Self-locking strap abdominal wall defect closure
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Solution Overview
Problem
Current methods for ventral hernia repair, such as conventional open and laparoscopic techniques, face challenges including high failure rates, postoperative complications, and the difficulty in manipulating sutures through multiple tissue layers, especially in obese patients, due to the need for large prosthetic mesh patches and numerous knots.
Innovation Solution
The use of self-locking straps with a lock-head, needles, and a guide system for minimally invasive closure, allowing for easier tensioning and reduced tissue pressure, with a system that includes a tensioner for measuring and displaying tension force, and a robotic interface for enhanced control.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional open repair methods are used to close abdominal wall defects, then the defect can be fully closed by suturing through all tissue layers, but the procedure requires a large abdominal incision causing significant postoperative pain
Solution Approach 1:
The procedure divides the closure process into multiple independent steps: first placing a large prosthetic mesh patch to cover the defect, then separately placing multiple sutures through tissue layers, and finally tying numerous knots. This segmentation allows the large incision to be avoided while achieving full-thickness closure through coordinated minimally invasive steps.
Solution Approach 2:
The patent employs nested structures where sutures are placed through multiple tissue layers (skin, subcutaneous fat, fascia, muscle) in sequence, with each suture path nested within the previous layer. The prosthetic mesh patch is positioned first, then sutures are nested through various layers to secure it, creating a layered closure structure that achieves full-thickness repair through minimally invasive access.
2Object-affected harmful factors
If laparoscopic repair with large prosthetic mesh patch is used, then postoperative pain is reduced, but the abdominal defect is not fully closed and complications such as seroma formation and infection increase
Solution Approach 1:
The patent employs dynamic tensioning of multiple sutures to progressively close the defect. Sutures are placed through full thickness of the abdominal wall and tensioned serially to gradually reduce the defect size, allowing dynamic adaptation to tissue movement and healing while maintaining complete closure. This dynamic approach replaces the static large mesh patch with an active, adjustable suture system.
Solution Approach 2:
The procedure changes the physical parameters of the repair by using multiple sutures with varying tension forces applied serially. Each suture is tensioned to specific force levels to achieve progressive defect closure, transforming the repair from a single static mesh placement to a multi-parameter suture system that achieves complete full-thickness closure while minimizing pain through laparoscopic access.
3Reliability
If multiple sutures are used to close the large abdominal defect, then the defect can be gradually closed, but the number of knots required increases to eighty or more making the procedure tedious
Solution Approach 1:
The patent employs preliminary placement of a large prosthetic mesh patch to cover the defect before placing sutures. This preliminary action provides a stable foundation that reduces the number of sutures and knots needed for final closure, as the mesh patch already provides structural support and coverage, allowing fewer tensioning steps to achieve complete closure.
Solution Approach 2:
The prosthetic mesh patch serves as an intermediary element between the sutures and the defect. It distributes the tension forces from fewer sutures across the entire defect area, reducing the need for numerous individually tensioned sutures. The mesh patch mediates the closure process by providing structural support that allows fewer knots to achieve the same closure effect that would otherwise require eighty or more knots.
4Reliability
If sutures are advanced through multiple layers of tissue including full-thickness abdominal wall, then complete closure is achieved, but the sutures become difficult to find and manipulate when inserted into the body cavity
Solution Approach 1:
The patent replaces manual suture manipulation with a motorized suture passer device that automatically advances sutures through multiple tissue layers. The mechanical system includes a motorized needle driver that pushes sutures through skin, subcutaneous fat, fascia, and muscle layers, eliminating the need for manual manipulation deep within the abdominal cavity. This mechanical substitution makes suture placement and tensioning significantly easier while maintaining complete full-thickness closure.
Data Source
AI summary
Systems and methods for closing a tissue defect are disclosed. The systems may include a subcutaneous guide that is placed transcutaneously between two skin access sites and a self-locking strap that may be advanced into the body through a first access site via a first needle and then passed to a second needle. The strap may be withdrawn with the second needle through a second access site to the outside of the body. The strap may be withdrawn from the first needle, leaving the strap placed through both access sites and across the defect. As the subcutaneous guide is withdrawn from the body it pulls the captured strap such that both ends of the strap protrude from the first access site, allowing the strap to be tightened around the defect. Devices for closure of a tissue defect are also disclosed.