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WO1996002197A1 - Instrument de chirurgie gynecologique chez la femme - Google Patents

Instrument de chirurgie gynecologique chez la femme Download PDF

Info

Publication number
WO1996002197A1
WO1996002197A1 PCT/NO1995/000126 NO9500126W WO9602197A1 WO 1996002197 A1 WO1996002197 A1 WO 1996002197A1 NO 9500126 W NO9500126 W NO 9500126W WO 9602197 A1 WO9602197 A1 WO 9602197A1
Authority
WO
WIPO (PCT)
Prior art keywords
arm
needle
holes
tubes
surgical device
Prior art date
Application number
PCT/NO1995/000126
Other languages
English (en)
Inventor
Latif Sadek
Original Assignee
Latif Sadek
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 Latif Sadek filed Critical Latif Sadek
Publication of WO1996002197A1 publication Critical patent/WO1996002197A1/fr

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
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • 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
    • A61B17/062—Needle manipulators
    • 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
    • A61B17/0482—Needle or suture guides
    • 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
    • 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
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06019—Means for attaching suture to needle by means of a suture-receiving lateral eyelet machined in the needle
    • A61B2017/06023—Multiple eyelets
    • 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
    • A61B2017/06095—Needles, e.g. needle tip configurations pliable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/0036—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable

Definitions

  • the invention relates to an instrument for use in the surgical treatment of gynaecological complaints.
  • Out-patient treatment of incontinence or gynaecological prolapse should fulfil the following criteria:
  • the surgical technique should be as simple as possible.
  • the surgical area should be as limited as possible to avoid the risk of bleeding.
  • US 5 019 032 is a similar instrument which also has the facility for visually monitoring the operation.
  • US 5 013 292 consists of a needle, cannula and sutures.
  • US 5 149 329 consists of a pliable tube, a pliable suture needle with a cutting edge and a needle holder. The needle is pushed through the tube with the aid of the needle holder which has a fingergrip. What is common to all these instruments is that they are constructed for a specific surgical technique and are not interchangeable.
  • the object of the present invention is therefore to present an instrument which can be used for surgical treatment fulfilling the above criteria.
  • the instrument is used for needle suspension of the bladder neck for treatment of women suffering from incontinence.
  • the instrument can also be used to perform a new and simple surgical technique for women with second degree of prolapsed uterus and utero- vaginal prolapse or for total vaginal (Vault's vaginal) prolapse following an earlier hysterectomy.
  • the use of the instrument is, however, not limited to these complaints.
  • the present invented instrument consists of a device 1, with two movable arms 2, 3, held together by a movable joint 4, with a spring tensioned ratchet 1 1.
  • the movable joint 4 with ratchet 11 prevents the device from opening unless released by manually turning the ratchet 1 1 so that the teeth are disengaged.
  • the lower arm 3 ends in a transverse ring 6, which fits on to a normal size finger.
  • arm 3 has one or more tubes 5 built into the arm, and the end opening of this or these is on the outer edge of the ring 6.
  • Tube(s) 5 has (have) a gently curved form and the other end is fastened in arm 3 with a bracket 9.
  • Upper arm 2 has in its tail end one or more oblong holes 7 so that when the device is shut it corresponds with the openings of the tubes 5 at the ring's outer edge 6.
  • the instrument contains one or more thin needles 8 which are sharp (cutting) in one end and blunt in the other and where one or more holes are positioned, side by side lengthwise which are of suitable diameter for double surgical thread.
  • the needle(s) will in use be guided through a tube 5 and must therefore be made of slightly pliable material.
  • the needle holder 10 should be employed. This has a suitably sized hole through it and a screwclamp to retain the needle.
  • Fig. 1 shows a sideview of a closed device
  • Fig. 2 shows the needle holder and the needle with the holes in the blunt end enlarged
  • Fig. 3 shows a sideview of the device with the movable connecting link dissembled and the arms removed
  • Fig. 4 shows a sideview of the bracket closed and a cross section of the device seen against the line V-V'.
  • Use of the instrument is initiated by opening the device, and inserting arm 3 into the vaginal opening, guiding it with a finger placed in ring 6, so that the end(s) of tube(s) 5 on ring 6 is (are) placed against a small lateral cut in the vagina.
  • the top end of arm 2 is placed in a small skin cut above the symphysis and at the side of the middle line.
  • the device will automatically lock with the ratchet 1 1 in the movable connecting link 4.
  • the hole(s) 7 on arm 2 are now positioned over the end(s) of tube 5 in arm 3.
  • Needle 8 is inserted into needle holder 10 and fastened with the needle holder screw, then inserted through tube 5 so that it penetrates connective tissue and muscle tissue in the abdominal wall and passes through hole 7 in arm 2.
  • the ratchet 11 now releases the movable connecting link 4 so that the device opens and can be pulled out. This leaves needle 8 in the abdominal wall with the blunt end, with the holes protruding from the vaginal opening and the sharp end sticking up through the skincut above the symphysis.
  • the bladder is viewed from the inside by cystoscopy to ensure that needle 8 does not penetrate the bladder. If this should happen, the needle 8 must be withdrawn, repositioned and checked again.
  • the threads from one stitch or more which have been made in the vaginal wall can now be inserted through the holes in needle 8 and pulled up through the abdominal wall with the help of the needle.
  • Several holes in needle 8 make it possible to keep apart the thread ends which are being pulled out.
  • the neck of the bladder or the vaginal wall or possibly the uterus can now be lifted up by fastening the thread ends in a band in the abdominal wall.
  • the skin cut and the cut in the vagina should now be closed by sutures.
  • the upper curved arm 2 has one, normally two, elongated holes 7 which are placed squarely across the arm so that they effectively lengthen the tube(s) when the device is shut.
  • the upper arm 2 is connected by a movable connecting joint 4 with a spring tensioned ratchet 1 1. These connections are so placed that when the device is shut the holes 7 will always be positioned virtually above the tube openings 5 in ring 6, with minimal lateral leverage.
  • the lower arm 3 is also curved so that when viewed from the side the devide is almost oval.
  • This distal part of the arm 3 ends in a ring placed across 6 which in its edge has one or more, (usually two) end openings for the tube(s) 5, whose openings are positioned against the holes 7 in arm 2 when the device is shut.
  • the ring 6 is gauged to the diameter of a normal finger.
  • the tube or tubes 5 which are rigid structures and are made of the same material as the arms 2 and 3 can be built into parts of arm 3 or be lying free on the outside of the arm. They must not however, be more curved than that the needle 8 can be drawn through the tube without difficulty.
  • Fig. 2 shows the needles 8 which are sharp (cutting) at one end and blunt with two holes positioned side by side lengthwise at the other end. Other models may have several holes.
  • the needles match the inner diameter of the tube 5 and may be made of a pliable material for example a steel alloy.
  • a needle holder 10 with holes can be pulled on to the needle and fastened onto this with a screw clamp.
  • Fig. 3 shows the device 1 with movable joint dissembled.
  • the movable joint consists of the element 4a on arm 2 with teeth in the outer edge and 4b on arm 3 where the ratchet 1 1 is attached and movable so that the spring loaded ball presses against the element 4b.
  • the movable joint can be released, and the ratchet's "toothed" end disenganged by pressing the "tongue" of the ratchet against arm 3.
  • Fig. 4 shows a side view of the closed device as in Fig. 1 and a cross section through line V-V', showing the formation of holes 7.
  • These can have any suitable shape but are usually elongated and make up the continuation of tube 5 when the bracket is shut.
  • the whole device 1 is made of the same material, e.g. hard plastic or a metal such as a steel alloy, while in another embodiment the arms 2, 3 are made of rigid plastic for single use
  • the arms 2, 3 are in this case connected to the movable joint with the aid of a single, rigid connection of known type.
  • the needle meets the holes 7 in arm 2 and passes out without the need for further palpation by the surgeon's finger from above, which could risk damage to the finger. This protects both the surgeon and the patient against transmittable blood diseases.
  • the instrument has several areas of use;

Landscapes

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

Abstract

Dispositif chirurgical constitué de deux bras (2, 3) reliés entre eux par une articulation mobile (4). L'extrémité de l'un des bras comporte un ou plusieurs trous allongés et lorsque le dispositif est fermé, ces trous s'étendent dans le prolongement d'un ou plusieurs tubes prévus sur l'autre bras. On peut ouvrir le dispositif en libérant les dents d'un rochet (11) des dents de l'élément (4), et on peut le fermer et le bloquer automatiquement dans une position où les trous de l'un des bras se trouvent dans le prolongement des tubes de l'autre bras. Le dispositif comporte également une ou plusieurs aiguilles longues et minces destinées, lors de l'utilisation, à s'engager dans le ou les tube(s) de l'un des bras, ainsi qu'un porte-aiguille mobile (10). Cet instrument a plusieurs applications, notamment comme support d'aiguille en cas d'incontinence ou de prolapsus.
PCT/NO1995/000126 1994-07-13 1995-07-11 Instrument de chirurgie gynecologique chez la femme WO1996002197A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NO942636 1994-07-13
NO942636A NO942636L (no) 1994-07-13 1994-07-13 Instrument til underlivsoperasjoner hos kvinner

Publications (1)

Publication Number Publication Date
WO1996002197A1 true WO1996002197A1 (fr) 1996-02-01

Family

ID=19897262

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/NO1995/000126 WO1996002197A1 (fr) 1994-07-13 1995-07-11 Instrument de chirurgie gynecologique chez la femme

Country Status (2)

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NO (1) NO942636L (fr)
WO (1) WO1996002197A1 (fr)

Cited By (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0792621A1 (fr) * 1996-02-29 1997-09-03 Munir Dr. Uwaydah Pince avec conduit de guidage pour suture
KR100522177B1 (ko) * 2000-07-29 2005-10-18 죠지 잉-리앙 후앙 전기 커넥터 및 이를 전기 케이블에 장착하기 위한 방법
US7077862B2 (en) 2002-01-09 2006-07-18 Myocor, Inc. Devices and methods for heart valve treatment
US7112219B2 (en) 2002-11-12 2006-09-26 Myocor, Inc. Devices and methods for heart valve treatment
US7189199B2 (en) 1997-01-02 2007-03-13 Myocor, Inc. Methods and devices for improving cardiac function in hearts
US7247134B2 (en) 2002-11-12 2007-07-24 Myocor, Inc. Devices and methods for heart valve treatment
EP1100378B1 (fr) * 1998-07-29 2009-09-09 Edwards Lifesciences AG Appareil d'alignement d'un implant transventriculaire
US7766812B2 (en) 2000-10-06 2010-08-03 Edwards Lifesciences Llc Methods and devices for improving mitral valve function
US7883539B2 (en) 1997-01-02 2011-02-08 Edwards Lifesciences Llc Heart wall tension reduction apparatus and method
US8092367B2 (en) 2001-09-07 2012-01-10 Mardil, Inc. Method for external stabilization of the base of the heart
US8226711B2 (en) 1997-12-17 2012-07-24 Edwards Lifesciences, Llc Valve to myocardium tension members device and method
US8579798B2 (en) 1998-09-21 2013-11-12 Edwards Lifesciences, Llc External cardiac stress reduction method
CN103860217A (zh) * 2014-03-05 2014-06-18 复旦大学附属华山医院 一种内窥镜下软组织缝合导向装置和方法
EP2180836A4 (fr) * 2007-07-26 2015-08-12 Alpha Scient Corp Dispositif chirurgical de suture, procédé et outils utilisés avec ce dispositif
US9226748B2 (en) 2007-07-26 2016-01-05 Alpha Scientific Corporation Surgical suturing device, method and tools used therewith
US9636110B2 (en) 2013-03-13 2017-05-02 Alpha Scientific Corporation Structural support incorporating multiple strands
US10299786B2 (en) 2013-03-15 2019-05-28 Alpha Scientific Corporation Surgical suturing device with transverse engagement

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1990003766A1 (fr) * 1988-10-04 1990-04-19 Peter Emanuel Petros Instrument chirurgical, prothese et son procede d'utilisation
WO1993019678A2 (fr) * 1991-12-03 1993-10-14 Vesitec Medical, Inc. Traitement chirurgical de l'incontinence urinaire a l'effort

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1990003766A1 (fr) * 1988-10-04 1990-04-19 Peter Emanuel Petros Instrument chirurgical, prothese et son procede d'utilisation
WO1993019678A2 (fr) * 1991-12-03 1993-10-14 Vesitec Medical, Inc. Traitement chirurgical de l'incontinence urinaire a l'effort

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
THE JOURNAL OF UROLOGY, Volume 152, 1994, THEODORE V. BENDEREV, "A Modified Percutaneous Outpatient Bladder Neck Suspension System", page 2316. *

Cited By (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0792621A1 (fr) * 1996-02-29 1997-09-03 Munir Dr. Uwaydah Pince avec conduit de guidage pour suture
US7189199B2 (en) 1997-01-02 2007-03-13 Myocor, Inc. Methods and devices for improving cardiac function in hearts
US8267852B2 (en) 1997-01-02 2012-09-18 Edwards Lifesciences, Llc Heart wall tension reduction apparatus and method
US7883539B2 (en) 1997-01-02 2011-02-08 Edwards Lifesciences Llc Heart wall tension reduction apparatus and method
US8226711B2 (en) 1997-12-17 2012-07-24 Edwards Lifesciences, Llc Valve to myocardium tension members device and method
US7981020B2 (en) 1998-07-29 2011-07-19 Edwards Lifesciences Llc Transventricular implant tools and devices
EP1100378B1 (fr) * 1998-07-29 2009-09-09 Edwards Lifesciences AG Appareil d'alignement d'un implant transventriculaire
US7722523B2 (en) 1998-07-29 2010-05-25 Edwards Lifesciences Llc Transventricular implant tools and devices
US8579798B2 (en) 1998-09-21 2013-11-12 Edwards Lifesciences, Llc External cardiac stress reduction method
KR100522177B1 (ko) * 2000-07-29 2005-10-18 죠지 잉-리앙 후앙 전기 커넥터 및 이를 전기 케이블에 장착하기 위한 방법
US9198757B2 (en) 2000-10-06 2015-12-01 Edwards Lifesciences, Llc Methods and devices for improving mitral valve function
US7766812B2 (en) 2000-10-06 2010-08-03 Edwards Lifesciences Llc Methods and devices for improving mitral valve function
US8092367B2 (en) 2001-09-07 2012-01-10 Mardil, Inc. Method for external stabilization of the base of the heart
US8128553B2 (en) 2001-09-07 2012-03-06 Mardil, Inc. Method and apparatus for external stabilization of the heart
US9289298B2 (en) 2001-09-07 2016-03-22 Mardil, Inc. Method and apparatus for external stabilization of the heart
US7077862B2 (en) 2002-01-09 2006-07-18 Myocor, Inc. Devices and methods for heart valve treatment
US7678145B2 (en) 2002-01-09 2010-03-16 Edwards Lifesciences Llc Devices and methods for heart valve treatment
US8070805B2 (en) 2002-01-09 2011-12-06 Edwards Lifesciences Llc Devices and methods for heart valve treatment
US7247134B2 (en) 2002-11-12 2007-07-24 Myocor, Inc. Devices and methods for heart valve treatment
US7112219B2 (en) 2002-11-12 2006-09-26 Myocor, Inc. Devices and methods for heart valve treatment
US7666224B2 (en) 2002-11-12 2010-02-23 Edwards Lifesciences Llc Devices and methods for heart valve treatment
EP2180836A4 (fr) * 2007-07-26 2015-08-12 Alpha Scient Corp Dispositif chirurgical de suture, procédé et outils utilisés avec ce dispositif
US9226748B2 (en) 2007-07-26 2016-01-05 Alpha Scientific Corporation Surgical suturing device, method and tools used therewith
US9622741B2 (en) 2007-07-26 2017-04-18 Alpha Scientific Corporation Surgical suturing device and tools used therewith
US10064617B2 (en) 2007-07-26 2018-09-04 Alpha Scientific Corporation Surgical suturing device, method and tools used therewith
US9636110B2 (en) 2013-03-13 2017-05-02 Alpha Scientific Corporation Structural support incorporating multiple strands
US10251737B2 (en) 2013-03-13 2019-04-09 Alpha Scientific Corporation Structural support incorporating multiple strands
US10299786B2 (en) 2013-03-15 2019-05-28 Alpha Scientific Corporation Surgical suturing device with transverse engagement
CN103860217A (zh) * 2014-03-05 2014-06-18 复旦大学附属华山医院 一种内窥镜下软组织缝合导向装置和方法

Also Published As

Publication number Publication date
NO942636D0 (no) 1994-07-13
NO942636L (no) 1996-01-15

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