CN103002839A - A system regulating the dispensing of a body fluid - Google Patents
A system regulating the dispensing of a body fluid Download PDFInfo
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- CN103002839A CN103002839A CN201080068040XA CN201080068040A CN103002839A CN 103002839 A CN103002839 A CN 103002839A CN 201080068040X A CN201080068040X A CN 201080068040XA CN 201080068040 A CN201080068040 A CN 201080068040A CN 103002839 A CN103002839 A CN 103002839A
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- bile
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/0003—Apparatus for the treatment of obesity; Anti-eating devices
- A61F5/0013—Implantable devices or invasive measures
- A61F5/0076—Implantable devices or invasive measures preventing normal digestion, e.g. Bariatric or gastric sleeves
Abstract
A system (11) for regulating the dispensing of body fluid comprises a regulating valve (12) adapted to be placed in the flow path of a body fluid and a physiological characteristic- sensing device (13) in signal communication with the regulating valve (12) and configured to generate a control signal (14) in dependency from the physiological characteristic, wherein the regulating valve (12) is adapted to change a rate of flow of the body fluid in response to the control signal (14).
Description
Technical field
The present invention relates generally to following apparatus and method, described apparatus and method are used for surgical operation ground change organ and blood vessel to affect patient's digestion, treat thus metabolic disease for example morbid obesity and relevant comorbidities, for example diabetes, heart disease, apoplexy, lung disease and accidental disease.
Background technology
Many non-operative treatment that do not have in fact permanent successful treatment morbid obesity had been attempted.
The surgical method for the treatment of morbid obesity has for example obtained increasingly extensive application for bad open, the abdominal cavity mirror of persistency food absorption and intracavity gastric bypass operation and has obtained than ten-strike.Yet the method that is used at present the execution gastric bypass relates to remarkable and common worthless modification consuming time and the gastrointestinal anatomical structure dependent surgery operating technology of high sensitivity and patient.
For fear of the shortcoming of gastric bypass operation and affect patient's digestion in mode more specifically and targetedly, the present invention emphatically research is used for major effect and revises intestinal-hepatic bile circulation but not gastral method and apparatus.For this reason, should be susceptible to following possibility method and the mechanism that acts on intestinal-hepatic bile circulation:
-modification intestinal-hepatic bile cycle frequency, especially bile circulation acceleration;
-revise contacting with interaction and by the physiological signal that contact triggering of bile with intestinal wall by the food of bile and enteral;
-food by revising bile and enteral or the attaching space between the chyme are with time of contact and by making bile separate targetedly to revise the food absorption ability from food.
Specific objective of the present invention is for providing following method and apparatus, and described method and apparatus is used for regulating body fluid, the especially distribution of gallbladder pancreatic juice, for example affects targetedly in the mode of Wicresoft especially and regulates digestion.
Clinical experiment shows, food is introduced the time in the jejunum and gallbladder pancreatic juice introduced the time in the jejunum and their are mixed and the interactional time can cause the loss in weight and/or allow to control diabetes.Therefore, bile and mixing of chyme need to be delayed in the gastrointestinal tract than low spot or stop bile to interact with gastrointestinal tract until reach than distal position and just discharge bile and permission mixes.
Be used for to digest secretions (for example, bile and pancreas secretions) and distad transfer to enteral known devices and to some extent discussion in US 2009/0062717 and US 7,314,489 of method.Be disclosed in US 7,314, the device in 489 comprises support, described support have far-end and engage in the ampulla of vater zone duodenal near-end and between near-end and far-end to produce the diameter parts that reduces of the annular volume that can collect bile.The device that is disclosed among the US 2009/0062717 comprises bearing support and conduit, and described bearing support has lateral opening, and described conduit extends between the near-end that is connected with lateral opening and distal open end, and the near-end of wherein said conduit can form reservoir.
The known devices and the method that are used for shift and assimilation secretions are collected bile, the distribution time of the bile of regulating on one's own initiative but they do not respond specific physiological property.
Therefore, another target of the present invention is incorporated into time in the gastrointestinal tract for revising according to the physiological property of patient's body relevant with passing gastrointestinal food intake and passage of food with gallbladder pancreatic juice.
Summary of the invention
Realize these targets by the system that is used for the distribution of adjusting body fluid, described system comprise in the flow channel that can be placed on body fluid control valve and with the physiological property sensing apparatus of control valve signal communication, the signal that wherein derives from the physiological property sensing apparatus can cause that valve changes the flow velocity of body fluid.Body fluid can be fluid in the part that bile or pancreatic juice and physiological property can be health, and for example pH value or the pH value of gastric content change.
Realize above-mentioned target by the method that is used for the distribution of adjusting body fluid in addition, said method comprising the steps of:
-control valve is placed on the primary importance place in the flow channel of the body fluid in the patient body;
-with sensing apparatus placement second position place in vivo; And
The physiological property of-sensing the second position; And generate control signal according to the physiological property of sensing; And
-control signal is provided to valve to regulate the flow velocity of body fluid.
According to an aspect of the present invention, provide the method for the flow velocity that is used for adjusting gallbladder pancreatic juice, said method comprising the steps of:
-the active adjustment valve is placed in the flow channel of gallbladder pancreatic juice; And
-the pH sensor is placed under one's belt; And
The pH of-sensing gastric content; And
-generate control signal according to the pH of sensing; And
-control signal is sent to the flow velocity that information that valve and utilization derive from control signal is regulated gallbladder pancreatic juice.
This is so that affect metabolism mechanism in patient's the situation of anatomical structure and become possibility need not the invasive surgical operation or significantly change.
According to another aspect of the present invention, provide the surgical method that is used for change patient's digestion, said method comprising the steps of:
-the support per os is placed to the active adjustment valve fluid at primary importance place on the flow channel that is positioned at gallbladder pancreatic juice is communicated with;
-the pH sensor is connected to the position of gastric; And
-support is anchored in the gastrointestinal part, thus support increased for the resistance that acts on the peristaltic forces on the support.
Description of drawings
By accompanying drawing and explanation thereof, it is obvious that these and other objects of the present invention and advantage will become, described accompanying drawing and explanation thereof show embodiments of the invention, and are used for explaining principle of the present invention together with the specific embodiment of the whole embodiment that describes and hereinafter provide of the present invention that provides above.
-Fig. 1 shows the method and apparatus according to the flow velocity that is used for the gallbladder pancreatic juice in the adjusting patient body of the first embodiment of the present invention;
-Fig. 2 is the schematic cross sectional views for the bile gathering-device of the method for Fig. 1;
-Fig. 3 shows the method and apparatus of the flow velocity that is used for the gallbladder pancreatic juice in the adjusting patient body according to a second embodiment of the present invention;
-Fig. 4 shows the apparatus and method that are used for the bile gathering-device is anchored at gastrointestinal tract of a third embodiment in accordance with the invention;
-Fig. 5 shows the apparatus and method that are used for the bile gathering-device is anchored at gastrointestinal tract of a fourth embodiment in accordance with the invention;
-Fig. 6 shows the apparatus and method that are used for the bile gathering-device is anchored at gastrointestinal tract according to a fifth embodiment of the invention;
-Fig. 7 shows the apparatus and method that are used for the bile gathering-device is anchored at gastrointestinal tract according to a sixth embodiment of the invention;
-Fig. 8 and 8A show the apparatus and method that are used for the bile gathering-device is anchored at gastrointestinal tract according to a seventh embodiment of the invention;
-Fig. 9,9A to 9C show the apparatus and method step that is used for the bile gathering-device is anchored at gastrointestinal tract according to the eighth embodiment of the present invention;
-Figure 10 shows the body fluid reservoir bag that has according to an embodiment of the invention the ACTIVE CONTROL valve;
-Figure 11 and 12 is the schematic diagram of the control system of regulating system according to an embodiment of the invention;
-Figure 13 and 14 is the schematic cross sectional views of control valve device according to an embodiment of the invention;
The specific embodiment
Referring to accompanying drawing, the wherein similarly similar anatomical structure of digitized representation and parts in some views, Fig. 1 is the partial view in patient's abdominal cavity, show have esophagus 1, the gastrointestinal tract of stomach 2, duodenum 3, jejunum 4, ileum 5, colon 6 and have liver, comprise gallbladder 8 biliary system 7, ductus pancreaticus 9 and the ampulla of vater major duodenal papilla 10 (bile and pancreatic juice pass it and normally enters duodenum 3) liver and gall and be used for regulating the system 11 that body fluid distributes.
According to embodiment, system 11 comprises flow rate regulating valve 12 and physiological property sensing apparatus 13, described flow rate regulating valve 12 can be placed in the flow channel of body fluid, described physiological property sensing apparatus 13 is with control valve 12 signal communication and can generate control signal 14 according to physiological property, and wherein control valve 12 responsive control signals 14 change the flow velocity of body fluid.
According to an aspect of the present invention, body fluid can be bile and or pancreatic juice, and physiological property can be pH value or pH changing value and/or temperature value or the temperature change value of the fluid (for example gastric content) in the part of health.
The detailed description of the embodiment of physiological property sensing apparatus
In the exemplary embodiment, physiological property sensing apparatus 13 can comprise pH sensor 18, described pH sensor 18 can be placed and be anchored in the patient body, especially in stomach 2, and can according to the pH value of gastric content or pH changing value generate pH control signal 14 and with pH control signal 14 directly be transferred to control valve 12 with set controller 15 or be transferred to alternatively remote control unit 16.
Physiological property sensing apparatus 13 also can comprise temperature sensor 19 (it can mechanically separate or mechanically be connected with pH sensor 18), described temperature sensor 19 can be placed and be anchored in the patient body, especially in stomach 2, and can according to the temperature of gastric content or variations in temperature generate temperature control signals and with temperature control signals 14 directly be transferred to control valve 12 with set controller 15 or be transferred to alternatively remote control unit 16.
Can provide radio-signal transmitter 20 to be used for wireless transmission control signal 14 at physiological property sensing apparatus 13.
According to embodiment, physiological property sensing apparatus 13 comprises for generating for sensing function and control signal and transmission provides the chargeable with live pond 21 of energy, and comprise wireless with live electrolytic battery charger 22, for example, ultrasound wave or magnetic field impulse are converted to the ultrasonic or induction electricity charger of electric energy so that battery 21 is recharged.
As limiting examples, physiological property sensing apparatus 13 can comprise the Bravo that can derive from Medtronic Functional Diagnostics (Minneapolis, Minnesota, USA)
Wireless pH capsule sensor.
Physiological property sensing apparatus 13 preferably is attached in single per os or the per nasal plug-in type capsule, described capsule be connected to distally esophagus or coat of the stomach and with the pH data communication device cross radiotelemetry be transferred to remote control unit 16 or directly be transferred to control valve 12 with set controller 15.
Sensing apparatus 13 capsules can be connected to the end of delivery catheter and pass mouthful or nose until it arrives desired locations, about 6cm place above the Z line that endoscope measures for example.After the location, sensing apparatus 13 permanently or temporarily is connected to esophagus or coat of the stomach.Then remove delivery catheter.When the patient is calm during splanchnoscopy or when the patient is clear-headed after esophageal manometry, can carry out oral inserting.
By drawing with regard to sensing apparatus 13 provisional fixing, it is similar to the fixing of above-mentioned BRAVO pH probe with regard to for example, but the latter need to and will not descend within the time period of 7 to 14 days scopes and be sent in the feces with the live electrolytic battery charger.Sensing apparatus 13 can maybe cannot reclaim and re-use.
In addition, physiological property sensing apparatus 13 can be attached in the capsule, described capsule can be swallowed and has a mating interface for the capsule acquisition equipment that automatically is docked to previous implantation according to the mode that is similar to pill.The possible embodiment of mating interface and capsule acquisition equipment has disclosed in for example U.S. Patent application US 2010/0063486, US 2010/0056874, US 2010/0049120, US2010/0049012, US 2009/0306632, and these patent applications relate to diagnostic pill capture systems and their full content all is incorporated herein by reference.
With regard to sensing apparatus 13 permanent fixing, but should be wireless recharging with the live pond.
In one embodiment, physiological property sensing apparatus 13 can be constructed to dental implants and can sensing patient's oral cavity in pH value or pH changing value.This embodiment provides simple implantation, maintenance and the replacing of sensing apparatus, and need not any surgical operation or endoscopic surgery.
The detailed description of the embodiment of control valve
In the exemplary embodiment of Figure 13, control valve 12 is globe valve, and described globe valve has the inside component of the strobe 28 that can discharge respectively and block fluid passage 27.
Figure 14 shows alternative embodiment, and wherein control valve 12 comprises elastic fluid channel 27 and can discharge respectively external gate member 29 with the elastic part of compression fluid passage 27.
It is mobile substantially without resistance that two illustrated embodiment of this of control valve 12 all allow body fluid to open in the configuration at it, and this controlled discharging for bile and pancreatic juice is essential, because their natural secretions is in the situation that do not exist remarkable pressure to produce.
The detailed description of the embodiment of system controller
According to embodiment, remote control unit 16 have sensor control signal receptor 23, program control signal resolution unit 24 (as, microprocessor) and valve control signal emitter 25, and can from pH sensor 13 reception control signals 14 and can according to the valve control sequence the control signal 14 that receives and the memorizer that is loaded into signal resolution unit 24 generate valve control signal 17, and valve control signal 14 can be transferred to control valve 12 with set controller 15.
In the situation that control signal 14 directly is transferred to control valve 12 from sensing apparatus 13, valve 12 can have control signal receptor 30 and program control signal resolution unit 31 with set controller 15, microprocessor for example, and can come starter gate valve actuator 26 from pH sensor 13 reception control signals 14 and according to the valve control sequence the control signal 14 that receives and the memorizer that is loaded into signal resolution unit 31.
Usually, can be from providing physiological property (for example with carrying formula valve control 15 or remote control unit 16, pH and/or the temperature of the content of patient's stomach 2) sensing apparatus 13 reception control signals 14, and operable valve actuator 26 is to adjust the flow section of fluid passage 27.
In one exemplary embodiment, be configured with program control with the signal resolution unit that carries formula valve control 15 or remote control unit 16 and measured physiological property value compared with the desired value of being scheduled to being used for.For example, if sensor device comprises pH sensor or temperature sensor, then signal resolution unit 24,31 pH that sensor device 13 can be detected or temperature and predetermined target pH or temperature compare.
In order to be conducive to comparison, can be constructed to receive the input signal of expression desired value with the signal resolution unit that carries formula valve control 15 or remote control unit 16.Except numerical value relatively, can be by program control variation for calculating physiological property according to a series of control signals that receive subsequently 14 and temporal information with the signal resolution unit that carries formula valve control 15 or remote control unit 16.
Also can be by fluid passage 27 flow sections of program control expectation for calculating control valve 12 to realize the target flow velocity of body fluid with the signal resolution unit that carries formula valve control 15 or remote control unit 16.
Be used for the distribution of adjusting body fluid and the system 11 of flow velocity and also can comprise outside program control device 32, described outside program control device 32 be communicated with the signal resolution unit 24,31 that carries formula valve control 15 or remote control unit 16 and can be incorporated in the external remote control unit 16.
Usually, program control device 32 can comprise user interface, and described user interface allows the operator to input one or more instruction to be sent to the signal resolution unit 24,31 that carries formula valve control 15 or remote control unit 16.For example, outside program control device 32 can change the pH of expression patient's gastric content or the bile hang-over delay of the signal of the predetermined target value of temperature and the expectation of expression for flowing through gastrointestinal food or bile discharge the signal of pre-set time and is transferred to signal resolution unit 24,31.Outside program control device 32 can comprise for the display element that information is sent (for example predetermined body fluid distributes the parameter of regulation scheme, the physiological property of measurement, low electric weight caution) to the user.
As previously mentioned, according to exemplary embodiment, implanted physiological property sensing apparatus 13, valve control 15, remote control unit 16 (if providing) and outside program control device 32 can be constructed to communicate by letter by radio frequency (RF).For this purpose, sensing apparatus 13, valve control 15, remote control unit 16 (if providing) and outside program control device 32 can comprise and can be constructed at the signal projector that sends to each other and/or receive signal and receptor or antenna.This communication allows the Noninvasive control of governor valve actuator 26.Antenna can have multiple structure, and can be arranged on a plurality of positions in the system 11.For example, in one exemplary embodiment, controller 15 and relative antenna all can be arranged on the implanted control valve 12.In another embodiment, controller 15 can be included in the implanted control valve 12, and antenna can be disposed on the independent implant.In another exemplary embodiment, external control unit 16 all can be arranged to control valve 12 with relative antenna and separate.
In one embodiment, valve control 15 or remote control unit 16 are configured with program control and come operating valve actuator 26 to close control valve 12 with response pH variation control signal 14, described pH changes control signal indication food and is introduced in the stomach 2, thereby bile and/or pancreatic juice accumulated in the flow channel and does not flow into digestive tract (this moment, food was distad walked in the small intestinal).
In another embodiment, valve control 15 or remote control unit 16 can be configured with program control and come operating valve actuator 26 to open control valve 12 with response pH variation control signal 14, described pH changes control signal indication food and has left stomach 2 and further be sent to gastral more distally, thereby after the specific time delay of walking from stomach with respect to food the small intestinal bile and/or pancreatic juice is assigned in the digestive tract.
In another exemplary embodiment, valve control 15 or remote control unit 16 can be configured with program control and compare to identify food with the reference value with pH and/or temperature control signals 14 or signal 14 sequences and storage and entered time point in the stomach 2 and food have been walked enteral from stomach 2 time point.
In addition, valve control 15 or remote control unit 16 can be configured and the time reference curve of the program control time point that enters intestinal with the time point that enters stomach according to food and food and storage or reference value extrapolate food or the position of chyme stream in gastrointestinal tract.
With carry formula valve control 15 or remote control unit 16 can by program control with according to food in gastrointestinal tract the position and food be sent to as in the jejunum and distribute between the gallbladder pancreatic juice preset pre-set time the interval and/or delay time lag activate to open and/or close and/or regulate the flow section of control valve 12.
The advantageous effects of weight saving and control diabetes can proofread and correct and can obtain according to unique physiological condition of patient to described flow adjustment method and apparatus.
According to embodiment, system 11 can comprise bile gathering-device 33 or support, described bile gathering-device 33 and support can be anchored in the small intestinal, especially the gallbladder pancreatic juice in duodenum 3 enters papilla of Vater 10 places of intestinal usually, and can capture gallbladder pancreatic juice and it is directed in the fluid passage 27 of control valve 12.
The detailed description of the embodiment of bile gathering-device
In the exemplary embodiment, bile gathering-device 33 comprises tubulose passage of food groove 34 and the open bile collecting chamber 37 of side direction, described tubulose passage of food groove 34 has the preferred infundibulate proximal open end 35 that can admit the food stream that transmits by enterokinesia and the preferred infundibulate distal open end 36 that food distad can be discharged into enteral from groove 34, and the open bile collecting chamber 37 of described side direction is with 34 isolation of passage of food groove and can limit with the adjacent part of intestinal wall the basically bile collecting chamber 38 of sealing.
According to exemplary, the non-limiting example shown in Fig. 1 and 2, bile collecting chamber 37 comprises the radially outer annular chamber, and described radially outer annular chamber is around 34 formation of passage of food groove and set boundaries by radially outstanding nearside tube chamber hermetic unit 39 and distally tube chamber hermetic unit 40 in the axial direction.
Tube chamber hermetic unit 39,40 preferably can expand from initial flexible radially less configuration, so that allow with bile gathering-device 33 through the chamber (for example per os) introduce and be sent to the selected duodenum part at papilla of Vater 10 places and finish its follow-up deployment by expansion tube cavity hermetic unit 39,40.
For this reason, tube chamber hermetic unit 39,40 can comprise inflatable sacculus sections, and described inflatable sacculus sections can permanently expand by injecting expansion fluid (for example saline solution) or setting expansion agent (for example hardening polymer foam or paste).
According to embodiment, nearside tube chamber hermetic unit 39 also can limit bile access opening 41, described bile access opening 41 passes into bile collecting chamber 37 and leads to bile conduit 42, conduit for example, described bile conduit 42 can be connected with for generation of with food and chyme isolation and also with the bile flow passage of intestinal wall isolation.
In the exemplary embodiment, bile conduit 42 is included in the flexible pipe that extends between proximal open end and the distal open end, wherein proximal open end is connected with the internal flow of bile collecting chamber 37, and distal open end can be positioned in the more enteral in distally of bile gathering-device 33, as illustrated in fig. 1 and 2.
In the exemplary embodiment, control valve 12 can be placed near the distal open end of bile conduit 42, thereby the extra bile accumulation space that is positioned at bile conduit 42 is provided.In alternative exemplary embodiment, control valve 12 can be placed near the proximal open end of bile conduit 42 or in its center.
In view of the above-mentioned feature of bile gathering-device 33, make in the situation that do not have chyme contact and in the situation with the extremely meticulous biliary system 7 of conduit contact not, collect gallbladder pancreatic juice and become possibility.
The embodiment that sees figures.1.and.2, bile collecting chamber 38 produces by following manner: lower to bile gathering-device 33 (still being in its initially flexible configuration) and the position of bile conduit 42 (if providing) oral delivery that is connected to the ampulla of vater 10 assisting of endoscope, dispose bile gathering-device 33 by its tube chamber hermetic unit 39,40 that expands subsequently.
In another exemplary embodiment, the bile gathering-device can comprise the support of type described in the U.S. Patent application 2009/0062717 of Laufer, and the content of this patent application is incorporated herein by reference.
According to alternative embodiment shown in Figure 10, the system that is used for the distribution of adjusting body fluid 11 can comprise reservoir bag 59, biliary drainage catheter 60, and bile distribution ducts 61, described reservoir bag 59 is used for building up and keeping gallbladder pancreatic juice, described biliary drainage catheter 60 can be the pin of introducing common bile duct 7 and the proximal open end in can being fixed on biliary system 7 and with distal open end that the nearside ingate of reservoir bag 59 is connected between extend, so that bile is directly drained into the reservoir bag 59 from biliary system, described bile distribution ducts 61 is connected the distally outlet opening of reservoir bag 59 with control valve 12 and (if providing) body fluid pumping system.
According to exemplary embodiment, reservoir bag 59 can comprise the inflatable sacculus, so that bile can enter in it and it is expanded for storing until when needing (, until start by the pH control valve divide timing).Sacculus self can be processed by PET.
According to another embodiment again, reservoir bag 59 can comprise that rigidity outer wall 62 is to serve as the protector for the inflatable inwall 63 of the flexibility that limits the bile storage area.
According to another embodiment, body fluid is discharged overflow valve or is discharged flood pump and can be provided and be integrated into possibly in the control valve 12, and can allow the part of the body fluid of building up to be discharged to enteral when reaching maximum body fluid storage volume.
The detailed description of embodiment that is used for the anchor of bile gathering-device and control valve
According to another aspect of the present invention, system 11 can be included in the first sleeve pipe 43 (being shown among Fig. 1) that extends between infundibulate proximal open end 44 and the distal open end 45, described infundibulate proximal open end 44 can for example be anchored in the stomach 2 by being connected with the suitable shape of pylorus, and described distal open end 45 is connected to the proximal aperture 35 of bile gathering-device 33.But the first sleeve pipe 43 anchoring bile gathering-devices 33 to be resisting preferably peristaltic forces, and can collect the food that is contained in the stomach 2 and it is directed in the passage of food groove 34 and does not contact intestinal wall.
In exemplary non-limiting example, the second sleeve pipe 64 can distad extend from the distal open end 36 of bile gathering-device 33, with food and the intestinal wall isolation with chyme or part digestion, and bile conduit 42 conduits can be with gallbladder pancreatic juice and intestinal wall and chyme isolation (contrast Fig. 2) simultaneously.
Alternatively or in addition, for resistant function is installing 33,42,12 peristaltic forces, can for example by stomach coil 46 these devices be anchored in the gastrointestinal tract, described stomach coil 46 can be from extended configuration (its per os or per nasal can be sent in the stomach 2) strain for screwing arc or circular in configuration (can fit that shape ground engages stomach 2 in order to provide anchoring to the anchor line of the near-end that is connected to bile gathering-device 33) (Fig. 3).
In one embodiment, physiological property sensing apparatus 13 can be contained in the stomach coil 46 or be connected to stomach coil 46, can be fixed on reliably in the stomach 2 thus.
In another exemplary embodiment shown in Figure 4, can for example anchor line 47 be connected to the folding folds in a garment 48 that before in coat of the stomach, forms by T shape hoop.
In another exemplary embodiment shown in Figure 5, can bile gathering-device 33 be anchored to intestinal wall by being with 49 under the mucosa, be with 49 to be inserted in the wall of the lumen and Perfect Ring extends around it under the described mucosa, for example form the anchoring ring in intestinal wall, to produce bottleneck portion, described bottleneck portion can engage at least one the interior corresponding ring-type anchoring groove 50 in the tube chamber hermetic unit 39,40 that is formed at bile gathering-device 33.
Fig. 6 shows and another exemplary embodiment, but wherein can bile gathering-device 33 be anchored in the gastrointestinal tract by rami gastrici frame 51 and the elastic expansion that is connected formula (possibly shape memory) bow 52, and described bow 52 can form suitable shape with stomach 2 and be connected.
Fig. 7 shows another exemplary embodiment, wherein can bile gathering-device 33 be anchored in the gastrointestinal tract by T shape hoop 53, and described T shape hoop 53 hits from enteral and delivers to the intestinal wall, thereby forms fixing point and be connected with the near-end of bile gathering-device 33.
Fig. 8 and 8A show another exemplary embodiment, wherein can bile gathering-device 33 be anchored in the gastrointestinal tract by the ring-type anchor part 54 with a plurality of anchoring barbs 55, described barb 55 can move from resting position (as, rotation) to the operating position, barb 55 transmits with the unobstructed intracavity that allows device 33 in described resting position is contained in the scope of anchorage part 54, barb 55 radially outward protrudes in described operating position, thereby pierces through wall of the lumen and thereby will install 33 and anchor to wall of the lumen.
In another exemplary embodiment shown in Fig. 9-9C, can bile gathering-device 33 be anchored in the gastrointestinal tract by the tubulose anchorage part 56 with one or more anchor hole 57, described anchor hole 57 is intended to towards the intestinal wall part, and can allow these intestinal wall partly are pulled in the hole 57 and with it and fix.Can be provided for from tubulose anchorage part 56 interior suction lumen wall parts and with its be pulled in the anchor hole 57 intracavity aspirator 58 and for generation of permanent (mushroom-head) swelling of wall of the lumen part, with the apparatus and method that prevent that it from withdrawing from from anchor hole 57.Can comprise and will be injected under extender or the sclerosing agent mucosa or with the plasticity pearl for generation of the such device of the permanent swelling of wall of the lumen part and method, for example poly-(methyl methacrylate) (PMMA) had been inserted into previous tractive and passed in the tissue part of anchor hole 57.
Although described the preferred embodiments of the present invention in detail, applicant's purpose is not that the scope with claim is limited to these specific embodiments, but covers within the scope of the invention all modifications form and alternate configuration.
Claims (31)
1. one kind is used for regulating the system (11) that body fluid distributes, described system (11) comprises control valve (12) and physiological property sensing apparatus (13), described control valve (12) can be placed in the flow channel of body fluid, described physiological property sensing apparatus (13) is with described control valve (12) signal communication and can generate control signal (14) according to physiological property, and wherein said control valve (12) can respond the flow velocity that described control signal (14) changes described body fluid.
2. system according to claim 1 (11), wherein said physiological property sensing apparatus (13) comprises pH sensor (18), described pH sensor (18) can be placed and be anchored in patient's the stomach (2), and can generate pH control signal (14) according to the pH value of gastric content, and described pH control signal (14) is transferred to the controller (15 of described control valve (12); 16).
3. system according to claim 1 and 2 (11), wherein said physiological property sensing apparatus (13) comprises temperature sensor (19), described temperature sensor (19) can be placed and be anchored in the stomach (2), and can generate temperature control signals according to the temperature of gastric content, and described temperature control signals directly is transferred to the controller (15 of described control valve (12); 16).
4. according to each described system (11) in the aforementioned claim, comprise radio-signal transmitter (20), described radio-signal transmitter (20) can be arranged on the described physiological property sensing apparatus (13), to be used for the wireless transmission of described control signal (14).
5. according to each described system (11) in the aforementioned claim, wherein said physiological property sensing apparatus (13) comprising:
-be used for to described sensing function and the generation of described control signal and transmit providing the chargeable with live pond (21) of energy,
-wireless with live electrolytic battery charger (22).
6. according to each described system (11) in the aforementioned claim, wherein said physiological property sensing apparatus (13) is bonded in the single per os plug-in type capsule.
7. system according to claim 6 (11), comprise the capsule acquisition equipment, described capsule acquisition equipment can be anchored in the esophageal-gastric tube chamber and have capsule catches interface, and described capsule is caught interface can optionally catch, keeps and discharge described sensing apparatus (13) capsule.
8. system according to claim 1 (11), wherein said physiological property sensing apparatus (13) is constructed to dental implants and can the intraoral pH value of sensing patient.
9. system according to claim 1 (11), wherein said control valve (12) comprises with carrying formula valve control (15), valve actuator (26) by described valve control (15) control, fluid passage (27), and component of the strobe (28), described component of the strobe (28) acts on described fluid passage (27) upward and can move between open position and closed position by described valve actuator (26), described component of the strobe (28) discharges described fluid passage (27) at described open position, so that body fluid can freely flow through described fluid passage (27), described component of the strobe (28) engages described fluid passage (27) in described closed position, thereby described fluid passage (27) are closed.
10. system according to claim 9 (11), the comprising with set controller (15) of wherein said control valve (12):
-control signal receptor (30), described control signal receptor (30) can receive described control signal (14) from described sensing apparatus (13);
-having the program control signal resolution unit (31) of memorizer and microprocessor, described program control signal resolution unit (31) can start described valve actuator (26) according to received control signal (14) and the valve control sequence that is loaded in the described memorizer.
11. system according to claim 1 (11) comprises remote control unit (16), described remote control unit (16) has:
-control signal receptor (23), described control signal receptor (23) can receive described control signal (14) from described sensing apparatus (13);
-having the program control signal resolution unit (24) of memorizer and microprocessor, described program control signal resolution unit (24) can generate valve control signal (17) according to received control signal (14) and the valve control sequence that is loaded in the described memorizer;
-valve control signal emitter (25), described valve control signal emitter (25) described valve control signal (14) can be transferred to described control valve (12) with set controller (15).
12. according to claim 10 or 11 described system (11), wherein said signal resolution unit (15; 16) be configured and by program control for:
-measured physiological property value and predetermined target value compared;
-the variation of calculating described physiological property according to a series of control signals that receive subsequently (14) and temporal information.
13. according to each described system (11) in the aforementioned claim, wherein valve control (15; 16) be configured and by program control for:
-response pH changes control signal (14) and comes operating valve actuator (26) to close described control valve (12), and described pH changes control signal indication food and is introduced in the stomach (2),
-response pH changes control signal (14) and comes operating valve actuator (26) to open described control valve (12) after the time delay of setting, and described pH changes control signal indication food and left stomach (2) and be sent to described gastral more distally.
14. according to each described system (11) in the aforementioned claim, wherein valve control (15; 16) be configured and by program control for:
-reference value of physiological property control signal (14) sequence and storage is compared to calculate food entered the time point of stomach (2) and food has been walked enteral from stomach (2) time point;
-time reference the value that enters the time point of stomach (2) and time point that food enters intestinal and storage according to food extrapolate food or the position of chyme stream in gastrointestinal tract;
-according to the food position in the gastrointestinal tract and food transmit and gallbladder pancreatic juice between distributing preset pre-set time the interval and delay time lag start the valve actuator (26) of described control valve (12), to regulate flow section.
15. according to each described system (11) in the aforementioned claim, comprise bile gathering-device (33), described bile gathering-device (33) can be located to be anchored in the small intestinal and can capture gallbladder pancreatic juice and it is directed in the fluid passage (27) of described control valve (12) at weary Te Shi nipple (10).
16. system according to claim 15 (11), wherein said bile gathering-device (33) comprising:
-tubulose passage of food groove (34), described tubulose passage of food groove (34) have the proximal open end (35) that can admit food stream and the distal open end (36) that food distad can be discharged into enteral from groove (34);
The open bile collecting chamber of-side direction (37), the open bile collecting chamber of described side direction (37) is with described passage of food groove (34) isolation and can limit with the adjacent part of intestinal wall the bile collecting chamber (38) of sealing,
Described control valve (12) is connected with described bile collecting chamber (37) fluid.
17. system according to claim 16 (11), wherein said bile gathering-device (33) comprises nearside tube chamber hermetic unit (39) and the distally tube chamber hermetic unit (40) that can expand from the radially less configuration of initial contraction, and described nearside tube chamber hermetic unit (39) and distally tube chamber hermetic unit (40) comprise can pass through injection expansion fluid or setting expansion agent and the inflatable sacculus sections of permanent expansion.
18. system according to claim 16 (11), comprise bile conduit (42), described bile conduit (42) has the flexible pipe that proximal open end and distal open end and between are extended, wherein said proximal open end is connected with the internal flow of the bile collecting chamber (37) of described bile gathering-device (33) and described distal open end can be positioned at described bile gathering-device (33) than the enteral in distally, and described control valve (12) is arranged in the bile flow velocity that therefrom passes with control in the described bile conduit (42).
19. system according to claim 1 (11) comprising:
-for the reservoir bag (59) of building up and keep gallbladder pancreatic juice;
-biliary drainage catheter (60), described biliary drainage catheter (60) for introduce pin in the described biliary system (7) and the proximal open end in can being fixed to described biliary system (11) and with distal open end that the nearside ingate of described reservoir bag (59) is connected between extend;
-bile distribution ducts (61), described bile distribution ducts (61) is connected the distally outlet opening of described reservoir bag (59) with described control valve (12).
20. system according to claim 19 (11), wherein said reservoir bag (59) comprises the inflatable sacculus, so that bile can be discharged in the described sacculus and make described inflation for storage.
21. system according to claim 15 (11), comprise the first sleeve pipe (43), described the first sleeve pipe (43) extends between infundibulate proximal open end (44) and distal open end (45), described infundibulate proximal open end (44) can be anchored in the stomach (2), described distal open end (45) is connected to the proximal aperture (35) of described bile gathering-device (33), and described the first sleeve pipe (43) can be anchored at described bile gathering-device (33) in the gastrointestinal tract and can collect the food that is contained in the stomach (2) and it is directed in the described passage of food groove (34) and does not contact with described intestinal wall.
22. according to claim 15 or 21 described systems (11), comprise the second sleeve pipe (64), described the second sleeve pipe (64) distad extends from the distal open end (36) of described bile gathering-device (33), with food and the isolation of described intestinal wall of partly digestion.
23. system according to claim 15 (11) comprises that described anchor is selected from for the anchor that described bile gathering-device (33) is anchored at gastrointestinal tract:
-stomach coil (46), described stomach coil (46) can be from being sent to the screw arcuate configuration of the interior extended configuration strain of stomach (2) for being connected with the suitable shape of stomach (2) with its per os or per nasal;
-anchor line (47), described anchor line (47) have T shape hoop connector to be used for being fixed to the folding folds in a garment (48) of coat of the stomach;
Band (49) and ring-type anchoring groove (50) under-the mucosa, band (49) can insert in the intestinal wall to form the anchoring ring under the described mucosa, and described ring-type anchoring groove (50) is formed in the described bile gathering-device (33) and can engages described anchoring ring;
-T shape hoop anchoring body (53), described T shape hoop anchoring body (53) can hit from enteral and deliver to the intestinal wall to form fixing point, and described T shape hoop anchoring body (53) can be connected with the near-end of described bile gathering-device (33);
-ring-type anchorage part (54), described ring-type anchorage part (54) has a plurality of anchoring barbs (55), described barb (55) can move to the operating position from resting position, be contained in the scope of described anchorage part (54) at the described barb of described resting position (55), radially outward protrude at the described barb in described operating position (55);
-tubulose anchorage part (56) thereby and prevent the device that it withdraws from from anchor hole (57) for generation of the permanent mushroom head swollen body of wall of the lumen part is swollen, described tubulose anchorage part (56) has one or more described anchor hole (57), and one or more described anchor hole (57) is intended to towards intestinal wall part and can allows these intestinal wall partly are pulled in the described hole (57) and with it fix.
24. one kind is used for regulating the method that body fluid distributes, said method comprising the steps of:
-control valve (12) is placed on the primary importance place in the flow channel of the body fluid in the patient body; And
-with physiological property sensing apparatus (13) placement second position place in vivo; And
Physiological property in the described second position of-sensing; And
-generate control signal (14) according to the physiological property of institute's sensing; And
-described control signal (14) is provided to described control valve (12) to regulate the flow velocity of body fluid.
25. method according to claim 1 may further comprise the steps:
-active adjustment valve (12) is placed in the flow channel of gallbladder pancreatic juice;
-pH sensor device (13) is placed in patient's the stomach (2);
The pH of-sensing gastric content;
-generate control signal (14) according to the pH of institute's sensing;
-described control signal (14) is sent to described valve (12);
-start described valve (12) to regulate the flow velocity of gallbladder pancreatic juice according to the information that is included in the described control signal.
26. method according to claim 25 may further comprise the steps:
-bile gathering-device (33) per os that will be communicated with active adjustment valve (12) fluid is placed on the primary importance place on the flow channel of gallbladder pancreatic juice;
-pH sensing apparatus (13) is connected to the interior position of stomach (2); And
-described bile gathering-device (33) is anchored in the gastrointestinal part.
27. method according to claim 25 may further comprise the steps:
-described pH sensing apparatus (13) is attached in the single capsule;
-described pH sensing apparatus (13) capsule is connected to the terminal of delivery catheter and it is passed mouthful or nose until it arrives the desired locations in the esophagus gastral cavity;
-described sensing apparatus (13) capsule is fixed to the esophagus coat of the stomach;
-remove delivery catheter.
28. method according to claim 27, the step that wherein described sensing apparatus (13) capsule is fixed to the esophagus coat of the stomach comprises by aspirating temporary fixed step.
29. method according to claim 25 may further comprise the steps:
-described physiological property sensing apparatus (13) is attached in the single capsule that can swallow;
-the capsule acquisition equipment is implanted in patient's the stomach (2);
-swallow described physiological property sensing apparatus (13) capsule;
-make described sensing apparatus (13) capsule be docked to described capsule acquisition equipment;
-after the seclected time interval, discharge described sensing apparatus (13) capsule from described capsule acquisition equipment.
30. method according to claim 25 comprises the step that produces in the following manner bile collecting chamber (38):
-the position of the ampulla of vater (10) of bile gathering-device (33) oral delivery in the small intestinal that under endoscope auxiliary, will have an inflatable tube chamber hermetic unit (39,40),
-be close to intestinal wall and dispose described bile gathering-device (33) by tube chamber hermetic unit (39,40) is expanded to subsequently.
31. method according to claim 25 may further comprise the steps:
-measured physiological property value and predetermined target value compared;
-response pH changes control signal (14) and comes operating valve actuator (26) to close described control valve (12), and described pH changes control signal indication food and is introduced in the stomach (2);
-response pH changes control signal (14) and comes operating valve actuator (26) to open described control valve (12) after the time delay of setting, and described pH changes control signal indication food and left stomach (2) and be sent to gastral more distally.
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| PCT/EP2010/060273 WO2012007046A1 (en) | 2010-07-16 | 2010-07-16 | A system regulating the dispensing of a body fluid |
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| Publication Number | Publication Date |
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| CN103002839A true CN103002839A (en) | 2013-03-27 |
| CN103002839B CN103002839B (en) | 2015-11-25 |
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| CN201080068040.XA Active CN103002839B (en) | 2010-07-16 | 2010-07-16 | Regulate the system that body fluid distributes |
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| CN (1) | CN103002839B (en) |
| WO (1) | WO2012007046A1 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104826217A (en) * | 2015-05-11 | 2015-08-12 | 大连大学 | Bile and pancreatic juice drainage tube |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| EP3736003A1 (en) | 2013-05-07 | 2020-11-11 | Sanofi-Aventis Deutschland GmbH | An injection device |
Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20050043817A1 (en) * | 2003-08-20 | 2005-02-24 | Mckenna Robert Hugh | Method and apparatus to facilitate nutritional malabsorption |
| US20050273060A1 (en) * | 2004-06-03 | 2005-12-08 | Mayo Foundation For Medical Education And Research | Obesity treatment and device |
| US20090062717A1 (en) * | 2006-03-02 | 2009-03-05 | Laufer Michael D | Gastrointestinal implant and methods for use |
| EP2074971A1 (en) * | 2007-12-27 | 2009-07-01 | Ethicon Endo-Surgery, Inc. | Fluid logic for regulating restriction devices |
| EP2095796A1 (en) * | 2008-02-26 | 2009-09-02 | Ethicon Endo-Surgery, Inc. | Controlling pressure in adjustable restriction device |
| CN101536938A (en) * | 2008-01-29 | 2009-09-23 | 伊西康内外科公司 | Sensor trigger |
Family Cites Families (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8597278B2 (en) | 2006-06-23 | 2013-12-03 | MEDIMETRICS Personalized Drug Delivery B.V. | Medicament delivery system and process |
| JP5331975B2 (en) | 2006-09-25 | 2013-10-30 | コーニンクレッカ フィリップス エヌ ヴェ | Drug delivery device |
| JP5528810B2 (en) | 2006-10-31 | 2014-06-25 | コーニンクレッカ フィリップス エヌ ヴェ | Swallowable multi-nozzle dosing device for releasing drugs in the digestive tract |
| US9878094B2 (en) | 2006-11-21 | 2018-01-30 | Stoco 10 GmbH | Medicament delivery device, capsule and in vivo medicine delivery or diagnostic system |
| CN101541237A (en) | 2006-11-21 | 2009-09-23 | 皇家飞利浦电子股份有限公司 | Ingestible electronic capsule and in vivo drug delivery or diagnostic system |
-
2010
- 2010-07-16 CN CN201080068040.XA patent/CN103002839B/en active Active
- 2010-07-16 WO PCT/EP2010/060273 patent/WO2012007046A1/en active Application Filing
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20050043817A1 (en) * | 2003-08-20 | 2005-02-24 | Mckenna Robert Hugh | Method and apparatus to facilitate nutritional malabsorption |
| US20050273060A1 (en) * | 2004-06-03 | 2005-12-08 | Mayo Foundation For Medical Education And Research | Obesity treatment and device |
| US20090062717A1 (en) * | 2006-03-02 | 2009-03-05 | Laufer Michael D | Gastrointestinal implant and methods for use |
| EP2074971A1 (en) * | 2007-12-27 | 2009-07-01 | Ethicon Endo-Surgery, Inc. | Fluid logic for regulating restriction devices |
| CN101536938A (en) * | 2008-01-29 | 2009-09-23 | 伊西康内外科公司 | Sensor trigger |
| EP2095796A1 (en) * | 2008-02-26 | 2009-09-02 | Ethicon Endo-Surgery, Inc. | Controlling pressure in adjustable restriction device |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104826217A (en) * | 2015-05-11 | 2015-08-12 | 大连大学 | Bile and pancreatic juice drainage tube |
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|---|---|
| CN103002839B (en) | 2015-11-25 |
| WO2012007046A1 (en) | 2012-01-19 |
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