ES2206964T3 - Dispositivo de extraccion de venas, en especial para endoextraccion. - Google Patents
Dispositivo de extraccion de venas, en especial para endoextraccion.Info
- Publication number
- ES2206964T3 ES2206964T3 ES98936473T ES98936473T ES2206964T3 ES 2206964 T3 ES2206964 T3 ES 2206964T3 ES 98936473 T ES98936473 T ES 98936473T ES 98936473 T ES98936473 T ES 98936473T ES 2206964 T3 ES2206964 T3 ES 2206964T3
- Authority
- ES
- Spain
- Prior art keywords
- vein
- rod
- thread
- extraction
- stop
- 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.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00008—Vein tendon strippers
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Rheumatology (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Endoscopes (AREA)
- Sink And Installation For Waste Water (AREA)
- Investigation Of Foundation Soil And Reinforcement Of Foundation Soil By Compacting Or Drainage (AREA)
- Polymers With Sulfur, Phosphorus Or Metals In The Main Chain (AREA)
Abstract
DISPOSITIVO DE STRIPING O DESMOLDEADOR QUE COMPRENDE UNA VARILLA SEMIRRIGIDA (1) PROLONGADA POR UN HILO (3) DE LONGITUD PRACTICAMENTE IGUAL A DOS VECES LA LONGITUD DE LA VARILLA (1), EN MEDIO DEL CUAL ESTA ENSARTADO UN ANILLO (4).
Description
Dispositivo de extracción en venas, en especial
para endoextracción.
El presente invento tiene como objeto un
dispositivo de extracción de venas quirúrgico o "stripper" en
el vocabulario anglosajón, de un solo uso, destinado a la ablación
de venas humanas, principalmente cuando dichas venas presentan
varices.
Tales operaciones son relativamente habituales en
el caso de flebotomías o de safenotomías y consisten en extraer la
vena enferma, reestableciéndose la circulación sanguínea por
derivaciones.
Los dispositivos de extracción de venas conocidos
incluyen habitualmente una varilla semirrígida, destinada a ser
introducida en la vena a extirpar, sobre la que es ligada una
extremidad de la vena, siendo la exéresis obtenida por tracción
sobre la varilla después de la ligadura de una extremidad de la
vena o del tramo. Pero, la extirpación se traduce en un plegado de
la vena a extraer, lo que lesiona los tejidos adyacentes y provoca
sangrados y telangiectasias sobre la piel a lo largo del trayecto de
extracción.
Los strippers conocidos tienen la característica
común de ser rígidos o semirrigídos para facilitar la
cateterización y la exéresis. Por ejemplo, la patente
FR-A-2 727 617 describe un
dispositivo de extracción de venas para realizar la extracción de
una vena por invaginación, incluyendo, en su extremo distal, un
órgano de estiba. Haciendo pasar un hilo por el interior del cierre
de estiba, es posible, según este documento, efectuar la extracción
de la vena en uno u otro sentido. Pero el dispositivo consiste
siempre en una varilla rígida, aunque pudiendo resbalar en una
envoltura.
La patente
AU-B-60597 describe un stripper
formado por un cable monofilamento orientado, en el que las
extremidades forman guías que facilitan el paso del cable a través
de una vena. Una oliva o boquilla de diámetro superior al de las
guías puede ser montada sobre uno de estos. Pero el guiado sigue
siendo aleatorio en el caso del trayecto sinuoso de las
varices.
El presente invento tiene por objeto paliar los
inconvenientes de los dispositivos conocidos y proponer un
dispositivo menos traumático.
Según el invento, el dispositivo de extracción de
venas para la ablación de una vena que incluye una varilla
semirrígida, se caracteriza porque la varilla es solidaria en uno
de sus extremos a un hilo flexible, cuya longitud es sensiblemente
igual a dos veces la longitud de la varilla, dotado, en el centro,
de un elemento de parada o tope.
El stripper está así constituido por un hilo
flexible y no, como en la técnica anterior, por una varilla más o
menos rígida. Según el invento la varilla semirrígida sólo sirve
para situar el hilo antes de la extracción de la vena. El elemento
de tope puede ser un anillo o una pequeña esfera engastada sobre el
hilo.
La varilla está, preferentemente, constituida por
material plástico biocompatible, armada por un mandril metálico de
aproximadamente 1,2 metros de longitud enlazado sobre un hilo
flexible, por ejemplo de poliamida de aproximadamente 2,6 metros de
largo sobre el que se sitúa, sensiblemente en el centro, un elemento
de tope constituido por un anillo ventajosamente engastado para la
fijación de la vena. El anillo de tope no tiene ni garganta ni
asperezas. Este engaste constituye un medio de parada simple y
fiable.
El invento permite la extracción de venas, en
particular de las venas safenas según las diferentes modalidades
posibles y principalmente en el sentido anterógrado o retrógrado,
el stripping largo o corto, y la endo o
exo-extracción de las venas.
Preferentemente, el stripper está destinado a la
realización de exéresis por endo-extracción con
sección progresiva de las colaterales, es decir con la extracción
de la vena enferma por invaginación o inversión de la vena sobre si
misma, a la manera de un dedo de guante cuando se extrae contra la
palma de este. Esta técnica presenta con respecto a la
exo-extracción practicada originalmente la ventaja
de ser menos traumatizante en el trayecto de la vena. Pero, si, por
un motivo cualquiera, la endo-extracción ha
fracasado, es posible situar, sobre el hilo, una aceituna para
realizar una exo-extracción es decir una extracción
directa sin invaginación.
La varilla semirrígida puede presentar, en su
extremo distal, un plegado en cola de cerdo que, como en sí
conocido, permite cateterizar la vena. La varilla puede ser
igualmente recta. Sólo tiene como objetivo guiar el hilo por el
interior de la vena. Pero el stripper propiamente dicho está
constituido por el hilo que sigue, de una forma flexible, el
trayecto de la vena en los tejidos y constituye el stripper real
para una endo- extracción.
Además, el anillo está engastado sobre el hilo y
puede servir de punto de parada para una oliva adaptable con el fin
de realizar una exo-extracción.
El modo operatorio es el siguiente: estando
situado el hilo en la vena, esta es fijada por un punto al anillo
de tope y mediante una tracción, a partir del punto de incisión, la
exo-extracción comienza y se continúa hasta que toda
la vena haya sido extraída.
Si la vena se desgarra, como ocurre alguna vez,
no es necesario proceder a una nueva cateterización. En efecto, la
longitud del hilo permite realizar una maniobra en sentido inverso
después de haber fijado la segunda parte de la vena en el punto de
parada.
Esta técnica puede realizarse desde el tobillo
hasta la ingle en el sentido anterógrado, siendo el stripping
efectuado de abajo a arriba poniendo un hilo de parada en el punto
de parada a nivel del tobillo. En este caso, el punto de parada debe
avanzar en la vena hasta el nivel de la ingle de manera que se
efectúe la endo-extracción de arriba abajo, lo que
disminuye el riesgo de alcance del nervio safeno interno satélite en
distalidad a la vena.
Igualmente, es posible introducir la varilla
semirrígida por la incisión de la ingle y dirigirla hacia el
tobillo, siendo la endo-extracción realizada
directamente de arriba a abajo fijando la vena al anillo. En este
caso, la vena es fijada desde el instante en que el anillo se
presenta al nivel de la ingle.
La característica principal del stripper, según
el invento, es utilizar para la extracción de la vena un hilo
flexible que está mejor adaptado para seguir el trayecto sinuoso de
una vena que una varilla aún siendo semirrígida, realizando la
varilla semirrígida, según el invento, únicamente el papel de una
guía o pasa-cintas. De esto resulta una mejor
invaginación y, en caso de ruptura de la vena, es posible, gracias a
la longitud del hilo, proceder a una
endo-extracción en sentido inverso sin tener que
recurrir de nuevo a la varilla semirrígida. Finalmente, si las
maniobras de ida y vuelta se traducen en repetidos fracasos, el
hilo transformado por la fijación de una oliva al nivel del punto
de parada o tope permite una exo-extracción.
Otras características y ventajas del presente
invento aparecerán en el transcurso de la siguiente descripción de
un ejemplo de realización particular, dado solamente como ejemplo
no restrictivo respecto a las figuras, que representan:
- la figura 1, una vista de un stripper según el
invento;
- las figuras 2, 2a y 2b, vistas de la oliva que
puede ser situada sobre el hilo.
En la figura 1, se ve que el stripper se compone
de una varilla semirrígida 1 que puede estar terminada en su parte
anterior 2 por una deformación en cola de cerdo, que, en
determinados casos, facilita la penetración de la varilla en el
trayecto, algunas veces sinuoso, de la vena y puede evitar
desgarramientos de esta. Pero la extremidad delantera puede ser
rectilínea. La varilla tiene una longitud del orden de 1,2 metros,
de manera que su extremidad delantera 2 pueda recorrer toda la
longitud de una vena. En la parte trasera de la varilla 1 está
fijado un hilo flexible 3 cuya longitud es sensiblemente igual a
dos veces la longitud de la varilla 1, es decir dos veces la
longitud posible de una vena. En el medio del hilo 3 está fijado un
anillo 4 destinado a servir de punto de enganche o de ligadura de
la vena a extraer.
Como se indicó anteriormente, el stripper puede
ser utilizado en sentido anterógrado o en sentido retrógrado.
Las figuras 2 a 2b representan una oliva o
boquilla 5, del tipo de las que son utilizadas en los artículos de
pesca, pudiendo ser montada de forma simple sobre el anillo 4 en el
caso en el que se haga necesaria una exo-extracción.
La oliva presenta un ranura radial 6 en la que puede ser
introducido el hilo 3, como aparece representado en la figura 2b
que es una vista inferior de la oliva 5. Al nivel a, cuyo corte
transversal está representado en la figura 2a, la ranura 6
desemboca en un ánima central 7 cuyo diámetro interior es
ligeramente inferior al diámetro exterior del anillo de tope 4. La
oliva puede de esta forma ser montada a la fuerza sobre el anillo,
lo que asegura la fijación deseada.
Por supuesto, pueden ser aportadas numerosas
variantes, principalmente por sustitución de medios técnicos
equivalentes, sin salir por ello del marco del invento, tal y como
se define por las reivindicaciones.
Claims (4)
1. Dispositivo de extracción de venas para la
ablación de una vena por invaginación, que incluyen una varilla
semirrígida (1), caracterizado porque la varilla (1) es
solidaria en una de sus extremidades (2) de un hilo flexible (3)
cuya longitud es al menos sensiblemente el doble de la de la varilla
(1), e incluyendo un elemento de tope o parada (4) sobre el hilo
flexible (3) a una distancia de la varilla (1) al menos
aproximadamente igual a la longitud de dicha varilla (1).
2. Dispositivo según la reivindicación 1,
caracterizado porque el hilo flexible (3) es de
poliamida.
3. Dispositivo según la reivindicación 1 ó 2,
caracterizado porque incluye una oliva (5) fijada al hilo
(3) al nivel del elemento de tope (4).
4. Dispositivo según la reivindicación 3
caracterizado porque incluye, además, una oliva (5) que
presenta un agujero axial (7) y una ranura radial (6) cuya anchura
es sensiblemente igual al diámetro del hilo (3), desembocando la
ranura radial en su parte superior en un ánima (7) cuyo diámetro
interior es inferior al diámetro del elemento de tope (4).
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR9708852A FR2765794B1 (fr) | 1997-07-11 | 1997-07-11 | Dispositif d'eveinage notamment pour endoeveinage |
FR9708852 | 1997-07-11 |
Publications (1)
Publication Number | Publication Date |
---|---|
ES2206964T3 true ES2206964T3 (es) | 2004-05-16 |
Family
ID=9509145
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES98936473T Expired - Lifetime ES2206964T3 (es) | 1997-07-11 | 1998-07-08 | Dispositivo de extraccion de venas, en especial para endoextraccion. |
Country Status (6)
Country | Link |
---|---|
EP (1) | EP0925029B1 (es) |
AT (1) | ATE248554T1 (es) |
DE (1) | DE69817747T2 (es) |
ES (1) | ES2206964T3 (es) |
FR (1) | FR2765794B1 (es) |
WO (1) | WO1999002088A1 (es) |
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Family Cites Families (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2788787A (en) * | 1955-09-16 | 1957-04-16 | Hebert D Trace | Surgical instrument for extirpation of varicose veins |
AU6059769A (en) * | 1969-09-08 | 1971-03-11 | MAURICE SHAMA KANBAR and JOSEPH RICHARD WILDER | Surgical vein stripping instrument for use in performing phlebectomies and method of making the same |
FR2619301B1 (fr) * | 1987-08-11 | 1990-01-12 | Monarque Suzanne | Instrument pour l'extraction de troncons de veines |
FR2727617B1 (fr) | 1994-12-02 | 1997-04-30 | Lebard Christian | Dispositif d'eveinage pour realiser l'ablation d'une veine par invagination |
-
1997
- 1997-07-11 FR FR9708852A patent/FR2765794B1/fr not_active Expired - Lifetime
-
1998
- 1998-07-08 EP EP98936473A patent/EP0925029B1/fr not_active Expired - Lifetime
- 1998-07-08 ES ES98936473T patent/ES2206964T3/es not_active Expired - Lifetime
- 1998-07-08 WO PCT/FR1998/001466 patent/WO1999002088A1/fr active IP Right Grant
- 1998-07-08 AT AT98936473T patent/ATE248554T1/de active
- 1998-07-08 DE DE69817747T patent/DE69817747T2/de not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
FR2765794A1 (fr) | 1999-01-15 |
EP0925029A1 (fr) | 1999-06-30 |
DE69817747D1 (de) | 2003-10-09 |
ATE248554T1 (de) | 2003-09-15 |
EP0925029B1 (fr) | 2003-09-03 |
DE69817747T2 (de) | 2004-07-29 |
WO1999002088A1 (fr) | 1999-01-21 |
FR2765794B1 (fr) | 1999-09-03 |
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