RU158261U1 - GRID GUIDE LOCK - Google Patents

Abstract

The fixer-guide of the mesh transplant for hernioplasty, consisting of a working plate 12 mm long, 22 mm wide, 2 mm thick, in the proximal direction the working plate passes into the rod in the form of a truncated cone, and the proximal part of the stem is connected to a curly handle with a hole for the finger characterized in that in the distal part of the working plate there are 4 plate protrusions 3 mm long, 3 mm wide and 3 mm gaps between them, in the middle of the protrusions there are cylindrical mesh retainers with a diameter of 1 mm and a length of 3 mm.

Description

The device relates to medicine, namely to surgery. For endoprosthetics of defects of the chest and abdominal walls or plastics of aponeurotic formations, mesh prostheses are applied with tweezers, clamps and other devices not adapted for these purposes, and in some cases, when the plastic objects are deeply located, their use is difficult.

As a prototype, a four-tooth plate hook was used, having a working plate 12 mm long, 22 mm wide, 2 mm thick, 4 3 mm wide plate hooks bent at right angles, the gap between the hook plates was 3 mm (Medical instruments catalog: http: // www.nworld.spb.ru/medinss_k011t.htm).

The disadvantage of using surgical hooks is the ability to provide only an overview of the surgical field without the function of placing the mesh transplant in the right place.

EFFECT: fast fixation of a portion of the edge of the mesh transplant, placing and holding it at the hemming site with a continuous suture, quick extraction of the tool and quick repetition of manipulation along the entire perimeter of the mesh.

The technical result is ensured by the fact that on the working plate of the four-tooth hook there are four plate protrusions 3 mm long, 3 mm wide, and in the middle there are cylindrical mesh latches with a diameter of 1 mm and a length of 3 mm.

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 mesh retainer-guide device consists of a working plate (1) 12 mm long, 22 mm wide, 2 mm thick, on which in the distal part there are 4 plate projections 3 mm long, 3 mm wide and 3 mm gaps between them, in the middle there are cylindrical mesh retainers with a diameter of 1 mm and a length of 3 mm, in the proximal direction the working plate passes the rod (2) in the form of a truncated cone with a diameter of the distal part of 2.5 mm and a diameter of the proximal part of 5 mm, the proximal part of the rod is connected to a curly handle ( 3) having a window for finger (Fig. 3).

THE DEVICE WORKS AS FOLLOWS

The grid guide-clamp with four needle clamps is brought to the grid at a distance of 5 mm from the edge, vertically pricks it with cylindrical clamps, then rotates 90 ° and is brought to the place of hemming and held in this position. In the usual way, 5 stitches are made with a continuous seam, capturing the edges of the mesh and aponeurosis, then the tool is removed towards the handle. Depending on the size of the graft, the number of manipulations is repeated as many times as necessary.

CLINICAL APPLICATION EXAMPLE

The mesh guide was used to perform aponeurosis for ventral hernias in 25 patients, plastic replacement of the aponeurosis defect in 6 patients, plastic closure of the chest defect in 4 patients.

Patient K., 64 years old. The history of the disease 1538. Hospitalized on 10/23/14 in the surgical department of the Clinical Clinical Hospital SMP in Kursk. Diagnosis: restrained postoperative ventral hernia. Operation No. 135, 10.24.14. 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, the anterior abdominal wall endoprosthesis is replaced with a mesh endoprosthesis of LLC Linteks measuring 10 × 20 cm using a mesh guide 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, drainage was removed after two days with ultrasound of the anterior abdominal wall on the third day of exudation in the projection of the endoprosthesis.

Patient P., 54 years old. Case history 1176. Hospitalized on 01.24.14 in the surgical department of the Clinical Clinical Hospital Nursing Home of Kursk. Diagnosis: irreducible umbilical hernia of large sizes. Operation No. 99, 01/24/14. 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 serous hernia 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 using the Linteks endoprosthesis of 15 × 10 cm in size using a hook-shaped guide, a mesh guide 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 G., 64 years old. Case history 18026. He was hospitalized on 12/27/14 in the surgical department of the Clinical Clinical Hospital Nursing Home of Kursk. Diagnosis: restrained umbilical hernia, necrosis of the small intestine, acute strictive small bowel obstruction. Operation No. 1689, 12/28/14. Hernia surgery was performed with endoprosthetics of the anterior abdominal wall, elimination of small bowel obstruction, resection of the small intestine loop, entero-enteroanastomosis, scientific research institute, drainage of the abdominal cavity. Endoprosthetics with a mesh endoprosthesis of LLC Linteks 10 × 20 cm with subaponeurotic placement using a hook-shaped guide and mesh retainer. The postoperative wound is sutured in layers. Iodine. Aseptic dressing. There were no postoperative complications.

Patient S., 24 years old. Case history 4945. He was hospitalized on 11/29/13 in the thoracic department of the Kursk Regional Oncology Dispensary. Diagnosis: Ewing's sarcoma XI ribs on the right, stage III, KG II (T3, N0, M0, M0). Operated on 12/05/13. A thoracophrenolumbotomy was performed on the right, combined removal of a chest wall tumor, resection of the X, XI, XII ribs, diaphragm and peritoneum section with endoprosthetics of the diaphragm and chest wall with a mesh transplant, rehabilitation, drainage of the abdominal cavity. During the Esfil mesh endoprosthesis replacement, a hook-shaped guide and mesh retainer were used. There were no complications associated with the use of surgical instruments. Discharged 12.25.13 in satisfactory condition under the supervision of an oncologist at the place of residence.

Analysis of the results of the clinical use of the device showed that the retainer-guide mesh facilitates the placement and fixation of the edge of the mesh endoprosthesis in all clinical situations, facilitating and accelerating the mesh hemming.

Thus, the fixer ”the mesh guide facilitates and accelerates the hemming of the mesh endoprosthesis in patients with ventral hernias and in all cases of plastic replacement of defects of the aponeurosis, tissues of the abdominal and chest walls, is convenient to use.

Claims (1)

The fixer-guide of the mesh transplant for hernioplasty, consisting of a working plate 12 mm long, 22 mm wide, 2 mm thick, in the proximal direction the working plate passes into the rod in the form of a truncated cone, and the proximal part of the stem is connected to a curly handle with a hole for the finger characterized in that in the distal part of the working plate there are 4 plate protrusions 3 mm long, 3 mm wide and 3 mm gaps between them, in the middle of the protrusions there are cylindrical mesh latches with a diameter of 1 mm, 3 mm long.

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