Patent RU-2211667-C2 (RU)
Title: Method for tying triple knot and cutting off redundant ends of knot ligature
Inventor: SHULJAK S A
IPC: A61B17/00
Filed: 2001-03-21
Granted: 2003-09-10
Abstract: FIELD: medicine. SUBSTANCE: method involves taking closed surgical scissors of 14 or 17 cm in length with cutting part of branches curved in plane with the first and the second fingers in the vicinity of screw and branch cross-over. The curved part of the scissor branches is to be concurrently turned to body so that the cutting part of scissor branches is directed towards radial side of the left hand. The scissors are brought near to the right hand. The window part of one of scissor branches that is near to the right hand is put on over the fourth right hand finger and is placed on the basic phalanx of this finger. The fourth right hand finger is introduced into window part of the scissors from its anterior side to which scissors cutting part of branches curvature is directed. The palmar surface of the right hand is directed to the side the cutting part of scissors branches is bent. The base phalanx of the fifth finger of the right hand is arranged under the other window part of the closed scissor branch. Maximum bending of the fourth and the fifth finger of the right hand is carried out and the screw and branch cross-over area is positioned in the vicinity of the first metacarpal bone of the right hand. The scissor is reliably fixed in the right hand. The hands are crossed so that the right hand is placed above the left one. Sequential fixation of one and the other end of ligature is carried out between the palmar surfaces of fingernail phalanges of the first and the second fingers of the hands. An additional fixation of one ligature end between the third and the fourth fingers of the left hand and an additional fixation of the same ligature end between the palmar surfaces of the third-fifth fingers of the left hand and the palmar surface of metacarpal zone of the left hand is done at the same time. The ligature ends are crossed in the middle zone of the second finger fingernail phalanx of the right hand on the palmar surface and the ligature cross is fixed between it and the palmar surface of the first finger fingernail phalanx of the same hand. The first and the second fingers of left hand slide along the hold ligature end in distal direction over 6-9 cm long distance eliminating the additional fixation of this ligature end at the same time with the third-fifth fingers of this hand. The ligature end is brought close to formed ligature window from the side of the back surface of the proximal part of the second finger fingernail phalanx of the right hand and towards the ligature end stretched all the time with this hand. The distal part of the fourth finger fingernail phalanx of the left hand is at the same time introduced into the ligature window from the back surface side of the right hand. The adjacent part of the ligature end is pulled aside closer to body with palmar surface of the fourth finger fingernail phalanx of left hand. The ligature end is taken away from the ligature window. The first, the second and the third simple knots are tied. The fourth and fifth fingers of the right hand are extended to one half of its extension amplitude. Sharp flexion movement is done by the basal phalanx of the fifth finger of the right hand. The scissor is pushed forward and the right hand moves concurrently forward and downward in placing the scissor on palmar surface of the second and the fourth finger of the right hand with its lateral surface. The first finger of the right hand is introduced into free window portion of scissor branch and redundant part of knot ligature end is cut off. EFFECT: high quality of knots; accelerated operation process.