RU160498U1 - LATCH AND LIFT FOR NET MECHANISM - Google Patents

Abstract

Clamp-elevator for mesh endoprosthetics, consisting of a single-tooth hook, a truncated conical rod, a curly handle, characterized in that it has a distal needle fragment 6 mm long, 1 mm in diameter; tissue piercing limiter in the form of an arcuate rod-shaped fragment of a rod 3 mm in diameter eccentrically located to the needle, with an arc of 6 mm radius; a straight rod segment in the form of a truncated cone with a distal diameter of 3 mm, a proximal diameter of 5 mm, and a length of 60 mm.

Description

The device relates to medicine, namely to surgery.

Plastic surgery of defects of the abdominal and chest walls with endoprosthetics with mesh prostheses of a large area requires hemming not only the perimeter of the mesh prosthesis, but also the application of nodal sutures in the central sections of the mesh. The use of conventional atraumatic needles for these purposes leads to suturing of the mesh and aponeurosis for a considerable length, which leads to the corrugation of these structures when tying the knot and worsens their adaptation to each other. Prevention of this defect is to reduce the length of stitched fabrics.

A single-tooth sharp hook was used as a prototype (Catalog of medical instruments: single-tooth sharp bone hook URL:), consisting of a single-tooth hook, a truncated conical rod, and a curly handle that is used to fix and reposition bone fragments.

The disadvantage of the prototype is the inability to use the tool for fixing and lifting a limited area of the mesh and aponeurosis for their subsequent flashing, as well as a significant length of the tool, which is inconvenient when working on limited areas of tissue.

The technical result is an improvement in the quality of fixation and lifting of a limited area of the mesh endoprosthesis and aponeurosis for flashing, simplification of suturing on the central sections of the endoprosthesis with the help of a latch-elevator device for mesh endoprosthetics.

The technical result is ensured by the fact that for fixing and lifting a limited area of tissues and their subsequent stitching, a latch-hoist for mesh endoprosthetics is used, consisting of a single-tooth hook, a truncated conical rod, a curly handle having a distal needle fragment 6 mm long, 1 mm in diameter; tissue piercing limiter in the form of an arcuate rod-shaped fragment of a rod 3 mm in diameter eccentrically located to the needle, with an arc of 6 mm radius; a straight segment in the form of a truncated cone with a distal diameter of 3 mm, a proximal diameter of 5 mm, a stem length of 60 mm and 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 single-tooth hook, a truncated conical rod, a curly handle having a distal needle fragment (1) 6 mm long, 1 mm in diameter; tissue piercing limiter (2) in the form of an arched rod fragment (3) eccentrically located to the needle, 3 mm in diameter, with an arc of 6 mm radius; a straight stem segment (4) in the form of a truncated cone with a distal diameter of 3 mm, a proximal diameter of 5 mm, a length of 60 mm and a curly handle (5) with a hole for the finger (Fig 3).

THE DEVICE WORKS AS FOLLOWS

The latch-elevator device for mesh endoprosthetics is brought in a horizontal position by a needle fragment to the site of hemming of the mesh endoprosthesis to the aponeurosis, the mesh and the aponeurosis are pierced. Then the handle of the device rises to a vertical position, describing the arc and turning along the distal arcuate fragment of the instrument located on the surface of the mesh and aponeurosis; however, a limited area of the mesh and aponeurosis impaled on a needle fragment rises. The protruded portion of the mesh and aponeurosis is stitched with a conventional pricking atraumatic needle. The stitched fragment of the mesh and aponeurosis is 3-5 mm.

CLINICAL APPLICATION EXAMPLE

The fixer-lift device for mesh endoprosthetics was used to simplify and accelerate the hemming of the central sections of mesh transplants in 40 patients.

Patient K., 62 years old. Medical history 2359. She was treated in the surgical department of the Municipal Clinical Hospital of the City Clinical Hospital of the Nursing School of Kursk from 02.16.15 to 02.26.15. Diagnosis: irreversible postoperative ventral hernia of large sizes. Date of operation 02.17.15. Protocol No. 62. The name of the operation: hernia repair, endoprosthesis replacement of the anterior abdominal wall.

Under spinal anesthesia, an old postoperative suture with an umbilical ring was excised. Hernial sac 20 × 20 × 30 cm. The contents of the hernial sac are a large omentum and loops of the small intestine. The large omentum is partially resected. Defect of the abdominal wall 10 × 8 cm. Aponeurosis sutured edge to edge. An endoprosthesis replacement of the anterior abdominal wall with a polypropylene prosthesis of 30 × 20 cm on lay was performed with a continuous suture by a monophile along the perimeter and nodal sutures of the central sections of the endoprosthesis using a fixation device. Two tubular drainages were delivered to the subcutaneous fat.

The postoperative period was uneventful. Drainages are removed on the third and fourth day. Skin healing by primary intention. There were no functional disorders of the abdominal wall in the postoperative period.

Patient G., 51 years old. The history of the disease is 2872. He was treated in the surgical department of the Municipal Clinical Hospital Municipal Clinical Hospital SMP in Kursk from 02.26.15 to 03.03.15. Diagnosis: postoperative ventral hernia. Date of operation 02.27.15. Protocol No. 87. Operation name: hernia repair with endoprosthesis replacement of the anterior abdominal wall.

Under spinal anesthesia with two bordering incisions, the old postoperative scar was excised. On the white line of the abdomen above the navel, a hernial sac 10 × 8 × 4 cm in size is highlighted. Opened. The contents are a large omentum and loops of the small intestine. The organs are viable, immersed in the abdominal cavity. Defect in aponeurosis 9 × 5 cm, sutured edge to edge. Lintex endoprosthesis repair is 15 × 10 cm. The central sections of the endoprosthesis are hemmed with interrupted sutures with the help of a latch-elevator. A tubular drainage has been placed to the endoprosthesis.

The postoperative period was uneventful. Drainage removed on day 4. Healing by first intention.

Patient P., 65 years old. Medical history 3821. She was treated in the surgical department of the Municipal Clinical Hospital of the City Clinical Hospital of the Nursing School of Kursk from 03.16.15 to 03.24.15. Diagnosis: postoperative ventral hernia. Date of operation 03.17.15. Protocol of operation No. 115. Operation name: hernia repair with endoprosthetics.

A skin-fat flap with granulations in the postoperative scar was excised under spinal anesthesia. The defect in the aponeurosis is 7 × 10 cm. The hernia sac is 15 × 10 × 8 cm. The second defect in the aponeurosis is 5 × 4 cm, the hernia sac is 7 × 6 × 5 cm. The hernia sacs are isolated, stitched, bandaged, excised, sutured. Aponeurosis defects are sutured edge to edge. Endoprosthetics of the anterior abdominal wall with an Esfil endoprosthesis 30 × 30 cm in size. The central mesh fragments are hemmed with interrupted sutures using an elevator fixator. Subcutaneous fat is drained by two tubes. Drainage removed after four days.

The postoperative period was uneventful. The wound healed by primary intention.

An analysis of the results of the clinical use of the fixator-lift device showed that the operation of suturing mesh endoprostheses was simplified and accelerated. Hemming of the mesh with interrupted sutures in a limited area of the aponeurosis excludes corrugation of the mesh, improves adaptation of the mesh and aponeurosis, reduces the exudative reaction, improves adhesion.

Thus, the clamp-elevator tool for mesh endoprosthetics simplified and accelerated the hemming of mesh endoprostheses to aponeurosis, as well as improved the quality of adaptation and fusion of mesh endoprostheses and aponeurosis. There were no complications associated with the use of the device.

Claims (1)

Clamp-elevator for mesh endoprosthetics, consisting of a single-tooth hook, a truncated conical rod, a curly handle, characterized in that it has a distal needle fragment 6 mm long, 1 mm in diameter; tissue piercing limiter in the form of an arcuate rod-shaped fragment of a rod 3 mm in diameter eccentrically located to the needle, with an arc of 6 mm radius; a straight rod segment in the form of a truncated cone with a distal diameter of 3 mm, a proximal diameter of 5 mm, and a length of 60 mm.

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