RU97616U1 - BLOOD REPAIR CLAMP - Google Patents

Abstract

 Hemostatic clamp for clamping the hepatoduodenal ligament, comprising a body, L-shaped jaws, one of which is rigidly connected to the body, and the second is made with the possibility of changing position by means of a screw lock, characterized in that the body of the hemostatic clamp is made with a bend of 155 ° the sagittal plane at a distance of no more than 110 mm from the L-shaped branches, the working part of which is made in the form of an elongated rectangular parallelepiped with rounded external edges, while the lower branch is connected It is connected with a screw lock sleeve by means of a rod, the middle part of which is made in the form of a cable.

Description

The utility model relates to medicine, in particular to medical instruments, and can be used in surgery for operations from mini-access.

A wide variety of hemostatic clamps are known in the art. The choice of clamp depends on the type of vessel, its caliber or diameter, type and operation conditions.

The closest in essential features, taken as a prototype, is Blok’s L-shaped clamp (Bakulev AN, Meshalkin EN, Congenital heart diseases. - M., 1955.), including a straight body on which L-shaped jaws, one of them is rigidly connected to the housing, and the second is made with the possibility of changing the position using a screw or gear lock. Blalock’s L-shaped clamp is intended for partial isolation of the lateral part of the vessel from the central blood flow, as well as for temporary isolation from the bloodstream of some parts of the heart (for example, the ear or part of the atrium).

The disadvantage of this tool is the impossibility of its use in operations from mini-access on the gallbladder and extrahepatic bile ducts, for example, for clamping the hepatoduodenal ligament. This is explained by the lack of bending of the body, which leads to a decrease in the operational review and interferes with the manipulation of other tools, i.e. expansion of operational access may be required. The second disadvantage of this device is the presence at the distal end of the L-shaped branches, an additional bend in the frontal plane, which prevents the safe supply of the lower branch under the hepatoduodenal ligament.

The task is to create a hemostatic clamp that provides an optimal operational overview and the possibility of atraumatic clamping of the hepatoduodenal ligament to temporarily stop bleeding from the cystic artery.

Technical result:

- maintaining the possibility of free confident manipulation of other instruments in the area of the hepatoduodenal ligament without changing the volume of the surgical space and the size of the surgical wound or the transition to median laparotomy;

- optimal conditions for the search and ligation of the cystic artery when the ligature slides in the infiltrate with destructive forms of cholecystitis or with its accidental damage.

To achieve this technical result, a known tool containing a housing on which L-shaped jaws are mounted, one of which is rigidly connected to the housing, and the second is made with the possibility of changing position due to the fact that it is connected to the screw lock rod, the following changes are made:

- the body of the hemostatic clamp is made with a bend of 155 ° in the sagittal plane, while the distance between the branches and the bend of the instrument does not exceed 110 mm, which is due to the average depth of the hepatoduodenal ligament.

- the working part of the L-shaped branches is made in the form of an elongated rectangular parallelepiped with rounded external edges;

- the core of the screw lock is made of two parts that are connected by a cable, while one part is screwed into the sleeve of the screw lock, and the second part is connected to the lower jaw. The presence of a cable in the middle part of the rod provides the ability to move the lower jaw in the presence of a bend of the device body.

The analysis of patent and technical literature did not reveal a combination of such features, which confirms the compliance of the proposed technical solution with the criterion of "novelty."

The utility model is illustrated by drawings, where

figure 1 shows the main view of the tool;

figure 2 shows a sectional view of the tool;

figure 3 shows the tool in closed form;

figure 4 shows the tool in an open form.

The device comprises a housing 1, curved in a sagittal plane at an angle of 155 °, the handle of which contains a screw lock consisting of a sleeve 2 and a sleeve 3. The sleeve 2 is movable relative to the sleeve 3. A grooved coating is applied to the handle of the device to prevent finger sliding. The screw lock rod 4 is made of two parts that are connected by a cable 5, while one part of the rod 4 is screwed into the sleeve 3 of the screw lock, and the second part of the rod 4 is connected to the lower jaw 6. The presence of the cable 5 in the middle part of the rod 4 makes it possible to move the lower jaw 6 relatively fixed on the housing 1 of the upper jaw 7 in the presence of a bend of the housing 1 of the device. The distance between the jaws and the tool bend does not exceed 110 mm. In the open state, the maximum distance between branches 6 and 7 is at least 35 mm. The working part of the L-shaped branches 6 and 7 is made in the form of an elongated rectangular parallelepiped with rounded external edges. The upper jaw 7 and the lower jaw 6 are bent relative to the plane of the surgical wound in the frontal plane at an angle of 90 °. The housing 1 of the device contains a groove 8 for the base of the lower movable L-shaped jaw 6. On the inner side of the jaw facing each other, an atraumatic notch is applied to better retain tissues and prevent the jaw from slipping from them. The device can be made of a corrosion-resistant medical alloy.

The device operates as follows.

The device 6 and 7 are introduced into the wound in the reduced position. The branches are brought to the hepatoduodenal ligament, the sleeve 3 is rotated counterclockwise, while both parts of the shaft 4 with the cable 5 are displaced together with the lower branch 6. The branches are extended to the maximum distance between the branches 6 and 7 equal to 35 mm. Then set the branches in such a way that the lower branch 6 is located under the hepatoduodenal ligament, and the upper branch 7 is located above the hepatoduodenal ligament. The jaws are smoothly adjustable closed by rotating the sleeve 3 clockwise, due to the reverse movement of the cable 5 and the rod 4. An atraumatic notch on the inner surface of the jaw prevents them from slipping off and ensures reliable tissue retention.

The proposed design of the hemostatic clamp allows you to not change the volume of the operating space during operations from mini access while maintaining the possibility of free manipulation of other instruments in the area of the hepatoduodenal ligament without expanding access or switching to median laparotomy. In addition, it provides the possibility of a minimum, but a sufficient degree of compression of the elements of the hepatoduodenal ligament in the anteroposterior direction for adequate temporary hemostasis without crushing tissue, the possibility of free manipulation of other instruments in the localization area of the cystic artery remains.

Claims (1)

Hemostatic clamp for clamping the hepatoduodenal ligament, comprising a body, L-shaped jaws, one of which is rigidly connected to the body, and the second is made with the possibility of changing position by means of a screw lock, characterized in that the body of the hemostatic clamp is made with a bend of 155 ° the sagittal plane at a distance of no more than 110 mm from the L-shaped branches, the working part of which is made in the form of an elongated rectangular parallelepiped with rounded external edges, while the lower branch is connected It is connected with a screw lock sleeve by means of a rod, the middle part of which is made in the form of a cable.