ES2350912T3 - Material de refuerzo de sutura para un dispositivo de sutura automático. - Google Patents
Material de refuerzo de sutura para un dispositivo de sutura automático. Download PDFInfo
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- ES2350912T3 ES2350912T3 ES04747929T ES04747929T ES2350912T3 ES 2350912 T3 ES2350912 T3 ES 2350912T3 ES 04747929 T ES04747929 T ES 04747929T ES 04747929 T ES04747929 T ES 04747929T ES 2350912 T3 ES2350912 T3 ES 2350912T3
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L17/00—Materials for surgical sutures or for ligaturing blood vessels ; Materials for prostheses or catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- 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
-
- 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
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
-
- 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
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07292—Reinforcements for staple line, e.g. pledgets
-
- 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
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/0477—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery with pre-tied sutures
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Vascular Medicine (AREA)
- Materials Engineering (AREA)
- Chemical & Material Sciences (AREA)
- Epidemiology (AREA)
- Materials For Medical Uses (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
- Details Of Garments (AREA)
- Lining Or Joining Of Plastics Or The Like (AREA)
Abstract
Material de refuerzo de sutura tubular (4) para un dispositivo de sutura automática (10), en el que ambos extremos de uno o dos materiales laminares están cosidos utilizando un punto de cadeneta con un único hilo para conformar una forma tubular, en el que dicho uno o dos extremos de hilo en uno o dos extremos de costura (2) están extendidos adecuadamente y en el que el extremo de hilo extendido se hace pasar a través de un bucle anterior (3) continuo hasta el extremo del hilo, impidiendo así que se desenrede un hilo.
Description
Material de refuerzo de sutura para un
dispositivo de sutura automático.
La presente invención se refiere a un material
de refuerzo de sutura tubular adecuado para su utilización en
dispositivos de sutura automática que se utilizan ampliamente en
operaciones quirúrgicas, etc. Más específicamente, la presente
invención se refiere a un material de refuerzo de sutura tubular con
el que se obtiene fácilmente una forma tubular, la productividad es
alta y la retirada del hilo se consigue de manera sencilla.
Hasta ahora, para suturar tejidos se han
utilizado dispositivos de sutura automáticos de tipo grapadora que
contienen una pluralidad de grapas. Sin embargo, cuando se aplica un
dispositivo de sutura de esta clase a la cirugía pulmonar, etc.,
pueden producirse fugas de aire desde el área suturada. Además,
cuando se aplica a tejidos blandos, pueden surgir problemas de
daños o desgarros de tejidos.
Con el fin de resolver los problemas anteriores,
la solicitante tiene ya diversas publicaciones que se refieren a
materiales de refuerzo de sutura tubular que se han de fijar a una
parte de grapa del dispositivo de sutura, impidiendo así la fuga de
aire desde el área suturada, reforzando el área, etc. (por ejemplo,
el modelo de utilidad registrado japonés nº 2604025; las patentes
japonesas nº 3136392, nº 3237749 y nº 3237750; las publicaciones de
patentes japonesas no examinadas nº 1997-24050, nº
1997-308635, nº 2000-157622, nº
2000-316963 y nº 2001-70433; y la
patente US nº 5.814.057).
Como otras publicaciones de la solicitante que
se refieren a materiales de refuerzo de sutura tubular, pueden
mencionarse la patente japonesa nº 3040930 y la publicación de
patente japonesa no examinada nº 1996-299427.
Las publicaciones mencionadas anteriormente
describen una estructura en la que un material laminar, tal como un
tejido no tejido o una película realizados en un material
biodegradable y bioabsorbible, se convierte en una forma tubular, o
una estructura en la que un tejido no tejido realizado en un
material biodegradable y bioabsorbible y un tejido estirable se
combinan de una sola pieza para crear una forma tubular. La forma
tubular se obtiene, por ejemplo, por un procedimiento para adherir
temporalmente ambos extremos (ambos bordes) de materiales laminares
apilados y un procedimiento para hilvanar ambos extremos de los
mismos utilizando puntadas bastas. Más específicamente, puede
mencionarse como ejemplo un cosido continuo en el que los lados
anterior y posterior de los materiales laminares apilados están a
su vez cosidos.
La adhesión o hilvanado temporal del material
laminar, como se describe anteriormente, se realiza con la finalidad
de separar fácilmente un material de refuerzo de sutura que debe
retirarse con una lesión respecto de un material de refuerzo de
sutura que debe dejarse en un cuerpo humano, cuando la lesión se
retira del cuerpo humano después de que la región afectada se haya
suturado y la lesión se aísle de tejidos normales utilizando un
dispositivo de sutura automática provisto de un material de
refuerzo de sutura.
Sin embargo, el material de refuerzo de sutura
tubular fabricado utilizando adhesión temporal es desventajoso
debido a que los materiales laminares unidos por adhesión tienden a
separarse uno de otro, y el material de refuerzo de sutura tubular
fabricado utilizando un cosido continuo es desventajoso porque la
manera de coser requiere mucho tiempo y habilidad y la retirada del
hilo es difícil dependiendo de la clase de material laminar, el
paso de costura, etc.
El objetivo de la invención consiste en superar
los inconvenientes descritos anteriormente. La invención proporciona
un nuevo material de refuerzo de sutura para un dispositivo de
sutura automática que puede fabricarse sin requerir una habilidad
avanzada y del que se puede retirar muy suavemente un hilo con
independencia de la clase de material utilizada y del paso de
costura del material de refuerzo de sutura, como se reivindica en
las reivindicaciones 1, 7 y 8, con formas de realización preferidas
como las referidas en las reivindicaciones dependientes 2 a 6.
La figura 1 representa esquemáticamente un
estilo de cosido de la invención.
La figura 2 representa esquemáticamente un
estilo de cosido de la invención.
La figura 3 representa esquemáticamente un
estilo de cosido de la invención.
La figura 4 representa esquemáticamente un
estilo de cosido de la invención.
La figura 5 representa esquemáticamente un
estilo de cosido de la invención.
La figura 6 representa esquemáticamente un
estilo de cosido de la invención.
La figura 7 representa esquemáticamente un
estilo de cosido de la invención.
La figura 8 es una vista en perspectiva que
representa una estructura de un material de refuerzo de sutura
según una forma de realización de la invención.
La figura 9 es una vista en perspectiva que
representa una estructura de un material de refuerzo de sutura
según otra forma de realización de la invención.
La figura 10 es una vista frontal que representa
un dispositivo de sutura automática provisto del material de
refuerzo de sutura de la invención.
La figura 11 es una vista frontal parcialmente
ampliada que representa el procedimiento de ajustar el material de
refuerzo de sutura de la invención de la figura 10 a un dispositivo
de sutura automática.
La figura 12 es una vista en perspectiva que
representa una estructura ejemplificativa de un material de refuerzo
de sutura.
La figura 13 es una vista en perspectiva que
representa un ejemplo de un material de refuerzo de sutura que
impide la retirada de un extremo o extremos de hilo.
La figura 14 es una vista en perspectiva que
representa otro ejemplo de un material de refuerzo de sutura que
impide la retirada de un extremo o extremos de hilo de la
invención.
La figura 15 es una vista en perspectiva que
representa otro ejemplo de un material de refuerzo de sutura que
impide la retirada de un extremo o extremos de hilo de la
invención.
La figura 16 es una vista en perspectiva que
representa una estructura de un material de refuerzo de sutura de
la invención en la que está conformado un saliente.
En las figuras 1 a 16, los números de referencia
indican lo que sigue: 1, extremo de hilo al comienzo de la costura;
2, extremo de hilo al final de la costura; 3, bucle; 4, material de
refuerzo de sutura tubular; 5, tejido no tejido biodegradable y
biorreabsorbible; 6, tejido powernet (tejido estirable); 7, puntadas
en el lado anterior; 8, puntadas en el lado posterior; 9, tapón;
10, dispositivo de sutura automática; 11, cartucho; 12, marco; 13,
nudo; 14, saliente; y 15, nudo.
A continuación, se describirá con detalle la
invención.
Una material laminar de la invención está
realizado en un material adecuadamente seleccionado de entre
materiales no bioabsorbibles, tales como poliamida, poliéster,
silicona, fluororresina, etc., y materiales biodegradables y
bioabsorbibles, tales como ácido poliglicólico, ácido poliláctico,
un copolímero de ácido glicólico y ácido láctico, un copolímero de
ácido glicólico y caprolactona, o una mezcla de los mismos,
poliparadioxanona, policaprolactona, quitina, tejidos animales y
similares. Los ejemplos de formaciones del material laminar incluyen
un material tricotado, un material tejido, un tejido no tejido, una
película, una lámina, una lámina de esponja, etc., realizados en
los materiales no bioabsorbibles y/o los materiales biodegradables y
bioabsorbibles mencionados anteriormente.
Los materiales particularmente preferidos
incluyen tejidos no tejidos realizados en ácido poliglicólico, que
es excelente en flexibilidad, transpirabilidad, rigidez, espesor,
propiedades de absorción de sangre, facilidad de penetración de
grapas e hidrolizabilidad. Dichos tejidos no tejidos pueden
prepararse por un procedimiento adecuado, tal como un procedimiento
de punzado de agujas, un procedimiento de soplado en fusión o
similar.
El material de refuerzo de sutura de la
invención se convierte en una forma tubular cosiendo ambos extremos
de un material laminar después de que se pliegue el material laminar
o apilando dos materiales laminares, y cosiendo a continuación
ambos extremos de los materiales laminares apilados. Cuando dos
materiales laminares se apilan para formar un material tubular, uno
de los dos materiales laminares puede ser un material estirable.
Los ejemplos preferidos de tales materiales laminares estirables
incluyen materiales tricotados o tejidos con estirabilidad en
direcciones longitudinal y/o transversal, en los que hilos de
caucho, hilos elásticos basados en poliuretano, hilos rizados e
hilos voluminosos, etc., están adecuadamente intertricotados o
intertejidos. Un material de refuerzo de sutura preparado
combinando un material estirable con un material no estirable
facilita la adaptación del material de refuerzo de sutura a un
dispositivo de sutura automática, el ajuste (corrección de
posición) después de la adaptación, etc., y, por tanto, es
preferible.
Aunque no existe limitación del modo de tricotar
o de tejer el material laminar estirable, un tejido powernet
producido por tricotado de urdimbre de hilos estirables obtenidos
cubriendo hilos de poliuretano por hilos de nylon es preferible en
vista del corte fácil, la costura fácil durante la formación de un
material tubular, la estabilidad de forma, etc.
En caso de utilizar un material laminar, el
material tubular puede obtenerse cosiendo uno a otro ambos extremos
de un material laminar que se corta según las dimensiones de la
superficie exterior de un dispositivo de sutura, después de que se
pliegue el material laminar. Alternativamente, en el caso de
utilizar dos materiales laminares, el material tubular puede
obtenerse apilándolos y cosiendo a continuación uno a otro ambos
extremos de los materiales laminares.
El término "tubular" utilizado en la
presente memoria indica que ambos extremos de un material laminar se
unen uno a otro, y una forma tubular puede ser un cilindro, un
prisma o un plano.
Los procedimientos de costura para obtener la
forma tubular pueden seleccionarse adecuadamente de entre el
procedimiento para coser ambos extremos del material o materiales
laminares en paralelo, el procedimiento para coser la parte de la
punta de los mismos de una manera estrechada, o el procedimiento
para coser la parte de la punta de los mismos de una manera similar
a una bolsa, etc. La parte de la punta estrechada o similar a una
bolsa es ventajosa puesto que el material tubular puede acoplarse
fácilmente a un dispositivo de sutura.
Aunque cualesquiera hilos utilizados para coser
paños pueden utilizarse con carácter general para coser ambos
extremos, resultan preferidas las suturas quirúrgicas biodegradables
y bioabsorbibles, tales como las fabricadas de ácido poliglicólico,
un copolímero de ácido glicólico y ácido láctico, un copolímero de
ácido láctico y coprolactona, etc. Esto es debido a que el material
de refuerzo de sutura es para uso en aplicaciones médicas y el
material podría dejarse erróneamente en el cuerpo humano.
La invención se caracteriza por el uso de un
cosido de cadeneta (cosido de intramallado) con un solo hilo como
estilo de cosido. El cosido de cadeneta (cosido de intramallado) con
un único hilo crea puntadas en las que se forman bucles con un
único hilo.
Los Ejemplos específicos de estilos de cosido de
la invención se representan en las figuras 1 a 7, pero la invención
no está limitada a los mismos. El término "lado de inserción de
aguja" utilizando a continuación indica el lado de inserción de
la aguja de los materiales laminares apilados, es decir, el lado
superior como se ve en las figuras, y el término "lado
posterior" indica el lado opuesto al lado de inserción de aguja
de los materiales laminares apilados, es decir, el lado inferior
como se ve en las figuras. En las figuras 1 a 6, no se ilustran los
materiales laminares apilados.
La figura 1 representa que un bucle 3 pasa a
través de los materiales laminares apilados desde el lado de
inserción de la aguja y a continuación se asegura por intramallado
con un bucle sucesivo en el lado posterior de los materiales
laminares apilados. En la invención, el "cosido de cadeneta
(cosido de intramallado)" indica que un bucle de hilo pasa a
través de otro bucle formado por el mismo hilo.
La figura 2 representa que un bucle 3 pasa hacia
dentro de los materiales laminares apilados desde el lado de
inserción de aguja, aparece en el lado de inserción de aguja a
través de una parte de los materiales laminares apilados y a
continuación se asegura por intramallado con un bucle sucesivo en el
siguiente punto de penetración de aguja. A continuación, la frase
"que aparece en el lado de inserción de aguja después de pasar a
través de una parte del material laminar" incluye el caso en el
que un bucle aparece en el lado de inserción de aguja pasando a
través de la superficie extrema de los materiales laminares
apilados, el caso en el que un bucle aparece en el lado de
inserción de aguja penetrando en los materiales laminares, etc.
La figura 3 representa que un bucle 3 pasa a
través de los materiales laminares apilados desde el lado de
inserción de aguja, avanza ligeramente, pasa a través de los
materiales laminares apilados para aparecer en el lado de inserción
de la aguja, y a continuación se asegura por intramallado con un
bucle sucesivo en el siguiente punto de penetración de aguja en el
lado de inserción de aguja del material laminar.
La figura 4 representa que un bucle 3 entra en
los materiales laminares apilados desde el lado de inserción de la
aguja, pasa a través de una parte de los materiales laminares
apilados para aparecer en el lado de inserción de la aguja y a
continuación se asegurar por intramallado con un bucle sucesivo en
el siguiente punto de penetración de aguja en una línea de
formación de puntadas (línea cosida).
La figura 5 representa un ejemplo modificado del
estilo de cosido de la figura 1, formando un patrón en
zig-zag.
La figura 6 representa que un bucle 3 pasa de
través para aparecer en el lado posterior de los materiales
laminares apilados desde el lado de inserción de aguja, retrocede
ligeramente, pasa a través de los materiales laminares apilados
para aparecer en el lado de inserción de aguja, y a continuación el
bucle 3 se asegura por intramallado con un bucle sucesivo 3 que
pasa a través de los materiales laminares apilados.
La figura 7 representa que un bucle 3 atraviesa
los materiales laminares apilados y un bucle que ha pasado ya a
través de los materiales laminares apilados para aparecer en el lado
de inserción de aguja de los materiales laminares apilados, y
además el bucle que pasa de través se extiende hasta el siguiente
punto de penetración de aguja a través de la superficie extrema de
los materiales laminares apilados.
En cada figura, el número de referencia 1 indica
un extremo de hilo al inicio de la costura y el número de
referencia 2 indica un extremo de hilo al final de la costura. En la
figura 1, los números de referencia indican lo que sigue: 3, un
bucle; 7, puntadas en el lado frontal, y 8, puntadas en el lado
posterior.
Cada ejemplo anterior representa un cosido de
cadeneta (cosido de intramallado) hecho por un único hilo. En el
cosido de cadeneta (cosido de intramallado), tirando del extremo o
extremos 2 de hilo en el extremo o extremos de costura, el hilo o
hilos se retiran de los bucles formados y así las costuras
realizadas se descosen suavemente. Tal costura puede hacerse a mano
y, de hecho, puede utilizarse también una máquina de coser
comercialmente disponible. En el último caso, la costura puede
hacerse muy eficientemente.
Resulta preferido extender el extremo del hilo
en una longitud adecuada de modo que una parte del material de
refuerzo de sutura a retirar con la lesión (por ejemplo, tejido
powernet) pueda separarse fácilmente de una parte del material de
refuerzo de sutura a dejar en el cuerpo humano (por ejemplo, un
material biodegradable y bioabsorbible). Los extremos extendidos
del hilo en los extremos de costura pueden atarse en forma de un
anillo. Como otro ejemplo, el extremo o extremos del hilo en el
extremo o extremos de costura pueden atarse al material laminar
(por ejemplo, tejido powernet) y los extremos extendidos del hilo en
los extremos de costura pueden atarse en forma de un anillo
(anular). En este caso, el hilo puede retirarse fácilmente y el
material laminar (por ejemplo, tejido powernet) puede retirarse
fácilmente con el hilo de coser después de una operación
quirúrgica.
Con el fin de impedir que el hilo se extraiga
involuntariamente del material de refuerzo de sutura, puede
disponerse un tapón en un bucle en el lado del extremo o extremos
del hilo en el extremo o extremos de costura, el extremo o extremos
del hilo pueden pasar a través del bucle anterior continuo hasta el
extremo o extremos del hilo en el extremo o extremos de costura, o
el bucle en el lado del extremo o extremos de costura puede pasarse
a través del bucle inmediatamente anterior y puede atarse con un
solo nudo.
Los dispositivos de sutura automática a los que
puede aplicarse el material de refuerzo de sutura de la invención
incluyen MULTIFIRE GIA80, MULTIFIRE GIA60, MULTIFIRE GIA50 y
MULTIFIRE GIA90P (fabricados por U.S. SURGICAL), PROXIMATE LINEAR
CUTTER 55 mm y PROXIMATE LINEAR CUTTER 75 mm (fabricados por Ethicon
Endo-Surgery), ENDO GIA(2)30, ENDO
GIA(2)45 y ENDO GIA(2)60 (fabricados por
U.S. SURGICAL), y ENDOPATH END CUTTER ETS45 y ENDOPATH END CUTTER
ETS EZ45 (fabricados por Ethicon Endo-Surgery).
El material de refuerzo de sutura de la
invención se aplica a un dispositivo de sutura encapsulándolo
(encajándolo) en un cartucho que contiene una grapa o en un marco
que presenta una ranura de recepción de grapa, o bien en ambos.
En este caso, para simplificar la adaptación del
material de refuerzo de sutura tubular a un dispositivo de sutura
automática, la parte o partes extremas de costura del material o
materiales laminares que forman el material de refuerzo de sutura
tubular pueden extenderse para formar un saliente.
A continuación, se describirán diversos
materiales de refuerzo de sutura haciendo referencia a los dibujos,
pero de manera no limitativa.
Forma de realización
1
Las figuras 8 y 9 representan el material de
refuerzo de sutura de la invención realizado mediante el estilo de
cosido representado en la figura 1. La figura 8 es un material de
refuerzo de sutura tubular 4 que se prepara apilando un tejido no
tejido biodegradable y bioabsorbible 5 y un tejido powernet
estirable 6, y cosiendo uno a otro ambos extremos de los materiales
apilados con una máquina de cosido de cadeneta de tipo DH fabricada
por Pegasus. La figura 9 representa un material de refuerzo de
sutura tubular 4 similar a una bolsa cuya parte de punta está
cerrada. El material de refuerzo de sutura tubular similar a una
bolsa se obtiene plegando una lámina del tejido no tejido 5,
apilando ambos extremos y cosiéndolos en una formar tubular con la
misma máquina de coser que se describe anteriormente.
Aunque no está representado, como un ejemplo
modificado de la figura 8, puede mencionarse también un material de
refuerzo de sutura cuya parte de punta se cose de una manera que se
va estrechando.
En cualquier caso, el extremo o extremos 2 del
hilo en el extremo o extremos de costura se extienden adecuadamente
para la retirada fácil del hilo.
Dos piezas del material de refuerzo de sutura 4
así obtenido se adaptan individualmente a un cartucho 11 que
contiene grapas y a un marco 12 del dispositivo de sutura automática
10 de la figura 10 para su uso, como se representa en una vista
ampliada de la figura 11. El material de refuerzo de sutura se
adapta al dispositivo de sutura automática 10 de tal manera que el
extremo extendido 2 del hilo en el extremo de costura se sitúe
hacia delante, es decir, en la parte de agarre del dispositivo de
sutura automática 10.
\newpage
Forma de realización
2
La figura 12 representa una estructura
ejemplificativa de un material de refuerzo de sutura. El material de
refuerzo de sutura es un material de refuerzo de sutura tubular que
se obtiene apilando un tejido no tejido biodegradable y
bioabsorbible 5 y un tejido powernet estirable 6, y cosiendo ambos
extremos. El extremo 1 del hilo al comienzo de la costura se une al
tejido powernet 6 y se atan los extremos 2 del hilo en los dos
extremos de costura para formar un anillo (anular).
Esta estructura con el extremo 2 del hilo en
forma de anillo en el extremo de costura facilita la manipulación
del material y la retirada del hilo. Además, puesto que el extremo 1
del hilo en el comienzo de la costura se ata al material powernet
6, el material powernet se retira fácilmente con el hilo después de
una operación quirúrgica.
\vskip1.000000\baselineskip
Forma de realización
3
Las figuras 13 y 14 representan cada una de
ellas otro ejemplo de material de refuerzo de sutura que está
estructurado para impedir que se desenreden los extremos 2 del hilo
en los extremos de costura.
La figura 13 representa que un tapón 9 pasa a
través de los bucles 3 de los extremos 2 del hilo en el extremo de
costura. El tapón 9 puede ser hilo, material o película finamente
cortado, etc., y pueden utilizarse materiales diferentes de una
fibra. Resulta preferido un material adecuadamente rígido que pueda
pasarse fácilmente a través del bucle y retirarse también
fácilmente de dicho bucle.
La figura 14 representa un material de refuerzo
de sutura según la invención en el que los extremos 2 del hilo en
los extremos de costura se hacen pasar a través de los bucles
anteriores 3 continuos hasta los extremos 2 del hilo, impidiendo
así que se desenreden los extremos 2 del hilo en los extremos de
costura, como se describe anteriormente. El extremo 2 del hilo se
hace pasar a través del bucle 3 mediante las etapas 1 a 4
siguientes, como se representa en la figura. Los extremos 2 del
hilo en los extremos de costura se hacen pasar a través del bucle 3
y, finalmente, se tira de los extremos 2 del hilo para
asegurarlo.
Estos procedimientos para impedir que el hilo se
desenrede evitan que el hilo se extraiga del material de refuerzo
de sutura debido a cualquier tensión que sea aplicada
involuntariamente al extremo 2 del hilo. En consecuencia, después
de que se complete el proceso de sutura predeterminado, el hilo es
extraído del bucle 3 retirando el tapón, devolviendo el extremo del
hilo que pasa a través del bucle 3 a la posición original, o
tirando del hilo.
La figura 15 representa otro procedimiento para
impedir que se desenrede un hilo.
En la estructura, el bucle 3 en el extremo de
costura se hace pasar a través de un bucle inmediatamente anterior
al bucle 3 y se fija por un único nudo 15, impidiendo así que el
bucle 3 sea extraído de la lámina. Más específicamente, esta
estructura puede impedir que se desenrede la costura, lo que es
provocado por tensión aplicada cuando el material se adapta a un
cartucho o a un marco. Después de que se complete el suturado, el
borde del tejido no tejido biodegradable y bioabsorbible 5 se rompe
tirando del extremo del hilo y, seguidamente, se desenreda la
costura. Así, el material powernet 6 puede retirarse fácilmente
junto con el hilo de costura.
\vskip1.000000\baselineskip
Forma de realización
4
La figura 16 representa una estructura de un
material de refuerzo de sutura tubular que puede adaptarse
fácilmente a un dispositivo de sutura automática. Más
específicamente, la parte extrema de costura de los materiales
laminares que forman el material de refuerzo de sutura tubular es
extendida para formar un saliente 14. En este ejemplo, la parte
extrema de costura del tejido powernet 6 se corta en una forma
convexa para configurar el saliente 14. Tirando del saliente 14, el
material de refuerzo de sutura tubular puede adaptarse fácilmente a
un dispositivo de sutura automática.
El saliente 14 puede configurarse adecuadamente
en cualquier forma y ajustarse a cualesquiera dimensiones
considerando su operabilidad. Puede utilizarse cualquier
procedimiento para formar un saliente en el tejido powernet 6,
además de cortar el material como se describe anteriormente. Por
ejemplo, dicho saliente puede formarse adhiriendo o cosiendo otros
materiales, tales como paño, película, etc. El saliente puede
formarse en un lado del tejido no tejido biodegradable y
bioabsorbible 5 o en ambos lados del tejido no tejido 5 y el
material powernet 6.
En el material de refuerzo de sutura de la
invención, una costura puede formarse fácilmente con una máquina de
coser ya existente, etc. Por tanto, puede fabricarse un material de
refuerzo de sutura tubular sin requerir habilidad y, además, la
productividad es alta y no hay variaciones en la calidad. En
comparación con las puntadas hechas por el cosido continuo
convencional, se retira suavemente un hilo, y un material laminar
puede ser separado sin dificultades después de la operación
quirúrgica. Además, el material de refuerzo de sutura de la
invención puede adaptarse fácilmente a un dispositivo de sutura
automática y puede impedirse que se desenreden los hilos durante el
proceso.
Claims (8)
1. Material de refuerzo de sutura tubular (4)
para un dispositivo de sutura automática (10), en el que ambos
extremos de uno o dos materiales laminares están cosidos utilizando
un punto de cadeneta con un único hilo para conformar una forma
tubular, en el que dicho uno o dos extremos de hilo en uno o dos
extremos de costura (2) están extendidos adecuadamente y en el que
el extremo de hilo extendido se hace pasar a través de un bucle
anterior (3) continuo hasta el extremo del hilo, impidiendo así que
se desenrede un hilo.
2. Material de refuerzo de sutura tubular (4)
para un dispositivo de sutura automática (10) según la
reivindicación 1, en el que la parte de punta del material de
refuerzo de sutura está cosida de manera ahusada o está cosida en
una forma similar a una bolsa.
3. Material de refuerzo de sutura tubular (4)
para un dispositivo de sutura automática (10) según la
reivindicación 1 ó 2, en el que por lo menos una parte del material
laminar está realizada a partir de por lo menos un elemento
seleccionado de entre el grupo constituido por materiales
tricotados, materiales tejidos, tejidos no tejidos, y película,
estando realizado dicho por lo menos un elemento en un material
biodegradable y bioabsorbible.
4. Material de refuerzo de sutura tubular (4)
para un dispositivo de sutura automática (10) según la
reivindicación 1, en el que el material laminar y un material
tricotado o material tejido estirable son apilados en una forma
tubular.
5. Material de refuerzo de sutura tubular (4)
para un dispositivo de sutura automática (10) según cualquiera de
las reivindicaciones 1 a 4, en el que se forma un saliente (14) en
la parte extrema de costura de dicho uno o dos materiales laminares
que conforman la forma tubular.
6. Material de refuerzo de sutura tubular (4)
para un dispositivo de sutura automática (10) según cualquiera de
las reivindicaciones 1 a 4, en el que los extremos del hilo
extendidos en el extremo de costura (2) se atan en una formar
anular.
7. Procedimiento para fabricar un material de
refuerzo de sutura tubular (4) para un dispositivo de sutura
automática (10), que comprende:
coser ambos extremos de uno o dos materiales
laminares utilizando un punto de cadeneta con un solo hilo para
formar un material de refuerzo de sutura tubular (10),
extender adecuadamente uno o dos extremos de
hilo en uno o dos extremos de costura (2), y
hacer pasar el extremo de hilo extendido a
través de un bucle anterior (3) continuo al extremo de hilo,
impidiendo así que se desenrede un hilo.
8. Dispositivo de sutura automática (10) que
comprende un cartucho (11) que contiene grapas y un marco (12)
provisto de una ranura de recepción de grapas, en el que un material
de refuerzo de sutura tubular (4) para un dispositivo de sutura
automática (10) según cualquiera de las reivindicaciones 1 a 6 se
adapta al cartucho (11) y/o al marco (12).
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2003-198240 | 2003-07-17 | ||
| JP2003198240 | 2003-07-17 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| ES2350912T3 true ES2350912T3 (es) | 2011-01-28 |
Family
ID=34074373
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| ES04747929T Expired - Lifetime ES2350912T3 (es) | 2003-07-17 | 2004-07-16 | Material de refuerzo de sutura para un dispositivo de sutura automático. |
Country Status (12)
| Country | Link |
|---|---|
| US (1) | US8177797B2 (es) |
| EP (1) | EP1647286B1 (es) |
| JP (2) | JP4675237B2 (es) |
| KR (2) | KR20110007244A (es) |
| CN (1) | CN100444905C (es) |
| AT (1) | ATE482656T1 (es) |
| DE (1) | DE602004029366D1 (es) |
| DK (1) | DK1647286T3 (es) |
| ES (1) | ES2350912T3 (es) |
| PT (1) | PT1647286E (es) |
| TW (1) | TW200507885A (es) |
| WO (1) | WO2005007208A1 (es) |
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- 2004-07-16 EP EP04747929A patent/EP1647286B1/en not_active Expired - Lifetime
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- 2004-07-16 PT PT04747929T patent/PT1647286E/pt unknown
- 2004-07-16 JP JP2005511934A patent/JP4675237B2/ja not_active Expired - Fee Related
- 2004-07-16 US US10/564,874 patent/US8177797B2/en not_active Expired - Fee Related
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- 2004-07-16 WO PCT/JP2004/010566 patent/WO2005007208A1/ja not_active Ceased
- 2004-07-16 ES ES04747929T patent/ES2350912T3/es not_active Expired - Lifetime
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| EP1647286A4 (en) | 2007-05-02 |
| US20070049953A2 (en) | 2007-03-01 |
| TWI300354B (es) | 2008-09-01 |
| EP1647286A1 (en) | 2006-04-19 |
| DE602004029366D1 (de) | 2010-11-11 |
| JPWO2005007208A1 (ja) | 2006-08-31 |
| EP1647286B1 (en) | 2010-09-29 |
| PT1647286E (pt) | 2010-11-30 |
| DK1647286T3 (da) | 2010-11-29 |
| US8177797B2 (en) | 2012-05-15 |
| ATE482656T1 (de) | 2010-10-15 |
| KR101136114B1 (ko) | 2012-04-17 |
| JP4675237B2 (ja) | 2011-04-20 |
| JP5241802B2 (ja) | 2013-07-17 |
| JP2011078799A (ja) | 2011-04-21 |
| US20060178683A1 (en) | 2006-08-10 |
| WO2005007208A1 (ja) | 2005-01-27 |
| KR20060033913A (ko) | 2006-04-20 |
| HK1088567A1 (zh) | 2006-11-10 |
| CN1822865A (zh) | 2006-08-23 |
| CN100444905C (zh) | 2008-12-24 |
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