WO2021096471A1

WO2021096471A1 - A surgical instrument for skeletonization of the internal mamarian artery during by-pass surgery

Info

Publication number: WO2021096471A1
Application number: PCT/TR2020/051087
Authority: WO
Inventors: Ilker KAYA
Original assignee: Kaya Ilker
Priority date: 2019-11-13
Filing date: 2020-11-12
Publication date: 2021-05-20
Also published as: TR201917605A2

Abstract

Invention relates to a surgical instrument (1) used in the bypass operation to remove the artery that extends from top to bottom at a distance of proximately 6-7 cm inside the chest, after the rib cage is divided in half during open-heart surgeries. More specifically, the present invention relates to a surgical instrument (1) that allows the surgeon to access the naked artery during operation by removing the internal mammary artery (IMA) from other tissues and veins.

Description

A SURGICAL INSTRUMENT FOR SKELETONIZATION OF THE INTERNAL MAMARIAN

ARTERY DURING BY-PASS SURGERY

Technical Field

Invention relates to a surgical instrument used in the bypass operation to remove the artery that extends from top to bottom at a distance of proximately 6-7 cm inside the chest, after the rib cage is divided in half during open-heart surgeries.

More specifically, the present invention relates to a surgical instrument that allows the surgeon to access the naked artery during operation by removing the internal mammary artery (IMA) from other tissues and veins.

Prior Art

Cardiovascular diseases have increased considerably as people have to eat more and more unhealthy food and started to live sedentary lifestyle like never before. As a result, there have been great increases in heart surgeries.

During open heart surgeries, the surgeons must reach to the IMA and operate on it. However, it is difficult to reach mentioned artery due to its location and anatomical structure. In order to reach said artery in operations, first of all, after cutting of the bone called the sternum that connects the patient’s two rib cage in the middle, both halves are positioned under the sternum bone in accordance with anatomy. After passing the skin and subcutaneous tissue, said artery is in the position closed with a tissue. In the traditional method, the IMA is removed together with the tissue and vein adjacent to the IMA in order to access the IMA. However, in this case, the circulation in the vein does not continue since the vein is also outside and, there is an increased risk of infection due to that majority of the tissues are outside and, there is a decrease in the blood supply of the area. Moreover, since the IMA removed with tissues will integrate with the tissues after surgery there is a risk of that the artery will be unnoticedly damaged in another heart surgery that the patient needs to have in the future. For this reason, there has been a need for a surgical instrument that removes the artery from the surrounding tissues without damaging the artery and at the same time increases motion capability of the surgeon.

The surgical scissors mentioned in the patent document no. US20050203556A1 is traditionally used instrument in today’s heart surgeries. However, due to the location and anatomical structure of the IMA, reaching the IMA with said surgical scissors is very difficult for surgeons and causes a great amount of time to be spent on this.

As a result, the require for a surgical instrument which cuts the sheath of the artery (at the top side) while leaning on the artery (at the bottom side) from its outside without damaging the artery, at the same time, which increases the motion capability of the surgeon with its ergonomic structure, has caused the present innovative solution to emerge out.

Objectives and Short Description of the Invention

Aim of the invention is to present a surgical instrument used in the bypass operation to skeletonize the artery that extends from top to bottom at a distance of proximately 6-7 cm inside the chest, after the rib cage is divided in half during open-heart surgeries.

Another aim of the invention is to present a surgical instrument that allows the surgeon to access the naked artery during operation by removing the internal mammary artery (IMA) from other tissues and veins.

Another aim of the invention is to present a surgical instrument which cuts the sheath of the artery (at the top side) while leaning on the artery (at the bottom side) from its outside without damaging the artery, at the same time, which increases the motion capability of the surgeon with its ergonomic structure.

Invention is a surgical instrument which, comprising a first piece having first holding hole, a second piece having second holding hole and a connection element providing rotational connection of mentioned two pieces to each other, used in the bypass operation to remove the artery that extends from top to bottom at a distance of proximately 6-7 cm inside the chest, after the rib cage is divided in half during open-heart surgeries, and

- said first piece comprises a first multi angular body and, a supporting part that leans on the IMA along its own lower surface,

- said second piece comprises a second multi angular body moving on mentioned first multi angular body and, a cutting part that performs the cutting operation by making a rotational sliding movement on the upper surface of mentioned supporting part.

In the preferred embodiment of the invention, the cutting part is smaller than the supporting part.

The first piece and the second piece comprise at least two corresponding corner zones where corresponding corner pairs provide the same angle with each other. In the preferred embodiment of the invention, the first piece and the second piece comprise four corresponding corner zones where corresponding corner pairs provide the same angle with each other.

Description of the Figures

In Figure 1 , the upper left perspective view of the present innovative surgical instrument is given.

In Figure 2, the left perspective view of mentioned innovative surgical instrument is given.

Reference Numbers

I . Surgical instrument

10. First piece

I I . First holding hole

12. First multi angular body

13. Supporting part

20. Second piece

21. Second holding hole

22. Second multi angular body

23. Cutting part 23.1. Cutting edge 25. Corner zone

30. Connection element

Detailed Description of the Invention

Present invention is a surgical instrument (1) which is used in the bypass operation to remove the artery that extends from top to bottom at a distance of proximately 6-7 cm inside the chest, after the rib cage is divided in half during open-heart surgeries, in order to provide this; which removes other tissues and veins on the artery without damaging the artery, and so allows the surgeon to access easily the naked artery during operation. After passing the fascia (subcutaneous), the artery which is operated on during open-heart surgeries, is in a closed position with a tissue. Due to its location, the angle is needed to reach the artery. It is not possible to give the necessary angle and reach the naked artery with the scissors used in today’s heart surgeries. For this reason, operation is done by taking out the IMA as whole together with surrounding tissue and vein. As a result of removing the IMA with the tissue and vein, the risk of infection increases and blood circulation in the vein is also disrupted. Thanks to the design of the present innovative surgical instrument (1), the IMA can be easily reached by providing the angle that the surgeon needs during the operation and said artery can be separated from the tissues on it. Thus, in order to that the surgeon reaches the IMA, it is not necessary to take out the IMA together with the surrounding tissue and vein. Thanks to the present invention, the IMA in the its own position within the body can be removed from the surrounding tissue and taken out alone and so, it becomes possible to operate on it outside. Thus, by reducing the amount taken out of the body during surgeries, the risk of infection is reduced and the blood flow in the vein is not disrupted.

An upper left perspective view of the present innovative surgical instrument (1) is given in Figure 1. As seen from the figure, the present innovative surgical instrument (1) is in the form of scissors and comprises generally

- a first piece (10) having first holding hole (11), first multi angular body (12) and supporting part (13),

- a second piece (20) which, having second holding hole (21), second multi angular body (22) and cutting part (23), moves on mentioned first piece (10) with a part of itself and

- a connection element (30) providing the connection of said two pieces.

The thumb is placed in the first holding hole (11) of said surgical instrument (1) while the middle finger is placed in the second holding hole (21) of it and, the surgical instrument (1) becomes functional by bringing the holding holes closer to each other and getting far them from each other. During the surgery, after positioning the bottom surface of mentioned supporting part (13) on the IMA, the cutting part (23) moves forth and back, and so it ensures the tissues staying on the upper part of the supporting part (13) to be removed from the IMA. Thus, as a result of that the surgeon leans supporting part (13) of the present innovative surgical instrument (1) on the IMA and operates by proceeding on the artery, the IMA is completely removed from the surrounding tissues and emerges as naked.

The supporting part (13) of the first piece (10) is larger than the cutting part (23) of the second piece (20) and is located below the cutting part (23) as requirement of the design. The relative movement between the supporting part (13) and the cutting part (23) is provided by the connection element (30) that provides the connection between the first piece (10) and the second piece (20).

The cutting part (23) is smaller than the supporting part (13). Thanks to the difference in their size, it is possible to continuously observe the artery and tissue that are operated on, during the usage of the surgical instrument (1). This allows the surgeon to perform more sensitive operation during surgery. This operation which resembles the stripping, is provided by that the cutting edge (23.1) of the cutting part (23) makes a rotational sliding movement on the upper surface of the supporting part (13). Thus, after the lower surface of the supporting part (13) is positioned on the IMA, the tissues remaining on the upper surface of the supporting part (13) are removed from the IMA by means of the cutting edge (23.1) of the cutting part (23).

The surgeon must be stand on the right side of the patient in order to reach the IMA on the left side and must be stand on the left side of the patient in order to reach the IMA on the right side. Surgical instrument (1) having the same angles can be used for the operations on both sides.

Moreover, the first piece (10) and second piece (20) comprises at least two corresponding corner zones (25) where corresponding corner pairs provide the same angle with each other. The preferred embodiment of the invention is given in figures, and here, the first piece (10) and the second piece (20) comprise four corresponding corner zones (12) where corresponding corner pairs provide the same angle with each other. Thus, a more ergonomic and practical surgical instrument (1) is obtained by providing the angle required for the surgeon to reach the IMA.

Claims

1. A surgical instrument (1) which, comprising a first piece (10) having first holding hole (11), a second piece (20) having second holding hole (21) and a connection element (30) providing rotational connection of mentioned two pieces to each other, used in the bypass operation to remove the artery that extends from top to bottom at a distance of proximately

6-7 cm inside the chest, after the rib cage is divided in half during open-heart surgeries, and characterized in that; said first piece (10) comprises a first multi angular body (12) and, a supporting part (13) that leans on the IMA along its own lower surface, said second piece (20) comprises a second multi angular body (22) moving on mentioned first multi angular body (12) and, a cutting part (23) that performs the cutting operation by making a rotational sliding movement on the upper surface of mentioned supporting part (13).

2. A surgical instrument (1) according to Claim 1 and, wherein the cutting part (23) is smaller than the supporting part (13).

3. A surgical instrument (1) according to one of the preceding claims and, wherein the first piece (10) and the second piece (20) comprise at least two corresponding corner zones (25) where corresponding corner pairs provide the same angle with each other.

4. A surgical instrument (1) according to Claim 3, and wherein the first piece (10) and the second piece (20) comprise four corresponding corner zones (25) where corresponding corner pairs provide the same angle with each other.