RU2511265C1 - Clamp forceps - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: clamp forceps comprises a handle that comprises at the end an inclined working member in the form of a loop with its wall having a through notch. Free end of the notch are necked in the loop, thereby forming a passage opposite a suture needle eye formed in the loop wall. The handle comprises an index finger support point between the loop and the free end of the handle.

EFFECT: invention provides optimising an angle between the clamp forceps and a surgeon's hand, improving structural harmony and handiness of the instrument, facilitating ligation, reducing blood loss and length of operation, higher comfort of using the instrument, correlating the applied force and mechanical strength of tissues.

1 tbl, 2 dwg

Description

The invention relates to veterinary surgery, namely to instruments for temporarily stopping bleeding during surgery. The most effective use of a hemostatic clamp when holding a needle and suture material for ligation of damaged blood vessels.

Known hemostatic clamp with a loop with a through slot and a movable element with the possibility of overlapping this slot. The movable element is kinematically connected to the drive mounted in the handle. This clamp is used to reduce blood loss during surgery [USSR Author's Certificate No. 1064942, class. A61B 17/12, Bull. No. 1, 1984].

Its disadvantage is that the manipulation of the movable element to close the slot in the loop brings additional time for the operation. At the same time, a loop cannot be excluded from a damaged blood vessel, which resumes bleeding and increases blood loss. Additional time and money are required to evacuate blood from the surgical wound. In addition, the production of hemostatic clamps of this design is labor intensive due to the need to equip them with a movable element.

The closest technical solution to the claimed hemostatic clamp is a hemostatic clamp containing a handle, at the end of which is a working element made in the form of a loop having a rectangular contour. In this case, the loop is located at an angle of 45 ° to the handle. A slot was made in the loop wall for ligature or working jaws of the clamping tool [USSR Author's Certificate No. 782804, class. A61B 17/12, Bull. No. 44, 1980].

However, the work with this hemostatic clamp is associated with certain efforts to achieve the correct position of the instrument in the hand, since the loop is located at an angle of 45 ° to the handle. Therefore, for a uniform fit of the loop along its entire perimeter to the damaged blood vessel, the surgeon needs to put the hand and elbow at a disadvantage, since at the time of ligation of the blood vessels they are in a bent state and tension, while at the physiological position of the hand and elbow their angle relative to both the lower and upper wound aperture is much less than 45 °. 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. 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, avoiding the uncomfortable position of the hand and elbow, they often place their hand in relation to the wound at an angle of 20 °.

In addition, it is difficult to choose in the lumen of the loop contour the injection site of a surgical needle with suture material for ligation of a damaged blood vessel. This often entails additional damage to it and improper imposition of the ligature is not excluded. Also, when conducting the thread through the slot of the loop, difficulties arise in finding the optimal path for its passage, while the edge of the loop wall is often seized with suture material. This generally increases the time for the operation and increases the blood loss of the operated animal.

The objective of the proposed solution is to optimize the angle between the styptic clamp and the surgeon's hand, increase the organics of the design and controllability of the instrument, facilitate ligature application, reduce blood loss, reduce the time it takes to perform an operation, increase the usability of the instrument, and make it possible to balance the applied efforts with the mechanical strength of the tissues.

The task is achieved due to the fact that the known hemostatic clamp containing a handle, at the end of which an operating element in the form of a loop is located at an angle, a through slot is made in the wall of which, according to the invention, the free ends of the slot are bent into the loop, forming a passage opposite which in the loop wall an eyelet for a surgical needle with suture material is made, and the handle is made with a supporting platform for the index finger located between the loop and the free end of the handle.

The technical essence of the proposed hemostatic clamp is shown in the drawing, where:

figure 1 shows the proposed hemostatic clamp (General view);

figure 2 diagram of the clamping of the defective area of the blood vessel of the proposed hemostatic clamp.

The hemostatic clamp contains a handle 1, at the end of which at an angle of 20 ° to the handle 1 there is a working element in the form of a loop 2, in the wall of which a through slot 3 is made, while the free ends of the slot 3 are bent into the loop 2, forming a passage opposite which in the wall of the loop 2, the eye 4 for the surgical needle with suture material is made, and the handle 1 is made with a support pad 5 for the index finger located between the loop 2 and the free end of the handle 1.

Hemostatic clamp works as follows.

If bleeding occurs during surgery, a clamp is applied to the bleeding area of the surgical wound so that the damaged blood vessel is in the center of loop 2. Its handle 1 is held with fingers, while the index finger is placed on the support pad 5. The direction of the hemostatic clamp is attached with the index finger, which direct the tool to the desired object in the necessary direction. If the bleeding has not stopped, then again change the location of the loop 2. Hemostatic clamp allows you to quickly block the flow of blood to the damaged area of the blood vessel.

After a temporary stop of bleeding, they begin to impose a ligature. At the same time, they aim the surgical needle by determining the place of its injection inside the loop of loop 2, namely in its eye 4. The place of the needle of the surgical needle is outside the loop 2 near the slot 3. Due to the eye 4, the ligature is facilitated, this also contributes to the slot 3, free the ends of which are directed inside the loop loop 2. After holding the suture material around the damaged blood vessel, a ligature node is formed on it. Then, the hemostatic clamp is removed outside the surgical wound.

The hemostatic clamp device allows the surgeon to work equally confidently with both his right and left hands. The position of the loop 2 at an angle of 20 ° to the handle 1 of the hemostatic clamp allows you to give the most favorable position of the hand and elbow of the surgeon, close to physiological. It should be noted that the implementation of the site 5 for the index finger increased the stability of the hemostatic clamp when working with it, excluding the inversion of the loop 2 of the hemostatic clamp to the side.

The application of the proposed hemostatic clamp allows you to:

- optimize the angle between the styptic clamp and the surgeon's hand;

- increase the organic design and controllability of the tool;

- facilitate the imposition of ligatures;

- reduce blood loss;

- reduce the time for the operation;

- increase the usability of the tool;

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

When using the proposed hemostatic clamp, the tactile relationship between the surgeon's hands and tissues was preserved, which is less observed when using the known hemostatic clamp. This significantly reduces the complexity of ligation of damaged blood vessels and increases the efficiency of the operation (see table).

Table Styptic clamp The number of animals operated Resumption of bleeding Complications after surgery Proposed 22 - - Famous 22 6 6

As can be seen from the table, the use of the proposed hemostatic clamp is more effective when suturing damaged blood vessels compared to the known one and eliminates postoperative complications.

The proposed hemostatic clamp was successfully used during operations in 22 dogs and cats on the basis of the veterinary diagnostic center of the Oryol State Agrarian University and the Department of Animal Anatomy, Physiology and Surgery of the Peoples' Friendship University of Russia.

Claims (1)

A haemostatic clamp containing a handle, at the end of which a working element in the form of a loop is located at an angle, a through slot is made in the wall, characterized in that the free ends of the slot are bent into the loop, forming a passage opposite which an eye for a surgical needle is made in the loop wall with suture material, and the handle is made with a support platform for the index finger, located between the loop and the free end of the handle.

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