Surgery – Instruments – Surgical mesh – connector – clip – clamp or band
Patent
1989-03-09
1990-09-18
Green, Randall L.
Surgery
Instruments
Surgical mesh, connector, clip, clamp or band
227180, A61B 1700
Patent
active
049574990
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD
The invention relates generally to surgical appliances and is concerned more specifically with surgical suturing instruments.
PRIOR ART
Known in the present state of the art is a surgical instrument adapted for establishing anastomoses with the aid of a staple suture applied to such tubular organs as those of the digestive canal. The instrument comprises a thrust die or matrix, a cylindrical body having at least one ring or surgical staples, a mechanism actuating the surgical staples, and a cylindrical scalpel, with the aid of which mechanism the staples make their way through tubular organs and get united at the surface of the thrust dies, while the scalpel cuts off an excess protion of the tubular organs being operated upon (GB, A, 2,133,735).
The aforesaid known instrument makes use of staples which remain for a prolonged time or permanently in the patient's organism. Such staples fail to establish a staunch suture which might inflict morbid postoperative events.
Another prior-art suturing instrument is known, adapted to establish circular compression anastomoses in the organs of the digestive tract. The instrument comprises a needle arrangement having a first ring-shaped element provided with a plurality of holes and a second ring-shaped element carrying a plurality of needles fixed in position thereon and equal in number to said holes in the first ring-shaped element, each of said needles corresponding to one of the aforesaid holes and at least part of said needles have a locking cone at the free end thereof. Both of the ring-shaped elements are coaxially arranged and enclosed in a hollow body, wherein a rod is accommodated, coaxial with the ring-shaped elements, said rod having at one of its ends a fixed connecting ring set with the aid of a round nut. When establishing an anastomosis the needles are passed through the connecting ring and some of them are fixed therein with the locking cones.
The instrument comprises also a cylindrical knife whose inside diameter is equal to the maximum nut diameter and which is secured on a hollow tube accommodated in the housing, a rod being coaxially accommodated in said tube. The cylindrical knife has a mechanical actuator adapted to interact with the hollow tube and comprising a movable handle rotatably mounted with respect to the body and provided with a lever which is to interact with the slots in the hollow tube (PCT/SU 79/00049).
The ring-shaped elements of the needle arrangement and the connecting ring are made of elastic or plastic materials which must be biologically inert, nontoxic and noncancerogenic.
In order to establish an end-to end anastomosis the instrument is to be placed inside the tubular organ operated upon. The ends of the tissue of the organs operated upon are fixed on the rod with the aid of purse-string sutures. Once the working members of the apparatus have been brought together and the needle arrangement has been approximated to the connecting ring, the tissues are also approximated till contacting with their exterior serous surfaces, whereupon the movable handle is depressed to actuate the hollow tube and the cylindrical knife to move concurrently with the travel of the needle arrangement, whereby the needles of the second ring-shaped element are urged to pierce the tissues, and the stationary fixed connecting ring is held thereto by means of the needles with the locking cones. Upon further advancing the cylindrical knife cuts off the excess tissues and cuts through the stationary fixed ring, thus establishing an anastomotic opening through which is withdrawn the rod end fitted with the round nut. The tissue confined between the needle arrangement and the connecting ring is compressed, thus ensuring a staunch suture, followed by reunion of the tissues and, 7 to 10 days after surgery, the needle arrangement and the connecting rign which compress the tissue involved are expelled into the interior of the hollow organ operated upon. Afterwards both the needle arrangement and the connecting ring are discharged through the
REFERENCES:
patent: 4289133 (1981-09-01), Rothfuss
patent: 4476863 (1984-10-01), Kanshin et al.
patent: 4505272 (1985-03-01), Utyamysher et al.
patent: 4567891 (1986-02-01), Kanshin et al.
Guskov Igor A.
Kanshin Nikolai N.
Lipatov Viktor A.
Green Randall L.
Jackson Gary
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