RU21016U1 - ATRAUMATIC NEEDLE - Google Patents

Abstract

Atraumatic needle, consisting of a curved body with sharp and blunt ends and a thread fixed in the body, while the sharp end is made according to the spatula type of sharpening and its edges are formed by cutting edges with an acute angle of sharpening, also converging at an acute angle, characterized in that the body made tubular, the thread is fixed at the sharp end, the angle between the cutting edges is 35-40, and the sharpening angle of each cutting edge along its entire length does not exceed 45.

Description

The utility model relates to medical equipment, namely atraumatic needles intended for surgical suturing in ophthalmology, neurosurgery, vascular surgery.

In the practice of surgery, curved needles equipped with the so-called spatula tip and suture material have spread. Suture material in such needles is fastened either by a groove in the longitudinal groove or by reaming with the subsequent one; by securing the thread in the groove or hole by caulking or with a pomp; it is bound; it. The spatula tip is made by flattening with subsequent sharpening of the cutting edges.

The disadvantage of such needles is the inability to firmly fix the thread in the needle. During surgery, constant kinks of the thread, pulling behind it increase the load on the working thread in the place of its attachment and lead to its breakage.

Reliable fastening of the thread in the atraumatic needle is achieved by making its body from a capillary tube and fastening the thread in the region of the tip (RF Patent No. 216919, publ. 04/26/99)

fibrous membrane are the crucial stage of the night of any complex operation on the organ of vision (cataract extraction, operations aimed at reducing intraocular pressure, removal of intraocular foreign bodies, tumors, etc.). When conducting any seam through fibrous), the fabric cannot be used with the so-called stitching (round) and triangular needles. Despite the fact that they are rather easily injected into the fabric, then such a needle moves forward with great difficulty, since increasing its diameter it experiences great resistance to the environment; their tissues.

Closest to the claimed one is an atraumatic needle consisting of a monolithic curved body with a tip having a spatula type of sharpening, the edges of which form cutting edges. The sharpening angle of these edges is at least 55, and the angle between the cutting edges converging at the tip is not more than 26 °. The thread is fixed in such a needle by a preliminary groove of the longitudinal groove followed by threading of the thread. V.M. Buyanov et al., Surgical suture material, series Abdominal surgery, introductory part, ed. CJSC Firm Antis, 2000, p. 29-30.

When piercing with a microneedle with a spatula sharpening of the cornea or sclera, the surgeon's hand practically does not feel the effort, which cannot be noted when using pricking needles, when there is strong resistance. However, stitching of the cornea or sclera is carried out only with a cutting needle with a spatula type of sharpening.

The limited length of the portion of the thread that is hammered into the groove of the needle increases the likelihood of the thread falling out of the needle at the moments of its maximum tension during use. Moreover, the multi-operation process of grooving a longitudinal groove and threading in it significantly complicates the stage of attachment of suture material to the needle.

The above sharpening angles of the spatula tip do not provide the minimum invasiveness of biological tissue during cutting, and the minimum puncture force.

For a needle made of a monolithic (solid) body, breaking off the tip can lead to serious consequences if the broken part of the needle is not quickly found and removed. All this causes certain difficulties in practical use, as well as at the stage of manufacture of such needles.

OOd :: fJG37 f

The utility model is based on the task of ensuring reliable fastening of suture material in a needle with a spatula type of sharpening the tip, reducing the puncture force and reducing injury to biological tissues when they are stitched together with increasing needle strength.

The problem is solved in that it consists of an atraumatic needle; it consists of a curved body with sharp and blunt ends and a thread fixed in the body, while the sharp end is made using a spatula type, its edges form cutting edges with an acute sharpening angle and

also converge at an acute angle, the body is tubular, the thread is fixed at the sharp end, the angle between the cutting edges is 35–40 °, the sharpening angle of each cutting edge along its entire length does not exceed 45 °.

Using a tubular body simplifies the stage of fixing the suture material in the needle in comparison with the solution taken as a prototype. At the same time, the increased length of the thread attachment section in the needle reduces the likelihood of the thread falling out of the needle at the moments of maximum thread tension in practical use.

Reinforcing the tubular needle body with a thread increases the strength characteristics of both the needle body and the spatula tip, and completely eliminates the risk of losing a broken part of the needle in case of breaking the needle.

An increase in the angle between the cutting edges converging at the tip of the needle to 35–40 ° with a simultaneous increase in the angle of sharpening of the cutting edges to 45 ° made it possible to reduce the force of puncture of the biological tissue with the inventive needle, to increase the cutting characteristics without losing the strength of the spatula of the needle tip, since the sharper sharpening angle and longer edge, the less effort to advance the needle.

In addition, the suture loop performs the connecting function if the thread completely fills the wound channel formed by the needle. In eye surgery, this condition is realized with

It’s hard, since the suture material is many times thinner than the diameter of the needle. The geometry of the presented spatula needle is such that the mechanical effect on the tissue is slightly different from the above prototype. After the initial puncture by the cutting edges of the needle with the opposite type of sharpening, the hole formed is available: its shape of the gap due to a decrease in the angle of sharpening begins to expand only in the horizontal direction. Deformation of the tissue in the vertical direction does not occur. In this case, the effect of self-sealing of the wound channel left by the working part of the needle is more pronounced, and thus the thread fully performs the function of bringing the edges of the surgical wound closer together.

In FIG. 1 shows a longitudinal section of the proposed atraumatic needle; figure 2 - section aa is a transverse section of the spatula part of the needle tip; in Fig.Z - section BB - cross section of the needle body; figure 4 is a view In the spatula of the needle tip.

The atraumatic needle consists of a tubular curved rod 1 with a sharp end 2 made in the form of a spatula and a blunt end 3. A surgical thread 4 is fixed at the sharp end 2 by plastic deformation.

the widest part of the spatula part (FIG. 3). The angle between the cutting edges converging at the tip of the needle is 35 - 40 ° (Fig. 4).

Examples of the use of the proposed needle for sealing the wound channel of various localization in ophthalmology.

Example 1. Patient C .. 29 years old, was admitted to the hospital with a diagnosis of penetrating linear wound of the optical zone of the cornea of the right eye.

Objectively: visual acuity of the right eye: 0.15 n / a. IOP: hypotension - 1.

The length of the corneal wound by a glass fragment was 5 mm in the vertical direction in the projection of the optical zone. The anterior chamber of the eye is absent. Corneal syndrome is expressed. Injury 3 hours ago. The patient underwent emergency surgical treatment of a corneal wound. A continuous suture along the pier was imposed on the corneal wound according to the proposed atraumatic needle with a spatula type of sharpening and 10/0 nylon thread; the anterior chamber of the eye was restored.

In the postoperative period, a course of local anti-inflammatory, reflex, absorbable and general trophic therapy was performed.

After treatment: a continuous suture from the cornea was removed after 2.5 months, full adaptation of the wound was achieved.

During biomicroscopy in a slit section on a Karl Zeiss lamp, a gentle scar of a linear shape in the vertical direction is visible. There are no scars at the points of injection of the spatula needle.

Example 2. Patient P., 37 years old, was admitted to the hospital with a diagnosis of penetrating wound of the limbo-sclerocorneal region with prolapse of the iris, hyphema, partial hemophthalmus, traumatic cataract of the right eye.

Objectively: the visual acuity of the right eye is the correct projection of light from all sides.

IOP: eye hypotension: -1. On the meridian from 6 to 7 hours a beveled wound is visible, with a length of up to 7 mm. In the wound, the precipitated iris is impaired. The anterior chamber is uneven, slit-like, smears of blood on the stroma of the iris, contusion traumatic cataract.

The patient underwent primary surgical treatment of the wound with the iris board in the anterior chamber, dialysis of the anterior chamber. Pa wound inflicted

8 nodal joints 10/0 nylon with the proposed needle design. The depth of injections was regulated due to its cutting properties, while the edges of the beveled wound are even, adapted, the anatomy of the anterior chamber angle is violated, there is no pinching of the iris in the wound, and the anterior chamber of the eye is restored.

Nodal sutures from the wound were removed after 2.5 months. A complete adaptation of the scar has been achieved. There are no anterior synechia, IOP with a tonometric study of 23 mm Nr.

Example 3. Patient P., 21 years old, was admitted with a diagnosis of:

Extensive post-concussion penetrate; her wounds to the sclera with a partial defect of prolapse of the vitreous body, total hemophthalmus of the left eye.

Ophthalmology: visual acuity of the left eye: 0.

In the lower part of the eyeball in the mid-outer zone, a scleral wound of irregular shape, with a length of 14 mm, is visible. In the wound, the vitreous precipitated along with blood clots.

The primary surgical treatment of the wound. A 10-wound suture was presented to the wound with the presented atraumatic needle with titanium thread 10/0. Through seams are made without much effort. Due to the increased strength of the titanium thread, it was possible to achieve the adaptation of defects of the scleral wound. At the same time, the nodes plunged into the wound. A continuous seam was placed on the conjunctiva above.

Example 4. Patient S., 63 years. Found in the clinic with a diagnosis of Blepharochalasis in both eyes.

In a planned manner, surgical treatment was performed to remove the folds of the thinned eyes, a continuous cosmetic suture was presented with the presented atraumatic needle and a thread made of 10/0 titanium alloy.

This suture was removed on the sixth day after surgery. The thread is easily removed from the wound channel. On the skin of the eyelids - a gentle cosmetic scar.

( 9

Claims (1)

Atraumatic needle, consisting of a curved body with sharp and blunt ends and a thread fixed in the body, while the sharp end is made using a spatula type of sharpening and its edges are formed by cutting edges with an acute angle of sharpening, also converging at an acute angle, characterized in that the body made tubular, the thread is fixed at the sharp end, the angle between the cutting edges is 35-40 ^o , and the sharpening angle of each cutting edge along its entire length does not exceed 45 ^o .