CN212281485U - Deformable self-assembly magnetic anastomosis ring for endoscopic lower gastrointestinal anastomosis - Google Patents

Abstract

A deformable self-assembled magnetic anastomosis ring for anastomosis of digestive tracts under endoscopes comprises auxiliary instruments and magnetic units, wherein the magnetic units are multiple, each magnetic unit is a trapezoidal magnet, the trapezoidal magnet is of a hexahedral structure, the upper surface and the lower surface of the trapezoidal magnet are mutually parallel rectangles, the front side surface and the rear side surface of the trapezoidal magnet are mutually parallel, congruent and symmetrical isosceles trapezoids, the left side surface and the right side surface of the trapezoidal magnet are congruent and symmetrical rectangles, a through rectangular through hole is formed in the trapezoidal magnet along the left and right directions of the trapezoidal magnet, and the left end and the right end of the trapezoidal magnet are respectively provided with an N pole and an S pole; the auxiliary instrument comprises a guide wire and a push catheter, the section of the guide wire is rectangular so as to penetrate through the rectangular through hole to enable all the magnetic units to be combined into a linear chain shape, the push catheter is a circular tube, and the inner diameter of the push catheter allows the guide wire to pass through. The advantage of the structural design is that the deformation characteristic of the magnetic anastomosis ring can enable the magnetic anastomosis ring to pass through a severely narrow tube cavity, and a larger anastomosis caliber can be established after self-assembly, so that the magnetic anastomosis ring has important clinical application value.

Description

Deformable self-assembly magnetic anastomosis ring for endoscopic lower gastrointestinal anastomosis

Technical Field

The invention belongs to the technical field of medical instruments, and particularly relates to a deformable self-assembly magnetic anastomosis ring for endoscopic gastrointestinal anastomosis.

Background

The gastroduodenal malignant obstruction is a serious malignant tumor complication which is caused by the gastric and duodenal output channel stenosis or obstruction caused by malignant tumor infiltration of stomach, duodenum or peripheral organs thereof and pressing gastroduodenum, and causes eating disorder, upper digestive tract obstruction, esophagitis and electrolyte disorder. For patients who can not be subjected to radical surgical resection, laparotomy or endoscopic surgical descending gastrointestinal bypass anastomosis is a traditional method for solving obstruction of a gastric outflow tract, but the actual clinical benefit of the patients is not great due to large trauma. The gastrointestinal tract stent placed under the endoscope has small wound and definite treatment effect, and is a preferred scheme for the gastroduodenal obstruction of patients with advanced malignant tumor. The existing endoscopic digestive tract stent implantation technology can be used for patients with mild and moderate gastroduodenal malignant obstruction, and when the obstruction is serious, the endoscopic stent implantation failure rate is high.

Magnetic surgery is a new surgical technique for completing functions of pressing anastomosis, traction anchoring, guiding positioning, tracing positioning and the like in surgical diagnosis and treatment by utilizing special magnetic field force among magnets, and is one of the most active research hotspots in the international surgical field at present. Magnetic anastomosis is one of the core clinical techniques of magnetic surgery. When in magnetic anastomosis, the specially designed magnetic devices are respectively arranged at two sides of the lumen to be anastomosed, and the pressed tissues between the magnets are subjected to ischemia-necrosis-shedding, and the tissues beside the press are subjected to adhesion-repair-healing through the non-contact magnetic field force between the magnets, so that the anastomotic reconstruction of the lumen of the digestive tract is realized. The current magnetic anastomosis research relates to vascular anastomosis, gastrointestinal tract anastomosis, closure and repair of rectovaginal fistula, dredging of biliary stricture after liver transplantation, congenital anal atresia recanalization and the like. The combination of the magnetic anastomosis technique and the endoscopic technique can realize the endoscopic treatment of the partial digestive surgery.

The "spacer attraction" is a fundamental property of magnets that is fundamental to supporting the magnetic surgical technique. Endoscopy of the digestive surgery is one of important directions of minimally invasive medical development, and the combination of the magnetic anastomosis technology and the endoscope technology can powerfully expand the clinical application range of the endoscope technology. Currently, the gastrointestinal bypass anastomosis can not be realized in a real sense by an endoscope technology. Magnetic anastomosis is used as a third anastomosis mode after manual suture anastomosis and nail type anastomosis, so that gastrointestinal bypass anastomosis under an endoscope is possible. Studies have reported that gastrointestinal bypass anastomosis can be achieved on experimental dogs by combining magnetic anastomosis with endoscopic techniques. In practical clinical application, the magnetic ring needs to pass through a seriously narrow digestive tract caused by pathological changes in the process of implantation, which puts higher requirements on the design of the magnetic anastomosis ring. An oval magnetic anastomosis ring is designed by research, the cross section area of a magnetic ring can be reduced, the magnetic anastomosis ring is convenient to insert, but the magnetic anastomosis ring cannot be inserted into a patient with serious stenosis.

Disclosure of Invention

In order to overcome the defects of the prior art, the invention aims to provide a deformable self-assembly magnetic anastomosis ring for endoscopic gastrointestinal tract anastomosis, which can meet the requirement of endoscopic gastrointestinal bypass anastomosis of patients with gastroduodenal obstruction based on the magnetic anastomosis principle.

In order to achieve the purpose, the invention adopts the technical scheme that:

a deformable self-assembly magnetic anastomosis ring for anastomosis of a digestive tract under an endoscope comprises auxiliary instruments and magnetic units, wherein the magnetic units are multiple, each magnetic unit is a trapezoidal magnet 2, the trapezoidal magnet 2 is of a hexahedral structure, the upper surface and the lower surface of the trapezoidal magnet are mutually parallel rectangles, the front side surface and the rear side surface of the trapezoidal magnet are mutually parallel, congruent and symmetrical isosceles trapezoids, the left side surface and the right side surface of the trapezoidal magnet are congruent and symmetrical rectangles, a through rectangular through hole 1 is formed in the trapezoidal magnet 2 along the left and right directions of the trapezoidal magnet, and the left end and the right end of the trapezoidal magnet 2 are respectively provided with an N pole and an S pole; the auxiliary instrument comprises a guide wire 3 and a push catheter 4, the section of the guide wire 3 is rectangular so as to penetrate through the rectangular through hole 1 to enable all the magnetic units to be combined into a linear chain shape, and the push catheter 4 is a circular tube, and the inner diameter of the push catheter allows the guide wire 3 to pass through.

The number of the trapezoidal magnets 2 corresponds to the inclination angles of the left side surface and the right side surface of the trapezoidal magnets, so that the trapezoidal magnets 2 can be attracted end to end by magnetic force to form a closed ring after the guide wire 3 is withdrawn.

Compared with the prior art, the cross-sectional area of the magnet in the embedding process can be reduced to the maximum extent, the size of the anastomosis opening meeting the requirement can be ensured to be established, and the design advantages are reflected in the following aspects:

(1) the magnetic anastomosis ring is decomposed into a plurality of magnetic units, the magnetic units are arranged in a specific order, when the magnet is placed in the anastomosis ring, the magnetic units are arranged in a straight chain shape, and when the magnet reaches a target position, the magnetic units can be self-assembled into a ring shape, so that the characteristics of homopolar repulsion and heteropolar attraction of the magnet are fully utilized.

(2) In order to ensure the stability of the magnetic units in the pushing process, the centers of the magnetic units adopt rectangular through holes, and the sections of the guide wires are also rectangular, so that the guide wires can restrict the magnetic units when the magnetic units are pushed along the guide wires, and the radial rotation distortion of the magnetic units can be effectively avoided.

(3) The magnetic units are controllably deformed through the guide wire, when the guide wire sequentially passes through the central through hole of each magnetic unit, the guide wire can effectively resist the suction force between two ends of the adjacent magnetic units, the linear chain state in the embedding process is ensured, and when the guide wire is gradually withdrawn after the guide wire reaches the target position, the adjacent magnetic units lose the resistance of the guide wire and automatically and tightly attract each other, so that the self-assembly process is completed.

Drawings

FIG. 1 is a schematic view of the structure of a magnetic cell of the present invention.

FIG. 2 is a schematic view of a self-assembled magnetic anastomosis ring structure according to the present invention.

Fig. 3 is a schematic view of a guide wire structure of the present invention.

Fig. 4 is a schematic view of a push catheter of the present invention.

FIG. 5 is a schematic diagram of the process of the present invention for deforming and self-assembling the magnetic anastomosis ring: (a) under the constraint of the guide wire, the magnetic units are arranged in a straight chain; (b) gradually removing the guide wires, and enabling adjacent magnetic units to attract and deform; (c) the magnetic cells self-assemble into a ring structure.

FIG. 6 is a schematic diagram of a path of clinical operation of the deformable self-assembled magnetic anastomosis ring of the present invention: (a) a gastroscope; (b) placing a guide wire through a gastroscope; (c) removing the gastroscope; (d) pushing the catheter along the guide; (e) an intestinal magnetic unit; (f) along the guide wire; (g) an intragastric magnetic unit; (h) an intragastric magnetic ring; (i) the magnetic ring falls off.

Detailed Description

The embodiments of the present invention will be described in detail below with reference to the drawings and examples.

The deformable self-assembly magnetic anastomosis ring is applicable to the alimentary canal. The core of the method is to realize two goals: firstly, the patient can get into a target position with the smallest cross section area by the slimming deformation during the implantation, so that the actual requirement of the patient with serious gastro-duodenal output obstruction clinically can be met; second, after implantation, "self-assembly looping", i.e., controllable deformation into a loop in the intestinal tract, and obtaining a larger loop area to ensure the establishment of anastomotic stoma sizes meeting clinical requirements.

In order to achieve the purpose, the specific structure of the invention comprises two parts, namely an auxiliary instrument and a magnetic unit, and an endoscope operation is used as a depending technical platform.

Referring to fig. 1, each of the magnetic units is a trapezoidal magnet 2, the trapezoidal magnet 2 has a hexahedral structure, the upper and lower surfaces of the trapezoidal magnet are rectangles parallel to each other, the front and rear side surfaces of the trapezoidal magnet are isosceles trapezoids parallel, congruent, symmetrical to each other, the left and right side surfaces of the trapezoidal magnet are congruent and symmetrical to each other, the included angle between the left and right side surfaces and the upper surface can be represented by α 1 and β 1, the included angle between the left and right side surfaces and the lower surface can be represented by α 2 and β 2, and it is obvious that α 1 is β 1, α 2 is β 2, and α 1+ α 2 is 180 °.

The trapezoidal magnet 2 is provided with a through rectangular through hole 1 along the left and right directions, and the rectangular through hole 1 is preferably positioned on the left and right central axes of the trapezoidal magnet 2. The left and right ends of the trapezoidal magnet 2 are respectively an N pole and an S pole. The number N of the trapezoidal magnets 2 is related to the value of alpha 1, so that after the trapezoidal magnets 2 are arranged according to N-S-N-S … N-S-N-S, N/S magnetic forces attract each other from head to tail to self-assemble a complete closed ring, as shown in FIG. 2. In this embodiment, N is 10, and in this case α 1 is 360 °/10 is 36 °, and may be slightly smaller than 36 ° as necessary to allow a partial error, but it is preferable not to be larger than 36 °.

The auxiliary instrument comprises a guide wire 3 and a push catheter 4, referring to fig. 3, the section of the guide wire 3 is rectangular, a rectangular through hole 1 can be penetrated under an endoscope, so that all the magnetic units are combined and unfolded to be in a linear chain shape, and after the guide wire 3 is removed, all the magnetic units are automatically assembled into a ring shape. Referring to fig. 4, the pusher catheter 4 is a circular tube with an inner diameter that allows the guide wire 3 to pass through.

Referring to fig. 5, the deformation principle and process of the self-assembled magnetic anastomosis ring of the present invention are as follows:

the guide wire 3 is guided through the rectangular through-holes 1 of the trapezoidal magnets 2, and the magnetic units are arranged in a straight-chain shape in the order of polarity of N-S-N-S … N-S-N-S, as shown in FIG. 5 (a); when the guide wire 3 is gradually withdrawn from each trapezoidal magnet 2, the adjacent magnetic units are attracted and deformed by the magnetic field attraction force between the N-S magnetic poles, as shown in fig. 5 (b); when the guide wire 3 is completely withdrawn, all the magnetic units are attracted by the end ends in sequence, and the deformation and the assembly are automatically completed to form a complete anastomosis ring, as shown in fig. 5 (c).

The present invention requires medical equipment in clinical use, including digestive endoscopy systems and C-arm X-ray systems. The digestive endoscope system is used for assisting the implantation of the magnetic anastomosis ring, and the C-shaped arm X-ray system is used for positioning the magnetic anastomosis ring and monitoring the deformation process.

Taking the gastrointestinal bypass anastomosis as an example, referring to fig. 6, the specific use process of the invention is as follows:

a: conventionally, a gastroscope is entered into the upper part of the duodenum stenosis through a mouth, as shown in fig. 6(a), a guide wire 3 is placed into a biopsy hole of the gastroscope, an endoscope is matched with an X-ray system to enable the head end of the guide wire 3 to reach the beginning part of the jejunum, as shown in fig. 6(b), the gastroscope is withdrawn, and the position of the head end of the guide wire is kept, as shown in fig. 6 (c);

b: the tail end of the guide wire 3 sequentially passes through the rectangular through holes 1 in the centers of the magnetic units, the guide wire 3 is sleeved with the push catheter 4, the push catheter 4 is pushed along the guide wire 3 to push the magnetic units to advance along the guide wire 3, and the magnetic units reach the tail end of the duodenum under the monitoring of X-rays as shown in fig. 6 (d); gradually withdrawing the guide wire 3 and the push catheter 4, and self-assembling the magnetic units in the intestinal tract into a magnetic anastomosis ring, as shown in fig. 6 (e);

c: the gastroscope is put into the stomach again in the same way, the guide wire 3 is kept in the stomach body again, and the gastroscope is withdrawn and the position of the guide wire 4 in the stomach is kept; the magnetic unit is sent into the stomach by means of the guide wire 3 and the push catheter 4 as in the anterior method, as in fig. 6 (f);

d: slowly withdrawing the guide wire 3 and the push catheter 4 in the stomach under the monitoring of X rays, and self-assembling the magnetic units in the stomach into a magnetic anastomosis ring, as shown in fig. 6 (g);

e: the magnetic anastomosis rings in the stomach and duodenum are mutually aligned and attracted to form a hierarchical structure of magnetic anastomosis ring-stomach wall-intestinal wall-magnetic anastomosis ring, as shown in fig. 6 (h). After a period of operation, the stomach-duodenum bypass can be established under the continuous squeezing action of the magnetic anastomosis ring, and meanwhile, the magnetic anastomosis ring falls into the intestinal tract, as shown in fig. 6(i), and is finally discharged out of the body through the digestive tract.

In conclusion, the magnetic anastomosis technology provides a new operation idea for gastrointestinal bypass anastomosis under an endoscope, and the design of the magnetic anastomosis ring and the planning of the operation path are the key points for realizing clinical application. In the magnetic anastomosis ring, all the magnetic units are arranged in sequence according to a specific magnetic pole direction and penetrate through the guide wire, all the magnetic units are linearly arranged when being placed, the guide wire is withdrawn after reaching the anastomosis part, and all the magnetic units are self-assembled into a ring shape. The advantage of the structural design is that the deformation characteristics of the magnetic anastomosis ring enable it to pass through a severely constricted lumen, yet enable it to establish a larger anastomosis caliber after self-assembly. The design structure is ingenious, the processing is easy, the operation is simple, and the clinical application value is important.

Claims (2)

1. A deformable self-assembly magnetic anastomosis ring for anastomosis of a digestive tract under an endoscope is characterized by comprising a plurality of auxiliary instruments and magnetic units, wherein each magnetic unit is a trapezoidal magnet (2), each trapezoidal magnet (2) is of a hexahedral structure, the upper surface and the lower surface of each trapezoidal magnet are rectangles which are parallel to each other, the front side surface and the rear side surface of each trapezoidal magnet are isosceles trapezoids which are parallel to each other, congruent and symmetrical, the left side surface and the right side surface of each trapezoidal magnet are congruent and symmetrical rectangles, a through rectangular through hole (1) is formed in each trapezoidal magnet (2) in the left-right direction of the trapezoidal magnet, and the left end and the right end of each trapezoidal magnet (2) are respectively provided with an N pole and; the auxiliary instrument comprises a guide wire (3) and a push catheter (4), the section of the guide wire (3) is rectangular so as to penetrate through a rectangular through hole (1) to enable all magnetic units to be combined into a linear chain shape, the push catheter (4) is a circular tube, and the inner diameter of the push catheter allows the guide wire (3) to pass through.

2. The deformable self-assembled magnetic anastomosis ring for endoscopic alimentary canal anastomosis according to claim 1, characterized in that the number of said trapezoidal magnets (2) corresponds to the inclination of the left and right lateral surfaces thereof, so that after the withdrawal of the guide wire (3), each trapezoidal magnet (2) can be magnetically attracted from head to tail to form a closed ring.

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