RU182974U1 - SCISSORS FOR THE FORMATION OF THE EDGE OF THE HESAL-GASTROINTESTINAL AND OES-GASTROINTESTINAL ANASTOMOSES - Google Patents

Abstract

The utility model relates to medical, namely surgical instruments, and can be used to form the edge of the esophageal-gastric and esophageal-intestinal anastomoses during resection of the esophagus for esophageal or cardio-esophageal cancer.

The technical result of the utility model is to create the ideal edge of the stump of the esophagus, stomach, intestine, which in turn improves the quality of the formed anastomosis, and also allows the surgeon to easily cut off the leaving parts of the esophagus, stomach, intestine due to the bending of the blades and the length of the branches, all this to reduce the number of organic and functional complications.

The device consists of two blades bent at an angle of 100 ° with cutting edges connected by a hinged screw, turning into branches, 200 mm long, at the ends of which there is a ring. Surgical scissors are made of medical steel. 2 ill.

Description

The utility model relates to medical, namely surgical instruments, and can be used to form the edge of the esophageal-gastric and esophageal-intestinal anastomoses during resection of the esophagus for esophageal or cardio-esophageal cancer.

As a prototype, surgical scissors were used (RF patent No. 86,440, A61B 17/32 (2006.01) having a convenient configuration for operation.

However, the disadvantage of these scissors is that the blades are too wide in relation to short jaws. As a result, this design does not allow to form a flat edge of the anastomosis, which in turn leads to increased trauma, submucosal bleeding and insolvency of the anastomosis.

The technical result is the creation of an ideal edge of the stump of the esophagus, stomach, intestine, which in turn improves the quality of the formed anastomosis, and also allows the surgeon to easily cut off the leaving parts of the esophagus, stomach, intestine due to the bending of the blades and the length of the branches, all this leads to a decrease the number of organic and functional complications in the early postoperative period.

The technical result is ensured by the fact that the proposed device consists of two blades bent at an angle of 100 degrees with cutting edges connected by an articulated screw, turning into branches, 200 mm long, at the ends of which there is a ring. Surgical scissors are made of medical steel.

The device, due to the bending of the blades, forms by cutting off the smooth edges of the anastomosing surfaces in the most remote places of the abdominal and chest cavity in one motion.

The utility model is illustrated by figures (Fig. 1-2)

In FIG. 1. View of the device in isometry.

In FIG. 2. Two blades with cutting edges.

The device consists of two blades (1) bent at an angle of 100 degrees with cutting edges connected by an articulated screw (2), turning into branches (3), 200 mm long, at the ends of which there is a ring (4). Surgical scissors are made of medical steel.

The device operates as follows

The device, due to the bending of the blades located at a perpendicular angle relative to the organ, forms, by cutting off, the smooth edges of the anastomosing surfaces in the area of the surgeon's work. Long branches of scissors allow you to work quite deeply, without causing discomfort. Massive and hard blades cut through the tissue simultaneously without unnecessary trauma.

The developed device was used in operations in 130 patients with cancer of the esophagus and cardio-esophageal cancer in the regional oncological clinic of Kursk since 2013.

A comparative analysis of the treatment of 90 patients using conventional surgical scissors (the first clinical group) and 130 patients using the developed device (the second clinical group) was carried out.

In the first clinical group, anastomotic stricture was 15.3%, and anastomotic failure was 5.8%.

In the second clinical group, the frequency of anastomotic stricture decreased to 4.0%, and the failure of the anastomosis was 2.0%.

Clinical example: Patient K., 1945 g / r. With a diagnosis of cardiac esophageal stage II T2N1M0 cancer, surgical treatment was performed in the amount of subtotal resection of the esophagus and lymphodissection and plasty of the esophagus by the gastric stem. In the work, a device was used to form the edge of the esophageal-intestinal or esophageal-gastric anastomoses. The postoperative period was uneventful. A similar case: patient F., 1951 g / r. With a diagnosis of cardiac esophageal stage II T2N1M0 cancer, surgical treatment was performed in the amount of subtotal resection of the esophagus and lymphodissection and esophagoplasty with the gastric stem using standard scissors, and anastamosis failure developed in the early postoperative period.

Thus, the device, due to the bending of the blades located at a perpendicular angle relative to the organ, forms, by cutting off, the smooth edges of the anastomosing surfaces, without additional trauma, in the surgeon's area of work, which reduces the number of organic complications in patients after resection of the esophagus in the early postoperative period.

Claims (1)

Device for forming the edge of the esophageal-intestinal or esophageal-gastric anastomoses, consisting of two blades turning into branches 200 mm long, connected by an articulated screw, characterized in that the blades are bent at an angle of 100 °.

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