CZ37938U1 - Surgical fixation clamp - Google Patents

Description

Surgical fixation clamp

Field of technology

The technical solution concerns a surgical fixation clamp for use especially in microsurgery and ophthalmic surgery, for example to prevent the longitudinal displacement of fibers, tissue and other materials.

Current state of the art

In surgery, especially in microsurgery, it is often necessary to fix fibers and tissues in order to prevent their unwanted longitudinal displacement, to improve transparency and the possibility of adjustment. The same or similar devices are often used to temporarily close vessels or other hollow organs.

To hold the tissue and fibers, tweezers are used, which require constant holding and attention, or clamps with two branches connected at a pivot point equipped with a lock (Pean, Kocher, etc.) that are held separately.

Known locking clamps for permanent clamping usually include two lugs and corresponding handles, connected at a pivot point, and locking teeth allowing the handles to be releasably secured together to hold the lug as described in US 2,796,065 A. Some lugs for holding the lug include a spring that deflects the handles towards each other.

For example, US 7 144 402 B2 describes a vascular clamp for temporary occlusion of a vessel, typically a microvascular clamp for temporary occlusion of small vessels, which consists of two parts, a sliding pivot point and two handles, between which a spring is placed so that the closing force is evenly distributed along the entire length of the cell.

US 8 246 094 B2 describes a clamping forceps comprising two flexible arms, two handles and an adjustment block. Both flexible arms are mutually connected at one end, so that it forms a connected end, and they start to open from the connected end.

Another option for clamping the fibers is bulldog clamps, the clamps of which are opened by pressing the operator's hand, and when the pressure is released, their spring mechanism returns the clamps to the clamped position, so that the clamp itself still holds the stitches, tissues or blood vessels.

These solutions are unsuitable for microsurgery, for example for setting the necessary length of fibers in flange techniques in eye surgery, especially in that:

- the miniaturization of the body does not allow sufficient miniaturization of the control member, which may interfere;

- they are composed of several parts, the connection of which, for example, rotating around a pin, or the connection of flexible and inelastic parts, will bring problems during their miniaturization, especially when a large clamping force is required;

- further miniaturization required would bring problems with controllability;

- if the tools were to be sufficiently miniaturized, there would be a risk of their loss during handling, because they are not strung on a fiber or do not have closed parts that could be used for their fastening or suspension to prevent loss;

- the greater height of the unit worsens the possibility of adjusting the length of the fiber in flange techniques.

- 1 CZ 37938 U1

In ophthalmic surgery, for example, no clamps are used when fixing the fibers in the Canabrava "flange" technique, and the fibers are only held with tweezers. This makes it difficult to adjust the fiber length. For the reasons mentioned above, surgical microclamps of the bulldog type, available on the market, are not suitable for securing the fibers.

There is therefore a need to provide clamps that maintain a firm grip even after the release of the control force, provide the possibility of one-handed manipulation, are manufacturable in a miniature design with low weight, preferably as single-cut, with low production costs, preferably from one piece of material, and have a limited possibility lost/embedded in the patient's tissue during the procedure.

The essence of the technical solution

The subject of the technical solution is a clamp for use in surgery, especially in microsurgery, for example to prevent the longitudinal displacement of fibers, tissue and other materials.

The essence and unit of thought of the technical solution of the clamp is a flexibly deformable control member in the shape of a generally planar closed curve, whose deformation is controlled by the action of a suitable tool by clamping the entire clamp. The control member lies in a plane, which is referred to here as the "plane of the control member". Deformation of the control member controlling the clamping of the entire clamp takes place in the plane of the control member, for example by grasping the control member of the clamp in opposite parts of the circumference of the control member with tweezers or a pen and pressing the control member.

The elastically deformable control member fulfills several functions: it serves to hold the clamp, provides the necessary flexibility for clamping the unit, a holding member (holding members) is attached to it, and its closed shape enables securing the clamp against loss, e.g. by threading it onto a fixing or auxiliary fiber.

The first and second basic execution of the technical solution according to claim 1 and, respectively 1b, is distinguished by the way the whole clamps are made:

- in the first basic embodiment, one holding member is connected to the control member, lying in the plane of the control member, outside the control member, where in the stationary state of the clamp, part of the outer circumference of the holding member is closely adjacent to part of the outer circumference of the control member, whereby these adjacent parts form a whole clamp , a

- in the second basic embodiment, two side-by-side holding members are connected to the control member, lying in the plane of the control member inside the control member, where in the rest state of the clamp, part of the outer circumference of the first holding member closely adjoins the part of the outer circumference of the second holding member, connecting them to each other adjacent parts form a whole clamp.

In both versions, the control member and the holding members lie in the same plane.

The term "closely fitting" is understood to mean that for two members located next to each other forming a whole clamp, the distance between their neighboring parts in the rest state of the clamp, at least in part of the length of the whole, is smaller than the thickness of the fiber or tissue for which the clamp is intended, so in the rest state, i.e. .without the action of an external force in the appropriate direction, the cells can tightly grip the fiber or tissue due to the flexibility of the control member.

In a view perpendicular to the plane of the control member (hereinafter "view from above"), the outer circumference of the control member has the shape of, for example, an oval, ellipse, ring, octagon or polygon. The shape of the outer circuit of the control element is understood here as the initial shape in the stationary state of the clamp, without the action of an external force, when the entire clamp is clamped. Deformation of the elastically deformable control member to open the whole of the clamp causes a change in its shape, for example a narrowing of the control member in the direction of the force. It is obvious that at least part of the inner surface of the control member must be empty so that

- 2 CZ 37938 U1 possible deformation of the control member was mentioned above.

When viewed from above, the control member can smoothly follow the basic geometric shape of a curve, for example an oval, ellipse, figure of eight or ring, but said geometric shape can be further deformed as needed, for example it can also contain straight, bent, bent or otherwise shaped pieces.

For example, to make it easier to grip the control member with a tool, e.g. tweezers, and to reduce the possibility of the tool slipping, suitable, preferably opposite sections of the outer circumference of the control member can have a deformed shape compared to the geometric shape, so that, for example, the opposite sections of the control member have an independent shape when viewed from above straight line, designated here as a straight section of the control member, or the shape of the bend of the control member directed inward, designated here as a bent section of the control member. Versions where the opposite sections have a mutually different shape are also considered, e.g. one has the shape of a straight line and the other is bent inside the control member.

In the first basic implementation of the technical solution, the above-described deformation of the outer circumference of the control member is advantageously found in at least one of the opposite sections of the control member, through which the axis of the unit does not pass. In both versions, however, versions are also considered when the elements do not form a straight line.

In the second basic embodiment of the technical solution, the above-described deformation of the outer circumference of the control member is advantageously found in at least one of the opposite sections of the control member through which the axis of the unit passes.

The section of the control member, through which the axis of the unit passes, in this embodiment is understood as a section of suitable length for pressing the clamps with a tool, for example 0.3 - to 0.1 times the longest outer dimension of the control member, so that the axis of the unit does not have to pass through the center of the section, and the length and shape of the opposite The segments can be the same or different.

Bending of the outer circumference of the control member naturally occurs, for example, in a control member with an outer shape of a rectangle, when two straight parts of the control member are adjacent to each other in the place of the bend.

However, it can also be used in the first basic design, for example, with a control member with a basic figure-eight or figure-of-eight shape (which is understood here as an eight-shaped shape that is open on the inside and not connected on the inside in the narrowed part), whose upper side is shaped into a straight line in contrast to the original geometric figure-of-eight shape, left and right connected to the remaining part of the control part by two bends of the outer circuit of the control member. In this way, it is possible to obtain the direct shape of the entire clamp formed by the part of the outer circuit of the control member in the first basic implementation of the technical solution.

If, in the second basic embodiment, the control member is pressed, always by a force acting in the plane in which the control member lies, in the direction of the longitudinal axis of the unit, or expanded in the direction perpendicular to the longitudinal axis of the unit, the control members will be deflected in the plane in which the controls lie member, from each other, thereby opening the unit, and conversely, releasing the pressure will cause the unit to tighten as a result of the flexibility of the control member.

The supporting members lying in the plane in which the control member lies, in the second basic embodiment, preferably have the shape of essentially flat triangles, but they can also have another suitable shape, for example trapezoids, and they can be solid, or they can preferably contain one or more in their surface holes or recesses of any shape. A member that basically has the shape of a triangle, most preferably a triangle provided with a recess for the formation of a flat tip of the siphon or a flat siphon, which with its tip points inward, preferably in the center of the control member, and is connected to the control member by both vertices of its base, is suitable.

In an advantageous embodiment, at least one free edge of the unit, i.e. the place of the unit through which the held material is inserted, is beveled or rounded when viewed from above to facilitate insertion into the slot

- 3 CZ 37938 U1 integral clamps of the material to be held by the integrals.

The essence of the technical solution is that the control member of the clamp serves as a spring inducing pressure on the whole of the clamp towards itself to hold the clamped material, and on the contrary, the whole is opened by the action of a suitable external force on the control member. By suitable shaping and choice of material of the control member, the clamping force of the unit can be set, or the force required to open them.

Shaping of the control member means its overall geometric shape when viewed from above, as well as the course of its transverse profile along the perimeter. When viewed from above, in the simplest case, the width of the control member can be the same all around. In another embodiment, the control member may have an increased width, for example, in at least one section intended for gripping the control member with a tool, thereby increasing the rigidity of this section of the control member. The most suitable is a continuous change in the width of the control member along its circumference.

In the side view, in the simplest case, the height of the control member and/or the member can be the same, which can be advantageous if the clamp is made from a sheet of flat material. However, it is also possible to reduce the height of certain sections of the control member or members, for example, one or both blades of the unit to increase the strength of the fiber holding, or some sections of the control member to apply more flexible deformation, preferably in the required sections of the control member.

A good material for the control member is an elastically deformable heat-resistant material, preferably steam-sterilizable, e.g. metal, such as stainless steel, preferably nitinol, in which its superelasticity is used. For example, the longest dimension of the control member of a clamp suitable for holding the fiber in eye surgery can be 2 to 4 mm. For other uses, for example in vascular surgery, clamps with correspondingly increased dimensions are also considered.

Depending on the intended use and the required size and grip strength, it is also possible to use plastic in some cases. However, it is also considered to implement when different parts of the clamps are made of different materials, for example, the edges of the members can be made of flexible plastic, etc.

Clamps according to the technical solution can be made, for example, by laser or other cutting from a sheet of suitable metal or non-metal material.

In the case of plastic, it could be considered, for example, pressing or extruding a tubular profile and cutting it into pieces of suitable length according to the required clamping force of the unit.

Clarification of the drawing

Giant. 1 shows a clamp according to the first basic embodiment with a holding member located outside the control member, viewed from above. Giant. 1a shows the clamp in a rest state with the clamps clamped. Giant. 1b shows the design of the clamp, where part of the outer circumference of the control member is formed in the shape of a straight section in one of the opposite sections and in the shape of a curved section in the other. Giant. 1c shows the clamp with the parts partially open in the direction indicated by the empty arrows, as a result of the force exerted on the control member of the clamp by the tool (parts of the tool in contact with the clamp are shown in gray in the figures) in the direction indicated by the seven arrows, with an inserted fiber, its cross-section is represented by an empty circle.

Giant. 2 shows a clamp according to the first basic embodiment with a holding member lying outside the control member, viewed from above, in a preferred embodiment with straight members. Giant. 2a shows the clamp in a rest state with the clamps clamped. Giant. 2b shows a clamp with partially open cells due to the force exerted on the control member of the clamp by the tool in the direction indicated, with the fiber inserted between the cells.

Giant. 3 shows a clamp according to the second basic embodiment with two placed next to each other

- 4 CZ 37938 U1 cantilever members, viewed from above. Giant. 3 and shows the clamp in a rest state with clamped cells. Giant. 3b and 3c show a clamp with partially open cells as a result of the force exerted on the control member of the clamp by the tool in the indicated direction, with the fiber inserted between the cells.

Giant. 4 is a perspective view of the terminal in a resting state.

Giant. 5 is a side view of the terminal in the rest state.

Examples of implementation of a technical solution

Example 1

In the embodiment shown in Fig. 1, the fixation clamp according to the first basic embodiment is shown in a top view, where the oval-shaped control member 1 is connected to the holding member 7 lying in the plane of the control member 1 outside the control member 1, through which in the shown rest state the clamp part the outer circumference of the holding member 7 facing the control member 1 forms a clamp unit 7a, which closely adjoins the part of the outer circumference of the control member 1 facing the holding member 7 and forming a clamp unit 1a. The free edge of the unit 7a, i.e. its upper edge, is rounded when viewed from above to make it easier to put on the fiber. The control member 1 of the clamp serves as a spring causing pressure on the unit 7a, 1a of the clamp towards each other to hold the clamped material, and also serves to control the opening of the unit if necessary as follows: by the pressure of a suitable tool (pean, tweezers) on the upper and lower sides of the control member 1 from the outside, as shown in Fig. 1c, in this embodiment by pressing the control member 1 in the places of the opposite curved sections 5 (Fig. 1a) or straight section 4 and curved section 5 (Fig. 1b), with integral parts 7a, 1a clamps apart, and between the cells 7a, 1a, a gap will be formed, which can be placed on the fiber. By releasing the pressure, the unit 7a, 1a will be clamped and the fiber will be fixed. The clamp is made of a flat sheet of nitinol material by laser cutting, so it has the same height in all its parts. The holding member 7 is made with an empty inside, the control member 1 also has an empty inside to enable control. The empty parts (holes or recesses in the material of the clamp) are useful for possibly securing the clamp with an auxiliary fiber against loss.

Example 2

In the embodiment shown in Fig. 2, a suitable fixing clamp according to the first basic embodiment is shown in a top view, which differs from the embodiment shown in example 1 in that the control part 1 is shaped like a vertically curved figure eight, open on the inside, although the left side is in contrast to the original geometric figure eight deformed into a straight line and connected at the top and bottom to the remaining part of the control part 1 by two turns of the outer circuit of the control member. This results in the straight shape of the clamp unit 1a, which in the stationary state of the clamp shown in Fig. 2a closely adjoins the unit 7a on the retaining member u 7. Fig. 2b shows the condition of the clamp with the unit 1a separated from the unit 7a in the direction of the empty arrow, as a result of the force exerted on the control member 1a of the clamp by the tool in the direction indicated by the seven arrows. The lower part of the clamp connecting the control part 1 with the retaining member 7 is reinforced to increase the stiffness of the control part 1 and the said connection.

Example 3

In the version shown in Fig. 3, a top view shows a fixing clamp with an oval-shaped control member 1 according to the second basic version, where two side-by-side members 2, 3 in the shape of flat arrows extend from the control member 1 to its center, which with their rounded the tips are directed to the center of the control member 1, and the outer vertices 6, 6 of their base are connected to the control member 1, whereby in the rest state of the clamp (Fig. 3a) the members 2, 3 are closely adjacent to each other with their adjacent sides and form a unit 2a, 3a terminals. The control member 1 of the clamp serves as a spring inducing pressure on the unit 2a, 3a of the clamp towards each other to hold the clamped material, and also serves to control the opening of the unit if necessary as follows: by the pressure of a suitable tool (pean, tweezers) on the upper and lower sides of the control member 1 from outside, in this

- 5 CZ 37938 U1 made by pressing the control member 1 in the places of the bent opposite sections 5 (fig. 3b), or by pressing the right and left sides of the control member 1 from the inside (fig. 3c), the elements 2a, 3a of the clamp are removed, and between the elements 2a, 3a creates an open slit from above, which can be placed on the fiber pulled through the control member 1. By releasing the pressure (or tension), the unit 2a, 3a is clamped and the fiber is fixed. Fitting the clamp to the fiber is facilitated by the rounding of the upper edge of the unit 2a, 3a, which is closer to the center of the control member 1.

In the indicated embodiment, when viewed from above, the width of the control member 1 in the upper bent section 5 is increased to increase the stiffness of this section, and thus to achieve a wider opening of the unit 2a, 3a. The clamp is made of a flat sheet of nitinol material by laser cutting, so it has the same height in all its parts.

Example 4

In a specific operation using the double or four flange technique with the anchoring of the flanges of the fiber to the sclera of the eye, the polypropylene fiber is threaded through a tunnel in the sclera (belime). A clamp is put on the outer (externalized) part of the train according to the technical solution, whereby the closed shape of the clamp pulled over the fiber prevents the loss of the clamp when it slips.

By pressing the tweezers or other similar tool from the outside on the opposite longer sides of the control member 1, as shown in Fig. 3b, or from the inside of the control member 1, as shown in Fig. 3c, the clamping units 2a, 3a are separated. Alternatively, the whole clamp can be removed by pressing, e.g., tweezers from the inside on the opposite shorter sides of the control member 1.

The fiber is moved longitudinally through the clamp, held with distant cells in the vicinity of the tunnel in the sclera, until it is reached by pulling the fiber of the found centering of the intraocular cock. By releasing the pressure of the tweezers on the control member 1 of the clamp, the whole of the clamp 1 is then brought closer, so that the fiber is fixed between the wholes of the clamp 2a, 3a, which prevents its displacement into the eye through the tunnel in the sclera.

Then the fiber is shortened at a suitable distance (according to the required size of the flange), e.g. 1 mm from the whole 2a, 3a of the clamp, and the flanges are formed by fusing.

Industrial usability

The clamp according to the technical solution is suitable for use in surgery, especially in microsurgery, for example to prevent the longitudinal displacement of fibers, tissue and other materials. The clamp is, for example, useful for fixing and adjusting the length of surgical mesh fibers in the flange technique for scleral fixation of the eye socket or artificial eye socket.

Claims (8)

1. Surgical fixation clamp, characterized by the fact that it contains a control member (1) in the shape of a generally planar closed curve and at least one support member (7, 2, 3) lying in the plane of the control member (1) and connected to the control member ( 1), where the control member (1) is elastically deformable in the plane of the control member to control the clamp unit (7a, 1a, 2a, 3a), and through a) one holding member (7) is connected to the control member (1) lying outside the control member (1), where in the rest state of the clamp part of the outer circumference of the holding member (7) closely adjoins the part of the outer circumference of the control member (1), whereby these adjacent parts form a whole (7a, 1a) clamp, or b) the control member (1) is connected to two side-by-side holding members (2, 3) lying inside the control member (1), where, in the rest state of the clamp, part of the outer circumference of the first holding member (2) closely adjoins the part of the outer circumference of the second of the holding member (3), whereby these adjoining parts form a whole (2a, 3a) clamp. 2. Surgical fixation clamp according to claim 1, characterized in that the outer circumference of the control member (1) is in the shape of an oval, ellipse, ring, octagon or polygon. 3. A surgical fixation clamp according to any one of claims 1 or 2, characterized in that part of the outer circumference of the control member (1) is formed in at least one of the opposite sections in the form of a straight section (4) or a bent section (5), where it goes inside the control member (1). 4. Surgical fixation clamp according to any one of claims 1, in embodiment b), 2 and 3, characterized in that part of the outer circumference of the control member (1) is at least one of the opposite sections of the control member (1) through which the axis of the member passes (2a, 3a) clamps, made in the form of a straight section (4) or a bent section (5), where the bend is directed inward of the control member (1). 5. A surgical fixation clamp according to any of the preceding claims, characterized in that the outer circumference of the control member (1) contains at least one bend. 6. A surgical fixation clamp according to any one of claims 1, in embodiments b), 2 to 5, characterized by the fact that at least one holding member (2, 3) has the shape of an arrow when viewed from above, which points its tip inside the control member (1 ), and it is connected to the control member (1) by both vertices (6, 6') of its base. 7. A surgical fixation clamp according to any of the preceding claims, characterized in that the free edge of at least one of the parts (7a, 2a, 3a) is beveled or rounded when viewed from above. 8. Surgical fixation clamp according to any of the preceding claims, characterized in that the width of the control member (1) is increased in at least one of its parts to increase the rigidity of this part of the control member (1).