KR101560477B1 - Artificial bowel sphincter device using artificial bowel extension prothesis and restoration method of anus using the same - Google Patents

Abstract

The present invention relates to an artificial anal sphincter apparatus and a method for restoring an anus using the same, and an artificial anal sphincter apparatus using the implant for a long stomach according to the present invention comprises a long elongated member formed of a biocompatible material anastomosed to a resected intestine, A balloon member installed outside the long elongated member and expanding by air injected into the elongated member to tighten the long elongated member to open and close the long elongated member, and a balloon member having one end communicated with the balloon member, And a catheter connected to the air injection device. The catheter is connected to the air injection device to prevent a tension from occurring in the long anastomosing part by using the long elongated member as a biocompatible implant, The long elongated member is tightened by the balloon member that opens and closes the long elongated member, And can restore the anal function by restoring the anus using the above-described anal sphincter device when it is cured after the perineurysmectomy, and can restore the intestinal function, and the patient can use the artificial anal sphincter device In addition, since the catheter is positioned from the peritoneal cavity to the outside of the patient's body to control the balloon member, it is not necessary to directly pressurize the catheter, thereby preventing erosion or ulceration in the intestines. The risks can also be lowered and hygienically improved artificial anal sphincter devices can be provided.

Description

TECHNICAL FIELD [0001] The present invention relates to an artificial anal sphincter apparatus using an artificial insufficiency implant, and a method of restoring anus using the same. [0002]

The present invention relates to an artificial anal sphincter apparatus and a method for restoring an anus using the same. More particularly, the present invention relates to an artificial anal sphincter apparatus, Device and a method of restoring anus using the same.

Recently, the incidence of cancer patients is increasing due to westernized dietary changes, and the rate of western type cancer such as rectal cancer and colorectal cancer is rapidly increasing year by year due to the change of environment. Most of the patients with colorectal cancer and rectal cancer are treated by surgical removal of the cancerous tissue, and most of the patients are treated with the procedure of making an intestine (anus) in the course of treatment.

In the case of incontinence, various treatments are currently being developed and various treatments using new technology are under development, but in severe cases, there is a case where the operation can not be corrected by the surgical method. Among the surgical methods of fecal incontinence, a device replacing the artificial anal sphincter is commercialized and used for surgery, which is a modification of the balloon-based instrument that has been used for the surgical treatment of urinary incontinence. A rectum with a sphincter - A balloon mechanism is wrapped around the anus, and the ball is inflated by moving the water through the switch to tighten the anus.

However, these devices are commonly used to tighten the intestinal tissue to function as an anal sphincter, but in this case, tissue erosion and ulceration occur, resulting in stenosis, in severe cases, ischemia, The possibility of infection is high. Other than using these artificial devices, there is a method of tightening the sphincter muscle and inducing muscle contraction through electrical stimulation. However, the success rate is rather low and the treatment rate is very low when the disease state is severe.

In addition, in the case of rectal cancer or benign colon cancer surgery, both ends of the remaining intestine should be anastomosed for continuity after resection of the intestine. If the resection margin is large even though the left colon is fully removed, the remaining colon is not sufficiently lowered, If there is tension in the anastomotic site and tension occurs at the anastomotic site, aneurysmal leakage is likely to occur. If leakage occurs, peritonitis may require other procedures or reoperation. In severe cases, sepsis or death may occur However, the leakage of anastomotic leak after cancer surgery slowed the postoperative period of the adjuvant chemotherapy and the immunity was weak, which was a cause of cancer recurrence.

In addition, due to the development of surgical techniques for rectal cancer, it has been possible to perform surgery to restore the anal sphincter muscle even if it is located close to the anal sphincter. However, it is still possible to perform surgery for perforation (including anal sphincter) Surgery, etc.), and in such cases, the patient's discomfort as well as the social life is hindered, and severe cases are treated with mental health medicine.

In addition, in the case of a conventional intestinal tract, which is currently used for various purposes in surgical operations, whether it is temporary or permanent, a portion of the intestine is out of the abdomen and is covered with only one plastic pocket, There was a problem that the smell was severe and the social life was restricted.

Practical New Practice 20-1997-0002898 Japanese Patent Publication No. 3285584

SUMMARY OF THE INVENTION It is an object of the present invention to solve the above-mentioned problems of the prior art, and it is an object of the present invention to provide a balloon expanding device for a balloon catheter, The present invention provides an artificial anal sphincter device capable of restoring an anal function and a method of restoring anus using the same.

It is another object of the present invention to provide an artificial anal sphincter apparatus which can open and close the patient's self-analgesic sphincter apparatus and is sanitarily improved.

In order to accomplish the above object, the present invention provides an artificial anal sphincter apparatus using a prosthesis for an elongated body, comprising: a long elongated member formed of a biocompatible material that is augmented with a resected intestine and stretchable; And a catheter having one end connected to the balloon member and the other end connected to an external air injection device, .

Here, the elongated member is formed of a biocompatible mesh formed of a porcine membrane of a pig or a gore-tex artificial implant.

Here, the inside of the balloon member is made of a stretchable material, and an opening / closing cap is formed at the other end of the catheter.

Wherein the long extension member is closed at both ends and an anvil for mechanical anchoring is provided at one side of the long extension member, the head portion of the anvil is inserted into the long extension member, And a portion extending through the long elongated member so as to be exposed to the outside.

In addition, the anus resection using an artificial anal sphincter apparatus according to the present invention includes a step of removing the left side of the intestine through the intestinal cleansing step and a step of removing the left side of the intestine from the distal end of the intestine Positioning an elongated member formed of a resilient biocompatible material between the resected sacs and performing anastomosis; positioning the anastomotic intestine within the abdominal cavity; The method of claim 1, wherein the intestine is anastomosed between the abdominal cavity and the abdominal cavity. The method of claim 1, The catheter connected to the long elongated member is lifted upward along the peritoneum and the lower abdomen or previously the permanent superstructure is installed The method comprising: through a take-out portion, characterized in that it comprises a step prior to closing the abdominal wall of the stoma site.

The step of performing the anastomosis includes the steps of inserting an anvil into a field opposite to the anus, performing a first mechanical anastomosis using an anvil inserted into the long elongated member by inserting a circular automatic inserter into the anus, And a second mechanical interlocking between the rectum opposite the anus and the long elongated member using an anvil inserted into the opposite side of the anus by inserting a circular automatic inserter again.

According to the artificial anal sphincter apparatus using the implant of the present invention having the above-described configuration, tension can be prevented from occurring in the long ankle joint using the long elongate member, which is a biocompatible implant, The elongated member can function as an artificial anus by the balloon member which expands by the air injected into the elongated member and tightens the elongated member to open and close the elongated member.

In addition, according to the present invention, when an aneurysmal sphincter device is cured after a double-perineal resection, the anal func- tion can be restored in a patient with permanent anastomosis or in a highly annoying patient by the method of restoring the anus using the above- .

In addition, it is possible not only to control the opening and closing of the artificial anal sphincter device by the patient himself, but also to prevent the erosion or ulceration in the intestines since the catheter is positioned from the abdominal cavity to the outside of the patient's body to control the balloon member, And is inserted into the abdominal cavity, so that the risk of infection can be lowered, and a hygienically improved artificial anal sphincter device can be provided.

1 is a view showing an artificial anal sphincter apparatus according to the prior art.
2 is a front view showing an artificial anal sphincter apparatus according to the present invention.
3 is a cross-sectional view of Fig.
4 is a view showing the use state of the artificial anal sphincter apparatus of the present invention.
5A and 5B are views showing another example of an anal sphincter apparatus according to the present invention.
Fig. 6 is an illustration of an anvil and an automatic door anchor for machine anastomosis in the example of Fig. 5;

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, an artificial anal sphincter apparatus using a prosthetic implant according to the present invention will be described in detail with reference to the accompanying drawings.

2 to 6, an artificial anal sphincter apparatus 1 using the implant for vertebroplasty according to the present invention includes a long elongated member 10, a balloon member 20, and a catheter 30 .

The long elongated member 10 is anastomosed to the resected field by cutting the intestine at a position where the intestine is to be formed. The long elongated member is a long elongated member and is configured to be formed of a stretchable biocompatible material.

In the present embodiment, the elongated member may be formed of a biocompatible mesh formed of, for example, a pericardium of pigs. Biocompatible meshes using porcine pericardium have already been known for their properties, so a detailed description thereof will be omitted. In addition, in the present embodiment, the long elongated member may be formed of a polymer synthetic fiber such as a polyester-based, fluororesin-based, polypropylene-based, or polyethylene-based polymer having excellent tissue bonding property, for example, a Gore-Tex artificial implant.

The long elongated member 10 is formed into a cylindrical shape having a diameter substantially equal to the diameter of the anastomotic field.

A balloon member (20) is provided outside the elongate member. The balloon member 20 is formed in an annular shape with an empty interior. The balloon member 20 formed in a ring shape is installed so as to surround a central portion of the elongated member.

The balloon member may be configured such that the inside of the balloon member, that is, the side in contact with the elongate member is formed in a wrinkled shape and is easily configured by the infusion of air, And only the inner side, that is, the side in contact with the elongated member, is configured to be inflatable, and is configured to be inflated only by the infusion of air as described later.

Air is injected into the balloon member 20 through an external air pump or the like through a catheter to be described later, and expanded by the air to be injected. The balloon member is inflated, and the inside of the balloon member is configured to open and close the elongated member by tightening the elongated member by expansion.

A catheter 30 is integrally formed on the balloon member 20. The catheter is formed in a tubular shape, and one end communicates with the balloon member.

The other end of the catheter is provided with an opening / closing cap 31 so that the opening / closing cap can be opened to connect to an external air injection device.

As shown in FIG. 3, the catheter may be composed of a straight tube. However, the catheter may be bent so that the central portion of the catheter may be bent and used by a patient.

5A and 5B are views showing another example of an anal sphincter apparatus according to the present invention. The cochlear implant device according to the present invention may further comprise an anvil 40 for mechanically anchoring the abscissa and the elongated member.

As shown in FIGS. 5A to 6, when the cut length and the long length extending member are to be anastomosed through anastomosis, the long length extending member 10 'is a long length extending member which is not opened at both ends but is closed Prepare. Here, an anvil 40 for mechanical anastomosis is provided at one end of the elongated member 10 ', that is, at a portion connected to the large intestine.

Wherein the anvil is installed such that the head portion of the anvil is inserted into the elongate member and the tube portion of the anvil passes through the elongate member and is exposed to the outside, So that the anastomosis can be easily performed at the head portion of the anvil.

A method of using the artificial anal sphincter apparatus of the present invention having the above-described configuration will be described.

As shown in Fig. 4, the opening and closing cap of the catheter is opened and air is injected through an external air injection device to inflate the balloon member. The long elongated member is tightened by the urging of the annular balloon member in accordance with the expansion of the balloon member so that the long elongated member is in contact with the inner side at the position where the balloon member is installed to close the elongated member. Then, the external air injection device is disassembled and the opening and closing cap is fastened to the catheter to close the balloon member and the catheter to keep the intestine closed.

On the other hand, when the patient wishes to open the bowel, when the opening / closing cap is removed, the air filled in the balloon member is exhausted to the outside, so that the long elongated member in the closed state is opened, And is discharged to the outside through the anus through the member. When the discharge of the intestinal contents is completed, the intestines may be closed again as described above.

The inventive artificial anal sphincter device having the above-described configuration can be installed in a patient who has no response to other treatment methods. In this case, the abdomen is removed from the abdominal cavity toward the anus and descended to the base of the pelvis, the rectum is removed from the base of the pelvis, and the long elongated member is positioned between the rectums.

Here, the intestinal anastomosis can be performed manually and mechanically combined using the anvil and the automatic anomaly described above. Then place the end of the connected catheter in the lower abdomen and close it.

Meanwhile, the artificial anal sphincter apparatus according to the present invention can be installed for restoration of an anus in a patient having permanent peroneal anastomosis after perineural resection. Hereinafter, a method of restoring an anus using the artificial anal sphincter of the present invention having the above-described configuration will be described.

First, the stomach inside the colon is removed by cleaning the bowel before surgery.

Then, the bowel is removed from the distal end of the bowel at a position in the range of 7 to 10 cm before the bowel is inserted into the peritoneal cavity. At this time, care should be taken to preserve the intestinal membrane and prevent ischemia from occurring at the end of the ablation site.

Then, an elongated member formed of a stretchable biocompatible material is placed between the ablated chambers and anastomosis is performed. Here, the reason why the elongated member is provided between the intestine and the intestine in the range of 7-10 cm from the distal end of the intestine is that it is easy to discharge the intestine remaining in the intestine located in the distal portion of the intestine And the artificial anal sphincter device according to the present invention does not come into direct contact with the outside, thereby reducing infection.

The anastomosis can be performed manually, but it can also be easily anastomosed through anastomosis using an elongated member having an anvil as shown in Fig.

When performing an anastomosis, first insert an anvil into the field opposite the anus. At this time, the anvil can be inserted easily because the section opposite to the anus is already cut open.

Then, a circular automatic inserter as shown in Fig. 6 is inserted into the anus, and the first mechanical anastomosis between the anus-side large bowel 2b and the long bow member is performed by using the anvil inserted into the long bowel member.

A circular automatic door machine used for anastomosis of a machine and a machine anastomosis method using the same are already known, so a detailed description thereof will be omitted.

Then, by inserting the circular automatic coupler again, the anastomosis of the rectum and the resected bowel is performed by using the anvil inserted in the opposite side of the anus, to combat the bowel (2a) opposite to the anus and the bow elongate member do.

The anastomotic site is placed in the peritoneal cavity and a hole is made in the anterior anal region to connect the abdominal cavity with the abdominal cavity until the abdominal cavity is connected. When the connection is completed, the prepared end of the large intestine is pulled toward the anus, .

Then, the catheter connected to the long elongated member anastomosing between the colonic resection sites is lifted upward along the peritoneum and taken out through the lower abdomen or the portion where the permanent erectile was previously installed, and the abdominal wall of the previous superficial portion is closed, Restoration of the anus is completed.

Thus, when a cure is completed after a double-perineal resection, the anal function can be restored and the intestines can be restored by the method of restoring the anus using the above-described sphincter apparatus.

Although several embodiments of the present invention have been shown and described, those skilled in the art will appreciate that various modifications may be made without departing from the principles and spirit of the invention . The scope of the invention will be determined by the appended claims and their equivalents.

1: Longitudinal device
10: Long elongated member
20: absence of balloon
30: catheter
40: Anvil

Claims (6)

A long elongated member which is anastomosed to a resected bowel and is formed of a stretchable biocompatible material,
A balloon member installed on the outer side of the elongate member and expanding by the air injected into the elongate member to tighten the elongate member to open and close the elongate member,
And a catheter having one end connected to the balloon member and the other end connected to an external air injection device.
The method according to claim 1,
Wherein the long elongated member comprises a biocompatible mesh formed of a porcine membrane of a pig or a gore-tex artificial graft.
The method according to claim 1,
Wherein the inside of the balloon member is configured to be stretchable,
And an opening / closing cap is formed at the other end of the catheter.
The method according to claim 1,
Wherein the long elongated member is closed at both ends,
An anvil for machine anchoring is provided on one side of the long elongated member,
Wherein the head portion of the anvil is inserted into the elongate member and the tube portion of the anvil passes through the elongate member to be exposed to the outside.
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