CN104771253A - Degradable backflow-prevention esophagastro anastomosis support - Google Patents
Degradable backflow-prevention esophagastro anastomosis support Download PDFInfo
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- CN104771253A CN104771253A CN201410016044.3A CN201410016044A CN104771253A CN 104771253 A CN104771253 A CN 104771253A CN 201410016044 A CN201410016044 A CN 201410016044A CN 104771253 A CN104771253 A CN 104771253A
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Abstract
The invention relates to a degradable backflow-prevention esophagastro anastomosis support, relates to a hollow or tubular prosthesis capable of being implanted in vivo, and particularly relates to a degradable backflow-prevention support used for esophagastro anastomosis. The degradable backflow-prevention esophagastro anastomosis support comprises a tubular support body made of a degradable material; and a backflow-prevention device capable of isolating objects contained in an esophagastro and an anastomosis opening is arranged inside the tubular support body. The esophagastro anastomosis support is provided with a detachable inner core penetrating an inner hole of the tubular support body; the esophagus end of the detachable inner core is hemi-ellipsoidal and extends out from the inner hole of the tubular support body; the stomach end of the detachable inner core is conic; grooves capable of being clamped through vessel clamps are formed in the two sides; and annular sunken ligation grooves are formed in the surface of the periphery of the tubular support body. In an esophagastro anastomosis operation, the detachable inner core can be used for clamping operation, and depending on the supporting function of the support body and the positioning function of the ligation grooves, the operation is convenient, simple and rapid; and the support is not high in material price, the manufacturing process is simple, the operation cost can be obviously reduced, and the loads of a patient are reduced.
Description
Technical field
The present invention relates to the prosthese of the hollow or tubulose in implantable, particularly relate to the anti-support that backflows of a kind of degradable for anastomose esophagus stomach.
Background technology
The esophageal carcinoma is one of common tumor, and operation is first-selected Therapeutic Method, and the position of Operation on Esophageal Cancer key is that esophageal-gastric is coincide, and is also the position the most easily developed complications.At present, anastomosis method mainly comprises: manual suture jacquard CAD and Anastomat hemorrhoidal circumcision method two kinds.Manual suture jacquard CAD is traditional methods of anastomosis, silk thread or absorbable thread manual suture is adopted to complete, complicated operation is loaded down with trivial details, the time of identical cost is longer, and complication is many, easy concurrent fistula of operative incision, the problem such as narrow, but this method cost is lower, is still main identical method in the area of some economics of underdevelopment.Anastomat hemorrhoidal circumcision method uses anastomat to complete identical technology, main adopts that circular staplers is capable to coincide, but also have and adopt the capable method of coincideing of linear anastomat.Circular staplers method of coincideing is method the most frequently used at present, and coincide and determine, the size of anastomotic stoma can be selected according to the condition of patient, method is ripe, but this anastomosis operation relative complex, also have about 3%-5% patient to occur fistula of operative incision or narrow complication, and anastomat price is higher.The technology of linear anastomat is still in the clinical applicable stage at present, and costly.
Support anastomosis is anastomosis newer at present, particularly biodegradable stent, also be applied to now intestinal Surgical healing, gastrointestinal anastomosis, Cholangio-jejunostomy, bile duct coincide and deferent duct coincide, on esophageal-gastric is coincide, also see have relevant report and clinical practice, such as, Chinese utility model patent " intracavity elastic force cerclage anastomat " (utility model patent number: 85203973.5 authorizes publication No.: CN85203973U) discloses a kind of intracavity elastic force cerclage anastomat for esophagus, stomach, large intestine.
But have special requirement to anastomosis bracket on gastro-esophageal anastomosis, first, after esophageal-gastric coincide local healing, the anastomosis bracket of inserting often needs to remove.Chinese utility model patent " a kind of spiral type degradable Esophageal Stent " (utility model patent number: ZL201220198703.6 Authorization Notice No.: CN202637199U) discloses a kind of spiral type degradable Esophageal Stent.Esophageal Stent two ends are flaring hollow cylinder dictyosome, and this dictyosome is made up of the elementary cell of rhombus, and stent ends is shirt rim shape structure, and the filament prepared by degradable polymer is worked out being interweaved on molding jig.
Secondly, the postoperative cardia of Esophagectomy is cut, loses the function that anti-gastric juice backflows, and gastric juice is easily backflowed.Therefore, needing to design implantation one in case the valve sampling device that backflows, in case gastric content from backwards flowing after coincideing, can develop complications, the development aggravated disease.Chinese utility model patent " the anti-Coated Stents in Treatment of Benign that backflows " (utility model patent number: ZL201120218143.1 Authorization Notice No.: CN202146373U) discloses a kind of anti-Coated Stents in Treatment of Benign that backflows, in the edge of Coated Stents in Treatment of Benign inner chamber lower end, be provided with at least two connections that contact with each other bag-shaped anti-valve that backflows that Open Side Down, outward flange above the bag-shaped anti-valve that backflows is fixedly connected with inner chamber overlay film respectively with the outward flange of side, the bag-shaped anti-valve that backflows closes the inner chamber of Coated Stents in Treatment of Benign after contacting with each other and connecting completely.
3rd, the coincide healing of local of esophageal-gastric needs the hypertrophy of tissue, mucosa, if local can discharge medicine or the biotic factor of promotion hamartoplasia, will contribute to the healing of anastomotic stoma.Chinese invention patent " a kind of can drug loading cover capsule Esophageal Stent and preparation method thereof " (application for a patent for invention number: 201010532866.9
publication number: CN101984940A) disclose a kind of Esophageal Stent being covered with medicine bag, this Esophageal Stent is made up of inner support tube and medicine bag two parts, described medicine bag is the cavity of the effective site of corrugated tube and one deck elastomer seal of its outer wrap, in corrugated tube effective site upper end, a drug-feeding tube communicated with medicine bag is fixed at tube wall place, promotes disease healing by release medicine.
Although above-mentioned prior art solves some technical problems of Esophageal Stent manufacture and use respectively, do not provide a kind of anti-anastomosis bracket that backflows of degradable meeting anastomose esophagus stomach requirements of operation.In addition, gastro-esophageal anastomosis position is positioned at position, thoracic cavity, the tension force that coincide is large, position is limited to, the technical requirement of gastro-esophageal anastomosis is higher, particularly because the rigid phase of biodegradable stent is to poor, more need to solve the ligation fixation problem of anastomosis bracket at the clamping of inserting in process and anastomotic position.
Summary of the invention
The object of this invention is to provide the anti-anastomose esophagus stomach support that backflows of a kind of degradable, comprehensively solve coincideing of esophageal-gastric in operation on esophagus, solve anti-backflowing simultaneously, inserting the clamping in process, and the technical problem such as the ligation of anastomotic position is fixing.
The present invention solves the problems of the technologies described above adopted technical scheme:
The anti-anastomose esophagus stomach support that backflows of a kind of degradable, comprises the tubular bracket main body that degradation material is made, it is characterized in that:
Described tubular bracket body interior, is provided with anti-recirculation device esophagus and stomach content and anastomotic stoma can isolated;
Described anastomose esophagus stomach support is furnished with the detachable inner core through tubular bracket main body endoporus;
The esophagus end of described detachable inner core is semielliptical shape, stretches out from the endoporus of tubular bracket main body; Conically, its basal diameter is consistent with the external diameter of tubular bracket main body for the stomach end of described detachable inner core; The groove of available vascular forceps clamping is provided with in described conical both sides.
Degradable of the present invention is prevented backflowing the preferred technical scheme of one of anastomose esophagus stomach support, it is characterized in that the degradation material for making rack body is medical degradable biomaterial, comprising polylactic acid, dioxanone and degradable magnesium alloy.
Degradable of the present invention is prevented backflowing the one preferably technical scheme of anastomose esophagus stomach support, it is characterized in that the outer surface of described tubular bracket main body, be provided with the ligation groove of 1-4 annular recess, the ligation of esophagus and stomach rhynchodaenm is fixed in described ligation groove, described ligation groove can regulate the elasticity of ligation, while playing fixing and sealing process, meet anastomotic part blood and transport unimpeded requirement.
Degradable of the present invention is prevented backflowing the better technical scheme of one of anastomose esophagus stomach support, it is characterized in that described detachable inner core adopts nontoxic hard material to make; After described anastomose esophagus stomach support is inserted, described detachable inner core can be extracted out from the stomach end of rack body and remove.
Degradable of the present invention is prevented backflowing the better technical scheme of another kind of anastomose esophagus stomach support, it is characterized in that described detachable inner core adopts airbag structure; After described anastomose esophagus stomach support is inserted, the detachable inner core of emptying airbag gas can be extracted out and remove from the endoporus of described rack body.
Degradable of the present invention is prevented backflowing a kind of technical scheme of improvement of anastomose esophagus stomach support, and it is characterized in that described anti-recirculation device is the valve of the unidirectional opening with 2-4 lobe leaf, described valve adopts biomaterial thin film to make; After described anastomose esophagus stomach support is inserted, the valve of tubular bracket body interior on the feed time direct motion open, oppositely then stop gastric content from backwards flowing to enter esophagus.
Degradable of the present invention prevents the technical scheme that the another kind backflowing anastomose esophagus stomach support improves, it is characterized in that in the degradation material of described rack body, or on the surface of described rack body, be added with x photodevelopment agent, the anti-anastomose esophagus stomach support that backflows of described degradable can observe the state of described rack body after inserting under x line.
Degradable of the present invention is prevented backflowing the technical scheme of a kind of further improvement of anastomose esophagus stomach support, it is characterized in that in the degradation material of described rack body, or on the surface of described rack body, be added with and stimulate tissue growth or anti-infective medicine or the factor; After the anti-anastomose esophagus stomach support that backflows of described degradable is inserted, described medicine or the factor can along with the degraded slow releasing of rack body.
The invention has the beneficial effects as follows:
1, the anti-anastomose esophagus stomach support that backflows of degradable of the present invention, can by detachable inner core clipping operation in esophagogastrostomy, by the support of rack body and the positioning function of ligation groove, and facilitating operation, simple and quick; Timbering material price is not high, and manufacturing process is simple, obviously can reduce the expense of operation, alleviate patient's burden.
2, the anti-anastomose esophagus stomach support that backflows of degradable of the present invention, isolates esophagus and stomach content and anastomotic stoma by anti-recirculation device, is conducive to the growth healing of anastomotic stoma, reduces the incidence rate of anastomotic leakage; Support, to the supporting role of anastomotic stoma, can prevent the generation of anastomotic stricture, reduces the incidence rate of the complication after anastomosis; Support can be degraded gradually after anastomotic healing, and degraded composition excretes by intestinal, and in digestive tract, foreign remains.
3, the anti-anastomose esophagus stomach support that backflows of degradable of the present invention, the medicine or the factor that stimulate tissue growth or infection etc. is contained at the material of support, can discharge in local slow along with its degraded while Stent Implantation, thus effectively promote the quickly-healing in anastomose esophagus stomach portion.
Accompanying drawing explanation
Fig. 1 is that degradable of the present invention is prevented backflowing the structural representation of anastomose esophagus stomach support;
Fig. 2 is that degradable of the present invention is prevented backflowing the rack body schematic diagram of anastomose esophagus stomach support;
Fig. 3 is three lobe leaf valve structure schematic diagrams of the anti-recirculation device of anastomose esophagus stomach support of the present invention;
Fig. 4 is that degradable of the present invention is prevented backflowing the detachable inner core schematic diagram of anastomose esophagus stomach support;
Fig. 5 is that degradable of the present invention is prevented backflowing the using state schematic diagram of anastomose esophagus stomach support.
In figure, 1-rack body, the anti-recirculation device of 2-, 3-ligation groove, the detachable inner core of 4-, 41-inner core esophagus end, 42-inner core stomach end, 43-clamp groove, 5-esophagus, 6-stomach, 7-ligature.
Detailed description of the invention
In order to technique scheme of the present invention can be understood better, describe in detail further below in conjunction with drawings and Examples.
Degradable of the present invention prevent backflowing anastomose esophagus stomach support an embodiment as shown in Figure 1, comprise the tubular bracket main body 1 that degradation material is made, see Fig. 2.Inner in tubular bracket main body 1, be provided with the anti-recirculation device 2 esophagus and stomach content and anastomotic stoma can isolated, see Fig. 2 and Fig. 3.Anastomose esophagus stomach support of the present invention is furnished with the detachable inner core 4 through tubular bracket main body 1 endoporus; The esophagus end 41 of detachable inner core 4, in semielliptical shape, stretches out from the endoporus of tubular bracket main body 1; Conically, the basal diameter of its cone is consistent with the external diameter of tubular bracket main body 1 for the stomach end 42 of detachable inner core 4; Described conical both sides are provided with the groove 43 of available vascular forceps clamping, see Fig. 4.
Degradable according to the present invention is prevented backflowing the embodiment of anastomose esophagus stomach support, is medical degradable biomaterial, comprises polylactic acid, dioxanone and degradable magnesium alloy for making the degradation material of rack body 1.
Prevent backflowing in the embodiment of anastomose esophagus stomach support at the degradable of the present invention shown in Fig. 1 and Fig. 2, the outer surface of tubular bracket main body 1, be provided with the ligation groove 3 of 1-4 annular recess, the ligation of esophagus and stomach rhynchodaenm is fixed in described ligation groove, ligation groove 3 can regulate the elasticity of ligation, while playing fixing and sealing process, meet anastomotic part blood and transport unimpeded requirement.Detachable inner core 4 is only for anastomose esophagus stomach operation process, and vascular forceps clamp groove 43 easy to use, puts into esophagus or stomach end by tubular bracket main body 1 on the one hand, is convenient to carry out sutural ligation operation on the other hand; After tubular bracket main body 1 has been inserted, detachable inner core 4 has needed to remove from the endoporus of tubular bracket main body 1 before operation terminates.
Degradable according to the present invention is prevented backflowing an embodiment of anastomose esophagus stomach support, and detachable inner core 4 adopts nontoxic hard material to make; After described anastomose esophagus stomach support is inserted, detachable inner core 4 can be extracted out from the stomach end of rack body 1 and remove.
Degradable of the present invention is prevented backflowing the better technical scheme of another kind of anastomose esophagus stomach support, it is characterized in that detachable inner core 4 adopts airbag structure; After described anastomose esophagus stomach support is inserted, the detachable inner core 4 of emptying airbag gas can be extracted out and remove from the endoporus of rack body 1.
Prevent backflowing in the embodiment of anastomose esophagus stomach support at the degradable of the present invention shown in Fig. 2 and Fig. 3, anti-recirculation device 2 is for having the valve of the unidirectional opening of 3 lobe leaves, and described valve adopts biomaterial thin film to make; Described anastomose esophagus stomach support is inserted and after removing detachable inner core 4, the valve of tubular bracket main body 1 inside on the feed time direct motion open, oppositely then stop gastric content from backwards flowing to enter esophagus, see Fig. 5.
Degradable according to the present invention is prevented backflowing an embodiment of anastomose esophagus stomach support, in the degradation material of described rack body 1, or on the surface of described rack body 1, be added with x photodevelopment agent, the anti-anastomose esophagus stomach support that backflows of described degradable can observe the state of rack body 1 after inserting under x line.
Degradable according to the present invention is prevented backflowing an embodiment of anastomose esophagus stomach support, in the degradation material of rack body 1, or on the surface of rack body 1, is added with and stimulates tissue growth or anti-infective medicine or the factor; After the anti-anastomose esophagus stomach support that backflows of degradable of the present invention is inserted, described medicine or the factor can along with the degraded slow releasing of rack body 1.
Degradable of the present invention is prevented backflowing the embodiment of anastomose esophagus stomach support using method:
The first identical method:
1, work as Esophagectomy, after stomach is ready, carry out pocket suture at esophageal stump, or in the perforate of Esophageal Resection Stump front side wall, the esophagus end of the anastomosis bracket with detachable inner core 4 is inserted in esophagus;
2, esophageal stump ligation is fixed in the ligation groove 3 of anastomosis bracket lower end, exits detachable inner core 4;
3, then process stomach, need the position coincide to do two concentric purse string sutures according to the size of anastomotic stoma at stomach;
4, then, do a suitable otch in pocket central authorities, by the stomach end of the rack body 1 after removal inner core, insert gastric through otch, then be enclosed within outside esophagus outside gastric is turned over, inner ring purse string suture toe-in is pricked in the same ligation groove be fixed on fixing esophagus.
5, after carrying coat of the stomach on, being pricked by outside purse string suture toe-in is fixed in the ligation groove of the upper end of anastomosis bracket, make to contact with each other with coat of the stomach seromuscular layer outside esophageal wall, the blood fortune of anastomotic part interior tissue is not blocked, ligation degree of tightness appropriateness, pine of trying one's best when playing fixing and sealing process, see Fig. 5, represent esophagus with reticulate pattern in figure, heavy line represents coat of the stomach.
The second coincide method:
1, the process of esophageal site is the same, esophageal stump ligation is fixed in the ligation groove 3 of anastomosis bracket lower end, retains detachable inner core 4;
2, at the reserved auxiliary incision of stomach, a minimal incision * is done needing the position coincide;
3, then, utilize the taper shape that anastomosis bracket detachable inner core 4 stomach distal process goes out, be inserted into by anastomosis bracket in the gastral cavity of identical incision, direct motion inserts gastric rack body 1, and coat of the stomach and esophageal wall are close to;
4, enter in gastral cavity by described auxiliary incision, in gastric wallflow ligation process, first ligature is fixed in the same ligation groove with fixing esophagus;
5, after carrying coat of the stomach on, outside purse string suture toe-in is pricked and is fixed in the ligation groove of the upper limb of anastomosis bracket, makes to contact with each other with coat of the stomach seromuscular layer outside esophageal wall, the blood fortune of anastomotic part interior tissue is not blocked, ligation degree of tightness appropriateness, pine of trying one's best when playing fixation, see Fig. 5;
6, then, the auxiliary incision of coniform inner core from stomach is gone out to extract, sew up the auxiliary incision described in closing.
The first identical method above-mentioned is applicable to the operation of stomach non-incision.But for the operation of stomach non-incision, a kind of method of better coincideing adopts the detachable inner core 4 with airbag structure.Adopt above-mentioned the second to coincide the step 1-5 of method, but do not need reserved described auxiliary incision; After being inserted by described anastomose esophagus stomach support, after step 6 changes the gas in emptying airbag structure into, then from the endoporus of rack body 1, extract detachable inner core 4 by esophagus out.
After anastomotic healing, the anti-anastomose esophagus stomach support that backflows of degradable of the present invention can be degraded gradually, and the medicine meeting slow releasing included, degraded composition excretes by intestinal, and in digestive tract, foreign remains.In anastomotic healing process, esophagus and stomach content and anastomotic stoma can be isolated by the anti-recirculation device in anastomosis bracket, are conducive to the growth healing of anastomotic stoma, reduce the incidence rate of anastomotic leakage, and play the effect preventing gastroesophageal reflux; Support, to the supporting role of anastomotic stoma, also prevent the generation of anastomotic stricture.After postoperative anastomotic healing is complete, the function of the anti-valve that backflows can not be needed.After scaffold degradation, its anti-valve backflowed can come off thereupon and excrete with gastrointestinal peristalsis.
Those of ordinary skill in the art will be appreciated that; above embodiment is only used to technical scheme of the present invention is described; and be not used as limitation of the invention; any the above embodiment is done based on connotation of the present invention change, modification, all will drop in the protection domain of claim of the present invention.
Claims (8)
1. the anti-anastomose esophagus stomach support that backflows of degradable, comprises the tubular bracket main body that degradation material is made, it is characterized in that:
Described tubular bracket body interior, is provided with anti-recirculation device esophagus and stomach content and anastomotic stoma can isolated;
Described anastomose esophagus stomach support is furnished with the detachable inner core through tubular bracket main body endoporus;
The esophagus end of described detachable inner core is semielliptical shape, stretches out from the endoporus of tubular bracket main body; Conically, its basal diameter is consistent with the external diameter of tubular bracket main body for the stomach end of described detachable inner core; The groove of available vascular forceps clamping is provided with in described conical both sides.
2. the anti-anastomose esophagus stomach support that backflows of degradable according to claim 1, is characterized in that the degradation material for making rack body is medical degradable biomaterial, comprising polylactic acid, dioxanone and degradable magnesium alloy.
3. the anti-anastomose esophagus stomach support that backflows of degradable according to claim 1, it is characterized in that the outer surface of described tubular bracket main body, be provided with the ligation groove of 1-4 annular recess, the ligation of anastomose esophagus stomach portion is fixed in described ligation groove, described ligation groove can regulate the elasticity of ligation, while playing fixing and sealing process, meet anastomotic part blood and transport unimpeded requirement.
4. the anti-anastomose esophagus stomach support that backflows of degradable according to claim 1, is characterized in that described detachable inner core adopts nontoxic hard material to make; After described anastomose esophagus stomach support is inserted, described detachable inner core can be extracted out from the stomach end of rack body and remove.
5. the anti-anastomose esophagus stomach support that backflows of degradable according to claim 1, is characterized in that described detachable inner core adopts airbag structure; After described anastomose esophagus stomach support is inserted, the detachable inner core of emptying airbag gas can be extracted out and remove from the endoporus of described rack body.
6. the anti-anastomose esophagus stomach support that backflows of degradable according to claim 1, is characterized in that described anti-recirculation device is the valve of the unidirectional opening with 2-4 lobe leaf, and described valve adopts biomaterial thin film to make; After described anastomose esophagus stomach support is inserted, the valve of tubular bracket body interior on the feed time direct motion open, oppositely then stop gastric content from backwards flowing to enter esophagus.
7. the anti-anastomose esophagus stomach support that backflows of the degradable according to arbitrary claim of claim 1 to 6, it is characterized in that in the degradation material of described rack body, or on the surface of described rack body, be added with x photodevelopment agent, the anti-anastomose esophagus stomach support that backflows of described degradable can observe the state of described rack body after inserting under x line.
8. the anti-anastomose esophagus stomach support that backflows of the degradable according to arbitrary claim of claim 1 to 6, it is characterized in that in the degradation material of described rack body, or on the surface of described rack body, be added with and stimulate tissue growth or anti-infective medicine or the factor; After the anti-anastomose esophagus stomach support that backflows of described degradable is inserted, described medicine or the factor can along with the degraded slow releasing of rack body.
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| CN201410016044.3A CN104771253B (en) | 2014-01-14 | 2014-01-14 | The anti-esophagus and stomach anastomosis bracket that backflows of a kind of degradable |
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| CN201410016044.3A CN104771253B (en) | 2014-01-14 | 2014-01-14 | The anti-esophagus and stomach anastomosis bracket that backflows of a kind of degradable |
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| CN104771253B CN104771253B (en) | 2016-06-08 |
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| CN105266935A (en) * | 2015-11-23 | 2016-01-27 | 孙思予 | Backflow-preventing valve gastric-biliary anastomosis stent |
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| CN115281764A (en) * | 2022-08-24 | 2022-11-04 | 安徽百诺佳医疗科技有限公司 | Operation anastomat |
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| CN104771253B (en) | 2016-06-08 |
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