Hasson H M
Weiss Hospital, 4640 N. Marine Drive, Suite 6150, Chicago, IL 60640, USA.
J Am Assoc Gynecol Laparosc. 2000 Nov;7(4):556-61. doi: 10.1016/s1074-3804(05)60375-1.
A special needle holder with a step and knot-forming stand was designed to permit wrapping sutures into distinctive sliding loops around the needle holder, outside the abdomen. The loaded instrument was introduced into the abdomen and the appropriate stitch was made. The suture next to the needle was grasped with the needle holder and pulled through the sliding loops(s) to establish a knot. When the needle was passed through a simple noose the needle-through-the-noose knot was created. This knot maintained tension on captured tissues, but it required additional half-hitches to secure. When the needle was passed through rolling hitch loops it established a knot that was secure in simple applications, but required one additional half-hitch to secure in vulnerable applications involving slippery sutures or tissue purchases subjected to disruptive tension. The procedures were first practiced on inanimate models using a laparoscopy training simulator and then performed successfully over 20 times in 11 patients who had laparoscopic myomectomy or hysterectomy.
设计了一种带有台阶和打结支架的特殊持针器，以便在腹部外将缝线缠绕成围绕持针器的独特滑动环。将装载好的器械插入腹部并进行适当的缝合。用持针器抓住靠近针的缝线，并将其拉过滑动环以形成一个结。当针穿过一个简单的套索时，就形成了针穿套索结。这个结能保持对捕获组织的张力，但需要额外的半结来固定。当针穿过卷结环时，就形成了一个在简单应用中很牢固的结，但在涉及光滑缝线或受到破坏性张力的组织抓取的易损应用中，需要额外一个半结来固定。这些操作首先在使用腹腔镜训练模拟器的无生命模型上进行练习，然后在11例接受腹腔镜子宫肌瘤切除术或子宫切除术的患者中成功进行了20多次。
