DE19900526A1 - Bloodless function test of implanted shunt system in patient with hydrocephalus - Google Patents
Bloodless function test of implanted shunt system in patient with hydrocephalusInfo
- Publication number
- DE19900526A1 DE19900526A1 DE1999100526 DE19900526A DE19900526A1 DE 19900526 A1 DE19900526 A1 DE 19900526A1 DE 1999100526 DE1999100526 DE 1999100526 DE 19900526 A DE19900526 A DE 19900526A DE 19900526 A1 DE19900526 A1 DE 19900526A1
- Authority
- DE
- Germany
- Prior art keywords
- shunt
- skin
- shunt system
- pressure wave
- sensor
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/03—Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs
- A61B5/031—Intracranial pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
- A61M27/002—Implant devices for drainage of body fluids from one part of the body to another
- A61M27/006—Cerebrospinal drainage; Accessories therefor, e.g. valves
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Molecular Biology (AREA)
- Hematology (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Engineering & Computer Science (AREA)
- Neurosurgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Physics & Mathematics (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
- External Artificial Organs (AREA)
Abstract
Description
Zur Behandlung von Patienten mit Hydrocephalus werden Shuntsysteme implantiert, die eine Drainge des Hirnwassers bei Überschreiten bestimmter Druckgrenzen im Hirnwasser bewirken und dadurch die Folgen eines Hydrocephalus verhindern können. Das Shuntsystem besteht in der Regel aus einem Ventrikelkatheter, einem Ventil und einem ableitenden Schenkel, der in den allermeisten Fällen in den Bauchraum (ventrikulo peritonealer Shunt) oder den rechten Herzvorhof (Ventrikuloatrialer Shunt) abgeleitet wird. Der Ventrikelka theter wird durch ein Bohrloch im Schädelknochen durch das Hirngewebe in einen Seitenventrikel implan tiert, das restliche System befindet sich subkutan. Das Ventil arbeitet in der Regel druckgesteuert und ist in verschiedenen Druckstufen kommerziell erhältlich.Shunt systems are implanted to treat patients with hydrocephalus Brain water when certain pressure limits are exceeded in the brain water and thereby the consequences prevent hydrocephalus. The shunt system usually consists of a ventricular catheter, a valve and a diverting leg, which in most cases goes into the abdomen (ventriculo peritoneal shunt) or the right atrium (ventriculoatrial shunt). The ventricle through a hole in the skull bone through the brain tissue into a lateral ventricle The rest of the system is subcutaneous. The valve is usually pressure controlled and is in various pressure levels commercially available.
Sehr häufig müssen die Shuntsysteme bei Säuglingen und sehr jungen Patienten implantiert werden. Aus diesem Grunde ist eine jahrzehntelange wartungsfreie Funktion erforderlich.The shunt systems very often have to be implanted in infants and very young patients. Out For this reason, decades of maintenance-free operation is required.
In der Praxis kommt es immer wieder zu Komplikationen durch einen teilweisen oder kompletten Verschluß der Systeme, aufgrund dessen der Patient erneut operiert und die defekte Shuntkomponente erneuert werden muß.In practice there are always complications from a partial or complete closure the systems on the basis of which the patient is operated on again and the defective shunt component is renewed got to.
Zur Lokalisation des Fehlers ist bisher ein invasives Verfahren üblich, bei dem versucht wird, den Fehler durch Punktion des Shuntsystems und nachfolgende Druckmessung oder Ablaufmessung festzustellen. Hierbei besteht ein sehr hohes Infektionsrisiko für den Patienten, da die Einnistung nur eines Bakteriums bereits das Gesamtsystem infiziert und somit potentiell lebensgefährlich werden kann. Außerdem kann es zu Hirnwas serlecks infolge der Punktion kommen.To date, an invasive method has been used to localize the error, in which an attempt is made to identify the error by puncturing the shunt system and subsequent pressure measurement or flow measurement. Here there is a very high risk of infection for the patient, since the implantation of only one bacterium already does that Entire system infected and can thus potentially be life-threatening. It can also cause brainwaves serlecks come as a result of the puncture.
Der Erfindung liegt die Aufgabe zugrunde, mit dem hier vorgeschlagenen Sensorsystem eine sichere und nichtinvasive Funktions-Diagnose zu erstellen, bei der es zu keinerlei Verletzungen und Gefährdungen des Patienten oder zu Schädigungen des Shuntsystems kommt.The invention is based, with the sensor system proposed here, a safe and the task to create non-invasive function diagnostics, in which there are no injuries or hazards to the Patient or damage to the shunt system.
Das Shuntsystem besteht prinzipiell aus zwei flexiblen Schlauchabschnitten, die durch einen Pumpenteil mit meist zwei Rückschlagventilen verbunden sind. Mindestens eines der Ventile wird durch eine geringe Feder kraft auf ein Schließen des Systems ausgelegt, welches sich ab einem definierten Überdruck auf der Hirnseite öffnet. Das Shuntsystem ist im normalen Betrieb komplett mit Hirnwasser gefüllt und leitet ohne Zutun des Patienten einen entstehenden Überdruck im Hirnwasser unmerklich in den Bauchraum oder ins Blut ab.The shunt system basically consists of two flexible hose sections that are connected by a pump part usually two check valves are connected. At least one of the valves is by a small spring designed to close the system, which starts at a defined excess pressure on the brain side opens. In normal operation, the shunt system is completely filled with brain water and conducts without doing anything Patients pass unnoticed excess pressure in the brain water into the abdomen or into the blood.
Das hier beschriebene Verfahren basiert auf einer Reaktionsanalyse des flexiblen Shuntsystems welches durch eine elektromechanische Vorrichtung mit einer definierten Druckwelle angeregt wird und deren Reaktionen mit Hilfe von mindestens einem Sensor an einer anderen Position des Shunts im Kopfbereich des Patienten abgegriffen werden.The method described here is based on a reaction analysis of the flexible shunt system which by an electromechanical device is excited with a defined pressure wave and its reactions with the help of at least one sensor at another position of the shunt in the patient's head area be tapped.
Da das Shuntsystem im Kopfbereich unter der Haut (subkutan) implantiert wird, kann die Störwelle durch einen Druckpuls auf der Haut über dem Shuntschlauch erzeugt und mit Hilfe empfindlicher Sensoren an ande ren Positionen auch wieder gemessen werden.Since the shunt system is implanted in the head area under the skin (subcutaneously), the interference wave can be caused by generates a pressure pulse on the skin over the shunt tube and with the help of sensitive sensors to others positions can be measured again.
Mit Hilfe moderner Datenanalyseverfahren kann aus den Druckreaktionen des Shunts seine ungestörte Funkti on überwacht, bzw. können Störungen durch teilweisen oder kompletten Verschluß einzelner Komponenten erkannt und ihre Position kann identifiziert werden.With the help of modern data analysis methods, the undisturbed function of the pressure reactions of the shunt on monitors or can malfunctions due to partial or complete closure of individual components recognized and their position can be identified.
Damit steht ein schmerzfreies und ungefährliches Verfahren zur Fehlererkennung an Shuntsystemen zur Verfügung, welches sich insbesondere bei sehr jungen Patienten als vorteilhaft erweist und unnötige und ge fährliche Operationen vermeidbar macht.This provides a painless and harmless procedure for fault detection in shunt systems Available, which proves to be particularly advantageous in very young patients and unnecessary and ge makes dangerous operations avoidable.
Claims (14)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE1999100526 DE19900526B4 (en) | 1999-01-11 | 1999-01-11 | Method and device for functional testing of shunt systems in patients with hydrocephalus |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE1999100526 DE19900526B4 (en) | 1999-01-11 | 1999-01-11 | Method and device for functional testing of shunt systems in patients with hydrocephalus |
Publications (2)
Publication Number | Publication Date |
---|---|
DE19900526A1 true DE19900526A1 (en) | 1999-11-25 |
DE19900526B4 DE19900526B4 (en) | 2006-01-12 |
Family
ID=7893825
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE1999100526 Expired - Fee Related DE19900526B4 (en) | 1999-01-11 | 1999-01-11 | Method and device for functional testing of shunt systems in patients with hydrocephalus |
Country Status (1)
Country | Link |
---|---|
DE (1) | DE19900526B4 (en) |
-
1999
- 1999-01-11 DE DE1999100526 patent/DE19900526B4/en not_active Expired - Fee Related
Also Published As
Publication number | Publication date |
---|---|
DE19900526B4 (en) | 2006-01-12 |
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Legal Events
Date | Code | Title | Description |
---|---|---|---|
OAV | Applicant agreed to the publication of the unexamined application as to paragraph 31 lit. 2 z1 | ||
OP8 | Request for examination as to paragraph 44 patent law | ||
OR8 | Request for search as to paragraph 43 lit. 1 sentence 1 patent law | ||
8122 | Nonbinding interest in granting licenses declared | ||
8127 | New person/name/address of the applicant |
Owner name: STENDEL, RUEDIGER, DR.MED., 12247 BERLIN, DE |
|
8364 | No opposition during term of opposition | ||
R119 | Application deemed withdrawn, or ip right lapsed, due to non-payment of renewal fee |
Effective date: 20130801 |