchial cavity to avoid the difficulty of loosening the knot; at the same time, the consumables required for this improvement are only surgical sutures and flexible biopsy forceps, which are cheap and easy to move; in addition, this method is simple, easy to implement and easy to promote, which can significantly reduce the difficulty of silicone stent implantation, and more patients can benefit. Beneficial effects: Compared with the traditional silicone stent pushing method, this invention reduces the resistance that may be encountered during the silicone stent pushing process, reduces damage to the bronchi, has a simple operation process, has no additional technical requirements for the operator, and does not increase the cost of surgery. It has obvious advantages in terms of operability, promotion and economy. Instruction manual drawings: Figure 1 A hole is opened 1 cm from the distal end of the Y-shaped silicone stent Figure 2 After suturing and tying a slipknot at the distal end of the Y-shaped silicone stent, place the slipknot through the hole into the stent Figure 3 The distal diameter of the silicone stent becomes smaller after knotting Figure 4 Surgical sutures visible under bronchoscopy Figure 5 Use biopsy forceps to remove sutures Figure 6 Y-shaped silicone bracket after the hair is treated with a loose knot.

Claims

1. The present invention relates to a method for inserting a silicone stent into the airway, which belongs to the field of respiratory endoscopic interventional treatment. The stent is inserted into the body after the distal end is sutured, and the suture is removed inside the body.

2. The technical solution of the present invention is a method for inserting a silicone airway stent, which comprises the following steps: making a small hole 1 cm away from the lower edge of the stent at the distal end of the longer branch of a fork of a Y-shaped silicone airway stent; then folding the distal end in half; sewing a stitch with surgical suture, tying a slipknot outside the body, and introducing the thread end of the slipknot into the stent through the opening; loading the sutured stent into a metal pusher normally; placing the sutured stent into the airway according to a normal pushing process, and adjusting the insertion position; when the stent is in place, using a flexible biopsy forceps, entering through the biopsy channel of a flexible bronchoscope, clamping the suture in the stent, removing the slipknot, and taking out the suture, after which the stent is successfully placed.

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