CN112773440A

CN112773440A - Anastomosis device

Info

Publication number: CN112773440A
Application number: CN202110164162.9A
Authority: CN
Inventors: 孙思予; 王晟; 韦建宇; 沈正华; 李常青; 冷德嵘; 周友琴; 张凯
Original assignee: Shengjing Hospital of China Medical University; Micro Tech Nanjing Co Ltd
Current assignee: Shengjing Hospital of China Medical University; Micro Tech Nanjing Co Ltd
Priority date: 2021-02-05
Filing date: 2021-02-05
Publication date: 2021-05-11
Also published as: WO2022166903A1

Abstract

The invention relates to the field of medical instruments, in particular to an anastomosis device which comprises a first bracket and a second bracket; the first bracket is provided with a first channel; the second bracket is provided with a second channel and is connected with the first bracket; the second support is positioned outside the first channel, and the first channel is communicated with the second channel; or, at least part of the second bracket is accommodated in the first channel. The anastomosis device has a small structural size and is convenient to install in an inserter, so that the difficulty of use can be reduced.

Description

Anastomosis device

Technical Field

The invention relates to the field of medical instruments, in particular to an anastomosis device.

Background

Gallstones can enter a common bile duct through a cystic duct to form common bile duct stones, the common bile duct stones are embedded in the ampulla of a kettle through an Oddi sphincter to cause pancreatitis, the choledocholithiasis is called cholegenic pancreatitis, gallbladder duodenal fistula or gallbladder colon fistula can be caused by gallbladder inflammation and chronic perforation caused by stone compression, intestinal obstruction caused by large stones entering an intestinal tract through a fistula is called cholelithiasis intestinal obstruction, and gallstone and long-term inflammation stimulation can induce gallbladder cancer.

At present, a treatment scheme of cutting the gall bladder can be adopted for treating gall-stone, but the cut gall bladder has the following defects: 1. is easy to cause dyspepsia and reflux gastritis; 2. problems with bile duct damage following cholecystectomy; 3. the incidence of choledocholithiasis after cholecystectomy is increased.

The traditional method for protecting gallbladder and removing calculus is to open abdomen, cut the gallbladder and remove calculus, and then suture the gallbladder. The calculus removal is carried out under naked eyes, a blind area is left, and tiny calculus cannot be found, so that the calculus residue rate in the gall bladder is increased, the calculus removal is called as blind person calculus removal, the residue rate is high, the wound is large, and the recovery is slow.

In another mode, under the guidance of ultrasonic waves, percutaneous gallbladder puncture is firstly carried out, then a puncture needle channel is enlarged, a cholecystoscope is inserted into a gallbladder, stones are crushed by using ultrasonic waves under the direct vision of the cholecystoscope, the residual rate of the crushed stones is extremely high after the crushed stones are sucked out, and the stones are only crushed without discharging stones in vitro at the stage. In addition, the anatomy of the biliary tract has specificity, which is completely different from the anatomical structure of the urinary system, and broken stones are easy to cause bile duct blockage, which is more dangerous than the body of a patient caused by no treatment.

In recent years, the operation of placing a liner anastomosis stent in a duodenum by an ultrasonic endoscope, anastomosing the duodenum and a gallbladder and then performing a gastroscopy operation is a new advanced and advanced gallbladder-protecting lithotomy. However, the operation type of placing the enterobiliary anastomosis stent in the duodenum requires an ultrasonic endoscope to pass through the cardia, the stomach and the pylorus to reach the duodenum, and the stent is placed, so that the operation difficulty is high, the learning curve is long, the popularization of the operation type to a common endoscope doctor is difficult, and the development of the operation type is limited.

Disclosure of Invention

The invention aims to provide an anastomosis device which has small structural size, is convenient to be arranged in an inserter and can reduce the difficulty of use.

The embodiment of the invention is realized by the following steps:

in a first aspect, the present invention provides an anastomosis device comprising a first scaffold and a second scaffold;

the first bracket is provided with a first channel;

the second bracket is provided with a second channel and is connected with the first bracket;

the second support is positioned outside the first channel, and the first channel is communicated with the second channel; or, at least part of the second bracket is accommodated in the first channel.

In an alternative embodiment, at least one flap is disposed within the second channel for unidirectional passage of the second channel from the distal end of the second stent to the proximal end of the second stent.

In an alternative embodiment, the distal end of the second stent is connected to the proximal or distal end of the first stent.

In an alternative embodiment, the distal end of the second bracket passes through the first channel to abut against the distal end of the first bracket, and the second bracket accommodated in the first channel is matched with the first channel.

In an alternative embodiment, a second bracket received within the first channel is an interference fit with the first channel.

In an alternative embodiment, the valve comprises a plurality of sub-valve bodies;

the plurality of sub-valve bodies are arranged at intervals in an annular mode around the axis direction of the first channel.

In an alternative embodiment, the second bracket comprises a first section and a second section which are arranged in sequence from the far end to the near end, and the second section is connected with the first section;

the first branch part and the second branch part are respectively provided with a first hollow inner cavity and a second hollow inner cavity, and the first inner cavity is communicated with the second inner cavity to form a second channel.

In an alternative embodiment, a first flap is disposed in the first lumen and a second flap is disposed in the second lumen.

In an alternative embodiment, the second flap is located at an end of the second section remote from the first section.

In an alternative embodiment, the first and second valve each comprise four sub-valve bodies.

In an alternative embodiment, at least one flap is disposed within the second channel, the flap being disposed in the first lumen or in the second lumen.

In an alternative embodiment, the end of the first section remote from the second section is provided with a first flared portion for connection to a first bracket.

In an alternative embodiment, the first flared portion is a first annular outer edge extending outwardly of the first section in a direction perpendicular to the axis of the second channel.

In an alternative embodiment, the first bracket is provided with a second flared portion and a third flared portion at both ends thereof, respectively.

In an alternative embodiment, the second flared portion and the third flared portion are each a second annular outer edge formed flared about the axis of the first channel.

In an alternative embodiment, the outer periphery of one of the second annular rims is crimped in the direction of its center to form an annular space that receives the distal end of the second stent.

In an alternative embodiment, the outer peripheries of the two second annular outer rims are curled in the direction of their centers to form annular spaces, one of which is used for accommodating the distal end of the second stent.

In an alternative embodiment, the first bracket and the second bracket each include a frame body and a film body covering the frame body.

In an alternative embodiment, the inner or outer circumferential surfaces of the first and second channels are coated with the film body.

In an alternative embodiment, the anastomosis device further includes a drainage tube connected to the proximal end of the second stent.

The embodiment of the invention has the beneficial effects that:

the anastomosis device comprises a first bracket and a second bracket; the first bracket is provided with a first channel; the second bracket is provided with a second channel and is connected with the first bracket; the second support is positioned outside the first channel, and the first channel is communicated with the second channel; or, at least part of the second bracket is accommodated in the first channel. The anastomosis device has a small structural size and is convenient to install in an inserter, so that the difficulty of use can be reduced. When the anastomosis device is used for performing a stomach-gallbladder anastomosis operation, two ends of the first bracket are respectively used for being accommodated in a gallbladder and a stomach of a patient and are respectively abutted against the gallbladder wall and the stomach wall so as to communicate the gallbladder with the stomach through the first channel or the second channel.

In the using process, the anastomosis device comprises the first support and the second support, and the mode that the second support and the first support are assembled is adopted, so that the structure is favorable for reducing the structural size of the anastomosis device, the anastomosis device is conveniently arranged in an inserter, the using difficulty is reduced, a larger flap installation space can be reserved, and the anti-reflux effect is improved.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings needed to be used in the embodiments will be briefly described below, it should be understood that the following drawings only illustrate some embodiments of the present invention and therefore should not be considered as limiting the scope, and for those skilled in the art, other related drawings can be obtained according to the drawings without inventive efforts.

FIG. 1 is a schematic view of an anastomosis device according to an embodiment of the present invention;

FIG. 2 is a cross-sectional view of an anastomosis device in accordance with an embodiment of the present invention;

FIG. 3 is a schematic view of the installation of the anastomosis device in accordance with an embodiment of the present invention;

FIG. 4 is a schematic view of a second bracket according to an embodiment of the present invention;

FIG. 5 is a schematic diagram illustrating a second perspective view of a second bracket according to an embodiment of the present invention;

FIG. 6 is a cross-sectional view of a second bracket from a third perspective in an embodiment of the present invention;

FIG. 7 is a cross-sectional view of a second bracket from a fourth perspective in an embodiment of the present invention;

FIG. 8 is a schematic diagram illustrating a first view of a first bracket according to an embodiment of the present invention;

FIG. 9 is a schematic diagram illustrating a second view of the first bracket according to the embodiment of the present invention;

FIG. 10 is a cross-sectional view of a first bracket in an embodiment of the invention;

FIG. 11 is a schematic view of the mounting of a first bracket according to an embodiment of the invention;

FIG. 12 is a schematic view of the mounting of a second bracket according to an embodiment of the invention;

FIG. 13 is a schematic view of the structure of a draft tube in another embodiment of the present invention.

200-anastomosis device; 210-a first scaffold; 211 — a first channel; 10-gallbladder; 20-stomach; 220-a second bracket; 221-a second channel; 222-a flap; 223-first division; 224-a second subsection; 225-a first lumen; 226-a second lumen; 227-a first flap; 228-a second flap; 229-a first flared portion; 231-a first annular outer edge; 232-sub-flap body; 212-a second flared portion; 213-third abduction; 214-a second annular outer rim; 215-an annular space; 230-a drainage tube; 30-duodenum.

Detailed Description

In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. The components of embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.

Thus, the following detailed description of the embodiments of the present invention, presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, it need not be further defined and explained in subsequent figures.

In the description of the present invention, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings or the orientations or positional relationships that the products of the present invention are conventionally placed in use, and are only used for convenience in describing the present invention and simplifying the description, but do not indicate or imply that the devices or elements referred to must have a specific orientation, be constructed and operated in a specific orientation, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," "third," and the like are used solely to distinguish one from another and are not to be construed as indicating or implying relative importance.

Furthermore, the terms "horizontal", "vertical" and the like do not imply that the components are required to be absolutely horizontal or pendant, but rather may be slightly inclined. For example, "horizontal" merely means that the direction is more horizontal than "vertical" and does not mean that the structure must be perfectly horizontal, but may be slightly inclined.

In the description of the present invention, it should also be noted that, unless otherwise explicitly specified or limited, the terms "disposed," "mounted," "connected," and "connected" are to be construed broadly and may, for example, be fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.

Gallstones can enter a common bile duct through a cystic duct to form common bile duct stones, the common bile duct stones are embedded in the ampulla of a kettle through an Oddi sphincter to cause pancreatitis, the choledocholithiasis is called choledochytic pancreatitis, gallbladder duodenal fistula or gallbladder colon fistula can be caused by gallbladder inflammation and chronic perforation caused by stone compression, intestinal obstruction caused by large stones entering an intestinal tract through a fistula is called cholelithiasis intestinal obstruction, and gallstones and long-term inflammation stimulation can induce gallbladder cancer.

At present, a treatment scheme of cutting the gall bladder can be adopted for treating gall-stone, but the cut gall bladder has the following defects: 1. is easy to cause dyspepsia and reflux gastritis; 2. problems with bile duct damage following cholecystectomy; 3. the incidence of choledocholithiasis after cholecystectomy is increased. The traditional method for protecting gallbladder and removing calculus is to open abdomen, cut the gallbladder and remove calculus, and then suture the gallbladder. The calculus removal is carried out under naked eyes, a blind area is left, and tiny calculus cannot be found, so that the calculus residue rate in the gall bladder is increased, the calculus removal is called as blind person calculus removal, the residue rate is high, the wound is large, and the recovery is slow. In another mode, under the guidance of ultrasonic waves, percutaneous gallbladder puncture is firstly carried out, then a puncture needle channel is enlarged, a cholecystoscope is inserted into a gallbladder, stones are crushed by using ultrasonic waves under the direct vision of the cholecystoscope, the residual rate of the crushed stones is extremely high after the crushed stones are sucked out, and the stones are only crushed without discharging stones in vitro at the stage. In addition, the anatomy of the biliary tract has specificity, which is completely different from the anatomical structure of the urinary system, and broken stones are easy to cause bile duct blockage, which is more dangerous than the body of a patient caused by no treatment.

In recent years, the operation of placing a liner anastomosis stent in a duodenum by an ultrasonic endoscope, anastomosing the duodenum and a gallbladder and then performing a gastroscopy operation is a new advanced and advanced gallbladder-protecting lithotomy. However, the operation type of placing the enterobiliary anastomosis stent in the duodenum requires an ultrasonic endoscope to pass through the cardia, the stomach and the pylorus to reach the duodenum, and the stent is placed, so that the operation difficulty is high, the learning curve is long, the popularization of the operation type to a common endoscope doctor is difficult, and the development of the operation type is limited. If the ultrasonic endoscope carries out the stomach-gallbladder anastomosis operation in the stomach through the cardia, the operation difficulty is greatly reduced, the success rate is high, but the problem that food residue or gastric acid in the stomach flows back to enter the gallbladder is faced, and serious infection accidents are easily caused.

For the above reasons, referring to fig. 1-3, fig. 1 and 2 show the structure of an anastomotic device according to an embodiment of the invention, and fig. 3 shows the installed state of the anastomotic device in the gallbladder and stomach according to an embodiment of the invention;

the present embodiment provides an anastomosis device 200, which includes a first stent 210 and a second stent 220;

the first bracket 210 is provided with a first passage 211; the second bracket 220 is provided with a second channel 221, and the second bracket 220 is connected with the first bracket 210;

the second bracket 220 is located outside the first channel 211, and the first channel 211 is communicated with the second channel 221; alternatively, at least a portion of the second bracket 220 is received within the first channel 211. In this embodiment, an embodiment is adopted in which at least a portion of the second bracket 220 is accommodated in the first channel 211, and the distal end of the second bracket 220 is connected to the first bracket 210, and the axis of the second channel 221 accommodated in the first channel 211 coincides with the axis of the first channel 211.

It should be noted that, in this embodiment, at least one flap 222 is disposed in the second channel 221, and the flap 222 is used for conducting the second channel 221 in a single direction from the distal end of the second stent 220 to the proximal end of the second stent 220.

When the anastomosis device 200 is used for performing a gastric-biliary anastomosis procedure, two ends of the first stent 210 are respectively accommodated in the gallbladder 10 and the stomach 20 of a patient and respectively abutted against the wall of the gallbladder 10 and the wall of the stomach 20, and the first channel 211 is used for communicating the gallbladder 10 and the stomach 20.

When the anastomosis device 200 is used for performing a gastric-biliary anastomosis operation, the operation principle of the anastomosis device 200 is as follows:

the anastomosis device 200 includes a first stent 210 and a second stent 220; the first stent 210 is provided with a first channel 211, and two ends of the first stent 210 are respectively accommodated in the gallbladder 10 and the stomach 20 of the patient and respectively abutted against the wall of the gallbladder 10 and the wall of the stomach 20, so as to communicate the gallbladder 10 with the stomach 20 through the first channel 211; the second stent 220 is provided with a second channel 221, at least one valve 222 is arranged in the second channel 221, and the valve 222 is used for conducting the second channel 221 in a one-way manner from the far end of the second stent 220 to the near end of the second stent 220; the distal end of the second bracket 220 is adapted to be connected to the first bracket 210, and the axis of the first channel 211 coincides with the axis of the second channel 221.

Since the flap 222 of the second stent 220 is used for conducting the second channel 221 in a one-way manner from the distal end of the second stent 220 to the proximal end of the second stent 220, that is, when the first stent 210 is connected with the second stent 220, the second channel 221 can be conducted in a one-way manner from the gallbladder 10 to the stomach 20 through the valve, so that food residue or gastric acid in the stomach 20 can be prevented from flowing back into the gallbladder 10, and serious infection accidents can be avoided. In the using process, since the anastomosis device 200 comprises the first bracket 210 and the second bracket 220 is assembled with the first bracket 210, the structure is beneficial to reducing the structural size of the anastomosis device 200, so that the anastomosis device 200 can be conveniently arranged in an inserter, the difficulty in use is reduced, a larger installation space for the membrane flap 222 can be reserved, and the anti-backflow effect is improved.

In the present embodiment, when the anastomotic device 200 is used to perform the gastroenteroanastomosis, the terms "distal end", "proximal end", and the like are explained in the entire text, and the explanation is only for better understanding of the present invention and is not to be construed as limiting the present invention. Generally, during use of the anastomosis device 200, a front end portion of the anastomosis device 200 (in the relative position in fig. 1, referred to as the left end of the anastomosis device 200) extends into the gallbladder 10, while a rear end portion of the anastomosis device 200 (in the relative position in fig. 1, referred to as the right end of the anastomosis device 200) is positioned within the stomach 20. Thus, "distal" may be understood as a feature or member that is relatively close to the anterior portion of the gallbladder 10, and "proximal" may be understood as a feature or member that is relatively close to the posterior portion of the stomach 20. Of course, when it is not explicitly indicated which part or component is "proximal" or "distal", the default designation is the proximal or distal end of the entire anastomosis device 200. And during the use process, both ends of the first stent 210 can be used as the distal end of the first stent 210 to be accommodated in the gallbladder 10 of the patient and abut against the wall of the gallbladder 10.

In this embodiment, when the first stent 210 and the second stent 220 are disposed, the first stent 210 and the second stent 220 both include a frame body and a membrane body covering the frame body, and the arrangement of the membrane body can prevent the leakage at the abutting position of the anastomosis device 200 and the gallbladder 10 or the stomach 20, or the leakage at the formed passage communicating the gallbladder 10 and the stomach 20. In other embodiments of the present invention, the inner or outer circumferential surfaces of the first and

second channels

211 and 221 may be covered with a film to prevent leakage from the channel connecting the gallbladder 10 and the stomach 20.

Further, when the second bracket 220 is coupled to the first bracket 210, the distal end of the second bracket 220 may be coupled to the proximal or distal end of the first bracket 210. Specifically, in the present embodiment, the distal end of the second bracket 220 passes through the first channel 211 to abut against the distal end of the first bracket 210, and the second bracket 220 accommodated in the first channel 211 is matched with the first channel 211. In addition, in order to prevent the second bracket 220 received in the first channel 211 from sliding relative to the first channel 211, the second bracket 220 received in the first channel 211 is in interference fit with the first channel 211.

Further, in the present embodiment, the flap 222 functions to unidirectionally communicate the second channel 221 from the distal end of the second stent 220 to the proximal end of the second stent 220, so as to ensure unidirectional communication of the second channel 221, in the present embodiment, when the flap 222 is disposed, a plurality of flaps 222 may be disposed at intervals in the second channel 221.

Specifically, in the present embodiment, at least two petals 222 are disposed at intervals in the second channel 221, and the two petals 222 are used for unidirectionally conducting the second channel 221 from the distal end of the second stent 220 to the proximal end of the second stent 220; also, the valve flap 222 includes a plurality of sub-flap bodies 232; the plurality of sub-petals 232 are each disposed at annular intervals around the axial direction of the first passage 211.

It should be noted that when two flaps 222 are provided, first, both flaps 222 can function to restrict the flow of fluid from the gallbladder 10 to the stomach 20; secondly, since the two flaps 222 are arranged in the second channel 221 at intervals, the two flaps 222 and the second channel 221 together form a cavity, the fluid entering the second channel 221 from the gallbladder 10 can flow into the stomach 20 after entering the cavity, and food residue or gastric acid in the stomach 20 is limited in the cavity or returns to the stomach 20 under the effect of the flow restriction of the other flap 222 even after entering the cavity through the flap 222 at the proximal end of the second bracket 220; therefore, the two flaps 222 can play a role of double-layer protection, so that food residues or gastric acid in the stomach 20 can be prevented from flowing back into the gallbladder 10, and serious infection accidents can be avoided.

Further, referring to fig. 1 to 7, fig. 4 to 7 show a structure of a second bracket according to an embodiment of the present invention, in this embodiment, when the second bracket 220 is disposed, the second bracket 220 includes a first sub-portion 223 and a second sub-portion 224 sequentially disposed from a distal end to a proximal end, and the second sub-portion 224 is connected to the first sub-portion 223; the first and

second sections

223 and 224 are respectively provided with a first hollow cavity 225 and a second hollow cavity 226, and the first cavity 225 and the second hollow cavity 226 are communicated to form a second channel 221; since at least one flap 222 is disposed within the second channel 221, the flap 222 may be disposed in the first lumen 225 or in the second lumen 226.

In the present embodiment, when two petals 222 are provided, a first petal 227 may be disposed in the first lumen 225 and a second petal 228 may be disposed in the second lumen 226. It should be noted that, as described above, since the flaps 222 in the second channel 221 are all used for one-way communication of the second channel 221 from the distal end of the second stent 220 to the proximal end of the second stent 220, that is, the flaps 222 in the second channel 221 are all used for one-way communication of the second channel 221 from the gallbladder 10 to the stomach 20, when the first flap 227 and the second flap 228 are disposed, the first flap 227 and the second flap 228 are both used for one-way communication of the second channel 221 from the distal end of the second stent 220 to the proximal end of the second stent 220, that is, the first flap 227 and the second flap 228 are both used for one-way communication of the second channel 221 from the gallbladder 10 to the stomach 20. Thus, by providing the first flap 227 in the first inner cavity 225 and the second flap 228 in the second inner cavity 226, the first flap 227 and the second flap 228 can be arranged in the second channel 221 at intervals, so that the first flap 227, the second flap 228 and the second channel 221 can jointly form a cavity to play a role of double-layer anti-backflow.

When the first inner cavity 225 and the second inner cavity 226 are disposed, both the first inner cavity 225 and the second inner cavity 226 may be cylindrical inner cavities extending along the axial direction of the second channel 221, the inner diameter of the first inner cavity 225 is larger than the inner diameter of the second inner cavity 226, and the area of the first flap 227 is larger than the area of the second flap 228, such a disposition enables the first flap 227 and the second flap 228 to have different flow limiting effects in the process of limiting the flow of the fluid in the second channel 221, which aims to enable the first flap 227 to limit the flow of the fluid in the cavity from flowing into the gallbladder 10 through the first flap 227, and enable the fluid in the cavity to be discharged out of the cavity through the second flap 228, i.e., the fluid in the cavity can flow back into the stomach 20.

When the second flap 228 is provided, the second flap 228 is located at an end of the second section 224 remote from the first section 223. It should be noted that, in the present embodiment, when the second section 224 is provided, the second section 224 is located outside the first passage 211 and in the stomach 20; in other embodiments of the invention, the second subsection 224 may also be located within the first channel 211.

Further, referring to fig. 1 to 7, in the present embodiment, when the first stent 210 and the second stent 220 are assembled, a manner that a distal end of the second stent 220 passes through the first channel 211 to abut against one end of the first stent 210 located in the gallbladder 10, and the second stent 220 accommodated in the first channel 211 is in interference fit with the first channel 211 is adopted, so that the connection stability of the first stent 210 and the second stent 220 is improved, and the distal end of the second stent 220 can abut against one end of the first stent 210 located in the gallbladder 10, therefore, one end of the first subsection 223 far away from the second subsection 224 is provided with a first flared portion 229, and the first flared portion 229 is used for abutting against one end of the first stent 210 located in the gallbladder 10. Specifically, the first flared portion 229 may be a first annular outer edge 231 extending radially outward of the first inner cavity 225, and an outer diameter of the first annular outer edge 231 is greater than an outer diameter of the first section 223.

First, since the first branch 223 and the second branch 224 are sequentially arranged from the distal end to the proximal end of the second bracket 220, the first branch 223 and the first channel 211 are in interference fit after the distal end of the second bracket 220 passes through the first channel 211 and abuts against the distal end of the first bracket 210; secondly, since the first cavity 225 and the second cavity 226 are both cylindrical cavities extending along the axial direction of the second channel 221, the first subsection 223 and the second subsection 224 are both cylindrical cavities extending along the axial direction of the second channel 221; therefore, the difference between the outer diameter of the first section 223 and the inner diameter of the first channel 211 satisfies the tolerance requirement of the interference fit, and thus, by making the outer diameter of the first annular outer edge 231 larger than the outer diameter of the first section 223, the first annular outer edge 231 can be kept in a state of abutting against the distal end of the first bracket 210 by the restriction of the first channel 211 even if it moves proximally in the axial direction of the first channel 211 by an external force after abutting against the distal end of the first bracket 210.

Further, referring to fig. 1-7, in the present embodiment, as can be seen from the above description, the first flap 227 and the second flap 228 are disposed at intervals in the second channel 221, when the first flap 227 and the second flap 228 are disposed, each of the first flap 227 and the second flap 228 includes a plurality of sub-flap bodies 232, each of the plurality of sub-flap bodies 232 is disposed at intervals in a ring shape around the axial direction of the first channel 211, and each of the plurality of sub-flap bodies 232 protrudes from the distal end direction to the proximal end direction of the second channel 221, so as to play a role of limiting the flow in the second channel 221.

In the present embodiment, each of the first flap 227 and the second flap 228 includes four sub-flaps 232, and since the four sub-flaps 232 are disposed at intervals in a ring shape around the axial direction of the first channel 211, such an arrangement can form a cross-shaped opening, and through such an arrangement, the second channel 221 can be conducted in a single direction from the distal end of the second stent 220 to the proximal end of the second stent 220.

Further, referring to fig. 1-10, fig. 8-10 show the structure of the first stent in the embodiment of the present invention, in this embodiment, in order to enable both ends of the first stent 210 to abut against the gallbladder 10 wall and the stomach 20 wall, both ends of the first stent 210 are respectively provided with a second flared portion 212 and a third flared portion 213, and one of the second flared portion 212 and the third flared portion 213 is used to abut against the gallbladder 10 wall, and the other of the second flared portion 212 and the third flared portion 213 is used to abut against the stomach 20 wall. That is, during use, the second flared portion 212 may be positioned within the gallbladder 10 and in abutment with the gallbladder 10 wall, and the third flared portion 213 may be positioned within the stomach 20 and in abutment with the stomach 20 wall; or such that the third flared portion 213 is located within the gallbladder 10 and abuts the gallbladder 10 wall and the second flared portion 212 is located within the stomach 20 and abuts the stomach 20 wall; thus, during use of the first stent 210, the end of the first stent 210 provided with the second flared portion 212 may be the distal end of the first stent 210, and the end of the first stent 210 provided with the third flared portion 213 may also be the distal end of the first stent 210.

Specifically, the second flared portion 212 and the third flared portion 213 are provided such that the second flared portion 212 and the third outer portion can respectively abut against the gallbladder 10 wall and the stomach 20 wall, and therefore, the second flared portion 212 and the third flared portion 213 are both second annular outer edges 214 formed by flaring around the axis of the first channel 211.

Since the distal end of the second holder 220 is adapted to pass through the first channel 211 to abut against the end of the first holder 210 located inside the gallbladder 10, the outer circumference of one of the second annular rims 214 is curled in the direction of its center to form an annular space 215 for accommodating the distal end of the second holder 220, thereby increasing the area of abutment against the distal end of the second holder 220 in such a way as to improve the mounting stability of the second holder 220.

It should be noted that, as described above, the first flared portion 229 is a first annular outer edge 231 extending outward in the radial direction of the first inner cavity 225, and the second annular outer edge 214 of the first holder 210 for abutting against the distal end of the second holder 220 is an annular space 215 formed by crimping, so that the annular space 215 has a shape corresponding to the first annular outer edge 231 to increase the contact area. Since the annular space 215 is formed by being curled, the cross-sectional profile thereof has a certain curvature, and thus, in order to increase the contact area between the first annular outer edge 231 and the annular space 215, the cross-section of the first annular outer edge 231 has a curvature corresponding to the annular space 215, thereby allowing the distal end of the second holder 220 to have a bell mouth shape.

Further, as can be seen from the above, in the present embodiment, during the use of the first bracket 210, the end of the first bracket 210 provided with the second flared portion 212 may be used as the distal end of the first bracket 210, and the end of the first bracket 210 provided with the third flared portion 213 may also be used as the distal end of the first bracket 210. Thus, the outer peripheries of the two second annular outer rims 214 may be curled toward the center thereof to form annular spaces 215, one of the annular spaces 215 being for receiving the distal end of the second holder 220.

Referring to fig. 1-12, fig. 3, fig. 11 and fig. 12 show the steps of installing the anastomosis device 200 according to the embodiment of the present invention, wherein the operation of the anastomosis device is as follows:

placing the first stent 210 through an introducer via an ultrasonic endoscopic forceps channel, and enabling a first position of the first stent 210 to be positioned in the gallbladder 10, the other end of the first stent 210 to be positioned in the stomach 20, and two second annular outer edges 214 of the first stent 210 to be respectively abutted with the wall of the gallbladder 10 and the wall of the stomach 20; at this time, the end of the first stent 210 located in the gallbladder 10 is the distal end of the first stent 210, and the end of the first stent 210 located in the stomach 20 is the proximal end of the first stent 210;

placing the second stent 220 with the applicator such that the first annular rim 231 of the distal end of the second stent 220 is positioned within and abuts the annular space 215 of the distal end of the first stent 210 and the proximal end of the second stent 220 is positioned within the stomach 20; the portion of the second bracket 220 located in the first channel 211 is in interference fit with the first channel 211;

therefore, the first stent 210 and the second stent 220 are assembled into a whole, and the anastomosis device 200 is conducted from the gallbladder 10 to the stomach 20 in one direction, so as to play a role in preventing the bile from flowing backwards in the stomach 20;

after a certain period of time, after the fistula between the gallbladder 10 and the stomach 20 has formed, the first stent 210 and the second stent 220 are removed, and stones in the gallbladder 10 are removed through the fistula; or the second stent 220 is removed, and the stone within the gallbladder 10 is removed through the first channel 211 of the first stent 210, followed by removal of the first stent 210.

Referring to FIG. 13 in conjunction with FIGS. 1-12, FIG. 13 shows the structure of a drainage tube in another embodiment of the present invention; in other embodiments of the present invention, the anastomosis device 200 may further include a drain 230 connected to the proximal end of the second stent 220; the distal end of the drainage tube 230 is connected to the proximal end of the second stent 220, and the proximal end of the drainage tube 230 extends into the duodenum 30 through the pylorus, so that in this way, the food in the stomach is prevented from flowing back into the gallbladder, and the drainage tube 230 may be further provided with small holes through which the bile can flow out of the body conveniently to aid digestion.

It should be noted that, based on the above, when food residue or gastric acid in the stomach 20 is prevented from flowing back into the gallbladder 10, the at least one flap 222 in the second channel 221 or the drainage tube 230 in the above may be adopted, or the at least one flap 222 and the drainage tube 230 in the second channel 221 may be combined to avoid serious infection.

The above description is only exemplary of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. An anastomosis device, comprising:

a first bracket (210), the first bracket (210) being provided with a first channel (211); and

a second bracket (220), the second bracket (220) being provided with a second channel (221), the second bracket (220) being connected with the first bracket (210);

wherein the second bracket (220) is positioned outside the first channel (211), and the first channel (211) is communicated with the second channel (221); or, at least part of the second bracket (220) is accommodated in the first channel (211).

2. The anastomosis device of claim 1, wherein:

at least one valve (222) is arranged in the second channel (221), and the valve (222) is used for conducting the second channel (221) in a single direction from the far end of the second bracket (220) to the near end of the second bracket (220).

3. The anastomosis device of claim 2, wherein:

the distal end of the second stent (220) is connected to the proximal or distal end of the first stent (210).

4. The anastomosis device of claim 3, wherein:

the far end of the second bracket (220) passes through the first channel (211) to be abutted against the far end of the first bracket (210), and the second bracket (220) accommodated in the first channel (211) is matched with the first channel (211).

5. The anastomosis device of claim 4, wherein:

the second bracket (220) accommodated in the first channel (211) is in interference fit with the first channel (211).

6. The anastomosis device of claim 2, wherein:

the valve (222) comprises a plurality of sub-valve bodies (232);

the sub-valve bodies (232) are arranged around the axis direction of the first channel (211) at intervals in an annular mode.

7. The anastomosis device according to any one of claims 1 to 6, wherein:

the second bracket (220) comprises a first branch part (223) and a second branch part (224) which are sequentially arranged from the far end to the near end, and the second branch part (224) is connected with the first branch part (223);

the first and second sections (223, 224) are respectively provided with a first hollow cavity (225) and a second hollow cavity (226), and the first cavity (225) and the second hollow cavity (226) are communicated to form the second channel (221).

8. The anastomosis device of claim 7, wherein:

a first flap (227) is disposed in the first lumen (225) and a second flap (228) is disposed in the second lumen (226).

9. The anastomosis device of claim 8, wherein:

the second flap (228) is located at an end of the second section (224) remote from the first section (223).

10. The anastomosis device of claim 8, wherein:

the first flap (227) and the second flap (228) each comprise four sub-flap bodies (232).

11. The anastomosis device of claim 7, wherein:

at least one flap (222) is disposed within the second channel (221), the flap (222) being disposed in the first lumen (225) or in the second lumen (226).

12. The anastomosis device of claim 7, wherein:

the end of the first section (223) remote from the second section (224) is provided with a first flared portion (229), the first flared portion (229) being adapted for connection to the first support (210).

13. The anastomosis device of claim 12, wherein:

the first flared portion (229) is a first annular outer edge (231) extending outward of the first subsection (223) in a direction perpendicular to an axis of the second channel (221).

14. The anastomosis device of claim 3, wherein:

two ends of the first bracket (210) are respectively provided with a second outward-extending part (212) and a third outward-extending part (213).

15. The anastomosis device of claim 14, wherein:

the second flared portion (212) and the third flared portion (213) are each a second annular outer edge (214) flared about an axis of the first channel (211).

16. The anastomosis device of claim 15, wherein:

the periphery of one of the second annular rims (214) is curled in the direction of its centre to form an annular space (215) accommodating the distal end of the second holder (220).

17. The anastomosis device of claim 16, wherein:

the peripheries of the two second annular outer edges (214) are curled towards the direction of the centers of the two second annular outer edges to form annular spaces (215), wherein one annular space (215) is used for accommodating the far end of the second bracket (220).

18. The anastomosis device of claim 1, wherein:

the first bracket (210) and the second bracket (220) both comprise a bracket body and a film body covering the bracket body.

19. The anastomosis device of claim 1, wherein:

the inner circumferential surface or the outer circumferential surface of the first channel (211) and the second channel (221) is coated with a film body.

20. The anastomosis device of claim 1, wherein:

the anastomotic device (200) further comprises a drainage tube (230) connected to the proximal end of the second stent (220).