CN105407815A - 用于吻合术的定位工具 - Google Patents

用于吻合术的定位工具 Download PDF

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CN105407815A
CN105407815A CN201480033057.XA CN201480033057A CN105407815A CN 105407815 A CN105407815 A CN 105407815A CN 201480033057 A CN201480033057 A CN 201480033057A CN 105407815 A CN105407815 A CN 105407815A
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magnet
stomach
probe
gripping tool
tool
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CN105407815B (zh
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D·克莱因
I·法比安
N·奥尔特曼
S·哈斯
Y·赫希
兰·门德勒维茨
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EASYNOTES Ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/0034—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00876—Material properties magnetic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A61B2017/1117—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus adapted for discharge after necrotisation, e.g. by evacuation, expulsion or excretion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1139—Side-to-side connections, e.g. shunt or X-connections

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Physiology (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Endoscopes (AREA)

Abstract

一种定位工具(10)，包括固定至抓取工具(14)的一部分的探针(12)。探针(12)的远端从抓取工具(14)向远侧突出一定距离，该距离对应于利用抓取工具(14)放置磁体(20)的位置。

Description

用于吻合术的定位工具
技术领域
本发明通常涉及用于在胃肠道(GI)内产生吻合的设备和方法，并且特别涉及用于相对于幽门瓣(幽门)定位胃吻合磁体的定位辅助工具。
背景技术
磁性吻合设备用于在两个脏器之间形成通道，其目的在于重新引导体液。例如，肠道内容物或胆汁可以在由于诸如肿瘤、溃疡、炎性狭窄或创伤等疾病状况而产生肠道或胆管内阻塞的患者内重新导向。一些磁性吻合设备包括第一和第二磁体组件，这些磁体组件包括由薄的金属圈围绕的磁芯。由于两个磁芯之间的磁性吸引，两个相邻内脏(例如，胆囊、胆总管、胃、十二指肠或空肠)的壁可能会被夹持或压缩在磁体组件之间，导致壁的缺血性坏死，从而在两个内脏之间产生吻合。
发明内容
本发明试图提供一种用于相对于幽门定位胃吻合磁体的定位辅助工具，如下文更加详细地描述的那样。
因此，根据本发明的实施方式提供了一种包括定位工具的组件，该定位工具包括固定至抓取工具的一部分的探针，其中所述探针的远端从抓取工具向远侧突出一定距离，该距离对应于利用抓取工具放置磁体的位置。所述组件还可包括胃吻合磁体，该胃吻合磁体包括供抓取工具抓取的保持部。
根据本发明的实施方式提供了一种方法，该方法包括：通过利用抓取工具抓取第一磁体将所述第一磁体递送至胃部内的位置，其中所述抓取工具的一部分固定有包括探针的定位工具；在递送所述第一磁体之前或之后，经过幽门将第二磁体递送至肠道内的位置，其中所述探针的远端从所述抓取工具向远侧突出一定距离，该距离对应于在所述胃部内放置所述第一磁体的合适位置；以及将所述第一磁体和所述第二磁体对准并释放所述第一磁体和所述第二磁体，使得磁力将所述第一磁体和所述第二磁体吸引在一起，从而将所述肠道和所述胃部的壁压缩在一起，用于最终形成吻合。
附图说明
通过下面详细描述并结合附图，将更加充分地理解和认识本发明，其中：
图1是根据本发明实施方式构造和操作的用于与胃吻合磁体一起使用的定位工具的简化图；以及
图2是根据本发明实施方式的附接至胃吻合磁体且距离幽门合适距离的定位工具的简化示意图。
具体实施方式
现在参照图1和图2，它们示出了根据本发明的实施方式构造和操作的用于与胃吻合磁体20一起使用的定位工具10。
定位工具10包括探针12，该探针固定至抓取工具14的一部分，诸如但不限于，活检钳或可通过内窥镜16(图2中示出)递送的其它内窥镜工具的远端。胃吻合磁体20具有保持部22，用于供抓取工具14抓取。探针12可以是纤细的细长构件，其具有相比其宽度至少长五倍的长度，并且可由医用安全材料制成，诸如金属或塑料。
磁体20被示出为具有大致盘形的形状，但也可以使用其它形状，诸如但不限于圆柱形、多面形、卵圆形、立方体等。磁体20可包括防护涂层(诸如，但不限于，聚四氟乙烯)，用于防止磁芯遭受腐蚀性消化酸或其它体液。
图2示出了被放置成用于在胃部和小肠的一部分(诸如十二指肠、空肠或回肠)之间形成吻合的磁体。除了磁体20之外，另一吻合磁体24已经穿过食道E、胃部S、幽门P、十二指肠D和空肠J进行递送。磁体24可借助于内窥镜、导丝、导管或其它设备进行递送，并被放置成靠近如图2中所示的肠壁(例如，空肠的肠壁)。
磁体20通过抓住穿过内窥镜16的抓取工具14而在胃部中被递送到位，或它可以借助于导丝、导管或其它设备以类似于引入磁体24的方式进行递送。磁体20靠近胃壁进行定位，与磁体24位置附近的空肠毗邻。如图2中能够看出的，探针12从抓取工具14向远侧突出的距离被选择成使得，在胃吻合磁体20被恰当地定位成与磁体24对置时，探针12的远端18将接触幽门。磁体24的位置可通过其递送系统进行调整以与磁体20对准。磁体20和24然后可被释放以使得磁力将这些磁体吸引在一起，从而将空肠和胃部的壁压缩在一起。一旦完成胃部和空肠的壁的坏死，就形成了吻合。磁体20和24然后就能够自然地穿过身体，或能够借助于诸如腹腔镜移除、内窥镜移除、或其它手术来移除。

Claims (4)

1.一种组件，该组件包括：
定位工具(10)，该定位工具包括固定至抓取工具(14)的一部分的探针(12)，其中所述探针(12)的远端从所述抓取工具(14)向远侧突出一定距离，该距离对应于利用所述抓取工具(14)放置磁体(20)的位置。
2.根据权利要求1所述的组件，该组件还包括胃吻合磁体(20)，该胃吻合磁体包括用于供所述抓取工具(14)抓取的保持部(22)。
3.根据权利要求1所述的组件，其中所述探针(12)的长度是宽度的至少五倍。
4.一种方法，该方法包括：
通过利用抓取工具抓取第一磁体将所述第一磁体递送至胃部内的位置，其中所述抓取工具的一部分固定有包括探针的定位工具；
在递送所述第一磁体之前或之后，经过幽门将第二磁体递送至肠道内的位置，其中所述探针的远端从所述抓取工具向远侧突出一定距离，该距离对应于在所述胃部内放置所述第一磁体的合适位置；以及
将所述第一磁体和所述第二磁体对准并释放所述第一磁体和所述第二磁体，使得磁力将所述第一磁体和所述第二磁体吸引在一起，从而将所述肠道和所述胃部的壁压缩在一起，用于最终形成吻合。
CN201480033057.XA 2013-04-14 2014-04-08 用于吻合术的定位工具 Expired - Fee Related CN105407815B (zh)

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US13/862,431 US20140309669A1 (en) 2013-04-14 2013-04-14 Positioning tool for anastomosis
US13/862,431 2013-04-14
PCT/US2014/033260 WO2014172141A1 (en) 2013-04-14 2014-04-08 Positioning tool for anastomosis

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US20140309669A1 (en) 2014-10-16
WO2014172141A1 (en) 2014-10-23
CN105407815B (zh) 2018-06-08
US10881407B2 (en) 2021-01-05
EP2986235A1 (en) 2016-02-24
EP2986235B1 (en) 2018-03-28
US20160287257A1 (en) 2016-10-06

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