CN103989498A - Guide suture instrument for anorectal PPH operation - Google Patents

Guide suture instrument for anorectal PPH operation Download PDF

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Publication number
CN103989498A
CN103989498A CN201410177274.8A CN201410177274A CN103989498A CN 103989498 A CN103989498 A CN 103989498A CN 201410177274 A CN201410177274 A CN 201410177274A CN 103989498 A CN103989498 A CN 103989498A
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China
Prior art keywords
split ring
anorectal
pph
rod
guiding
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CN201410177274.8A
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Chinese (zh)
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CN103989498B (en
Inventor
肖卫东
杨桦
张朝军
王文生
李云波
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Second Affiliated Hospital of TMMU
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Second Affiliated Hospital of TMMU
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Priority to CN201410177274.8A priority Critical patent/CN103989498B/en
Publication of CN103989498A publication Critical patent/CN103989498A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115Staplers for performing anastomosis in a single operation

Abstract

The invention discloses a guide suture instrument for an anorectal PPH operation. The guide suture instrument comprises an open ring which is made of elastic materials and can stretch into the anal tube, rods capable of being held by human hands are arranged at the two ends of the open position of the open ring respectively, and the caliber of the open ring can be adjusted by adjusting the distance between the two rods. According to the guide suture instrument for the anorectal PPH operation, a doctor can be assisted in guaranteeing the purse string suture position and depth and the purse string completeness precision in the PPH operation process, and the situation that the operation effect is poor, and the subsidiary injury occurs due to the fact that the purse string suture position and depth are controlled improperly in the former PPH operation is effectively avoided.

Description

Guiding stiching instrument for anorectal PPH operation
Technical field
The present invention relates to a kind of medical apparatus and instruments, relate in particular to a kind of anorectal PPH operation with guiding stiching instrument.
Background technology
Wicresoft's hemorrhoid operation (PPH) claims again mucosa procedure in anastomat hemorrhoid, is the new technique that uses anastomat treatment ring-type prolapsus hemorrhoid.Be widely used in recent years all kinds of hemorrhoid, especially the patient of Severe internal hemorrhoids and part prolapse of rectal mucosa.The principle of PPH operation is: retain anus pad, when in part internal hemorrhoid and hemorrhoid, resection and anastomosis is gone in ring in mucosa, mucosa undertissue, carrying out moment coincide.Both blocked the blood supply of hemorrhoid, again that the suspention of slippage tissue is fixing, the anorectal region of pathological state is returned to normal anatomic status.Carrying out PPH operation in the past, and except the most basic PPH anastomat of needs, must with anorectal dilator, anorectal introducer and anorectal, tie device respectively and assist PPH anastomat, and making to perform the operation smooth.
The operation method of prior art is: the special transparent annular anorectal dilator for PPH operation is inserted to anal canal, take out anorectal introducer, anorectal is tied to device and insert in anorectal dilator.On pectinate line, about 4cm place ties device with suture by rotation and does clockwise purse string suture under 1 circle or 2 circle mucosas.Take out anorectal and tie device, after PPH anastomat is opened up into greatest extent, per anum intestinal dilator extend into purse string suture line top by its head end, tightens up suture knotting.With the supporting line device of holding, by PPH anastomat side opening, suture is pulled out, suitably draw ligature, make the mucosa of prolapsus enter anastomat sleeve pipe, tighten up anastomat percussion.Keep it closing the about 20s of head status, prevent hemorrhage.Hemorrhoid anastomat is partially opened, extract gently.
On pectinate line the height of purse string suture, the degree of depth and pocket integrity be guarantee PPH surgical effect, the committed step of the secondary damage of avoiding performing the operation.Adopt the PPH operation of prior art to have following problem: while 1) performing the operation, purse string suture line requires about 4cm place more than pectinate line, and anastomotic stoma 1~2cm on pectinate line is advisable, and the too low anastomotic position that makes in position relates to anus pad, because blood vessel in anus pad is more, postoperative easily hemorrhage; Position is too high, and the tractive making progress and suspension function to anus pad that operation produces weaken, and surgical effect is not obvious, invalid even.Because seam pocket process is completely with doctor's experience manual operations, lack auxiliary device, while therefore performing the operation, purse string suture line position cannot be accomplished accurately; 2) while performing the operation, the depth requirements of purse string suture, in tela submucosa, was sewed up shallow the tearing of mucosa that easily cause when tractive, crossed dark easily damage intestinal wall flesh layer, adopted existing anorectal to tie the degree of depth that device cannot guarantee purse string suture; 3) female patient drag wire should avoid being positioned at rectum front wall, should will check whether posterior vaginal wall is pulled in anastomat, prevents that posterior vaginal wall from being excised in the lump, causes postoperative recto-vaginal fistula before closing anastomat and anastomat percussion simultaneously.Above-mentioned some problem, by existing anorectal, tying device cannot solve.
For the problems referred to above, the inventor has designed a kind of simple in structure, can assist doctor under the prerequisite of guaranteeing purse string suture quality, efficiently complete operation guiding stiching instrument for anorectal PPH operation.
Summary of the invention
In view of this, the object of this invention is to provide a kind of anorectal PPH operation with guiding stiching instrument, by this apparatus is auxiliary, can accurately to the height of purse string suture on pectinate line, the degree of depth and pocket integrity, carry out accurate quality control, solve the problem such as purse string suture height and the difficult assurance of the degree of depth while adopting prior art operation.
The present invention addresses the above problem by following technological means:
The invention provides a kind of anorectal PPH operation with guiding stiching instrument, comprise the split ring in the extend into anal canal of being made by elastomeric material, the two ends of described split ring opening part are respectively provided with one can supply the hand-held body of rod of people, regulates distance between two bodies of rod can regulate the caliber size of described split ring.
Further, on described split ring, be evenly provided with along the axially extended catch of split ring.
Further, the free end of described catch is crooked to the axle center of split ring.
Further, described split ring is bent and is formed by flaky elastic material, offers strip through-hole groove on the outer circumference surface of described split ring, the length direction of described through-hole groove and split ring axially perpendicular.
Further, described split ring is along self being axially set side by side with two, the two ends of each split ring opening part are respectively provided with one can supply the hand-held body of rod of people, the body of rod at one of them split ring opening part two ends is arranged to cylindrical shape, and these columnar two bodies of rod are set in respectively on the body of rod at another split ring two ends.
Beneficial effect of the present invention: guiding stiching instrument for anorectal PPH operation of the present invention, can guarantee that PPH operation time carries out accurate quality control to the height of purse string suture on pectinate line, the degree of depth and pocket integrity, avoid in PPH operation in the past the generation because of purse string suture position and the improper malpractice causing of the degree of depth.
Accompanying drawing explanation
Below in conjunction with drawings and Examples, the invention will be further described.
Fig. 1 is the perspective view that in embodiment 1, guiding stiching instrument is used in anorectal PPH operation of the present invention, and figure split shed loop section is in deployed condition;
Fig. 2 is the perspective view that in embodiment 1, guiding stiching instrument is used in anorectal PPH operation of the present invention, and figure split shed loop section is in crimped configuration;
Fig. 3 is structural representation when anorectal PPH operation of the present invention is used in conjunction with guiding stiching instrument and anorectal dilator in embodiment 1;
Fig. 4 is the perspective view that in embodiment 2, guiding stiching instrument is used in anorectal PPH operation of the present invention, and figure split shed loop section is in deployed condition;
Fig. 5 is the perspective view that in embodiment 3, guiding stiching instrument is used in anorectal PPH operation of the present invention, and figure split shed loop section is in crimped configuration;
Fig. 6 is the perspective view that in embodiment 4, guiding stiching instrument is used in anorectal PPH operation of the present invention, and figure split shed loop section is in crimped configuration;
Fig. 7 is structural representation when anorectal PPH operation of the present invention extend into anal canal inside by guiding stiching instrument in embodiment 4.
The specific embodiment
Below with reference to drawings and Examples, the present invention is described in detail:
Embodiment 1 guiding stiching instrument for anorectal PPH operation
As shown in Figures 1 to 3, the guiding stiching instrument for anorectal PPH operation of the present embodiment, comprise the split ring 1 in the extend into anal canal of being made by elastomeric material, the two ends of described split ring 1 opening part are respectively provided with one can supply the hand-held body of rod 2a of people, regulates distance between two body of rod 2a can regulate the caliber size of described split ring 1.During operation, anorectal dilator inserts after anal canal, distance between two bodies of rod of scalable diminishes split ring bore and puts into anorectal dilator rear portion, discharge two bodies of rod, make the split ring of crimped configuration rely on self elastic force expansion amplification, and then split ring can be contacted with mucosal tissue in anal canal, pulling out the body of rod can make part mucosal tissue be compressed between split ring end face and anorectal dilator 5 inner side ends, form protuberance state, now doctor can enter pin from the mucosa of protuberance, can make into the position of pin accurate, the degree of depth that has simultaneously guaranteed purse string suture is accurate, for making the degree of depth of purse string suture accurate, the height of above-mentioned anorectal dilator 5 should be larger than the height of anorectal dilator in prior art, be that anorectal dilator distal end end face should just approach the above 4cm of pectinate line place.
Anorectal PPH operation in the present embodiment is sewed up utensil with guiding simple in structure, easy to operate, the accurate advantages of higher of pocket seam guide.
Embodiment 2 guiding stiching instrument for anorectal PPH operation
As shown in Figure 4, the guiding stiching instrument for anorectal PPH operation of the present embodiment, comprise the split ring 1 in the extend into anal canal of being made by elastomeric material, the two ends of described split ring 1 opening part are respectively provided with one can supply the hand-held body of rod 2a of people, regulate distance between two body of rod 2a can regulate the caliber size of described split ring 1, on described split ring 1, be evenly provided with a plurality of along the axially extended catch 3 of split ring 1, catch is set can be so that the mucosal tissue being exposed between split ring 1 and anorectal dilator distal end end face presents fragmentation state, solution enters pin on the mucosa swelling continuously, the difficult problem of holding into the pin degree of depth.Preferably, the free end of described catch is crooked to the axle center of split ring, and while making to pull out body of rod 2a, catch 3 tips can not puncture mucous membrane of anal canal.
Embodiment 3 guiding stiching instrument for anorectal PPH operation
As shown in Figure 5, the guiding stiching instrument for anorectal PPH operation of the present embodiment, comprise the split ring 1 in the extend into anal canal of being made by elastomeric material, the two ends of described split ring 1 opening part are respectively provided with one can supply the hand-held body of rod 2a of people, regulate distance between two body of rod 2a can regulate the caliber size of described split ring 1, described split ring 1 is bent and is formed by flaky elastic material, on the outer circumference surface of described split ring 1, evenly offer three strip through-hole grooves 4, the length direction of described through-hole groove 4 and split ring 1 axially perpendicular, particularly, sewing up for convenience after-opening ring 1 can take out smoothly, between every adjacent two through-hole grooves 4, should offer the finedraw that allows stitching thread to pass through.PPH operation in the present embodiment with anorectal seam guide device in use, its split ring 1 needn't coordinate with the clamping of anorectal dilator distal end end face makes mucosal tissue protuberance, but by discharging two body of rod 2a, launch split ring 1, the lateral wall of split ring 1 can be close on the interior mucosal tissue of anal canal, thereby compressing mucosal tissue come out from through-hole groove 4.In the present embodiment, PPH operation is by the advantage of anorectal seam guide device: the degree of depth that 1) split ring 1 is inserted in anal canal can regulate arbitrarily; 2) by increasing split ring bore, oppress the mode that exposes mucosal tissue, compare employing method of clamping, that can further improve sewing needle enters the pin degree of depth, and then significantly improves success rate and the degree of safety of operation.
Embodiment 4 guiding stiching instrument for anorectal PPH operation
As shown in Figures 6 and 7, the guiding stiching instrument for anorectal PPH operation of the present embodiment, comprise the split ring 1 in the extend into anal canal of being made by elastomeric material, the two ends of described split ring 1 opening part are respectively provided with one can supply the hand-held body of rod 2a of people, regulate distance between two body of rod 2a can regulate the caliber size of described split ring 1, described split ring 1 is along self being axially set side by side with two, the two ends of each split ring 1 opening part are respectively provided with one can supply the hand-held body of rod 2a of people, 2b, the body of rod 2b at one of them split ring 1 opening part two ends is arranged to cylindrical shape, these columnar two body of rod 2b are set in respectively on the body of rod 2a at another split ring 1 two ends.In operation process, by the columnar body of rod 2b of push-and-pull, the distance between two split rings 1 of scalable, and then adjust the bump height that is clamped in mucosal tissue between two split rings 1, that can further improve equally sewing needle enters the pin degree of depth, significantly improves success rate and the degree of safety of operation.
Finally explanation is, above embodiment is only unrestricted in order to technical scheme of the present invention to be described, although the present invention is had been described in detail with reference to preferred embodiment, those of ordinary skill in the art is to be understood that, can modify or be equal to replacement technical scheme of the present invention, and not departing from aim and the scope of technical solution of the present invention, it all should be encompassed in the middle of claim scope of the present invention.

Claims (5)

1. an anorectal PPH operation is with guiding stiching instrument, it is characterized in that: comprise the split ring (1) in the extend into anal canal of being made by elastomeric material, the two ends of described split ring (1) opening part are respectively provided with one can supply the hand-held body of rod (2a) of people, regulates distance between two bodies of rod (2a) can regulate the caliber size of described split ring (1).
2. anorectal PPH operation according to claim 1, with guiding stiching instrument, is characterized in that: on described split ring (1), be evenly provided with a plurality of along the axially extended catch of split ring (1) (3).
3. anorectal PPH operation according to claim 2, with guiding stiching instrument, is characterized in that: the free end of described catch (3) is crooked to the axle center of split ring (1).
4. anorectal PPH operation according to claim 1 is with guiding stiching instrument, it is characterized in that: described split ring (1) is bent and formed by flaky elastic material, on the outer circumference surface of described split ring (1), offer strip through-hole groove (4), the length direction of described through-hole groove (4) and split ring (1) axially perpendicular.
5. anorectal PPH operation according to claim 1 is with guiding stiching instrument, it is characterized in that: described split ring (1) is along self being axially set side by side with two, the two ends of each split ring (1) opening part are respectively provided with one can supply the hand-held body of rod (2a of people, 2b), the body of rod (2b) at one of them split ring (1) opening part two ends is arranged to cylindrical shape, and these columnar two bodies of rod (2b) are set in respectively on the body of rod (2a) at another split ring (1) two ends.
CN201410177274.8A 2014-04-29 2014-04-29 Guide suture instrument for anorectal PPH operation Active CN103989498B (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104207808A (en) * 2014-09-05 2014-12-17 北京中法派尔特医疗设备有限公司 Transfixion device
RU2775581C1 (en) * 2022-02-18 2022-07-04 Федеральное государственное бюджетное учреждение "Национальный медицинский исследовательский центр колопроктологии имени А.Н. Рыжих" Министерства здравоохранения Российской Федерации Method for eliminating a fistulous opening in the rectum with a circular stapler in the treatment of high-level rectovaginal fistulas

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6102271A (en) * 1998-11-23 2000-08-15 Ethicon Endo-Surgery, Inc. Circular stapler for hemorrhoidal surgery
US20040254590A1 (en) * 2003-06-16 2004-12-16 Hoffman Gary H. Method and instrument for the performance of stapled anastamoses
US20050228414A1 (en) * 2004-04-12 2005-10-13 Mayoral Jaime L Apparatus and method of use of a circular surgical stapler
FR2890847A1 (en) * 2005-09-22 2007-03-23 Claude Franceschi Device for arresting and controlling haemorrhages of arterial or venous wounds whilst leaving the haemorrhage zone clear for inspection
CN101190144A (en) * 2006-11-27 2008-06-04 苏州天臣国际医疗科技有限公司 Hemorrhoids surgical instrument
CN101757717A (en) * 2008-12-01 2010-06-30 苏州天臣国际医疗科技有限公司 Novel anus spreader base
CN201612650U (en) * 2010-02-26 2010-10-27 中山大学附属第六医院 Anal speculum stitching device
WO2011047857A1 (en) * 2009-10-23 2011-04-28 Le Groupe Hospitalier Des Diaconesses Croix Saint-Simon Circular hemostatic apparatus and method of use thereof
CN202950698U (en) * 2012-12-14 2013-05-29 南京曙光医院 Mucosal open ring type fixed suturing device on hemorrhoids

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6102271A (en) * 1998-11-23 2000-08-15 Ethicon Endo-Surgery, Inc. Circular stapler for hemorrhoidal surgery
US20040254590A1 (en) * 2003-06-16 2004-12-16 Hoffman Gary H. Method and instrument for the performance of stapled anastamoses
US20050228414A1 (en) * 2004-04-12 2005-10-13 Mayoral Jaime L Apparatus and method of use of a circular surgical stapler
FR2890847A1 (en) * 2005-09-22 2007-03-23 Claude Franceschi Device for arresting and controlling haemorrhages of arterial or venous wounds whilst leaving the haemorrhage zone clear for inspection
CN101190144A (en) * 2006-11-27 2008-06-04 苏州天臣国际医疗科技有限公司 Hemorrhoids surgical instrument
CN101757717A (en) * 2008-12-01 2010-06-30 苏州天臣国际医疗科技有限公司 Novel anus spreader base
WO2011047857A1 (en) * 2009-10-23 2011-04-28 Le Groupe Hospitalier Des Diaconesses Croix Saint-Simon Circular hemostatic apparatus and method of use thereof
CN201612650U (en) * 2010-02-26 2010-10-27 中山大学附属第六医院 Anal speculum stitching device
CN202950698U (en) * 2012-12-14 2013-05-29 南京曙光医院 Mucosal open ring type fixed suturing device on hemorrhoids

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104207808A (en) * 2014-09-05 2014-12-17 北京中法派尔特医疗设备有限公司 Transfixion device
RU2775581C1 (en) * 2022-02-18 2022-07-04 Федеральное государственное бюджетное учреждение "Национальный медицинский исследовательский центр колопроктологии имени А.Н. Рыжих" Министерства здравоохранения Российской Федерации Method for eliminating a fistulous opening in the rectum with a circular stapler in the treatment of high-level rectovaginal fistulas

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