DE2305815A1 - DEVICE FOR SEPARATING SURGICAL FEEDS - Google Patents
DEVICE FOR SEPARATING SURGICAL FEEDSInfo
- Publication number
- DE2305815A1 DE2305815A1 DE19732305815 DE2305815A DE2305815A1 DE 2305815 A1 DE2305815 A1 DE 2305815A1 DE 19732305815 DE19732305815 DE 19732305815 DE 2305815 A DE2305815 A DE 2305815A DE 2305815 A1 DE2305815 A1 DE 2305815A1
- Authority
- DE
- Germany
- Prior art keywords
- wire
- flexible
- guide hose
- attached
- holder
- 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.)
- Pending
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
Description
Vorrichtung zum Trennen von chirurgischen Fäden Die Erfindung betrifft eine Vorrichtung zum Trennen von chirurgischen Fäden im operierten Magen und Darm und ist zur Anwendung im gesamten Intestinaltrakt geeignet. So verbleibt beispielsweise bei etwa 10 % der Magenoperierten Naht#aterial, das nicht verdaut wird, in der Magenschleimhaut. Dieses persistierende Nahtmaterial stellt einen dauernden Fremdkörporreiz für das menschliche Magen-Darm-#ewebe dar und ruft nicht selten Gesehwürsbildungen hervor. Nur selten gelingt es, derartige Fäden auf endoskopischem Wege zu trennen und mit der Zange heraus zuziehen. Apparatus for severing surgical threads The invention relates to a device for cutting surgical sutures in the operated stomach and intestines and is suitable for use throughout the intestinal tract. So remains for example in about 10% of gastric surgery sutures that are not digested in the gastric mucosa. These persistent sutures are a permanent stimulus for foreign bodies human gastrointestinal tissue and often causes ulcer formation. It is only rarely possible to separate such threads by endoscopic means and with them the pliers out.
Es ist bekannt, zur Betrachtung und Untersuchung des Intestinaltraktes Endoskope, sogenannte Ösophago-, Gastro-, Duodeno-und Entero-Coloskope zu verwenden, die im wesentlichen aus einem langen flexiblen Fiberglaslichtleiter bestehen, der einen Instrumentierkanal aufweist. Durch diesen Instrumentierkanal kann man z.B. Biopsiezangen in das zu untersuchende Organ einführen, um dort Gewebeproben für Untersuchungszwecke zu entnehmen.It is known for viewing and examining the intestinal tract To use endoscopes, so-called esophago-, gastro-, duodeno and entero-coloscopes, which essentially consist of a long flexible fiberglass light guide, the has an instrumentation channel. This instrumentation channel can e.g. Insert biopsy forceps into the organ to be examined to collect tissue samples for To be taken from the purposes of the investigation.
Auf einem solchen Instrument baut die Erfindung auf und ihr liegt die Aufgabe zugrunde, für diese bekannten Geräte eine Vorrichtung zu schaffen, mit der Fäden aus Kunststoff und Textilfasern getrennt werden können, die als Operationsmaterial im Magen-Darm-Trakt zurückgeblieben sind, was bisher nicht möglich war.The invention is based on such an instrument and lies with it the task of creating a device for these known devices with The threads made of plastic and textile fibers can be separated, which are used as surgical material remained in the gastrointestinal tract, which was previously not possible.
Diese Aufgabe wird gemäß der Erfindung mit einer Vorrichtung der eingangs beschriebenen Art dadurch gelöst,#daß ein federnder Drahthaken, der an eine Hochfrequenzspannungsquelle anschaltbar ist, an einem Ende eines biegsamen Drahtschiebers befe#stigt und mittels eines am anderen Ende des Drahtschiebers angebrachten Griffstückes im Instrumentierkanal längsverschieblich ist. Zweckmäßiger Weise wird der Drahtschieber in einem biegsamen Kunststoffschlauch geführt, der seinerseits im Instrumentierkanal längsverschieblich ist.This object is achieved according to the invention with a device of the opening paragraph described type solved # that a resilient wire hook, which is connected to a high-frequency voltage source can be switched on, attached to one end of a flexible wire slider and by means of a handle attached to the other end of the wire slider in the instrument channel is longitudinally displaceable. Appropriately, the wire slider is flexible Out of plastic tubing, which in turn can be moved lengthways in the instrument channel is.
Um den Drahthaken unter den Faden einhaken zu können, ist es.notwendig, ihn in jede räumliche Lage zu bringen. Deshalb wird der Drahtschieber vorzugsweise aus einer biegsamen-Welle-gebildet, mit deren Hilfe der Drahthaken durch entsprechende Handhabung des Griffstückes auch-noch um seine Bangsachse spannungsfrei verdreht werden kann.In order to be able to hook the wire hook under the thread, it is necessary to to bring him into any spatial position. Therefore, the wire pusher becomes preferable from a flexible-shaft-formed, with the help of which the wire hook by appropriate Handling of the handle also-still twisted tension-free about its Bangsachse can be.
Bei der praktischen --Handhabung der neuen Vorrichtung wird der Drahthaken zunchst vollständig in den Fiiiirungsschlauch eingezogen, um bei der Durchführung durch den Instrumentierkanal das Instrument nicht zu beschädigen. Nach Passage des Instrumentes wird der Drahthaken ausgeführt, zwischen den persistierenden Faden und die Schleimhaut gebracht und dort verhakt, damit der Faden von der Schleimhaut abgehoben werden kann. Nach langsamen Aufheizen des Drahthakens mit Hilfe der angelegten HF-Energie wird der Faden diathermisch zerschnitten (nach Art einer "elektrischen Schere") und anschließend mit der Biopsiezange aus der Zagendarmwand herausgezogen. Beim Schneidevorgang ist der Drahthaken über die metallische, biegsame Welle am anderen Ende mit einem handelsüblichen Hochfrequenz-Chirurgiegerät verbunden.In the practical handling of the new device, the wire hook at first completely drawn into the flow tube in order to be able to carry out not to damage the instrument through the instrument channel. After passage of the Instrument, the wire hook is carried out between the persistent thread and brought the mucous membrane and hooked it there, thereby removing the thread from the mucous membrane can be withdrawn. After slowly heating up the wire hook with the help of the applied HF energy, the thread is cut diathermally (like an "electrical Scissors ") and then pulled out of the intestinal wall with the biopsy forceps. During the cutting process, the wire hook is on the flexible metal shaft the other end connected to a commercially available high-frequency surgical device.
Durch Drehen der biegsamen Welle ist die Aus#richtung des Drahthakens entsprechend der Lage des Fadens möglich.The wire hook is aligned by turning the flexible shaft possible depending on the position of the thread.
Weitere Merkmale und Einzelheiten der Erfindung sind nun im folgenden an Hand zweier Ausführungsbeispiele näher beschrieben und in der Zeichnung dargestellt.Further features and details of the invention are now set out below described in more detail using two exemplary embodiments and shown in the drawing.
Figur 1 zeigt die gesamte Vorrichtung in der Seitenansicht, teilweise im Schnitt; Figur 2 zeigt die vergrößerte Darstellung einer Einzelheit im Schnitt.Figure 1 shows the entire device in a side view, partially on average; Figure 2 shows an enlarged view of a detail on average.
Die neue Vorrichtung zum diathermischen Trennen von Nahtmaterial umfaßt im wesentlichen die Halterung 1, den an ihr befestigten flexiblen Führungsschlauch 2, der aus elastischem Kunststoff besteht, ein Griffstück 3, das in der Halterung 1 axial-verschieblich geführt ist und an dem ein aus Federdraht oder einer biegsamen Welle bestehender Drahtschieber 4 befestigt ist, der am anderen Ende mit einem federnden Drahthaken 5 in Verbindung steht. Der Drahthaken 5 ist aus nichtrostendem Federstahidraht von etwa 0>2 bis 0,3 mm Durchmesser hergestellt.The new device for diathermally severing sutures includes essentially the holder 1, the flexible guide hose attached to it 2, which consists of elastic plastic, a handle 3, which is in the holder 1 is guided axially displaceably and on which one made of spring wire or a flexible one Shaft existing wire slide 4 is attached, the other end with a resilient Wire hook 5 is in connection. The wire hook 5 is made of stainless spring steel wire from about 0> 2 to 0.3 mm in diameter.
Nach Figur 2 ist der Drahthaken -5a aus einem ösenförmig gebogenen, parallel verlaufenden Doppeldraht gebildet und derart#geformt, daß er am vorderen Ende Sb eine halbkreisförmige Biegung aufweist, deren Durchmesser kleiner als die lichte Weite des Ftilirungsschlauches 2 ist; In dieser Figur ist der Drahthaken 5a beim Einziehen auf halbem Wege gezeigt.According to Figure 2, the wire hook -5a is made of an eyelet-shaped bent, formed parallel double wire and shaped in such a way that it is at the front End Sb has a semicircular bend, the diameter of which is smaller than that inside diameter of the ventilation hose 2 is; In this figure is the wire hook 5a shown halfway through when retracting.
Die Halterung 1 besteht aus einem Hohlzylinder, an dem ein Anschlußstutzen 9 befestigt ist, der über einen Schlauch 10 mit einer nicht dargestellten Schutzgasflasche, etwa mit Kohlendioxyd, in Verbindung steht. Das Griffstück 3 ist am Ende einer Schiebestange 11 befestigt, deren anderes Ende mittels einer Gleitführung 12 in dem Zylinderraum der Halterung 1 geführt wird.The holder 1 consists of a hollow cylinder on which a connection piece 9 is attached, which via a hose 10 with a protective gas bottle, not shown, for example with carbon dioxide. The handle 3 is at the end of a push rod 11 attached, the other end by means of a sliding guide 12 in the cylinder space the bracket 1 is guided.
Die Schiebestange 11 ist gegenüber der Halterung 1 abgedichtet, so daß ein geschlossener Raum für die Zuführung des Schutzgases aus der Gasflasche über den Schlauch 10, den Anschlußstutzen 9 und den Führungsschlauch 2 bis zum Drahthaken besteht. Am vorderen Ende ist der Fhhrungsschlauch 2 mit mindestens einer seitlichen Öffnung 13 versehen, so daß das Schutzgas nicht nur vorn in Richtung des Drahthakens 5, sondern auch seitlich austreten kann und das gesamte Arbeitsfeld laufend umspült. Denn es kann unter ungünstigen Umständen vorkommen, daß beim Abtragungs- bzw.The push rod 11 is sealed against the holder 1, so that a closed space for the supply of protective gas from the gas bottle via the hose 10, the connecting piece 9 and the guide hose 2 to the wire hook consists. At the front end is the guide hose 2 with at least one side Opening 13 is provided so that the protective gas is not only forward in the direction of the wire hook 5, but can also emerge from the side and continuously wash around the entire work area. Because under unfavorable circumstances it can happen that during the removal or
Trennvorgang kleine Funken entstehen, die an sich ungefährlich sind, aber zur Entzündung führen können, wenn das Arbeitsfeld von zündfähigen Gasen, zum Beispiel Methan, umgeben ist. Durch die Zuführung des Schutzgases wird aber jede Entzündungsgefahr mit Sicherheit vermieden.The separation process produces small sparks that are inherently harmless, but can lead to ignition if the working area is exposed to ignitable gases Example methane, is surrounded. By the supply of the protective gas but any risk of ignition is avoided with certainty.
Am Griffstück 3 ist ein Anschluß 14 für die Zuführung der zur Durchtrennung der Fäden notwendigen HF-Energie vorgesehen. Soll nun mit der neuen Vorrichtung gearbeitet werden, wird der Führungsschlauch 2 mit eingezogenem Drahthaken 5 durch den Instrumentierkanal des nicht dargestellten Endoskopes, das bereits in den Patienten eingeführt ist, geschoben, bis das vordere Ende des Führungsschlauches aus dem Instrumentierkanal heraustritt.On the handle 3 is a connection 14 for the supply of the cut RF energy required for the threads. Should now with the new device be worked, the guide hose 2 with retracted wire hook 5 through the instrument channel of the endoscope, not shown, which is already in the patient is inserted, pushed until the front end of the guide tube out of the instrument channel steps out.
Dann wird durch das Eindrücken des Griffstücks 5 in die Halterung 1 der Drahthaken 5 ausgefahren und unter Sicht um den Faden gelegt. Dabei wird der Drahthaken 5 über das Griffstück 3 und die biegsame Welle 4 gedreht und in eine Lage gebracht, die es ermöglicht, den Fäden zu haken. Danach wird die S6hutzgasversorgung sichergestellt und die Hochfrequenzenergie zugeschaltet.Then by pressing the handle 5 into the holder 1 of the wire hook 5 extended and laid around the thread under view. The Wire hook 5 rotated over the handle 3 and the flexible shaft 4 and into a Brought to the point where the thread can be hooked. The protective gas supply is then switched on ensured and switched on the high-frequency energy.
Durch Ziehen am Griffstück 3 wird der Drahthaken 5 langsam eingezogen; der F~uhrungsschlauch 2 wird dabei vorgeschoben und schützt dadurch das Gewebe vor Verletzungen.By pulling on the handle 3, the wire hook 5 is slowly drawn in; the guide tube 2 is pushed forward and thereby protects the tissue Injuries.
Claims (7)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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DE19732305815 DE2305815A1 (en) | 1973-02-07 | 1973-02-07 | DEVICE FOR SEPARATING SURGICAL FEEDS |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19732305815 DE2305815A1 (en) | 1973-02-07 | 1973-02-07 | DEVICE FOR SEPARATING SURGICAL FEEDS |
Publications (1)
Publication Number | Publication Date |
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DE2305815A1 true DE2305815A1 (en) | 1974-08-08 |
Family
ID=5871127
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19732305815 Pending DE2305815A1 (en) | 1973-02-07 | 1973-02-07 | DEVICE FOR SEPARATING SURGICAL FEEDS |
Country Status (1)
Country | Link |
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DE (1) | DE2305815A1 (en) |
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US4655217A (en) * | 1985-10-11 | 1987-04-07 | Reed Matt H | Method and apparatus for disabling vein valves in-situ |
US5439467A (en) * | 1991-12-03 | 1995-08-08 | Vesica Medical, Inc. | Suture passer |
US5474565A (en) * | 1992-07-16 | 1995-12-12 | Linvatec Corporation | Endoscopic suturing needle |
US5544664A (en) * | 1991-12-03 | 1996-08-13 | Benderev; Theodore V. | Method of advancing a suture through tissue |
US5766221A (en) * | 1991-12-03 | 1998-06-16 | Boston Scientific Technology, Inc. | Bone anchor implantation device |
US5836315A (en) * | 1991-12-03 | 1998-11-17 | Boston Scientific Technology, Inc. | Method of tensioning a suspended tissue mass |
US6334446B1 (en) | 1992-11-13 | 2002-01-01 | American Medical Systems, Inc. | Medical sling procedures and anchor insertion methods and devices |
US6544273B1 (en) | 1999-01-08 | 2003-04-08 | Ams Research Corporation | Tack device with shield |
US6612977B2 (en) | 2001-01-23 | 2003-09-02 | American Medical Systems Inc. | Sling delivery system and method of use |
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US6641525B2 (en) | 2001-01-23 | 2003-11-04 | Ams Research Corporation | Sling assembly with secure and convenient attachment |
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-
1973
- 1973-02-07 DE DE19732305815 patent/DE2305815A1/en active Pending
Cited By (168)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4655217A (en) * | 1985-10-11 | 1987-04-07 | Reed Matt H | Method and apparatus for disabling vein valves in-situ |
US6056688A (en) * | 1991-12-03 | 2000-05-02 | Boston Scientific Technology, Inc. | Device and method for transvaginally suspending the bladder neck |
US5544664A (en) * | 1991-12-03 | 1996-08-13 | Benderev; Theodore V. | Method of advancing a suture through tissue |
US5439467A (en) * | 1991-12-03 | 1995-08-08 | Vesica Medical, Inc. | Suture passer |
US5611515A (en) * | 1991-12-03 | 1997-03-18 | Boston Scientic Corporation | Bladder neck suspension procedure |
US5620012A (en) * | 1991-12-03 | 1997-04-15 | Benderev; Theodore V. | Method of percutaneously anchoring a suture to a bone |
US5749884A (en) * | 1991-12-03 | 1998-05-12 | Boston Scientific Technology, Inc. | Bone anchor implantation device and method |
US5766221A (en) * | 1991-12-03 | 1998-06-16 | Boston Scientific Technology, Inc. | Bone anchor implantation device |
US5813408A (en) * | 1991-12-03 | 1998-09-29 | Boston Scientific Technology, Inc. | Surgical drape |
US5836315A (en) * | 1991-12-03 | 1998-11-17 | Boston Scientific Technology, Inc. | Method of tensioning a suspended tissue mass |
US5836314A (en) * | 1991-12-03 | 1998-11-17 | Boston Scientific Technology, Inc. | Surgical treatment of stress urinary incontinence |
US5842478A (en) * | 1991-12-03 | 1998-12-01 | Boston Scientific Technology, Inc. | Method of securing a bone anchor |
US5860425A (en) * | 1991-12-03 | 1999-01-19 | Boston Scientific Technology, Inc. | Bladder neck suspension procedure |
US5938686A (en) * | 1991-12-03 | 1999-08-17 | Boston Scientific Technology, Inc. | Method of installing bone anchor |
US5474565A (en) * | 1992-07-16 | 1995-12-12 | Linvatec Corporation | Endoscopic suturing needle |
US6663642B2 (en) | 1992-11-13 | 2003-12-16 | Ams Research Corporation | System for bone screw insertion |
US6592610B2 (en) | 1992-11-13 | 2003-07-15 | Ams Research Corporation | Medical sling procedures and anchor insertion methods and devices |
US6575984B2 (en) | 1992-11-13 | 2003-06-10 | Ams Research Corporation | Medical sling procedures and anchor insertion methods and devices |
US6575998B2 (en) | 1992-11-13 | 2003-06-10 | Ams Research Corporation | Medical sling procedures and anchor insertion methods and devices |
US6635058B2 (en) | 1992-11-13 | 2003-10-21 | Ams Research Corporation | Bone anchor |
US6746455B2 (en) | 1992-11-13 | 2004-06-08 | Ams Research Corporation | Bone anchor inserter with retractable shield |
US6334446B1 (en) | 1992-11-13 | 2002-01-01 | American Medical Systems, Inc. | Medical sling procedures and anchor insertion methods and devices |
US6641524B2 (en) | 1997-03-18 | 2003-11-04 | Ams Research Corporation | Sling system for treating incontinence |
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