RU2535908C1 - Forceps for removal of organs in laparoscopic operations - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment, namely to forceps for removal of organs in laparoscopic operations. Forceps contain two hingedly connected to each other crossing branches with rings for fingers and rack-type lock on one end and working jaws of oval shape on the other end. Groove is made on internal surface of working jaws of a third of oval circumference closer to hinged connection, and a third of oval circumference, located on the end of working jaws, is provided with cutting edges.

EFFECT: application of invention makes it possible to increase volume and provides good fixation of ablated tissues.

3 dwg

Description

The invention relates to medicine, in particular to surgery and surgical instruments, and can be used to extract resected organs and tissues from the abdominal cavity during laparoscopic interventions.

There are devices for extracting removed material from the abdominal cavity through laparoscopic access - laparoscopic nets of various manufacturers - net for extraction of organs to be removed (Catalog of medical instruments for endosurgery. Kazan, 1996, p.27; Catalog of surgical instruments "Kovidien AG", 2008 ., p. 47). The disadvantage of analogues is the inability to extract material larger than the diameter of the trocar, which requires the expansion of operational access.

The closest analogue prototype is hemorrhoidal forceps (Product catalog MIZ Tumbotino, Moscow, 2008, p. 67). It is a window clamp with a rounded shape of the working jaws of an oval shape with a groove around the entire perimeter of the oval. The disadvantage of the prototype is the inability to fragment the removed tissues for convenient extraction, which makes it impossible to extract tissues larger than the diameter of the trocar.

The task is to offer a device for the extraction of distant organs and tissues from the abdominal cavity during laparoscopic interventions, which does not require the expansion of surgical access.

The technical result - the ability to extract from the abdominal cavity of removed organs and tissues larger than the diameter of the trocar using the proposed device by applying the proposed method.

The drawings depict the proposed forceps. Figure 1 is a front view, figure 2 is the inner surface of the working jaws.

The tongs according to the invention are a window clamp made in the form of two intersecting branches with pivot rings and finger locks at one end and oval-shaped working jaws at the other end (Fig. 1). The inner surface of the working jaws is made as follows: a groove is made on the third circumference of the oval closer to the jaw joint, a third of the oval circumference located at the end of the working jaws is provided with cutting edges.

The technical result is achieved by the fact that after removal of an organ or tissue site, one of the trocars with a diameter of 10 mm is removed from the abdominal cavity, a sterile polypropylene bag is introduced into the abdominal cavity through the released puncture, the removed material is placed by manipulators in the bag, then the upper part of the bag is removed from the abdominal cavity . After that, the proposed tool inside the package perform fragmentation of the resected material with cutting edges with the simultaneous capture of tissue fragments between the branches in the groove area with the gradual extraction of small parts of the organ (figure 3). All manipulations inside the abdominal cavity are performed under the control of a laparoscope.

The advantages of the proposed device:

- The ability to remove resected organs and tissues through a trocar puncture without expanding access;

- No need for suturing on the aponeurosis, since there is no expansion of access above 10 mm;

- Reducing the risk of infection of the edges of the wound in case of removal of seeded material, as there is no contact of the edges of the wound with the material being removed.

Brief Description of the Drawings

Figure 1: The forceps are a fenestrated clamp made in the form of two intersecting branches with pivot rings and finger locks at one end and oval-shaped working jaws at the other end. Total weight - 80 g, total length - 230 mm, finger ring width - 75 mm.

Figure 2: The inner surface of the working jaws is made as follows: a groove is made on the third circumference of the oval closer to the swivel joint, a third of the oval circumference located at the end of the working jaws is provided with cutting edges, the length of the working jaws is 30 mm, the width of the working jaws is 12 mm, the thickness of the working jaws is 2 mm.

Figure 3: The figure illustrates a method of extracting a removed organ from the abdominal cavity using the present invention through laparoscopic access.

Clinical examples

Example 1. Patient K., 24 years old, was taken to the clinic by an ambulance team with suspected acute appendicitis. When examined in the admission department after completing additional diagnostic methods and examining a gynecologist, the diagnosis is confirmed, indications for emergency laparoscopic appendectomy are established. During laparoscopic appendectomy, the diameter of the apex of the inflamed appendix was 15 mm; an attempt to extract it from the abdominal cavity using a packet was ineffective due to the large size of the removed appendix. Extraction of the remote appendix was performed by the proposed method. The postoperative period was favorable, the patient was discharged on the fifth day after surgery in a satisfactory condition.

Example 2. Patient F., 59 years old, was admitted to the clinic for planned surgical treatment for cholelithiasis: chronic calculous cholecystitis. According to ultrasound, the gallbladder is 6 × 4 cm, filled with calculi. Laparoscopic cholecystectomy was performed as planned. It was found intraoperatively that the gallbladder is filled with calculi, 6.5 × 4 cm, with thin walls. After performing standard laparoscopic cholecystectomy due to the high risk of perforation of the gallbladder wall during its removal from the peritoneal cavity, extraction was performed by the proposed method. The postoperative period was uneventful, the patient was discharged on the third day after the operation.

Claims (1)

Forceps for organ harvesting during laparoscopic surgery, including two intersecting jaws articulated with finger rings and a snap lock at one end and oval-shaped working jaws at the other end, characterized in that on the inner surface of the working jaws one third of the oval circumference is closer to A groove is made to the hinge and a third of the circumference of the oval, located at the end of the working jaws, is equipped with cutting edges.

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