WO2016085419A1

WO2016085419A1 - Rib and sternum bone suture apparatus

Info

Publication number: WO2016085419A1
Application number: PCT/TR2014/000477
Authority: WO
Inventors: Mahmut Tokur
Original assignee: Mahmut Tokur
Priority date: 2014-11-28
Filing date: 2014-11-28
Publication date: 2016-06-02

Abstract

A rib and sternum bone suture apparatus (1) invented for usage in medical areas, applying suture on ribs by means of metals, such as titanium or steel, endoscopically in the scope of rib fracture treatments requiring surgical intervention and comprising of a punch channel (1.1), punch pusher (1.2), punch handle (1.3), compactor (1.5), punch bending channel a (1.6), punch bending channel b (1.7), medical staple (2), connection point (3), connection apparatus (3.1);also the invention is related to a medical staple (2) which can be positioned on the bone to make broken bones hold on to each other through rib and sternum bone suture apparatus (1) of the present invention and is made of lightweight and long-lasting metals having no adverse effect on human body, like titanium.

Description

RIB AND STERNUM BONE SUTURE APPARATUS DESCRIPTION

Technical Field

The invention is related to bone suturing punch and the staple made of metals like titanium, which are realized for usage in medical areas and enable stitching on rib by means of titanium, steel and similar metals endoscopically and in the scope of rib fracture treatments requiring surgical intervention. In addition, this invention is used for sternum suture that is cut for any surgical operation.

State of the Art Rib cage of human body encloses vital organs, such as heart, liver, lungs, splenic and major veins carrying blood to the body and connected to the heart. These vital organs are enclosed and protected by a solid structure that is a combination of twelve ribs on each side of rib cage, sternum bone in the middle and muscle, as well as the tissues. Ribs are hard, but flexible, which provides both necessary hardness and durability for protection of viscera and the flexibility required during breathing and movement.

In case of rib cage injuries, ribs are the most injured structures. Any fracture in ribs and simple fractures do not bear high level of complication risk and generally are left to heal spontaneously. Completely broken ribs may injure blood vessels and internal organs. Certain complications may arise with respect to number of ribs broken. Possible complications are as follows;

Injuries on aorta or other major vessels: Any break in one or more first three ribs at the top of rib cage may result with tear or rupture on aorta or other major vessels. Lung injuries: The jagged end of broken bone may puncture a lung and cause it to collapse. This is called pneumothorax. Or bleeding called hemothorax can be experienced. Injury on liver or kidneys: The bottom two ribs rarely fracture, because they are more flexible than do the middle and upper ribs. Despite great flexibility, any break in bottom ribs may cause serious damage on spleen, liver or kidneys due to broken ends. Herniation of lung: Lung herniates towards muscles or subcutaneous tissue through intercostal space whose integrity is damaged.

Breaks in more than one rib may result in flail chest. In case of flail chest, contrary to the breathing movement, broken rib regions move into the rib cage when breathing in and outwards when breathing out. In this case, breathing movement of the patient is impaired that may be life threatening.

High number of rib breaks, their relevant complications and lung contusion may result with respiratory failure. Patients suffering from above mentioned matters should be connected to the breathing machine. Long-term mechanical ventilation may cause many infections, such as, respiratory tract in particular, and death.

A fractured rib usually takes six weeks to heal. It can be treated with specific painkillers. However, in cases where pains are not treated with painkiller medications or increase in respiratory failure is possible due to pains, nerve blocks can serve as another option where long-term anesthetic injection is made on nerves around the rib. Specific surgical treatments may be required in case of emergence of any above complications. Today, many methods and instruments are used in surgical treatment of rib fractures. In the scope of surgical method, broken ribs are accessed through open surgery and stabilized with kirschner wire, wire stitches, intramedullary nails, staples and various special plaques. Furthermore, osteosynthesis plaque, titanium plaques and U- plaques are preferred. It is observed recently that adsorbable plaques are also used in this context.

Today, sternum is cut to access surgery region for treatment of open-heart surgery in particular, heart, major vessels and mediastinum surgical diseases. This process is called sternotomy. This incision is mainly on longer axis of sternum and runs down the middle through whole bone, but in some cases, it may be partially through long axis or transversely on short axis. After completion of surgical process, it is predominantly closed with steel wire sutures.

The method preferred mostly by the prior art displays some disadvantages arisen out of instruments used for stabilization of rib by combining rib fractures end to end or superposing them. It is not possible to apply Kirschner wires on all rib fractures. Plaques, which represent another method used by the prior art, are expensive and cannot be implemented for all rib fractures. In addition, they should be removed out in the future through a surgical operation. Soluble plaque and nails are not necessarily to be removed, but they are expensive too and may be less durable then required.

In the scope of another method, steel suture wires can be implemented, but they also cannot be used for treatment of all rib fractures and possess the risk of break and hence, stick in vital organs enclosed by rib cage as an outcome of which it may be life-threatening. Rib fractures may be treated through Judet staples; however, it may cause chronic intercostal pains by causing permanent damage on neurovascular structures on rib bed between two ribs.

Another method benefits from intramedullary nails, which may cause different complications through migration.

In addition to pitfalls of above instruments, implementation method stirs up troubles. In other words, primary drawback is implementation of above instruments through open surgery method on the patients having high rate of broken rib, feeling great pain and therefore, bearing the risk of respiratory failure; because large surgery incisions should be made on rib cage of the patient to treat rib fracture by placing above instruments to the broken rib. Through such incisions, patient's skin, rib cage muscles are cut and thereafter, rib is accessed and rib fractures are treated. Such a large surgery incision made on the patient, who suffers from many broken rib as a result of severe injury, means a new injury. Pain suffered due to such incision can cause respiratory failure after the surgery operation.

Another problem triggered by the open surgery method used in the present technique is the risk of non-access to all rib fractures through large incision made on any region of rib cage. In this case, either new surgery incision should be made or some inaccessible rib fractures may not be treated through surgical methods.

Steel wire used in the course of sternum bone suture may break due to excessive twisting. In this case, all stitches should be re-put after other unbroken wire sutures are cut and removed. This causes extension in time period of surgical operation. In addition, sternum bone may not, in anatomic sense, face each other through steel wire suturing process that may result with complications such as bone union matters, infections, opening on bones. Another complication experienced, in particular, by thin-skin patients, is the wire suture edges going out of the skin. This situation causes emergence of many complications. Break of the wire in chest internal surface constitutes more risky problem and may result with deaths as a result of sticking in heart and major veins. Another method is an American patent application having publication no "US2013261625 (A1)" and heading "BONE FIXATION MEMBER SYSTEMS AND METHODS OF USE".

Another method is an American patent application / document having publication no "US2006161161 (A1)" and invention heading "Sternal closure system, method and apparatus therefor". In the state of the art, other method is Mexican patent document numbered "MX2011011117". This document describes a paper clip inserted onto the rib in case of rib fractures suffered due to traumatic accidents. Another method is the Canadian Patent Document numbered "CA1067373". This document describes the apparatus used to connect collarbone and rib. Structure of the apparatus is like a gun firing metal part. However, the metal part/hook inserted by the apparatus onto the broken bone cannot fix the bones in steady and efficient manner.

Another method is the American Patent document numbered "US3960147". This document describes staple combining broken ribs. However, the staple cannot wrap and cover the broken bones completely and efficiently. In conclusion, a need to produce rib and sternum suturing apparatus has arisen due to above drawbacks and insufficiency of available solutions.

Brief description of the invention Present invention is related to rib and sternum suturing apparatus meeting above requirements, eliminating overall disadvantages and bringing specific additional advantages.

Primary purpose of the invention is to improve a punch apparatus enabling rib suture endoscopically and a staple made of light and long-life materials like titanium that has not negative impact on human body.

Another purpose of the invention is to prevent possible complications through anatomic and rapid suturing of sternum bone incised for any surgical operation.

The invention further aims to reduce pains and eliminate the risk of surgery related respiratory failure, as the new technique invented is implemented through endoscopic method and a few incisions of 1-2 centimeters are applied. Another aim of the invention is to access all broken ribs and to treat them in surgical sense. Another object of the invention is the fact that anatomic suture eliminates any complication.

The structural properties and characteristics and all advantages of the invention can be clearly understood with below drawings and detailed descriptions of the drawings and assessment should be made considering these drawings and their detailed descriptions.

Drawings Of The Invention

"Rib and sternum bones suture apparatus", which is subject matter of our application, is shown in enclosed figures that are listed as following;

Figure-1 : Perspective view of rib and sternum bones suture apparatus (1 ) of the present invention Figure-2: Perspective view of compactor of rib and sternum bones suture apparatus (1 ) of the present invention

Figure-3: Perspective view showing entry of medical staple (2) of the present invention to the compactor

Figure-4: Perspective view showing edges of medical staple (2) of present invention turning around in compactor

Figure-5: Perspective view showing application method of the rib and sternum bone suture apparatus (1 ) of the present invention in the course of surgical intervention

Figure-6: Perspective view showing sternum bone and rib structure of the medical staple (2) of the present invention after surgery Drawings should not be necessarily scaled and unnecessary details for understanding the invention may be omitted. Other elements that are at least mainly equivalent to each other or that have at least mainly equivalent functions to each other are indicated with the same number.

Description of Part References 1. Rib and sternum bones suture apparatus;

1.1 Punch channel

1.2 Punch pusher

1.3Punch handle

1.4Clamping arm

1.5 Compactor

1.6 Punch bending channel a

1.7 Punch bending channel b

2. Medical staple

3. Connection point

3.1 Connection apparatus

4. Sternum bone

5. Ribs

Detailed Description of the Invention

In this detailed description, the preferred embodiments of rib and sternum bones suture apparatus (1) of the present invention are only described for better understanding the invention without causing any limiting affect. Furthermore, some components in the detailed description can be used in various forms for better understanding and content integrity in the sentence. Components in various statements represent the component with the same number. The invention is related to bone suturing punch (1 ) and the medical staple (2) made of lightweight and long-lasting metals having no adverse effect on human body, like titanium that is invented for usage in medical areas, to apply medical staple (2) suture on rib endoscopically and in the scope of rib fracture treatments requiring surgical intervention.

The rib and sternum bone suture apparatus of the present invention (1 ) is a mechanism comprising of the parts whose reference numbers are indicated above and having its part functions mentioned below and used for suturing of bones like sternum bone (4), ribs (5).

Punch channel (1 .1 ) is positioned on punch handle (1.3) and has a span on its edge with the dimensions enabling passage of medical staple (2).

Punch pusher (1.2) collects medical staples (2) over punch channel (1 .1 ) towards the end of rib and sternum bone suture apparatus (1 ) and makes them ready for usage.

Punch handle (1 .3) is the component whose one end is handled by the surgeon during operations and having punch channel (1 .1 ) and punch pusher (1 .2) on its other edge.

Clamping arm (1.4) is the component whose one end is handled by the surgeon during operations and having compactor (1 .5) on its other edge.

Compactor (1 .5) is positioned on clamping arm (1 .4), having on its top the punch bending channel a (1.6) and punch bending channel b (1 .7) and enabling the medical staple (2) to take appropriate form to hold the bone operated. Punch bending channel a (1.6) is the component having deeper gap inside of it when compared to punch bending channel b (1.7) and enables bending of the medical staple (2) to take appropriate form during application. Punch bending channel b (1.7) is the component having less depth inside of it when compared to punch bending channel a (1 .6) and enables bending of the medical staple (2) to take appropriate form during application. Medical staple (2) is positioned over the bone to make broken bones hold on each other through rib and sternum bones suture apparatus (1 ) of the present invention and is made of lightweight and long-lasting metals having no adverse effect on human body, like titanium. Connection point (3) is the part on which punch handle (1 .3) and clamping arm (1 .4) hold on each other.

Connection apparatus (3.1 ) connects punch handle (1 .3) and clamping arm (1.4). Sternum bone (4) is the rib cage bone keeping right and left side ribs of human body together and stands between right ribs (5) and left ribs (5).

Rib (5) exists within the human body and is the naming used for each bone that protects vital organs of humans.

Operating principle of rib and sternum suture apparatus (1 ) of the present invention:

Punch handle (1.3) and clamping arm (1 .4) of rib and sternum bone suture apparatus

(1 ) of the present invention are interconnected by a connection apparatus (3.1 ) on the part called as connection point (3). By this way, punch handle (1 .3) and clamping arm (1 .4) can perform opening and closing functions manually, such as scissors. Connection point (3) can be at anywhere over these handles. Connection apparatus can be made to have hydraulic mechanism. This may create stronger medical staple

(2) clamping effect by applying less force.

Punch channel (1.1 ) is made to insert medical staples (2) made of various metals inside of it. Punch channel (1 .1 ) is placed on punch handle (1 .3) and has, on its end, a span in dimension enabling passage of medical staple. This span provides insertion of the staple towards the compactor.

Punch pusher (1.2) makes medical staples (2) within the punch channel (1 .1 ) to be pushed towards compactor (1 .5). Punch pusher (1 .2) and medical staple (2) on the punch handle (1 .3) can operate with pneumatic mechanism as a compactor system.

Punch bending channel a (1 .6) and punch bending channel b (1 .7) positioned on the compactor (1.5) are placed in parallel to each other. These channels enable bending of medical staple (2) edges. One end of punch bending channel a (1 .6) and punch bending channel b (1.7) is deep, whereas the other end is shallower. In other words, deeper edge surfaces with a specific angle and catches up the level of table. This structure is configured reversely on punch bending channel a (1 .6) and punch bending channel b (1 .7). This means that shallower edge of punch bending channel b (1.7) is available beside the deeper edge of punch bending channel a (1 .6).

In this way, medical staple (2) is bended from outward to inward as to make its edges face each other. After completion of bending, it sticks in the bone on both edges. This process prevents ends of medical staple (2) to be buried in the bone and accordingly any damage on the organs beneath the bone. As distinct from other punches, availability of two punch bending channel called punch bending channel a (1 .6) and punch bending channel b (1 .7) makes bending of both punch edge through its full thickness. In this way, bone compression resistance increases and separation of the bone sutures is inhibited.

Claims

A rib and sternum bone suture apparatus (1) that enables suturing on rib (5) endoscopically in the scope of treatment of rib (5) fractures, characterized in that the said apparatus comprises;

• At least one punch channel (1.1) positioned on punch handle (1.3) and having a space on its edge in dimension enabling passage of medical staple (2),

• Punch pusher (1.2) that collects medical staples (2) on punch channel (1.1) towards edge of rib and sternum bone suture apparatus (1) and makes them ready for usage,

• Punch handle (1.3) whose one end is handled by the surgeon during operations and having punch channel (1.1) and punch pusher (1.

2) on its other edge,

• Clamping arm (1.4) whose one end is handled by the surgeon during operations and having compactor (1.5) on its other edge,

• At least one punch bending channel a (1.6) that enables bending of the medical staple (2) to take appropriate form during application,

• At least one punch bending channel b (1.7) that enables bending of the medical staple (2) to take appropriate form during application,

• Connection point (3) on which punch handle (1.3) and clamping arm (1.4) hold on each other,

• At least one connection apparatus (3.1) that connects punch handle (1.3) and clamping arm (1.4).

A rib and sternum bone suture apparatus (1) according to claim 1 , characterized in that the apparatus comprises medical staple (2), which makes broken bones hold on to each other by means of rib and sternum bones suture apparatus (1) and is positioned on the bone and made of lightweight and long-lasting metals having no adverse effect on human body, like titanium.

3. A rib and sternum bone suture apparatus (1) according to claim 1 , characterized in that the ends of medical staples (2) applied are inside of the bone after the application.

4. A rib and sternum bone suture apparatus (1) according to claim 1 , characterized in that the aforementioned punch bending channel a (1.6) has triangular form.

5. A rib and sternum bone suture apparatus (1) according to claim 1 , characterized in that the aforementioned punch bending channel b (1.7) has triangular form.