SU740238A1

SU740238A1 - Method of applicating microsurgical vessel suture

Info

Publication number: SU740238A1
Application number: SU782671674A
Authority: SU
Inventors: Владислав Данилович Розвадовский; Александр Александрович Артюгин
Original assignee: За витель
Priority date: 1978-10-16
Filing date: 1978-10-16
Publication date: 1980-06-15

Description

Изобретение относится к области медицины, а именно, к хирургии, и может быть применено для соединения кровеносных сосудов от 0,5 мм в диаметре и выше.The invention relates to medicine, namely to surgery, and can be used to connect blood vessels from 0.5 mm in diameter and above.

Известен способ наложения микрохирургического сосудистого шва путем прокапы- ⁵вания стенок сосуда с последующим наложением й затягиванием стежков. £1].A known method of applying a microsurgical vascular suture by instillation of vessel walls ^5, followed by stitching and tightening. £ 1].

Однако известный способ не обеспечивает герметичности шва. .However, the known method does not ensure the tightness of the seam. .

Целью изобретения является повышение герметичности шва.The aim of the invention is to increase the tightness of the seam.

Эта цель достигается тем, что на края сшиваемых сосудов накладывают два стежка, один из которых ближе к краю сосуда, β а другой - отступя по оси сосуда на 2-3 диаметра иглы, далее узлы завязывают и формируют муфту из краев сосуда.This goal is achieved by the fact that two stitches are applied to the edges of the stitched vessels, one of which is closer to the edge of the vessel, β and the other is retreating along the axis of the vessel by 2-3 needle diameters, then the knots are tied and form a sleeve from the edges of the vessel.

Способ осуществляют следующим образом. 20The method is as follows. 20

Перед сшиванием пересеченной артерии адвентиция по краям сосуда не иссекается. Сосуд захватывают пинцетом через всё слои. При прбшивании вкол делают тотчас у бранш пинцета, так как стенка сосуда в этом месте фиксирована и не ускользает от иглы.Before stitching of the intersected artery, adventitia along the edges of the vessel is not excised. The vessel is captured with tweezers through all layers. When piercing, an injection is done immediately at the tweezers branch, since the vessel wall in this place is fixed and does not escape from the needle.

Атравматической иглой с нитью 7/010/0 прокалывают стенку центрального конца артерии через все слои на расстоянии 3 диаметров иглы от края. Вкол ведут' снаружи во внутрь сосуда перпендикулярно краю разреза. Периферический отрезок прокапывают со стороны интимы в -сторону адвентииии на таком же расстоянии от края сосуда.An atraumatic needle with a thread 7/010/0 pierces the wall of the central end of the artery through all layers at a distance of 3 needle diameters from the edge. An injection is conducted from the outside to the inside of the vessel perpendicular to the edge of the incision. The peripheral segment is dug from the side of the intima to the side of Advent, at the same distance from the edge of the vessel.

Второй вкол делают этой же иглой в таком же порядке, как й первый, но на расстоянии в один диаметр иглы от края сосуда. · .The second injection is made with the same needle in the same order as the first, but at a distance of one needle diameter from the edge of the vessel. ·.

• Завязывают узел. При затягивании первого узла происходит свертывание краев стенок сшиваемого сосуда валиком, после чего завязывают второй фиксирующий узел.• Tie a knot. When tightening the first node, the edges of the walls of the stitched vessel are coagulated with a roller, after which the second fixing node is tied.

Вначале накладывают шов на заднюю стенку анастомоза, затем на переднюю.First, a suture is applied to the posterior wall of the anastomosis, then to the anterior.

f . _: f. _:

740238 ' 4 □ппрзиционно накладывают боковые швы. При круговом шве накладывают всего четыре шва, что является вполне достаточным для прочного и герметичного соединения сосуда. Время операции сокра- ₅шается вдвое.740238 '4 □ Use side seams almost completely. With a circular seam, only four seams are imposed, which is quite sufficient for a strong and tight connection of the vessel. The reduction operation time by half ₅ creases.

Предлагаемый способ обеспечивает плотное и полное прилегание внутренних оболочек по внутренней линии анастомоза.' 10The proposed method provides a tight and full fit of the inner membranes along the internal line of the anastomosis. ' 10

Claims

(54) METHOD OF MICRO-SURGERY 1, The invention relates to the field of medicine, namely, surgery, and may be used to connect blood vessels from 0.5 mm in diameter and above. There is a method of applying microsurgical vascular suture by puncturing the walls of the vessel with stitching and stitching, l. However, the known method of removal does not provide a seal of the seam. The aim of the invention is to improve the seal of the seam. This goal is achieved by the fact that {The heap of stitched vessels imposes two stitches, one of which is closer to the edge of the vessel and the other is indented along the axis of the vessel by 2-3 needle diameters, then knots are tied and form a sleeve from the edges of the vessel. The method is carried out as follows. Before stitching the crossed artery, the adventitic along the edges of the vessel is not dissected. The vessel is seized with tweezers through all layers. When sewing vcol do immediately VASCULAR seam at the brush as the vessel wall in this place is fixed and does not escape the needle. An atraumatic needle with a thread 7 / O10 / 0 pierces the wall of the central end of the artery through all layers at a distance of 3 needle diameters from the edge. Vcol lead outside the inside of the vessel tterpendikudarno edge of the cut. The peripheral segment is digged from the intima side towards the adventitia at the same distance from the edge of the vessel. The second hopper is made with the same needle in such a manner as the first needle, but at a distance and ONE diameter of the needle from the edge of the vessel. . Tie a knot. When the first knot is tightened, the edges of the walls of the stitched vessel are wiped with a roller, after which the second fixing knot is filled. Initially, the suture is applied to the back wall of the anastomosis, then to the front. 37 Oppressively overlay the side seams. In the case of a circular seam, only four seams are placed, which is, in fact, sufficient for a firm and tight joint of the vessel. The operation time is halved. The proposed method provides a tight and complete fit of the inner membranes along the internal line of ansh: tomoz. The invention of the method of imposing a microsurgical vessel of the FCM by piercing the walls of the vessel with subsequent stitching and tightening of stitches is also different because, in order to improve the seam tightness, two stitches are applied to the edges of the stitched vessels, one of which directly the vessel, and the other indent along the vessel axis by 23 needle diameters, then the nodes tie and form a sleeve from the edges of the vessel. Sources of information taken into account during the examination 1. B. V. Petrovsky and V. S. Krylov. Microsurgeons, M ., 1976, p. 34- 54.