RU2268011C1 - Device for applying vascular anastomoses - Google Patents

Abstract

FIELD: medicine, vascular surgery.

SUBSTANCE: the present innovation could be applied for developing vascular anastomosis while fulfilling reconstructive operations upon limbs' vessels and, also, for developing arterio-venous fistulas to be applied for carrying out chronic hemodialysis. The suggested device for applying vascular anastomosis consists of an one-piece part as a handle and a hollow one. The latter is located perpendicular to the former one being designed as branches with possibility for approaching. External diameter of a hollow part is 1.5 times smaller against the diameter of a vessel with the least lumen, not less and 2 times smaller against that of an one-piece part, not less. In the middle of a hollow part there is an opening at diameter being equal to that of an one-piece part. As a result, the device has been designed for developing anastomosis upon vessels of minor diameter.

EFFECT: higher efficiency.

1 dwg

Description

The invention relates to medicine, in particular to vascular surgery, and can be used for the formation of vascular anastomoses during reconstructive operations on the vessels of the limbs, as well as for the formation of arteriovenous fistulas (AVF) used for chronic hemodialysis.

To date, there was no special device for applying AVF. For this purpose, the following technique was used: after isolating the vessels to be anastomosed, sutures were placed on the posterior and anterior walls of the vessels, thus forming the anterior and posterior lips of the anastomosis (Kleiza Yu.V., Dainis B.E. Angiosurgical aspects of preparing the patient for hemodialysis, 1980, 204 pp.). For the formation of AVF, vessels of small diameter are mainly used, which leads to technical difficulties in suturing, primarily on the posterior wall of the anastomosis. Insufficient visualization of the edges of the stitched vessels may lead to the capture of the front wall in the seam or the absence of capture of one of the rear walls into the seam and, thus, to the unsuitability of the AFF, which requires the application of the AFF proximal to the previous one.

As a prototype for the closest technical essence, we have chosen a metal bougie used to form aorto-coronary anastomoses (Burakovsky V.I., Bokeria L.A., Cardiovascular surgery, M., 1989, 751 pp.). The bougie is represented by metallic olive on a metal holder. The use of metal bougie for the formation of AVF is limited by the fact that the introduction of bougie into the anastomotic zone through the lateral vein branch is impossible due to its small diameter, the extraction of bougie from the anastomosis before completion of the formation of the anterior wall is impossible due to the rigidity of the structure, which leads to the eruption of sutures and the failure of the anastomosis .

The objective of the invention is to develop a device for the formation of anastomoses on vessels of small diameter.

The problem is solved in that the device for applying vascular anastomoses, including the solid part in the form of a handle, is made of polyvinyl chloride and additionally contains a hollow part, which is perpendicular to the solid part and made in the form of branches having the possibility of rapprochement, and the outer diameter of the hollow part is not less than than 1.5 times less than the diameter of the vessel with a smaller clearance and not less than 2 times less than the diameter of the solid part, and in the middle of the hollow part there is an opening with a diameter equal to the diameter of the solid parts.

The execution of one of the parts of the device hollow allows you to provide a sufficient frame function of the device while maintaining its flexibility.

The execution of the hollow part with the hole and the perpendicular solid part allows you to position the hollow part in the anastomotic zone so that one branch is located in one vessel (for example, in an artery), and the other in the second vessel (for example, in a vein), which provides good visualization back and front walls of the formed anastomosis.

The presence of a hole in the middle of the hollow part, as well as the execution of the hollow part in the form of branches with the possibility of rapprochement, allows the device to easily fold when it is removed from the anastomosis zone.

The outer diameter of the hollow part must be at least 1.5 times smaller than the diameter of the vessel with a smaller clearance to prevent the device from blocking the back wall of the anastomosis during its formation.

The diameter of the hollow part must be at least 2 times smaller than the diameter of the solid part so that when the device is removed from the anastomosis in the region of the front wall of the jaw of the hollow part, they are formed and their diameter is not more than the diameter of the solid part, which allows you to remove the device without injury seam areas.

The device is made of polyvinyl chloride to ensure the softness of the structure while maintaining its frame properties.

The listed salient features of the device are new.

Thus, the claimed device meets the conditions:

- patentability of the invention by the criterion of "novelty", since it is unknown from the prior art and allows the formation of anastomoses between vessels of not only medium but also small diameter;

- industrial applicability, as it is ready for use in medicine;

- the device also meets the criterion of "inventive step", since the design of the device does not follow explicitly from the prior art.

A device for the formation of vascular anastomoses, shown in the drawing, contains the following elements:

1 - solid part in the form of a handle;

2 - hollow part;

3 - hole in the hollow part;

4, 5 - branches of the hollow part.

The device works as follows: after preparing the vessels for the formation of the anastomosis and imposing guiding sutures, the surgeon, using the solid part (1) as a handle, inserts the device into the anastomotic zone so that one branch (4) is in the lumen of one vessel and the other ( 5) - in the lumen of the second vessel. The device thus positioned allows the anterior walls of the vessels to be retracted and the posterior wall of the anastomosis well visualized. Before the end of the formation of the front wall, when the diameter of the hole in the front wall of the anastomosis is equal to the diameter of the solid part, the device is removed from the anastomosis, while the branches come together and the device is freely removed due to the presence of the hole in the middle of the hollow part (3).

For the first time, a device for applying vascular anastomoses during reconstructive operations on the vessels of the limbs has been proposed, which allows the formation of anastomoses between vessels of not only medium but also small diameter. The use of this device will also reduce blood loss when the reconstructed vessels are included in the bloodstream.

Claims (1)

A device for applying vascular anastomoses, comprising a solid part in the form of a handle, characterized in that it is made of polyvinyl chloride and further comprises a hollow part, which is perpendicular to the solid part and made in the form of branches having the possibility of rapprochement, the outer diameter of the hollow part not less than 1.5 times smaller than the diameter of the vessel with a smaller clearance and not less than 2 times smaller than the diameter of the solid part, and in the middle of the hollow part there is a hole with a diameter equal to the diameter of the solid part.