Method adaptation of tissues with different thickness of the subcutaneous fat
The invention relates to medicine, namely to surgery, and may be applicable for the adaptation of tissues with different thickness of the subcutaneous fat. Produce separation of skin from underlying tissue. Perform vcol needle and thread from the inside outwards from one side of the wound and re-from the inside outwards from the other side of the wound. The method allows to prevent deformation of the operated area. 1 Il. The invention relates to the field of medicine, particularly surgery and plastic surgery, and can be used for adaptation of tissues with different thickness of subcutaneous fat in patients with different nature of the surgical intervention.A similar method are different types of adapting the seams, such as vertical mattress stitch the Donati, horizontal mattress suture, cosmetic stitch, blanket stitch. These species adapt seams are well established and have for a long time used in plastic surgery more fully the nature and species adapt seams and the technique of their application are reflected in the book Professor Zoltan J. Cicatrix optima (operating equipment and conditions for optimal wound healing. - Budapest, Publishing house of Academy of Sciences of Hungary, 1983.When all neapturami subcutaneous tissue of different thicknesses to date proposed no. The main reason is lack of understanding of what the correct adaptation of the underlying tissue is half the success of a good cosmetic result.The prototype of our method are adapting cosmetic seams type Donati.Analysis of the known level of science and technology showed the novelty of the method, because up to the present time to adapt subcutaneous fat layer used conventional methods (plain stitch, plain stitch when connecting the edges of the wound with neodinakovy thickness). Using our method, we can perform the adaptation of the subcutaneous fat without breaking the anatomical relationships of the surrounding tissues.The technical result of the invention consists in the adaptation of tissues with different thickness of the subcutaneous fat. This is achieved by applying a special seam, namely, in contrast to the simple joint, the imposition of which vcol needle is outside medially and then from the inside out, our seam involves fundamentally different movement. Originally for the best offset produced by szeparowka skin from the underlying tissues, and then do vcol needle and thread from the inside outwards from one side of the wound and re-from the inside outwards from the other side of the wound. CX is her namely:the force vector And is part of the line goes up and down, as if squeezing the most part, and the force vector In-part thread directed upwards only, without reducing the thickness of the subcutaneous fat layer.And part of the leg presses deep into the wounds of the upper edge of the fat layer, and the part of the thread raises the bottom edge of the fat layer and simultaneously maps the upper edge of the fat layer one side with the upper edge of the other side, and creates an exact adaptation of tissues with different thickness.This technique has been tested on a large number of patients in whom it was necessary to adapt the subcutaneous fat layer with different thickness. In all cases there was a positive effect of adaptation without deformation of the operated area. The method is illustrated by examples.Example 1. Patient U. was performed a wide excision of the breast tissue, after which there appeared a large defect that need to be filled by the local tissue, however, after allocation to the surrounding tissue thickness of the subcutaneous fat from one side of the wound significantly exceeds the thickness of the tissue with the other hand. Was applied our proposed method. Achieved the exact adaptation of tissues and a good cosmetic result.Example enemy. When trying to match the edges of the wound revealed a strong deformation of the operated area. We used the proposed method adaptation of the tissues, resulting in a good cosmetic result.
ClaimsMethod adaptation of tissues with different thickness of the subcutaneous fat, including the use of adapting seam, characterized in that the produce szeparowka skin from the underlying tissues, and then perform vcol needle and thread from the inside outwards from one side of the wound and re-from the inside outwards from the other side of the wound.
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