RU38574U1 - VASCULAR HOLDER - Google Patents

Abstract

A useful model device relates to the field of medicine, in particular to experimental and clinical surgery, and can be used in operations on vessels, namely when creating vascular anastomoses. The device includes two branches with rings, a gear lock for the dosed approach of the branch. The working part is represented by two metal branches, the end parts of which are rectangularly expanded, from the end surfaces are provided with recesses in the form of a groove, the size of which corresponds to the size of the tail of the standard vascular terminal of Blok, on which the main instrument is inserted during the operation. The proposed device allows the rapprochement of the mobilized ends of stitched vessels. Dosed rapprochement allows you to adjust the distance between the ends of the vessel, does not injure the walls of the vessels, due to the removability of the terminals, they can initially be installed, and then attach the proposed vascular holder to them; convenience of work deep in the wound, the ability to operate without an assistant.

Description

A useful model device relates to the field of medicine, in particular to experimental and clinical surgery, and can be used in operations on vessels, namely when creating vascular anastomoses.

One of the problematic issues of vascular surgery remains various types of vascular reconstructive operations, which are often the only method of restoring blood flow in case of thrombosis, trauma, atherosclerosis, and post-thrombophlebitis syndrome.

When stitching the ends of the vessel, their mobilization from surrounding tissues is necessary. To stop bleeding from them, Blok's vascular terminals are used, the design feature of which allows to completely stop blood flow, without injuring the walls of the vessel. The assistant for the terminals makes the ends of the vessel come closer, and the surgeon sews them together. However, while the assistant’s hands are in the area of the surgeon’s activity and interfere with vision, the ends of the vessel can be displaced relative to each other, which will greatly interfere with the surgeon, especially when working with magnification. In this regard, a device is needed that brings the ends of the stitched vessel together and holds them together.

As a prototype for the vascular holder, a direct hemostatic clamp of Billroth was taken, since by design features it is most similar to it. The Billroth clamp consists of two branches with rings and a lock, the working part of two metal branches, which on the surfaces in contact with each other have small notches, the working parts of the branches to the ends are gradually narrowed. This clip is designed to stop bleeding from

small and large vessels, followed by dressing or stitching. Thus, it is unsuitable for reconstructive surgery.

The vascular holder developed by the authors meets the requirements of reconstructive vascular surgery, which makes it possible to bring together the mobilized ends of the stitched vessels and compare them. The vascular holder includes jaws, the ends of which are rectangularly expanded and are provided with a recess in the form of a groove from the end surface, the dimensions of which correspond to the dimensions of the tail of the vascular terminal of Block.

The tool is made of X18H10T stainless steel with an additional titanium nitrite coating.

The proposed device is shown in the diagram.

Figure 1: depicts a vascular holder top view; figure 2: the same view from the side; figure 3: the end parts of both branches; figure 4: the tool is in operation.

The vascular holder is designed to create a vascular anastomosis of the type "end to end". The tool consists of No. 1 of two jaws with rings, No. 2 of an elongated gear lock for dosed rapprochement of the jaws and fixing them in the right position, No. 3 of the working part of two metal jaws, the ends of which are expanded in the form of rectangle No. 4, for the possibility of making a groove in it, the dimensions of which correspond to the dimensions of the tail of the vascular terminal of Block No. 5. This correspondence makes it easy to make the tool tip on the terminals and remove it during the surgeon's work.

An example of a specific implementation.

Blok's vascular terminals are superimposed on the ends of the intersected vein, The ends of the veins are mobilized, the intersection line is aligned, the tail parts of the terminals are inserted into the grooves of the vascular holder

in the open position. The vascular holder closes until the ends of the stitched vein come into contact. Using the microsurgical technique, the anastomosis anterior lip is formed with separate interrupted sutures. The vascular holder is transferred to the other side of the surgical wound, thus the anastomosis posterior lip is exposed, which is also formed using microsurgical technique with separate interrupted sutures. The vascular holder is transferred to its original position and freed from the terminals, which are then removed from the stitched vein, first from the proximal side, then from the distal side. The proposed vascular holder provides:

1. rapprochement and accurate matching of the ends of stitched vessels;

2. reducing trauma to the vessel wall;

3. the ability to perform the main stage without an assistant;

4. reducing the time to create an anastomosis;

5. convenience of work deep in the wound.

All these positive qualities of the vascular holder are ensured by the simplicity of design, the large working stroke of the tool branches, the simple and reliable lock, and the use of serial Blok vascular terminals.

The vascular holder was tested in experiments on outbred dogs (15) and sectional material of human corpses (10) when stitching limb veins and has established itself as a very convenient tool in the work of an angiosurgeon.

Claims (1)

A vascular holder comprising two metal jaws with rings and a lock, characterized in that the ends of the working jaws are rectangularly expanded, from the end part there are recesses in the form of a groove, the dimensions of which correspond to the dimensions of the tail of the Blok vascular terminal.