WO1990001346A1 - Dispositif d'aspiration et de reinjection de tissus adipeux - Google Patents

Dispositif d'aspiration et de reinjection de tissus adipeux Download PDF

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Publication number
WO1990001346A1
WO1990001346A1 PCT/EP1989/000907 EP8900907W WO9001346A1 WO 1990001346 A1 WO1990001346 A1 WO 1990001346A1 EP 8900907 W EP8900907 W EP 8900907W WO 9001346 A1 WO9001346 A1 WO 9001346A1
Authority
WO
WIPO (PCT)
Prior art keywords
container
cannula
suction
valve
tissue
Prior art date
Application number
PCT/EP1989/000907
Other languages
German (de)
English (en)
Inventor
Johannes Reinmüller
Original Assignee
Sterimed Gesellschaft Für Medizinischen Bedarf Mbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Sterimed Gesellschaft Für Medizinischen Bedarf Mbh filed Critical Sterimed Gesellschaft Für Medizinischen Bedarf Mbh
Publication of WO1990001346A1 publication Critical patent/WO1990001346A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/89—Suction aspects of liposuction
    • A61M1/895—Suction aspects of liposuction with means for reinjection of collected fat
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/64—Containers with integrated suction means
    • A61M1/66—Pre-evacuated rigid containers, e.g. Redon bottles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/89—Suction aspects of liposuction
    • A61M1/892—Suction aspects of liposuction with treatment of the collected fat
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/08—Lipoids

Definitions

  • the invention relates to a device for suctioning and for re-injection of adipose tissue.
  • the phenotypic appearance of a person is largely determined by the formation and distribution of his fat tissue. Incorrect distributions or other disorders in the build-up of adipose tissue inevitably lead to disorders of the external appearance. It is therefore a goal of medicine to treat the misdistribution of adipose tissue, be it genetically or by internal illnesses or by external influences.
  • the subcutaneous adipose tissue is the goal of such measures.
  • the drop-like or lobular character of the fine structure of the subcutaneous fatty tissue favors this procedure.
  • the suction is carried out by means of a metal cannula, which is inserted through a skin incision into the subcutaneous tissue to be treated.
  • the end of the cannula penetrating the tissue is usually blindly closed and rounded.
  • the wall of the cannula has one or more perforations, the diameter of which corresponds approximately to the inside diameter of the cannula.
  • the other end of the cannula is open and is connected with the help of a connector via a plastic tube with a collecting vessel of 3 to 5 liters.
  • a vacuum pump By means of a vacuum pump, a vacuum is generated in the collecting vessel, which continues through the large-lumen, relatively rigid-walled plastic tube into the cannula.
  • the negative pressure leads to the suction or penetration of adipose tissue particles or drops into the interior of the cannula.
  • the aspirated fatty tissue particles are detached from their connective tissue anchors and sucked through the cannula and the plastic tube in the direction of the collecting vessel.
  • a reduction in the fatty tissue is thus achieved at the site of the surgical procedure.
  • substitution of adipose tissue is to take place locally as a result of adipose tissue atrophy, there is the possibility of obtaining adipose tissue, for example in the area of the lower abdomen, using the above-described method, so that it can subsequently be autologous at a suitable recipient site - ie on the same individual - transferred to.
  • the collection of aspirated fat tissue which is then filled sterile into a suitable syringe, is required under sterile conditions.
  • the fat tissue is usually implanted at the recipient site using large-lumen injection cannulas and a syringe. Since it is extremely difficult to extract lipid tissue under sterile chewing from the collecting vessel near the vacuum pump, special collecting containers according to the type of washing bottle used in chemistry have been developed, which can be inserted between the suction cannula and the collecting vessel. These containers must not leave the sterile area near the operating area during suction. Only then can sterile fat be removed. Due to their design, the vacuum pumps cannot be included in the ster range.
  • US-A-3833000 discloses a pre-evacuable container with a valve and a suction cannula placed on it for carrying out abortions according to the suction method. Non-liquid components of the extracted material are collected in a sack-like insert made of filter fabric.
  • US-A-4568332 describes a hollow handpiece which has a connection for a liposuction cannula and a connection which can be closed by a valve for a vacuum source. As soon as the adipose tissue particles are loosened sufficiently by pushing the liposuction cannula back and forth in the tissue, the valve is opened in order to aspirate the adipose tissue particles.
  • US-A-4753634 discloses a suction device for removing and re-injecting fatty tissue which can be brought in connection with external vacuum sources and which contains a device for washing the fatty tissue and for separating out undesirable constituents of the fatty tissue. The removed adipose tissue is transferred to a syringe for reinjection.
  • FR-AI 2581546 describes a device for liposuction and autologous fat injection. This consists of a cylindrical syringe body m at one end attached suction cannula and a connection for a vacuum pump pe.
  • the suction cannula is replaced by an injection cannula and the connection for a vacuum pump is replaced by a syringe plunger for the auto-injection of the aspirated fatty tissue.
  • a central problem is the maintenance of sterility in the surgical area both with liposuction and with the filling of the material obtained.
  • the slightest bacterial contamination can lead to wound infections in the surgical area with the known consequences.
  • the fillable adipose tissue is particularly susceptible to bacterial infections, since it no longer has to be nourished via its own vascular connections but by diffusion from the environment of the recipient region and is therefore insufficiently protected by the body's own defenses until the development of new vascular sprouts. Any infection of such a fat tissue graft must lead to the purulent dissolution of the transferred tissue and thus to the failure of the operation.
  • Sterility in liposuction is constantly at risk due to conventional methods, mainly due to the spatial separation of vacuum pump and suction cannula. This is due to the design features of the pump, which is placed on its own tripod in the non-sterile area of the operating room due to its external dimensions and because of the mostly high weight (over 10 kg).
  • a voluminous and heavy-weight collecting container is connected to the pump, which for reasons of negative pressure and repeatable sterilizability consists of thick-walled glass.
  • the connection to the sterile surgical field is established by a large-lumen and relatively rigid-walled plastic tube (PVC, inner diameter approx. 3 cm).
  • the length of the hose is usually 3 to 4 for reasons of bridging the border area sterile / non-sterile.
  • the aim of the invention is therefore to make the processes of liposuction and fat filling by reinjection safer from a hygienic point of view and simpler and less expensive from the point of view of handling by the surgeon.
  • a device for suctioning and reinjecting adipose tissue characterized by a vacuum-proof container with a first connecting piece with valve, a liposuction cannula that can be attached to it, an injection cannula that can be attached and a bacteria filter that can be attached.
  • a device according to the invention is preferred in which the container is a barrel solution capacity of 20 to 1000 ml, preferably from 100 to 500 ml.
  • a device according to the invention in which a part of the container is designed as a handle.
  • a device in which a second connection piece, which can be closed with a valve and is equipped with a bacterial filter, is provided, which is attached relative to the first connection piece on the opposite side of the container.
  • a device according to the invention in which the inner walls of the container are coated with lubricants and / or with agents which inhibit the formation of coagulum.
  • the vacuum-proof evacuated container is preferably made of transparent materials. Glass is suitable in principle, however, because of the mechanical properties, which are more favorable for these purposes, sterilisable plastics are preferred.
  • the suitable plastics including their processing into the containers according to the invention are known to the person skilled in the art, for example in connection with the pre-evacuated plastic bottles used for wound drainage (Redon bottles).
  • the capacity of the container is between 20 and 1000 ml, preferably between 100 and 500 ml.
  • the container can be, for example, bottle-shaped, spherical, cylindrical or conical. It is expediently designed so that it is easy for the operator to handle. For this reason, asymmetrical shapes like cup handles are also possible.
  • the first connection piece is molded onto the container and has a length of 2 to 10 cm with a free lumen between 1 and 30, preferably 5 and 15 mm.
  • This first connection piece has a valve which shuts off the interior of the container from the surrounding atmosphere. The valve can be opened and closed again manually, preferably continuously, by the operator during use.
  • valves can be used alone or in combination. Find: clamp closures, slide, two-way valve etc.
  • the valve is integrated in a handle with button-like operation.
  • the suction cannula is placed on the first connecting piece with a valve before liposuction begins.
  • the suction cannulas in question are known to the person skilled in the art. They are between 100 and 500 mm long.
  • the cannula wall has one or more round or oval, heart-shaped or lancet-shaped perforations near the end intended for insertion into the fatty tissue.
  • the end itself is usually closed and designed in a special way approximately beak-shaped, so that no tips or edges arise.
  • the suction cannula consists of a slightly tapered tube, the suction end of which is cut obliquely to the axis at an angle between 20 and 60 degrees, so that the lumen is opened towards the front.
  • the free edges that surround the lumen are crimped into the lumen. There are no further openings in the lumen.
  • This embodiment has the advantage that the adipose tissue is not only sucked in when the suction cannula is advanced, but is also pressed into the lumen by the thrust force. When the suction cannula is pulled back, the flanged edge provides resistance to the elastic restoring forces in the adipose tissue in addition to the suction force.
  • the suction cannula can be made from various mechanically resistant materials: metal, glass, plastics, composite materials. An embodiment in transparent, cold re-formable plastic is preferred. The deformability allows the surgeon to adapt the suction cannula to anatomical conditions, e.g. in the extraction of adipose tissue below the chin from a retroauricular access.
  • the inner diameter of the suction cannula should not be greater than that of the pipe socket or that of the blocking device.
  • the embodiments of the described components of the device according to the invention make it possible to manufacture the parts (containers with connecting pieces, valve, suction cannula, injection cannula and bacterial filter) in an industrially sterile manner as a usable unit.
  • this unit can also be manufactured for single use. This makes complex clocks ⁇ steps and remains' lisa tion for repeated use. Since the container can be vented ready during manufacture of the entire device and that the valve to be closed on the position permanently prevents re-ventilation, the unit can be used by the surgeon according to the invention after sterile delivery directly from the packaging.
  • the extracted fat tissue collects in the container.
  • it is disposed of in accordance with the legal regulations for the disposal of waste in hospitals together with the device according to the invention, which in this case is a device for single use, but is not limited to this.
  • the device according to the invention which in this case is a device for single use, but is not limited to this.
  • it is possible to autologously transplant the fat tissue obtained directly from the container.
  • the new autologous transfer of suctioned adipose tissue is carried out as follows: After the suction cannula has been removed from the wound, the valve is disconnected after the valve is closed, so that no uncontrolled ventilation of the container can take place. A bacteria-proof air filter is then attached to the free end of the valve instead of the suction cannula. When the valve is opened, the aseptic ventilation of the container then takes place. In the next step, with the help of a conventional plastic or glass syringe, air is additionally brought germ-free into the container via the free end of the filter, so that excess pressure, ie an air pressure greater than the atmospheric pressure in the operating room, is generated, up to 2 bar. as a rule, however, lower and around 1.2 bar.
  • valve is then closed again, the air filter is disconnected and a suitable injection cannula is placed on the free end of the valve.
  • liquid or viscous content (aspirated fatty tissue and tissue fluid) can be caused to collect in or in front of the connecting piece.
  • the injection cannula can then be inserted percutaneously into the desired location.
  • dosed opening of the valve the one prevailing in the container Overpressure the previously aspirated fatty tissue is expelled into the recipient tissue in a sterile manner.
  • the valve is closed and the injection cannula is withdrawn.
  • the device shafts are cleaned and resterilized according to the known rules of hygiene.
  • a second connection piece with valve can be provided on the container.
  • This second connecting piece can - after interposing a bacteria-proof air filter - regardless of the dismantling of the suction or injection cannula, both a ventilation and a ventilation of the container can be performed. This is particularly important if, due to incorrect operation of the valve at the end of the cannula, air inadvertently gets into the container or has escaped from it.
  • a second valve on the container can also be meaningfully combined with the parts of an existing conventional suction device.
  • the container in this case serves as a rechargeable vacuum container.
  • the repeated charges in the course of major surgical interventions can then take place by means of the conventional vacuum pump via the known hose and the second valve according to the invention on the container.
  • the advantage of this procedure is the greater freedom of movement for the surgeon (without the permanent disability due to a hose), the improved hygiene and the protection of the vacuum pump, which only has to be activated briefly during the charging process.
  • Coating can be considered: hydrogels, methyl cellulose, gelatin, oils, waxes, albumins, glycosaminoglycans (hyaluronic acid), heparins.
  • the coating can be carried out by simple physical adsorption or by chemical bonding.
  • Protective substances can be: glucose, antibiotics, buffer substances, enzyme inhibitors, especially protease inhibitors, emulsifiers, oxidants, reducing agents, dimethyl sulfoxide, complexing agents (EDTA), heparins, hyaluronic acid, hydrolases (hyaluronidase, collagenase), peptides, hormones, growth factors (EGF, FGF, IGF, PDGF), specialties for freezing, such as the substance RPMI 1640, etc.
  • enzyme inhibitors especially protease inhibitors, emulsifiers, oxidants, reducing agents, dimethyl sulfoxide, complexing agents (EDTA), heparins, hyaluronic acid, hydrolases (hyaluronidase, collagenase), peptides, hormones, growth factors (EGF, FGF, IGF, PDGF), specialties for freezing, such as the substance RPMI 1640, etc.
  • Fig. 1 shows a schematic cross section through a device for liposuction.
  • Fig. 2 is a section along the line II-II in Fig. 1.
  • Figs. 3 and 4 show parts of a device for liposuction.
  • the vacuum-proof container 1 shown schematically in cross section in FIG. 1 has a first connecting piece 2 at the patient end.
  • This connection piece 2 can be shut off by a valve 3.
  • a liposuction cannula 4 is placed on the connecting piece 2.
  • This liposuction cannula 4 can be exchanged for a bacterial filter 6 and an injection cannula 5.
  • Fig. 2 which shows a section along the line II-II in Fig. 1, it can be seen that the vacuum-proof container has a handy shape, as it e.g. is known from the housing of hand mixers.
  • the upper part of the container 1 is designed as a handle 11.
  • the pressure indicator 7 can e.g. be designed as a bellows.
  • FIG. 4 shows a cross section through the end of the vacuum-proof container 1 remote from the patient with a second connecting piece 8 which can be closed by a valve 9.
  • the end of the second connecting piece 8 near the examiner is provided with a bacterial filter 10. Due to the bacterial filter 10, the bacterial filter 6 which can be placed on the connecting piece 2 is unnecessary.
  • the order of valve 9 and bacterial filter 10 relative to container 1 can also be reversed.

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biomedical Technology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgery (AREA)
  • External Artificial Organs (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)

Abstract

Un dispositif d'aspiration et de réinjection de tissus adipeux comprend un récipient (1) fermé sous vide hermétiquement pourvu d'une première tubulure de raccordement (2) avec une soupape (3), une canule (4) pour aspirer la graisse, une canule d'injection (5) et un filtre de bactéries (6) qui peuvent être fixés sur la tubulure (2). Ce dispositif permet d'exécuter des opérations d'aspiration de graisse et de remplissage avec de la graisse de manière plus sûre du point de vue hygiénique et de manière plus aisée et économique du point de vue de la manipulation.
PCT/EP1989/000907 1988-08-04 1989-08-02 Dispositif d'aspiration et de reinjection de tissus adipeux WO1990001346A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DEP3826484.6 1988-08-04
DE3826484 1988-08-04

Publications (1)

Publication Number Publication Date
WO1990001346A1 true WO1990001346A1 (fr) 1990-02-22

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1989/000907 WO1990001346A1 (fr) 1988-08-04 1989-08-02 Dispositif d'aspiration et de reinjection de tissus adipeux

Country Status (1)

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WO (1) WO1990001346A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107641595A (zh) * 2017-08-15 2018-01-30 中国人民解放军第二军医大学第二附属医院 关节镜下获取无菌膝髌下脂肪垫组织提取装置及方法
CN109876201A (zh) * 2019-03-07 2019-06-14 杭州百桥医疗技术有限公司 一种自体脂肪抽吸、纯化、精准注射与安全监测系统
CN110523491A (zh) * 2019-09-30 2019-12-03 中南大学湘雅医院 一种脂肪切割器

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH496482A (fr) * 1969-08-07 1970-09-30 Lugon Georges Procédé pour recouvrir la paroi interne d'un récipient d'une couche de fines particules séparées d'au moins un produit chimique
US3939835A (en) * 1972-06-02 1976-02-24 Henry Bridgman Medical aspiration system vacuum level indicator
FR2389422A1 (en) * 1977-05-02 1978-12-01 Rigollot Annie Keeping a dispensable liq. sterile by enclosing in a valved dispenser - esp. for rinsing contact lenses
DE8530626U1 (de) * 1985-10-29 1986-02-27 CYTOMED Medizintechnik GmbH, 8750 Aschaffenburg Entsorgungsbehälter bei medizinischen Behandlungen
FR2581546A1 (fr) * 1985-05-10 1986-11-14 Medicalex Seringue-canule a aspiration et injection

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH496482A (fr) * 1969-08-07 1970-09-30 Lugon Georges Procédé pour recouvrir la paroi interne d'un récipient d'une couche de fines particules séparées d'au moins un produit chimique
US3939835A (en) * 1972-06-02 1976-02-24 Henry Bridgman Medical aspiration system vacuum level indicator
FR2389422A1 (en) * 1977-05-02 1978-12-01 Rigollot Annie Keeping a dispensable liq. sterile by enclosing in a valved dispenser - esp. for rinsing contact lenses
FR2581546A1 (fr) * 1985-05-10 1986-11-14 Medicalex Seringue-canule a aspiration et injection
DE8530626U1 (de) * 1985-10-29 1986-02-27 CYTOMED Medizintechnik GmbH, 8750 Aschaffenburg Entsorgungsbehälter bei medizinischen Behandlungen

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107641595A (zh) * 2017-08-15 2018-01-30 中国人民解放军第二军医大学第二附属医院 关节镜下获取无菌膝髌下脂肪垫组织提取装置及方法
CN107641595B (zh) * 2017-08-15 2023-03-21 中国人民解放军第二军医大学第二附属医院 关节镜下获取无菌膝髌下脂肪垫组织提取装置及方法
CN109876201A (zh) * 2019-03-07 2019-06-14 杭州百桥医疗技术有限公司 一种自体脂肪抽吸、纯化、精准注射与安全监测系统
CN110523491A (zh) * 2019-09-30 2019-12-03 中南大学湘雅医院 一种脂肪切割器

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