SI9600124A - Prosthesis for bowel evacuation control - colostomy tube - Google Patents

Abstract

The problem which is solved by a prosthesis for bowel evacuation control at the incontinence of an artificial or natural anus in accordance with the invention is how to provide simple, safe and reliable control of bowel evacuation in artificial or natural incontinence, where under artificial incontinence colostomy, i.e. a surgically formed opening in the large intestine through the abdominal wall is understood, and under natural incontinence the incontinence of the anal sphincter is understood. The illustrated prosthesis inserted in a colostomy, i.e. a bowel (1) extended through the abdominal wall (2), consists of an inner ring (3) which continues into a pellicular tube (4) and this into a faceplate (5), and of a cover (8). In this embodiment the inner ring (3) is carried out as a ring made of pliable, organism-friendly material with a built-in reinforcement (9) providing a sufficient force for reexpansion of the ring (3) and preventing its deformation when being inserted into the bowel lumen. The inner ring (3) continues along its entire circumference into the tube (4) whose thin walls are made of a material with similar characteristics as the inner ring (3). The diameter of an unstretched tube (4) is a little smaller than the diameter of the inner ring (3). The length of the tube (4) in this embodiment is a little smaller than the thickness of the abdominal wall (2). At the end lying opposite to the inner ring (3) the tube (4) continues into a faceplate (5) which is preferably of circular form and made of firm material or dimensioned so that it is firm yet pliable. The plate (5) has an opening in the centre in which the cover (8) is inserted which prevents the faeces from escaping.

Description

The subject of the invention is a prosthesis designed to control the incontinence of the artificial and natural bowel output and to solve the problems of rectal prolapse. The bowel incontinence prosthesis according to the invention provides an easy, safe and reliable control of excretion in artificial or natural incontinence.

A problem that has not yet been satisfactorily solved and solved by a prosthesis for the control of bowel output incontinence according to the invention is a simple, safe and reliable excretion control for artificial or natural incontinence and for problems with rectal prolapse, which is understood as artificial incontinence of the stoma, ie. surgically shaped opening of the large intestine through the abdominal wall and as a natural incontinence of the anal sphincter.

The problem described so far has been addressed in several ways. The most common way to care for stoma is to collect gut secretions with adhesive bags on the skin - self-adhesive bags or bags with a skin lining. One of the methods is irrigation or self-listing of the stoma. There is also a method of stopping the intestinal outlet with a plug of material that, when moistened, expands and closes the outlet.

Technically more complex solutions to the problem of artificial incontinence are roughly divided into four groups.

The first group includes various types of adhesive bags that are glued to the skin, ie self-adhesive sealed bags and discharge bags. The disadvantage of these solutions is skin irritation beneath the sticky surface. Newer solutions in this group are two-part systems, with the skin lining with the shutter permanently attached to the skin and the bag being interchangeable.

The second group includes devices or devices. closures that can be inserted into the gut. This includes e.g. inflatable balloon that acts as a closure buffer and lies in a column and is described in Tenney JB's article, Graney MJ: The quest for continence: A morphologic survey of approaches to a continent colostomy. Dis Colon Rectum 1978; 21: 552. Another solution in this group is the so-called control knob, which consists of a rubber plug and an aluminum leather panel. The solution is described in U.S. Pat. No. 2 510 766. A third characteristic solution in this group is a colostomy plug, commercially known as Conseal. It is made of an adhesive base plate and colostomy plug. A retention ring is embedded in the normal skin lining as in the two-piece bag system. Instead of the collecting bag, the stud on the washer in the washer is closed. The plug is made of polyurethane foam and wrapped with a thin film that squeezes that foam. Under the influence of moisture in the gut, a thin layer of the lining dissolves, the plug opens and gets a bell-shaped shape with a wide part in the gut. Once the plug is removed, a simple collection bag can be fitted in place of it, which seals on the integrated ring. The solution is described in part Burchart F, Ballan A,

-2Kyllberg F, Rasmussen SN. The colostomy plug is a new disposable device for continent colostomy. I_ancet1986; 2: 1062.

The third group is a combination of surgery and a passive implant. Typical solutions in this group are the magnetic shutter, commercially known as the Maclet System, and the Prager locking plug, where the inner ring is operatively sewn around the bowel and an inflatable balloon is inserted through the anus preterm, which rests against the ring.

The last group are artificial sphincters, namely Buuck's patent, Giori's patent, Summes's patent, the circumferential balloon sphincter proposed by Heilblum and Cordoba, and the Szinicz sphincter.

Directions for resolving the problem of natural incontinence are surgical, with the insertion of mechanical support and techniques to promote muscle activity.

The aforementioned known state shows that the problem of simple, safe and reliable excretion control in artificial or natural incontinence and problems with rectal prolapse has not been satisfactorily solved since it irritates the solutions by gluing the lining to the skin, and the collection and drainage bags are annoying for the user. The problem with all types of plugs is that they need to be constantly pulled out and inserted into the stoma or. anus directly, which is uncomfortable and can damage the gut.

The object of the invention is to avoid the stated disadvantages of the known solutions and to enable simple, safe and reliable control of excretion in artificial or natural incontinence and problems with rectal prolapse.

According to the invention, the problem is solved by a prosthesis for controlling the incontinence of the intestinal outlet according to the marking part of the main patent claim, which enables simple, safe and reliable control of excretion in artificial or natural incontinence.

The invention will be described on embodiments and drawings showing:

Figure 1 is a first embodiment of a prosthesis in a stoma;

Figure 2 is another embodiment of a prosthesis in a stoma;

sketch 3 depicting a deformed lid sketch 4 depicting a deformed lid upon insertion sketch 5 depicting a deformed inserted lid sketch 6 depicting a deformed lid upon withdrawal

The prosthesis for controlling the incontinence of the intestinal outlet according to the first embodiment according to Fig. 1, showing the prosthesis inserted into the colostomy, i. into the intestine 1, through the abdominal wall 2, consists of bursting the anchor bead 3, which continues into the sleeve 4, the support plates 5 and the cover 8. In this embodiment, the bead 3 is made as a ring made of an elastic, organism-friendly material having its

The interior 9 is made as a narrow spring ring, preferably of thermoplastic. The armature 9 prevents the spatial deformation of the buccal 3, but enables a plane, which is important for insertion of the prosthesis into the stoma and will be further described. At the same time, the armature 9 provides sufficient opening force for the bucket 3, which is important for safe anchoring and sealing. The bead 3 extends throughout its circumference in one piece into a sheath sleeve 4, which is made of thin-walled material of the same or similar properties as the bead 3. The diameter of the non-soaked sleeve 4 is slightly smaller than the diameter of the bead 3. The length of the sleeve 4 is slightly less than the thickness of the abdominal wall 2. The abutment plate 5 is preferably centered on the skin of the abdominal wall 2, which is preferably circular in shape and is made of a firmer material or is dimensioned so that it is firm but still elastically flexible. The plate 5 has an opening made in the center in the form of a bent 6, which at the same time forms a ring bearing 7. In the opening, that is, under the bends 6, according to the drawing 1, a cover 8 is inserted which prevents the sludge from leaving. It is understood that instead of the cover as shown in figure 1, the opening can be inserted into the opening 6, e.g. gas-permeable lid with integrated filter, with connection to collecting or drainage bag, for irrigation, etc.

The prosthesis of the invention according to the first embodiment is used to assemble the sleeve 4 and the plate 5 with respect to the thickness of the abdominal wall 2 by dragging through the aperture of the plate 5 the opposite end of the sleeve 4, which is wound over a curved 6 such that it is recessed into bay 7. Thereafter, the jug 3, e.g. diametrically squeezes with the thumb and index finger and pushes longitudinally into the gut 1 under the abdominal wall 2 so that the sleeve 4 is facing the opening and the plate 5 is out of the gut 1. The inserted bead 3 is opened in the gut 1 under the abdominal wall into a ring . The elastic sleeve 4 thus simultaneously presses the suture 3 against the wall of the intestine 1 along the inside of the abdominal wall 2, thereby allowing reliable anchoring and sealing and holding the plate 5 on the skin. This creates a simple, safe and reliable stoma discharge that is both replaceable and hygienic.

The prosthesis for controlling the incontinence of the artificial and natural intestinal outlet according to the second embodiment according to Fig. 2, showing a prosthesis inserted into a colostomy, i.e. into the intestine 1 through the abdominal wall 2, consists of an anchor bead 3, which continues in one piece into a sleeve 4, which in one piece into a support plate 5 and a cover 8. A bead 3 with armature 9 is made in the same way as in the first embodiment case. The bead 3 extends throughout its perimeter into a membrane 4 which is thin-walled from a material having the same or similar properties as the bead 3. The diameter of the bead 4 is smaller than the diameter of the bead 3. The length of the bead 4 is less than the thickness of the abdominal wall. the bead 3 at the opposite end, the sleeve 4 extends in one piece into a support plate 5, preferably circular in shape, made of a firmer material or dimensioned to be rigid but still elasticly flexible. Plate 5 is open in the middle. In its initial part, that is, just after the passage of the sleeve 4 into the plate 5, the plate 5 has a circular groove 10 in its inner circumference in the opening, 10 according to the drawing 2, which prevents the exit of the sludge by sliding into the groove 10.

The prosthesis of the invention according to another embodiment is used such that jug 3 e.g. squeezes diametrically with thumb and index finger, pushes longitudinally into gut 1 below abdominal wall

-42 so that the sleeve 4 faces the opening. The inserted beetle 3 in the intestine 1 under the abdominal wall 2 opens into a ring, and the plate 5 contacts the skin centrally on the stoma. The elastic sleeve 4 thus simultaneously presses the bucket 3 against the wall of the intestine 1 along the inside of the abdominal wall 2, thereby allowing it to anchor and seal, and hold the plate 5 on the skin. This creates a simple, safe and reliable stoma discharge that is both replaceable and hygienic.

In both embodiments, the lid 8 of Figure 3 is preferably constructed as a hollow snap plug with relatively thin walls and made of a flexible but sufficiently rigid material. The cover 8 is basically a spindle shape, the bottom 11 being slightly conical and extending into the snap ring 12. The height of the circumference 14 is slightly larger for use in the first embodiment of the prosthesis and smaller for use in the second embodiment of the prosthesis. The top of the lid 8 is folded into the cap 13. The meaning of such construction will be described below with the help of sketches 4, 5 and 6. As previously described, the lid 8 can be further equipped with filters, or replaced with a collector or drainage bag attachment, for irrigation etc.

Figure 4 shows the deformation of the cover 8 upon insertion into the opening of the plate 5. The deformed structure of the cover 8 due to deformation causes the diameter of the bottom 11 and the ring 12 to be reduced, thereby facilitating the insertion of the cover 8 into the opening of the plate 5.

Figure 5 shows the deformation of the inserted cover under the influence of the pressure P of the sludge on the bottom 11. The described construction of the cover 8 in this case causes an increase in the diameter of the bottom 11 and the ring 12, and thus the forces B, and the firm engagement of the cover 8 in the opening of the plate 5 or its groove 10.

Figure 6 shows the deformation of the cover 8 as it is pulled out of the opening. The edge of the cap 13 provides a simple and firm grip with the fingers. When the force F at one point pulls the lid 8 out of the opening of the plate 5, the lid 8 is deformed so that the ring 12 pops out of the opening, thereby facilitating the removal of the lid 8.

The prosthesis for controlling the incontinence of the natural anus is basically the same as described above, except that the geometry of the plate 5 and the lid 8, and thus partly of the sleeve 4, is adapted to the geometry of the tissue to which the plate 5 rests.

All elements of the incontinence control prosthesis are made of elastic materials that must meet medical needs. Latex and silicone proved to be the most suitable.

Claims (5)

PATENT APPLICATIONS A prosthesis for controlling the incontinence of the artificial and natural intestinal outlet, characterized in that the annular bead (3) passes into a narrow thin-walled sleeve (4), which is detachably or inseparably connected to the washer plate (5) on the opposite side; in the bead (3) the armature (9). 2. Intestinal bowel incontinence check prosthesis according to claim 1, characterized in that the armature (9) is constructed as a narrow and relatively high spring ring. Intestinal bowel incontinence exit prosthesis according to claim 1, characterized in that the plate (5) in the middle has an opening made in the form of a curvature (6), which at the same time forms an annular bearing (7). A bowel outlet incontinence prosthesis according to claim 1, characterized in that at the opposite end of the bumblebee (3), the sleeve (4) extends in one piece into a support plate (5) which is centrally open and has at its initial work a circular groove (10) along its inner circumference in the opening. A prosthesis for checking the incontinence of the intestinal outlet, characterized in that the lid (8) is a hollow locking pin, the bottom (11) being slightly conical and extending into the locking ring (12) and the tip being folded into the cap (13) .