Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
  • A61B17/132—Tourniquets
  • A61B17/1322—Tourniquets comprising a flexible encircling member
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
  • A61F5/0003—Apparatus for the treatment of obesity; Anti-eating devices
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
  • A61B17/132—Tourniquets
  • A61B17/1322—Tourniquets comprising a flexible encircling member
  • A61B17/1327—Tensioning clamps
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
  • A61B2017/00539—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated hydraulically

Definitions

• the present invention relates to an apparatus for forming a stoma opening in the stomach or oesophagus of a patient.
• the apparatus comprises a constriction device adapted to be applied on the patient's stomach or oesophagus and including an elongate adjustable constriction member adapted to extend in a loop around and constrict the stomach or oesophagus to form the stoma opening therein, the constriction member having first and second end portions.
• the apparatus further comprises a connection device for releasably connecting the first and second end portions of the constriction member to each other, and an adjustment device that adjusts the longitudinal extension of the constriction member in said loop to change the size of the stoma opening
• This kind of apparatus in the form of a gastric banding device in which a band encircles a portion of a patient's stomach to restrict the food intake of the patient, have been used in surgery for morbid obesity to form a small gastric pouch above the band and a reduced stoma opening in the stomach.
• a band is applied around the stomach to obtain an optimal stoma opening during surgery
• some prior gastric banding devices are provided with an adjustment device enabling a minor post- operation adjustment of the size of the stoma opening.
• the kind of apparatus presented initially has also been used for treating heartburn and reflux disease due to hiatal hernia, i.e. a portion of the stomach immediately below the gastric fundus slides upwardly through the esophageal hiatus. In consequence, stomach acids and foods are regurgitated into the oesophagus.
• a prior art prosthesis called Angelchik according to U.S. Patent No. 3 875 928, was used to operatively treat heartburn and reflux disease.
• the Angelchik prosthesis had a major disadvantage in that it was not possible to adjust the size of the restriction opening after the operation.
• a further disadvantage was that the prosthesis did not satisfactorily protect the oesophagus and the surrounding area against injuries due to poor shape of the prosthesis. Therefore, operations using the Angelchik prosthesis are no longer practised.
• the prime object of the present invention is to provide a new adjustable apparatus designed to form an adjustable stoma opening in the stomach or oesophagus of a patient, wherein the new apparatus is suited for treating obese patients as well as patients suffering from heartburn and reflux disease.
• Another object of the present invention is to provide a new convenient apparatus for forming a stoma opening, which is easy to apply around the stomach or oesophagus and easy to remove from the stomach or oesophagus.
• connection device includes a female part and a male part fitting into the female part to lock them together.
• the male part includes a shank and a head on the shank and the female part includes two jaws defining a bore for receiving the head of the male part and a passage narrower than and extending from the bore for receiving the shank of the male part, whereby the male part can be locked to the female part by laterally displacing the head and shank of the male part into the bore and passage, respectively.
• the jaws are formed with indentations in the bore adjacent the passage, such that the head can be displaced laterally relative to the bore into the indentations, whereby the head is prevented from being displaced out of the bore.
• male and female parts may be designed as snap fasteners or male and female pipes, which may or may not be provided with threads.
• the constriction member may be non-inflatable and the adjustment device may include a motor for adjusting the non-inflatable constriction member.
• the constriction member may be a hydraulic constriction member, typically with an inflatable cavity, and the adjustment device may includes a pump hydraulically connected to the hydraulic constriction member.
• the adjustment device comprises a powered adjustment device, for example including a motor, preferably an electric motor.
• the apparatus may comprise an implantable energy-transforming device adapted to transform wireless energy emitted from outside the patient's body into an energy form suited for powering the adjustment device. Such an energy form may be electric energy for powering an electric motor of the adjustment device.
• the apparatus may comprise a wireless remote control for controlling the adjustment device from outside the patient's body to adjust the constriction device to change the size of the stoma opening.
• the invention also provides a method for laparoscopically implanting in a patient a constriction device of the apparatus as described above to form a stoma opening in the patient's stomach or oesophagus.
• the method comprises insufflating the patient's abdomen, placing at least two laparoscopic trocars in the abdomen, using a dissecting tool inserted through the laparoscopic trocar, dissecting the region of the oesophagus or stomach, introducing a constriction device of the apparatus described above through the trocars, and using tools inserted, in the trocars forming a loop of the constriction member of the restriction device around the stomach or oesophagus in the dissected region and connecting the male and female parts to each other.
• the invention also provides a method for laparoscopically removing a constriction device of the apparatus as described above applied on the stomach or oesophagus of a patient.
• the method comprises insufflating the patient's abdomen, placing at least two laparoscopic trocars in the abdomen, and using tools inserted in the trocars releasing the male and female parts of the constriction device from each other and then removing the constriction device from the patient.
• Figure 1 is a view of the apparatus of the invention with a connection device
• Figure 2 is a schematic view of the connection device in an unlocked state
• Figure 3 is a schematic view of the connection device in a pre-locked state
• Figure 4 is a schematic view of the connection device in a final locked state
• Figure 5 illustrates the apparatus of the invention implanted in an obese patient.
• Figure 1 shows the apparatus of the present invention including a constriction device having an elongated constriction member 1 to be formed into a closed loop around a patient's stomach or oesophagus to form a stoma opening therein.
• An adjustment device 2 includes an elongate housing 3 connected to an end portion 4 of the constriction member 1.
• connection device in the form of a male part 5 on another end portion 6 of the constriction member 1 and a female part 7 formed on the housing 3.
• the male part 5 may be provided on the housing 3 and the female part 7 may be formed on the end portion 6.
• the male part 5 has a shank 8 and a spherical head 9 on the shank 8 and the female part 7 has two jaws 10,11 defining a circular bore 12 for receiving the head 9 and a passage 13 narrower than and extending from the bore 12 for receiving the shank 8.
• the male part 5 can be pre- locked to the female part 7 by laterally displacing the head 9 and shank 8 into the bore 12 and passage 13, respectively.
• the jaws 10,11 are formed with spherical segment indentations 14,15 complementary to the spherical head 9.
• the indentations 14,15 are located in the bore 12 adjacent the passage 13.
• the male part 5 can be finally locked to the female part 7 by displacing the head 9 laterally relative to the bore 12 into the indentations 14,15.
• the pressure that the stomach or oesophagus constantly exerts on the constriction member when the apparatus is implanted ensures that the connection device 5,7 is kept in a locked state.
• the surgeon may conveniently use laparoscopic surgery to introduce a suitable tool into the patient's abdomen to release the head 9 from the jaws 11 ,11 and displace the head 9 out of the bore 12.
• FIG 5 illustrates the constriction device the embodiment shown in Figures 1-4 applied on the stomach 16 of an obese patient.
• the elongate constriction member 1 and housing 3 of the constriction device extend in a loop around and constricts the stomach 16 to form an upper pouch 17 of the stomach 16 and a restricted stoma opening in the stomach 17.
• a rechargeable electric power supply 18 is implanted in the patient and fixed to the breastbone 19 (the sternum).
• An external remote control 20 controls the adjustment device 2 and transmits signals that are received by a combined control and energy transforming unit 21 subcutaneously implanted in the patient.
• the unit 21 is electrically connected to the electric power supply 18 and transforms the energy of the signals into an electric current that is used for charging the electric power supply 18.
• the signals may include electromagnetic waves and the unit 21 may include an electric p-n junction element that transforms the wireless energy into an electric current.
• a resilient insulated electric wire 22 connects the power supply 18 and an electric motor of the adjustment device 2 contained in the housing 3.
• the electric wire 22 extends helically between the power supply 18 and housing 3, in order to permit the electric wire 22 to be temporarily extended when dynamic movements of the stomach 16 and oesophagus occur, so that the risk of breaking the electric wire 22 is eliminated.

Landscapes

• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• Veterinary Medicine (AREA)
• Vascular Medicine (AREA)
• Public Health (AREA)
• Surgery (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• General Health & Medical Sciences (AREA)
• Molecular Biology (AREA)
• Medical Informatics (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Reproductive Health (AREA)
• Child & Adolescent Psychology (AREA)
• Obesity (AREA)
• Nursing (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Orthopedics, Nursing, And Contraception (AREA)
• Surgical Instruments (AREA)
• Prostheses (AREA)

Priority Applications (1)

Applications Claiming Priority (3)

Related Child Applications (1)

Publications (1)

Family

ID=23231607

Family Applications (2)

Family Applications Before (1)

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• 2002
  • 2002-09-05 AT AT06076851T patent/ATE504274T1/de not_active IP Right Cessation
  • 2002-09-05 WO PCT/SE2002/001591 patent/WO2003020184A1/en not_active Application Discontinuation
  • 2002-09-05 EP EP06076851A patent/EP1745765B1/de not_active Expired - Lifetime
  • 2002-09-05 EP EP02797720A patent/EP1435884A1/de active Pending
  • 2002-09-05 DE DE60239714T patent/DE60239714D1/de not_active Expired - Lifetime

Non-Patent Citations (1)

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