RU155664U1 - APONEUROTIC MULTIFUNCTIONAL RESPATOR - Google Patents

Abstract

Multifunctional aponeurotic raspator, consisting of a working plate, cone-shaped rod, curly handle, characterized in that the working plate is a rectangular frame 40 mm long, 27 mm wide, side fragments 4 mm wide, 5 mm base and 5 mm cutting part; the cutting part has a taper angle of 24 ° from the front surface, the thickness of all parts of the working frame is 2 mm; the base of the working frame in the middle part is connected to the stem in the form of a truncated cone with a diameter of the distal part of 3 mm, proximal - 5 mm, stem length 25 mm.

Description

The device relates to medicine, namely to surgery.

Hernia repair for ventral and recurrent hernias is accompanied by endoprosthetics with mesh transplants with different options for their placement. All of them require the allocation of different surfaces of the aponeurotic formations. To date, there is no convenient tool for these purposes. Mobilization is carried out bluntly or sharply by using clamps with a hoop or scissors. Such mobilization options lead to soft tissue trauma and take a long time.

A four-tooth plate hook was used as a prototype (Catalog of medical instruments: four-tooth plate hook middle URL: http://www.nworld.spb.ru/medinss_k007v.htm), which is used to breed the edges of soft wound tissues.

The disadvantage of using a four-toothed plate middle hook is that it is designed to dilute the edges of the wound and cannot be used to highlight aponeurosis.

EFFECT: improved quality and accelerated mobilization of aponeurotic tissue sites in all layers of the abdominal wall, as well as simplified hemostasis from skeletonized or damaged perforating vessels, muscles using the aponeurotic multifunctional raspator.

The technical result is ensured by the fact that the aponeurotic multifunctional raspator is used, having a working part in the form of a rectangular frame 40 mm long, 27 mm wide, with side frame fragments 4 mm wide, a base 5 mm wide and a cutting part 5 mm wide, the cutting part of the frame has an angle sharpening 24 ° from the front surface, the thickness of all parts of the working frame 2 mm The base of the working frame in the middle part is connected to the stem in the form of a truncated cone with a diameter of the distal part of 3 mm, the proximal part - 5 mm, the length of the rod 25 mm The proximal part of the stem is connected to a curly handle with a hole for the finger.

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 rectangular frame (1) 40 mm long, 27 mm wide, the width of the side fragments of the frame 4 mm (3); base 5 mm wide and the cutting part (2) 5 mm wide, the cutting part has a taper angle of 24 ° from the front surface, the thickness of all parts of the working frame is 2 mm. The base of the working frame in the middle part is connected to the stem (4) in the form of a truncated cone with a diameter of the distal part of 3 mm, the proximal part - 5 mm, the length of the rod 25 mm. The proximal part of the rod is connected to a curly handle (5) having a hole for the finger (Fig. 3).

THE DEVICE WORKS AS FOLLOWS

The aponeurotic multifunctional raspator device is used to mobilize aponeurotic tissues in all parts of the abdominal wall and in all its layers. The edges of the aponeurosis are captured by the clamps, and the cutting part of the working frame of the raspator is located above the aponeurosis, under the aponeurosis or when opening the rectus muscles of the vagina of the rectus muscles, their front or back wall can be distinguished. The cutting part of the working frame of the raspator is the shift of fatty tissue or rectus abdominis muscles. Skeleton perforated vessels are stitched and bandaged. Bleeding from dangling perforating veins is stopped by pressing tissue with a bleeding vessel to the frame of the raspator and placing the vessel in the window of the frame. The damage area of the vessel is drained, viewed and flashed in the lumen of the frame of the raspator. Due to the short length of the device, it is also convenient to use it when skeletonizing the posterior surface of the vagina of the rectus abdominis muscles, separating the peritoneum.

CLINICAL APPLICATION EXAMPLE

1. Patient F., 49 years old. The history of the disease 967. He was hospitalized in the OBUZ GKB SMP Kursk from 01/21/12 to 01/29/12. Diagnosis: restrained umbilical hernia, diastasis of the rectus abdominis muscle 2 degrees. 01.21.12 hernia repair with endoprosthetics performed in lay. Protocol of operation No. 97. Under umbilical anesthesia, the umbilical ring was excised with two bordering incisions, a hernial sac 6 × 5 × 4 cm was selected, opened, 10 ml of clear hernial water was excreted, aponeurosis defect 4 × 3 cm, a large omentum section was impaired. After dissection of the infringing ring, the omentum is viable, immersed in the abdominal cavity, the hernial sac is stitched at the neck, cut off. Diastasis of the rectus abdominis muscles over the navel 2 degrees. The vagina of the rectus abdominis was opened. The posterior wall of the anterior sheet of the vagina was mobilized using an aponeurotic raspator by 6 cm. The posterior sheets of the vagina of the rectus muscles were sutured. Plastic surgery of the anterior vaginal wall was made with suturing of the mesh polypropylene prosthesis 10 × 6 cm to the aponeurosis of the anterior sheet of the vagina of the rectus abdominis muscles. Rubber graduate in subcutaneous tissue. Stitches to the skin. Iodine. Aseptic dressing. The postoperative period was uneventful.

2. Patient S., 50 years old, medical history 4019. She was hospitalized at the Clinical Hospital for Clinical Emergencies, Kursk from 03.19.15 to 03.28.15. Diagnosis: ventral hernia, diastasis of the rectus abdominis muscles of the second degree. 03.20.15 hernia repair performed with sub lay endoprosthetics. Under a spinal anesthesia, a 12 cm long incision was made with an umbilical ring excision, a defect in the aponeurosis region 4 × 4 cm in size, a hernial sac 8 × 5 × 4 cm. The contents of the hernial sac are a large omentum, accrued to the peritoneum. The gland section is resected. The aponeurosis is dissected upward, the posterior wall of the vagina of the rectus abdominis above and below the umbilical ring with the help of an aponeurotic raspberry is highlighted, skeleton perforating vessels are bandaged. Lintex polypropylene endoprosthesis of size 15 × 10 cm performed endoprosthetics according to the sub lay technique. The aponeurosis is sutured by a monophile, a drainage tube is placed in the subcutaneous tissue. The drainage is removed on the third day. The postoperative period without complications.

3. Patient K., 53 years old, medical history 2480. She was undergoing treatment at the Clinical Clinical Hospital Nursing Unit at Kursk from 02/18/15 to 02/26/15. Diagnosis: recurrent postoperative ventral hernia. 02/19/15 performed hernia surgery with endoprosthetics on lay. Protocol of operation No. 72. Under spinal anesthesia with bordering incisions with excision of the old postoperative scar and umbilical ring, a hernial sac measuring 7 × 5 × 4 cm is identified along the white line, opened, contains a large omentum, the latter is not changed, is immersed in the abdominal cavity. Aponeurosis is highlighted. The hernial gate is 5 × 4 cm in size. The hernial sac is excised, the defect in the aponeurosis is sutured edge-to-edge with a monophile, the plastic of the anterior abdominal wall on lay with a Lintex endoprosthesis of 15 × 10 cm. Hemostasis during surgery. A drainage tube has been brought to the prosthesis through a contra-hole. Drainage removed after three days. The postoperative period was uneventful.

Thus, the aponeurotic multifunctional raspator tool improved the quality and accelerated the process of mobilization of aponeurotic tissue sites in all layers of the abdominal wall, as well as simplified the implementation of hemostasis from skeletonized or damaged perforating vessels.

Claims (1)

Multifunctional aponeurotic raspator, consisting of a working plate, cone-shaped rod, curly handle, characterized in that the working plate is a rectangular frame 40 mm long, 27 mm wide, side fragments 4 mm wide, 5 mm base and 5 mm cutting part; the cutting part has a taper angle of 24 ° from the front surface, the thickness of all parts of the working frame is 2 mm; the base of the working frame in the middle part is connected to the stem in the form of a truncated cone with a diameter of the distal part of 3 mm, proximal - 5 mm, stem length 25 mm.

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