TR201412735A2 - A laparoscopic closed morselayon bag and its method of use. - Google Patents
A laparoscopic closed morselayon bag and its method of use. Download PDFInfo
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- TR201412735A2 TR201412735A2 TR2014/12735A TR201412735A TR201412735A2 TR 201412735 A2 TR201412735 A2 TR 201412735A2 TR 2014/12735 A TR2014/12735 A TR 2014/12735A TR 201412735 A TR201412735 A TR 201412735A TR 201412735 A2 TR201412735 A2 TR 201412735A2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00287—Bags for minimally invasive surgery
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Abstract
Bu buluş, laparoskopik ameliyatlarda batın (A) (karın bölgesi) içerisindeki numunenin (S) (specimen) çıkartılmasını kolaylaştıran ve katı materyallerin çıkartılmasında parçalayıcı (morselatör (M)) cihazlarının kullanımı sırasında parçalanan numunenin (S) batın (A) içerisine dağılmasına bağlı komplikasyonların oluşmasının önüne geçilmesini sağlayan bir laparoskopik kapalı morselayon poşeti (enclosed laparoscopic morcellation bag) (1) ve bunun kullanım metodu ile ilgilidir.SUMMARY OF THE INVENTION The present invention is directed to the complications of the dispersion of the disintegrated sample (S) into the abdomen (A) during laparoscopic surgery, which facilitates the removal of the specimen (S) in the abdomen (A) (abdomen) and the use of disintegrant (M) devices for the removal of solid materials. This invention relates to a closed laparoscopic morcellation bag (1) and its method of use.
Description
TARIFNAME BIR LAPAROSKOPIK KAPALI MORSELAYON POSETI VE BUNUN KULLANIM METODU Teknik Alan Bu bulus, laparoskopik ameliyatlarda batin (karin bölgesi) içerisindeki numunenin (specimen) çikartilmasini kolaylastiran ve kati materyallerin çikartilmasinda parçalayici (morselatör) cihazlarinin kullanimi sirasinda parçalanan numunenin batin içerisine dagilmasina bagli komplikasyonlarin olusmasinin önüne geçilmesini saglayan bir laparoskopik kapali morselayon poseti (enclosed laparoscopic morcellation bag) ve bunun kullanim metodu ile ilgilidir. Önceki Teknik Cerrahi alaninda hizla gelisen ve yayginlasan bir yöntem olan laparoskopik cerrahi, tüm cerrahi alanlarda oldugu gibi jinekolojik cerrahi alaninda da her geçen gün daha siklikla tercih edilmektedir. Laparoskopik cerrahi, Vücutta genis kesiler yapilmasina gerek kalmadan, sadece belirlenen birkaç noktadan kalem kalinliginda metal borular (trokar-port) ve bir kameranin yardimi ile gerçeklestirilen ameliyatlardir. Geleneksel uygulamalardaki genis kesitlere karsilik olarak laparoskopik ameliyatlarin gerçeklestirilmesi durumunda iyilesme daha hizli bir sekilde gerçeklesmekte ve hasta günlük yasamina daha hizli dönebilmektedir. DESCRIPTION A LAPAROSCOPIC CLOSED MORCELAION POSITION AND ITS USE METHOD Technical Area This invention shows that the sample in the abdomen (abdominal region) in laparoscopic surgeries (specimen) for the removal of solid materials that facilitate their removal During the use of disintegrating (morcellator) devices, the fragmentation of the sample It prevents the occurrence of complications due to its dispersal into the abdomen. A laparoscopic closed morcellation bag (enclosed) laparoscopic morcellation bag) and its method of use. Prior Art Laparoscopic surgery, which is a rapidly developing and widespread method in the field of surgery, surgery, in the field of gynecological surgery as well as in all surgical fields. It is preferred more and more day by day. Laparoscopic surgery, Large body without the need to make incisions, only a few specified points thick metal pipes (trocar-port) and with the help of a camera. performed surgeries. To large cross sections in traditional applications in turn, improvement in the case of performing laparoscopic surgeries occur more quickly and the patient can enter his daily life more quickly. can return.
Laparoskopik cerrahinin en önemli sorunlarindan birisi, cerrahi sonrasinda karin içerisinden çikartilmak istenen hastalikli dokunun (numunenin) karin bölgesi disina alinmasinin kolay olmamasidir. Özellikle kati kitlelerin karin bölgesi disina alinmasi neredeyse imkansizdir. Bu sebeple, bu kitlelerin karin bölgesi (batin) disina alinmasi sirasinda morselatör (morcellator) olarak adlandirilan parçalayici cihazlar kullanilmaktadir. Jinekoloji alaninda myomektomi ameliyatlarindan , sonra myomlarin ve subtotal histerektomi ameliyatlarindan sonra uterusun batin disina alinmasi sirasinda laparoskopik morselatörler kullanilmakta ve çikarilacak olan materyal batin içerisinde morselatör ile parçalanarak batin disarisina alinmaktadir. Batin içerisinde morselatör ile yapilan bu parçalama islemi sirasinda hastalikli dokunun batin içerisine kontrolsüz bir sekilde dagilmasi riski bulunmaktadir. Özellikle subtotal histerektomi ameliyatlarinda uterus sarkomlarinin (sarcoma) batin içerisinde yayilmasi riski ve myomektomi ameliyatlarinda yine myometrial sarkomunun batin içi yayilimi ve ayrica parazitik myom gelismesi riski bulunmaktadir. Bu sebeple, basta FDA olmak üzere, birçok önemli uluslararasi jinekolojik endoskopi dernegi laparoskopik morselasyon kullanimi hakkinda dikkatli olunmasi yönünde deklerasyonlar yayinlamaktadir.Teknigin bilinen durumunda, laparoskopik ameliyatlarda, numunenin batin disina alinmasi için gelistirilmis bazi yöntemler bulunmaktadir. Bunlar genellikle batin disarisina alinacak numunenin çesitli kapali ya da açik posetler içerisinde parçalanmasi ve sonrasinda batin disarisina bu posetler ile alinmasina dayandirilmaktadir. Ancak bu malzemelerin kullanilmasi özellikle operasyon süresinde uzamaya ve operasyonda teknik karmasiklar olusmasina yol açmaktadir. One of the most important problems of laparoscopic surgery is the abdominal pain after surgery. Abdominal region of the diseased tissue (sample) to be removed is that it is not easy to be taken out. Especially outside the abdominal region of solid masses it is almost impossible to get. For this reason, the abdominal region (abdomen) of these masses disintegrator called morcellator during removal devices are used. One of myomectomy surgeries in the field of gynecology , then the abdomen of the uterus after fibroids and subtotal hysterectomy operations Laparoscopic morcellators are used during removal and will be removed. The material, which is in the abdomen, is crushed with a morcellator and transferred to the outside of the abdomen. is taken. During this shredding process, which is done with a morcellator inside the abdomen, The risk of uncontrolled distribution of diseased tissue into the abdomen are available. The uterus, especially in subtotal hysterectomy operations Risk of spreading of sarcomas (sarcoma) in the abdomen and myomectomy intra-abdominal spread of myometrial sarcoma and also parasitic There is a risk of myoma development. For this reason, many important international society of gynecological endoscopy laparoscopic morcellation declares to be careful about its use. There are some developed methods for taking it. These are usually the The sample to be taken out is in various closed or open bags. disintegrating and then being taken out of the abdomen with these bags is based. However, the use of these materials is especially important for operation. It leads to a prolongation of the time and technical complications in the operation.
Açik posetler içerisinde yapilan parçalama islemlerinde, özellikle büyük boyutta posetler kullanildigi için öncelikle bu posetlerin batin içerisine alinmasi zordur. Particularly in large sizes, in shredding operations in open bags. Since bags are used, it is difficult to get these bags into the abdomen.
Bu büyük boyutlu posetlerin bati içerisinde uygun pozisyona getirilmesi ve agizlarindan içerisine numunenin alinmasi zor bir islemdir ve ileri derece cerrahi deneyim ve yetenek gerektirmektedir. Ayrica, açik poset içerisinde parçalama yapilmasi da bu posetin kullanilmamasi durumundaki gibi batin içerisine hastaligin yayilmasi ihtimalini tasimaktadir. Islem sonunda batin içerisindeki posetin agzinin kapatilmasi ve batin disina alinmasi karmasik ve zorlu bir islemdir. Placing these large-sized bags in a suitable position in the west and It is a difficult procedure to take the sample into the mouth and it is highly surgical. requires experience and skill. Also, shredding in open bag It is also applied to the abdomen, as in the case of not using this bag. carries the possibility of spreading the disease. At the end of the procedure, inside the abdomen Closing the mouth of the bag and taking it out of the abdomen is a complex and difficult task. is the transaction.
Kapali poset içerisinde morselasyon uygulamasinin yapilmasinin zorluklari ise; 1. Büyük poset kullanilmasi ve bu posetlerin batin içerisine alinmasinin zor olmasi, 2. Batin' içerisine alindiktan sonra agzinin açilmasi ve numunenin poset içerisine alinmasi için fazlasiyla cerrahi tecrübe ve yetenek gerektirmesi, 3. Numunenin poset içerisine alinmasi sirasinda, farkli boyutlarda laparoskopik kameralar ile farkli portlar üzerinden. islemin takip edilmesinin islemi karmasiklastirmasi ve kamera degisikliklerinin islem sürecini uzatmasi, 4. Numune poset içerisine alindiktan sonra posetin agzinin kapatilmasi ve posetin batin disina alinmasi sirasinda farkli kameralara gerek duyulmasi, . Agzi batin disinda kalan posetin sisirilmesi sonrasi batin içerisindeki fakli bir trokar ile posetin delinmesi ve içeri girilmesi gerekmekte, bu islem yapilirken kameranin poset içerisinde bulunmasi sebebiyle islemin yari kör bir sekilde gerçeklestirilmesi ve bu delme isleminin batin içerisinde bir bölgede intrabdominal yaralanma riskini ortaya çikarmasi, 6. Farkli bir trokar ile poset delinerek içerisine girildikten sonra tek tip trokara bagimli kalinarak posetin bu trokar ile batin duvari arasina sikistirilmasinin gerekmesi, 7. Bu asamadan sonra kamera degistirilerek parçalama islemi gerçeklestirilmekte, parçalama islemi sonrasinda posetin batin disina alinmasi sirasinda farkli bir kamera kullanilarak poset batin disarisina çikarilmakta ve tam da bu sirada batin içerisinde posetin delindigi yerden batin içerisine siVi materyal veya numune parçalarinin dagilmasini engellemek için Özel önlemlerin alinmasi gerekmektedir. Bu islemlerin es zamanli olarak yapilmasi islemdeki karmasikligi attirmasi. dokümanlari laparoskopik cerrahide morselasyon ile parçalanan numunenin batin disina alinmasindan bahsetmektedir. The difficulties of applying morcellation in a closed bag are; 1. It is difficult to use large bags and to get these bags into the abdomen. to be, 2. Opening the mouth after taking it into the abdomen and taking the sample into the bag Requires a lot of surgical experience and skill to be included, 3. At the time of taking the sample into the bag, different sizes via different ports with laparoscopic cameras. follow up your transaction Complicating the process and making camera changes prolonging the process 4. After the sample is taken into the bag, closing the mouth of the bag and The need for different cameras during the removal of the bag from the abdomen, . After inflating the bag whose mouth is outside the abdomen, the difference in the abdomen it is necessary to puncture and enter the bag with a trocar, this process Due to the fact that the camera is in the bag during the process, the process is half blind. performed in a certain way and this piercing process is performed in the abdomen. reveals the risk of intrabdominal injury in the region, 6. After the bag is pierced with a different trocar and entered, a uniform adhering to the trocar, placing the bag between this trocar and the abdominal wall. need to be compressed, 7. After this stage, the camera is changed and the shredding process is performed. is carried out, after the shredding process, the bag is placed outside the abdomen. Using a different camera during removal, the bag is taken out of the abdomen. It is taken out and at this very moment in the abdomen from where the bag was pierced. dispersion of liquid material or sample pieces into the abdomen. Special precautions must be taken to prevent These are the names Doing it in a timely manner increases the complexity of the process. Abdominal examination of the specimen whose documents were broken down by morcellation in laparoscopic surgery. He talks about his expulsion.
Bulusun Kisa Açiklamasi Bulusun amaci, küçük ve sisirilebilir yapida elastik bir materyalden imal edilen ve numunenin içerisine alindiginda içerisinde morselasyonun yapilmasini mümkün kilan bir laparoskopik kapali morselasyon poseti gerçeklestirmektir. Brief Description of the Invention The object of the invention is a small and inflatable device made of an elastic material. It is possible to make morcellation in the sample when it is taken inside. What makes it possible is to perform a laparoscopic closed morcellation bag.
Bulusun diger amaci, dis yüzeyinden uzanan ve laparoskopik olarak kullanilan portlardan disari kolayca çikarilan parmak seklindeki çikintilar sayesinde disari çikarildiktan sonra laparokopik enstrümanlarin ve morselatörlerin içerisine sokulabilecegi bir laparoskopik kapali morselasyon poseti gerçeklestirmektir. Another aim of the invention is to extend from the outer surface and used laparoscopically. with finger-shaped protrusions that are easily removed from the ports. into laparoscopic instruments and morcellators after removal. is to perform a laparoscopic closed morcellation bag into which it can be inserted.
Bulusun bir diger amaci, ameliyat süresinin kisaltilmasini saglayan bir laparoskopik kapali morselasyon poseti gerçeklestirmektir. Another object of the invention is to provide a shortening of the operative time. is to perform laparoscopic closed morcellation bag.
Bulusun Ayrintili Açiklamasi Bu bulusun amacina ulasmak için gerçeklestirilen “Bir laparoskopik kapali morselasyon poseti” ekli sekillerde gösterilmis olup; bu sekillerden: Sekil 1 - Laparoskopik morselasyon öncesi numunenin hasta dokudan kesilerek ayrilmasinin sematik gösterilmesidir. Detailed Description of the Invention To achieve the aim of this invention, “A laparoscopic closed “morcellation bag” is shown in the attached figures; of these sequences: Figure 1 - Sample from patient tissue before laparoscopic morcellation is the schematic representation of the separation by cutting.
Sekil 2 - Bulus konusu laparoskopik morselasyon posetinin agiz açma aparatinin bükülmesi ile cilt kesisi üzerinden batin içerisine sokulmasinin sematik gösterimidir. Figure 2 - Mouth opening of the laparoscopic morcellation bag, which is the subject of the invention With the bending of the apparatus, over the skin incision into the abdomen sematic representation of insertion.
Sekil 3 - Bulus konusu laparoskopik morselasyon posetinin agzinin açik olarak batin içerisinde sematik gösterimidir. Figure 3 - Open mouth of the inventive laparoscopic morcellation bag as a sematic representation in batin.
Sekil 4 - Kamera üzerinden gözlemlenerek laparoskopik enstrüman vasitasiyla numunenin bulus konusu laparoskopik morselasyon poseti içerisine alinmasinin sematik gösterimidir. Figure 4 - Laparoscopic instrument observing through the camera The subject of the invention is laparoscopic morcellation of the sample through It is the sematic representation of being included in the bag.
Sekil 5 ~ Numunenin laparoskopik morselasyon poseti içerisine alinmasinin sematik gösterimidir. Figure 5 ~ Taking the sample into the laparoscopic morcellation bag sematic representation.
Sekil 6 ~ Laparoskopik morselasyon posetinin agzinin laparoskopik enstrüman ile çekilerek batin disina alinmasinin gösterimdir. o Sekil 7 - Bulus konusu laparoskopik morselasyon poseti içerisinde kamera gözleminde morselasyon yapilmasinin sematik gösterimidir. Figure 6 ~ The mouth of the laparoscopic morcellation bag It is a demonstration of taking it out of the abdomen by pulling with the . He Figure 7 - Camera in the laparoscopic morcellation bag, which is the subject of the invention It is a schematic representation of morcellation in observation.
Sekil 8 - Bulus konusu laparoskopik morselasyon posetinin morselasyon islemi sonrasinda batin disina çikarilmis halinin sematik gösterimidir. Figure 8 - Morcellation of the laparoscopic morcellation bag of the invention The schematic of the state of being taken out of the abdomen after the procedure is the display.
Sekil9- Agzin tutulmasinda kullanilan kelepçe tasariminin açik halinin perspektif görünümüdür. Figure 9- Open version of the clamp design used to hold the mouth perspective view.
Sekil 10 -Agzin tutulmasinda kullanilan kelepçe tasariminin kapali halinin perspektif görünümüdür. Figure 10 -Closed version of the clamp design used to hold the mouth perspective view.
Sekillerdeki parçalar numaralandirilmis olup karsiliklari asagida verilmistir 1. Laparoskopik kapali morselasyon poseti 2. Gövde 3. Agiz 4. Agiz açma aparati . Çikintilari 6. Kelepçe 6.1. Sabit bölüm 6.2. Hareketli bölüm A. Batin C. Kamera M. Morselatör P. Port S. Numune L. Laparoskopik enstrüman Bulus konusu laparoskopik kapali morselasyon poseti (1), laparoskopik cerrahi operasyonlarinda batin (A) (karin bölgesi) içerisindeki numunenin (specimen) (S) çikartilmasini kolaylastiran ve kati materyallerin çikartilinasinda parçalayici (morselatör (M)) cihazlarinin (M) kullanimi sirasinda parçalanan numunenin (S) batin (A) içerisine dagilmasinaç bagli komplikasyonlarin olusmasinin önüne geçilmesini saglayan ve - içerisine hava üflenerek sisirilebilen bir elastik malzemeden üretilen, batin (A) içerisine alindiktan sonra hava ile sisirilmesi sayesinde içerisinde morselasyon isleminin yapilabilecegi bir yapay hacim olusturan ve içerisine alinan numunenin (S) ve sivinin batin (A) içerisine geçmesini engelleyecek sekilde sizdirmaz bir kapali hazne görevi gören en az bir - gövdenin (2) numuneye (S) bakan bölümünde yer alan ve bir port (P) kesisi içerisinden batin (A) içerisine itilmesi sonrasinda açilarak numunenin (S) gövde (2) içerisine alinmasini mümkün kilan en az bir agiz - agiz (3) üzerinde konumlandirilan ve kolaylikla bükülüp egrilebilen ve üzerine uygulanan basinç kesilince önceki formuna dönen böylelikle bükülüp batin (A) içerisine atildiktan sonra kendiliginden açilarak kendisine tutturulan agzin (3) da açilmasini saglayan en az bir agiz açma - gövdenin (2) yüzeyinden disari dogru uzanan, gövde (2) içerisi ile baglantili bir kanal formunda olup uç kismi kapali olan ve kapali olan bu ucu batin (A) üzerindeki cilt kesileri üzerinden batin (A) disina dogru bir tutucu yardimiyla çikartilabileri ve bu kapali uçlarin kesilmesiyle laparoskopik aparatlarin gövde (2) içerisine girebilecegi bir kanal görevi gören en az bir çikinti (5) içermektedir. The parts in the figures are numbered and their equivalents are given below. 1. Laparoscopic closed morcellation bag 2. Body 3. Mouth 4. Mouth opening device . protrusions 6. Clamp 6.1. fixed partition 6.2. movable part A. Abdominal C. Camera M. Morcellator P. Port Q. Sample L. Laparoscopic instrument The subject of the invention is the laparoscopic closed morcellation bag (1), laparoscopic surgery In operations, the sample (specimen) in the abdomen (A) (abdominal region) (S) disintegrating, facilitating the removal of solid materials (S) of the fragmented sample (M) during the use of the (morcellator (M)) devices (M) It prevents the formation of pain-related complications in the abdomen (A). enabling the passage and - the abdomen, made of an elastic material that can be blown into the inflatable (A) After being taken inside, it is inflated with air. creating an artificial volume where morcellation can be performed and It allows the sample (S) and the liquid taken into the abdomen (A) to pass through. at least one that acts as a sealed chamber to prevent - a port (P) located on the part of the body (2) facing the sample (S) It is opened after being pushed into the abdomen (A) through the incision. at least one mouth that makes it possible to take the sample (S) into the body (2) - positioned on the mouth (3) and easily bent and curved, and It returns to its previous form when the pressure applied on it is cut off. it opens by itself after being bent and thrown into the abdomen (A) at least one opening that allows the attached mouth (3) to also open - with the inside of the body (2), extending outward from the surface of the body (2) It is in the form of an interconnected channel and its end part is closed and closed. with the tip out of the abdomen (A) over the skin incisions on the abdomen (A). they can be removed with the help of the holder and by cutting these closed ends It acts as a channel through which laparoscopic apparatuses can enter into the body (2). It contains at least one protrusion (5) that sees.
Bulusun tercih edilen uygulamasinda agiz açma aparati (4), agzin (3) içerisinden geçip etrafini tutacak sekilde etrafina sarilmaktadir. In the preferred embodiment of the invention, the mouth opening apparatus (4) is inserted through the mouth (3). It wraps around him in such a way as to pass and hold him.
Bulusun bir diger uygulamasinda agiz açma aparati (4), agiz (3) üzerine bütünlesiktir. In another embodiment of the invention, the mouth opening apparatus (4) is placed on the mouth (3). it is integrated.
Bulusun bir uygulamasinda farkli laparoskopik enstrümanlarin (L) kullanilmasi amaciyla farkli portlar (P) üzerinden bir tutucu yardimiyla batin (A) disina çikarilan ve uç kisimlari kesilerek gövde (2) içerisine dogru uzanan kanallar görevi gören çok sayida çikintilar (5) bulunmaktadir. Use of different laparoscopic instruments (L) in an embodiment of the invention With the help of a holder through the different ports (P) for the purpose of inserting it out of the (A) the channels that are removed and the ends of which are cut and extend into the body (2) There are many protrusions (5) that act as
Bulusun bir diger uygulamasinda, morselasyon islemi sonrasinda gövde (2) içerisindeki küçük doku parçalarinin ve sivinin batin (A) içerisine dökülmesini engellemek için, ucu kesilerek açilan çikinti (5) ve/veya agiz (3) üzerine, çikintinin (5) ve/Veya agzin (3) çeperlerinin sikica birbirine temas etmesini saglayacak sekilde sikistiran ve çeperlerin içerisine yerlestirildigi bir sabit bölüm (6.1) ve sabit bölüme (6.1) bir ucundan tutturularak bu eksende döndürülüp çeperleri sabit bölümde (6.1) sikistiran en az bir hareketli bölüme (6.2) sahip en az Bulusun farkli bir uygulamasinda agiz (3), etrafinda yer alan bir büzme kanali içerisinden geçirilen ipin batin (A) disarisinda operatör tarafindan çekilmesi ile büzülerek kapatilmaktadir. In another embodiment of the invention, after the morcellation process, the body (2) to pour small tissue pieces and fluid into the abdomen (A). on the protrusion (5) and/or the mouth (3), the end of which is cut off, to prevent make sure that the walls of the protrusion (5) and/or the mouth (3) touch each other tightly. a fixed section in which the walls are inserted and tightened to provide (6.1) and fixed section (6.1) at one end and rotated on this axis. having at least one movable part (6.2) clamping the walls in the fixed part (6.1) In a different embodiment of the invention, the mouth (3) is a shirring channel located around it. With the pulling of the rope passed through it by the operator outside the abdomen (A) is closed by shrinkage.
Bulus konusu laparoskopik kapali morselasyon posetinin (1) kullanim yöntemi olup, laparoskopi ameliyatlarinda ameliyatin ön safhalarinda bagli bulundugu dokudan ayrilan numunenin (S) batin disina alinmasini saglayan ve, - laparoskopik ameliyatinda doku parçasi numunesinin (S) kesilmesi sonrasinda, kesme isleminde kullanilan bir laparoskopik enstrümanin (L) içerisinden geçirildigi port (P) ile birlikte cilt kesisinden çikarilmasi, - bosalan cilt kesisi içerisinden önce bükülen agiz açma aparatinin (4) ve agzin (3) sonra da gövdenin (2) geçirilmesi, - batin (A) içerisinde üzerine uygulanan basincin kalkmasi ile agiz açma aparatinin (4) dolayisiyla da agzin (3) açilmasi, - gövdenin (2) üzerindeki çikintilardan (5) en az birinin gövdenin (2) girdigi cilt kesisinden batin (A) disinda birakilmasi, - farkli bir port (P) içerisinden geçirilen bir laparoskopik enstrüman (L) vasitasiyla numunenin (S), diger bir porttan (P) geçirilen kamera (C) ile gözlemlenerek açik olan agiz (3) içerisinden gövde (2) içine alinmasi, dolayisiyla agzin (3) batin (A) disina çikarilmasi ve bu sirada laparoskopik enstrüman (L) ve içinden geçtigi portun (P) yerinden sökülmesi, - kameranin (C) ve içerisinden geçirildigi portun (P) birlikte cilt kesisinden çikarilmasi, - batin (A) disina dogru uzanan agzin (3) içerisine port (P) ve kameranin (C) 1 O geçirilmesi, - gövde (2) içerisine agiz (3) üzerinden gaz verilerek yapay hacim olusturulmasi, - disarida birakilan çikintinin (5) ucunun kesilmesi, - çikintinin (5) kesilen ucu içerisinden gövde (2) içerisine dogru bir morselatörün (M) geçirilmesi, - gövde (2) içerisindeki numunenin (S) kamera (C) ile gözlemlenerek morselatör (M) vasitasiyla parçalanmasi, - morselatörün (M) içerisinden geçtigi çikintidan (5) çikarilarak, çikintinin (5) ucunun sizdirmaz bir sekilde kapatilmasi, - batin (A) disinda kalan agiz (3) üzerinden, parçalanmis numune (S) parçalarinin ve sivisinin içerisinde yer aldigi gövdenin (2) batin disina çekilmesi adimlarini içermektedir. The method of use of the laparoscopic closed morcellation bag (1), which is the subject of the invention It is related to the anterior stages of the surgery in laparoscopy surgeries. which ensures that the sample (S) separated from the tissue is taken out of the abdomen and, - cutting the tissue piece sample (S) in laparoscopic surgery Afterwards, a laparoscopic instrument (L) used in the cutting process to be removed from the skin incision together with the port (P) through which it is passed, - the mouth opening apparatus (4), which is bent before the empty skin incision, and passing the mouth (3) and then the body (2), - opening the mouth with the removal of the pressure exerted on it in the abdomen (A) opening of the apparatus (4) and therefore the mouth (3), - at least one of the protrusions (5) on the body (2) enters the body (2) excluding the abdomen (A) from the skin incision, - a laparoscopic instrument (L) passed through a different port (P) the sample (S) through the camera (C) passed through another port (P). being taken into the body (2) through the open mouth (3) by observing, therefore, removal of the mouth (3) out of the abdomen (A) and laparoscopic disassembling the instrument (L) and the port (P) through which it passes, - through the skin incision together with the camera (C) and the port (P) through which it is passed removal, - port (P) and camera (C) into the mouth (3) extending outward from the abdomen (A) 1 O passing, - artificial volume by injecting gas into the body (2) through the mouth (3) creation, - cutting off the end of the protrusion (5) left out, - through the cut end of the protrusion (5) into the body (2) passing the morcellator (M), - by observing the sample (S) inside the body (2) with the camera (C) disintegration by morcellator (M), - by removing the protrusion (5) through which the morcellator (M) passes, (5) sealing the end, - fragmented sample (S) over the mouth (3) outside the abdomen (A) outside the abdomen of the body (2) in which the parts and the liquid are located. Includes withdrawal steps.
Bulusun tercih edilen uygulamasinda, çikintinin (5) kesilerek açilan ucu morselasyon islemi sonrasinda gövde (2) içerisindeki küçük doku parçalarinin ve sivinin batin (A) içerisine dökülmesini engellemek için sütür ile sizdirrnaz bir sekilde kapatilmaktadir. In the preferred embodiment of the invention, the cut-open end of the protrusion (5) After the morcellation process, small tissue pieces in the body (2) and To prevent the fluid from spilling into the abdomen (A), it is sealed with a suture. is being shut down.
Laparoskopi ameliyatlarinda karin içerisinden çikartilacak organ ya da hastalikli doku operasyon sirasinda bagli oldugu dokulardan kesme ve koagulasyon islemleri ile ayrilmaktadir. Bu asamadan sonra karin içerisinden çikartilacak organ ya da hastalikli doku karin içerisinde serbest olarak durur. Serbest kalan numune (S) laparoskopik kapali morselasyon poseti (1) içerisine alinir ve batin (A) disina Laparoskopik cerrahi operasyonun gerçeklestirilmesi amaciyla karin bölgesinde (A) açilan her biri 5 mm çapinda en az üç porttan (P) ortada yer alanin çapi öncelikle bulus konusu laparoskopik kapali morselasyon posetinin (l) arindan da kameranin (C) batin (A) içerisine alinmasi için 12-15 mm genisletilmektedir. Organ or diseased organs to be removed from the abdomen in laparoscopy surgeries cutting and coagulation of tissue from the tissues to which it is attached during the operation separated by their names. After this stage, the organ to be removed from the abdomen or the diseased tissue remains free in the abdomen. Released sample (S) is taken into the laparoscopic closed morcellation bag (1) and removed from the abdomen (A). In order to perform laparoscopic surgery in the abdominal region (A) the diameter of the middle one (P) of at least three openings, each 5 mm in diameter First of all, after the laparoscopic closed morcellation bag (l), which is the subject of the invention, It is expanded by 12-15 mm to accommodate the camera (C) in the abdomen (A).
Esnek bir metal aksam vasitasiyla cilt kesisi üzerinden batin (A) içerisine geçirilmekte ve batin (A) içerisinde agiz (3) açilmaktadir. Numune (S) açik olan agiz (3) üzerinden gövde (2) içerisine alinmaktadir. Morselatörün (M) ve diger laparoskopik enstrümanlarin gövde (2) içerisine alinabilmesi için çikintilar (5) bir metal aksam ile portlar (P) üzerinden batin (A) disina çikarilir ve batin (A) disinda kalan uçlari kesilerek gövde (2) içerisine uzanan kanallar olusturulmus olur. Bu asamada gövde içerisine hava veya CO2 gazi verilerek morselasyon isleminin gerçeklestirilecegi yapay bir hacim-alan yaratilmaktadir. Morselasyon islemi bitince morselatörün (M) poset (1) içine alindigi çikintinin (5) lümeni kapatilir. Into the abdomen (A) over the skin incision using a flexible metal part. and the mouth (3) is opened in the abdomen (A). Sample (S) is open It is taken into the body (2) over the mouth (3). Morcellator (M) and other protrusions (5) for taking laparoscopic instruments inside the body (2) It is taken out of the abdomen (A) through the ports (P) with the metal part and out of the abdomen (A) the remaining ends are cut and channels extending into the body (2) are formed. This At the next stage, the morcellation process is carried out by injecting air or CO2 gas into the body. an artificial volume-space is created in which Morcellation process When it is finished, the lumen of the protrusion (5) where the morcellator (M) is taken into the bag (1) is closed.
Morselatörün (M) poset (1) içine alindigi çikintinin (5) lümeninin kapatilmasi sonrasi poset (1) ve içerisindeki doku parçaciklari ve sivi-kan, göbek deligine karsilik gelen cilt kesisi üzerinden batin (A) disina alinir. Closing the lumen of the protrusion (5) where the morcellator (M) is taken into the bag (1) the bag (1) and the tissue particles and liquid-blood in it, into the navel The abdomen (A) is taken out through the corresponding skin incision.
Laparsokopik kapali morselasyon poseti (1) silikon bazli olmasi nedeni ile batin (A) içine atildiginda kendiliginden açilir. Latex bazli sisebilen poset (1) açildiktan sonra agizdan (3) alinmak istenen kitle posetin (1) içine yerlestirilir. Laparsokopik kapali morselasyon poseti (1) latexli nonoxynol-9, lambistik, poliüretan, poliisopren”den üretilebilir. Laparoscopic closed morcellation bag (1) is silicone-based. (A) opens by itself when thrown into it. After opening the latex-based inflatable bag (1) then the mass to be taken from the mouth (3) is placed in the bag (1). laparoscopic closed morcellation bag (1) nonoxynol-9 with latex, lambic, polyurethane, It can be produced from polyisoprene.
Bulus konusu laparoskopik kapali morselasyon poseti (1), trokar kesi yerinden batin (A) içerisine alinacak ve otomatik olarak agiz (3) kismi açilacaktir. ( 30 Geleneksel uygulamalardan farkli olarak, (tercihen lateks veya kauçuktan imal edilen) esneyerek sisebilen yapisi sayesinde batin (A) içerisine alinmadan önce küçük yapida olan ve trokar kesi yesi yerinden rahatlikla batin (A) içerisine alinan morselasyon poseti (1), batin (A) içerisinde numune (S) posetin içerisine alindiktan sonra sisirilecek ve bu sayede parçalayici (morselasyon) için yeterli hacim-alan kazanilmis olacaktir. Parçalanma (morselasyon) islemi sonrasinda içerisindeki gazin bosaltilmasi ile morselasyon posetinin (1) boyutu yeninde küçülecek ve batin (A) içerisinden geleneksel uygulamalara kiyasla daha rahat bir sekilde çikarilacaktir. The subject of the invention is the laparoscopic closed morcellation bag (1) from the trocar incision. It will be taken inside the abdomen (A) and the mouth (3) will be opened automatically. ( 30 Unlike traditional applications, (preferably made of latex or rubber) before being taken into the abdomen (A) thanks to its flexible and inflatable structure. which has a small structure and is easily taken into the abdomen (A) from the trocar incision. morcellation bag (1), sample (S) in the abdomen (A) into the bag After it is taken, it will be inflated and thus sufficient for morcellation. volume-area will be gained. After the disintegration (morcellation) process With the evacuation of the gas inside, the size of the morcellation bag (1) is restored. will be smaller and more comfortable inside the abdomen (A) compared to traditional applications. will be removed as follows.
Bulus konusu laparoskopik kapali morselasyon poseti (1), dis yüzeyinden disari dogru uzanan ve poset (1) içerigi ile devamlilik gösteren parmak benzeri 3-4 çikintiya (5) sahiptir. Morselasyon poseti (l) batin (A) içerisine alindiktan sonra, batin (A) içerisinde kalan agzi açilacak ve numune (S) posetin içerisine alinacaktir. Morselasyon posetinin (1) üzerinde yer alan çikintilar (5), laparoskopik tutucular ile tutularak cilt kesileri üzerinden batin (A) disarisina alinmaktadir. Benzer sekilde agiz (3) da, benzer bir laparoskopik tutucu ile disari alinmaktadir. Disari alinan agiz (3) batin (A) disarisinda açilacak ve kamera (C) ve içerisinden geçirildigi port (P) bu agiz (3) üzerinden geçirilmektedir. Poset (1) hava ile sisirilir ve sisirilen posetin (l) içerisine yerlestirilen port (P) yoluyla kamera (C) posetin içerisine alinmaktadir. Morselasyon posetinin batin (A) disina alinan parmak benzeri çikintilarindan (5) morselatörün (M) girecegi çikintinin (5) tepe kismi kesilerek morselatörün (M) parmak seklindeki çikintilari (5) üzerinden morselasyon posetinin (l) gövdesi (2) içerisine girmesi saglanmaktadir. Ihtiyaç duyulmasi halinde parmak seklindeki çikintilardan (5) biri farkli bir cilt kesisi üzerinden batin (A) disina çikarilmakta ve morselatör (M) de oldugu gibi çikintinin (5) kesilen ucu üzerinden farkli bir laparoskopik enstrüman (L) gövde (2) içerisine geçirilmektedir. Bu asamada posetin (l) içerisinde numune (S), kamera (C) ve morselatör (M) bulunacaktir. Böylece karin boslugu içerisinde ikinci bir yapay bosluk olusturulmus olacak ve numune (S) direk optik gözlem altinda parçalara ayrilarak batin (A) disina alinacaktir. The subject of the invention is the laparoscopic closed morcellation bag (1), protruding from the outer surface. 3-4 finger-like extending outwards and continuing with the contents of the bag (1) it has protrusion (5). After the morcellation bag (l) is taken into the abdomen (A), The mouth remaining in the abdomen (A) will be opened and the sample (S) will be placed in the bag. will be taken. The protrusions (5) on the morcellation bag (1), Out of the abdomen (A) over the skin incisions, holding it with laparoscopic holders. is taken. Similarly, the mouth (3) is removed with a similar laparoscopic holder. is taken. The extracted mouth (3) will open outside the abdomen (A) and the camera (C) and the port (P) through which it is passed is passed over this mouth (3). Bag (1) it is inflated with air and through the port (P) placed in the inflatable bag (l). the camera (C) is taken into the bag. Morcellation bag outside of the abdomen (A) one of the finger-like projections (5) taken from the projection (5) where the morcellator (M) will enter. the top part of the morcellator (M) is cut off over the finger-shaped protrusions (5). It is ensured that the morcellation bag (1) is inserted into the body (2). Need If heard, one of the finger-shaped protrusions (5) is a different skin incision. It is taken out of the abdomen (A) and the morcellator (M) is a different laparoscopic instrument (L) body over the cut end of the protrusion (5) (2) is passed in. At this stage, the sample (S) in the bag (l), camera (C) and morcellator (M). Thus, in the abdominal cavity A second artificial cavity will be created and the sample (S) will be subjected to direct optical observation. It will be taken out of the abdomen (A) by disassembling under it.
Parçalama (morselasyon) sonrasinda posetin (l) içerisinde elde edilen küçük doku parçalari ve sivi artiklar kalmaktadir. Morselasyon islemi sonrasinda batin (A) disina alinir ve morselatörün (M) girdigi çikintinin (5) açik kismi sütür ile baglanip kapatilmaktadir. Böylelikle morselasyon posetinin (l) batin (A) disina alinmasi sirasinda batin (A) içerisine sivi ve/veya kan bulasi yayilmasi (spillage dissemination) veya doku parçalarinin geçisi cngellenmektedir. The small tissue obtained in the bag (l) after shredding (morcellation) fragments and liquid residues remain. Abdomen after morcellation (A) is taken out and the open part of the protrusion (5) where the morcellator (M) enters is sutured. is connected and closed. Thus, the morcellation bag (l) goes outside the abdomen (A). Spread of fluid and/or blood into the abdomen (A) during removal (spillage dissemination) or the passage of tissue fragments is blocked.
Son olarak gövde (2) içerisindeki hava, kamera (C) portu (P) üzerinden bosaltilmakta ve morselasyon posetinin (l) boyutu yeniden trokar kesi yerinden kolayca çikarilabilecek boyuta getirilmektedir. Kamera portu (P) ve kamera (C) batin (A) disina alinmakta ve morselasyon poseti (1) batin (A) disinda kalan agiz (3) üzerinden çekilerek cilt kesisi üzerinden disari çikarilmaktadir. Morselasyon posetinin (l) öncelikle gövde (2) kismi sonrasinda çikintilari (5) batin (A) disina çikacaktir. Çikintilarin (5) kesik ucu sütür ile baglandigi için bu kesikler üzerinden sivi ve/veya kanin ve küçük doku parçalarinin batin (A) içine sizmasi engellenmektedir. Finally, the air inside the body (2) passes through the camera (C) port (P). It is emptied and the size of the morcellation bag (l) is re-displaced from the trocar incision. is sized to be easily removed. Camera port (P) and camera (C) The mouth is removed from the abdomen (A) and the morcellation bag (1) is outside the abdomen (A). (3) it is pulled out over the skin incision. morcellation first of the body (2), then the protrusions (5) out of the bottom (A) of the plastic bag (l) will come out. Since the cut ends of the protrusions (5) are tied with sutures, these incisions leakage of fluid and/or blood and small pieces of tissue from the inside of the abdomen (A) is blocked.
Bulus konusu laparoskopik kapali morselasyon poseti (1), özellikle jinekolojik laparoskopik cerrahi operasyonlarda batin (A) içerisinden kati cerrahi numunelerinin (S) batin (A) disina alinmasini ve bu islem sirasinda gerçeklestirilen laparoskopik morselasyon islemini kolaylastirmaktadir. Daha da önemlisi morselasyon islemi sirasinda numune (S) alinan hastalikli bölümden batin (A) içerisine dagilmanin temasin dolayisiyla da batin (A) içerisine bu hastaligin dagilmasi önlenmektedir. Geleneksel uygulamalarin en temel sorunlarindan biri olan ve uluslararasi saglik kuruluslarinin da üzerinde siklikla durduklari bu konunun giderilmesi bu cerrahi operasyonlarin sonrasinda güven yaratacaktir. Laparoskopik cerrahide kati numunenin (S) batin (A) disina alinmasi özellikle myomektomi ve subtotal histerektomi operasyonlarinda gerçeklestirilmektedir. The subject of the invention is the laparoscopic closed morcellation bag (1), especially for gynecological solid surgery through the abdomen (A) in laparoscopic surgical operations samples (S) to be taken out of the abdomen (A) and during this process facilitates the laparoscopic morcellation procedure. even more most importantly, from the diseased part from which the sample (S) was taken during the morcellation process. Due to the dispersion in the abdomen (A) and the contact, this flow into the abdomen (A) spread of the disease is prevented. The most basic of traditional practices which is one of the most common problems of international health organizations Elimination of this issue, which they stopped, can be confident after these surgical operations. will create. Removal of the solid sample (S) from the abdomen (A) in laparoscopic surgery especially in myomectomy and subtotal hysterectomy operations is carried out.
Bulus konusu laparoskopik kapali morselasyon posetinin (l) geleneksel uygulamalardan farkli kilan iki temel yönü bulunmaktadir. Bunlardan birincisi morselasyon posetinin (l) sisirilme ile genlesebilir elastik bir malzemeden imal edilmesidir. Böylelikle küçük boyutlarda üretilmesine ragmen laparoskopik ameliyat sirasinda batin (A) içerisindeyken daha büyük bir hacme sahip olabilmektedir. Ikinci olarak morselasyon posetinin gövdesinden (2) disari dogru uzanan ve ucu kapali bir kanal formunda olan çikintilarin (5) bulunmasidir. Bu çikintilar (5) morselasyon posetinin (1) sisirilmesi sonrasinda portlardan (P) batin (A) disarisina çikarilmakta uçlari kesilerek laparoskopik enstrümanlarin (L) ve morselatörlerin (M) gövde (2) ve dolayisiyla batin (A) içerisine alinmasini saglayan kanal görevini görmektedir. Bulus konusu morselasyon poseti (l) sayesinde gövde (2) içerisine alinan numunenin (S) parçalanmasi gövde (2) içerisinde gerçeklestirilmekte ve morselasyon (parçalanma) sonrasi, morselasyon poseti herhangi bir sizinti veya doku parçasinin batin (A) içerisinde birakilmasi olmaksizin batin (A) disina çikarilabilmektedir. Böylelikle herhangi bir hastalikli dokunun batin içerisine dagilmasinin da önüne geçilmektedir. The subject of the invention is the traditional laparoscopic closed morcellation bag (l). There are two main aspects that make it different from the applications. The first of these The morcellation bag (l) is made of an elastic material that can be expanded by inflating. is to be done. Thus, although it is produced in small sizes, laparoscopic has a larger volume while in the abdomen (A) during surgery can happen. Second, out of the body (2) of the morcellation bag. It is the presence of protrusions (5) that extend and are in the form of a closed channel. This protrusions (5) after inflating the morcellation bag (1), insert from the ports (P) (A) is taken out, the ends are cut off and the laparoscopic instruments (L) and Morcellators (M) are taken into the body (2) and therefore the abdomen (A). acts as a supply channel. Morcellation bag (l) which is the subject of the invention fragmentation of the sample (S) taken into the body (2) by means of the body (2). It is carried out in and after morcellation (fragmentation), morcellation leaving any leaks or tissue fragments in the abdomen (A) It can be taken out of the abdomen (A) without Thus, any disease It is also prevented that the tissue is dispersed into the abdomen.
Bulus konusu laparoskopik kapali morselasyon poseti (1) sayesinde numune (S) kapali bir ortamda parçalanmakta ve batin (A) disina bu sekilde alinabilmekte ve geleneksel benzer uygulamalara kiyasla daha hizli ve ameliyat süresi uzamadan bunu gerçeklestirilebilmektedir. Laparoskopik morselasyon böylelikle daha hizli ve daha kolayca gerçeklestirilebilmektedir. Islemin kapali bir poset içerisinde gerçeklestirilmesi sayesinde hastalikli numunenin (S) batin (A) içerisine yayilma riskinin önüne geçilmektedir. Laparoskopik cerrahi yolla numunenin (S) çikartilmasi islemi kolaylasacagi için açik cerrahi gerçeklestirilecek olan durumlarda laparoskopik yolla operasyonun yürütülebilmesi daha mümkün olacak ve laparoskopik cerrahiden faydalanabilecek hastalarin sayisi artacaktir. Sample (S) thanks to the laparoscopic closed morcellation bag (1), which is the subject of the invention It disintegrates in a closed environment and can be taken out of the abdomen (A) in this way and faster and without prolonging the operation time compared to traditional similar applications this can be realized. Laparoscopic morcellation is thus faster and more easily implemented. Your transaction is in a sealed bag spreading of the diseased sample (S) into the abdomen (A) risk is avoided. (S) of the sample via laparoscopic surgery Since it will facilitate the removal process, open surgery will be performed. In such cases, it will be more possible to carry out the operation by laparoscopic method. and the number of patients who can benefit from laparoscopic surgery will increase.
Claims (8)
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| Application Number | Priority Date | Filing Date | Title |
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| TR2014/12735A TR201412735A2 (en) | 2014-10-30 | 2014-10-30 | A laparoscopic closed morselayon bag and its method of use. |
| PCT/TR2015/050154 WO2016068825A1 (en) | 2014-10-30 | 2015-10-28 | A laparoscopic enclosed morcellation bag and its usage method |
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| TR2014/12735A TR201412735A2 (en) | 2014-10-30 | 2014-10-30 | A laparoscopic closed morselayon bag and its method of use. |
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| Publication Number | Publication Date |
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| TR201412735A2 true TR201412735A2 (en) | 2016-05-23 |
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| TR2014/12735A TR201412735A2 (en) | 2014-10-30 | 2014-10-30 | A laparoscopic closed morselayon bag and its method of use. |
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| TR (1) | TR201412735A2 (en) |
| WO (1) | WO2016068825A1 (en) |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| EP3471627A4 (en) | 2016-06-16 | 2020-02-19 | Ark Surgical Ltd. | Tissue containment device for use in surgical procedures |
| EP3509501A1 (en) | 2016-09-10 | 2019-07-17 | Ark Surgical Ltd. | Laparoscopic workspace device |
| CN110123421A (en) * | 2019-04-18 | 2019-08-16 | 朱育春 | Single-hole laparoscopic multifunctional channel |
| CN111991040B (en) * | 2020-08-27 | 2023-06-23 | 成都市妇女儿童中心医院 | Laparoscopic surgery exposing device |
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| US5037379A (en) | 1990-06-22 | 1991-08-06 | Vance Products Incorporated | Surgical tissue bag and method for percutaneously debulking tissue |
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| DE9109389U1 (en) | 1991-07-30 | 1991-10-24 | Martini-Eggert, Karin, 2000 Hamburg, De | |
| US5352184A (en) | 1992-03-12 | 1994-10-04 | Uresil Corporation | Reservoir for enclosing and retrieving body specimens |
| DE4220785C2 (en) | 1992-06-25 | 1994-09-22 | Udo Dr Auweiler | Laparoscopic pouch |
| DE4242153C2 (en) | 1992-12-14 | 1994-09-08 | Rainer Dr Deckardt | Pick-up and retrieval bags for minimally invasive surgery, as well as device for emptying the bag |
| US5785677A (en) | 1993-06-22 | 1998-07-28 | Auweiler; Udo | Laparoscopy bag |
| US5618296A (en) | 1995-07-24 | 1997-04-08 | Endomedix Corporation/Box 330 | Tissue morcellator system and method |
| US5735289A (en) | 1996-08-08 | 1998-04-07 | Pfeffer; Herbert G. | Method and apparatus for organic specimen retrieval |
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| JP2000037388A (en) | 1998-05-20 | 2000-02-08 | Osamu Yoshida | Organ housing bag and organ housing bag inserter |
| US6206889B1 (en) | 1998-06-26 | 2001-03-27 | Roberto Bennardo | Device for removing anatomical parts by laparoscopy |
| US20040158261A1 (en) * | 2002-05-15 | 2004-08-12 | Vu Dinh Q. | Endoscopic device for spill-proof laparoscopic ovarian cystectomy |
| US6685628B2 (en) | 2002-05-15 | 2004-02-03 | Dinh Q. Vu | Endoscopic balloon for spill-proof laparoscopic ovarian cystectomy |
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| JP2017510413A (en) * | 2014-04-03 | 2017-04-13 | ヴェオル メディカル テクノロジーズ ピーブイティー． リミテッド | Tissue isolator |
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| WO2016068825A1 (en) | 2016-05-06 |
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