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WO2010099799A1 - Aiguille de ponction pour correction laparoscopique d'une aplasie vaginale - Google Patents

Aiguille de ponction pour correction laparoscopique d'une aplasie vaginale Download PDF

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Publication number
WO2010099799A1
WO2010099799A1 PCT/EG2009/000008 EG2009000008W WO2010099799A1 WO 2010099799 A1 WO2010099799 A1 WO 2010099799A1 EG 2009000008 W EG2009000008 W EG 2009000008W WO 2010099799 A1 WO2010099799 A1 WO 2010099799A1
Authority
WO
WIPO (PCT)
Prior art keywords
vaginal
puncturing needle
dimple
tape
needle
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/EG2009/000008
Other languages
English (en)
Inventor
Atef Mohammad Mostafa Darwish
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/EG2009/000008 priority Critical patent/WO2010099799A1/fr
Publication of WO2010099799A1 publication Critical patent/WO2010099799A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B17/06109—Big needles, either gripped by hand or connectable to a handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00805—Treatment of female stress urinary incontinence

Definitions

  • Vaginal agenesis is a rare anomaly that carries serious pychologic, social and sexual impacts on the patient and her family as well (1,2).
  • the main goal of treatment should focus in restoring normal sexual function of the neovagina.
  • the ideal method of vaginal replacement should provide a cosmetically acceptable, low maintenance vaginal substitute with minimal morbidity and excellent long-term function.
  • Dilators are generally effective in creating a functionally useful vagina (Frank Method) (7).
  • Vecchietti operation is a surgical modification of Frank's method and is subjected to some modifications (8) and can be easily performed laparoscopically (9, 10). Most of the novel advances in vaginal reconstruction have been related to the advances made in laparoscopic techniques (11). Nevertheless, Vecchietti operation is tedious and usually performed by well-trained specialized teams utilizing sophisticated instrumentation. This patent aims to assess safety, feasibility and efficacy of an alternative trans-vaginal traction (TVT) vaginoplasty procedure utilizing an olive attracted upwards towards the anterior abdominal wall via space of Reitzus.
  • TVT trans-vaginal traction
  • the bladder Under general anesthesia, the bladder is evacuated followed by insertion of a rigid catheter guide (bladder stylet) loaded inside a urethral catheter. It aims to mobilize the bladder neck away from the tip of the needle when it passes into the retropubic space.
  • a 7 mm suprapubic incision is made 2 cm on both sides of the midline in the suprapubic area 2 cm above the symphysis pubis in the same manner as tension-free vaginal tape (TVT) operation for treating genuine stress incontinence.
  • a specially designed sharp curved needle with a wide mutum attached to a plastic handle is used to perforate the vaginal dimple bilaterally just 1 cm below the bladder neck.
  • a 1 cm width and 30 cm length strip of mesh is stretched then loaded into the fenestrum of the needle ( Figure 1).
  • a fenestrated oval 2x3 cm plastic olive is loaded on the tape.
  • the needle is inserted through the vaginal dimple skin without prior incision directed upwards and slightly lateral towards the space of Reitzus with simultaneous mobilization of the bladder inwards and laterally to the ipsilateral side with the bladder stylet. Thereafter, the needle is directed slightly medial towards the suprapubic incision of the ipsilateral side. Once the tape is seen, the needle is withdrawn while the tape is clamped by a forceps. The bladder catheter is then removed followed by cystoscopic examination. If the bladder is intact, the same steps were repeated on the other side.
  • Traction on the tape is maintained by applying an umbilical cord plastic clamp on each arm.
  • an intervening layer of sterile gauze is placed underneath a stainless steel fenestrated plate.
  • a urethral catheter is inserted and fixed. After a short postoperative interval, before discharge, the patient is instructed to maintain antibiotic coverage and to take a non-steroidal antiinflammatory drug whenever required. She is taught how to evacuate and care for the urine collection bag, make frequent proper vaginal douches using bovidone iodine 10%, and apply sterile vulvar dressings to guard against ascending infection.
  • a specially designed sharp curved needle with a wide mutum attached to a plastic handle is used to perforate the vaginal dimple bilaterally just 1 cm below the bladder neck to allow a tape for traction.
  • a fenestrated oval plastic olive is loaded on the tape.
  • the needle may be sealed with the tape.

Landscapes

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

Abstract

L'invention concerne une aiguille de ponction à forte courbure et à large fenêtre spécialement conçue pour la ponction bilatérale de la cupule vaginale. Une bande à laquelle est reliée une olive en plastique peut être attachée à la fenêtre de l'aiguille de ponction et insérée à travers les incisions. Une mise en tension continue de la bande exerce une pression d'étirement sur la cupule vaginale de façon à permettre la formation d'un néovagin.
PCT/EG2009/000008 2009-03-02 2009-03-02 Aiguille de ponction pour correction laparoscopique d'une aplasie vaginale Ceased WO2010099799A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/EG2009/000008 WO2010099799A1 (fr) 2009-03-02 2009-03-02 Aiguille de ponction pour correction laparoscopique d'une aplasie vaginale

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EG2009/000008 WO2010099799A1 (fr) 2009-03-02 2009-03-02 Aiguille de ponction pour correction laparoscopique d'une aplasie vaginale

Publications (1)

Publication Number Publication Date
WO2010099799A1 true WO2010099799A1 (fr) 2010-09-10

Family

ID=42709227

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EG2009/000008 Ceased WO2010099799A1 (fr) 2009-03-02 2009-03-02 Aiguille de ponction pour correction laparoscopique d'une aplasie vaginale

Country Status (1)

Country Link
WO (1) WO2010099799A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11969819B2 (en) 2013-04-26 2024-04-30 Vactronix Scientific, Llc Adaptive guide bushing for laser tube cutting systems
US12447552B2 (en) 2013-04-26 2025-10-21 Vactronix Scientific, Llc Adaptive guide bushing for laser tube cutting system

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060229676A1 (en) * 2003-10-24 2006-10-12 Frank Doll Device for fixing and tensioning at least one pulling thread for applying a neovagina

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060229676A1 (en) * 2003-10-24 2006-10-12 Frank Doll Device for fixing and tensioning at least one pulling thread for applying a neovagina

Non-Patent Citations (3)

* Cited by examiner, † Cited by third party
Title
ATTUAL OSTET GINECOL, vol. 11, 1965, pages 131 - 147 *
DATABASE MEDLINE VECCHIETTI, G.: "Creation of an artificial vagina in Rokitansky- Kuster-Hauser syndrome.", accession no. STN Database accession no. 1966019996 *
VECCHIETTI, G.: "Creation of an artificial vagina in Rokitansky- Kuster-Hauser syndrome.", ATTUAL OSTET GINECOL, vol. 11, 1965, USA, pages 131 - 147 *

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11969819B2 (en) 2013-04-26 2024-04-30 Vactronix Scientific, Llc Adaptive guide bushing for laser tube cutting systems
US12447552B2 (en) 2013-04-26 2025-10-21 Vactronix Scientific, Llc Adaptive guide bushing for laser tube cutting system

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