Gastrotomy Closure Device Nested Tissue Layer Alignment
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Solution Overview
Problem
Existing minimally invasive surgical procedures face challenges in securely closing the gastrotomy site without requiring separate closure of each muscle and tissue layer in the abdominal wall, particularly in patients with extensive scarring, obesity, or diminished abdominal wall integrity.
Innovation Solution
A surgical instrument with a hollow tip extending at an acute angle is used to form a gastrotomy, allowing the inner tissue layer to be stretched and aligned with the outer layer for instrument passage, enabling the gastrotomy site to be closed without needing separate closure of each muscle and tissue layer, utilizing a method that involves stretching the inner tissue layer and forming aligned holes for surgical access and subsequent natural sealing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of time
If minimally invasive procedures are used to access the abdominal cavity, then patient recovery time is reduced and pain is minimized, but secure closure of the gastrotomy site becomes difficult without separately closing each muscle and tissue layer
Solution Approach 1:
The closure device segments the gastrotomy closure into discrete components: a first element with a first lumen for the inner tissue layer and a second element with a second lumen for the outer tissue layer. This segmentation allows each layer to be closed independently through separate lumens, simplifying the overall closure process while maintaining security.
Solution Approach 2:
The closure device employs a nested structure where the first element and second element are positioned concentrically relative to each other. The first element is inserted through the inner tissue layer while the second element is inserted through the outer tissue layer, with both elements nesting within the gastrotomy site. This nested arrangement enables simultaneous closure of multiple tissue layers through a single access point.
2Ease of operation
If a formal laparotomy is performed to access the abdominal cavity, then adequate exposure is achieved, but extensive scarring and longer recovery time result
Solution Approach 1:
The closure device acts as an intermediary tool that enables adequate closure of the gastrotomy site without requiring a formal laparotomy. By providing a structured approach to close both inner and outer tissue layers through minimal incisions, the device mediates between the need for adequate exposure during surgery and the desire for minimal scarring and rapid recovery.
3Reliability
If separate closure of each muscle and tissue layer is performed after the procedure, then secure gastrotomy closure is achieved, but surgical time and complexity increase
Solution Approach 1:
The closure device is prepared in advance with its first and second elements positioned and configured before insertion. The first element is pre-configured for insertion through the inner tissue layer and the second element is pre-configured for insertion through the outer tissue layer. This preliminary preparation allows for rapid deployment during surgery, maintaining secure closure while improving surgical efficiency.
Solution Approach 2:
The closure device combines multiple closure functions into a single instrument. Both the first element and second element work together to close different tissue layers, making the device universal for addressing both inner and outer tissue layer closure needs. This multi-functionality eliminates the need for multiple separate closure instruments and procedures.
Data Source
AI summary
A surgical instrument for forming a gastrotomy. In various embodiments, the surgical instrument may comprise a hollow tip for attachment to a distal end of a tubular member such as an endoscope. In other embodiments, the hollow tip is integrally formed on the distal end of the endoscope. The hollow tip is configured such that when it is brought into contact with the inner layer of tissue in the stomach, the tissue is caused to stretch. A hole-forming device may be passed through the hollow tip to pierce through the stretched inner layer and adjacent outer layers of tissue to form a passageway therethrough for permitting surgical procedures to be performed therethrough. After the surgical procedures are performed through the passageway, the hollow tip is removed from contact with the inner layer of tissue to permit the inner layer of tissue to relax and to cause the holes formed through the inner layer and outer layers of tissue to be offset from each other.