Apparatus for applying circular anastomoses between the digestive tract

 

(57) Abstract:

Usage: in medicine, when imposing circular anastomoses between the digestive tract. The essence of the invention: hard head is a flexible plastic substrate and lockwasher. Cylindrical knife after dissection of tissues fixed reference puck. 2 C. p. F.-ly. 3 Il.

The invention relates to medical equipment, namely to sewing devices, and can be used when applying circular anastomoses between the digestive tract.

Known sewing machines, allowing to impose a circular anastomosis to esophagus (SP C-25), intestine (ZC-28) and other gastrointestinal canal (Kalinina, T. B. and Kazulin C. C. application of the apparatus DCC-25 and CC-28 in surgical practice. M., 1968).

Known surgical apparatus for creating anastomoses of different diameters between the digestive tract, is provided with a detachable bracket and hard heads several sizes (Author's certificate N 264612, class. And 61 In 17/11, 1970).

This device has a major drawback: not possible during the operation to quickly change sewing and persistent elements of the eye and the cap nut bracket head from the tubular body of the device.

During the reverse stroke after flashing the petal pusher suck in the bracket grooves affected the content of hollow organs, making it difficult preoperative preparation of the apparatus and when it is re-applied after reloading does not exclude infection mechanical seam.

The purpose of the invention is to simplify the design of the device and reduce the invasiveness of the suture zone when removing the device.

This objective is achieved in that the device for applying circular anastomoses between the digestive tract that contains drive information with the rod, the mechanism flashing with stock, removable hard head with a stopper and a plastic substrate, a removable bracket head with the plunger, a cylindrical blade and the guide ring with bracket slots, additionally install the retainer cylindrical knife, placed in a hard head. Between the follower and the guide ring bracket head set coil spring, a plunger fixed to the cylindrical knife connecting the screw element and establish interoperable with the end surface of the rod and the stopper is made in the form of spring CLASS="ptx2">

The retainer cylindrical knife perform as lock washers, and placed under a plastic substrate, and the thrust cylinder provide additional locking spring ring.

In the bracket head set shims between the cylindrical spring and the guide ring, and between the cylindrical knife and pusher.

Thus, the developed device bracket head is fixed with the body only locking nut, and after flashing due to the release of a cylindrical knife is connected with persistent head that allows both heads be removed from the apparatus after it is used simultaneously (single unit) by removing the cap nut and pull conical spring stop (stop), after removing the protective sealing cap.

The retainer cylindrical knife provides a strong connection resistant head with the cutting edge not only for flash but with a maximum breeding bracket and hard heads, to retrieve the device after application of the anastomosis with any gap flashing in the possible interval.

When recharging apparatus for it is considerably simplifies and speeds up the preparation of the machine to work.

Bench and pilot scale testing of a prototype apparatus was allowed to establish that after flashing due to the fixation of the cutting edge of the cylindrical knife in the thickness of the locking washer eliminates the return stroke of the pusher until the trigger is installed in the bracket to the cylinder, a cylindrical spring. The actuation of the spring occurs when breeding bracket and thrust heads up interval that is larger than necessary to perform the extraction of the device from the lumen anastomosing bodies. As a result, the petal pusher block bracket slots, protecting them from possible contact with blood and intestinal contents after applying apparatus, easier than pre-sterilization processing is already used for flashing the device.

Due to the connection of the cutting edge of the cylindrical knife with lock washer in the cavity of the knife isolated cut off when flashing unviable edges of the wall body of the overlay zone anastomosis, which ensures aceptic execution phase extraction apparatus and shift kit sewing items.

In addition, it was found that the outer surface of the knife at the moment of extraction of the device prevents prolabo the Arata before connecting rod and prevents possible injury zone imposed mechanical seam.

In Fig. 1 shows a longitudinal section through the working parts of the apparatus at the time of introduction into the cavity anastomosing bodies; Fig.2 - the same, at the time of extraction; Fig.3 - the same, after disconnecting from the vehicle.

Apparatus for applying circular anastomoses between the digestive tract has a piston rod 1 made relatively independent of the pusher 2 and the cylindrical knife 3. The plunger 2 is fixed with a cylindrical blade 3 connecting the screw element 4. The pressure head 5, the apparatus contains a flexible plastic substrate 6 teething on her tissues, tab 7 of the cylindrical knife in the form of a lock washer, is placed beneath the plastic substrate 6 and an annular groove 8 for protecting the cutting edge 9 of the cylindrical knife 3 from damage.

In the initial state (Fig. 1) the plunger 2 with a cylindrical blade 3 is held at the base of the bracket head 10 by a cylindrical spring 11 placed between the base of the pusher 2 and the end surface 13 of the guide ring 12 with the bracket slots 14.

The adjusting strip 15 serves to provide the maximum compressed state of the cylindrical spring 11 in the end of flashing. When this rod lindrical knife 3 with respect to the bottom of the annular groove 8 of the thrust head 5 with a minimum gap flashing, and the gasket 17 allows you to adjust the bracket used head for engagement with the rod 1.

After flashing (Fig. 2) the rod 1 is returned to its original position, and the push rod 2 remains in place due to the interaction of the cutting edge 9 of the cylindrical knife 3 release 7 of the knife and the plastic substrate 6. As a result, the lobes 18 of the pusher 2 fill bracket grooves 14 even when breeding sewing and hard heads. Clipped edge 19 anastomosing bodies 20 are sealed in the cavity 21 of the cylindrical knife 3 and the outer surface 22 prevents polarisavenue created lip 23 of the anastomosis in the cavity of the apparatus, while removing.

Shift bracket head 10 after flashing occurs with persistent head 5 as a single unit in detaching a cap nut 24 from the tubular housing 25 at the time of releasing the stopper 26, the locking thrust cylinder 5 on the rod 27 of the device.

The stopper 26 is installed in the groove of the rod 27 and tightened by a spring 28. Its tapered surface 29 provides automatic fixation of resistant head 5 on the rod 27, and a protective sealing cap 30 with notches for the fingers 31 isolates elements of the stopper 26. Moreover, protection is changing the sewing elements of the stopper 26 is provided with additional locking spring ring 33, introduced in the thrust cylinder 5 .

The detach sewing elements (Fig.3) bracket head 10 is fixed with thrust cylinder 5 by the action of the spring 11 and the use of sewing elements during the operation again, without additional processing, is completely eliminated.

The invention is illustrated by the following examples: an experiment in dogs when modeling autotransplantation segment of the rectum apparatus for applying circular anastomoses between the digestive tract used twice when creating the proximal and distal anastomoses, after preliminary recharge during the operation of sewing items (kit bracket and hard heads).

Confirmed quick change heads, aceptic run stage reloading apparatus and the ease of extraction of the working parts of the device from the lumen of the body at the time of breeding bracket and hard heads.

After surgery, animals were examined endoscopically, using targeted biopsy of the area created anastomosis to control the processes of tissue regeneration.

The characteristics of the course of the wound process-related nalozeni is possible.

Apparatus for applying circular anastomoses between the digestive tract is recommended during gastrojejunocolic operations in the superposition of two or more anastomoses with interchangeable sewing elements of different diameters.

The use of the device reduces the time of surgical intervention, increases aceptic and reliability imposed anastomoses by reducing the injury to the tissues in the area of the seams, simplifies the change of sewing items, accelerate their preparation for future work and eliminates repeated use without pre-treatment, thus the opportunity to use incomplete between a bracket and thrust heads of various sizes.

1. APPARATUS FOR applying CIRCULAR ANASTOMOSES BETWEEN the DIGESTIVE TRACT, containing the actuator rod, the mechanism flashing with stock, removable hard head with a stopper and a plastic substrate and a removable bracket head with the plunger, a cylindrical blade and the guide ring with bracket slots, characterized in that, to reduce the morbidity and simplify the design, it is equipped with latch, a cylindrical knife, which is located in uptal associated with a cylindrical blade connecting the screw member and is mounted for engagement with the end surface of the rod, and the stopper is made in the form of spring cone emphasis placed made on the rod groove and provided with a protective sealing cap.

2. The apparatus according to p. 1, characterized in that the retainer cylindrical knife is made in the form placed beneath the plastic substrate of the locking washer, and thrust head is equipped with the optional retainer spring ring.

3. The apparatus according to p. 1, characterized in that between the cylindrical spring and the guide ring and between the circular knife and pusher installed shims.

 

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