HU180047B - Apparatus for moving in materials into the tuba vterina - Google Patents

Abstract

1470572 Syringes: catheters POPULATION RESEARCH INC 8 March 1974 [9 March 1973 31 Jan 1974] 49022/76 Divided out of 1470571 Heading A5R The subject matter of the specification is disclosed in Specification 1470571 but the claims relate to an instrument for dispensing fluid material into the Fallopian tubes comprising a catheter having an expandable member at one end for location in the uterus and a dispensing unit remote from the one end, the unit having means for expanding the expandable member, means for dispensing material through the catheter into the uterus and a single actuator for operating both means.

Description

The present invention relates to a device for delivery of substances through the uterine cavity into the fallopian tubes, in particular for sterilization. The apparatus of the present invention comprises a dispensing device provided with an expandable jacket that can be inserted into the uterine cavity, which expands to form a seal in the lower portion of the uterine cavity, an elongated tubular catheter is attached to the jacket, and the dispenser is dispensed into

Bilateral ovariectomy is a commonly used surgical procedure for sterilization of female mammals. The oviducts are then • cut and ligated. Such an intervention is very risky and costly. In addition, the intervention also reduces the natural movement of the fallopian tubes. Uterine utensils, such as tampons and yarns, are also commonly used to temporarily sterilize women. These devices include tampons that are placed in the fallopian tube to prevent the ovum from passing through the fallopian tube into the uterine cavity. However, such tampons can move and fail without the user being aware of it. As a result, the effectiveness of such solutions is inadequate. Swabs which are placed on the uterine wall for temporary sterilization to prevent the ovary from entering the fallopian tube are also known. Such contraceptive tampons also provide only limited safety, as eggs can bypass the tampon and pass through them into the uterine cavity.

Also known are experiments (see Corfman et al., Obstetrics and Cynecology, Obstetrics and Gynecology).

Volume 27, Volume 6, pp. 880-883. June 1966, which are intended to deliver directly to the fallopian tube substances which are intended, inter alia, for temporary sterilization. A cervical injection needle is used to deliver the material, the front end of which is filled with a predetermined amount of material when the needle plunger is retracted. To do this, they use an expandable rubber balloon, which is located on the cervix to tighten the anterior end of the injection needle into the horn and fix it there before the substance is pushed into the fallopian tube by the plunger of the injection needle. According to another very similar procedure (see German Patent Nos. 2,407,852 and 3,855,767), the fallopian tube is closed by insertion of a flexible extension needle of a mixing needle into the uterine cavity, followed by a blind or simultaneous X-ray undergoing a liquid mixture of an elastomer and a catalyst for its curing at the uterine end of the fallopian tube, and injected into the fallopian tube through a flexible extension by actuation of an injection needle. When injected directly into the fallopian tube as described above, the result is most dependent; 5 exactly how they can guide the tip of the structure to the uterine end of the fallopian tube. Even if, in practice, the size and shape of the uterine cavities and the fallopian tubes are very different, the jugular part of the fallopian tubes is also unlikely to be successful in the injection. will be if the operation is performed with the help of an x-ray machine. As a result, the success rate of interventions is not necessarily satisfactory. The use of a well-known device requires well-trained staff, as the tip of the device is difficult to find at the ends of the fallopian tubes. The procedure is time-consuming, since the insertion of the tip of the device at the end of the fallopian tube must be done separately for each fallopian tube, which is two: an extreme procedure. The patient is exposed to X-rays throughout the burn procedure, which is undesirable in terms of radiation hazard.>

The procedure for sealing the fallopian tube is also known (see Rakshit, "Calcutta Med. J." 65 Ni · 3, March 1968, and Ralph Rechart, "Human Sterilization," Sterilization of Man), pp. 213-221. (1971), in which a desired substance is simply injected into the uterine cavity with the aid of a needle and cannula in the hope that a sufficient amount of material will itself penetrate the oviduct. The uterine cavity is eventually emptied. Patients have a high percentage of patients with insufficient or insufficient closure of the fallopian tubes. Devices having a similar structure are known and can be squeezed out of them (see German Patent Nos. 554,179 and 593,010) for delivering ointments to body openings such as bees. would like to introduce a substance, the success would be largely by chance; 'moreover, the uterine wall is exposed to a large area of the delivered material, which is often to be avoided ...... 7'

In addition, a cervical cannula (see U.S. Patent No. 3,312,215) which has an axis and is also known. the length of this axis corresponds to the length of the cervix; and from above there is a head attached thereto, in the form of a butt-shaped transverse transducer A, which is formed in a plurality of longitudinally extending arms. Can be placed at the bottom end of the A-cannula, at ^ r. The damage to the caries is caused by the slipping of the gelatine into the gelatine into the body; vftiely ^ á in the womb á 'body / back ^ ^ humpgolVad ·. The stakes were crawling over and g.taétóal lie to him, so. â € “ The material is the Imriülöki quill; bee-honeybee hay comb Jutafatyak '^ p. J & peretesjeáéh Mjüwűfi'Sf Síéh'ea? a catheter (see U.S. Patent No. 3,490,406), which has an opening at the uterine end of the cervical collar and has a shaft extending through the cervical canal, whereby a drug or other fluid can be introduced into the uterus. However, none of the known devices can deliver the desired substance exclusively to the fallopian tube. Also known is a method of injecting elastomeric materials into the fallopian tube into the fallopian tube (see Hefnawi et al., Amer. J. Obst. And Gynecology, Vol. 99, Volume 3, pp. 421-427). pages (October 1967). Such a procedure requires leave surgery, along with all its unwanted accompanying phenomena and dangers.

It is an object of the present invention to provide a device which enables fast and reliable delivery of a predetermined material, irrespective of the anatomical features, the shape and size of the uterus in each case, in a particularly simple manner, at the same time as the two oviducts. · .. ........ . . ·

The object is solved by the creation of a device whose casing can be expanded to provide complete filling of the uterine cavity and close to the inner wall of the uterine cavity, including the uterine buttocks, by means of fluid introduced through a dilator.

With the device of the invention, material can be introduced from the reservoir through the catheter into the uterine cavity just before or after the uterine cavity is completely filled by the expanded mantle. When the material _is introduced, the mantle which fills the greater part of the uterine cavity on the one hand protects the uterine wall from the introduced aria. and, on the other hand, it may expose the substance to areas of the uterine cavity that are only adjacent to the oviducts. .This is a reliable means of introducing the substance into both ovarian ducts / The bee comes into contact with the substance only for a 'very limited area' 7. Extremely small amount of material is sufficient for injection into the fallopian tube. However, handling and operation of the device is very simple and safe for the patient. ' . '. , 7 7

In a preferred improved embodiment of the invention, the device is provided with structures that can be actuated as desired to deliver material from the uterine cavity to the fallopian tubes. This optional actuator is particularly advantageous in that it is designed, heated, and expanded. .horseshoes in its repository are connected to each other. after partially expanding the mantle, a sputtering effect is applied to the material introduced into the uterine cavity by further opening the mantle; aminbk Tannic acid is a caustic substance that is extracted from the uterine cavity into the fallopian tubes. the solution is; Instead, the khaki juice is further stored; You can enter this item into the "To get it out" section. egg essence /, products] effect san g the input of g differs from the sum total: request k <single hands: seeing ,; a and k incremental beekeeping tv the tow pull;

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The artwork! dick! After insertion of a pendant, an inert fluid may be introduced between the expanded mantle and the uterus, thereby forcing the material into the fallopian tubes. By pushing the material from the uterine cavity into the fallopian tubes, it is possible to ensure that substantially all of the material enters the fallopian tubes. As a result of the pumping action on the material, the material flows into the fallopian tubes particularly rapidly. This is important because, in practice, the resistance of the two fallopian tubes to the substance is sometimes different, and in such cases, the slow passage of the substance carries the risk that all of the substance will fall into the lower tube.

Operation and operation of the device is particularly simple if it is provided with a program controller coupled to an expansion device and a storage device which controls the automatic partial expansion of the mantle to introduce the material into the uterine cavity and further expand the mantle. In this case, it is expedient to provide the program control with a means for shrinking the mantle after pumping the material from the uterine cavity into the fallopian tube, so that at the end of the process the catheter can be pulled out of the uterus without fatigue.

The program control is preferably provided with a single continuously adjustable actuator. This reliably eliminates errors when operating the unit.

It goes without saying that not only is the uterus dilated, but usually it must be safely prevented from passing through the fallopian tubes into the abdominal cavity or into the bloodstream. In order not to depend on the skill and experience of the user, the expansion device is preferably provided with a pressure limiter that limits the pressure prevailing in the expanded jacket, and the pressure relief device is preferably coupled to a control unit that maintains the pressure of the fluid in the expanded jacket. The same operating conditions are achieved by providing the expansion device with a reservoir for storing the fluid used to form the mantle and for actuating the expansion fluid from the container to expand the mantle in the uterine cavity to the mantle. It is particularly convenient and useful to have two chambers in the housing housing for receiving the fluid reservoir and the material reservoir, which are connected to a fluid permeable channel or a material permeable channel of the catheter.

The use of the device becomes even easier when the fluid-permeable and the material-permeable are preferably connected by means of a needle through which the fluid container or the material container may be pierced.

Preferably, a first and second drive means are coupled to the actuator, by means of which, depending on the configuration of the actuator of the jacket, a fluid is pressurized to the filling of the uterine cavity and the material in the uterine cavity is conveyed.

The material may also be a mixture of materials which hardens after mixing. In such a case, it is preferable to provide the device with an additional container for storing the second material and for mixing the materials prior to delivery to the uterine cavity. This prevents premature curing of the mixture of materials in the catheter: 0 by providing a mixing device with a mixing head provided with channels directly adjacent to the front of the jacket for receiving and mixing materials and for delivering the mixture to the uterine cavity. device.

In a further preferred embodiment of the device according to the invention, the jacket is made of a sheet material having a low surface tension and having tubular shape with substantially identical elongation mark plates in all directions. This ensures that the pressure on the uterine wall is substantially uniform and allows the expansion pressure to be kept relatively low regardless of the size and shape of the uterus. A jacket in the form of a balloon made of latex rubber or soft elastic plastic has proved particularly suitable for this purpose.

The device of the present invention will be described in more detail below with reference to the accompanying drawings, in which: Figure 1 is a longitudinal sectional view of the female genital system with the device introduced into the uterine cavity;

Figure 2 is a plan view of the emitter of the device of Figure 1:

Figure 3 is a sectional view taken along line 3-3 of Figure 1 in a larger scale;

Figure 4 is a sectional view taken along line 4-4 of Figure 3, also in a larger scale;

Figure 5 is a sectional view taken along line 5-5 of Figure 4 ';

Figure 6 is a sectional view similar to Figure 4, but showing the dispenser unit in an operating position while discharging fluid;

Figure 7 is a cross-sectional view of a further embodiment of the device of the present invention;

Figure 8 is a sectional view taken along line 8-8 of Figure 7;

Figure 9 is a sectional view similar to Figure 7 showing the dispenser in the position in which the liquid medium is discharged;

Fig. 10 schematically illustrates a further embodiment of the release unit of the device according to the invention in a resting position;

Figure 11 is a sectional view similar to Figure 10 showing the emitter unit in an operating position;

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illustrates a further embodiment of its hatching unit in a longitudinal section in a resting position; FIG. 13 is a sectional view similar to FIG. 12, with the difference that the emitter unit is in an operational position;

Figure 14 is a side view of a container and a needle spaced therethrough, through which a medium can flow out of the container;

FIG. a view of the closed end of a container according to the invention; Figure 16 is a longitudinal sectional view taken along line 16-16 of Figure 15;

'Figure 17 shows a sectional view of the closed end of the container in a larger scale;' Figure 18 is a sectional view taken along line 18-18 of Figure 14; Figure 19 is a sectional view similar to Figure 16 illustrating the container for its interaction with the needle;

Figure 20 is a plan view of a further embodiment of the device of the invention;

Figure 21 is a sectional view taken along line 21-21 of Figure 20 in a larger scale;

Figure 22 is a sectional view taken along line 22-22 of Figure 21;

Fig. 23, - a sectional view taken along line 23-23 of Fig. 20 in a larger scale;

Figure 24 is a sectional view similar to Figure 23, with the closure shown in the free release position;

Figure 25 is a sectional view similar to Figure 23, showing another embodiment of the closure or lock;

Figure 26 is a top plan view of a further embodiment of the device according to the invention;

Figure 27 is a sectional view taken along line 27-27 of Figure 26 in larger scale;

Figure 28 is a sectional view taken along line 28-28 of Figure 27; Fig. 29 is a larger sectional view taken along line 29-29 of Fig. 27;

Fig. 30 is a sectional view similar to Fig. 29, in which the adjustable body is shown in a second position;

Figure 31 is a larger sectional view of a container intended for the device of the present invention; Figure 32 is a fragmentary sectional view of a female and female mammalian reproductive artery with the device of the present invention introduced therein, for use in delivering a deep preparation to the two fallopian tubes; · '' · ^; Fig ^. 33 is a longitudinal sectional view of the dispenser of the device; Figure 34 is a sectional view taken along line 34-34 of Figure 321 '; · Figure 35 is a female; or a female mammalian reproductive trunk, abbreviated as "metatarsal"; with the device according to the invention, ¹ 'wherein the balloon expands into the uterine cavity, and the afflWÜJi Att Ytri-mi A: «1 10 /! .1. !

the preparation is being introduced into the uterine cavity; Fig. 36 is a sectional view similar to that of Fig. 35, wherein the balloon is completely dislocated in the uterine cavity;

Figure 37 is a partially sectional, partly sectional view of an embodiment similar to that of Figure 35, 'Figure 38 is a sectional view of the outlet end of the device of Figure 37 in a larger scale ....

Figure 1 schematically depicts the genital system. A 21 uterine catheter is introduced into the genital system to provide a fluid medium, e.g. used to deliver a drug, tissue adhesive, or other chemical or pharmaceutical preparation to the fallopian tubes. As a tissue adhesive, isobutyl 2-cyanoacrylate monomer, silver nitrate or quinacrine may be used. The cyanoacrylate monomer is a liquid plastic that hardens or polymerizes when exposed to moisture, thereby sealing the fallopian tubes. A preparation may be used which closes the fallopian tubes only 'temporarily'. After a period of time, the fallopian tubes will open and resume their normal function.

The catheter 21 has a rather long first tube 38 which can be inserted through the vagina into the uterine cavity 27. At the upper end of the tube 38, an expandable jacket or sheath 39 or the like is fastened by means of bands 40. The outer end of the jacket 39 extends to the outer end of the tube 38. The jacket 39 is a flexible elastic body made of stress-free rubber. The rubber material has the same surface tension and the same expansion properties. The jacket 39 is expanded so that it is in uniform and firm contact with the inner wall of the uterus, irrespective of the size of the uterine cavity. As a result, the same catheter structure can be used to treat all female or female mammals. The jacket 39, when expanded, forms a substantially pear-shaped chamber 41 filled with a liquid or gaseous medium, water, air, and the like. The tube 38 has a plurality of holes 42 which connect the inner space of the tube 38 to the chamber 41. The upper end of the tube 38 is closed by a stopper 43. The end of the tube 38 projecting from the sheath 24 is connected in its entirety to a dilator 44 for discharging a liquid or gaseous medium. The tube 38 may be disposed releasably or rigidly on the expansion device 44. The expansion device 44 has a body 46 having an adjustable piston 47. When the piston 47 moves in the direction of arrow 48, it is a liquid or gaseous medium, e.g. water is pushed from the expansion device 44 to the expandable jacket 39, thereby sealing and filling the uterine cavity 27.

Two thinner tubes 49 and 52 extend through the tubular space 38 through which the liquid or gaseous medium may be delivered to the uterine cavity 27. The tube 49 has an 'outward' section from the tube 38, on which there are a total of 51 heat sinking units; AZ 52 pipe is connected to the 53 h dosing unit gel. THERE IS A CLEAR CASE TO OPEN A BOTTOM HOOK OPEN, PERFORMED, AND / OR A VERY FUCKING CAT 68A.

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The dosing units 1 and 53 are constructed in the same manner and may be used in the same manner ^ same. or to release different substances at different 'times.' One dosing unit can deliver a neutralizing medium to the uterine cavity. The dosing unit 51 will now be described in detail.

As shown in FIGS. 6 to 9, the dispensing unit 51 has a housing 57 having a cylindrical side wall 58 and an end wall 59. The housing 57 forms a chamber 61 and is provided with outwardly extending projections 62 and 63. The projections 62 and 63 extend from opposite sides of the open end of the casing 57 and from opposite cylindrical side walls 58 in opposite diameters. The chamber 61 includes a collapsible container 64. The container contains a pharmaceutical or chemical preparation for treating and / or sealing the fallopian tubes. The container 64 has an accordion-like cylindrical side wall 66 connected to a transversely extending, substantially flat bottom plate 67. The central section of the bottom dam 67 is provided with a longitudinally extending tube section 68. The tube section 68 has an outwardly extending portion 68A and an inwardly extending portion 68B. Is the tube section 68 sealed with a transversely extending membrane 69? The membrane 69 is a relatively thin disk disposed in the plane of the bottom plate 67. The opposite end of the container 64 is formed by a transversely folded closure member 71. ¹

Preferably, the container 64 is made of a deformable lead alloy having good moisture vapor impermeability. Other materials of deformable structure having this property may be used to make the container. These properties are required to prevent the polymerization or curing of moisture or vapor sensitive materials during storage. In addition, the material of the container shall be chemically inert to the fluid stored in the container. '' '

The container 64 has a longitudinally extending needle 73. placed. The needle 73 has a hollow design and an inclined tip 74 adjacent the inner side of the membrane 69. The other end of the needle 73 is located on a circular head 76. As can be seen from Figures 4 and 5, the needle 73 is provided with a longitudinal channel 77 which is wound at the pointed needle end. The side wall of the needle 73 is provided with a hole 78 so that fluid can flow from the container through the needle. The needle 73 with multiple holes may be provided with a longitudinal slot so that a fluid medium can pass through the needle.

The chamber 61 is closed by the piston 79. A portion of the piston 79 extends into the chamber and is provided with outwardly extending ribs 81 and 82 located in longitudinally extending grooves 83 and 84 on the inside of cylindrical sidewall 58. As shown in FIG. The ribs 81 and 82 hold together the ^! The plunger 9 and the housing 57 and the plunger 79 are guided in a four-line line which is located inside the chamber 61. The piston 79 is provided with an inwardly opening cavity 86 for receiving the outer end of the container 64. 8 in the center of the bottom of the cavity 86? nesting, gn ^ y ^ e.ja., the closure member 71 may be inserted. A. A piston 79 can be pulled out of the side wall 68 to remove the container 64 from the chamber. it can be removed and replaced with another tank. . _:

As shown in Figure 6, the dosing assembly 51 is operated by inserting the piston 79 into the chamber 6'1. This can be done by exerting a force on the outer end of the piston 72 in the direction of arrow 88? During operation n, place the ring and index finger 62 and 63 under the projections while applying pressure to the pistons 79 with your thumb. Thus, the needle 73 pierces the membrane 69. The fluid in the reservoir 64 is pressurized and pressed through the hole 78 and the channel 77 into the tube 49. Through the tube 49, the liquid or gaseous medium enters the uterine cavity 27. The fluid exits through the end portion 54 and enters the conduits 36 and 37 of the fallopian tubes along the inner wall of the cavity. The plunger 79 is pressurized until all of the fluid in the reservoir 64 is removed. By contacting the 3p mantle with the inner wall of the uterus, the amount of acid that can accumulate on this inner wall is limited. '. Ά: -,; ..; ·

Dispenser 51 is a disposable unit containing a single dose or preparation unit. For example, the dispensing unit 51 may be used as part of a syringe to deliver a serum to the body. The tube 49 may be replaced by a tubular needle which may be mounted on the outwardly extending portion of the tube portion 68. The tube section 38 is provided with a thread to provide a releasable connection of the needle. The tube section 68 may be interconnected either extensively or permanently with a longitudinally extending outlet tube. Figure 9 illustrates an embodiment of a device according to the invention for delivering a fluid or gaseous medium, such as a pharmaceutical preparation, under pressure to a tube or needle of a subcutaneous syringe. The body has a cylindrical chamber 106 having an open end opposite to the end wall 104 Projections 107 and 108 are fixed./ // - ¹ . .

The chamber 106 is provided with an ampoule or container 109 which is a liquid medium, e.g. for use as a medicine, tissue adhesive, water, air, gas, semi-fluid or similar. The plunger 109 can be compressed. Do the 109 storage compartments have a cylindrical Iliolds ^ wall and / 112 / bottom bump? Á / 112: Lime oil '1Ő4. song to her. In the center of the base plate 112 there is a longitudinally extending tube section 113

-5180047 arranged. A portion of the tubular section 113 extends through the opening 114 into the bottom panel 112. The tube portion 113 is provided with an outwardly extending portion 113A and an inwardly extending portion 113B. A transverse disk or membrane 116 is disposed in the central portion of the tube section 113, which blocks the flow of material through the tube section 113. The opposite or upper end of the container is provided with a folded closure member 117. A longitudinally extending needle 118 is disposed within the container 109. The needle 118 has a tip 119 located in the inner upper portion of the tube section 113. The other end of the needle 118 is disposed on a transverse head 121. The head 121 rests on the inside of the upper wall of the container 109. As shown in Figure 8, the needle 118 has a substantially U-shaped cross-section. One side of the needle 118 is open toward the liquid medium in the container. As a result, the medium may flow through the needle tip 119 in the longitudinal direction of the container as the needle 118 pierces the membrane 116. The needle 118 may also be configured as a longitudinally extending tubular structure provided with one or more holes engaging the needle channel as illustrated in Figure 6 for the needle 73.

The piston 122 closes the open end of the housing 102. The piston 122 is provided with two diametrically opposed projections or ribs 123, 124. The ribs 123 and 124 are located in longitudinally extending grooves 126 and 127, which are formed on the inner surface of the side wall 103 of the housing. These grooves 126, 127 guide the piston 122 in its housing 102 during longitudinal movement thereof. The inside face of the piston 122 is provided with an annular recess 128 into which portions of the container can be inserted when the piston 122 is pressed into the chamber 106. A piston 129 is provided in the central region of the piston 122 for receiving the folded closure member 117 of the container.

As the device is operated, the piston 122 is exerted in the direction of arrow 131 as shown in Figure 9, thereby inserting the piston 122 into the chamber 106. Piston 122 compresses reservoir 109 and pierces needle 118 through membrane 116. Once the tip 119 of the needle 118 has passed through the membrane 116, the fluid in the reservoir 109 may enter the tube 101 via the needle 118. The fluid continues to flow through the needle 118 as long as the piston 122 is exerted. The piston 122 may be pushed into the chamber 106 until the head 121 contacts the inner portion of the tube section 113.

Figures 10 and 11 schematically illustrate a further embodiment of the needle container assembly, the container base 132 having a substantially flat end wall 133. A longitudinally extending tube portion 134 is provided in the central portion of the end wall, the tube portion 134 being provided with an outwardly extending portion 134A and an inwardly extending portion 134B. In the middle region of the tube section 134, there is provided a disc or diaphragm 136 which, with the end wall 133, is essentially an XF.F. , ra.

plane. A needle shown schematically and represented by the reference number 137 is located in the same longitudinal direction as the permeable portion of the tube section 134. The needle tip 137 has a tapered head signal 138. The head 138 is connected to a longitudinally extending shaft 139. If the 137 needles a

It is moved in the direction of arrow 141, the head 138 pierces. membrane 136 as shown in FIG. The hole in the diaphragm 136 is larger than the diameter of the stem 139 so that the fluid in the reservoir can pass through the diaphragm 136 to the outlet portion of the tube section 134. The outwardly extending portion of the tube portion 134A is provided with a thread 142 which may be connected to a connecting threaded portion 15, such as a nut or sleeve, to a receiving device for the fluid medium. It is understood that other connection solutions may be used to connect the tube section 134 to the receiving structure.

Figures 12 and 13 show a container 143, which has a cylindrical side wall 144 that encloses a chamber 145. The latter serves to hold a liquid substance. The sidewall 144 is made of a non-compressible material. Connected to one end of the side wall 144 is a substantially flat transverse end wall 146 which forms a unit with the side wall. An elongate, longitudinally extending tube section 147 is provided in the circumferential portion of the end wall 146. The tubular section 147 has an outer portion 147A extending outwardly from the end wall 146 and an inner portion 147B extending into the chamber 145. The central portion of the tubular section 147 is sealed with a membrane 35 1 48. The diaphragm 148 is aligned transversely with the end wall 146 and consists of a structure material that can be pierced by a needle.

The chamber 145 includes longitudinal needles 40,149. The front end of the needle 149 is located in the space surrounded by the inner portion 147B and ends at the tip 151. The other end of the needle 142 is mounted on a transverse head 152. The annular outer peripheral surface of the head 152 forms a seal 153 with an adjacent portion of the inner surface of the sidewall 45 144. The outer circumferential surface of the head 152 is in frictional contact with the inner surface of the side wall 144 for sealing. This prevents moisture, air, 50 or other material from entering chamber 145. The needle 149 has a substantially U-shaped cross-section, similar to the needle 118 described in connection with FIG. However formed may be equipped, the tubular needle 149 cross-section, in which case one or more lateral holes ^55, so that the fluid in the chamber 145 can exit at the front end 149 of the needle. The needle may be formed in the same manner as the needle 137 described in connection with Figures 10 and 11. Of course, other shape and training needles may also be contemplated in order to pass the liquid medium through the membrane after the needle tip has been pierced by the membrane.

Again, the device is used in such a way that the head 152 is illustrated in Fig. 13; t (insertion of st.

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In the direction of the arrow 154, the needle 149 penetrates the membrane 148 and pierces it. The fluid in the chamber 145 passes through the needle 149 and the pierced membrane into and exits the outer portion 147A of the tubular section 147.

14-19. In the exemplary embodiment of Figures 1 to 4, the container 160 serves to store the liquid material. The container 160 is provided with a longitudinally extending tubular needle 161. The needle 161 is mounted on a substantially transversely extending head 162 and has a sharp edge or tip 163 at its leading edge. The head 162 is housed in a housing (not shown) so that the position of the needle 161 is fixed.

The container 160 is formed as a one-piece body having a through side wall 164. The side wall 164 is of tensile accordion shape and cylindrical shape; a chamber 166 for receiving the liquid medium. The front end is closed by a diaphragm or cylindrical disk forming the end wall 167.

An outwardly extending longitudinally extending sleeve 168 is disposed on the outer rim of the end wall 167, forming an extension of the container. Made of flexible, permeable material eg. a stopper or cushion 169 made of foam rubber, plastic foam or the like is disposed on the top of the sleeve 168, which covers the end wall 167. The outer edge of the sleeve 168 is provided with an inwardly extending flange 171 which secures the plug 169 inside the sleeve 168.

The rear end of the container 160 is closed by an end wall 172. The transverse folded closing member 173 of the end wall 172 provides fluid and moisture sealing of the container. As shown in Figure 17, the folded closure member 173 has overlapping and inwardly folded flanges which are firmly connected to one another. The container 160 is made of a moisture and vapor impermeable material. This material is preferably a deformable lead alloy which is chemically inert to the liquid material stored in the container.

Again, the device is operated by applying force to the end wall 172 in the direction of arrow 174. The container 160 is thereby brought into contact with the needle 161, the side wall 164 being compressed; and the needle 161 pierces both the stopper 169 and the end wall 167. The stopper 169 has an opening 176 which is sealed to the outer surface of the needle 161. The needle 161 further forms an opening 177 in the end wall 167. The hollow tubular needle 161 provides a conduit through which fluid from chamber 166 to a receiving device, e.g. flow into the catheter tube.

Figure 20 shows a device according to the invention with a delivery device 200 provided with an elongated balloon catheter 202. The dispenser 200 has a housing 201 which is secured to an elongated straight tube 203 which is a. as part of a catheter. The tube 203 may be formed in a member or be releasably connected to the housing 201. At the outer end of the catheter is a balloon-like expandable jacket 204 into which a fluid or gaseous material, e.g. water or some gas can be supplied. As shown in FIG. 22, a second thinner tube 206 is located in the tube 203. The tube 206 extends along the entire length of the tube 203 and is provided with an outlet 205 at its outer end through which liquid material can exit the catheter. The outer end 203 may be provided with a cutout to ensure that the medium can flow out of the outlet 205.

The tube 201, as shown in Figure 22, is provided with two longitudinally running chambers 207 and 208. Chambers 207 and 208 are positioned adjacent to one another in a substantially horizontal plane. Alternatively, the chambers may be arranged in a substantially vertical plane. The chamber 207 is connected to the inner space of the tube 203 by a fluid-permeable channel 209. The chamber 208 is connected to the inner space of the tube 206 through a similar fluid-permeable channel 211. A short tubular needle 212 extends along chamber 207 in its longitudinal direction. The needle 212 is mounted on a transverse head 213 located at the end of the chamber 207 including the channel 209. The outer flange of the head 213 is located in a groove of the housing so that the position of the head 213 and the needle 212 is fixed relative to the chamber 207. The needle 212 has a channel aligned with the channel 209 so that the liquid material can pass through the needle 212 to the channel 209.

A second tubular needle 214 extends along the chamber 208 in its longitudinal direction. Needle 214 is disposed on head 216 located at end of chamber 208 adjacent to channel 211. The outer flange of the head 216 extends into a groove in the housing 201 so that the attachment of the head 216 and the needle 214 to the chamber 208 is secured. The channel of needle 214 is flush with channel 211 so that liquid material can pass through needle 211.

The chamber 207 is provided with an ampoule or container 217 having a chamber 218; the latter serves to absorb a liquid substance such as water. The membrane 219 of the container 217 is facing the needle 212. A stopper 221 made of resilient material is disposed between the membrane 219 and the pointed end of the needle 219. At the opposite end of the container 217, a piston 222 is provided. A suitable dovetail-shaped conduit 237 may connect the reservoir 217 and the piston 222. Alternatively, the container 217 may be secured to the piston 222. Connected to the piston 222 is a piston rod 223 extending into the bore 224 of the housing 201. Screw spring 226 surrounds piston rod 223; abuts the housing 201 and the piston 22, thereby biasing the piston toward the needle 212.

The piston rod 223 has a detachable closure 227 thereon to hold the piston 222 in a tensioned position in which the diaphragm 219 is spaced from the needle 212. As shown in Figures 23 and 24, the closure member 227 is provided with a cylindrical pin 228 which engages the groove 230 of the piston rod 223

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It extends into 229 openings in 201 houses. The studs 228 are provided with a semicircular groove 231 which is aligned with the piston rod 223. The upper free end of the pin 228 is provided with a handle 232. The handle 232 is movable in the direction of arrow 223 (Fig. 20), thereby allowing groove 231 to overlap piston rod 223. Once the groove 231 is positioned relative to the piston rod 223 in the position illustrated in Figure 24, the piston rod 223 can be displaced. Screw spring 226 biases piston 222 in the direction of a tubular needle 212. As a result, the container 217 and the membrane 219 contact the needle 212. The pointed end of needle 212 pierces plug 221 and membrane 219. The needle 212 forms a seal with the membrane 219 so that the liquid material in the chamber 218 passes through the needle 219 and channel 209 into the interior of the catheter tube 203. Due to the tension force exerted by the coil spring 226, substantially all of the liquid material from the chamber 218 is forced through the needle 212.

As shown in Fig. 21, a cam 234 extending upwardly on the piston 222 is provided. The cam 234 extends through the longitudinal slot 236 of the housing 201. The upper end of cam 234 can be gripped by hand. When the cam 234 is subjected to force, the piston 222 moves backward, causing the reservoir 217 to expand. This causes the liquid material in the catheter to retract; the volume of the inflatable or expandable jacket 204 decreases. The piston 222 may be moved as long as the closure 227 is actuated to secure the position of the piston 222 in the housing. The expansion of the container 217 to receive the liquid material from the jacket 204 may be accomplished by other means.

A chamber 238 is disposed adjacent the needle 214 in the chamber 208. The container 233 has a chamber 239 for storing a pharmaceutical composition, tissue adhesive, or other material. One end of the container 238 is formed as a diaphragm 240 which is formed with a stopper 242 of a resilient material at a defined distance from the tip of the needle 214. Since moisture- and vapor-sensitive materials must be stored, the container must be made of a material with good moisture and vapor impermeability. Preferably, the container material may be a deformable lead alloy. Opposite the other end of the container 238 is a piston 243. The piston rod 244 disposed on the piston 243 extends into the bore 246 of the housing 201. The spring 241 disposed in the chamber 208 rests on the housing 201 and the piston 243 so that the piston 243 is biased toward the needle 214. A releasable locking member serves to hold the plunger rod 244 in a fixed position. The construction of the closure 248 is the same as that of the closure 227. It is actuated by moving the handle of the closure member 248 to the position indicated by the dotted line in FIG. Thus, the piston rod 224 is released so that the spring 247 shifts the piston 243 and the diaphragm 241 moves toward the needle 214. The tip of the needle 214 pierces the membrane 241 to provide a connection between the chamber 239 and the channel 211 leading to the tube 206. The diaphragm 241 is sealed with the needle 214 so that the material in the chamber 239 of the container 238 can be pushed through the passage 214 through the passageway 211 and the inside of the tube 206 by the spring 247.

The housing 201 is provided with flaps or closures that close the openings leading to the chambers 207 and 208 so that the containers 217 and 238 10 can be removed and replaced. Of course, design containers other than those described may be placed in the chambers.

Fig. 25 illustrates another embodiment of the releasable closure. The closure 250 shown in the figure has a pin 251 having a semi-cylindrical cutout 252. The piston rod 223 is provided with a similar cutout. The spring 253 disposed in the lower part of the hole 224 tends the pin 251 upwards. The pin 251 has an upper 20 V / Un. 254 heads are arranged.

During use, a portion of the pin 251 engages in a lateral cutout of the piston rod 223, thereby holding the piston rod 223 in a tensioned position as shown in FIG. The piston rod 223 is released by pushing the head 254 downward in the direction of arrow 256 until the cutout 252 overlaps the piston rod 223. The screw spring 223 can push the plunger rod 223 forward, thereby causing the diaphragm contact 219 to break with the needle 212.

Figures 26, 27, 28 and 29 illustrate a further embodiment of the apparatus, designated 300. The device 300 includes a dosing device 301 and an elongated tubular catheter 302 35. The dosing unit 301 has a housing 303 that is releasably or insoluble attached to the longitudinal tube 304 of the catheter. At the end of the tube 304, an expandable jacket 305 is provided per balloon. The ends 40 of the jacket 305 and the tube 304 are connected by a band 303. The sheath 305 is made of a material of elastic flat surface, e.g. made of stress-free rubber, plastic or the like. When the mantle 305 is expanded in the uterine cavity, it exerts an even pressure toward the uterine wall. The expanded jacket 305 prevents material injected into the uterine cavity from contacting or exiting the greater part of the uterine wall. From inside the tube 304, the material is 50 µl. water may enter through the openings 307 at the end of the tube 304 into the space surrounded by the sheath 305, thereby providing an expansion of the sheath 305. Inside the tube 304 is an elongated tube 308 having a smaller internal diameter. The tube 308 has an outlet end 309 at the outer end 55 of the tube 304.

The jacket 303 is provided with two chambers 311 and 312 adjacent to each other (longitudinally extending in a common horizontal plane). Alternatively, the chambers 311 and 312 60 may be arranged on top of one another in a common vertical plane. The chamber 311 is connected to the tube 304 by a channel 313. The chamber 312 is similarly connected to the tube 308 through the channel 314. The chamber 311 is displaceably housed with a du65 piston 316. Charging the Piston 316 Backward S The 31 amel · Paired Gene Giving Image Blade Stretching Amel · Raises the sight of the firing pin head Air 319 d. The dik e! 33I that dugaí el'v. or head m <artificial stone aperture A. · is present together rod b element i eye A house 333 ff interest; The 338 puts the servant's tap in place to seal it. This tap is the tyuriud scarf. its position is such that i

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A piston rod 317 directed toward -817 is disposed substantially parallel to the piston rod 316. In the chamber 312, a second piston 318 is displaceable. The piston 318 is provided with a piston rod 319 extending rearwardly substantially parallel to the piston rod 317. At the rear of the housing, an actuator or trigger 320 is located at the rear ends of the piston rods 317 and 319. The release mechanism 320 is provided with a lever 321. An opening is provided in the center of the lever arm 321 for receiving a transversely extending hinge plate 322. The hinge 322 is located in a downwardly revolving grocery store 323 which is secured to the rear of the housing 303. The lever arm 321 is provided with a transverse head 324. Between the housing 303 and the upper end of the lever 321, a spring 325 is disposed which holds the lever 321 in the rearward tensioned position. The front portion of the head 324 is slidably engaged with the ends of the piston rods 317 and 319.

As shown in Figures 29 and 30, the head 324 has a through opening 326 extending longitudinally for the piston 319. A through hole 327 extends transversely into the passage 326. A slidable pin 328 is disposed in bore 327 and plug 333 closes end of bore 327. Spring 332 tends to pin 328 so that it extends into the through hole 326. The piston rod 317 is provided with a rear cam 334. When the piston rod 317 is in the rear or tensioned position, the cam 334 is located behind the head 331; in this case, it acts as a stop that prevents the pin 328 from being pushed into the passage 326.

The piston rod 317 has a slot 336 in the upper portion thereof. The slot 336 cooperates with a locking member 337, as a result of which the piston rod 317 can be locked in the retracted position. The locking member 337 has an adjustable pin 338 located in an opening surrounded by eyes 339. The pin 338 is provided with a head 341 disposed above the housing 303 and gripped to release the locking member 337. At the front end of pin 338 is a C-shaped spring ring 342 which serves as a stop for spring 343. The spring 343 concentrically surrounds the pin and rests on a portion of the housing 303, thereby tensioning the pin 338 toward the piston rod 317. As the plunger rod 317 is pushed inwardly, the pin 338 engages the slot 336 to lock the plunger rod 317. The piston rod 319 is provided with a slot 344. Housing 303 is provided with a closure member 346 which retains piston rod 319 in its retracted position. The closure 346 is constructed in the same manner as the closure 337.

After actuating the lever 321, the piston rod 317 is retained in the retracted position of the locking member 337. The piston rod 319 is not displaced because the head 324 is set relative to the piston rod 319 and the piston rod 319 moves through the slot 326. When the head 324 is retracted to its rear starting position by the spring 325, the pin 328 is pushed by the spring 332 into the slot 326. With the second adjustment of the lever 321 in the direction of the revolver bore 323, the piston rod 319 moves forward.

As shown in Figure 28, the chamber 311

There are 350 tanks. One forward

The needle 351, which is mounted on a transversely extending support member 352, is disposed in the front of the chamber 311. The needle 351 is hollow and is connected to the channel 313.

The chamber 312 is provided with a reservoir 353. At the forward end of chamber 312, a longitudinally extending needle 354 is secured to a transverse support member 356. The needle 354 is hollow and has a through opening which is connected to the interior of the tube 308. The container 353 is formed as an elongated cylindrical body made of glass, plastic or the like and has a head 357. The head 357 is provided with a rubber stopper (not shown) which is aligned with the needle 354. The reservoir 353 is provided with a slider 35 which defines the material 359 within the reservoir. The piston 318 extends into the reservoir 353 and can thus be engaged with the slider 358. As the plunger 318 is advanced, the needle 354 pierces the head 357 to provide a connection between the inner space of the tank 353 and the tube 308. Slider 358 is advanced to expel material from container 353.

The container 350 shown in Figure 31 has a cylinder 361 which is a fluid 362, e.g. water storage. The front end of the cylinder 361 is provided with a head 333 having a stopper 364 with a stopper. The open end of the cylinder 361 is closed by a push rod 366 provided with a piston 367. The rear portion of the push rod 366 is provided with an outwardly extending flange 368 on which a spring 369 rests. The front end of the spring 359 engages the annular shoulder 371 on the roll 361. The spring 369 tends to push the push rod 366 so as to move out of the roll 361. The push rod 366 is provided with an elongated hole 372 in which the actuator member 373 is slidably embedded. The actuator 373 is provided with an axial bore which receives a compression rod 374, which compression spring 374 forms a resilient actuating member between the actuator member 373 and the push rod 366.

The piston 316, fixed on the piston rod 317, puts it on the end of the actuator member 373. When the piston 366 is moved forward, the spring 374 is first compressed, thereby applying a uniform pressure to the push rod 366. The roller 361 is then advanced so that the needle 351 pierces the stopper 364 to provide a connection between the interior space of the container 350 and the channel 313. By pushing the piston 316, the piston 367 moves in the direction of the piston 364. Liquid is ejected from cylinder 361: The discharged fluid flows through tube 304 and passes through apertures 307 to casing 305, which, as illustrated in Figure 28 by dashed lines, expands. The expansion of the sheath 305 occurs at constant pressure; thus, it fills the uterine cavity and exerts an even pressure on its inner wall. Is the pressure exerted by the mantle 305 on the uterine cavity always constant, regardless of the size of the uterine cavity?

The housing 303 is provided with closures that close the openings leading to the chambers 311 and 312 so that the containers 550 and 353 can be removed and replaced. Containers of a different type and design may be placed in the chambers.

During the application of the equipment, any material, eg. drug, tissue adhesive, contraceptive gel, or the like into the fallopian tubes. To this end, the elongated catheter 302, with the jacket 305 in the constricted state, is introduced through the cervical orifice into the uterine cavity. The mantle 305 is expanded with pressurized fluid to fill the uterine cavity and exert a uniform pressure on the inner surface of the uterine wall. The pressure fluid is passed through the inside of the tube 304 to the sheath 305. The dispenser 320 is advanced to exert pressure on the piston 316 and engage the reservoir 350 with a needle 351. The needle 351 pierces the stopper 364 so that the fluid 362 flows through the interior of the tube 304 into the jacket 305 and expands it. The surface tension of the mantle exerts a small and uniform stretching effect on the inner surface of the uterine cavity. This results in an effective seal and a secure fit so that the same catheter structure can be used to treat different females or female mammals, regardless of the size of the uterine cavity.

The fluid is then inserted between the dilated mantle and the cervix into the uterine cavity. delivered. As the material is in motion, it moves towards and penetrates the fallopian tubes. The expanded mantle on the wall of the uterus facilitates the movement of the material towards the fallopian tubes. Then, the liquid in the jacket is released and the jacket shrinks. The catheter is then withdrawn from the uterine cavity.

Figure 32 shows a further exemplary embodiment of the device designated 420.

The device 420 has an elongated tubular catheter 441 which is long enough to pass through the vaginal cavity 427 into the uterine cavity 432. The catheter 441 is provided with a channel 442 extending over its entire length. A balloon structure 443 is disposed at the outer end or at the upper end of the tubular catheter 441. The balloon assembly 443 has a flexible and expandable jacket 444 that surrounds the upper end of the catheter 441 with a fastening member 446, e.g. the collar or thread loop connects the upper end of the jacket 444 with the catheter 441. By means of a similar fastener 447, the other end of the jacket 444 is connected to the catheter 441. The catheter 441 is provided with a plurality of openings 448 for communication between the channel 442 and the chamber 449 located inside the jacket 444,

The jacket 444 consists of a tubular flat member made of a soft, tension-free, flexible and elastic material, e.g. made of rubber or plastic, which can be expanded with minimum stress. For the manufacture of the jacket 444, e.g. thin latex rubber with low surface tension can be used. The low surface tension of the rubber allows for an even expansion of vi10 f

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487 parts using relatively low pressure. The structure of the 444 * pad easily expands, so that the uterine cavity can be filled to fit its dusk shape without being subjected to extreme pressure by the area delimited by the side walls of 422 mi 437 and 438 When the uterine cavity 432 is complete, the mantle 444! As shown in Figure 36, the pad 444 is in uniform, filial contact with the 439 membrane of uterus 422.

The outer end of the catheter 441 is closed by a head 451 The head 451 has a transverse channel 452 extending from the opposite side of the head 451. A longitudinally extending tube 453 is mounted on the head 451. The tube 453 runs in the longitudinal direction of the catheter 441 and is provided with a channel 454 through which material can be introduced into the canal 452, which in the opposite directions can feed the material into the upper portion of the bee 432 in two opposite directions. The head 451 is provided with a cap having an upper side lying against the inner wall of the bee 436. The cap 45i holds the channel 452 at a sufficient distance from the inner side of the uterus 436 and thus acts as a stop.

As shown in FIG. 33, device 420 is provided with a longitudinally extending housing 457 disposed at the end of catheter 441, housing 457 having a first chamber 458 for receiving an elongated cylindrical container 459. The reservoir 459 is provided with a protruding neck 461 connected to a tube 462. The tube 462 is provided with a fluid-permeable section that is connected to the channel 442 of catheter 441 such as a fluid or gaseous medium, e.g. the air stored in the container 459 may be introduced through the duct 442 into the chamber 4 of the balloon structure, thereby allowing the jacket 44 to be expelled. The container 459 open end of the piston _463: tyúval is closed to prevent escape of the materials into the chamber 46. The butter container 459 has a seam 466 near the piston 463 through which air and sterilizing gas can flow into the chamber 464.

Behind the piston 463 is a drive means 467 for pushing the piston 463 in the reservoir 459. The drive 467 is connected to an actuator 468 projecting from the housing 457 to the rear.

Is the 457 housing a brake on the side next to the front chamber? the second chamber has 469 chambers. The sleeve 457 is provided with a permeable tube 471 which connects the tube 453 to the chamber 4S9; The tube 471 has a longitudinally extending needle 472 extending into the chamber 469. The tapered end of the tube 471 is located in a stopper 473 which closes the catheter end; and connected to the tube 453 which leads to the head 451. Camel 469 has an elongated shape and faces toward the top of housing 457 as shown in FIG. A cylindrical container 474 is disposed within the canyon 469. The container jSj is aligned with the needle 472. The stopper 474 has a stopper 476 extending in the same direction as the needle 472 at the front end of the tuft 474. The opening of the container 474 is closed by a displaceable piston 477, which hinges the operation of the actuator 4 in the direction 46. nésztet:

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A second drive means 479 extends rearwardly of the container 474, which is connected to the actuator 468. The actuator 468 can be adjusted so that the material can be introduced into the oviducts 433 and 434 of the uterine cavity 434A and 434B in a single stroke. The back of the housing 457 is provided with flanges 481 and 482 that extend outwardly in the opposite direction, and below which the operator's fingers can be pushed when adjusting the actuator 468. The actuator 468 is provided with an opening 483 for receiving the pin 483A and the pin 483A for locking the actuator 468. The 483A pin prevents unintentional operation of the device.

By means of the drive mechanism 467, the piston 463 can be pushed into the reservoir 459. As a result, the pressure in the pressure medium system of the balloon assembly 443 is increased and the jacket 444 expands. The drive assembly 467 has a sleeve 484 in which a body 486 is displaceably disposed. The upper end of the sleeve 484 is connected to the head 487. The head 487 has a central opening 488 through which the inner space of the sleeve 484 can be closed. The outer end of the piston 463 is provided with a conical portion 489 which abuts the conical outer end of the head 487. The central opening 488 is aligned with the adjusting screw 491 driven into the body 486. The position of the adjusting screw 491 relative to the body 486 is a tool, e.g. screwdriver which can be inserted through the central opening 488. Two springs 492 and 493 tension the sleeve 484 and body 486 in opposite directions, thereby holding the first drive assembly 467 in a caked position.

The spring 492 is located on the head 487. Spring 493 a

It sits on 491 adjusting screws. By adjusting the adjusting screw 491, the force of the spring 493 can be controlled: it is the spring that preloads the head 487 and the body 486 in the opposite direction. The adjusting screw 491 thus allows fine adjustment of the spring force so that fluctuations in the nominal values of the spring 493 can be taken into account and the desired pressure in the chamber 449 is maintained. Between the springs 492 and 493 there is provided a disc 494 with a central hole for guiding the tool. It is weak relative to spring 492 and spring 493. The weak spring 492 at low load, e.g. It is compressed at a pressure of 0.14-0.21 bar so that the 494 dial a

The spring 492, when in the compressed state, rests on the head 487. As a result, the jacket 444 partially expands at a specified low pressure. The predetermined maximum pressure is determined by the nominal value of spring 493 and allows the device to be applied to any bee or size since spring 493 can follow these differences. The sleeve 484 and body 486 are held together by a pin 496 extending through a longitudinally extending slot 497 of the sleeve 484. Slit 497 allows compression of springs 492 and 493 to allow the 4β4 sleeve to move relative to body 486. Pin 496 extends through longitudinal slot 497 a

The housing 457 also has a longitudinally extending groove 498 and thereby prevents the drive assembly 467 from rotating relative to the housing 457.

The body 486 is provided with a transverse groove 499 for receiving the drive 501. The drive member 501 is provided with opposing ends of a conical member which are connected to one another by a transversely extending connecting member or tube. One end of the actuator 501 extends into a groove 502 formed on the side of the actuator 468. The actuator 468 has a second groove 503 for receiving the mandrel 501. Below the groove 503 is located a shoulder 504 which engages the end of the body 468 when the drive 501 engages the groove 503. The house is equipped with 457 slot 506, which opposite right end ²⁰ of the carrier body 501 can fit in. The groove 506 is in front of the starting position of the actuator 501 shown in Fig. 33, such that the actuator 467 is interrupted at intervals until the end of the body 25 468 rests on the shoulder 504. After this, the adjustment of the drive mechanism 467 can be continued. The position of the groove 506 for the position of a further groove 521 of the housing 457 may be determined by overlapping the initial expansion 30 of the jacket 444 with the delivery of material into the uterine cavity and the additional expansion of the jacket 444. In this case, continuous expansion of the jacket 444 may be provided until the jacket is below the maximum pressure of the liquid. In the bore 508 of the body 486, an adjustable closure 507 is provided. The closure member 507 has a push rod 509 provided with an outwardly extending extension 510. The extension 510 engages the housing 457 with one or more teeth 511. The teeth 511 are facing the drive mechanism 4S7. The teeth 511 are configured as ratchet teeth, which only allow the drive mechanism to move backward when the closure member 507 is in working position relative to the teeth 511. The push rod 509 is tensioned outwardly by a spring 512 that rests on the bottom of the bore 508. The sleeve 484 is provided with an opening 513 in front of the extension 510. When the spring 492 and 493 are compressed, the body 486 moves toward the sleeve 484 until the extension 510 is aligned with the opening 513. The spring 512 then pushes the extension 510 through the opening 513 and engages it with one of the teeth 511. This prevents further propulsion of the drive assembly 467 and limits the pressure of the material contained in the chamber 449 of the jacket 444.

The second drive assembly 479 allows the container 474 to be pushed into the needle 472 and

The plunger 477 is pushed into the container 474 to provide a

Material 478 is forced through needle 472 into tube 453. Through the tube 453, the material enters the head 451, where it is led in opposite directions to the upper portion of the uterine cavity 432. As shown in FIG. 33, the second drive means 479 has an elongated slider rod 514 which engages the

-1123 is displaceably arranged in a longitudinal channel 515 of the housing. The front end 516 of the push rod 514 may rest on the piston 477. The other end of the push rod 514 is provided with a transverse cutout 517. In the groove 517, a drive member 518 is located. The actuator 518 has conical ends which have a rigid intermediate member, e.g. are connected by a pipe. One end of the actuator 518 extends into a hemispherical groove 519 formed on the side of the actuator 468. The other end of the actuator 518 rests on the side wall of the housing 457, which defines the channel 515 so that the actuator 518 is retained in the groove 519. In front of actuator 518, groove 521 of housing 457 is maintained such that actuator 518 remains in actuation engagement with actuator 468 until actuator 518 is pushed into recess 521 so that actuator 514 remains in an anterior position as actuator actuator 468 moves.

The device 420 is packaged together with the container 474 in the chamber 469. The actuator 468 is locked by the pin 433A, inserted through the opening 483, at rest. The pin 483A lies against the end of the housing 457 and prevents the actuator 468 from being pushed into the housing. The entire device must be sterilized before use.

The device is operated by first pushing the balloon assembly 443 through the inlet 428 of the sleeve 426 into the vaginal cavity 427 and then through the cervical opening 431 into the uterine cavity 432 as illustrated in FIG. The jacket 444 is then tightened so that the balloon structure can be easily inserted into the uterine cavity. The catheter 441 is pushed forward into the uterine cavity until the head 451 contacts the uterus 436. As is known, the shape, size and position of the uterus varies from person to person so that the balloon structure may be located either symmetrically or asymmetrically with respect to the fallopian tubes 423 and 424. In the case illustrated in Figure 32, the balloon structure 443 is located in the center of the uterine cavity 432. In other cases, the balloon structure may be offset to one side or the other of the uterine cavity. However, the device 420 can deliver the material to both oviducts regardless of the position of the balloon structure within the uterine cavity 432.

The pin 483A is pulled out of the opening 483. The pusher-like actuator 468 can then be inserted into the housing 457 to expand the jacket 444 and deliver the material to the uterine cavity 432, after which the jacket 444 is fully expanded and the material can be aspirated or pressed into the ovaries. During the operation, the operator puts his fingers under the flanges 481 and 482 to exert an inward force on the actuator 486. In the embodiment of Figure 35, a short section of actuator 468 is inserted into housing 457 such that the first drive assembly pushes piston 463 into reservoir 459. As a result, the sheath 444 is so enlarged that it forms a seal in the lower portion of the cavity 432. The jacket 444 is then brought into close contact with the 439 side wall of the uterus. The actuator 501 engages the actuator 468 with the first actuator 467 so that movement of the actuator 468 is transmitted to the actuator 467. As a result, the piston 463 is pushed into the chamber 464. The actuator 518 establishes a connection between the push rod 514 and the actuator 468 so that the front end 516 of the push rod rests on the piston 477 in the container 474.

As shown in FIG. 36, when the actuator 468 is further adjusted, the shoulder 504 contacts the underside of the body 468. At the same time, the drive 501 is inserted into the groove 503 so that the drive 501 is separated from the slot 560. The actuator 468 is pushed into the housing 457 to increase the pressure in the chamber 464. Thus, the jacket 444 expands further. The expanding jacket 444 transfers material from the upper part of the uterine cavity through the exit points 433A and 434A

433 and 434 into the fallopian tubes. The jacket 444 expands until the pressure in the system surrounding the jacket and chambers 449 and 464 reaches about 0.56 bar. Other pressure values can be specified as upper limits. This pressure is determined by the properties of the springs 492 and 493 and the adjusting screw 491. By compression of the springs 492 and 493, the body 486 enters the sleeve 484. This movement continues until the extension 510 is aligned with the opening 513. The spring 512 then pushes the extension 510 through the opening 513 and is inserted into the space between adjacent teeth 511. The extension 510 rests on one of the teeth, thereby preventing further insertion of the actuator 468 into the housing 457. Since the closure member 507 prevents further penetration of the actuator into the housing 457, the pressure in the chamber 449 of the balloon is limited to a predetermined maximum, which depends on the spring properties of the springs 492 and 493.

As the actuator 468 is moved from its position shown in Fig. 35 to its position in Fig. 36, the actuator 518 exits from groove 519 and enters groove 521. Thus, the advancement of the push rod 514 is completed; no further material can be introduced into the 432 uterine cavity. Further adjustment of actuator 468 increases the pressure in chamber 449. As a result, the mantle 444 expands and the material is released from the uterine cavity 432 into the 433 and

434 suction or suction in the fallopian tubes. The pumping effect ceases when the jacket 44 expands completely, as shown in FIG. The substance therefore enters the fallopian tubes; the force exerted on the substance is not strong enough to penetrate the oviducts into the body cavity.

The actuator 468 is then removed from the housing 457. The actuator 501 is tipped into the groove 503 to provide a connection between the body 486 and the actuator 468. The extension 510 of the closure member 507 slides over the teeth 511. In this way, the piston 463 is removed from the chamber 464. Liquid in chamber 449 flows back into chamber 464; 444 Sheath Tightener '• ii ···

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Figures 37 and 38 show a further embodiment of the device according to the invention, which is designated 420A. The 420A is illustrated in FIGS. The corresponding genitalia and structural members are designated by the reference numerals used therein, but are supplemented with an "A" index.

The 420A has two components! suitable for the administration of a preparation.

To this end, a mixing head 651 is located at the outer end of the catheter 411A. The agitator head 651 is provided with a transversely extending passage 652 having opposed outlets which pass the mixture into two parts of the upper region of the uterine cavity 432A. A first tube 653 and a second tube 654 are connected to the mixing head 651. The mixing head 651 is provided with a mixing chamber 655 which communicates with the interior of the tubes 653 and 654 and the passage 652.

The housing 457A is formed with two chambers 656 lying adjacent to the chamber 458A and receiving two containers 657, 659. The container 657 serves to store the first material 658, while the container 659 serves to store the second material 660. In the reservoir 657, a plunger 661 is displaceable. Similarly, the piston 662 is displaceably disposed in the reservoir 659. The push rod 514A of the second drive mechanism 479A has a fork-like end portion provided with two teeth 663 and 664. The tooth 663 extends into the reservoir 657 and rests on the piston 661. The tooth 664 immersed in the reservoir 659 cooperates with the piston 662. Tubes 653 and 654 extend into housing 457A and terminate in needles 666 and 667. The needles 666 and 667 are coincident with the transverse end portions of the containers 657 and 659.

When adjusting the common actuator 468A, the actuator 467A first expands the jacket 444A by filling and sealing the lower portion of the uterine cavity 432A. Further adjusting the actuator 468A, the actuator 468A contacts the actuator 479A so that the teeth 663 and 664 are offset. The push rod 514A moves forward as shown in FIG. As a result, the tanks 657 and 659 are pressed onto the needles 666 and 667, respectively. The teeth 663 and 664 associated with the pistons 661 and 662 simultaneously push the materials 658 and 660 through the tubes 654 and 653. The materials are simultaneously introduced into the mixing chamber 655. The mixing chamber 655 receives substantially the same amounts of material, so that the mixing mixture is approx. Contains 50-50% of each ingredient. In Figure 37, the mixture of substances designated as 668 enters the upper portion of the uterine cavity 432A. The material mixture flows in substantially the same quantities in opposite directions. Flow continues until the end of stroke of the pusher 514 is reached. From this point on, due to the continuous displacement of the actuator 468A, the jacket 444A expands further, causing the mixture to press into the ducts of the tubules 423A and 424A.

Materials 658 and 660 may have a composition which, upon mixing, will cure with semi-rigid plastics. The hardening of the mixture may be triggered by moisture, temperature or other factors in the body tissues. The reaction time of the formation of the mixture is determined so that before the mixture hardens, it can be introduced into the ducts of 433A and 434A. The two-component mixture may consist of two parts epoxy resin, two parts tissue adhesive, RTV silicone rubber or medical silicone rubber. Of course, other materials which cure after mixing may also be used. In addition, the proportion of the components can be varied, in which case the size of one of the containers must be changed. For example, one component can be mixed and one component can be mixed to form containers of appropriate size in the 457A housing.

The material to be administered to the fallopian tubes is usually a liquid or semi-liquid medium which is used to test, treat, or block the fallopian tubes. For example, an adhesive may be used which may consist of cyanoacrylate or similar material used as a surgical adhesive. Cyanoacrylate is a liquid which hardens or polymerizes when exposed to moisture. Cells adjacent to the adhesive are damaged and eventually replaced by fibrous tissue. This obstructs the fallopian tubes. Suitable cyanoacrylates include methyl cyanoacrylate, methyl 2-cyanoacrylate, ethyl cyanoacrylate, n-propyl cyanoacrylate, n-butyl cyanoacrylate, n-amyl cyanoacrylate, n-hexicyanoacrylate, n-heptyl cyanoacrylate, isobutyl. The composition may be a substance which hardens on the basis of body heat or other triggering factors. The composition can also be used to create a permanent fallopian tube closure. However, it is also possible to use a material which will only temporarily block the fallopian tubes, so that the fallopian tubes will reopen later and function normally. Such compositions include, for example, contraceptive gels, water, silicone elastomers, formaldehyde-like substances and the like.

The material used can also be a topical contraceptive, which is also delivered to the fallopian tubes and uterus. In the fallopian tubes, for example, microspheres of biologically absorbable contraceptive preparations may be conducted. The microspheres, e.g. they decompose in one year and provide contraception during this time.

For tissue treatment, biological materials eg. fibrinolytic enzymes can also be introduced into the fallopian tubes and uterine cavity. Such biological agents are used to treat inflammation and to prevent adhesions around the ends of the fallopian tubes.

Using the device described above

-1327 diagnostic materials can also be delivered to the fallopian tubes.

The device of the invention can also deliver anesthetics to the fallopian tubes.

The preparation may also be composed of substances that are used to treat the oviducts and the uterus in order to facilitate the movement of eggs and sperm in the fallopian tubes and the uterus. Substances that expand or open the ovaries in order to facilitate artificial insemination may also be used. For the local control of inflammation, antiinflammatory agents, e.g. cordocoids may be used. Antibiotics may also be used for topical treatment of the fallopian tubes.

In some cases, infertility can be attributed to the inability of sperm to pass through the cervix and endometrial cavity. The device of the present invention allows the delivery of sperm to the uterine cavity and the fallopian tubes, thereby facilitating fertilization.

Claims (28)

Patent claims Apparatus for introducing substances through the uterine cavity into the fallopian tubes, in particular for sterilization purposes, comprising a dispensing device, wherein the dispensing device is provided with a longitudinally extending tubular catheter with an expandable jacket which can be inserted into the uterine cavity, and a storage device for introducing the material into the oviducts via the catheter through the uterine cavity sealed by the jacket, characterized in that the jacket (39, 204, 305, 444, 444A) is a reservoir (217, 350, 459, 459A) and with a fluid introduced through an expansive gland (44) comprising a plunger (222, 316, 463, 463A), regardless of the size of the uterine cavity, until the uterine cavity is completely filled and the mantle tightens against the inner wall of the uterine cavity, also bee-bottom, expandable design. An embodiment of the device according to claim 1, characterized in that it is operable to press the material from the uterine cavity into the fallopian tubes by means of a jacket (444, 444A), a plunger (463, 463A), a drive mechanism (467, 467A), an actuator (467, 467A). 468, 468A), body (468) and shoulder (504). An embodiment of the device according to claim 2, characterized in that the expansion device (44) and the storage device (100) consisting of the container (474, 657, 659) and the piston (477, 661, 662) are in communication. An embodiment of the device according to claim 3, characterized in that it comprises a program control unit consisting of a drive device (467), an actuator (468) and a further drive device (479), which comprises the expansion device (44) and the storage device (100). is connected. . ....... An embodiment of the device of claim 4, wherein Five punching units are provided with a guide means (50) and a groove (503). An embodiment of the device according to claim 4 or 5, wherein the actuator (468, 468A) of the program control unit is 10 continuously adjustable actuators. 7. The device of claim 2 further comprising a storage device. 8. Figures 1-7. Device according to any one of claims 1 to 4, characterized in that the expansion device (44) is provided with a pressure transducer comprising an adjusting screw (491), a spring (492, 493) and a disc (494), which comprises a closing member (507) and an opening (513, 513A). with pressure relief valve 20 are added. 9. The device of claim 8, wherein the pressure transmitting unit is provided with a control unit comprising a spring (492, 493). 25 10. Figures 1-9. Device according to any one of claims 1 to 4, characterized in that the expansion device (44) is provided with an actuator 30 consisting of a plunger (47), a screw spring (226), a locking element (227), a release device (320) and an actuator (468, 468A). 11. An apparatus according to claim 10, wherein the housing comprises a balloon catheter (201) and a housing (303, 457, 457A), which are two pieces for storing fluid. 35 serving containers (217, 350, 459, 459A) and a single storage container (238, 353, 474, 657, 659) for receiving material (207, 208, 311, 458, 458A, 469, 656) provided with a fluid-permeable channel (209, 40313) and a tube (462, 462A) and a substance-permeable channel (211, 314) and tube (471, 653, 654) for the catheter, respectively. 12. The device of claim 11 wherein the material is permeable. The 45 needle passageways (211, 314) communicate with the container (471) and the tube (653, 654) with a needle (214, 354, 472, 666, 667), the tip of which is a container (238, 353, 474) for storing material. 657, 659) are movably disposed facing the wall. 50 An embodiment of the device according to claim 11 or 12, characterized in that the fluid-permeable channel (209, 313) is in communication with a needle (212, 351) which is pointed toward the wall of the container (217, 350) for storing the liquid. is movably arranged. 14. An embodiment of a device according to any one of claims 1 to 4, wherein the actuator comprising the trigger (320) and actuator (468, 468A) is It is coupled to a first drive unit consisting of 60 pistons (316), a piston rod (317) and a drive assembly (467, 467A). 15, The device of claim 14, wherein the first drive The structure 65 (467, 467A) is provided with a closure member (507). 511 form agents 17 shapes datt gOVE storage (511 18 finished work rods 479 / thol. 19 shapes other <and picture 518) 20 finished other <tally see: Figure 21 -14 = 3 >> lil I 7 _> i X i The device of claim 14, wherein the first drive assembly (467, 467A) is provided with teeth (511) fixed to the housing and arranged in cooperation with the closure member (507). An apparatus according to claim 16, characterized in that the closure member (507) is provided with a push rod (509) and a spring (512) supplemented by an extension (510), the extension (510) having two adjacent teeth (511) ) with a drop-in design. 18. A, 14-18. An embodiment of a device according to any one of claims 1 to 3, characterized in that the actuator is coupled to a second drive unit consisting of a piston (318), a piston rod (319) and a drive mechanism (479, 479A). 19. The device of claim 18, wherein the first and second actuators (467,467A, 479, 479A) and the actuator (468, 468A) are provided with first and second actuators (501, 518). provided. 20. A, 11-19. An embodiment of the device according to any one of claims 1 to 3, characterized in that it is provided with an additional container (659) for storing the second material and a mixing head (651). 21. An embodiment of the device of claim 20, wherein a duct (652) and a mixing chamber (655) are connected to the mixing head (651) and the fitting thus formed is located at the front of the jacket (444A). 22, pp. 11-21. A process according to any one of claims 1 to 4 The device 5 is characterized in that a head (451) with a lateral channel (452, 652) and a mixing head (651) are provided at the forward end of the catheter (441, 441A). 23. Device according to any one of claims 1 to 4, characterized in that the catheter (441, 441A) is provided with a cap (456). 24. An embodiment of the device according to any one of claims 1 to 3, characterized in that the jacket (39, 204, 305, 444, 4444A) is tubular, and 15 is made of a low surface tension, stretchable material having substantially the same tensile properties in all directions. 25. An embodiment of a device according to any one of claims 1 to 5, characterized in that a 20 shells (39, 204, 305, 444, 444A) are formed as balloons. 26. An embodiment of a device according to any one of claims 1 to 3, characterized in that the jacket (39, 204, 305, 444, 444A) is made of latex rubber 25 designed. 27. An embodiment of the device according to any one of claims 1 to 4, characterized in that the jacket (39, 204, 305, 444, 444A) is soft, elastic It is made of 30 plastics.