RU2619751C1 - Extracorporal sliding surgery matveev-petrov node and tying method - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: end of the first thread held by fingers 1 and 2 of the right hand is drawn around finger 5 and placed on the palm surface of fingers 3 and 4. The end of the second thread, held by fingers 1 and 2 of the left hand, is also placed on the palm surface of fingers 2 and 3 of the right hand near the end of the first thread. Bend the nail phalanx of finger 3 of the right hand in the distal interphalangeal joint, the second thread is drawn, fixed by fingers 1 and 2 of the left hand and located on the palm surface of fingers 3 and 4 of the right hand, its back surface is directed under the end of the first thread held by fingers 1 and 2 of the right hand, and by rear extension of the phalanx a loop is formed on finger 3 of the right hand of the two threads. The end of the second thread, fixed by fingers 1 and 2 of the left hand, is intercepted and fixed by fingers 1 and 2 of the right hand along with the end of the first thread. Fingers 2 and 3 of the left hand are placed in a loop created on finger 3 of the right hand, under the second thread, grasping the ends of threads with fingers 2 and 3 of the left hand and moving them into the loop. The end of the second thread is held by fingers 1 and 2 of the left hand and the slip knot is lowered to the sutured cut surface in the cavity by a pusher taken by the right hand fingers.

EFFECT: method allows to improve holding properties of the node.

8 dwg, 1 tbl

Description

The invention relates to medicine, namely to surgery, to surgical equipment and methods of tying surgical nodes.

In surgical practice, lapar and thoracoscopic operations for ligation of the lumen of hollow organs use both extracorporeal and intracorporeally tied surgical nodes. With the advent of monofilament synthetic yarns, with very low strength holding properties in the knot, there was a need to develop a sliding knot suitable for reaching the ends of the threads in various cavities of the body, with high strength characteristics.

The closest in structure to the proposed node is the extracorporeally tied self-tightening Ryder knot (Sleptsov I.V., Chernikov R.A. Knots in surgery. Edited by Dr. med. T.K. Nemilova. - St. Petersburg: Salit-Medkniga, 2000, p. 147-149).

However, the disadvantage of this knot is that the technique of tying it is complicated. In the cavities, after being placed there through the laparotomy ports, he does not always reach. The ends of the thread in the knot do not slide well. It does not have sufficient mechanical strength, which makes it unsuitable for the formation of a knot of monofilament yarns.

The aim of the invention is to increase the strength holding properties of a sliding surgical site created by monofilament threads.

This goal is achieved by the fact that one of the ends of the thread in the proposed site is passed through a loop created at the other end of the thread, pull it in the opposite direction to the other end of the thread, which allows the threads to easily slide in the proposed site relative to each other, and due to complex weaving threads in the node to give it a higher mechanical strength compared to the prototype.

Tying the knot is carried out as follows (see Fig. 1-8).

Position number 1. The end of the thread A (white) is held by 1 and 2 fingers of the right hand, and the end of the thread B (black) is held by 1 and 2 fingers of the left hand (Fig. 1).

Position number 2. Held by 1 and 2 fingers of the right hand, the end of thread A is circled around 5 fingers and placed on the palm surface of 3 and 4 fingers. The end of thread B, held by 1 and 2 fingers of the left hand, is also placed on the palm surface of 3 and 4 fingers of the right hand near the end of thread A (Fig. 2).

Position number 3. Bend the nail phalanx of 3 fingers of the right hand in the distal interphalangeal joint, circle the thread B, fixed with 1 and 2 fingers of the left hand and located on the palm surface of 3 and 4 fingers of the right hand, wind it with the back surface at the end of the thread A, held by 1 and 2 fingers the right hand, and the back extension of the phalanx form a loop on the 3rd finger of the right hand from threads A and B (Fig. 3).

Position number 4. The end of thread B, fixed with 1 and 2 fingers of the left hand, is intercepted and fixed with 1 and 2 fingers of the right hand along with the end of thread A (Fig. 4).

Position number 5. 2 and 3 fingers of the left hand are placed in a loop made on the 3rd finger of the right hand under the thread B (Fig. 5).

Position number 6. The ends of threads A and B are captured, fixed with 1 and 2 fingers of the right hand, 2 and 3 with fingers of the left hand and move them into the loop (Fig. 6).

Position number 7. Hold the end of the thread B 1 and 2 with the fingers of the left hand and with the fingers of the right hand with the pusher lower the sliding knot to the surface of the stitched incision in the cavity (Fig. 7).

Position number 8. The final view of the sliding surgical site proposed by the authors (Fig. 8).

The experimental studies of comparative mechanical strength for dissolving the known and proposed surgical nodes showed the following results (table. 1):

The proposed surgical unit is sliding, it reaches well in the depths of the cavity and does not dissolve, has high mechanical and strength properties, which allows it to be recommended in everyday surgical practice for stitching biological tissues with monofilament threads during various surgical operations.

Literature

1. Sleptsov I.V., Chernikov R.A. Nodes in surgery. Ed. Dr. med. Sciences T.K. Nemilova. - St. Petersburg: Salit-Medkniga, 2000, p. 147-149.

Claims (1)

A method of tying an extracorporeal sliding surgical site, in which the end of the first thread held by 1 and 2 fingers of the right hand is circled around 5 fingers and placed on the palm surface of 3 and 4 fingers, the end of the second thread held by 1 and 2 fingers of the left hand is also placed on the palm surfaces of 3 and 4 fingers of the right hand near the end of the first thread, bend the nail phalanx 3 fingers of the right hand in the distal interphalangeal joint, circle the second thread fixed with 1 and 2 fingers of the left hand and located on the palm the surfaces of the 3 and 4 fingers of the right hand, start it with the back surface at the end of the first thread, held by 1 and 2 fingers of the right hand, and with the back extension of the phalanx form a loop on the 3 finger of the right hand of two threads, the end of the second thread, fixed with 1 and 2 fingers of the left the brushes intercept and fix with 1 and 2 fingers of the right hand along with the end of the first thread, 2 and 3 fingers of the left hand are placed in the loop created on the 3 fingers of the right hand, under the second thread, grab the ends of the threads with 2 and 3 fingers of the left hand and move them in a loop, hold the end of the sec yarn 1 and 2 with the fingers of the left hand and the fingers taken with the right hand with the pusher bring the sliding knot down to the surface of the stitched incision in the cavity.

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