SU1242140A1 - Surgical apparatus for placing anastomoses on hollow organs - Google Patents

Description

The invention relates to medical technology, namely to surgical suturing devices for applying anastomoses between hollow organs.

The aim of the invention is to reduce the trauma of the anastomosis when the apparatus is removed from the hollow organ after suturing by making the stop head flat, pivotally mounted on the rod, and providing it with a fixed device that provides longitudinal movement of the head and rotation around the axis of the hinge.

FIG. 1 shows a surgical apparatus for imposing an anastomosis on the hollow organs, a section along the tubular bracket body, a general view; in fig. 2 is a section A-A in FIG. one; in fig. 3 - working part of the apparatus with a hinged lock, the first position of the stop head; in fig. 4 - the same, the second position of the stop head; in fig. 5 - working part of the apparatus at the time of the imposition of the anastomosis; in fig. 6 is a section BB in FIG. one; in fig. 7 is a variant of the thrust head, made ellipsoidal.

The surgical apparatus contains a tubular staple case 1 with a fixed handle 2, a hollow rod 3 with a pusher 4 and a knife 5 placed inside the staple case, a rod 6 placed inside the hollow rod 3, a stop head 7 with holes 8 for the bend of the brackets, a piercing gap selection mechanism , made in the form of a nut 9, having a threaded connection with the rod 6 and a lever drive of piercing, made in the form of a movable handle 10 pivotally mounted on the housing 1 and meshed with the hollow rod 3.

The stop head 7 is made flat, provided with a fixing device 11, and 1 is mounted on the rod 6.

At one end of the tubular bracket housing 1, a magazine 12 is installed with bracket slots 13 for U-shaped metal brackets 14, and at the other end there is a guide sleeve 15 for the hollow rod 3 and the rod 6. The guide sleeve 15 is fixed to the bracket housing 1 by a cap nut 16. On the cape nut 16 there is a protruding cylindrical part 17 with a circular groove 18. On the cylindrical part G / there is a movable nut 9 of the stitch gap selection mechanism rotatably relative to the central axis 19 of the apparatus. The nut 9 from longitudinal movement is fixed by a screw 20, the cylindrical non-threaded end 21 of which is located in the circular recess 18, and has a threaded connection with the rod 6.

The fixed handle 2 is attached to the housing 1 by means of a bracket 22.

The pusher 4 of the hollow stem 3 is a cylindrical cup, the side walls of which are cut into separate

five

petals 23. The end of each petal 23 of the pusher 4 is located in a separate bracket slot 13. The inside of the cylindrical glass of the pusher 4 on the rod 3 is fixed cylindrical knife 5 with a cutting edge 24. The diameter of the stop head 7, on which the holes 8 are located to bend the brackets, must be larger than the diameter of the overlapped seam (Fig. 6) and, all the more, the diameter of the cut out of my hole (anastomo Q behind) with the knife 5, which should be located inside the bracket seam.

On the side surface of the stem 3, remove the flats (not shown) for engagement with the movable handle 10. The hollow stem 3 is located inside the tubular bracket housing 1, and inside the hollow 3 there is a stem 6. At one end of the stem 6, the thrust head 7 is pivotally mounted the other end is threaded by means of which the rod 6 is connected to the nut 9 by the mechanism for selecting the piercing gap.

The movable handle 10 of the lever drive of the firmware is mounted on the crown of the chain 22 with the possibility of rotation around the axis 25. Its end 26 is made in the form of a plug,

5 encompasses the rod 3 in the area of the bald patches, forming ledges on the rod (not shown), against which the forked end 26 of the handle 10 rests.

On the fixed handle 2, the stop 27 is mounted, and on the movable handle iO - the latch 28 can be rotated around the axis 29, and its end 30 interacts with the stop 27.

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Latch 28 is a safety measure against accidentally pushing the staples into an operative and ion wound prior to suturing.

The locking device can be made in several versions.

Option 1.

The locking device is made in the form of a hollow tube 3 with lateral longitudinal slits 32 mounted on the rod 3. In the tube the slider 33 with protrusions 34 is mounted for longitudinal movement, and the protrusions 34 of the slider 33 are located in longitudinal slits 32 tubes 31 and associated with a stop head 7.

Option 2.

The locking device is made in the form of a hinge lock, installed with the possibility of fixing the stop head 7 in two positions - vertical and horizontal. The hinged clamp contains a pin 35 with a spherical end, a spring 36 and a screw 37. In drawing 6, the sphe are made. pits 38 under the spherical end of 1 pin 35.

The stop head 7 can also be made in various versions. For technical reasons, it is made in a circular form. Resistant head

it can also be made ellipsoidal and pivotally mounted on the rod so that it can rotate around the short axis of the ellipse. In this case, the tubular bracket body and the plunger are also made ellipsoidal in accordance with the stop head.

The device works as follows.

Each staple groove 13 of magazine 12 is charged with a U-shaped metal bracket 14. A elastic washer (mainly made of polyvinyl chloride) plastic washer 39 is inserted into the thrust head to cut the fabric on it.

In this form, the apparatus is sterilized.

Before stitching, the device is inserted into one of the stitched hollow organs or through a natural opening (for example, an anus), or through a special lateral incision, so that the abutment head 7 escapes through the resectable portion of the hollow organ.

By turning the nut 9 of the forgiveness selection mechanism, the stop head 7 is retracted from the tubular bracket body 1 by 5 or 6 cm.

One hollow organ is fastened with a purse string around the rod 6 near the housing 1, and the organ with which the stitching is carried out is put on by a resectable section or with a special hole on the stop head and is fastened with a string of suture around the rod b near the stop head 7 (Fig. 5) .

By turning the nut 9 clockwise, the thrust head 7 approaches the tubular bracket body 1 before the piercing gap (a gap equal to the distance between

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case 1 and the stop head 7, on which you can make flashing).

The latch 28 rotates around the axis 29 so that its end 30 moves away from the stop 27 and releases the movable handle 10. By pressing the movable handle 10, the pusher 4 with the knife 5 moves towards the stop head 7. The pusher petals 4 are pushed out of the bracket grooves 13 of the bracket 14, which pierce stitched fabric with their built-in legs, and resting against holes 8 to bend the staples, bend into a B-shape, firmly joining the fabric.

Together with the pusher 4, the knife 5 is moved to the side of the stop head 7, which presses the fabric against the elastic plastic washer 39, and, inserting into it, cuts a hole, forming an anastomosis. Flashing is finished.

The stop head 7, by rotating the nut 9 counterclockwise, is retracted from the tubular bracket body 1 by 7 or 8 cm and rotated 90 ° through the tissue of the hollow organ. In this form, the apparatus is removed from the stitched hollow organs. In this case, the resistant head easily passes through the anastomosis, slightly moving the tissue apart and without breaking the staple seam.

Compared with the base object, the proposed device does not cause additional injury in the suture area when the apparatus is removed after the organs are stitched, thereby reducing postoperative inconsistency of the sutures and, as a result, post-operative recovery periods, hospital stay and mortality.

FIG. 2

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FIG. five

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FIG. 7

Editor A. Shandor Order 3637/7

VNIIPI USSR State Committee

for inventions and discoveries

113035, Moscow, Zh-35, Raushsk nab. 4/5

Branch PPP "Patent, Uzhgorod, st. Project, 4

Compiled by A. Mikhaltsov

Tehred I. VeresKorrektor M. Sharoshi

Circulation 660 Subscription

Claims (2)

1. SURGICAL APPARATUS FOR APPLICATION OF ANASTOMOSES ON THE HOLLOW BODIES, comprising a tubular bracket body with a fixed handle, a hollow stem with a pusher and knife located inside the bracket body, a rod located inside the hollow stem, a stop head with holes for bending brackets, a gap selection mechanism stitching and lever stitching drive, characterized in that, in order to reduce trauma to the anastomosis when removing the apparatus from the hollow organ after suturing, the thrust head is made flat, pivotally mounted on erzhne and it is provided with a locking device to allow longitudinal movement and rotation of the head about the hinge axis. 2. The apparatus by π. 1, characterized in that the flat thrust head is made ellipsoidal with the possibility of rotation along the hinge axis parallel to the short axis of the ellipse, and the tubular bracket body and pusher are also made ellipsoidal in accordance with the thrust head. SU ,,, 1242140 Fig. 1