CN100473432C - Liver segment positioning catheter - Google Patents
Liver segment positioning catheter Download PDFInfo
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- CN100473432C CN100473432C CNB2006100953864A CN200610095386A CN100473432C CN 100473432 C CN100473432 C CN 100473432C CN B2006100953864 A CNB2006100953864 A CN B2006100953864A CN 200610095386 A CN200610095386 A CN 200610095386A CN 100473432 C CN100473432 C CN 100473432C
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- catheter
- catheter body
- liver
- sacculus
- tube
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Abstract
The invention relates to a liver positioning tube, formed by main body and guide wire made from macromolecule materials, wherein the front of main body has at least three ball bubbles; each ball bubble has liquid outlet of liquid tube, air outlet of air tube and air bubble; the liquid tube and air tube are in the main body; the liquid outlet and air outlet extend out the front tube of main body distantly; the air bubble through to the air inlet is on the outer tube of main body; the liquid inlet and the air inlet extend outside the main body; the wire is longer than liquid tube; the wire is smaller then liquid tube. The inventive tube can use multi-chamber multi-bubble to judge the integral interface of liver, to mark target liver in short time.
Description
Technical field
The invention belongs to Genneral Surgery and learn the field, relate to the liver segment positioning catheter in the hepatectomy.
Background technology
Along with surgical technic and theoretical progress, the surgery of liver level also is greatly improved, and the disease that can't cure has obtained treatment in the past, and the hepatocarcinoma that can't excise also can be excised now.The progress of surgical instruments, clinical practice as ultrasonic attraction cutter Cusa, depletion of blood dissecting knife TissueLink etc., make the develop rapidly of hepatectomy technology, the doctor can be handy excise, as long as delimitate or suppose boundary, can excise according to set or imaginary tangent plane, intraoperative hemorrhage is few, minimum to the upset of patient's Pathophysiology, but safety and steady is spent in the art.Patient's ability to shoulder economically and peri-operation period management technique improved a lot more in the past, and these all provide bigger support for the recovery of patient's postoperative.
One of characteristic of hepatocarcinoma is sent out for portal vein, and its excision should be walked line range along portal vein and carries out in theory.At present clinical liver subsection commonly used adopts the Couinaud method of fractionation, and its segmentation principle is along the GlissonShi system, also can be understood as along the portal vein traveling and carries out segmentation.Therefore can draw, hepatocarcinoma can enlarge excision, and enlarging excision extension in theory should walk the behavior foundation with portal vein, and promptly should adopt hepatic segments is this hepatectomy, just can reach curative effect preferably.From the angle of surgical instruments, the enforcement of regular hepatic segments excision has not been obstacle, and key is the judgement of regular hepatic segments scope.
The decision procedure of hepatic segments scope roughly has following several at present:
1) liver surface sign and Couinaud segments theory: advantage is roughly to judge, and is convenient and swift.Shortcoming is that the experience dependency is strong, and is difficult to the accuracy that reaches higher, and the boundary in the liver parenchyma can't finely be judged.
2) above-mentioned first method is judged substantially in conjunction with B ultrasonic again: advantage is an easy operating, and accuracy strengthens.Shortcoming easily causes and strides the hepatic segments excision for still accurate inadequately, and consequence can cause: the imperfect or damage of a. structure, leave over, and cause gallbladder leakage, remaining hepatic necrosis or residual hepatic insufficiency; B. focus or cancer embolus are left over, thus easily the recurrence or art in send out.
3) B ultrasonic guiding THPV puncture down, U.S. blue injection; The Japan scholar early adopts this method and uses morely, and advantage is that it is accurate substantially to judge if skilled, and the excision extension indication is ideal comparatively.Shortcoming is that operation easier is big, the patient need be familiar with and on top of ultrasonic technique and the puncture knowledge.But for the surgeon, unless through corresponding training, puncture generally is difficult for successfully, and in practice, even puncture successfully, also causes U.S. blue reverse diffusion feasible dyeing expanded range or very fast drainage, boundary to disappear easily; The risk that also has the needle track diffusion for tumor patient.
4) method of continuing to use lobectomy of liver is as dissecting first hepatic portal, and free left and right sides hepatic portal is blocked respectively, and this method can only be judged right front, right back blood vessel and be blocked or cut off, and can't reach the branch of hepatic segments, causes too much healthy liver to be destroyed easily.
In sum, hepatic segments excises for liver lesion especially hepatocarcinoma, is a kind of ideal excision mode.Present existing resection instrument can satisfy the requirement of hepatic segments excision fully, judges shortcomings such as poor accuracy and/or technical difficulty are big, be difficult for controlling but the decision technology of hepatic segments but exists, even also has the risk that worsens the state of an illness.
Summary of the invention
At the deficiencies in the prior art, purpose of the present invention is exactly that a kind of liver segment positioning catheter that can accurately judge hepatic segments and processing ease, handy and safe will be provided.
For achieving the above object, the present invention is a kind of liver segment positioning catheter, comprises catheter body and the seal wire made by macromolecular material, and the diameter of the leading portion part of this catheter body is less than the portal vein and the ramose diameter thereof of hepatic segments; Leading portion in described catheter body partly is provided with at least three group sacculus unit, and to the afterbody axis, the sacculus unit has each other at interval and is provided with along the head of described catheter body; Every group of sacculus unit comprises the gas outlet of the liquid outlet of a catheter, an airway and the air bag that communicates with this gas outlet, and this air bag is made by macromolecular material; Catheter and airway all are arranged in the cavity of catheter body, and the head of every catheter is that liquid outlet, afterbody are supply opening, and the head of airway is that gas outlet, afterbody are gas injection port; The liquid outlet of every group of unitary catheter of sacculus and the gas outlet of airway stretch out successively catheter body leading portion tube wall and have each other at interval, the corresponding air bag that communicates with this gas injection port is arranged on the outer tube wall of catheter body, and the supply opening of catheter and the gas injection port of airway all stretch out outside the catheter body from the catheter port of the afterbody of catheter body; The length of described seal wire is greater than the length of described catheter, and the diameter of seal wire is less than the diameter of catheter.
Further, described sacculus unit is four groups; To caudal directions, the diameter of catheter body increases gradually along the head of described catheter body.
Compared with prior art, liver segment positioning catheter of the present invention, by the many air bags of multi-cavity, help the patient in operation on liver, to judge the complete boundary of purpose hepatic segments comparatively intuitively, simply and accurately, guarantee that the patient judges in the short period of time and labelling purpose hepatic segments, for the standard hepatic segmental resection provides reliable foundation.
Description of drawings
Fig. 1 is the structural representation of liver segment positioning catheter of the present invention;
Fig. 2 is the schematic cross-section at the middle part of liver segment positioning catheter;
Fig. 3 is for respectively successively after four catheters inject the U.S. orchid of gradient, the sketch map after the hepatic segments dyeing;
Fig. 4 is the sketch map by seal wire conversion liver segment positioning catheter position.
The specific embodiment
Among Fig. 1-4, liver segment positioning catheter comprises catheter body 5 and the seal wire of being made by macromolecular material 9.To afterbody, its diameter increases gradually along head for catheter body 5, and the diameter of the leading portion part 6 of catheter body 5 is less than the portal vein and the main ramose diameter thereof of hepatic segments.Be provided with in the cavity of catheter body 5 four catheters 1 (2,3,4) and four airways 1 ' (2 ', 3 ', 4 '), four catheters 1 (2,3,4) head is liquid outlet a1 (a2, a3, a4), afterbody be supply opening A1 (A2, A3, A4), four airways 1 ' (2 ', 3 ', 4 ') head be gas outlet b1 (b2, b3, b4), afterbody is gas injection port B1 (B2, B3, B4), four airways 1 ' (2 ', 3 ', 4 ') gas outlet b1 (b2, b3, b4) respectively with four air bag c1 (c2, c3 c4) communicates, and air bag is to be made by macromolecular material, can expand rapidly after the inflation, air bag is arranged on the outer tube wall of catheter body 5.The length of seal wire 9 is greater than the length of every catheter, and the diameter of seal wire 9 is less than the diameter of every catheter.Along the head of catheter body 5 to caudal directions, four catheters 1 (2,3, liquid outlet a1 4) (a2, a3 is a4) with four catheters 1 (2,3,4) gas outlet b1 (b2, b3, b4), stretch out successively catheter body 5 leading portion tube wall and remain with suitable distance each other, the supply opening A1 (A2 of catheter, A3, A4) and gas injection port B1 (B2, the B3 of airway, B4), all stretch out outside the catheter body 5 from the catheter port 8 of the afterbody part 7 of catheter body 5.
A liquid outlet, a gas outlet and sacculus unit of a common composition of corresponding air bag, as shown in Figure 1, axis along the head of catheter body 5 to afterbody, on the leading portion part 6 of catheter body 5, have four sacculus unit, and all be separated with suitable distance between each sacculus unit each other.
During operation, seal wire 9 is entered in the catheter 1 through the supply opening A1 of catheter 1, under the B ultrasonic guiding, by the adjusting of seal wire 9, the head of liver segment positioning catheter of the present invention is inserted the portal vein end, then successively by four airways 1 ' (2 ', 3 ', 4 ') the gas injection port B1 (B2 of afterbody, B3, B4) injecting gas, four airways 1 ' (2 ', 3 ', 4 ') gas outlet b1 (b2, b3, b4) corresponding four air bag c1 (c2, c3, c4) gassy expands, make positioning catheter place branch of portal vein be closed, again by its corresponding four catheters 1 (2,3,4) the supply opening A1 (A2 of afterbody, A3 A4), injects the U.S. blue dyestuff of four kinds of different diluted concentrations.Because four air bag c1 (c2, c3, blocking effect c4), U.S. blue dyestuff only can dye the hepatic segments of its front end, can not occur the situation that dyestuff spreads everywhere, and pigmented section is comparatively constant.
In addition, the dyeing of zones of different liver can also adopt indocyanine green or different coloring matters to inject, and coloring matter all need meet the clinical safety and the clear and definite requirement of dyeing, and also can adopt the different diluted concentrations of dyestuff of the same race to inject.Because liver segment positioning catheter disposes seal wire 9, make gas bag unit in the portal vein blood vessel, regulate the handling stronger of direction, under most situation, can be in art B ultrasonic guide next time that property enters the purpose lobe of the liver, and then judge the purpose hepatic segments easily.Even liver segment positioning catheter fails to enter the purpose lobe of the liver first, also can comparatively fast finish the judgement of purpose hepatic segments by the conversion of seal wire 9 at the unitary catheter of different bladder.
Because right liver is comparatively complicated, is divided into 5,6,7,8 sections, thus below be judged to be example with the hepatic segments of right liver, specify the using method of liver segment positioning catheter of the present invention by specific embodiment:
Embodiment 1: the 7th section judgement of liver, it is applicable to 7 sections excisions
1, after the operation beginning, carries out the far-end ligation, seal wire 9 is inserted in the catheter 1, under the guiding of seal wire 9, portal vein is inserted in the sacculus unit of this liver segment positioning catheter from near-end through right gastroepiploic vein;
2, the patient inserts the right side or offside door venous tributary with hands guiding sacculus unit;
3, after the offside door vein is inserted in the sacculus unit, continue to send into and make its access door vein end always, make foremost by gas injection port B1 and to expand after the air bag c1 gas injection, survey in liver surface with B ultrasonic this moment, and the position that draws this place, sacculus unit that can be very easy is that the right front lobe of the liver of liver still is right back lobe of the liver;
4, as shown in Figure 3, suppose that the sacculus unit is positioned at right back leaf.Proper amount of gas by gas injection port B1 injection, should be enough to make air bag c1 to seal the lacuna of this branch of portal vein, extract seal wire 9 then out, (used U.S. orchid is gradient concentration to inject diluted concentration comparatively U.S. blue by supply opening A1, adopt the comparatively concentration of dilution earlier), judge that once more dyeing hepatic segments position I still is right back leaf in right front leaf;
5 if the liver that is colored among Fig. 3 for dyeing I zone, hepatic segments position, then can determine that it is the 7th section substantially.Further judge then, according to the method described above air bag b2 inflated again, inject dense slightly U.S. orchid, following two kinds of situations will occur through supply opening A2:
1. as shown in Figure 3, the liver that is colored is dyeing II zone, hepatic segments position, and the II zone, hepatic segments position of decidable dyeing at this moment still is 7 sections branch of portal vein scopes.When this kind situation occurring, should continue further to judge, according to above-mentioned same method, be colored fully until the 7th section all branches of portal vein, therefore, again air bag b3, air bag b4 are inflated, until the liver that occurs being colored during, can judge that liquid outlet ax is the branch of portal vein that all outlets are the 7th section liver of domination before the liquid outlet a3 among Fig. 3 for the zone of the dyeing hepatic segments position III among Fig. 3;
2. as when dyeing hepatic segments position III zone occurring among Fig. 3, then pointing out the liquid outlet hepatic segments that a2 is arranged is the 6th section, and the 7th period of this moment is that the purpose hepatic segments is the branch of portal vein that liquid outlet a1 is arranged.After judgement is clear, then adopt the U.S. blue inlet injection before liquid outlet a3 of maximum concentration, make the pigmented section boundary more clear and definite, 7 sections livers are promptly judged.
The judgement that embodiment 2 livers are the 5th section
1, liver segment positioning catheter first positioning instant be positioned at right front leaf liver, just the 7th section described in the location of the 5th and the 8th section liver as the above-mentioned embodiment 1 then, determination step is identical;
2, as if the assumed conditions that continues among the embodiment 1, liver segment positioning catheter is positioned right back leaf liver first, then carries out following steps:
1. successively by after air supply opening B1, air supply opening B2, air supply opening B3 and the air supply opening B4 inflation, again successively by supply opening A1, supply opening A2, supply opening A3 and supply opening A4, inject the U.S. blue of gradient dilution respectively, till right front dyeing occurring, judge that then liquid outlet ax promptly is the duct of leading to right front branch of portal vein, liquid outlet ax is liquid outlet a4 as shown in the figure;
2. as shown in Figure 4, insert seal wire 9 until passing through liquid outlet a4 through supply opening A4, after the B ultrasonic indication and confirming to be positioned at branch of portal vein intracavity end, emit the gas of each air bag to pairing right front branch of portal vein end, keep seal wire 9, take out catheter body 5;
3. after catheter body 5 is taken out, penetrate seal wire 9 with liquid outlet a1, until from supply opening A1 seal wire 9 being passed, then the head 6 of catheter body 5 will enter right front lobe of the liver;
4. so far, then the 5th, the 8th section judgement is once more as the operation of embodiment 1, occurs the branch of portal vein that the liquid outlet ax in dyeing hepatic segments IV zone is arranged at last, is the domination portal vein of the 5th section liver.
In addition, in operating process, as inject when U.S. blue, pressure is high but do not have zone dyeing and increase, and represents then that ax is pairing to be the portal vein residual cavity, should continue backward this moment to judge, after corresponding hepatic segments dyeing occurring, then adopt the U.S. orchid of maximum concentration to dye, deepen dyed color, thus final definite operation boundary.
Claims (2)
1, a kind of liver segment positioning catheter is characterized in that, comprises catheter body and the seal wire made by macromolecular material, and the diameter of the leading portion part of this catheter body is less than the portal vein of hepatic segments and the diameter of main split thereof; Leading portion in described catheter body partly is provided with at least three group sacculus unit, and to the afterbody axis, the sacculus unit has each other at interval and is provided with along the head of described catheter body; Every group of sacculus unit comprises the gas outlet of the liquid outlet of a catheter, an airway and the air bag that communicates with this gas outlet, and this air bag is made by macromolecular material; Catheter and airway all are arranged in the cavity of catheter body, and the head of every catheter is that liquid outlet, afterbody are supply opening, and the head of airway is that gas outlet, afterbody are gas injection port; The liquid outlet of every group of unitary catheter of sacculus and the gas outlet of airway stretch out successively catheter body leading portion tube wall and have each other at interval, the corresponding air bag that communicates with this gas injection port is arranged on the outer tube wall of catheter body, and the supply opening of catheter and the gas injection port of airway all stretch out outside the catheter body from the catheter port of the afterbody of catheter body; The length of described seal wire is greater than the length of described catheter, and the diameter of seal wire is less than the diameter of catheter.
2, liver segment positioning catheter according to claim 1 is characterized in that: described sacculus unit is four groups; To caudal directions, the diameter of catheter body increases gradually along the head of described catheter body.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB2006100953864A CN100473432C (en) | 2006-12-30 | 2006-12-30 | Liver segment positioning catheter |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB2006100953864A CN100473432C (en) | 2006-12-30 | 2006-12-30 | Liver segment positioning catheter |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1994487A CN1994487A (en) | 2007-07-11 |
| CN100473432C true CN100473432C (en) | 2009-04-01 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB2006100953864A Expired - Fee Related CN100473432C (en) | 2006-12-30 | 2006-12-30 | Liver segment positioning catheter |
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| CN (1) | CN100473432C (en) |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104224271B (en) * | 2014-09-11 | 2018-11-23 | 中国人民解放军第三军医大学第二附属医院 | Branchofiberoscope biopsy hemostatic ball cuff pipe |
| CN111408018A (en) * | 2020-04-02 | 2020-07-14 | 西安交通大学医学院第一附属医院 | Hepatobiliary tract angiography device and using method thereof |
Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4423725A (en) * | 1982-03-31 | 1984-01-03 | Baran Ostap E | Multiple surgical cuff |
| CN87202584U (en) * | 1987-02-21 | 1987-10-14 | 湖南省人民医院 | Biliary tract catheter with multiple inflatable capsules |
| WO1987007510A1 (en) * | 1986-06-12 | 1987-12-17 | Ernesto Fina | Two ballooned catheter device for diagnostic and operative use |
| EP0364799B1 (en) * | 1988-10-21 | 1995-05-03 | Delcath Systems, Inc. | Cancer treatment |
| CN2411014Y (en) * | 1999-12-25 | 2000-12-20 | 徐州医学院肿瘤防治研究所 | Hepatic artery retaining saccule catheter |
| US6485500B1 (en) * | 2000-03-21 | 2002-11-26 | Advanced Cardiovascular Systems, Inc. | Emboli protection system |
| JP2004135688A (en) * | 1998-11-12 | 2004-05-13 | Yoshino Seiki:Kk | Balloon catheter for blood vessel |
| JP2006346449A (en) * | 2005-06-17 | 2006-12-28 | Konko Ri | Manufacturing apparatus of balloon catheter and manufacturing method thereof |
-
2006
- 2006-12-30 CN CNB2006100953864A patent/CN100473432C/en not_active Expired - Fee Related
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4423725A (en) * | 1982-03-31 | 1984-01-03 | Baran Ostap E | Multiple surgical cuff |
| WO1987007510A1 (en) * | 1986-06-12 | 1987-12-17 | Ernesto Fina | Two ballooned catheter device for diagnostic and operative use |
| CN87202584U (en) * | 1987-02-21 | 1987-10-14 | 湖南省人民医院 | Biliary tract catheter with multiple inflatable capsules |
| EP0364799B1 (en) * | 1988-10-21 | 1995-05-03 | Delcath Systems, Inc. | Cancer treatment |
| JP2004135688A (en) * | 1998-11-12 | 2004-05-13 | Yoshino Seiki:Kk | Balloon catheter for blood vessel |
| CN2411014Y (en) * | 1999-12-25 | 2000-12-20 | 徐州医学院肿瘤防治研究所 | Hepatic artery retaining saccule catheter |
| US6485500B1 (en) * | 2000-03-21 | 2002-11-26 | Advanced Cardiovascular Systems, Inc. | Emboli protection system |
| JP2006346449A (en) * | 2005-06-17 | 2006-12-28 | Konko Ri | Manufacturing apparatus of balloon catheter and manufacturing method thereof |
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| Publication number | Publication date |
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| CN1994487A (en) | 2007-07-11 |
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Granted publication date: 20090401 Termination date: 20101230 |