RU2317040C1 - Needle holder - Google Patents

Abstract

FIELD: veterinary surgery, in particular, instruments used for connecting tissues after operative treatment.

SUBSTANCE: needle holder has pair of branches pivotally connected through pivot joint and having jaws at their one end and rings at their other ends. Retaining mechanism formed as rack-type lock is fixed on rings. Ring of one branch is offset toward jaws relative to ring of other branch and is provided with portion for forth finger.

EFFECT: reduced labor intensity during stitching and increased effectiveness in performing operation.

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Description

The invention relates to veterinary surgery, and in particular to tools for connecting tissues after surgery. The most effective use of the needle holder when fixing the needle while holding it through the fabric for suturing.

Known needle holder Mathieu having an automatic shutter and handles without rings. It is used to fix the needle during its passage through the tissue [Magda II, Itkin BZ, Voronin II Surgical surgery with the basics of topographic anatomy of domestic animals. - M .: Kolos, 1979, p.78.].

Its disadvantage is that the surgeon's hand is clenched into fist during operation. This stress state leads to premature fatigue by the surgeon and possible errors during the operation. In addition, it is possible that the hand could slide off the handles, as well as opening the lock during excessively applied force by the surgeon during an injection or injection of the needle, which leads to the loss of the needle in the wound or cavity. All this increases the risk of causing unjustified injury to organs and tissues.

The Geghar needle holder is also known, which is necessary for firmly fixing the needle with thread at the moment of suturing and which is a pair of identical branches with rings in the handles. The jaws are movably connected by a hinge, the rapprochement of the handles with the rings brings the jaws together, creating the ability to capture and hold the needle. Fixation and immobility of the jaws in the gripping position is carried out with a creme lock located at the end of the handles near the rings [A. Kuznetsov Veterinary surgery, ophthalmology and orthopedics. - Leningrad: Publishing House "Kolos", 1969, p.102.].

However, working with this needle holder is associated with certain efforts to achieve the correct position of the tool in the hand, since the needle holder rings are on the same level. While in the physiological position of the hand, the III finger protrudes forward relative to the I finger (these fingers are threaded into the needle holder rings). Rings located at the same level act on the brush through the fingers and put it at a disadvantage; it is in a constantly bent state and tension. As a result of this, it is often difficult for the surgeon to balance his efforts with the mechanical strength of the tissues, as well as evaluate the role of the instrument's own mass. In addition, during the puncture of the needle, the brush quite often leaves the stress state (tends to a physiological position), which entails the stratification of the tissues by the needle and the channel in the soft tissues, after holding the needle, moves away from the shape of its diameter, taking the shape of a gap (in some tissues up to 0 5 cm). This affects the fixing ability of the joints, as well as their tightness, which is especially dangerous when suturing hollow organs. The stress state of the hand also makes it difficult to change the position of the forearm when the needle is punctured, for this you have to rotate the shoulder. As a result of this, the needle “wanders” in the tissues and finds its own way. The zone of damage to instruments increases, which can lead to unjustified tissue injury. When analyzing the work of many surgeons, it was noted that often, avoiding the uncomfortable position of the hand, they wrap around the needle holder ring intended for the third finger.

The objective of the proposed solution is to eliminate these disadvantages, increasing the organic design of the needle holder and its controllability.

The problem is achieved due to the fact that the known needle holder containing a pair of branches that are movably hinged by a hinge and having jaws at one end and rings on which the locking mechanism is located in the form of a cremallera lock, according to the invention, the ring of one of the branches is offset towards the jaws relative to the ring of another branch and is made with a platform for the fourth finger.

The technical essence of the proposed needle holder is presented in the drawings, where

figure 1 - the proposed needle holder (General view);

figure 2 - the proposed needle holder in working condition.

The needle holder contains a crossing pair of jaws 1 and 2, having sponges 3 at one end to hold the needle 4, and rings 5 on the other end, on which the locking mechanism is located in the form of a cremallera lock 6. The jaws 1 and 2 are connected by a hinge 7 and are movable. The ring 5 of the jaw 2 is offset relative to the ring 5 of the jaw 1 in the direction of the jaws 3 and is made with a platform 8 for the IV finger

The needle holder works as follows: it is held by I, II, III, and IV fingers of the hand, for this I finger is inserted into ring 5 of jaw 1, III finger is inserted into ring 5 of jaw 2, and IV finger is placed on the pad 8. With the sponges 3 of the needle holder grab the needle 4 on the border of the middle third of its length and bring branches 1 and 2 together by pressure of I, III and IV fingers. In this case, jaws 1 and 2 are rotated on the hinge 7, the cremaleric lock 6 is closed, and the needle 4 is securely fixed. Suture material is inserted into the needle 4. The direction of the needle holder is attached with a II finger, which is placed on top of the needle holder and direct the tool to the desired object in the required direction. Depending on the direction of puncture of the stitched tissues, the needle 4 is fixed in the needle holder with the tip to itself or away from itself, or to the left or to the right. When stitching the tissue, rotational movements are made with the forearm in the direction of the tip of the needle 4. In this case, the needle 4 should be aimed in advance, determining the location of both its injection and puncture. When suturing “on oneself”, it is necessary to pre-pronate the forearm, which is at the time of needle 4 in the supination position. When suturing "on my own" at the time of puncture, the forearm is in the pronation position, and when the needle 4 is removed, it is pre-supinated. Sewing of tissues is carried out by pronational and supination movements of the forearm with a fixed hand fixing the needle holder. After the injection and puncture, the needle 4 is released from the needle holder by opening the cremallera lock 6, branches 1 and 2 are bred with I, III fingers. After that, the part of the needle 4 protruding from the tissues is again grasped with jaws 3 and fixed by closing the cremallera lock 6. The needle 4 is completely passed through the tissues.

The needle holder device allows the surgeon to work equally confidently with both his right and left hands. It should be noted that the displacement of the ring does not affect the stability of the needle holder when working with it, since the symmetry of the applied force is maintained due to the platform 8 for the fourth finger, that is, the needle holder of the proposed design is turned upside down.

The use of the proposed needle holder allows you to:

- increase the angle between the needle holder and the hand of the surgeon, which allows you to give the most favorable position of the hand, close to physiological;

- increase the controllability of the tool;

- measure the applied efforts with the mechanical strength of the tissues;

- to exclude rotation of the shoulder, leading to "wandering" of the needle;

- reduce the area of damage to instruments;

- to prevent stratification of tissues, thereby eliminating the violation of the tightness of the seams (hollow organs) and a decrease in their fixing ability;

- avoid unjustified tissue injury.

When using the proposed needle holder, the tactile relationship between the surgeon's hands and tissues was noted, which is less observed when working with the known needle holder. This significantly reduces the complexity of suturing and increases the efficiency of the operation (see table 1).

Table 1 Needle holder The number of animals operated Unjustified tissue injury Complications after surgery Proposed eighteen - - Famous eighteen 6 four

As can be seen from the table, the use of the proposed needle holder is more effective when suturing compared to the known and eliminates postoperative complications. In addition, the identified shortcomings of the known needle holder should be attributed to other surgical instruments with rings in the handles located at the same level. Therefore, it is advisable to change the position of the ring intended for the third finger to achieve the most favorable position of the brush when using hemostatic tweezers, scissors, clamps, slippers, etc.

The proposed needle holder was successfully used during operations in 18 dogs and cats on the basis of the medical and diagnostic veterinary center Orel GAU.

Claims (1)

A needle holder containing a pair of branches that are movably hinged by a hinge and having sponges on one end and rings on the other end, on which a locking mechanism is located in the form of a cremeler lock, characterized in that the ring of one of the branches is offset towards the jaws relative to the ring of the other branch with pad for IV finger.

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