Surgery – Instruments – Suture – ligature – elastic band or clip applier
Patent
1996-08-19
1998-10-27
Buiz, Michael Powell
Surgery
Instruments
Suture, ligature, elastic band or clip applier
606139, 289 17, A61B 1704
Patent
active
058273000
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
1. Field of the Invention
The invention relates to a set of medical instruments for shifting and placing knots produced in surgical sutures during surgery. Surgery of this kind, in which sutures are placed and knotted and must then be brought to certain locations, occurs for example, during the reconstruction of a tear of the rotator cuff in which tendons must be sutured.
2. Background Art
In conventional reconstruction of a tear of the rotator cuff, it has always been necessary heretofore to open the involved portion of the patient's shoulder over a relatively large area to create sufficient room for the operation. Operations within such large areas however always involve very high stress on the patient and require a correspondingly long period of convalescence.
Efforts have therefore been made to perform surgery as transarthroscopic surgery with correspondingly small surgical incisions, so that the disadvantages of conventional surgical methods are avoided. To perform such transarthroscopic surgery and reconstruction, even with the consequence of suturing tears, require however correspondingly adapted and new instruments in order to be able to perform the tasks required, even in correspondingly small surgical incisions.
SUMMARY OF THE INVENTION
The goal of the present invention is to provide a set of medical instruments for performing transarthroscopic reconstruction surgery of an tear of the rotator cuff for example, in which sutures are placed, knotted, pulled tight, and brought to the correct location.
As a set of medical instruments for placing and shifting knots produced in surgical sutures during operations, the invention proposes an arrangement characterized in that it contains a cylindrical rod displaceable lengthwise in a cylindrical sleeve, said rod projecting beyond the sleeve at both ends, with said rod having a head end that can be pulled into the sleeve and a gripping end that can be struck externally at the other end of the sleeve, and the head end of the cylindrical rod is designed as a knot shifter for shifting and tightening a knot produced in the suture, and the sleeve end into which the rod can be retracted is designed as a knot cutter with a cutting edge in order to separate the suture ends from the knots.
With the knot shifter and knot cutter proposed according to the invention, reliable knotting and hence immobilization of parts such as tendons reattached by surgical sutures to their original fastening surfaces can be accomplished.
Advantageous embodiments of the instruments according to the invention, which serves as a knot shifter and knot cutter, can be derived from the characterizing features of the subclaims. In particular, the cylindrical rod is designed as a knot shifter with a convexly rounded head end, with two through bores extending from the head end, through which bores a suture can be pushed to the cylindrical jacket surface of the rod. These two continuous bores serve so to speak as needle eyes, with one suture end being pushed through each. Preferably, these two through bores used as needle eyes are formed diametrally opposite one another on the head end of the rod, with the bores extending diagonally from the end of the rod to the jacket surface. These two continuous bores used as needle eyes are relatively small and short, particularly 2-4 mm long with a diameter of 1-2 mm. In addition, the knot shifter and knot cutter according to the invention is provided with an additional through bore for pulling a suture through in the vicinity of the head end of the cylindrical rod, said bore being arranged transversely with respect to the lengthwise axis of the cylindrical rod in such fashion that they do not touch the bores that serve as needle eyes. The transverse through bore is preferably located slightly below the outlets of the two bores starting at the head end on the cylindrical jacket surface of the rod and shortly below the latter. In order to avoid rubbing a suture as it is pulled through the transverse bore, it is proposed that the
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Buiz Michael Powell
Pham Tina T. D.
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