Device for laparoscopic hernioplasty
The invention relates to medicine and can be used in laparoscopic treatment of hernias. The device consists of a blunt needles, hooks, tubes and mesh attached to it threads. The blunt needle and the hook is made for introduction into the tube. The grid is made to collapse into a roll when injected into the abdominal cavity through the trocar and the expander roll in the abdominal cavity. The result is a device that completely eliminates the complications and the use of expensive devices. 3 C.p. f-crystals, 8 ill. The invention relates to medicine, namely to laparoscopic treatment of hernias. A device - assisted laparoscopic stapler and extractor for laparoscopical hernia repair with the use of staples to secure the grid .The problem is the treatment of hernias is of great importance, because according to international statistics, 10% of people suffer from hernias.Laparoscopic treatment of hernias in comparison with traditional has some big advantages. However, laparoscopic treatment of hernias with the use of staples to secure the mesh and its peritoneal has its dangerous complications: 1. Unreliable fastening clips of the grid, because the clips under the action of twitch muscles cut fabric, e is isace grid clips, i.e. the connection of the sheets of peritoneum clips over the net. Due to the tension of the sheets of peritoneum staples partially unfold and turn into sharp hooks that hang different parts of the intestine or omentum and develops intestinal obstruction, which requires emergency surgery.3. Unreliable peritonial grid is explained by the eruption of clips of thin sheets of peritoneum, and then between the grid and the sheets of peritoneum form "pockets", which are partially loops of intestine and omentum. They violated in these "pockets" and developed a bowel obstruction, which requires emergency surgery. This complications of first-degree endangering the patient's life, but there are minor in severity of complications: - infringement clips nerves, injury of blood vessels, which sometimes requires repeated complex operations to remove the staples that are difficult to find in the tissues, especially after surgery after 10-12 days; the disadvantage of the known device for laparoscopic hernia repair using staples we attribute the high cost of the device and additional thereto laparoscopic instruments, all totaling about $ 5,000 (laparoscopic stapler, laparoscopic extractor, 12 mm trocar, script is jnani and expensive devices. The set task is solved by the use of the device for laparoscopic hernioplasty containing the grid, characterized in that it consists of blunt needles, hooks, tubes and mesh with fixed thereto by threads, and the blunt needle and the hook is made for insertion into the tube, and the grid is made to collapse into a roll when injected into the abdominal cavity through the trocar and the expander roll in the abdominal cavity.The use of the proposed device is performed in the following way. Prepare a plot of the abdominal wall, his release from peritoneal and adipose tissue. Through the trocar is introduced into the abdominal cavity rolled into a roll of mesh. Under the control of laparoscopy rolled into a roll of mesh unwrap and place on the prepared area of the abdominal wall attached to it threads. The free ends of the filaments in the form of loops located on the edge of the grid or on its surface (Fig.1). The grid is fixed at a prescribed place threads that tied in pairs on the anterior abdominal wall, and the nodes are immersed in the subcutaneous tissue. For ease of folding mesh in roll during its introduction into the abdominal cavity through the trocar and the expander roll mesh in the abdominal cavity under the control of laparoscopy threads are placed on PowerNet leather size 8-10 mm on the anterior abdominal wall above the projection grid in the center.Multi-tool, consisting of needles, hooks and tubes, injected into the skin incision. Translational-rotational motion of the tool advancing through the tissue of the anterior abdominal wall. Under the control of laparoscopy put out from the tissues in the abdominal cavity and the needle passes through one of the loops (Fig.1). Hook (Fig.2) under control of laparoscopy capture loop and instrument display it in a skin incision made on the anterior abdominal wall. The tool is removed (Fig.3).The above operation is repeated, all the threads out through a single skin incision on the anterior abdominal wall (Fig.4). Fed through an incision in the skin of the first and second thread and tie knot are immersed in the subcutaneous tissue (Fig.5). The operation of the third and fourth thread repeat (Fig.6, 7 and 8). The edges of the sheets of peritoneum under the control of laparoscopy connect over the net in the described manner, place the bottom sheet of peritoneum under the top sheet of peritoneum and fix their U-shaped seam. Tools of the abdomen is removed. The edges of the skin incision closer to contact them and fix the medical patch. The surgery is performed under General, epidural or local anesthesia.Sources of information 1. The prospectus of the company ETHICON ENDO-SURGERY. Technique/p>1. Device for laparoscopic hernioplasty containing the grid, characterized in that it consists of blunt needles, hooks, tubes and mesh with fixed thereto by threads, and the blunt needle and the hook is made for insertion into the tube, and the grid is made to collapse into a roll when injected into the abdominal cavity through the trocar and the expander roll in the abdominal cavity.2. The device under item 1, characterized in that on the net secured the ends of the threads, loose ends are in the form of a loop feature on the edge of the grid or on its surface.3. The device according to PP.1 and 2, characterized in that the threads are placed on the surface of the mesh spiral or parallel lines and fix.4. The device according to PP.1-3, characterized in that the blunt needle and hook combined into a single tool.
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
FIELD: medical engineering.
SUBSTANCE: method involves mounting implant on supporting platform. The platform is turned and moved about and along its longitudinal axis to enable one to arrange needle in any given position on implant surface. The needle is controllable in a way that the first thread is brought through the implant wall from the first side of the wall. The first loop is formed from the first loop on the second implant wall. The thread is brought through the loop. The loop is tightened to produce a stitch. The stage the thread is passed through the loop is carried out by means of device movable back and forth along longitudinal implant axis. The device additionally has at least one driving mechanism for turning and moving transplant platform about and along its longitudinal axis to enable one to arrange needle in any given position on implant surface and additional driving mechanism for passing thread through the loop back and forth along longitudinal implant axis. Main device head piece is movable into any required position as a result of implant-carrying cylinder rotation or axial displacement on implant surface.
EFFECT: wide range of functional applications; enabled fitting of anatomical tubes of different diameters in several points arranged on an axis.
11 cl, 7 dwg
FIELD: medical engineering.
SUBSTANCE: device has handle having reel inside and casing having end for capturing needle. The handle has transverse reels and is connected to the hollow casing. Longitudinal bed bearing manipulation plate having lock and manipulation hook. The manipulation plate becomes a rod in its frontal part. Adaptation spring and eccentric pressed cone are put-on over the rod. The cone serves for fixing needle and reaches casing rest member. The rod comes in into opening of the rest member being convex ahead of it. Transverse concave groove is available near the rest member base for receiving curved surgical needle. The eccentric pressed cone base and the adaptation spring are covered with stabilizing buckle. Holes for passing thread ends are available above the buckle. Members for fixing ends of threads, coming from the reels placed in the handles, are arranged near the holes.
EFFECT: accelerated suturing process; retained suture material sterility; reduced thread consumption.
4 cl, 4 dwg
FIELD: medicine, abdominal surgery.
SUBSTANCE: one should perform marginal serous-muscular-submucous suturing for every wall of intestinal wound in oblique direction against cross-sectional intestinal axis being parallel to lateral branches of intraparietal intestinal vessels at an angle being opened towards mesenteric edge. Puncturing in and puncturing out of stitches at the serous membrane of every further suture should be performed being on the same line with puncturing in and puncturing out of stitches at the border of submucous and mucous layers of previous suture. Sutures should be tightened at forming the knots at serous membrane. The innovation suggested enables to decrease the frequency in developing failed sutures.
EFFECT: higher efficiency.
FIELD: general surgery methods and facilities.
SUBSTANCE: material for various genesis, localization, and configuration defect grafting is made from thin (up to 100 mcm in diameter) titanium nickelid wire weaved into porous-permeable structure according to knitted-fabric and textile technology or by felting. Thanks to plasticity of titanium nickelid and quasiplasticity of woven structure, effective plasticity of material is many times superior to that in nonwoven porous sheet materials and meets requirements of congruent disposition of materials in organs and tissues to be operated.
EFFECT: increased plasticity of grafting material.
FIELD: medicine, surgery.
SUBSTANCE: one should apply a P-shaped suture, then it is necessary to form a V-shaped suture: one of the free ends of a ligature should be applied under the one that forms the top of letter P, then this ligature should be tightened and thrown over the wound as a Latin letter V. Then free ends of ligature should be tightened into the knot. The method enables to improve hemostasis and increase reliability of sutures.
EFFECT: higher efficiency.
3 dwg, 1 ex
FIELD: medicine; traumatic surgery; orthopedics; neuron-surgery.
SUBSTANCE: device can also be used in rehabilitation surgery for curing nerve pipes. Extension has drive mechanism and traction unit, both disposed inside cylindrical case onto vertical axis. Case and cap have cylindrical shape. Drive mechanism is made in form of spring-loaded unit which has crown-shaped ring with beveled teeth and double-teeth pusher with single-sided beveled teeth connected by compression-torsion spring. Drive mechanism is installed of form of horizontal protrusions inside guides onto internal surface of case to provide movement of rest pins along circle onto horizontal arms of which pins it is placed. Under pressure applied to cap of case, reciprocal motion of cap transforms to interrupted rotational motion of coil in cheek of which coil the rest pins are fixed. Coil has flexible link fastened onto hub. Free end of flexible link is drawn outside through the hole in wall of case. Coil and hub compose traction unit being rigidly connected with axis of the extension. Lugs provided with holes are made in bottom of case.
EFFECT: reduced traumatism of surgical operation; better results of cure.
FIELD: medicine; medical engineering.
SUBSTANCE: method involves implanting a ribbon into the body on each side of the urethra between the vaginal wall and abdominal wall. The ribbon is drawn above the pubic bone. The ribbon is introduced on both sides of the urethra to make a loop around the urethra. It is arranged on each side of the urethra between the vaginal wall and abdominal wall and stretched by pulling its ends brought outside of the abdominal wall. The ribbon is introduced pulling it inside through two holes produced in soft tissues with needle-shaped member using tubular envelope prefitted on the needle-shaped member. The tubular envelope is left in the hole when pulling the needle-shaped member from the hole in the direction reversed with respect to PIERCE direction. Ribbon is pulled into the hole in the introduced tubular envelope drawing the corresponding end. Then the tubular envelope is removed from the body in the direction of ribbon end. Surgical instrument has implantable ribbon and rod having handle on the first end with curved needle-shaped member on the second end and through hole on the free end with an ear which sizes are enough for passing from the internal surface of the vagina wall above the posterior back side of the pubic bone to the external surface of the abdominal wall. The instrument additionally has removable tubular envelope which dimensions allow the ribbon under implantation, moving through the hole. The removable tubular envelope is fittable over curved needle-shaped member as far as possible from the rod side to the prominent free end of the curved needle-shaped member projecting from the tubular envelope.
EFFECT: enhanced effectiveness of treatment; reduced instrument production costs; simplified design.
23 cl, 8 dwg
FIELD: medicine, surgery.
SUBSTANCE: one should apply a single-row uninterrupted suture upon skin and subcutaneous fiber, fix ligature in subcutaneous fiber in one of the wound's corners, apply a subcutaneous-intracutaneous suture up to the wound's opposite corner, form a knot in subcutaneous fiber with the help of terminal ligature of aponeurosis suture. The method enables to prevent purulent complications and provide the development of valuable cicatrix.
EFFECT: higher efficiency of suturing in post-operational wound.
1 dwg, 2 ex
FIELD: medicine, surgery.
SUBSTANCE: one should dissect epidermis up to derma along pre-set lines, perform deepidermization of the stripe of 55 mm width from the side of removed skin section, dissect derma as it is along stripe's edge and then - fatty fiber, apply subcutaneous buried interrupted sutures onto deepidermized stripe of derma by the following technique: perform puncture in into deepidermized skin stripe of one of the edges of skin wound from the side of subcutaneous fiber followed by puncture out at the distance of 1 mm against the edge of dissected epidermis. At another edge of skin wound one should make puncture in with a needle into deepidermized skin stripe at the distance of 1 mm against the edge of dissected epidermis and puncture out from the side of subcutaneous fiber. Then one should apply removable intracutaneous suture. The innovation enables to increase quality of derma healing.
EFFECT: decreased risk for skin deformation.
2 dwg, 1 ex