WO2004064871A2

WO2004064871A2 - Surgical ligature holder

Info

Publication number: WO2004064871A2
Application number: PCT/EG2004/000002
Authority: WO
Inventors: Mohamed Mansour Ragheb
Original assignee: Mohamed Mansour Ragheb
Priority date: 2003-01-19
Filing date: 2004-01-13
Publication date: 2004-08-05
Also published as: WO2004064871A3

Abstract

Surgical forceps consisting of two connected arms at their upper ends, made of plastic or stainless steel. Its total length (P) ranges 18/20/22 cm, width of each arm is 0.3 cm at its lower end and 1 cm at the upper end, thickness 0.2 cm, outer surface has transverse ridges in its middle third and smooth inner surface. The lower end of each arm is connected with the middle of the closed end of an inverted “U” or semi oval shaped structure. Its height is 2 cm, width at the open end 1.3 cm (0.2 cm width of each limb or inverted U, 0.9 cm for distance in between). Its inner surface is rough (has criss - cross striation) while its outer is smooth. Connection angle between the inverted U and forceps arm is either 0 or 25 or 45 degrees.

Description

Surgical Ligature Holder ( agheb Forceps)

1 - The Prior Arts

Passing . a ligature or a tape behind a vascular pedicle (as renal pedicle) or tubular structure as ureter or bile duct is a common surgical procedure. This can be done either using aneurysm needle (see figure A, B, C) or passing first a curved clamp behind the structure in concern by the main surgeon and then the assistant handles, using a non- toothed forceps, the ligature or tape to be caught by the curved clamp (see figure D).

Aneurysm needle is not suitable in the deep cavities as the pelvic cavity, thoracic cavity and below the diaphragm because its handle has no curves that facilitate handling; moreover, the needle itself is relatively pointed.

The second technique, assistant's aid ligature handling, is not an easy procedure in most situations especially in deep cavities, as only the eyes of the assistant or the surgeon can see the handling steps (one head in the operation field). Also, the assistant should use his both hands, one pulling on its upper end and the other holding its lower end by the non toothed forceps or a straight clamp, to be handled between the jaws of the clamp that passed by the surgeon behind the structure in concern. This technique usually needs two trials and the tip of the non toothed or the assistant clamp might injure the surrounding structure during handling (see figure D). The Needle's Eye Ligature

Needle's Arm

Figure (A): Aneurysm Needle

Figure (B): The Ligature mounted needle is passed behind an artery

Figure (C): One end of the ligature is caught by the non- toothed forceps and the needle is withdrawn

Figure (D): Traditional Method of ligature handling by the assistant

2 - Detailed Drawings Description

Number of drawings 6/6

Figure 1/6

(R) the width of the forceps from the top is 1cm - (T) the thickness of the forceps from the top is 0.6 cm - (N) the width of the forceps body in the middle section is 1 cm - (U) the thickness of the forceps arm is 0.2 cm - (M) the width of the forceps in the end of the middle third section is 0.5 cm - (Q) the length is 5 cm - (O) the length is 5 cm - (P) the total length of the forceps is 18 cm - (S) the length is 1.9 cm - (X) the thickness of the forceps arm is 0.2 cm - (V) the angle of inclination of the horseshoe with respect to the rest of the forceps arms is 25 degrees.

Figure 2/6

(A) The width of the arm of the horseshoe is 0.2 cm - (B) the total width of the horseshoe is 1.3 cm - (C) the inner distance between the two arms of the horseshoe is 0.9 cm - (D) the radius of curvature of arc connecting the two arms of the horseshoe is 0.45cm - (E) the serration is 0.7x40° - (F) the width of the arm of the horseshoe is 0.2 cm - (G) the length of each arm of the horseshoe is 1.5 cm - (H) the length of the solid part above the horseshoe arm is 0.5 cm - (I) the angle of inclination of the horseshoe with respect to. the rest of the forceps arms is 25 degrees. Figure 3/6

(A) Ragheb Forceps - (B) Surgeon's left hand holding the forceps - (C) The horseshoe and how it grips the ligature - (D) the ligature.

Figure 4/6

How to use Ragheb Forceps to pass a ligature behind an artery:

(A) the lower part of Ragheb the forceps holding one end of the ligature -

(B) the ligature - (C) the artery - (D) a forceps that has been passed under the artery and is been opened - (E) grip the ligature with the forceps and pull backwards with the arrow - (F) the withdrawal of the forceps with it holding one end of the ligature.

Figure 5/6

Transverse Section shows how to use Ragheb Forceps to protect the lingual vessels during snipping the tongue-tie:

(A) The tongue - (B) Ragheb Forceps - (C) the lower lip - (D) teeth - (E) the arrow point out the direction of cutting of the tissues of the tongue-tie - (F) tongue-tie tissues - (G) lingual vessels.

Figure 6/6

How to use Ragheb Forceps in transfixing the neck of the hernial sac (inguinal or femoral) to avoid injury of the underlying structures as intestine, spermatic cord, inferior epigastric vessels or femoral vessels: (A) Hernial sac - (B) Ragheb Forceps - (C) ligature - (D) the needle while it is penetrating the neck of the hernial sac - (E) the neck of the hernial sac - (F) spermatic cord.

3 - Detailed Description

The designed forceps consists of two connected arms at their upper ends, made of plastic or stainless steel (figure 1/6 and 2/6). Its total length ranges are 18 / 20 / 22 cm, width of each arm is 0.3 cm at its lower end and lcm at the upper one, thickness of 0.2 cm, and the outer surface of each arm has transverse ridges in the middle third and smooth inner one,....

The lower end of each arm is connected with the middle of the closed end of an inverted U or semi oval shaped structure. Its height is 2cm, width at the open end of 1.3 cm (0.2 cm width of each limb or inverted U and 0.9 cm for the distance in between). Its inner surface is rough (has interlace striation) while its outer one is smooth. In addition, the connection angle between the inverted U and the forceps arm is either 0 or 25 Or 45 degrees.

This new forceps is simple, and the surgeon can handle the ligature by using his left hand (or right hand if he is left handed) to be caught by the clamp that passed behind the vessel or tube in concern. So, the procedure can be done much easier, no need for assistant's hands and can be manipulated safely in deep cavities (figure 3/6 and 4/6).

In addition to the above, this forceps can be used to protect the lingual vessel's during snipping the tongue tie (figure 5/6) and during transfixing the neck of the hernial sac (inguinal or femoral) to avoid injury of the underlying structures as intestine, spermatic cord, inferior epigastric vessels or femoral vessels (figure 6/6).

Claims

- Claims

1. This Surgical Ligature Holder is named "Ragheb Forceps"

2. The new invention in this forceps is its lower end, which is an inverted U - Shaped or in the shape of two horseshoes (each horse shoe is one arm). Their inner surface is a rough one to enable it to grasp the surgical ligature or. catheter or tape firmly between the.two arms of the horseshoe. In addition, there should be a free distance between them to be able to grab the surgical ligature with a forceps to pass it behind an artery.

3. The shape of the horseshoe: the height is about 2 cm from outside, about 1.5 cm from inside, a distance between the two ends of the horse shoe from inside is about 0.9 cm, the thickness of each arm of the horse shoe is about 0.2 cm and its width is about 0.2 cm, its inner surface is rough by means of interlace striations (horizontal and vertical) to grip firmly the surgical ligature and to prevent its slippage. This shape is connected to each arm of the forceps with an angle ranges from 0 to 45 degrees (preferably 0/25/45 degrees).