WO1993010723A1 - Prothese a ballon pour les poumons, et procedes - Google Patents

Prothese a ballon pour les poumons, et procedes Download PDF

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Publication number
WO1993010723A1
WO1993010723A1 PCT/US1992/010252 US9210252W WO9310723A1 WO 1993010723 A1 WO1993010723 A1 WO 1993010723A1 US 9210252 W US9210252 W US 9210252W WO 9310723 A1 WO9310723 A1 WO 9310723A1
Authority
WO
WIPO (PCT)
Prior art keywords
balloon
prosthesis
chest cavity
lung
subcutaneous
Prior art date
Application number
PCT/US1992/010252
Other languages
English (en)
Inventor
Robert L. Johnson, Jr.
Connie C. W. Hsia
Original Assignee
Board Of Regents, The University Of Texas System
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 Board Of Regents, The University Of Texas System filed Critical Board Of Regents, The University Of Texas System
Publication of WO1993010723A1 publication Critical patent/WO1993010723A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0063—Implantable repair or support meshes, e.g. hernia meshes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/02—Devices for expanding tissue, e.g. skin tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2002/043—Bronchi
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30706—Features concerning an interaction with the environment or a particular use of the prosthesis specially designed for children, e.g. having means for adjusting to their growth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0082—Additional features; Implant or prostheses properties not otherwise provided for specially designed for children, e.g. having means for adjusting to their growth

Definitions

  • This invention relates to prosthetic appliances for humans and other animals, and in particular it relates to a prosthetic device to occupy the chest cavity left vacant after excision of a lung.
  • the prosthesis of this invention performs the separating and supporting functions performed by the lung, without interfering with the performance of the heart or any other organs and without impairing the breathing function of the remaining lung.
  • This invention also relates to a method for making and using such a prosthesis.
  • pneumonectomy The removal of one lung (i.e. pneumonectomy) is a surgical procedure not uncommonly performed for cancer, trauma, or infection of the lung.
  • Prevention of overdistension of the remaining lung after pneumonectomy has been a concern to thoracis surgeons for many years. They anticipated that overdistension would cause distortions of remaining structures inside the thorax leading to abnormal heart and lung function.
  • Many surgical procedures were designed to prevent overexpansion.
  • investigators placed hollow lucite balls in the vacant chest cavities of dogs and humans to prevent overdistension of the remaining lung and to maintain the mediastinum in the midline following pneumonectomy. This work was described in Johnson et al . , Journal of Thoracic Sur ⁇ ery 18:164 (1949).
  • Other substances and devices have been used to replace an excised lung and to correct the problems associated therewith, including gelatin foam, plastic sponge (Ivalon) and a polythene bag filled with fiberglass. Since the early 1960's these procedures have generally been abandoned as unnecessary.
  • tissue expanders Numerous types of tissue expanders have been used by medical practitioners, such as those disclosed in, for example, U.S. Patent Nos. 4,095,295, 4,643,733, 4,800,901, 4,685,446, and 4,969,899. These are all designed for use in muscular and cutaneous tissue and are filled with a fluid or gelatinous material. Ordinary tissue expanders are not well suited for use as lung prostheses, however, because (a) they do not conform to the shape of the lung, so normal anatomy is not restored, (b) they generally contain saline, which is heavy and which does not restore normal compliance around the heart, and (c) they are not expandable to the extent required to permit implantation in a child and subsequent expansion to accommodate normal growth.
  • a lung prosthesis be adapted to permit adjustment to its volume by injection and withdrawal of fluid (liquid or gas) without additional surgery, and that the prosthesis be expandable to permit its use in a growing patient by periodically injecting additional fluid to increase the volume of the prosthesis.
  • the goals outlined above are in large part achieved by the device and method of the present invention.
  • a method of preventing mediastinal shift and overdistension and displacement of the remaining organs after pneumonectomy is provided.
  • the lung prosthesis according to this invention is hollow and lightweight, yet it effectively and compliantly supports the heart and mediastinal structures and inhibits their movement from normal positions, preventing adhesion of the heart to other structures to avoid fibrous encasement of the heart.
  • the prosthesis may be custom molded to fit the chest cavity into which it is intended to be placed and provided with a subcutaneous septal port which allows fluid to be injected into and withdrawn from the implanted prosthesis without additional surgery.
  • An elastic material may be chosen to construct the prosthesis to permit volume changes as the patient grows.
  • the prosthesis may be designed to allow for uniform expansion of the prosthesis to accommodate growth of a young patient while maintaining its anatomically correct shape over a range of volumes.
  • the custom molding method of making a balloon prosthesis comprises obtaining a computer model of the chest cavity the prosthesis is intended to occupy using non-invasive imaging techniques, for example, magnetic resonance imaging or computer to ographic (CT) scanning.
  • CT computer to ographic
  • a three dimensional physical model may be made based on the computer model, from which a mold may be constructed to form the balloon.
  • the computer model may be generated at the hospital or clinic where the patient is examined and transferred to the balloon fabricator, or it may be generated by the fabricator.
  • the invention also includes a method for preventing mediastinal shift and overdistension and displacement of organs following pneumonectomy, comprising providing a prosthetic balloon as described herein, implanting it in a patient following pneumonectomy, filling the balloon with fluid, and adjusting the volume of the balloon as desired.
  • the balloon may be implanted at the time of surgery to remove the damaged lung, and the balloon may be filled to occupy the vacant chest cavity without being under tension and without applying pressure to the adjacent organs and structures.
  • the volume of the balloon may be adjusted without requiring surgery by accessing the subcutaneous septal port of the preferred embodiment with a hypodermic needle and selectively injecting or withdrawing fluid from the prosthesis.
  • the prosthesis may be filled with either gas or liquid.
  • a gaseous filler is desirable so the volume inside the prosthesis can be periodically adjusted, and the gas composition, may be selected to minimize volume change due to transfer of gas across the wall of the prosthesis.
  • the gas may be withdrawn and replaced with a light liquid such as a silicone solution.
  • the present invention therefore provides an improved prosthesis for occupying the vacant chest cavity after a pneumonectomy. It also provides methods for making the prosthesis and for using the prosthesis to prevent or correct mediastinal shift and overdistension of the remaining lung, and to provide a substitute cardiac fossa to compliantly support the heart.
  • the prosthesis of this invention is lightweight and safe, and it can be adjusted after implantation without surgery as necessary to compensate for growth of the patient or other .factors that might alter the shape or volume of the patient's chest.
  • FIGURE 1 is a perspective view of a prosthesis manufactured in accordance with this invention.
  • FIGURE 2 illustrates the prosthesis of this invention in position in a person's chest, with the subcutaneous septal port located on the lower lateral portion of the patient's torso.
  • FIGURE 3 is a block diagram of a method of making a customized prosthesis in accordance with this invention.
  • a hollow balloon-like silicone prosthesis 10 is surgically inserted into the vacant chest cavity of a patient 11 who has undergone pneumonectomy.
  • Balloon 12 of the prosthesis 10 may be sized and shaped to occupy the vacant cavity so a.s to separate and support the walls of the chest cavity and the surrounding organs such as the heart and the remaining lung.
  • balloon 12 may be placed in the vacant chest cavity and filled to a volume necessary to assume the shape and size of the removed lung tissue. The thorax is then closed in layers. Any air surrounding the prosthesis 10 after closure will be resorbed by the patient's body.
  • the prosthesis 10 may be filled with any suitable fluid, either gaseous or liquid.
  • the prosthesis is gas filled, either with air or any other suitable gas or combination of gases. It . has been noted in experimental use of a balloon prosthesis in a dog that when a similar prosthesis is air filled it tends to lose volume due to transfer of oxygen molecules out of the balloon across the silicone membrane of the tested prosthesis.
  • the prosthesis is filled in part with sulfur hexafluoride (SF 6 ) , the large molecules of which are unable to permeate the silicone material of the prosthesis. Experiments have also revealed, however, that when the balloon is filled with SF 6 it tends to gain volume and pressure due to transfer of C0 2 across the silicone membrane into the balloon.
  • SF 6 sulfur hexafluoride
  • the prosthesis is filled with a mixture of air and SF 6 in a proportion that inhibits the prosthesis from either expanding or contracting due to transfer of gasses across the silicone membrane.
  • a preferred proportion of air to SF 6 is approximately 50% air to 50% SF 6 .
  • Light liquids such as silicone, as well as gaseous mixtures of air with other inert gases such as neon and krypton, may also be suitable for inflation of the prosthesis.
  • balloon 12 of the prosthesis is provided with a filling tube 14, the interior of which is in communication with the interior of balloon 12.
  • the tube 14 is placed in the patient's body such that its distal end 22 can be accessed by a physician without major surgery.
  • the distal end 22 may be, for example, extended exterior to the patient's body through an infection resistant cutaneous penetration, or it may be terminated subcutaneously.
  • distal end 22 of tube 14 is connected to a subcutaneous septal port 16.
  • the port is implanted under the patient's skin at an accessible location, and the physician can access the interior of the balloon/tube/port combination by sterilely inserting a hypodermic needle 20 through self-sealing septum 18 of port 16 for injecting and removing gases or other materials from the prosthesis.
  • the septum 18 will typically be self-sealing upon withdrawal of needle 20 therefrom.
  • prosthesis 10 is not under pressure, and the aforementioned access means is sufficient to prevent fluids from unintentionally entering or escaping the prosthesis 10 through septal port 16.
  • balloon 12 is constructed to be slightly larger than the chest cavity it is intended to occupy so that the balloon membrane is not under tension when filled to the selected volume.
  • balloon 12 is constructed approximately 10% larger than the chest cavity it is intended to occupy at the end of a normal exhalation.
  • balloon 12 of prosthesis 10 is designed to permit uniform, shape- retaining expansion.
  • This expandable embodiment is intended for implantation in children and youth, and it allows periodic non-surgical expansion of the prosthesis as the patient grows.
  • regions of the balloon that are under the most stress or strain during expansion may be made . thicker or reinforced with materials such as Dacron. Fluid may be added at a rate commensurate with the rate of growth of the patient's chest cavity.
  • the prosthesis is designed to expand in volume while retaining its overall shape and compliance, so its support function is maintained.
  • pressure relieving means may be provided for relieving excessively high pressure which may build up in the prosthesis 10 under certain unusual circumstances, causing undesirable pressure to be exerted by prosthesis 10 on the organs and structures surrounding the chest cavity. Pressure may be exerted by balloon 12 on the surrounding structures when the patient, for example, enters a region of lower ambient atmospheric pressure, for exampled, when the patient rides in an airplane or travels to high elevations.
  • the pressure relieving means may comprise, for example, a permeable panel in the subcutaneous infusion port which allows excess fluid to bleed into and be absorbed by the surrounding tissues, a pressure relief valve that vents excess fluid into a conduit which penetrates the patient's skin, or a normally empty reservoir bag 23 implanted subcutaneously and in communication with the balloon 12.
  • reservoir bag 23 is normally empty since the mean pressure in balloon prosthesis 12 is generally below ambient atmospheric pressure. However, should the fluid inside balloon 12 expand for any reason, the excess volume will be displaced into reservoir bag 23.
  • prosthesis 10 may be filled with a light liquid, such as liquid silicone, which would obviate the need for periodic volume adjustment and pressure relief means while maintaining the compliance of the prosthesis.
  • a light liquid such as liquid silicone
  • the balloon 12 and tube 14 of this prosthesis can be formed of any suitable bioco patible material, such as, for example, silicone materials, Mylar, and Dacron reinforced silicone material.
  • a material should be chosen which evokes minimal fibrotic tissue response and pleural inflammation, and which is adequately inert to be suitable for long-term implantation.
  • the rates at which the fluids interior and exterior to balloon 12 will pass through the chosen material, by osmosis or otherwise, should be taken into account when choosing the fluid or combination of fluids with which to fill balloon 12.
  • balloon 12 is constructed of silicone material, for example that used by CUI Corp. , Carpenteria, California, with a wall thickness of, for example, approximately 0.5 - 1.5 mm.
  • Filling tube 14 may be constructed of a like material with an interior diameter of 1.0 mm and a wall thickness of 0.5 mm.
  • a suitable subcutaneous septal port 16 is commercially available from CUI Corp.
  • balloon prostheses 10 of the present invention used experimentally in dogs have not experienced fluid influx and have remained gas-filled, although, as discussed above, gas transfer has been observed across the balloon membrane.
  • the balloon prosthesis 10 of this invention can be constructed to precisely fit into the chest cavity of a particular patient by a method for making balloon 12 comprising constructing a model of the patient's chest cavity using imaging means, building a mold for the balloon from the model, and manufacturing balloon 12 from the mold.
  • computerized imaging means 30 which may be, for example, magnetic resonance imaging or computerized tomographic imaging, is utilized to generate a three-dimensional computer model 32 of the patient's chest cavity or of the lung which is to be replaced by the prosthesis.
  • Computer model 32 may be obtained by the prosthesis fabricator from the hospital or clinic where the imaging is performed, or the •fabricator may obtain the imaging data and generate computer model 32 itself.
  • a physical model 34 of the chest cavity or lung may then be constructed from computer model 32 by conventional methods, for example using computerized machining equipment.
  • the computer model 32 may be used to make a plurality of physical "slices" of the computer modeled shape, which slices may be affixed together in proper alignment and orientation to produce a terraced physical model of the computer modeled shape.
  • the terraced surface of the model may then be smoothed by, for example, filling and cutting, to form physical model 34 of the patient's chest cavity.
  • Mold 36 may then be made from physical model 34 by conventional methods, and a custom fitted balloon 12 according to this invention may be constructed in mold 36 by molding methods well known in the art.
  • filling tube 14, septal port 16 and other selected devices, for example, pressure relieving means such as reservoir bag 23, may be attached to balloon 12 to form completed prosthesis 10.
  • a plurality of prostheses over a range of suitable sizes and shapes may be constructed and made available to the physician in a kit, who may then select the appropriate prosthesis 12 from the kit for each patient who requires such a device.
  • inventions disclosed herein are intended for human use as well as for veterinary use.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Dermatology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Pathology (AREA)
  • Transplantation (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Prostheses (AREA)

Abstract

Une prothèse (10) est destinée à remplacer un poumon excisé, et consiste en une structure semblable à un ballon creux (12) et ayant la forme générale du poumon, un tube de remplissage, et un orifice de remplissage. Cette prothèse occupe la cavité de la poitrine laissée vacante après une pneumonectomie afin d'empêcher une distension excessive et un décalage médiastinal ainsi qu'un déplacement du poumon et autres organes restants. Cette prothèse assure également le support élastique du c÷ur et empêche ce dernier d'entrer en contact avec d'autres structures et d'adhérer à d'autres structures dans la cavité pulmonaire. Le volume de la prothèse peut être réglé après implantation sans procéder à une chirurgie postérieure, et ce par l'intermédiaire d'un orifice septal subcutané (16). Une combinaison de gaz est choisie pour remplir la prothèse afin de réduire au minimum la modification de volume due au transfert des gaz à travers la membrane du ballon. L'invention concerne également un procédé de prévention d'une distension excessive et d'un décalage médiastinal ainsi que la prévention du déplacement d'organes suite à une pneumonectomie, en utilisant la prothèse de cette invention, ainsi qu'un procédé de fabrication de cette prothèse.
PCT/US1992/010252 1991-11-27 1992-11-27 Prothese a ballon pour les poumons, et procedes WO1993010723A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US800,509 1977-05-25
US80050991A 1991-11-27 1991-11-27

Publications (1)

Publication Number Publication Date
WO1993010723A1 true WO1993010723A1 (fr) 1993-06-10

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Application Number Title Priority Date Filing Date
PCT/US1992/010252 WO1993010723A1 (fr) 1991-11-27 1992-11-27 Prothese a ballon pour les poumons, et procedes

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AU (1) AU3149593A (fr)
WO (1) WO1993010723A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994016630A1 (fr) * 1993-01-19 1994-08-04 Loma Linda University Medical Center Retracteur endoscopique gonflabe
WO1996012518A1 (fr) * 1994-10-20 1996-05-02 Children's Medical Center Corporation Systemes et procedes de promotion de la croissance de tissus
US6048330A (en) * 1994-10-20 2000-04-11 Children's Medical Center Corporation Systems and methods for promoting tissue growth
US6653525B2 (en) * 2001-01-18 2003-11-25 The Brigham And Women's Hospital, Inc. Prosthetic device for respiratory patients
US10258457B1 (en) * 2018-07-04 2019-04-16 Ghassan E. Jweied Dynamic dual chamber breathing prosthesis and methods

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4044401A (en) * 1975-08-04 1977-08-30 Jacques Guiset Artificial bladder
US4651717A (en) * 1985-04-04 1987-03-24 Dow Corning Corporation Multiple envelope tissue expander device
US4828560A (en) * 1988-02-17 1989-05-09 Mcgman Medical Corporation Spring ring tissue expander
US4969899A (en) * 1989-03-08 1990-11-13 Cox-Uphoff International Inflatable implant

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4044401A (en) * 1975-08-04 1977-08-30 Jacques Guiset Artificial bladder
US4651717A (en) * 1985-04-04 1987-03-24 Dow Corning Corporation Multiple envelope tissue expander device
US4828560A (en) * 1988-02-17 1989-05-09 Mcgman Medical Corporation Spring ring tissue expander
US4969899A (en) * 1989-03-08 1990-11-13 Cox-Uphoff International Inflatable implant

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994016630A1 (fr) * 1993-01-19 1994-08-04 Loma Linda University Medical Center Retracteur endoscopique gonflabe
US5588951A (en) * 1993-01-19 1996-12-31 Loma Linda University Medical Center Inflatable endoscopic retractor with multiple rib-reinforced projections
WO1996012518A1 (fr) * 1994-10-20 1996-05-02 Children's Medical Center Corporation Systemes et procedes de promotion de la croissance de tissus
US5858003A (en) * 1994-10-20 1999-01-12 Children's Medical Center Corporation Systems and methods for promoting tissue growth
US6048330A (en) * 1994-10-20 2000-04-11 Children's Medical Center Corporation Systems and methods for promoting tissue growth
US6287275B1 (en) 1994-10-20 2001-09-11 Children's Medical Center Corporation Systems and methods for promoting tissue growth
US6432081B1 (en) 1994-10-20 2002-08-13 Children's Medical Center Corporation Systems and methods for promoting tissue growth
US6653525B2 (en) * 2001-01-18 2003-11-25 The Brigham And Women's Hospital, Inc. Prosthetic device for respiratory patients
US10258457B1 (en) * 2018-07-04 2019-04-16 Ghassan E. Jweied Dynamic dual chamber breathing prosthesis and methods
WO2020010266A1 (fr) * 2018-07-04 2020-01-09 Jweied Ghassan E Prothèse respiratoire à double chambre dynamique et méthodes associées

Also Published As

Publication number Publication date
AU3149593A (en) 1993-06-28

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