A device for assessing the length of the resected portion of the small intestine during bladder plastic surgery

Abstract

This utility model relates to the field of medicine and medical technology, specifically surgical urology, and is designed to determine the length of the small intestine required for cystoplasty. This is achieved by the device being a plate with a smooth ventral surface and a dorsal surface containing notches delimiting sectors with numerical designations corresponding to the size of the small intestine to be resected, depending on its semicircular length. The sectors are arranged along the length of the plate, from the largest to the smallest transverse dimension. This utility model enables accurate intraoperative assessment of the size of the organ to be resected. 3 fig.

Description

[0001] The utility model relates to the field of medicine and medical technology, namely operative urology, and is intended to determine the length of the small intestine section required for cystoplasty.

[0002] As is known, taking into account the morphometric parameters of a specific patient's small intestine allows for the most accurate determination of the size of the resected organ, which has a positive impact on the overall outcome of bladder reconstruction surgery. However, it should be noted that specialized devices for such measurements are currently unavailable, and standard rulers require additional mathematical calculations.

[0003] A method is known for determining the length of the resected portion of the small intestine for bladder plastic surgery [RU 2444307 C1, IPC A61B 17 / 00, published 10.03.2012], including measuring the morphometric parameters of the small intestine, characterized in that the required length of the resected portion of the small intestine is determined by the formula H=P:2L, where H is the length of the resected portion of the small intestine; P is the derivative value from the planned volume of the created bladder, calculated by the formula , where V is the volume of the created bladder; L is the length of the semicircle of the intestine of a particular patient.

[0004] The disadvantage of the known solution is the need to perform auxiliary calculations during surgery, which lengthens the course of the operation itself.

[0005] The objective of the utility model is to create an easy-to-use and convenient device that allows for the most effective determination of the length of the small intestine section required for bladder plastic surgery.

[0006] When implementing the utility model, the stated task is solved by achieving a technical result, which consists in ensuring an accurate intraoperative assessment of the size of the resected organ.

[0007] The specified technical result is achieved by the fact that the device is made in the form of a plate with marks and digital values ​​applied to it, determining the length of the resected part of the small intestine required for cystoplasty.

[0008] Fig. 1 shows a general view of the utility model.

[0009] Fig. 2 shows the position of the device on the compressed section of the small intestine; its walls in this position correspond to the length of the semicircle and correspond to the sector with a digital value indicating the required resection length.

[0010] Fig. 3 shows the device being held in the hand while being applied to the intestine.

[0011] The device consists of a plate 1 made of bioinert plastic. The ventral side is smooth, while the dorsal side contains notches 2 delimiting sectors with numerical values ​​corresponding to the size of the resected portion of the small intestine, depending on its semicircular length. The lengths of the resected portion of the small intestine are determined according to RU 2444307 C1.

[0012] The utility model is used as follows.

[0013] To create a bladder of optimal volume, during the operation the device with its plate 1 is placed on the small intestine in such a way that its ventral part is tightly pressed against the wall of the organ.

[0014] The operator then determines the length of the resection based on the digital values ​​delimited by the 2 marks on the dorsal surface of the plate, which is achieved by accurately matching the edges of the flattened intestine with the transverse dimension of a certain sector.

[0015] After determining the length of the intestinal section to be removed, the device is removed from the wound and the operation proceeds to the next stage.

[0016] The description of the utility model is supplemented by an example.

[0017] Case 1. Patient I., 54 years old. Diagnosis: Bladder cancer T2aN0M0G3. Cysts in both kidneys. Prostatic hyperplasia stage II. Chronic pyelonephritis, inactive phase. Indicated for radical cystoprostatovesiculectomy, extended pelvic lymphadenectomy, and orthotopic bladder plastic surgery using an isolated segment of the small intestine.

[0018] During the surgery, to estimate the length of the portion to be removed, plate 1 was pressed tightly against the small intestine until its diametrically opposite sides were aligned. The first sector, beyond which the walls of the flattened organ did not extend, was then visually identified, and the resection length itself was determined using the numerical designation (in this case, 38 cm). The device was then removed from the wound, and procedures continued according to protocol.

[0019] The design of the device ensures ease of use with the most effective determination of the area for removal of the small intestine required for cystoplasty, which is achieved by providing the ability to accurately compare the length of the semicircle of the organ being removed with the outer edges of a specific sector bearing a certain numerical value, which corresponds to the size of the resection.

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