SU1225541A1 - Surgical apparatus for placing linear sutures - Google Patents

Description

2. The apparatus according to claim 1, characterized in that it is additionally provided with a guide conductor consisting of a handle, a flexible rod and an olive, made in the form of a stop 1

The invention relates to medical technology, namely to surgical suturing apparatus for imposing linear sutures on biological tissue during surgery.

The purpose of the invention is to create opportunities for the imposition of schvov in narrow and deep wounds and reducing the time of congestion.

FIG. 1 shows a surgical suturing apparatus, general view; in fig. 2 is a section A-A in FIG. one; in fig. 3 is a view B in FIG. one; in fig. 4 is a view of B in FIG. 3 (with a longitudinal incision along the upper sponge and partial digging along the lower sponge); in fig. 5 - flexible conductor to the surgical apparatus for applying linear sutures; in fig. 6 is a cross-section of the FIG. five.

The surgical apparatus for applying linear sutures contains two pivotally connected branches 1 and 2 with handles 3 and 4 at one end and with bracket 5 and with retaining 6 jaws at the other. A magazine 8 with bracket slots 9, pushers 10 and a knife 11 are located in the longitudinal groove 7 of the bracket sponge, and a matrix with holes 12 is located on the support sponge 6.

The device is provided with a locking fork 13 with protrusions 14 and a flexible rod 15, which can be moved along branch 2.

The branches 1 and 2 are bent in the plane of the branch and equipped with a plate 16 with a curved groove 17 that interacts with the flexible rod 15 of the plug 13 by means of a pin 18. On the outer surface of the bracket sponge there are made transverse grooves 19 under the projections 14 of the fork 13. The pushers 10 are equipped with tailings 20 which are installed in the longitudinal grooves 21, made on the surface of the longitudinal groove 7 of the bracket sponge 5, and in the case of the magazine 8 there are windows 22 for the shanks of 20 pushers. Store 8 in the sponge 5 is spring-loaded flat spring 23.

The locking plug 13 and the plate 16 are mounted with the possibility of disconnecting the magazine 8 and the bracket sponge 5 on the piercing gap.

The device is additionally equipped with a guide conductor consisting of a handle 23, a flexible rod 24 and an olive of an extended ball and a conical guide, and a guide groove is made along the olive tree, corresponding to the support sponge of the device.

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filled in the form of an anvil 25 and a cone-shaped guide 26, with the guide groove 27 corresponding to the anvil sponge 6 of the apparatus along the olive tree.

By stitching clearance 28, we mean the distance between the bracket sponge 5 and the stop sponge 6, to which the fabric is stitched and on which the stitching is performed.

The branches 1 and 2 are interconnected in 0 of the castle part 29 by means of a hinge 30.

In the bracket grooves 9, in addition to the pushers 10, U-shaped metal brackets 31 are installed.

The pushers 10 are made in the form of plates arranged in staple slots 9. The shanks 20 are fixed on the plates.

The springs 23 contribute to the fact that the working part 32 of the magazine 8 is maximally removed from the sponge 5 beyond the limits of its working part 33, the store 8 is held in the extended 0 slot of the sponge 5 by means of friction. The springs 23 are curved in an arc and fixed on the sponge 5. the middle part, and with their ends abut the magazine 8. For a more reliable retention of the magazine 8 in the sponge 5, grooves or holes can be made on it for interaction with the ends of the spring 23.

The knife 11 is installed in the longitudinal groove 7 of the magazine 8 and is held in this groove by friction.

On the thrust sponge 6, there is a groove 34 under the cutting edge 35 of the knife I, which runs along the holes 12 to bend the staples.

Between branches 1 and 2, a return spring 36 is installed.

An anvil 37 is mounted on the anvil sponge 6 to guarantee the installation of a flashing gap. The device works as follows. The clamping magazine 8 is loaded with U-about-Q with different metal brackets 31 and inserted into the sponge 5 so that the shanks 20 of the pushers 10 fit into the longitudinal grooves 21. In this way, the flat spring 23 locks the magazine 8 from longitudinal movement in the sponge 5 and extends as far as possible - 5 there is no its working part 32 in the direction of the resistant sponge 6.

The device is ready for operation (for flashing) and is sterilized as such.

When flashing, the thumb and index fingers of the hand are inserted into the ring handles 3 and 4. Maximize their separation, open the jaws 5 and 6 of the apparatus and place the sewn-in fabric between them. As the knobs 3 and 4 approach each other, the jaws 5 and 6 approach each other. During this approach, the pins 18 slide along the curved groove 17 of the plate 16.

As a result of the impact of the curved groove 17 on the pins 18, the bend of the ha 15 will move toward the ring handle 4.

The movements of the sponges 5 and 6 of the flexible rod 15 continue until the sponge 5 contacts the stop 37 located on the sponge 6.

In this case, one protrusion 14 t of gi 15 is aligned with transverse slots 19 of sponge 5, and the other protrusions will extend beyond sponge 5, with the result that shop 8 will receive freedom of vertical movement relative to sponge 5. Store 8, abutted against abutment 37, stands on place, maintain a constant predetermined gap of the piercing 28, and the sponge 5 continues to move towards the sponge 6, its longitudinal grooves 21 by interaction on the shanks 20 will mix the pushers 10 along the bracket grooves 9 of the magazine 8. The pushers 10 push the brackets 31 out of the bracket grooves 9. Brackets 31 pierce with their pointed legs, the fabric and, resting against the holes 12 of the support sponge 6, are bent into the V-shape, firmly joining the fabric.

Thus, the installation of the flashing gap and the flashing process itself is carried out with a single movement of the surgeon's fingers when the knobs 3 and 4 approach each other, which reduces the time of the operation.

The apparatus allows for various operational techniques, especially in hard-to-reach places; forgiveness of the proximal and distal ends of the vessels and ducts, followed by the intersection of the latter between the sutures; papillosphincterotomy with plasty; virgsungtoma with plastic.

Example. Clinical diagnosis; gallstone disease. Stenosis of the large duodenal papilla, stenosis of the Wirsung duct.

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Operation; choledochotomy, duodenotomy, papillosphincterotomy with plastic, virgotomoti with plastic.

After laparotomy, a supraodenal choledochotoma is produced. The proposed probe with the guide groove of the corresponding lower abutment sponge of the apparatus, on which duodentia is produced, is 1-1.5 cm long, is introduced into the lumen of the choleoclone. A large duodenal nipple is inserted into the incision on the probe. With complete stenosis of the nipple, the latter is incised over the probe. At the mouth of the large duodenalgrune of the nipple, along the groove in the probe (which corresponds to 11 hours), the lower abutment sponge of the apparatus is inserted and pressing the branches of the apparatus produces a sphincterotomy with plastics. The length of the sphincterotoma produced is determined by the number of brackets inserted under the front wall of the large duodenal papilla participating in the plastics (each bracket corresponds to 3 m.m). After opening the branches, remove the device and change the magazine. If necessary, a spinterterotomy of more than 15 mm can be achieved by reintroducing the anvil sponge in the mouth of the large duodenal papilla to the upper boundary of the produced sphincterotomy, and the latter is extended to the desired size.

The vial of the duodenal papilla was examined. When the Wirsung duct stenosis is detected, the lower thrust sponge of the device is introduced into the mouth of the latter with smooth semi-rotational movements along the longitudinal axis of the device and the viral sinus is performed with a plastic for a given length according to the described procedure.

The use of the proposed apparatus minimizes the number of necessary manipulations performed by the surgeon, releases the surgeon’s hand during the operation, has almost no effect on the overview of the operative field at the site of suturing and cutting the tissues, while making it economical; 11th, traumatizing the tissue to a minimum, reduces the number of complications and postoperative lethality, shortens the suture time from 0.5 min to tenths of a second, and also allows the apparatus to walk through narrow and deep wounds.

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FIG. five

FIG. eight

Claims (2)

1. A SURGICAL APPARATUS FOR LINEAR SEAMS, comprising articulated jaws with handles at one end and a brace and stop jaw on the other, with a magazine with bracket grooves and pushers and a knife in the longitudinal groove of the brace sponge, and a matrix with holes on the stop sponge characterized in that, in order to create opportunities for suturing in narrow and deep wounds and reduce stitching time, it is equipped with a locking fork with protrusions and a flexible rod having the ability to move along the jaw and, the branches are made curved in the plane of the branches and provided with a plate with a curved groove interacting with the flexible rod of the fork by means of a pin, on the outer surface of the bracket jaw there are transverse grooves for the protrusions of the fork, the pushers are equipped with shanks that are installed in longitudinal grooves made on the surface of the longitudinal groove the sponge, and in the case of the store there are windows for the shanks of the pushers, while the store in the sponge is spring-loaded, and the fixing fork and plate are installed with the possibility of merging the magazine and the sponge on the flashing gap. G <0 2. The apparatus by π. 1, characterized in that it is additionally equipped with a guide conductor, consisting of a handle, a flexible rod and olive, made in the form of a thrust ball and a cone-shaped guide, and along the olive there is a guide groove corresponding to the thrust sponge of the apparatus.