RU141181U1 - DEVICE FOR SURGICAL Junction of Hollow Organs - Google Patents

Abstract

1. A device for the surgical connection of hollow organs, containing a base of cylindrical shape (1) with cone-shaped constrictions on both sides (2) turning into cylindrical rods (3) with sharpenings at the end; based on the grooves (4) for surgical filaments, and the grooves continue on a cone-shaped narrowing; by means of rods, the base is connected to two nozzles (5) of a cylindrical shape, the peripheral end of each nozzle has a pointed shape (6) and holes (7) are located on it for mounting the ends of straight needles connected to surgical threads; the base has a cylindrical removable shell, consisting of two halves (10), each half of the outer shell has two wings (11), located opposite each other in the middle part of the shell in the area of contacting surfaces, and connected by removable brackets (12) .2. The device according to claim 1, in which the diameter and size of the base are selected taking into account the diameter of the connected structures. The device according to claim 1, wherein the base is made of hard material. The device according to claim 3, in which metal or plastic is used as a rigid material. The device according to claim 1, wherein the base is made of soft material. The device of claim 5, wherein the polymer composition is used as a soft material.

Description

The device relates to medicine, and can be used in pediatric surgery, transplantology, cardiovascular surgery, operations on the liver, pancreas, ureters, urethra, microsurgery.

Currently, the formation of an anastomosis or connection between hollow organs of small diameter (blood vessels, ducts of the liver, pancreas, ureter, urethra, etc.) is performed manually. The quality and reliability of the connection is largely due to the individual abilities and experience of the operating surgeon.

Existing devices designed for the formation of anastomoses between the hollow organs can conditionally be divided into three main groups:

1. The vast majority of devices are based on the use of different designs of compression rings, which are first connected in different ways to the ends of the joined hollow organs, and then with each other (Patent: US 3258012, US 5336233, US 6569173) However, the use of such devices has not found wide application on practice. The main disadvantages of these devices:

1. complexity of use;

2. high invasiveness of the method in relation to the connected biological structures;

3. low reliability of the connection;

4. the constant presence in the body of foreign material;

5. development of coarse scar tissue at the junction.

2. Devices based on the use of mechanical circular joints using metal brackets (clips) of various configurations (RF patent 2055541, Patent: US 6461365, US 366462)

The disadvantages of this group of devices are the same as those of the devices of the first group.

3. Devices using surgical suture as the basis of the compound (Patent: US 5320632, US 4553543, US 6280460)

This group of devices is essentially similar to the proposed device, however, it also has disadvantages:

1. devices are difficult to manufacture and use;

2. design features do not allow to rely on their application when connecting hollow organs of small diameter (less than 5 mm)

3. cannot be used to connect the ducts of parenchymal organs (liver, pancreas);

4. do not allow simultaneous flashing of both ends of the connected hollow organs.

The closest analogue is the invention of DeLange; Gregory S. (San Antonio, TX) Method and device for surgically joining luminal structures US Patent; 5554162 (1994). The device consists of a cylinder, inside of which on two sides there are two pistons, to which, in turn, several curved surgical needles with threads are fixed. The method of flashing hollow organs consists in alternately introducing the end of the cylinder into the lumen of the hollow organ and conducting surgical needles through the wall of the organ due to the translational movement of the piston inside the cylinder using a special pusher. After flashing both hollow organs, the needles are removed and the threads are connected.

The disadvantages of the method include:

1. The use of bent needles and the peculiarity of their placement inside the cylinder does not allow the use of this device for flashing hollow organs of small diameter (less than 5 mm)

2. The use of bent needles and the peculiarity of their placement inside the cylinder does not allow the use of more than 4 needles, which is insufficient to form a reliable connection

3. The threads between the surgical needles are located outside the cylinder and do not have an ordered arrangement, which increases the likelihood of them becoming entangled during operation of the device

4. The lack of stock of the length of the threads in view of the features of their location in the device does not allow the surgeon to reliably form a surgical site.

In this utility model, the task of developing a device to eliminate the disadvantages of the closest analogue was solved.

The technical result achieved is to automate the process of applying a surgical suture when connecting tubular structures of various diameters (for example, ducts of the liver or pancreas with the intestinal lumen), including small diameter, which allows:

- suture at a programmable distance from each other and from the edge of the hollow organ in a predetermined amount, which eliminates the "human factor" as a potential source of error;

- accurately compare the connected hollow organs with each other;

- connect tubular structures, hollow organs of small diameter (less than 5 mm);

- significantly accelerate the formation of a surgical anastomosis;

- optimize the process of connecting structures in cramped conditions of the surgical field;

- use surgical suture material for the formation of anastomosis (including absorbable), which is currently the most physiological method of combining biological structures.

The developed device consists of a base of a cylindrical shape (1) with cone-shaped narrowings on both sides (2) turning into cylindrical rods (3) with sharp points at the end (Fig. 1). The diameter and size of the base is determined by the diameter of the hollow structures for the flashing of which it is planned to use it. The material from which the base is made can be hard (metal or plastic) or soft (polymer composition).

The base of the device has several grooves (slots) (4), the number of which depends on the number of threads (4, 6, 8 or more) used to connect the hollow organs. The grooves continue on a cone-shaped narrowing.

The structure of the device includes two nozzles (5) of cylindrical shape, which are connected to the rods of the base (figure 2). The outer diameter of the nozzles is determined by the internal diameter of the hollow organs for the connection of which they are used. As the material from which the nozzle is made, for example, a synthetic polymer can be used. The free (peripheral) end of each nozzle has a pointed shape (6) and there are several holes (7) on it for installing the ends of straight needles connected to surgical sutures. The number of holes depends on the number of threads used to connect the hollow organs.

Surgical sutures of a certain length and diameter are inserted into the device (depending on the diameter of the connected hollow organs). The material from which the thread is made is determined by the biological feature of the connected hollow organs.

Both ends of the surgical thread (8) are atraumatically connected to direct surgical needles (9) of a certain diameter and length, which depend on the diameter of the connected hollow organs (Fig. 3).

Straight needles (9) of a certain size and diameter, connected to surgical threads (8) of a certain length and diameter, are inserted into the holes (7) of the nozzle at a certain angle so that the sharp ends of the needles are facing out and the ends of the needles connected to the thread, facing the pointed end of the nozzle (FIG. 4).

When assembled, all openings of both nozzles are charged with needles with threads in an amount determined by the planned number of sutures for joining two hollow organs.

The free part of each thread (8) between two needles (9) inserted into the holes (7) of both nozzles (5) is laid in the groove (4) in the base of the device (1) in the form of several zigzag or spiral loops (Fig. 5). The groove (4), in which the thread is laid, must be strictly oriented to the corresponding holes in the nozzles, where both needles of the corresponding thread are charged. The number of loops that are used when laying the thread in the groove is determined by the length of the thread and the length of the groove of the base.

The base of the device has an external removable shell of cylindrical shape, consisting of two identical halves (10) (Fig. 6). The shell is made of hard material (metal or plastic). Each half of the outer shell has two wings (11), located opposite each other in the middle part of the shell in the area of contacting surfaces. When closing the outer shell around the base, both halves come into contact with each other. The connection of both halves of the outer shell is ensured by two removable brackets (12) that are worn on contacting wings (Fig. 7).

FIG. 1 device base, general view (A), cross section of the base (B), side view (C):

1 - cylindrical base

2 - conical narrowing

3 - a cylindrical rod with a point

4 - grooves (slots).

FIG. 2 nozzle. Side view

5 - nozzle

6 - pointed end

7 - holes in the nozzle.

FIG. 3 Thread with needles. Side view.

8 - thread

9 - surgical straight needles.

FIG. 4 Side view of a nozzle with a charged needle, side view (side section) (A), Side view of the nozzle with charged needles (B), side view of the nozzle with charged needles (C)

5 - nozzle

6 - pointed end

7 - holes in the nozzle

8 - thread

9 - surgical straight needles.

FIG. 5 Assembled device with inserted needles and threads. Side view in section (A) Cross-section through the base of the device (B).

1 - cylindrical base

4 - grooves (slots).

5 - nozzle

7 - holes in the nozzle

8 - thread

9 - surgical straight needles.

FIG. 6 Device in assembled form with an open outer shell General view

1 - cylindrical base

10 - two halves of the outer shell of the device

FIG. 7 Outer shell of the device general view (A), the outer shell of the device in assembled condition around the base. Cross section (B). General view of the device with a closed outer shell. The arrows indicate the direction for the connecting brackets (C).

1 - cylindrical base

10 - two halves of the outer shell of the device

11 - wings of the outer shell

12 - connecting bracket

Device Description

Step 1. The pointed end of the nozzle, along with the needles, is inserted into the lumen of one of the connected hollow organs

Step 2. Reverse thrust (traction) of the device from the lumen of the hollow organ is performed. In this case, the tips of the needles pass through the wall of the stitched hollow organ and appear on the outer surface of the organ.

Step 3. The tips of the needles are captured by surgical clamps and are alternately removed along with the threads from the device to a distance convenient for the surgeon for subsequent manipulations.

Step 4. After removing all the needles, the nozzle is removed from the lumen of the hollow organ.

Steps 1, 2, 3, and 4 are repeated with respect to the second connected hollow organ from the opposite side in the same sequence.

After flashing both connected organs, the fixing brackets are removed from the wings of the outer shell and both halves are removed from the base of the device.

All threads are alternately released from the grooves (slots) of the base. The base of the device is removed from the surgical field.

Alternately tying the threads until the two hollow organs are completely connected. After tightening all the nodes, the loose threads are cut off. The formation of the end-to-end anastomosis is completed.

Claims (6)

1. A device for the surgical connection of hollow organs, containing the base of a cylindrical shape (1) with cone-shaped narrowings on both sides (2) turning into cylindrical rods (3) with sharp points at the end; based on the grooves (4) for surgical filaments, and the grooves continue on a cone-shaped narrowing; by means of rods, the base is connected to two nozzles (5) of a cylindrical shape, the peripheral end of each nozzle has a pointed shape (6) and holes (7) are located on it for mounting the ends of straight needles connected to surgical threads; the base has a removable shell of a cylindrical shape, consisting of two halves (10), each half of the outer shell has two wings (11), located opposite each other in the middle part of the shell in the area of contacting surfaces, and connected by removable brackets (12). 2. The device according to claim 1, in which the diameter and size of the base are selected taking into account the diameter of the connected structures. 3. The device according to claim 1, in which the base is made of hard material. 4. The device according to claim 3, in which metal or plastic is used as a rigid material. 5. The device according to claim 1, in which the base is made of soft material. 6. The device according to claim 5, in which the polymer composition is used as a soft material.

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