METHOD AND DEVICE FOR PERFORMANCE OF PLEURODESIS

摘要

FIELD: medicine; surgery.;SUBSTANCE: two thoracoports are installed in the area of highest accumulation of exudate, one of which is used to install optics, and the other one is used to insert the device for pleurodesis performance into thoracic cavity, which is used to dissect parietal pleura with single-stage electromechanical preparation of dissected pleura edges. Created pleura-free wound surfaces are coagulated to achieve hemostasis. After performance of maximum possible dissection of parietal pleura device is withdrawn, and wounds are sutured in layers. At that ultrasonic examination is performed prior to operation to define the area of highest accumulation of exudate, which is marked onto skin surface, and thoracoports are inserted into marked section. Device used for pleurodesis is arranged in the form of flexible unipolar electrode and comprises handle covered with insulation material, working part free from insulation material, cutting element installed at the end of working part with possibility to be connected to electrosurgical block. Cutting element of device is arranged in the form of irregular trihedral pyramid with sharpened facets, at that middle sharpened facet is inverted to working part and is arranged for dissection of pleura along middle line of every intercostal gap with single-stage electromechanical preparation of edges to the sides from performed dissection by suprapleural structures cutting with side facets at the distance of 3-4 mm.;EFFECT: higher efficiency of parietal and visceral pleura adhesion, cessation of exudate supply or its significant reduction.;2 cl, 1 ex, 2 dwg