Gathered with saws: an unparalleled medical instrument will improve bone grafting

Russia has developed a medical saw for field surgery, which will improve operations in extreme conditions where there is no access to stationary equipment. The development, which received a patent from the Russian Federation, is based on a hacksaw blade with "pockets" for chip removal. The solution eliminates the tool from jamming, avoids chipping, ensures precise cutting and halves the operation time. This reduces the risk of soft tissue damage and reduces the burden on the surgeon. But, as the experts interviewed by Izvestia noted, in order to put the invention into practice, long-term clinical trials are needed.

How "pockets" in the fabric improve cutting accuracy

Scientists at the Nizhny Novgorod State Technical University named after R.E. Alekseev have created a medical saw that is designed for performing operations and jewelry removal of bone defects in extreme conditions — when time is limited and it is not possible to use full-fledged surgical kits. It can be used in field hospitals, emergency zones, disaster sites, as well as in hard-to-reach areas. A patent of the Russian Federation has been obtained for the invention.

Photo: press service of NSTU named after R.E. Alekseev

As the developers explained, the tool is based on a hacksaw blade of an original design, on which special "pockets" are made every four teeth—cuts that serve to remove chips.

— The principle of operation of the tool is simple: as sawing proceeds, bone and soft tissue waste is forced into the recesses and removed from the cutting area, so that the blade works without jamming and disruption, and the doctor does not interrupt work, — the author of the development, director of the Avtozavodsk Higher School of Management and Technology of NSTU, Professor, Doctor of Technical Sciences, told Izvestia. Sciences Vladimir Sivkov.

The new design, he added, allows for a clean and precise cut, which is important for subsequent implant placement. At the same time, the surgeon's workload is reduced, and the operation time is halved. The doctor does not have to constantly remove the saw from the wound to remove the chips, which means that the patient experiences less pain and the soft tissues are less injured. Such saws can be mass-produced at standard industrial facilities.

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What tools are needed in extreme conditions

According to the inventor, the "pockets" in the canvas have a precise geometry. The shape of the teeth has been worked out in detail. And additional grooves on both sides of the canvas reduce friction.

— Field surgery places special demands on the instrument. Work in such conditions should be carried out as quickly as possible, since the life of the wounded often depends on the speed of the operation. At the same time, every extra millimeter of destroyed bone can cost the patient a limb. The new design shows high efficiency in this regard," the developer said.

Photo: press service of NSTU named after R.E. Alekseev

In the near future, he shared, there are plans to create a line of modified saws for various applications. In addition to medicine, the proposed principle is in demand, for example, in logging, metalworking, house construction, rescue operations, and other areas where hand tools are used.

— Against the background of increased injuries requiring amputation, osteotomy (artificial fracture with fixation of fragments) or bone resection (removal of part of the bone to eliminate the focus of pathology), the introduction of an instrument that simplifies surgical procedures is an urgent solution. The development will shorten the surgery time and reduce soft tissue injuries. It will be in demand in traumatology, surgery, and neurosurgery, especially in the military field," Mikhail Ksenofontov, Associate Professor of the Department of Traumatology, Orthopedics, and Military Extreme Medicine at Penza State University, told Izvestia.

According to him, the shortcomings of the invention include heating the saw, which, when working continuously, can cause tissue burns. The disadvantage can be eliminated by using special materials in the manufacture of the tool.

Photo: IZVESTIA/Polina Violet

The expert noted that for the full implementation of the solution in medical practice, clinical trials, tests on biological tissues and subsequent registration with Roszdravnadzor are necessary.

— Improving the miniaturization and precision of operations is not an easy task. Especially in field medicine, where there are high demands on ergonomics, reliability, sterility, instrument safety, as well as ease of use and minimizing the burden on surgeons who are already working at their limit. Therefore, any design solutions that simplify the work of doctors and speed up surgery without loss of quality are useful innovations," said Alexey Karfidov, Head of the Department of Technological Equipment Engineering at NUST MISIS, General Designer of Karfidov Lab Design Bureau.

The proposed principle of special "pockets" in the hacksaw blade, he suggested, may also be interesting in the composition of equipment for the manufacture of small precision parts.