Surgery – Instruments – Surgical mesh – connector – clip – clamp or band
Patent
1989-02-09
1990-10-23
Green, Randall L.
Surgery
Instruments
Surgical mesh, connector, clip, clamp or band
128898, A63B 1700
Patent
active
049648632
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD
This invention relates to devices for establishing communication between tubular organs of human body and is particularly concerned with devices of establishing esophagoenterostomies.
PRIOR ART
Known in the art are suturing instruments for establishing entero- and colostomies which provide for application of a staple suture. However, such instruments fail to provide the required tightness of the applied suture which is especially necessary in surgery on the intestinal tract. Besides, the suture applied is neither adequately hemostatic nor aseptic.
One state-of-the-art device for joining tubular organs in known to comprise telescopically interconnected an outer cylindrical sleeve and an inner cylindrical sleeve having axial openings in the bottoms, and elastic ring located on the outside surface of the inner sleeve. The outer sleeve is provided with a coaxial tubular handle which is in fact a hollow housing communicating with the opening in the bottom of the outer sleeve. The device comprises also a probe and a bushing with an annular groove (SU, A, 1,158,176).
The inner sleeve is extended from the outer one so as to form an area whereon the elastic ring is located before the anastomosing procedure.
In the course of anastomosis formation the tissues to be joined are arranged on the circular groove of the bushing and are compressed by the elastic ring. The probe made as a hollow tube is passed through the interior spaces of all the elements. One of the organs being anastomosed is made fast on the probe using a purse-string, while the other organ, that is, an intestine encompasses the sleeves.
However, when the nonfixed intestine is made to plunge into the interior of the inner sleeve the tissue folds placed between the bottom of the inner sleeve and the bushing are different in thickness due to arbitrary sinking of the intestine into the inner sleeve and a possible displacement of the purse-string suture, which results in a dissimilar position of the bushing with respect to the inner sleeve so that when the elastic ring is thrown off it fails to get in between the bushing shoulders at all times but might rest upon the bushing shoulder, with the result that no suture is formed whatever. Permanent presence of the probe in the bushing till rejection of the necrosed constricted intestinal and esophageal tissues causes congestion of infected contents in the esophageal cavity, which is fraught with a danger of regurgitation of said contents into the respiratory tracts. This in turn may lead to grave complications within the postoperative period.
DISCLOSURE OF THE INVENTION
The principal object of this invention is to provide a device for establishing esophagoenterostomies, which would ensure mutual orientation of an elastic ring and a bushing in the course of anastomosis formation due to a modified construction of the anastomosis formation unit as a whole.
The aforesaid problem is accomplished due to the fact that a device for establishing esophagoenterostomies, comprising a hollow housing, an outer sleeve and an inner sleeve telescopically interconnected and communicating with the hollow housing, the inner sleeve being extended from the outer one to form an area adapted to receive an elastic ring which compresses the biological tissues being joined together, each of said sleeves having an opening in the bottom thereof, through which the respective sleeve communicates with the hollow housing, a bushing accommodated in one of the organs to be anastomosed and having a first annular groove on its outside surface for anastomosis formation by means of the elastic ring, and a probe connected to the bushing and passing through the interior spaces of the bushing, sleeves and hollow housing, according to the invention, the device incorporates a second bushing having an annular groove on its outside surface for securing thereon, with a purse-string suture, the end of the other organ of the esophagointestinal tract being anastomosed, while the first bushing has a second annular groove on its outside su
REFERENCES:
patent: 4476863 (1984-10-01), Kanshin et al.
patent: 4567891 (1986-02-01), Kanshin et al.
Guskov Igor A.
Kanshin Nikolai N.
Lipatov Viktor A.
Green Randall L.
Jackson Gary
Moskovsky Gorodskoi Nauchno-Issledovatelsky Institut Skoroi Pomo
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