Device for inguinal ligament fixation and surgery method thereof

Abstract

A device for inguinal ligament fixation includes a suspension mesh, wherein the suspension includes: a cervix and anterior vaginal wall sling; wherein a first end of the cervix and anterior vaginal wall sling is connected to a cervix or an anterior vaginal wall; two inguinal ligament suspension arms, wherein a second end of each of the two inguinal ligament suspension arms is connected to a second end of the cervix and anterior vaginal wall sling, and the two inguinal ligament suspension arms are placed in a symmetrical form; and two sacral ligament and posterior vaginal wall suspension arms, wherein a second end of each of the two sacral ligament and posterior vaginal wall suspension arms is connected to the second end of the cervix and anterior vaginal wall sling, and the two sacral ligament and posterior vaginal wall suspension arms are placed in a symmetrical form.

Claims

1. A surgery method for inguinal ligament fixation, comprising steps of: at a bladder lithotomy position of a patient, providing routine disinfection for abdominal and perineal skins, and applying a sterile towel; opening a bladder and back-folding a peritoneum; pushing down the bladder for exposing a vaginal wall; fixing a cervix and anterior vaginal wall sling of a suspension mesh on a cervical isthmus with several absorbable or non-absorbable sutures; respectively suturing two sacral ligament and posterior vaginal wall suspension arms of the suspension mesh on a posterior vaginal wall, and fixing the sacral ligament and posterior vaginal wall suspension arms on an inguinal ligament; pulling out two inguinal ligament suspension arms of the suspension mesh along outside portions of peritoneum at two sides of an uterus; opening the peritoneum at a position where a round ligament is attached on the uterus, and suturing the suspension mesh on a myometrium avascular zone under the round ligament; opening the peritoneum below the round ligament; outside the peritoneum and parallel to the round ligament, passing the suspension mesh through anterior superior iliac crest inguinal ligament, fascia and aponeurosis which directly reach an inlet of an inguinal canal, and dragging the suspension mesh until a pre-set length is reached; then opening surface peritoneum of the inguinal ligament and a fascia, and fixing the two inguinal ligament suspension arms on the inguinal ligament, the fascia and the aponeurosis; closing all peritoneal incisions so as to place the suspension mesh outside the peritoneum, and then closing an abdomen.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) FIG. 1 is a sketch view of a device for inguinal ligament fixation according to a preferred embodiment 1 of the present invention.

(2) FIG. 2 is a sketch view of the device according to a preferred embodiment 2 of the present invention.

(3) FIG. 3 is a top view of a vaginal vault supporting board according to the preferred embodiment 2 of the present invention.

(4) FIG. 4 is a side view of the vaginal vault supporting board according to the preferred embodiment 2 of the present invention.

(5) FIG. 5 is a top view of a vaginal vault cone according to the preferred embodiment 2 of the present invention.

(6) FIG. 6 is a side view of the vaginal vault cone according to the preferred embodiment 2 of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

(7) Preferred Embodiment 1: Inguinal Ligament Fixation for a Patient With Uterus Remained

(8) Referring to FIG. 1 of the drawings, a device for inguinal ligament fixation according to the preferred embodiment 1 of the present invention is illustrated, comprising a suspension mesh, wherein suspension mesh comprises:

(9) a cervix and anterior vaginal wall sling 2; wherein a first end of the cervix and anterior vaginal wall sling 2 is fixed on a cervix;

(10) two inguinal ligament suspension arms 1, wherein first ends of both the two inguinal ligament suspension arms 1 are respectively fixed on two inguinal ligaments, a second end of each of the two inguinal ligament suspension arms 1 is connected to a second end of the cervix and anterior vaginal wall sling 2, and the two inguinal ligament suspension arms 1 are placed in a symmetrical form; and

(11) two sacral ligament and posterior vaginal wall suspension arms 3, wherein a first end of each of the two sacral ligament and posterior vaginal wall suspension arms 3 is fixed on a sacral ligament, a second end of each of the two sacral ligament and posterior vaginal wall suspension arms 3 is connected to the second end of the cervix and anterior vaginal wall sling 2, and the two sacral ligament and posterior vaginal wall suspension arms 3 are placed in a symmetrical form.

(12) Preferably, an angle between each of the two sacral ligament and posterior vaginal wall suspension arms 3 and the cervix and anterior vaginal wall sling 2 in length directions is 120 degrees; and an angle between each of the two inguinal ligament suspension arms 1 and the cervix and anterior vaginal wall sling 2 in the length directions is 150-165 degrees.

(13) Preferably, a length of each of the two inguinal ligament suspension arms 1 is 12.0-17.0 cm, and a width thereof is 1.5-2.5 cm; a length of the cervix and anterior vaginal wall sling 2 is 3.5-12.0 cm, and a width thereof is 3.5-4.0 cm; and a length of each of the two sacral ligament and posterior vaginal wall suspension arms 3 is 8.0-12.0 cm, and a width thereof is 1.5-2.5 cm.

(14) Preferably, the two inguinal ligament suspension arms 1, the cervix and anterior vaginal wall sling 2, and the two sacral ligament and posterior vaginal wall suspension arms 3 are made of a synthetic material or a biological material.

(15) A surgery method according to the preferred embodiment 1 comprises steps of: at a bladder lithotomy position of a patient, providing routine disinfection for abdominal and perineal skins, and applying a sterile towel; opening a bladder and back-folding a peritoneum; pushing down the bladder for exposing a vaginal wall; fixing a cervix and anterior vaginal wall sling 2 of a suspension mesh on a cervical isthmus with several absorbable or non-absorbable sutures; respectively suturing two sacral ligament and posterior vaginal wall suspension arms 3 of the suspension mesh on a posterior vaginal wall with the absorbable or non-absorbable suture, and fixing on an inguinal ligament; pulling out two inguinal ligament suspension arms 1 of the suspension mesh along outside portions of peritoneum at two sides of an uterus; opening the peritoneum at a position where a round ligament is attached on the uterus, and suturing the suspension mesh on a myometrium avascular zone under the round ligament with the absorbable or non-absorbable suture; opening the peritoneum below the round ligament; outside the peritoneum and parallel to the round ligament, passing the suspension mesh through anterior superior iliac crest inguinal ligament, fascia and aponeurosis which directly reach an inlet of an inguinal canal, and dragging the suspension mesh until a pre-set length is reached; then opening surface peritoneum of the inguinal ligament and the fascia, and two fixing two inguinal ligament suspension arms 1 on the inguinal ligament, the fascia and the aponeurosis with the absorbable or non-absorbable suture; closing all peritoneal incisions so as to place the suspension mesh outside the peritoneum, and then closing an abdomen. The surgery has been successfully performed in 15 cases.

(16) Preferred Embodiment 2: Inguinal Ligament Fixation for a Hysterectomy Patient

(17) Referring to FIGS. 2-6 of the drawings, a device for inguinal ligament fixation according to the preferred embodiment 1 of the present invention is illustrated, comprising a suspension mesh, wherein suspension mesh comprises:

(18) a cervix and anterior vaginal wall sling 2; wherein a first end of the cervix and anterior vaginal wall sling 2 is fixed on an anterior vaginal wall;

(19) two inguinal ligament suspension arms 1, wherein first ends of both the two inguinal ligament suspension arms 1 are respectively fixed on two inguinal ligaments, a second end of each of the two inguinal ligament suspension arms 1 is connected to a second end of the cervix and anterior vaginal wall sling 2, and the two inguinal ligament suspension arms 1 are placed in a symmetrical form; and

(20) two sacral ligament and posterior vaginal wall suspension arms 3, wherein a first end of each of the two sacral ligament and posterior vaginal wall suspension arms 3 is fixed on a posterior vaginal wall, a second end of each of the two sacral ligament and posterior vaginal wall suspension arms 3 is connected to the second end of the cervix and anterior vaginal wall sling 2, and the two sacral ligament and posterior vaginal wall suspension arms 3 are placed in a symmetrical form.

(21) Preferably, an angle between each of the two sacral ligament and posterior vaginal wall suspension arms 3 and the cervix and anterior vaginal wall sling 2 in length directions is 180 degrees; and an angle between each of the two inguinal ligament suspension arms 1 and the cervix and anterior vaginal wall sling 2 in the length directions is 90 degrees.

(22) Preferably, a length of each of the two inguinal ligament suspension arms 1 is 12.0-17.0 cm, and a width thereof is 1.5-2.5 cm; a length of the cervix and anterior vaginal wall sling 2 is 3.0-12.0 cm, and a width thereof is 3.0-4.0 cm; and a length of each of the two sacral ligament and posterior vaginal wall suspension arms 3 is 3.0-12.0 cm, and a width thereof is 3.0-4.0 cm.

(23) Preferably, the two inguinal ligament suspension arms 1, the cervix and anterior vaginal wall sling 2, and the two sacral ligament and posterior vaginal wall suspension arms 3 are made of a synthetic material or a biological material.

(24) According to the preferred embodiment 2, the device further comprises a vaginal vault supporting board 4 for supporting and lifting a vaginal vault, wherein the vaginal vault supporting board 4 is 10.0 cm long with two segments, and an angle between the two segments is 150 degrees; the vaginal vault supporting board 4 is 4.0 cm or 5.0 cm wide and 0.3 cm thick.

(25) Preferably, a rear end of the vaginal vault supporting board 4 is connected to a handle which is 25.0 cm long and 1.0 cm wide.

(26) Preferably, the vaginal vault supporting board 4 is made of a heat-resisting repeatable material or a disposable sterile material.

(27) According to the preferred embodiment 2, the device further comprises a vaginal vault cone 5 for supporting and lifting a vaginal vault, wherein the vaginal vault cone 5 is 10.0 cm long with a curved side section and 4.0 cm wide; a front end of the vaginal vault cone 5 is 0.8 cm thick and the vaginal vault cone 5 gradually becomes oval from the front end to a rear end.

(28) Preferably, the rear end of the vaginal vault cone 5 is connected to a handle which is 25.0 cm long and 1.0 cm wide.

(29) Preferably, the vaginal vault cone 5 is made of a heat-resisting repeatable material or a disposable sterile material.

(30) A surgery method according to the preferred embodiment 2 comprises steps of: providing double-oophorectomy hysterectomy to a patient, and continuously suturing a vaginal cuff with an absorbable suture; lifting the vaginal cuff with a vaginal vault supporting board 4, lifting with a vaginal vault cone 5 for vaginal vault prolapse patients, and opening a surface membrane of the vaginal cuff; separating a vagina from a bladder with a first gap of 3-4 cm long and 4-5 cm wide, and separating the vagina from a rectum with a second gap of 3-4 cm long and 4-5 cm wide; then fixing with a suspension mesh, wherein specifically, respectively suturing a cervix and anterior vaginal wall sling 2 and two sacral ligament and posterior vaginal wall suspension arms 3 of the suspension mesh on anterior and posterior vaginal wall muscle fibers in different rows with an discontinuous form; opening an inguinal ligament and an aponeurosis surface peritoneum in front of an anterior superior iliac crest outside a round ligament which reach an inlet of an inguinal canal; passing two inguinal ligament suspension arms 1 of the suspension mesh through the anterior superior iliac crest inguinal ligament and fascia which directly reach the inlet of the inguinal canal, and dragging the suspension mesh until a pre-set length is reached; then suturing broken ends of the two inguinal ligament suspension arms 1 on the inguinal ligament and the fascia for 2-3 needles with a non-absorbable suture; suturing the suspension mesh on the round ligament at one position of a peritoneum; suturing an broken end of the round ligament on the vaginal cuff with the absorbable suture; and then closing all peritoneal incisions so as to place the suspension mesh outside the peritoneum. The surgery has been successfully performed in 20 cases.

(31) Therefore, the present invention is able to cure pelvic organ prolapse with one surgery, which provides overall repair to whole pelvic floor and simplifies surgical procedures. The present invention is reasonable, simple, effective and practical, which further satisfies requirements of overall pelvic repair theories. With the present invention, uterus of the patent is able to be remained during surgery, so as to retain physiological and reproductive functions without complications caused by conventional surgeries. For hysterectomy patients, the present invention is sufficient for repairing vaginal vault prolapse and anterior or posterior vaginal wall prolapse, which fully achieves effects of conventional surgical sacrocolpopexy. Especially, the present invention is suitable for treating vaginal vault prolapse of patients who accepted passive hysterectomy due to certain diseases, wherein such patients often suffer from pelvic and intestinal adhesions due to surgeries. However, the present invention will not pass through intestine and ureter, enabling shorter surgical learning curve and less complication risk.

(32) One skilled in the art will understand that the embodiment of the present invention as shown in the drawings and described above is exemplary only and not intended to be limiting.

(33) It will thus be seen that the objects of the present invention have been fully and effectively accomplished. Its embodiments have been shown and described for the purposes of illustrating the functional and structural principles of the present invention and is subject to change without departure from such principles. Therefore, this invention includes all modifications encompassed within the spirit and scope of the following claims.