CN110946650A - Double-layer anti-adhesion bag-shaped hernia repair method and system - Google Patents
Double-layer anti-adhesion bag-shaped hernia repair method and system Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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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
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/04—Macromolecular materials
- A61L31/048—Macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06F—ELECTRIC DIGITAL DATA PROCESSING
- G06F18/00—Pattern recognition
- G06F18/20—Analysing
- G06F18/21—Design or setup of recognition systems or techniques; Extraction of features in feature space; Blind source separation
- G06F18/211—Selection of the most significant subset of features
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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
- A61B2017/00238—Type of minimally invasive operation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/107—Visualisation of planned trajectories or target regions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
Abstract
The invention belongs to the technical field of hernia repair, and discloses a double-layer anti-adhesion bag-shaped hernia repair method and a double-layer anti-adhesion bag-shaped hernia repair system, wherein a cutter with a preset shape is used for cutting a double-layer anti-adhesion hernia repair patch into a preset size and shape through ultrasonic waves; sterilizing the external skin of the site to be operated and injecting an anesthetic; placing the double-layer anti-adhesion hernia repair patch at an accurate and proper position under the guidance of a laparoscope, and sewing the hernia repair patch and the local tissue into a bag shape by using a puncture fixing needle; performing ligation hemostasis on the large and small bleeding points; the minimally invasive wound on the surface of the skin is sutured by using an absorbable surgical thread, and then is disinfected and bandaged. The invention uses the ABUS technology to effectively and reliably extract the features, has high efficiency and can effectively improve the classification precision of the three-dimensional ultrasonic image of the lightweight incisional hernia patch. The double-layer anti-adhesion repairing patch used by the invention is a light-weight patch, has small foreign body residual quantity, firmly grows on the abdominal wall after being implanted, has good anti-adhesion effect and ensures the operation effect.
Description
Technical Field
The invention belongs to the technical field of hernia repair, and particularly relates to a double-layer anti-adhesion bag-shaped hernia repair method and system.
Background
Currently, the closest prior art:
hernia refers to the condition that one part of human tissue or organ leaves the original position and enters another position through gaps, defects or weak parts of the human body, and on average, 500 tens of thousands of people are diagnosed with hernia every year, wherein the hernia is the most common, and particularly, the hernia in the inguinal region accounts for about 90% -95% of the hernia. Hernia is usually not self-healed and can be healed by hernia repair. Hernia repair is one of the most common types of surgery. The traditional hernia repair is a tissue-to-tissue hernia repair technique, but the method has the disadvantages of long operation time and postoperative recovery time, great pain, high recurrence rate and less use. Instead, there is no tension hernia repair, proposed by Lichtenstein in 1989 in the united states journal of surgery. The method uses prosthesis material to replace local tissue defect, conforms to normal physiological anatomy, has no joint tension, small operative injury, no need of limiting physical activity after operation, quick recovery, small pain, low complication incidence and low hernia recurrence rate. Despite the variety of hernia patches, clinical studies have found that there are still many problems in the performance of current hernia patches, such as postoperative infection and secondary infection, postoperative recurrence, pain caused by foreign body sensation.
Meanwhile, due to the unicity of materials and structures, the prior art is difficult to ensure that the patch is well fused with the abdominal wall and the adhesion between the patch and internal organs can be reduced. Adhesions are the main cause of postoperative complications such as chronic pelvic pain, small intestinal obstruction, etc. caused in operations involving the peritoneum, and are the result of peritoneal injury and inflammation. At the site of peritoneal damage, the permeability of the blood vessels is increased to form inflammatory infiltrates and a fibrin matrix is locally formed. These fibrin matrices form fibrin bundles between adjacent tissues, and once fibroblasts invade the fibrin bundles and cause collagen deposition, clinically visible adhesions form.
Therefore, there is a need for a new anti-adhesion hernia repair method to overcome the drawbacks of the prior art and solve the problems in the prior art.
In summary, the problems of the prior art are as follows:
(1) the prior art has the problems of postoperative infection and secondary infection, postoperative recurrence, pain caused by foreign body sensation and the like.
(2) Due to the unicity of materials and structures, the prior art is difficult to ensure that the patch is well fused with the abdominal wall, and the adhesion between the patch and internal organs is difficult to reduce.
Disclosure of Invention
Aiming at the problems in the prior art, the invention provides a double-layer anti-adhesion bag-shaped hernia repair method and a double-layer anti-adhesion bag-shaped hernia repair system.
The invention is realized in such a way that a double-layer anti-adhesion bag-shaped hernia repair method comprises the following steps:
step one, preoperative preparation: and cutting the prepared double-layer anti-adhesion hernia repair patch into a preset size and shape by adopting a cutter with a preset shape through ultrasonic waves.
Step two, disinfection and anesthesia: the external skin of the site to be operated was disinfected with an alcohol cotton ball and injected with anesthetic.
And step three, placing the double-layer anti-adhesion hernia repair patch at an accurate and proper position under the guidance of a laparoscope, and sewing the hernia repair patch and the local tissue into a bag shape by using a puncture fixing needle.
Step four, performing ligation hemostasis on the large bleeding point and the small bleeding point; and (4) sewing the minimally invasive wound on the skin surface by using an absorbable surgical thread, and then sterilizing and binding the minimally invasive wound again.
Further, the double-layer anti-adhesion hernia repair patch comprises a polypropylene patch and an expanded polytetrafluoroethylene anti-adhesion patch, and the expanded polytetrafluoroethylene anti-adhesion patch is compounded on the polypropylene patch.
Further, the polypropylene patch is a tension-free polypropylene patch and is a mesh-shaped braided fabric; the expanded polytetrafluoroethylene anti-adhesion patch is a film.
Further, the cutter with the preset shape is circular, oval, rectangular or irregular.
Further, the preset shape of the double-layer anti-adhesion hernia repair patch is a circular shape, an oval shape, a rectangular shape or an irregular shape.
Further, the anesthetic may be one selected from procaine, tetracaine, lidocaine, bupivacaine, and ropivacaine.
Further, the injection site of the anesthetic is used for epidural anesthesia in adults, ketamine anesthesia in children or sacral anesthesia.
Further, the laparoscope carries a three-dimensional ultrasonic image feature extraction chip, the chip automatically quantifies and extracts relevant texture feature parameters of a region to be classified in the VOI of the ABUS image by using a texture feature extraction algorithm, and a patch and a fascia are distinguished; aiming at the problem that two-dimensional texture parameters are sensitive to space transformation such as curling and contraction after an incisional hernia patch is operated, three-dimensional texture parameters and three-dimensional position parameters are introduced, and finally feature selection is performed by using a similar interval algorithm and a sequential forward search method.
Furthermore, the puncture fixing needle comprises a main puncture needle and an auxiliary puncture needle, a needle head of the main puncture needle is provided with a threading hole, and a needle head of the auxiliary puncture needle is provided with a threading belt outlet notch; the main puncture needle consists of a main puncture needle end part and a main puncture needle body part, the main puncture needle end part and the main puncture needle body part are connected through a conical connecting part, a guide tube hole is formed in the main puncture needle body part, and a needle body of the auxiliary puncture needle is arranged in the guide tube hole.
Another object of the present invention is to provide a double-layer adhesion-preventing baggy hernia repair system using the double-layer adhesion-preventing baggy hernia repair method, wherein the system function module comprises: the patch cutting module, the anesthesia module, the image feature extraction module, the guiding module, the stitching module and the main control module.
And the patch cutting module is connected with the main control module and is used for cutting the double-layer anti-adhesion hernia repair patch by utilizing a cutter with a preset shape through ultrasonic waves.
The anesthesia module is connected with the main control module and used for injecting anesthetic into a patient through the injector to perform local anesthesia.
And the image feature extraction module is connected with the main control module and is used for extracting the data features in the abdominal cavity through a three-dimensional ultrasonic image feature extraction chip carried by the laparoscope.
And the guide module is connected with the main control module and is used for suturing and guiding the operation by utilizing the guide pipe hole of the main puncture needle body.
And the suture module is connected with the main control module and is used for suturing by inserting the surgical thread through the thread hole on the needle head of the main puncture needle.
And the main control module is connected with the patch cutting module, the anesthesia module, the image feature extraction module, the guide module and the sewing module and controls the operation of each functional module.
In summary, the advantages and positive effects of the invention are:
the double-layer anti-adhesion repairing sheet is formed by adopting polypropylene repairing sheet and expanded polytetrafluoroethylene anti-adhesion repairing sheet materials, and is characterized by taking the advantages of no tension of the polypropylene repairing sheet and adhesion prevention of the expanded polytetrafluoroethylene anti-adhesion repairing sheet materials into consideration, namely, the tension-free polypropylene mesh tissue grows well, the expanded polytetrafluoroethylene materials can grow firmly on the abdominal wall after being implanted, can be placed in the abdominal cavity and contact with internal organs, and has a better anti-adhesion effect. The double-layer anti-adhesion hernia repair patch is sewn into a bag shape, so that the double-layer anti-adhesion hernia repair patch can not move in the abdominal cavity, and the operation effect is ensured.
The double-layer anti-adhesion repairing patch is a light-weight repairing patch, the thickness of the repairing patch is usually less than 0.5mm, the weaving aperture is more than 3mm, and the residual quantity of foreign matters is small. In abdominal hernia repair, lightweight patches may be placed in four locations in relation to the abdominal wall anatomy hierarchy, anterior to the abdominal wall fascia, between the muscles, the space between fascia and peritoneum, and the intra-peritoneal wall within the abdominal cavity.
The invention not only effectively and reliably extracts the features of the light-weight type patch with wide application prospect by using the ABUS technology, but also realizes the optimized selection of the three-dimensional ultrasonic image features of the light-weight type incisional hernia patch, effectively improves the accuracy of classification and identification and reduces the classification working time. The method has good characteristic selection effect and high efficiency, and can effectively improve the classification precision of the three-dimensional ultrasonic image of the light-weight incisional hernia patch.
Drawings
Fig. 1 is a flow chart of a double-layer anti-adhesion bag-shaped hernia repair method according to an embodiment of the invention.
FIG. 2 is a block diagram of a double-layered anti-adhesive bag-like hernia repair system according to an embodiment of the present invention;
in the figure: 1. a patch cutting module; 2. an anesthesia module; 3. an image feature extraction module; 4. a guide module; 5. a stitching module; 6. and a main control module.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described in detail with reference to the following embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
In view of the problems of the prior art, the present invention provides a double-layer anti-adhesion bag-shaped hernia repair method and system, which will be described in detail with reference to the accompanying drawings and specific embodiments.
As shown in fig. 1, the double-layer anti-adhesion bag-shaped hernia repair method provided by the embodiment of the invention comprises the following steps:
s101: and (3) preparing before operation, and cutting the prepared double-layer anti-adhesion hernia repair patch into a preset size and shape by adopting a cutter with a preset shape through ultrasonic waves.
S102: disinfecting and anaesthetizing, disinfecting the external skin of the position to be operated by using an alcohol cotton ball, and injecting an anaesthetic.
S103: the double-layer anti-adhesion hernia repair patch is placed at an accurate and proper position under the guidance of a laparoscope, and the hernia repair patch and the local tissues are sewed into a bag shape by a puncture fixing needle.
S104: performing ligation hemostasis on the large and small bleeding points; and (4) sewing the minimally invasive wound on the skin surface by using an absorbable surgical thread, and then sterilizing and binding the minimally invasive wound again.
Further, the double-layer anti-adhesion hernia repair patch comprises a polypropylene patch and an expanded polytetrafluoroethylene anti-adhesion patch, and the expanded polytetrafluoroethylene anti-adhesion patch is compounded on the polypropylene patch.
Further, the polypropylene patch is a tension-free polypropylene patch and is a mesh-shaped braided fabric; the expanded polytetrafluoroethylene anti-adhesion patch is a film.
Further, the cutter with the preset shape is circular, oval, rectangular or irregular.
Further, the preset shape of the double-layer anti-adhesion hernia repair patch is a circular shape, an oval shape, a rectangular shape or an irregular shape.
Further, the anesthetic may be one selected from procaine, tetracaine, lidocaine, bupivacaine, and ropivacaine.
Further, the injection site of the anesthetic is used for epidural anesthesia in adults, ketamine anesthesia in children or sacral anesthesia.
Further, the laparoscope carries a three-dimensional ultrasonic image feature extraction chip, the chip automatically quantifies and extracts relevant texture feature parameters of a region to be classified in the VOI of the ABUS image by using a texture feature extraction algorithm, and a patch and a fascia are distinguished; aiming at the problem that two-dimensional texture parameters are sensitive to space transformation such as curling and contraction after an incisional hernia patch is operated, three-dimensional texture parameters and three-dimensional position parameters are introduced, and finally feature selection is performed by using a similar interval algorithm and a sequential forward search method.
Furthermore, the puncture fixing needle comprises a main puncture needle and an auxiliary puncture needle, a needle head of the main puncture needle is provided with a threading hole, and a needle head of the auxiliary puncture needle is provided with a threading belt outlet notch; the main puncture needle consists of a main puncture needle end part and a main puncture needle body part, the main puncture needle end part and the main puncture needle body part are connected through a conical connecting part, a guide tube hole is formed in the main puncture needle body part, and a needle body of the auxiliary puncture needle is arranged in the guide tube hole.
As shown in fig. 2, in an embodiment of the present invention, a double-layer adhesion-preventing bag-shaped hernia repair system is provided, wherein the system function module includes: the patch cutting module 1, the anesthesia module 2, the image feature extraction module 3, the guiding module 4, the stitching module 5 and the main control module 6.
And the patch cutting module 1 is connected with the main control module 6, and the double-layer anti-adhesion hernia repair patch is cut by using a cutter with a preset shape through ultrasonic waves.
And the anesthesia module 2 is connected with the main control module 6 and used for injecting anesthetic into a patient through an injector to perform local anesthesia.
And the image feature extraction module 3 is connected with the main control module 6 and is used for extracting the data features in the abdominal cavity through a three-dimensional ultrasonic image feature extraction chip carried by the laparoscope.
And the guide module 4 is connected with the main control module 6 and is used for suturing and guiding the operation by utilizing the guide pipe hole of the main puncture needle body.
And the suturing module 5 is connected with the main control module 6 and is used for suturing by inserting surgical threads through the threading hole in the needle head of the main puncture needle.
And the main control module 6 is connected with the patch cutting module 1, the anesthesia module 2, the image feature extraction module 3, the guide module 4 and the sewing module 5 and controls the operation of each functional module.
Proof part (concrete examples/experiments/simulation/pharmacological analysis/positive experimental data, evidential material, appraisal reports, business data, research and development evidence, business cooperation evidence, etc. capable of proving the inventive aspects of the present invention)
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents and improvements made within the spirit and principle of the present invention are intended to be included within the scope of the present invention.
Claims (10)
1. A double-layer anti-adhesive pocket hernia repair method, comprising the steps of:
step one, preoperative preparation: cutting the prepared double-layer anti-adhesion hernia repair patch into a preset size and shape by adopting a cutter with a preset shape through ultrasonic waves;
step two, disinfection and anesthesia: disinfecting the external skin of a position to be operated by using an alcohol cotton ball, and injecting anesthetic;
placing the double-layer anti-adhesion hernia repair patch at an accurate and proper position under the guidance of a laparoscope, and sewing the hernia repair patch and the local tissue into a bag shape by using a puncture fixing needle;
step four, performing ligation hemostasis on the large bleeding point and the small bleeding point; and (4) sewing the minimally invasive wound on the skin surface by using an absorbable surgical thread, and then sterilizing and binding the minimally invasive wound again.
2. The double-layer adhesion-preventing bag-shaped hernia repair method according to claim 1, wherein the double-layer adhesion-preventing hernia repair patch comprises a polypropylene patch and an expanded polytetrafluoroethylene adhesion-preventing patch, and the expanded polytetrafluoroethylene adhesion-preventing patch is compounded on the polypropylene patch.
3. The double-layer anti-adhesive bag-like hernia repair method of claim 2, wherein the polypropylene patch is a tension-free polypropylene patch and is a mesh-like fabric; the expanded polytetrafluoroethylene anti-adhesion patch is a film.
4. The double-layer anti-adhesive pocket hernia repair method of claim 1, wherein the predetermined shape cutter is circular, oval, rectangular, or irregular.
5. The double-layer adhesion-preventing bag-shaped hernia repair method according to claim 1, wherein the predetermined shape of the double-layer adhesion-preventing hernia repair patch is a circular shape, an oval shape, a rectangular shape, or an irregular shape.
6. The double-layered anti-adhesive pocket hernia repair method of claim 1, wherein the anesthetic is selected from the group consisting of procaine, tetracaine, lidocaine, bupivacaine, and ropivacaine.
7. The bi-layer anti-adhesive pocket hernia repair method of claim 1, wherein the injection site of the anesthetic is epidural anesthesia for adults, ketamine anesthesia for children, or sacral anesthesia.
8. The double-layer anti-adhesion bag-shaped hernia repair method according to claim 1, wherein the laparoscope is equipped with a three-dimensional ultrasonic image feature extraction chip, the chip uses a texture feature extraction algorithm to automatically and quantitatively extract relevant texture feature parameters of an area to be classified in VOI of an ABUS image, and the patch and the fascia are distinguished; aiming at the problem that two-dimensional texture parameters are sensitive to space transformation such as curling and contraction after an incisional hernia patch is operated, three-dimensional texture parameters and three-dimensional position parameters are introduced, and finally feature selection is performed by using a similar interval algorithm and a sequential forward search method.
9. The double-layer anti-adhesion bag-shaped hernia repair method according to claim 1, wherein the puncture fixing needle comprises a main puncture needle and an auxiliary puncture needle, the needle head of the main puncture needle is provided with a threading hole, and the needle head of the auxiliary puncture needle is provided with a threading belt notch; the main puncture needle consists of a main puncture needle end part and a main puncture needle body part, the main puncture needle end part and the main puncture needle body part are connected through a conical connecting part, a guide tube hole is formed in the main puncture needle body part, and a needle body of the auxiliary puncture needle is arranged in the guide tube hole.
10. A double adhesion-preventing pouch-like hernia repair system using the method of claim 1, wherein the system function module comprises: the device comprises a patch cutting module, an anesthesia module, an image feature extraction module, a guide module, a suture module and a main control module;
the patch cutting module is connected with the main control module and is used for cutting the double-layer anti-adhesion hernia repair patch by using a cutter with a preset shape through ultrasonic waves;
the anesthesia module is connected with the main control module and used for injecting anesthetic into a patient through an injector to perform local anesthesia;
the image feature extraction module is connected with the main control module and is used for extracting the data features in the abdominal cavity through a three-dimensional ultrasonic image feature extraction chip carried by the laparoscope;
the guide module is connected with the main control module and is used for suturing and guiding the operation by utilizing the guide pipe hole of the main puncture needle body;
the suture module is connected with the main control module and is used for suturing by inserting a surgical thread through a thread hole on the needle head of the main puncture needle;
and the main control module is connected with the patch cutting module, the anesthesia module, the image feature extraction module, the guide module and the sewing module and controls the operation of each functional module.
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| US20090270999A1 (en) * | 2008-04-24 | 2009-10-29 | Brown Roderick B | Patch for endoscopic repair of hernias |
| CN102068325A (en) * | 2010-12-21 | 2011-05-25 | 常州市三联星海医疗器械制造有限公司 | Compound anti-blocking herniorrhaphy patch and preparation method thereof |
| CN103906479A (en) * | 2011-02-16 | 2014-07-02 | 柯惠Lp公司 | Hernia repair system |
| CN107088109A (en) * | 2017-06-15 | 2017-08-25 | 莫经刚 | Indirect inguinal hernia inner ring seals sticking patch and its application method |
| US20180028303A1 (en) * | 2016-07-28 | 2018-02-01 | Ethicon, Inc. | Mesh Positioning System for Laparoscopic Ventral Hernia Repair |
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2019
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Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20090270999A1 (en) * | 2008-04-24 | 2009-10-29 | Brown Roderick B | Patch for endoscopic repair of hernias |
| CN102068325A (en) * | 2010-12-21 | 2011-05-25 | 常州市三联星海医疗器械制造有限公司 | Compound anti-blocking herniorrhaphy patch and preparation method thereof |
| CN103906479A (en) * | 2011-02-16 | 2014-07-02 | 柯惠Lp公司 | Hernia repair system |
| US20180028303A1 (en) * | 2016-07-28 | 2018-02-01 | Ethicon, Inc. | Mesh Positioning System for Laparoscopic Ventral Hernia Repair |
| CN107088109A (en) * | 2017-06-15 | 2017-08-25 | 莫经刚 | Indirect inguinal hernia inner ring seals sticking patch and its application method |
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