RU72619U1 - SURGICAL NEEDLE - Google Patents

Abstract

The utility model relates to the field of medical technology, namely to surgical needles intended for stitching tissues when performing operations in an endoscopic manner in various fields of surgery. To solve the problem of improving operational. properties of the surgical needle, in particular its controllability, expansion of functionality in the surgical needle, consisting of a curved body with a sharp end on one side and a thread fixed in it, and the juvenile end of the needle is also sharp, and the thread is fixed, or in the middle part of its body , or closer to one of the ends. Also, the body of the needle can be made either arcuate, or straight, or made in the form of a "ski" with one of the ends bent arcuate. Also, the thread can be fixed either in the middle of the straight part of the body, or in the middle of the body of the needle, or at the junction of the direct and curved portion of its body. Also, the needle body can be made with a round, oval or quadrangular cross section with rounded edges 9 of FIG.

Description

The utility model relates to the field of medical technology, namely to surgical needles intended for stitching tissues when performing operations in an endoscopic manner in various fields of surgery.

Closest to the proposed is a surgical needle for performing operations with endoscopic access with a pointed first end, a curved body and a second end compressed around the thread (TU 9432-002-24648800-2005). The body of the needle can be made of various bending diameters and cross sections. The thickness and material of the thread are also diverse. Such a needle with a thread is disposable. During endoscopic operations, the needle is brought to the site of the operation through access instruments - trocars. Sewing of tissues is carried out by manipulating needle holders specially manufactured for endoscopic operations. During endoscopic operations, the angle of approach of the instruments - the needle holder and the tool for intercepting the needle (clamp, dissector), is limited and determined by the introduced trocars. Manipulations take a long time, require high manual skill of surgeons. It is difficult to fix the needle, due to the possibility of its rotation during the manipulation, which complicates them and lengthens the time of surgery, increases the risk of tissue trauma.

A new technical task is improving the operational properties of a surgical needle, in particular its controllability, and expanding functional capabilities.

To solve the problem in a surgical needle, consisting of a body with a sharp end on one side and a thread fixed in it, the second end of the needle is also sharp, and the thread is fixed either in the middle part of her body or closer to one of the ends, and, the body can be made straight, or arched, or in the form of a "ski" with one of the ends curved arched.

The invention is illustrated in FIG. 1 (a, b, c) and FIG. 2 (a, b, c). In FIG. 1 (a, b, c,) shows a needle consisting of body 1 with ends pointed at both sides 2, 3 and threads 4 fixed in the middle part of her body.

The device operates as follows. Sewing fabrics is as follows:

1. The needle is inserted into the trocar to the operation site with one of the clamps.

2. The needle holder grabs one end of the needle. At the other end of the needle, the tissue of the organ that is the object of suturing is sutured (Fig. 4).

3. After the end of the needle is punctured, the end of the needle emerging from the tissue is captured by another needle holder, the first needle holder is opened and the needle is removed from the tissues (Fig. 5).

4. While holding the captured needle with the second needle holder, the fabric is again stitched with the free end of the needle (63).

5. After the second impregnation of the tissue, the first needle holder again grabs the needle and removes it from the tissues (Fig. 7).

6. If a nodal suture is required, the thread is tied, forming a knot (Fig. 8).

If a continuous suture is required, repeat the steps by applying a line of sutures of the required length (Fig. 9).

Several needle options are offered, depending on the shape of her body, the location of the thread on it and the shape of the cross section of her body.

1. The body of the needle is made in the form of an arc. The shape of such a needle is represented by a part of a circle of various diameters, depending on the type of operations and the nature of the stitched fabrics. (Fig. 1a). The length parameters are L, and the radius is R variable. Height - H is determined by the trocar access tool, the inner diameter of which is 10-12 mm. This version of the needle can be used for stitching hollow organs, or tissues with a large thickness (parenchymal organs). This can be tissue of the lung, liver, kidneys, or for suturing a defect in the round shape of the intestine or stomach (perforated ulcer, for example). The body of the needle in the form of an arc allows, having injected the needle into the tissue, to withdraw the end of the needle from the tissue, at a distance from the injection site. The magnitude of the radius of curvature of the needle determines the distance of the puncture from the injection site. When stitching massive fabrics, a longer needle, for example 40-50 mm, is required. When stitching tissue with a small thickness, a smaller needle is required, for example, stitching of hollow organs, blood vessels, and similar tissues. Indicate approximate recommended values for radii, lengths and heights.

2. A needle having a straight-shaped body. Such a needle is represented by a straight segment of various lengths, which is also associated with the type of operation. (Fig.1b) Length - L is variable. A needle with a straight-shaped body allows stitching of tissue with a transverse (with respect to stitched fabric), introduction of a needle. As an example, stitching the edges of the peritoneum (peritonization) after hernia repair or removal of part of the intestine. Stitching of the peritoneum (peritonization)

and tissue after removal of the uterus and its appendages. It is advisable to stitch the mesentery of the intestines with such a needle, for example, with appendectomy.

3. A needle whose body is made in the form of a "ski". One end of such a needle is straight, the other end of the needle has a rounding of various diameters, which is also associated with the type of operation and the nature of the stitched fabrics. (Fig. 1c). The length parameters are L, and the radius is R variable. Height - H is determined by the trocar access tool, the inner diameter of which is 10-12 mm.

This body shape of the needle combines the capabilities of the needle in the form of an arc and in the form of a "ski". This allows you to flash fabrics of various structures and thicknesses. By manipulating both working ends of the needle - straight and rounded, it is possible to stitch dissimilar tissues, which expands the scope of this version of the needle.

4. The needle in which the thread is fixed between the two ends of the needle. The thread can be fixed, both exactly in the middle and closer to one of the ends of the needle. The location on the body of the needle is determined by the nature of the stitched fabric. (Fig. 2a, b, c). Such options are explained both by the surgeon’s tasks of stitching tissues of various shapes and structures, and by the goal of increasing the strength of the needle. Closer placement of the thread to the rounded end increases the strength under load perpendicular to the longitudinal axis of the needle. This strength is necessary when stitching dense fabrics. As an example, suturing a perforated ulcer, in which the edges of the hole are tight, require effort when inserting a needle.

Placing the thread closer to the straight end makes it possible to flash a large array of tissue with the exit of the needle further from the injection site, without the application of force when inserting the needle. For example, when flashing a lung, kidney, fatty tissue.

5. The cross section of the needle body can be round, or oval, or flattened. (Fig. 3a, b, c). The oval or flattened section of the needle body allows you to more securely hold the needle with a tool. Facilitates the manipulation of the orientation of the needle in the clamp, which avoids unnecessary movements when orienting the needle and setting it to its working position in the jaws of the needle holder. In addition, the presence of an oval or flattened section of the needle body increases the strength of the needle to a force perpendicular to the longitudinal axis of the needle.

7. The thread material is offered different. It can be a thread of absorbable and non-absorbable material. The thread can be woven and monofilament. Any surgical thread approved for use in medicine may be used.

9. The material from which the needle is made can be used in a variety of ways - both metal and plastic, which are approved for use in medicine.

Example

03/10/2006, a patient of 54 years old was operated on for a bilateral inguinal hernia. After installing and fixing the mesh explant, the proposed needle in the form of a "ski" (Fig. 1C) (according to the claims), the peritoneum (peritonization) of the inguinal canal was sutured on both sides with a continuous suture. The time spent on this stage of the operation is halved compared to using a conventional surgical atraumatic needle. The postoperative period was uneventful. The patient was discharged with recovery on the third day. Disability restored on the 15th day.

The needle is proposed to perform operations endoscopically, with various types of interventions. The proposed needle allows you to more freely manipulate thanks to the Fastening of the thread in its middle part makes it easier to manipulate the needle. Also, due to the fact that both ends of the needle are pointed, it is possible to stitch fabrics without additional interception of the needle.

In total, 12 surgical interventions of various nature were performed using various options of the proposed needle.

Thus, the use of the proposed needle allows

1. Reduce the time of surgery due to more free manipulation of the needle.

2. To expand the scope, due to the expansion of functional properties, that the use of the needle of different options in the shape of the body and the location of the thread on it. When manipulating a needle of various shapes, it is possible to stitch all kinds of organs and tissues, which ultimately makes it possible to perform a wider range surgical interventions performed by endoscopic technology.

3. Makes it possible for surgeons to more easily master the manual technique of manual suture in endoscopic surgery.

4. Reduces the cost of the operation due to the refusal to purchase disposable stapling instruments.

Claims (6)

1. A surgical needle, consisting of a body with a sharp end on one side and a thread fixed in it, characterized in that the second end of the needle is sharp and the thread is fixed either in the middle of her body or closer to one of the ends. 2. The surgical needle according to claim 1, characterized in that the body of the needle can be made arcuate. 3. The surgical needle according to claim 1, characterized in that the needle body can be made straight. 4. The surgical needle according to claim 1, characterized in that the body of the needle can be made in the form of a "ski" with one of the ends curved arcuate. 5. The surgical needle according to claim 3, characterized in that the thread can be fixed either in the middle of the straight part of the body, or in the middle of the needle body, or at the junction of the direct and curved portion of its body. 6. The surgical needle according to claim 1, characterized in that the body of the needle can be made with a round, oval or quadrangular cross section with rounded edges.