RU153897U1 - DEVICE FOR INTRAOPERATIVE DETERMINATION OF THE DEGREE OF TENSION OF THREADS AND FABRICS - Google Patents

Abstract

A device for intraoperative determination of the degree of tension of threads and fabrics, including a hollow cylindrical body, a measuring scale and a hook; a movable piston with a spring is located in the housing, the diameter of which is smaller than the internal diameter of the housing; one end of the spring is attached to the piston; characterized in that a measuring scale with a step of 0.1 N is applied to the outer surface of a transparent hollow cylindrical body made of a biologically and chemically inert material; the hook for attaching the ligature is the end of the spring, which is brought out through an opening in the wall of the housing.

Description

The utility model relates to the field of medicine, in particular to devices designed to determine the degree of tension of tissues that connect during surgical interventions or tissue joints, as well as for dosing the degree of application of force to cross-linking structures during surgical operations.

From the literature it is known that to determine the degree of tension of the edges of the aponeurosis when performing hernioplasty, a household steelyard is used as a dynamometer (1).

The disadvantage of this device is that household steelyards are not medical devices, this does not provide for their processing, and after the processing cycles used, the devices can fail. In addition, household steelyards provide significant measurement errors within 30 g / weight. The use of household steelyards to measure tissue tension is long. The materials used in the design of household steelyards do not meet the standards for medical devices.

A known apparatus is an analog tensometer of various models DX-2, ZD-2, etc., used to measure the degree of tension of threads in the aviation, machine, textile, and medical industries. Manufacturer HansSchmidt, Germany. This strain gauge is adapted to measure the tension of the thread, wire, yarn. In theory, it can be used to measure the tension of the threads when connecting tissues in surgery, the design of the device does not provide for its processing and use in sterile conditions. (2) The disadvantage of this apparatus is that it cannot be adapted for intraoperative use.

A device is known for determining the degree of tension of tissues, containing two articulated jaws, direct fixing needles and a measuring spring device for determining the degree of tension of tissues (3).

The disadvantage of this device is that it is difficult to use. This device is subjected to processing after its use - disinfection, pre-sterilization cleaning, sterilization, which may entail a violation of its integrity, failure of certain parts, and as a result, the indication of false results.

A device is known for determining the efforts of the tension of the stitched wound edges during surgical operations, including a body, a piston with a spring, a pointer and a measuring scale, characterized in that the body is equipped with a cross-shaped clamp, and the pointer is made in the form of a plate with holes (4). Stainless steel is used as a material for the manufacture of the device, which allows sterilization to be applied directly during surgical operations. The disadvantage of this device is that it is inconvenient to use, has a complex structure. This device is taken as a prototype.

The purpose of developing a utility model is to create a device for strain measurement, which allows to measure the degree of tension of threads and tissues intraoperatively.

This goal is achieved by the fact that a measuring scale with a step of 0.1 N is applied to the outer surface of a transparent hollow cylindrical body made of a biologically and chemically inert material; the hook for attaching the ligature is the end of the spring, which is brought out through an opening in the wall of the housing.

The technical result of the creation of the device is the possibility of intraoperative measurement of the degree of tension of threads and fabrics.

Comparison of the proposed device with others known in the field of medicine, shows its compliance with the criteria of a utility model.

The utility model is illustrated by graphic material. The figure 1 shows the proposed device. The device consists of a transparent hollow cylindrical body (1) of a biologically and chemically inert material. On the outer surface of the housing (1), a measurement scale of 0.1 N is applied - 1 step (2); inside the housing (1) on one side are a movable piston (3) with a pad (4) and a spring (5) whose diameter is smaller than the inner diameter of the housing (1), one end of it is attached to the platform (4) of the piston (3), and the other has a hook shape and serves to attach the ligature (6); on the other side of the housing (1) there is an opening (7) through which a hook with a ligature (6) is discharged.

The device is used as follows. The fixation of the thread or tissue within the surgical field is carried out for the ligature (6), attached to the spring (5) for the hook, brought out through the hole (7) of the housing (1) of the device. When performing tension, pulling the thread until the edges of the wound come closer to assess the degree of tension, the spring (5) is stretched, which ensures the movement of the piston (3) in the housing (1), because the spring (5) is firmly fixed to the platform (4) of the piston (3). The moving piston (3) in a transparent case (1) makes it possible to interpret the measurement results on a measurement scale (2). The measurement is carried out in Newtons 0.1 N = 1 step.

Given the possibility of processing the device by immersion in a disinfectant solution, it is possible to use it repeatedly within one operating day. Exposure times are selected according to their recommendations for use. Given the fundamental possibility of parsing the device into its constituent elements, it is possible to replace one element that has failed while the other components are intact. Compared with the prototype, the device has a simplicity of design and ease of use. A transparent body and a measuring scale applied to its outer surface allow you to quickly interpret the measurement results.

Clinical example 1. Patient B., 58 years old, diagnosed with gigantic correctable postoperative ventral hernia (history of acute intestinal obstruction). The size of the hernia gate intraoperatively is 18 cm, with the closure of the aponeurosis defect significant tension is manually determined. Tissue measurement with an intraoperative tensometry instrument - an instrument is attached to the edges of the aponeurosis, a tissue tension measurement of 13.4 N is made. This indicates a high tension of their own tissues. And it was key in the choice of hernia repair due to the high tension of their own tissues. The decision was made - combined hernioplasty with a mesh implant using the inlay technique. The outcome is recovery.

Clinical example 2. Patient S., 60 years old, diagnosed with chronic post-traumatic osteomyelitis of the bones of the right lower leg, fistulous form. Condition after extramedullary osteosynthesis of the right tibia. A history of 3 operations for osteomyelitis, necrosecvestrectomy. Operation progress: removal of a plate and 7 screws, necrsecvestrectomy. The skin of the lower leg is scarred, thinned. When closing the wound there is a risk of high tension and eruption of ligatures. When nodal ligatures were applied, a measurement was used by the device for intraoperative tensometry - a ligature was attached to the device. The measurement result is 4.2 N. This should be interpreted as moderate tension. Closing a wound is possible with its own tissues without the risk of thinning ligatures and necrosis of the skin in the postoperative period. The result - tissue ischemia did not occur. The wound healed by primary intention. Recovery.

This device can be widely used both in research laboratories, and medical hospitals, diagnostic and specialized medical centers.

INFORMATION SOURCES:

1. Thesis research Krasnolobov R.A. “Differentiated approach to surgical treatment of small and medium postoperative ventral hernias” St. Petersburg, 2008

2. Analogue of models DX-2, ZD-2 (Manufacturer HansSchmidt, Germany)

3. RF patent for the invention No. 2283027, IPC A61B Device for measuring the degree of tissue tension and the size of the hernia gate.

4. RF patent for utility model No. 64887 of July 27, 2007, “A device for determining the tension forces of the stitched wound edges during surgical operations”.

Claims (1)

A device for intraoperative determination of the degree of tension of threads and fabrics, including a hollow cylindrical body, a measuring scale and a hook; a movable piston with a spring is located in the housing, the diameter of which is smaller than the internal diameter of the housing; one end of the spring is attached to the piston; characterized in that a measuring scale with a step of 0.1 N is applied to the outer surface of a transparent hollow cylindrical body made of a biologically and chemically inert material; the hook for attaching the ligature is the end of the spring, which is brought out through an opening in the wall of the housing.

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