WO2017144756A1 - Instrument de mesure de paramètres associés à une incision dans un tissu et procédé pour mesurer des paramètres dans une incision dans un tissu au moyen dudit instrument - Google Patents

Instrument de mesure de paramètres associés à une incision dans un tissu et procédé pour mesurer des paramètres dans une incision dans un tissu au moyen dudit instrument Download PDF

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Publication number
WO2017144756A1
WO2017144756A1 PCT/ES2017/070096 ES2017070096W WO2017144756A1 WO 2017144756 A1 WO2017144756 A1 WO 2017144756A1 ES 2017070096 W ES2017070096 W ES 2017070096W WO 2017144756 A1 WO2017144756 A1 WO 2017144756A1
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WO
WIPO (PCT)
Prior art keywords
instrument
arms
tissue
incision
pair
Prior art date
Application number
PCT/ES2017/070096
Other languages
English (en)
Spanish (es)
Inventor
Joan Roca Enrich
Maria Carmen MIAS CARBALLAL
Miquel Nogues Aymami
Rafael Noé VILLALOBOS MORI
Original Assignee
Universitat De Lleida
Institut De Recerca Biomèdica De Lleida Fundació Doctor Pifarré
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.)
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Application filed by Universitat De Lleida, Institut De Recerca Biomèdica De Lleida Fundació Doctor Pifarré filed Critical Universitat De Lleida
Publication of WO2017144756A1 publication Critical patent/WO2017144756A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1072—Measuring physical dimensions, e.g. size of the entire body or parts thereof measuring distances on the body, e.g. measuring length, height or thickness
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1075—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions by non-invasive methods, e.g. for determining thickness of tissue layer
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/44—Detecting, measuring or recording for evaluating the integumentary system, e.g. skin, hair or nails
    • A61B5/441—Skin evaluation, e.g. for skin disorder diagnosis
    • A61B5/445—Evaluating skin irritation or skin trauma, e.g. rash, eczema, wound, bed sore
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/067—Measuring instruments not otherwise provided for for measuring angles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2505/00—Evaluating, monitoring or diagnosing in the context of a particular type of medical care
    • A61B2505/05—Surgical care
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/44—Detecting, measuring or recording for evaluating the integumentary system, e.g. skin, hair or nails
    • A61B5/441—Skin evaluation, e.g. for skin disorder diagnosis
    • A61B5/442—Evaluating skin mechanical properties, e.g. elasticity, hardness, texture, wrinkle assessment

Definitions

  • the present description refers to instruments for measuring parameters, such as, for example, forces and distances, associated with an incision in a tissue, such as a human or animal biological tissue.
  • the present description also refers to procedures for measuring said parameters in an incision in a tissue by means of said instruments.
  • incisions are made that cover all the anatomical planes.
  • a laparotomy is usually performed, that is, an incision in the abdominal wall. This procedure is performed at the beginning of any abdominal surgery.
  • the incision made on the abdominal wall should be closed using a suture that joins both edges of the incision.
  • a suture that joins both edges of the incision.
  • incisional herniation or eventration When the healing process of the closure of a laparotomy is not correct, an abdominal wall defect occurs in the scar tissue called incisional herniation or eventration. It is essential for the surgeon to carry out a correct technique during the closure of the abdominal wall despite the existence of some predisposing factors of the patient who are difficult to control and are out of reach.
  • One of the most relevant risk factors for developing an eventration and that can be controllable during the surgical intervention by the surgeon is the excessive tension in the suture with which the abdominal wall is closed.
  • the ideal tension at which an abdominal wall of a laparotomy should be closed is a parameter that is currently unknown and that corresponds to the tension necessary to compensate for the separation force of the tissue plus a minimal compression between edges.
  • the closing force of a suture corresponds to the sum of the force necessary to approximate the edges plus the compression force between the edges of the tissue.
  • the surgeon does not know the force of separation in the incision that must compensate. Excessive compression between the edges generates a decrease in their irrigation with the consequent poor healing, while a closure with little compression prevents a proper apposition of the aponeurotic edges and, consequently, a bad healing is obtained again. Therefore, both situations are not desirable and it is necessary to obtain a balanced compression between edges to promote proper healing.
  • document EP0998877 proposes an apparatus comprising a clamp-like structure formed by two arms articulated by one end which are intended to be applied to a fabric.
  • the apparatus includes a measuring element to determine the static force exerted on the arms and the distance between them.
  • US2014276232 describes a blood pressure monitor. It consists of two arms articulated by one end while their opposite ends are intended to be fixed on the skin. The tensiometer also includes a measuring element to determine the distance between the ends of the arms.
  • This instrument is of particular application in surgery, experimental surgery, medical instruments, biomechanics, etc. to accurately measure parameters associated with an incision in a tissue.
  • this instrument can be used in many other applications where accurate dynamic measurements are necessary.
  • the described instrument comprises at least one pair of arms articulated with each other, which define a compass structure in which the arms can rotate with each other around a point of articulation, approaching or separating their ends.
  • the arms are adapted to be anchored by their free ends on both sides separated from the tissue at points near the edges of the incision.
  • each of the free ends of the arms of the instrument there is at least one anchoring element, such as a barb, a needle , a clamp, or other similar element suitable for securely fastening the free ends of the instrument arms in the tissue.
  • an anchoring element such as a barb, a needle , a clamp, or other similar element suitable for securely fastening the free ends of the instrument arms in the tissue.
  • each arm includes two or more anchoring elements at each end
  • said anchoring elements may be coupled to the support by one or more joints, so that the end of the arm receives the sum of the forces applied at each end.
  • Anchoring element and their values are distributed uniformly thanks to the possibility of relative movement between the set of anchoring elements at the end of each arm.
  • the anchoring elements are barbed, they preferably have rounded or blunt tips in order to prevent damage to the tissue when the arms are anchored therein and to be able to fractionate without tearing it.
  • the anchoring elements are preferably coupled to the removable support separated from each other a certain distance that may correspond to the distance or passage of the suture to be applied to the tissue in the incision. This separation distance may be the same in all arms or may vary as required.
  • removable supports facilitates sterilization of the anchoring elements, which is important since it is an element that is in contact with biological tissues.
  • the feature of having a support with removable anchoring elements coupled to the end of each arm allows to be able to exchange supports with anchoring elements, such as spikes, for example, to easily adapt the number and type to the characteristics of the fabric. and the incision.
  • a measuring device Associated with the pair of arms is a measuring device that is adapted to perform dynamic measurements of at least one magnitude over time associated with said tissue in the incision.
  • dynamic measurements refers to the determination, for example in real time, of multiple values of specific parameters, such as forces, distances, etc., associated with the tissue in the incision, which vary with the weather.
  • this locking mechanism would be adapted to keep the locked arms releasably in position, that is, capable of keeping the temporarily locked arms, preventing them from moving with each other, while taking measurements. Once the measurements have been completed, the arms could be unlocked so that they can move again.
  • the present instrument may not incorporate any arm locking mechanism.
  • the measuring device would be incorporated, for example, at the end of one of the arms.
  • the locking mechanism can be any suitable mechanical mechanism arranged between the arms to block their mutual movement in various different angular positions. These various angular positions of the arms correspond to different distances between the edges of the tissue where an incision has been made.
  • the arm locking mechanism may comprise an operable support having a first part, for example in the form of a lever, associated with an arm of the pair of arms, and a second part or coupling part coupled to the other arm of the pair of arms.
  • the coupling part of the locking mechanism is adapted to be able to be released from the other arm by operating the lever-actuated support, which causes the mutual release of the arms so that they can move again with respect to each other.
  • the coupling part of the operable support can have a toothed area adapted to engage in a corresponding toothed zone formed on a shoulder of the other arm.
  • the teeth in both toothed areas act as a self-adjusting gear that ensures the blocking of the arms of the instrument in a certain position, ensuring the balance of forces and moments involved during the measurement at different distances of separation of the edges of the tissue in the incision, despite the force that is applied at the ends of the instrument arms due to the tendency of the incision tissue edges to open or separate from each other.
  • One of the magnitudes that the measuring device can measure can be a force at the edges of the tissue in the incision or in the vicinity thereof.
  • This force refers to the closing force of a suture, which is equal to the sum of the force necessary to approximate the edges and the compression force between the edges of the tissue. Therefore, the present instrument measures both defined traction force and transverse force necessary to keep the edges of a fabric at a distance, or joined together. human or animal in which an incision has been made, as a compression force defined as a transverse force applied at the edges of the tissue in the incision area.
  • the measuring device may incorporate one or more suitable force sensors to measure said transverse forces at the edges of the tissue where the incision was made.
  • the force sensor or sensors
  • Another of the magnitudes that the measuring device can measure can be a separation distance between the arms of the pair of arms.
  • the measuring device can incorporate one or more angular position sensors arranged (s) in the joint between two arms.
  • the measuring device may be able to measure both forces and distances in a surgical incision in a human or animal tissue. This measurement of forces and distances in a surgical incision can be performed simultaneously if necessary. It is not ruled out, however, the measurement of parameters other than or derived from them, through this instrument.
  • the measuring device may be able to emit a signal that is conveniently processed by an electronic device, such as a remote device.
  • This signal together with other parameters, such as the geometry of the instrument and the type of tissue (it should be taken into account, for example, that the edges of a superficial surgical wound are formed by skin with certain biomechanical characteristics, while the edges of a deep surgical wound that includes muscle and aponeurosis have other biomechanical characteristics associated with the contractile property of the tissue) is part of information that is provided to the operator or surgeon and that characterizes the suture to be used to close the incision, for example in terms type of suture, suture technique to practice, etc.
  • the present instrument may further comprise devices for recording the multiple dynamic measurements of magnitude, whether forces, distances, etc., made by the measuring device. These recording devices can be incorporated, for example, in the electronic equipment mentioned above.
  • the present measuring instrument could be configured by coupling two or more pairs of arms articulated with each other. In this configuration, a pair of arms would be arranged in parallel with a pair of adjacent arms. In said configuration, the resulting instrument would incorporate corresponding measuring devices associated with the pairs of arms adapted to perform multiple dynamic measurements of forces, distances, etc., along at least a part of the incision in a human or animal tissue .
  • the instruments could be coupled to each other by coinciding with their axis of articulation but with free turning movement with respect to each other.
  • a technician such as a surgeon performs the following procedure.
  • the surgeon places the instrument described above by anchoring each arm of the instrument at its free end respectively at opposite edges of the tissue near an area where an incision has been made through corresponding anchoring elements.
  • the surgeon may have previously defined in the tissue a series of anchoring holes to insert the anchoring elements of the arms of the instrument in order to properly anchor it in the tissue.
  • the surgeon blocks the arms from each other by means of the locking mechanism described above and, while the arms are locked, multiple dynamic measurements of at least one magnitude, such as tensile and compressive forces, are made using the instrument. , distance of separation of the arms, etc. over time associated with said tissue in the incision.
  • the technician can previously measure the closing force of an incision before suturing it from the tensile and compression forces that the measuring device reads associated with the separation of the arms, which corresponds to the distance between the edges of a living or dead soft biological tissue in different anatomical planes where an incision has been made.
  • the technician can characterize the type of suture to be used to close the incision, such as its caliber, material, technique to use, as well as if you have to use a prosthetic reinforcement (mesh) or not.
  • Figure 1 is an elevation view schematically showing an example of the present instrument for measuring forces and distances in an incision in a tissue
  • Figure 2 is a partial elevational view according to Figure 1 showing in detail an embodiment of the anchoring elements.
  • the measuring instrument of the non-limiting example shown in the figure has been jointly designated by reference 100.
  • the instrument 100 is intended to accurately perform dynamic measurements of forces F and distances D in an incision I in a human T tissue or animal so that a surgeon can determine the type of suture that has to be applied to close the incision I in the T tissue.
  • the instrument 100 shown in Figure 1 comprises a first arm 200 and a second arm 300. Both arms 200, 300 of the instrument 100 are articulated to each other at a mutual articulation point 320. Said arms 200, 300 thus form a structure compass type, as can be seen in the figure.
  • FIG. 400 shows in detail the example of the anchoring elements formed by spikes. 400.
  • the barbs 400 are adapted to be anchored in anchor holes 700 that have previously been formed at opposite edges T1, T2 of the tissue T, close to an area where the incision I has been made, as shown in Figure 1
  • the barbs 400 have their rounded ends, as shown in Figure 2.
  • the barbs 400 of the end 205, 305 thus allow the arms 200 to be anchored.
  • the instrument 100 illustrated by way of example in Figure 1 also includes a measuring device 500.
  • the measuring device 500 is intended to perform dynamic measurements of forces F and distances D over time associated with tissue T.
  • the measuring device 500 thus allows to measure parameters associated with tissue T in said incision I (forces F and distances D) that vary over the time during which the measurement is being carried out through instrument 100.
  • the measuring device 500 of the instrument 100 comprises an angular position sensor 560 disposed next to the joint 320 between the arms 200, 300 and a force sensor 570 disposed in a first part 625 of an operable support 620 associated with the first arm 200, which will be described later.
  • the angular position sensor 560 is adapted to measure a separation distance D between the first arm 200 and the second arm 300.
  • the separation distance D between the first arm 200 and the second arm 300 is proportional to the distance of separation of the edges T1, T2 of the tissue T in the incision I.
  • the force sensor 570 is adapted to measure transverse forces F at, or in the vicinity of, the edges T1, T2 of the tissue T in which an incision has been made I. Such transverse forces F tend to maintain the edges T1, T2 of said tissue T at a certain distance or joined together. These forces F can be both compression and tensile.
  • the transverse forces F are measured indirectly, that is, the force sensor 570 normally receives a force value at each end 205, 305 of the arms 200, 300 that is proportional to the actual value of the sum of forces in the area of the edges T1, T2 of tissue T.
  • the reading of said force values F can then be corrected appropriately by an appropriate proportionality factor, for example, through a remote electronic equipment (not shown in the figure).
  • the measurement of transverse forces F could also be carried out directly.
  • Both the angular position sensor 560 and the force sensor 570 of the measuring device 500 can work simultaneously if necessary. Both sensors 560, 570 allow to emit a signal, while performing dynamic parameter measurements on the T-tissue, which is conveniently processed by said remote electronic equipment. This signal is processed as information that, together with other parameters such as the geometry of the instrument 100 and the type of tissue T, is provided to the technician. This information adequately characterizes the suture, such as the type of suture, the suture technique to be practiced, etc. for closing the incision I.
  • the instrument 100 incorporates a locking mechanism 600.
  • the locking mechanism 600 consists of a toothed brace 350 which is fixed to the second arm 300 of the instrument 100 through anchor points 355.
  • the teeth of the brace 350 engage with teeth formed in a coupling part 630 of the operable support 620 mentioned above.
  • the coupling part 630 of the operable support 620 is described below.
  • the operable support 620 has a first part 625 rotatably coupled to the first arm 200.
  • the first part 625 is configured as a lever adapted to be operated by the operator or surgeon exerting a force in the direction represented by the arrow A in the figure.
  • the operable support 620 also has a second part or coupling part 630, which has been mentioned above, coupled to the first part 625 through a corresponding anchor point 635.
  • This coupling part 630 of the operable support 620 is provided with teeth adapted to engage the teeth of said brace 350 of the second arm 300.
  • the spring 640 cited above is arranged with one end fixed to the first part 625 of the operable support 620 and with the opposite end fixed to the first arm 200.
  • the spring 640 acts to maintain the coupling between the teeth of the rod 350 of the second arm 300 and the teeth of the coupling part 630 of the operable support 620, preventing the arms 200, 300 from moving together while the dynamic measurements are made.
  • an interchangeable removable support 450 is arranged on each free end 205, 305 of the arms 200, 300 on each free end 205, 305 of the arms 200, 300.
  • This removable support 450 incorporates anchoring elements which, in the example shown , they comprise two spikes 400 that are separated from each other a distance d in accordance with the passage of the suture to be applied to the tissue T in the incision I, which corresponds to the distance between two adjacent anchor holes 700 of the edges T1, T2 of tissue T.
  • This distance d between the pins 400 can always be the same or vary between arms 200, 300 according to the needs.
  • the tines 400 are mounted on each support 450 so that they can move with respect to it with the possibility of rotation in a range of movement of up to 360 °.
  • the surgeon can adapt the number and type of spikes 400 to the characteristics of the T tissue where the incision I is formed.
  • the surgeon initially marks on the T tissue the length that will define the surgical incision I to practice.
  • a series of points are marked at a constant transverse distance d of said line and longitudinally equidistant from each other.
  • the incision I is made in the T tissue, after which the surgical intervention for which said incision has been necessary can be carried out.
  • the previously marked points define corresponding determined positions that can be used to make anchor holes 700 to insert the pins 400 of the measuring instrument 100. It is preferable that the longitudinal distance d between said marked points corresponds substantially at the distance between each pair of barbs 400 of the instrument 100.
  • the surgeon blocks the arms 200, 300 from each other through the locking mechanism 600 described above, so that the arms 200, 300 are kept apart from each other, without the possibility of movement, a transverse distance D according to the position of the edges T1, T2 of the tissue T in the incision I.
  • the arms 200, 300 locked together, and through the sensors 560, 570 of the measuring device 500, multiple dynamic measurements of the forces F and of the transverse distances D of the incision I which vary over the time during which the arms 200, 300 of the instrument 100 are locked together.
  • the surgeon obtains information, as described above, about the type of suture to be used to close said incision I in terms of caliber, type of material , technique to use, use of prosthetic reinforcements (meshes), etc.
  • the surgeon removes the instrument 100 by unpinning the pins 400 of the edges T1, T2 of the T tissue and proceeding to close the incision I by means of the suture that has been determined based on the information obtained by the instrument 100.
  • the operator or surgeon can use the anchoring holes 700 that have been previously made at the edges T1, T2 of the T tissue.
  • the present instrument has been described formed by at least one pair of arms articulated with each other, defining a compass type structure
  • the arms of the instrument alternatively, could be joined together in another mobile way. appropriate.
  • the arms could be linked together so that they can slide together.
  • the present instrument adapted to perform dynamic measurements of at least one magnitude over time has been described, for example determining multiple values of forces, distances, etc. of specific parameters (for example, in real time) that vary with time
  • the present instrument could also perform dynamic measurements, that is, it could determine particular values of specific parameters at a given time, without measuring or recording those parameters during a specific time interval

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • Dentistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Dermatology (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un instrument (100) comprenant une paire de bras (200, 300) articulés entre eux, au moins un élément d'ancrage (400) associé à l'extrémité (205, 305) de chaque bras (200, 300) pour s'ancrer sur des bords opposés (T1, T2) du tissu (T) proches d'une zone au niveau de laquelle est pratiquée l'incision (I), un dispositif de mesure (500) associé à la paire de bras (200, 300) et conçu pour effectuer des mesures dynamiques d'au moins une grandeur, telle que des forces ou distances (F, D) dans le temps, associée audit tissu (T) dans l'incision (I) ; et un mécanisme de blocage (600) destiné à maintenir les bras (200, 300) bloqués de manière à éviter qu'ils ne se déplacent pendant la mise en oeuvre des mesures dynamiques.
PCT/ES2017/070096 2016-02-23 2017-02-22 Instrument de mesure de paramètres associés à une incision dans un tissu et procédé pour mesurer des paramètres dans une incision dans un tissu au moyen dudit instrument WO2017144756A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ESP201630202 2016-02-23
ES201630202A ES2630977B1 (es) 2016-02-23 2016-02-23 Instrumento para medir parámetros asociados a una incisión en un tejido y procedimiento para medir parámetros en una incisión en un tejido mediante dicho instrumento

Publications (1)

Publication Number Publication Date
WO2017144756A1 true WO2017144756A1 (fr) 2017-08-31

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PCT/ES2017/070096 WO2017144756A1 (fr) 2016-02-23 2017-02-22 Instrument de mesure de paramètres associés à une incision dans un tissu et procédé pour mesurer des paramètres dans une incision dans un tissu au moyen dudit instrument

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ES (1) ES2630977B1 (fr)
WO (1) WO2017144756A1 (fr)

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US5997545A (en) * 1998-11-06 1999-12-07 Johnson & Johnson Professional, Inc. Knee incision tensile gauge
EP0998877A1 (fr) 1998-11-06 2000-05-10 JOHNSON & JOHNSON PROFESSIONAL Inc. Jauge de mesure de la tension tissulaire utilisée dans la chirurgie du genou
WO2001028436A1 (fr) * 1999-10-20 2001-04-26 Sdgi Holdings, Inc. Instruments et procedes de stabilisaton de structures osseuses
US20050234304A1 (en) * 2002-06-26 2005-10-20 Sdgi Holdings, Inc. Instruments and methods for minimally invasive tissue retraction and surgery
WO2006119776A1 (fr) * 2005-05-12 2006-11-16 Om Surgical (Uk) Limited Systeme, procede et outil pour assurer l'insertion correcte d'une articulation de hanche artificielle
US20140276232A1 (en) 2013-03-15 2014-09-18 Gregory L. Ruff Skin tensiometer

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2023084002A1 (fr) * 2021-11-11 2023-05-19 Freie Universität Berlin Instrument pour mesurer la tension d'une plaie

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ES2630977A1 (es) 2017-08-25

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