CN104771253B - The anti-esophagus and stomach anastomosis bracket that backflows of a kind of degradable - Google Patents
The anti-esophagus and stomach anastomosis bracket that backflows of a kind of degradable Download PDFInfo
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- CN104771253B CN104771253B CN201410016044.3A CN201410016044A CN104771253B CN 104771253 B CN104771253 B CN 104771253B CN 201410016044 A CN201410016044 A CN 201410016044A CN 104771253 B CN104771253 B CN 104771253B
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Abstract
The anti-esophagus and stomach anastomosis bracket that backflows of a kind of degradable, relate to the prosthese of hollow or tubulose in implantable, particularly relate to a kind of anti-support that backflows of degradable coincideing for esophagus and stomach, including the tubular bracket main body that degradation material is made, tubular bracket body interior is provided with can by the anti-recirculation device of esophagus and stomach content with anastomotic stoma isolation; Esophagus and stomach anastomosis bracket is furnished with the detachable inner core through tubular bracket main body endoporus; The esophagus end of detachable inner core is semielliptical shape, stretches out from the endoporus of tubular bracket main body; The stomach end of detachable inner core is conical; Both sides are provided with the groove of available vascular forceps clamping; The outer surface of tubular bracket main body is provided with the ligation groove of annular recess. In esophagogastrostomy can by detachable inner core clipping operation, by the positioning function of the support of rack body and ligation groove, facilitating operation, simple and quick; Timbering material is inexpensive, and manufacturing process is simple, can obviously reduce the expense of operation, alleviates patient's burden.
Description
Technical field
The present invention relates to the prosthese of hollow or tubulose in implantable, particularly relate to a kind of anti-support that backflows of degradable coincideing for esophagus and 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 being easiest to develop complications. At present, anastomosis method specifically includes that 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, easily concurrent fistula of operative incision, the problem such as narrow, but this method is less costly, is still main identical method in the area of some economics of underdevelopment. Anastomat hemorrhoidal circumcision method is to use anastomat to complete the technology coincideing, and main employing circular staplers row coincide, but also has the method adopting linear anastomat row to coincide. The identical method of circular staplers is current most common method, coincide and determines, the size of anastomotic stoma can select according to the condition of patient, method is ripe, but this anastomosis operation relative complex, also has about 3%-5% patient fistula of operative incision or narrow complication occur, and anastomat price is higher. The technology of linear anastomat is suitable for the stage still in clinic 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, authorize publication No.: CN85203973U) disclose a kind of for esophagus, stomach, large intestine intracavity elastic force cerclage anastomat.
But, anastomosis bracket is had special requirement by gastro-esophageal anastomosis, first, after esophageal-gastric coincide local healing, the anastomosis bracket inserted generally requires removal. 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, degradable polymer the filament prepared 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 makes gastric juice easily backflow. In case the valve sampling device that backflows, in case gastric content from backwards flowing after coincideing, can develop complications accordingly, it would be desirable to design implants one, 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, edge in Coated Stents in Treatment of Benign inner chamber lower end, it is provided with at least two to contact with each other the bag-shaped anti-valve that backflows that connects that Open Side Down, the above outward flange of the bag-shaped anti-valve that backflows and the outward flange of side are fixed with inner chamber overlay film respectively and are connected, the bag-shaped anti-valve that backflows contacts with each other after connection, the inner chamber of completely enclosed Coated Stents in Treatment of Benign.
3rd, the healing of the identical local of esophageal-gastric needs the hypertrophy of tissue, mucosa, if local can discharge the medicine or biotic factor that promote hamartoplasia, it will help the healing of anastomotic stoma. Chinese invention patent " a kind of load medicine cover capsule Esophageal Stent and preparation method thereof " (application for a patent for invention number: 201010532866.9Publication 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 effective site cavity with one layer of elastomer seal of its outer wrap of corrugated tube, fix a drug-feeding tube communicated with medicine bag at tube wall place, corrugated tube effective site upper end, can pass through to discharge medicine and promote disease healing.
Although above-mentioned prior art solves some technical problems of Esophageal Stent manufacture and use respectively, but does not provide a kind of anti-anastomosis bracket that backflows of degradable meeting esophagus and stomach anastomosis operation requirement. In addition, gastro-esophageal anastomosis position is positioned at position, thoracic cavity, the tension force that coincide is big, position is limited to, the technology of gastro-esophageal anastomosis requires higher, especially because the rigidity of biodegradable stent is relatively poor, with greater need for the ligation fixation problem solving anastomosis bracket clamping in inserting process and anastomotic position.
Summary of the invention
It is an object of the invention to provide the anti-esophagus and stomach anastomosis bracket that backflows of a kind of degradable, comprehensive solve coincideing of esophageal-gastric in operation on esophagus, solve anti-backflowing simultaneously, the clamping in inserting process is, and the technical problem such as the ligation of anastomotic position is fixing.
This invention address that above-mentioned technical problem be the technical scheme is that
The anti-esophagus and stomach anastomosis bracket that backflows of a kind of degradable, including the tubular bracket main body that degradation material is made, it is characterised in that:
Described tubular bracket body interior, being provided with can by the anti-recirculation device of esophagus and stomach content with anastomotic stoma isolation;
Described esophagus and stomach anastomosis bracket 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; The stomach end of described detachable inner core is conical, and its basal diameter is consistent with the external diameter of tubular bracket main body; The groove of available vascular forceps clamping it is provided with in the both sides of described cone.
The degradable of the present invention is prevented backflowing a kind of preferred technical scheme of esophagus and stomach anastomosis bracket, it is characterised in that be medical degradable biomaterial for making the degradation material of rack body, including polylactic acid, dioxanone and degradable magnesium alloy.
The degradable of the present invention is prevented backflowing the one preferably technical scheme of esophagus and stomach anastomosis bracket, it is characterized in that the outer surface of described tubular bracket main body, it is provided with the ligation groove of 1-4 annular recess, esophagus and stomach rhynchodaenm ligation is fixed in described ligation groove, described ligation groove can regulate the elasticity of ligation, while playing fixing and sealing process, meet the requirement that anastomotic part blood fortune is unimpeded.
The degradable of the present invention is prevented backflowing a kind of superior technique scheme of esophagus and stomach anastomosis bracket, it is characterised in that described detachable inner core adopts nontoxic hard material to make; After described esophagus and stomach anastomosis bracket is inserted, described detachable inner core can be extracted out from the stomach end of rack body and remove.
The degradable of the present invention is prevented backflowing the another kind of superior technique scheme of esophagus and stomach anastomosis bracket, it is characterised in that described detachable inner core adopts airbag structure; After described esophagus and stomach anastomosis bracket is inserted, the detachable inner core of emptying airbag gas can be extracted out from the endoporus of described rack body and remove.
The degradable of the present invention is prevented backflowing the technical scheme of a kind of improvement of esophagus and stomach anastomosis bracket, it is characterised in that described anti-recirculation device is the valve of the unidirectional opening with 2-4 leaflet, and described valve adopts biomaterial thin film to make; After described esophagus and stomach anastomosis bracket is inserted, the valve of tubular bracket body interior on the feed time direct motion open, reversely then stop gastric content from backwards flowing to enter esophagus.
The degradable of the present invention is prevented backflowing the another kind of technical scheme improved of esophagus and stomach anastomosis bracket, it is characterized in that in the degradation material of described rack body, or the surface at described rack body, it is added with x photodevelopment agent, after the anti-esophagus and stomach anastomosis bracket that backflows of described degradable is inserted, it is possible to observe the state of described rack body under x line.
The degradable of the present invention is prevented backflowing the technical scheme of a kind of further improvement of esophagus and stomach anastomosis bracket, it is characterized in that in the degradation material of described rack body, or the surface at described rack body, is added with stimulation tissue growth or anti-infective medicine or the factor; After the anti-esophagus and stomach anastomosis bracket 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-esophagus and stomach anastomosis bracket that backflows of the degradable of the present invention, in esophagogastrostomy can by detachable inner core clipping operation, by the positioning function of the support of rack body and ligation groove, facilitating operation, simple and quick; Timbering material is inexpensive, and manufacturing process is simple, can obviously reduce the expense of operation, alleviates patient's burden.
2, the anti-esophagus and stomach anastomosis bracket that backflows of the degradable of the present invention, by anti-recirculation device by esophagus and stomach content and anastomotic stoma isolation, is conducive to the growth of anastomotic stoma to heal, reduces the incidence rate of anastomotic leakage; The support supporting role to anastomotic stoma, it is possible to 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 can be excreted by intestinal, foreign residual in digestive tract.
3, the anti-esophagus and stomach anastomosis bracket that backflows of the degradable of the present invention, material at support contains the medicine or the factor that stimulate tissue growth or infection etc., can discharge in local slow along with its degraded while Stent Implantation, thus effectively facilitating the quickly-healing of esophagus and stomach anastomotic part.
Accompanying drawing explanation
Fig. 1 is that the degradable of the present invention is prevented backflowing the structural representation of esophagus and stomach anastomosis bracket;
Fig. 2 is that the degradable of the present invention is prevented backflowing the rack body schematic diagram of esophagus and stomach anastomosis bracket;
Fig. 3 is three leaflet valve structure schematic diagrams of the anti-recirculation device of the esophagus and stomach anastomosis bracket of the present invention;
Fig. 4 is that the degradable of the present invention is prevented backflowing the detachable inner core schematic diagram of esophagus and stomach anastomosis bracket;
Fig. 5 is that the degradable of the present invention is prevented backflowing the use view of esophagus and stomach anastomosis bracket.
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
For better understanding of the technique scheme of the present invention, it is described in detail further below in conjunction with drawings and Examples.
The degradable of the present invention prevents backflowing an embodiment of esophagus and stomach anastomosis bracket as it is shown in figure 1, include the tubular bracket main body 1 that degradation material is made, referring to Fig. 2. Inside tubular bracket main body 1, it is provided with the anti-recirculation device 2 esophagus and stomach content can isolated with anastomotic stoma, referring to Fig. 2 and Fig. 3. The esophagus and stomach anastomosis bracket 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; The stomach end 42 of detachable inner core 4 is conical, and the basal diameter of its cone is consistent with the external diameter of tubular bracket main body 1; The both sides of described cone are provided with the groove 43 of available vascular forceps clamping, referring to Fig. 4.
Degradable according to the present invention is prevented backflowing the embodiment of esophagus and stomach anastomosis bracket, is medical degradable biomaterial for making the degradation material of rack body 1, including polylactic acid, dioxanone and degradable magnesium alloy.
The degradable of the present invention shown in Fig. 1 and Fig. 2 prevent backflowing esophagus and stomach anastomosis bracket embodiment in, the outer surface of tubular bracket main body 1, it is provided with the ligation groove 3 of 1-4 annular recess, esophagus and stomach rhynchodaenm ligation is fixed in described ligation groove, ligation groove 3 can regulate the elasticity of ligation, while playing fixing and sealing process, meet the requirement that anastomotic part blood fortune is unimpeded. Tubular bracket main body 1 only for esophagus and stomach anastomosing surgical procedure, one side vascular forceps clamp groove 43 easy to use, is put into esophagus or stomach end by detachable inner core 4, is convenient for the ligation operation of stitching thread on the other hand; After tubular bracket main body 1 has been inserted, detachable inner core 4 needs 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 esophagus and stomach anastomosis bracket, and detachable inner core 4 adopts nontoxic hard material to make; After described esophagus and stomach anastomosis bracket is inserted, detachable inner core 4 can be extracted out from the stomach end of rack body 1 and remove.
The degradable of the present invention is prevented backflowing the another kind of superior technique scheme of esophagus and stomach anastomosis bracket, it is characterised in that detachable inner core 4 adopts airbag structure; After described esophagus and stomach anastomosis bracket is inserted, the detachable inner core 4 of emptying airbag gas can be extracted out from the endoporus of rack body 1 and remove.
The degradable of the present invention shown in Fig. 2 and Fig. 3 prevent backflowing esophagus and stomach anastomosis bracket embodiment in, anti-recirculation device 2 is the valve of the unidirectional opening with 3 leaflets, and described valve adopts biomaterial thin film to make;After detachable inner core 4 is inserted and removed to described esophagus and stomach anastomosis bracket, the valve within tubular bracket main body 1 on the feed time direct motion open, reversely then stop gastric content from backwards flowing to enter esophagus, referring to Fig. 5.
Degradable according to the present invention is prevented backflowing an embodiment of esophagus and stomach anastomosis bracket, in the degradation material of described rack body 1, or the surface at described rack body 1, it is added with x photodevelopment agent, after the anti-esophagus and stomach anastomosis bracket that backflows of described degradable is inserted, it is possible to observe the state of rack body 1 under x line.
Degradable according to the present invention is prevented backflowing an embodiment of esophagus and stomach anastomosis bracket, in the degradation material of rack body 1, or the surface at rack body 1, it is added with stimulation tissue growth or anti-infective medicine or the factor; After the anti-esophagus and stomach anastomosis bracket that backflows of the degradable of the present invention is inserted, described medicine or the factor can along with the degraded slow releasing of rack body 1.
The degradable of the present invention is prevented backflowing the embodiment of esophagus and stomach anastomosis bracket using method:
The first identical method:
1, work as Esophagectomy, after stomach is ready, carries out pocket suture at esophageal stump, or in Esophageal Resection Stump front side wall perforate, 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 coincideing 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, the stomach end of the rack body 1 after inner core will be removed, insert gastric through otch, then gastric is turned over outer be enclosed within outside esophagus, inner ring purse string suture line ligation is fixed on in the same ligation groove of fixing esophagus.
5, after lifting up coat of the stomach, outside purse string suture line ligation is fixed in the ligation groove of upper end of anastomosis bracket, make outside esophageal wall and coat of the stomach seromuscular layer contacts with each other, the blood fortune of anastomotic part interior tissue is not blocked, ligation degree of tightness appropriateness, plays when fixing and sealing process as far as possible loose, referring to Fig. 5, representing esophagus with reticulate pattern in figure, heavy line represents coat of the stomach.
The second coincide method:
1, the process of esophageal site is ibid, 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 little otch is done needing the position coincideing;
3, then, the cone utilizing the detachable inner core 4 stomach distal process of anastomosis bracket to go out, anastomosis bracket is inserted in the gastral cavity of identical incision, direct motion inserts gastric rack body 1, makes coat of the stomach and esophageal wall be close to;
4, enter in gastral cavity by described auxiliary incision, process in gastric wallflow ligation, first ligature be fixed on in the same ligation groove of fixing esophagus;
5, after lifting up coat of the stomach, outside purse string suture line ligation is fixed in the ligation groove of the upper limb of anastomosis bracket, makes outside esophageal wall and coat of the stomach seromuscular layer contacts with each other, the blood fortune of anastomotic part interior tissue is not blocked, ligation degree of tightness appropriateness, plays when fixation as far as possible loose, referring to Fig. 5;
6, then, go out to extract from the auxiliary incision of stomach by coniform inner core, sew up and close described auxiliary incision.
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 is the detachable inner core 4 adopting and having airbag structure.Adopt the step 1-5 of the identical method of above-mentioned the second, but do not need reserved described auxiliary incision; After being inserted by described esophagus and stomach anastomosis bracket, step 6 extracts detachable inner core 4 out again through esophagus after changing the gas in emptying airbag structure into from the endoporus of rack body 1.
After anastomotic healing, the anti-esophagus and stomach anastomosis bracket that backflows of the degradable of the present invention can be degraded gradually, and the medicine meeting slow releasing included, degraded composition can be excreted by intestinal, foreign residual in digestive tract. In anastomotic healing process, the anti-recirculation device in anastomosis bracket by esophagus and stomach content and anastomotic stoma isolation, can be conducive to the growth of anastomotic stoma to heal, reduce the incidence rate of anastomotic leakage, and play the effect preventing gastroesophageal reflux; The support supporting role to anastomotic stoma, also prevent the generation of anastomotic stricture. After postoperative anastomotic healing is complete, it may be unnecessary to the function of the anti-valve that backflows. After scaffold degradation, its anti-valve backflowed can come off therewith and excrete with gastrointestinal peristalsis.
Those of ordinary skill in the art will be appreciated that; above embodiments is intended merely to explanation technical scheme; and it is not used as limitation of the invention; any embodiment described above is made based on the connotation of the present invention change, modification, all by the scope of the claims dropping on the present invention.
Claims (8)
1. the anti-esophagus and stomach anastomosis bracket that backflows of degradable, including the tubular bracket main body that degradation material is made, it is characterised in that:
Described tubular bracket body interior, being provided with can by the anti-recirculation device of esophagus and stomach content with anastomotic stoma isolation;
Described esophagus and stomach anastomosis bracket 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; The stomach end of described detachable inner core is conical, and its basal diameter is consistent with the external diameter of tubular bracket main body; The groove of available vascular forceps clamping it is provided with in the both sides of described cone.
2. the anti-esophagus and stomach anastomosis bracket that backflows of degradable according to claim 1, it is characterised in that the degradation material being used for making rack body is medical degradable biomaterial, including polylactic acid, dioxanone and degradable magnesium alloy.
3. the anti-esophagus and stomach anastomosis bracket that backflows of degradable according to claim 1, it is characterized in that the outer surface of described tubular bracket main body, it is provided with the ligation groove of 1-4 annular recess, esophagus and stomach anastomotic part ligation is fixed in described ligation groove, described ligation groove can regulate the elasticity of ligation, while playing fixing and sealing process, meet the requirement that anastomotic part blood fortune is unimpeded.
4. the anti-esophagus and stomach anastomosis bracket that backflows of degradable according to claim 1, it is characterised in that described detachable inner core adopts nontoxic hard material to make; After described esophagus and stomach anastomosis bracket is inserted, described detachable inner core can be extracted out from the stomach end of rack body and remove.
5. the anti-esophagus and stomach anastomosis bracket that backflows of degradable according to claim 1, it is characterised in that described detachable inner core adopts airbag structure; After described esophagus and stomach anastomosis bracket is inserted, the detachable inner core of emptying airbag gas can be extracted out from the endoporus of described rack body and remove.
6. the anti-esophagus and stomach anastomosis bracket that backflows of degradable according to claim 1, it is characterised in that described anti-recirculation device is the valve of the unidirectional opening with 2-4 leaflet, described valve adopts biomaterial thin film to make;After described esophagus and stomach anastomosis bracket is inserted, the valve of tubular bracket body interior on the feed time direct motion open, reversely then stop gastric content from backwards flowing to enter esophagus.
7. the anti-esophagus and stomach anastomosis bracket that backflows of degradable according to any claim of claim 1 to 6, it is characterized in that in the degradation material of described rack body, or the surface at described rack body, it is added with x photodevelopment agent, after the anti-esophagus and stomach anastomosis bracket that backflows of described degradable is inserted, it is possible to observe the state of described rack body under x line.
8. the anti-esophagus and stomach anastomosis bracket that backflows of degradable according to any claim of claim 1 to 6, it is characterized in that in the degradation material of described rack body, or the surface at described rack body, is added with stimulation tissue growth or anti-infective medicine or the factor; After the anti-esophagus and stomach anastomosis bracket 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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Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN105266935B (en) * | 2015-11-23 | 2017-10-13 | 孙思予 | A kind of antireflux film omasum courage anastomosis bracket |
| CN108186160A (en) * | 2017-11-28 | 2018-06-22 | 王勇 | The anti-Esophageal Stent that backflows of one kind |
| CN109620331A (en) * | 2019-01-31 | 2019-04-16 | 杭州医美医疗器械有限公司 | Detachable vascular anastomosis bracket |
| CN111437489A (en) * | 2020-03-06 | 2020-07-24 | 巴彦淖尔市医院 | Flow guide pipe in indirect jejunum operation and method thereof |
| CN115281764B (en) * | 2022-08-24 | 2023-03-24 | 安徽百诺佳医疗科技有限公司 | Operation anastomat |
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