RU86438U1 - LIGATURE HINGE NEEDLE - Google Patents

Abstract

A needle for holding a ligature loop having an eye on the tip of the needle, characterized in that the needle is fixed to the handle, longitudinal grooves are made on both sides of the needle’s length along its entire axis, parallel to the axis, a slot is made on one side of the eye, and the needle’s tip is flat-pointed, and the needle is fixed in the handle at an angle of 120-160º.

Description

The proposed utility model relates to the field of medicine, namely to ophthalmology and is intended for surgical manipulations inside the eye.

A known needle for suturing an intraocular lens, which is curved at the boundary of the lower and middle third at an angle of 90 °, has a through hole for holding the thread at the bend, and the needle tip has the shape of a lancet (see PM RF No. 7000, A61F 9/00, 1998).

The closest is the needle for suturing the postoperative wound, which has a 180 ° bend, the needle tip has an eye for holding the thread and is made stitching or cutting (see. PM RF No. 39801, A61B 17/06, 2004).

However, well-known instruments cause an additional traumatic effect due to the large number of tissue punctures with a needle to fix the structures inside the eye to the sclera.

The technical result of the proposed needle is to reduce the traumatic effect of the needle on the tissue and ease of use.

What is new in achieving the technical result is that the needle is fixed on the handle, longitudinal grooves are made along the entire axis parallel to the axis on both sides of the needle’s eye, a slot is made on one side of the eye, the tip of the needle is flat-sharpened, and the needle is fixed at an angle to the handle 120-160 degrees.

Making a slot on the eye of the needle allows you to tightly fix the loop of the ligature thread and at the same time piercing the needle with the needle to bring out the loop of the ligature thread without additional puncture.

The implementation of the needle tip with a flat-sharpened gives the needle at the time of puncture of the tissue piercing and cutting properties, which provides better adaptation of the edges of the wound at the puncture site.

Performing longitudinal grooves on both sides of the needle’s eye along its entire length parallel to the axis provides a minimum cross-sectional area of the needle and thread at the puncture site, minimizing the traumatic effect on the tissue.

Fixing the needle in the handle at an angle of 120-160 ° provides the convenience of manipulation using an operating microscope when performing microsurgical operations.

Comparative analysis with the prototype shows that the proposed needle differs from the known one in that the needle is mounted on the handle, longitudinal gutters are made along the entire axis parallel to the axis on both sides of the needle, a slot is made on one side of the eye, the tip of the needle is made flat-layered, and the needle fixed in the handle at an angle of 120-160 degrees, which meets the criterion of "novelty."

The proposed needle for holding the ligature loop reduces the traumatic effect of the needle on the tissue and the convenience when performing microsurgical operations, which meets the criterion of "industrial applicability".

The proposed needle is illustrated by the following figures, where Fig. 1 shows a general view of the needle, a top view, where 1 is the tip of the needle, 2 is the eyelet, 3 is the groove, 4 is the angle at the point of attachment to the handle; figure 2 is a side view of the needle and figure 3 is a needle tip front view.

The needle for ophthalmic surgery contains a tip with an eye 1, one side of which has a slot 2, the tip of the needle is made flat-pointed. On both sides of the needle’s eye along the entire length parallel to the axis of the needle, longitudinal grooves 3 are made. The length of the needle from the tip to the bend at the handle is 15-18 mm. For ease of use, the needle is fixed in the handle at an angle of 120-160 °.

The proposed needle is used as follows. A fixed tissue is pierced with a needle, a loop of the ligature thread is tucked into the eyelet, and a loop of thread is removed from the fabric. If necessary, pre-thread the loop of thread into the eye of the needle, pierce the fixed tissue with a needle, followed by the removal of the loop of the ligature thread. This property of the needle is especially valuable during surgical procedures inside the eye to fix various structures to the sclera.

Example 1. Patient B., 35 years old, complained of low vision in his right eye. Vision decreased as a result of shell shock 3 years ago. At the time of examination, the visual acuity of the right eye is 0.2, is not corrected. Objectively: there is a separation of the iris from the sclera over 120 °, the displacement of the pupil relative to the optical axis of the eye, iridofacodenesis. Diagnosis: Traumatic iridodialysis, ectopia of the pupil. Subluxation of the lens of the 1st degree of the right eye.

To restore the diaphragmatic properties of the iris and pupil centering, it is necessary to fix the root of the iris at the site of iridodialysis to the sclera. Using the proposed needle in the projection of iridodialysis, the sclera is punctured radially at the point of attachment of the iris root to the sclera and the tip of the needle with the eye is brought into the anterior chamber of the eye, then the iris is pierced at the point of separation from the sclera in the same direction. Through a pre-performed corneocentesis, a loop of thread with a thickness of 10.0 is introduced and inserted into the slot of the needle eye. By moving the needle in the opposite direction, a loop of thread is brought out through the root of the iris and sclera. About 3-5 mm depart from the first puncture of the sclera and repeat the manipulation of the needle and thread. At the final stage, the free ends of the thread are brought out by a needle and passed through the previously looped threads, uniformly pull them, thereby fixing the torn root of the iris to the place of separation to the sclera. Due to the reposition of the iris to the place of its anatomical attachment, the pupil is centered relative to the optical axis of the eye. The free ends of the thread are connected together. As a result of the treatment, the diaphragmatic properties of the iris were restored, the pupil was centered, visual acuity increased to 0.8 7 days after surgery. Diagnosis at discharge: Artifakia of the right eye.

Example 2. Patient Yu., 67 years old. He complained of a gradual decrease in left eye vision over the course of the year. 6 years ago, cataract extraction was performed with the implantation of an intracapsular IOL model. Denies eye and head injury. At the time of the examination, the visual acuity of the left eye is 0.02, with a correction of + 12D it is 0.9. Objectively: the optical media of the eye are transparent, the pupil in the optical zone, with a diameter of 3 mm. The capsule lens bag with a fixed IOL in it is decentered for the projection of the pupil. Pronounced exfoliative changes in the lens capsule and its ligamentous apparatus, pseudofacodenesis. Deep-lying structures - without pathological changes. Diagnosis: Decentration of the IOL, artifact. Pseudoexfoliation syndrome of the left eye.

For centering relative to the optical axis of the eye using the proposed needle and ligature thread 10.0. The operation is performed against a background of drug mydriasis. Perform corneocentesis in the opposite place from the direction of displacement of the capsular bag with IOL. A needle is passed through it, with a loop of the ligature thread, which is inserted through the slot of the eye of the needle. The needle tip captures the haptic element of the IOL, leads in the direction of the equator of the lens, pierces its capsule and carries out a puncture in the projection of the attachment of the zinc ligaments to the sclera. Similarly, a U-shaped seam is applied on the sclera with an indent between stitches of 2-3 mm. The ends of the threads are brought out to the sclera, pulled and tied together. Thus, centering relative to the optical axis of the eye and stabilization of the capsular bag and intracapsular IOL were performed. The diagnosis at discharge: Artifakia. Pseudoexfoliation syndrome of the left eye.

Example 3. Patient P., 5 years old, poor eyesight from birth, Marfan syndrome. Objectively: the visual acuity of both eyes is 0.05, is not corrected. The optical media of the eyes are transparent, the lenses are reduced in size, are displaced upwards and inwards in the plane of the iris to 1/2 the area of the pupil. Phacodenesis. Partial lysis and overstretching of the zinc cords in the opposite place of the ectopic lens. Reflexes of a macula are accurate. Diagnosis: Congenital ectopy of the lens. Subluxation of the lens. Refractive Amblyopia Marfan's syndrome of both eyes.

In order to center the ectopic lens, a number of technologies use intracapsular rings, which are fixed with ligature threads. At the initial stage of the operation, an intracapsular ring is implanted through capsulorexis and phacoaspiration is performed. Next, corneocentesis is performed in the opposite place from the ectopic lens. A needle is passed through it with a loop of the ligature thread 10.0. The needle tip picks up the intracapsular ring and leads in the direction of fixing the zinc cords, punctured on the sclera. After 2-3 mm from the first injection, repeat, imposing a U-shaped seam on the sclera. The ends of the threads are brought out to the sclera, pulled up and tied together, reaching the centering of the capsular bag. An IOL is implanted inside the centered capsule bag for optical correction. The diagnosis at discharge: Artifakia. Obscuration amblyopia. Marfan's syndrome of both eyes.

Example 4. Patient S., 67 years old, complaints of low vision without glasses on the right eye after cataract surgery 7 years ago. The left eye is poor eyesight since childhood. Visual acuity of the right eye is 0.05, correction is + 11D-0.8. Objectively: postoperative corneoscleral scar of the cornea in the upper segment, the lens is absent, the optical media are transparent, the fundus without visible pathological changes. Diagnosis: aphakia of the right eye.

For intraocular correction of aphakia, a rigid posterior chamber IOL of polymethylmethacrylate was selected. To fix it to the sclera in a ciliary sulcus, ligature threads 10.0 are used. Before implantation of the IOL, ligature threads are tied to the nodes of the lens haptic elements and with the help of the proposed needle they are brought out through the sclera in the projection of the ciliary groove. IOLs are centered by the dosed tension of the thread and fixed by a knot. Diagnosis at discharge: Artifakia of the right eye, visual acuity of the right eye 6 days after surgery 0.9-1.0.

Claims (1)

A needle for holding a ligature loop having an eye on the tip of the needle, characterized in that the needle is fixed to the handle, longitudinal grooves are made on both sides of the needle’s length along its entire axis, parallel to the axis, a slot is made on one side of the eye, and the needle’s tip is flat-pointed, and the needle is fixed in the handle at an angle of 120-160º.