SU1743593A1 - Medical forceps - Google Patents

Abstract

Essence: tweezers contain two spring-loaded branches connected to each other with working jaws, on which several transverse grooves are made, forming a series of internal cylindrical channels with different diameters. On each sponge there is a guide longitudinal slot for mounting the cutting tool. The lateral grooves are located at an acute angle to the longitudinal slot, and the thickness of the working jaws is made variable in the longitudinal direction. 3 il.

Description

The invention relates to medicine, namely to medical instruments, and can be used for microsurgery of nerves and individual fascicular nerves.

Known designs of tweezers containing spring-loaded branches with working jaws having a longitudinal slot and transverse grooves on the inside.

All these tools do not allow performing precisely dosed overcutting of fasciculi and are not convenient for operation, since when crosscutting fascicularis of different diameters requires a whole set of tools with transverse grooves of different radii of curvature.

Closest to the proposed and adopted for the prototype is a tweezer-clamp containing spring-loaded jaws with working jaws, which have a longitudinal slot for the cutting tool and an internal cylindrical groove for bundles of nerve fibers.

However, this tweezers are not convenient in operation, which increases the time of the operation, and not

eliminates injuries to nerve fibers when they are crossed over a certain depth.

The purpose of the invention is to shorten the operation time and reduce the traumatic rate by carrying out simultaneous dosed nicketing of bundles of nerve fibers of different diameters.

This goal is achieved by the fact that in tweezers containing spring-loaded jaws with working jaws, which have a longitudinal slit for the cutting tool and an inner cylindrical groove for bundles of nerve fibers, the working jaws are provided with additional internal cylindrical grooves with different diameters. In this case, the axes of the grooves are located at an acute angle to the longitudinal slot, and the minimum distances between the outer surface of the jaws and the surfaces of the cylindrical grooves satisfy the relation

F-m- ° 2 u L Dn 6Hi +

 H2 +

-n- + pg

WITH

J

SA O S

where Hi, H2, ..., Hn are the minimum distances between the outer surface of the jaws and the surfaces of the cylindrical grooves;

Di, DZ, ..., Dn are the diameters of the inner cylindrical grooves;

1/6 - constant part of the diameters of the inner cylindrical grooves, on which it is necessary to cut bundles of nerve fibers.

FIG. 1 shows the tweezers, general view; in fig. 2 - working sponge tweezers, side view; in fig. 3 - the same, top view.

The tweezers contain two spring-connected branches 1 connected to each other and

2c working jaws 3 and 4, on which several transverse grooves are made

5 and 6, forming a series of internal cylindrical channels with different diameters Di, Da ... Dn when the working jaws are closed. Each sponge 3 and 4 is provided with a longitudinal guide slit 7 for mounting the cutting tool. The lateral grooves 5 and 6 are located at an acute angle to the axis of the longitudinal slot 7. The thickness of the working jaws 3 and 4 is made variable in the longitudinal direction so that the minimum distances between the outer surface of the jaws 3 and 4 and the surfaces of the cylindrical grooves 5 and 6 were satisfied

  H2-f- ° f ... Hi, N2 ... Hn - minimum distances between the outer surface of the jaws and the surfaces of the cylindrical grooves;

Di, Da ... Dn are the diameters of the inner cylindrical grooves;

1 / К - constant part of the diameters of the inner cylindrical grooves, on which it is necessary to cut bundles of nerve fibers.

This ratio can be realized by making the outer surface of the working jaws along the corresponding Curve, or by changing the distance between the grooves with a linear change in the thickness of the working jaws.

Example. The working jaws 3 and 4 have five transverse grooves 5 and 6, which form when closing five cylindrical channels with a diameter of Di 3 mm, D2 2.4 mm,

03 1.8 mm, D4 1.5 mm and DS 0.9 mm. These values are chosen on the basis of the most common diameters of fasciculi nerve in practice. The value K was chosen equal to 6, since, according to the method of innervation, it is necessary to notch the fascicles to a depth of 1 / b of their diameter. Exodus

from this, the thickness of the sponges above the grooves 5 and

b are made with the following values: Hi 1.2 mm, H2 1.3 mm, Ns 1.4 mm, Sch 1.45 mm and Hs 1.55 mm. The angle between the axes of the transverse grooves and the axis of the longitudinal slot has a value of 45 °.

Tweezers are used after sterilization as follows.

In the free state, the working sponges 3 and 4 branches are closed. The tool is fed with the jaws 3 and 4 to the prepared fasciculi tuft. When force is applied to fingers 1 and 2 at the place of holding the forceps-fixer, the working jaws 3 and 4 are opened. One or several fasciculi are placed in transverse grooves 5 and 6 corresponding in diameter so that their ends slightly protrude beyond the edges of the sponges and weaken the forces on branches 1 and 2 until the jaws 3 and 4 are completely closed. In this case, the fasciculars are fixed in transverse channels. A sharp cutting tool is held along the edge of the working jaws and cut off the ends of the fasciculars, getting a cut at an angle of 45 °. Then, a cutting tool is installed in one of the slits 7 and, moving it along the slit, fasciculars are incised at a predetermined depth, which is set by focusing on the cutting tool, i.e. the blade should penetrate into slot 7 to a depth of Hi + 1 / K (in our case, this value is 1.7 mm). Pressing the jaws 1 and 2, slightly spreading the jaws 3 and 4 and moving them along the fasciculi (along the length of the fasciculi) fix the tool in the right place and re-cut the fasciculars, which, if necessary, turn them to fixed angles to apply notches all around. In addition, for convenience, a guide slot 7 can be used both on the sponge 3 and on the sponge 4. After processing all the fasciculi for the necessary time for innervation, the sponges 3 and 4 are opened and the tweezers are removed,

The tool increases the convenience of the surgeon and allows you to simultaneously process several fasciulets of different diameters, h, about shortens the time of surgery. In addition, the execution of notches of fasciculi at an acute angle provides a greater height contact of the neural tissue itself and the muscle fibers, which shortens the re-invasion time of the muscle tissue.

Claims (1)

Invention Formula Tweezers containing spring-loaded jaws with working jaws, on which a longitudinal slit for the cutting tool and an internal cylindrical groove for bundles of nerve fibers are made, which is aimed at reducing the time of the operation and reducing the trauma by carrying out a simultaneous dosed cut-out bundles of nerve fibers of different diameters, working sponges are provided with additional internal cylindrical grooves with different diameters, with the axes of the grooves located at an acute angle to the longitudinal slot, and the minimum distance between the outer surface of the jaws and the cylindrical surfaces of the grooves satisfy the relationship: + Di  H2 + D2 6  ... NP + Dn where f, nap is the minimum distance between the outer surface of the jaws and the surfaces of the cylindrical grooves; Di, D2, ..., Dn are the diameters of the inner cylindrical grooves; 1/6 - a constant part of the diameters of the inner cylindrical grooves on which the bundles of nerve fibers are to be cut. L