CN107072663A - 幽门阻塞装置 - Google Patents

幽门阻塞装置 Download PDF

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CN107072663A
CN107072663A CN201580045983.3A CN201580045983A CN107072663A CN 107072663 A CN107072663 A CN 107072663A CN 201580045983 A CN201580045983 A CN 201580045983A CN 107072663 A CN107072663 A CN 107072663A
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尼尔·阿尔特曼
伊扎克·法比安
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EASYNOTES Ltd
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Abstract

阻塞装置(10)包括安装在轴杆(14)上的阻塞盘(12)。盘(12)包括附接至外围框架(18)的隔膜(24)。锚定构件(16)从轴杆(14)的远侧部延伸。轴杆(14)、锚定构件(16)和外围框架(18)可以一起具有由弯曲的细长元件制成的整体结构。

Description

幽门阻塞装置
技术领域
本发明总体上涉及用于阻塞或减少通过体腔的流动的装置，特别地涉及用于阻塞或减少胃内容物流过幽门瓣的装置。
背景技术
已知胃手术用于治疗肥胖、胃食道反流疾病(GERD)、癌症、糖尿病等。胃旁路术包括著名的Roux-En-Y手术，以及其它的缩小胃大小和/或在胃或胃肠道的其它部分形成限制性屏障、替代路径、囊腔等的技术。这些外科手术能够通过使用诸如胃镜的内窥镜工具来执行，尽管传统上它们通过使用开腔或微创外科手术器械来执行。
在现有技术中，在胃手术或涉及十二指肠的手术过程中需要闭塞幽门时，外科医生钉住(胃中的)幽门，并且这是一个短期的闭塞以允许十二指肠从手术中恢复。已经提出横断幽门的装置，其可以局部和/或间断性阻塞幽门，进而减少胃内容物流入十二指肠中。
PCT专利申请PCT/US20112/64050描述了一种幽门阻塞装置。改阻塞盘安装在轴杆的近侧部上，并且一个或多个锚定构件(例如，环)安装在轴杆的远侧部上。阻塞盘被输送至幽门的近侧，并且锚定构件处于幽门的远侧上。环足够地小以能够穿过幽门。
发明内容
如在下文中更加详细地描述地，本发明试图提供一种用于阻塞或减少通过幽门瓣(幽门)的流动的改进装置。本装置特别地有助于经口胃肠道手术，但本发明不限于经口胃手术中，而是可以在其它腹腔镜手术、内窥镜手术或其它体腔自然开口手术中使用。
本发明特别地有助于阻止胃内容物流入包括十二指肠和空肠开始部分的近端内脏。例如，当开辟一条绕过近端内脏的流经胃-空肠道吻合口的替代路径后产生该需求。可能有产生该需求的其它情形，诸如在十二指肠区域或胰腺或胆汁流出到十二指肠处进行手术后。另外一种迹象能够是需要利用内窥镜对膨胀的胃进行胃手术。在这种情况下，插塞保持住胃中的膨胀气体并且其不会膨胀肠。
因此，根据本发明的实施例提供一种阻塞装置，其包括安装在轴杆上的阻塞盘。所述盘包括附接至外围框架隔膜。锚定构件从轴杆的远侧部延伸。轴杆、锚定构件、和外围框架一起具有由弯曲的细长元件制成的整体结构。
附图说明
根据结合附图的以下详细说明，将会更加全面地理解和认识本发明，其中：
图1和图2是处于展开构造的、根据本发明的非限制实施例构造和操作的阻塞装置的简化的形象示意图；
图3是以拉平构造处于输送管中的阻塞装置的简化示意图；
图4A是根据本发明的实施例的安装在内窥镜工具中的输送管和阻塞装置的简化的形象示意图；
图4B是安装在内窥镜工具中的输送管和阻塞装置的简化的形象示意图，示出了用于将阻塞装置推出到输送管外的推动器；并且
图4C是安装在内窥镜工具中的输送管和阻塞装置的简化的形象示意图。
具体实施方式
现在参照图1和图2，其示意了根据本发明的非限制实施例构造和操作的阻塞装置10。
阻塞装置10包括安装在轴杆14上的阻塞盘12。锚定构件16从轴杆14的远侧部延伸。在优选实施例中，阻塞盘12包括外围框架18，其与轴杆14及锚定构件16一起具有由弯曲的金属丝(或任意剖面形状的其它细长元件)制成，诸如由形状记忆合金(例如，镍钛诺)制成的整体(一体式)结构。可替代地，框架18、轴杆14和锚定构件16可由一个以上的零件来制成。轴杆14可以在中心弯曲点20处(例如，大体上以90°)弯曲以形成臂22(图1)，臂22从中心轴线(限定为垂直于中心弯曲点20的轴线)径向向外延伸，并且其随后绕中心轴线周向弯曲以形成阻塞盘12的外围框架18。臂22可以是直的或者可以具有弯曲形状(图1中所示)。
阻塞盘12可包括附接至外围框架18的隔膜24。隔膜24可以密封地附接至外围框架18，使得盘对空气或其它流体不可渗透，取决于特定需求。隔膜24可由任意医疗安全材料制成，诸如但不限于塑料，诸如硅树脂、有机硅弹性体、乳胶、聚氨酯、PTFE(聚四氟乙烯)、FEP(氟化乙丙烯)、尼龙等。一个或多个耳部26可以附接或以其它方式从阻塞盘12的外围框架18延伸。例如，耳部26可以由医疗安全金属制成并焊接或结合至外围18。可替代地，耳部26可以由外围框架18制成或弯曲形成，且这样与外围框架18、轴杆14和锚定构件16形成完整的一体式结构。耳部26能够便于抓取工具(未示出)抓取，用于在需要时取出阻塞装置10。
如图2中能够看出，锚定构件16可具有由远侧弯曲部28(其关于隔膜24是凹形的)、圆角29、以及圆尖突30(其关于隔膜24也是凹形的)构成的新月形状。该形状特别有效地将装置10维持在位并阻止其迁移穿过幽门。该形状还基本上自定中心于胃肠道内，这帮助使该装置与幽门正确地对准。
如图3中所示，为了输送插塞(阻塞装置)10，插塞10被拉伸至拉平构造且被放置在输送管32中。如图4A中看出的，输送管32与内窥镜工具36一起组装。该工具36能够被放置在内窥镜(例如，胃窥镜)50的工作通道34中，如图4C中看出。内窥镜工具36具有第一(例如，前侧或远侧)手柄38和第二(例如，后侧或近侧)手柄40。第二手柄40可操作地连接至设置在工作通道34中的推动器42(图4B)。推动器42是滑动活塞或其布置为用以推挤阻塞装置10的阻塞盘12其它合适元件。第一手柄38可操作地连接至输送管32。
插塞10的安装如下。将带有拉平的阻塞装置10的输送管32装载在内窥镜工具36中。内窥镜工具36用于将输送管32输送至幽门的近侧，并且向远侧略微更远地移动内窥镜工具36，使得输送管32的远侧端延伸到幽门中。操作者向前(向远侧)推动输送系统的第二手柄40直至第二手柄40到达止挡件42(图4A)。该推动动作导致推动器42将锚定构件16向远侧推出到输送管32外，由此锚定构件16弹出至图1和2的展开构造。锚定构件16现在在十二指肠中从幽门向远侧展开。现在向后(向近侧)拉动第一手柄38以便将阻塞装置10的阻塞盘12从输送管32释放，由此阻塞盘12弹出至图1和2的展开构造。阻塞盘12现在从幽门向近侧展开。轴杆14用作在阻塞盘12和锚定构件16之间的在幽门中的间隔件。轴杆14的尺寸与幽门肌的有效宽度相关。输送管32然后能够与内窥镜工具36的其余部分一起回缩并移除。耳部26用于抓取插塞10，以用于取出。

Claims (10)

1.一种阻塞装置(10)，包括：
阻塞盘(12)，所述阻塞盘(12)安装在轴杆(14)上，所述盘(12)包括附接至外围框架(18)的隔膜(24)；以及
锚定构件(16)，所述锚定构件(16)从所述轴杆(14)的远侧部延伸；
其特征在于，所述轴杆(14)在中心弯曲点(20)处弯曲以形成臂(22)，所述臂(22)从中心轴线径向向外延伸，并且所述臂(22)随后绕所述中心轴线周向弯曲，以形成所述外围框架(18)。
2.根据权利要求1所述的阻塞装置(10)，其中，所述隔膜(24)密封地附接至所述外围框架(18)。
3.根据权利要求1所述的阻塞装置(10)，其中，所述弯曲的轴杆(14)由形状记忆合金制成。
4.根据权利要求1所述的阻塞装置(10)，其中，所述阻塞盘(12)、所述轴杆(14)和所述锚定构件(16)具有由弯曲的细长元件制成的整体结构。
5.根据权利要求4所述的阻塞装置(10)，其中，所述臂(22)是弯曲的。
6.根据权利要求1所述的阻塞装置(10)，其中，一个或多个耳部(26)从所述外围框架(18)延伸。
7.根据权利要求1所述的阻塞装置(10)，其中，所述锚定构件(16)具有由远侧弯曲部(28)、圆角(29)以及圆尖突(30)构成的新月形状。
8.根据权利要求1所述的阻塞装置(10)，所述阻塞装置(10)还包括输送管(32)，所述阻塞装置(10)以拉平构造设置在所述输送管(32)中。
9.根据权利要求8所述的阻塞装置(10)，所述阻塞装置(10)还包括内窥镜(50)，所述内窥镜(50)具有工作通道(34)，所述输送管(32)和所述阻塞装置(10)被安装在所述工作通道(34)中。
10.根据权利要求9所述的阻塞装置(10)，所述阻塞装置(10)包括推动器(42)，所述推动器(42)可操作以将所述锚定构件(16)向远侧推出到所述输送管(32)外。
CN201580045983.3A 2014-08-24 2015-08-24 幽门阻塞装置 Pending CN107072663A (zh)

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US14/467,013 US9381020B2 (en) 2014-08-24 2014-08-24 Pyloric obstruction device
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PCT/IB2015/056409 WO2016030810A1 (en) 2014-08-24 2015-08-24 Pyloric obstruction device

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US20160051262A1 (en) 2016-02-25

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