RU163478U1 - HERNIORAPHY NEEDLE - Google Patents

Abstract

The needle for hernioraphia consists of a needle 90-110 mm long with an outer diameter of 3-4 mm and an inner 1.5-2 mm, a cannula for a syringe is mounted on the proximal end of the needle, and the distal end is curved oval, in the lumen of the needle there are two threads: the main and the auxiliary, the main thread passes through the inner lumen of the needle and is fixed on the outer surface of the needle with a plastic holder, and the auxiliary thread also passes through the lumen of the needle and displayed along the outer surface of the needle to the level of the cannula.

Description

The utility model relates to the field of medicine and medical technology, namely to devices designed for the surgical treatment of congenital inguinal hernias in children using the minimally invasive method of suturing the internal inguinal ring.

The problem of the treatment of hernias of any localization is very relevant. More than 400 surgical methods are known, but not one of them guarantees the patient from a hernia recurrence. Most commonly used open hernioplasty. When using this technique in various modifications, relapses are possible in 5-30% of cases of operated patients. Modern endoscopic technology has made it possible to introduce a number of radical changes in the technique of hernia repair, which has significantly reduced the occurrence of hernia recurrence by up to 4.5%. However, the use of gas for the purpose of applying pneumoperitoneum can become a source of subcutaneous emphysema, pneumoperitoneum. In connection with the foregoing, we proposed a device for minimally invasive surgical operations of congenital inguinal hernias in children.

Most of the devices used for surgical treatment of inguinal hernias have a complex structure and are designed to install a mesh explant or prosthesis in a hernial defect [Patent RU No. 80652 U1 of 02.20.2009; Patent RU No. 94838 U1 dated 06/10/2010; Patent RU No. 2557422 C1 of 07.20.2015]. It is proposed to use retractors to close a hernial defect [Patent RU No. 2173965 C1 of 09.27.2001; RU No. 2207068 C2 of June 27, 2003]. The use of the proposed devices is accompanied by injuries and a certain complexity in the process of surgical intervention.

As a prototype, we have chosen the “Device for suturing the inner inguinal ring” [Patent RU No. 153074 U1 dated 06/05/2015], consisting of a body, the distal end of which is completed with a stitching part, and the proximal end goes into the handle, which has an elastic passage through it stock carrying the surgical thread.

The main disadvantages of the proposed device: 1) the surgical suture is inserted into the abdominal cavity using a rod, 2) the body of the device is made in the form of a rod, which creates certain difficulties for holding the surgical suture around the inguinal ring.

The objective of the utility model is to create a simple and easy-to-use device for minimally invasive suturing of an inguinal hernia ring.

The technical result of the proposed device is that in the lumen of the needle for hernioraphy there are two threads: auxiliary and main, which allows using the auxiliary thread to draw the main thread around the inguinal ring and pulling the main thread to eliminate the clearance in the inguinal ring.

According to the technical solution, the utility model consists of a needle 90-110 mm long with an external diameter of 3-4 mm and an internal 1.5-2 mm, a syringe cannula is mounted at the proximal end of the needle, and the distal end is oval bent, two threads pass in the lumen of the needle : the main and auxiliary, the main thread passes through the inner lumen of the needle and is fixed on the outer surface of the needle with a plastic holder, and the auxiliary thread also passes through the lumen of the needle and is discharged along the outer surface of the needle to the level of the cannula.

The proposed utility model is illustrated by graphic material.

The figure 1 shows a General view of the device, where 1 is the needle for hernioraphy, 2 is the cannula, 3 is the distal end of the needle, bent oval, 4 is the main thread, 5 is the plastic holder of the main thread on the outer surface of the needle, 6 is an auxiliary thread passing through the lumen of the needle and on the outer surface of the needle reaches the cannula.

The proposed device is used as follows: Puncture the anterior abdominal wall to the peritoneum, then, under the control of the video system, conduct a needle along the medial semicircle of the internal inguinal canal. In the semicircle of the inguinal canal, a loop is formed from the middle part of the auxiliary thread. The needle is removed and reinserted through the lateral semicircle of the internal inguinal canal. The distal end of the needle is visualized by the optical system and introduced into the loop formed by the auxiliary thread. The main thread is fixed with a loop of auxiliary thread and brought to the surface of the skin. So, the main thread runs through the entire circumference of the inner inguinal ring. When tightening the free ends of the main thread, the inner inguinal ring closes. The nodes are immersed under the skin and the optical system is removed from the abdominal cavity.

An example of practical use. Patient B, 3 years old, was admitted as planned in the direction of a pediatric surgeon with a diagnosis of Inguinal-scrotal hernia on the right. The diagnosis is set to honey. inspection before entering kindergarten. On admission: the external genitalia are developed according to the male type, asymmetry of the scrotum due to an increase in the right half is noted. Testicles in the scrotum. On palpation in the right half of the scrotum, a soft-elastic formation with a size of 2.5 × 3.0 cm of testiform consistency was revealed, which was freely fixed in the abdominal cavity. On the day of admission, the child is operated on. The ligature herniography on the right was carried out using a needle for hernioraphia.

A puncture of the anterior abdominal wall to the peritoneum was performed, then, under the control of the video system, a needle was inserted into the medial semicircle of the internal inguinal canal. A loop was formed in the semicircle of the inguinal canal from the middle part of the auxiliary thread. The needle was removed and reinserted through the lateral semicircle of the internal inguinal canal. The distal end of the needle was visualized using an optical system and inserted into a loop of an auxiliary thread. The main thread was fixed in the loop of the auxiliary thread and brought to the surface of the skin. As a result of the manipulation, the main thread passed through the circumference of the inner inguinal ring. When tightening the free ends of the main thread, the inner inguinal ring closed. The nodes were immersed under the skin and the optical system was removed from the abdominal cavity. Skin suturing was not required.

The postoperative period was uneventful. The child is activated 3 hours after surgical treatment. No pain syndrome was noted. Examination on the next postoperative day: the external genitalia are developed according to the male type, the scrotum is symmetrical, there is no swelling of the soft tissues. Testicles in the scrotum. When straining hernial protrusion was not determined. In the right inguinal region, a postoperative wound is 2 mm long with no signs of inflammation. In the navel area there is also a linear wound 3 mm long - without signs of inflammation. The wounds are treated with brilliant green. The child was discharged on the 1st postoperative day with recovery under the supervision of a surgeon in the clinic at the place of residence. At the control examination 1 month after the operation, hernial protrusion was not determined. In the right inguinal region and in the umbilicus, postoperative scars are practically invisible.

The proposed utility model is implemented on the basis of Design Bureau No. 2 of Tyumen. Conducted 16 operations with a positive effect.

Claims (1)

The needle for hernioraphy consists of a needle 90-110 mm long with an outer diameter of 3-4 mm and an inner 1.5-2 mm, a cannula for the syringe is mounted on the proximal end of the needle, and the distal end is curved oval, in the lumen of the needle there are two threads: the main and the auxiliary, the main thread passes through the inner lumen of the needle and is fixed on the outer surface of the needle with a plastic holder, and the auxiliary thread also passes through the lumen of the needle and displayed along the outer surface of the needle to the level of the cannula.

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