RU2764871C1 - Surgical needle holder - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, in particular to surgical instruments, and can be used when suturing living tissues during various surgical operations. The surgical needle holder contains a body with a fixed branch in its front part and a movable spring-loaded branch connected to it, a spring-loaded trigger made with the ability to move along the body and elastically return to its original position and having a bevel connected to the trigger to affect the branch and turn it, and a lock connected to the trigger and spring-loaded relative to the trigger with the possibility of rotation around the transverse axis when exposed to the lock button protruding from the body. The lock has a tooth for engagement with the toothed surface of the housing, made on its inner surface.

EFFECT: use of the invention makes it possible to reduce the efforts exerted by the surgeon to control the branches.

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Description

The invention relates to the field of medicine, in particular to surgical instruments and can be used for suturing living tissues during various surgical operations. Stitching of living tissues is one of the most important stages of a surgical operation, requiring a significant investment of the surgeon's time, a high degree of attention and physical stress.

EFFECT: invention allows suturing organs and tissues of different stiffness and hardness, for example, from loose subcutaneous adipose tissue and submucosal layer of the intestine to aponeuroses and skin. The invention also makes it possible to suture organs of different sizes, both a blood vessel and the wall of the stomach, to suture both hollow and parenchymal organs, in addition to suturing especially strong tissues, such as tendons. Stitching is done with special needles curved along an arc of a circle. At the beginning of the stapling process, the needle is clamped between the jaws (branches) of the needle holder, a puncture is made, and then the needle is released - the needle holder jaws are unclenched. In order to pull the needle out of the tissue, it is necessary to clamp it again between the jaws. All the above manipulations are repeated with each stitch.

The prior art known needle holder [Patent US5662665, publ. 09/02/1997, dated 06/06/1995, IPC A61B17 / 04, A61B17 / 00, SEC A61B17 / 062], made in the form of scissors with elongated handles and rings for holding fingers on one side and jaws on the other side to hold the thread.

The well-known Gegar needle holders require the application of a certain force on the handles (rings) to clamp the needle. To release the needle (interception), it is necessary to develop the same force on the handles. The creation of force requires the tension of the surgeon's fingers, in which sharp movements of the instrument are possible, increasing the risk of microtrauma and leading to loss of time during surgery. At the same time, needle holders of this type are characterized by strength and provide reliable (strong) clamping of the needle. Fixing the position of the handle of the Hegar needle holder is carried out by means of a lock (kremalier) or by the surgeon's hand.

At the same time, the well-known microsurgical needle holders are characterized by smooth surfaces of the working parts and have a more anatomical shape, are more convenient to use, but provide weak clamping of the needle. For example, the classic Castroviejo needle holder [first published as US Patent 2652832, publ. 09/22/1953, dated 12/27/1950] is made in the form of two branches located opposite each other and fixed on an axis with the possibility of rotation holding the needle with elastic arms extending from the branch, connected at opposite ends. On the inside of the handles there is a lock that fixes the needle holder handles in the needle clamp position.

Thus, the prior art does not know a durable and strong needle holder like Hegar's needle holders, and at the same time possessing the advantages of microsurgical needle holders - their ergonomics and ease of use.

The main drawback of all existing designs of needle holders is that it takes a force to open the needle, no less than when clamping. Thus, to form one stitch, the surgeon must apply force to the needle holder handles twice. This requires tension in the fingers, which can lead to sudden movements, which, in turn, can lead to microtrauma and loss of time during surgery.

The technical result achieved by the implementation of the invention is to reduce the effort that the surgeon makes to control the branches. In particular, the force that must be applied to open the needle, as well as the effort required to hold the branches in one position or another. This reduces the tension of the surgeon's fingers when suturing living tissues. The needle holder is more ergonomic, and the main part of the muscle tension is transferred from the rotator muscles to the finger flexor muscles, as they are stronger. This reduces the time spent on this part of the operation, and therefore, on the entire operation as a whole, reduces the risk to the patient's health, fatigue of the surgeon (including due to the possibility of changing the shape of the handle). At the same time, the design is easy to assemble, which is important for periodic sanitization of the device and its components.

Surgical needle holder, contains:

- a body with a fixed jaw in its front part and a movable spring-loaded jaw connected to it, which, due to rotation around the transverse axis, occupies an open or closed position,

- a spring-loaded trigger, configured to move along the body under the action of the force applied by the surgeon, and elastically return to its original position when the latch is released, and having a bevel associated with the trigger to act on the jaw and rotate it around the transverse axis,

- a latch connected to the trigger and spring-loaded relative to the trigger with the possibility of rotation around the transverse axis when the surgeon acts on the latch button protruding from the body,

- moreover, the latch has a tooth for engagement with a toothed profile surface of the body, made on its inner surface, for jamming the latch and, accordingly, keeping the jaw from opening,

- as well as the needle holder handle designed to hold the device.

Closing the jaw to hold the needle is done by pressing the trigger, which directs the bevel of the trigger, acting on the jaw to rotate it. The branch is fixed in the closed position due to the interaction of the latch tooth with the profile surface of the body, which means that the surgeon does not have to make additional efforts to hold the needle. The jaws are released by lightly pressing the latch button, which stimulates the rotation of the latch to disengage it from the profiled surface, that is, a minimum application of effort is required to decompress.

Preferably, the needle holder has a stop at the rear of the housing with a trigger return spring to guide and stop it.

The handle is preferably removable, for this it has a dovetail-shaped groove corresponding to a transverse groove made on the rear surface of the housing. Connecting the body and handle through these slots allows for an easy-to-assemble and secure connection, which allows the handle to be changed depending on the manipulation and/or surgeon preference. For additional fixation of the handle, it has a hole in its middle part, and on the outer part of the stopper there is a spring-loaded button corresponding to the handle hole. Thus, the stopper in this case performs a dual function - it directs the return spring of the trigger and additionally fixes the handle.

To simplify the design of the device, its assembly and disassembly, the branch spring and/or the latch spring can be made as part of the corresponding element. The spring is made in the form of a plate, one end of which is connected to the jaw/latch, and the other end is made free with the possibility of elastic movement. In this case, after the termination of the force that presses the jaw/retainer with a spring to the body, the jaw/retainer tends to return to its original position due to the elasticity of the spring.

The proposed design allows you to create an anatomical and easy-to-use needle holder, which at the same time provides reliable clamping of the needle and has sufficient strength. The unclamping of the needle is made with a force several times less than the force for clamping. This is achieved due to the ability to control the position of the branches with a trigger and the mechanism used to fix them both in the position of clamping the needle and in the position of unclenching.

The preferred embodiment of the invention and the principle of operation of the proposed design are illustrated by drawings, which show:

- Figure 1 - General view of the needle holder;

- Figure 2 - longitudinal section of the needle holder in the position of the mechanism parts with the jaw closed;

- Figure 3 - longitudinal section of the needle holder in the position of the mechanism parts with the jaw open;

- Figure 4 - fastening the handle to the body.

The general view of the needle holder (see figure 1) shows a hollow body 1 with a fixed jaw in its front part, a movable jaw 2 to hold the needle by interacting with the jaw of the body 1, a trigger 4 to control the movement of the jaw, a latch button 5 and a handle 7, allowing the surgeon to hold the device. For the location and movement of the trigger 4 in the body 1, a longitudinal groove 18 is made. The body 1 protects the components of the device from ingress of organic particles and, at the same time, living tissues from injury by the moving parts of the device. The remaining parts are located inside the housing 1 (see Fig.2, 3).

Branch 2 is a two-arm lever and is connected to the body 1 by axis 3 with the possibility of movement around it. To ensure rotation of the branch 2 around the axis 3 by interacting with the bevel 16 of the trigger 4, the branch 2 has a corresponding bevel 16 shape of the branch shank.

Elastic movement relative to the axis 3 is provided through the use of the spring 11, made in the jaws 2 or attached to it. The spring 11 as part of the jaw is preferably a flat straight spring - a plate, one end of which is connected to the jaw 2, and the other is made free with the possibility of elastic movement. The implementation of the spring 11 as part of the branch allows you to simplify both the design itself and its assembly, disassembly and processing of parts of the device, as it reduces the number of individual parts of the device that require installation using special tools.

The inner surface of the body in its part, interacting with the tooth 22 of the latch 5, has a profile surface 12, where the toothed surface is made, for example, according to the principle of a ratchet mechanism. That is, the geometry of the teeth of the surface 12 is made in such a way as to allow the movement of the tooth 22 when the trigger 4 is cocked, but to prevent spontaneous disengagement of the tooth 22 from the profile surface 12 when the trigger 4 is released.

The trigger 4 is located in the lower part of the body 1 and has an anatomical shape that provides comfort for the fingers of the surgeon. The trigger 4 is structurally connected with the elements that ensure the rotation of the jaw 2 and its fixation - the bevel 16, the latch 5 and the jumper 17 of the trigger so as to ensure their joint movement inside the body 1 when the trigger 4 moves. The spring 9 of the trigger 4 is necessary to return the trigger 4 to its initial position, enters at one end into the socket 24 of the spring 9 of the trigger 4, and the other end rests against the body of the stopper 8. The spring 9 of the trigger 4 is guided by the rod 19 of the stopper 8.

The latch 5 ensures that the branch 2 is held in the position of clamping and fixing the needle. The latch 5 is spring-loaded relative to the trigger 4, in particular its jumper 17, by the spring 10, made as part of the latch 5 (similar to the flat spring of the branch 2) or attached to it. Similarly to the spring of the branch 2, the implementation of the spring 10 as part of the latch 5 simplifies the design as such, as well as its assembly and disassembly. The latch 5 is fixed with the help of the axis 6 fixed in the hole 21 of the trigger 4 and ensuring its rotation around it at a small angle to change the nature of interaction with the profile surface 12 of the housing 1.

The stopper 8 is located in the back of the housing 1 and performs a dual function. On the one hand, the stopper 8 is used to guide the return spring 9, which ensures the movement of the trigger 4, which is put on the rod 19. On the other hand, the button 26, made on the outside of the stopper 8, is designed to fix the handle 7. In this case, the spring 9 acts as a return spring and for button 26.

The surgical needle is clamped between the working surface 14 of the body 1 and the working surface 13 of the branch 2 (see Fig.2,3). When the needle is clamped, the branch 2 rotates counterclockwise due to the action of the bevel 16 of the trigger 4 on the bevel 15 of the branch 2 when the trigger 4 moves to the right (towards the handle) in the longitudinal groove 18 of the body 1 under the influence of the surgeon's finger. The trigger 4 moves, and the button 23 of the latch 5 is lowered into the longitudinal groove of the body 1. The tooth 22 of the latch 5 is pressed under the action of the spring 10 against the profile surface 12 of the body 1, while the spring 10 of the latch 5 abuts against the jumper 17 of the trigger 4. So the latch 5 due to engagement with the teeth of the profile surface 12 prevents the trigger 4 from moving and returning to its original position, thereby preventing the jaw 2 holding the needle from expanding.

To open the needle, the surgeon must press the button 23 of the latch 5, thereby initiating its rotation around the axis 6, which removes the tooth 22 from engagement with the profile surface 12 of the body 1. The trigger 4, in the absence of engagement, freely moves to the left (away from the handle) under the action of the trigger spring 9 4, returning to its original position. The bevel 16 of the trigger 4 is also shifted to its original position, thereby stopping the impact on the branch 2. In this case, the branch 2 rotates clockwise under the influence of the spring 11 of the branch 2 and the needle is opened. In the open position, the branch 2 is held by holding the trigger 4 by the spring 9, to change the position of which it is necessary to apply force to the trigger 4 again.

The original design of the needle holding mechanism, controlled by the action of the surgeon's fingers on the trigger 4, provides easy opening of the needle. The geometry of the tooth 22 of the latch 5 and the profile surface 12 of the body 1 are calculated in such a way that when the trigger 4 is actuated, the latch 5 is wedged. For wedging of the latch 5, a slight (1-2 H) impact on the button 23 of the latch 5 is sufficient. The termination of such an impact leads back to jamming of the latch 5. The jaw 2 can be in both the open and closed position. Thus, the surgeon does not need to hold the jaw 2 either in the open position when gripping the needle, or in its closed position.

Reliable clamping of the needle is ensured by a high gear ratio of the mechanism (1:10) due to the angle of transmission of movement between the bevel of the trigger and the jaw, as well as the ratio of the shoulders in the jaw itself as a lever mechanism. Due to this, when the trigger is pressed with a force of 20-40 N, the jaw presses the needle with a force of 200-400 N.

Handle 7 is designed to hold the device in the hands of the surgeon. It has a dovetail groove 27 corresponding to a transverse groove 20 which is provided in the rear of the housing 1 (see FIG. 4). In its middle part, the handle 7 has a hole 25. Moreover, the middle part should be understood as that part of the handle, which, depending on its shape, size, geometry, material, the handle 7 is attached to the body 1. The stopper 8 has a spring-loaded button 26 corresponding to the hole 25 for additional fixation of the handle 7.

To install the handle on the body 1, the handle 7 enters with its groove 27 in the form of a dovetail into the reciprocal groove 20 of the body 1. The stopper 8 has a button 26 spring-loaded by a spring 9, which enters the hole 25 of the handle 7 and fixes it. To remove the handle 7, it is necessary to press the button 26 of the stopper 8 and move the handle 7 up along the grooves 27 and 20.

The removable handle of the needle holder allows you to use its various forms, the most convenient for a particular job or a particular surgeon. To make a quick replacement of the handle allows the original design of its fastening and fixation relative to the body (see Fig.4).

The shape of the connecting surface "dovetail" allows you to securely fix the handle and is able to transfer high loads. In turn, the spring-loaded button 26 of the stopper 8 selects the gap in this connection and makes it easy to separate the parts by pressing the button 26 with any pointed tool (screwdriver, needle, pin, awl, etc.) Fixing the handle 7 with the button 26 additionally prevents disconnection handles 7 when vibrations, various variable loads, and other phenomena occur during the operation of the device.

Due to the concise design, the device is easily assembled and disassembled, including for the purpose of processing internal parts. To disassemble, just press the button 26, remove the handle 7, then the stopper 8 with the spring, remove the trigger 4. When assembling, the trigger 4 is inserted until it stops, the return spring 9 with the stopper 8, then the handle 7 is put on, which with the stopper 8 mutually fix each other .

Thus, an increase in convenience and a reduction in the effort and time spent on the crucial stage of any surgical operation - the suturing of living tissues - is achieved. In turn, this leads to a reduction in the time spent on the surgical operation as a whole, which means it reduces the risks to the health of patients and reduces the fatigue of surgeons.

Claims (8)

1. Surgical needle holder, containing: - a body with a fixed jaw in its front part and a movable spring-loaded jaw connected to it, - spring-loaded trigger, made with the ability to move along the body and elastically return to its original position and having a bevel associated with the trigger to act on the jaw and rotate it, - a latch connected to the trigger and spring-loaded relative to the trigger with the possibility of rotation around the transverse axis when exposed to the latch button protruding from the body, and the latch has a tooth for engagement with the serrated surface of the body made on its inner surface. 2. The needle holder according to claim 1, characterized in that it contains a stopper in the rear of the body with a trigger return spring. 3. The needle holder according to claim 1 or 2, characterized in that it contains a detachable handle, which has a dovetail-shaped groove corresponding to a transverse groove made on the rear surface of the body. 4. The needle holder according to claim 3, characterized in that the handle has a hole in its middle part, and a spring-loaded button is made on the outer part of the stopper, corresponding to the handle hole. 5. The needle holder according to claim 1, characterized in that the spring of the branch and/or the spring of the retainer is made as part of the jaw or retainer, respectively, in the form of a plate, one end of which is connected to the jaw or retainer, and the second is made free with the possibility of elastic movement.

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