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 [1].

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.

 

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