Purse Suturing Device for Hollow Viscus Anastomosis
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Solution Overview
Problem
Conventional methods for performing anastomoses in hollow viscera, such as in esophageal and low rectal surgeries, face challenges with mechanical end-to-end or end-to-side anastomoses due to difficulties in closing the rectal stump and creating a secure vascularized edge, leading to potential dehiscence and complications.
Innovation Solution
A purse-suturing device comprising a circular stapler and suturing thread that creates a mechanical purse suture by tightening the viscus wall around a pole and stapling it to secure the layers, facilitating end-to-end or side-to-end anastomoses, especially in areas like the lower rectum where hand-sewn sutures are difficult.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If a linear stapler is used to close the rectal stump, then the closure can be performed in difficult-to-reach areas, but multiple firings are required and there is a high possibility of leaving suture outside the stapler coverage area
Solution Approach 1:
The circular stapler is divided into two functional components: a purse-suturing component that creates a circumferential suture, and a stapling component that performs the actual anastomosis. This segmentation allows the purse suture to be formed first, ensuring complete coverage, followed by the stapling action that secures the closure without requiring multiple firings.
Solution Approach 2:
The purse suture is formed as a preliminary action before the main stapling operation. The suture thread is positioned around the viscus and tightened to create a purse-string configuration, which prepares the tissue for subsequent stapling and ensures that the closure will be complete and secure.
2Reliability
If hand-sewn purse suture is performed, then a secure vascularized edge is created, but the procedure is technically difficult and requires significant training
Solution Approach 1:
The device performs the purse-suturing function automatically through mechanical means. The surgeon loads the suture thread into the device, which then automatically guides, tightens, and secures the thread around the viscus using a ratchet mechanism, eliminating the need for manual needle passing and knot tying while maintaining the quality of vascularized edge creation.
Solution Approach 2:
The manual hand-sewn suture technique is replaced with a mechanical purse-suturing device that uses a ratchet mechanism and pre-formed suture loops to create the purse-string closure. This mechanical substitution maintains the surgical outcome while significantly reducing the technical skill barrier.
3Ease of operation
If conventional purse-string device with linear staples is used, then the device can be operated, but the staples cannot be curved and fixation is weak causing staples to detach
Solution Approach 1:
The staples are designed with a curved or U-shaped configuration rather than straight linear shapes. This curvature allows the staples to conform to the cylindrical geometry of the hollow viscus, distributing the fixation force more evenly and preventing detachment that occurs with straight staples that cannot adapt to tissue movement or organ shape.
Data Source
AI summary
A purse suturing device includes a circular stapler having a tubular stapler head adapted to be inserted inside a section of the hollow viscus to be sutured, a handle with an actuator connected to the stapler head, and an anvil against which the staples may be folded. The anvil has a pole adapted to be inserted into the tubular stapler head. A suturing thread is wound around the hollow viscus and tightened, causing a section of the hollow viscus to be tightened around the pole. The tightened section also includes a pursed, or folded, section of the wall of the hollow viscus, in which two layers of the wall of the hollow viscus are stapled together.