WO2016087896A1 - Appareil pour la réparation laparoscopique d'une hernie inguinale chez des enfants, des nouveau-nés et des adultes - Google Patents

Appareil pour la réparation laparoscopique d'une hernie inguinale chez des enfants, des nouveau-nés et des adultes Download PDF

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Publication number
WO2016087896A1
WO2016087896A1 PCT/IB2014/066497 IB2014066497W WO2016087896A1 WO 2016087896 A1 WO2016087896 A1 WO 2016087896A1 IB 2014066497 W IB2014066497 W IB 2014066497W WO 2016087896 A1 WO2016087896 A1 WO 2016087896A1
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WO
WIPO (PCT)
Prior art keywords
mesh
hollow
attached
hollow semi
string
Prior art date
Application number
PCT/IB2014/066497
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English (en)
Inventor
Bahar ASHJAEI
Original Assignee
Ashjaei Bahar
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Application filed by Ashjaei Bahar filed Critical Ashjaei Bahar
Priority to PCT/IB2014/066497 priority Critical patent/WO2016087896A1/fr
Publication of WO2016087896A1 publication Critical patent/WO2016087896A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00407—Ratchet means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A61F2002/0072—Delivery tools therefor

Definitions

  • This invention is related to the field of surgery especially pediatric surgery and laparoscopic surgery.
  • the present invention concerns the field of surgical techniques for hernia repair in any sites of the human and animal bodies especially for inguinal and femoral canals. This is more special to repair of inguinal canal hernia in children , infants and neonates.
  • the present invention relates to surgical device and more particularly to an apparatus, method and system for the simultaneously employment and fixation of a surgical mesh inside of a patient's body.
  • Hernia is a defect or hole in the abdominal wall which allows protruding the intraperitoneal components outside the peritoneal cavity. This defect is located in the inguinal canal more than the other sites of the peritoneal cavity. Patients feel discomfort of protruding the intraperitoneal organs from this defect.
  • the U.S. patent No. 5,263,969 ( 1993 ) is a tool for inserting a mesh prosthesis into the retroperitoneal space in the laparoscopic repair of inguinal and femoral hernia , but it is not for intraperitoneal space therefore it needs some other instruments for retroperitoneal dissection for inserting and fixing the surgical mesh.
  • the U.S. patent No. 5,366,479 ( 1994 ) is an apparatus and surgical staple for attaching a surgical mesh to body tissue in laparoscopic hernia repair, but it is not for inserting and spreading the surgical mesh over the hernia defect and we need more ports for inserting more other instruments for the
  • the U.S. patent No. 5,370,650 (1994) is an apparatus for positioning surgical implants adjacent to body tissue. It can't fix or staple the surgical mesh and we need more other ports for inserting the other instruments in the abdominal wall for this purpose. (5)
  • the U.S. patent No. 8,097,008 B2 (2012) is an apparatus which is provided for the laparoscopic deployment and positioning of surgical materials, such as mesh.
  • this patent includes an attaching mechanism at the end of the arm to secure the repair material to an abdominal wall.
  • attaching mechanisms include surgical staplers, adhesive dispenser and/or heating element.
  • the attaching mechanism is not designed and mentioned as a possible mechanism.
  • the fiber optic rod for visualization the surgical field is designed in the body of the device.
  • the site of fixation is inside the inguinal canal by two strings which are equipped with two parts of a staple therefore it can acts as an apparatus for single port repair of inguinal hernia specially in children with indirect inguinal hernia.
  • the process of repairing is just one shoot in inguinal hernia, left or right.
  • All the surgical instruments which are needed for laparoscopic hernia repair are designed in the body of this apparatus. These components are mesh inserting and
  • spreading part it is named as mesh holder part or mesh positioner part
  • stapling part it is named as inner blade and outer blade
  • visual field producer is named as cold light conductor and lens or fiber optic rod
  • laparoscopic hernia repair in children is laparoscopic hernia repair with endoneedle.
  • This procedure has some advantages comparable to those with open surgery like the shorter time of operation, more easear than the other methods and reproductive system remains intact.
  • the procedure can be performed more easily than the enoneedle procedure and the time of operation is shorter than the endoneedle operation and the reproductive system will be intact.
  • endoneedle technique is not a single port technique.
  • hook method Another method for laparoscopic hernia repair in children is hook method. This method is a time consuming method and it needs more skill to perform in comparison to our method. Furthermore our device is designed for single port operation but the hook technique is not a single port technique. (8)
  • Needlescopic aproach to inguinal hernia repair is another laparoscopic inguinal hernia repair in method in children. This method is a time consuming method too and it needs more skill to perform in comparison to our method. Furthermore our device is designed for single port operation but the hook technique is not a single port technique. (9)
  • Trans umbilical endoscopic surgery TUES is another method for laparoscopic inguinal hernia repair in children. This method is safe, effective and cosmetic reliable but is a time consuming method too and it needs more skill to perform in comparison to our method. Furthermore in TUES method two trocar is inserted through two incisions in the paraumbilicus area but our device is designed for single port operation but the hook technique is not a single port technique. (10) & (11)
  • Laparoscopic resection of hernia sac without suture is another method for laparoscopic hernia repair in children. This method is a time consuming method too and it needs more skill to perform in comparison to our method. Furthermore our device is designed for single port operation but the hook technique is not a single port technique. (12)
  • Inguinal hernia is a current disease in children and adults. In this disease there is a defect or a weakness in the abdominal wall of the patient. We close this defect or strengthen the weakness by some different methods. In traditional methods the abdominal wall is opened and the defect is closed by sutures and in adults we can use the mesh for this purpose.
  • This invention consists of some segments that can enter the peritoneal cavity from a single opening that is made in or under the umbilicus.
  • this device is designed for single port laparoscopic hernia repair, especially in children.
  • the device can hold a mesh that is attached to a staple to its end by two strings or two cord-like segments.
  • the light and the lens (fiber optic rod) are attached to the same device and the peritoneal cavity and inguinal ring can be seen at the same time by the said device
  • the device can press the staple and fix it by applying just one pressure.
  • the mesh holder segment of the device can open and the said mesh will exit from it and will be fixed over the defect or inguinal internal ring.
  • This method and device for inguinal hernia repair is more time saving rather than all existing traditional and laparoscopic methods, furthermore we don't need numerous skills to do this method in comparison with the other existing methods.
  • One embodiment disclosed here is related to a device for laparoscopic hernia repair in children and neonates and indirect inguinal hernia in adults.
  • This device is made for the placement of a mesh in the inguinal canal to repair indirect inguinal hernia.
  • the said mesh consists of several parts that will be explained.
  • One part is a discoid or circle shaped part that is made of PVDF or other materials like that. This part of mesh can become crumpled to be placed into the mesh holder segment of the device.
  • the others parts of the said mesh are two strings or two cord-like segments that are made of a non reactive material to the body like silicon and other similar materials.
  • One of these cord-like parts is attached to the central part of the mesh in one end and has a hollow circle at the other end. This hollow circular part has the same material as the cord-like part that is attached to it.
  • Another part of the said mesh is another string or cord-like segment that is made of a non reactive material to the human body such as silicon and other similar materials.
  • This cord-like part is attached to the central part of the mesh lateral to the first cord-like segment in one end and is attached to a metal or rigid segment in another end.
  • This metal segment works as a staple.
  • This metal part doesn't have any reaction to the body of patient and is made of three parts. One part is like a disk and the other two parts are like two nails that are attached to the center of that metal discoid part.
  • the cord-like part of the mesh that has a hollow circle at one end will be placed to the inguinal canal from the same end.
  • Another cord-like part that is attached to the metal staple will be placed in the peritoneal cavity in front of the recent cord-like part that can be fixed to it by closing two blades of the mesh holder segment of the apparatus.
  • This laparoscopic device can enter to the peritoneal cavity from one hole that is made in the umbilicus and every side inguinal hernia, left or right; can be repaired from the same hole in the umbilicus.
  • the said laparoscopic apparatus consists of three main parts.
  • the first part is a handle that works as a driver part. This part is held outside of the patient's body in the surgeon's hand.
  • the second part is a hollow cylinder shaped part that conducts the movement to the third part.
  • 3- The third part that works as a mesh holder part. This third part can deliver and insert the mesh through the inguinal canal. Moreover the third part can fix the mesh in the inguinal canal and over the internal ring of inguinal canal by stapling the staple that is placed in the mesh.
  • mesh holder part The third part of the laparoscopic device, which is named mesh holder part is made of different parts that we will explain them.
  • This mesh holder part can be separated and fused to the cylinder by twisting with a nut which is prepared at its proximal end.
  • One nut is prepared in proximal end in the mesh holder part and a screw is prepared at the distal end of the cylinder part.
  • the mesh holder part consists of two main parts.
  • One part is like a half of a hollow cone, named as inner semi cone.
  • This inner semi cone is attached to a hollow semi cylinder part and this recent part has a round concavity at the end to keep the hollow ring part of the said mesh.
  • the outer part is like a half of a hollow cone, which is named outer semi cone.
  • This outer semi con is attached to a hollow semi cylinder part and this recent part has a round concavity at the end to keep the metal part of the said staple.
  • a hinge is prepared in both lateral sides of proximal end of the outer semi cone, which joins the outer semi cone to the inner semi cone.
  • FIG 1 Whole view of the laparoscopic apparatus.
  • FIG 2 the hollow cylinder part of the instrument that connects the driver handle part to the hollow cone-shaped mesh holder part.
  • A Cylinder part of the instrument.
  • FIG 3 Inner hollow semi cone of the mesh holder part.
  • A the front view of B.
  • FIG 4 Detailed view of the instrument.
  • A the front view of the instrument.
  • FIG 5 The lever bar.
  • A front view of the lever bar.
  • D detailed view of the part (circular sign) ( ⁇ ) in the E.
  • E 3 dimensional view of A.
  • FIG 6 digitate part of the driving handle.
  • A Front view of the digitate part of the driving handle.
  • D 3 dimensional view of A.
  • FIG 7 Housing cover
  • C upper view of A.
  • D 3 dimensional view of A.
  • FIG 8 Outer hollow semi cone part.
  • A left view of the outer hollow semi cone part.
  • D 3 dimensional view of A.
  • FIG 9 Mesh and mesh holder part.
  • C front view of the said mesh when it is in the mesh holder and is crumpled.
  • D a schematic view of the said mesh when it is crumpled.
  • FIG 1 Whole view of the laparoscopic apparatus.
  • A Front view of the laparoscopic apparatus. This is a laparoscopic
  • This apparatus to repair inguinal hernia. This apparatus is made for holding a mesh and placing the mesh in the inguinal canal and upon inguinal internal ring and fixing the mesh in this position by stapling one staple that is
  • This apparatus has three main parts.
  • One part is a hollow cone shaped part that is made of two hollow semi cone pieces.
  • This hollow cone shaped part is named mesh holder part.
  • the other part is a handle that will be held in surgeon's hand which can open and close the two hollow semi cone parts and can fix the staple just by one shoot.
  • This recent part is named the driver handle part.
  • the third part is a hollow slenderer part that is placed between the mesh holder part and the driver handle part that connects them together.
  • Part (a) is a part of the driver handle which starts and performs the process of shooting.
  • Part (b) is the hollow cylinder part which connects the driver handle to the hollow cone shaped mesh holder part and conducts the process of shooting from (a) to (f&g).
  • Part (c) Is a spring that can be compressed and decompressed by moving part (d).
  • Part (d) Part is a pressure button which is marked as part (g) of (A) of FIG 5. Can compress and decompress the spring and perform the process of shooting and conduct the stapling.
  • Part (e) is the housing cover of the driver handle that is marked in FIG 4 (A) as part (e) of device.
  • Part (f) is the outer hollow semi cone shaped part that will be placed outside the inguinal canal from its narrow tip which can help the fixation process of the mesh over the internal ring of inguinal canal.
  • Part (g) is the internal hollow semi cone part of the mesh holder which will be placed against part (f) and inside the inguinal canal this part fixes the staple of the mesh through the process of shooting.
  • This part is the mesh holder hollow cone-shaped part that can place the mesh on the internal ring of the inguinal canal that performs the stapling process and fixing the mesh over the inguinal internal ring.
  • This part can be attached or detached to the hollow cylinder part by screwing. This screwing action is required to place the mesh into the mesh holder part. (loading action)
  • This part can do the screwing action of the mesh holder part. This action can attach or detach the mesh holder part to the hollow cylinder part and we can place the mesh inside the mesh holder part when it is detached from the hollow cylinder part.
  • FIG 2 the hollow cylinder part of the instrument that connects the driver handle part to the hollow cone-shaped mesh holder part.
  • A This is the hollow cylinder part of the instrument that connects the driver handle part to the hollow cone-shaped mesh holder part.
  • One lever bar is prepared in this hollow cylinder part which conducts the shooting process from pressure button to the mesh holder part.
  • This lever bar is shown as a spotted line inside the hollow cylinder part in (B).
  • the part (a) is the holding part which connects the driver handle to the hollow cylinder part.
  • Part (b) is a beam which connects the lever bar in the hollow cylinder part to the driver handle and conducts the shooting process to the mesh holder part.
  • Part (1) is hollow cylinder part which enfolds the lever bar. Two parts are prepared outside this cylinder part. One part is a lens which creates the visual field of inspection of intra peritoneal cavity.
  • Part (1) is a notch or chamber through which a beam is prepared that can move through it.
  • Part (d) is the cold light conductor which conducts the cold light from light source to the peritoneal cavity.
  • Part (e) is the lens which creates the visual field for surgeon to watch the operation field.
  • Parts (d&e) can be as a single part (fiber optic rod).
  • Circle sign in (A) which is named circle (B) in (A) is the same as (E) which can screw and fix the hollow cylinder part to the mesh holder part.
  • Parts (f), (g), (h), (i) are grooves or sluts which hold the holding part in its position.
  • Part (j) is the cold light conductor which conducts the cold light from light source to the peritoneal cavity.
  • Part (k) is the lens which creates the visual field for the surgeon to watch the operation field.
  • the two parts (j), (k) can be juxtaposed and attached together or can be separated from each other and with some space between them.
  • Part (j) is the cold light conductor which conducts the cold light from light source to the peritoneal cavity.
  • Part (k) is the lens which creates the visual field for the surgeon to watch the operation field.
  • the two parts (j), (k) can be juxtaposed and attached together or can be separated from each other and with some space between them.
  • Parts (j, k) can be in collection as a fiber optic rod.
  • FIG 3 Inner hollow semi cone of the mesh holder part.
  • A This is the front view of inner hollow semi cone of the mesh holder part.
  • Part B This is the left view of inner hollow semi cone of the mesh holder part.
  • Parts (a & h) are nut which can be attached to the body of the apparatus or the hollow cylinder part.
  • Part (b) is the body of the inner semi cone which is hollow.
  • Part (c) is the inner hollow semi cylinder shaped part which is attached to the inner hollow semi cone part and the inner string part of the mesh can be placed in it.
  • Part (d) is a depression or notch which the hollow circle or ring part of the inner string of the said mesh can be Placed in it and the process of stapling will be completed by the movement of the tip of the outer hollow semi cone.
  • Part (e) is the tip of the inner hollow semi cylinder part of the mesh holder which is an arch shaped for easy movements and being safe with no sharp edges.
  • Part (f) is a prominence part which is prepared in the hollow semi cone part to create an opening in it to hinge or join the two hollow semi cone parts.
  • Part (g) is an opening which is prepared in part (f) to hinge or join the two hollow semi cone parts.
  • FIG 4 Detailed view of the instrument.
  • Part (a) is a part of the driver handle which starts and performs the process of shooting.
  • Part (b) is the hollow cylinder which connects the driver handle to the mesh holder part.
  • Part (h) is one spring which can create the potential ability of shooting.
  • Part (d) is the lever bar which conducts the force of shooting from the driver handle to the mesh holder part.
  • Part (e) is a housing cover.
  • Part (f) is the inner hollow semi cone-shaped part of the mesh holder part. This part will be placed inside the inguinal canal partially from its narrow end before shooting process.
  • Part (g) is the outer hollow semi cone-shaped part of the mesh holder which will be placed outside the inguinal canal.
  • Parts (f), (g) can perform the process of stapling and fixing the mesh over the inguinal internal ring.
  • Circle sign (A) is the screw part of the body or cylinder which can join the cylinder to the mesh holder by screwing.
  • Circle sign(C) is the mesh holder part which can be attached or detached to the cylinder part by a nut which is prepared in it.
  • This part is a hollow cone-shaped part which is made of two hollow semi cone shaped parts. These two semi cone shaped parts can perform the process of placing the mesh, stapling the mesh and fixing the mesh.
  • FIG 5 The lever bar.
  • Part (g) is the pressure button which triggers the shooting process.
  • Part (f) is the lever bar which conducts the shooting process to the mesh holder part.
  • Part (h) is the outer part of a T slut rail which is prepared to protect the collection of (A) from sliding during its movements.
  • Part (a) is the tip of the said ratchet performing the main movements and positions of the ratchet specially the locking process.
  • Part (b) is the tip of the lever bar which is connected to the mesh holder part.
  • Part (c) is the tip of the body of the ratchet which has an arch for the free movement of the lever bar.
  • Part (d) is a ratchet which can place the lever bar in locking and shooting process.
  • These positions can be more than two for some purposes, for example the semi-opened position which is between the locking and shooting position. This semi-opened position is suitable to enter the mesh holder part to the peritoneum from an opening which is made inside the umbilicus.
  • Part (e) is the inner part of a T slut rail which is prepared to protect the collection of (A) from sliding during its movements.
  • FIG 6 digitate part of the driving handle.
  • Part (a) is a circle to be held by the surgeon's fingers.
  • Part (b) is releaser.
  • Part (c) is a channel for the placement of the beam of lever bar in it.
  • Part (d) is a hollow body space.
  • Part (e) is a rail which T slut rail can slide on it.
  • Part (f) is a cover fixer guide which guides the cover housing fixation.
  • Part (g) is a cover fixer to fix the housing cover.
  • Part (h) is a stopper which works to stop the stapling process.
  • Part (i) is a hollow space.
  • Part (j) is a cavity for placing the housing cover and part (k) is a cavity for placing the lever bar.
  • FIG 7 Housing cover
  • A This is the front view of housing cover.
  • Part (a) is a square-shaped channel which a prominent part of part (a) in (A) of FIG 4 be placed inside it.
  • Part (b) is oblique edge of inner surface in housing cover.
  • Part (c) is a rail which the lever bar can slide in it.
  • Part (d) is a benchmark to fix the sliding level.
  • B This is the left view of (A).
  • Part (e) is the fixing body which part (a) of (A) in FIG 4 or fixing guide can be placed inside it.
  • FIG 8 Outer hollow semi cone part.
  • Part (a) is the position to place the beam or the other end of lever bar in it.
  • Part (b) is the outer hollow semi cone part which the mesh can be placed inside it.
  • Part (c) is the inner part of the outer hollow semi cone part and the said mesh is shown by spotted line.
  • Part (d) is a depression or notch which the staple part of the said mesh can be placed inside it.
  • Part (e) is the tip of the outer hollow semi cylinder part of the outer hollow semi cone which is arch shaped for easy movement and being safe with no sharp edge.
  • Part (f) is a hollow semi cylinder shaped part which is attached to the outer hollow semi cone part and the outer string part of the mesh can be placed in it.
  • Part (g) is an arch to join or hinge and perform easy movement of the join.
  • Part (h) is a hollow circle for hinging tow semi cones together.
  • Part (i) is a prominence part which the end of the lever bar or beam can be placed over it.
  • FIG 9 Mesh and mesh holder part.
  • Part (a) is the ring-shaped part of the mesh which can be fixed to the internal aspect of posterior wall of the inguinal canal by one staple.
  • Part (b) is the inner string part of the said mesh which is attached to the ring-shaped part.
  • Part (c) is the inner hollow semi cylinder part of the mesh holder which can embrace the string part of the said mesh.
  • Part (d) is discoid part of the staple.
  • Parts (e) are two needle-shaped parts of staple.
  • Part (f) is outer hollow semi cylinder part of outer semi cone part of the mesh holder.
  • Part (g) is the said mesh which is placed inside the mesh holder.
  • Part (h) is the hollow semi cone of mesh holder.
  • Part (I) is the position for the placement of the beam of lever bar.
  • Part (j) is the outer hollow semi cone.
  • Part (k) is the opening to join the two hollow semi cone of mesh holder.
  • E This is the 3 dimensional view of the said mesh when it is crumpled.
  • Part (f) is the discoid part of the said mesh when it is crumpled.
  • Part (g) is the central part of the mesh which the two strings are attached.
  • Part (a) is the discoid part of the said staple.
  • Part (b) is the outer string part of the said mesh which the staple is attached to it.
  • Part (c) is the two Needle-shaped parts of the staple.
  • Part (e) is the inner string part of the said mesh which the ring part of the mesh is attached to it.
  • Part (d) is the ring part of the said mesh,

Abstract

La présente invention concerne un appareil et un système pour le traitement mini-invasif et rapide d'hernie inguinale par utilisation et fixation simultanées de treillis chirurgical à l'intérieur du corps d'un patient, l'appareil comprenant un bras ou un corps, une poignée de commande, et une agrafeuse pour attacher le treillis au moyen d'une agrafe, une tige de fibre optique (un conducteur de lumière froide), et un support de treillis qui est en forme de cône creux. Le treillis comprend trois parties dont une partie est une partie circulaire ou en forme de disque et les deux autres parties sont des liens fixés au point central de la partie circulaire individuellement. Aux extrémités de chacun des liens, une partie d'agrafe est fixée. Le treillis est constitué de PVDF qui peut être inséré à travers le sac d'hernie inguinale et au-dessus de l'anneau inguinal interne par application d'une pression.
PCT/IB2014/066497 2014-12-02 2014-12-02 Appareil pour la réparation laparoscopique d'une hernie inguinale chez des enfants, des nouveau-nés et des adultes WO2016087896A1 (fr)

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CN112426213A (zh) * 2020-12-09 2021-03-02 淮北市人民医院 一种用于小儿疝气腹腔镜手术的设备

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US8097008B2 (en) * 2005-09-09 2012-01-17 University Of South Florida Laparoscopic hernia mesh spreader

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US8097008B2 (en) * 2005-09-09 2012-01-17 University Of South Florida Laparoscopic hernia mesh spreader
US20090048537A1 (en) * 2006-01-31 2009-02-19 Angiotech Biocoatings Corp. Lubricious coatings

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CN112426213A (zh) * 2020-12-09 2021-03-02 淮北市人民医院 一种用于小儿疝气腹腔镜手术的设备
CN112426213B (zh) * 2020-12-09 2023-05-30 淮北市人民医院 一种用于小儿疝气腹腔镜手术的设备

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