CN100558317C - 脐疝或脐旁疝的修补物 - Google Patents

脐疝或脐旁疝的修补物 Download PDF

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CN100558317C
CN100558317C CNB2004800436250A CN200480043625A CN100558317C CN 100558317 C CN100558317 C CN 100558317C CN B2004800436250 A CNB2004800436250 A CN B2004800436250A CN 200480043625 A CN200480043625 A CN 200480043625A CN 100558317 C CN100558317 C CN 100558317C
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implantable prosthesis
prosthesis according
lamella
defective
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CN1993088A (zh
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斯蒂芬·乔治·爱德华·巴克
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Evexar Medical Ltd
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Evexar Medical Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063Implantable repair or support meshes, e.g. hernia meshes

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

一种用于修补肌肉壁缺陷例如疝的可植入修补物,尤其用于修补脐疝或脐旁疝和可能的腹疝或者半月线疝,该可植入修补物包括:一外科用的相容性网或聚四氟乙烯材料的上部片层(1)和一外科用的相容性网或聚四氟乙烯材料(3)的下部扣状物(2),例如一复合聚丙烯网/聚四氟乙烯。该下部扣状物通过桥状部分(5)与该上部片层连接,但是有间隔。该扣状物(2)的最里层表面包括一聚四氟乙烯或等同材料的内脏粘连抑制材料(4)。

Description

脐疝或脐旁疝的修补物
技术领域
本发明涉及一种可植入装置,主要是涉及一种用于修补脐或脐旁成疝的修补物,即疝凸出部分发生在脐部或临近脐部的地方。该装置也可以用于其他部位,例如小的腹疝,或者半月线疝(Spigelean herniae)。这种疝通常很小,但会显著的扩大。
背景技术
以前,修补一直是通过各种简单的封口的方式来实现的,但是这种封口是一种“拉紧”的修补方法,并且会导致高复发率。一种平面的、外科可接受的网状材料被用于封闭缺陷部位,但是保留了病痛凸起部分,并且,在某些情况下,复发率依然很高。而在肌肉壁下面进行修补产生效果较好,却存在着形成修补物内部粘连或者相当大的切开手术的危险。
对于脐疝或脐旁疝的修补,建议采用专业修补网状材料,且这种网包括提供“不粘”特性的聚四氟乙烯(polytetrafluoroethylene,PTFE)或者其他等同材料在一侧形成一涂层。这种材料建议放置在腹壁或者腹内肌肉层的下面,但是包括一比正常情况下更大的的切口。因此,在缺陷的肌肉壁前面放置涂层网的技术一般避免使用。
发明内容
本发明的主要目的在于,提供一种主要用于脐疝或脐旁疝修补的修补物,该修补物具有很好的负荷消散的特性,并且只需较小切口便可以植入,利用一面为不粘成分,而另一面与周围组织相结合的优点。
根据本发明提供的一种用于肌肉壁缺陷如出现在疝处的缺陷的修补物,该修补物包括一外科用的相容性材料的上部片层,用于与周围组织相结合,和一外科用的相容性材料的下部扣状物,与该上部片层连接,但是有间隔,该扣状物的最里层表面包括内脏粘连抑制物质或者由内脏粘连抑制物质构成,如PTFE。
该上部片层和下部扣状物可以通过一位于中心的桥状部分连接,该桥状部分可以包括通过该扣状物中间区域变形方便地形成的一部分。该片层和扣状物处于大体平行的平面,且在使用中,从缺陷部位的相对两面包围肌肉壁,通过穿过肌肉壁的桥状部分连接。该片层以无张力的方式,覆盖在缺陷处和周围健康组织上面,用于在腹部的肌肉壁外皮层前面的缝合连接和加固,且可以采用现有技术中公知的符合这个目的网状材料。该扣状物可以包括一复合材料,例如聚丙烯网(以最大化临近肌肉的周围组织的增长),和相对面聚四氟乙烯或类似材料的内脏粘连抑制物质的复合材料的涂层。
该扣状物应小于上部片层,以便于穿过缺陷部位放置,其可放置在腹腔内或者前腹膜上。作为本发明的改动,该扣状物被弯曲或折叠且可以在穿过缺陷部位后张开。该片层和扣状物在一定程度上可以根据手术时的需要进行切割,且可以为圆形,矩形的或者其他形状,该扣状物的材料可以是生物可分解材料。
本发明的一个重要特征是该上部片层和下部扣状物组成的两部分结构,且该下部扣状物采用小尺寸,以便于穿过缺陷处。
附图说明
图1为本发明一典型修补物的横截面剖视图;
图2为图1修补物在使用状态下的示意图;
图3为修补物下方视角的立体图;
图4为下方视角的平面一维视图;
图5为图4的侧视图。
具体实施方式
参考附图描述和阐明本发明的一实施例。
参见附图,一可植入修补物,主要用于肌肉壁上缺陷如疝的修补,尤其是用于修补脐疝或脐旁疝和可能的腹疝或半月线疝。该修补物包括一外科用的相容性网状材料或者PTFE材料构成的上部片层1,和一下部的状物2,该扣状物2由外科用的相容性网状材料或者PTFE材料3构成,如的复合聚丙烯网状材料或者PTFE,该扣状物2通过桥状部分5与上部片层间隔连接。该扣状物2的最里层表面包含有由PTFE或等同材料构成的内脏粘连抑制材料4。
该上部片层1和下部扣状物2通过桥状部分5连接,且这可能包括一独立的连接部分,但是这里显示更简便地通过该扣状物变形为突起而形成,该片层1和扣状物2处于大体上平行的平面,且在使用中,从缺陷部位的相对两面包围肌肉壁M,以扣状物穿过缺陷部位使得位于临近腹膜或肠,通过桥状部分5延伸穿过缺陷开口D(见图2)。
该片层1可以包括一标准的聚丙烯网状材料,用于缺陷部位周围区域的缝合。该扣状物2可以包括覆有PTFE或者层4的薄片聚丙烯网3。该层4可以围绕网3的边缘延伸。其他特性材料可以根据兼容性来选用,例如,所有织构的(textured)和非织构的(non-textured)PTFE。熟知现有技术的人都知道专业术语“织构的”的含义,在此不进行进一步的举例说明。
在一个例子中,该片层1为70毫米的正方形(典型的范围为60-100毫米之间),并带有10MM的圆角,且该扣状物2的直径为40毫米,典型的范围在30-60毫米之间。该片层和扣状物间隔8毫米,典型的范围为7-10毫米。类似的尺寸,可以构造一系列大小的本发明装置。
在使用中,该扣状物穿过缺陷部位开口,使得在给定的尺寸下较小范围的切口,以在临近腹膜或者肠(也就是腹内)下面的地方停止移动,同时该上部片层在腹肌壁肌外皮前面被缝合,提供一无张力的修补和负荷的分散。材料1和3用于与周围的组织相结合。特别地,PTFE覆层4防止肠粘连。

Claims (20)

1、一种用于修补肌肉壁缺陷的可植入修补物,该修补物包括:
一外科用的相容性材料的上部片层,用于与周围的组织相结合;
一外科用的相容性材料的下部扣状物;以及
一外科用的相容性材料的桥状部分,将该片层连接到该扣状物;
其中在将该扣状物穿过该缺陷放置之前,该片层与该扣状物通过桥状部分隔开,并且其中该扣状物的一里层表面包括内脏粘连抑制材料,且该扣状物小于该片层,以便该扣状物穿过该缺陷放置。
2、根据权利要求1所述的可植入修补物,其中该内脏粘连抑制材料为聚四氟乙烯。
3、根据权利要求1所述的可植入修补物,其中该桥状部分包括该扣状物的中间区域部分变形形成。
4、根据权利要求1所述的可植入修补物,其中该片层和扣状物位于大体平行的平面。
5、根据权利要求1所述的可植入修补物,其中该片层和扣状物在使用中被设置成从该缺陷的相对两面包围肌肉壁,同时该桥状部分穿过该缺陷。
6、根据权利要求1所述的可植入修补物,其中该片层在使用中被设置成以无张力的方式,覆盖在该缺陷和周围健康组织上面,并用于在腹部的肌肉壁外皮层前面的缝合连接和加固。
7、根据权利要求1所述的可植入修补物,其中该片层包括一外科用的相容性网状材料。
8、根据权利要求1所述的可植入修补物,其中该扣状物的材料是生物可分解的。
9、根据权利要求1所述的可植入修补物,其中该扣状物包括一复合材料。
10、根据权利要求9所述的可植入修补物,其中所述复合材料包括一覆有内脏粘连抑制材料的聚丙烯网。
11、根据权利要求1所述的可植入修补物,其中该扣状物是可弯曲或者可折叠的,使得该扣状物被弯曲或折叠以使其穿过该缺陷,并在其穿过该缺陷后张开。
12、根据权利要求1所述的可植入修补物,其中该片层能被切割。
13、根据权利要求1所述的可植入修补物,其中该扣状物能被切割。
14、根据权利要求1所述的可植入修补物,其中该片层和/或扣状物为圆形或矩形。
15、根据权利要求1所述的可植入修补物,其中该片层大体上呈正方形,边长在60至100毫米之间。
16、根据权利要求15所述的可植入修补物,其中该正方形的片层具有圆角。
17、根据权利要求16所述的可植入修补物,其中该圆角半径为10毫米。
18、根据权利要求1所述的可植入修补物,其中该扣状物呈圆形。
19、根据权利要求18所述的可植入修补物,其中该扣状物的直径为30至60毫米。
20、根据权利要求1所述的可植入修补物,其中该扣状物与该片层的间隔为7至10毫来。
CNB2004800436250A 2004-07-20 2004-07-20 脐疝或脐旁疝的修补物 Expired - Fee Related CN100558317C (zh)

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CN1993088A (zh) 2007-07-04
EP1773238A1 (en) 2007-04-18
WO2006008429A1 (en) 2006-01-26
US20080172071A1 (en) 2008-07-17

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