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WO1991002491A1 - Instrument et procede de resection du colon et du rectum - Google Patents

Instrument et procede de resection du colon et du rectum Download PDF

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Publication number
WO1991002491A1
WO1991002491A1 PCT/DK1989/000197 DK8900197W WO9102491A1 WO 1991002491 A1 WO1991002491 A1 WO 1991002491A1 DK 8900197 W DK8900197 W DK 8900197W WO 9102491 A1 WO9102491 A1 WO 9102491A1
Authority
WO
WIPO (PCT)
Prior art keywords
snare
intestine
support
instrument
diathermy
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/DK1989/000197
Other languages
English (en)
Inventor
Lars Stig JØRGENSEN
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to PCT/DK1989/000197 priority Critical patent/WO1991002491A1/fr
Publication of WO1991002491A1 publication Critical patent/WO1991002491A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop

Definitions

  • the present invention relates to an instrument for colon and rectum resection and a method wherein such a resection is performed by use of the instrument.
  • Colon and rectum resections are relatively often performed on surgical wards. The operation is most often performed on grounds of cancer, but also on grounds of other conditions as e.g. diverticulum disease and inflammatory intestinal diseases, colitis ulceration and Crohn's dis ⁇ ease.
  • Today colon resection is performed by division of the intestine after it has been dissected free of peritoneum and mesenteriu . There ⁇ after the intestine continuity is reestablished by anastomizing the two open ends in one or two layers. This may take place either by con- ventional hand suturation or by special instruments (autosuture in ⁇ struments).
  • Contamination from the opened intestine involves a risk of infection (wound infection, intraperitoneal absces, peritonitis, sep- ticaemi) as colon is heavily colonialized with bacteria. It has been attemped to limit the infection risk through a reduction of the quan- tity of faeces in the intestine by some form of mechanical cleansing, by antibiotic pretreatment of the intestine and/or by preoperative or peroperative systemic antibiotic profylaxis. By conventional pretreat ⁇ ment without antibiotic profylaxis there is a substantial risk of some form of infection in connection with colon resection. Anastomosis leak- age is another significant complication and it is believed that infec ⁇ tion influences such a leakage.
  • SE patent No. 356,896 and DE patent No. 2,513,868 The instrument known from SE patent No. 356,896 is intended for proc- tologic operations.
  • This apparatus comprises grasping and extracting means which may extract a diseased mucosa from the lower part of rec ⁇ tum. After the extraction, external cutting means are used to remove the diseased mucosa.
  • This instrument will provide some of the desirable advantages, but the instrument has a limited field of application and it is also complicated to handle.
  • an instrument for colon and rectum resec ⁇ tion comprising cutting means and extraction means, characterized in that the cutting means are provided in the form of a diathermal cutting snare and a support snare supporting the diathermy snare, that the diathermy snare, the support snare and the extraction means are arranged to be introduced via anus, and to be activated via a flexible tubular connection means and by means of operating means in a handle outside the body, that the support snare is introduced via two guides in the tubular connection means and is so arranged that it can be re- leased from the diathermy snare and thus be extracted through one of the guides, that the extraction means are constituted of a thin, but rigid wire connected to the tubular connection means and having a cir ⁇ cular end section with a diameter smaller than the diameter of the optional opening of the support snare and the diathermy snare support- ed thereon, and that a
  • the instrument according to the invention is introduced via anus with ⁇ out opening the intestine.
  • the end section of the extraction wire is placed immediately in front of the support snare and the diathermy snare supported thereon, and this unit is introduced through the in ⁇ testine approximately to the place of the distal resection line.
  • the support and diathermy snare are opened so that they press gently against the intestinal wall.
  • the end section of the extraction wire is pushed through the support snare and the diathermy snare supported thereon and forwards to approximately the middle of the intestine sec ⁇ tion to be removed.
  • the surgeon will be able to place the instrument cor ⁇ rectly in a quick and easy way from the outside. After the end section of the extraction wire has been placed correctly, it is fixed to the intestine from the outside, e.g. with a ligature. By the operating means, the surgeon is hereafter able to invaginate the diseased intes- tine section through the support snare and the diathermy snare and down into the healthy intestine.
  • the support snare is located at the fold which results from the invagination.
  • the instrument When the invagination is completed and the two places on the intestine to be anastomosized have met, the instrument is fixed from the outside by means of the plate bearing against anus. Hereby the invaginated intestine will not be able to slip back.
  • the surgeon may easily suture along the fold as the suture place is presented as tubular and inverted.
  • the anastomosis may optionally be applied with autosuture instruments or by conventional hand suturation.
  • the support snare is extracted and the diathermy snare is tightened and an attached traditional diathermy apparatus is activated whereby the invaginate is burnt through and released from the intestine. It may hereafter by extracted through anus together with the instrument. The operation has taken place from the inside of the intestine which has at no time been opened thereby reducing the risk of infection considerably.
  • the instru ⁇ ment may hereafter be prepared for reuse. Certain parts of the instru ⁇ ment may be exchangeable without affecting the instrument costs essen ⁇ tially. As the instrument permits an operation from the inside of the intes ⁇ tine, the risk of infection is reduced and hereby the need for use of antibiotics is reduced as well. Thus the instrument permits a cost- saving operation and at the same time it reduces the risk of antibio- tic-associated complications.
  • the instrument may advantageously be wrapped in a sterile bag having a glue edge which is attached around anus.
  • This bag may confine only a part of the instrument and may terminate immediately before the ope- ration means so that a surgeon may easily adjust them.
  • Examples of the known technology within the field may include the ope- ration methods described in US Patents Nos. 3,472,231, 4,328,805, 3,771,526, and 4,705,040.
  • None of the operation methods de ⁇ scribed in these patents point out satisfactorily a method to be used for colon and rectum resection and reducing the infection risk.
  • the instrument prior to the release of the intestine section the instrument is intro ⁇ quizzed via anus, that the instrument with the diathermy and support snares closed around the end section of the extraction wire is introduced approximately to the place of the distal resection line, as the surgeon has a visual indication of the position of the support snare from the outside of the intestine and as the surgeon controls the introduction of the instrument through the intestinal wall, that the end section of the extraction wire is displaced further for ⁇ wards through the support snare and the cutting snare to a position shortly beyond the centre of the intestine section to be removed, that the intestine is fixed to the extraction wire with a ligature or the like behind the end section of the extraction wire, that the support snare and the diathermy snare supported thereon are opened by means of a handle so that the snares exert a gentle pressure onto the intestinal wall, that the intestine section to be removed is then led down into the healthy intestine by invagination until
  • the intestine is not opened in connection with the division.
  • the division takes place inside the intestine only after the diseased part of the intestine has been invagineted down into the healthy intestine and after the intestine has been sutured.
  • an aseptic resection is achieved by the method whereby the risk of infection deriving from the contamination from the open intestine is substantially avoided.
  • the resection may also be performed quickly and safely as the invagination ensures that the suture place is presented as turbular and inverted.
  • it be ⁇ comes possible to perform a quick and simple suture. This may be per ⁇ formed by means of autosuture instruments or by conventional hand su ⁇ turation.
  • the described method may very advantageously be used in case of acute operations. As there are no risk of complications associ ⁇ ated with joining the intestine ends by the method according to the invention it will not be necessary to perform a temporary colostomy to be reperformed after a couple of months. Thus this method will cause less inconvenience to the patient. In addition, this yields further capacity and social advantages as only one operation is required in order to finish the treatment of the patient. Furthermore, the method may be used when treating cancer diseases where tissue as for example mesenterium and omentum is to be removed together with the intestine. Generally, these appendices have to be removed in advance in order to facilitate the invagination. This may be done quickly and simply with a pair of scissors as the blood supply is cut off after the dissection.
  • the described method may advantageously be combined with a lavement, using an instrument comprising a suction and flushing passage.
  • the method may be used for resection of the small intestine in the same way as by colon resection.
  • an alternative method may be used as referred to in claim 8.
  • an aseptic operation is achieved together with the advantages associated with the above-described method.
  • the alternative method will be slightly slower as a constriction and a removal of the part of the intestine which cannot be invaginated has to take place initially.
  • Fig. 1 illustrates a partial view of a detail of an instrument ac ⁇ cording to the invention
  • Fig. 2 illustrates a partial view of another detail of the instru ⁇ ment
  • Fig. 3 illustrates a partial view of a further detail of the in ⁇ strument
  • Fig. 4 illustrates a method according to the invention
  • Fig. 5 illustrates an alternative method according to the inven ⁇ tion.
  • FIGS 1,2, and 3 illustrate an instrument according to the invention. It is noted that the illustrated elements are partly dis- torted by way of illustration.
  • Fig. 1 shows the front end of the instrument, i.e. that part which is intended to be conducted into the intestine via anus.
  • Fig. 2 illustra- tes that part of the instrument which is intended to be outside the body and
  • Fig. 3 illustrates the operation means of the element which also are outside the body.
  • the instrument comprises a diathermy snare 1.
  • the diathermy snare 1 is only uninsulated over a short distance 2.
  • the cutting effect is concentrated and when used for cutting off an intestine section, the thread will not give rise to unsuitable heating of a larger area which would otherwise possibly have involved that cells denature.
  • the diathermy snare is supported by a support snare 3 constituted of a flexible relatively rigid element, e.g. a wire formed of spiral thread.
  • the element runs through two guides 4 forming the support snare at the front end of the instrument.
  • the guides 4 and a protection casing 5 for the diathermy snare are placed in a flexible tubular connection means 6.
  • the tubular connection means 6 also comprises a passage 7 for injection of protection gas, prefera ⁇ bly C0 2 . An injection with C0 2 eliminates the risk of explosions when the diathermy thread is activated with a cutting current.
  • the tubular connection means also supports the extraction means in form of a thin, but rigid wire 8 having a circular end section 9.
  • the diameter of the circular end section 9 is smaller than the optional opening 10 for the support snare 3 and the diathermy snare 1 supported thereon.
  • the wire 8 is optionally connected to the tubular connection means 6 by means of an elastic connection, e.g. of one or more rubber bands 6a which allow a displacement of the wire 8.
  • the diathermy snare 1 and the support snare 3 are mutually connected by means of loops 11. Only two are shown, but also two or more loops 11 may be used. The loops 11 make it possible to release the connec ⁇ tion between the two snares so that the support snare 3 may be extract ⁇ ed through one of the guides 4.
  • Fig. 1 illustrates a sterile bag 12 which encases the instrument and is provided with a glue edge 13 intented for application around anus.
  • the sterile bag 12 may encase the entire instrument including the handle part 14 as illustrated in Fig. 3. However, this bag may also be arranged to end before the handle 14 so that the latter may be ope- rated in a more easy way.
  • Fig. 2 illustrates a plate 15 intended to bear against anus.
  • the plate 15 is provided with clamping means (not shown) making it possible to perform a mutual fitting of the extrac ⁇ tion wire 8 and the plate 15. The importance of this will be explained later on.
  • the handle 14 establishes a mutual connection between the diathermy snare 1 and the support snare wire 3.
  • the connection is releasable as the diathermy snare thread 1 is connected to a clamping device 16 and the support snare wire 3 is connected to a clip 17 at each end.
  • the support snare wire 3 may be extracted through the one guide 4 when the diathermy snare is in its place.
  • the support snare and the diathermy snare are clamped in the clamping device 16 and in the clips 17, respectively, they will accompany each other when the handle 14 is operated.
  • Fig. 3 also shows that the extraction wire 8 is pro ⁇ vided with a grip 18 which may be activated independently of the han ⁇ dle 14.
  • Fig. 1 shows that the ends 19 of the guides 4 are orientated substan ⁇ tially perpendicular to the tubular connection means 6.
  • the orientation substantially perpendicular to the tubular connection means is imparted to the support snare and may thereby be visually followed when it is conducted through the intestine as a surgeon with the hand may conduct the support snare 3 with the diathermy snare 1 supported thereon to the correct position for these elements.
  • the length of the tubular connection means 6 may vary from approx. 30 cm to approx. 150 cm depending on where in the intestine the instru- ment is inteded to be used in the intestine.
  • the passage 7 of the instrument may be used as a suction and flushing passage which may be an advantage in acute operations as hereby it becomes possible to evacuate the intestine.
  • the instrument may be provided with a thermometer (not shown) measuring the temperature in the area at the uninsulated part 2 of the diathermy thread. The thermometer may be connected to guide means (not shown) interrupting the cutting cur ⁇ rent when there is a risk of denaturation of cells.
  • the end section 9 of the ex ⁇ traction wire is disc-shaped as shown in Fig. 1. This is especially the case when the instrument is used during rectum resection.
  • the apparatus according to the invention may be used by a method ac ⁇ cording to the invention for colon and rectum resection and which is explained in the following with reference to Figs. 4 and 5.
  • Fig. 4 illustrates a method wherein an intestine section 19 contains .a tumour 20.
  • the tumour 20 is so small that it is possible to invaginate the diseased intestine section 19 into the healthy intestine section 21.
  • the instrument is introduced via anus with the support snare 3 and the diathermy snare 1 supported thereon tightened completely around the end section 9 of the extraction wire. Preferably this takes place before the operation starts as the sterile bag 12 may be pulled over the instrument and glued around anus before a skin disinfection and a sterile covering of the patient are performed.
  • the intestine section 19 is laid free in the usual manner.
  • the relatively rigid support snare gives the surgeon a visual indication of the position of the snares.
  • the two sites 23,24 on the intestine to be anastomosized are located and the snares are introduced approximately to the distal resection line 23.
  • the snares 1,3 are opened by means of the handle 14 and the end section 9 of the extraction wire is displaced through the support snare and the cutting snare 3,1 to a position shortly beyond the mid ⁇ dle of the intestine section 19 (Fig. 4b).
  • the intestine is constricted behind the end section 9 by means of a sewing thread 22.
  • the intestine section 19 may be invaginated into the healthy intestine 21 until the two sites 23,24 on the intestine to be anastomosized meet (Fig. 4c).
  • the intestine section 19 is invaginated through the support snare 3 and the cutting snare 1 which has been pressed upwards against the fold 25 formed by the invagination. After the invagination, the snares are easily closed and the intestine is tubular and inverted because of the position of the invagination.
  • holding sutures 26,27 are pulled mesenterically and antimesenterically (Fig. 4c).
  • the invaginated intestine section is held under tension as the plate 15 is locked relative to the tubular means 6 and thus in relation to the extraction wire 8 in a position where the extraction wire is drawn backwards. Thereafter the intestine is sutured with soluble liga ⁇ ture 28 all the way around.
  • the support snare 3 is extracted through one of its guides 4 and the diathermy snare 1 is tightened (Fig. 4d) whereafter the cutting current is activated.
  • the in- testine section 19 is released from the remaining part of the intesti ⁇ ne and may thereafter be extracted (Fig. 4e) through anus together with the instrument.
  • the wound in the abdominal wall may be closed in the usual manner.
  • the intestine has not been opened at any time and the risk of infection is thereby avoided.
  • the use of antibiotics is considerably reduced which also reduces the risk of resistance development and of antibiotic-associated com ⁇ plications.
  • the instrument proper is relatively inexpensive to produce as it consists of simple elements which may be reused. Furthermore, the use of the instrument is inexpensive and effective as the surgeon needs only one operation to finish the treatment of the patient.
  • Fig. 5 An alternative method for using the instrument according to the inven ⁇ tion is illustrated in Fig. 5.
  • This method is used when the tumour 20 found is so large that the invagination is impossible.
  • the tumour is identified (Fig. 5a) in the usual manner.
  • the instrument is introduced via anus whereafter the sterile bag 12 may be pulled over the instrument and glued around anus.
  • a con ⁇ striction of the intestine is performed (5c).
  • the constriction is per- formed by means of two pair of clips 29 applied immediately adjacent to each other on each side of the tumour 20.
  • the intestine is divided by cutting 30 between each of the two pairs of clips 29 and the intestine section 31 containing the tumour is removed.
  • the end section 9 of the extraction wire is pushed forward to come into contact with the distal constricted end of the intestine.
  • a constriction of the distal intestine end behind the end sec ⁇ tion 9 is performed by means of a thread 32.
  • the two intestine ends are connected either by means of the thread 32 or by means of coupling means on the two clips 29.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Physiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

Un instrument pour effectuer une résection du colon et du rectum et une anastomose ultérieure permet une intervention aseptique et facile. Ledit instrument comprend une anse de diathermie (1) supportée sur une anse de support rigide (3) laquelle permet de procéder à la localisation précise de ladite anse de diathermie (1). Ledit instrument comporte un fil d'extraction (8) présentant une section terminale circulaire (9) dont le diamètre est inférieur au diamètre de l'ouverture possible desdites anses de support et de diathermie (3, 1). Ladite anse de support est introduite par l'intermédiaire de deux liquides (4) dans un moyen de connexion tubulaire (6) lequel est également raccordé audit fil d'extraction (8). On introduit ledit instrument via l'anus jusqu'à la section intestinale malade (19). On déplace ladite section terminale (9) par l'intermédiaire desdites anses de support et de diathermie auxquelles on fixe l'intestin, après quoi on procède à une invagination. On suture l'intestin sans l'ouvrir après retrait de l'anse de support, puis on resserre ladite anse de diathermie (1) autour de l'intestin et ce dernier est coupé. L'intestin invaginé peut ensuite être extrait via l'anus avec l'instrument. Ainsi, l'intestin n'a pas été ouvert pendant l'intervention.
PCT/DK1989/000197 1989-08-24 1989-08-24 Instrument et procede de resection du colon et du rectum Ceased WO1991002491A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/DK1989/000197 WO1991002491A1 (fr) 1989-08-24 1989-08-24 Instrument et procede de resection du colon et du rectum

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Application Number Priority Date Filing Date Title
PCT/DK1989/000197 WO1991002491A1 (fr) 1989-08-24 1989-08-24 Instrument et procede de resection du colon et du rectum

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WO1991002491A1 true WO1991002491A1 (fr) 1991-03-07

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Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996018344A3 (fr) * 1994-12-07 1997-10-23 Mcguckin James F Jr Appareil et procede de chirurgie colique/rectale
AU736420B2 (en) * 1994-12-07 2001-07-26 James F. Mcguckin Jr. Apparatus and method for performing colon/rectal surgery
US7235089B1 (en) 1994-12-07 2007-06-26 Boston Scientific Corporation Surgical apparatus and method
RU2456944C2 (ru) * 2010-07-19 2012-07-27 Государственное образовательное учреждение высшего профессионального образования "Мордовский государственный университет им. Н.П. Огарева" Способ формирования антирефлюксного инвагинационного тонко-толстокишечного анастомоза
RU2471439C2 (ru) * 2011-04-08 2013-01-10 Федеральное государственное бюджетное учреждение "Ростовский научно-исследовательский онкологический институт" Министерства здравоохранения и социального развития Российской Федерации (ФГБУ "РНИОИ" Минздравсоцразвития России) Способ наложения инвагинационного аппаратного анастомоза при передне-верхней резекции прямой кишки по поводу рака
CN109223116A (zh) * 2018-11-28 2019-01-18 刘润瑞 一种新型微创手术切除体表皮下肿物的器械
CN110353766A (zh) * 2019-08-07 2019-10-22 辽宁省肿瘤医院 一种适用于noses切除拖出式手术的新型无菌保护套
US10806457B1 (en) 2017-04-13 2020-10-20 Charles H Vanderpool Intraluminal anastomotic device and method
US11559293B1 (en) 2021-05-06 2023-01-24 Charles H Vanderpool Apparatus for facilitating access to abdominal cavity of a patient and removing larger cancerous tumors
US11801056B2 (en) 2021-05-06 2023-10-31 Charles H Vanderpool Apparatus for facilitating access to abdominal cavity of a patient and removing larger cancerous tumors
US12414773B2 (en) 2023-12-13 2025-09-16 Invertes Inc. System and method for blocking a luminal body

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SE356896B (fr) * 1969-08-11 1973-06-12 Joe Wai R Tjong
US3771526A (en) * 1972-02-07 1973-11-13 P Rudie Anastomosis clamp
US4503855A (en) * 1981-12-31 1985-03-12 Harald Maslanka High frequency surgical snare electrode
FR2619301A1 (fr) * 1987-08-11 1989-02-17 Monarque Suzanne Instrument pour l'extraction de troncons de veines

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SE356896B (fr) * 1969-08-11 1973-06-12 Joe Wai R Tjong
US3771526A (en) * 1972-02-07 1973-11-13 P Rudie Anastomosis clamp
US4503855A (en) * 1981-12-31 1985-03-12 Harald Maslanka High frequency surgical snare electrode
FR2619301A1 (fr) * 1987-08-11 1989-02-17 Monarque Suzanne Instrument pour l'extraction de troncons de veines

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
DERWENT'S ABSTRACT, No. 87-361 074/51; & SU,A,1 309 972, publ. week 8751, (TOPUZOV), see figures 1-5. *

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996018344A3 (fr) * 1994-12-07 1997-10-23 Mcguckin James F Jr Appareil et procede de chirurgie colique/rectale
AU716048B2 (en) * 1994-12-07 2000-02-17 James F. Mcguckin Jr. Apparatus and method for performing colon/rectal surgery
US6264086B1 (en) 1994-12-07 2001-07-24 Mcguckin, Jr. James F. Surgical apparatus and method
AU736420B2 (en) * 1994-12-07 2001-07-26 James F. Mcguckin Jr. Apparatus and method for performing colon/rectal surgery
US7235089B1 (en) 1994-12-07 2007-06-26 Boston Scientific Corporation Surgical apparatus and method
JP2008142557A (ja) * 1994-12-07 2008-06-26 James F Mcguckin Jr 外科手術装置
RU2456944C2 (ru) * 2010-07-19 2012-07-27 Государственное образовательное учреждение высшего профессионального образования "Мордовский государственный университет им. Н.П. Огарева" Способ формирования антирефлюксного инвагинационного тонко-толстокишечного анастомоза
RU2471439C2 (ru) * 2011-04-08 2013-01-10 Федеральное государственное бюджетное учреждение "Ростовский научно-исследовательский онкологический институт" Министерства здравоохранения и социального развития Российской Федерации (ФГБУ "РНИОИ" Минздравсоцразвития России) Способ наложения инвагинационного аппаратного анастомоза при передне-верхней резекции прямой кишки по поводу рака
US10806457B1 (en) 2017-04-13 2020-10-20 Charles H Vanderpool Intraluminal anastomotic device and method
CN109223116A (zh) * 2018-11-28 2019-01-18 刘润瑞 一种新型微创手术切除体表皮下肿物的器械
CN110353766A (zh) * 2019-08-07 2019-10-22 辽宁省肿瘤医院 一种适用于noses切除拖出式手术的新型无菌保护套
US11559293B1 (en) 2021-05-06 2023-01-24 Charles H Vanderpool Apparatus for facilitating access to abdominal cavity of a patient and removing larger cancerous tumors
US11801056B2 (en) 2021-05-06 2023-10-31 Charles H Vanderpool Apparatus for facilitating access to abdominal cavity of a patient and removing larger cancerous tumors
US12414773B2 (en) 2023-12-13 2025-09-16 Invertes Inc. System and method for blocking a luminal body

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