Anchor for legiment and muscles reinsetion in case of their separation from bones and key for installation and removal
SUBSTANCE: anchor for legiments and muscles reinsertion in case of separation from the bone comprises a threaded cylindrical portion and a head for the anchor installation and removal key, with hole and slots in the thread on both sides. Grooves are made along the entire length of the thread, a suture hole extends perpendicularly to the side surface and connects slots in the middle part, the key head has a cylindrical shape with flats at the grooves in the thread. The key for installation and removal of the above anchor is T-shaped and includes a handle and a rod. The working end of the rod is a stepwise cup, two opposing recesses are arranged on the lower step, coming from the edges of the rod to the handle. The recess height exceeds the anchor head height by 1 mm, while the walls of the lower cup step are flat from the inside at anchor head flats. The side wall of the rod contains an inclined channel extending to the upper step of the cup for suture withdrawal from the rod cavity, the channel outlet opening is located in a plane perpendicular to the side recesses plane.
EFFECT: structural strength to secure the suture, suturing without any contact with the cutting edge of the anchor.
2 cl, 6 dwg
SUBSTANCE: ablation of nucleus pulposus and sequestrectomy are carried out; implant is introduced into enucleated disc. As implant applied is nitinol thread, folded in form of spherical ball, diameter of which is 4-6 mm larger than height of disc cavity. Preliminarily cooled implant is pressed, and after its placement into disc, work spherical shape is given by heating to 40-45°C.
EFFECT: method makes it possible to reduce complications, which is reached due to elasticity of nitinol, providing protection of over- and underlying vertebrae from increased load from implant, with nitinol shape-memory effect ensuring support of given shape of intervertebral disc.
SUBSTANCE: ventral release from a toracotomy approach at an apex is accompanied by excising the seventh, or eighth, or ninth rib to gain an access in the form of an autograft 15-20 cm long. An excised rib autograft is placed into a pocket bed pre-formed from the toracotomy incision in subcutaneous fat and fixed to the subiculum to be used as the autograft; the excised rib autograft is underrun for a period from the moment of the final stage of dorsal correction. The second stage of the surgical treatment is preceded by vertical dry halotraction under the patient's body standing in the space of a therapeutic four-wheel frame equipped with a telescopic arm for the patient's head suspension. At the stage of the dorsal correction, the excised rib autograft is removed through a 2-3-cm incision along the postoperative toracotomy scar from the pocket bed in the subcutaneous fat, cleaned from soft tissues, treated in the antiseptic solution, and placed onto the decorticated posterior elements of the operated spine.
EFFECT: adequate spinal fusion involving the configuration recovery of the spinal canal.
4 cl, 3 ex
SUBSTANCE: slightly arciform incision is created along the anterior edge of the deltoid. The coracoids with attached muscles is exposed. The rotator cuff is incised along the intertubercular groove. A tendon of the caput longum of the biceps brachii is separated. The tendon of the caput longum of the biceps brachii is displaced inwards, and two ligatures are delivered under it. Sponge forceps are used to create a passage behind the subcapular muscle with two ligatures delivered through it, and tensioned to the coracoids. The wound is sutured in layers and covered with a retentive bandage for 4-5 weeks.
EFFECT: method enables reducing surgical injuries with using the reliable reinforcement of the anterior rotator cuff taking into account biomechanical features of the proximal shoulder.
2 dwg, 1 ex
SUBSTANCE: group of inventions relates to traumatology and orthopaedics. A set of instruments for the protection of the popliteal artery in the operation of arthroscopic reconstruction of the posterior cruciate ligament includes a guide-pin, which is sharpened from both ends, with a sharpening from one end being trihedral; the device for the protection of the popliteal artery, consisting of a working part and a handle, rigidly fixed at the right angle to each other, with the working part representing a cylindrical rod, which at the free end has a flattened section with through holes, located at an equal distance from each other, at an angle to the longitudinal axis of the working part, the flattened section of the working part is smoothly curved at an obtuse angle; a limiter on a cannulated drill, representing hollow cylinders of the different height with an internal diameter, corresponding to the drill diameter. A step-by-step formation of the tibial bone tunnel is realised. The operated extremity is bent in the knee joint at the right angle. Beginning of the tibial tunnel is determined more laterally and lower than the tibial tuberosity and formed at an angle of not less than 55° to the articulate surface of the tibia. The guide-pin is passed with the sharp trihedral sharpening forward, then removed and introduced with the other end forward. After that, the device for the protection of the popliteal artery is introduced through the posterior-medial access, and the guide-pin is wedged in the closest to it hole of the flattened section of its working part. Limiters are successively put on the drill, with the number of limiters being selected in such a way that the part of the drill, free from the limiters, corresponds to the tibial tunnel length. The cannulated drill is passed along the guide-pin, fixed in the device for the protection of the popliteal artery, and the tibial tunnel is formed.
EFFECT: group of inventions makes it possible to reduce a risk of injuring the popliteal artery, reduce a risk of purulent-inflammatory complications.
2 cl, 1 ex, 10 dwg
SUBSTANCE: osteotomy is performed with exposing the distal ulnar metaphysis by a long linear incision 3.0-4.5 cm along the ulnar surface. Distal ulnar osteotomy and intraoperative single-step redressment are performed through the approach created at 3.0 cm above the ulnar styloid at an angle of 45°. The radiocarpal joint is fixed with an orthosis for 2-2.5 weeks.
EFFECT: method enables reducing the number of intraoperative injuries, gaining in the radiocarpal motions as much as possible, avoiding metal structures to be applied, and reducing the immobilisation length.
2 ex, 1 dwg
SUBSTANCE: musculocutaneous vascularised and innervated island flap comprising the active greater teres muscle, a descending branch of the circumflex scapular artery, and the subscapular nerve is separated. The above flap is moved towards the elbow joint, with its muscular portion placed between the caput mediale and caput longum of the triceps muscle of the arm and anchored to a transition point of the tendon portion of the triceps muscle into the muscular one. The greater teres muscle is preserved attached to the humerus. As it may be required to bring the above flap down, it is possible to dissect away its attachment point of the greater teres muscle from the humerus. A tendon auto- or allograft is used to anchor the flap to the transition point of the tendon portion of the triceps muscle into the muscular one if the muscular portion does not appear to be long enough.
EFFECT: eliminating flexion contracture in the elbow joint and recovering the active flexion of the forearm in the motor unit deficiency.
4 cl, 7 dwg, 1 ex
SUBSTANCE: invention relates to traumatology and orthopaedics and can be applied for realisation of periacetabular triple osteotomy of pelvis in teenagers. Access to ischial and pubic bone is realised in projection of adductor muscles - longitudinal adductor access, in position of bending and abduction in hip joint. Tenomyotomy of adductor muscles is performed. In intermuscular space in blunt way performed is access to femur trochantin, where tendon part of iliolumbar muscle is exposed and its tenotomy is carried out. Branch of ischial bone, covered from outside with external obturator muscle, is identified under acetabulum. External obturator muscle is perforated. Ischial bone is bypassed with raspatories from inside and outside and oblique osteotomy is performed in front-to-back direction. Osteotomy of upper branch of pubic bone is performed. Osteotomy of ilium is performed from front access.
EFFECT: method makes it possible to reduce access trauma, provide realisation of surgery under conditions of hip head compression or its high position in case of dislocation.
SUBSTANCE: tendons of flexors and extensors of additional and basic rays are cut at the level of medium third of metatarsal bone and medium third of second instep bone respectively. Underdeveloped metatarsal bone of additional ray and underdeveloped first finger of base ray are removed. Anatomically correctly developed finger of additional ray is transferred on anatomically correctly developed metatarsal bone of basic ray. Flexor and extensor tendons of formed first ray are sutured at the level of medium third of formed ray. Fixation of transferred fragments is realised due to K-wires and gypsum bandage in medium position of foot to knee joint.
EFFECT: method ensures normal growth of first ray and support ability of foot.
SUBSTANCE: invention relates to traumatology and orthopaedics and can be applied for the treatment of purulent arthritis. Arthrotomy is carried out. Necrotised tissues, injured elements of the joint are ablated. Primarily a spacer from bone cement with an antibiotic is installed. The wound is sutured layer-by-layer. Drainage is carried out in portions, with the periodical closure of draining tubes in such a way, that drainage is realised for 5-10 min each hour on the first 2-3 days after operation. The spacer is replaced for the joint endoprosthesis after cupping the infectious process.
EFFECT: method makes it possible to reduce a risk of endoprophesies septic instability.
SUBSTANCE: invention refers to medicine, namely orthopaedics, and aims at treating a long-term rotator cuff injury. An incision 5-8 cm long is made from an inferior edge of a clavicle along an anterior surface of a shoulder along sulcus deltoideus (Ollier type) to access a rotator cuff. In an inner rotation position, the rotator cuff is sutured two or three times successively with the stitches transversely directed under each other to form a duplex rotator cuff segment.
EFFECT: invention enables reducing tissue injuries potentially accompanying a surgical intervention and the lengths of treatment and rehabilitation.
1 dwg, 2 ex
SUBSTANCE: invention refers to medicine. A retention suture has a supporting frame of the retention suture and a needle case. The supporting frame of the retention suture protects a retention suture end against retraction into a suturing area. The needle case is configured as a tube with a through hole, which extends through both ends.
EFFECT: retention suture is used for suturing without fastening several or all knots to be fastened during suturing.
26 cl, 9 dwg
SUBSTANCE: invention refers to surgery. A suturing apparatus comprises an upper base, a lower base, a surgical needle, a needle control unit; the upper base comprises a rail; the lower base, surgical needle and needle control unit form a suturing unit; the surgical needle functions in relation to the lower base by the needle control unit so that a first surgical suture and a second surgical suture are interlaced together by means of the surgical needle; the needle control unit is configured to move along the rail mounted on the upper base, and to face the lower base; both the upper base, and the lower base, as well as the suturing unit comprise a rotation unit.
EFFECT: device enables reducing the suturing time and the risk of cicatrisation.
3 cl, 5 dwg
SUBSTANCE: invention relates to medicine, namely to surgery, and can be applied for the enhancement of hemocirculation in a suture belt of the interintestinal anastomosis in experiment. For this purpose 0.25% solution of trimecaine is introduced in a dose of 400-88 ml per day into the mesentery of the intestine in the zone of the anastomosis under peritonitis conditions in dogs after the small intestine resection. 500 IU of heparin and a daily dose of an antibiotic are additionally added into the trimecaine solution.
EFFECT: method provides the enhancement of hemocirculation in suture belts of the interintestinal anastomosis due to the increase of intramural pressure.
SUBSTANCE: invention relates to medicine, namely to neurosurgery, neurooncology, and can be used for the treatment of glial brain tumours of a supratentorial localisation. For this purpose photodithazine in a dose of 1 mg/kg of body weight is introduced to a patient 2 hours before the tumour ablation. After that, surgical access to the tumour is performed. The operation wound is illuminated by blue colour with a wavelength of 400 nm, and the tumour boundaries are determined by means of fluorescence of photodithazine, selectively accumulated in the tumour tissue. The tumour is ablated under control of the tumour luminescence in blue colour with the application of an operation microscope. After that, a flexible light guide from a radiation source with a wavelength of 662 nm and power of 2.0 W with a light dispersing nozzle is placed into the tumour bed and the perifocal zone of the tumour is irradiated. The dose of irradiation is determined by the disappearance of fluorescence.
EFFECT: method provides an increase of the treatment efficiency due to the reliable clear determination of the tumour tissue boundaries with the normal brain substance independent on the malignancy degree and character of the tumour growth, with an increase of its ablation radicality, as well as due to the destruction of cells, located in the perifocal zone.
2 cl, 1 ex
SUBSTANCE: invention refers to medicine, namely to surgery. A partial nephrectomy with a tumour is preceded by putting preventive 8-shaped sutures at 1 cm from a border of the renal parenchyma along the whole circular length of the tumour. The sutures are tied up above the parenchyma. The nephrectomy is performed within the marked circle. After the haemostasis is achieved, the partial nephrectomy area is closed with covering the applied sutures. When closing the partial nephrectomy, muscular space filler is used.
EFFECT: method provides creating the conditions for lower parenchymal angiostaxis, reducing a risk of pinched renal artery and developing renal ischemia by reducing the length of the operation.
2 cl, 7 dwg
SUBSTANCE: invention relates to medicine and can be used for the placement of a thread in fabric. A sewing device includes a handle with a drive, a shaft, connected to the handle, and a head. The head is connected to the shaft and includes a proximal part with a needle and a distant part. The distant part is separated from the proximal part with a neck and has a cavity. The needle can travel through a hole of the needle exit. The drive is adapted for moving the needle from the hole of the needle exit in the proximal part of the head and through the neck to catch a capsule. The capsule is located in the cavity in the distant end of the head and is attached to the thread.
EFFECT: system improvement.
12 cl, 17 dwg
SUBSTANCE: method for the surgical connection of hollow organs with the use of a device: a) inserting a pointed tip end together with needles into a lumen of one of the connected hollow organs; b) performing a device traction from the hollow organ lumen so that the needle tips pass through a wall of the sutured hollow organ and appear on an outer surface of the organ; c) gripping the needle with surgical forceps or a needle holder and removing together with the suture from the tip with passing through the organ wall; d) fixing the removed needle with the suture between the spring coil in the respective sector. The stages c and d are performed again in the same sequence alternatively with all the needles and sutures in the tip with each suture fixed in the separate sector. That is followed by performing the stage f) that involves removing the tip from the hollow organ lumen. That is followed by performing the stages a, b, c, d and f again in the same sequence from the other side of the second connected structure. After both connected organs are sutured together, the spring-assisted plates are removed from the outer surface; both ends of the same needle sutures brought through the wall of the connected organs are found in each spring sector. The plates with sutures are diverged, and both halves of the surface and the tipped rod are sequentially removed from a surgical site. The sutures are sequentially removed from the spring and fastened until two hollow organs are connected completely; the free ends are cut off after tightening the knots.
EFFECT: improving the method and device.
12 cl, 13 dwg
SUBSTANCE: invention refers to medicine, namely to surgery, and can be used in surgical management of tumours and complicated ulcers of the distal one-third of the stomach and duodenum. The Bilroth's II gastrectomy is performed. The stomach is transacted along the border of the proximal and middle one-thirds with a linear suturing apparatus from a lesser curvature. An opening 1.5 cm long is formed from an opposite end of a gastric stump. The Roux isolated enteric loop is formed. An enterotomic opening is formed at 5 cm from the stump of the Roux isolated enteric portion. One branch of the linear stapling apparatus is inserted into the gastric lumen through the provided gastrotomic opening of the stump towards a greater curvature. The second branch is inserted through the enterotomic opening towards the enteric stump. The gastroenteroanastomosis is partially formed. The rest portion of the gastroenteroanastomosis is formed between the gastric stump and the enteric enterotomic opening by an uninterrupted manual suture.
EFFECT: method provides reducing the contamination of the surgical field, the length of the surgical intervention and the risk of postoperative complications by the small gastrotomic opening and the formed gastroenteroanastomosis by the linear stappling apparatus and the manual suture between the stump and the greater curvature.
SUBSTANCE: invention refers to medicine, namely to surgery, and can be used in a laparoscopic hepaticojejunostomy accompanying pancreatoduodenal resection. A pancreatectomy is performed. A side-to-end pancreaticojejunoanastomosis is created on the Roux isolated jejunal loop. The hepaticojejunostomy follows. An intestinal lumen is exposed at 10-15 cm from the created pancreaticojejunoanastomosis; the opening diameter is equal to that of a common hepatic duct. The needle is first pricked in a point of 9 o'clock. After knotting, traction of a free end of the needle is generated to extend a posterior wall of the common hepatic duct. A posterior lip of the anastomosis is created by locking continuous stitching at 0.1-0.3 cm to the level of 3 o'clock. The second knot is formed. An anterior lip of the anastomosis is created by locking continuous stitching at 0.1-0.3 cm. Once reaching the position of 9 o'clock, the free ends of the suture are tied together.
EFFECT: method provides reducing the intraoperative injuries, the length of treatment, and the risk of postoperative ventral hernias by applying the laparoscopic approach involving no injuries of the muscles of the anterior abdominal wall and providing the reliable anastomosis to be created.
SUBSTANCE: invention refers to experimental medicine and immunology, and can be used for the assessment of the millimetre-range electromagnetic wave (EHF) effect within a three-component model of cytostatic exposure. That is ensured by a thymus exposure in the group of animals to the millimetre-range electromagnetic wave (EHF) effect at wavelength 5.6 mm for 2 weeks every 1-2 days. A single exposure of the physical factor makes 1-2 minutes for 2 weeks every 1-2 days. That is followed by simulating a surgical intervention by opening and closing a peritoneum. On the seventh postoperative day, the animals are exposed to three-fold fractionated external gamma exposure in a single dose of 2.5 Sv every single day. Thereafter, cyclophosphan is administered intraperitoneally in a dose of 4 mg/100 g of animal's body weight. On the 14th day after the cytostatic is administered, the animals are killed to examine their blood and immune competent organs. That is combined with determining a thymus cellularity (TC) in 106cell./100 mg of its weight, a functional lymphocyte activity in a nitroblue tetrazolium test (NTT) in units, a spleen antibody-forming cell (AFC) count according to N.K.Erne in cells/"чП", apoptosis in an annexin test (AT), %, blood serum circulating immune complex (CIC) in units. That is followed by calculating a physical factor effect index (FI) by formula:
EFFECT: method provides the objective assessment of the millimetre-range electromagnetic wave (EHF) effect within the three-component model of the cytostatic exposure.
1 tbl, 3 ex
FIELD: medical engineering.
SUBSTANCE: device has elongated body having operation end engageable with ligature loop, lateral slit for ligature to exit and movable rod, mounted in the device body, having operation end for holding the ligature. The elongated body has special purpose design to match endosurgical port or trocar lumen. The rod is spring-loaded and has nonworking end projecting from the device body as handle. The rod operation end is hook arranged in front of the lateral slit for ligature to exit and making displacement at a distance minimum equal to distance from operation body end to end face of slit for ligature to exit, oriented towards the handle.
EFFECT: improved tissue and organ engagement conditions; simplified maintenance procedure; accelerated operation process.
3 cl, 2 dwg