CN101077310A - Hernia repair device - Google Patents
Hernia repair device Download PDFInfo
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- CN101077310A CN101077310A CN 200610078408 CN200610078408A CN101077310A CN 101077310 A CN101077310 A CN 101077310A CN 200610078408 CN200610078408 CN 200610078408 CN 200610078408 A CN200610078408 A CN 200610078408A CN 101077310 A CN101077310 A CN 101077310A
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- hernia
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Abstract
The repairing unit for no-tension inguinal hernia repairing operation includes one bottom sheet for being set on the peritoneum front gap, one surface sheet for being sett on the transverse fascia, and one connecting body for being set in the hernial ring to connect the bottom sheet and the surface sheet. The circular bottom sheet and surface sheet are set separately on two ends of the connecting body coaxially, and the axial projection of the surface sheet is fallen within that of the bottom sheet. The present invention is one kind of 3D repairing sheet with short operation period, high safety and good post-operational effect.
Description
Technical field
The present invention relates to the device repaired of defective in the tissue, being specifically related to inguinal hernia does not have the used repair apparatus of tension force kposthesis.
Background technology
Hernia is the weak or rimose zone of abdominal muscles, cause internal organs or tissue via weak spot to external outstanding formation.Common cause is to have: congenital local stomach wall weakness; Posteriority stomach wall weakness is as the old people; Be engaged in heavy physical labour for a long time; Perhaps some disease causes that long-term abdominal pressure increases, as the chronic cough that chronic bronchitis causes, and dysuria that prostate hyperplasia causes and habitual constipation etc.
Hernia has a variety of, can be according to it in the position of stomach wall or concrete genetic classification.Inguinal hernia is modal hernia, is longer than " internal ring " position of stomach wall, and the male is easy to morbidity than the women.
The unique method of treatment hernia is to implement operation.The surgical operation of repairing hernia mainly contains two big classes: tension force reparation and do not have the tension force reparation.
When adopting tension force to repair, the doctor will give prominence to and organize Hui Na in the abdominal cavity at the position of patient's celiocele otch, hernia portion be sewed up again, promptly adopt the repairing of tissues, tissue, expense is low, simple to operate, but postoperative is painful big, recover slow, and relapse rate is higher, is approximately 10%-15%.
About the existing several different methods of no tension force reparation, introduce modal several method below.
The plain net repairing method
Behind the otch, a slice plain net sheet is sewed up along hernia above outstanding tissue.This method is not suitable for bigger hernia, need carry out relatively large stitching for reinforcing, and can increase the risk of nerve injury.Hernia ring fill-type kposthesis:
Shortcoming is that suture tension force is too high, and some patients are because of feeling that the extruding of filling sheet does not feel well for a long time.Because of the contraction of filling sheet can cause recurrence, or make tissue depart from original position.
Laparoscopic hernia repair
Laparoscopic hernia repair surgery cost height needs general anesthesia, pneumoperitoneum, and can affect to breathing and circulation, the doctor lacks the hands sense of touch, and vision becomes two dimension from three-dimensional, and need special apparatus, late result and complication are still indeterminate in addition, thereby have limited its development.
The looped network repairing method:
It is another kind of rear portion recovery technique.This net sheet is surrounded by fixed external rings, helps to fix.Whether shortcoming is that the easy postoperative of external rings causes the pain discomfort, and be difficult to observe the net sheet correctly open behind the location.
Three dimensional network sheet repairing method:
Have in recent years a kind of 3 D stereo product is provided, prior art provides the product of three kinds of sizes at present, referring to Fig. 2, Fig. 3 and Fig. 4 illustrate the hernia mending device (11 of multi-form correlation technique respectively, 12,13), this device comprises: top layer sheet (111,121,131), repair on the stomach wall surface; Bottom chip (113,123,133) carries out the rear portion and repairs in the stomach wall inboard; And, the middle cylindrical net sheet (112,122,132) that links to each other.Material therefor is the filament knotting plain net that can not absorb, and is used to strengthen or connect the fault location of inguinal hernia, to provide support when wound recovers.After the net sheet was implanted, very thin one deck tissue fibers can be sticked and through the interstital growth on the net sheet, the net sheet be combined with tissue.It is soft that the net sheet keeps, and can not produce infringement to wound healing.The material of net sheet can not absorb, and also can not weakened because of the effect of histaminase.
The three dimensional network sheet of prior art is flat-shaped at abdominal part, makes the human body postoperative more comfortable, and compares with other products and to be not easy to be moved, and the location has reduced the requirement of sewing up with fixing more convenient.The special advantage of this product is, realized the rear portion repairing with better simply operational approach, thereby more reliable hernia reparation is provided, and obtains the approval of this area.
The product that provides on the market has three kinds of forms, specifically sees Table 1.
Table 1 commercially available prod gauge size
| Component names | Comparative example 1 | Comparative example 2 | Comparative example 3 |
| Top layer sheet (rectangular, two semicircle) | The long 10.00cm of wide 4.5cm | The long 10.00cm of wide 4.5cm | The long 12.5cm of wide 5.5cm |
| Connector (column) | The high 1.27cm of diameter 1.91cm | The high 1.27cm of diameter 1.91cm | The high 1.27cm of diameter 1.91cm |
| Bottom chip (circle) | Diameter 7.50cm | Diameter 10.00cm | Diameter 10.00cm |
Through application in practice, the inventor finds that still there is certain deficiency in this technology, the tool leeway that has greatly improved.
In clinical practice, the inventor finds this technology, and there are the following problems.
Be the problem that better understanding is found, at first concise and to the point the description utilizes the three dimensional network sheet to carry out the step that inguinal hernia is repaired:
Step 1: gap under the free obliquus externus abdominis m. aponeurosis (aponeuroses), can be suitable for placing the top layer sheet.
Step 2: fully free hernical sac.
Step 3: hernical sac Hui Na.
Step 4: the preperitoneal space that dissociates from inside to outside, or be referred to as " preperitoneal spaceization ".
Step 5: suitably mode places sticking patch the preperitoneal space of separator well.
Step 6: the upper strata sticking patch is extracted out gently, be able to the smooth preperitoneal space that is positioned over fully until lower floor's sticking patch.Describe for convenient, hereinafter this step is abbreviated as " rear portion repairing ".
Step 7: the upper strata sticking patch is placed under the obliquus externus abdominis m. aponeurosis (aponeuroses) in the gap, needs simultaneously sticking patch is covered in the scope above arciform lower edge of transversus abdominis m. and pubic tubercle.With upper strata sticking patch sutured at the middle part of pubic tubercle and transversus abdominis m., and, the upper strata sticking patch is made a spermatic cord opening, after the processing it is closed, be sewn to the inguinal ligament edge.Periphery at sticking patch is made sutured.At last spermatic cord and ilioinguinal nerve are positioned over the surface of sticking patch.Describe for convenient, hereinafter this step is abbreviated as " upper strata repairing ".
In aforesaid operations, first problem is, the bottom chip of prior art is bigger, be placed on the dark face of blood vessel under the stomach wall, be covered in the Bogros gap, protect whole pectineus hole, but in the Bogros gap, have the vein ring (ilium shame vein, hemorrhoidal veins) that can cause active hemorrhage; May there be ilium shame tremulous pulse in gap location under a few cases, and separation might cause hemorrhage.
The bottom chip that prior art provides is generally circular piece, and general diameter is 10.00cm, and minimum diameter has 7.50cm.As in above-mentioned step 2, need fully free hernical sac in the operation process, isolate preperitoneal space, to be used for that bottom chip is placed this gap, realize the repairing of abdomen rear portion.Because herein tissue blood vessel is abundant, cause easily excessive hemorrhage, and cause repair apparatus insert comparatively difficulty of operation, thereby require the doctor that skilled operational capacity is arranged, thereby cause the difficulty of operation.Further, operation for convenience, this device connector length is 1.27cm normally, this length is not the human comfort optimum selection, but some have slightly been grown, so that the doctor carries out the operation that sticking patch is inserted preperitoneal space, clinical effectiveness shows that this connector is to cause postoperative patient sensation foreign body and uncomfortable main cause.
In addition, the top layer sheet of this product is for laterally longer, and two round sheet longly is 10.00cm to 12.50cm, wide is 4.50 to 5.50cm, it approaches the plain net sheet that adopts in the plain net prothesis, thereby its sewing method also is similar to plain net repairs, for the male patient, in step 7, the upper strata sticking patch to be made a spermatic cord opening, after the processing it be closed, be sewn to the inguinal ligament edge.This handles step also is time-consuming step in the operation, has improved the difficulty of operation, has prolonged operating time.
Summary of the invention
The technical problem to be solved in the present invention is the above-mentioned problem of finding in clinical practice, provides a kind of easier of surgeon's operation, shortens operation time, reduce tissue injury, and can further reduce the postoperative sense of discomfort, thereby improve the hernia repairing effect, and ensure the reparation reliability.
For addressing the above problem, the invention provides a kind of hernia mending device, comprise bottom chip, be used to be placed on the stomach wall inboard; The top layer sheet is used to be placed on stomach wall table side; And connector, be used to be placed on hernia ring place, and connect described bottom chip and described top layer sheet, wherein, described bottom chip and described top layer sheet all have circular contour, are set in parallel in described connector two ends, and coaxial with described connector.When described axle axially on projection, the outline projection of described top layer sheet all drops within the outline projection of described bottom chip.
Further, described bottom chip outline diameter is less than 7.50cm, and connector higher primary school is in 1.27cm, and top layer sheet outline diameter is less than 4.50cm.
Most preferred scheme provided by the invention is hernia mending device bottom chip outline diameter 6cm, connector height 1.0-1.2cm, and top layer sheet outline diameter 4.0cm.
The improvement of above-mentioned size and structure and adjustment, applicant's careful observation and summarizing from clinical practice proposes, and by above-mentioned improvement, has obtained beat all good result, thereby has solved above-mentioned technical problem, and realized purpose of the present invention.To be specifically addressed construction features of the present invention hereinafter, and beneficial effect of the present invention will be described.
At first, referring to Figure 1A and Figure 1B, on the profile of the present invention be with the most tangible difference of prior art products, the top layer sheet is circular, and, when hernia mending device axially on during projection, the outline projection of described top layer sheet all drops within the outline projection of described bottom chip, anticipate promptly, top layer sheet outline is less than the outline of bottom chip.
The top layer sheet of the relevant hernia mending device of prior art is a strip, transverse ends is circular, its width is 4.50cm to 5.50cm, length is 10.00cm to 12.50cm, and this top layer sheet function is equivalent to plain net repairs, in order to handle spermatic cord, need in the horizontal the one side in axle center to cut off the net sheet in the operation, form two relatively long fins, spermatic cord is wrapped in the middle of two fins, and then carry out sutured.
Comparatively speaking, top layer of the present invention chip size obviously reduces, and it outwards is evenly to extend from the connector top, thereby constitutes circular outline, is used to provide " upper strata repairing ".Because size reduces, thus the minimizing of required sewing needle number, simultaneously,, only need simple opening for avoiding spermatic cord, need not special additional seams and handle, therefore, substantially simplified the operation in the above-mentioned steps, and shortened operating time.
This structure is based on following consideration, when adopting the three dimensional network chip technology to carry out defect repair, the bottom web sheet has been realized the theory that repair at the rear portion, being equivalent to provides repairing from the inside of a bucket to it, it is enough to provide needed repairing intensity, at this moment, in fact repairing desirable strength in top layer requires and can reduce greatly, can not influence repair efficiency, though thereby dwindled the repairing area on top layer, reduce and tissue attachment, but in fact can not influence repair efficiency, thereby can simplify the operation, the processing that easier realization spermatic cord of while passes, and littler near the interference of tissue.
Second aspect in the hernia mending device of the present invention, compared with prior art, has reduced the bottom chip outline diameter.The inventor finds that in clinical practice the bottom chip of prior art is bigger, has exceeded the required size of actual repairing.Satisfying under the prerequisite of repairing intensity, dwindle this size, mean in above-mentioned steps four, promptly in " preperitoneal spaceization " step, can reduce separation, thereby reduce surgical procedures in blood vessel and neural abundant zone for preperitoneal space, operating difficulty and risk have been reduced, further, step 6 " rear portion repairing " is simplified easier operation.
The third aspect in the hernia mending device of the present invention, compared with prior art, has reduced the connector height.The connector height of prior-art devices is not enough optimization for meeting people's bulk properties, and its length is bigger, promptly, it slightly is longer than the distance between peritoneum and the transverse fascia, therefore, the thin partially patient of health has uncomfortable sensation after the operation, becomes the main cause that causes the long-term sense of discomfort of patient.Technical scheme of the present invention provides the scheme of more optimizing by reducing the connector height, thus the postoperative effect that improves.
In addition, the present invention adopts polypropylene monofilament braiding, and the relevant device of prior art adopts the sticking patch structure of mariages, and between the mariages to adhere to relative monofilament structure bacterial adhesion probability big slightly, and implant the back patient reaction sticky feeling arranged.
In sum, adopt structure of the present invention after, reduced linked groups's separation, simplified operation technique, shortened the operating time, and more optimized because of structure and to have improved postoperative effect.Modern medical mode is not only to solve physiological disease, more pays attention to improving patient's psychology and life quality.Propose in the stomach wall surgery special meeting of China medical association in August, 2003: the hernia operations treatment should reach the standard that pain is light, rehabilitation duration is short, relapse rate is low, complication is few.The improvement of this operation art formula and the renewal of material meet this demand.
Description of drawings
In conjunction with the drawings to the explanation of the preferred embodiment for the present invention, the present invention may be better understood and purpose and advantage, wherein:
Fig. 1 is the hernia mending device structural representation of this invention, and Figure 1A is a vertical view, and Figure 1B is a front view;
Fig. 2 is a comparative example 1, the hernia mending device structural representation that a kind of prior art is relevant, and Fig. 2 A is a vertical view, Fig. 2 B is a front view;
Fig. 3 is a comparative example 2, the hernia mending device structural representation that another prior art is relevant, and Fig. 3 A is a vertical view, Fig. 3 B is a front view; And
Fig. 4 is a comparative example 3, the hernia mending device structural representation that another prior art is relevant, and Fig. 4 A is a vertical view, Fig. 4 B is a front view.
The specific embodiment
Preferred implementation according to the present invention is below described hernia mending device of the present invention.As shown in Figure 1, Fig. 1 is the structural representation of hernia mending device 10 of the present invention, and Figure 1A is a vertical view, and Figure 1B is a front view.
Hernia mending device 10 comprises: bottom chip 103 is used to be placed on the stomach wall inboard; Top layer sheet 101 is used to be placed on stomach wall table side; And connector 102, have roughly cylindricly, be used to be placed on hernia ring place, and connect described bottom chip 103 and described top layer sheet 101.Wherein, bottom chip 103 and top layer sheet 101 all have circular contour, are set in parallel in the two ends of connector 102, and coaxial with connector.
The material of this hernia mending device 10 can be the organic synthesis material that can meet the demands, for example polyester, polypropylene, politef etc.Ideal sticking patch should satisfy following aspect: body does not repel (rejection), does not cause infection (infectivity), fixed performance good (stationarity), and, host's tissue can grow into (growing into property of host) in the sticking patch.
Studies have shown that the advantage of polypropylene sticking patch has: 1) but cutting and be applicable to the abdominal-wall defect of arbitrary size, 2) can tolerate bending and infection, 3) and in the zoopery during pyogenic infection granulation tissue still can breed in the polypropylene sticking patch.
In addition, in polyester, polypropylene, politef, polypropylene sticking patch foreign body reaction minimum, it is 260 (about 127 ℃) that this material has very strong tensile strength, good, the anti-a lot of chemical substances of flexibility, softening temperature, can be soaked into by connective tissue after the implantation.Therefore, preferably adopt polypropylene material in the present invention.
The preferred du pont company polypropylene material that adopts is made hernia mending device of the present invention, and thickness is about 0.4mm to 0.6mm, and the thick partially net sheet of preferred 0.6mm increases to improve support force, and competent connection power is provided.
The net sheet preferably adopts the monofilament braiding, and the sticking patch of monofilament braiding has roomy gap, be difficult for the concealment antibacterial, and neutrophil cell can be come in and gone out.Under the effect of organizing the endogenous fibrin gel, sticking patch just was adhesively fixed in a few minutes.Surface and relative roomy space that sticking patch is slightly crude, but the fibroblast reaction increased, promote a large amount of fibroblasts to enter in the sticking patch.These zooperies prove.
Further introduce hernia mending device 10 most preferred sizes of the present invention, its bottom chip 103 is that diameter is the sticking patch of 6.0cm, insert in the preperitoneal space through the hernia ring, and be target with the transverse fascia weak area around the repairing hernia ring; What be connected with bottom chip 103 is that a diameter is 2.0cm and highly is the connector 102 of 1.0-1.2cm, and this connector 102 is inserted hernia ring place.The border, upper end of connector 102 and the top eaves of wide 1.0cm join, and this top eaves has constituted the top layer sheet 101 of hernia mending device 10, the about 4.0cm of outline diameter.During operation the attached fascia transversalis around top eaves and the hernia ring is sewed up, suture is about 1cm at interval, and net was filled in before stitch points had been fixed whole peritoneum apart from eaves edge 0.6cm.
The three dimensional network sheet treatment step of operating procedure and prior art is similar, difference comparatively speaking is: 1) isolate the required separating area of preperitoneal space and reduce, 2) reduce owing to the bottom chip size, thereby its easier smooth expansion, by sticking patch thickness being selected and the material selection, further strengthened the power of opening of bottom chip, make down synusia location and maintenance easily, thereby realize " rear portion repairing ", 3) because aforesaid operations is more easy, thereby further guarantee can be adopted the connector length that more meets the characteristics of human body, promptly shortens connector length, to alleviate or to eliminate the foreign body sensation of postoperative patient, 4) the top layer sheet reduces, save unnecessary sew application, made the processing of dodging spermatic cord more easy, greatly shortened operating time.
The whole surgery process only needs half an hour to one hour, otch intradermic suture about 3cm, the postoperative appearance is good, postoperative is all painful little in the art, and local anaesthesia patient's postoperative gets final product out-of-bed activity, need not to take out stitches, most patients can not be in hospital, and week back rehabilitation also recovers normal live and work.
The present invention can have other embodiment, one of ordinary skill in the art will readily recognize that the present invention comes down to from different starting points prior art to be changed, at first changed the size and dimension of top layer sheet, next has reduced the size of bottom chip, has further shortened the length of connector.Therefore, those skilled in the art adopt combinations thereof to change easily and propose numerous embodiments.
Therefore, will be understood that present embodiment and embodiment are illustrative and nonrestrictive, and the present invention is not limited to the details that this paper provides, but can in the scope of claims and equivalent replacement, changes.
The Reference numeral list
10 hernia mending devices
11 hernia mending devices (prior art)
12 hernia mending devices (prior art)
13 hernia mending devices (prior art)
101 top layer sheets
111 top layer sheets
121 top layer sheets
131 top layer sheets
102 connectors
112 connectors
122 connectors
132 connectors
103 bottom chips
113 bottom chips
123 bottom chips
133 bottom chips
Claims (8)
1. hernia mending device comprises:
Bottom chip is used to be placed on preperitoneal space;
The top layer sheet is used to be placed on the transverse fascia; And
Connector is used to be placed on hernia ring place, and connects described bottom chip and described top layer sheet,
Wherein, described bottom chip and described top layer sheet all have circular contour, are set in parallel in described connector two ends, and coaxial with described connector, when described axle axially on projection, the outline projection of described top layer sheet all drops within the outline projection of described bottom chip.
2. hernia mending device according to claim 1, wherein said top layer sheet outline diameter is less than 4.50cm.
3. hernia mending device according to claim 1, wherein said bottom chip outline diameter is less than 7.50cm.
4. hernia mending device according to claim 1, the height of wherein said connector is less than 1.27cm.
5. hernia mending device according to claim 1, wherein said bottom chip outline diameter 6cm, described connector height 1.0-1.2cm, and described top layer sheet outline diameter 4cm.
6. according to the described hernia mending device of claim 1-5, wherein said top layer sheet is made of the eaves portion that is connected with described connector cylinder-shaped upper part outer rim.
7. according to the described hernia mending device of claim 1-5, be to weave by polypropylene monofilament.
8. hernia mending device according to claim 7, net sheet thickness is 0.55mm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 200610078408 CN101077310A (en) | 2006-05-24 | 2006-05-24 | Hernia repair device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 200610078408 CN101077310A (en) | 2006-05-24 | 2006-05-24 | Hernia repair device |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN101077310A true CN101077310A (en) | 2007-11-28 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 200610078408 Pending CN101077310A (en) | 2006-05-24 | 2006-05-24 | Hernia repair device |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN101077310A (en) |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102058442A (en) * | 2010-12-21 | 2011-05-18 | 常州市三联星海医疗器械制造有限公司 | Compound anti-adhesion herniorrhaphy tablet and manufacturing method thereof |
| CN102217957A (en) * | 2011-06-03 | 2011-10-19 | 雷泽华 | Transabdominal children hernial sac closer |
| CN104203123A (en) * | 2012-02-13 | 2014-12-10 | 因赛特拉医药公司 | Implant for hernia repair |
-
2006
- 2006-05-24 CN CN 200610078408 patent/CN101077310A/en active Pending
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102058442A (en) * | 2010-12-21 | 2011-05-18 | 常州市三联星海医疗器械制造有限公司 | Compound anti-adhesion herniorrhaphy tablet and manufacturing method thereof |
| CN102217957A (en) * | 2011-06-03 | 2011-10-19 | 雷泽华 | Transabdominal children hernial sac closer |
| CN104203123A (en) * | 2012-02-13 | 2014-12-10 | 因赛特拉医药公司 | Implant for hernia repair |
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