FR2682867A1 - Method and device for locking a wire in core surgery. - Google Patents

Method and device for locking a wire in core surgery. Download PDF

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Publication number
FR2682867A1
FR2682867A1 FR9113593A FR9113593A FR2682867A1 FR 2682867 A1 FR2682867 A1 FR 2682867A1 FR 9113593 A FR9113593 A FR 9113593A FR 9113593 A FR9113593 A FR 9113593A FR 2682867 A1 FR2682867 A1 FR 2682867A1
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FR
France
Prior art keywords
parts
male
female
characterized
wire
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Withdrawn
Application number
FR9113593A
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French (fr)
Inventor
Nouaille Jean-Marc
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
NOUAILLE JEAN MARC
Original Assignee
NOUAILLE JEAN MARC
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by NOUAILLE JEAN MARC filed Critical NOUAILLE JEAN MARC
Priority to FR9113593A priority Critical patent/FR2682867A1/en
Publication of FR2682867A1 publication Critical patent/FR2682867A1/en
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122Clamps or clips, e.g. for the umbilical cord
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0483Hand-held instruments for holding sutures
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0487Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00349Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0446Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0448Additional elements on or within the anchor
    • A61B2017/045Additional elements on or within the anchor snug fit within the anchor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0446Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0454Means for attaching and blocking the suture in the suture anchor the anchor being crimped or clamped on the suture
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0487Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
    • A61B2017/0488Instruments for applying suture clamps, clips or locks

Abstract

<P> - The device according to the invention is used, more particularly, in laparoscopic surgery to block at least one wire. The device consists of a male part (2) and a female part (3) intended to delimit between them at least one wedging zone for the wire, when the male and female parts are nested one inside the other. / P>

Description

METHOD AND DEVICE FOR LOCKING A COELOSURGERY THREAD
The present invention relates to the field of apparatuses, devices or means designed to make it possible to ensure the blocking of a wire during the practice of surgical techniques and, more particularly, of laparoscopic surgery.

 In general, laparoscopic surgery concerns an operating technique that does not require the making of incisions or openings made to give access to the part to be treated of a person's organism. This technique requires the implementation of suitable instruments for crossing the abdominal wall in order to authorize the performance of specific interventions, for example at the level of the appendix or the gallbladder. These instruments generally have a passage section of the order of 5 to 10 mm and a length of 400 mm. These instruments are intended to be manipulated by the surgeon from outside the body, in order to perform specific surgical operations inside a person's body.

 These operations generally require the creation of stitches or ligatures, by means of one or more threads. A particularly difficult problem to solve is that of stopping or blocking the thread or the suture or ligature threads. Likewise, making knots using known laparoscopic instruments is difficult, if not impossible.

 The object of the invention is to remedy this problem by proposing a device to be used in surgery and, more particularly, in laparoscopic surgery to allow the blocking of the wires used to ensure ligation or suturing, for example.

 The object of the invention also aims to propose a device capable of dispensing with the making of knots, by making it possible to link together at least two end parts of a wire or of two wires.

To achieve this objective, the system according to
The invention consists of a male part and a female part intended to delimit between them at least one wedging zone for the wire, when the male and female parts are fitted one into the other.

 According to an advantageous characteristic of the invention, the male and female parts are equipped with means for immobilizing them relatively when these parts are fitted into one another.

 To facilitate gripping of the wire, the male part or the female part comprises at least one notch ensuring the engagement of the wire on the part, prior to its jamming.

The object of the invention also aims to propose a method for blocking at least one wire consisting in
- insert a blocking device in
A person's body, using a
instrument of the type comprising a piston
sliding in a sheath,
- control by instrument, movement
relative of the male part with respect to the part
female to ensure their nesting for the
wire jamming,
- and act on the instrument to allow
disconnect the locking device from
The instrument.

 Various other characteristics will emerge from the description given below with reference to the appended drawings which show, by way of nonlimiting examples, embodiments of the object of the invention.

 Fig. 1 is an exploded perspective view of a first alternative embodiment of a locking device according to the invention.

Fig. 2 is a sectional view taken substantially along line 11-11 of FIG. 1. showing the device according to
The invention in the wire locking position.

 Fig. 3 is a perspective view, partially broken away, showing a locking device produced according to a different structure.

 Fig. 4 is a general view of an exemplary embodiment of an instrument suitable for ensuring the establishment of the blocking device by the technique of laparoscopic surgery.

 Fig. 5 is a view of another embodiment of an instrument ensuring the establishment of a blocking device in laparoscopic surgery.

 Fig. 6 is a perspective view of another alternative embodiment of a locking device according to the invention.

 Fig. 7 is a sectional view taken substantially along the lines VII-VII of FIG. 6.

 Figs. 1 and 2, illustrate a device 1 according to the invention, used in laparoscopic surgery and intended to ensure the blocking of at least one wire, in the general sense, to produce, for example an overlock, a suture or a ligature. The blocking device 1 according to the invention comprises a male part 2, intended to be fitted at least partially inside a female part 3. The parts 2 and 3 are adapted to provide for each other, during their fitting, at least one zone 4 ensuring the jamming of at least one and, in the example illustrated, of two end parts 51 of one or two wires 5.

 In the example illustrated in fig. 1 and 2, the male part 2 is produced in the form of a truncated cone, for example of circular base, while the female part 3 has a bore 6 of shape complementary to the envelope of the male part 2. According to this example, the wires 5 extend on either side of the diameter of the part 2, so that the wires 5 are wedged by two zones 4 which are delimited by surfaces with complementary inclined profile, namely the surface of external revolution 7 of the male part 2 and the surface of the bore 6.

 Of course, the male 2 and female 3 parts can be produced in other forms than those shown in FIGS. 1 and 2. By way of example, FIG. 3 illustrates the parts 2 and 3 having complementary trapezoidal shapes, whose main flat faces 8 and 9, respectively of the parts 2 and 3, delimit two wedging zones 4. For example, the main faces 8 of the male part 2 are parallel between them, while the faces 9 of the female part 3 are also parallel, so that the clearance separating the faces 8, 9 facing each other, makes it possible to wedge the wires 5. Preferably but not exclusively, the two faces planes 8 and 9 may have an additional inclination to facilitate the wedging of the wires 5.

According to an advantageous characteristic of the invention, the male 2 and female 3 parts are equipped with means ensuring
Their relative immobilization when these parts are fitted into one another. These immobilization means are constituted, for example, by elements of complementary structures carried by the male and female parts, such as, for example, clearances, lights or grooves 12 made, at least
Locally, on the peripheral surface of the part 2 and intended to cooperate with notches, lugs or projections 13 formed inside the part 13.

According to another advantageous characteristic of
The invention, One of the parts, namely the male part 2 in
The example illustrated comprises at least one notch 14 facilitating the gripping of the wire, with a view to its jamming in zone 4.

The notch 14 is formed according to the diameter of the male part 2, in a direction substantially perpendicular to the direction of interlocking of the parts, represented by the arrow f. The male part 2 thus holds the wires 5 during the introduction of the male part 2 inside the female part 3.

 The method or method for blocking a thread in laparoscopic surgery with the device according to the invention follows directly from the above description. As shown more precisely in FIG. 4, the positioning of this blocking device is effected by means of an instrument 16 of conventional design, comprising a piston 18 controlled to slide in a sheath 19 by means of a rod 20.

 It is recalled that the sheath generally has a section of the order of 10 mm and a length of the order of 400 mm. The instrument defines, at its end intended to be inserted inside the body of a person, a well 22 for loading and ejection for at least one device.

blocking 1.

 By way of example, the piston 18 maintains, in cooperation with an elastic member 25 carried by the sheath 19, the male 2 and female 3 parts partially nested one inside the other.

After the introduction of the lower end of the instrument 16, inside the body, the instrument is moved to allow engaging the wire or wires to be blocked, inside.

The notch 14.

 The piston 18 is then moved in sliding fashion to ensure the fitting of the male 2 and female 3 parts, so as to wedge the wire or wires in the zones 4. The piston 18 is moved so that the notches 13 cooperate with the grooves 12 , in order to obtain a relative immobilization of the two parts. The piston 18 is then pushed back, so that the locking device 1, elastically urged by the element 25, is detached from the instrument to be left in place inside the body.

 The jamming of the wire by the zones 4, combined with the means 12, 13 making it possible to immobilize the two parts 2 and 3 together, ensures obtaining an effective and lasting blocking of the wire or wires 5. Such a device offers the advantage of allowing easy production of knots by wedging the two end parts of one or two wires. The jamming of the wire or wires is greatly facilitated by your use of the notch 14 which makes it possible to position and guide the wire or wires during the entire blocking operation.

 Of course, the device 1 is made of a material capable of being supported by the body of a person and can have a length of up to 10 mm. In addition, provision may be made for a disposable instrument after the installation of a single device or capable of receiving a battery of locking devices according to the invention, brought successively to the level of the well 22.

 Fig. 5 illustrates, by way of example, another alternative embodiment of an instrument 16 capable of being used in laparoscopic surgery to ensure the establishment of a blocking device 1 according to the invention. According to this variant, the male 2 and female 3 parts are held together during their introduction inside the body, by means of the piston 18 comprising a shoulder 23 for centering the female part 3 and using a link 26 fixed to the male part 2 and on the outer sheath 19. The relative movement of the sheath 19 relative to the piston 18 makes it possible to ensure the engagement of the male part 2 inside the female part 3 The rupture of the link 26 after the complete fitting of the two parts allows the locking device according to the invention to be left in place.

 Figs. 6 and 7 illustrate another alternative embodiment of the locking device 1 according to the invention. According to this variant, the male 2 and female 3 parts are articulated along a common pivot line 27. The male part 2 is in the form of a shell whose bottom 30 is bordered by two lateral flanks 31 each having a trapezoidal shape .

As shown more precisely in FIG. 7, the flanks 31 are flared to delimit, with the flanks 32 of the male part 2, two wedging zones 4 for a wire 5. Advantageously, provision is made to make, on the bottom 30 of the female part 3, a tongue 35 intended to cooperate with a groove 36 formed in the male part 2. Such a configuration forms a baffle constituting an additional zone of jamming for the wire, making it possible to ensure a fixed blocking of a wire.

 Advantageously, the male part 2 is arranged to comprise at least one notch 14 formed from the pivot line 27, so as to ensure, on the one hand, the engagement of the wire and, on the other hand , to avoid any slip of the wire during the relative pivoting of the two parts. The final blocking of these two parts can be ensured by means of a lug 13 formed on the male part 2 and intended to cooperate with a housing 12 formed on the return 37 of the female part 3.

 Of course, the installation of such a device is carried out with the aid of an instrument provided, at its end, with a clamp system, to ensure the pivoting and nesting of parts 2 and 3.

 The invention is not limited to the examples described and shown, since various modifications can be made thereto without departing from its scope.

Claims (11)

 1 - Device used more particularly in laparoscopic surgery to block at least one wire (5) and made of a material adapted to allow it to be tolerated by the body of a person,
 characterized in that it is constituted by a male part (2) and a female part (3) intended to delimit between them at least one wedging zone (4) for the wire, when the male and female parts are fitted together one inside the other.
 2 - Device according to claim 1, characterized in that the male (2) and female (3) parts are equipped with means (12, 13) for immobilizing them relatively, when these parts are fitted into one another.
 3 - Device according to claim 1 or 2, characterized in that the male part (2) or the female part (3) comprises at least one notch (14) ensuring the gripping of the wire (5), with a view to its jamming.
 4 - Device according to one of claims 1 to 3, characterized in that the male (2) and female (3) parts are held together using connecting means (26, 27).
 5 - Device according to claim 2, characterized in that the means (12, 13) for immobilization are constituted by elements of complementary structures formed on the male (2) and female (3) parts and intended to cooperate together in the end of nesting of the two pieces.
 6 - Device according to claim 1, characterized in that each wedging zone (4), delimited between the male and female parts, is formed by surfaces with complementary inclined profile formed on the parts.
 7 - Device according to one of claims 1 to 4, characterized in that the male (2) and female (3) parts are articulated around a common pivot line (27), one of the parts being provided with 'one tongue (35), while the other has a groove (36) extending substantially perpendicular to the pivot line and intended to cooperate with the tongue during the fitting of the parts to form a wedging zone.
 8 - Method for blocking at least one thread in laparoscopic surgery, characterized in that it consists in
 - introduce into the body of a person,
 using an instrument (16) of the type comprising
 a piston (18) sliding in a sleeve (19),
 a locking device (1) according to one
 from claims 1 to 7,
 - control by movement (16) the movement
 relative of the male part (2) with respect to the
 female part (3) to ensure their interlocking
 with a view to jamming the wire,
 - and act on the instrument to allow
 disconnect the locking device (1) from
 the instrument (16).
 9 - Method according to claim 8, characterized in that it consists in positioning the male (2) and female (3) parts so as to ensure the engagement of the wire (5) inside a notch (14 ).
 10 - Method according to claim 8, characterized in that it consists in separating the locking device (1) from the instrument (16), by the rupture of a link (26) retaining the male part (2) and fixed on the sheath (19).
 11 - Method according to claim 8, characterized in that it consists in placing, inside the body, a series of blocking devices (1) mounted in battery inside
The instrument (16) before completely removing the latter from the body of the person.
FR9113593A 1991-10-29 1991-10-29 Method and device for locking a wire in core surgery. Withdrawn FR2682867A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR9113593A FR2682867A1 (en) 1991-10-29 1991-10-29 Method and device for locking a wire in core surgery.

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR9113593A FR2682867A1 (en) 1991-10-29 1991-10-29 Method and device for locking a wire in core surgery.
PCT/FR1992/001012 WO1993008747A1 (en) 1991-10-29 1992-10-29 Method and device for holding a celiotomy wire

Publications (1)

Publication Number Publication Date
FR2682867A1 true FR2682867A1 (en) 1993-04-30

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
FR9113593A Withdrawn FR2682867A1 (en) 1991-10-29 1991-10-29 Method and device for locking a wire in core surgery.

Country Status (2)

Country Link
FR (1) FR2682867A1 (en)
WO (1) WO1993008747A1 (en)

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