DE2908695A1 - Endoscopic scissor type stitching instrument - has protected needle with eye opened by strings from handle in any desired position - Google Patents

Abstract

The stritching instrument has a long projected needle, whose eye can be opened and shut to release the stitch by a string-operated mechanism from the handle. A transporter moves the sliding know forward through a guide aperture above a pulley while under observation from the endoscope lens, thus avoiding cutting of body tissue or formation of stitch loops. A long-armed shear with lens cuts tissue and stitch while under observation. The needle has a retractable point which is spring-loaded, to avoid body injury. The needle has a long flexible shield, allowing the eye to release the stitch in any desired position under control of the string mechanism. The transporter has a long shield and an oblique drilling at the head, by which the knot is thrust forward.

Description

Endoscopic suture cutlery (@niche name) @ndungsgebiet: Das endoscopic cutlery made up of surgical instruments allows the surgeon in the body cavities in mengsglen and in the animal under electric light supply by means of an endoscope shaft with optics under view without an "open operator" Sew body fabric.

@@: Given the multitude of walling purposes in body cavities, there are two Examples mentioned: 1. To eliminate urinary incontinence in men caused by Injuries to the external bladder sphincter caused sinu, which can be caused by electrical Streams of pickling lines made accessible to the injuries stele with this cutlery, which is inserted through the urinary tube to the sphincter by means of an endoscope wind, can be sutured without risk, without the urinary bladder, the urethra, or the abdominal cavity to open up the perineal area.

2. The woman can endoscopic through a labaroscope with this Cutlery can be carried out without risk. Since this is terminal it can be undone without risk using the same cutlery.

1 of the technology: Regarding the first exemplary embodiment: Fs are a large number of offer incontinence operation metrodes for men, some of which involve major surgical procedures Aufweng, on the other hand, are afflicted with a booing complicity failure rate. Also the artificial Sphincter did not meet all of the expectations placed on him. Part of it because of technical defects that have occurred, partly because of the need to remove them this artificial sphincter muscle when infections had set in. With the man In contrast to women, the perinsal access to the sphincter muscle is through the stool relocated. The "endoscopic cutlery" can be used like no other known Method of the urinary bladder sphincter transurethral, that is, through the urethra risk-free after electrosurgical refresher under faradic interval control can be sewn directly. In this way, the injuries caused by men can also be avoided Urinary incontinence, which is a constantly leaking urinary bladder, which is extremely dangerous to the patient strong physical and psychological burdens are imposed and eliminated.

Regarding the second exemplary embodiment: a reversible one, that is, it is reversible again There is currently no tube ligation to be performed laparoscopically. With the "endoscopic "Cutlery", an end-to-end ligature of the tubes can be carried out in women without risk will. Because of the end of the tube ligation, the same cutlery can be used the removal of the ligature must be restored. This, too, is risk-free. It is omitted in this method there are cicatricial tube closures which make the reversibility of the Prevent ligature, on the other hand there is no risk of thermal tissue damage of the neighboring tissue, such as of the intestine. To the "endoscopic Cutlery "goköntein surgical sight scissors, with which the end ligated tube ends be resected. As a result, tubes are reopened without a stenosis.

References: 1. Hatz, J.K.J.Brol. (Baltimure) 98, 174 (1986) 2. @@@ zbs, E.A. Srit. U.Urol. 38, 2 (1986) 3. Werdernes, R.T. J. Mrel. (Baltimore), 4, 39 (19 @@) 4. Stoeckel, W. Synäkologische Urologie, IIHandbuch der Gynäkologie X. Volume II part, Munich, J.F. Bergmann Verlag 1938 5. Structure and Innervation of Smooth Muscle in the Wall of the Bladder Neck and Procimal Urethral Fosling, J.A.Dixon, J.S. Br. J. Urel. 47: 549-558 (1975) 6. Observations on Musculature of Urinary Bladder and Urethra in Human Fetus Droes, J., Br.J. Urol. 48: 179-138 (1974) Task: The invention is based on the task of using body cavities without "open Operation "Being able to sew body blown with surgical sutures.

Solution: This task is solved as follows: Introduced into the The body cavity concerned is an endoscope through which a long-armored handle (fig 1), whose he frees the end in every desired situation - @@@@@@@@ en. That @@@@ is bestügkt with an En @@ des Fahere and durchstisbt @@@@ Srite des to be carried out Tissue in this body cavity. After that, this thread end of the Nariel is through Opening of the ore freed and the other still lying outside the body cavity The end of the thread goes through the contralateral side of the fabric to be sewn in the same way guided. The thread now connects both lips from outside the body cavity u-shaped. Both ends lie in the body cavity. Be with a plate Fertenenden through the endoscope shaft over a Bellenzur (Figure 3) through a Guide passage out of the body cavity back to the outside to be knotted to become. A sliding knot is formed outside the body cavity, which is connected to the a knot transporter (Figure 2) through guide passage over the Bollenzug under View of how it is guided over a cable winch and fixed in the body cavity. Guide passage, Roller tongue and knot transporter connect the looping of the suture material and cutting through the corpuscle with the mowing material. Then a long armored Scissors (Figure 4) passed through the endoscope and the end of the thread under view Shortened 1 cm to the knot.

Further embodiment Further embodiment of the invention: Use of the "endos of the invention: copical cutlery" 1. through the bronchoscope. 2. through the bectoscope.

Achievable advantages: The advantages given with the invention are 1. Hubs in a body cavity under sight without an open space, w @@@ oislang night was possible.

2. Risk-free feasibility.

3. Direct access to the fabric to be sewn, for example in the Trap of the urinary bladder sphincter in men because of the cavernous bodies that cover it from the dam area not: is possible.

ibrungsbeispiele: 5 embodiments of the invention are shown in the drawings 1 - 5 shown.

Figure 1 long-armored needle, the eye of which by a rope mechanism can be opened and closed at any point using the handle So thread is released again in any desired situation.

Finur 2 knot gymnast moving the sliding knot forward.

Figure 3 Roller pull with guide passage through the guide passage is the sliding knot over the pulley with the help of the knot transporter like over a winch guided under view by means of an endoscope optics. This will be Cutting through the body tissue with the thread and looping the suture material prevented.

Figure 4 long-armored scissors with optics, with the body tissue and sutures can be incised under sight in the body cavity.

Figure 5 lansarmierte needle with an insertable and executable point -ein Variant of Figure 1 with a spring balancer to avoid tissue injuries in body cavities. Otherwise in the same function as Figure 1.

Claims (5)

Patent claims Generic term 1. Long-armored needle, whose Ör is through a Cable mechanism opened and closed at any point from the handle can be - so the thread is released again in any desired situation. 2. Knot transporter that moves the sliding knot forward. 3. Flollenzug with a drive throughIass. Through the guide passage the sliding knot over the pulley with the help of the knot transporter as for one Cable winch guided under view by means of endoscope optics. This will cut through of the body tissue with the thread as well as looping of the suture material. 4. Armored scissors with optics, with the body tissue and sutures can be cut under view. 5. Long armored needle with a tip that can be inserted and removed - a variant to figure with spring balancer to avoid tissue injuries in body cavities. Otherwise functions as in Figure 1. Identifying parts: The needle (Figure 1) is characterized by that a long flexible armoring the Nadelör the thread in any desired Situation by a rope mechanism that can be operated from the handle in releases any desired situation. The knot transporter (Figure 2) is characterized as that with it a sliding knot with long reinforcement and an inclined hole on the head can be moved forward. The roller train with guide passage (Figure 3) is characterized by that there is a roll at the tip of the instrument. There is also in the reinforcement an opening, the so-called guide passage, which the thread and lets the knot transporter pass. The long-armored scissors (Figure 4) is characterized in that it is long armored and at the tip short cutting surfaces angled from the armoring wearing. These scissors are closed and opened using the handle. The needle with a tip that can be inserted and removed (FIG. 5) is dadurc! L characterized in that they are for the purpose of introducing and executing by one on the handle located spring pressure is to be used - a variant of Figure 1 with otherwise the same Function and operation. Generic term of the subclaim. Endoscopic cutlery according to claim 1 Characteristic parts of the dependent claim: Characterized as that the endoskopisdne cutlery is used in connection with 1. the bronchoscope and 2. the rectoscope