Surgical apparatus for suspending abdominal organs and structures in minimally invasive surgery

Abstract

The invention is a surgical apparatus (A) designed to suspend abdominal organs and structures using at least one surgical thread (30) in minimally invasive surgery, characterized by a first component (10) with at least one needle (11) at the lower end of its body (12) for invasive entry, and at least one handle (13) at the other end for holding the surgical apparatus, to which a surgical thread (30) is attached, having at least one nail (132) to which the surgical thread (30) is attached, connected to the handle (13), and a second component (20) with at least one first slot (22) and at least one second slot (23) for threading the surgical thread (30) through the first component (10), and at least one needle channel (25) through which the needle of the first component (10) passes, and at least one thread channel (24) for threading the surgical thread (30) through the first and second slots (22, 23).

Description

[0001] DESCRIPTION

[0002] Surgical Apparatus for Suspending Abdominal Organs and Structures in Minimally Invasive Surgery

[0003] Technical Field

[0004] The invention relates to a surgical apparatus designed to suspend abdominal organs and structures in minimally invasive surgery.

[0005] Specifically, the invention involves a surgical apparatus that effectively removes the large intestines and, if necessary, the small intestines from the surgical field without causing harm, thus providing the surgeon with a clearer and more maneuverable operative field.

[0006] State of the Art

[0007] Laparoscopic and robotic surgeries are commonly performed in clinics specializing in intra-abdominal operations (e.g., gynecology, urology, general surgery, pediatric surgery). During such minimally invasive procedures, keeping the surgical field open, free, and easily manipulable is critical. Ideally, the surgical field should not be occupied by organs or tissues unrelated to the surgery. Moreover, these organs should be clearly visible, allowing the surgeon and assistant to perform desired surgical maneuvers comfortably.

[0008] However, during many minimally invasive surgeries (e.g., laparoscopic or robotic hysterectomy, sacrocolpopexy, pelvic or para-aortic lymphadenectomy), organs not directly related to the surgery (e.g., small intestines, large intestines, bladder, etc.) can occupy the operative field, making the surgery more complex, prolonging the operation time, and increasing the risk of complications. The technical complexity and prolonged duration can increase the surgical team's fatigue and reduce their concentration, potentially leading to unwanted thermal (heat-induced) and / or mechanical injuries, thereby creating a basis for complications. Gynecological surgeries, especially those performed using minimally invasive techniques in the pelvic area (e.g., hysterectomy), cover a sensitive area. This region already has a narrow and limited working space, and the presence of organs like the large intestines or small intestines increases the risk of damage to these organs during the final stages of surgery. Similarly, the bladder, which sags in this area, may be at risk of damage or perforation during vaginal suturing. To prevent such complications, assistants often employ various maneuvers to retract these organs. However, this can hinder the assistant's primary duties, such as pulling the thread during suturing or controlling bleeding. Additionally, the increased number of tasks the assistant must focus on can prolong the operation time.

[0009] In oncological surgeries, such as those involving pelvic or para-aortic lymphadenectomy performed using minimally invasive methods, one of the biggest challenges during intra-abdominal surgery is the small intestines entering the operative field and obstructing the work area. This issue can persist even when the patient is in a head-down tilted position. The surgeon may inadvertently cause thermal damage or mechanical injury to the small intestines, leading to injuries. To keep the surgical field open, small intestines are usually retracted from the surgical field using additional surgical ports (entry and exit points for surgical instruments), handled by the first and second assistants.

[0010] Single-incision minimally invasive surgeries: In this type of surgery, performed through a single incision in the umbilicus, surgical procedures are carried out using laparoscopic surgical instruments specifically developed for these procedures. Often, the assistant merely holds the camera and does not contribute to the surgery using a surgical instrument.

[0011] The descriptions of the surgical interventions used in the known state of the art are as follows:

[0012] Laparoscopic Hysterectomy: A surgery for removing the uterus using long, thin surgical instruments through a 1 cm incision in the navel for the camera and 5 mm ports in the lower abdomen (entry and exit points for surgical instruments). It is the most commonly performed gynecological surgery worldwide. Laparoscopic Radical Prostatectomy: A surgery for removing the prostate using long, thin surgical instruments through a 1 cm incision in the navel for the camera and 5 mm ports in the lower abdomen. It is the most commonly performed urological cancer surgery worldwide.

[0013] Robotic Hysterectomy: The robotic version of the uterus removal surgery.

[0014] Robotic Radical Prostatectomy: The robotic version of the prostate removal surgery.

[0015] Laparoscopic Sacrocolpopexy: A closed surgery performed as a corrective procedure for uterine or bladder prolapse.

[0016] Robotic Sacrocolpopexy: The robotic version of the above-mentioned surgery.

[0017] Laparoscopic Para-aortic Lymphadenectomy: A surgery involving the collection of lymph nodes located around the body's main vessels (aorta and inferior vena cava) using long, thin surgical instruments through a 1 cm incision in the navel for the camera and 5 mm ports in the lower and upper abdomen, used in women with uterine, cervical, or ovarian cancers, and in men with bladder or prostate cancers.

[0018] Robotic Para-aortic Lymphadenectomy: The robotic version of the above-mentioned surgery.

[0019] In conclusion, due to the aforementioned negative aspects and the inadequacy of existing solutions on the subject, it has been deemed necessary to make an improvement in the relevant technical field.

[0020] Objective of the Invention

[0021] The primary objective of the invention is to effectively remove the large intestines and, if necessary, the small intestines from the surgical field without causing harm, thereby keeping the surgical field open and free. The invention provides the surgeon with a better view and maneuvering space during the operation. Another objective of the invention is to reduce the assistant's workload and facilitate assistance to the surgeon. The invention allows the surgical team to work more efficiently.

[0022] Another objective of the invention is to contribute to shortening the operation time. A more effective surgical field and better assistance can help reduce the operation time.

[0023] Another objective of the invention is to eliminate the use of additional surgical ports, thus contributing to making the surgery less invasive.

[0024] Another objective of the invention is to assist the surgeon during single-entry minimally invasive surgeries. The invention provides the ability to assist the surgeon in cases where the assistant port is not used.

[0025] Another objective of the invention is to offer an economically and environmentally sustainable solution by presenting a reusable structure. The invention can be reused after being washed, cleaned, and sterilized, thereby providing long-term service.

[0026] Another objective of the invention is to achieve cosmetically satisfying healing results, requiring only a very small skin incision. The invention provides better aesthetic outcomes for patients.

[0027] To achieve these objectives, the invention comprises a first component with at least one needle at its lower end for invasive entry, and a handle at the other end for holding the surgical apparatus, to which a surgical thread is attached, having at least one first slot and at least one second slot for threading the surgical thread through the first component, and at least one needle channel through which the needle of the first component passes, and at least one thread channel for threading the surgical thread through the first and second slots.

[0028] Description of Figures

[0029] Figure 1 : Perspective view of the surgical apparatus subject to the invention.

[0030] Figure 2: Detailed view of the first component of the surgical apparatus subject to the invention. Figure 3: Detailed view of the second component of the surgical apparatus subject to the invention.

[0031] Figure 4: Representative view of the surgical apparatus ready for use.

[0032] Description of Part References

[0033] A. Surgical Apparatus 20. Second Component

[0034] 10. First Component 21. Second Component Body

[0035] 11. Needle 22. irst Slot

[0036] 12. First Component Body 23. Second Slot

[0037] 13. Handle 24. Thread Channel

[0038] 13.1 Groove 25. Needle Channel

[0039] 13.2 Nail 30. Surgical Thread

[0040] Detailed Description of the Invention

[0041] This detailed description explains the preferred structures of the invention solely to contribute to a better understanding of the subject, without forming any limiting effect.

[0042] Referring to Figure 1, the surgical apparatus (A) subject to the invention consists of two main components: the first component (10) and the second component (20).

[0043] Referring to Figure 2, the first component (10) preferably has a long body (12) with a length of 25 cm and a diameter of 2.5 mm. The end is designed as a sharp needle (11). The handle (13) is preferably fan-shaped and has grooves (13.1) formed on its surface to prevent slipping from the hand. The handle (13) is attached to at least two preferably inverted shaped nails (13.2), spaced approximately 1 cm apart. The sharp end is thinner for 3.5 cm and ends in a needle (11). The tip of this needle (11) is designed to be horizontally inserted into the needle channel (25) of the second component. The exposed part is designed to pierce the skin and abdominal tissues. This component does not contain any slots.

[0044] Referring to Figure 3, the second component (20) functions as a hanger and is preferably 3 cm long and 2.5 mm in diameter. The second component body (21) has two slots: the first slot (22) and the second slot (23). The distance between the first slot (22) and the second slot (23) is preferably 0.5 cm, with the second slot (23) being wider. A long needle channel (25) cuts perpendicularly through the first slot (22) and the second slot (23). The part of the needle channel (25) between the first slot (22) and the second slot (23) is wider. There is a thread channel (24) created above this needle channel (25). The surgical thread (30) passes through this thread channel (24). Since the surgical thread (30) will pass through the thread channel (24), it is designed to be narrower than the needle channel (25). The second component (20), a cylindrical component, is made of metal and designed to be connected to the first component (10).

[0045] The basic working principle of this invention is as follows:

[0046] Preparation Phase Before Minimally Invasive Surgery:

[0047] Referring to Figure 4, in the first phase, a surgical thread (preferably 3 / 0 vicryl) is tightly knotted through the first slot (22) and the second slot (23) via the thread channel (24) in the second component (20). The short end of the knot is cut, while the long end is not cut, and the protrusion created by the knot is placed inside the thread channel (24).

[0048] In the second phase, the second component (20) is fixed with the needle (11) of the first component (10). In the third phase, the long end of the thread on the second component (20) is pulled, tightly wrapped 4-5 times around the inverted ' L' shaped nails (13.2) of the first component (10), and then knotted. In this way, the surgical thread (30) is tensioned and fixed. After these steps, the surgical apparatus (A) subject to the invention is ready for use.

[0049] Application Phase During Minimally Invasive Surgery:

[0050] In the first phase, a skin incision of approximately 3 mm is made, and the needle (11) of the first component (10) is inserted under the skin. The abdominal cavity is entered, which has been inflated with carbon dioxide gas. Using the first component (10), the desired organ or structure is passed through and exited again. In the second phase, the second component (20) is fixed by the surgeon with an instrument. Then, the knot of the surgical thread (30) wrapped around the back of the first component (10) is untied, and the thread is released by turning it in the opposite direction. In the third phase, the first component (10), disconnected from the surgical thread (30), is pulled back and removed from the body while holding the second component (20) with a surgical instrument. In this way, the second component (20) is freed and passed behind the desired organ / tissue. In the final phase, the surgical thread (30) attached to the second component (20) is brought out through the exit point of the skin with a suitable surgical instrument. Under video camera supervision, the tension of the surgical thread (30) can be adjusted as desired.

[0051] Termination Phase of Minimally Invasive Surgery:

[0052] At the end of the surgery (or when the hanging function of the surgical field is no longer needed), the apparatus (A) subject to the invention can be easily removed. The removal process consists of three phases. In the first phase, the second component (20) is grasped with a laparoscopic holding instrument. In the second phase, the surgical thread (30) attached to the second component (20) is released by opening the surgical instrument (forceps) over the skin. In the third and final phase, the first component (10) is removed from the body through the skin incision together with the second component (20).

[0053] Examples of Use of the Invention:

[0054] 1. Scenario (Gynecology and Obstetrics and Urology Branches): During laparoscopic / robotic hysterectomy or prostatectomy, when it is necessary to remove the rectosigmoid colon, the final part of the large intestine, from the surgical field, the first component (10) is used to pass through the fatty extensions (appendix epiploica) of this colon and then exit. While the second component (20) is fixed by the surgeon, the first component (10) is pulled back and removed from the body. Finally, the surgical thread (30) exiting the skin is gently pulled. In this way, the rectosigmoid colon is easily removed from the surgical field.

[0055] 2. Scenario (Gynecology & Obstetrics Branch): During laparoscopic / robotic hysterectomy or prostatectomy, when suturing the vaginal cuff or prostate, the peritoneal membrane's end is passed through using the prepared first component (10) and then exited. While the second component (20) is fixed by the surgeon, the first component (10) is pulled back and removed from the body. Then, the peritoneal membrane is pulled upward using the second component (20) and the attached surgical thread (30). In this way, the bladder is removed from the surgical field.

[0056] 3. Scenario (Urology Branch, Gynecology & Obstetrics Branch, General Surgery Branch): During laparoscopic / robotic para-aortic lymphadenectomy, when it is necessary to suspend the small intestines obstructing the operator's view, the end of the peritoneal membrane covering the major vessels is passed through using the first component (10) and then exited. While the second component (20) is fixed by the surgeon, the first component (10) is pulled back and removed from the body. Then, the peritoneal membrane is pulled upward using the second component (20) and the attached surgical thread. This process can be applied to multiple points of the peritoneal membrane. In this way, the small intestines are removed from the surgical field.

Claims

CLAIMS1. The invention is a surgical apparatus (A) designed to suspend abdominal organs and structures using at least one surgical thread (30) in minimally invasive surgery, characterized by:• A first component (10) with at least one needle (11) at the lower end of its body (12) for invasive entry, and at least one handle (13) at the other end for holding the surgical apparatus, to which a surgical thread (30) is attached, having at least one nail (13.2) to which the surgical thread (30) is attached, connected to the handle (13),• A second component (20) with at least one first slot (22) and at least one second slot (23) for threading the surgical thread (30) through the first component (10), and at least one needle channel (25) through which the needle of the first component (10) passes, and at least one thread channel (24) for threading the surgical thread (30) through the first and second slots (22, 23).

2. A surgical apparatus (A) according to claim 1 , characterized by the handle (13) having grooves (13.1) to prevent slipping from the hand.

3. A surgical apparatus (A) according to claim 1 or 2, characterized by the handle (13) being preferably fan-shaped.

4. A surgical apparatus (A) according to claim 1, characterized by the nail (13.2) being in the form of an inverted “L” to prevent the surgical thread (30) from moving outward from the nail (13.2).

5. A surgical apparatus (A) according to claim 1, characterized by the second slot (23) being wider than the first slot (22) to facilitate the passage of the surgical thread (30) through the second component body (21).

6. A surgical apparatus (A) according to claim 1 , characterized by the first component body (12) and the second component body (21) being cylindrical.

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