RU2768452C1 - Device for creating intra-abdominal hypertension in experiment - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention relates to experimental medicine and can be used to create high intra-abdominal pressure in laboratory animals and cadaver examination. Device for creating intra-abdominal hypertension in experiment in laboratory animals and in cadaver examination consists of an external tube with diameter of 2 cm and length of 45 cm, an inner tube with diameter of 0.5 cm and length of 120 cm with an elastic cylinder fixed on it with a plug in the form of an elastic plug, a bulb for air injection and a pressure gauge for measuring pressure.EFFECT: using the invention enables creating the intra-abdominal hypertension in an experiment with maximum accuracy.1 cl, 2 dwg

Description

The invention relates to experimental medicine and can be used to create increased intra-abdominal pressure in laboratory animals and in cadaveric examination.

It is known that intra-abdominal hypertension occurs in surgical practice quite often. First of all, this applies to urgent pathology of the abdominal cavity (intestinal obstruction, peritonitis, pancreatic necrosis, etc.). Increased pressure in the abdominal cavity occurs in patients with volumetric formations, obesity, etc. It is also known that intra-abdominal hypertension adversely affects the functional state of almost all organs, primarily the cardiovascular and pulmonary systems. Of particular relevance is increased intra-abdominal pressure in the early postoperative period after suturing large and giant hernias with the development of compartment syndrome. There are numerous studies on the prediction, treatment and prevention of intra-abdominal hypertension. Part of the work is devoted to cadaver studies and experiments on animals.

A device is known for creating increased intra-abdominal pressure in laboratory animals (dissertation for the degree of candidate of medical sciences Ladik "Therapeutic, diagnostic and prognostic significance of intra-abdominal pressure control in cardiac surgery patients" Tomsk - 2019), representing a cuff with which external compression of the abdominal cavity to create increased intra-abdominal pressure (IAP). IAP was measured through the bladder. The study itself is not highly correct, since the creation of the IAP is carried out externally and its measurement is not direct, but indirect.

In cadaveric studies, three methods for creating increased intra-abdominal pressure are described (Khripun A.I., Vladimirov V.G., Zarinskaya S.A. et al. “Experimental modeling of intra-abdominal hypertension” Bulletin of the All-Russian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences, 2010, No. 3 (73)) .

One way to model intra-abdominal hypertension involves the introduction of fluid into the abdominal cavity. The negative side of this model is the impossibility of performing decompression or other experimental manipulations in case of purposeful or accidental dissection of the parietal peritoneum.

The next method is to introduce fluid into the paraperitoneal tissue, which is accompanied by the development of intra-abdominal hypertension. However, the method is technically difficult. The technique excludes the possibility of regulating hypertension, especially if it is necessary to reduce it (Khripun A.I., Vladimirov V.G., Zarinskaya S.A. et al. “Experimental modeling of intra-abdominal hypertension” Bulletin of the All-Russian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences, 2010, No. 3 (73 )).

.The closest analogue is a device in the form of a polyethylene tank with a size of at least 20 × 20 × 50 cm and a volume of at least 20 liters. The reservoir is implanted into the abdominal cavity through a pararectal mini-access with subsequent air injection into it to the pressure specified by the study (Khripun A.I., Vladimirov V.G., Zarinskaya S.A. et al. “Experimental modeling of intra-abdominal hypertension” Bulletin of VSNC SO RAMS, 2010, No. 3 (73)).

The disadvantages of the prototype are:

- technical complexity of implantation and expansion in the abdominal cavity of the reservoir,

- the presence of a cosmetic defect after mini-access,

- reproducible hypertension is limited by the volume and rigidity of the reservoir walls.

The technical result of the present invention is the creation of a device of a simple design that allows you to safely, with maximum accuracy, create intra-abdominal hypertension in the experiment.

The solution of the set technical conditions provides a device for creating increased intra-abdominal pressure in the experiment (figure 1).

A device for creating a model of intra-abdominal hypertension during cadaveric examination consists of an outer tube with a diameter of 2 cm and a length of 45 cm, an inner tube with a diameter of 0.5 cm and a length of 120 cm with an elastic balloon fixed on it with a plug, a "pear" for air injection and a pressure gauge for pressure measurements. Depending on the goals, the shape of the balloon can be different in shape and length. The plug is represented by an elastic plug fixed to the apical part of the balloon and is designed to prevent injury to the internal organs of the abdominal cavity when the device is inserted through the anterior abdominal wall (figure 1). The device is assembled as follows. The inner tube is inserted into an elastic rubber reservoir, which is fixed at the base with a ligature. Industrial products such as rubber balloons, condoms, etc. can be used as a reservoir. First, an inner tube with a balloon is inserted into the outer tube and advanced to the stop with a plug. The inner tube after its introduction to the required depth is attached to the bulb with a pressure gauge (figure 2).

To create a model of intraperitoneal hypertension, the distance between the alleged puncture of the anterior abdominal wall and the proposed location of the balloon in the abdominal cavity is first measured with a centimeter tape. On the outer tube of the device, according to the required length, a mark is applied with a marker.

A scalpel is used to puncture the anterior abdominal wall (usually in the left iliac region) with a diameter corresponding to the thickness of the outer tube. Through the puncture, sliding along the peritoneum, the tube is inserted to the required depth and location of the balloon. This method of balloon insertion is simple and prevents damage to internal organs. The outer tube is then removed from the abdomen. In this case, the inner tube with the balloon is held in a static position.

A "pear" with a pressure gauge is attached to the inner tube. With the help of a pear, air is pumped into the cylinder to the planned pressure, which is reflected on the pressure gauge in mm Hg. Art.

The creation of intra-abdominal hypertension during cadaveric examination with the proposed device is characterized by ease of execution, high efficiency, the ability to quickly control pressure, safety and low cost.

The proposed device for creating intra-abdominal hypertension in the experiment has the following advantages:

- easily reproducible from improvised means,

- the technique using the proposed device has low labor intensity and excellent reproducibility,

- safe in terms of damage to internal organs,

- provides controlled hypertension in a wide range,

- provides increased intra-abdominal pressure in a given mode, even if the peritoneum is damaged or dissected,

- the proposed technique does not lead to significant cosmetic defects of the abdominal wall.

Using the device, a study was made of the effect of increased intra-abdominal pressure on the tension of the tissues of the aponeurosis of the white line of the abdomen. The experiment was carried out on five corpses of both sexes without visible interventions on the anterior abdominal wall. In all cases, a controlled model of intra-abdominal hypertension was created without problems. Regardless of the location of the air reservoir, the pressure, according to Pascal's law, was evenly distributed throughout the abdominal cavity with the creation of increased tension on the aponeurosis of the white line of the abdomen along the entire length. After dissection of the aponeurosis in various modes of intra-abdominal pressure (from 5 to 25 mm Hg), the tension of the wound edges was measured. The dissection of the peritoneum did not change the parameters of intra-abdominal pressure, respectively, the results of the study.

Claims (1)

A device for creating intra-abdominal hypertension in an experiment in laboratory animals and in a cadaver study, consisting of an outer tube with a diameter of 2 cm and a length of 45 cm, an inner tube with a diameter of 0.5 cm and a length of 120 cm with an elastic balloon fixed on it with a plug in the form of an elastic cork , pears for air injection and a manometer for measuring pressure.

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