WO2012119582A1

WO2012119582A1 - Aid for forming a knot from a medical suture thread structure

Info

Publication number: WO2012119582A1
Application number: PCT/DE2012/000216
Authority: WO
Inventors: Peter Paul Fink
Original assignee: Medi-Globe Vascutec Gmbh
Priority date: 2011-03-04
Filing date: 2012-03-01
Publication date: 2012-09-13
Also published as: DE102011013055A1

Abstract

The invention relates to an aid (1) for forming a knot from a medical suture thread structure (10) having two thread end portions (11, 12). The suture thread structure is intended to close an opening (15) in tissue (14). The aid contains a holding or handle part (2) having a thread-clamping device (5; 6) which can be used for clamping the one thread end portion (11), and a thread-receiving device (7, 8, 9) which can be used for receiving a thread portion (17) running between the thread-clamping device (5; 6) and a thread-receiving/thread-discharge point (13) in the tissue (14) and for being wrapping round by a different thread portion (18) of the suture thread structure (10) running from a different thread-receiving/thread-discharge point (16) in the tissue (14). After being looped at least once around the thread portions (17, 18) running into/out of the edge region and optionally out of/into the tissue opening (15), the thread end portion (12) belonging to the other thread portion (18) of the suture thread structure (10) can be led through a loop opening (20) formed by the wrapping round process in order to form a knot.

Description

AUXILIARY DEVICE FOR MAKING A KNOT FROM ONE

MEDICAL NEEDLE PATTERN

The present invention relates to an auxiliary device for forming a knot from a medical Nähfadengebilde comprising at least one medical suture thread having a first Fadenendteil and a second Fadenendteil and with which an existing in a tissue of an individual tissue opening is closable by that parts of the Nähfadengebtldes through the edge region of the tissue opening and also optionally through the relevant tissue opening one or more times feasible and contractible with its two yarn end parts for knot formation. The invention also relates to a method using such an auxiliary device for forming a knot from a medical suture.

The formation of a knot from a medical sewing thread formation comprising at least one sewing thread is known, for example, from DE 103 05 584 A1. It also a hand instrument is used, which is, however, only a so-called knot pusher. The actual forming of a knot, however, is accomplished by having a surgeon who has passed a medical suture through a tissue portion of an individual grasping a suture end with one hand and then taking the other suture end with his other hand Sewing thread to form a Schlaufenteties at least once to wrap or loop around. By means of the mentioned knot shifter, the surgeon then pushes the respective loop part towards the fabric part and then devours the two sewing thread ends into a knot. However, this handling of the suture is often a difficult procedure overall, especially if it is to be performed in the presence of body fluids such as blood. Therefore, it is desirable to facilitate forming a knot from a medical suture.

The invention is therefore based on the object to show a way how such a relief when forming a knot from a medical Nähfa the structure can be achieved both in terms of apparatus or device as well as procedurally.

The object indicated above is achieved, on the one hand, in an auxiliary device of the type mentioned at the outset, according to the invention,

that a holding or gripping part to be gripped and held by hand is provided,

in that a thread-holding or thread-clamping device is connected to the holding or gripping part, which allows the one end of the thread-forming part of the sewing-thread structure to be held up and held releasably,

and that with the holding or gripping part also a thread receiving device is connected, which is for receiving a connected between the thread clamping device and a Fadenaufnahme- or yarn delivery point of the fabric, connected to the one yarn end part yarn part and for wrapping by one connected to the other yarn end Thread portion of the thread structure can be used, the said other yarn end portion after at least one wrap around the running in and / or out of the edge region and optionally from and / or in the fabric opening thread regions by a loop formed from the wrapping thread to form a knot is feasible ,

This results in the advantage that a relatively easy to set up auxiliary device is available, with which the formation of a knot of a medical suture is facilitated. Namely, a surgeon who has to attach a knot of a medical suture to a tissue does not need to constantly work with the two suture ends or suture end portions of the suture, but can work in knotting by clamping one suture end and using the suture Considerably facilitate thread take-up device; he actually needs to hold knot formation with his one hand only the holding or gripping part and can then easily make the mentioned Fadenumschlingung and the actual knot formation with his other hand. This is particularly advantageous when working in environments with body fluids, such as blood.

According to an expedient embodiment of the invention, the thread receiving device comprises at least two spaced apart in or on her or transverse to the respective thread running direction thread receiving members. This results in the advantage of a relatively easy-to-form thread take-up device.

The thread receiving members are expediently provided on the grip part itself or on one or more extension parts projecting from the grip part. As a result, the advantage is achieved that relatively simple trained thread receiving members may be provided on the device according to the invention.

Preferably, in the presence of three suture receiving members, two of these suture receiving members are provided at spaced apart distal end portions of the holding or gripping member itself or extension members projecting therefrom, and the third suture receiving member is spaced apart from the distal end portions of the extension members of the holding or gripping member this provided. This has the advantage that it can be done with structurally particularly simple thread take-up members.

Conveniently, the thread receiving members are each hook-shaped. This results in the advantage that the sewing thread parts respectively picked up by the thread takeup elements can be held securely on or off these thread takeup elements until they are removed from these thread takeup elements in the course of the actual knot formation.

On the other hand, the above object is achieved according to the invention by a method of forming a knot from a medical suture comprising at least one medical suture by using a haptic according to the invention with a holding or gripping member comprising a clamping device and a suture receiving device with at least two of them protruding or formed on him thread receiving members, wherein the Nähfadengebilde an existing in a tissue of an individual tissue opening is closed by the suture itself through the edge region and optionally through the relevant tissue opening one or more times passed and pulled together with its two yarn end parts for knot formation This method is characterized by the following steps:

after the suture or sewing thread by Fadenaufnahmebzw. Thread delivery points of the tissue is performed, the first is a denendteil the Nähfadengebildes clamped in the thread clamping device of the auxiliary device;

then the thread part extending from the thread clamping device to the one thread receiving or thread delivery point of the fabric is guided around at least one of the thread receiving elements of the auxiliary device;

Thereafter, the other yarn end portion of the suture is coming from the other Fadenaufnahme- or yarn delivery point of the fabric coming around the thread receiving members of the auxiliary device;

then said other yarn end part is at least once around in and out of the edge region and optionally in and / or out of the

Tissue opening extending thread areas wrapped to form a thread loop;

and then the said other yarn end part is passed through a loop opening formed between at least two yarn receiving members of the auxiliary device and, together with the one yarn end part loosened from its clamping, is pulled together into a knot.

This has the advantage that an effectively executable method for facilitating the formation of a knot from a medical suture structure with a relatively simple auxiliary device is provided. Namely, a surgeon who has to attach a knot of a medical suture to a tissue of an individual does not need to constantly work with the two ends of the suture, but can work by knotting by clamping one suture end and using the sutures Considerably facilitate thread take-up device; he needs to knot with his one hand only hold the holding or grip part and then can easily make the mentioned Fadenumschlingung and the actual knot formation with his other hand. This is especially beneficial when working in body fluid environments such as blood.

Preferably, when using an auxiliary device with hook-shaped thread receiving members, the contraction of the two Fadenendbereiche made only after loosening the Nähfadengebildes of the thread receiving members. This ensures safe handling of the suture with the relevant auxiliary device. An exemplary embodiment of the auxiliary device according to the invention and a method using this auxiliary device for forming a knot from a medical suture structure will be explained in more detail below with reference to a drawing.

In the drawing, which represents an embodiment of the invention auxiliary device is shown in a perspective view and generally designated 1.

The auxiliary device 1 here consists of a flat, plate-shaped holding or gripping part 2, which can capture and hold a surgeon when using the auxiliary device 1 with his one hand.

Of the holding or handle part 2 are available as extension parts from two support arms 3 and 4, which are formed with the holding or handle part 2 either contiguous or which may be connected as separate members with this handle part 2. The two support arms 3 and 4 are spread starting from the holding or gripping part 2 - similar to the open cutting parts of a pair of scissors.

In or on the two support arms 3 and 4 is in each case a Fadenfesthalte- or thread clamping device 5 and 6. Here, each Fadenfesthalte- or thread clamping device 5, 6 formed by a connected to the support arm 3 and 4 clamping member. These clamping members are formed by indenting and receiving receiving these openings in the respective support arm 3 and 4 respectively. The indenting parts in question can be positively and positively received in their receiving openings, and they can also be withdrawn from the receiving openings. In the non-positive and positive recording of the indenting in the receiving openings previously inserted in these receiving openings thread parts can be clamped so that they can only be pulled out of the respective Fadenfesthalte- or thread clamping devices 5, 6 again after their indenting parts from their receiving openings are solved.

At this point it should be noted that in principle, however, only one of the Fadenfesthalte- or thread clamping devices 5, 6 manages. As will be seen in more detail below, the thread-holding or thread-clamping device 5 or 6 serves to receive and releasably hold the one end region of a sewing thread or short thread structure 10. With the holding or gripping part 2 also a thread receiving device is connected, which consists of three hook-shaped thread receiving members 7, 8 and 9 here. Of these thread take-up members, which may optionally also be formed by hook-shaped projections, the two thread receiving members 7 and 8 are provided at spaced distal end portions of the holding or gripping member 2 itself or extending from this extension parts. More specifically, these two suture receiving members 7 and 8 are provided at the distal end portions of the support arms 3, 4 protruding from the holding or gripping member 2 as extension members, either as individual members attached thereto or with the respective support arm 3 and 4, respectively integrally formed.

The third thread receiving member 9 is provided here as a Fadenumlenkglied at a distance from the distal end portions of the support arms 3, 4 on the holding or gripping part 2, and viewed in the longitudinal direction of the auxiliary device 1 between the positions of said two thread receiving members 7 and 8.

The three thread receiving members 7, 8 and 9 serve, as will be seen in more detail below, for receiving the medical suture assembly 10 which consists of at least one medical suture and in the present embodiment also contains only this suture 10. The two ends or Nähfadenendteile of the suture or sewing thread 10 are designated in the drawing with 11 and 12 respectively.

Of the three thread-receiving members 7, 8 and 9, the two thread receiving members 9 and 8, as shown in the drawing, the recording of a running between the thread clamping device 5 and a Fadenaufnahme- or thread delivery point 13 of a fabric 14 of an individual thread parts 17, the with the sewing thread 11 is connected. All three thread receiving members 7, 8 and 9 serve for wrapping by another with the Nähfadenende 12 connected thread portion 18 of the suture 10. The aforementioned fabric 14 has a fabric opening 15, such as an incision, and another Fadenaufnahmebzw. Thread delivery point 16 on. A sewing thread part 17 of the sewing thread formation or sewing thread 10 extending between the two thread take-up points or thread delivery points 13 and 16 behind the fabric 14 can be seen in the area of the fabric opening 15. It should be noted at this point that the thread take-up device does not necessarily have to have the three thread take-up members 7, 8 and 9 shown in the drawing. In general, the thread receiving device comes with at least two spaced apart in the auxiliary device 1 or extending transversely to the respective thread running direction thread receiving members. The thread receiving members can also be formed by cuts or indentations in or by projections on the support arms 3, 4 or the holding or gripping part 2 for receiving the suture formation 10. All parts of the auxiliary device 1 are preferably made of biocompatible material, such as a plastic.

Having previously described with reference to the drawing an embodiment of the auxiliary device 1 according to the invention in an area sufficient for an understanding of the invention, the method according to the invention will now be considered, with which a knot of the at least one medical suture comprehensive medical Nähfadengebilde 10 can be formed using the relevant auxiliary device 1.

In order to close the tissue opening 15 of the fabric 14 by means of the medical sewing thread 10 and to secure the respective closure knot by a sewing thread, the following method steps are carried out:

After the sewing thread formation 10 or the sewing thread 10 is guided through the thread take-up points or thread delivery points 3 and 16 of the fabric 14, first the thread end region of the sewing thread formation or sewing thread 10 connected to the sewing thread end 11 is in the thread clamping device 5 of the auxiliary device 1 clamped. Then the yarn part 17 extending from the thread clamping device 5 to the thread receiving or yarn delivery point 13 of the fabric 14 is merely guided around the two thread receiving elements 9 and 8 of the auxiliary device 1.

Thereafter, the other, connected to the sewing thread 12 thread portion 18 of the suture or thread 10 from the other Fadenaufnahme- or yarn delivery point 16 of the fabric 10 coming around the three thread take-up members 7, 9 and 8 of the auxiliary device 1 is placed. Then this other thread part 18 with the other yarn end 12 at least once - in the present case twice - to the in and out of the edge region and optionally in the and / or thread regions or parts 17, 18 extending from the fabric opening 15, to form a sewing thread loop 19. In contrast to the prior art considered at the beginning, this sewing thread loop 9 therefore encloses two thread regions (17 and 18) and thus leads to a particularly firm sewing thread knot.

Subsequently, the suture end 12 of said other suture end portion 18 is passed through a loop opening 20 formed between the three suture receiving members 7, 9 and 8 of the auxiliary device 1 and contracted together with the suture end 11 of the released from its clamping Fadenendbereiches 17 together with the suture loop 19 to a node ,

Since the thread take-up members 7, 8 and 9 are hook-shaped in the case of the auxiliary device 1 explained here as an exemplary embodiment, the above-mentioned contraction of the two yarn end regions of the sewing thread or sewing thread 10 is made only after it has been detached from the thread take-up members 7, 8 and 9 , In this context, it should also be noted that the auxiliary device 1 before the final contraction of the two end portions of the suture thread or thread 10 thread 10 or more about its longitudinal axis - the practically in the direction of the two to or from the fabric extending thread parts 17th and 18 extends - can be rotated to twist the thread parts 17 and 18 in front of the fabric 14. This contributes to an even firmer Nähfadenverknotung.

In addition, it should be noted that the method according to the invention for forming a knot from the at least one medical suture thread sewing medical thread formation 10 can be carried out in a corresponding manner, as explained, with an auxiliary device 1, the only two or even more than three thread receiving members having. Essential for the formation of knots is that by means of the thread take-up members a loop opening 20 corresponding loop opening from the suture or sewing thread 10 is formed to thereby pull the suture end 12 corresponding suture end of a suture.

In the above, the invention has been explained with reference to an existing only of a medical suture thread suture 10, by the edge region of the tissue opening 15 is passed. It should be noted, however, that the invention can be used in the same way even when using a Nähfadengebildes containing a plurality of medical sutures. Incidentally, the sewing thread or at least individual sewing threads of a sewing thread formation comprising a plurality of sewing threads can be guided through the edge area and with their respective other sewing thread area (the other sewing thread end in each case) through the tissue opening 15 to be closed.

LIST OF REFERENCE NUMBERS

1 auxiliary device

2 holding or grip part

3 extension part or support arm

4 extension part or support arm

5 thread holding or thread clamping device

6 thread holding or thread clamping device

7 thread take-up member

8 thread take-up member

9 thread take-up member or Fadenumlenkglied

10 sewing thread or sewing thread

11 sewing thread end or yarn end part

12 sewing thread end or yarn end part

13 thread take-up or thread delivery point

14 tissues

15 tissue opening

16 thread take-up or thread delivery point

17 threading! or area

18 thread part or area

19 thread loop

20 loop opening

Claims

claims

An auxiliary device (1) for forming a knot from a medical suture structure (10) comprising at least one medical suture (10), which has a first suture end part (11) and a second suture end part (12) and with which one in a tissue ( 14) of an individual tissue opening (15) is thereby closable, that parts of the suture (10) through the edge region of the tissue opening (15) and also optionally through the respective tissue opening (15) one or more times passable and with its two yarn end parts (11 , 12) are contractible for knotting,

characterized,

a hand-held and holding holding or gripping part (2) is provided,

in that a thread-holding or thread-clamping device (5; 6) is connected to the holding or gripping part (2), which permits the one end of the thread (11) of the sewing thread formation (10) to be held in a releasable manner,

and in that a thread-receiving device (7, 8, 9) is connected to the holding or gripping part (2), which is designed to receive one between the thread clamping device (5, 6) and a thread take-up point (13) of the Tissue (14) extending, with the one yarn end part (11) connected thread part (17) and for wrapping by one with the other yarn end part (12) connected thread part (18) of the thread structure (10) can be used, said other yarn end part (12 ) after at least one time looping around in and / or out of the edge region and optionally from and / or in the fabric opening (15) extending thread regions (17, 18) by a formed from the wrapping thread loop (loop opening 20) to form a knot feasible is.

2. Auxiliary device according to claim 1,

characterized in that the thread receiving device (7, 8, 9) at least two spaced apart in or on her or transverse to the respective thread running direction thread receiving members (7, 8) summarizes.

3. Auxiliary device according to claim 2,

characterized in that the thread receiving members (7, 8, 9) on the holding or grip part (2) itself or on one or more of the Haltebzw. Handle part (2) protruding extension parts (3, 4) are provided.

4. auxiliary device according to claim 3,

characterized in that in the presence of three thread receiving members (7, 8, 9) two thread receiving members (7, 8) of these thread receiving members (7, 8, 9) at spaced distal end portions of the holding or gripping member (2) itself or at are provided by this protruding extension parts (3, 4) and that the third thread receiving member (9) is provided as Fadenumlenkglied at a distance from the distal end portions of the extension parts (3, 4) of the holding or grip part (2) on this.

5. Auxiliary device according to one of claims 2 to 4,

characterized in that the thread receiving members (7, 8, 9) are each hook-shaped.

A method of forming a knot from a medical suture sheet (10) comprising at least one medical suture (10) using an auxiliary device (1) according to any one of claims 1 to 5 with a holding or gripping member (2) comprising a clamping means (5; 6) and a thread receiving device with at least two of the holding or gripping part (2) projecting or formed on this thread receiving members (7, 8, 9), wherein the Nähfaden- fabric (10) in a tissue (14) of an individual existing fabric opening (15) is closed by the Nähfadengebilde (10) through its edge region and optionally also through the relevant tissue opening (15) even one or more times passed and contracted with its two yarn end parts (11, 12) for knotting,

characterized by the following steps:

After the sewing thread formation (10) or the sewing thread (10) is passed through thread take-up points (13, 16) of the fabric (14), a yarn end part (11) of the sewing thread formation (10) in the thread clamping device (5; 6) of the auxiliary device (1) clamped;

Then, the thread running from the thread clamping device (5, 6) to the one thread receiving or yarn delivery point (13) of the fabric (14) denteil (17) led around at least one of the thread receiving members (7, 8, 9) of the auxiliary device (1);

Thereafter, the other thread part (18) of the suture thread (10) from the other Fadenaufnahme- or yarn delivery point (16) of the fabric (14) coming around the thread receiving members (7, 8, 9) of Hilfsvor rectification (1) laid around;

then another yarn end part (12) is wound at least once around the yarn parts (17, 18) extending into and out of the edge region and optionally into and / or out of the fabric opening (15) to form a sewing thread loop (19);

and then said other yarn end portion (12) is passed through a loop opening (20) formed between at least two thread receiving members (7, 8, 9) of the auxiliary device (1) and, together with the yarn end portion (11) released from its clamping, becomes a knot drawn together.

7. The method according to claim 6,

characterized in that when using an auxiliary device (1) with hook-shaped thread receiving members (7, 8, 9) pulling together the two Fadenendteile (11, 12) only after loosening the Nähfadengebildes (10) of the Fadenaufnahmegliedern (7, 8, 9 ) is made.