EP3934545A1 - Outil d'écartement des tissus pendant des opérations de chirurgie - Google Patents
Outil d'écartement des tissus pendant des opérations de chirurgieInfo
- Publication number
- EP3934545A1 EP3934545A1 EP20725856.7A EP20725856A EP3934545A1 EP 3934545 A1 EP3934545 A1 EP 3934545A1 EP 20725856 A EP20725856 A EP 20725856A EP 3934545 A1 EP3934545 A1 EP 3934545A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- valves
- tool according
- spacer tool
- valve
- pins
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 210000004872 soft tissue Anatomy 0.000 claims abstract description 12
- 125000006850 spacer group Chemical group 0.000 claims description 44
- 239000000463 material Substances 0.000 claims description 6
- 238000000465 moulding Methods 0.000 claims description 5
- 230000000284 resting effect Effects 0.000 claims description 4
- 238000001356 surgical procedure Methods 0.000 claims description 4
- 238000003892 spreading Methods 0.000 claims description 3
- 230000007480 spreading Effects 0.000 claims description 3
- 239000004744 fabric Substances 0.000 claims description 2
- 210000001519 tissue Anatomy 0.000 abstract description 9
- 238000003825 pressing Methods 0.000 abstract description 3
- 210000000988 bone and bone Anatomy 0.000 description 7
- 238000000926 separation method Methods 0.000 description 7
- 230000000903 blocking effect Effects 0.000 description 5
- 230000007246 mechanism Effects 0.000 description 4
- 210000000709 aorta Anatomy 0.000 description 2
- 210000001367 artery Anatomy 0.000 description 2
- 210000003323 beak Anatomy 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 210000003205 muscle Anatomy 0.000 description 2
- 238000012958 reprocessing Methods 0.000 description 2
- 208000007623 Lordosis Diseases 0.000 description 1
- 241000920340 Pion Species 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 238000004873 anchoring Methods 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 238000005202 decontamination Methods 0.000 description 1
- 230000003588 decontaminative effect Effects 0.000 description 1
- 238000009826 distribution Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000036541 health Effects 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 238000007689 inspection Methods 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 239000007769 metal material Substances 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 230000004220 muscle function Effects 0.000 description 1
- 230000000737 periodic effect Effects 0.000 description 1
- 230000001954 sterilising effect Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 238000003860 storage Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0206—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0293—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
Definitions
- the present invention relates to a spreader tool for performing soft tissue spreading during surgery.
- the posterior or anterior or anterolateral route also called retro-peritoneal, which, unlike the posterior route, makes it possible to reduce muscle disinsertions, bleeding and infections, restore better lordosis and therefore improve results by facilitating the restoration of muscle function.
- different soft tissue spacing systems are used comprising valves forming the support on these soft tissues, fixed on a rigid structure, to release access to the spine in order to perform the surgery.
- the valves generally have an elongated shape having on one side called the front part a curved shape in the transverse direction. At least two valves are used, interconnected by their rear ends by means of a mechanical system, which separates these ends to press the convex outer face of their front parts on the tissues in order to separate and hold them.
- a known spacer tool presented in particular by document US-A1 - 2005159650, comprises a system for connecting at least two valves between they, being fixed in a transverse plane at the rear end of these valves in order to maintain their spacing and their angular inclination with respect to the direction perpendicular to this plane.
- the connection system comprises various components making it possible to form a closed loop, receiving at least two valves, the geometry of which can be adjusted to obtain the desired spacing and inclinations of the front parts of these valves.
- a clamp placed perpendicular to the plane of the connection system is operated to achieve the separation constraint on the soft tissues before blocking the connection system holding the valves in position.
- Another known spacer tool presented in particular by document US AI -5931777, comprises a clamp arranged in the plane of the connecting system, in order to separate the valves fixed to the ends of the jaws of this clamp in a perpendicular direction, and curved locking bars which fix the position of this clamp once the distance has been obtained.
- Another known spacing tool comprises a clamp arranged in the plane of the connecting system, a threaded rod connecting the two handles of the clamp making it possible to adjust the distance between the clamps. beaks of this forceps, and valves attached to the ends of these beaks to maintain the spacing of the tissues.
- these connecting systems do not make it possible to achieve the separation progressively by adapting to all the anatomical variabilities, then to freeze the operating field in place, as it has been installed on each particular patient.
- Another problem posed by these spacer tools is that the connecting system generally forms a closed loop completely encircling the operating field, which hinders the passage of the surgeon's hands towards the area to be operated on.
- these known spacing tools include connecting systems comprising several complex parts, with geometries which may have cavities that are difficult to clean, generally made of a metallic material, which entails high manufacturing costs. They can be reused for another operation, but it is then necessary to provide for disassembly of all the parts in order to achieve complete sterilization, then reassembly, which results in additional occupancy time for the staff.
- connection system generally comprising pivots, notches, teeth or racks to achieve the separation
- connection system can wear out which requires periodic inspection and an exchange of components taking time, and requiring transport and storage logistics.
- Said device comprises an adjustable quadrilateral frame composed of two slotted L-shaped elements each arm of which is provided with a slit, a square hole being provided in the corner and the inner ends of the slits being widened.
- the device also comprises valves with a hook at each end, the rear face of the valves being provided with a slit whose center is enlarged.
- the two frame elements fit together by means of bolts and wing nuts, the slots in the frame elements allow them to be adjusted as desired, and these slots, in cooperation with the valve slots, allow adjustment. the frame blades.
- This type of device has the drawback of being difficult to put in place, the handling of the bolts and wing nuts being long and difficult during an operation, and the link arms completely close the operating field, this which hinders the passage of the surgeon's hands to the area to be operated on. Disclosure of the invention
- the object of the present invention is in particular to avoid these drawbacks of the prior art.
- a tool for spreading soft tissue towards an outward direction during surgical operations comprising a connecting system intended to be disposed in a main surface, and at least two valves having an elongated front part with an outer side for bearing on the tissues, intended to be disposed substantially perpendicular to the main surface, and having a rear face intended to be disposed in the main surface for fixing the connection system, said connection system comprising at least one elongate connection element comprising a plurality of connection points designed to connect the at least two valves to one another or to connect at least one valve to at least one other elongate connection means; said tool is remarkable in that each valve has on its rear face two pins provided to fit into the bores of the connecting elements.
- an advantage of this spacer tool is that the elongated connecting elements are easy to connect to each other or to the valves, in particular by superimposing them one on top of the other, and by fixing them quickly and simply by choosing the positions, to freeze the assembly with distances and / or orientations determined thanks to the connection points giving different positions.
- connection system It is possible to use two or more valves, and one, two or more connecting elements, to form the connection system, with, if necessary, a rapid locking of the position of these valves.
- the connecting elements can form an open contour which provides access to the operating area.
- such a spacer tool allows numerous mounting configurations, so that the surgeon can assemble the valves and the elongated connecting elements according to a geometry which appears to him to be the most suitable for the surgical act to be performed.
- valves and the connection system having simple shapes, with connections comprising for example pins fitted in bores, without a complex mechanism, they can easily be produced economically by molding a rigid plastic material, or by bending sheets, which gives disposable components after use. In this way, handling and health risks associated with reprocessing of components are reduced. When reused, the absence of a complex mechanism facilitates decontamination and / or cleaning and / or reprocessing.
- the spacer tool according to the invention may further include one or more of the following features, which may be combined with each other.
- the pegs of the rear faces have a shoulder at their ends, provided to fit into a bore of a connecting element forming a buttonhole, then to slide in this buttonhole to prevent unhooking. It will be observed that the difference in diameter between the pin and its shoulder prevents unhooking as soon as the various elements are put under tension.
- the connecting elements comprise a plurality of adjustment positions, such as for example bores or slots arranged along their length, forming the connecting points between them. These different adjustment positions left to the choice of the surgeon make it possible to control both the position and the tension of the assembly.
- the connecting elements may include a succession of holes which are regularly spaced.
- the regular spacing may correspond to that of the pins located on the rear part of the valves.
- the spacer tool may include connecting elements that are flat and bent in the direction of the main surface.
- the spacer tool comprises two bent connecting elements each comprising on one side of this bend a succession of aligned holes or a rectilinear slot, forming connection points provided to be superimposed between the two elements. link.
- the spacer tool may include two movable pins, or an interference latch comprising two pins, provided to fit into superimposed bores of the two connecting elements.
- each elbow connecting element connecting two valves has a rectilinear slot offset laterally with respect to the axis passing through these valves, comprising on at least one side locking notches.
- the notches can form a rack comprising teeth inclined in a direction opposite to the connection with the valve, receiving a point of a pin linked to the other connection element.
- the spacer tool can include two identical connecting elements.
- one edge of the outer contour of two connecting elements may include notches forming a rack, the connecting system comprising a ring receiving these two connecting elements superimposed on each other. the interior, having an edge of its interior contour resting on the notches.
- the rear face of the valves may have a cylindrical shape, formed for each valve by two arms extending in the transverse direction of the cylinder, which slide one above the other by reversing this superposition on both sides. .
- valves and the connection system are made by molding a plastic material.
- FIG. 1 is a perspective view of a spacer tool with two valves according to the invention, comprising a connecting system with two curved bars forming a closed contour;
- FIG. 2 is a perspective view of an alternative embodiment of a two-valve spacer tool, with two curved bars forming an open contour;
- FIG. 3 is a perspective view of an alternative embodiment of a three-valve spacer tool, with two curved bars forming an open contour;
- FIG. 4 is a perspective view of an alternative embodiment of a spacer tool with two valves and a spindle, with three curved bars forming a closed contour;
- FIG. 5 is a perspective view of an alternative embodiment of a three-valve spacer tool, with two curved bars and a straight bar forming a closed contour
- - Figure 6 is a perspective view of an alternative embodiment of a spacer tool with three valves, with a curved bar and two straight bars forming a closed contour
- FIG. 7 is an exploded perspective view of an alternative embodiment of a spacer tool with two valves, with two angled bars forming an open contour, connected by two pins inserted in buttonholes;
- FIG. 8 is a perspective view of an alternative embodiment of a spacer tool with two valves, with two angled bars connected by a latch combining the function of the two pins;
- FIG. 9 is an exploded perspective view of a variant of a spacer tool with two valves, with two angled bars connected by a latch forming a sliding system in one direction and self-locking in the other;
- FIG. 10 is a top view of the angled bars connected by a latch of the variant embodiment of the two-valve spacer tool according to the invention shown in Figure 9; ;
- FIG. 11 is a perspective view of an alternative embodiment of an angled bar of a spacer tool according to the invention, comprising a fixed pin disposed outside a groove;
- FIG. 12 is a top view of two angled bars connected by a latch of the embodiment of the two-valve spacer tool according to the invention shown in Figure 11;
- FIG. 13 is a perspective view of an alternative embodiment of an angled bar of a spacer tool according to the invention, comprising an offset pin;
- FIG. 14 is a perspective view of an alternative embodiment of a bar of a spacer tool according to the invention, comprising a rack;
- FIG. 15 is a top view of two angled bars of the variant embodiment of the spacer tool with two valves according to the invention shown in Figure 14;
- - Figure 16 is a top view in perspective of an alternative embodiment of a spacer tool according to the invention, comprising a ring connecting the racks of each bar;
- FIG. 17 is a perspective view of an alternative embodiment of a spacer tool according to the invention, comprising a connecting system with a single bent bar;
- FIG. 18 is an exploded perspective view of an alternative embodiment of a spacer tool according to the invention comprising a valve and a curved bar coming along a curved main surface;
- FIG. 19 is a perspective view of the alternative embodiment of a spacer tool according to the invention shown in Figure 18;
- FIG. 20 is a perspective view of a pliers for the variant embodiment of the spacer tool according to the invention shown in Figures 18 and 19;
- FIG. 21 is a perspective view of the clamp between the valves of the spacer tool according to the invention shown in Figures 18 and 19;
- FIG. 22 is a perspective view of the gripper in the spacing position of the valves of the spacing tool according to the invention shown in Figures 18 and 19.
- FIG. 1 shows a spacer tool comprising two identical valves 2 arranged in opposition, the upper ends of which forming an elongated rear transverse face 8 arranged in a main plane forming a main surface, are interconnected by a connecting system comprising two curved bars 20 forming a closed contour arranged on this plane.
- a connecting system comprising two curved bars 20 forming a closed contour arranged on this plane.
- the interior and exterior sides are in the main plane or surface, defined as being respectively towards the center and towards the exterior of the connection system.
- Each valve 2 comprises an elongated front part 4 having a substantially constant cross section, comprising a curved shape, the outer convex side of which is intended to bear on the tissues.
- the front end of the elongated part 4 has a small flange 6 facing outward at an angle of approximately 105 ° plus or minus 20 °, allowing a catch on the fabrics to prevent a longitudinal sliding of this elongated part or a sliding of the separated tissues under the valve 2.
- Said rim 6 thus makes it possible to scrape the soft tissues from the surface of the vertebrae, for example, and to prevent the aorta artery and the vena cava from passing under the valve 2.
- the inner end of the elongated rear face 8 comprises two pins 10 aligned perpendicularly to the longitudinal direction of this face, the outer end comprising a bore 12 allowing the rear face to be hooked.
- connection system comprises two bent bars 20, each bar forming a connecting element having on each side of this bend a large side and a small side, forming a flat placed on the rear face 8 of the valves 2, comprising a series of holes. 22 regularly spaced along the bar at a standard pitch.
- Each bar 20 has a first additional hole 24 towards the outside of the elbow, and at the end of the short side towards the outside of this elbow a second additional hole 26. These additional holes allow an angular variation between the valve 2 and the or strips 20.
- a pin 14 having a pointed front end is fitted in a guide 16 forming a loop disposed in the axis of the concave side of the front part 4 of the valve 2, in order to be able to slide along this front part in order to be supported with this point in a bone, such as a vertebra for example, by maintaining the lower part of the valve 2 in position
- Each pin 14 has a stopper 18 resting on the upper edge of the guide 16 when the tip of the pin 14 is introduced into the bone thus avoiding too deep an introduction of the pin 14 into the bone and also providing an anchoring of the valve 2 on the bone, preventing it from going up and allowing the aorta artery and the vena cava to pass.
- Each angled bar 20 receives in the end bore of the short side a pin 10 of a valve 2, and in the middle of the large side a pin of the other valve.
- the two bars 20 are placed in opposition to one another to form the closed contour.
- a separation of the upper parts of the valves 2 withdrawing the soft tissues is carried out until the surgeon obtains the space necessary for the operation. It then performs a simple and rapid engagement of the pins 10 in the bores 22 of the bars 20 corresponding to the spacing, to maintain the position of the valves 2 between them.
- valves 2 and the bars 20 have simple shapes, easy to obtain by molding a rigid plastic material.
- Figure 2 shows two angled bars 20, each receiving in the first and third bore 22 on the small side a pin 10 of a valve 2. In this way, we obtain an angular setting of each bar 20 on the rear face 8 of each valve 2.
- a flat blocking part 30 forming an elbow in the width comprises on its lower face a central blocking pin 32 and at each end an end locking pin 34. The distance between the central pin 32 and each end pin 34 corresponds to a distance between the bores 22 of the bars 20.
- the surgeon After having obtained the desired spacing of the valves 2, the surgeon introduces the central pin 32 of the locking piece 30 into two superimposed bores of the two bars 20 and an end pin 34 in another bore of each bar, which fixes quickly and easily the angular positioning of these two bars between them.
- connection system with an open contour, this opening completely freeing access for the surgeon's hand to pass during the surgical operation.
- Figure 3 shows the ends of the short sides of the two bent bars 20 superimposed, so as to engage in the first and third end bore 22 of each short side the two pins 10 of the rear face 8 of a central valve 2a . In this way, an angular setting of the two bars 20 is obtained with respect to this central valve 2a.
- a pin 10 of a side valve 2b which allows to set a spacing between the three valves.
- a connection system is also obtained having an open contour connecting three valves 2.
- FIG. 4 shows a substantially straight bar 40 forming a connecting element, comprising a series of bores 22 distributed over its length according to the same standard pitch, receiving in two bores two pins 10 of two valves 2 to maintain their spacing.
- the two pins 10 of the two valves 2 which are close to each other.
- the two elongated rear faces 8 of the valves 2 form an angle of approximately 120 °.
- Each remaining pin 10 of each valve 2 is inserted into the end bore of the short side of an angled bar 20.
- the rear end of a pin 14 is inserted into two superimposed bores 22 in the middle of the long side of the two bars. elbows 20, to close the outline of the connection system by positioning the two valves 2 and this pin.
- Figure 5 shows a similar connection system with the straight bar 40 connecting two valves 2, receiving instead of the pin 14 inserted in the two superimposed bores of the two bent bars 20, a valve 2c comprising its two pins 10 each inserted in a hole in each bar.
- FIG. 6 shows a central valve 2a, each pin 10 of which is inserted into an end bore of a straight bar 40, the two pins 10 of two lateral valves 2b being fitted in a bore arranged near the other end of these two straight bars.
- An angled bar 20 connects the two side valves 2b by fitting on the two pins 10 of each of these valves, so as to obtain a closed contour of the connection system.
- FIG. 7 shows an elongated rear face 8 of each valve 2 comprising on the inside two pins 10 aligned transversely, each comprising a cylindrical body of small diameter terminating in a flat head of larger diameter.
- Each bar 50 at a substantially 90 ° square, forming a connecting element comprises on one long side a series of regularly spaced holes 52, and at the end of the short side two holes each forming a buttonhole 54. It will be noted that by “substantially 90 °” is meant an angle of 90 ° plus or minus 10 °. Furthermore, the branches of the angled bar 50 may form an angle of between 60 ° and 120 ° and each branch may have any shape, not rectilinear for example, without departing from the scope of the invention.
- Each buttonhole 54 has a small-diameter hole fitted to the body of the pin 10, these two small holes being aligned along the longitudinal axis of the short side.
- Each buttonhole extends in the transverse direction of the short side, outward from the elbow for the end buttonhole and inward for the other buttonhole, through a large diameter hole allowing the head of pin 10 to pass through,
- Figure 8 shows two angled bars 50 similar to the bars shown in Figure 7, comprising on each bar instead of the row of bores 52, a longitudinal slot 60 receiving by superposition a succession of circular bores 52 regularly spaced, centered on the axis of this slot, having a diameter a little greater than the slot.
- the two movable pins 56 are replaced by an interference latch 64 performing the same function, comprising two parallel cylindrical parts 66 forming the two pins coming into two circular bores 52, connected by a longitudinal bar fitting in the slot 60, and a rear head of greater width.
- the interference latch 64 is introduced after having superimposed the circular bores 52 of the two bent bars 50, which maintains the spacing of the valves 2.
- Figure 9 shows two angled bars 50 similar to the bars shown in Figure 8, comprising for the slot 60 a close succession of circular holes which overlap sufficiently between them to form an elongated passage with notches 68 on each side, allowing in this length the free sliding of the cylindrical parts 66 of the interference latch 64 when the holes in the two bars are superimposed.
- the interference latch 64 is engaged in the elongated passages of the two bars 50, then the two valves 2 are moved apart while keeping these two passages aligned with one another, the latch sliding freely to follow this movement. .
- FIG. 10 shows the free spacing of the two valves 2 which superimposes the two long sides with their slots 60, then after having obtained the sufficient spacing the slackening of the bars 50 which causes with the thrust of these valves an inclination of the two slots l 'relative to each other as shown in this figure, by pressing the two cylindrical parts 66 of the interference latch 64 against the bottom of notches 68.
- the two bars 50 are self-locking between them, which increases with this force, while maintaining the distance between these valves.
- Figure 11 shows two angled bars 50 similar to the bars shown in Figure 9, comprising on the side of the slot 60 disposed inside of the elbow a close succession of circular holes forming notches 68, the side outside the elbow remaining smooth.
- a shouldered pin 72 having a large head is fixed in the axis of the slot 60, between its end and the elbow of the bar 50.
- the end of the slot 60 disposed on the side of the elbow, has a large bore. diameter forming a buttonhole 70 allowing the passage of the head of the shouldered pin 72.
- Figure 12 shows, after having engaged each shouldered pin 72 in a buttonhole 70 of the other bar 50, a free sliding of these pins in the slots 60 by separating the valves 2 and maintaining the two superimposed slots as shown in this figure.
- valves 2 When releasing the bars 50, in the same way the valves 2 apply a force which tends to incline the two slots 60 with respect to each other, by pressing the cylindrical part of each shouldered pin 72 in the notches 68 of the other bar.
- Figure 13 shows an angled bar 50 similar to the bar shown in Figure 11, comprising a pin 80 offset from the axis of the slot 60, which replaces the attached shouldered pin 72.
- connection system is similar after having introduced the two detached pins 80 in the slots 60 of the two bars 50, with a release in the direction of the spacing of the valves 2 and a blocking in the other direction.
- Figure 14 shows an angled bar 50 similar to the bar shown in Figure 11, with the notches 68 on the side of the slot 60 inside the elbow forming a rack comprising teeth inclined towards the end of the large side of this bar.
- the central part of the shouldered pin 72 has a point 90 turned on the same side as the notches 68.
- Figure 15 shows in the direction of the spacing of the valves 2 the shouldered pin 72 resting on the smooth side of the slot 60, which allows free sliding.
- the tightening force of the two valves 2 causes an adjustment of the tip 90 in a notch 68 of the rack, which prevents movement.
- Figure 16 shows bars 50 having an elbow at approximately 120 °, the long part of each bar having on the inner edge at the bend a rack 92 with teeth inclined towards the end of this long part.
- a connecting ring 94 has a flat inner contour making it possible to receive the two superimposed long parts of the two bars 50.
- the width of the inner contour is a little greater than the width of the long parts of the bars 50, which makes it possible to keep the short parts. parallel, the long parts forming an angle of about 30 ° between them.
- FIG. 17 shows a curved bar 20 with circular bores 22, comprising two straight ends forming an angle of approximately 30 ° between them, constituting between them a passage which opens outwards.
- Two valves 2 each have an elongated rear face 8 comprising two pins 10 aligned transversely, having a shoulder at their ends, which fit into two bores 22 of one of the right ends of the bar 20.
- FIGS. 18 and 19 show two identical valves 2, each comprising a rear face 8 which is curved along a cylindrical surface, comprising two parallel arms 104 which extend in a transverse direction of the cylinder.
- the two arms 104 have concave upper faces slightly offset in height, the height offset being substantially equal to the thickness of said arms 104, and the curvatures of the concave upper faces of said arms 104 have slightly different radii, the radius of curvature of the concave upper face of the first arm 104 extending below the first arm 104 being substantially equal to the radius of curvature of the convex lower face of the second arm 104 which extends above the first arm 104, so as to adjust an arm of one sliding under that of the other, with a role reversal on both sides.
- the valves 2 are guided between them, with a pivoting connection around the axis of the cylindrical shape.
- Each rear face 8 is extended outwardly by a handle 100 arranged in a transverse direction of the cylinder, making it possible to easily rotate the valves 2 to obtain the separation of their front parts. 4. Said handles 100 also make it possible to block the position of the valves 2 by means of a table arm not shown in the figures.
- each valve 4 having the smallest diameter of curvature comprises two pins with shoulder 10 aligned in the transverse direction of the cylinder.
- a curved plate 102 forming a bar constitutes a loop having two parallel straight sides each fitting on an upper arm 104 of the valves 2.
- Each right side has buttonholes 54 aligned along the length of this side, which extend in the transverse direction.
- the plate 102 After having adjusted the spacing of the valves 2 by acting on the handles 100, the plate 102 is lowered by entering the shoulders of the pins 10 in the wide part of the corresponding buttonholes 54, then this plate is slid transversely to lock the assembly of the pins. pions.
- this variant embodiment makes it possible to promote a separation at the level of the operating site, that is to say at the end of valve 2, while avoiding too large an incision of the soft tissues which cover the operating site, such as muscles and skin.
- the device according to the invention also comprises a clamp 106 consisting of two semi-cylindrical arms 108 articulated around an axis 110 close to the proximal end of the arms 108, the proximal end of the arms 108 being tapered to a height corresponding to the height slightly less than that of the valve 2 to form a stop 112.
- the distal end of the arms 108, opposite to the tapered proximal end, is slightly pointed and allows, by being oriented downwards with the forceps in the closed position, to penetrate the soft tissues and to scrape the bone.
- the arms 108 comprise above the axis 110, recesses 114 allowing easy gripping of the arms 108 in order to make them pivot about the axis 110.
- the leaflets 2 are introduced into the soft tissues after incision of the latter, the lower parts of the leaflets 2 extending in parallel. Then, the clamp 106 in the closed position is introduced between the valves 2 until the sharp distal ends rest on the bone to scrape it. The clamp 106 is withdrawn and then returned, still in the closed position, and introduced between the valves 2 until the stops 112 bear on the rear faces 8 of the valves 2. It will be observed that the position of the stops 112 makes it possible to have a common axis of rotation between the clamp 106 and the cylindrical surface of the two valves 2. Then, with reference to FIG.
- the arms 108 of the clamp 106 are pivoted about the axis 110 to open the latter and provide the pivoting and, ultimately, the spacing of the valves 2. Said valves 2 are then held in this spacing position by means of the handles 100, either manually or by means of a table arm not shown in the figures, then the clamp 106 is removed and plate 102 is placed as previously described.
- the valves 2 as well as the various connecting systems are simple and economical elements, without a complex mechanism, which can be easily produced by molding a rigid plastic material. Disposable systems are obtained, easy to configure in any case, which allow a wide field of action for the surgeon.
- the pins and the holes receiving them, to fix the bars 20, 40, 50 on the valves 2 can be arranged upside down by mounting these pins on the bars and the holes on the valves.
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR1902306A FR3093417A1 (fr) | 2019-03-07 | 2019-03-07 | Outil d’ecartement des tissus pendant des operations de chirurgie |
PCT/FR2020/050475 WO2020178539A1 (fr) | 2019-03-07 | 2020-03-09 | Outil d'écartement des tissus pendant des opérations de chirurgie |
Publications (1)
Publication Number | Publication Date |
---|---|
EP3934545A1 true EP3934545A1 (fr) | 2022-01-12 |
Family
ID=68733090
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP20725856.7A Withdrawn EP3934545A1 (fr) | 2019-03-07 | 2020-03-09 | Outil d'écartement des tissus pendant des opérations de chirurgie |
Country Status (4)
Country | Link |
---|---|
US (1) | US20220142632A1 (fr) |
EP (1) | EP3934545A1 (fr) |
FR (1) | FR3093417A1 (fr) |
WO (1) | WO2020178539A1 (fr) |
Family Cites Families (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US1707689A (en) * | 1928-06-22 | 1929-04-02 | Sharp & Smith | Retractor |
DE68926506T2 (de) * | 1988-07-29 | 1996-10-31 | Michelson Gary K | Rückgratretraktor |
US6030340A (en) * | 1997-12-19 | 2000-02-29 | United States Surgical | Surgical retractor |
US5931777A (en) | 1998-03-11 | 1999-08-03 | Sava; Gerard A. | Tissue retractor and method for use |
DE19935394C1 (de) * | 1999-07-29 | 2001-04-26 | Max Hauser Sueddeutsche Chirur | Vorrichtung zum Spreizen von Gewebe, Gewebeteilen, Organen, Knochen oder anderen Körperteilen bei chirurgischen Eingriffen |
US7481766B2 (en) | 2003-08-14 | 2009-01-27 | Synthes (U.S.A.) | Multiple-blade retractor |
EP1706041B1 (fr) | 2003-12-18 | 2015-11-18 | DePuy Spine, Inc. | Systemes ecarteurs chirurgicaux, catheters eclaires, et procedes d'utilisation |
WO2013138117A1 (fr) * | 2012-03-12 | 2013-09-19 | Emory University | Écarteur sternal |
DE102013102902A1 (de) * | 2013-03-21 | 2014-09-25 | Aesculap Ag | Chirurgische Retraktionsvorrichtung |
CN104799896B (zh) * | 2015-05-20 | 2016-09-14 | 南方医科大学南方医院 | 用于腹腔手术的可伸缩两用拉钩装置 |
CA2992288C (fr) * | 2015-08-10 | 2023-10-17 | Ramon F. Cestero | Ecarteur chirurgical a verrouillage reglable |
-
2019
- 2019-03-07 FR FR1902306A patent/FR3093417A1/fr active Pending
-
2020
- 2020-03-09 US US17/434,439 patent/US20220142632A1/en not_active Abandoned
- 2020-03-09 WO PCT/FR2020/050475 patent/WO2020178539A1/fr active Application Filing
- 2020-03-09 EP EP20725856.7A patent/EP3934545A1/fr not_active Withdrawn
Also Published As
Publication number | Publication date |
---|---|
WO2020178539A1 (fr) | 2020-09-10 |
FR3093417A1 (fr) | 2020-09-11 |
US20220142632A1 (en) | 2022-05-12 |
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