JP3048058B2 - Inflatable envelope for stretching tubular or linear tissue - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION INDUSTRIAL APPLICATION The present invention resects a lesion and allows the rest of the tissue to be interpolated with other vascular segments or joined directly without the use of connecting devices. The present invention relates to an inflatable envelope for stretching tubular and linear tissues such as blood vessels (tubular) and nerves (linear tissue).

[Prior art] Human body tissue is often an important part of the anatomy,
Sometimes they get sick or get amputated. In order to recover its function, it is necessary to resect a diseased or injured site and rejoin the cut end.

The problem of rejoining is that the length of the rest of the tissue is often too short to rejoin directly, and it is necessary to use a part of another similar tissue or to perform an artificial transplant such as a synthetic resin tube. May not be. Such methods are very time consuming, especially when cutting and joining tissue from other parts of the human body.

Another problem with conventional methods is the need to create two separate suture stump joints, each of which creates problems associated with its unique surgical skill.

Another problem that is often encountered is the incorporation of physically and physiologically different human vessels at the junction.

[Problems to be Solved by the Invention] It is much more preferable to join the ends of the same tissue than to incorporate structures having different properties. In many situations,
The joining of two ends that are part of a previously continuous blood vessel and are separated cannot be done by simply pulling each other.

An example of the tissue will be described using a blood vessel. Other tissues work similarly in the present invention.

Blood vessels are somewhat elastic and can vary in length.
However, blood vessels are not simple structures. Blood vessels have at least several inner physiological layers as intima, which cannot withstand strong compressive or grasping forces. Applying such strong forces will cause bruising, which can lead to embolism and blood clots. Strong gripping or pulling on a blood vessel can cause serious damage to the blood vessel.

However, blood vessels have inherent elasticity and yield within a stretch limit of less than 50%. Thus, if the rest of the blood vessel can be permanently and sufficiently stretched to reconstruct the resected length, the joining end can be substantially relaxed. Of course, this assumes that stretching does not damage blood vessels, especially the intima. This requires a method of gradually and gently stretching the blood vessel without applying strong grasping force or sudden stretching force. The above objects cannot be achieved by conventional techniques and devices, but can be achieved by the means of the present invention.

In discussing the present invention, it is noted that the present invention is almost always employed as part of a normal anesthetized surgical procedure. Surgery is highly dependent on the duration and depth of anesthesia. Also, surgeons are more fatigued over longer periods of time than shorter operations.

An important example is replacing part of the length of the coronary artery with part of the vein taken from the leg. Generally, cutting a vein from the leg takes about 45 minutes to 1 hour. Most of this surgery involves the removal of a vein from the leg.

SUMMARY OF THE INVENTION It is an object of the present invention to provide an expandable inflatable envelope for stretching tissue as a first aid during surgery while avoiding the need to cut away other tissue.

The present invention to achieve the above object is an inflatable envelope for expanding tubular or linear tissue, which is soft and elastic, has an outer surface that expands when expanded, and has a predetermined unidirectional surface. A fluid-impermeable envelope enveloping the inner chamber, having a smooth mounting path extending along the inner surface of the tissue and allowing free sliding between the tissue and the mounting path; Slip prevention means provided on each side of the mounting path so that the tissue cannot slide freely so as to be held in alignment with the mounting path;
A filling tube communicated with the inner chamber for injecting fluid into the inner chamber and extracting fluid from the inner chamber for expanding and contracting the envelope is provided. Also,
In the present invention, the envelope has a surface that has been subjected to a surface treatment on the opposite side to the surface having the path described above so as to prevent sliding between the envelope and an anatomical support on which the envelope is placed. Can be prepared. Further, in the present invention, a pierceable storage portion is connected to the filling tube, so that fluid can be injected from the storage portion into the envelope and fluid can be withdrawn from the envelope into the filling tube. Furthermore, the present invention can include a valve in the filling tube so that fluid can be injected and withdrawn. Moreover,
In the present invention, the mounting path may be a groove having a bottom portion on the outer surface and two side walls, and the side walls may serve as the slip prevention means. Further, according to the present invention, the slip prevention means may comprise a projection on an outer surface.

Incidentally, examples of the organization according to the present invention are as follows. Tubular tissues include veins and arteries (blood vessels), fallopian tubes, vas deferens, ureters, urethra, lymph glands, intestinal tract, esophagus, stomach, and the like. There are muscles and nerves as linear tissues. These are given as examples, and there are other examples, and there is no limitation. All of these features reside in the shape or cellular structure that can be extended linearly. The present invention does not extend the skin in completely different ways.

[Operation] The present invention utilizes an expandable envelope, and the outer surface expands as the envelope expands. The envelope is positioned beneath the vessel between the anatomical support and the tissue, and the tissue juxtaposed to the outer surface that extends. The envelope is initially unexpanded and has a small volume. Next, a fluid is injected into the envelope and gradually expanded. As the envelope expands, the length of the vessel along the envelope increases with increasing length of the envelope along the outer surface.

In general, blood vessels are attached to anatomical supports such as bones and muscles, so their longitudinal movement is limited, so that when the envelope is placed between the blood vessel and the anatomical supports, the envelope expands. Works effectively for blood vessel stretching. The blood vessels may separate from the anatomical support at the site of extension, but remain attached beyond the site of the separation, with a pulling force acting between them and spanning the entire length of the blood vessel. And can simply be pulled, thereby preventing local stretching. At the same time, the restriction at the "fixation" of the blood vessel remains normal, not a pinch grip. Thus, each end of the envelope is gripped to support the blood vessel, but this is not required.

Since the damaged part of the blood vessel will be discarded, it is not a good method to pull it, and there is no good thing even if it is stretched. Thus, the present invention employs a method of extending the length of normal tissue away from the lesion. In this way, when the lesion is excised, the end of the stretched vessel can be pulled in the direction of the resulting gap and sutured directly to the other incised end.

The sutured blood vessel is not stressed longitudinally and has only one joint. The number of sutures can be reduced by half, and the treated vessels have no physical or physiological discontinuities. This operation can be performed quickly.

Since the above method was simple, there were some potential difficulties that were overcome. This method is not a transplant in the sense of closing the incised site. This method does not occlude. The stretching procedure can take less than about 10 to 15 minutes, especially for small diameter vessels. Further, the blood vessel is not attached to the envelope. Thus, the stretched blood vessels can slip off the envelope.

Furthermore, because the envelope is placed on an anatomical support, the whole is damp and slippery and is washed intraoperatively. The downward pressure exerted on the upper surface of the envelope by the stretched blood vessel may exert an eccentric force on the envelope and shift it to one side.

In any of the above disadvantages, the envelope and the blood vessels cannot maintain alignment in order to exert a stretching effect. Such inconvenience was immediately noticed in a simple open incision performed according to the present invention. Therefore, what is more important in the present invention is that the envelope itself has a surface that reduces the above-mentioned disadvantages. Efforts have been made to inflate the envelope for a long time to stretch the blood vessels. However, they were in fact transplants and obstructed the incision. In that case, there is a problem that it is not known until the incision is opened again that the assembly has not been maintained to maintain the correct arrangement. Also, tying blood vessels risks damaging them. The present invention can avoid such danger.

Accordingly, the envelope according to the invention comprises surface means for stabilizing the blood vessel on the envelope so as not to slip off,
The envelope is retained on the anatomical support and is characterized by not slipping or rolling off below the blood vessel.

Other objects, advantages and novel features of the present invention will become apparent from the detailed description of the invention when considered with reference to the accompanying drawings.

EXAMPLE FIGS. 1 to 3 show a blood vessel 10 having a longitudinal axis 11. The blood vessel 10 is a tube having an outer wall 12 through which blood flows and an inner lumen 13. In the initial unstressed state (FIG. 1), the blood vessel 10 is a substrate or anatomical support, such as muscle or bone.
Along 15

The blood vessel 10 is stretched between points A and B. One of these points is that the damaged area 16
Or not too far from the traumatic defect. The lesion 16 is to be resected at planes E and F in FIG. 1 and joined at the ends 17 and 18 of the blood vessel 10.

Stretching occurs along the longitudinal direction at the elongating nodes. As shown in FIG. 1, the initial length between surfaces A and B is indicated by C. In FIG. 2, the length after extension is indicated by D. The difference between the lengths of C and D is the extension required by the present invention. This extension length
It must be at least as long as the node 20 to be resected (the length between planes E and F). After resection of the node 20, the ends 17 and 18 (or the other end of the injured blood vessel 10) are joined. To extend the node AB, as shown in FIG.
Then, the contracted envelope 30 is inserted between the blood vessels 10. Envelope 30
Is made of a material that elastically expands without bursting. For example,
Medical silicone elastomers are preferred. Usually, it consists of the material used for a tissue expander for skin expansion. The envelope 30 has a required plane dimension. What is required from this method is that the envelope 30 generally has a limited width G (see FIG. 4).
And AB have a length of about a straight line distance.

Whatever the initial shape, the envelope 30 will be spherical when inflated and will have no flats. Fig. 4 shows the envelope
Shows 30 preferred shapes. Generally, the envelope 30 is formed into a rectangular shape having a width 31 and a length 32 in a contracted state.

The envelope 30 has a peripheral wall 35 surrounding the inner chamber 36. The filling tube 37 is connected to the inner chamber 36 from the storage section 38 as shown in FIGS. 1 to 7, or to the valve as shown in FIG. The storage section 38 is formed from a material that seals the needle-shaped channel. The volume of fluid injected into the reservoir 38 is equal to the volume entering the expanding envelope 30. Therefore, the expansion rate is known. The fluid withdrawn from the storage section 38 can also cause the envelope 30 to contract, as described below.

FIG. 9 shows another embodiment for the storage section 38. A valve 50 is provided as a self-sealing inlet. The valve 50
Is a crushing pusher that can be self-sealed at the end of the filling tube 37.
The valve 50 has a syringe needle for injecting or flowing fluid.
Stab 51. When the injection needle 51 is pulled out, its flow path is closed. In this sense, the push is a valve. Other valves or valve equivalents can be used in place of the reservoir 38.

Preferably, the envelope 30 is completely flat when contracted as shown in FIGS. 4 and 5, and expands as shown in FIGS. 2, 3, 6, and 7. FIG.

In FIG. 3, the blood vessel 10 has a reference central portion 40,
Note that the envelope 30 has a reference center 41 and a contact center 42 between the envelope 30 and the anatomical support 15. These are arranged in a straight line, and the apparatus operates normally. However, when the blood vessel 10 shifts to one side from a line drawn to the reference center portion 41 and the contact center portion 42, the blood vessel 10
Easily slips off the envelope 30 and does not stretch.

Similarly, if the force exerted by the blood vessel 10 on the envelope 30 deviates from that line, the envelope 30 becomes slippery to one side, and the blood vessel 10 easily slips off the envelope 30.

In addition, since the length of the stretched blood vessel 10 is different from the length of the envelope 30, it is best that the two are relatively displaced from each other along the stretched line.

For this reason, the mounting path 45 is formed on the surface of the envelope 30 so as to have a smooth and stretchable mounting direction with little resistance to sliding of the blood vessel 10.

A surface treatment is applied to each of the side portion 46 and the side portion 47 on the upper surface of the envelope 30 so that the envelope 30 is less likely to slide in the lateral direction. As an example of this, a projection is provided at the edge of the mounting path 45. For this purpose, it is preferable to simply roughen the side portion by spraying with sand or forming with a mold bent with a hammer.

Also, the bottom of the envelope 30 in contact with the anatomical support 15
48 will be treated similarly. Therefore, the blood vessel 10 is stable in a triple structure, and is fixed at the time of extension.

Another embodiment of a surface means for laterally limiting the blood vessel 10 is shown in FIG. The envelope 55 has almost the same characteristics as the above-described envelope 30, and a groove 56 is formed as a “mounting path”. The side walls 57 and 58 on each side of the groove 56 limit movement of the blood vessel 10. Even when the groove 56 is provided, it is preferred to provide surface means on each side and bottom thereof.

In this method, it is best to gradually increase the force in the extension direction while pausing. This has two advantages. One is that by stopping the tension periodically, blood has enough time to flow and escape from necrosis.

A second advantage is that if the blood vessel 10 is stretched and relaxed above its elastic limit and then stretched and relaxed again above its elastic limit, it can remain permanently extended with little trauma.

This criterion can be applied to other organizations of the present invention. Blood vessels
What has been described above for the ten stretches is a general example,
It is not limited.

The blood vessel 10 elongates for about 1 and a half minutes, relaxes for about 1/2 minute, and increases the elongation tension from the previous time four times, so that the initial length of most tissues elongates by about 50%. Can be. When treating tubular tissue, it is desirable to restore blood flow for a short period of time. This can be done by relaxing.

The above method is applicable to stretching any type of tubular tissue. A similar method can be applied to linear tissue with similar results. Generally, the tissue and the envelope are washed to ensure axial freedom of the tissue on the envelope.

The method and its envelope are effective in a first aid surgical environment and are not long term implantable.

It should be understood that the shape of the envelope is arbitrary. In the present invention, the length of the vascular nodes C and D is important.

The present invention is not intended to be limited to the specific embodiments described, but will occur to those skilled in the art from a consideration of the general disclosure, illustrative details, and the claims appended hereto. It is to be understood that all such perverts are covered.

[Effect of the Invention] According to the present invention, the operation time can be significantly reduced. Reducing the time under anesthesia and reducing the chance of bacterial invasion is crucial for the patient and is a significant factor in patient recovery. The inflatable inflatable envelope of the present invention eliminates the need for tissue implantation and can be performed in only about 10 to 15 minutes in emergency surgery.

This device, when used optimally, can stretch and relax tissue at least three times, no matter what the intimal fragments and the products produced by the above forces, and whether they are contaminated with any other fluid. Can be washed. Depending on the situation, it may be extended only once or only twice. In any case, the device allows the tissue to be stretched with little trauma.

[Brief description of the drawings]

FIG. 1 is a longitudinal sectional view showing an envelope according to the present invention arranged to stretch tissue in a contracted state. In the case where the tissue is a blood vessel, FIG. 2 shows the envelope of FIG. 1 expanding and stretching the blood vessel. 3 is a sectional view taken along section line 3-3 of FIG. 2, FIG. 4 is a top view of the contracted envelope of FIG. 1, and FIG. 5 is a view taken along line 5-5 of FIG. FIG. 6 is a sectional view showing the expanded envelope of FIG. 4, and FIG. 7 is a side view taken along the line 7-7 in FIG. FIG. 8 is a partial sectional view showing another embodiment of the surface means for stabilizing a blood vessel, and FIG. 9 is a partial side view and a partial sectional view showing an alternative part of the storage part. 15 ... anatomical support, 16 ... obstacle site, 17 ... end,
18 ... end, 30 ... envelope, 36 ... inner chamber, 37 ... filling tube, 45 ... mounting path, 46 ... side, 47 ... side, 55 ... envelope.

Continuing the front page (72) Inventor Amado Louise-Lazura United States Texas 77002 Houston Labranch 1919 Inside the Saint Joseph Hospital Plastic Surgery Service (72) Inventor Benjamin Emanuel Cohen United States Texas 77002 Houston Suite 920 Calhoun Street 1315 (56) References JP-A-61-268268 (JP, A) JP-A-2-7953 (JP, A) U.S. Pat. No. 4,683,469 (US, A) U.S. Pat. (US, A) US Patent No. 4738657 (US, A) US Patent No. 4666447 (US, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 17/00-17/34

Claims (6)

(57) [Claims] 1. An inflatable tubular or linear tissue expandable envelope having a flexible and resilient outer surface that expands when expanded.
The extending outer surface has a smooth mounting path extending along a predetermined direction, and allows fluid to be freely slid between the tissue and the mounting path. An anti-slip means provided on each side of the mounting path so that the tissue cannot slide freely so as to hold the tissue in alignment with the mounting path; A filling tube communicating with the inner chamber for injecting a fluid into the inner chamber and extracting a fluid from the inner chamber to expand and contract the envelope; and a tubular or linear tissue comprising: Inflatable envelope for stretching. 2. The surface of the envelope which has been subjected to a surface treatment on a side opposite to the surface on which the path is placed so as to prevent sliding between the envelope and an anatomical support on which the envelope is placed. The inflatable tubular or tubular tissue expandable envelope according to claim 1, further comprising: 3. A pierceable storage portion is connected to the filling tube so that fluid can be injected from the storage portion into the envelope and fluid can be withdrawn from the envelope into the filling tube. Item 10. An inflatable envelope for stretching tubular or linear tissue according to Item 1. 4. The inflatable envelope for expanding tubular or linear tissue according to claim 1, wherein a valve is provided on the filling tube so that fluid can be injected and withdrawn. 5. The tubular or linear pipe according to claim 1, wherein the mounting path comprises a groove having a bottom on the outer surface and two side walls, and the side walls serve as the slip preventing means. Inflatable envelope for tissue stretching. 6. An inflatable tubular or linear tissue expanding envelope according to claim 1, wherein said anti-slip means comprises a projection on an outer surface.