| 摘要 |
The present invention relates to an instrument for performing sutures endoscopically with classical threads, set up essentially for laparoscopic surgery. Slight modifications will permit adaptation for other specialties which perform endoscopic surgery. The instrument is made up of two tubes of rigid and flexible metal with a length of 26 cm, external diameter of 1.8 mm and internal diameter of 1 mm (Fig. 1:1), with a longitudinal slot of 0.5 mm along the entire length (Fig. 1:4), which are integral, parallel and spaced 5 mm apart, over a length of 20 cm, 6 cm remaining free and flexible (Fig. 1). The tip of these free ends is curved, the lumens of the two tubes being opposite each other (Fig. 1:3). At the other end there is a sealing device (Fig. 1:5,6) for fixing the instrument in a metal sheath with a length of 23 cm, external diameter of 10 mm and internal diameter of 9.5 mm (Fig. 1:7), making this end of the "sheath-instrument" assembly (Fig. 1:10) as hermetic as possible. The suture material, made up of a filament of hard flexible plastic with a length of about 60 cm and diameter of 0.6 mm (Fig. 1:8), has one of the ends pointed so as to pierce organic tissues, and the other end fixed to a classical surgical suture thread with a length greater than 60 cm (Fig. 1:9). In order to perform a suture the instrument (Fig. 1:10) is introduced by the end with curved tips into a trocar suitable for laparoscopic surgery, until it is visualized in the operative field. The suture filament is introduced by the pointed end, through the proximal orifice of one of the metal tubes (Fig. 2:2), and is pushed through until the tip emerges in the distal orifice near the wound to be sutured, causing it to pierce the edges of the wound and directing it to the lumen of the other tube (Fig. 2:3,4). By pushing from outside, the filament passes through the entire length of the metal tubes, emerging in the proximal orifice of the second tube alongside the entry orifice (Fig. 2:5). By pulling the filament from the outside, the suture thread which is attached to it is passed into the edges of the wound (Fig. 2:6). Repeating this manoeuvre a second time (Fig. 2:7), one part of the suture thread will be in the edges of the wound (Fig. 2:8) and one part outside (Fig. 2:9). On pulling the "filament-needle" (Fig. 2:10), the external part of the thread slides to the edges of the wound through the slots in the tubes 2:11, 12, 13, 14. The principal originality of this device lies in the solution found for moving the suture thread from the outside to the edges of the wound, through the slots in the metal tubes which guide the suture material. <IMAGE>
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