WO2012119582A1 - Dispositif auxiliaire pour la formation d'un nœud à base d'une structure médicale de fil à coudre - Google Patents

Dispositif auxiliaire pour la formation d'un nœud à base d'une structure médicale de fil à coudre Download PDF

Info

Publication number
WO2012119582A1
WO2012119582A1 PCT/DE2012/000216 DE2012000216W WO2012119582A1 WO 2012119582 A1 WO2012119582 A1 WO 2012119582A1 DE 2012000216 W DE2012000216 W DE 2012000216W WO 2012119582 A1 WO2012119582 A1 WO 2012119582A1
Authority
WO
WIPO (PCT)
Prior art keywords
thread
suture
holding
auxiliary device
receiving members
Prior art date
Application number
PCT/DE2012/000216
Other languages
German (de)
English (en)
Inventor
Peter Paul Fink
Original Assignee
Medi-Globe Vascutec Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Medi-Globe Vascutec Gmbh filed Critical Medi-Globe Vascutec Gmbh
Publication of WO2012119582A1 publication Critical patent/WO2012119582A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0483—Hand-held instruments for holding sutures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0474—Knot pushers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0475—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery using sutures having a slip knot

Definitions

  • the present invention relates to an auxiliary device for forming a knot from a medical Nähfadengesente comprising at least one medical suture thread having a first Fadenendteil and a second Fadenendteil and with which an existing in a tissue of an individual tissue opening is closable by that parts of the Nähfadengebtldes through the edge region of the tissue opening and also optionally through the relevant tissue opening one or more times feasible and contractible with its two yarn end parts for knot formation.
  • the invention also relates to a method using such an auxiliary device for forming a knot from a medical suture.
  • a knot from a medical sewing thread formation comprising at least one sewing thread is known, for example, from DE 103 05 584 A1. It also a hand instrument is used, which is, however, only a so-called knot pusher.
  • the actual forming of a knot is accomplished by having a surgeon who has passed a medical suture through a tissue portion of an individual grasping a suture end with one hand and then taking the other suture end with his other hand Sewing thread to form a Sch Stammteties at least once to wrap or loop around.
  • the surgeon then pushes the respective loop part towards the fabric part and then devours the two sewing thread ends into a knot.
  • this handling of the suture is often a difficult procedure overall, especially if it is to be performed in the presence of body fluids such as blood. Therefore, it is desirable to facilitate forming a knot from a medical suture.
  • the invention is therefore based on the object to show a way how such a relief when forming a knot from a medical Nähfa the structure can be achieved both in terms of apparatus or device as well as procedurally.
  • a thread-holding or thread-clamping device is connected to the holding or gripping part, which allows the one end of the thread-forming part of the sewing-thread structure to be held up and held releasably,
  • a thread receiving device is connected, which is for receiving a connected between the thread clamping device and a Fadenability- or yarn delivery point of the fabric, connected to the one yarn end part yarn part and for wrapping by one connected to the other yarn end Thread portion of the thread structure can be used, the said other yarn end portion after at least one wrap around the running in and / or out of the edge region and optionally from and / or in the fabric opening thread regions by a loop formed from the wrapping thread to form a knot is feasible ,
  • the thread receiving device comprises at least two spaced apart in or on her or transverse to the respective thread running direction thread receiving members. This results in the advantage of a relatively easy-to-form thread take-up device.
  • the thread receiving members are expediently provided on the grip part itself or on one or more extension parts projecting from the grip part. As a result, the advantage is achieved that relatively simple trained thread receiving members may be provided on the device according to the invention.
  • two of these suture receiving members are provided at spaced apart distal end portions of the holding or gripping member itself or extension members projecting therefrom, and the third suture receiving member is spaced apart from the distal end portions of the extension members of the holding or gripping member this provided.
  • the thread receiving members are each hook-shaped. This results in the advantage that the sewing thread parts respectively picked up by the thread takeup elements can be held securely on or off these thread takeup elements until they are removed from these thread takeup elements in the course of the actual knot formation.
  • the above object is achieved according to the invention by a method of forming a knot from a medical suture comprising at least one medical suture by using a haptic according to the invention with a holding or gripping member comprising a clamping device and a suture receiving device with at least two of them protruding or formed on him thread receiving members, wherein the Nähfadengetrucke an existing in a tissue of an individual tissue opening is closed by the suture itself through the edge region and optionally through the relevant tissue opening one or more times passed and pulled together with its two yarn end parts for knot formation
  • This method is characterized by the following steps:
  • the first is a denendteil the Nähfadengesentes clamped in the thread clamping device of the auxiliary device;
  • the thread part extending from the thread clamping device to the one thread receiving or thread delivery point of the fabric is guided around at least one of the thread receiving elements of the auxiliary device;
  • said other yarn end part is at least once around in and out of the edge region and optionally in and / or out of the
  • auxiliary device with hook-shaped thread receiving members
  • contraction of the two Fadenend Schemee made only after loosening the Nähfadengesentes of the thread receiving members. This ensures safe handling of the suture with the relevant auxiliary device.
  • An exemplary embodiment of the auxiliary device according to the invention and a method using this auxiliary device for forming a knot from a medical suture structure will be explained in more detail below with reference to a drawing.
  • auxiliary device is shown in a perspective view and generally designated 1.
  • the auxiliary device 1 here consists of a flat, plate-shaped holding or gripping part 2, which can capture and hold a surgeon when using the auxiliary device 1 with his one hand.
  • holding or handle part 2 are available as extension parts from two support arms 3 and 4, which are formed with the holding or handle part 2 either contiguous or which may be connected as separate members with this handle part 2.
  • the two support arms 3 and 4 are spread starting from the holding or gripping part 2 - similar to the open cutting parts of a pair of scissors.
  • each Fadenfesthalte- or thread clamping device 5, 6 formed by a connected to the support arm 3 and 4 clamping member.
  • These clamping members are formed by indenting and receiving receiving these openings in the respective support arm 3 and 4 respectively.
  • the indenting parts in question can be positively and positively received in their receiving openings, and they can also be withdrawn from the receiving openings.
  • thread parts can be clamped so that they can only be pulled out of the respective Fadenfesthalte- or thread clamping devices 5, 6 again after their indenting parts from their receiving openings are solved.
  • the thread-holding or thread-clamping device 5 or 6 serves to receive and releasably hold the one end region of a sewing thread or short thread structure 10.
  • a thread receiving device is connected, which consists of three hook-shaped thread receiving members 7, 8 and 9 here.
  • the two thread receiving members 7 and 8 are provided at spaced distal end portions of the holding or gripping member 2 itself or extending from this extension parts. More specifically, these two suture receiving members 7 and 8 are provided at the distal end portions of the support arms 3, 4 protruding from the holding or gripping member 2 as extension members, either as individual members attached thereto or with the respective support arm 3 and 4, respectively integrally formed.
  • the third thread receiving member 9 is provided here as a Fadenumlenkglied at a distance from the distal end portions of the support arms 3, 4 on the holding or gripping part 2, and viewed in the longitudinal direction of the auxiliary device 1 between the positions of said two thread receiving members 7 and 8.
  • the three thread receiving members 7, 8 and 9 serve, as will be seen in more detail below, for receiving the medical suture assembly 10 which consists of at least one medical suture and in the present embodiment also contains only this suture 10.
  • the two ends or Nähfadenendmaschine of the suture or sewing thread 10 are designated in the drawing with 11 and 12 respectively.
  • the two thread receiving members 9 and 8 As shown in the drawing, the recording of a running between the thread clamping device 5 and a Fadenability- or thread delivery point 13 of a fabric 14 of an individual thread parts 17, the with the sewing thread 11 is connected. All three thread receiving members 7, 8 and 9 serve for wrapping by another with the Nähfadenende 12 connected thread portion 18 of the suture 10.
  • the aforementioned fabric 14 has a fabric opening 15, such as an incision, and another Fadenability organs Thread delivery point 16 on.
  • a sewing thread part 17 of the sewing thread formation or sewing thread 10 extending between the two thread take-up points or thread delivery points 13 and 16 behind the fabric 14 can be seen in the area of the fabric opening 15.
  • the thread take-up device does not necessarily have to have the three thread take-up members 7, 8 and 9 shown in the drawing.
  • the thread receiving device comes with at least two spaced apart in the auxiliary device 1 or extending transversely to the respective thread running direction thread receiving members.
  • the thread receiving members can also be formed by cuts or indentations in or by projections on the support arms 3, 4 or the holding or gripping part 2 for receiving the suture formation 10.
  • All parts of the auxiliary device 1 are preferably made of biocompatible material, such as a plastic.
  • auxiliary device 1 in an area sufficient for an understanding of the invention, the method according to the invention will now be considered, with which a knot of the at least one medical suture comprehensive medical Nähfadengetrucke 10 can be formed using the relevant auxiliary device 1.
  • this other thread part 18 with the other yarn end 12 at least once - in the present case twice - to the in and out of the edge region and optionally in the and / or thread regions or parts 17, 18 extending from the fabric opening 15, to form a sewing thread loop 19.
  • this sewing thread loop 9 therefore encloses two thread regions (17 and 18) and thus leads to a particularly firm sewing thread knot.
  • suture end 12 of said other suture end portion 18 is passed through a loop opening 20 formed between the three suture receiving members 7, 9 and 8 of the auxiliary device 1 and contracted together with the suture end 11 of the released from its clamping Fadenend Suitees 17 together with the suture loop 19 to a node ,
  • the thread take-up members 7, 8 and 9 are hook-shaped in the case of the auxiliary device 1 explained here as an exemplary embodiment, the above-mentioned contraction of the two yarn end regions of the sewing thread or sewing thread 10 is made only after it has been detached from the thread take-up members 7, 8 and 9 .
  • the auxiliary device 1 before the final contraction of the two end portions of the suture thread or thread 10 thread 10 or more about its longitudinal axis - the practically in the direction of the two to or from the fabric extending thread parts 17th and 18 extends - can be rotated to twist the thread parts 17 and 18 in front of the fabric 14. This contributes to an even firmer Nähfadenverknotung.
  • the method according to the invention for forming a knot from the at least one medical suture thread sewing medical thread formation 10 can be carried out in a corresponding manner, as explained, with an auxiliary device 1, the only two or even more than three thread receiving members having.
  • Essential for the formation of knots is that by means of the thread take-up members a loop opening 20 corresponding loop opening from the suture or sewing thread 10 is formed to thereby pull the suture end 12 corresponding suture end of a suture.
  • the invention has been explained with reference to an existing only of a medical suture thread suture 10, by the edge region of the tissue opening 15 is passed. It should be noted, however, that the invention can be used in the same way even when using a Nähfadengetruckes containing a plurality of medical sutures.
  • the sewing thread or at least individual sewing threads of a sewing thread formation comprising a plurality of sewing threads can be guided through the edge area and with their respective other sewing thread area (the other sewing thread end in each case) through the tissue opening 15 to be closed.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Materials For Medical Uses (AREA)

Abstract

L'invention concerne un dispositif auxiliaire (1) pour la formation d'un nœud à partir d'une structure de fil à coudre (10) médicale, présentant deux parties d'extrémités de fil (11, 12), structure avec laquelle une ouverture (15) d'un tissu (14) doit être fermée. Le dispositif auxiliaire contient une partie de retenue ou une partie de préhension (2) avec un appareil de serrage de fil (5; 6) pouvant être utilisé pour le blocage de l'une des parties d'extrémités de fil (11) et un appareil de logement de fil (7, 8, 9), qui peut être utilisé pour le logement d'une partie de fil (17) agencée entre l'appareil de serrage de fil (5; 6) et un point de logement de fil/point de prélèvement de fil (13) du tissu (14) et pour un enroulement par une autre partie de fil (18), agencée à partir d'un autre point de logement/point de prélèvement de fil (16) du tissu (14), de la structure de fil à coudre (10), dont la partie extrême du fil (12) appartenant à l'autre partie de fil (18) peut être guidée après au moins un unique enroulement des parties de fil (17, 18) agencées à l'entrée/à la sortie de la zone de bord et éventuellement à la sortie/à l'entrée de l'ouverture de tissu (15) à travers une ouverture de boucle (20) formée à partir de l'enroulement en formant un nœud.
PCT/DE2012/000216 2011-03-04 2012-03-01 Dispositif auxiliaire pour la formation d'un nœud à base d'une structure médicale de fil à coudre WO2012119582A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102011013055.1 2011-03-04
DE201110013055 DE102011013055A1 (de) 2011-03-04 2011-03-04 Hilfsvorrichtung und diese verwendendes Verfahren für das Bilden eines Knotens aus einem medizinischen Nähfadengebilde

Publications (1)

Publication Number Publication Date
WO2012119582A1 true WO2012119582A1 (fr) 2012-09-13

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Application Number Title Priority Date Filing Date
PCT/DE2012/000216 WO2012119582A1 (fr) 2011-03-04 2012-03-01 Dispositif auxiliaire pour la formation d'un nœud à base d'une structure médicale de fil à coudre

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Country Link
DE (1) DE102011013055A1 (fr)
WO (1) WO2012119582A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102015122502A1 (de) 2015-12-22 2017-06-22 Karl Storz Gmbh & Co. Kg Hilfsvorrichtung für das Bilden eines chirurgischen Knotens

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4760848A (en) * 1986-11-03 1988-08-02 Hasson Harrith M Rotational surgical instrument
US5147373A (en) * 1991-04-29 1992-09-15 Ferzli George S Laparoscopic instrument
US5364409A (en) * 1992-05-08 1994-11-15 Ethicon, Inc. Endoscopic needle holder
US5709694A (en) * 1995-03-22 1998-01-20 Human Factors Industrial Design, Inc. Endoscopic intracorporeal suture tying aid
DE29912712U1 (de) * 1999-07-21 2000-04-20 Sarbu, Joan, Dr., 28832 Achim Instrument zum Herstellen eines Knotens in einem Faden, insbesondere für die endoskopische Chirurgie
DE10305584A1 (de) 2002-02-04 2003-08-07 Arthrex Inc Knotenschieber und Fadengreifer
US20090204127A1 (en) * 2008-01-31 2009-08-13 Medicinelodge, Inc. System and method for tying surgical knots

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4760848A (en) * 1986-11-03 1988-08-02 Hasson Harrith M Rotational surgical instrument
US5147373A (en) * 1991-04-29 1992-09-15 Ferzli George S Laparoscopic instrument
US5364409A (en) * 1992-05-08 1994-11-15 Ethicon, Inc. Endoscopic needle holder
US5709694A (en) * 1995-03-22 1998-01-20 Human Factors Industrial Design, Inc. Endoscopic intracorporeal suture tying aid
DE29912712U1 (de) * 1999-07-21 2000-04-20 Sarbu, Joan, Dr., 28832 Achim Instrument zum Herstellen eines Knotens in einem Faden, insbesondere für die endoskopische Chirurgie
DE10305584A1 (de) 2002-02-04 2003-08-07 Arthrex Inc Knotenschieber und Fadengreifer
US20090204127A1 (en) * 2008-01-31 2009-08-13 Medicinelodge, Inc. System and method for tying surgical knots

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102015122502A1 (de) 2015-12-22 2017-06-22 Karl Storz Gmbh & Co. Kg Hilfsvorrichtung für das Bilden eines chirurgischen Knotens

Also Published As

Publication number Publication date
DE102011013055A1 (de) 2012-09-06

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