JP4097022B2 - Sphincter substitute device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a sphincter substitute device having a function of a sphincter that controls the opening and closing of a tube part of an organ such as the urethra and anus.
[0002]
[Prior art]
[Patent Document 1]
JP-A-3-57448 [Patent Document 2]
JP-A-7-51304 [Patent Document 3]
JP, 2001-161729, A In order to prevent the incontinence etc. which occur by the function fall of a sphincter, the sphincter substitute device attached to a urethra, an anus, etc. is proposed.
FIG. 6 shows a configuration of a sphincter substitute device known as an AMS Sincincter 800, which is a sphincter substitute device using a conventional pump. In addition, [Patent Document 1] describes a sphincter substitute device having the same function as that of the AMS Spincter 800.
[0003]
A cuff K is attached around the urethra 12 connected to the bladder 11, and the urethra 12 is opened and closed by tightening and relaxing the cuff K. The cuff K has a bag-like shape and can be filled with a liquid. The cuff K communicates with the reservoir R through the tube T1, the pump P, and the tube T2. The reservoir R is filled with a liquid. When the liquid of the reservoir R is fed into the cuff K by the pump P, the cuff K tightens and closes the urethra 12 by swelling (expanding). Conversely, when the cuff K liquid is sent to the reservoir R by the pump P, the reservoir R contracts and relaxes, and opens the urethra 12.
The cuff K, tubes T1, T2, pump and reservoir R are embedded in the body.
[0004]
A sphincter substitute device that opens and closes the urethra using a shape memory alloy and a sphincter substitute device that opens and closes the anus using a shape memory alloy have also been proposed (for example, see Patent Document 2 and Patent Document 3).
[0005]
[Problems to be solved by the invention]
A conventional sphincter substitute device using a pump is composed of a large number of parts such as the cuff K, tubes T1 and T2, pump P, and reservoir R, so that it is not easy to be embedded in the body. Further, since a power source for driving the pump is required, the burden of maintenance is large, and a pump switching control means is required to send and suck liquid into the cuff K, so that the apparatus becomes complicated. In addition, since the liquid is moved by the pump, the response speed of opening and closing of the urethra and the like is slowed down.
[0006]
A sphincter substitute device using a shape memory alloy requires a means for heating the shape memory alloy, a heating power source, or a heat source, so that the device is complicated, cumbersome to handle, and a heavy maintenance burden. In addition, the shape memory alloy has a slow response speed for opening and closing the urethra and the like.
[0007]
In view of these problems of the conventional sphincter substitute device, the present invention is a sphincter substitute device that controls the opening and closing of a tube part of an organ such as the urethra. The structure is simple, small, fast and reliable, and easy to operate. Thus, an object of the present invention is to provide a sphincter substitute device that has a simple drive source for opening and closing means such as the urethra and that is easy to maintain.
[0008]
[Means for Solving the Problems]
The present invention sphincter substitute apparatus according to claim 1 for achieving the object is composed of a body of permanent magnet to be moved by the fixed magnetic body and outside of the magnet in the body, said magnetic body and said permanent magnet look narrow tube portion of the organ during said permanent magnet, characterized in that said attracted to the magnetic body to close the tube section, and are attracted to the outside of the magnet and configured to open the tube portion And
Sphincter substitute apparatus according to claim 2 is composed of a body of permanent magnet to be moved by the fixed magnetic body and outside of the magnet in the body, see clamping a pipe portion of the organ between the magnetic member and the permanent magnet The permanent magnet is attracted to the magnetic body to close the tube portion, and is attracted to an external magnet to open the tube portion, and a spacer is provided between the magnetic body and the permanent magnet. It is arranged.
The sphincter substitute device according to claim 3 is the sphincter substitute device according to claim 1 or 2, wherein the extracorporeal magnet is a permanent magnet.
The sphincter substitute device according to claim 4 is the sphincter substitute device according to claim 1 or 2, wherein the extracorporeal magnet is an electromagnet.
The sphincter substitute device according to claim 5 is the sphincter substitute device according to claim 1, 2, 3 or 4, wherein the tube portion is a urethra.
[0009]
DETAILED DESCRIPTION OF THE INVENTION
A sphincter substitute device according to an embodiment of the present invention will be described with reference to FIGS. In addition, the same code | symbol is used for the part common to each figure.
[0010]
FIG. 1 is a view showing a state in which a sphincter substitute device according to an embodiment of the present invention is attached to a urethra, FIG. 1 (a) is a plan view (partially sectional view), and FIG. It is sectional drawing of the arrow direction of the X1-X1 part of 1 (a).
In FIG. 1, 11 is the bladder, 12 is the urethra, 13 is the skin of the body, 20 is the sphincter substitute device, 21 is the case, 22 is the opening of the case 21, 23 is a soft magnetic material, and 24 and 31 are permanent magnets. .
[0011]
The sphincter substitute device 20 includes a case 21, a soft magnetic body 23, and a permanent magnet 24. The soft magnetic body 23 is fixed to the case 21, and the permanent magnet 24 can move in the case 21 in a direction perpendicular to the urethra 12. As installed. The sphincter substitute device 20 is attached so that the urethra 12 passes through the opening 22 of the case 21 and the urethra 12 is sandwiched between the soft magnetic body 23 and the permanent magnet 24. In order for the urethra 12 to pass through the opening 22 of the case 21, the case 21 must be divided into two, which will be described later.
[0012]
Since the permanent magnet 24 is attracted to the soft magnetic body 23 side with the soft magnetic body 23 and the permanent magnet 24 sandwiching the urethra 12, the urethra 12 is pushed by the permanent magnet 24 as shown in FIG. Close to. That is, the sphincter muscle contracts and the urethra 12 is closed. When opening the urethra 12, when the permanent magnet 31 is brought close to the permanent magnet 24 outside the body, the permanent magnet 24 is attracted to the permanent magnet 31 to open the urethra 12. That is, the sphincter is relaxed and the urethra 12 is opened.
[0013]
For example, a plastic such as a silicone resin or a fluororesin can be used for the case 21, and for example, iron, permalloy, or the like can be used for the soft magnetic material.
[0014]
FIG. 2 is a view for explaining opening and closing of the urethra by the sphincter substitute device of FIG.
FIG. 2A shows a state in which the permanent magnet 24 is attracted to the soft magnetic body 23 side and the urethra 12 is closed. In the state of FIG. 2A, when the external permanent magnet 31 is brought close to the permanent magnet 24, the permanent magnet 24 is drawn toward the permanent magnet 31 side to open the urethra 12 as shown in FIG. In the state of FIG. 2B, when closing the urethra 12, if the polarity of the permanent magnet 31 is reversed as shown in FIG. 2C and approaches the permanent magnet 24, both permanent magnets repel each other and become permanent. The magnet 24 is pushed toward the soft magnetic body 23 and is attracted to the soft magnetic body 23 to close the urethra 12 again.
[0015]
2B, when the permanent magnet 31 is moved away from the permanent magnet 24, the permanent magnet 24 is attracted to the soft magnetic body 23 and moves to the soft magnetic body 23 side. In order to ensure this, it is preferable to reverse the polarity of the permanent magnet 31 as shown in FIG. Further, the permanent magnet 24 can be moved in the same manner as in FIGS. 2B and 2C by using an electromagnet instead of the permanent magnet 31 and changing the polarity of the voltage applied to the exciting coil.
[0016]
FIG. 3 shows an example in which the sphincter substitute device of FIG. 1 is composed of two parts.
The sphincter substitute device 20 includes a case 211 and a case 212. The case 211 is formed with a U-shaped opening 221. The case 212 is formed with a U-shaped opening 222 similar to the opening 221. It is. The soft magnetic body 23 is fixed to the case 211, and the permanent magnet 24 is attached so that it can move in the case 212.
[0017]
The case 211 and the case 212 are separated into right and left in FIG. 3, the two cases are brought close together with the urethra 12 sandwiched between the openings 221 and 222 of both cases, and the sphincter substitute device 20 is returned to the state of FIG. 3. Can be attached to the urethra 12.
[0018]
FIG. 4 is an example in which a spacer is disposed between the soft magnetic body and the permanent magnet of the sphincter substitute device of FIG. 1, and 25 is a non-magnetic spacer. 4A shows a state where the urethra is open, and FIG. 4B shows a state where the urethra is closed.
The urethra of a living body is not a simple tube having a complicated structure, but has a mucous membrane 121 inside as shown in FIG. 4 and a urine passage portion 122 through which urine passes at the center of the mucous membrane 121. Therefore, the urethra 12 is closed without pressing strongly as shown in FIG. The diameter of the urethra 12 is about 10 mm in the case of a human being, but when pressed by a permanent magnet 24 about 2-3 mm (if deformed), the urethra 12 is closed as shown in FIG.
[0019]
When the polarity of the permanent magnet 31 is reversed in the state where the urethra 12 is open as shown in FIG. 4A, the permanent magnet 24 moves to the soft magnetic body 23 side by a repulsive force, and moves the urethra 12 through the soft magnetic body 23. It pushes to the side, stops at the position of the spacer 25, and becomes the state of FIG. At this time, if the thickness of the spacer 25 is set so that the deformation amount (movement amount) of the urethra 12 is about 2 to 3 mm, the urethra 12 is closed. Therefore, by changing the thickness of the spacer 25, the deformation amount (movement amount) of the urethra 12 can be adjusted, and the pressing force of the urethra 12 can be adjusted.
In the case of FIG. 4, the pressing force of the urethra 12 can be set to a minimum value necessary for the urethra 12 to close. Therefore, the urethra 12 is pressed more than necessary to cause a blood circulation disorder in the urethra. It can eliminate hurting the urethra.
Although FIG. 4 demonstrated the example which provided the recessed part corresponding to the urethra 12 in the soft-magnetic body 23, it is not necessary to provide a recessed part. The spacer 25 is not limited to a non-magnetic material and may be a magnetic material.
[0020]
FIG. 5 shows an example in which two cases of the sphincter substitute device can be opened and closed by being connected by a pivot member such as a hinge. 5A shows a state before the sphincter substitute device is attached to the urethra, FIG. 5B shows a procedure of attaching the sphincter substitute device to the urethra, and FIG. 5C shows a plane of the inner surface of one case. The figure is shown.
In FIG. 5, 213 and 214 are cases, 215 is a hinge, 216 is a rotating shaft, 26 is a cap, and 217 is a threaded portion.
[0021]
The sphincter substitute case 213 and case 214 can be opened and closed by two hinges 215 and can be opened as shown in FIG. A soft magnetic material 23 and a spacer 25 are fixed to the cases 213 and 214, and screw portions 217 are formed at the ends of both cases.
The cases 213 and 214 are opened as shown in FIG. 5A, and the urethra 12 is fitted into the opening 22 and closed as shown in FIG. In this closed state, the permanent magnets 24 are inserted into both cases, and a cap 26 is attached to both cases to store the permanent magnets 24 in both cases. At this time, the cap 26 is attached by engaging a screw portion (not shown) on the inner surface with the screw portion 217 of both cases.
[0022]
When the cases 213 and 214 are closed as shown in FIG. 5B, in order to keep the distance between the two cases constant, for example, a protrusion having a predetermined height on the lower side of the opening 22 (the side opposite to the hinge 215). May be provided. Further, when the cases 213 and 214 are closed as shown in FIG. 5B, an engaging means may be provided so that both cases do not open (so as not to return to the state shown in FIG. 5A).
[0023]
The screw part 217 is not limited to FIG. 5, and is provided on the inner surface of the case 213, 214, and a screw part is formed on the outer periphery of the cap 26, or a convex part that fits into the case 213, 214 is provided on the cap 26. A screw portion may be formed on the outer periphery of the convex portion. The coupling means between the cap 26 and the cases 213 and 214 may be a friction means (brown shape) instead of the screw means. The caps 26 may be provided not only at one end of the cases 213 and 214 but also at both ends.
[0024]
In the case of FIG. 5, the case 213 and the case 214 are coupled by two hinges 215, so that they can be attached to the urethra 12 simply by opening both cases as shown in FIG. Therefore, when performing an operation for attaching a sphincter substitute device, work in the body with limited space is facilitated.
[0025]
In the above embodiment, an example of opening and closing the urethra has been described. However, the sphincter substitute device of the present invention can be used for an organ in which a tube part such as the external anus of the urethra is opened and closed by the sphincter. The sphincter substitute device of the present invention is not limited to being directly attached to an organ of a living body, but can also be used as an opening / closing means for a tube portion of an artificial organ such as an artificial urethra and an artificial anus made of a tube made of an elastic material.
[0026]
【The invention's effect】
Since the sphincter substitute device of the present invention has a structure in which a magnetic body is fixed in a case and a permanent magnet can be moved so as to be movable, the structure is simple and small. Therefore, the mounting space in the body is reduced and failure is reduced.
Since the sphincter substitute device of the present invention controls the opening and closing of the tube part of the organ such as the urethra by an extracorporeal magnet, it is easy to operate and pushes the permanent magnet toward the magnetic body by reversing the polarity of the magnet to open it. The urethra etc. can be closed reliably. Moreover, since the sphincter substitute device of the present invention uses attraction and repulsion of the permanent magnet, the opening and closing speed of the urethra and the like is increased.
[0027]
The sphincter substitute device of the present invention does not require a power source or the like for driving the opening / closing means such as the urethra when a permanent magnet is used as an extracorporeal magnet. Therefore, maintenance becomes easy.
In the sphincter substitute device of the present invention, when an electromagnet is used as an extracorporeal magnet, the polarity of the magnet can be reversed only by switching the polarity of the excitation power source of the electromagnet with a switch, so that the operation becomes simple. Further, by changing the exciting current of the electromagnet, the attractive force and repulsive force of the sphincter substitute device on the permanent magnet can be arbitrarily adjusted.
[0028]
The sphincter substitute device of the present invention can adjust the pressing force of the urethra etc. by arranging a spacer between the magnetic material sandwiching the urethra and the permanent magnet, and changing the thickness of the spacer. Therefore, it is possible to prevent blood flow disorders such as the urethra and the occurrence of wounds.
[Brief description of the drawings]
FIG. 1 is a view showing a state in which a sphincter substitute device according to an embodiment of the present invention is attached to a urethra.
FIG. 2 is a diagram for explaining the operation of the sphincter substitute device of FIG. 1;
FIG. 3 is a diagram showing an example in which the sphincter substitute device of FIG. 1 is configured by two parts.
4 is a view showing an example in which a spacer is arranged between a soft magnetic body and a permanent magnet of the sphincter substitute device of FIG. 1;
FIG. 5 is a view showing an example in which two cases of the sphincter substitute device are configured so as to be opened and closed by being connected by a pivot member such as a hinge.
FIG. 6 is a plan view of a conventional sphincter substitute device.
[Explanation of symbols]
11 bladder 12 urethra 121 mucosa 122 urinary passage 13 skin 20 sphincter substitute devices 21, 211, 212, 213, 214 case 215 hinge 217 screw part 22, 221, 222 opening 23 soft magnetic body 231 recess 24 permanent magnet 26 cap 31 permanent magnet

Claims (5)

Consists of a body of permanent magnet to be moved by the fixed magnetic body and outside of the magnet in the body, the saw clamping a pipe portion of the organ between the magnetic member and the permanent magnet, the permanent magnet is attracted to the magnetic body The sphincter substitute device is configured to close the tube portion and to be drawn by the magnet outside the body to open the tube portion . Consists of a body of permanent magnet to be moved by the fixed magnetic body and outside of the magnet in the body, the saw clamping a pipe portion of the organ between the magnetic member and the permanent magnet, the permanent magnet is attracted to the magnetic body The sphincter substitute device is characterized in that the tube portion is closed, the tube portion is opened by being attracted by an external magnet, and a spacer is disposed between the magnetic body and the permanent magnet.   The sphincter substitute device according to claim 1 or 2, wherein the extracorporeal magnet is a permanent magnet.   The sphincter substitute device according to claim 1 or 2, wherein the extracorporeal magnet is an electromagnet.   5. The sphincter substitute device according to claim 1, wherein the tube part is a urethra.

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