ES2606788A1 - Blood vessel anastomosis device (Machine-translation by Google Translate, not legally binding) - Google Patents
Blood vessel anastomosis device (Machine-translation by Google Translate, not legally binding) Download PDFInfo
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- ES2606788A1 ES2606788A1 ES201531359A ES201531359A ES2606788A1 ES 2606788 A1 ES2606788 A1 ES 2606788A1 ES 201531359 A ES201531359 A ES 201531359A ES 201531359 A ES201531359 A ES 201531359A ES 2606788 A1 ES2606788 A1 ES 2606788A1
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- 210000004204 blood vessel Anatomy 0.000 title claims abstract description 41
- 230000003872 anastomosis Effects 0.000 title claims abstract description 27
- 238000000926 separation method Methods 0.000 claims description 4
- 238000000034 method Methods 0.000 abstract description 4
- 230000004308 accommodation Effects 0.000 abstract 1
- 210000001367 artery Anatomy 0.000 description 3
- 210000003462 vein Anatomy 0.000 description 2
- 206010002329 Aneurysm Diseases 0.000 description 1
- 241000270923 Hesperostipa comata Species 0.000 description 1
- 208000007536 Thrombosis Diseases 0.000 description 1
- 206010047249 Venous thrombosis Diseases 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 230000000295 complement effect Effects 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 239000011521 glass Substances 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- 238000009958 sewing Methods 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1132—End-to-end connections
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- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
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Abstract
Description
DISPOSITIVO DE ANASTOMOSIS DE VASOS SANGUINEOSBLOOD VESSEL ANASTOMOSIS DEVICE
D E S C R I P C I OND E S C R I P C I ON
5 OBJETO DE LA INVENCION5 OBJECT OF THE INVENTION
La presente invencion se enmarca dentro del campo tecnico de los dispositivos de uso medico.The present invention is part of the technical field of medical devices.
Mas concretamente se describe un dispositivo de anastomosis de vasos sangumeos que 10 permite al cirujano dar correctamente los puntos de sutura evitando el peligro de que el punto de sutura atraviese dos veces la pared del vaso sangumeo y por tanto lo cierre total o parcialmente. Ademas permite atravesar la pared del vaso con todas las agujas e hilos necesarios con un movimiento unico y hacer la anastomosis de forma mas rapida.More specifically, an anastomosis device of blood vessels is described which allows the surgeon to correctly give the stitches avoiding the danger of the suture crossing twice the wall of the blood vessel and therefore closing it totally or partially. It also allows to cross the wall of the vessel with all the needles and threads necessary with a unique movement and make the anastomosis faster.
15 ANTECEDENTES DE LA INVENCION15 BACKGROUND OF THE INVENTION
La anastomosis de vasos sangumeos es la union, entre si, de vasos sangumeos y la micro anastomosis es la union de pequenos vasos, arterias y venas, de entre 2mm y 4mm. Una anastomosis vascular termino-terminal consiste en unir los dos extremos libres de dos vasos 20 sangumeos para restablecer la continuidad del flujo sangumeo a traves de ellos.The anastomosis of blood vessels is the union, among themselves, of blood vessels and the micro anastomosis is the union of small vessels, arteries and veins, between 2mm and 4mm. A terminal-terminal vascular anastomosis consists of joining the two free ends of two blood vessels to restore the continuity of the blood flow through them.
Generalmente la anastomosis de pequenos vasos sangumeos se realiza de forma manual con puntos de sutura, empleando aguja e hilo, y la micro anastomosis se realiza con la ayuda visual de un microscopio o unas gafas-lupa (dispositivos de magnification de la imagen).Generally the anastomosis of small blood vessels is performed manually with stitches, using a needle and thread, and the micro anastomosis is performed with the visual help of a microscope or magnifying glasses (magnification devices of the image).
2525
Del estado de la tecnica se conocen tambien dispositivos para la realization de la anastomosis de vasos sangumeos como por ejemplo el empleo de grapadoras para realizar la union con grapas. Los problemas tecnicos asociados a esta tecnica son que en algunos casos las grapas no atraviesan completamente la luz de los vasos sangumeos y que una vez terminada la 30 operation de anastomosis las grapas, que son cuerpos extranos, se quedan en el interior delDevices for performing anastomosis of blood vessels are also known from the state of the art, such as the use of staplers for joining with staples. The technical problems associated with this technique are that in some cases the staples do not completely pass through the blood of the blood vessels and that once the operation of anastomosis is finished, the staples, which are foreign bodies, remain inside the
paciente.patient.
Asimismo se conoce un dispositivo que comprende dos anillos de material plastico que seAlso known is a device comprising two rings of plastic material that
colocan uno en cada vaso sangumeo a unir y que se anclan a dichos vasos. Un problema tecnico muy importante asociado a este dispositivo es que no se puede emplear en arterias porque provoca aneurismas en la zona anterior a la de la colocacion de los anillos.they place one in each blood vessel to be joined and they are anchored to said vessels. A very important technical problem associated with this device is that it cannot be used in arteries because it causes aneurysms in the area before the placement of the rings.
5 Asimismo, otro problema asociado al uso de los anillos es que despues de la anastomosis se quedan instalados en los vasos sangumeos y son cuerpos extranos que se quedan en el interior del cuerpo del paciente. Otra desventaja adicional de estos dispositivos es que aumentan el riesgo de trombosis venosa.5 Likewise, another problem associated with the use of the rings is that after the anastomosis they remain installed in the blood vessels and are foreign bodies that remain inside the patient's body. Another additional disadvantage of these devices is that they increase the risk of venous thrombosis.
10 DESCRIPCION DE LA INVENCION10 DESCRIPTION OF THE INVENTION
La presente invencion propone un dispositivo de anastomosis de vasos sangumeos de pequeno tamano, es decir, de arterias y venas de entre 2mm y 4mm. Se trata de un dispositivo disenado para ser empleado con la tecnica de sutura manual.The present invention proposes an anastomosis device for small-sized blood vessels, that is, arteries and veins between 2mm and 4mm. It is a device designed to be used with the manual suture technique.
15fifteen
El dispositivo permite simplificar la tecnica de sutura mediante hilo y aguja ya que, mediante el movimiento de un cuerpo que es accionado por el usuario, las agujas penetran en las paredes de los vasos sangumeos en el punto correcto para la sutura.The device makes it possible to simplify the suture technique by means of a thread and needle since, by the movement of a body that is operated by the user, the needles penetrate the walls of the blood vessels at the correct point for the suture.
20 Los elementos esenciales del dispositivo son una estructura de soporte con un extremo distal y un extremo proximal y un cuerpo tubular que se desplaza por la estructura de soporte arrastrando consigo unas agujas dobles de sutura ya enhebradas.The essential elements of the device are a support structure with a distal end and a proximal end and a tubular body that travels through the support structure by dragging double threaded suture needles.
El dispositivo esta disenado para ser empleado con agujas dobles con una configuracion deThe device is designed to be used with double needles with a configuration of
25 sector circular (pueden ser semicirculares o de menor tamano de longitud de arco) que se colocan entre el cuerpo tubular y la estructura de soporte en el extremo proximal. Cuando se utiliza el dispositivo se enfrenta el extremo proximal al vaso sangumeo correspondiente y se desplaza el cuerpo tubular que ejerce presion contra las agujas que estan en contacto con el, desplazandolas. El movimiento de dichas agujas, debido a su configuracion, es un movimiento25 circular sector (can be semicircular or smaller in arc length) that are placed between the tubular body and the support structure at the proximal end. When the device is used, the proximal end faces the corresponding blood vessel and the tubular body that presses against the needles that are in contact with it moves. The movement of said needles, due to their configuration, is a movement
30 de giro que provoca que atraviesen las paredes del vaso sangumeo y salgan de nuevo. Como en el momento en que se monta el dispositivo las agujas ya estan enhebradas, los hilos correspondientes atraviesan tambien las paredes del vaso sangumeo. Es decir, los hilos atraviesan el vaso sangumeo desde el interior.30 of rotation that causes them to pass through the walls of the blood vessel and come out again. As at the time the device is mounted, the needles are already threaded, the corresponding threads also pass through the walls of the blood vessel. That is, the threads pass through the blood vessel from the inside.
La misma operation se repite en las dos secciones del vaso sangumeo que se quiere unir para tener los hilos alrededor de ambas de forma que simplemente hay que unirlos mediante una operacion de anudado, por fuera del vaso sangumeo para evitar trombosis. Posteriormente el 5 sobrante de los hilos se corta.The same operation is repeated in the two sections of the blood vessel that you want to join to have the threads around both so that you simply have to join them by a knot operation, outside the blood vessel to avoid thrombosis. Subsequently the remaining 5 of the threads is cut.
En las operaciones manuales del estado de la tecnica se emplean agujas sencillas. Como la operacion que hay que realizar cuando se trabaja manualmente es la de ir pasando el hilo por las paredes y anudandolo fuera en cada punto, despues de varios puntos el espacio de trabajo 10 se va reduciendo considerablemente. Esto dificulta mucho las operaciones y aumenta mucho el riesgo de que alguno de los puntos llegue a atravesar la pared en mas de un sitio, provocando una reduction de la section interior libre del vaso sangumeo.Simple needles are used in manual operations of the state of the art. As the operation to be performed when working manually is to run the thread through the walls and knotting it out at each point, after several points the work space 10 is considerably reduced. This makes operations very difficult and greatly increases the risk of any of the points coming through the wall at more than one site, causing a reduction of the free inner section of the blood vessel.
El dispositivo de la presente invention permite realizar todos los puntos al mismo tiempo para 15 evitar los problemas descritos. Preferentemente se emplean unas seis a ocho agujas dobles para cada sutura. Ademas, para aumentar la velocidad de las operaciones de anastomosis se pueden emplear dos dispositivos, cada uno de ellos para pasar los hilos por una de las secciones que se van a unir. El cirujano puede tener preparado un dispositivo para cada seccion a unir y hacer las suturas casi instantaneamente en ambas. Posteriormente solo hay 20 que atar los hilos que quedan en cada seccion.The device of the present invention allows all the points to be made at the same time to avoid the problems described. Preferably, about six to eight double needles are used for each suture. In addition, to increase the speed of anastomosis operations, two devices can be used, each of them to pass the wires through one of the sections to be joined. The surgeon can have a device prepared for each section to join and make the sutures almost instantaneously in both. Subsequently there are only 20 to tie the remaining threads in each section.
DESCRIPCION DE LOS DIBUJOSDESCRIPTION OF THE DRAWINGS
Para complementar la description que se esta realizando y con objeto de ayudar a una mejor 25 comprension de las caracteristicas de la invencion, de acuerdo con un ejemplo preferente de realization practica de la misma, se acompana como parte integrante de dicha descripcion, un juego de dibujos en donde con caracter ilustrativo y no limitativo, se ha representado lo siguiente:To complement the description that is being made and in order to help a better understanding of the characteristics of the invention, according to a preferred example of practical realization of the same, a set of said description is accompanied as an integral part of said description. Drawings where the following has been illustrated and not limited to:
30 Figura 1.- Muestra una vista explosionada del dispositivo de anastomosis de vasos sangumeos.30 Figure 1.- Shows an exploded view of the blood vessel anastomosis device.
Figura 2a.- Muestra una vista del dispositivo de anastomosis de vasos sangumeos en position cercana al vaso sangumeo para su empleo.Figure 2a.- Shows a view of the blood vessel anastomosis device in position close to the blood vessel for use.
Figura 2b.- Muestra una vista del dispositivo de anastomosis de vasos sangumeos en funcionamiento, con las agujas insertadas en el vaso sangumeo. El vaso sangumeo se ha representado seccionado para mostrar la posicion del cuerpo tubular y de las agujas.Figure 2b.- Shows a view of the functioning blood vessel anastomosis device, with the needles inserted in the blood vessel. The blood vessel has been shown sectioned to show the position of the tubular body and needles.
55
Figura 3.- Muestra la seccion A-A de la figura 2b.Figure 3.- Shows section A-A of figure 2b.
Figura 4.- Muestra la seccion B-B de la figura 2b.Figure 4.- Shows section B-B of figure 2b.
10 Figura 5.- Muestra la seccion C-C de la figura 2b.10 Figure 5.- Shows section C-C of figure 2b.
REALIZACION PREFERENTE DE LA INVENCIONPREFERRED EMBODIMENT OF THE INVENTION
A continuacion se describe, con ayuda de las figuras 1 a 5, un ejemplo de realizacion de la 15 invencion.An example of embodiment of the invention is described below with the help of Figures 1 to 5.
El dispositivo de anastomosis de vasos sangumeos se muestra en una vista explosionada en la figura 1. En dicha figura se aprecia una estructura de soporte (1) con un extremo distal (2) con un primer orificio (3) y con un extremo proximal (4) con un segundo orificio (5). Asimismo 20 comprende un cuerpo tubular (6) que esta alojado en la estructura de soporte (1) y que tiene posibilidad movimiento deslizante a traves del primer orificio (3) y del segundo orificio (5). Dicho cuerpo tubular (6) es de goma para permitir la colocacion de una pluralidad de agujas dobles (8) entre el cuerpo tubular (6) y el extremo proximal (4). Tambien forma parte del dispositivo un elemento de sujecion (7) dispuesto en el extremo proximal (4) que esta configurado para 25 mantener las agujas circulares (8) en contacto con la estructura de soporte (1) y el cuerpo tubular (6).The blood vessel anastomosis device is shown in an exploded view in Figure 1. In said figure a support structure (1) with a distal end (2) with a first hole (3) and with a proximal end ( 4) with a second hole (5). Also, it comprises a tubular body (6) that is housed in the support structure (1) and that has the possibility of sliding movement through the first hole (3) and the second hole (5). Said tubular body (6) is made of rubber to allow the placement of a plurality of double needles (8) between the tubular body (6) and the proximal end (4). Also part of the device is a fastener (7) disposed at the proximal end (4) that is configured to keep the circular needles (8) in contact with the support structure (1) and the tubular body (6).
En la figura 2a se observa el dispositivo ya montado con las agujas dobles (8) colocadas en el extremo proximal (4). Cuando se va a realizar la anastomosis se acerca el dispositivo al vaso 30 sangumeo y se coloca el extremo proximal (4) lo mas cerca posible de dicho vaso sangumeo. Como se aprecia en la imagen, las agujas dobles (8) estan en una posicion en la que la que solo una de sus puntas sobresale del extremo proximal (4) en la direction del interior del vaso sangumeo.Figure 2a shows the device already mounted with double needles (8) placed at the proximal end (4). When the anastomosis is to be performed, the device is brought closer to the blood vessel 30 and the proximal end (4) is placed as close as possible to said blood vessel. As can be seen in the image, the double needles (8) are in a position in which only one of their tips protrudes from the proximal end (4) in the direction of the interior of the blood vessel.
Durante la operacion de anastomosis el cirujano empuja el cuerpo tubular (6) para desplazarlo por el interior del primer orificio (3) y por tanto del segundo orificio (5), tal y como se aprecia en la figura 2b. Al realizar ese movimiento, conforme el cuerpo tubular (6) atraviesa el segundo 5 orificio (5), arrastra consigo las agujas dobles. Debido a la configuration de estas, el movimiento que realizan es un movimiento circular alrededor de un eje que esta determinado por el segundo orificio (5) (ya que giran alrededor del extremo proximal (4) en este punto de contacto). Este movimiento de las agujas dobles (8) provoca que atraviesen la pared del vaso sangumeo, haciendo que el hilo de costura que debe llevar enhebrado cada una de ellas tambien atraviese 10 la pared.During the anastomosis operation the surgeon pushes the tubular body (6) to move it inside the first hole (3) and therefore the second hole (5), as can be seen in Figure 2b. When performing this movement, as the tubular body (6) passes through the second hole (5), it carries with it the double needles. Due to their configuration, the movement they perform is a circular movement around an axis that is determined by the second hole (5) (since they rotate around the proximal end (4) at this point of contact). This movement of the double needles (8) causes them to pass through the wall of the blood vessel, causing the sewing thread to be threaded each of them also through the wall.
Para terminar la operacion de anastomosis hay que realizar la misma operacion en las dos partes del vaso sangumeo que se quieren unir. De esta forma ambas partes quedan atravesadas por una pluralidad de hilos de sutura y el cirujano simplemente tiene que 15 anudarlos.To finish the anastomosis operation, you must perform the same operation on both parts of the blood vessel that you want to join. In this way both parts are traversed by a plurality of sutures and the surgeon simply has to knot them.
Como se aprecia en la figura 3, preferentemente el extremo proximal (4) esta conformado por dos piezas semicirculares (9) que tienen posibilidad de separation entre si. Esta realization esta destinada a permitir retirar el dispositivo con facilidad cuando ya se han hecho los puntos de 20 sutura en el vaso sangumeo. Cuando se ha terminado el recorrido de las agujas dobles (8) (provocado por el desplazamiento del cuerpo tubular), los hilos que tienen enhebrados las agujas quedan atrapados entre el cuerpo tubular (6) y las paredes del segundo orificio (5) en el extremo distal (4). En este ejemplo de realizacion se ha disenado el dispositivo con un extremo distal (4) conformado por dos piezas semicirculares (9) que al separarse generan un espacio 25 entre el extremo distal (4) y el cuerpo tubular (6) que permite la liberation de los hilos.As can be seen in Figure 3, preferably the proximal end (4) is formed by two semicircular pieces (9) that have the possibility of separation from each other. This realization is intended to allow the device to be removed easily when the stitches of the suture have already been made in the blood vessel. When the path of the double needles (8) (caused by the displacement of the tubular body) is finished, the threads that have the needles threaded are caught between the tubular body (6) and the walls of the second hole (5) in the distal end (4). In this embodiment, the device has been designed with a distal end (4) formed by two semicircular pieces (9) which, when separated, generate a space 25 between the distal end (4) and the tubular body (6) that allows the release of the threads.
Preferentemente, en este ejemplo de realizacion, la estructura de soporte (1) comprende unas barras (10) de union entre el extremo distal (2) y el extremo proximal (4) y cada pieza semicircular (9) esta unida al menos a una de las barras (10). Dichas barras (10) se pueden 30 apreciar por ejemplo en las figuras 2, 3 y 4, y permiten la separacion de las piezas semicirculares (9) entre si manteniendo la estructura de soporte (1) como un cuerpo unico. Las barras (10) son ligeramente flexibles para permitir la separacion de las piezas semicirculares (9) tal y como se ha descrito.Preferably, in this exemplary embodiment, the support structure (1) comprises connecting bars (10) between the distal end (2) and the proximal end (4) and each semicircular piece (9) is attached to at least one of the bars (10). Said bars (10) can be seen, for example, in Figures 2, 3 and 4, and allow the separation of the semicircular pieces (9) from each other while maintaining the support structure (1) as a single body. The bars (10) are slightly flexible to allow the separation of the semicircular pieces (9) as described.
En una realization preferente el extremo distal (4) comprende una ranura perimetral (11) destinada a recibir el elemento de sujecion (7). Esto es especialmente util en las realizaciones en las que el extremo proximal (4) esta conformado por dos piezas semicirculares (9) para 5 asegurar que se mantengan unidas durante el empleo del dispositivo, es decir, durante la colocacion de la sutura.In a preferred embodiment the distal end (4) comprises a perimeter groove (11) intended to receive the fastener (7). This is especially useful in the embodiments in which the proximal end (4) is formed by two semicircular pieces (9) to ensure that they are held together during the use of the device, that is, during the placement of the suture.
El elemento de sujecion (7) puede ser una goma circular configurada para mantener unidas las piezas semicirculares (9). En estos casos, cuando se han introducido ya las agujas dobles (8) 10 con sus correspondientes hilos en la pared del vaso sangumeo, para liberar los hilos, simplemente hay que cortar la goma para poder separar las dos piezas semicirculares (9).The fastener (7) can be a circular rubber configured to hold the semicircular pieces (9) together. In these cases, when the double needles (8) 10 with their corresponding threads have already been introduced into the wall of the blood vessel, to release the threads, the rubber must simply be cut in order to separate the two semicircular pieces (9).
Claims (5)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| ES201531359A ES2606788B1 (en) | 2015-09-23 | 2015-09-23 | BLOOD VESSEL ANASTOMOSIS DEVICE |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| ES201531359A ES2606788B1 (en) | 2015-09-23 | 2015-09-23 | BLOOD VESSEL ANASTOMOSIS DEVICE |
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| Publication Number | Publication Date |
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| ES2606788A1 true ES2606788A1 (en) | 2017-03-27 |
| ES2606788B1 ES2606788B1 (en) | 2018-01-03 |
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| Application Number | Title | Priority Date | Filing Date |
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| ES201531359A Active ES2606788B1 (en) | 2015-09-23 | 2015-09-23 | BLOOD VESSEL ANASTOMOSIS DEVICE |
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Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1985003858A1 (en) * | 1984-03-05 | 1985-09-12 | Amarasinghe Disamodha C | Suturing assembly and method |
| WO2001019259A1 (en) * | 1999-09-14 | 2001-03-22 | Abbott Laboratories | Device and method for performing end-to-side anastomosis |
| US20020022852A1 (en) * | 1997-05-19 | 2002-02-21 | Pepi Dakov | Connector system and methods for cutting and joining hollow anatomical structures |
| US20110306994A1 (en) * | 2010-06-11 | 2011-12-15 | Bassan Harmanpreet | Device for performing end-to-end anastomosis |
-
2015
- 2015-09-23 ES ES201531359A patent/ES2606788B1/en active Active
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1985003858A1 (en) * | 1984-03-05 | 1985-09-12 | Amarasinghe Disamodha C | Suturing assembly and method |
| US20020022852A1 (en) * | 1997-05-19 | 2002-02-21 | Pepi Dakov | Connector system and methods for cutting and joining hollow anatomical structures |
| WO2001019259A1 (en) * | 1999-09-14 | 2001-03-22 | Abbott Laboratories | Device and method for performing end-to-side anastomosis |
| US20110306994A1 (en) * | 2010-06-11 | 2011-12-15 | Bassan Harmanpreet | Device for performing end-to-end anastomosis |
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| Publication number | Publication date |
|---|---|
| ES2606788B1 (en) | 2018-01-03 |
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