RU2638432C2 - Simulator for application of vascular and tendon sutures - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: simulator for application of vascular and tendon sutures contains a tablet and fixators with screw terminals mounted thereon. The tablet is equipped with a system for vascular suture application and system for tendon suture application, interconnected and mounted on supports with a cylindrical cup fixed thereon and having a longitudinal slit-like window. In the cavity of the cylindrical cup, a spring and a movable rod are placed, the free end of which is provided with an abutment adjacent to the pusher of the stretching mechanism. The simulator is equipped with three bars, two of which are fixed to the supports and each is represented by two pivotally connected levers. The free end of one bar is equipped with a fixator for the blood vessel, and the other - for the tendon. The second fixator for the tendon is installed on the loose end of the third movable bar with a longitudinal slit-like window with a guide pin, which is still attached to the rack installed on the tablet. The second end of the third bar is pivotally connected to the rod abutment.

EFFECT: increased efficiency at mastering of technics of vascular and tendon sutures application.

3 cl, 4 dwg

Description

The invention relates to medical equipment and can be used to train students, surgeons, angiosurgeons, traumatologists and orthopedists in the application of vascular and tendon sutures.

The technical solution of the known simulators for applying tendon or vascular sutures includes the presence of a platform to which the tendon clamps (blood vessel) are rigidly attached or their imitators equipped with a screw mechanism with a fixing nut [Treadmills for applying a tendon suture: 1-7; simulators for vascular suture: 8-20].

Each of the presented well-known simulators can functionally provide only one operation - the imposition of tendon or vascular sutures. Some of the simulators are equipped with devices for determining the strength of a tendon suture or the tightness and strength of a vascular suture.

Closer in technical solution to the proposed invention are simulators according to the copyright certificate of the USSR 1387032, G09B 23/28, publ. 04/07/1988 and copyright certificate of the USSR 1418804, G09B 23/28, publ. 08/23/1988. These simulators are assembled on a platform consisting of two halves with nodes fixed to them for fixing a simulated tendon or blood vessel.

The disadvantages of the analogues are: insufficient training when using simulators that have the properties to perform only one type of operation - the application of vascular or tendon sutures; lack of quality control of the applied tendon or vascular sutures; stitching on imitators of a tendon or blood vessel, which does not form the student’s sensation of the characteristics of biological tissue.

The technical task of the claimed invention is to eliminate the negative qualities of known simulators by creating a universal simulator for greater efficiency in its use in mastering the technique of vascular and tendon sutures.

The scheme of the proposed simulator for applying vascular and tendon sutures is presented in FIG. 1-4:

- in FIG. 1-2 shows a General view of the simulator, prepared for applying a tendon suture (top view);

- in FIG. 3-4 shows a General view of the simulator, prepared for the application of a vascular suture (front view).

The problem is solved in that the simulator for applying vascular and tendon sutures is assembled on the platform (1) and has two interconnected functional systems: one for applying a vascular suture, the other for applying a tendon suture.

The system for applying a vascular suture is mounted on two supports (2 and 3), on which a cylindrical-shaped glass (4) with a longitudinal slit-like opening (5) is fixedly mounted. A spring (6) and a movable shaft (7) are located in the cavity of the glass. Attached force recorder (8) is attached to the rod 7 (see section AA ¹ ), the pointer of which is aligned with the zero division of the scale (not shown in the diagram) applied to the glass body along the hole 5. The free end of the movable rod 7 is equipped with a stop (9) which is in contact with the pusher (10) of the tensile mechanism (11), represented by a screw (12), which is aligned with the internal thread of the hole of the housing (13) mounted on the platform 1. To the supports 2 and 3 from the open (14) and blind ( 15) the ends of the glass fixed rods (16 and 17), each of which has two levers (18 and 19) combined by a swivel (20) with a screw clamping device (21) (see footnote I). The levers 18 of the rods 16 and 17 are fixedly mounted on the supports 2 and 3. At the free end of the lever 19 of the rod 16 is a latch (22) of the tendon or its simulator (23) with a screw clamping device (24). The pressure plate (25) of the screw pressure device (24) on the side facing the lever 19 of the rod 16 has a semi-oval cutout (26) for the tendon 23. On the lever 19 of the rod 16 in contact with the pressure plate 25 there is a similar cutout (see footnote II). At the free end of the lever 19 of the rod 17 is a latch (27) of a blood vessel or its simulator (28) with a screw clamping device (29). The latch 27 on the mating surfaces of the clamping plate (30) and the lever 19 of the rod 17 has cutouts (31) in the form of a semicircle (see footnote I). This form provides fixation of the blood vessel 26 (or its simulator) with a pipe (32) inserted into it with a cannula (33) for connecting a syringe 2/3 filled with water.

The tendon suture system is assembled using the technical design of the vascular suture system. One end of the tendon 23 is fixed in the latch 22 of the fixed rod 16, and the other end in the latch (34) of the tendon 23 of the movable rod (35), one end of which is movably connected by an axis (36) to the stop 9 of the rod 7. The clamp 34 of the tendon 23 has a clamping bar (37) and screw clamping device (38). The rod 35 has a longitudinal slit-like window (39) with a guide pin (40) fixedly mounted on a stand (41) mounted on the tablet 1, which allows the rod 35 to be displaced with a tendon clamp 34 when the rod 7 is pressed into the cup 4 with a screw 12 of the stretching mechanism 11 to rupture of the tendon suture (42). The applied force is determined on a scale on the outer wall of the glass 4 by the indicator of the registrar of the applied force 8.

The principle of operation on the simulator for applying vascular and tendon sutures 1.

When a vascular suture is applied, one end of the blood vessel or its simulator (hereinafter referred to as the preparation) is sealed by fixing it in the tendon clamp of the rod 16. A conduit 32 is introduced into the lumen of the blood vessel through the second end and, with a slight tension, fix it along with the pipeline in the vascular clamp of the rod 17. Then, loosening the hinge on the rods 16 and 17, a convenient position for the preparation is established, which is cut and a manual or mechanical vascular suture is applied, acting accordingly ohm task. After suturing the preparation in the projection of the vascular suture, containers are placed on the platform 1, and a 20-ml syringe filled with 2/3 of water is connected to the cannula 33. First, pulling the piston removes air from the drug, and then fill it with water under pressure. The strength and tightness of the vascular suture are determined by the amount of leaked fluid.

2. When a tendon suture is applied, the ends of the tendon or its simulator (hereinafter the preparation) are clamped in the tendon clamps of the rods 16 and 35 with a slight tension. The drug is cut and, acting according to the task received, a tendon suture is applied. After applying the tendon suture by rotation of the screw 12 of the stretching mechanism 11, the preparation is stretched until the preparation ruptures at the place of its suturing. Determine the applied force on a scale on the cup body 4.

Positive effect of using the simulator for vascular and tendon sutures

1. The ability to master the technique of applying a vascular (manual or mechanical) and tendon sutures on one simulator with control of the tightness and strength of the vascular suture and the strength of the tendon suture;

2. The ability to develop original or modify known methods for applying vascular or tendon sutures with a comparison of their tightness and strength;

3. Simplicity in preparing the device for work and the ability to quickly switch from the application of a vascular suture to the work of applying a tendon suture;

4. The proposed simulator can be used individually in any audience, does not require additional technical support, has a simple design, does not contain expensive parts and can be performed without any special production costs.

Information sources

Treadmill simulators:

1. USSR Author's Certificate 1387032, G09B 23/28, publ. 04/07/1988.

2. Patent for utility model BY 2646, G09B 23/32, publ. 04/30/2006.

3. RF patent 2370221, А61В 17/00, А61В 17/04, publ. 10/20/2009.

4. RF patent 2523660, G09B 24/30, publ. 07/20/2014.

5. Peshikov OV The simulator for practicing surgical skills / O.V. Peshikov, A.V. Chukichev, O.A. Neveitseva // Continuing Medical Education and Science. - 2015. - T. 10, No. 2. - S. 3-6.

6. Sukhoverkhov R.I. The simulator for working out the technique of surgical operations / Sukhoverkhov R.I., Krivoshchekov EP // Military Medical Journal. - 2001. - No. 9. - S. 70.

7. The simulator for the development of tendon suture technique / [Zolotov A.S., Pak O.I., Zolotova Yu.A., Kudran SP] // Surgery named after N.I. Pirogov. - 2014. - No. 1. - S. 73-75.

Trainers for vascular suture:

8. Copyright certificate of the USSR 138329, A61B, publ. 05/31/1967.

9. Copyright certificate of the USSR 349393, A61B 17/04, publ. 09/04/1972.

10. Copyright certificate of the USSR 1418804, G09B 23/28, publ. 08/23/1988.

11. Copyright certificate of the USSR 1801225, G09B 23/28, publ. 03/07/1993.

12. Patent US 3775865, G09B 23/28, publ. 12/04/1973.

13. Patent US 4854318, G09B 23/32, publ. 08/08/1989.

14. Patent US 5320537, G09B 23/32, publ. 06/14/1994.

15. Patent for utility model BY 1114, А61В 17/12, G09B 23/32, publ. 12/30/2003.

16. Patent US 20080118902, G09B 23/28, publ. 05/22/2008.

17. Patent WO 2011021685, G09B 23/28, publ. 02.24.2011.

18. Patent US 20120141964, G09B 23/32, publ. 06/07/2012.

19. Patent EP 2469500, G09B 23/28, A61B 19/00, A61B 17/04, G09B 9/00, publ. 06/27/2012.

20. Khomyakova D.A. Preparing students for the technique of performing a vascular suture / D.A. Khomyakova, M.A. Chernykh, O.A. Neveitseva // Young scientist. - 2016. - No. 3. - S. 333-337.

Claims (3)

1. A simulator for applying a vascular and tendon sutures, comprising a tablet and fixators with screw clamps installed on it, characterized in that the tablet is equipped with a system for applying a vascular suture and a system for applying a tendon suture, connected to each other and mounted on supports fixed to them with a cylindrical glass having a longitudinal slit-like window, and a spring and a movable rod placed in the cavity of the cylindrical glass, the free end of which is provided with a stop adjacent to the pusher tensioning mechanism, and the simulator itself is equipped with three rods, two of which are fixedly fixed to the supports and each is represented by two pivotally connected levers, the free end of one rod is equipped with a clamp for a blood vessel, and the other for a tendon, while the second clamp for a tendon is mounted on a free the end of the third movable rod having a longitudinal slit-like window with a guide pin, which is fixedly mounted on the stand mounted on the tablet, and the second end of the third rod with an axis along Vision is connected to the rod abutment. 2. The simulator according to claim 1, characterized in that the pusher of the stretching mechanism is made in the form of a screw with the ability to move along the internal thread of the housing opening and spring-loaded to move the rod into the glass with an increase in the distance between the tendon clamps, which is torn at the place of application of the suture, and the registrar pointer is attached forces mounted on the rod and combined by means of a longitudinal slit-like window with zero division of the scale located on the outer surface of the glass located along the longitudinal slit-like KPA. 3. The simulator according to claim 1, characterized in that the clamps of the tendons, blood vessel and articulated joints are equipped with screw clamping devices, while on the contacting surfaces of the clamps of the tendon there are cuts of a semi-oval shape, and on the clamp of a blood vessel cutouts are made in the form of a semicircle for fixing the end of the blood vessel a vessel with a pipe inserted into it having a cannula for connecting a syringe to

filled with water, the other end of the blood vessel being held in the tendon retainer.

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