ITPI20100099A1 - INNOVATIVE DEVICE FOR SURGICAL USE TO BE USED IN MUSCLE / TENDINE TRANSPLANTATION CARRIED OUT IN ARTHROSCOPY - Google Patents

Description

Description accompanying the patent application for industrial invention entitled: "INNOVATIVE DEVICE FOR SURGICAL USE TO BE USED IN MUSCLE / TENDON TRANSPLANTS PERFORMED IN ARTHROSCOPY"

DESCRIPTION

The present invention relates to a specific device for surgical use to be used in the management of sutures and in muscle / tendon transplants performed by a minimally invasive way and, in particular, for endoscopic assisted transfer of the great dorsal spine. As known to the experts in the field, the aforementioned interventions are currently very delicate, exposing the patient to some risks. The axillary nerve is certainly among the most vulnerable structures. In fact, it crosses the space through which the muscle-tendon unit is transferred, so it can be damaged, especially if not visualized and if sharp surgical instruments are used. Another crucial aspect is the management of the sutures that arm the transplant: these should be protected from any abrasions during their sliding and should be kept parallel so that they do not cross and therefore do not rotate the graft; they should also be able to be released individually so as to fix the first pair while keeping the second ones (and the transplant itself) as close as possible to the area in which they will subsequently be insured.

For the purpose of the present patent application it appears superfluous to describe the various remedies and accessories currently used to obviate the aforementioned problems since their operation is familiar to all technicians in the field, being known art, and they are in any case inadequate to solve the difficulties envisaged. The main purpose of this instrument is to eliminate or, at least, limit the drawbacks described above by providing all surgeons in the field with a specific and dedicated device, to be used in the management of sutures and in muscle / tendon transplants, with particular reference to the transfer of the grand dorsal performed minimally invasive. This result has been achieved, in accordance with the invention, by adopting the technical solution of creating a system having the characteristics described in the independent claims. Other particularities of the present invention are the subject of the dependent claims.

The advantages deriving from the present invention essentially consist in the fact that, by adopting the innovative tool that we are going to illustrate, some surgical operations concerning muscle / tendon transplants (transfer of the great dorsal) can be performed more easily and safely. minimally invasive. These and further advantages and features of the present industrial invention will be better and to a greater extent understood by every person skilled in the art from the following description and with the help of the attached drawings given as an example of the invention and should not be considered in a limiting sense.

- Table 1 shows us the object under examination complete with all the parts of which it is composed. Fig. 1 shows the particular device (1) to be used in the management of sutures and in muscle / tendon transplants, and more particularly the transfer of the great dorsal bone performed minimally, with in the foreground: the perforated cannulae (2 , 2B) integral with the central rod (3), which separates and connects them at the same time, the apex of which is conveniently beveled so as to avoid damage to the muscles, nerves and blood vessels when acting as a probe; the shaped handle (4) whose knurled finish improves grip even when wearing wet and consequently slippery gloves. In Fig. 2 the rear surface of the handle (4B) is visible on which two distinct chromatic zones are evident, one of which is perfectly smooth (5) and the other (5B), on the other hand, opaque so finished because they must be immediately identifiable from the operator who, thanks to this expedient, will be able to easily prevent the involuntary rotation of the instrument during its use, thus preventing the crossing of the sutures and therefore the consequent rotation of the transplant itself. Also on the rear surface of the handle (4B) are the holes (6, 6B) attributable to the opening lumen of the cannulae (2C, 2D) - (sectional views) and the four cylindrical elements (7, 7B, 7C, 7D) whose function is to hook the ends of each suture, blocking them with a system defined as "throttling".

- Table 2 reproduces the invention, object of the present patent, in use in order to better understand its operation. In Fig. 3 the device (1B) is again shown with in sequence: the perforated cannulas (2E, 2F) integral with the central rod (3B), which separates and connects them at the same time, the apex of which is conveniently beveled so as to avoid damage to muscles, nerves and blood vessels when acting as a probe; the shaped handle (4C) in whose rear surface two distinct chromatic zones are evident, one of which is perfectly smooth (5C) and the other (5D), on the other hand, opaque so finished because they must be immediately identifiable by the operator who thanks to this expedient can easily prevent the involuntary rotation of the instrument during its use, thus preventing the crossing of the sutures (8, 8B) and therefore the consequent rotation of the graft (9) itself (tendon of the great dorsal). Also on the external surface of the handle (4C) there are the holes (6C, 6D) attributable to the opening lumen of the aforementioned cannulas (2E, 2F) and the four cylindrical elements (7E, 7F, 7G, 7H) whose function is that of hooking the ends of each suture (8, 8B), locking them with a system defined as "throttling". Fig. 4 shows the terminal part of the device (1, 1B) with in detail the perforated cannulas (2G, 2H) - (partially seen), integral with the central rod (3C), inside which the sutures are inserted ( 8C, 8D), introduced by means of special slotted metal wires commonly used in surgery.

- Table 3 shows the present invention still in use so as to better understand its operation. Fig. 5 shows again the specific device (1C) introduced through a small hole (10) currently known as the “posterior arthroscopic portal”. The instrument, visualized thanks to a common arthroscope, in turn introduced into a different "portal" (not visible in the figure), is pushed by the operator towards the armpit (11). This surgical phase, performed up to now in the open (extending the skin, muscle and tendon incision for the entire stretch between the site of definitive fixation of the transplant and the armpit itself), can be avoided thanks to and found in the object. In fact, it can reach the axilla (11), where it will have to "load" the transplant (9B), through the entire space in a safe way for the vascular-nerve structures (12) that it crosses in the tract, thanks to its particular shape and the absence of sharp, sharp or abrasive edges. Reached the armpit (11) the device (1C) will emerge through the incision, made previously, for the preparation of the musculotendinous unit of the great dorsal, finding itself in the same surgical field with the transplant (9B), suitably armed, at the end of which the ends of the sutures emerge (8E, 8F). The subsequent and essential surgical step sees a fundamental contribution from the device (1, 1B, 1C) already mentioned previously. The sutures (8E, 8F) that emerge from the apex of the graft (9B) are easily transported inside the cannulas (21, 2L), with slotted metal wires commonly used in surgery, to be then wrapped around the four cylindrical elements (not visible in the figure) present on the back of the instrument handle and finally blocked. In this way the muscle-tendon transplant is made integral with the instrument, which draws it into the subacromial space (the space not violated by the surgical incisions which are, conversely, necessary in traditional open surgery) and drags it forward until it reaches the area where the graft itself, through its sutures (8E, 8F), will have to be definitively fixed. Once the desired area has been reached, these sutures (8E, 8F) are always easily released from the four cylindrical elements (not visible in the figure) to which they had previously been blocked.

Reduced to its essential structure and with reference to the figures of the accompanying drawings of a specific device for surgical use to be used in the management of sutures and in muscle / tendon transplants performed by a minimally invasive way and, in particular, for the transfer of the large dorsal assisted endoscopy, the invention includes:

- means for optimally and safely performing suture management in muscle / tendon transplants performed minimally invasive and, more particularly, for endoscopically assisted transfer of the dorsal spine thanks to a specific device (1, 1B, 1C) for surgical use designed for this specific purpose; means for equipping the specific device (1, 1B, 1C), object of this patent, with two perforated cannulas (2, 2B, 2C, 2D, 2E, 2F, 2G, 2H, 21, 2L) integral with a central rod (3, 3B, 3C) which separates and connects them at the same time;

means for equipping the specific device (1, 1B, 1C), in question, with a central rod (3, 3B, 3C) whose apex is conveniently beveled so as to avoid damage to the muscles, nerves and blood vessels when it acts from probe;

- means for equipping the specific device (1, 1B, 1C), object of this patent, with a shaped handle (4, 4B, 4C) whose knurled finish improves grip even if wet and consequently slippery gloves are worn; - means to equip the specific device (1, 1B, 1C), in question, with a shaped handle (4, 4B, 4C) in the rear part of which two distinct chromatic zones are evident, one of which is perfectly smooth (5, 5C) and the other (5B, 5D), on the other hand, opaque (or, alternatively, adopting different colors), because the same must be immediately identifiable by the surgeon who, thanks to this expedient, can easily prevent Γ involuntary rotation of the instrument during its use thus preventing Γ crossing of the sutures (8, 8B, 8C, 8D, 8E, 8F) and therefore the consequent rotation of the graft itself (9, 9B);

- means for equipping the specific device (1, 1B, 1C), object of this patent, with a shaped handle (4, 4B, 4C) in the rear part of which there are holes (6, 6B, 6C, 6D) which can be traced to the opening lumen of the aforementioned perforated cannulas (2, 2B, 2C, 2D, 2E, 2F, 2G, 2H, 21, 2L) integral parts of the system;

means for equipping the specific device (1, 1B, 1C), in question, with a shaped handle (4, 4B, 4C) in the rear part of which there are four cylindrical elements (7, 7B, 7C, 7D, 7E, 7F , 7G, 7H) having the function of hooking the ends of each suture (8, 8B, 8C, 8D, 8E, 8F) locking them with a system defined as "throttling";

- means for constructing the special device (1, 1B, 1C), object of this patent, by adopting materials of different types, whether they are of ferrous, composite, plastic or other nature, without thereby compromising its correct functioning.

Advantageously, thanks to the special device (1, 1B, 1C) under examination, the management of sutures in muscle / tendon transplants performed minimally invasive and, more particularly, for the transfer of the great dorsal assisted by endoscopy.

Advantageously, the special device (1, 1B, 1C) object of the patent has two perforated cannulas (2, 2B, 2C, 2D, 2E, 2F, 2G, 2H, 21, 2L) integral with a central rod (3 , 3B, 3C) which separates and connects them at the same time.

Advantageously, the special device (1, 1B, 1C) under examination has a central rod (3, 3B, 3C) whose apex is conveniently blunted so as to avoid damage to the muscles, nerves and blood vessels when it acts as a probe.

Advantageously, the special device (1, 1B, 1C) object of the patent, has a shaped handle (4, 4B, 4C) whose knurled finish improves grip even if wet and consequently slippery gloves are worn.

Advantageously, the special device (1, 1B, 1C) in question has a shaped handle (4, 4B, 4C) in the rear part of which two distinct chromatic zones are evident, one of which is perfectly smooth (5, 5C) and the 'other (5B, 5D), on the other hand, opaque (or, alternatively, adopting different colors), because the same must be immediately identifiable by the surgeon who, thanks to this expedient, can easily prevent Γ involuntary rotation of the instrument during its use, preventing, in this way, the crossing of the sutures (8, 8B, 8C, 8D, 8E, 8F) and therefore the consequent rotation of the graft itself (9, 9B).

Advantageously, the special device (1, 1B, 1C) object of the patent, has a shaped handle (4, 4B, 4C) in the rear part of which there are holes (6, 6B, 6C, 6D) attributable to the lumen of opening of the aforementioned perforated cannulas (2, 2B, 2C, 2D, 2E, 2F, 2G, 2H, 21, 2L) integral parts of the system.

Advantageously, the special device (1, 1B, 1C), under examination, has a shaped handle (4, 4B, 4C) in the rear part of which there are four cylindrical elements (7, 7B, 7C, 7D, 7E, 7F , 7G, 7H) having the function of hooking the ends of each suture (8, 8B, 8C, 8D, 8E, 8F) locking them with a system defined as "throttling".

Advantageously, the special device (1, 1B, 1C) object of the patent can be constructed by adopting materials of different types, whether they are of ferrous, composite, plastic or other nature, without compromising its correct functioning.

In practice, the details of execution can in any case vary in an equivalent manner in the shape, dimensions, arrangement of the elements, nature of the materials used, without however departing from the scope of the idea of the solution adopted and therefore remaining within the limits of the protection granted by this patent for industrial invention.

Claims (8)

CLAIMS 1) Innovative device (1, 1B, 1C) for surgical use characterized by the fact that by adopting it, suture management in muscle / tendon transplants performed in a minimally invasive way can be performed in an optimal way, and in complete safety, and more specifically , for endoscopic assisted transfer of the great dorsal bone. 2) Innovative device (1, 1B, 1C) for surgical use as per claim 1, characterized by the fact that it has two perforated cannulas (2, 2B, 2C, 2D, 2E, 2F, 2G, 2H, 21, 2L) integral with a central rod (3, 3B, 3C) which separates and connects them at the same time. 3) Innovative device (1, 1B, 1C) for surgical use as per claim 1, 2, characterized by the fact that it has a central rod (3, 3B, 3C) whose apex is conveniently beveled so as to avoid damage to the muscles, nerves and blood vessels when it acts as a probe. 4) Innovative device (1, 1B, 1C) for surgical use as per claim 1, 2, 3, characterized by the fact that it has a shaped handle (4, 4B, 4C) which knurled finish improves grip even if wet and slippery gloves are worn. 5) Innovative device (1, 1B, 1C) for surgical use as per claim 1, 2, 3, 4, characterized by the fact that it has a shaped handle (4, 4B, 4C) in the rear part of which two distinct chromatic zones of which one perfectly smooth (5, 5C) and the other (5B, 5D), on the other hand, opaque (or, alternatively, adopting different colors), because the same must be immediately identifiable by the surgeon who thanks to this expedient can easily prevent Γ involuntary rotation of the instrument during its use, thus preventing the crossing of the sutures (8, 8B, 8C, 8D, 8E, 8F) and therefore the consequent rotation of the graft itself (9, 9B) . 6) Innovative device (1, 1B, 1C) for surgical use as per claim 1, 2 3, 4, 5, characterized by the fact that it has a shaped handle (4, 4B, 4C) in the rear part of which there are holes (6, 6B, 6C, 6D) attributable to the opening lumen of the aforementioned perforated cannulas (2, 2B, 2C, 2D, 2E, 2F, 2G, 2H, 21, 2L) integral parts of the system. 7) Innovative device (1, 1B, 1C) for surgical use as per claim 1, 2, 3, 4, 5, 6, characterized by the fact that it has a shaped handle (4, 4B, 4C) in the part of which posterior there are four cylindrical elements (7, 7B, 7C, 7D, 7E, 7F, 7G, 7H) with the function of hooking the ends of each suture (8, 8B, 8C, 8D, 8E, 8F) locking them with a system defined as "throttling". 8) Innovative device (1, 1B, 1C) for surgical use as per claim 1, 2, 3, 4, 5, 6, 7, characterized by the fact that it can be built by adopting materials of different types, whether of ferrous, composite, plastic or other types without compromising its correct functioning.