RU182215U1 - Miniflebectomy puncher - Google Patents

Abstract

The utility model relates to medicine, in particular to surgical instruments, and can be used when performing operations on saphenous and perforating veins from mini-access. The technical result achieved by using the claimed utility model is to reduce the morbidity of the operation. A perforator for miniflebectomy containing a tubular body, according to the claimed technical solution, contains a steel tube and a stop fixed to it, while the stop and steel tube are fixed motionless in the tubular body, the distal end of the steel tube is sharpened at an angle of 14 ° for directional skin incision, while sharpening length does not exceed the thickness of the skin and is 3 mm of the lower leaf, the handle and emphasis are made in the form of a threaded connection. 5 of FIG.

Description

The utility model relates to medicine, in particular to surgical instruments (trocars, puncture needles) and can be used when performing operations on saphenous and perforating veins from mini-access.

Known surgical pointed scalpel with blades of sizes 10 ... 36 for performing operations to dissect the skin, soft tissues and facilitate access to vessels of various manufacturers: "Huaiyin Medical Instruments Co., Ltd.", "Troge Medical GMBH", "Apexmed" and others. (http://medams.ru/lezviya-i-skalpeli-hirurgicheskik-o). Disadvantage: large bleeding, damage to nerves and extracted vessels.

Also known is a perforator for embolization of tumors, containing a handle and a main tubular body with an end sharpening, an additional tubular body having a connecting element on the inactive end for interconnecting with a negative pressure source, the main tubular body having a connecting end on the non-working end for interconnecting with the introduction means embolizing material and a mandrin installed in the cavity, the working end of which is flush with the end sharpening, and the handle has a flattened shape and is located in the plane of the longitudinal axes of the housings or oriented to the plane of the longitudinal axes of the housings at an angle of 60-120. However, this perforator is quite time-consuming and not suitable for miniflebectomy (Patent No. 2233131. Neurosurgical perforator for embolization of tumors. Arustamyan SR, Shkarubo AN, Lubnin A.Yu., Zorina EA, application 14.02.2003 , publ. 07.27.2004) - prototype.

The objective of the utility model is to develop the design of a perforator for minimally invasive dissection of the skin and facilitate access to vessels.

The technical result of a useful model of a perforator is to reduce the morbidity of the operation.

The technical result is achieved due to the fact that the structural element of the punch - a steel tube is made in the form of a pointed distal part at an angle of 14 ° for directional dissection of the skin, while the length of the cutout or groove exceeds the thickness of the skin and is maximum 4 mm.

The utility model is illustrated by the drawings of FIG. 1-5, where:

FIG. 1 - General view of the punch,

FIG. 2 - handle

FIG. 3 - emphasis

FIG. 4 - steel tube

FIG. 5 - sequence of manipulations during surgery.

In FIG. 1 shows the developed design of the punch, where: 1 - handle, 2 - emphasis, 3 - steel tube. Steel tube 3 and stop 2 are mounted in the handle 1. For the manufacture of the stop 2 and handle 1, medical stainless steel grade 12X18H10T according to TU 3-1002-77 is used, for a steel tube 3, medical stainless steel 36NXTY according to TU 14-1-2554- 78.

In FIG. 5 shows the sequence of manipulations using a perforator during surgery, where: 4 - a semicircular incision, 5 - skin, open like a window, 6 - hole in the skin, 7 - venoextractor (Ash hook), 8 - varicose vein.

дюйма 1,5×50 мм. Стальная трубка 3 представляет собой полуокружность с заточенными краями на дистальном конце, длина выреза или паза превышает толщину кожи и составляет максимум 4 мм (Богачев В.Ю. Местное лечение хронических заболеваний вен // Фарматека. - 2013. - №. 10. - С. 83-87, толщина кожи на нижних конечностях 2…4 мм). Упор 2 имеет ограничитель, чтобы не повреждать подлежащие к коже образования (сосуды, нервы), тем самым избежать кровотечения, повреждения нервов и не повредить (пересечь) извлекаемый сосуд.The proposed utility model contains a tubular body, which is a handle 1 and an abutment 2 fixed on it, a steel tube 3 made as a pointed scalpel or scarifier or injection needle 18Gx1

inches 1.5 × 50 mm. Steel tube 3 is a semicircle with sharpened edges at the distal end, the length of the cutout or groove exceeds the thickness of the skin and is a maximum of 4 mm (Bogachev V.Yu. Local treatment of chronic venous diseases // Farmateka. - 2013. - No. 10. - C . 83-87, the thickness of the skin on the lower extremities 2 ... 4 mm). The stop 2 has a limiter so as not to damage the formations (vessels, nerves) to the skin, thereby avoiding bleeding, damage to the nerves and not damage (cross) the extracted vessel.

In the developed model of the punch, the radius of rounding of the circumference of the steel tube is R 0.75; sharpening angle 14 °. On the stopper and the handle there is a thread with a fine pitch, M8 × 0.5 thread, this allows you to adjust the depth of puncture, which is usually 2 ... 4 mm, while 3 mm is optimal.

An advantage over the known prototype: the device’s design does not require skin incisions to access the trunk and perforating saphenous veins, there are no skin sutures and complications associated with suture healing (divergence, teething, scar formation, healing by secondary tension), cosmetic - no sutures, incisions on skin, non-surgical method: there is no incision, this is not an operation, but manipulation, anesthesia - local anesthesia. There is no need for cerebrospinal anesthesia or general anesthesia, conducting on an outpatient basis (observation up to 2-3 hours), early activation of the patient - he can walk right away, which is the prevention of thromboembolic complications, cost-effective in hospital days, instead of from 1 to 10 days in in a hospital, outpatient stay for 2-3 hours, the possibility of surgery by one doctor without an assistant, reducing the cost of scalpels, suture material, etc.

It is also an advantage that the semicircle will have better access to the vein, since when the vein is removed from under the skin, the semicircle will open like a window and also close without creating a defect in the skin, FIG. 5.

The punch works as follows. The sequence of manipulations during the operation using a perforator (Fig. 1), containing a handle 1, a stop 2 fixed on it, and a steel tube 3, is shown in FIG. 5. Using the handle 1 and the stop 2 of the perforator, a certain length of the steel tube 3 is fixed. The skin incision 4 is made in a semicircle so that if the semicircular incision of the hole 6 in the skin is straightened to a linear size, the length will be sufficient to extract the vein 8 from a small to large diameter from 1 to 8 mm. When a varicose vein is removed, the skin of the hole 6 is stretched in a semicircle, and the skin 5 is opened like a window. The enlarged vein 8 is removed by means of a vein extractor (Ash hook) 7. The skin 5 covers the hole in the skin 6 after removing the vein and does not tear. Typically, with a linear skin incision causing the formation of rough scars, suturing is often required, which, accordingly, leads to additional costs for suture material and tools: needle holder, tweezers, scissors. Thus, the operation time is increased. The advantage of the developed design of the hammer drill is that the operating working field remains free for viewing and manipulating tools.

Claims (1)

A perforator for miniflebectomy, comprising a tubular body and a handle, characterized in that the tubular body is made in the form of a steel tube, on which a stop is connected, connected to the handle by a threaded connection, while the distal end of the steel tube is sharpened at an angle of 14 ° for directional skin incision, sharpening length does not exceed the thickness of the skin and is 3 mm of the lower sash.

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