RU2197207C2 - Device for performing episcleral filling - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has fixing member designed as wedge-shaped clamp with spring-loaded branches and lips shaped as cylinder parts on the working ends. The lips have needle-shaped awls and internal diameter corresponding to filling material. The device has bevels on branch on both sides and a hook-shaped member. The hook-shaped member for removing the device having filling material for performing episcleral filling has handle and slider. The slider envelops the handle and has curved end shaped as rest member. The handle is plate having curved end rounded operation end. The operation end has a through opening for catching the hook-shaped member having fixing member. The slider has two parallel junction plates and is reciprocally movable along the handle. EFFECT: eliminated disadvantages of ophthalmic forceps. 2 cl, 9 dwg

Description

 The invention relates to medicine, namely to ophthalmology, can be used for circular episcleral filling.

 In ophthalmic practice, with retinal detachments, anatomical curved eye tweezers are used for filling material (Instruments for Ophthalmic Surgery. Moscow, TsBNTI, Medprom, 1978, p. 26, Fig. 3 and 6). A known tool contains springy branches, which are simultaneously a handle, the working body of which is curved and has notches on the working surface.

The disadvantages of the known tool adopted for the prototype include
- the force (elastic force) of the springing branches does not provide sufficient self-opening of the working body when it is under the muscles to capture the filling material;
- existing notches on the working surface do not provide capture and reliable fixation of the filling material;
- when carrying out the filling material under the muscles, the surgeon's hand is in constant tension, which creates discomfort;
- repeated manipulations of capture and fixation of filling material due to unreliable fixation of the forceps by the working body lead to additional injuries of the surrounding tissues of the eyeball and lengthen the operation time;
- when the jaws of the tweezers are opened under the muscles to capture the filling material, the eyeball and surrounding tissues are injured.

 Problem to be solved: elimination of the above-mentioned disadvantages of the known tool.

The task is solved by the device
"a") containing a locking body in the form of a wedge-shaped clamp with spring jaws, the working ends of which have jaws, while the device has a hook-shaped element for its output with filling material by the device of claim 2, slices made on the jaw from two edges, and sponges in in the form of cylinder parts equipped with needle-shaped spikes, the jaws having an inner diameter corresponding to the diameter of the filling material;
"b") equipped with a handle and a handle covering the handle, having an end curved in the form of a support, the handle being made in the form of a plate with a curved end and with a rounded working end having a through hole for gripping the hook-like element of the device according to claim 1, wherein the slider has two parallel scarves and installed with the possibility of reciprocating movement along the handle.

 The presence of a hook-like element at device “a”, a through hole at the end of the handle of device “b”, ensures its movement under the U-shaped seams, muscles of device “b”, i.e. functional connection of two devices.

 Slices made on the jaw of the device “a” from two edges and the headscarves of the slider of the device “b” interacting to capture and release the filling material with the jaws of the device “a”.

 The presence of sponges of needle-shaped spikes and the correspondence of their internal diameter to the diameter of the filling material ensures reliable fixation of the filling material.

 Figure 1 shows a diagram of episcleral filling devices "a" and "b", General view; figure 2 is the same front view; figure 3 - device "a", side view; figure 4 is the same, a top view; figure 5 is the same, a view along arrow A in figure 3; figure 6 is the same, view along arrow B; Fig.7 - device "b", side view; in Fig.8 is the same, a top view; in Fig.9 is the same, view along arrow B in Fig. 7. The device “a” for episcleral filling contains a locking body 1 made in the form of a wedge-shaped clamp with springy branches 2 and 3, jaws 4 and 5 having needle-shaped spikes 6. Jaws 4 and 5 at the working ends of branches 2 and 3 have the form of a part cylinders whose inner diameter corresponds to the diameter of the filling material. The device "a" has a hook-shaped element for its output (movement) with the filling material device "b". Branch 1 at two edges has 8 slices.

The device "b" for episcleral filling:
- the handle 9, made in the form of a plate with a curved end 12, the working end 10 of which is rounded, has a through hole 11 to capture the hook element 7 of the device "a";
- a slider 13, covering the handle 9, and the slider 9 has two parallel scarves 14 and the protrusion 15 and is installed with the possibility of reciprocating movement on the handle 9.

 Devices for episcleral filling "a" and "b" are functionally connected, but are structurally independent objects.

 Functional communication of the proposed devices.

 The hook-shaped element 7 of the device "a" through the hole 11 is engaged with the handle 9 of the device "b". The slider 13 is moved forward to the device "a". In this case, the scarves 14 enter under the slices 8, the branch 2 moves upward, revealing the pharynx between the jaws 4 and 5. Capture the filling material. The slider 13 for the protrusion 15 is taken back, the device "b" is removed - the filling material is fixed by the device "a". To carry out the filling material under the U-shaped seams and muscles, the working end 10 of the device “b” is inserted under the muscles and seams, the hook-like element is captured (hooked) by the hole 11, the filling material is pulled forward.

 Episcleral filling with the proposed devices is as follows.

 The end of the filling material is captured and fixed by the device "a". After a circular incision of the conjunctiva of the eyeball in the limb, rectus muscles of the eye are secreted to the ligature. Ophthalmoscopically determine the site of rupture or detachment of the retina and in the necessary places preliminarily apply the required number of U-shaped sutures between the muscles. Under the muscles and U-shaped sutures, the working end 10 of the device “b” is introduced, with the hole 11, the hook-shaped element 7 of the device “a” is captured (hooked) and the material together with the filling material is removed from under the muscles and U-shaped sutures. The filling material is released from the device "a". Tighten the U-shaped seams and tie, the ends of the filling material also tighten and grab the U-shaped seam. A continuous suture is placed on the conjunctiva.

 In the clinic of the Ufa Research Institute of Eye Diseases using the proposed devices, 23 patients were operated on.

 A positive clinical result has been achieved.

The problem is solved and achieved:
- exact localization of the gap and detachment of the retina:
- targeted suturing under epi-endoscleral control ;,
- atraumatic manipulation;
- reduction of operation time;
- facilitate the work of the surgeon.

 Example 1. Patient M. 4, years. D-3: The right eye is a funnel-shaped retinal detachment. Circular episcleral filling of the retina was carried out using the proposed devices. The anatomical fit of the retina is achieved.

 Example 2. Patient N. 6 years. D-3: The left eye is a funnel-shaped retinal detachment. Circular episcleral filling of the retina was carried out using the proposed devices. The anatomical fit of the retina is achieved.

Claims (2)

 1. Device for episcleral filling, containing a locking body in the form of a wedge-shaped clamp with springy branches, the working ends of which have jaws, characterized in that it has a hook-shaped element for its output with the filling material by the device according to claim 2, slices made on a jaw with two edges and sponges in the form of a cylinder part provided with needle-shaped spikes, the sponges having an inner diameter corresponding to the diameter of the filling material.  2. Device for episcleral filling, characterized in that it is equipped with a handle and a slider covering the handle, having an end curved in the form of a support, while the handle is made in the form of a plate with a curved end and with a rounded working end having a through hole for gripping the hook element of the device according to claim 1, wherein the slider has two parallel scarves and is mounted with the possibility of reciprocating movement along the handle.

Images