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WO2006113948A2 - Dispositif et procede pour mesurer la force de traction exercee sur deux parties corporelles - Google Patents

Dispositif et procede pour mesurer la force de traction exercee sur deux parties corporelles Download PDF

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Publication number
WO2006113948A2
WO2006113948A2 PCT/AT2006/000067 AT2006000067W WO2006113948A2 WO 2006113948 A2 WO2006113948 A2 WO 2006113948A2 AT 2006000067 W AT2006000067 W AT 2006000067W WO 2006113948 A2 WO2006113948 A2 WO 2006113948A2
Authority
WO
WIPO (PCT)
Prior art keywords
measuring
force
thread
body parts
housing
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/AT2006/000067
Other languages
German (de)
English (en)
Other versions
WO2006113948A8 (fr
WO2006113948A3 (fr
Inventor
Heinrich Schubert
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Innovationsagentur GmbH
Original Assignee
Innovationsagentur GmbH
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 Innovationsagentur GmbH filed Critical Innovationsagentur GmbH
Publication of WO2006113948A2 publication Critical patent/WO2006113948A2/fr
Publication of WO2006113948A3 publication Critical patent/WO2006113948A3/fr
Publication of WO2006113948A8 publication Critical patent/WO2006113948A8/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • 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
    • A61B17/0483—Hand-held instruments for holding sutures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8869—Tensioning devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0042—Surgical instruments, devices or methods with special provisions for gripping
    • A61B2017/00429—Surgical instruments, devices or methods with special provisions for gripping with a roughened portion
    • 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
    • A61B2017/0496—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures

Definitions

  • the invention relates to a device for measuring the force acting on two parts of the body, in particular vessels or nerves, tensile force which occurs when a combination and connection of these body parts with a surgical thread.
  • the invention also relates to a method for measuring the force acting on two body parts, in particular vessels or nerves, pulling force, which occurs when these body parts are brought together and connected with a surgical thread.
  • the present application is generally directed to the connection of two body parts, it relates in particular to the connection of vessels or nerves as they are joined together in microsurgery.
  • Other examples include the connections of bowel parts or tendons.
  • the structures to be sutured e.g. Vascular stumps must be connected by a surgical suture.
  • the two body parts to be joined are approximated and fixed by a first seam. At the beginning of the suturing process, the entire tensile load required to fix the organs in shock-to-thrust is loaded on this first seam.
  • the suture of small vessels is one of the most complicated and complicated procedures in surgery.
  • a faulty suture endangers the organ supplied by the corresponding vessel, for example a finger or an arm.
  • plastic surgery with a lack of vascular connection and a free flap graft may be at risk.
  • the suture which joins two stumps together, interferes with the integrity of the vessel wall by breaking it and subsequently by the foreign body in the blood flow.
  • Nerves unlike vessels, have none with a delicate lining. However, the tensile load has a significant effect on the perfusion of the nerve stumps and the formation of connective tissue between the nerve endings. These barriers prevent the reunification of the nerve endings and thus the trespassing of sprouting nerve fibers from a nerve stump in order to restore function Too much tension on a nerve connection, eg due to defects after accidents, can be relieved in a similar way as with vascular connections with grafts The knowledge of the tensile force acting on two body parts, in particular vessels or nerves, which in a combination and connection of these body parts, in particular Vessels or nerves, with a surgical fade n occurs, therefore, for the quality of the connection of the Body parts essential.
  • a holding device for a surgical thread is known, with which too high a tension when knotting the thread can be prevented, and thus an excessive tightening of the seam in the course of the knotting process can be prevented.
  • the surgical thread is clamped between two forceps-like elements, from which an element can be moved against a spring force. If the tensile force on the surgical thread exceeds this spring force, which can also be changed by the surgeon, the surgical thread falls from the forceps-like restraint.
  • this device although the tension on the surgical thread during the knotting process can be determined or prevented that a certain upper limit is not exceeded.
  • the EP 115 624 A shows a device for testing the tension during the surgical moving of skin flaps, which is formed by a tweezers or forceps-like device with wide-sided ends of the clamping legs, the clamping legs are individually or jointly connected via tension tension meter with a grip part. This allows the surgeon to measure the tension that occurs during surgery on the flap of skin to be moved. This gives the surgeon additional information and support for planning relief cuts.
  • a device is not able to affect the force acting on two body parts traction - A - measure what occurs in a combination and connection of these body parts with a surgical thread. In particular, the device is not suitable for microsurgery.
  • US 2003/0208210 A1 shows a device for tensioning wires, which serve to fix bone fragments.
  • the device measures too high forces on the wire to prevent cutting through the steel wires. A detection of the forces acting on two parts of the body tensile force is thus not possible.
  • the object of the present invention is therefore to provide an above-mentioned measuring device, with the too high tensile force on two body parts, especially vessels or nerves, which are combined with a surgical thread and connected to recognize the chances of success by unacceptably high tensile forces not decrease.
  • the device should be particularly suitable for microsurgery, in which vessels and nerves are interconnected.
  • Another object of the present invention is to provide a method of measuring the tensile force acting on two body parts, which allows a simple and rapid application by the surgeon and thus meets with high acceptance, thereby improving the quality of the surgical joint and thus the healing process can be accelerated.
  • the first object of the invention is achieved in that a device for measuring a force in a measuring direction is provided with a housing and a measuring element, wherein the measuring element comprises means for attaching the thread and the housing is attached to an element for guiding the thread.
  • the force measuring device is able to detect the force in a specific measuring direction.
  • the surgical thread is connected to the measuring element in such a way that the tensile force acting thereon can be determined via the surgical thread when contracting the body parts to be joined.
  • the measuring device according to the invention is applied before setting the first seam, so that already in advance, ie before setting the first seam It can be clarified whether an unacceptably high tensile force would act on the body parts to be connected, in particular vascular or nerve parts, which would reduce the chances of success.
  • the sewing thread is first inserted into the parts of the body to be joined together and arranged the thread according to the measuring device according to the invention and then applied in a similar manner as in knotting a tensile force on the thread.
  • the gauge displays the tension or a value proportional to it, which acts on the parts to be joined if they have been joined together with the first seam.
  • the measuring device If the tensile force or tensile stress occurring is within the permissible range, the measuring device is removed and the surgical thread is knotted in a conventional manner. Since the greatest stress rests on the first seam, no increase in tensile force or tensile stress can take place through the sewn seams, as a result of which it is highly probable that good jointing of the body parts can be achieved with a high chance of success. If the measuring device registers an unacceptably high value for the tensile force, the surgeon can introduce at least one body part to be connected closer to the other body part by appropriate free-cutting or reduce the force that occurs by using intermediate pieces. For example, it is customary to use vessel parts, for example donor veins, in the connection of vessels. It is also common to merge and connect nerves to use pieces of donor nerves for the connection. After the measurement, the surgeon can continue his work as usual without any loss of time.
  • vessel parts for example donor veins
  • the guide element and the means for attaching the thread are arranged in the measuring direction of the force measuring device. This ensures that the force detected by the force measuring device substantially corresponds to the tensile force acting on the two body parts.
  • the means for attaching the thread may be formed by an eyelet connected to the measuring element. In this eyelet, the surgical thread is threaded before the measurement and removed after the measurement. Alternatively, the means for attaching the thread may also be formed by a hook connected to the measuring element. In contrast to the eyelet mentioned above, the surgical thread need not be threaded when using a hook, which facilitates and accelerates the procedure.
  • the guide element may be formed by a rod connected to the housing of the force measuring device, at the end of which a deflection element for the thread is arranged.
  • the guide element serves to bring the surgical thread to the force measuring device in such a way that the force occurring at the thread essentially corresponds to the tensile force acting on the two body parts.
  • the deflecting element can be formed by an eyelet, a hook, a roller or a groove for guiding the thread.
  • At least part of the housing of the force measuring device has a coating of elastic material, in particular a rubber coating.
  • a coating of elastic material in particular a rubber coating.
  • a device for clamping the thread can also be provided on the housing of the force measuring device.
  • This device can be realized for example by a notch, a V-shaped slot or by more complex mechanical clamping mechanisms.
  • the guide element is formed by a wire and at least one deflecting element by a loop.
  • the wire is preferably made of surgical steel and can thus be disinfected without sacrificing quality.
  • the force measuring device can be formed for example by a spring balance with a spring as a measuring element. Such an embodiment is particularly robust and requires no electrical current for the function.
  • the force measuring device can also be formed by an electronic sensor, for example with a piezoelectric element or a strain gauge as a measuring element.
  • the object of the invention is also achieved in terms of the method in that one end of the surgical thread is fixed to a device for measuring a force in a measuring direction with a housing and a measuring element, the thread is guided over a measuring element and onto the other end of the surgical thread a tensile force is applied, which is necessary to bring the two body parts together and that the force registered by the measuring element is measured.
  • This force registered by the measuring element is an indicator of the tensile force acting on two body parts to be joined together.
  • the measured force substantially corresponds to the tensile force acting on the body parts.
  • the thread is released from the force gauge and then the body parts are surgically connected together in a known manner.
  • Fig. 1 is a schematic block diagram for illustrating the balance of power
  • 2 shows an embodiment of the measuring device according to the invention. shown schematically;
  • FIG. 3-9 an embodiment of the measuring device according to the invention for illustrating the application.
  • Fig. 10 shows a further preferred embodiment of the invention.
  • Fig. 1 shows a schematic block diagram for illustrating the forces occurring when using the measuring device according to the invention.
  • Two body parts 1, 2, in particular vascular stumps or nerve parts are brought together with the aid of a surgical thread 3 and connected to one another.
  • the tensile forces F ZG1 and F ZG2 act on the body parts 1 and 2.
  • the inventive device for measuring the force acting on the two body parts I 1 2 tensile force F ZG , which by the sum of the individual tensile forces F ZG i and F ZG 2 on given the body parts 1, 2, measures this tensile force F G via the force F A , which is exerted by the surgical thread 3 during the merging of the body parts 1, 2.
  • the surgical thread 3 is fixed at a point 4 and deflected accordingly and a device 5 for measuring a force F A guided in a measuring direction X.
  • a measuring element 6 is provided for measuring the force F A .
  • the measuring element 6 has means 7 for attaching the thread 3. With the help of the surgeon's hand, a manual pulling force F ZH is exerted on the free end of the thread until the two body parts 1, 2 have been brought together. It applies
  • the force F A measured by the measuring device 5 is equal to the tensile force F ZG acting on the two body parts 1, 2. _Q_
  • Fig. 2 shows an embodiment of the invention using a spring balance as a force gauge 5 for measuring a force F A in a measuring direction X with a housing 8 and a measuring element 6, which by a corresponding spring (not shown) is formed.
  • the measuring element 6 has a means 7 formed by a hook for attaching the surgical thread 3.
  • On the housing 8, an element 9 is attached to guide the yarn 3.
  • the surgical thread 3 is fixed, for example with the help of the finger 10 of the surgeon on the housing 8 of the force gauge 5.
  • a part of the housing 8 may have a coating, for example a rubber coating, in order to prevent the surgical thread 3 from slipping.
  • devices for clamping the thread 3 may be provided.
  • Figures 3 to 9 show an embodiment of a measuring device according to the invention in the application for measuring the force acting on two body parts 1, 2 pulling force before sewing these two body parts 1, 2.
  • the measuring device consists of a spring balance formed from a force gauge 5 with a housing. 8 and a measuring element 6, wherein the measuring element 6 has means 7 for attaching the surgical thread 3.
  • a deflecting element 12 which may be formed by an eyelet 13 is arranged.
  • the means 7 for attaching the thread 3 may be formed by an eyelet connected to the measuring element 6. 4 shows the arrangement of the measuring device in addition to two body parts 1, 2 to be connected.
  • the needle 16 with the surgical thread 3 is first threaded through the deflecting element 12 arranged at the end of the guide element 9, then the two body parts 1, 2, which are to be brought together and connected, are pierced and finally corresponding to FIG. 6 the thread again threaded through the deflecting element 12.
  • the thread 3 is then threaded through the means 7 for attaching the thread 3 to the measuring element of the force measuring device 5. Thereafter, the thread 3 is again threaded through the deflecting element 12. 5, the thread 3 is fixed to the housing 8, for example, pressed with the finger against the housing 8 and applied to the free end 15 of the surgical thread 3, for example manually a tensile force F ZH until the body parts 1, 2 were merged.
  • the force F A measured by the measuring element 6 then substantially corresponds to the tensile force F ZG , which acts on the body parts 1, 2 to be joined.
  • F ZG tensile force
  • Fig. 10 shows a further embodiment of the invention, in which the force-measuring element 5 is again formed by a spring balance.
  • the means 7 for attaching the thread 3 to the measuring element ⁇ is formed by a hook.
  • the guide element 9 is constructed by a wire, preferably of surgical steel, which has been correspondingly bent to form the deflecting elements 12, 14. This allows the hooking of the surgical thread 3 with one hand and does not require threading in the deflecting elements 12, 14 or the means 7 Handling easier and faster. Likewise, the release of the thread 3 can be accelerated by the device according to the invention.
  • the deflection element 12 While, for example, a tensile force F ZH is applied manually to the free end of the thread 3, the deflection element 12 is arranged between the body parts 1, 2 to be joined, so that it does not lead to a sideways deflection of the body parts 1, 2 and thus to a further falsification Force increase comes.
  • an electronic sensor with the aid of strain gauges or piezo elements can also be used.
  • such devices require an electrical supply.

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)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Force Measurement Appropriate To Specific Purposes (AREA)
  • Investigating Strength Of Materials By Application Of Mechanical Stress (AREA)

Abstract

L'invention concerne un dispositif permettant de mesurer la force de traction (FZG) exercée sur deux parties corporelles (1, 2) notamment des vaisseaux ou des nerfs, lors de la réunion et de la liaison de ces parties du corps (1, 2) par un fil chirurgical (3). L'invention vise à mettre au point un dispositif de mesure de ce type qui permette de mesurer de manière fiable la force de traction (FZG) sur les parties corporelles à lier et d'augmenter par la même occasion les perspectives de réussite. A cet effet, il est prévu un dispositif (5) pour mesurer une force (FA) dans un dispositif de mesure (X) comportant un boîtier (8) et un élément de mesure (6). Ledit élément de mesure (6) présente des moyens (7) pour mettre le fil (3) en place et un élément (9) est fixé sur le boîtier (8) pour guider le fil (3). Avant la mise en place du premier noeud, la force de traction attendue peut être déterminée de manière fiable et rapide sur les parties du corps (1, 2).
PCT/AT2006/000067 2005-04-27 2006-02-21 Dispositif et procede pour mesurer la force de traction exercee sur deux parties corporelles Ceased WO2006113948A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ATA709/2005 2005-04-27
AT0070905A AT501615B1 (de) 2005-04-27 2005-04-27 Einrichtung zur messung der auf zwei körperteile wirkenden zugkraft

Publications (3)

Publication Number Publication Date
WO2006113948A2 true WO2006113948A2 (fr) 2006-11-02
WO2006113948A3 WO2006113948A3 (fr) 2007-07-26
WO2006113948A8 WO2006113948A8 (fr) 2007-09-27

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/AT2006/000067 Ceased WO2006113948A2 (fr) 2005-04-27 2006-02-21 Dispositif et procede pour mesurer la force de traction exercee sur deux parties corporelles

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Country Link
AT (1) AT501615B1 (fr)
WO (1) WO2006113948A2 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111766008B (zh) * 2020-05-18 2021-10-15 宁波创导三维医疗科技有限公司 一种缝合线张力测量装置

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE1958429A1 (de) * 1969-11-21 1971-07-22 Johannes Dr Gaeckel Spannvorrichtung fuer medizinische Zwecke
US5037426A (en) * 1988-09-19 1991-08-06 Marlowe Goble E Procedure for verifying isometric ligament positioning
IL122994A (en) * 1998-01-19 2001-12-23 Wisebands Ltd Suture tightening device for closing wounds and a method for its use
US6260552B1 (en) * 1998-07-29 2001-07-17 Myocor, Inc. Transventricular implant tools and devices
US6302840B1 (en) * 1998-09-21 2001-10-16 Theodore V. Benderev Surgical monitor
US6050937A (en) * 1998-09-21 2000-04-18 Benderev; Theodore V. Surgical tension/pressure monitor
US7247134B2 (en) * 2002-11-12 2007-07-24 Myocor, Inc. Devices and methods for heart valve treatment

Also Published As

Publication number Publication date
WO2006113948A8 (fr) 2007-09-27
AT501615B1 (de) 2006-10-15
WO2006113948A3 (fr) 2007-07-26
AT501615A4 (de) 2006-10-15

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