SURGICAL CLAMP FOR PILORIC TRAUMAMIOPLASTIABACKGROUND OF THE INVENTIONThe surgical instrument used since 1912 to resolve hypertrophic pyloric stenosis is a scalpel or surgical knife that contains a very sharp blade at its distal extremity with which it is operated on a newborn who is the carrier of the disease and It consists of the following surgical steps:1. - It opens in 4 cm. or more the abdominal wall, the viscera are separated with intestinal tweezers or abdominal separators. 2. - The pylorus is taken towards the abdominal wound until it is grasped with the fingers and held with the left hand. 3. - It is cut with the scalpel in its upper edge in an approximate extension of 2.5 to 4 cm. which is the range of the hypertrophy, encompassing the muscular wall of the pylorus (PILOROMYOTOMY), without damaging the mucosa. 4. - With a "Benson" clamp that is inserted through the pyloric wound the edges of the lesion are separated until it is seen through a groove made in that form, the mucosa intact and the obstruction is resolved. 5.- When the bleeding is present, there are points with absorbable material to make hemostasis, and the procedure is terminated.
However, this brings a series of situations: Wound of more than 4 cm. in the skin, maneuvers for localization, support of the stomach to go up to the pylorus outside the abdominal cavity and hold it with the fingers of the left hand, which causes exposure of the abdominal viscera to the outside and surgical handling, in addition; complications in approximately 10% of cases with perforation of the mucosa that causes an immediate and infectious chemical peritonitis later, trans and post operative hemorrhage, prolonged hospital time and sometimes death.
The invention consists of a surgical clamp that has the mechanical and technical ability to perform a TRAUMAMIOPLASTIA: with abdominal puncture with a trocar in the upper part of the abdomen of 7 mm through which the surgical clamp is inserted for laparoscopy and the operation is performed; another puncture with another 10 mm trocar. around the umbilical scar where the optic equipment and the laparoscope are inserted. With the clamp, the pylorus is taken in its upper third and the lesion is produced (TRAUMA), through the application of a firm, persistent and manual compressive pressure until the separation, disintegration of the muscle fibers (MIOS) to produce two grooves along the entire length both on its anterior and posterior surfaces; after so many takes and traumas or injuries so long is the pylorus, which resolves the obstruction that causes the disease by expanding the light of the stern pylorus modifying its anatomical configuration (PLASTIA), all this carried out in a single movement and for a single instrument that carries out a complete surgery, resolutive and without complications.
DESCRIPTION OF THE INVENTIONThe characteristic details of the present invention are detailed in the following description and in the accompanying figures, referring to the parts thereof for a better explanation.
The present invention has to do with an instrument called SURGICAL CLAMP FOR PILORIC TRAUMAMYPLASTY in laparoscopy that is performed when a newborn has hypertrophic pyloric stenosis.
Figure 1.- It is a side view of the integrated clamp. Figure 2.- It is a top view of the integrated clamp. Figure 3.- It is a longitudinal section of the distal part or tip of the clamp. Figure 4 .- Is a conventional perspective view of the distal or tip of the clip.
With reference to said figures, the clamp of the present invention is constituted of a fixed handle (1) and another movable handle (2), there are no links or rack bar, like the existing or conventional clamps to measure the intensity of the pressure, since it is exercised by the surgeon with his hand firmly, progressively and persistently until he sees, feel and hear that it has caused the injury (TRAUMA), which disperses and disintegrates the muscle fibers until producing the pylon grooves (MIOS), which transforms the obstruction of the pyloric channel, enlarging it, modifying its anatomy and functionality (PLASTIA) and resolving the cause of the illness. Both handles (1 and 2) make scissors fixed by a support (3), immediately above in a notch where the ball joint or joint (4) joins the scissors with the longitudinal axis of the clamp where the stainless steel rod goes (7), covered in cylindrical form by the sliding tube (6) that gives body to the clip, wide enough to allow passage through the punch or post for laparoscopy, which has a smooth and hermetic sliding with a stop external (5), place to where the clamp can be inserted in the abdomen and in the distal part a Teflon seal (8), which prevents the gas used in the operation from leaking. The inner rod (7) ends in a bolt (9) as a guide that supports a double-traction scissors (10) that can be observed through an upper groove (11), that when the rod is operated from the handles (1 and 2). ), open wide enough the spoons (12) to make the bite (14) of the upper edge of the pylorus, with a sufficiently thin angulation and thickness and a smooth surface and / or ROMA that produces the injury and solves the problem.
It is worth mentioning that this clip is special for operating a newborn, so that the spoons (13), with a triangular shape, are sufficiently wide with the sides projecting as wide as possible for the taking or biting (14 ), with contact surface faded to half its thickness and a blunt cutting surface to cause the injury and solve the problem.
This instrument allows an opening of the branches (12) of the spoons (13), its sufficient angulation, the progressive reduction of its distal end with a blunt surface and sufficiently thin (14) to produce the lesion with an amplitude of the clamp in the viscera and perform in a single time the operation of the problem of the newborn.
With this we have a surgical clamp for traumamioplasty, which is less aggressive because it has a distal part in a blunt form, it bleeds less because it is not sharp, it does not expose the abdominal viscera to the outside, it avoids surgical handling, surgical times, so that the procedure is faster, and does not require extra surgical maneuvers, since it is a single instrument: the surgical clamp for pyloric traumamioplasty by laparoscopy.
Therefore, the invention also has to do with a more efficient method for pyloric surgical intervention, especially in newborns. Which consists of using the clamp described in the present invention, for all the benefits it has.