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Power regulation mechanisms for surgical instruments and accumulator batteries Battery packs may contain multitude of accumulator cells and comprise movable terminal for discharging. When connected to a surgical instrument the terminal for discharging may couple electrically anode of the battery pack to cathode of the battery pack, for example, by means of resistance element intended for discharge of the battery pack. |
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Method for spiral embolisation of open arterial duct Common femoral vein is catheterised under Seldinger's general anaesthesia. That is followed by an X-ray controlled catheterisation of the pulmonary artery through the inferior vena cava, right auricle, right ventricle. An open arterial duct is catheterised in the frontal projection through the pulmonary artery. An aortography and angiography of the open arterial duct are performed in the lateral projection. The formed angiogram images are used to specify the anatomy and size of the open arterial duct; a controlled spiral of an adequate size is selected. A guide wire is inserted through a catheter into the descending aorta. The catheter is removed through the guide wire. The guide wire is left in the descending aorta. A catheter is inserted in the retrodgrade direction through the open arterial duct into the descending aorta. The inserted catheter is used to deliver the controlled spiral into the open arterial duct ampulla and descending aorta in the up-flow retrodgrade direction through the duct from the side of the pulmonary artery. The controlled spiral turns are released from the catheter. After the desired number of the controlled spiral turnes has been released, the whole system is pulled up through the open arterial duct towards the pulmonary artery; the spiral fixation is checked for durability in the duct ampulla and aorta under X-ray control. The rest turns of the controlled spiral in the pulmonary artery are also released, and the whole system is pulled up once again towards the pulmonary artery. The controlled spiral turns are arranged so that final spiral positioning makes 2-3 turns found in the open arterial duct ampulla and aorta. Echocardiography aims at controlling the spiral position in the open arterial duct, and a release blood amount through the open arterial duct. The spiral is detached from the delivery system; the latter together with the catheter and introducer are removed from the femoral artery; homeostasis is conducted within the access site. |
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Method and device for tissue approach Invention relates to medicine. Set contains multitude of knots for wound sewing in one package. Each knot for wound sewing additionally contains curved introduction device with distal and proximal ends, between which thread-like element is placed. First fixer is connected with thread-like element between its first and second ends. Second fixer is placed on distal end of thread-like element. Thread-like element is made with possibility to form sliding knot between first and second fixers in such a way as to provide reduction of distance between first and second fixers by pulling out proximal end of thread-like element. Distal end of curved introduction device is accepted into channel in first fixer. Channel passes along longitudinal length of first fixer. |
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Method for transcutaneous repair of vertebral body Body of adjacent vertebras are approached by transcutaneous insertion of trocars through vertebral arch roots. Guide pins are inserted through the trocars. The trocars are removed. Transpedicular screws are inserted through the guide pins. A rod is secured between the transpedicular screws on one side of the spinal cord with the spinal cord being extended and distracted. On the opposite side, a trocar is used to create a canal through a pedicular segment of the involved vertebral arch towards its body. A guide pin is inserted through the trocar. An osteoplastic material introduction device is mounted through the guide pin. The osteoplastic material introduction device facilitates filling the transpedicular canal with osteoplastic material. The osteoplastic material introduction device is removed. A transpedicular screw is inserted through the canal into the involved vertebral body. A structure is mounted by connecting the adjacent vertebras and the involved vertebra by extending and distracting. |
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Method for accessing short rectal stump in contracted pelvis in reconstructive operations of colon Method involves identifying a wall of the short rectal stump for the purpose of a reconstructive operation. That is followed by mobilising a urinary bladder and a pelvic portion of an ureter from one side. An umbilical artery, upper and lower vesical arteries and veins are transected and ligatured. In females, leaves of a mesoderma are incised; a round ligament of uterus, uterine vessels, and a paravaginal ligament are transected up to a pelvic floor and ligatured. In males, a pelvic peritoneum is incised, and a seminal duct is skeletonised. The mobilised organs are displaced into an opposite side of the pelvis. The rectal stump is sharply separated. |
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Method for lymph node dissection in combined gastrectomy in oncology patients Invention refers to medicine, namely surgery. The abdominal cavity is opened and inspected; the stomach with lymph nodes is mobilised; that is followed by lymph node dissection of a hepatoduodenal ligament. The gastroduodenal artery is transected and ligatured. Thereafter, common hepatic and proper hepatic arteries are taken aside in the cranial direction; the lymph nodes are removed along the portal vein and common hepatic artery. That is followed by ligaturing left gastric and splenic arteries at their bases, performing a splenectomy, lymph node dissection around the celiac artery, transectingthe oesophagus and creating digestive anastomoses. |
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Method for segmental vertebrotomy Posterior structure of roots of vertebral arches and bodies are excised, and a deformity is corrected until edges of the formed excision defect close completely by means of a fixation device. A cranial portion of the broken spine, a degenerated disk and a caudal vertebral end plate of an overlying spine are excised horizontally throughout the entire anteroposterior length up to an anterior longitudinal ligament in order to ensure the planned correction manipulations in all planes and bring bones of the two adjoining spines in close contact in the position of the ensured correction. |
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Invention refers to medicine and may be used for wound suturing when inserting an endoscope into the digestive tract. The suturing device comprises a front portion, a back portion, a unit for moving the front portion and back portion closer to each other and further from each other, and a unit for relative rocking of the front portion and back portion. The back portion comprises a needle-like element provided on the surface from the front portion so that its axial direction is parallel with the direction, in which the front portion and back portion can move closer to each other and further from each other. The front portion is able to enclose a tip of the needle-like element, when the front portion and back portion are moved closer to each other. Each of the enclosing cavities integrates an engagement element, which can engage with the needle-like element. The engagement elements enclosed into the respective enclosing cavities are connected by a retention suture. The suturing device may be attached to a flexible endoscope, and the surgical procedure may be only performed by the endoscope. |
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Guide for port group formation Guide assembly for port formation in hip arthroscopy comprises a guide and a first surgical device. A guide comprises a body having a first set of marks, and a connector having a through hole and configured movable along the length of the above body. The first surgical device has a hook-shaped distal end having a second set of marks. The guide is connected to the first surgical device. When the connector is found at one of the marks from the first set, a long axis of the above through hole is co-radial with one of the marks from the second set. |
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Suturing head assembly of surgical instrument with starter lock Invention refers to medicine. A head of a surgical suturing instrument comprises a staple cartridge accommodating one or more surgical staples, a movable core, at least one staple ejector projecting from the core, and a body. The body is configured so as to hold the staple cartridge at least partially, and receive the movable core and staple ejector. A casing comprises at least one retainer movable from a first position to a second position. When the retainer is found in the second position, the staple ejectors are locked from actuation or staple ejection. |
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Central and peripheral nerve ends are vivified until observing normal fascicles; an epineural flap is formed; a subepineural suture of the central and peripheral nerve ends is formed, and the epineural flap is fixed. The central nerve end is vivified at the level of the greatest diameter of a regeneration neuroma around the circumference of the neuroma. An epineurium is mobilised; a circular epineural flap is formed and displaced in the proximal direction. Thereafter, the central nerve end is vivified until observing normal fascicles; the subepineural suture of the central and peripheral nerve ends is formed by aligning the ends circumferentially; the flap is turned out, and the circular epineural flap is fixed overlapping the epineurium of the peripheral nerve end. |
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Removing tissue from paranasal sinus and nasal cavity Group of inventions refers to medicine, namely to minimally-invasive medical systems and methods for performing therapeutic procedures in sinuses. In different embodiments, a sinus (sinuses) to be treated may comprise one or more of maxillary sinus, frontal sinus, ethmoidal sinus and/or sphenoidal sinus. In different embodiments, the methods and systems involve removing tissue and/or material from one or more sinuses and/or nasal cavity, widening one or more foramens to one or more paranasal sinuses, widening other regions or structures in the nasal cavity, or performing these procedures in any combinations acceptable. In those embodiments, where a foramen to the paranasal sinus is supposed to be widened, the foramen may represent a natural mouth of the paranasal sinus, or an artificial foramen. In some embodiments, the natural mouth of one sinus and the artificial foramen of the other sinus may be widened by means of the same system. Any combination of these and other stages of operation is allowed. |
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Method for osteoplastic ultrasonic surgery of paranasal sinuses Mucous membrane is incised in a projection of an operated sinus. An ultrasonic cutting instrument is used to cut out a U-shaped flap as a single fragment. A base of the cut out flap is cracked, and the sinus is exposed by bending the base. After the pathological content is removed, and the sinus is irrigated, the flap is placed back. The wound is closed. If using an extranasal approach, the flap is formed of bone, periosteum and soft tissues as a single fragment. The flap is bent upwards. If using an endonasal approach, the flap is formed of bone, periosteum, soft tissues and mucous membrane as a single fragment. The flap is bent upwards, downwards or backwards. |
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Method for hand repair in amputation stumps of all fingers Stem is formed of a non-free tubular inguinal flap. The stem is anchored to the thumb stump and a donor stump to form a loop. A gradual axial distraction of a distal fragment of the metacarpal bone together with pedicles thereby burying into a stem pedicle is performed 2 months later. A longitudinal osteotomy of the distal fragment is performed with forming two segments: dorsal and palmar, with preserving a constraint of the bone fragments with the dorsal and palmar pedicles, and the junction of the formed distraction regenerate with the dorsal segment. The dorsal and palmar segments are mobilised on the pedicles of the same name. The stem loop is divided into lateral and medial portions in the form of an adipocutaneous flap keeping the stump constraint intact. The palmar segment is transferred onto the thumb stump on the palmar pedicle; the dorsal segment is mobilised on the dorsal pedicle and transferred onto the stump of the third metacarpal bone. Tissue defects of the thumb and third fingers are replaced by flaps of the medial and lateral halves of the stem. |
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Method for hip fracture osteosynthesis and device for implementing it Fenestrated cannulated compression screw comprises a cylindrical rod of an external diameter of 4-8 mm from a proximal portion and 9-11 mm from a distal portion, 40-120 mm long, with an axial through hole to make it possible to insert the screw along a pin during the osteosynthesis process and supply osteogenesis stimulating substances into the fracture area; the cylindrical rod is provided with an external thread formed from the distal and proximal portions of the screw, as well as with the holes created in a rod wall. Some holes are arranged between the proximal and distal portions on its smooth surface and oval-shaped and configured on the cylindrical rod to ensure a uniform distribution of the substances supplied along an axial passage within the fraction; some holes are provided on the thread of the proximal portion and have dimensions smaller than the oval-shaped holes; total area of the holes on the cylindrical rod makes 40-100 mm2. A method for hip fracture osteosynthesis involves inserting three cannulated compression screws, two of which are provided with a proximal thread, whereas the third one - according to patent claim 1. |
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Method for metal wire fixation of zygomatic fracture Zygomatic fragments are repositioned by means of Limberg hook with skin pre-punctured under general/local anaesthesia. In the absence of stable fixation, a metal wire is inserted by means of an electric drill without incising soft tissues, through the zygomatic bone in the anterior, downward and inward direction towards a nasal spine. Once the fixation is considered stable, the wire is cut off at 0.5 cm from the bone. Then the end of the bone is immersed under the skin. As soon as clinical and X-ray findings show the zygomatic fragment synostosis, the wire is removed. |
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Posterior wall of bladder is separated from an anterior wall of vagina and uterus in an area free from adhesions. The adhesions are dissected in the medial direction from lateral portions to a median line of the uterus. Round ligaments of the uterus, uterine tube ends, ovarian branches of uterine arteries, anterior and posterior leaves of broad ligaments of the uterus are coagulated and dissected. Paravesicular spaces are separated from both sides up to the level of an anterior fornix of the vagina; uterine vessels are coagulated, transected from both sides; the posterior wall of the bladder is separated by a retrograde blunt technique from the anterior fornix of the vagina and an anterior surface of the uterine neck in the area free from the adhesions. |
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Device for bone fragment reduction in ilizarov's apparatus Invention refers to medical equipment, namely to devices applicable in traumatology and orthopaedics. A device for bone fragment reduction in an Ilizarov's apparatus represents a reduction unit substituting threaded bars connecting external supports of the Ilizarov's apparatus and consists of a plate, two threaded bars (long and cross), supporting arms and nuts, and provides a precision and gradual three-plane displacement of one (distal bone fragment or extremity segment in relation to the other (proximal) bone fragment or extremity segment. The distal fragment or extremity segment is displaces along the length and axis by screwing the nuts on the long threaded bar, and across the width - on the cross one. Besides, the long threaded bar is fixed with two supporting arms and nuts on the plate that ensures an adequate degree of security for the precision displacement of the distal fragment or extremity segment and prevents deformities and strain distortion in the Ilizarov's apparatus system under the action of extremity muscle traction that is caused by the three-point fixation of the long bars. |
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Device for extrafocal osteosynthesis of open shin fractures Device for extrafocal osteosynthesis of open shin fractures consists of components of a standard kit of Ilizarov's apparatus, namely rings, telescopic and threaded bars, plates, support brackets, bolts and nuts. Para-articular rings are urgently connected by means of the telescopic bars, which are changed in the delayed manner by modular-type distraction racks able to enlarge an inner parameter of an outer frame of Ilizarov's apparatus more than an outer diameter of the apparatus rings. |
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Device for insertion and fixation of a metal implant in surgical management of traumatically injured pubic symphysis of the pelvic ring consists of a parallelepiped-shaped conductor one of narrow front sides of which is concaved with radius R3 and has round-angled borders skewed at 22°. A lower surface of the conductor has a groove configured as a flat ring segment and limited by arches of two circles with the centre common with that of the concaved front side of the conductor with radius R3. Radiuses of the two circles - smaller - R2 and greater - R1, fit those of a metal implant plate temporary used during the surgical intervention. A groove width equals to that of the metal implant plate. A groove depth makes 0.4 of a thickness of the metal implant plate. At the intersection of a long symmetry plane of the conductor and the mean radius R of the annular groove, there is a through threaded hole with a buried captive screw temporary securing the metal implant plate to the conductor before the surgical intervention. The threaded hole has a cylindrical slot enclosing a screw head flush with an upper surface of the conductor. On the upper surface of the conductor on radius R fitting the mean radius R of the annular groove, there are two cylinders configured integrated with the conductor body and mirror-symmetrical, in relation to the long symmetry plane of the conductor; the cylinders have an external diameter of 14 mm and a height of 28 mm; on their side surfaces, the cylinders have on all height facing flat cuts spaced at 8.5 mm. A distance of the cylinder axes of the conductor equals to that of the axes of the two holes formed on the metal implant plate and used to bury fixing screws used to secure the metal implant plate to the injured pubic symphysis of the pelvic ring during the surgical intervention, and makes 20 mm. Along the axes, the cylinders of the conductor have through holes 9 mm in diameter used to alternately enclose a detachable guide applicable to drill the pubic symphysis of the pelvic ring during the surgical intervention. A through hole diameter of the cylinder fits the external diameter of the guide, and an external diameter of a head of the pelvic fixing screw used to secure the metal implant plate to pubic symphysis of the pelvic ring during the surgical intervention. The other wide front side of the conductor has a round-angled rectangular to attach and secure a parallelepiped-shaped onlay to the conductor; the parallelepiped-shaped onlay comprises a round-angled rectangular through hole shaped the same as the rectangular projection on the wide front side of the conductor. In the centre of the rectangular projection of the conductor, there is a through threaded hole to secure the onlay to the conductor manually by means of a wide-head screw. On the opposite side of the onlay, there are two through holes of the same diameter mirror-symmetrical, in relation to the long symmetry plane of the onlay and applicable to enclose alternately a removable trocar with a tubular guide and insert locking retainers in the pubic symphysis during the surgical intervention. A distance of the through hole axes of the onlay equals to that of the axes of the two holes formed on the metal implant plate and used to bury the fixing screws used to secure the metal implant plate to the injured pubic symphysis of the pelvic ring during the surgical intervention, and makes 20 mm. An onlay length is specified so that a distance from an inner surface of the annular ring of the conductor to a horizontal plane passing through the axes of the two mirror-symmetrical holes of the onlay equals to a length of the pelvic fixing screws used during the surgical intervention. |
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Method of treating congenital abnormal development of pelvic ring accompanying bladder extrophy Markers - injection needles - are inserted in projection of sacroiliac joints in the longitudinal direction. After an X-ray inspection, an osteoperforation of external cortical plates is performed from one or two punctures at 5 mm in the lateral direction from the sacroiliac joints and in parallel; the perforation openings make a single line. The markers are removed. Flexibility of the pelvic halves is controlled when bringing the anterior pelvic ring together and providing its symmetry; an aseptic bandage is applied; the patient is laid on his/her back with a cushion placed under his/her lower back. Three rods directed towards S2, S3 spines are inserted into an iliac body at a depth of 4-5 cm; the first rod is inserted into the area of an anterior superior iliac spine; the other two - at 1.5-2 cm and 3-4 cm in the proximal direction respectively. The apparatus is assembled on semi-ring supports and connected by threaded rods arranged in front of the pelvis in the horizontal plane, in parallel at 3-5 cm from each other. A dynamic compression follows by approximating the supports along the rods. Once a pubic bone space reaches 2-2.5 cm, and soft tissue tension in this area decreases, after performing a repair of the anterior wall of the bladder and the anterior abdominal wall, the pubic bones are brought together completely under visual control; the apparatus is stabilised; the wound is sutured. |
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Method of treating delayed union and unfused fractures of long bones Method involves using calcium-phosphate coated (CPC) implants with the coating formed of calcium phosphate globules 0.8-150 mcm in diameter and consisting of spherolith-like crystals forming a coating surface macrorelief with a pore size falling within the range of 5-100 mcm. The used CPC is characterised by porosity 50-60%, thickness 10-40 mcm. The CPC composition contains, vol %: hydroxyapatite - 66-72, titanium - 1.3-1.8, titanium dioxide - 2.0-2.4, the rest - an amorphous phase. The amorphous phase of the CPC consists of at least one compound specified in a group including calcium dihydrophosphates, calcium hydroxyphosphates, calcium titanate, calcium titanium diphosphate. |
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Method of treating bone tumours and tumour-like bone disorders Invention refers to medicine, namely bone oncology, and can be used for treating bone tumours and tumour-like bone disorders. That is ensured by separating a pathological focus, excising the tumour or tumour-like disorder, performing a cryoexposure on the post-excision bone defect three times and closing the wound. The cryoexposure is ensured by 'Medical Cryoapplicator' by placing its balls on a surgical suture into the post-excision bone defect and cooling with liquid nitrogen for 10-60 s. That is followed by thawing in normal saline heated to plus 38°C. After the three cryoexposures, 'Medical Cryoapplicator' is removed. A post-excision defect is repaired if indicated. |
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Method for surgical management of pancreatic head cysts Surgical management of a pancreatic head cyst involves dissecting a pyloric part away from a stomach. A posterior wall of the pyloric part is incised. An anterior wall of the pancreatic head cyst is incised. An anastomosis is formed between the pyloric part and the cyst cavity. The pyloric part is closed tightly with a one-row suture. The discontinuity of the gastrointestinal tract is repaired by applying the anastomosis between the stomach and jejuneum. |
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Control elements for pivoted surgical device Invention refers to medicine. An electrosurgical device comprises a body, end effector, cutting element and rod. The end effector comprises a pair of branches and at least one electrode. The electrode provides RF energy output into the tissues clamped by the branches. The cutting element is designed for cutting the tissue clamped by the branches. The rod comprises a pivot portion, which allows turning the end effector selectively in relation to the rod. The body comprises a control mechanism. The control mechanism may comprise a release trigger. The trigger actuates the cutting element. |
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Method for first metacarpal bone repair in extensive defects of soft tissues of hand stump Invention refers to medicine, namely reconstructive hand surgery. An adipocutaneous coverage flap is presented by a double adipocutaneous flap. After the first metacarpal bone is formed, it is placed into the double flap in the adduction position. After consolidation of the bone fragments, a thumb and first web space are formed by cutting out leaved flaps on the back of the hand with their base on the first metacarpal bone, and on the palmar surface of the hand with their base on the second metacarpal bone. Opposite U-flaps with a proximal base on the back and palm of the hand are formed within an expected first web space; the repaired first metacarpal bone is abducted; the tissue defects on the first and second metacarpal bones are closed by means of the leaved flaps. A bottom of the first web space is creased by suturing apexes of the U-flaps. To close the wounds in the areas where the U-flaps have been taken, the leaved flaps are sutured to lateral sides of the U-flaps within the web space. |
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Method for anterior abdominal wall reconstruction in lateral and anterolateral hernias Invention refers to medicine, namely herniology. A method involves a herniotomy with separating and opening a hernial sac, inspecting its content, dissecting it away, closing the abdominal cavity with a continuous suture tightly. A hernial orifice presented by both aponeurotic, and muscular components is reinforced by means of two synthetic prostheses. Leaving an external oblique abdominal muscle non-mobilised in the Sub lay position edges of the first prosthesis are fixed with vicryl U-sutures at 3-4 cm from the defect edges; the prosthesis are fixed to the hernial defect edges by means of a continuous suture. In the On lay position, the second prosthesis is placed; it has been cut out 3-4 cm larger than the defect; it is fixed to the muscle or aponeurosis of the external oblique abdominal muscle with a continuous vicryl suture, and then by means of interrupted sutures to the hernial defect. |
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Midfoot skeleton is approached through an ulcerative defect found on a plantar surface within the greatest deformity. The ulcer is dissected together with cicatrically changed tissues up to intact anatomical structures. A bone conglomerate presented by degenerative and dystrophic changed bone with portions of chronic purulent inflammation. That is followed by a peripheral excision of the bone conglomerate to flatten the plantar surface of the foot. The foot is repaired by displacing the pre-mobilised m. adductor hallucis brevis or m.flexor digitorum brevis into the surgical area and repairing the wound by means of local tissues with eliminating the cover tissue defect with antibacterial-coated absorbable suture material. |
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Device and method of fastening suture fixer in solid tissue Invention relates to medical equipment, namely to device for fastening suture fixer in hole, made in solid tissue, by means of material with thermoplastic properties and energy, supplied to suture fixer for local liquefaction of, at least, part of material with thermoplastic properties. device for fastening suture fixer contains distal surface of instrument and axial channel with distal input section, located in distal surface of instrument, and in fact tubular contact element, inserted into axial channel of instrument, with axial channel of instrument and contact element being provided with gripping elements, interacting with each other for gripping proximal end of contact element into axial channel, when contact element moves in proximal direction in axial channel. Suture fixer is connected with distal end of contact element and contains fixer leg, through which suture material in form of loop is passed, and thermoplastic shell. |
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Connecting system, intended for application with drill, for elimination of bone defects contains first cannulated connector, connected in non-detachable way with second cannulated connector. First connector is made with possibility of connection with drill, and second connector is made with possibility of connection with device for liquid supply or device for liquid discharge. Drill unit for elimination of bone defects contains cannulated drill, which has distal and proximal parts, first cannulated connector, connected with proximal part of drill, and second cannulated connector, connected with first connector in non-detachable way. Set for elimination of bone defects contains at least one drill and at least one said connecting system. Inventions are aimed at creation of single adapter, providing connection of cannulated drill with drill device and syringe. |
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Method for sialolithotomy in upper pole of submandibular salivary gland Invention refers to surgical dentistry and is applicable for treating sialolithiasis. Sub-lingual tissues are incised directly above a sialolith after preliminary manual pressing and continuous fixation of the salivary gland as high as possible to a sub-lingual mucosa. The sub-lingual tissues and salivary gland are incised by means of an L-shaped needle electrode of an electrosurgical apparatus operating in the pulse mode of cutting and coagulation. The power is 7 W; the length of contact to the incised tissues is 1-2 s. |
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Method for surgical management of patients suffering hallux valgus Invention refers to medicine, particularly traumatology and orthopaedics. An incision is made in a first intertarsal space, and an adductor tendon is separated and dissected away. An incision is made along an inner surface of a head of a first metatarsal bone; a capsule of a first toe of a phalanx joint is used to create a flap with its base facing distally. After an osteochondral growth is removed, a surface of the metatarsal bone is marked with planned osteotomy lines: for the first osteotomy, a lower line is drawn in parallel with an axis of the metatarsal bone at 1/4 diameters of the metatarsal bone upwards from an inferior surface of an articular cartilage, up to an inferior cortical layer of the metatarsal bone in the proximal direction from a vascular bundle of the head of the metatarsal bone; for the second osteotomy, a distal upper line starts from a superior border of the articular cartilage and further perpendicularly to the axis of the metatarsal bone up to an intersection point with the lower line; for the third osteotomy, a proximal upper line is drawn parallel with the distal upper line at approximately 5 mm. A pin is inserted into an angle formed by the distal upper and lower lines, advanced along a line connecting projections of the first and second osteotomies, and brought out through a medial cortical layer in a termination point of the 3rd osteotomy. Osteotomies are performed along the marked lines with sawing out a bone wedge with a base of 5 mm. A bonesaw-line is drawn in a metaphysis of the first metatarsal bone at 1 cm from a metatarsal wedge joint, perpendicularly to the axis of the metatarsal bone at 2/3 thicknesses of the metatarsal bone. An osteotomy area is enlarged by inclining the metatarsal bone laterally. The formed bone wedge is laid into the formed slot even with the cortical layer. The bone fragments of the distal osteotomy are aligned; the head of the metatarsal bone is displaced downwards at approximately 3-4 mm, thereby forming a lateral anterior arch of foot. The bone fragments are fixed; the hallux adductor tendon is brought under the head of the 1st metatarsal bone and sutured to the joint capsule from the medial side, closer to a back surface of the first metatarsal bone, thereby forming the lateral arch of foot. A supination is eliminated by sawing out the bone wedge from the proximal fragment of the metatarsal bone and performing external rotation of the head. The metatarsal bone is shortened by the osteotomy in parallel with the third one. |
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Driving unit for instrument of endoscopic surgical apparatus Driving unit for an instrument of an endoscopic surgical apparatus comprises a body and a system of drive shafts connected to pin joints. Operating mechanisms of an end effector are configured in the form of four independent helical gearboxes, each of which is connected to the drive shaft. The drive shafts are arranged coaxially, have different diameter and length, and transmit a rotation torque to respective pin joints. One helical gearbox comprises a driven wheel with a press-fitted threaded bushing to transform the rotation torque into reciprocation of the drive shaft along a guide which is formed in an insert between the driven wheels of helical pairs. A driving unit control mechanism can be coupled with a control portion of an assistant robot-aided surgical complex. |
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Method for vascularised humeral periosteal grafting for treating false joints Invention refers to traumatology and orthopaedics and is applicable for vascularised humeral periosteal grafting for treating false joints. Periosteal U-grafts with a base being in vascular connection to the bone are formed on proximal and distal fragments. The periosteal graft of the proximal fragment is turned and moved towards the distal fragment, and the periosteal graft of the distal fragment - to the proximal fragment so that the grafts overlap a false joint region, whereas a cambial layer of the periosteum is placed onto the humeral bone. The graft borders are placed under a plate and fixed to the proximal and distal fragments by means of interrupted sutures through plate openings. |
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Under regional anaesthesia, a fasciocutaneous flap is separated from a dorsal approach in a second intermetacarpal space on the periphery on a third metacarpal. A dorsal transverse artery of wrist with accompanying veins is separated and ligatured twice, and transected in between. A second metacarpal graft vascularised by a second metacarpal artery, which is a branch of the dorsal transverse artery of wrist is transplanted on a thumb stump. The transplanted graft is fixed with wires. |
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Method of treating dupuytren's contracture Destruction of chords is performed by transcutaneous introduction of needles. Before operation high-frequency Doppler examination of affected palm in supposed points of needle introduction is carried out, points, free of vessels, outside formed white-coloured zones of ischemia, outside folds and nodes on palm, as well as part of skin, tightly commissured with palmar aponeurosis, are marked. With introduction of anaesthetic hydropreparation is realised, skin is exfoliated from scar-modified ray of palmar aponeurosis, points of anaesthetic introduction correspond to ports, marked for introduction of needles; in the process of dissection of bands of palmar aponeurosis ends of needles are moved in three planes - vertical, horizontal and sagittal. Movements of needle do not exceed 2-3 mm. To dissect thin and flat bands pendulum-like movements with needle are realised, in the process of dissection of thick bands and nodes frequent movements of needle in vertical plane are used. After operation at night time immobilisation of palm with gypsum splint is realised, with stopping immobilisation at day time and carrying out active bending and unbending in joints of fingers. Patients begin self-catering and everyday loadings the following day, starting hard physical exercise and return to labour five days after operation. |
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Method for surgical treatment of third-degree rectocele Invention relates to medicine, surgery. A lyre-shaped incision of the vaginal mucosa and the skin of the perineum with an apex at the posterior fornix is made. A flap, limited by the incision, is separated by an acute method. The separated muscles of the levators are exposed in a blunt and sharp way to the lateral sides of the wound. A ring of the wound-extender "Mini-Assistant" with retractors is installed. An excessive anterior wall of the ampullar part of the rectum is corrugated by means of separate interrupted vicryl sutures. The levators are cut at the level of the border between the posterior and middle third of the vagina by means of a harmonic scalpel. The obtained muscle portions are transferred from the sagittal to the frontal plane. An H-shaped transplant is cut out according to the defect size. The transplant is installed in the area of the rectovaginal septum to the pelvic peritoneum with the letter "H" top. The lower part of the letter "H" bridge covers the sutured levators. Up to 3 cm long flaps are cut out from the deep transverse perineal muscle. The flaps on a feeding pedicle are transferred into the frontal plane. The flaps are sewn to each other with an absorbable suture material above the mesh transplant. The long retractors are removed. The mesh is fixed to the underlying muscular tissues by two monofilament material sutures. Instruments of the wound-extender are removed. The vaginal mucosa is sutured with an uninterrupted suture. |
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Method for breast reconstruction 7 days before a principal stage of the operation, a lipofilling procedure is performed within a layout; lipografts are implanted in three layers: superficial subcutaneous - above a femoral fascia, deep subcutaneous - under the femoral fascia, and intramuscularly - in the thickness of a broadest muscle of back. After 7 days, a skin-preserving mastectomy is performed with removing a lymph node basin en bloc from a subaxillary incision. A pre-expanded musculocutaneous flap is cut out from the broadest muscle of back so that a superficial thickened layer of subcutaneous fat compensates an existing soft tissue defect in a donor area, whereas the thickened deep layer of the subcutaneous fat and broadest muscle of back are used to fill the volume of the removed breast; the flap is moved and used to fill a skin case of the breast; the flap is fixed in the wound by inner sutures. |
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Method for alloplasty applied to postoperative ventral hernias Method involves an incision of skin and subcutaneous fat, separation and preparation of a hernia sac and a plastic repair of a hernia defect with a synthetic mesh prosthesis in a preperitoneal or axillary position. The mesh prosthesis is formed of rectangular synthetic mesh prosthesis with making incisions from two opposite edges towards each other and cutting out strips. The strips are delivered through muscular-aponeurotic edges of a hernia orifice inside out, pulled up and sutured together with an opposite strip or portion of the synthetic mesh prosthesis at a nearest edge of the hernia defect. When the hernia defect edges brought together, the strips are sutured to opposite ones with the use of absorbable sutures. If bringing the hernia defect edges together appears to be impossible, the strip is sutured to a prosthesis portion at the nearest hernia defect edge with the use of absorbable sutures. Besides, at the site of bringing through the muscular-aponeurotic structures, the strips are selectively transected; the formed ends are sutured to the prosthesis portion at the hernia defect edge with the use of continuously absorbable sutures. |
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Method for repairing extensive defect of bottom of anterior cranial fossa Defect of the bottom of the anterior cranial fossa is replaced with a prepared individual endoprosthesis made of porous titanium nickelide placed on the periphery of the defect on the side of the cranial cavity. The defect of the bottom of the anterior cranial fossa is preliminary coated with a pericranial periosteal flap supplied by frontal and supraorbital arteries and fixed to the periphery of the skull base defect with an adhesive composition. The above endoprosthesis is place over the above pericranial defect, and the dura mater defect is closed with using a broad fascia. |
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Method of treating secondary lower limb lymphedema of stage ii-iii Limb surgery is preceded by a diagnostic study. That is followed by surgical thoracic duct cannulation with providing continuous external lymph excretion. The lymph excretion is accompanied by daily gradual mechanical lymph compression therapy of the limb followed by using a special surgical corset individually tailored of linen and profiled according to the enlarged limb with a number of adhesive stabiliser bands ensuring tight fixation of the surgical corset. A session of the mechanical lymph compression therapy is followed by recycling high and very high toxic lymph; as the excreted lymph toxicity decreases, a lymphoplasmapheresis is performed with lymphoplasmasorption and reinfusion of the purified lymph through a catheter in the vein inserted during the thoracic duct cannulation. If the lymph appears to be non-toxic, it is re-infused into an internal jugular immediately. The mobile fat folds formed on a shin and foot after the active drainage therapy are excised under general anaesthesia up to a fascia: on the shin from internal and anterior-external surfaces only, and on the foot - along an external lateral surface transferring onto a posterior surface, and along an internal surface below the ankle. The lymph excretion is performed for the whole postoperative period. Two days before the patient is discharged from hospital, the thoracic duct cannula is preserved by forming an internal lymphovenous bypass between the thoracic duct cannula and internal jugular catheter and positioning it subcutaneously. The next course of the above treatment is performed depending on the limb oedema intensity, postoperative scar condition and reparative process activity; that is preceded by surgical removal of the lymphovenous bypass from under the skin, separation thereof and lymph efflux recovery under general anaesthesia for the purpose of continuous lymph excretion and reinfusion into the vein. The mechanical lymph compression therapy continues until the mobile fat folds are formed. The newly formed excessive skin and subcutaneous fat together with the existing postoperative scar is excised under general anaesthesia up to the fascia. Once the treatment is completed, the thoracic duct cannula and internal jugular catheter are removed. After the patient is discharged from hospital, conducting the compression therapy and wearing compression garments are required. |
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Metal implant for osteosynthesis of injured bones of pubic symphysis of pelvic ring Metal implant for osteosynthesis of injured bones of pubic symphysis of pelvic ring is shaped as a plate with fixing screw holes. The plate represents a round-cornered flat ring sector, which is a part of the plane between segments of two circles with a common centre and different radii limited by two radial lines to the ends of the segment with a greater radius. Two holes 6.6-6.8 mm in diameter mirror symmetric in relation to a symmetry plane of the plate, having inner sockets 1.45-1.55 mm deep and 9.15-9.25 mm in diameter for pelvic fixing screws are created along the midline of the plate. The centres of the two mirror symmetric holes for the pelvic fixing screws are spaced as much as 20 mm. Two holes 4.1-4.3 mm in diameter mirror symmetric in relation to the symmetry plane of the plate, having inner spherical facets for cancellous screws are created along the midline of the plate. The centres of the two mirror symmetric holes for the cancellous screws are spaced as much as 49.5 mm. There is one working hole with metric screw-thread M 5 at the intersection of the midline and the symmetry plane. |
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Gastric fistula is restored for the purpose of examining an extended oesophageal stricture with a bougie. An endoscope is placed at the level of an upper border of the oesophageal stricture. Air is insufflated into the stomach through an endoscope canal. Tissues of an anterior abdominal wall and gastric wall are incised at depth 1 cm within the postoperative scar from the gastric fistula at an angle of 45 degrees. A second endoscope is inserted into the stomach through the created gastric fistula up to a lower boundary of the stricture. A guide string is delivered through the endoscope canal through a scar stricture. The string is taken with forceps and brought out through a mouth. A guide suture is fixed to the guide string. The suture is pulled through the gastric fistula. The suture is fixed to the skin within the restored gastric fistula and to a wing of nose. |
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Method for unilateral brain perfusion in operations on aortic arch Arterial cannula is installed for antegrade brain perfusion in synthetic prosthesis, preliminarily anastomosed with artery. The following decannulation is realised by prosthesis clipping. |
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Method for reconstructing through defect of nose lateral wall Through defect of nose lateral wall is eliminated. Transpositional skin-and-fat flap is cut out of skin of nose ridge and lateral wall of the opposite side. It is turned by 180 degrees, laid on defect with skin surface inside and sewn to wound edges. Internal lining of nose lateral wall on the side of ablated tumour is formed. Transpositional skin-and-fat flap is formed from cheek skin on the side, where tumour was ablated, and laid on defect of nose lateral wall and fixed. Donor wound on cheek is closed with local tissues. |
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Device for bone fragment approximation and fixation Device for bone fragment approximation and fixation comprises movably jointed branches with a ratchet, and handles. The branches have end threaded pins and two removable adapters configured as a regular quadrangular prism with through holes in mutually perpendicular planes, and two removable jaws having two conical pins and one threaded pin opposing the conical ones. |
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Method of microdiscectomy with fibrous ring plasty and preservation of yellow ligament At stage of surgical access flap is cut out from yellow ligament. Disc hernia is ablated. Plasty of fibrous ring is performed by laying defect edges in initial anatomical position and their gluing with fibrin glue are carried out. After that, yellow ligament flap is returned into inter-arch space, fixed with suture and, restore integrity of yellow ligament after applying fibrin glue on flap edges. |
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Method of surgical access in case of cervical lymph node dissection Surgical access in case of cervical lymph node dissection is realised in form of two cuts. First cut is made in prootic area in tragus base to earlobe, moving on mandibular angle with continuation in chin and submental area. Second cut is started on mastoid process with further movement on posterior contour of sternocleidomastoid muscle with transition on its anterior surface in middle third and to sternum. Triangular flap, which is withdrawn to middle line of neck, is formed. |
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Method for surgical management of proximal femoral deformities in children Wedge-shaped autograft is taken from an end face of a distal fragment of femur within an osteotomy by sawing out a bone centre in a sagittal plane to form a wedge-shaped cavity with its base facing the area of osteotomy and apex distally directed along a femoral axis. Once the femoral fragments are reduced into an anatomically correct position, the distal portion of the proximal fragment from an inside of the femur into the cavity formed in the distal fragment. The wedge-shaped defect formed within the osteotomy between the plate and femoral fragments are filled with the taken autograft so that the base of the latter faces the plate. The achieved position of the femoral fragments is fixed by performing an external osteosynthesis by means of angularly stable blocking compression plate. |
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Method for bone augmentation within alveolar process defect Method involves taking fatty tissue from an anterior abdominal wall by liposuction, fermenting it with collagenase added, centrifuging it to produce a stromal-vascular fraction. An osteoconductive material is presented by porous titanium nickelide granules. The latter are saturated with the produced stromal-vascular fraction and placed within the defect. It is shaped as restored bone tissue by means of a xenogenic bone matrix which is also laid within the defect; the wound is closed. |
Another patent 2551096.