WO1987006450A1

WO1987006450A1 - A device for use in surgical procedures

Info

Publication number: WO1987006450A1
Application number: PCT/GB1987/000294
Authority: WO
Inventors: Joseph Lennox Peters
Original assignee: Clinical Product Development Ltd.
Priority date: 1986-05-02
Filing date: 1987-05-05
Publication date: 1987-11-05
Also published as: GB8610825D0; AU7353787A

Abstract

A surgical device for use in hernia repair. It is made of a flat body of flexible material having a head portion (1) and tail portion (2). The head portion (1) is shaped to fit the space between the bladder, peritoneum and pre-peritoneal tissues during a hernia repair to prevent their prolapse into the operation field, and for hernia operations on the male, the tail portion is split (3 and 4) with a slot (5) formed on the line (6) of the split (5) to accommodate the male spermatic cord. The tail portion (2) also provides means to enable the device to be pulled from a small wound aperture after completion of hernia repair and substantial closure of the operation wound.

Description

A Device for Use in Surgical Procedures

FIELD OF THE INVENTION The present invention relates to a device for use in surgical procedures particularly for the protection of internal organs and membranes of the body during inguinal hernia suture repair.

BACKGROUND OF THE INVENTION Hernia repair for defects in the peritoneum and abdominal wall muscles in the inguinal or groin region of the body is one of the commonest surgical procedures required for men and women of all ages. The principles of the surgical correction of this problem demand that the abnormal peritoneal sac or defect should be dissected, ligated and excised, and then the indivi- dual anatomical layers of fascia and muscle should be carefully and precisely sutured together using currently available synthetic materials.

These operations may be performed under general, spinal or local infiltration anaesthesia. During this procedure, under the influence of either natural or mechanically assisted ventilation of the lungs, the abdominal and pre-peritoneal contents and tissues keep prolapsing into the operative field, thereby hindering the accurate and effective insertion of the repair sutures into the very important innermost layer of tissue or fascia in this region, viz. the transversalis fascia. SUMMARY OF THE INVENTION It is an object of the present invention to provide the surgeon with a device for safe insertion in the space between the peritoneal cavity, bladder and other pre-peritoneal tissues and the overlying trans- versalis fascia which obviates the above difficulties. According to the invention there is provided a device for use in a surgical procedure such as an inguinal hernia suture repair comprising a body of flexible sheet material having a head and tail portion, the head portion being shaped to fit the space between the bladder, peritoneum and pre-peritoneal tissues of the body and prevent prolapse thereof into the operation field, during repair procedures, with the tail portion extending from the said operation field and providing means for pulling said body free after the operation wound has been substan¬ tially closed.

The device as defined above complements the anatomy of the structures in the vicinity of the inguinal canal and thereby acts as a "third hand" or retractor, and allows the relevant tissue layers to be separated and protected during the suture repair procedure of the transversalis fascia.

This layer can be plicated together over the device and when repair of this structure is nearly complete, the flexible nature of the component allows it to be slipped out of the wound. The design of the device allows it to be used on both the right and left sides of the body.

Advantageously the body of the device is a i flat flexible radio-opaque membrane of silicone rubber

5 or other plastics material compatible with body tissue.

A thickness of approximately two millimetres advantageously provides the necessary functional properties.

Other features and advantages of the invention will become apparent from the following description 10 of preferred embodiments of the invention taken with reference to drawings accompanying this disclosure. BRIEF DESCRIPTION OF THE DRAWINGS The drawings accompanying this disclosure are comprised of: 15 Figure 1 which is a perspective view of a surgical device for use in male hernia repair; and

Figure 2 is a top view of a surgical device for use in a female hernia repair.

BEST MODES OF CARRYING OUT THE INVENTION 20 The surgical devices shown in the drawings comprise a body of a flexible material such as silicone rubber or latex, having a head portion 1 and tail portion 2.

The head portion 1 is shaped to fit the space

„ 25 between the bladder, peritoneum and pre-peritoneal tissues

Ά during a hernia repair procedure to prevent their prolapse into the operative field. In the Figure 1 embodiment, the tail portion 2 is formed of two separable parts 3 and 4 with a slot 5 formed in the tail portion along the line of separa¬ tion 6 of the tail parts 3 and 4. The provision of the slot 5 allows the spermatic cord of the male to be enclosed and variations in the anatomical size of the patient to be accommodated.

The tail portion 2 of the surgical devices shown in the drawings is defined by two parallel rectilinear edges 7 and 8.

In the Figure 1 embodiment, one rectilinear edge 8 is of greater linear extent that the other 7, which greater extent 9 forms part or substantially part of the head portion 1 of the device as shown. In the Figure 2 embodiment, the rectilinear edges 7 and 8 terminate at the formation of the head portion 1.

. In Figure 2 the equivalent extension 9 of the edge 8 in the Figure 1 embodiment, is formationally displaced, but in both embodiments terminates in a recess

10 and a sequentially formed protuberance 11 forming part of the head portion 1, the recess 10 and protuberance

11 being provided to fit closely to the inside aspect of the pubic tubercle of the pubic bone. Between the protuberance 11 and the other edge 7 of the tail portion 2 of each Figure 1 and Figure 2 device, the edge of the head portion 1 is curved to provide a profile 12 which slips behind the conjoint tendon of the internal oblique muscle and the external oblique muscle and rectus abdominis muscles. The tail portion 2 in both embodiments may be used quickly and easily to remove the device after completion of the hernia repair, and just before the operation wound has been finally closed.

Claims

1. A device for use in a surgical procedure such as an inguinal hernia suture repair comprising a body of flexible sheet material having a head and tail portion, the head portion being shaped to fit the space between the bladder, peritoneum and pre-peri¬ toneal tissues of the body and prevent prolapse thereof into the operation field, during repair procedures, with the tail portion extending from the said operation field and providing means for pulling said body free after the operation wound has been substantially closed.

2. A device as claimed in claim 1 wherein the tail portion defines two parallel rectilinear edges, one of said edges being longer than the other, that longer extent of said one edge being part or substantially part of said head portion.

3. A device as claimed in claim 2 wherein a recess and a protuberance are formed sequentially in the outer edge of said head portion beginning at the termination of said longer extent of said one edge of the tail portion, said recess and protuberance being provided to conform to the profile of the pubic tubercle of the pubic bone.

4. A device as claimed in claim 3 wherein the outer edge of the head portion between said protuberance and the other one of said rectilinear edges of the tail portion is curved to slip behind the conjoint tendon of the internal oblique muscle and the external oblique muscle and rectus abdominis muscle..

5. A device as claimed in any preceding claim wherein said tail portion is formed of two separable parts, a slot in the tail portion being provided in the line of separation of said two parts to permit the spermatic cord of the male to be enclosed within said slot during repair procedures.