FR2647005A1 - SPHINCTEROTOME - Google Patents

SPHINCTEROTOME Download PDF

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Publication number
FR2647005A1
FR2647005A1 FR8906595A FR8906595A FR2647005A1 FR 2647005 A1 FR2647005 A1 FR 2647005A1 FR 8906595 A FR8906595 A FR 8906595A FR 8906595 A FR8906595 A FR 8906595A FR 2647005 A1 FR2647005 A1 FR 2647005A1
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FR
France
Prior art keywords
metal wire
wire
sphincterotome
high frequency
guide wire
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.)
Withdrawn
Application number
FR8906595A
Other languages
French (fr)
Inventor
Jacques Moret
Michel Tempereau
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Guerbet SA
Original Assignee
Guerbet SA
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Guerbet SA filed Critical Guerbet SA
Priority to FR8906595A priority Critical patent/FR2647005A1/en
Priority to PCT/FR1990/000305 priority patent/WO1990014047A1/en
Publication of FR2647005A1 publication Critical patent/FR2647005A1/en
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • 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
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/32—General characteristics of the apparatus with radio-opaque indicia

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Otolaryngology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)
  • Instruments For Viewing The Inside Of Hollow Bodies (AREA)

Abstract

The subject of the invention is a sphincterotome with a high frequency current of the type which includes a metallic wire (8) connected to a source of high frequency, and a flexible isolating sleeve (16) into which the metallic wire (8) is inserted. The distal end of said metallic wire (8) can be withdrawn from the isolating sleeve (16) to allow for the cutting of a sphincter. The sphincterotome also includes a radiopaque guiding wire (18) and is characterised by the fact that said guiding wire (18) is an isolated metallic wire which can slide into the isolating sleeve (16).

Description

La présente invention concerne un sphinctérotome à courant haute fréquence. The present invention relates to a high frequency current sphincterotome.

Pour réaliser la section de sphincters tels que le sphincter d Oddl on utilise actuellement des appareils appelés sphinctérotomes qui sont introduits dans le corps humain à l'aide d'un endoscope et qui permettent la section de la paroi du sphincter sous l'action d'un courant haute fréquence. En plus du fil métallique conducteur du courant haute fréquence. un sphinctérotome comporte normalement une gaine isolante souple à l'extrémité de laquelle le fil métallique est susceptible de sortir pour permettre la section d'un sphincter. To make the section of sphincters such as the sphincter of Oddl we currently use devices called sphincterotomes which are introduced into the human body using an endoscope and which allow the section of the wall of the sphincter under the action of high frequency current. In addition to the metallic wire conducting the high frequency current. a sphincterotome normally includes a flexible insulating sheath at the end of which the metal wire is capable of coming out to allow the section of a sphincter.

En outre. le sphinctérotome est généralement conçu de façon à permettre le passage dans la gaine isolante d un liquide notamment d un produit de contraste qui est ainsi injecté au niveau du sphincter. In addition. the sphincterotome is generally designed so as to allow the passage through the insulating sheath of a liquid in particular of a contrast product which is thus injected at the level of the sphincter.

De plus le sphinctérotome doit comporter un fil de guidage relativement rigide et radioopaque qui permet 1 insertion de l extremíté du sphinctérotome à 1 interieur du sphincter. In addition, the sphincterotome must include a relatively rigid and radioopaque guidewire which allows the insertion of the end of the sphincterotome inside the sphincter.

Jusqu à présent les fils de guidage utilisés sont métalliques et les sphinctérotomes doivent comporter une gaine souple munie de 2 canaux. l'un pour le passage du fil métallique relié à la source haute fréquence. l'autre pour le passage du fil de guidage de façon å, isoler les 2 fils. Il en résulte que les sphinctérotomes ont des diamètres relativement importants et doivent donc etre utilisés-avec des endoscopes ayant un diamètre intérieur relativement important (2.8 ou 3.7 mm). De plus dans ce type d'appareil le jeu entre le fil de guidage et le canal dans lequel il est inséré est forcément faible ce qui rend difficile la manipulation du fil de guidage.  Until now, the guide wires used are metallic and the sphincterotomes must include a flexible sheath provided with 2 channels. one for the passage of the metallic wire connected to the high frequency source. the other for the passage of the guide wire so, isolate the 2 wires. As a result, the sphincterotomes have relatively large diameters and must therefore be used with endoscopes having a relatively large internal diameter (2.8 or 3.7 mm). In addition, in this type of device, the clearance between the guide wire and the channel in which it is inserted is necessarily low, which makes it difficult to manipulate the guide wire.

La présente invention vise à fournir un sphinctérotome de plus petit diamètre que les appareils existants et permettant donc son insertion dans des endoscopes de plus petit diamètre. The present invention aims to provide a sphincterotome of smaller diameter than existing devices and therefore allowing its insertion into endoscopes of smaller diameter.

A cet effet la présente invention a pour objet un sphinctérotome à courant haute fréquence du type comprenant un fil métallique qui est relié à une source de courant haute fréquence, une gaine isolante souple dans laquelle est inséré le fil métallique, l'extrémitè distale de ce fil métallique étant susceptible de sortir de la gaine isolante pour permettre la section d'un sphincter, ainsi qu'un fil de guidage radioopaque, caractérisé en ce que le fil de guidage est un fil métallique isolé coulissant dans la gaine isolante. To this end, the present invention relates to a high frequency current sphincterotome of the type comprising a metal wire which is connected to a high frequency current source, a flexible insulating sheath in which the metal wire is inserted, the distal end of this metal wire being able to leave the insulating sheath to allow the section of a sphincter, as well as a radio-opaque guide wire, characterized in that the guide wire is an insulated metal wire sliding in the insulating sheath.

Le fil métallique isolé constituant le fil de guidage peut être constitué simplement par un fil métallique recouvert d'une enveloppe de matière plastique. The insulated metal wire constituting the guide wire can be constituted simply by a metal wire covered with a plastic envelope.

Pour permettre la commande du fil de guidage, le sphinctérotome selon 1 invention comprend avantageusement au voisinage de l'extrémité proximale du fil métallique, un conduit de dérivation en Y pour le passage du fil de guidage. To allow control of the guide wire, the sphincterotome according to 1 invention advantageously comprises, in the vicinity of the proximal end of the metal wire, a Y-branch conduit for the passage of the guide wire.

On décrira ci-après un mode de réalisation de la présente invention en se référant au dessin annexé sur lequel
- la Fig. 1 est une vue longitudinale avec coupe partielle d'un sphinctérotome selon 1 invention,
- la Fig. 2 est une vue en coupe longitudinale d'une portion de l'appareil.An embodiment of the present invention will be described below with reference to the accompanying drawing in which
- Fig. 1 is a longitudinal view with partial section of a sphincterotome according to 1 invention,
- Fig. 2 is a view in longitudinal section of a portion of the device.

- la Fig. 3 est une coupe selon Il de la
Fig. 2. - Fig. 3 is a section according to Il of the
Fig. 2.

Le sphinctérotome représenté sur la Fig. 1 comprend une poignée de commande en matière plastique 1 en forme de pistolet comportant dans l'axe du pistolet un anneau 2 coulissant dans un guide 3. The sphincterotome shown in FIG. 1 comprises a control handle made of plastic 1 in the form of a pistol comprising, in the axis of the pistol, a ring 2 sliding in a guide 3.

A l'extrémité frontale 4 de la poignée 1 et dans l'axe du pistolet est fixé un tube 5 de matière plastique dans lequel est disposé un tube métallique 6 qui est recouvert de Téflon isolant et qui est relié à l'extrémité frontale 4 de la poignée par une bague 7 d'étanchéité. At the front end 4 of the handle 1 and in the axis of the gun is fixed a tube 5 of plastic material in which is disposed a metal tube 6 which is covered with insulating Teflon and which is connected to the front end 4 of the handle by a sealing ring 7.

A l'intérieur du tube 6 est disposé un fil métallique 8 coulissant à travers la bague d'étanchéité 7 et dont l'extrémité proximale est fixée à l'anneau 2 et comporte à ce niveau une prise de courant électrique haute fréquence 9. Inside the tube 6 is arranged a metal wire 8 sliding through the sealing ring 7 and the proximal end of which is fixed to the ring 2 and comprises at this level a high frequency electrical outlet 9.

Par ailleurs sur le tube 5 est branche un tube 10 qui est muni d'un bouchon d'étanchéité 11. Ce tube 10 peut être ;relié à un réservoir de liquide, notamment un produit de contraste ou un lubrifiant. Furthermore, on the tube 5 is connected a tube 10 which is provided with a sealing plug 11. This tube 10 can be connected to a reservoir of liquid, in particular a contrast product or a lubricant.

A l'extrémité du tube 5 est fixé par l in- termédiaire d'un raccord 12,-la branche droite 13 d'un
Y de dérivation 14.At the end of the tube 5 is fixed by means of a fitting 12, the straight branch 13 of a
Bypass Y 14.

A l'autre extrémité de la branche droite 13 est fixé par l'intermédiaire d'un raccord 15 une gaine en matière plastique souple 16 dans lequel passe le fil métallique 7, comme représenté sur les Fig 2 et 3. At the other end of the straight branch 13 is fixed by means of a connector 15 a flexible plastic sheath 16 through which the metal wire 7 passes, as shown in FIGS. 2 and 3.

A l extremité de la branche en dérivation 17 du Y de dérivation 14 pénètre un fil de guidage 18. At the end of the branch branch 17 of the branch Y 14 enters a guide wire 18.

L'étanchéité et le blocage du fil de guidage au niveau de l'extermite de la banche en dérivation 17 est assuré par un système d'étanchéité et de blocage 19.The sealing and blocking of the guide wire at the end of the branch panel 17 is ensured by a sealing and blocking system 19.

Le fil de guidage 18 est constitue par un fil métallique 20 relativement rigide muni d'un reve tement de matière plastique 21. Au-delà du Y de dérivation 14, la gaine 16 contient à la fois le fil métallique 8 et le fil de guidage 18. The guide wire 18 is constituted by a relatively rigid metal wire 20 provided with a plastic coating 21. Beyond the bypass Y 14, the sheath 16 contains both the metal wire 8 and the guide wire 18.

A l'extrémité distale 22 de la gaine 16, le fil métallique est rendu solidaire de la gaine 16. Au voisinage de cette extrémité distale 22, la gaine 16 présente une fente permettant la sortie du fil métal-lique 8 lorsque l'on tire l'anneau de commande 2 en arriere. At the distal end 22 of the sheath 16, the metal wire is made integral with the sheath 16. In the vicinity of this distal end 22, the sheath 16 has a slot allowing the exit of the metal wire 8 when pulling the control ring 2 back.

A cette me-me extrémité distale 22 le fil de guidage 18 est susceptible de sortir de la gaine. At this distal end me-me 22 the guide wire 18 is capable of coming out of the sheath.

Le fonctionnement de l'appareil est le suivant. The operation of the device is as follows.

Le fil de guidage 18 est inséré dans la gaine 16 et la gaine est introduite dans le canal intérieur d'un endoscope. The guide wire 18 is inserted into the sheath 16 and the sheath is introduced into the interior channel of an endoscope.

Lors de l'utilisation chez l'homme par exemple pour sectionner le sphincter d Oddi le fil de guidage 18 est poussé de façon à ce que son extrémité dépasse de la gaine 16 et par visualisation aux rayons
X on dirige l'extrémité du fil de guidage 18 dans le sphincter d Oddi. On tire alors 1 anneau 2 pour faire sortir le fil de coupe 8 de la gaine 16 et on procède à la section du sphincter sous l'action d'un courant haute fréquence.When used in humans, for example to cut the sphincter of Oddi, the guide wire 18 is pushed so that its end protrudes from the sheath 16 and by ray display
X the end of the guide wire 18 is directed into the sphincter of Oddi. A ring 2 is then pulled to bring out the cutting wire 8 from the sheath 16 and the sphincter is sectioned under the action of a high frequency current.

Dans l'appareil selon l'invention les organes de commande sont rassemblés sur la poignée et son voisinage. In the device according to the invention, the control members are assembled on the handle and its vicinity.

L'appareil selon l'invention assure une sécurité complète du patient et des manipulateurs lors de l'utilisation du courant haute fréquence par l'emploi de matières thermoplastiques isolantes et par l'étanchéité totale de tous les canaux opérateurs.  The device according to the invention ensures complete safety for the patient and the manipulators during the use of the high frequency current by the use of insulating thermoplastic materials and by the total sealing of all the operating channels.

Une fois l'opération pratiquée, le fil de guidage peut être laissé en place dans le patient pour une seconde utilisation : passage de sonde de drainage, de sonde guide, voire de prothèses. Once the operation has been carried out, the guide wire can be left in place in the patient for a second use: passage of a drainage probe, guide probe, or even prostheses.

La manipulation de l'appareil est aisée en raison du renfort du fil de guidage sur toute la longueur de la gaine ou partiellement. The handling of the device is easy due to the reinforcement of the guide wire over the entire length of the sheath or partially.

Tous les organes mobiles sont situés à l'intérieur de la gaine facilitant les manipulations et assurant la fiabilité du système. All the moving parts are located inside the sheath, facilitating handling and ensuring the reliability of the system.

L'appareil est utilisable avec tous les types d'endoscopes du marché dont les canaux opérateurs ont des diamètres intérieurs de 2 mm, 2,8 mm et 3,7 mm (le diamètre extérieur de la gaine de l appa- reil selon l'invention peut être par exemple de 1,7 mm).  The device can be used with all types of endoscopes on the market whose operating channels have internal diameters of 2 mm, 2.8 mm and 3.7 mm (the external diameter of the device's sheath according to the invention can be for example 1.7 mm).

Claims (3)

REVENDICATIONS 1. Sphinctèrotome à courant haute fréquence du type comprenant un fil métallique (8) qui est relié à une source de courant haute fréquence, une gaine isolante souple (16) dans laquelle est inséré le fil métallique (8), l'extrémité distale de ce fil métallique (B) étant susceptible de sortir de la gaine isolante (16) pour permettre la section d'un sphincter, ainsi qu'un fil de guidage radioopaque (18), caractérisé en ce que le fil de guidage (18) est un fil métallique isolé coulissant dans la gaine isolante (16). 1. High frequency current sphincterotome of the type comprising a metal wire (8) which is connected to a high frequency current source, a flexible insulating sheath (16) into which the metal wire (8) is inserted, the distal end of this metal wire (B) being capable of coming out of the insulating sheath (16) to allow the section of a sphincter, as well as a radio-opaque guide wire (18), characterized in that the guide wire (18) is an insulated metal wire sliding in the insulating sheath (16). 2. Sphinctérotome selon la revendication 1. 2. A sphincterotome according to claim 1. le fil métallique isolé est constituée par un fil métallique (20) recouvert d'une enveloppe (21) de matière plastique.the insulated metal wire is constituted by a metal wire (20) covered with an envelope (21) of plastic material. 3. Sphinctérotome selon la revendication 1 ou la revendication 2, caractérisé en ce qu'il comprend au voisinage de l'extrémité proximale du fil métallique (8) un conduit de dérivation (14) en Y pour le passage du fil de guidage (18).  3. Sphincterotome according to claim 1 or claim 2, characterized in that it comprises, in the vicinity of the proximal end of the metal wire (8) a bypass duct (14) in Y for the passage of the guide wire (18 ).
FR8906595A 1989-05-19 1989-05-19 SPHINCTEROTOME Withdrawn FR2647005A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
FR8906595A FR2647005A1 (en) 1989-05-19 1989-05-19 SPHINCTEROTOME
PCT/FR1990/000305 WO1990014047A1 (en) 1989-05-19 1990-04-26 Sphincterotome

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
FR8906595A FR2647005A1 (en) 1989-05-19 1989-05-19 SPHINCTEROTOME

Publications (1)

Publication Number Publication Date
FR2647005A1 true FR2647005A1 (en) 1990-11-23

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Family Applications (1)

Application Number Title Priority Date Filing Date
FR8906595A Withdrawn FR2647005A1 (en) 1989-05-19 1989-05-19 SPHINCTEROTOME

Country Status (2)

Country Link
FR (1) FR2647005A1 (en)
WO (1) WO1990014047A1 (en)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0519214A1 (en) * 1991-05-17 1992-12-23 Wilson-Cook Medical Inc. Electrically isolated guide wire for papillotome/sphincterotome procedures
WO1993004724A1 (en) * 1991-08-28 1993-03-18 Rissman, John, A. Steerable stylet and manipulative handle assembly
US5396902A (en) * 1993-02-03 1995-03-14 Medtronic, Inc. Steerable stylet and manipulative handle assembly
WO2001087399A2 (en) * 2000-05-18 2001-11-22 Wilson-Cook Medical Inc. Medical device with improved wire guide access

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE136920C (en) *
DE2429462A1 (en) * 1973-06-20 1975-01-16 Olympus Optical Co ELECTROSURGICAL INSTRUMENT
GB1435797A (en) * 1973-10-22 1976-05-12 Surgimed As Catheter guide for use in insertion of a catheter into the human body
EP0141006A1 (en) * 1983-09-16 1985-05-15 Terumo Kabushiki Kaisha Guide wire for catheter
US4554929A (en) * 1983-07-13 1985-11-26 Advanced Cardiovascular Systems, Inc. Catheter guide wire with short spring tip and method of using the same
EP0274705A1 (en) * 1986-12-18 1988-07-20 Frimberger, Erintrud Probe for introduction into the human or animal body, in particular papillotome

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE136920C (en) *
DE2429462A1 (en) * 1973-06-20 1975-01-16 Olympus Optical Co ELECTROSURGICAL INSTRUMENT
GB1435797A (en) * 1973-10-22 1976-05-12 Surgimed As Catheter guide for use in insertion of a catheter into the human body
US4554929A (en) * 1983-07-13 1985-11-26 Advanced Cardiovascular Systems, Inc. Catheter guide wire with short spring tip and method of using the same
EP0141006A1 (en) * 1983-09-16 1985-05-15 Terumo Kabushiki Kaisha Guide wire for catheter
EP0274705A1 (en) * 1986-12-18 1988-07-20 Frimberger, Erintrud Probe for introduction into the human or animal body, in particular papillotome

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0519214A1 (en) * 1991-05-17 1992-12-23 Wilson-Cook Medical Inc. Electrically isolated guide wire for papillotome/sphincterotome procedures
WO1993004724A1 (en) * 1991-08-28 1993-03-18 Rissman, John, A. Steerable stylet and manipulative handle assembly
US5439006A (en) * 1991-08-28 1995-08-08 Medtronic, Inc. Steerable stylet and manipulative handle assembly
US5662119A (en) * 1991-08-28 1997-09-02 Medtronic Inc. Steerable stylet and manipulative handle assembly
US5873842A (en) * 1991-08-28 1999-02-23 Medtronic, Inc. Steerable stylet and manipulative handle assembly
US5396902A (en) * 1993-02-03 1995-03-14 Medtronic, Inc. Steerable stylet and manipulative handle assembly
WO2001087399A2 (en) * 2000-05-18 2001-11-22 Wilson-Cook Medical Inc. Medical device with improved wire guide access
WO2001087399A3 (en) * 2000-05-18 2002-04-04 Wilson Cook Medical Inc Medical device with improved wire guide access
US6533782B2 (en) 2000-05-18 2003-03-18 Wilson-Cook Medical Incorporated Medical device with improved wire guide access
KR100767155B1 (en) * 2000-05-18 2007-10-15 윌슨-쿡 메디컬, 인크. Medical device with improved wire guide access

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Publication number Publication date
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