RU2197208C2 - Device for performing episcleral filling - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has spring-loaded branches which working members are shaped as cylinder parts and provided with thorns. Doublestepped rod placed in the space between the working members to allow the rod to make normalized axial displacement. Thick portion diameter is by 0.8-1.0 mm greater than filling material diameter. EFFECT: high reliability in catching and fixing filling material. 7 dwg

Description

 The invention relates to medicine, namely to ophthalmic surgery, can be used for detachment of the retina for episcleral filling of the retina.

 In ophthalmic practice, with retinal detachments, anatomical ocular curved tweezers are used to perform filling material (Instruments for Ophthalmology. Catalog, M., TsBNTI Medprom., 1978, 26 pp., Fig. 3.6).

 The known tool contains springy branches, the working element of which is curved, has notches on a flat surface.

The well-known tool adopted for the prototype has several disadvantages:
- the force of the springy branches of the tweezers does not provide sufficient opening (when under the muscles) of the working elements of the jaw to capture the filling material;
- existing notches on a flat surface do not provide reliable grip and stable retention of the filling material of circular cross section when it is held under the muscles of the eyeball;
- opening the branch under the muscles is traumatic;
- when capturing and conducting filling material under the muscles, the surgeon's hand is in constant tension.

 We set the task of creating a device that eliminates the listed disadvantages of the prototype.

 The problem is solved by a device whose branches are made with a self-locking memory (the elastic deformation force of the branches is directed towards), and their working elements are made as part of the cylinder and equipped with spikes, a two-stage rod is placed in the space between the working elements of the branch with the possibility of movement, the diameter of the thickened part of which 0.8-1.0 mm larger than the diameter of the filling material, in addition, the handle is equipped with a stop screw, the distal end of the two-stage rod is rounded and streamlined.

 The implementation of the working elements of the branches in the form of a cylinder, the presence of spikes provides a reliable grip and fixation of the filling material of circular cross section.

 The placement in the space between the working elements of the working elements of the jaw of a two-stage rod with the possibility of movement, the diameter of the thickened part of which is 0.8-1.0 mm larger than the diameter of the filling material, allows reliable capture, fixing and holding of the filling material without opening the jaw, which reduces trauma muscle tissue of the eyeball.

 The rounded distal end of the rod and its streamlined shape provide a smooth passage under the muscles without tissue trauma.

 The presence of a locking screw provides a normalized stroke of a two-stage rod during the capture and fixation of filling material.

 The execution of a jaw with a self-locking memory ensures self-locking and fixing of the filling material, therefore eliminating the tension on the surgeon's hands.

 Figure 1 shows a General view of the device in its original position, a longitudinal section; in FIG. 2 - the same, the moment of coverage of the filling material, a longitudinal section; figure 3 is the same, the moment of fixation of the filling material; figure 4 is the same, General view; figure 5 is a view along arrow a in figure 1; 6 is a view along arrow B in FIG. 3; in Fig.7 is a section CC in Fig.6.

 The device for episcleral filling contains springy to each other (i.e., the elastic deformation force is directed towards each other) branches 1 and 2, which pass into the handle 3; working elements 4 and 5, branches 1 and 2 are made in the form of a cylinder part and are provided with spikes 6. The handle 3 is provided with a cover 7 having a concentric hole and a stop screw 8; a two-stage rod 9, the diameter of the thickened part of which is 0.8-1.0 mm larger than the diameter of the filling material; the rod 9 has a restrictive button 10. The springing branches are made with a self-closing memory.

 The device is in the initial position: the rod 9 is shifted to the left, the restrictive button 10 is in contact with the cover 7 of the handle 3. The distal end of the thickened part of the rod 9 is between the working elements 4 and 5 of the branches 1 and 2. The rounded ends of the thickened part of the rod 9 and the working elements 4 and 5 form a streamlined shape and a smooth surface, which eliminates the trauma of tissues when using the device.

Device operation:
a) the locking screw 8 is screwed to the end. The rod 9 is moved to the right against the stop screw 8. The thickened part of the rod 9 partially frees up the space between the working elements 4 and 5 of the jaw 1 and 2, forming a pharynx to cover the front end of the filling material;
b) the screw-stopper 8 is lifted, the rod 9 is moved longitudinally against the stop to the cover 7. In this case, the rod 9 completely leaves the space between the working elements 4 and 5 of the branches 1 and 2. Due to the elastic deformation, the branches 1 and 2 are closed and fixed with spikes material.

With circular episcleral filling, the proposed device is used as follows:
- after a circular incision of the conjunctiva, the limb secrete the rectus muscles of the eyeball into the ligature;
- under the direct muscle, the working elements 4 and 5 of the device are turned on flat in the initial position;
- screw the stop screw 8; the rod 9 is moved to the right to the stop in the screw-stopper 8, while part of the space between the working elements 4 and 5, the branches 1 and 2 are freed, i.e. pharynx is formed;
- pharynx is pushed onto the front end of the filling material;
- the screw-stopper 8 is lifted;
- the rod 9 is moved to the right to the right, while the rod 9 leaves the space between the working elements 4 and 5 of the branch, the latter are closed under the action of elastic deformation forces, fix the filling material;
- filling material is carried out under the muscles of the eyeball;
- The same manipulations are repeated with the remaining three muscles.

Using the proposed device has the following advantages:
- provides reliable capture, fixation and carrying out filling material of circular cross section;
- clamping of the filling material by the force of elastic deformation of the branch does not require tension on the hands of the surgeon;
- reduces the time of surgery and trauma to the tissues of the eyeball.

 Example 1

 Patient G., 2 years old, DS OD retinopathy of premature stage IV. Ultrasonography research data: funnel-shaped retinal detachment, mooring. The operation of round episcleral filling with silicone seal using the proposed device and total vitrectomy. After the operation, the anatomical fit of the retina to the sclera was noted.

 Example 2

 Patient K., 8 years old, DS OS retinopathy of preterm IV stage. Ultrasonography research data: funnel-shaped retinal detachment, mooring. The operation was performed with transciliary cryopexy of the retina, circular episcleral filling using the proposed device, total vitrectomy. After the operation, the anatomical fit of the retina to the sclera was noted.

Claims (1)

 A device for episcleral filling containing spring jaws with working elements, characterized in that the device has a handle with a stop screw, the force of elastic deformation of the branches is directed towards them, the working elements of the branches are made as part of a cylinder and provided with spikes, in the space between the working elements the branches are placed a two-stage rod with the ability to move to capture the filling material, while the diameter of the thickened step of the rod is selected 0.8-1.0 mm larger than the diameter of the filling Container material.

Images