RU2257862C1 - Device for dissecting and ligating tissues and vessels - Google Patents

Abstract

FIELD: medicine, surgery.

SUBSTANCE: the suggested device contains a tissue clamp consisted of a hook-like gripper and a clamp. The gripper is located at the end of a body and has a grove for knife's passage. A clamp is designed as a slipper with holes for loops' knots. A slipper should be replaced with a pusher supplied with a rotating wedge-like clamp that fixes tissues with a screw. The knife is designed with two blades at its edge at a sharp angle and groves to locate and supply loops to the site of knots' tightening and with a draw with a handle. Outside there is a tube with holes at an edge, moreover, there may be spring-controlled linkages for ligatures' ends and a handle to replace a tube. As a result, a convenience in ligating has been achieved under conditions of restricted or closed space.

EFFECT: shortened time for operation and decreased traumatism in patients during operation.

3 dwg, 1 tbl

Description

The present invention relates to medicine, namely to surgery, and can be used in open and endoscopic operations.

Analogs of the invention are:

1. Safe apparatus for surgical occlusion with a cutting device (US patent No. 4569346). The device is equipped with 2 paired clip applicators for applying onto fabrics, V-shaped metal clips and a retractable knife. The disadvantages include:

- unreliability of ligation due to slipping clips, high cost of clips;

- the risk of leaving rigid foreign bodies in the body.

2. Double ligating and separating apparatus (US Patent No. 5,336,229), consisting of a tubular rod with a slot for gripping fabric, having a device for laying threads. The apparatus performs bilateral ligation and tissue dissection. The disadvantages of such an apparatus include:

- high complexity, multi-linking of the working bodies, which complicates its manufacture and maintenance;

- the unreliability of fixing the tightened loop on ligated tissues.

3. Bipolar forceps with gripping and cutting function (Endo WORLD LAP Bulletin No. 30-R 1995 Kar D STO RZ Germany and KAR D STORZEN DOS SDPU America) closest to the proposed invention in terms of bilateral ligation, consisting of forceps-clamps that compress tissue in two places and conducting bipolar current, a movable scalp-shaped blade with a control handle.

It should be noted the significant disadvantages of such a device:

- the complexity, duration and insecurity of coagulation of small blood vessels;

- the possibility of burns to surrounding tissues.

The problem to which the claimed invention is directed is to perform convenient separation and capture of ligated tissues, clamp of ligated tissues, fixing the clamp, dissection of tissues with loop removal to the tightening site, reliable ligation of tissues, vessels with structures contained inside, ease of ligation in conditions limited or enclosed space, reducing the time of surgery and the invasiveness of the patient.

To solve the tasks, the device comprises a hook-shaped grip made at the end of the case with a groove for the knife to pass, and a clamp that can be fixed with a screw, made in the form of a crawler, equipped with holes for the loop nodes, which can be moved by means of a pusher with a wedge rotary clamp, the knife is made with two blades at the end face at an acute angle, equipped with grooves for placing and feeding the loops to the place of tightening the nodes and has the ability to move the rod with the handle, and on the outside, on the case, a tube with holes at the end is inserted to accommodate the second knots of the loops and bring them to the place of tightening, moreover, spring fastenings of the ends of the threads and a day handle for moving the tube to the place of tightening of the nodes are provided on the tube.

A device for dissection and ligation of tissues, blood vessels is shown in figures 1 to 3.

Figure 1 - General view of the device.

Figure 2 - view of the device in cross section aa.

Figure 3 is a view of the device along section BB.

The device for dissection and ligation of tissues and vessels is equipped with: a hook-shaped gripper - 1, made at the end of the body with a groove for the knife to pass, a knife - 2 with two blades at the end, at an acute angle equipped with grooves - 3 for placing and feeding the loops to the place of tightening the nodes by traction - 15, with a handle - 16, with a clip - 4, made in the form of a crawler, equipped with holes - 9 for loop nodes, which can be moved by means of a pusher - 5 with a clip rotary clamp - 6, with a handle - 7, a clamp fixing screw - 8, with preload spring - 10, with an outer tube - 11, with holes - 12 at the end to accommodate the second nodes, with spring fastening of the ends of the threads - 13, the handle of the tube - 14.

The device for dissecting and ligating tissues and vessels is performed in the following sequence: loops of the Roeder or Melse type fit into grooves - 3 knives - 2, the knife is recessed with loops through the handle - 16 through the rod - 15, the loop nodes fit into the holes - 9 on the clip - 4 and in the holes - 12 on the tube - 11, the ends of the threads are fixed with spring fasteners - 13, the device is brought to the place of ligation of the fabric, open the grip with a tap hold - 4 with the handle - 7 using the pusher - 5 and the spring - 10, with the hook-shaped grip - 1 capture cloth clamp they wrap it with a clamp - 4 with a wedge clamp - 6 by turning the handle - 7, fix the fabric clamp - 4 with a screw - 8, cross the fabric with a knife - 2, the handle - 16 by means of the tie - 15, bringing the knots to the place of tightening the knots tighten the knots. If it is necessary to tighten the second nodes of the loops, the tube 11 is brought to the place of tightening of the second nodes. Through the handle - 14 tighten the second nodes. The clamp fixation is released by the screw - 8. The clamp is removed by turning the clip clamp - 6 by means of the handle - 5 and the spring - 10. The ligated stumps are released by the device.

We tested a sample of the device with new solutions, clamping the fabric by means of a clip clamp, fixing the clamp with a screw, as well as attaching the ends of the strings of the loops by spring fastening, the test results are listed in the table.

TABLE.
Test results of a device sample with a new solution for tissue clamping, as well as fastening of the ends of the thread, loops with clamp fastening. Name of manipulation Number of tests The number of successful manipulations separately on each of the working sides of the device left right Fixation of knots of loops in holes fifty 90 100 Fixing the ends of the threads in the spring mounts fifty 100 100 Fabric clamp fifty 98 98 Dissection of the fabric with the removal of loops of threads to the place of tightening nodes * fifty 92 98 Tightening the loop knots
Tissue stump ligation * fifty
fifty 92
90 96
96

* The average time to complete dissection and ligation of tissues was 70 seconds.

The test results of a device for dissection and ligation of tissues using a conditional vessel confirms the possibility of carrying out the invention and can be recommended for clinical trials.

Claims (1)

A device for dissection and ligation of tissues, blood vessels, containing a knife and a clamp of ligated tissue, characterized in that the tissue clamp contains a hook-shaped grip made on the end of the body with a groove for the knife to pass, and a clamp having the ability to be fixed with a screw, made in the form of a crawler equipped holes, for loop nodes that can be moved by means of a pusher with a wedge-shaped rotary clamp, while the knife is made with two blades at the end face at an acute angle, equipped with grooves for placing and feeding the loops to the tightening point knots and has the ability to move the rod with a handle, and on the outside of the case there is a tube with holes at the end to place the second knots of the loops and bring them to the place of tightening, and on the tube there are spring fastenings of the ends of the threads and a handle to move the tube to the place of tightening of the second nodes .

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