RU154029U1 - HOOK NEEDLE - Google Patents

Abstract

A needle hook consisting of a working plate, a cylindrical rod, a curly handle, characterized in that the distal part of the working plate has two arcuately curved lamellar teeth 8 mm long with rounded ends, the distance between the teeth is 2 mm, a rounded needle is located in the proximal direction latch 8 mm long, 1.5 mm in diameter, at an angle of 50 ° to the plane of the working plate and in the opposite of the lamellar teeth.

Description

The device relates to medicine, namely to surgery.

In cases of hernioplasty with endoprosthetics with mesh prostheses of a large area, the mesh is hemmed to the aponeurosis with separate nodal sutures to adapt the mesh to the underlying tissues. This technique fixes the mesh, but the use of conventional surgical needles leads to hemming of the aponeurosis and mesh with each stitch over a considerable length of area, which is accompanied by knotting knitted with corrugation of stitched fabrics and mesh, with subsequent deterioration of the quality of regeneration.

As a prototype, a small two-tooth hook was used, having a working part in the form of a plate with two arcuately curved teeth (Medical Instruments Catalog: surgical two-tooth hook URL: http://www.nworld.spb.ru/medinss_k007t.htm).

The technical result is a quick and easy way to fix and lift a limited area of the mesh endoprosthesis and the aponeurosis section for flashing.

The technical result is ensured by the fact that a needle hook is used, having a round needle retainer with a length of 8 mm and a diameter of 1.5 mm, directed at an angle of 50 ° to the plane of the working plate and fixed at the base of the hook teeth, which are arcuately curved, directed in the opposite direction from the needle retainer 8 mm long, tooth edges rounded.

USEFUL MODEL EXPLAINED BY FIGURES (Figs. 1-3)

In FIG. 1. View of the device in isometry.

In FIG. 2. General view of the device, top view.

In FIG. 3. General view of the device, side view.

The device consists of a working plate (1) with a length of 8 mm, a width of 6 mm, and a thickness of 2 mm, the shoulders of the plate are beveled at an angle of 50 ° to the side of the stem and curly handle, the distal part of the plate has 2 arcuately curved lamellar teeth (2) with a length of 8 mm s rounded ends, the distance between the teeth 2 mm, at the base of the teeth is located in the proximal direction, a round needle retainer (3) with a length of 8 mm, a diameter of 1.5 mm At an angle of 50 ° to the plane of the working plate and opposite from the lamellar teeth, the working plate passes into a truncated conical rod (4) with a diameter of the distal part of 2.5 mm, the proximal part - 5 mm, the latter is connected to a curly handle (5) having window for the finger (Fig. 3).

THE DEVICE WORKS AS FOLLOWS

The needle hook device is brought in a horizontal position by a needle retainer to the site of the planned hemming of the mesh to the aponeurosis, the mesh and the aponeurosis are pierced. The handle of the device rises describing the arc around the needle retainer, which protrudes a limited area of the aponeurosis and mesh. The protruded fragment of the aponeurosis and the mesh is stitched with a needle in one of the directions: either in the direction of the needle retainer or perpendicular to it. The device is removed by a needle hook and a ligature is tied. A fragment of stitched aponeurosis is 4-5 mm.

CLINICAL APPLICATION EXAMPLE

The needle-hook device was used to suture the central parts of the mesh endoprostheses to aponeurosis when performing hernioplasty of ventral hernias on 20 in patients.

Patient K., 64 years old. He was hospitalized in the surgical department GKB SMP Kursk. Diagnosis: restrained postoperative ventral hernia. An operation was performed for hernia repair, endoprosthesis replacement of the abdominal wall. Under spinal anesthesia with two bordering incisions, the old postoperative scar was excised. A multi-chamber hernial sac was identified along the midline: 10 × 7 × 6 cm in size and a second 5 × 4 × 4 cm sac. A lock of a large omentum was grown in the hernial sac and was viable. The omentum is partially resected. There is no effusion in the abdominal cavity. The hernial sac is sutured, the aponeurosis is sutured edge-to-edge, an anterior prosthetic endoprosthesis replacement with a mesh endoprosthesis of LLC Linteks 10 × 20 cm in size was performed using a mesh retainer and a needle hook. Hemostasis during the operation. In the subcutaneous tissue, two tubular drainages were delivered to the endoprosthesis. Stitches to the skin. Iodine. Aseptic dressing. The postoperative period was uneventful, the drainage was removed after two days. Ultrasound of the anterior abdominal wall on the third day of exudation in the projection of the endoprosthesis was not detected.

Patient P., 54 years old. Hospitalized in the surgical department GKB SMP Kursk. Diagnosis: irreducible umbilical hernia of large sizes. A hernia surgery with endoprosthetics was performed. Under spinal anesthesia, two bordering incisions excised a section of skin with an umbilical ring. A hernial sac measuring 15 × 16 × 10 cm was isolated from subcutaneous tissue, opened, 10 ml of light hernial water was released. The contents of the hernial sac is a large omentum and a loop of the small intestine. The gland is soldered to the wall of the hernial sac. The lock of the omentum is partially resected. There is no effusion in the abdominal cavity. The hernial sac is excised. The hernia gate is sutured with a continuous suture. An abdominoplasty of the anterior abdominal wall was performed with an endoprosthesis of LLC Linteks measuring 15 × 10 cm using a hook-shaped guide, a mesh retainer and a needle hook. The postoperative wound is sutured in layers. Aseptic dressing. The postoperative period was uneventful. On the third day, ultrasound of the abdominal cavity and anterior abdominal wall was performed. There is no free fluid in the abdominal cavity, in the projection of the endoprosthesis about 50 ml of exudate, which was evacuated by puncture under the control of ultrasound.

Patient B., 64 years old. He was hospitalized in the surgical department GKB SMP Kursk. Diagnosis: right-sided strangulated inguinal-scrotal hernia (Nyhus III B). A hernia surgery with plastic surgery according to Liechtenstein was performed. Under spinal anesthesia, a linear incision was made in the inguinal region to the right above the hernial protrusion, the anterior wall of the inguinal canal was dissected, a hernial sac 12x8x8 cm in size was distinguished, the hernial sac was opened, the contents of the sac were the small intestine, the lock of the omentum and up to 10 ml of serous hernial water, tissues are viable, immersed in the abdominal cavity. There is no effusion in the abdominal cavity, the hernial sac is excised, stitched at the neck, plastic of the posterior wall of the inguinal canal according to Lichtenstein was performed with endoprosthetics with a mesh prosthesis of LLC Linteks 8 × 12 cm and using a mesh retainer and a needle hook. Subcutaneous tissue is drained by a rubber graduate. The postoperative wound is sutured in layers. Iodine. Aseptic dressing. The postoperative period was uneventful.

An analysis of the results of the clinical use of the needle-hook device showed that the method of suturing the mesh endoprosthesis to aponeurosis has been simplified and accelerated. There was an opportunity to hem the mesh to a limited area of the aponeurosis, which eliminates the corrugation of the mesh and improves the adaptation of the mesh to the aponeurosis. In the postoperative period, a decrease in serous exudation was noted.

Thus, the needle hook tool simplified and accelerated the stitching of the mesh endoprosthesis in ventral hernia hernioplasty using the on lay method, improved the quality of mesh adaptation to aponeurosis, and decreased serous exudation in the transplant area.

There were no complications associated with the use of the device.

Claims (1)

A needle hook consisting of a working plate, a cylindrical rod, a curly handle, characterized in that the distal part of the working plate has two arcuately curved lamellar teeth 8 mm long with rounded ends, the distance between the teeth is 2 mm, a rounded needle is located in the proximal direction latch 8 mm long, 1.5 mm in diameter, at an angle of 50 ° to the plane of the working plate and in the opposite of the lamellar teeth.

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