CN103501735B - 用于造口的医疗装置 - Google Patents
用于造口的医疗装置 Download PDFInfo
- Publication number
- CN103501735B CN103501735B CN201280021901.8A CN201280021901A CN103501735B CN 103501735 B CN103501735 B CN 103501735B CN 201280021901 A CN201280021901 A CN 201280021901A CN 103501735 B CN103501735 B CN 103501735B
- Authority
- CN
- China
- Prior art keywords
- proximal
- portions
- distal part
- devices
- intestines
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
- 210000000936 intestine Anatomy 0.000 claims abstract description 64
- 210000002784 stomach Anatomy 0.000 claims abstract description 22
- 230000008961 swelling Effects 0.000 claims abstract description 14
- 239000000463 material Substances 0.000 claims description 25
- 238000005452 bending Methods 0.000 claims description 15
- 230000007246 mechanism Effects 0.000 claims description 11
- 206010016717 Fistula Diseases 0.000 claims description 10
- 230000003890 fistula Effects 0.000 claims description 10
- 230000000968 intestinal effect Effects 0.000 claims description 9
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 claims description 7
- 230000007704 transition Effects 0.000 claims description 7
- 229910001000 nickel titanium Inorganic materials 0.000 claims description 6
- 230000004888 barrier function Effects 0.000 claims description 5
- 210000001035 gastrointestinal tract Anatomy 0.000 claims description 5
- 230000006835 compression Effects 0.000 claims description 3
- 238000007906 compression Methods 0.000 claims description 3
- 229920000642 polymer Polymers 0.000 claims description 3
- 229910000831 Steel Inorganic materials 0.000 claims description 2
- 230000002787 reinforcement Effects 0.000 claims description 2
- 239000010959 steel Substances 0.000 claims description 2
- 210000000232 gallbladder Anatomy 0.000 claims 1
- 210000003200 peritoneal cavity Anatomy 0.000 claims 1
- 210000000115 thoracic cavity Anatomy 0.000 claims 1
- 210000001519 tissue Anatomy 0.000 claims 1
- 210000003932 urinary bladder Anatomy 0.000 claims 1
- 238000000034 method Methods 0.000 description 9
- 210000000056 organ Anatomy 0.000 description 9
- 238000007455 ileostomy Methods 0.000 description 5
- 230000008569 process Effects 0.000 description 5
- 230000003187 abdominal effect Effects 0.000 description 4
- 238000004873 anchoring Methods 0.000 description 3
- 230000008901 benefit Effects 0.000 description 3
- 230000000903 blocking effect Effects 0.000 description 3
- 239000011248 coating agent Substances 0.000 description 3
- 238000000576 coating method Methods 0.000 description 3
- 238000010276 construction Methods 0.000 description 3
- RVTZCBVAJQQJTK-UHFFFAOYSA-N oxygen(2-);zirconium(4+) Chemical compound [O-2].[O-2].[Zr+4] RVTZCBVAJQQJTK-UHFFFAOYSA-N 0.000 description 3
- 210000000683 abdominal cavity Anatomy 0.000 description 2
- 239000000560 biocompatible material Substances 0.000 description 2
- 208000002925 dental caries Diseases 0.000 description 2
- 230000002708 enhancing effect Effects 0.000 description 2
- 229920002313 fluoropolymer Polymers 0.000 description 2
- 239000004811 fluoropolymer Substances 0.000 description 2
- -1 polyethylene Polymers 0.000 description 2
- 208000034530 PLAA-associated neurodevelopmental disease Diseases 0.000 description 1
- 239000004698 Polyethylene Substances 0.000 description 1
- 239000004642 Polyimide Substances 0.000 description 1
- 239000004743 Polypropylene Substances 0.000 description 1
- 230000003213 activating effect Effects 0.000 description 1
- 230000000844 anti-bacterial effect Effects 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 239000003795 chemical substances by application Substances 0.000 description 1
- 229920001577 copolymer Polymers 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000007599 discharging Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 230000029142 excretion Effects 0.000 description 1
- 210000003608 fece Anatomy 0.000 description 1
- 239000010795 gaseous waste Substances 0.000 description 1
- 238000001727 in vivo Methods 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 239000002085 irritant Substances 0.000 description 1
- 231100000021 irritant Toxicity 0.000 description 1
- 210000002429 large intestine Anatomy 0.000 description 1
- 230000002045 lasting effect Effects 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 238000012423 maintenance Methods 0.000 description 1
- 230000005012 migration Effects 0.000 description 1
- 238000013508 migration Methods 0.000 description 1
- 210000003097 mucus Anatomy 0.000 description 1
- 239000010813 municipal solid waste Substances 0.000 description 1
- 229920000728 polyester Polymers 0.000 description 1
- 229920000573 polyethylene Polymers 0.000 description 1
- 229920001721 polyimide Polymers 0.000 description 1
- 229920000098 polyolefin Polymers 0.000 description 1
- 229920001155 polypropylene Polymers 0.000 description 1
- 229920001296 polysiloxane Polymers 0.000 description 1
- 229920001343 polytetrafluoroethylene Polymers 0.000 description 1
- 230000002265 prevention Effects 0.000 description 1
- 239000012779 reinforcing material Substances 0.000 description 1
- 238000007634 remodeling Methods 0.000 description 1
- 230000008439 repair process Effects 0.000 description 1
- 238000007789 sealing Methods 0.000 description 1
- 238000009958 sewing Methods 0.000 description 1
- 210000000813 small intestine Anatomy 0.000 description 1
- 239000002910 solid waste Substances 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 238000012546 transfer Methods 0.000 description 1
- 238000011144 upstream manufacturing Methods 0.000 description 1
Classifications
-
- 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
- A61F5/44—Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices
- A61F5/445—Colostomy, ileostomy or urethrostomy devices
-
- 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/0247—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
-
- 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/064—Blood vessels with special features to facilitate anastomotic coupling
-
- 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- 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
- A61F2/00—Filters 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
- A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
-
- 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
- A61F5/44—Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices
- A61F5/445—Colostomy, ileostomy or urethrostomy devices
- A61F2005/4455—Implantable
Abstract
一种装置包括:近侧部分,近侧部分适于居中地定位在中空体腔内以捕获和转移内容物;近侧部分能从初始状态膨胀至用于使近侧部分接合中空体腔内壁的膨胀状态,在初始状态,近侧部分具有初始直径,而在膨胀状态,近侧部分具有比初始直径大的直径;以及远侧部分,远侧部分连接至近侧部分,远侧部分适于延伸通过腹壁或延伸入肠子,从而将中空体腔内容物引导出近侧部分。
Description
相关申请的交叉引用
本申请要求2011年3月8日提交的美国临时申请第61/450,422号的优先权。
技术领域
本发明涉及经皮应用的装置,该装置由经历外科手术的患者使用,该外科手术会产生留在诸如肠子的中空体腔的壁内和/或在腹壁内的开口或造口。
背景技术
对于经历肠外科手术或其它手术的患者来说,为了修复或去除一段肠子,常常需要实施结肠造口术或回肠造口术。对于结肠造口术来说,将大肠通过腹壁拿出,而对于回肠造口术来说,将小肠通过腹壁拿出。在所有情况下,都形成所谓造口的开口以提供允许废弃物从患者体内排出的通道。来自患者消化系统的排泄或排放是通过腹壁中的开口或造口进行的。从腹壁突出的体管一般缝合至或以其它方式粘附至开口周围的皮肤。柔性袋子或其它接纳装置一般附连至造口以收集和保持通过造口排出的液体、固体和气态废弃物。
图1A和1B示出了一示例性的手术过程,所示为环型回肠造口术10。通过切割从腹部突出的肠环来形成造口14。肠子的上游段13通过造口清空肠子内容物。黏液瘘管11形成在肠子的下游端12,一般是当造口在位时阻止该段接纳肠子内容物。分流器15有时用在皮肤和肠环之间。
在肠子外形成造口有缺点。有时很难控制肠子内容物的流动,因此有感染和皮肤刺激的风险。附连造口术器具以用于收集肠内物质也会很困难。肠子的狭窄和脱垂是这种手术过程另外的风险。
可采取类似的手术过程以在体内连接两个中空体腔或器官,由此允许一个器官排入另一器官。例如,可在人体内的中空体腔中形成造口,从而允许体腔排入胃肠道。
发明内容
申请人已经通过提供一种装置来解决了与传统造口相关的许多缺点,可将该装置用于造口,例如无需再将肠子定位通过腹壁之外。在一示例性实施例中,本发明提供一种装置,该装置包括:近侧部分,所述近侧部分适于居中地定位在肠子、其它中空体腔或器官内以捕获和转移内容物;所述近侧部分可选地通过使用可自膨胀镍钛诺支架能从初始状态膨胀至用于使近侧部分接合肠子内壁的膨胀状态,在所述初始状态,所述近侧部分具有小于肠子直径的初始直径,以将所述近侧部分插入所述肠子,而在所述膨胀状态,所述近侧部分具有比所述初始直径大的直径;以及远侧部分,所述远侧部分连接至所述近侧部分,所述远侧部分适于延伸通过腹壁或延伸入另一中空体腔或器官,从而将内容物引导出所述近侧部分。在另一实施例中,该装置还包括阀,所述阀连接至所述远侧部分以提供自控,从而允许内容物选择性地从所述远侧部分排放。该装置可选地包括连接所述近侧部分和所述远侧部分的过渡部分。近侧部分可选地能从所述膨胀状态压缩,以用于从肠子或其它中空体腔或器官移除近侧部分。
在另外的实施例中,远侧部分具有可调整长度,该可调整长度通过压缩或通过以受控方式去除装置的部分来实现。远侧部分还可选地是波纹状的。该装置可以是柔性的、抗压坏的和抗扭折的。
在另一方面,提供一种排放中空体腔内容物的方法,包括以下步骤:(a)在胃肠道中形成切口;(b)将切口形成入中空体腔壁;(c)将根据本发明的装置插入通过所述切口;(d)将所述近侧部分定位在所述中空体腔内;(e)展开所述近侧部分以捕获和转移中空体腔内容物;以及(f)将所述远侧部分定位在所述胃肠道内,以将中空体腔内容物排放出所述近侧部分并进入胃肠道。
在另一方面,本发明提供一种将肠子内容物从肠子转移而不使肠子穿过腹部的方法,包括以下步骤:(a)通过腹壁形成切口;(b)将切口形成入肠子,而不切断肠子的全部直径;(c)将根据本发明的装置经皮地插入通过所述切口;(d)将所述近侧部分定位在肠子内;(e)展开所述近侧部分以捕获和转移肠子内容物;以及(f)将所述远侧部分定位成延伸通过腹壁,以将肠子内容物引导出所述近侧部分。可选的是,本发明包括以下步骤:将阀附连至装置以提供自控,从而允许肠子内容物选择性地从所述装置排放。另外的可选步骤包括:将肠子附连至腹部内壁以密封肠子,以及调节远侧部分的长度以考虑腹壁的厚度。本发明还替代地包括以下步骤:从肠子移除所述装置。
附图说明
图1A是根据现有技术的环型回肠造口术的侧视图。
图1B是根据现有技术的环型回肠造口术的示意侧视图。
图2是本发明一示例性实施例的侧视图。
图3是本发明另一示例性实施例的侧视图。
图4是本发明另一示例性实施例的侧视图。
图5是本发明另一示例性实施例的侧视图。
图6是本发明另一示例性实施例的侧视图。
图7是本发明另一示例性实施例的侧视图。
图8是本发明另一示例性实施例的侧视图。
图9是本发明另一示例性实施例的侧视图。
图10是本发明另一示例性实施例的侧视图。
图11是开始翻转的图10所示实施例的侧视图。
图12是已部分翻转的图10所示实施例的立体图。
图13是已偏向性弯曲成C形定向的、本发明装置的一个实施例的侧视图。
图14是图13所示装置在使用中的立体图。
图15是本发明的另一实施例的立体图。
具体实施方式
图2示出了根据本发明的装置的一示例性实施例。装置的近侧部分10居中地设置在肠子11内。本文所用的“居中地”是指位于一段肠子之内,与位于肠子的外科手术切断端之处不同。近侧部分10适于捕获和转移来自肠子11的肠子内容物。构成近侧部分10的材料可以是可靠的生物相容屏障材料,该材料防止泄漏并允许肠子内容物沿近侧部分10的内部段经过而不粘连于其上。这些性质可通过材料本身来实现,或可通过将该材料与合适涂层组合来实现。较佳的是,近侧部分10由多层构造的含氟聚合物形成,诸如膨胀聚四氟乙烯(ePTFE)。用于近侧部分10的替代材料包括其它含氟聚合物(诸如FEP)、聚乙烯、聚丙烯、聚烯烃、聚酰亚胺、聚酯、硅酮、氟硅酮、以及诸如PGA、TMC、PLA的聚合物和共聚物的生物可吸收材料、以及任意这些材料的任意组合。在一些实施例中,近侧部分的屏障材料上可包括至少一个孔。
近侧部分10包括支承结构19。支承结构19较佳地是自膨胀材料,诸如镍钛诺。或者,支承结构19是不锈钢或其它生物相容材料或聚合物,其可通过施加外力而膨胀,诸如可气囊膨胀的材料。或者,支承结构19可由聚合材料形成。支承结果19可以是生物可吸收的或生物不可吸收的。
支承结构19可设置在远侧部分10的周界的内侧或外侧上;也就是说,支承结构19可围绕用作近侧部分10的ePTFE(例如)的外侧,或者它可设置在用作近侧部分10的ePTFE的内侧。替代的是,它可夹在用作近侧部分10的材料的层或涂层之间。在任何情况下,它附连至ePTFE(例如),且用于施加接合肠子11内壁的外力并将近侧部分10固定在位,允许肠子内容物从肠子11基本完全转移。
支承结构19能使近侧部分10从初始状态膨胀到膨胀状态,在该初始状态,近侧部分10具有小于肠子11直径的初始直径以将近侧部分插入肠子11,在该膨胀状态,近侧部分10具有大于所述初始直径的直径以将近侧部分10与肠子11的内壁12接合。近侧部分10也可从其膨胀状态压缩,以将近侧部分从肠子11移除。
图3示出了本发明的另一实施例。具体地说,在图3中,支承结构19延伸近侧部分10的长度,并超越地延伸入近侧部分10下方的肠子11。该结构提供附加的增强,且因此对造口部位的肠子11提供明显附加的增强。它限制了肠子11在造口部位附近的扭曲或扭折,提供了以下益处:防止肠子11的窄化(诸如由于阻塞或堵塞)导致肠內流动的不希望减速。
图4示出了本发明的一实施例,其中,支承结构19被包括在远侧部分13中。支承结构可以是与上述近侧部分10有关的相同替代构造。
图15示出了另一替代支承结构19,其中,沿装置长度的部分未被支承,而远侧部分13和近侧部分10的区域被支承。
如图2-4所示,该装置还包括连接至近侧部分10的远侧部分13。远侧部分13可适于延伸通过腹壁14以将肠子内容物引导出近侧部分10。至少远侧部分13可以是抗扭折的以防止其扭曲或扭折。这可通过以下方式来完成:用可形成管子的任何生物相容材料来构造远侧部分13。较佳的是,远侧部分13由ePTFE制成,由支承结构增强,类似于以上结合支承结构19所述的。图4示出了一较佳实施例,其中用于远侧部分13的支承结构是镍钛诺环系列。或者,增强材料可以是FEP。在一些实施例中,远侧部分的材料中可包括至少一个孔。
远侧部分13可选地具有可调整的长度以适应腹壁14的不同宽度。可调整的长度可通过以下方式来提供:选择切割至应有尺寸的材料,或使用波纹或伸缩构造以有利于压缩性或延伸性。
本发明的装置还可包括位于装置远端的漏斗结构(未示出),该漏斗结构可有助于防止装置的迁移或移动,并还可能避免装置拉过造口。
本发明的装置可选地包括过渡部分15,该过渡部分将近侧部分10连接至远侧部分13,从而将肠子11附连至腹壁14的内壁16。凸缘或其它固定装置18也可选地被包括在开口处,以将远侧部分13连接和密封至患者皮肤。
在另外的实施例中,本发明的装置包括在沿装置的任意位置被结合的阀,较佳地该阀可连接至所述近侧部分11或所述远侧部分13以用于为患者提供自控,由此允许肠子内容物选择性地从远侧部分13排放。位于近侧部分11的阀可提供以下优点:阀开口的较大直径可允许材料的较易通过并还可能减小堵塞的风险。在另一实施例中,阀可位于装置的近侧部分中,但可受远侧部分控制。
图5示出了本发明的一实施例,包括位于近侧部分52上的保持装置51,其可以是倒钩或鳞状件或类似物,用于将装置50在肠子内保持在位。该实施例中的支承结构53包括镍钛诺支架环,该镍钛诺支架环从近侧部分52延伸整个长度而通过并包括远侧部分54。在该实施例中,装置50还包括保持环55和气动致动的隔膜阀56。保持环55设计成位于腹部内壁上,以防止装置50移动或迁移出患者。隔膜阀56旨在允许患者对于肠子内容物的向外释放进行控制,且设计成位于体外。
图6示出了本发明的另一方面。图6示出了双盘瘘管套环60。套环60较佳地由生物可再吸收材料制成,该生物可再吸收材料设计成只要装置在位就维持着。可使用更加耐久的装置,例如ePTFE支架可与生物可再吸收材料一起使用。瘘管套环60的目的是将肠子内侧锚固至腹壁。这为经由腔63通过套环60中部的装置提供支承。这有利于肠子的密封,从而肠子内容物不漏入腹腔。装置55上的保持套环(55,图5)防止装置50回撤入腹腔。套环60的端部61设计成放置在肠子内侧,而端部62设计成抵靠腹壁放置。压索64在定位之后被拉动,以允许中央腔63的摺状效应,从而夹紧在装置50上并将肠子拉向腹壁。
图7示出了本发明的另一方面。图7示出了肠塞70,该肠塞用于密封在移除装置之后保留的天然瘘管通道。肠塞70,如同双盘瘘管套环60那样,可由生物可再吸收材料制成,单独地或带有例如由ePTFE制成的支架以提供强度和较长寿命。双盘瘘管套环60在移除装置之后留在患者体内。肠塞70的设计类似于双盘瘘管套环60,但没有中央腔63。肠塞70的端部71设计成放置在肠子内侧,而端部72设计成抵靠腹壁放置。压索74将两个盘71和72拉在一起。
图8示出了本发明的一实施例,其中,留置装置显示成处于定位之后和移除之前。近侧部分81转移肠子内容物。双盘瘘管套环82将装置锚固在位。保持套环83防止装置回撤入肠子。隔膜阀84允许患者对于肠子内容物的释放进行控制。压索85密封肠子并将肠子拉向腹壁。该实施例中的支承结构86是镍钛诺框架,该镍钛诺框架包括脊部,该脊部在该装置中产生偏向性弯曲,其有助于将装置在肠子内保持在位,但该镍钛诺框架足够柔性以允许利用移除护套来移除装置。注意,装置弯曲的底部通过双盘瘘管套环82保持在位。
图9示出了根据本发明的装置的移除。移除护套90用来压缩装置,从而它可被经皮地移除,较理想地是在门诊条件下就可从患者身上经皮地移除。移除护套90是中空聚合管,该中空聚合管尺寸设计成允许在所示实施例中、装置91回撤入移除护套90的中央腔中。移除护套90足够硬,以防止装置91移除时塌陷或褶皱。拉紧构件92附连至装置91的端部(在移除阀之后),从而将支架移植物拉入护套。当拉紧构件被拉动以完全捕获装置91然后从患者移除时,护套前进。图9是装置91的视图,其处于回撤入护套90的过程中。
图10-12示出了另一移除方法,其中,装置的近端可翻转入装置的主通道以易于移除。图10示出了本发明的一实施例,包括径向部件101,该径向部件减小近侧部分10的直径,或至少减小装置100的近端103的直径。与径向部件101连通的是拉紧构件102,该拉紧构件可以例如呈拉索或撤回线的形式。拉索或撤回线可以是与径向部件分开的构件,或者可以是径向部件的延伸端部。如图11所示,一旦力施加至拉紧构件,拉力就施加至径向部件101,其减小了装置至少近端和锚固翅片111(其周向地定位在装置的近侧部分和/或近端上)的直径且与周围组织脱开。一旦近端如此地减小,施加至拉紧构件102的附加力就用来将装置的近端拉入装置的主通道内,并开始翻转过程,如图12所示。因此减小了近侧部分的较大直径。
在另一实施例中,本发明的装置可以受控的方式拉开,从而便于从肠子或其它中空体腔或器官移除。在一个实施例中,为了有利于拉开方式,该装置可包括撤回线,该撤回线直接附连至支承框架的近端,该支承框架是诸如镍钛诺的一件式金属丝框架。拉动撤回线可将支承件的近端拉出移植物材料。位于撤回线上的持续拉力会继续将镍钛诺金属丝以连续的长度拉出移植物材料。在一个实施例中,当足够的金属丝已被拉出从而被支承的近侧区域具有类似于造口直径的直径时,装置就可被移除。或者,在装置包括一件式镍钛诺金属丝支承框架但不存在撤回线的情况下,人们可以在镍钛诺金属丝的远端上开始拉动。该方法将需要使用者在移除之前拆开装置的大部分,因为装置的最大直径部分最终将不被拆开。
如上所述,本发明的装置还可包括偏向性弯曲机构,一旦装置膨胀,该偏向性弯曲机构就施加一曲率半径至装置的一区域,偏向性地沿一个方向。装置的、能实现曲率半径的区域可位于装置的近侧部分、装置的远侧部分或其间任何过渡部分。偏向性弯曲机构可以呈沿着装置区域一侧的脊部的形式。在装置包括支承框架的情况下,在相对两侧上不对称的支承框架可提供合适的脊部,以实现一旦膨胀之后的装置偏向性弯曲。如图11所示,在装置包括支承框架53的情况下,在沿装置至少一侧区域的相邻支架环上的顶点113之间的较长顶点距离112可为装置提供脊部,并将是合适的偏向性弯曲机构。或者,偏向性弯曲机构可以呈沿一段装置将装置一侧上的相邻支架环连接起来的桥接构件的形式,由此形成脊部。或者,脊部可包括沿装置区域一侧的较致密屏障材料区域或任何其它纵向加固构件。图13示出了沿装置100的脊部150偏向性弯曲的装置,从而使装置呈c形或j形。在图15中,装置的脊部150包括沿装置另外未被支承区域一侧的纵向支承结构,其提供合适的偏向性弯曲机构。
偏向性弯曲机构还可包括锁定部件,该锁定部件允许装置保持在弯曲位置,直到该锁定部件被移除或打开时为止。将装置锁定在偏向性弯曲定向的一个优点是,装置本身可作为夹具工作,由此夹紧周围组织,并无需附加的锚固装置来锚固在位和防止迁移。通常,装置的近侧部分将位于第一中空体腔或器官内,装置的远端可位于第二中空体腔内,适于接纳来自第一体腔或通过腹壁的排泄物。然而,本发明的装置还可通过粘附至周围组织而保持在位,例如通过缝合或其它方式。图14示出了在使用中已锁定且已偏向性弯曲的装置100,该装置将两个中空体腔或器官连接起来。
任何数量的诸如抗菌剂之类的活性剂也可与本文所述的任何实施例结合以作为填充件或涂层。
尽管已在此示出和描述了本发明的具体实施例,但本发明不应局限于这种说明和描述。显而易见的是,变化和改型可包含并且在下述权利要求书的范围内作为本发明的一部分来实施。
Claims (25)
1.一种装置,包括:
a.近侧部分,所述近侧部分适于定位在中空体腔内以捕获和转移所述中空体腔内容物;至少所述近侧部分能从初始状态膨胀至用于接合中空体腔组织的第一膨胀状态,在所述初始状态,所述近侧部分具有初始直径以将所述近侧部分插入所述中空体腔,而在所述第一膨胀状态,所述近侧部分具有比所述初始直径大的直径;
b.远侧部分,所述远侧部分具有可调整长度,所述远侧部分适于延伸通过在所述中空体腔的壁中的造口,从而将所述中空体腔内容物引导出所述近侧部分;
c.过渡部分,所述过渡部分连接所述近侧部分和所述远侧部分;
d.支承结构,所述支承结构设置在所述近侧部分中或者设置在所述近侧部分和所述远侧部分两者中,所述支承结构具有接合肠子内壁且将近侧部分固定于其中的外力;以及
e.偏向性弯曲机构,一旦所述装置膨胀,所述偏向性弯曲机构沿一个方向施加曲率半径至所述装置的一区域。
2.如权利要求1所述的装置,其特征在于,所述远侧部分和所述近侧部分包括至少一层屏障材料。
3.如权利要求2所述的装置,其特征在于,所述支承结构还包括可膨胀支承框架,所述可膨胀支承框架具有一长度和延伸通过其中的通道。
4.如权利要求1所述的装置,其特征在于,在所述初始状态,所述装置是基本轴向定向的,而在所述第一膨胀状态,所述装置包括至少一个具有曲率半径的区域。
5.如权利要求1所述的装置,其特征在于,所述偏向性弯曲机构是纵向加固构件。
6.如权利要求1所述的装置,其特征在于,所述偏向性弯曲机构还包括锁定部件。
7.如权利要求3所述的装置,其特征在于,所述可膨胀支承框架具有基本圆形的横截面。
8.如权利要求7所述的装置,其特征在于,所述可膨胀支承框架在所述通道的相对两侧上不对称。
9.如权利要求3所述的装置,其特征在于,所述近侧部分还包括径向部件,一旦拉紧,所述径向部件就减小所述近侧部分的直径。
10.如权利要求9所述的装置,其特征在于,所述装置还包括与所述径向部件连通的拉紧构件。
11.如权利要求10所述的装置,其特征在于,所述拉紧构件定向在所述通道内且从所述近侧部分延伸至所述远侧部分。
12.如权利要求1所述的装置,其特征在于,所述近侧部分还包括锚固部件。
13.如权利要求2所述的装置,其特征在于,所述屏障材料包括至少一个孔。
14.如权利要求1所述的装置,其特征在于,所述中空体腔选自以下:肠、胃、胆囊、膀胱、腹膜腔、胸腔。
15.如权利要求1所述的装置,其特征在于,所述近侧部分适于定位在胃肠道内。
16.如权利要求1所述的装置,其特征在于,所述远侧部分适于延伸通过腹壁。
17.如权利要求1所述的装置,其特征在于,还包括阀,所述阀连接至所述装置以提供自控,从而允许中空体腔内容物选择性地从所述远侧部分排放。
18.如权利要求1所述的装置,其特征在于,所述过渡部分包括双盘瘘管套环。
19.如权利要求1所述的装置,其特征在于,所述远侧部分能从第二初始状态膨胀至第二膨胀状态,在所述第二初始状态,所述远侧部分具有第二初始直径,而在所述第二膨胀状态,所述远侧部分具有比所述第二初始直径大的直径。
20.如权利要求19所述的装置,其特征在于,所述近侧部分和所述远侧部分能从所述第一和第二膨胀状态压缩,以用于从所述中空体腔移除。
21.如权利要求1所述的装置,其特征在于,所述远侧部分是波纹状的。
22.如权利要求3所述的装置,其特征在于,所述可膨胀支承框架是镍钛诺。
23.如权利要求3所述的装置,其特征在于,所述可膨胀支承框架是不锈钢。
24.如权利要求3所述的装置,其特征在于,所述可膨胀支承框架是聚合物。
25.如权利要求3所述的装置,其特征在于,所述可膨胀支承框架是生物可再吸收的。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161450422P | 2011-03-08 | 2011-03-08 | |
US61/450,422 | 2011-03-08 | ||
PCT/US2012/027984 WO2012122220A1 (en) | 2011-03-08 | 2012-03-07 | Medical device for use with a stoma |
Publications (2)
Publication Number | Publication Date |
---|---|
CN103501735A CN103501735A (zh) | 2014-01-08 |
CN103501735B true CN103501735B (zh) | 2016-04-06 |
Family
ID=45841657
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN201280021901.8A Expired - Fee Related CN103501735B (zh) | 2011-03-08 | 2012-03-07 | 用于造口的医疗装置 |
Country Status (12)
Country | Link |
---|---|
US (2) | US10864106B2 (zh) |
EP (2) | EP3031428B1 (zh) |
JP (3) | JP6235345B2 (zh) |
KR (1) | KR20140015413A (zh) |
CN (1) | CN103501735B (zh) |
AU (1) | AU2012225575B9 (zh) |
BR (1) | BR112013022861A2 (zh) |
CA (1) | CA2829097C (zh) |
ES (1) | ES2567186T3 (zh) |
HK (1) | HK1188551A1 (zh) |
RU (1) | RU2550435C1 (zh) |
WO (1) | WO2012122220A1 (zh) |
Families Citing this family (17)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
RU2550435C1 (ru) | 2011-03-08 | 2015-05-10 | В. Л. Гор Энд Ассошиейтс, Инк. | Медицинское устройство для применения со стомой |
CN103405845B (zh) * | 2013-08-30 | 2015-08-19 | 任东林 | 一种回肠造瘘管 |
US11712230B2 (en) | 2014-05-02 | 2023-08-01 | W. L. Gore & Associates, Inc. | Occluder and anastomosis devices |
US11439396B2 (en) | 2014-05-02 | 2022-09-13 | W. L. Gore & Associates, Inc. | Occluder and anastomosis devices |
US9993251B2 (en) | 2014-05-02 | 2018-06-12 | W. L. Gore & Associates, Inc. | Anastomosis devices |
US11426302B2 (en) | 2014-11-03 | 2022-08-30 | Fistula Solution Corporation | Containment devices for treatment of intestinal fistulas and complex wounds |
US11724075B2 (en) | 2017-04-18 | 2023-08-15 | W. L. Gore & Associates, Inc. | Deployment constraining sheath that enables staged deployment by device section |
CN107307934A (zh) * | 2017-06-19 | 2017-11-03 | 汪校 | 一种可拆卸式肠造口支架及其使用方法 |
TWI666008B (zh) * | 2017-07-17 | 2019-07-21 | 林志豪 | 造口接合儲存裝置 |
JP2021517479A (ja) * | 2018-03-08 | 2021-07-26 | ザ インサイズ カンパニー リミテッド | 外科的に作成されたオリフィスと共に使用する装置 |
CN110856676B (zh) * | 2018-08-24 | 2021-11-02 | 长庚医疗财团法人高雄长庚纪念医院 | 人工造口装置 |
US11207097B2 (en) * | 2019-02-13 | 2021-12-28 | Andrew Thomas Obst | Fluid management device for medical tubes and drainage incisions |
CN109893330A (zh) * | 2019-04-15 | 2019-06-18 | 上海市东方医院(同济大学附属东方医院) | 一种腹壁管道及经腹壁可调节回肠造口装置 |
US11523932B2 (en) | 2019-06-26 | 2022-12-13 | Andrew Thomas Obst | Enteric fistula, rectovaginal fistula, and ostomy effluent containment system, and devices and methods thereof |
EP3824852A1 (en) * | 2019-11-22 | 2021-05-26 | Enterme Medicine International Co., Ltd. | Artificial stoma device |
WO2022079708A1 (en) * | 2020-10-14 | 2022-04-21 | Stomtop Ltd. | Ostomy devices |
FR3126300A1 (fr) * | 2021-08-31 | 2023-03-03 | Hospices Civils De Lyon | Prothèse pour endopontage en attente d’une future anastomose |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3818511A (en) * | 1972-11-17 | 1974-06-25 | Medical Prod Corp | Medical prosthesis for ducts or conduits |
US4119100A (en) * | 1977-03-18 | 1978-10-10 | John William Stanley Rickett | Surgical device for discharge of faecal matter from the colon |
US5261898A (en) * | 1990-11-13 | 1993-11-16 | Polin Stanton G | Temporary colostomy apparatus |
GB2409978A (en) * | 2004-01-19 | 2005-07-20 | Peter Andrew Priest | Fistula Connector |
US7037344B2 (en) * | 2002-11-01 | 2006-05-02 | Valentx, Inc. | Apparatus and methods for treatment of morbid obesity |
CN101951983A (zh) * | 2007-09-20 | 2011-01-19 | 金伯利-克拉克环球有限公司 | 改进的带套囊的气管造口导管 |
Family Cites Families (170)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4338937A (en) * | 1980-12-05 | 1982-07-13 | Lerman Sheldon H | Mechanical continent ileostomy or colostomy |
US4381765A (en) * | 1981-04-02 | 1983-05-03 | Waters Instruments, Inc. | Ileostomy valve |
US5669936A (en) | 1983-12-09 | 1997-09-23 | Endovascular Technologies, Inc. | Endovascular grafting system and method for use therewith |
DE69229433T2 (de) | 1991-10-24 | 1999-11-25 | Canon Kk | Einrichtung und Verfahren zur kinematischen Simulierung |
DE69334196T2 (de) | 1992-01-21 | 2009-01-02 | Regents Of The University Of Minnesota, Minneapolis | Verschlusseinrichtung eines Septumschadens |
US5224953A (en) | 1992-05-01 | 1993-07-06 | The Beth Israel Hospital Association | Method for treatment of obstructive portions of urinary passageways |
US5354308A (en) | 1992-05-01 | 1994-10-11 | Beth Israel Hospital Association | Metal wire stent |
US6171329B1 (en) | 1994-12-19 | 2001-01-09 | Gore Enterprise Holdings, Inc. | Self-expanding defect closure device and method of making and using |
US6110187A (en) | 1995-02-24 | 2000-08-29 | Heartport, Inc. | Device and method for minimizing heart displacements during a beating heart surgical procedure |
US5797933A (en) | 1996-07-16 | 1998-08-25 | Heartport, Inc. | Coronary shunt and method of use |
US6579314B1 (en) | 1995-03-10 | 2003-06-17 | C.R. Bard, Inc. | Covered stent with encapsulated ends |
ATE440559T1 (de) | 1995-10-13 | 2009-09-15 | Medtronic Vascular Inc | Vorrichtung für interstitiellen transvaskulären eingriff |
EP0932426A4 (en) | 1996-02-02 | 2003-07-30 | Transvascular Inc | METHOD AND DEVICE FOR CONNECTING OPENINGS IN NEIGHBORHOOD BLOOD VESSELS OR IN OTHER ANATOMIC STRUCTURES |
DE19604817C2 (de) | 1996-02-09 | 2003-06-12 | Pfm Prod Fuer Die Med Ag | Vorrichtung zum Verschließen von Defektöffnungen im menschlichen oder tierischen Körper |
CA2192520A1 (en) | 1996-03-05 | 1997-09-05 | Ian M. Penn | Expandable stent and method for delivery of same |
US6666883B1 (en) | 1996-06-06 | 2003-12-23 | Jacques Seguin | Endoprosthesis for vascular bifurcation |
US6007544A (en) | 1996-06-14 | 1999-12-28 | Beth Israel Deaconess Medical Center | Catheter apparatus having an improved shape-memory alloy cuff and inflatable on-demand balloon for creating a bypass graft in-vivo |
GB9614950D0 (en) | 1996-07-16 | 1996-09-04 | Anson Medical Ltd | A ductus stent and delivery catheter |
US6391039B1 (en) | 1996-07-23 | 2002-05-21 | United States Surgical Corporation | Anastomosis instrument and method |
US5741297A (en) | 1996-08-28 | 1998-04-21 | Simon; Morris | Daisy occluder and method for septal defect repair |
US6432127B1 (en) | 1996-10-11 | 2002-08-13 | Transvascular, Inc. | Devices for forming and/or maintaining connections between adjacent anatomical conduits |
US5755778A (en) | 1996-10-16 | 1998-05-26 | Nitinol Medical Technologies, Inc. | Anastomosis device |
KR100573504B1 (ko) | 1997-01-24 | 2006-04-26 | 파라곤 인텔렉츄얼 프라퍼티즈 엘엘씨. | 팽창형 장치용의 양방향 안정성 스프링 구조물 |
US5868783A (en) | 1997-04-16 | 1999-02-09 | Numed, Inc. | Intravascular stent with limited axial shrinkage |
US5957949A (en) | 1997-05-01 | 1999-09-28 | World Medical Manufacturing Corp. | Percutaneous placement valve stent |
FR2764794B1 (fr) | 1997-06-20 | 1999-11-12 | Nycomed Lab Sa | Dispositif tubulaire expanse a epaisseur variable |
NL1007349C2 (nl) | 1997-10-24 | 1999-04-27 | Suyker Wilhelmus Joseph Leonardus | Systeem voor het mechanisch vervaardigen van anastomoses tussen holle structuren; alsmede inrichting en applicator voor gebruik daarbij. |
US6330884B1 (en) | 1997-11-14 | 2001-12-18 | Transvascular, Inc. | Deformable scaffolding multicellular stent |
WO1999030641A1 (en) | 1997-12-15 | 1999-06-24 | Prolifix Medical, Inc. | Vascular stent for reduction of restenosis |
US6193734B1 (en) | 1998-01-23 | 2001-02-27 | Heartport, Inc. | System for performing vascular anastomoses |
EP1051128B1 (en) | 1998-01-30 | 2006-03-15 | St. Jude Medical ATG, Inc. | Medical graft connector or plug structures, and methods of making |
US6994713B2 (en) | 1998-01-30 | 2006-02-07 | St. Jude Medical Atg, Inc. | Medical graft connector or plug structures, and methods of making and installing same |
US6129756A (en) * | 1998-03-16 | 2000-10-10 | Teramed, Inc. | Biluminal endovascular graft system |
KR20010052459A (ko) | 1998-05-29 | 2001-06-25 | 바이-패스, 인크. | 혈관 수술용 방법 및 그 장치 |
US6168621B1 (en) | 1998-05-29 | 2001-01-02 | Scimed Life Systems, Inc. | Balloon expandable stent with a self-expanding portion |
US6224627B1 (en) | 1998-06-15 | 2001-05-01 | Gore Enterprise Holdings, Inc. | Remotely removable covering and support |
US6290728B1 (en) | 1998-09-10 | 2001-09-18 | Percardia, Inc. | Designs for left ventricular conduit |
US7018387B2 (en) | 1998-10-22 | 2006-03-28 | Innovative Interventional Technologies B.V. | Mechanical anastomosis system for hollow structures |
US6712836B1 (en) | 1999-05-13 | 2004-03-30 | St. Jude Medical Atg, Inc. | Apparatus and methods for closing septal defects and occluding blood flow |
US6428550B1 (en) | 1999-05-18 | 2002-08-06 | Cardica, Inc. | Sutureless closure and deployment system for connecting blood vessels |
JP2001340346A (ja) | 1999-06-08 | 2001-12-11 | Sumitomo Bakelite Co Ltd | 医療用処置用具 |
US6485507B1 (en) | 1999-07-28 | 2002-11-26 | Scimed Life Systems | Multi-property nitinol by heat treatment |
AU5812299A (en) | 1999-09-07 | 2001-04-10 | Microvena Corporation | Retrievable septal defect closure device |
US6964674B1 (en) | 1999-09-20 | 2005-11-15 | Nuvasive, Inc. | Annulotomy closure device |
US6585758B1 (en) | 1999-11-16 | 2003-07-01 | Scimed Life Systems, Inc. | Multi-section filamentary endoluminal stent |
US6458153B1 (en) | 1999-12-31 | 2002-10-01 | Abps Venture One, Ltd. | Endoluminal cardiac and venous valve prostheses and methods of manufacture and delivery thereof |
US6602263B1 (en) | 1999-11-30 | 2003-08-05 | St. Jude Medical Atg, Inc. | Medical grafting methods and apparatus |
US6468303B1 (en) | 2000-03-27 | 2002-10-22 | Aga Medical Corporation | Retrievable self expanding shunt |
US6315708B1 (en) | 2000-03-31 | 2001-11-13 | Cordis Corporation | Stent with self-expanding end sections |
US6214029B1 (en) | 2000-04-26 | 2001-04-10 | Microvena Corporation | Septal defect occluder |
US6629992B2 (en) | 2000-08-04 | 2003-10-07 | Advanced Cardiovascular Systems, Inc. | Sheath for self-expanding stent |
US6776785B1 (en) | 2000-10-12 | 2004-08-17 | Cardica, Inc. | Implantable superelastic anastomosis device |
US6899727B2 (en) | 2001-01-22 | 2005-05-31 | Gore Enterprise Holdings, Inc. | Deployment system for intraluminal devices |
DE10118944B4 (de) | 2001-04-18 | 2013-01-31 | Merit Medical Systems, Inc. | Entfernbare, im wesentlichen zylindrische Implantate |
US6620122B2 (en) | 2001-04-26 | 2003-09-16 | Scimed Life Systems, Inc. | Gastric pseudocyst drainage and stent delivery system for use therein |
US7338514B2 (en) | 2001-06-01 | 2008-03-04 | St. Jude Medical, Cardiology Division, Inc. | Closure devices, related delivery methods and tools, and related methods of use |
US7115136B2 (en) | 2001-06-20 | 2006-10-03 | Park Medical Llc | Anastomotic device |
JP4201702B2 (ja) | 2001-06-20 | 2008-12-24 | パーク メディカル リミテッド ライアビリティ カンパニー | 吻合装置 |
US7288105B2 (en) | 2001-08-01 | 2007-10-30 | Ev3 Endovascular, Inc. | Tissue opening occluder |
US20060052821A1 (en) | 2001-09-06 | 2006-03-09 | Ovalis, Inc. | Systems and methods for treating septal defects |
US20070129755A1 (en) | 2005-12-05 | 2007-06-07 | Ovalis, Inc. | Clip-based systems and methods for treating septal defects |
US7892247B2 (en) | 2001-10-03 | 2011-02-22 | Bioconnect Systems, Inc. | Devices and methods for interconnecting vessels |
DE60236755D1 (de) | 2001-10-04 | 2010-07-29 | Neovasc Medical Ltd | Flussverringerndes implantat |
JP2003116982A (ja) | 2001-10-10 | 2003-04-22 | Medicos Hirata:Kk | 内視鏡下経十二指腸的胆曩ドレナージ用システム |
US6958037B2 (en) * | 2001-10-20 | 2005-10-25 | Applied Medical Resources Corporation | Wound retraction apparatus and method |
US6945994B2 (en) | 2001-12-05 | 2005-09-20 | Boston Scientific Scimed, Inc. | Combined balloon-expanding and self-expanding stent |
US7318833B2 (en) | 2001-12-19 | 2008-01-15 | Nmt Medical, Inc. | PFO closure device with flexible thrombogenic joint and improved dislodgement resistance |
US7182771B1 (en) | 2001-12-20 | 2007-02-27 | Russell A. Houser | Vascular couplers, techniques, methods, and accessories |
US20030139819A1 (en) | 2002-01-18 | 2003-07-24 | Beer Nicholas De | Method and apparatus for closing septal defects |
US7029482B1 (en) | 2002-01-22 | 2006-04-18 | Cardica, Inc. | Integrated anastomosis system |
US7223274B2 (en) | 2002-01-23 | 2007-05-29 | Cardica, Inc. | Method of performing anastomosis |
US8430934B2 (en) | 2002-03-01 | 2013-04-30 | Regents Of The University Of Minnesota | Vascular occlusion device |
EP1480565B8 (en) | 2002-03-01 | 2009-04-01 | Regents Of The University Of Minnesota | Vascular occlusion device |
WO2003103476A2 (en) | 2002-06-05 | 2003-12-18 | Nmt Medical, Inc. | Patent foramen ovale (pfo) closure device with radial and circumferential support |
US7025777B2 (en) * | 2002-07-31 | 2006-04-11 | Unison Therapeutics, Inc. | Flexible and conformable stent and method of forming same |
JP4425135B2 (ja) | 2002-07-31 | 2010-03-03 | アボット ラボラトリーズ バスキュラー エンタープライゼズ リミテッド | 血管および組織の穿刺孔をシールするための装置 |
US20040044364A1 (en) | 2002-08-29 | 2004-03-04 | Devries Robert | Tissue fasteners and related deployment systems and methods |
EP1613242B1 (en) | 2003-03-26 | 2013-02-20 | The Foundry, LLC | Devices for treatment of abdominal aortic aneurysms |
US20050049675A1 (en) | 2003-03-28 | 2005-03-03 | Board Of Regents, The University Of Texas System | Medical devices and related methods |
US7530963B2 (en) | 2003-04-24 | 2009-05-12 | Wisconsin Alumni Research Foundation | Method of maintaining patency of opening in third ventricle floor |
US7331976B2 (en) | 2003-04-29 | 2008-02-19 | Rex Medical, L.P. | Distal protection device |
US9861346B2 (en) | 2003-07-14 | 2018-01-09 | W. L. Gore & Associates, Inc. | Patent foramen ovale (PFO) closure device with linearly elongating petals |
US20050070935A1 (en) | 2003-09-30 | 2005-03-31 | Ortiz Mark S. | Single lumen access deployable ring for intralumenal anastomosis |
US7608086B2 (en) | 2003-09-30 | 2009-10-27 | Ethicon Endo-Surgery, Inc. | Anastomosis wire ring device |
US8052749B2 (en) | 2003-12-23 | 2011-11-08 | Sadra Medical, Inc. | Methods and apparatus for endovascular heart valve replacement comprising tissue grasping elements |
US7585306B2 (en) | 2003-12-24 | 2009-09-08 | Maquet Cardiovascular Llc | Anastomosis device, tools and methods of using |
US7901459B2 (en) * | 2004-01-09 | 2011-03-08 | Warsaw Orthopedic, Inc. | Split spinal device and method |
DE202004000630U1 (de) * | 2004-01-15 | 2004-06-09 | Asia Regent Ltd. | Yoga-Balancetrainer |
EP1718213B1 (en) | 2004-02-04 | 2007-07-11 | Carag AG | An implant for occluding a body passage |
US20050187568A1 (en) | 2004-02-20 | 2005-08-25 | Klenk Alan R. | Devices and methods for closing a patent foramen ovale with a coil-shaped closure device |
JP2007530128A (ja) * | 2004-03-23 | 2007-11-01 | アトロポス・リミテッド | 創傷レトラクタ器具 |
US20050234509A1 (en) | 2004-03-30 | 2005-10-20 | Mmt Medical, Inc. | Center joints for PFO occluders |
US8425539B2 (en) | 2004-04-12 | 2013-04-23 | Xlumena, Inc. | Luminal structure anchoring devices and methods |
US20050228413A1 (en) | 2004-04-12 | 2005-10-13 | Binmoeller Kenneth F | Automated transluminal tissue targeting and anchoring devices and methods |
US8308760B2 (en) | 2004-05-06 | 2012-11-13 | W.L. Gore & Associates, Inc. | Delivery systems and methods for PFO closure device with two anchors |
WO2005110240A1 (en) | 2004-05-07 | 2005-11-24 | Nmt Medical, Inc. | Catching mechanisms for tubular septal occluder |
US7704268B2 (en) | 2004-05-07 | 2010-04-27 | Nmt Medical, Inc. | Closure device with hinges |
US7678135B2 (en) | 2004-06-09 | 2010-03-16 | Usgi Medical, Inc. | Compressible tissue anchor assemblies |
EP1765451B1 (en) | 2004-06-14 | 2021-11-17 | Edwards Lifesciences Corporation | Devices for arterio-venous fistula creation |
JP2006006648A (ja) | 2004-06-25 | 2006-01-12 | Terumo Corp | 血管接合具および血管接合装置 |
EP1763327B1 (en) | 2004-07-02 | 2018-09-12 | Cook Medical Technologies LLC | Balloon / self-expanding stent graft |
US7971333B2 (en) * | 2006-05-30 | 2011-07-05 | Advanced Cardiovascular Systems, Inc. | Manufacturing process for polymetric stents |
US7828814B2 (en) | 2004-08-27 | 2010-11-09 | Rox Medical, Inc. | Device and method for establishing an artificial arterio-venous fistula |
US9706997B2 (en) | 2004-08-27 | 2017-07-18 | Rox Medical, Inc. | Device and method for establishing an artificial arterio-venous fistula |
US20060047337A1 (en) | 2004-08-27 | 2006-03-02 | Brenneman Rodney A | Device and method for establishing an artificial arterio-venous fistula |
US8372113B2 (en) | 2005-03-24 | 2013-02-12 | W.L. Gore & Associates, Inc. | Curved arm intracardiac occluder |
WO2006121855A2 (en) | 2005-05-06 | 2006-11-16 | Johns Hopkins University | Transcaval mesenteric venous anastomosis and access system |
CA2616760C (en) | 2005-07-26 | 2014-10-07 | Rox Medical, Inc. | Devices, systems, and methods for peripheral arteriovenous fistula creation |
CA2619429A1 (en) | 2005-08-22 | 2007-03-01 | Incept, Llc | Flared stents and apparatus and methods for making and using them |
ES2425948T3 (es) | 2005-11-14 | 2013-10-18 | Covidien Lp | Sistema de aporte de cánula para emplazamientos ostiales dentro de un conducto |
US20070123917A1 (en) | 2005-11-29 | 2007-05-31 | Ortiz Mark S | Anastomotic device promoting tissue necrosis |
US8435284B2 (en) | 2005-12-14 | 2013-05-07 | Boston Scientific Scimed, Inc. | Telescoping bifurcated stent |
RU56190U1 (ru) * | 2006-02-03 | 2006-09-10 | Казбек Эдуардович Зураев | Устройство для кишечной декомпрессии |
JP2009532123A (ja) | 2006-03-31 | 2009-09-10 | エヌエムティー メディカル, インコーポレイティッド | 可変長の卵円孔開存(pfo)オクルーダ及びキャッチシステム |
US8870916B2 (en) | 2006-07-07 | 2014-10-28 | USGI Medical, Inc | Low profile tissue anchors, tissue anchor systems, and methods for their delivery and use |
WO2008042229A2 (en) | 2006-09-28 | 2008-04-10 | Nmt Medical, Inc. | Implant-catheter attachment mechanism using snare and method of use |
DE102006050385A1 (de) | 2006-10-05 | 2008-04-10 | pfm Produkte für die Medizin AG | Implantierbare Einrichtung |
US8029532B2 (en) | 2006-10-11 | 2011-10-04 | Cook Medical Technologies Llc | Closure device with biomaterial patches |
US9232997B2 (en) | 2006-11-07 | 2016-01-12 | Corvia Medical, Inc. | Devices and methods for retrievable intra-atrial implants |
US20110257723A1 (en) | 2006-11-07 | 2011-10-20 | Dc Devices, Inc. | Devices and methods for coronary sinus pressure relief |
WO2008055301A1 (en) | 2006-11-07 | 2008-05-15 | Univ Sydney | Devices and methods for the treatment of heart failure |
AU2008266238A1 (en) | 2007-06-12 | 2008-12-24 | Convatec Technologies Inc. | Ostomy appliance |
US8366741B2 (en) | 2007-09-13 | 2013-02-05 | Cardia, Inc. | Occlusion device with centering arm |
US20090143713A1 (en) | 2007-11-30 | 2009-06-04 | Jacques Van Dam | Biliary Shunts, Delivery Systems, Methods of Using the Same and Kits Therefor |
US8920463B2 (en) | 2008-02-15 | 2014-12-30 | Rex Medical, L.P. | Vascular hole closure device |
DE102008012113A1 (de) * | 2008-03-02 | 2009-09-03 | Transcatheter Technologies Gmbh | Stent, welcher vom expandierten Zustand erneut im Durchmesser kontrolliert verringerbar ist |
US9119607B2 (en) | 2008-03-07 | 2015-09-01 | Gore Enterprise Holdings, Inc. | Heart occlusion devices |
US20130165967A1 (en) | 2008-03-07 | 2013-06-27 | W.L. Gore & Associates, Inc. | Heart occlusion devices |
US8454632B2 (en) | 2008-05-12 | 2013-06-04 | Xlumena, Inc. | Tissue anchor for securing tissue layers |
WO2009146369A1 (en) | 2008-05-29 | 2009-12-03 | Cook Biotech Incorporated | Devices and methods for treating rectovaginal and other fistulae |
US20100010520A1 (en) | 2008-07-11 | 2010-01-14 | Olympus Medical Systems Corp. | Tissue fastener |
US9820746B2 (en) | 2008-07-28 | 2017-11-21 | Incube Laboratories LLC | System and method for scaffolding anastomoses |
EP2344070B1 (en) | 2008-10-20 | 2017-08-09 | Corassist Cardiovascular Ltd. | Ventricular function assisting device and apparatus for implanting it |
US8343088B2 (en) * | 2008-10-21 | 2013-01-01 | Douglas Bates | Apparatus and method for treating occluded infection collections of the digestive tract |
US8398676B2 (en) | 2008-10-30 | 2013-03-19 | Abbott Vascular Inc. | Closure device |
GB2464978B (en) | 2008-10-31 | 2010-10-20 | Cook William Europ | Introducer for deploying a stent graft in a curved lumen |
US8197498B2 (en) * | 2008-11-06 | 2012-06-12 | Trinitas Ventures Ltd. | Gastric bypass devices and procedures |
US9055946B2 (en) | 2008-11-26 | 2015-06-16 | Phraxis Inc. | Anastomotic connector |
US8029534B2 (en) | 2009-03-16 | 2011-10-04 | Cook Medical Technologies Llc | Closure device with string retractable umbrella |
EP2421468B1 (en) | 2009-04-20 | 2016-12-07 | Rox Medical, Inc. | Device for establishing an artificial arterio-venous fistula |
US20120130417A1 (en) | 2010-10-25 | 2012-05-24 | Keke Lepulu | Apparatus and method for penetrating and enlarging adjacent tissue layers |
WO2010129162A1 (en) | 2009-05-06 | 2010-11-11 | Hansa Medical Products, Inc. | Self-adjusting medical device |
US9901347B2 (en) | 2009-05-29 | 2018-02-27 | Terus Medical, Inc. | Biliary shunts, delivery systems, and methods of using the same |
US20100305590A1 (en) | 2009-05-29 | 2010-12-02 | Gi Dynamics, Inc. | Transpyloric Anchoring |
DK2442860T3 (da) | 2009-06-15 | 2019-06-24 | Perflow Medical Ltd | Apparat til muliggørelse af blodstrømning gennem et okkluderet kar |
US20110118765A1 (en) | 2009-11-18 | 2011-05-19 | Aguirre Andres F | Anastomosis stent |
WO2011100367A2 (en) | 2010-02-10 | 2011-08-18 | Trivascular, Inc. | Fill tube manifold and delivery methods for endovascular graft |
US8992604B2 (en) | 2010-07-21 | 2015-03-31 | Mitraltech Ltd. | Techniques for percutaneous mitral valve replacement and sealing |
US9463269B2 (en) | 2010-09-10 | 2016-10-11 | W. L. Gore & Associates, Inc. | Anastomotic devices and methods |
US9186152B2 (en) | 2010-11-12 | 2015-11-17 | W. L. Gore & Associates, Inc. | Left atrial appendage occlusive devices |
US20120130480A1 (en) | 2010-11-18 | 2012-05-24 | Robert Falotico | Local vascular delivery of adenosine a2a receptor agonists to reduce myocardial injury |
RU2550435C1 (ru) | 2011-03-08 | 2015-05-10 | В. Л. Гор Энд Ассошиейтс, Инк. | Медицинское устройство для применения со стомой |
EP4119095A1 (en) | 2011-03-21 | 2023-01-18 | Cephea Valve Technologies, Inc. | Disk-based valve apparatus |
KR101311756B1 (ko) | 2011-07-06 | 2013-09-26 | 신경민 | 인체 기관의 인접 조직 연결 시술용 스텐트 |
US9629715B2 (en) | 2011-07-28 | 2017-04-25 | V-Wave Ltd. | Devices for reducing left atrial pressure having biodegradable constriction, and methods of making and using same |
US20130041451A1 (en) | 2011-08-09 | 2013-02-14 | Cook Medical Technologies Llc | Prosthesis deployment system for open surgical repair |
WO2013028579A1 (en) | 2011-08-19 | 2013-02-28 | Cox Brian J | Expandable occlusion device and methods |
EP2785277B1 (en) | 2011-12-04 | 2017-04-05 | Endospan Ltd. | Branched stent-graft system |
US9592058B2 (en) | 2012-02-21 | 2017-03-14 | Cardia, Inc. | Left atrial appendage occlusion device |
WO2013152891A2 (en) | 2012-02-29 | 2013-10-17 | Occlutech Holding Ag | A device for occluding an opening in a body and associated methods |
US9375308B2 (en) | 2012-03-13 | 2016-06-28 | W. L. Gore & Associates, Inc. | External steerable fiber for use in endoluminal deployment of expandable devices |
US9067050B2 (en) | 2012-03-30 | 2015-06-30 | Medtronic Vascular, Inc. | Arteriovenous shunt having a flow control mechanism |
US9314239B2 (en) | 2012-05-23 | 2016-04-19 | Depuy Mitek, Llc | Methods and devices for securing suture to tissue |
US9445797B2 (en) | 2012-09-13 | 2016-09-20 | Medtronic, Inc. | Percutaneous atrial and ventricular septal defect closure device |
EP2958527B1 (en) | 2013-02-21 | 2020-07-22 | Boston Scientific Scimed, Inc. | Devices for forming an anastomosis |
US11911258B2 (en) | 2013-06-26 | 2024-02-27 | W. L. Gore & Associates, Inc. | Space filling devices |
US9993251B2 (en) | 2014-05-02 | 2018-06-12 | W. L. Gore & Associates, Inc. | Anastomosis devices |
US11712230B2 (en) | 2014-05-02 | 2023-08-01 | W. L. Gore & Associates, Inc. | Occluder and anastomosis devices |
US11439396B2 (en) | 2014-05-02 | 2022-09-13 | W. L. Gore & Associates, Inc. | Occluder and anastomosis devices |
US11724075B2 (en) | 2017-04-18 | 2023-08-15 | W. L. Gore & Associates, Inc. | Deployment constraining sheath that enables staged deployment by device section |
-
2012
- 2012-03-07 RU RU2013144903/14A patent/RU2550435C1/ru active
- 2012-03-07 EP EP15196870.8A patent/EP3031428B1/en active Active
- 2012-03-07 JP JP2013557815A patent/JP6235345B2/ja active Active
- 2012-03-07 EP EP12709235.1A patent/EP2683341B1/en active Active
- 2012-03-07 BR BR112013022861A patent/BR112013022861A2/pt not_active Application Discontinuation
- 2012-03-07 WO PCT/US2012/027984 patent/WO2012122220A1/en active Application Filing
- 2012-03-07 US US13/413,921 patent/US10864106B2/en active Active
- 2012-03-07 CA CA2829097A patent/CA2829097C/en active Active
- 2012-03-07 ES ES12709235.1T patent/ES2567186T3/es active Active
- 2012-03-07 AU AU2012225575A patent/AU2012225575B9/en active Active
- 2012-03-07 KR KR1020137025488A patent/KR20140015413A/ko not_active Application Discontinuation
- 2012-03-07 CN CN201280021901.8A patent/CN103501735B/zh not_active Expired - Fee Related
-
2014
- 2014-02-20 HK HK14101618.4A patent/HK1188551A1/zh not_active IP Right Cessation
-
2017
- 2017-06-21 JP JP2017121658A patent/JP6863833B2/ja active Active
-
2018
- 2018-04-06 US US15/947,059 patent/US10980663B2/en active Active
-
2019
- 2019-05-29 JP JP2019100736A patent/JP2019171098A/ja active Pending
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3818511A (en) * | 1972-11-17 | 1974-06-25 | Medical Prod Corp | Medical prosthesis for ducts or conduits |
US4119100A (en) * | 1977-03-18 | 1978-10-10 | John William Stanley Rickett | Surgical device for discharge of faecal matter from the colon |
US5261898A (en) * | 1990-11-13 | 1993-11-16 | Polin Stanton G | Temporary colostomy apparatus |
US7037344B2 (en) * | 2002-11-01 | 2006-05-02 | Valentx, Inc. | Apparatus and methods for treatment of morbid obesity |
GB2409978A (en) * | 2004-01-19 | 2005-07-20 | Peter Andrew Priest | Fistula Connector |
CN101951983A (zh) * | 2007-09-20 | 2011-01-19 | 金伯利-克拉克环球有限公司 | 改进的带套囊的气管造口导管 |
Also Published As
Publication number | Publication date |
---|---|
ES2567186T3 (es) | 2016-04-20 |
JP2019171098A (ja) | 2019-10-10 |
EP2683341B1 (en) | 2015-12-30 |
AU2012225575A1 (en) | 2013-10-10 |
EP3031428B1 (en) | 2020-11-18 |
HK1188551A1 (zh) | 2014-05-09 |
AU2012225575B9 (en) | 2015-08-20 |
US20180221194A1 (en) | 2018-08-09 |
JP6235345B2 (ja) | 2017-11-22 |
WO2012122220A1 (en) | 2012-09-13 |
US20120232505A1 (en) | 2012-09-13 |
KR20140015413A (ko) | 2014-02-06 |
RU2013144903A (ru) | 2015-04-20 |
EP2683341A1 (en) | 2014-01-15 |
US10864106B2 (en) | 2020-12-15 |
AU2012225575B2 (en) | 2015-01-22 |
CN103501735A (zh) | 2014-01-08 |
US10980663B2 (en) | 2021-04-20 |
JP2017192768A (ja) | 2017-10-26 |
CA2829097C (en) | 2016-01-05 |
JP2014511251A (ja) | 2014-05-15 |
BR112013022861A2 (pt) | 2016-12-06 |
RU2550435C1 (ru) | 2015-05-10 |
EP3031428A1 (en) | 2016-06-15 |
CA2829097A1 (en) | 2012-09-13 |
JP6863833B2 (ja) | 2021-04-21 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CN103501735B (zh) | 用于造口的医疗装置 | |
CN102281840B (zh) | 造口术器具 | |
US9326879B2 (en) | Systems and methods for bariatric therapy | |
JP7422438B2 (ja) | 組織空洞内にシースを係留するためのデバイスおよび方法 | |
US8636683B2 (en) | Systems and methods for bariatric therapy | |
EP3106108A1 (en) | Tissue anchor for securing tissue layers | |
WO2009140195A1 (en) | Tissue anchor for securing tissue layers | |
CN105708511A (zh) | 用于管状体部的衬垫以及用于施加衬垫的设备和方法 | |
WO2016094727A2 (en) | Fistula treatment devices and methods | |
JP2024510846A (ja) | 胃腸チューブおよびその固定 |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
C06 | Publication | ||
PB01 | Publication | ||
C10 | Entry into substantive examination | ||
SE01 | Entry into force of request for substantive examination | ||
C14 | Grant of patent or utility model | ||
GR01 | Patent grant | ||
CF01 | Termination of patent right due to non-payment of annual fee | ||
CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20160406 Termination date: 20170307 |