WO2004066845A1 - Elastic percutaneous surgical instrument and uses thereof - Google Patents

Elastic percutaneous surgical instrument and uses thereof Download PDF

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Publication number
WO2004066845A1
WO2004066845A1 PCT/FR2004/000121 FR2004000121W WO2004066845A1 WO 2004066845 A1 WO2004066845 A1 WO 2004066845A1 FR 2004000121 W FR2004000121 W FR 2004000121W WO 2004066845 A1 WO2004066845 A1 WO 2004066845A1
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WIPO (PCT)
Prior art keywords
awls
instrument
handle
instrument according
surgical instrument
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PCT/FR2004/000121
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French (fr)
Inventor
Frédérique KIRSCH NOIR
Original Assignee
Assistance Publique Hopitaux De Paris
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Publication of WO2004066845A1 publication Critical patent/WO2004066845A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets 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, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets 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
    • A61B17/06109—Big needles, either gripped by hand or connectable to a handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets 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
    • A61B2017/0472—Multiple-needled, e.g. double-needled, instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets 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
    • A61B2017/06042—Means for attaching suture to needle located close to needle tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets 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
    • A61B2017/0608—J-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets 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
    • A61B2017/06085—Needles, e.g. needle tip configurations having a blunt tip

Definitions

  • the invention relates to an elastic percutaneous surgical instrument and to its different uses.
  • This instrument is used in particular in general surgery, and in particular in surgery for prolapse and / or female incontinence.
  • This technique makes it possible to reconstitute the floor of the urethra by providing support to the perineal musculature in order to strengthen the normal mechanisms of continence.
  • This support amounts to forming a real hammock, or shoulder, of the urethra.
  • This strip is passed through the tissues of the body on each side of the bladder, thanks to two needles arranged on either side of the strip. The latter is then inserted up to the skin above the pubis, in two different small openings arranged side by side. The surgeon collects each needle at each of the small openings above the pubis, then cuts each piece of strip flush with the skin.
  • this technique has various drawbacks. In fact, it uses two different needles, which pass along two different paths through the body's tissues.
  • the needles used having to be sharp enough to pass through each tissue, have the disadvantage of risking bladder perforations linked to the plugging of the bladder or the bladder neck by the needles, and / or nerve wounds. , and / or vascular wounds.
  • Another technique for caring for female incontinence is the " ⁇ retex" technique.
  • this technique uses a passage from the surgical instrument from top to bottom, that is to say from the skin located above the pubis towards the vaginal part. This type of passage allows a more direct journey through the body without leaving the pubic symphysis, thus avoiding bladder wounds.
  • this technique requires making a larger vaginal incision to introduce a finger. to the lower edge of the symphysis, to meet the needle which passes through the skin located above the pubis.
  • Such blind trips of surgical instruments through human tissue involve the significant risk of vascular and / or nerve wounds, and / or organ perforations.
  • Other techniques such as the so-called Peirera technique, also use two needles intended to pass through the body with portions of the path blind.
  • the instrument used in this technique uses two parallel needles, which are never contiguous. Even if this instrument allows two wires to pass through the tissue in a single passage, the space between the distal ends is such that two blind runs are made, and two must be controlled simultaneously. extremities during blind time.
  • an elastic percutaneous surgical instrument which allows a single passage by elastic wire, by a single path in the organism, from top to bottom or from bottom to top, by vaginal route with above pubic approach, or by trans- obturator, sub urethral, sub vesical or prerectal, while having to control only one perforating end of the surgical instrument, and without having the risk of organic perforations, vascular and / or nerve wounds.
  • the subject of the invention is therefore an elastic percutaneous surgical instrument, characterized in that it comprises a handle extended by two awls, said awls being simultaneously separated from one another at their fixing points on the handle, and contiguous at their terminal ends opposite their fixing points on the handle.
  • the instrument according to the invention has the advantage of making surgical procedures easier and faster, and of minimizing the risks of operational complications due to internal wounds.
  • the awls are spaced from each other at their point of attachment by a distance ranging from about 1 to 2 cm, and preferably about 1 cm.
  • each awl has a foam end, and each may include an opening intended for the passage of at least one wire, also called eye.
  • the awls can be of choice of substantially elongated or curved shapes so that they can be easily used in different parts of the human body.
  • the lengths and curvatures of the awls are adapted to the different places in the body from which the surgeon can operate.
  • the awls are preferably made of a sterilizable material chosen from stainless steel, plastic composites and their mixture; this material can be sterilized according to the usual known sterilization techniques.
  • Another object of the invention relates to a use of the instrument as defined above as a grommet in general surgery.
  • this instrument can be done in particular in surgery for human or animal, female or male urogenito-anal prolapse.
  • this instrument is carried out in vaginal prolapse surgery with a suprapubic and / or trans-obturator approach.
  • Another use of this instrument can be done in abdominal surgery.
  • FIG. 1 shows a schematic front view of the instrument of the invention
  • Figure 2 shows a schematic sectional view of the instrument according to the invention.
  • the surgical instrument comprises a handle 1 made of a plastic material, extended by two awls 2 and 3 made of stainless steel, separated from each other of about 1cm, at their fixing points 4 and 5 on the handle 1.
  • the two awls 2 and 3 have their ends 6 and 7 joined in a flexible and elastic manner. These contiguous ends are located on the opposite side from that of the attachment points to the handle 4 and 5.
  • Each end further comprises an opening 8a, 8b, (or eye) which allows the passage of a wire, for its passage through the tissues of the body.
  • Figure 1 shows the instrument of the invention in a substantially elongated shape.
  • each awl 2 and 3 may have a substantially curved shape.
  • the ends of each awl 2 and 3 also each include an opening (or eye) intended for the passage of at least one wire.
  • the different curvatures and lengths that the awls 2 and 3 can have of the instrument of the invention are studied so as to be able to easily adapt to the suprapubic and / or transobturator pathways of the body.
  • the end of the awls 2 and 3 is foam. This allows the instrument to easily pierce the fascia when it enters the body, without puncturing an organ, such as the bladder, or even causing vascular or nerve wounds. Indeed, the foam tip of this instrument allows it, when it comes into contact with an organ or a vessel, to slide over it and thus avoid the appearance of involuntary wounds.
  • the surgeon keeps the ends 6 and 7 of the two awls 2 and 3 apart by a distance of about 1 cm by sliding a finger between the awls, at the time of penetration of the instrument in the organism; the two awls each comprising a thread.
  • This spacing operated by the surgeon ensures sufficient aponevrotic support of the knot produced using the thread of each awl 2,3.

Abstract

The invention relates to an elastic percutaneous surgical instrument and to the uses thereof. The inventive instrument is characterised in that it comprises a handle (1) which extends into two awls (2, 3), said two awls (2, 3) being spaced apart from each other at the points (4, 5) at which they are fixed to the handle and joined together at the ends (6, 7) thereof away from the handle (1).

Description

INSTRUMENT CHIRURGICAL PERCUTANE ELASTIQUE ET SES ELASTIC PERCUTANE SURGICAL INSTRUMENT AND ITS
UTILISATIONSUSES
L'invention se rapporte à un instrument chirurgical percutané élastique et à ses différentes utilisations.The invention relates to an elastic percutaneous surgical instrument and to its different uses.
Cet instrument est notamment utilisé en chirurgie générale, et notamment dans la chirurgie du prolapsus et/ou de l'incontinence féminine.This instrument is used in particular in general surgery, and in particular in surgery for prolapse and / or female incontinence.
Pour lutter contre les fuites urinaires liées à l'effort dans le sexe féminin, les chirurgiens disposent aujourd'hui de différents moyens.To fight against urinary leakage linked to effort in the female sex, surgeons today have different means.
Parmi eux, on peu citer ceux qui consistent à mettre en place un fil ou une bandelette en tissu synthétique sous la partie inférieure de l'urètre pour le soutenir.Among them, we can cite those which consist in placing a wire or a strip of synthetic fabric under the lower part of the urethra to support it.
Parmi les différentes techniques opératoires de soin, on dispose de la technique TVT (« Tension free Vaginal Tape ») encore appelé Technique de la bandelette vaginale sans tension.Among the various surgical operating techniques, there is the TVT technique (“Tension free Vaginal Tape”) also called the Tension-free vaginal strip technique.
Cette technique permet de reconstituer le plancher de l'urètre en fournissant un soutien à la musculature périnéale afin de renforcer les mécanismes normaux de continence. Ce soutien revient à former un véritable hamac, ou épaulement, de l'urètre. Par cette technique, qui consiste à incorporer le moyen de soutien de bas en haut? on pratique une petite ouverture au niveau du vagin. Par cette ouverture, on dépose une bandelette auto-aggripante constituée en polypropylène élastiqueThis technique makes it possible to reconstitute the floor of the urethra by providing support to the perineal musculature in order to strengthen the normal mechanisms of continence. This support amounts to forming a real hammock, or shoulder, of the urethra. By this technique, which consists in incorporating the support from the bottom up ? a small opening is made in the vagina. Through this opening, a self-gripping strip made of elastic polypropylene is deposited
(connu sous le nom commercial de « Prolène ») d'environ 11 mm de large sous la partie antérieure de l'urètre, afin de le remonter vers la base vésicale.(known by the commercial name of "Prolene") of approximately 11 mm wide under the anterior part of the urethra, in order to raise it towards the bladder base.
Cette bandelette est passée au travers des tissus de l'organisme de chaque côté de la vessie, grâce à deux aiguilles disposées de part et d'autre de la bandelette. Cette dernière est ensuite insérée jusqu'à la peau au-dessus du pubis, en deux petites ouvertures différentes disposées côte à côte. Le chirurgien récupère chaque aiguille au niveau de chacune des petites ouvertures au-dessus du pubis, puis coupe chaque morceau de bandelette au ras de la peau.This strip is passed through the tissues of the body on each side of the bladder, thanks to two needles arranged on either side of the strip. The latter is then inserted up to the skin above the pubis, in two different small openings arranged side by side. The surgeon collects each needle at each of the small openings above the pubis, then cuts each piece of strip flush with the skin.
Mais cette technique présente différents inconvénients. En effet, elle utilise deux aiguilles différentes, qui passent selon deux trajets différents au travers des tissus de l'organisme. De plus, les aiguilles utilisées, devant être suffisamment pointues pour passer au travers de chaque tissu, présente l'inconvénient de risquer des perforations vésicales liées à l' embrochage de la vessie ou du col vésical par les aiguilles, et/ou des plaies nerveuses, et/ou des plaies vasculaires.However, this technique has various drawbacks. In fact, it uses two different needles, which pass along two different paths through the body's tissues. In addition, the needles used, having to be sharp enough to pass through each tissue, have the disadvantage of risking bladder perforations linked to the plugging of the bladder or the bladder neck by the needles, and / or nerve wounds. , and / or vascular wounds.
Une autre technique de soin de l'incontinence féminine est la technique « ϋretex ». Contrairement à la technique TVT, cette technique utilise un passage de l'instrument chirurgical de haut en bas, c'est-à-dire de la peau située au-dessus du pubis vers la partie vaginale. Ce type de passage permet d'effectuer un trajet plus direct dans l'organisme sans quitter la symphyse pubienne, évitant ainsi les plaies vésicales. Toutefois cette technique nécessite de réaliser une incision vaginale plus grande pour introduire un doigt jusqu'au bord inférieure de la symphyse, à la rencontre de l'aiguille qui passe par la peau située au-dessus du pubis .Another technique for caring for female incontinence is the "ϋretex" technique. Unlike the TVT technique, this technique uses a passage from the surgical instrument from top to bottom, that is to say from the skin located above the pubis towards the vaginal part. This type of passage allows a more direct journey through the body without leaving the pubic symphysis, thus avoiding bladder wounds. However, this technique requires making a larger vaginal incision to introduce a finger. to the lower edge of the symphysis, to meet the needle which passes through the skin located above the pubis.
De plus, ces deux techniques exposées précédemment présentent l'inconvénient majeur d'effectuer des passages en aveugle dans l'organisme sur une portion du trajet des aiguilles, avant que le doigt du chirurgien, introduit par le vagin, ne repère la présence de l'aiguille et puisse la guider jusqu'à la sortie du vagin.In addition, these two techniques described above have the major drawback of making blind passages in the body over a portion of the path of the needles, before the surgeon's finger, introduced by the vagina, spots the presence of the needle and can guide it to the exit of the vagina.
De tels trajets en aveugle, d'instruments chirurgicaux, à travers des tissus humains, entraînent le risque important de plaies vasculaires et/ou nerveuses, et/ou de perforations d'organes. D'autres techniques, telles que celle dite de Peirera, utilise également deux aiguilles destinées à passer au travers de l'organisme avec des portions de trajet en aveugle.Such blind trips of surgical instruments through human tissue involve the significant risk of vascular and / or nerve wounds, and / or organ perforations. Other techniques, such as the so-called Peirera technique, also use two needles intended to pass through the body with portions of the path blind.
L'instrument utilisé dans cette technique utilise deux aiguilles parallèles, qui ne sont jamais jointives. Même si cet instrument permet de faire passer, au travers des tissus, deux fils en un passage unique, l'espace situé entre les extrémités distales, est tel que l'on effectue deux trajets en aveugle, et qu' il faut contrôler simultanément deux extrémités lors du temps aveugle.The instrument used in this technique uses two parallel needles, which are never contiguous. Even if this instrument allows two wires to pass through the tissue in a single passage, the space between the distal ends is such that two blind runs are made, and two must be controlled simultaneously. extremities during blind time.
Aussi il subsiste le besoin de disposer d' un instrument chirurgical percutané élastique qui permet un passage unique par fil élastique, par un seul trajet dans l'organisme, de haut en bas ou de bas en haut, par voie vaginale avec abord sus pubien, ou par voie trans- obturateur, sous urétrale, sous vésicale ou prérectale, tout en n'ayant à contrôler qu'une seule extrémité perforatrice de l'instrument chirurgical, et sans avoir le risque de perforations organiques, de plaies vasculaires et/ou nerveuses.Also there remains the need to have an elastic percutaneous surgical instrument which allows a single passage by elastic wire, by a single path in the organism, from top to bottom or from bottom to top, by vaginal route with above pubic approach, or by trans- obturator, sub urethral, sub vesical or prerectal, while having to control only one perforating end of the surgical instrument, and without having the risk of organic perforations, vascular and / or nerve wounds.
L'invention a donc pour objet un instrument chirurgical percutané élastique, caractérisé en ce qu'il comprend un manche prolongé par deux alênes, lesdites alênes étant simultanément écartées l'une de l'autre à leurs points de fixation sur le manche, et jointives à leurs extrémités terminales opposées à leurs points de fixation sur le manche.The subject of the invention is therefore an elastic percutaneous surgical instrument, characterized in that it comprises a handle extended by two awls, said awls being simultaneously separated from one another at their fixing points on the handle, and contiguous at their terminal ends opposite their fixing points on the handle.
L'instrument selon l'invention présente l'avantage de rendre plus faciles et plus rapides les interventions chirurgicales, et de limiter au maximum les risques de complications opératoires du fait de plaies internes.The instrument according to the invention has the advantage of making surgical procedures easier and faster, and of minimizing the risks of operational complications due to internal wounds.
De préférence, les alênes sont écartées l'une de l'autre à leur point de fixation d'une distance allant d'environ 1 à 2 cm, et de préférence d'environ 1cm.Preferably, the awls are spaced from each other at their point of attachment by a distance ranging from about 1 to 2 cm, and preferably about 1 cm.
De préférence, chaque alêne a une extrémité mousse, et chacune peut comprendre une ouverture destinée au passage d'au moins un fil, encore appelée chas.Preferably, each awl has a foam end, and each may include an opening intended for the passage of at least one wire, also called eye.
Les alênes peuvent être au choix de formes sensiblement longilignes ou courbes de manière à pouvoir être utilisées facilement dans différentes parties du corps humain. Les longueurs et courbures des alênes sont adaptées aux différents endroits de l'organisme à partir desquels le chirurgien peut opérer. Les alênes sont de préférence constituées en un matériau stérilisable choisi parmi l'acier inoxydable, les composites plastiques et leur mélange ; ce matériau pouvant être stérilisé selon les techniques habituelles connues de stérilisation.The awls can be of choice of substantially elongated or curved shapes so that they can be easily used in different parts of the human body. The lengths and curvatures of the awls are adapted to the different places in the body from which the surgeon can operate. The awls are preferably made of a sterilizable material chosen from stainless steel, plastic composites and their mixture; this material can be sterilized according to the usual known sterilization techniques.
Un autre objet de l'invention se rapporte à une utilisation de l'instrument tel que défini précédemment comme passe-fil en chirurgie générale.Another object of the invention relates to a use of the instrument as defined above as a grommet in general surgery.
L'utilisation de cet instrument peut se faire notamment en chirurgie du prolapsus urogénito-anal humain ou animal, féminin ou masculin.The use of this instrument can be done in particular in surgery for human or animal, female or male urogenito-anal prolapse.
De préférence, l'utilisation de cet instrument s'effectue en chirurgie du prolapsus par voie vaginale avec abord sus-pubien et/ou trans-obturateur . Une autre utilisation de cet instrument peut s'effectuer en chirurgie abdominale.Preferably, the use of this instrument is carried out in vaginal prolapse surgery with a suprapubic and / or trans-obturator approach. Another use of this instrument can be done in abdominal surgery.
L'invention va maintenant être illustrée à l'aide des figures qui suivent, qui sont données uniquement à titre d'exemple de réalisation, et qui ne limitent en aucune façon l'objet de l'invention, et dans lesquelles : la figure 1 représente une vue schématique de face de l'instrument de l'invention, la figure 2 représente une vue schématique en coupe de l'instrument selon l'invention.The invention will now be illustrated with the aid of the figures which follow, which are given solely by way of example of embodiment, and which in no way limit the subject of the invention, and in which: FIG. 1 shows a schematic front view of the instrument of the invention, Figure 2 shows a schematic sectional view of the instrument according to the invention.
Comme on peut le voir sur la figure 1, l'instrument chirurgical selon l'invention comprend un manche 1 constitué en un matériau plastique, prolongé par deux alênes 2 et 3 constituées en acier inoxydable, écartées l'une de l'autre d'environ 1cm, en leurs points de fixation 4 et 5 sur le manche 1.As can be seen in Figure 1, the surgical instrument according to the invention comprises a handle 1 made of a plastic material, extended by two awls 2 and 3 made of stainless steel, separated from each other of about 1cm, at their fixing points 4 and 5 on the handle 1.
Les deux alênes 2 et 3 ont leurs extrémités 6 et 7 jointives de manière souple et élastique. Ces extrémités jointives se situent du côté opposé à celui des points de fixation au manche 4 et 5.The two awls 2 and 3 have their ends 6 and 7 joined in a flexible and elastic manner. These contiguous ends are located on the opposite side from that of the attachment points to the handle 4 and 5.
Chaque extrémité comprend de plus une ouverture 8a, 8b, (ou chas) qui permet le passage d'un fil, en vue de son passage au travers des tissus de l'organisme. La figure 1 représente l'instrument de l'invention selon une forme sensiblement longiligne.Each end further comprises an opening 8a, 8b, (or eye) which allows the passage of a wire, for its passage through the tissues of the body. Figure 1 shows the instrument of the invention in a substantially elongated shape.
Comme le montre la figure 2, l'instrument de 1' invention peut présenter une forme sensiblement courbe. Les extrémités de chaque alêne 2 et 3 comprennent également chacune une ouverture (ou chas) destinée au passage d'au moins un fil.As shown in Figure 2, the instrument of one invention may have a substantially curved shape. The ends of each awl 2 and 3 also each include an opening (or eye) intended for the passage of at least one wire.
Les différentes courbures et longueurs que peuvent présenter les alênes 2 et 3 de l'instrument de l'invention sont étudiées de façon à pouvoir s'adapter facilement aux voies sus-pubienne et/ou transobturatrice de l'organisme.The different curvatures and lengths that the awls 2 and 3 can have of the instrument of the invention are studied so as to be able to easily adapt to the suprapubic and / or transobturator pathways of the body.
L'extrémité des alênes 2 et 3 est mousse. Ceci permet à l'instrument de pouvoir percer facilement l'aponévrose lorsqu'il pénètre dans l'organisme, sans pour autant perforer un organe, tel que la vessie, ou encore provoquer des plaies vasculaires ou nerveuses. En effet, l'embout mousse de cet instrument lui permet, lorsqu'il arrive en contact d'un organe ou d'un vaisseau, de glisser dessus et ainsi d'éviter l'apparition de plaies involontaires. Lors de l'utilisation de l'instrument selon l'invention, le chirurgien maintient écartées les extrémités 6 et 7 des deux alênes 2 et 3 d'une distance d'environ 1cm en glissant un doigt entre les alênes, au moment de la pénétration de l'instrument dans l'organisme ; les deux alênes comprenant chacune un fil.The end of the awls 2 and 3 is foam. This allows the instrument to easily pierce the fascia when it enters the body, without puncturing an organ, such as the bladder, or even causing vascular or nerve wounds. Indeed, the foam tip of this instrument allows it, when it comes into contact with an organ or a vessel, to slide over it and thus avoid the appearance of involuntary wounds. When using the instrument according to the invention, the surgeon keeps the ends 6 and 7 of the two awls 2 and 3 apart by a distance of about 1 cm by sliding a finger between the awls, at the time of penetration of the instrument in the organism; the two awls each comprising a thread.
Cet écartement opéré par le chirurgien assure un appui aponevrotique suffisant du nœud réalisé à l'aide du fil de chaque alêne 2,3.This spacing operated by the surgeon ensures sufficient aponevrotic support of the knot produced using the thread of each awl 2,3.
Ensuite, une fois le passage de l'aponévrose effectué, le chirurgien enlève le doigt qui permettait l' écartement des alênes 2 et 3. Ainsi ces deux alênes 2 et 3 redeviennent jointives, du fait de leur élasticité naturelle. Le chirurgien peut alors enfoncer dans l'organisme les alênes 2 et 3 de l'instrument jusqu'à la sortie de l'instrument de l'organisme.Then, once the aponeurosis has been passed, the surgeon removes the finger which allowed the spreading of the awls 2 and 3. Thus these two awls 2 and 3 become contiguous again, due to their natural elasticity. The surgeon can then insert the awls 2 and 3 of the instrument into the body until the instrument leaves the body.
Ces dernières étant jointives ne forment alors qu'un passage unique, tout en détenant deux fils destinés à faire les nœuds, divisant ainsi par deux le risque de perforation et/ou de plaies lors du passage en aveugle dans l'organisme, par rapport aux systèmes connus jusqu'ici. The latter being contiguous then form only a single passage, while holding two wires intended to tie the knots, thus dividing by two the risk of perforation and / or wounds during the blind passage in the body, compared to the systems known so far.

Claims

REVENDICATIONS
1. Instrument chirurgical percutané élastique, caractérisé en ce qu'il comprend un manche (1) prolongé par deux alênes (2,3), lesdites alênes (2,3) étant écartées l'une de l'autre à leurs points de fixation (4,5) sur le manche (1), et étant jointives à leurs extrémités terminales (6,7) opposées à leurs points de fixation (4,5) sur le manche.1. Elastic percutaneous surgical instrument, characterized in that it comprises a handle (1) extended by two awls (2,3), said awls (2,3) being separated from one another at their fixing points (4,5) on the handle (1), and being contiguous at their terminal ends (6,7) opposite their fixing points (4,5) on the handle.
2. Instrument selon la revendication 1, caractérisé en ce que les alênes (2,3) sont écartées l'une de l'autre à leur point de fixation d'une distance allant d'environ 1 à 2 cm, et de préférence d'environ 1cm.2. Instrument according to claim 1, characterized in that the awls (2,3) are spaced from each other at their fixing point by a distance ranging from about 1 to 2 cm, and preferably d 'about 1cm.
3. Instrument selon la revendication 1, caractérisé en ce que les alênes (2,3) ont une extrémité moussé.3. Instrument according to claim 1, characterized in that the awls (2,3) have a foamed end.
4. Instrument selon la revendication 1, caractérisé en ce que les extrémités (6,7) des alênes (2,3) comprennent une ouverture destinée au passage d' au moins un fil .4. Instrument according to claim 1, characterized in that the ends (6,7) of the awls (2,3) comprise an opening intended for the passage of at least one wire.
5. Instrument selon la revendication 1, caractérisé en ce que les alênes sont au choix de forme sensiblement longilignes ou sensiblement courbes.5. Instrument according to claim 1, characterized in that the awls are optionally of substantially elongated or substantially curved shape.
6. Instrument selon la revendication 1, caractérisé en ce que les alênes (2,3) sont constituées en un matériau stérilisable choisi parmi l'acier inoxydable, les composites plastiques et leur mélange.6. Instrument according to claim 1, characterized in that the awls (2,3) consist of a sterilizable material chosen from stainless steel, plastic composites and their mixture.
7. Utilisation de l'instrument tel que défini selon l'une des revendications précédentes comme passe-fil. 7. Use of the instrument as defined according to one of the preceding claims as a grommet.
PCT/FR2004/000121 2003-01-23 2004-01-20 Elastic percutaneous surgical instrument and uses thereof WO2004066845A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR03/00731 2003-01-23
FR0300731A FR2850267B1 (en) 2003-01-23 2003-01-23 ELASTIC PERCUTANE SURGICAL INSTRUMENT AND USES THEREOF

Publications (1)

Publication Number Publication Date
WO2004066845A1 true WO2004066845A1 (en) 2004-08-12

Family

ID=32669167

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/FR2004/000121 WO2004066845A1 (en) 2003-01-23 2004-01-20 Elastic percutaneous surgical instrument and uses thereof

Country Status (2)

Country Link
FR (1) FR2850267B1 (en)
WO (1) WO2004066845A1 (en)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE424807C (en) * 1924-12-05 1926-02-04 Fried Krupp Akt Ges Thread guide
DE8711570U1 (en) * 1987-08-26 1988-09-29 Schnepp-Pesch, Wolfram, 7505 Ettlingen, De
US5474543A (en) * 1993-05-17 1995-12-12 Mckay; Hunter A. Single needle apparatus and method for performing retropublic urethropexy
US5782845A (en) * 1996-07-31 1998-07-21 Shewchuk; Dwight Trocar site suturing device

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE424807C (en) * 1924-12-05 1926-02-04 Fried Krupp Akt Ges Thread guide
DE8711570U1 (en) * 1987-08-26 1988-09-29 Schnepp-Pesch, Wolfram, 7505 Ettlingen, De
US5474543A (en) * 1993-05-17 1995-12-12 Mckay; Hunter A. Single needle apparatus and method for performing retropublic urethropexy
US5782845A (en) * 1996-07-31 1998-07-21 Shewchuk; Dwight Trocar site suturing device

Also Published As

Publication number Publication date
FR2850267A1 (en) 2004-07-30
FR2850267B1 (en) 2005-04-01

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