RU2086192C1 - Surgical suture appliance - Google Patents
Surgical suture appliance Download PDFInfo
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- RU2086192C1 RU2086192C1 RU95103896A RU95103896A RU2086192C1 RU 2086192 C1 RU2086192 C1 RU 2086192C1 RU 95103896 A RU95103896 A RU 95103896A RU 95103896 A RU95103896 A RU 95103896A RU 2086192 C1 RU2086192 C1 RU 2086192C1
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Abstract
Description
Изобретение относится к медицинской технике и предназначено для ушивания ран апоневроза, например, после лапароскопии. The invention relates to medical equipment and is intended for suturing wounds of an aponeurosis, for example, after laparoscopy.
Известен хирургический сшивающий аппарат, содержащий подсоединенный привод и шарнирно соединенные изогнутые бранши с кольцевидными рукоятками, стопором и рабочими частями со скобочными пазами. Known surgical stapler, containing a connected drive and articulated curved branches with annular handles, a stopper and working parts with bracket grooves.
Недостатком известного аппарата является то, что при использовании устройства затруднена защита выступающих в рану внутренних органов П-образными скобками после извлечения тубуса лапароскопа. A disadvantage of the known apparatus is that when using the device, it is difficult to protect the internal organs protruding into the wound with U-shaped brackets after removing the laparoscope tube.
В связи с близостью конструктивного замысла устройство принято за базовый объект. Due to the proximity of the design concept, the device is taken as the base object.
Цель изобретения облегчить ушивание ран апоневроза после лапароскопии. The purpose of the invention to facilitate the closure of wounds of the aponeurosis after laparoscopy.
Цель достигается тем, что рабочие части выполнены в виде размещенных на осях валиков с продольными наружными выступами под привод в виде тубуса лапароскопа с ответными поперечными выступами на наружной поверхности, при этом изгиб бранш выполнен ступенчатым, скобочные пазы расположены на валиках и выполнены под скобу кольцеобразной формы, имеющую игольчатые зубья и внутреннюю поверхность под тубус лапароскопа, а стопор выполнен в виде подпружиненного храповика, соединенного гибкой тягой с дополнительной рукояткой, причем храповик установлен с возможностью взаимодействия с продольными выступами и расположен в направляющих уступах на боковых поверхностях бранш; скоба кольцеобразной формы снабжена установочными выступающими элементами и выполнена с противоположными истонченными боковыми участками, причем игольчатые зубья ориентированы перпендикулярно ее рабочей поверхности. The goal is achieved by the fact that the working parts are made in the form of rollers placed on the axes with longitudinal external protrusions for the drive in the form of a laparoscope tube with reciprocal transverse protrusions on the outer surface, while the jaws are bent in steps, the bracket grooves are located on the rollers and made under a ring-shaped bracket having needle teeth and an inner surface under the tube of the laparoscope, and the stopper is made in the form of a spring-loaded ratchet connected by a flexible rod with an additional handle, and the ratchet mouth updated with the ability to interact with longitudinal protrusions and is located in guide ledges on the side surfaces of the branches; the ring-shaped bracket is provided with mounting protruding elements and is made with opposite thinned side sections, and the needle teeth are oriented perpendicular to its working surface.
На фиг. 1 дан вид хирургического сшивающего аппарата сбоку; на фиг. 2 - вид аппарата спереди; на фиг. 3 вид аппарата сверху; на фиг. 4 скоба кольцеобразной формы, вид сбоку; на фиг. 5 скоба кольцеобразной формы, вид сверху; на фиг. 6 вид кольцеобразной скобы в ране; на фиг. 7 исходное положение аппарата с кольцеобразной скобой по отношению тубуса лапароскопа; на фиг. 8 блокировочное устройство аппарата, вид сверху; на фиг. 9 - блокировочное устройство аппарата, вид спереди; на фиг. 10 работа аппарата при извлечении тубуса лапароскопа из брюшной полости; на фиг. 11 вид раны с кольцевидной скобой и валиками аппарата после удаления тубуса лапароскопа; на фиг. 12 это же состояние раны, вид сверху; на фиг. 13 смыкание краев ран с кольцеобразной скобой при сближении валиков аппарата; на фиг. 14 вид ушитой раны с кольцеобразной скобой после снятия хирургического сшивающего аппарата. In FIG. 1 is a side view of a surgical stapler; in FIG. 2 is a front view of the apparatus; in FIG. 3 top view of the device; in FIG. 4 ring-shaped bracket, side view; in FIG. 5 ring-shaped bracket, top view; in FIG. 6 view of the ring-shaped staples in the wound; in FIG. 7, the initial position of the apparatus with an annular bracket in relation to the tube of the laparoscope; in FIG. 8 locking device, top view; in FIG. 9 - locking device, front view; in FIG. 10 operation of the apparatus when removing the laparoscope tube from the abdominal cavity; in FIG. 11 is a view of a wound with a ring-shaped bracket and apparatus rollers after removal of a laparoscope tube; in FIG. 12 the same condition of the wound, top view; in FIG. 13 closing of the edges of the wounds with an annular bracket when the apparatus rollers come closer; in FIG. 14 is a view of a sutured wound with an annular bracket after removal of the surgical stapler.
Хирургический сшивающий аппарат состоит из двух ступенчатоизогнутых и шарнирно соединенных браншей 1 и 2 (фиг. 1, 2 и 3) с кольцевидными рукоятками 3 и 4 на одном конце и с установленными осями 5 и 6 на другом, на которые установлены валики 7 и 8, на поверхности которых выбраны продольные выступы 9 и пазы 10, в которые вставляются выступы 11 (фиг. 4 и 5) кольцеобразной скобы 12. На противоположной поверхности кольцеобразной скобы 12 установлены игольчатые зубья 13, а боковые части ее истончены на участках 14 и 15. На наружной поверхности тубуса лапароскопа 16 (фиг. 6 и 7) так же образованы выступы 17, но в поперечном направлении по отношению его продольной оси. Хирургический сшивающий аппарат снабжен блокировочным устройством (фиг. 8 и 9), состоящим из храповика 18 со стержнем 19, снабженым тыльником 20. Стержень 19 проходит через отверстие выступа 21, а к тыльнику 20 прикреплена гибкая тяга 22, которая пропущена через отверстия выступов 23 и 24 и прикреплена к дополнительным рукояткам 25. Между тыльником 20 и выступом 21 размещена возвратная пружина 26. The surgical stapler consists of two stepwise curved and articulated
Работа аппарата. На тубус лапараскопа 16 надевается кольцеобразная скоба 12, после чего известным способом конец тубуса вводится в брюшную полость (фиг. 6). После окончания лапароскопии или лапаскопической операции бранши 1 и 2 разводят и в пазы 10 валиков 7 и 8 вставляются выступы 11 кольцеобразной скобы 12, и скоба 12 с помощью сшивающего аппарата опускается вниз так, чтобы поверхности валиков 7 и 8 при этом не соприкасались с тубусом 16, с ее зубчатыми выступами 17. Игольчатые зубья 13 кольцеобразной скобы 12 проходят через апоневроз 27 (фиг. 7). The operation of the apparatus. An
Повреждение внутренних органов при этом исключается, так как воздух в брюшной полости удерживает брюшную стенку на расстоянии от внутренних органов. Сжимая за кольцевидные рукоятки 3 и 4 первым и четвертым пальцами правой руки, сближают валики 7 и 8 до соприкосновения их с выступами 17 тубуса лапароскопа 16, а вторым и третьим пальцами оттягивают дополнительные рукоятки 25, в результате чего происходит деблокировка валиков 7 и 8. При подтягивании тубуса лапароскопа 16 вверх валики 7 и 8 начинают вращаться (фиг. 10), в результате чего кончики игольчатых зубьев 13 кольцеобразной скобы 12 упираются о поверхность с выступами 17 тубуса лапароскопа 16 и сгибаются. После удаления тубуса лапароскопии 16 (фиг. 11 и 12) остается зияющая рана 28 в апоневрозе 27. При сжимании браншей 1 и 2 за кольцевидные рукоятки 3 и 4 кольцеобразная скоба 12 сгибается в истонченных ее участках 14 и 15 и сплющивается, в результате чего края раны 28 смыкаются (фиг. 13). После освобождения кольцеобразной скобы 12 от валиков 7 и 8 аппарат извлекают из раны. Кольцеобразная скоба 12 сжимает края раны 28 благодаря жесткости кольца 12, а игольчатые зубья 13 не только удерживают кольцо 12 в заданном положении, но частично внедряются в противоположные края раны, дополнительно сгибаются (фиг. 14) и укрепляют шов. Damage to internal organs is thus excluded, since air in the abdominal cavity keeps the abdominal wall at a distance from the internal organs. Squeezing the
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RU95103896A RU2086192C1 (en) | 1995-03-17 | 1995-03-17 | Surgical suture appliance |
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RU95103896A RU2086192C1 (en) | 1995-03-17 | 1995-03-17 | Surgical suture appliance |
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