GB2618230A - Peritoneal dialysis indwelling catheter fixing apparatus - Google Patents

Peritoneal dialysis indwelling catheter fixing apparatus Download PDF

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Publication number
GB2618230A
GB2618230A GB2310240.3A GB202310240A GB2618230A GB 2618230 A GB2618230 A GB 2618230A GB 202310240 A GB202310240 A GB 202310240A GB 2618230 A GB2618230 A GB 2618230A
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United Kingdom
Prior art keywords
elastic
dialysis catheter
ring
peritoneal dialysis
wire
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GB2310240.3A
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GB202310240D0 (en
Inventor
Hu Mengsi
Zhang Yuezhong
Lv Zhimei
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Shandong Provincial Hosptial Affiliated To Shandong First Medical Univ
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Shandong Provincial Hosptial Affiliated To Shandong First Medical Univ
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Publication of GB202310240D0 publication Critical patent/GB202310240D0/en
Publication of GB2618230A publication Critical patent/GB2618230A/en
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    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • A61M1/285—Catheters therefor
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0194—Tunnelling catheters
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
    • 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
    • A61M29/00—Dilators with or without means for introducing media, e.g. remedies
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0194—Tunnelling catheters
    • A61M2025/0197—Tunnelling catheters for creating an artificial passage within the body, e.g. in order to go around occlusions
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A61M2025/0213—Holding devices, e.g. on the body where the catheter is attached by means specifically adapted to a part of the human body
    • A61M2025/0233—Holding devices, e.g. on the body where the catheter is attached by means specifically adapted to a part of the human body specifically adapted for attaching to a body wall by means which are on both sides of the wall, e.g. for attaching to an abdominal wall
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A61M2025/0293—Catheter, guide wire or the like with means for holding, centering, anchoring or frictionally engaging the device within an artificial lumen, e.g. tube
    • 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
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/10—Trunk
    • A61M2210/1017—Peritoneal cavity

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Emergency Medicine (AREA)
  • Urology & Nephrology (AREA)
  • Vascular Medicine (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • External Artificial Organs (AREA)

Abstract

A peritoneal dialysis indwelling catheter fixing apparatus, comprising: a guide sheath (101), wherein the guide sheath is a cavity-type guide member; a guide sheath core (102), wherein the front end of the guide sheath core is of a conical structure, the guide sheath core is used for being inserted into the guide sheath (101) to expand an abdominal cavity wall puncture hole, and a through hole cavity is formed in the center of the guide sheath core along the axis direction of the guide sheath core (102); and an elastic catcher (103), wherein the elastic catcher comprises a non-closed elastic ring (1031) formed by bending an elastic wire, the elastic ring (1031) is located at the middle of the elastic wire and used for penetrating through the guide sheath (101) to fix a dialysis catheter, the two ends of the elastic wire are used for being arranged outside the guide sheath (101), and one end of the elastic wire is used for fixing a dialysis catheter fixing line, and the other end of the elastic wire serves as a holding portion. The apparatus can achieve the purpose of reliably fixing a peritoneal dialysis indwelling catheter, effectively reduces complications caused by the floating of the peritoneal dialysis catheter after an operation, and during the operation, has the advantages of being simple to operate, small in wound, and high in success rate.

Description

PERITONEAL DIALYSIS INDWELLING CATHETER FIXING APPARATUS
CROSS-REFERENCES TO RELATED APPLICATIONS
This application claims priority benefits to Chinese Patent Application No.202111305642.9, entitled "PERITONEAL DIALYSIS CATHETER FIXATION DEVICE", filed on November 05, 2021. The entirety of this application is incorporated herein by reference.
TECHNICAL FIELD
The present invention relates to the field of peritoneal dialysis, and specifically to a peritoneal dialysis catheter fixation device.
BACKGROUND
Peritoneal dialysis is a common and effective renal replacement therapy in clinic for patients with end-stage renal disease or acute renal failure. The peritoneal dialysis is to use peritoneum as semi-permeable membrane, and the prepared dialysate is poured into the peritoneal cavity of the patient through the catheter by gravity. There is a concentration gradient difference of solute on both sides of the peritoneum, and the solute on the high concentration side moves to the low concentration side; water moves from the low osmotic side to the high osmotic side. The peritoneal dialysis fluid is constantly replaced to remove metabolites, toxic substances and correct water and electrolyte balance disorders. Before peritoneal dialysis, it is necessary to establish a peritoneal dialysis channel and implant the peritoneal dialysis catheter into the peritoneal cavity of the patient, that is, a peritoneal dialysis catheterization.
In the traditional peritoneal dialysis catheterization, the peritoneal dialysis is performed using a non-fixed peritoneal dialysis catheterization, that is, a special peritoneal dialysis catheter is implanted into the rectovesical pouch of male patients or the Douglas' pouch of female patients. Because the peritoneal dialysis catheter is not fixed in the peritoneal cavity, the peritoneal dialysis catheter implanted in the patient is easy to float and displace. Therefore, after the conventional non-fixed peritoneal dialysis catheterization, about 15 -20% of patients experience floating displacement of the peritoneal dialysis catheters, which may lead to catheter dysfunction during peritoneal dialysis and even re-operation, which would increase the pain and economic pressure of patients.
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At present, the improved peritoneal dialysis catheterization is to fix the peritoneal dialysis catheter in the abdominal wall, and comparing with the conventional non-fixed peritoneal dialysis catheterization, the floating displacement of the peritoneal dialysis catheters after the operation can be effectively avoided; however, if the ventral fixation is performed without the aid of a special instrument, it is necessary to make a re-incision about 3 cm below the incision for placement of the peritoneal dialysis catheter and suture the anterior sheath, rectus abdominis, posterior sheath, and peritoneum; therefore, the catheterization of the peritoneal dialysis catheter fixation in the abdominal wall has several disadvantages, including prolonged surgical process and more tissue damage due to additional incision in the abdominal wall, etc., and such peritoneal dialysis catheter may not be fixed successfully in patients with obese or high peritoneal pressure.
In order to solve the above problems, some special peritoneal dialysis catheter fixation tools have been developed to avoid the floating displacement of the peritoneal dialysis catheter, for example, the Patent CN101391119A discloses a peritoneal dialysis catheter fixation device, in which a sleeve with a tube core is placed under the anterior abdominal wall at the peritoneal incision ruff (peritoneal dialysis catheter placing in incision), and the bent section of an arm of the sleeve is used to lift the abdominal wall slightly. Then, the tip of the tube core is used to pierce the abdominal wall, and the tube core is pulled out from the ruff with the catheter fixation wire, and one end of the fixation wire is fixed on the peritoneal dialysis catheter, and the other end is fixed at the location of the perforation hole, thus playing the role of fixing the peritoneal dialysis catheter. However, the technology disclosed in the patent has operational insecurities, which are as follows: 1. the passage of the sleeve under the abdominal wall is a blind operation, and there is a risk of damaging the peritoneal organs; and 2. due to the large individual differences of patients, the exit of the tube core puncture does not necessarily coincide exactly with the place where the bent section of the ann of the sleeve slightly tops up the abdominal wall, and there is a risk that the puncture opening is not ideal or the puncture damages other organs and vessels.
SUMMARY
In response to the deficiencies of the prior art, it is an object of the present invention to provide a peritoneal dialysis catheter fixation device, which can achieve the purpose of effectively fixing the peritoneal dialysis catheter, avoiding the floating displacement of the catheter in the peritoneal cavity and reducing the incidence of secondary surgery. The operation thereof is simple, and the fixation position does not require additional incision, which is less traumatic and facilitates quick recovery of the patient. And the operation process is safe and can be carried out under compatible visual guidance, avoiding the risk of unpredictable organ damage to the patient due to blind operation during surgery.
To achieve the above purpose, the present invention is realized by the following technical solutions: An example of the present invention is to provide a peritoneal dialysis catheter fixation device, the device including: a guiding sheath, being a cavity-type guiding member; a guiding sheath-core with a tapered structure at front end, could be inserted into the guiding sheath to dilate a puncture hole in the abdominal wall, and a through-hole cavity is provided in the center of the guiding sheath-core along the axial direction of the sheath-core; and an elastic capturer, including an elastic ring formed by bending an elastic wire. The elastic ring is located in the middle portion of the elastic wire, which is used to pass through the guiding sheath to fix a dialysis catheter; both ends of the elastic wire are provided outside the guiding sheath, one of which is used to fix a dialysis catheter fixation wire, and the other one is used as a grip section.
As a further technical solution, the grip section of the elastic wire is provided with a handle.
As a further technical solution, the end of the elastic wire for fixing the dialysis catheter fixation wire is provided with a fixation hole.
As a fUrther technical solution, the elastic capturer is of a split structure.
As a further technical solution, the elastic capturer includes a first elastic capturing member and a second elastic capturing member, wherein a first end of the first elastic capturing member is provided with a first elastic semi-ring, a first end of the second elastic capturing member is provided with a second elastic semi-ring, and the first elastic semi-ring and the second elastic semi-ring being connected together to form the elastic ring.
As a further technical solution, a second end of the first elastic capturing member is provided with the handle.
As a further technical solution, a second end of the second elastic capturing member is provided with the fixation hole.
As a further technical solution, a position of the first elastic semi-ring or the second elastic semi-ring may be operationally adjusted to actively capture the dialysis catheter into an internal space structure thereof As a further technical solution, a radian of the first elastic semi-ring or the second elastic semi-ring may be greater than the radian of a semicircle.
As a further technical solution, the elastic capturer is made of an elastic metal wire.
The beneficial effects of embodiments of the present invention are as follows: The present invention provides a peritoneal dialysis catheter fixation device, which can achieve the purpose of reliably fixing the peritoneal dialysis catheter and effectively reduce the complications caused by the floating displacement of the peritoneal dialysis catheter after surgery, and meanwhile, the surgical process has the advantages of simple operation, small trauma and high success rate in the operation process. The details are as follows: 1. the present device may effectively fix the peritoneal dialysis catheter to avoid the floating displacement of the catheter in the peritoneal cavity and reduce the incidence of secondary surgery; 2. a catheterization process of the present device is easy to operate, with puncture implantation and fixed position without incision, which is less traumatic in order to facilitate the quick recovery of the patient; and 3. the present device may be compatible with visual guidance for surgery, and may be implemented with the help of modern medical imaging technology for navigation, avoiding the risk of unpredictable organ damage to patients due to blind operation during surgery.
BRIEF DESCRIPTION OF THE DRAWINGS
The accompanying drawings constituting a part of the present invention are used to provide a further understanding of the present invention. The exemplary examples of the present invention and descriptions thereof are used to explain the present invention, and do not constitute an improper limitation of the present invention.
FIG. 1 is a schematic diagram of a guiding sheath and a guiding sheath-core disclosed in Example I; FIG. 2 is a schematic diagram of an elastic capturer disclosed in Example 1; FIG. 3 is a schematic diagram of the elastic capturer compressed through the guiding sheath disclosed in Example 1; FIG. 4 is a schematic diagram of the elastic capturer stretching through the guiding sheath disclosed in Example 1; FIGs. 5(1) to 5(5) are schematic diagrams of an operation process of the guiding sheath and the guiding sheath-core disclosed in Example 1; FIG. 6 is a structural diagram of an elastic capturer disclosed in Example 2; and FIGs. 7(1) and 7(2) are schematic diagrams of an operation process of a guiding sheath and a guiding sheath-core disclosed in Example 2.
In figures: 101 -guiding sheath, 102 -guiding sheath-core, 103 -elastic capturer, 1031 -elastic ring, 1032 -recovery handle, 1033 -fixation wire fixation hole; 203 -first elastic capturing member, 2031 -first elastic semi-ring, 2032 -recovery handle, 2033 -magnet; 204 -second elastic capturing member, 2041 -second elastic semi-ring, 2042 -fixation wire fixation hole, and 2043 -magnet
DETAILED DESCRIPTION
It should be pointed out that the following detailed descriptions are all illustrative and are intended to provide further descriptions of the present invention. Unless otherwise specified, all technical and scientific terms used in the present invention have the same meanings as those usually understood by a person of ordinary skill in the art to which the present invention belongs.
As described in the background, there are deficiencies in the prior art. To solve the above technical problems, the present invention provides a peritoneal dialysis catheter fixation device, which can fix the peritoneal dialysis catheter through surgical operation, effectively reduce the complications caused by the floating displacement of the peritoneal dialysis catheter after surgery, and meanwhile, the surgical process has the advantages of simple operation, small trauma and high success rate. The details are as follows: I) the present device may effectively fix the peritoneal dialysis catheter to avoid the floating displacement of the catheter in the peritoneal cavity and reduce the incidence of secondary surgery; 2) a catheterization process of the present device is easy to operate, with puncture implantation and fixed position without incision, which is less traumatic in order to facilitate the quick recovery of the patient; and 3) the present device may be compatible with visual guidance for surgery, and may be implemented with the help of modern medical imaging technology for navigation, avoiding the risk of unpredictable organ damage to patients due to blind operation during surgery.
Example 1
An exemplary example of the present invention, disclosing a peritoneal dialysis catheter fixation device, comprising a guiding sheath, a guiding sheath-core, and an elastic capturer; the guiding sheath is a thin-walled cavity-type guide device for introducing the elastic capturer into the peritoneal cavity at a position where a peritoneal dialysis catheter needs to be fixed. The guiding sheath-core is used in conjunction with the guiding sheath and has a tapered structure at the front end for dilating a puncture hole in the abdominal wall; a through-hole cavity is provided in the center of the guiding sheath-core to facilitate the passage of a puncture guiding wire for the directional dilatation of the abdominal wall. The elastic capturer is made of an elastic metal wire with the capability to return to an original shape after undergoing large deformations and is used in conjunction with the guiding sheath. The present device can be used in peritoneal dialysis catheterization to fix the peritoneal dialysis catheter safely and effectively. The present device may be used in conjunction with a peritoneal puncture kit, which is a commonly used clinical instrument and often consists of a puncture needle and a puncture guiding wire.
The present invention will now be described with reference to the accompanying drawings.
The peritoneal dialysis catheter fixation device disclosed in the present example includes at least three parts: a guiding sheath 101, a guiding sheath-core 102, and an elastic capturer 103.
As shown in FIG. 1, the guiding sheath 101 is the thin-walled cavity-type guiding device that is used to introduce the elastic capturer 103 into the peritoneal cavity at the position where the peritoneal dialysis catheter needs to be fixed. Further, in the present example, for convenience of operation, a protrusion is also provided at a tail portion of the guiding sheath 101. It should be further noted that the thin-wall herein does not refer specifically to the thickness of a particular size, and the thickness thereof is sufficient to meet the operational needs.
As shown in FIG. 1, the guiding sheath-core 102, which has a tapered structure at the front end, is used for dilating the puncture hole in the abdominal wall; the guiding sheath-core 102 is used in conjunction with the guiding sheath 101 and has the through-hole cavity of about (I/1.0 mm in the center of the guiding sheath-core 102 in the direction of the axis of the guiding sheath 102, which facilitates the passage of the puncture guiding wire for directional dilatation of the abdominal wall. Further, in the present example, in order to limit the position of the guiding sheath-core 102 within the guiding sheath 101, a protrusion is also provided at a tail portion of the guiding sheath-core 102, and when a head portion of the protrusion contacts a tail portion of the guiding sheath 101, it indicates that the guiding sheath-core 102 is punctured in place.
In addition, it should be noted that a diameter of the through-hole cavity in the center of the guiding sheath-core 102 is provided according to the diameter of the puncture guiding wire and is not limited to (1)1.0 mm as disclosed in the present example.
As shown in FIG. 2, in the present example, the elastic capturer 103 is an integral structure, which is made of the elastic metal wire (a nickel-titanium alloy wire or other elastic materials that can meet the basic performance) and has the ability to recover its original shape after undergoing a large deformation. The elastic capturer 103 described in the present example, due to its elastic characteristics, has the following capabilities when used in conjunction with the guiding sheath 101, which are: 1. it can be compressed and enter a cavity of the guiding sheath 101 and return to its original shape after passing through the guiding sheath (as shown in FIG. 3); and 2. it can be pulled out from one end through the guiding sheath by pulling into a nearly straight shape with the assistance of an external force (as shown in FIG. 4).
Further, the elastic capturer 103 is formed by bending the elastic wire to have the elastic ring 1031, the recovery handle 1032, and the fixation wire fixation hole 1033. The elastic ring 1031 is located in the middle portion of the elastic wire (the middle portion here does not specifically refer to the central position), and the elastic ring 1031 provides a passable lumen for the dialysis catheter to pass through the center of the elastic ring 1031 under the guidance of ultrasound or other modern medical imaging techniques; the fixation wire fixation hole 1033 is located at a first end of the elastic metal wire, which is used to fix the dialysis catheter fixation wire; the recovery handle 1032 is located at a second end of the elastic metal wire, and during operation, the entire elastic capturer 103 can be pulled out of the guiding sheath by pulling the recovery handle 1032 (as shown in FIG. 4) and simultaneously pulling out one end of the fixation wire after wrapping it around the dialysis catheter, thereby fixing the dialysis catheter to the abdominal wall by the fixation wire after withdrawal of the device of the present invention.
It should be further noted that the elastic ring 1031 is not a completely closed ring, as it is formed by bending the elastic metal wire, so it cannot be completely closed, there is a certain gap at the bend position, and the elastic ring 1031 is not necessarily a circular ring, and the shape thereof is not limited.
A specific process of using the present device is described below: Step 1: during the peritoneal dialysis catheterization, determining a suitable fixation position near the entrance of the dialysis catheter, puncturing the abdominal wall by using the peritoneal puncture kit, placing the guiding wire, and withdrawing the puncture needle, as shown in FIG. 5(1); Step 2: inserting the guiding sheath-core 102 into the guiding sheath 101, inserting the guiding wire into the through-hole cavity of the guiding sheath-core, pushing the guiding sheath-core 102 along the guiding wire until the front end of the guiding sheath 101 penetrates the abdominal wall into the peritoneal cavity, and withdrawing the guiding wire and the guiding sheath-core 102; FIG. 5(2) shows a schematic diagram of a state of the guiding sheath-core 102 and the front end of the guiding sheath 101 penetrating the abdominal wall into the peritoneal cavity; Step 3: compressing and delivering the elastic capturer 103 through the guiding sheath 101 until the elastic ring 1031 completely enters the peritoneal cavity and returns to its original shape, as shown in FIG. 5(3); Step 4: under the guidance of ultrasound or other modern medical imaging techniques, passing the dialysis catheter through the center of the elastic ring 1031 and pushing the dialysis catheter to the appropriate position; fixing one end or the middle portion of the dialysis catheter fixation wire fit usually is a suture) on the fixation wire fixation hole 1033, as shown in FIG. 5(4); and Step 5: pulling slowly the recovery handle 1032 until the elastic capturer 103 is pulled out of the guiding sheath 101 as a whole, withdrawing the guiding sheath 101 (at this time, the dialysis catheter fixation wire should be kept on wrapping around the dialysis catheter and the two ends remain outside the abdominal wall), tightening the dialysis catheter fixation wire and knotting the dialysis catheter fixation wire at the appropriate tissue location in the human body (such as muscle, subcutaneous, abdominal wall), closing the puncture hole, and completing the operation of the dialysis catheter fixation, as shown in FIG. 5(5).
It should be noted that the materials used in the present example should meet the requirements of biocompatibility and the ability to develop under ultrasound or other modern medical imaging systems.
Example 2
The present example discloses another peritoneal dialysis catheter fixation device, in which a guiding sheath 101 and a guiding sheath-core 102 are identical to Example 1 and will not be described here. The difference between the present example and the Example 1 mainly lies in the structure of the elastic capturer, which is specifically as follows: In the present example, the disclosed elastic capturer used in conjunction with the guiding sheath 101 is of a split structure, including two parts, which are, respectively, a first elastic capturing member 203 and a second elastic capturing member 204; the first elastic capturing member 203 and the second elastic capturing member 204 are made of elastic metal wire (nickel-titanium alloy wire or other elastic materials that can meet the basic performance), and also have the ability to recover its original shape after undergoing a large deformation, which, being used in conjunction with the guiding sheath 101, have the abilities as follows: 1, they can be compressed and enter a cavity of the guiding sheath 101 and return to its original shape after passing through the guiding sheath; and 2. they can be pulled out from one end through the guiding sheath by pulling into a nearly straight shape with the assistance of an external force.
Further, the first elastic capturing member 203 includes a magnet 2033 and a first elastic semi-ring 2031 and a recovery handle 2032 formed by bending the elastic metal wire; wherein the first elastic semi-ring 2031 is formed at a first end of the elastic metal wire, the recovery handle 2032 is formed at a second end of the elastic metal wire, and the magnet 2033 is located on the first elastic semi-ring 2031. Further, in the present example, a radian of the first elastic semi-ring 2031 is greater than the radian of the semicircle, and the purpose of this designed is that the dialysis catheter can be actively captured into by operationally adjusting the position of the first elastic semi-ring 2031, and an internal space structure of the first elastic semi-ring 2031 is the passage lumen of the dialysis catheter, and the dialysis catheter can be passed through the center of the first elastic semi-ring 2031 under the guidance of ultrasound or other modem medical imaging techniques, or the dialysis catheter can be captured into the annular internal space structure by operating the recovery handle under the guidance of ultrasound or other modern medical imaging techniques; the recovery handle 2032 is used to withdraw the first elastic capturing member 203 and the second elastic capturing member 204; the magnet 2033 is used to connect the first elastic capturing member 203 and the second elastic capturing member 204. -9 -
Further, the second elastic capturing member 204 includes a magnet 2043 and a second elastic semi-ring 2041 and a fixation wire fixation hole 2042 formed by bending the elastic metal wire, wherein the second elastic semi-ring 2041 is formed at a first end of the elastic metal wire and the fixation wire fixation hole 2042 is formed at a second end of the elastic metal wire, and the magnet 2043 is located on the second elastic semi-ring 2041; a radian of the second elastic semi-ring 2041 is smaller than the radian of the semicircle, and the second elastic semi-ring 2041 can be combined with the first elastic semi-ring 2031 through the magnet 2043 and the magnet 2033 into a non-closed circle, which can accommodate the dialysis catheter; the fixation wire fixation hole 2042 is used to fix the dialysis catheter fixation wire.
It should be noted that in other examples, the radians of the first elastic semi-ring 2031 and the second elastic semi-ring 2041 may also be designed such that the radian of the second elastic semi-ring 2041 is greater than the radian of the semicircle, and the radian of the first elastic semi-ring 2031 is smaller than the radian of the semicircle.
Further, the magnet 2033 and magnet 2043 are used in conjunction to combine the first elastic capturing member 203 and the second elastic capturing member 204 into a whole to form the elastic capturer, the magnetic force between the two can meet the requirement of pulling the combination of the first elastic capturing member 203 and the second elastic capturing member 204 out of the guiding sheath by pulling the recovery handle 2032.
A usage and operation process of the device disclosed in the present example specifically is as follows: Step 1: during the peritoneal dialysis catheterization, determining a suitable fixation position near an entrance of the dialysis catheter, puncturing the abdominal wall by using the peritoneal puncture kit, placing the guiding wire, and withdrawing the puncture needle, as shown in FIG. 5(1); Step 2: inserting the guiding sheath-core 102 into the guiding sheath 101, inserting the guiding wire into the through-hole cavity of the guiding sheath-core, pushing the guiding sheath-core 102 along the guiding wire until the front end of the guiding sheath 101 penetrates the abdominal wall into the peritoneal cavity, and withdrawing the guiding wire and the guiding sheath-core 102, as shown in FIG. 5(2); -10 -Step 3: compressing and delivering the first elastic capturing member 203 through the guiding sheath 101 until the first elastic semi-ring 2031 completely enters the peritoneal cavity and returns to its original shape; Step 4: under the guidance of ultrasound or other modern medical imaging techniques, passing the dialysis catheter through the center of the first elastic semi-ring 2031 and pushing the dialysis catheter to the appropriate position; or under the guidance of ultrasound or other modern medical imaging techniques, operating the recovery handle to capture the dialysis catheter into the interior of the first elastic semi-ring 2031, as shown in FIG. 7(1); Step 5: compressing and delivering the second elastic capturing member 204 through the guiding sheath 101 until the second elastic semi-ring 2041 completely enters the peritoneal cavity and returns to its original shape; adjusting the position of the compressed second elastic capturing member 204 so that the magnet 2033 and the magnet 2043 are attached to each other; fixing the dialysis catheter fixation wire (it usually is a suture) on the fixation wire fixation hole 2042, as shown in FIG. 7(2); and Step 6: pulling slowly the recovery handle 2032 until the combination of the first elastic capturing member 203 and the second elastic capturing member 204 is pulled out of the guiding sheath 101, withdrawing the guiding sheath 101 (at this time, the dialysis catheter fixation wire should be kept on wrapping around the dialysis catheter and the two ends remain outside the abdominal wall), tightening the dialysis catheter fixation wire and knotting the dialysis catheter fixation wire at the abdominal wall, closing the puncture hole, and completing the operation of the dialysis catheter fixation, as shown in FIG. 5(5).
The materials used in the present example should meet the requirements of biocompatibility and the ability to develop under ultrasound or other modern medical imaging systems.
The schematic diagrams used in the present example of the present invention are only for illustration, and the shape of the actual implementation solution may be different from that of the schematic diagram, and the first elastic semi-ring 2031 and the second elastic semi-ring 2041 may also be rectangular, polygonal and other spatial shapes, as long as the above functions can be realized.
Example 3
The difference between the present example and the Example 1 or the Example 2 is that: the -11 -fixation wire fixation hole is eliminated, and the elastic capturer is directly used as the fixation wire to fix the dialysis catheter. Other structures are completely the same as those in the Example 1 or the Example 2, and will not be described in detail herein.
The materials used in the present example should meet the requirements of implantable biocompatibility and the ability to develop under ultrasound or other modern medical imaging systems.
Example 4
The difference between the present example and the Example 1 or the Example 2 is that: the fixation wire fixation hole and the recovery handle are eliminated simultaneously, the first end of the elastic capturer is directly used as the fixation wire to fix the dialysis catheter, and the second end of the elastic capturer is directly used as a handle to hold it. Other structures are completely the same as those in the Example 1 or the Example 2, and will not be described in detail herein.
The materials used in the present example should meet the requirements of implantable biocompatibility and the ability to develop under ultrasound or other modern medical imaging systems.
Example 5
The difference between the present example and the Example 2 is that: the first elastic capturing member 203 and the second elastic capturing member 204 are not provided with the magnets, and mechanical structures that can be reliably connected and separated may be provided therebetween, such as a movable snap structure, a ring structure, a hook structure, and other feasible structures, and the rest of the structures are completely the same as the Example 2, Example 3, or Example 4.
The materials used in the present example should meet the requirements of biocompatibility and the ability to develop under ultrasound or other modern medical imaging systems.
In summary, the elastic capturer disclosed in the present example may be integral or split, and the functions that can be achieved are as follows: 1. may be unfolded and present an annular or other spatial structure after being delivered into the peritoneal cavity through the guiding sheath, an interior thereof can accommodate the passage of the dialysis catheter; -12 - 2. may allow the dialysis catheter to pass through the center thereof under the guidance of ultrasound or other modern medical imaging techniques, or can actively capture the dialysis catheter into an internal spatial structure thereof by operationally adjusting the position thereof when the capturer is in split form; 3. may fix the dialysis catheter fixation wire at one end, the whole of which can be pulled out of the guiding sheath by pulling the other end and simultaneously guiding the dialysis catheter fixation wire, and the end is pulled out of the guiding sheath after fixation wire is wrapped around the dialysis catheter, so that the dialysis catheter can be fixed to the abdominal wall by the fixation wire after withdrawing the elastic capturer; 4. when the capturer is of the integral type it may also be used directly as a fixation device to fix the dialysis catheter; and 5, when the capturer is of the split type, a structure that can be reliably connected and separated may be provided therebetween, such as a magnetic connection, a movable snap structure, a ring structure, a hook structure, and other feasible structures.
It should be noted that the device disclosed in examples of the present invention may be used in conjunction with the peritoneal puncture kit, and can be used in a normal state, an artificial ascites, a pneumoperitoneum, etc., and can also be used for short-term or long-term fixation of implanted medical devices in human organs.
In addition, it should be particularly noted that the technical solutions disclosed in the above five embodiments are not mutually exclusive, and the peritoneal dialysis catheter can be fixed simultaneously by using the above multiple devices or any one, or any two, or any three devices in the same peritoneal surgery.
Finally, it should also be noted that relationship terms such as first and second are used only to distinguish one entity or operation from another entity or operation, and do not necessarily require or imply any such actual relationship or sequence between these entities or operations.
The foregoing descriptions are merely preferred embodiments of the present invention but are not intended to limit the present invention. A person skilled in art may make various alterations and variations to the present invention. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention shall fall within the protection scope of the present invention.
-13 -

Claims (1)

  1. CLAIMS1 A peritoneal dialysis catheter fixation device, comprising: a guiding sheath, being a cavity-type guiding member; a guiding sheath-core, with a tapered structure at a front end thereof, being inserted into the guiding sheath to dilate a puncture hole in an abdominal wall of a patient, and a through-hole cavity is provided in a center of the guiding sheath-core along an axial direction of the guiding sheath-core; and an elastic capturer, comprising an elastic ring formed by bending an elastic wire, the elastic ring is located in a middle portion of the elastic wire, which is used to pass through the guiding sheath to fix a dialysis catheter; both ends of the elastic wire are provided outside the guiding sheath, one of which is used to fix a dialysis catheter fixation wire, and the other one is used as a grip section 2. The peritoneal dialysis catheter fixation device according to claim 1, wherein the grip section of the elastic wire is provided with a handle.3. The peritoneal dialysis catheter fixation device according to claim I, wherein the end of the elastic wire for fixing the dialysis catheter fixation wire is provided with a fixation hole.4. The peritoneal dialysis catheter fixation device according to claim 1, wherein the elastic capturer is of a split structure.5. The peritoneal dialysis catheter fixation device according to claim 4, wherein the elastic capturer comprises a first elastic capturing member and a second elastic capturing member, wherein a first end of the first elastic capturing member is provided with a first elastic semi-ring, a first end of the second elastic capturing member is provided with a second elastic semi-ring, and the first elastic semi-ring and the second elastic semi-ring being connected together to form the elastic ring.6. The peritoneal dialysis catheter fixation device according to claim 5, wherein a second end of the first elastic capturing member is provided with a handle.7. The peritoneal dialysis catheter fixation device according to claim 5, wherein a second end of the second elastic capturing member is provided with a fixation hole.8. The peritoneal dialysis catheter fixation device according to claim 5, wherein a position of the first elastic semi-ring or the second elastic semi-ring is operationally adjusted to actively capture the dialysis catheter into an internal space structure of the first elastic semi-ring or the second elastic -14 -semi-ring.9. The peritoneal dialysis catheter fixation device according to claim 5, wherein a radian of the first elastic semi-ring or the second elastic semi-ring is greater than a radian of a semicircle.10. The peritoneal dialysis catheter fixation device according to claim 1, wherein the elastic capturer is made of an elastic metal wire.-15 -
GB2310240.3A 2021-11-05 2022-07-26 Peritoneal dialysis indwelling catheter fixing apparatus Pending GB2618230A (en)

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CN113877017B (en) 2023-10-20

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