Surgical holder

Abstract

This utility model relates to medical instruments, specifically surgical holders, and can be applied in aesthetic, reconstructive, and maxillofacial surgery, as well as neurosurgery. The essence of the utility model lies in a surgical holder containing jaws with flat ends for mounting hooks designed to grasp and hold an implant, wherein the ends of the hooks have a spherical shape. The technical result achieved by this utility model is to reduce the risk of mechanical damage to the implant when it is grasped and held by the surgical holder. 1 c.p. cl., 4 fig.

Description

[0001] The utility model relates to the field of medical instruments, in particular to surgical holders, and can be applied in aesthetic, reconstructive and maxillofacial surgery, as well as in neurosurgery.

[0002] Currently, the fields of reconstructive, aesthetic, maxillofacial, and neurosurgery are actively developing, aimed at restoring anatomical proportions and achieving optimal aesthetic and functional results. The goals of these fields include correcting age-related changes, eliminating tissue ptosis (drooping), and restoring anatomical structures in patients undergoing surgical interventions, pathologies, or injuries that require soft tissue movement and fixation.

[0003] To solve these problems, biodegradable implants are used to fix soft tissues in the desired position. Surgical holders are used to manipulate these implants during surgery. These holders typically feature hinged jaws with flat ends for attaching hooks.

[0004] One of such solutions is a well-known surgical holder containing branches, at the ends of which flat surfaces are made for installing hooks designed to capture and hold an implant, the hooks are made cylindrical, and at the ends of the hooks there are protrusions in the form of parallelepipeds [Internet resource: https: / / www.researchgate.net / publication / 8180612_Endoscopic_Forehead-Lift_Using_a_Bioabsorbable_Fixation_Device, date of publication: 11 / 30 / 2004].

[0005] The disadvantage of the known technical solution is the high risk of damage to the implant when gripped by the holder, caused by the concentration of stress on the sharp edges and corners of the protrusions made at the ends of the hooks when they come into contact with the surfaces of the implant.

[0006] Another similar solution is a surgical holder selected as a prototype, containing branches, at the ends of which hooks are made, designed to grasp and hold an implant, the ends of which have disc-shaped protrusions, while at the places of transition of the curved surfaces of the disc-shaped protrusions into the flat surfaces of the disc-shaped protrusions, roundings are made [EP 4516268 A1, publication date: 05.03.2025].

[0007] The advantage of the prototype over the known technical solution is the reduced risk of damage to the implant when grasped by the holder due to the absence of sharp edges on the protrusions made at the ends of the hooks.

[0008] However, a drawback of the prototype is the low reliability and stability of implant grip by the surgical holder, due to the suboptimal geometry of the hook ends. Specifically, the disc-shaped protrusions, despite their rounded transitions, have a limited contact surface and a pronounced flat shape, which does not provide sufficient self-alignment when gripping the implant at an angle and can lead to implant displacement during manipulation. The flat areas of the disc-shaped protrusions tend to make linear or point contact with the implant surface, especially with the slightest misalignment of the jaws, leading to slippage, loss of fixation, and decreased surgeon control. Furthermore, this shape does not facilitate implant centering in the working position of the holder; impact, jamming, or abrupt engagement are possible, complicating precise positioning.

[0009] Thus, the absence of sharp edges alone is not sufficient to ensure a stable, reliable and predictable hold if the geometry of the toe does not provide for full load distribution and adaptation to micro-movements.

[0010] These shortcomings determine the need to develop an improved design of a surgical holder with optimized hook geometry.

[0011] The technical problem that the utility model is aimed at solving is the need to eliminate the shortcomings of the prototype.

[0012] The technical result that the utility model is aimed at achieving is to reduce the risk of mechanical damage to the implant when it is captured by a surgical holder.

[0013] The essence of the utility model is as follows.

[0014] The surgical handle contains jaws with flat ends for attaching hooks designed to grasp and hold the implant. Unlike the prototype, the hook ends are spherical.

[0015] The jaws of the surgical handle are designed to transmit force from the handle to the working part of the instrument, ensuring that when the jaws are closed, the hooks designed to grasp and hold the implant are brought together. Flat surfaces are provided at the ends of the jaws to accommodate the hooks designed to grasp and hold the implant. The hooks designed to grasp and hold the implant can be attached to these flat surfaces using permanent connections, such as welding or soldering.

[0016] The flat surfaces are also designed to contact the implant surfaces and secure its position within the holder's working space, formed between two hooks designed to grasp and hold the implant and two flat surfaces for mounting the hooks. To improve the reliability of implant fixation within the holder's working space, these flat surfaces can be parallel to the flat contact surfaces of the implant when the holder's jaws are closed, increasing the rigidity of implant fixation within the holder's working space.

[0017] These hooks, designed to grasp and hold the implant, ensure secure fixation of the implant in the holder's working space by interacting with the implant's recesses, preventing displacement, rotation, and loss during surgical procedures. The hook ends are spherical, increasing the reliability and stability of the surgical holder's grip on the implant. Spherical shape refers to ends that are spherical, near-spherical, or ellipsoidal.

[0018] The utility model can be made from known materials using known means, which indicates its compliance with the patentability criterion of “industrial applicability”.

[0019] The utility model is characterized by a previously unknown set of essential features, notable in that the ends of the hooks are spherical. This shape ensures smooth and controlled engagement of the hooks with the implant surfaces at all stages of gripping, eliminating the risk of jamming or snagging of the hooks on the implant surfaces. It also ensures uniform distribution of contact forces when the implant is compressed by the holder and prevents stress localization at a single point, thereby preventing damage to the implant.

[0020] This ensures the achievement of a technical result consisting in reducing the risk of mechanical damage to the implant when grasped by a surgical holder.

[0021] The utility model is characterized by a set of essential features previously unknown in the state of the art, which indicates its compliance with the patentability criterion of “novelty”.

[0022] The utility model is explained by the following figures.

[0023] Fig. 1 - Surgical holder, jaws closed, isometric view.

[0024] Fig. 2 - Enlarged fragment of a surgical holder, jaws open, isometric view.

[0025] Fig. 3 - Enlarged fragment of a surgical holder, jaws closed, top view.

[0026] Fig. 4 - Enlarged fragment of the surgical holder oriented opposite the implant, jaws open, isometric view.

[0027] To illustrate the possibility of implementation and a more complete understanding of the essence of the utility model, a particular case of its implementation is presented below, which can be changed or supplemented in any way, while the present utility model is in no way limited to the presented particular case.

[0028] The surgical holder comprises jaws 10, the ends of which are provided with flat surfaces 12 for mounting hooks designed to grasp and hold an implant. The flat surfaces 12 for mounting the hooks, when the jaws 10 of the holder are closed, are parallel to the flat contact surfaces of the implant. Hooks 14 are mounted on said flat surfaces 12, designed to grasp and hold the implant. The ends of the hooks 14 are spherical.

[0029] The utility model operates as follows.

[0030] To grasp the implant with the surgical holder, the doctor spreads the rings of the holder, thereby opening the jaws 10 and orienting the holder relative to the implant 20 in such a way that the flat surfaces 12 for installing the hooks when the jaws of the holder are closed will be parallel to the flat contact surfaces of the implant 20, and the plane of opening and closing of the jaws 10 of the holder is co-directed with the plane along which recesses are made in the implant 20 for placing the hooks 14 in them.

[0031] The physician approaches the open holder to the implant 20 and positions the hooks 14 opposite the recesses formed in the implant 20, intended for receiving the hooks therein. The physician then begins to insert the hooks 14 into the said recesses by bringing together the rings of the holder and closing the jaws 10. As the surfaces of the implant 20 contact the hooks 14, the ends of which are made spherical, the implant 20 gradually moves deeper into the working space of the holder, formed between the two hooks 14 and two flat surfaces 12 for installing the hooks, while the displacement of the implant 20 occurs in the direction of the said flat surfaces 12, and it is automatically centered and securely fixed in the working space of the holder. The spherical design of the ends of the hooks 14 ensures smooth and controlled interaction of the hooks 14 with the surfaces of the implant 20 at all stages of capture, eliminating the risk of jamming and snagging on its surfaces.Due to the absence of sharp edges, the spherical ends of the hooks 14 are able to gently slide into the recesses of the implant 20, automatically correcting the position of the implant 20 in the event of minor distortions or inaccuracies in the positioning of the holder.

[0032] After grasping implant 20 with the holder, the surgeon secures the position of the jaws 10 with a rack and begins manipulations on the pre-prepared surgical field. The position of implant 20 relative to the holder and its working space does not change during the manipulations, as the flat contact surface of implant 20 is completely pressed against the parallel flat surfaces 12 of jaws 10, and implant 20 itself is rigidly fixed between two hooks 14, the spherical ends of which provide support for implant 20 from within the recesses in which they are installed. The spherical shape of the ends of hooks 14 ensures uniform distribution of contact forces across the area of ​​interaction with the surfaces of implant 20, preventing stress localization at one point. This significantly reduces the risk of mechanical damage to implant 20, including its deformation, microcracks, or fracture, especially when working with implants 20 made of biodegradable materials.

[0033] After implantation, the surgeon releases the holder from holding implant 20. To do this, the surgeon opens the ratchet, opens jaws 10, and removes hooks 14 from the recesses in implant 20.

[0034] The following is a description of a clinical case in which a biodegradable implant was installed using a holder of the above-described design.

[0035] Patient: female, 53 years old.

[0036] Complaints: age-related changes in the upper third of the face, low eyebrow position, longitudinal and transverse wrinkles in the forehead, “tired” appearance of the face.

[0037] History: unremarkable. The patient denies any chronic, infectious (except childhood infections), sexually transmitted, oncological, or mental illnesses, endocrine disorders, or tuberculosis. Allergic reactions to medications are denied. The patient states that he has not previously undergone any surgeries (including cosmetic ones).

[0038] On examination: low eyebrow tails, drooping brows, and transverse and longitudinal wrinkles in the forehead are noted. The scalp is of moderate thickness.

[0039] Diagnosis: gravitational ptosis of the soft tissues of the forehead, tails of the eyebrows and temporal regions.

[0040] Planned treatment: endoscopic lifting of the forehead, eyebrow tails and temporal areas using biodegradable implants and a surgical holder for their installation, similar in design to the holder described above.

[0041] Anesthesiology manual: ETN + M / A.

[0042] The patient was positioned supine. The surgical site was prepared with an antiseptic solution. Under ETN, after infiltration anesthesia, incisions were made in the temporal and frontal areas behind the hairline according to preliminary markings. Using endoscopic equipment, total subperiosteal mobilization of the soft tissues of the frontal, temporal, and parietal areas was performed, transecting the ligamentous apparatus that anchors the eyebrows. Hemostasis was monitored.

[0043] Two biodegradable implants were used to fix the mobilized tissues, each of which contained a platform with teeth and a cylindrical retainer, in which recesses were made designed to accommodate hooks for capturing and holding the implant.

[0044] Stages of implant installation.

[0045] Under visual control, using the tools from the installation kit (a hand drill and a drill with a depth stop), a blind bone hole was created in the right frontal bone. The hole's size corresponded to the size of the cylindrical retainer of the implant being installed. Residual bone chips were removed using an aspirator. Then, under visual control, using the tools from the installation kit (a hand drill and a drill with a depth stop), a blind bone hole was created in the left frontal bone. The hole's size corresponded to the size of the cylindrical retainer of the implant being installed. Residual bone chips were removed using an aspirator.

[0046] Installation of implants.

[0047] The first implant was fixed with a tool from the installation kit - a holder.

[0048] To grasp the implant with the surgical holder, the physician oriented the open jaws of the holder relative to the implant in such a way that the flat surfaces of the jaws intended for installing the hooks were parallel to the flat contact surfaces of the implant when the jaws of the holder were closed, and the plane of opening and closing of the jaws of the holder was co-directed with the plane along which recesses were made in the implant for placing the hooks in them.

[0049] Then, the physician moved the open holder toward the implant, positioned the hooks opposite the implant's recesses, and began inserting the hooks into the recesses by closing the jaws and bringing the hooks together. Contacting the hooks, whose ends are spherical, the implant gradually moved deeper into the holder's working space, formed between the two hooks and two flat surfaces for hook placement, toward the aforementioned flat surfaces. As a result, when the jaws closed, the implant was secured within the holder's working space. The implant's movement into the holder's working space was facilitated by the spherical ends of the hooks.Moreover, due to the fact that the flat surfaces of the jaws, intended for installation of the hooks, were parallel to the flat contact surfaces of the implant when the jaws of the holder were closed, automatic centering of the implant in the working space of the holder was ensured, which further facilitated the process of gripping the implant by the holder, and also made it possible to reliably fix the position of the implant relative to the holder by eliminating play between the surfaces of the implant and the holder in contact with each other.

[0050] After being grasped by the holder, the implant is oriented so that the triangular platform faces the soft tissue being fixed, and the cylindrical retainer is strictly aligned with the blind bone hole. The implant is progressively inserted into the blind bone hole on the right by axially moving the cylindrical retainer deeper into the hole. Once the implant platform reaches the bone, the holder's hooks are removed from the recesses of the cylindrical implant retainer.

[0051] The stability of the implant fixation in the blind bone hole on the right was checked.

[0052] The second implant was then secured with a holder from the installation kit. The holder was then used to secure the second implant in the same manner as described above.

[0053] The stability of the implant fixation in the blind bone hole on the left was checked.

[0054] Soft tissue fixation.

[0055] The mobilized soft tissues were moved to a higher position and secured to the prongs of the bioabsorbable implants. The prongs on the platform ensured secure fixation of the soft tissues as a single unit without the need for additional sutures. Symmetry and hemostasis were monitored. The wound edges were sutured with 3 / 0 Prolene sutures. An aseptic pressure dressing was applied.

[0056] The postoperative period is uneventful.

[0057] At 1, 3, 6 and 12 months after the operation, a lasting aesthetic result was noted: a 4-5 mm lift of the eyebrow tails, elimination of the “tired” appearance of the face, the absence of longitudinal and transverse wrinkles in the forehead area, a more “open” look, which confirms the reliability of fixation and good tolerance of the implants.

[0058] The above clinical case demonstrates the high efficacy and safety of the proposed surgical holder with spherical hooks in surgery. The described holder design ensures reliable, stable, and precise fixation of the bioabsorbable implant with the surgical holder at all stages of the surgical procedure.

[0059] This ensures the achievement of a technical result consisting in reducing the risk of mechanical damage to the implant when grasped by a surgical holder.

Claims

1. A surgical holder containing branches, the ends of which have flat surfaces for mounting hooks designed to grasp and hold an implant, characterized in that the ends of the hooks have a spherical shape.

2. A surgical holder according to claim 1, characterized in that the flat surfaces for installing the hooks intended for gripping and holding the implant are parallel to the flat contact surfaces of the implant.

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