WO2014184415A1 - Séparateur pour chirurgie à travers l'aisselle - Google Patents

Séparateur pour chirurgie à travers l'aisselle Download PDF

Info

Publication number
WO2014184415A1
WO2014184415A1 PCT/ES2014/070404 ES2014070404W WO2014184415A1 WO 2014184415 A1 WO2014184415 A1 WO 2014184415A1 ES 2014070404 W ES2014070404 W ES 2014070404W WO 2014184415 A1 WO2014184415 A1 WO 2014184415A1
Authority
WO
WIPO (PCT)
Prior art keywords
leaflet
separator
distal
handle
section
Prior art date
Application number
PCT/ES2014/070404
Other languages
English (en)
Spanish (es)
Inventor
Miguel Lorenzo Campos
Original Assignee
Servicio Andaluz De Salud
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 Servicio Andaluz De Salud filed Critical Servicio Andaluz De Salud
Publication of WO2014184415A1 publication Critical patent/WO2014184415A1/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
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors

Definitions

  • the present invention belongs to the field of medicine, and more specifically to the field of surgical instruments.
  • the object of the present invention is a new separator provided with a leaflet specially designed to carry out surgical operations of removal of the axillary ganglia in the treatment of breast cancer.
  • the standard treatment of breast cancer is conservative surgery. This surgery involves dissecting or removing the axillary ganglia through small incisions that are made in an area slightly below the armpit. For this, the surgeon uses a separating instrument equipped with a leaflet that allows the incision made to be kept open while lifting the pectoralis major, being able to access the ganglia of the armpit through this opening with the help of another instrument.
  • the Doyen separator has an excessive blade width, so it does not fit well through the armpit hole.
  • the Roux separator has a different sized leaflet at each end, but it is too short to raise the patient's breastplate.
  • the inventor of the present application has developed a new instrument that solves the above problems thanks to the modification of an instrument already known in the art, the Balfour separator.
  • the Balfour separator is an instrument designed for use as a complement in laparotomies. It is also used in the gynecology field, where it is used to separate the pubis / mount of Venus to better access the minor pelvis.
  • the Balfour separator essentially comprises a structure to which two separation arms and a leaflet that is slidably fixed to said structure are fixed.
  • the leaflet has an essentially semicircular shape with a width of approximately 6 cm and with the rounded edges out.
  • the inventor of the present application has designed a new separator equipped with a valve similar to that of Balfour but modified to adapt it for use in surgery through the armpit.
  • the main modifications consist, firstly, in reducing the overall width of the leaflet, and secondly, in making the width essentially decrease uniformly from the base or proximal end to the distal tip or end. These modifications allow adequate insertion through the small holes used to access through the armpit, unlike the Balfour leaflet, which is too large.
  • the present document describes an additional optional improvement consisting in changing the usual handle of the Balfour leaflet for a handle more suitable for use for surgery through the armpit, specifically for a handle similar to that of the Doyen leaflet with long enough to allow the surgeon to hold it properly.
  • the present invention is directed to a spacer for surgery through the armpit which essentially comprises a leaflet and a handle.
  • a spacer for surgery through the armpit which essentially comprises a leaflet and a handle.
  • the leaflet comprises a first proximal section with an essentially cylindrical shape and a second distal section with an essentially straight shape.
  • the width of said leaflet essentially decreases uniformly from 3-4 centimeters along its proximal end to about 2-3 centimeters along its rounded distal end.
  • essentially cylindrical or “essentially straight” refers to a fundamentally cylindrical or straight shape respectively, but which, depending on the needs of each application, could be combated or undulate in any direction as long as it does not separate significantly of said cylindrical or straight form.
  • the angle between the handle and the second separator distal portion of the shell is between 5 and 30 °, and even more preferably between 10 ° and 20 °. It is easy appreciate that this angle is more closed than that of the Balfour leaflet, since this allows the pectoralis to be held better.
  • the instrument of the invention is inspired by the use of the hand for said function, and specifically of the fingers.
  • the fingers When the fingers are used to lift the pectoralis major muscle, the hand tends to close at angles similar to those described in order to properly engage the muscle.
  • the distal phalanges would be even more curved to act as a tractor against the muscle. Therefore, in a preferred embodiment of the invention the leaflet further comprises a tip of the distal section inclined inwards, for example the last 1-3 centimeters.
  • the total length of the second straight section would preferably be between 3-6 centimeters.
  • the handle of the separator of the present invention preferably comprises a proximal protuberance and a distal protrusion protruding in the same plane as the leaflet. These protrusions, protruding outward from the separator, prevent the handle from draining from the surgeon's hand during the operation, since each protuberance is located on the side of the surgeon's fist.
  • Figs. 1a and 1b respectively show a side view and a front view of the separator according to the present invention.
  • Fig. 2 shows the leaflet of the present invention developed on a plane so that the decrease in width can be seen more clearly.
  • FIG. 1a and 1b show both profile and elevation views of a separator (1) where the leaflet (2) and the handle (3) are appreciated.
  • the leaflet (2) has two distinct sections, a first proximal section (2a) essentially cylindrical and a second distal section (2b) essentially straight.
  • the second essentially straight distal section (2b) is approximately 4 centimeters long from the end of the second essentially cylindrical proximal section (2a) to the distal end (2d) or tip of the leaflet (2).
  • the leaflet (2) has the last 2 centimeters of the distal end (2d) folded or tilted inwards, in a manner similar to the way that the fingers of one hand would take to lift the pectoral muscle of a patient.
  • proximal (2a) and distal (2b) sections have been represented as completely cylindrical and straight respectively, it should be understood that one or both sections may have, in a manner similar to other similar instruments used in the art (by example, the Balfour leaflet or the Doyen leaflet), the side edges bent outwards of the separator (1).
  • This form is used so that the leaflet (2) adapts to the shape of the patient's tissues during the use of the separator (1), thus decreasing the possibility of damaging the patient's tissues with the edges of the leaflet (2).
  • the "outside of the separator” reference is made to the side of the separator (1) corresponding to the concave part of the curvature of the leaflet (2).
  • the width of the leaflet (2) represented in the figures decreases approximately linearly from the area adjacent to its proximal end (2d), where it is about 3.5 centimeters wide, to the area adjacent to its distal end ( 2c), where its width is approximately 2.5 centimeters.
  • This can be seen in Fig. 1b, as well as in Fig. 2, where the leaflet (2) is developed on a plane so that the decrease in width is better appreciated.
  • angle ⁇ formed by the handle (3) with the second distal section (2b) essentially straight in this example it is an angle ⁇ of about 25 °, although as mentioned above, smaller angles could be used.
  • the handle (3) is similar to the one commonly used in the Doyen leaflet, and consists of an ergonomic handle similar to that of a kitchen knife from which two proximal (3a) and distal (3b) protrusions protrude within the main plane of the instrument. (1) that contains the handle (3) and the center line of the leaflet (2) and oriented towards the outside. These protuberances (3a, 3b) prevent the handle (3) from draining from the surgeon's hand during use, since one is left on each side of the fist while holding. Also shown in the figures is an intermediate bar or section that connects the valve itself (2) to the handle (3). This new separator (1), because it is narrower, especially in the second straight distal section (2b) that is closer to the tip (2d), is easily introduced through the incision.
  • the tip (2d) of the distal stretch (2b) tilted inward helps to better engage the pectoral muscle.
  • the length of said straight distal section (2b) and the angle it forms with the handle (3) allow it to rest its outer side on the patient's bone structure and exert a force on the patient's tissues with its inner side that tends to open the incision made. This leaves enough free space to introduce the rest of the instruments necessary for surgery.

Abstract

L'invention concerne un séparateur (1) pour chirurgie à travers l'aisselle comprenant une valve (2) et un manche (3), caractérisé en ce que la valve (2) comporte un premier segment proximal (2a) de forme essentiellement cylindrique et un second segment distal (2b) de forme essentiellement droite, la largeur de ladite valve (2) diminuant essentiellement de manière uniforme de 3 à 4 cm au niveau de son extrémité proximale (2c) à 2 à 3 cm au niveau de son extrémité distale (2d) arrondie.
PCT/ES2014/070404 2013-05-16 2014-05-16 Séparateur pour chirurgie à travers l'aisselle WO2014184415A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ES201330595U ES1084356Y (es) 2013-05-16 2013-05-16 Separador para cirugía a través de la axila
ESU201330595 2013-05-16

Publications (1)

Publication Number Publication Date
WO2014184415A1 true WO2014184415A1 (fr) 2014-11-20

Family

ID=48629037

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/ES2014/070404 WO2014184415A1 (fr) 2013-05-16 2014-05-16 Séparateur pour chirurgie à travers l'aisselle

Country Status (2)

Country Link
ES (1) ES1084356Y (fr)
WO (1) WO2014184415A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN106859712A (zh) * 2017-03-09 2017-06-20 赵同刚 一种新型普外科手术用肌肉牵开装置

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3994301A (en) * 1975-04-14 1976-11-30 S & S Medical Products Co., Inc. Submammary dissector
CN101366645A (zh) * 2007-08-17 2009-02-18 罗婷 乳腺癌手术多功能拉钩

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3994301A (en) * 1975-04-14 1976-11-30 S & S Medical Products Co., Inc. Submammary dissector
CN101366645A (zh) * 2007-08-17 2009-02-18 罗婷 乳腺癌手术多功能拉钩

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
DATABASE WPI Derwent World Patents Index; AN 2009-G02241 *
FAICO: "instrumental quirúrgico", 30 December 2012 (2012-12-30), Retrieved from the Internet <URL:http://www.faico.com.ar/separadores.htm> [retrieved on 20140724] *

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN106859712A (zh) * 2017-03-09 2017-06-20 赵同刚 一种新型普外科手术用肌肉牵开装置

Also Published As

Publication number Publication date
ES1084356Y (es) 2013-10-02
ES1084356U (es) 2013-07-05

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