GB2181950A

GB2181950A - Ligature holder

Info

Publication number: GB2181950A
Application number: GB08526297A
Authority: GB
Inventors: Yaroslav Petrovich Kulik; Ivan Ivanovich Shmyrin; Rustam Ismailovich Utyamyshev; Marina Nartsiss Vyrzhikovskaya; Boris Andreevich Smirnov
Original assignee: BLAGOVESHCHENSK G MED INST; VNI I ISPYTATELJNY I MED TEKHN; BLAGOVESCHENSKY GOSUDARSTVENNY MEDITSINSKY INSTITUT
Current assignee: BLAGOVESHCHENSK G MED INST; VNI I ISPYTATELJNY I MED TEKHN; BLAGOVESCHENSKY GOSUDARSTVENNY MEDITSINSKY INSTITUT
Priority date: 1985-10-30
Filing date: 1985-10-24
Publication date: 1987-05-07
Also published as: GB8526297D0; FR2589348A1; DE3538611A1; FR2589348B1; GB2181950B

Abstract

A ligature holder which is a supporting ring (1) carrying ligature fixing devices (2) which are secured on the lateral outside surface (4) of the supporting ring (1) and are made as spring elements which are hooks whose open portion faces in a direction opposite to the surgery field. <IMAGE>

Description

SPECIFICATION Ligature Holder The invention relates to medical instruments and, in particular, to ligature holders used in reconstructive surgery.

The invention can be used in surgery for implantation and transplantation of organs and tissues, or in cardiovascular surgery, for example, in valve implantation operations.

The quality of reconstructive operations largely depends on the quality of sutures, particularly, on the tightness and uniformity of sutures along the perimeter of the artificial or biological implant.

Known in the art is a device for fixing the ligature ends during heart operations (cf., for example, MEZA Catalogue, p. 11, Fig. LBY 042), which comprises a ring which is placed, during an operation, so that the surgery field is within the ring, and ligature fixing devices secured to the top butt surface of said ring.

But this device is deficient in that it makes visual control during suturing the antrioventricular fibrous ring difficult because the ligature which is used to stitch the fibrous ring along the perimeter thereof and the collar of the artificial valve obstructs the surgery field almost completely when attaching the ligature ends in the fixing devices.

Moreover, the known device cannot be manipulated to achieve a uniform tension of the atrioventricularfibrous ring by the ligatures and uniform suturing becomes virtually impossible. The surgeon has a difficult time suturing in the obstructed field, time is wasted, the operation is prolonged unnecessarily, and, consequently, the outcome of the operation is affected.

This object is achieved in that in a ligature holder comprising a supporting ring featuring fixing devices arranged thereon, according to the invention, said ligature fixing devices are rigidly secured on the external lateral surface of the supporting ring and are made as spring hooks whose open portions face in the direction opposite to the surgery field, and the area of the supporting ring is substantially less than the area of the surgery field.

In the process of an operation the ligature can be reliably secured in the holder due to the effort produced by the spring portion of the hook. The ligature can be efficiently and swiftly engaged or disengaged since the hooks are disposed on the outside lateral surface of the supporting ring and their open portions face in the direction opposite to the surgery field.

The area of the supporting ring is substantially less than that of the surgery field and the ligature holder is therefore not an obstacle to the visual control during suturing, permits an unobstructed view of the surgery field. The ligature holder can be manipulated so that the ligature is kept at a constant tension in the zone of stitching.

The invention will now be described in greater detail with reference to a specific embodiment thereof, taken in conjunction with the accompanying drawings, wherein: Fig. 1 shows a general view of a ligature holder, and Fig. 2 shows a lateral view of a supporting ring.

A ligature holder embodying the invention comprises a supporting ring 1 (Fig. 1) and fixing devices 2.

The supporting ring 1 (Fig. 2) has a base 3, a lateral surface 4 and is provided with a cover 5.

The fixing devices 2 are arranged on the lateral surface 4 of the ring 1 at an equal distance from one another.

These fixing devices 2 can be made as spring hooks comprising a stationary part 6 rigidly secured to the lateral surface 4 of the support ring 1, a spring portion 7 intended for attachment of the ligature 8 and an open portion 9 through.which the ligature is inserted into the fixing devices 2.

The cover 5 is provided with a knob 10 positioned in the center thereof and through holes 11 (Fig. 1) which are for convenience of the ligature holder setting above the suturing zone.

Fixing devices 2 can be any spring elements uniformly distributed throughout the perimeter of the lateral surface 4 of the ring 1.

For convenience the ligature holder can be provided with a device by which it can be easily attached to a valve holder (not shown).

The ligature holder is placed over the zone of an operative field where the implantation is to be performed.

During implantation of, for example, a heart valve, the ligature holder is attached by means of the knob 10 and holes 11 in the cover 5 and positioned directly above the implant valve secured in the valve holder. Then the antrioventricularfibrous ring and the collar of the artificial valve (not shown) are stitched. Both ends of the ligature of each suture are engaged through the open portion 9 of the fixing device 2 so that the ligature is located between the stationary part 6 and the spring portion 7 of the fixing device 2, the effort produced by the spring portion 7 prevents the ligature 8 from disengaging from the fixing device 2 but in no way obstructs the tightening of the ligature 8.

After the suturing of the antioventricular fibrous ring and the artificial valve collar is completed, the implant valve is placed in the initial position and uniform tension of the ligature 8 is achieved by manipulating the ligature holder. After that the ligature 8 is removed successively from the fixing devices 2 and the ends are tied by interrupted sutures.

Since the ligature holder is placed directly above the surgery field where implantation of, for example, an artificial valve is performed and the area of the supporting ring 1 is only insignificantly larger than that of the implant, specifically of the largest heart valve, the stitching of the antrioventricularfibrous ring can be performed under constant visual control of the surgeon. The sutures can be made uniform, the antrioventricular fibrous ring can be exactly matched with the artificial valve, and the ligature holder can be manipulated to ensure constant tension of the ligatures in the stitching zone. All this contributes to a substantial improvement of the quality of the operation, cuts down the operation time by providing a surgeon with convenient conditions.

Claims

1. A ligature holder above a surgery field, comprising a supporting ring, ligature fixing devices secured rigidly on the lateral outside surface of said supporting ring and made as spring hooks whose open portion faces in a direction opposite to said surgery field, the area of said supporting ring being substantially less than that of said surgery field.

2. A ligature holder substantially as described herein with reference to the accompanying drawings.