RU220955U1 - Device for intraoperative determination of the degree of tension of threads and tissues - Google Patents

Abstract

The utility model relates to the field of medicine, in particular to devices intended for determining the degree of tension of tissues connected during surgical interventions or sutures connecting tissues, as well as for dosing the degree of force applied to the suturing structures during surgical operations.

The purpose of developing a utility model is to create a device for strain measurement that allows one to measure the degree of tension of threads and tissues intraoperatively.

This goal is achieved by the fact that a measuring scale in increments of 0.1 N is applied to the outer surface of a transparent hollow cylindrical body made of biologically and chemically inert material; The hook for attaching the ligature is a loop at the end of a braided nylon thread, which is brought out through a hole in the wall of the body. A nylon thread connects a loop for fixing the thread or body tissue with the syringe piston.

This device can be widely used both in research laboratories and in hospitals, diagnostic and specialized medical centers.

Description

The utility model relates to the field of medicine, in particular to devices intended for determining the degree of tension of tissues connected during surgical interventions or sutures connecting tissues, as well as for dosing the degree of force applied to the suturing structures during surgical operations.

It is known from the literature that to determine the degree of tension of the edges of the aponeurosis when performing hernioplasty, a household steelyard is used as a dynamometer [1].

The disadvantage of this device is that household steelyards are not medical devices, this does not provide for their processing, and after the used processing cycles the devices may fail. In addition, household steelyards provide for significant measurement errors within 30g/weight. The use of household steelyards to measure fabric tension varies in duration. The materials used in the construction of household steelyards do not meet the standards for medical products.

A device for determining the tension forces of stitched wound edges during surgical operations is known, which includes a housing, a piston with a spring, a pointer and a measuring scale, characterized in that the body is equipped with a cross-shaped lock, and the pointer is made in the form of a plate with holes [2]. The material used for the manufacture of the device is stainless steel, which allows sterilization for use directly during surgical operations. The disadvantage of this device is that it is inconvenient to use and has a complex design.

A device is also known for determining the degree of tension of tissues connected during surgical interventions or sutures connecting tissues, as well as for dosing the degree of application of force to stitching structures during surgical operations consisting of a cylindrical body, a movable piston with a platform, a spring, a ligature and a hook. The elements of the device are biologically and chemically inert materials, which allows sterilization for use directly during surgical operations. [3] The disadvantage of the prototype is the deformation of the spring due to the unintended stretching function, deformation of the spring under the forces exerted on the ligature and hook, which leads to changes in the characteristics of the device and incorrect results during further use. This device is taken as a prototype.

The goal of developing a utility model is to create a device for strain measurement that allows one to measure the degree of tension of threads and tissues intraoperatively without damaging the moving elements of the device.

This goal is achieved by installing a ligature into the cylindrical body in which the spring is located, with a diameter 1 mm smaller than the diameter of the body, with an attachment point in the piston area and a loop removed from the body through a hole in the opposite side.

The technical result of creating the device is the ability to intraoperatively measure the degree of tension of threads and tissues without changing the technical characteristics of the device elements, which makes it possible to give accurate measurements after repeated use.

Comparison of the proposed device with others known in the field of medicine shows its compliance with the criteria of a utility model.

The utility model is illustrated with graphic material. In fig. 1 shows the proposed device. The device consists of a transparent hollow cylindrical body 1 made of biologically and chemically inert material. A measurement scale 2 is applied to the outer surface of the housing 1, 0.1 N - 1 step; inside the housing 1, on one side there is a movable piston 3 with a platform 4 and a spring 5, the diameter of which is less than the internal diameter of the housing 1, one of its ends is attached to the platform 4 of the piston 3, and on the other side it rests against the walls of the housing 1. A nylon ligature is placed inside the spring 6, on one side attached to the piston platform 4, on the other hand it exits through a hole in the body 7 by 1-2 cm and ends with a loop 8. Using a node 9 with a larger diameter than the hole 7, the thread is prevented from getting into the elements of the spring 5.

The device is used as follows. Fixation of the thread or tissue located within the surgical field is carried out using loop 8 or with a clamping device or hook captured by the loop of the device. When performing tension, pulling the thread until the edges of the wound come together in order to assess the degree of traction, the ligature 6 is tensioned, which ensures the movement of the piston 3 in the housing 1. The moving piston 3 in the transparent housing 1 makes it possible to interpret the measurement results on the measurement scale 2. Since the resistance springs 5, gradually increases, on the body 1 there is a scale 2 with measurements. The measurement is carried out in Newtons 0.1 N=1 step.

Given the possibility of treating the device by immersion in a disinfectant solution, it can be used repeatedly during one operating day. Exposure time is selected according to their recommendations for use. Also, due to the absence of deformation of the moving elements of the device, this device can be used repeatedly. Taking into account the fundamental possibility of disassembling the device into its component elements, it is possible to replace one element that has failed while the other components are intact. Compared to the prototype, the device has an increased service life and an accurate measuring scale on the body, which will allow the device to be used repeatedly without obtaining measurement errors and accurate measurement values to quickly interpret measurement results in intraoperative conditions

The method is illustrated by a clinical example.

Clinical example 1. Patient V., 59 years old, diagnosed with a large reducible postoperative ventral hernia (history of acute appendicitis, peritonitis. The size of the hernial orifice intraoperatively is 13x14 cm, when closing the aponeurosis defect, a significant tension is manually determined. Measuring tissue with a device for intraoperative tensometry - a device was attached to the edges of the aponeurosis, tissue tension was measured, which was 11.5 N. This indicates a high tension of the own tissues. And it was key in choosing hernia repair due to the high tension of the own tissues. A decision was made to use combined hernioplasty mesh implant using the Novitski technique. The outcome is recovery.

Clinical example 2. Patient G., 60 years old, diagnosed with chronic post-traumatic osteomyelitis of the bones of the left leg, fistulous form. Condition after extramedullary osteosynthesis of the left tibia. There is pronounced cicatricial deformation and thinning of the skin along the anterior surface of the leg. Progress of the operation: removal of the plate and screws, necrosequestrectomy. During the operation, significantly altered tissues, including skin, were excised. When closing a surgical wound, there is a risk of high tension and cutting through the ligatures. When applying knot ligatures, a measurement was used with an intraoperative tensometry device - the ligature was attached to the device. The measurement result is 4.5 N. This should be interpreted as a moderate tension. The incision is lengthened to reduce tension. It is possible to close the wound using your own tissues without the risk of cutting through ligatures and skin necrosis in the postoperative period. The result is that tissue ischemia did not occur. The wound healed by primary intention. Recovery.

This device can be widely used both in research laboratories and in hospitals, diagnostic and specialized medical centers.

INFORMATION SOURCES:

1. Dissertation research Dzavarian T.G. “Clinical and anatomical rationale for the method of separation repair for large ventral hernias” Moscow, 2020

2. RF patent for invention No. 2283027, IPC A61B “Device for intraoperative determination of the degree of tension of threads and tissues.”

3. RF patent for utility model No. 64887 dated July 27, 2007 “Device for determining the tension forces of stitched wound edges during surgical operations.”

Claims (1)

A device for intraoperative determination of the degree of tension of threads and tissues, including a hollow cylindrical body with a measuring scale in increments of 0.1 N applied to the outer surface; the body contains a movable piston with a spring, the diameter of which is less than the internal diameter of the body; one end of the spring is attached to the piston; characterized in that the diameter of the spring is 1 mm smaller than the internal diameter of the housing; inside the cylinder along the midline there is a nylon thread, fixed at one end to the piston and the other to a loop, which is brought out through a hole in the wall of the housing made of biologically and chemically inert material .