RU2504352C2 - Method of application of hermetic suture on operational incision of conjunctiva and tenon's capsule of eye - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to ophthalmo-surgery and can be applied for application of hermetic suture on operational incision of conjunctiva and Tenon's capsule of eye. Uninterrupted suture is applied on operational incision of Tenon's capsule, loop is left and uninterrupted suture is applied on operational incision of conjunctiva in reverse direction. Removal of suture is performed by gripping loop and following pulling out suture thread.

EFFECT: method makes it possible to improve impermeability.

1 dwg

Description

The invention relates to medicine, namely to methods for suturing the wound of the conjunctiva and tenon capsule.

Known traditional methods of suture sealing incisions of the tenon capsule and conjunctiva. One method involves the application of individual nodal joints [1, 2, 3]. Another method involves the application of a continuous seam [1, 2].

However, in some cases, for example, when performing filtering operations for glaucoma , especially careful sealing is required to prevent outward fistulation of the formed filter pad [1, 3]. So , when applying separate sutures to the conjunctiva and tenon capsule, filtration between ligatures is primarily possible. The closest prototype is the imposition of two rows of continuous sutures, however, this complicates or excludes the possibility of its extraction from the incision of the tenon capsule from under the conjunctiva.

The objective of the proposed method is to create an airtight seam, eliminating the possibility of filtering through the surgical incision of the conjunctiva and tenon capsule and simultaneously removing the two-row seam by pulling on the formed loop.

The task is achieved due to the fact that a continuous suture is applied to the operative incision of the tenon capsule, the loop is left and reverse - a continuous suture is made to the operative incision of the conjunctiva, the suture is removed by gripping the loop and then pulling the suture thread.

Figure 1 shows a diagram of the imposition of a sealed seam, where 1 is the conjunctiva; 2 - tenon capsule; 3 - the first injection (the beginning of the seam); 4 - a continuous suture for an incision, a wound of a tenon capsule; 5 - free loop; 6 - continuous suture for conjunctival incision; 7 - completion of suturing.

The proposed method of suturing was used when performing operations for glaucoma 1800 eyes (1100 people). In no case was wound filtration observed.

The proposed method is as follows (Figure 1): in the surgical section, the edge of the conjunctiva is determined - 1 and tenon capsule - 2; suture begins with the first injection - 3 into the conjunctiva - 1 and tenon capsule - 2, departing from the angle of the surgical incision 2-3 mm; impose a continuous seam on the surgical incision of the tenon capsule - 4; the ligature does not cross, do not tighten, leaving in the form of a free loop - 5; impose a continuous seam on the surgical incision of the conjunctiva in the opposite direction - 6; at the end of the suture, the ligature is cut off at the beginning of the seam - 7.

thus, a double-row seam is formed with a loop at one end.

The removal of the seam is carried out by grabbing the loop - 5 and then pulling the suture thread.

The proposed method allows to achieve complete sealing of the surgical incision of the conjunctiva and tenon capsule during operations, both with glaucoma and other surgical interventions requiring subsequent sealing.

Example 1

Patient S. at 68 years old was operated on for open-angle glaucoma II. From the right eye. Subscleral scleridectomy of the right eye was performed. The operation was completed by applying the proposed continuous double-row seam with a loop at one end. The seam was removed on the sixth day by grasping the loop and then pulling. At discharge, a filter pad is formed without signs of filtration.

Example 2

Patient T. , 42 years old , was operated on for secondary post-traumatic subcompensated glaucoma of the left eye. An operation was performed to drain the anterior chamber with the Ahmed valve of the left eye. The operation was completed by applying the proposed continuous double-row seam with a loop at one end. The seam was removed on the sixth day by grasping the loop and then pulling. At discharge, intraocular pressure compensation was achieved.

Bibliography

1. Gorban A.I., Dzhaliashvili O.A. Eye microsurgery errors and complications. St. Petersburg. Hippocrates Publishing House. 1993.

2. Broshevsky T.I. Eye diseases. M .: Medicine. 1977.

3. Krasnov M.M. Glaucoma microsurgery. - M.: Medicine. 1980.

Claims (1)

The method of applying a sealed seam to the operative incision of the conjunctiva and tenon capsule of the eye, including the application of a continuous suture, characterized in that a continuous suture is applied to the surgical incision of the tenon capsule, the loop is left and backward - a continuous seam is made to the surgical incision of the conjunctiva, the suture is removed by capturing the loop and then pulling the suture thread.

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