RU182975U1 - Surgical needle holder - Google Patents

Abstract

The surgical needle holder relates to medicine, namely surgery. The technical result of using the surgical needle holder is a simple connection and reliable fastening of surgical needles of various sizes with the distal principle of ligature capture by a hook-like fragment and the needles are fixed in the needle holder using a new design fixation unit, the speed of flashing soft tissues, increased safety in the depths of limited wounds and body cavities, since the proximal caudal ca The needle holder was closed in the fixation site of the needle holder, it became possible to replace needles of different sizes for different tissues, the need for multiple transfer of the needle holder to the needle when stitching soft tissues disappeared. The use of the surgical needle holder was evaluated in an experiment on 10 dogs and clinical practice in 20 patients with soft tissue injuries , 15 patients with laparotomy at the stage of suturing laparotomic wounds, suturing the walls of the stomach and small intestine. There were no complications associated with the use of the new tool. Ustroys yours consists of a needle fixing unit, which is a cylinder with a diameter of 6.0 mm, length 10.0 mm in the distal part 3.0 mm from the end, has a transverse slot of the diameter, 1.2 mm wide, on the distal wall at the base of the slot there is a recess for needles 1.0 mm and 2.0 mm wide, from the level of the distal edge of the slot on the cylinder there is a metric thread and a nut with longitudinal knurling, the diameter of the nut is 8.0 mm, the length is 5.0 mm, the proximal fixation unit has a cylindrical fragment with a diameter 4.0 mm, a length of 6.0 mm and then goes into a cylindrical rod with a diameter of 5, 0 mm, which is proximally connected to the plate handle of an elongated drop-shaped configuration 85.0 mm long. 3 ill.

Description

The device relates to medicine, namely to surgery.

For the application of hand sutures on soft tissues during surgery, disposable and reusable surgical needles and needle holders of the clamping principle of action are used.

The disadvantage of this method of suturing tissue is the multi-stage transfer of existing needle holders on the needle from the proximal part to the distal and back when stitching each wall of the wounds.

As a prototype, a surgical screw needle holder tool was used, patent for utility model RU 175236 U1, 11.28.2017, which simplifies and speeds up the sewing of soft tissues by eliminating the multiple transfer of the needle holder to the needle using conventional clamp-type needle holders and various surgical needles.

A surgical screw needle holder, consisting of a unit for fixing needles, a rod and a curly handle, a unit for screw fixing of needles is a screw for fixing needles and a distal part of the rod for fixing interchangeable needles, a stem diameter of 5.0 mm, a length of 80.0 mm, in the distal part 2.0 mm from the end of the rod there is a window for needles of rectangular configuration located along the axis of the rod, passing through its center 3.0 mm long, 1.2 mm wide, the axis of the window is located at an angle of 60 ° to the plane of the curly handle, in the distal there is a 2.0 mm diameter hole at the end of the stem axis thread where the screw is screwed to fix interchangeable needles, the rod is proximally connected to a curly handle with an elongated drop-shaped configuration with a length of 85.0 mm, a screw for fixing interchangeable needles with a head with a diameter of 6.0 mm, a thickness of 2.6 mm and straight groove, a cylindrical rod with a diameter of 2 0 mm, length 2.3 mm with external metric thread.

The disadvantage of the prototype is the small size of the screw and the holes for its introduction, as well as the window for the needles, which creates difficulties in the assembly of the device and charging the needle during surgery.

EFFECT: simple connection option and reliable fastening of surgical needles of various sizes with the distal principle of ligature fixation, reduction of injury risk due to concealment of one end of the needle in the fixation unit, elimination of multi-storey transfer of the needle holder to the needle when suturing wounds.

The technical result is achieved due to the presence in the device of the needle fixing unit and a cylindrical rod with a diameter of 5.0 mm, which is proximally connected to the plate shaped handle of an elongated drop-shaped configuration with a length of 85.0 mm, the needle fixing unit is a cylinder with a diameter of 6.0 mm, length 10, 0 mm in the distal part 3.0 mm from the end has a transverse slot on Vi of diameter 1.2 mm wide, on the distal wall at the base of the slot there is a recess for needles 1.0 mm wide and 2.0 mm wide, from the level of the distal edge of the slot on the cylinder there is -parameter and the nut thread having a longitudinal knurled nut diameter 8.0 mm, length 5.0 mm, the proximal locking knot fragment has a cylindrical diameter of 4.0 mm, 6.0 mm, and then proceeds to said cylindrical rod.

USEFUL MODEL EXPLAINED BY FIGURES (Figs. 1-3)

In FIG. 1. Isometric view of the device

In FIG. 2. General view of the device, top view

In FIG. 3. General view of the device, side view

диаметра, шириной 1,2 мм, на дистальной стенке у основания прорези имеется углубление для игл на 1,0 мм и шириной 2,0 мм, с уровня дистального края прорези на цилиндре имеется метрическая резьба и гайка (2) с продольной накаткой, диаметр гайки 8,0 мм, длина 5,0 мм, проксимально узел фиксации имеет цилиндрический фрагмент диаметром 4,0 мм, длиной 6,0 мм и далее переходит в упомянутый цилиндрический шток (Фиг. 3).The device consists of a needle fixing unit (1) and a cylindrical rod (3) with a diameter of 5.0 mm, which is proximally connected to a plate shaped handle (4) of an elongated drop-shaped configuration with a length of 85.0 mm, the needle fixing unit is a cylinder with a diameter of 6.0 has a length of 10.0 mm in the distal part 3.0 mm from the end has a transverse slot on

diameter, 1.2 mm wide, on the distal wall at the base of the slot there is a recess for needles of 1.0 mm and a width of 2.0 mm, from the level of the distal edge of the slot on the cylinder there is a metric thread and nut (2) with longitudinal knurling, diameter nuts 8.0 mm, length 5.0 mm, the proximal fixation unit has a cylindrical fragment with a diameter of 4.0 mm, a length of 6.0 mm and then goes into the said cylindrical rod (Fig. 3).

THE DEVICE WORKS AS FOLLOWS

The nut of the fixing device is twisted from the cylindrical part of the device towards the needle holder handle by 2.0 mm, the surgical needle with the proximal blunt end intended for fastening in the fixing device is inserted into the needle slot in the direction necessary for convenient operation and clamped by tightening the fixing nut.

EXAMPLES OF EXPERIMENTAL AND CLINICAL USE OF THE DEVICE

In an experiment on 10 dogs, a technique was developed for applying nodal sutures using a universal and curved hook-shaped needle holder to the aponeurosis of the abdominal wall with fluoride, catgut muscle, wounds of the small intestine and stomach with PHA thread and fluoride. There were no complications associated with the use of the new instrument during the operation and in the postoperative period.

In clinical practice, the universal needle holder tool and the hooked needle were used in 20 patients with soft tissue injuries (skin, subcutaneous fat and muscle) and in 15 patients with laporatomy at the stage of suturing of laparatoma wounds, suturing of the small intestine and stomach.

Patient 3., 30 years old. He was hospitalized in the Municipal Clinical Hospital of Municipal Health and Public Health of Kursk from 05/18/17 to 05/29/17. Diagnosis: peptic ulcer of the duodenum, stage of exacerbation. Chronic ulcer of the anterior wall of the duodenal bulb, complicated by perforation. Common serous fibrinous peritonitis. 05/18/17, the operation was performed: Laparotomy, excision of a perforated ulcer, debridement, drainage of the abdominal cavity.

Under endotracheal anesthesia, the upper median laparotomy was performed. In the subhepatic space and along the right lateral canal, up to 100 ml of serous effusion with fibrin. The stomach is of normal size. On the front wall of the LDK ulcerative infiltrate with a diameter of up to 20.0 mm, with a perforated hole in the center up to 3.0 mm in diameter. The ulcerative infiltrate was excised, the defect was sutured with a double-row suture of the PHA and fluoride using a surgical needle holder with a universal and curved hook-shaped needle. The abdominal cavity is sanitized with a solution of furatsilina and is drained by tubular drainage in the right hypochondrium. Using a universal needle holder and a curved hooked needle, the abdominal cavity is sutured in layers.

Long operation 50 minutes. The postoperative period was uneventful.

Patient E., 21 years old. She was hospitalized in the Municipal Clinical Hospital of the Northern Mesmeria of Kursk from 05.23.17 to 05.27.17. Diagnosis: acute phlegmonous appendicitis. 05.24.17 under intravenous anesthesia, a laparoscopic appendectomy and drainage of the abdominal cavity were performed.

During revision of the abdominal cavity: the appendix is phlegmonous changed, up to 70.0 mm long. In the iliac region, up to 10.0 ml of turbid serous effusion. The mobilization of the appendix is completed. The base of the appendix is ligated with two loops of Raeder (PHA No. 2/0). The appendix is cut off and removed from the abdominal cavity in the container. The mucous stump is coagulated by a bipolar coagulator. The pelvic cavity is drained by tubular drainage. The soft tissue suturing was performed by a universal needle holder and a hook-shaped needle. The duration of the operation is 30 minutes. The postoperative period was uneventful. Sutures were removed on an outpatient basis, healing by first intention.

Patient T., 68 years old. I was hospitalized in the Municipal Clinical Hospital of the Northern Mesopotamia of Kursk from 05.22.17 to 05.29.17. The diagnosis of right-sided adjustable oblique inguinal hernia. Nyhus 3B.

Operation 05/23/17. Hernia repair on the right with plastic surgery according to Liechtenstein.

Under spinal anesthesia, an incision was made in the inguinal region on the left, above the hernial protrusion. The anterior wall of the inguinal canal has been dissected, a hernial sac of 40.0 * 40.0 * 30.0 mm in size has been identified, opened. The contents are a fixed lock of a large omentum. Introduced into the abdominal cavity. The hernial sac is stitched at the neck and excised. Hernial gates up to 20.0 mm in diameter, height of the inguinal gap up to 30.0 mm. Plastic surgery of the posterior wall of the inguinal canal according to Liechtenstein using the Lintex endoprosthesis of 80.0 * 120.0 mm was performed. A universal surgical needle holder and a curved hooked needle were used. Subcutaneous tissue is drained by a rubber graduate. The postoperative wound is sutured in layers. Iodine, aseptic dressing. The duration of the operation is 40 minutes The postoperative period without complications.

Patient S., 17 years old. He was hospitalized in the Municipal Clinical Hospital of the Nursing School of Nursing in Kursk from 05/30/17 to 06/06/17 Diagnosis: Acute catarrhal appendicitis. 05/30/17 appendectomy operation.

Under intravenous anesthesia, a laparotomy was performed according to Volkovich-Dyakonov. There is a small amount of serous effusion in the right iliac fossa. Drained. The appendix is 80.0 mm long, thickened, hyperemic, catarrhal. Appendectomy was performed with immersion of the stump of the process in purse-string and Z-shaped sutures. The mesentery of the appendix is stitched and bandaged. There is no effusion in the pelvis. Layered sutures on the wound using a surgical needle holder and a curved hooked needle. Iodine. Aseptic dressing. The postoperative period was uneventful with healing by primary intention.

Patient P., 67 years old. He was hospitalized at the Kursk City Clinical Hospital for Emergency Medicine, from 05/18/17 to 06/08/17. Diagnosis: Obliterating atherosclerosis of the vessels of the lower extremities. Lerish's syndrome. Thrombosis of the right femoral artery of a long statute of limitations. INC on the right GU, left III art. Wet gangrene of the right foot. 05/25/17 operation: Amputation of the right lower limb at the level of the upper third of the thigh, drainage of the stump. Under spinal anesthesia, two skin-muscle flaps were cut at the level of the upper third of the thigh. There is no swelling of soft tissues, blood flow is satisfactory. The muscles are crossed. The femoral artery and vein are stitched and bandaged separately. The lumen of the femoral artery is obstructed by an atherosclerotic plaque. The femoral nerve is isolated, tied with catgut, excised. I cut through the femur at the level of the upper third. Bone sawdust processed. Hemostasis. Blood loss - 100.0 ml. During the operation, a surgical needle holder was used and the hooked needle was curved. Rare stitches in the wound. Rubber graduates (2) in the wound. Iodine. Ace. bandage. The wound healed by primary intention.

Thus, the method of using a surgical needle holder of a new design and needles with a distal principle of suture fixation simplified the application of nodal sutures by different types of elastic suture materials on different types of soft tissues, the duration of surgical intervention was reduced, the technique of working with a needle in a limited surgical field and its risk of injury, complications associated with it were simplified with the use of a new tool, there was no multi-stage transfer of the needle holder to the needle.

Claims (1)

Surgical needle holder, consisting of a needle fixation unit and a cylindrical rod 0.5 mm in diameter, which is proximally connected to a plate handle with an elongated drop-shaped configuration 85.0 mm long, characterized in that the needle fixation unit is a cylinder with a diameter of 6.0 mm, length 10.0 in the distal part 3.0 mm from the end has a transverse slot on

diameter, 1.2 mm wide, on the distal wall at the base of the slot there is a recess for needles of 1.0 mm and a width of 2.0 mm, from the level of the distal edge of the slot on the cylinder there is a metric thread and a nut with longitudinal knurling, nut diameter 8, 0 mm, length 5.0 mm, the proximal fixation unit has a cylindrical fragment with a diameter of 4.0 mm, a length of 6.0 mm and then goes into the said cylindrical rod.

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