WO1998027878A1 - A prosthesis for thoracostomy and method for its implantation - Google Patents

A prosthesis for thoracostomy and method for its implantation Download PDF

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Publication number
WO1998027878A1
WO1998027878A1 PCT/BR1996/000070 BR9600070W WO9827878A1 WO 1998027878 A1 WO1998027878 A1 WO 1998027878A1 BR 9600070 W BR9600070 W BR 9600070W WO 9827878 A1 WO9827878 A1 WO 9827878A1
Authority
WO
WIPO (PCT)
Prior art keywords
tubular body
prosthesis
thoracic cage
portion
characterized
Prior art date
Application number
PCT/BR1996/000070
Other languages
French (fr)
Inventor
Luiz TARCÍSIO BRITO FILOMENO
Helena Taeko Tanaka Oyama
Marina Junko Shiotsu Maizato
Original Assignee
Fundação E.J. Zerbini
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 Fundação E.J. Zerbini filed Critical Fundação E.J. Zerbini
Priority to PCT/BR1996/000070 priority Critical patent/WO1998027878A1/en
Publication of WO1998027878A1 publication Critical patent/WO1998027878A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/0247Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3415Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M27/00Drainage appliances for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002Implant devices for drainage of body fluids from one part of the body to another
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B2017/348Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3482Means for supporting the trocar against the body or retaining the trocar inside the body inside
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B2017/348Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3492Means for supporting the trocar against the body or retaining the trocar inside the body against the outside of the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/0247Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A61M2039/0261Means for anchoring port to the body, or ports having a special shape or being made of a specific material to allow easy implantation/integration in the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/0247Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A61M2039/0291Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body method or device for implanting it in the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2210/00Anatomical parts of the body
    • A61M2210/10Trunk
    • A61M2210/101Pleural cavity

Abstract

A Prosthesis for thoracostomy and method for its implantation, said prosthesis comprising a tubular body (10) preferably made of silicone, to be introduced in an opening made in the thoracic cage of a patient. An end of the tubular body (10) incorporates an edge portion (11) to be seated internally to the wall of the thoracic cage, the tubular body (10) being provided along its length with a plurality of external superficial accidents (12), axially and equally spaced relative to each other, and between which is relatively fixed and axially retained a retaining means (20) which is externally seated onto the wall of the thoracic cage.

Description

A PROSTHESIS FOR THORACOSTOMY AND METHOD FOR ITS

IMPLANTATION

Field of the Invention

The present invention refers to a tubular prosthesis to be adapted through the wall of the thoracic cage of a patient, aiming the drainage of the liquids formed and accumulated therein as a consequence of serious pulmonary diseases which cause chronic empyema . The invention still refers to a method for the implantation of the prosthesis.

Background of the Invention

As known in the prior art, the human thoracic cage, where the lungs are accomodated, is internally covered by a membrane called pleura and, under normal health conditions, there is no gap between the pleura and the lungs. However, after serious pulmonary diseases, which reduce the volume of the lungs, the formation and accumulation of pus inside the thoracic cage may occur, more specifically in the pleural space, that is, in the gap formed between the pleura and the reduced lungs, being this problem known in medicine as chronic empyema .

The only way for treating chronic empyema is by providing the permanent drainage of this pus, and for this purpose there are some known techniques.

The first one basically consists in introducing, in the pleural space, a relatively long tube having, in the portion internal to the thoracic cage, a plurality of radial holes through which the pus gets inside the tube, the free end of its external portion remaining submerged in a water seal, i. e. , a container with water or physiological serum.

Thus, the simple pressure difference that naturally exists between the inside of the thoracic cage and the external environment promotes the pus drainage, making it penetrate in the tube through its radial holes and be conducted to the outside up to the water seal. This technique is usually applied with the patient hospitalized. However, when the patient begins to recover, a reduction in the length of the external part of the draining tube is made, by coupling a collecting bag to its end. Nevertheless, this type of drainage, besides presenting a limited efficiency, causes a great discomfort to the patient, who has to live with the umpleasant presence of the collecting bag close to himself .

Other technique used to drain the pleura is known as thoracostomy , consisting in the surgical construction of an opening in the thorax wall, close to the lower end of the thoracic cage. For such, the surgeon, after making an incision from 5 to 8 centimeters in the patient, resects two, three or four rib segments, followed by the resection of the muscle area surrounding said incision, or by the separation of a large skin area and subcutaneous tissue to obtain the epithelization of the thorascostom, that is, the lining of the opening being made by stretching the separated skin and subcutaneous tissue and by introducing these parts into said opening. This type of thoracostomy, although being a procedure of great utility in the treatment of chronic empyemas, with a level of drainage efficiency higher than the technique described above, has some inconveniences, such as being a relatively complex surgical act for the intended function, besides being extremely traumatic for the patient who suffers a lot of pain due to the large opening made, together with the removal of rib portions, skin separation, etc. Such facts result in a relatively long hospitalization, as well as a long post operation recuperation period, with consequent higher costs for this type of surgery. Furthermore, the resultant plastic aspect is extremely unpleasant to the patient, who has to start living with a substantially large opening in his thorax. Disclosure of the Invention

It is a general object of the present invention to provide a prosthesis, which can be applied through the thoracic cage of a patient with a minimum surgical traumatism, assuring an efficient pleural drainage and substantially reducing the esthetic sequels.

It is a further object of the invention to provide a method for the surgical implantation of a tubular prosthesis for thoracostomy. According to the invention, the prosthesis comprises a tubular body, to be introduced in an opening made in the thoracic cage of a patient, comprising open ends, a diameter approximately equal to the average width of a rib and with a length substantially larger than the total thickness of the wall of the thoracic cage, said tubular body incorporating, at one of its ends, at least one external peripheral edge portion to be seated internally to the wall of the thoracic cage and, along its longitudinal length, a plurality of perimetral alignments of external superficial accidents, which are axially and equally spaced relatively to each other; and a retaining means having a lock portion fittable around the tubular body, between any two consecutive external superficial accidents, in a way to restrain the retaining means from moving axially in relation to the tubular body, and a stop portion projecting radially outwardly from and fittable against the external face of the thoracic cage.

According to the invention, the method of prosthesis implantation for thoracostomy comprises the steps of: - Making, in the patient's thorax and close to the bottom of the thoracic cage, an incision with a dimension sufficient to allow the subsequent resection of only one rib portion, defining an opening in said thoracic cage; - Introducing, through said opening, one of the open ends of a tubular body with a length substantially larger than the total thickness of the thoracic cage and seating the edge of said end against the internal face of the severed edges of said rib, so as to restrain said tubular body from moving axially outwardly from the thoracic cage;

Mounting around the portion of the tubular body, which is projected outwardly from the thoracic cage, a retaining means (20) restrained from axial movements relatively to the tubular body and seated against the external face region of the thoracic cage which surrounds said opening for introducing the tubular body ; and

Cutting the portion of the tubular body located externally to the retaining means, in order to adjust the prosthesis according to the wall thickness of the patient's thorax.

The provision of the new prosthesis results in a surgical technique which is extremaly more simple than the classic surgery and substantially less traumatic to the patient, whether on the esthetic point of view, or on the surgical point of view, the latter having positive characteristics, such as using a smaller quantity of anesthesia during surgery, a shorter hospitalization time for the patient, who has less time of post operation recovery and suffers less pain, and finally, lower costs. Brief Description of the Drawings

The invention will be described below with reference to the attached drawings, in which: Fig. 1 is an exploded perspective view of the prosthesis of the present invention;

Fig. 2 is a diametral cross-sectional view of the prosthesis adapted to the thoracic cage of a patient; and

Figs . 3 and 4 are frontal schematic perspective views of the thorax of a patient, whose right lung shows a reduced volume, said figures illustrating the two basic steps of the method for the prostesis implantation. Best Mode for Carrying Out the Invention

According to the attached drawings, the prosthesis in discussion comprises a tubular body 10, which is preferably cylindrical and made of silicone an which is dimensioned to be introduced in an opening provided by surgery in the thoracic cage of a patient, said opening or thoracostom being lined and so permanently opened by the prosthesis . It should be understood that the tubular body 10 may have other transversal sections other than the circular one. The tubular body 10 has open ends, a diameter approximately equal to the average width of a rib and with a length substantially larger than the total thickness of the wall W of the thoracic cage. At one of the ends, the tubular body 10 incorporates at least one portion of an external peripheral edge 11 that in the illustrated embodiment has the form of a continuous flange with a substantially elliptical contour and has a smaller shaft projecting slightly outwardly from the contour of the transversal section of the tubular body 10. This peripheral flange can be replaced by portions of peripheral edges dimensioned to be seated against the internal face of the wall W of the thoracic cage, restraining the tubular body 10 from axial outward movements. In the preferred construtive form, the external peripheral edge portion 11 has a certain flexibility in order to be elastically deformed by the surgeon, in order to reduce its radial length during its introduction inside the thoracic cage. Along its longitudinal length, the tubular body 10 incorporates a plurality of perimetral alignments of external superficial accidents 12, axially and equally spaced relative to each other. In the illustrated embodiment, these external superficial accidents are defined by respective continuous perimetral projecting edges, defining between each other grooves 13, whose bottoms are defined by the external surface of the tubular body 10. It should be understood that the superficial accidents can still be defined by discontinuous projections or depressions, provided that they define accidents against which a retaining means

20 (to be described ahead) can be axially locked.

The retaining means 20 has preferably the form of a circular ring to be adapted around the tubular body 10 of cylindrical form, being the internal contour of the ring dimensioned to fit by elastic deformation between any two consecutive external superficial accidents 12, the external contour being dimensioned in a way to surpass the external contour of the opening of the thoracic cage. Thus, the retaining means can be axially locked around the tubular body 10, in a certain position to be seated against the external face of the wall W of the thoracic cage, affixing the tubular body 10 to said external face. The retaining means 20 may have other forms other than the annular, provided that it comprises a lock portion

21 that can be inserted and axially locked between two external superficial accidents 12 of the tubular body 10, and a stop portion 22, in the form a continuous or discontinuous radial edge, dimensioned to be seated against the external face of the wall W of the thoracic cage .

According to the method of prosthesis implantation, the surgeon makes, in the patient's thorax and close to the bottom B of the thoracic cage, an incision I of sufficient dimension, usually of about 3 cm, for the subsequent resection of only one rib portion R, defining an opening in said thoracic cage. Then, it is introduced through said opening the end of the tubular body 10 provided with the external peripheral edge portion 11, the latter being partially and elastically bent by the surgeon to facilitate the insertion through the wall W of the thoracic cage. When the external peripheral edge portion 11 is released, it returns to its original form and thus it may be seated against the internal face of the wall W of the thoracic cage and more exactly against the internal face of the edges of the severed rib portion R. This arrangement axially restrains the tubular body 10 from moving outwardly from the thoracic cage. Around the length of the tubular body 10 which is projected outwardly from the thoracic cage, the retaining means 20 may be mounted in a position that assures it to be simultaneously axially locked relatively to the tubular body 10 and be seated against the external face of the wall W of the thoracic cage, against the patient's skin.

The portion of the tubular body 10 external to the retaining means 20, illustrated in dotted lines in figure 2, is then eliminated by a simple cut, the prosthesis remaining adjusted to the thickness of the wall of the patient's thoracic cage.

Claims

1. A prosthesis for thoracostomy, characterized in that it comprises a tubular body (10), to be introduced in an opening made in the thoracic cage of a patient, comprising open ends, a diameter approximately equal to the average width of a rib and with a length substantially larger than the total thickness of the wall of the thoracic cage, said tubular body (10) incorporating, at one of its ends, at least one portion of peripheral external edge (11) seated internally to the wall of the thoracic cage and, along its longitudinal length, a plurality of perimetral alignments of external superficial accidents (12), which are axially and equally spaced relatively to each other; and a retaining means (20) having a lock portion (21) fittable around the tubular body (10), between any two consecutive external superficial accidents (12), in a way to restrain said retaining means (20) from moving axially in relation to the tubular body (10), and a stop portion (22) projecting radially outwardly and fittable against the external face of the thoracic cage .
2. The prosthesis, according to claim 1, characterized in that the portion of the peripheral external edge
(11) is selectively and elastically deformable to reduce its radial dimension when introduced inside the thoracic cage of the patient.
3. The prosthesis, according to claim 2, characterized in that the portion of the peripheral external edge
(11) takes the form of a continuous flange.
4. The prosthesis, according to claim 3, characterized in that the portion of the peripheral external edge (11) takes the form of a flange with a substantially elliptical contour with a smaller shaft slightly projecting outwardly from the contour of the transversal section of the tubular body (10).
5. The prosthesis, according to claim 1, characterized in that the external superficial accidents (12) are defined by respective perimetral projecting ridges.
6. The prosthesis, according to claim 1, characterized in that the tubular body (10) is cylindrical.
7. The prosthesis, according to claim 1, characterized in that the tubular body (10) is made of silicone. 8. The prosthesis, according to claim 1, characterized in that the retaining means (20) takes the form of a ring with its internal contour defining the lock portion (21) and dimensioned to fit, by elastic deformation, around the tubular body (10), between two consecutive external superficial accidents (12), and with an external contour defining the stop portion and being larger than the contour of the opening for introducing the tubular body (10) in the thoracic cage. 9. A method for the implantation of prosthesis for thoracostomy, characterized in that it comprises the following steps :
Making in the patient's thorax and close to the bottom (B) of the thoracic cage an incision (I) with a dimension sufficient to allow the subsequent resection of only one rib portion R, defining an opening in said thoracic cage;
- Introducing, through said opening, one of the open ends of a tubular body with a length substantially larger than the total thickness of the thoracic cage and seating the edge of said end against the internal face of the severed edges of said rib R, so as to restrain said tubular body (10) from moving axially outwardly from the thoracic cage;
Mounting around the portion of the tubular body, which is projected outwardly from the thoracic cage, a retaining means (20) restrained from axial movements relatively to the tubular body (10) and seated against the external face region of the thoracic cage which surrounds said opening for introducing the tubular body (10); and
- Cutting the portion of the tubular body (10) located externally to the retaining means (20), in order to adjust the prosthesis according to the wall thickness of the patient's thorax.
AMENDED CLAIMS
[received by the International Bureau on 10 October 1997 (10.10.97); original claims 1-9 amended (3 pages)]
1. A prosthesis for thoracostomy, characterized in that it comprises a tubular body (10), to be introduced in an opening made in the thoracic cage of a patient, comprising open ends, a diameter approximately equal to the average width of a rib and with a length substantially larger than the total thickness of the wall of the thoracic cage, said tubular body (10) incorporating, at one of its ends, at least one portion of flexible peripheral external edge (11) elastically deformed in order to be introduced in the thoracic cage and seated internally to the wall thereof [of the thoracic cage] and, along its longitudinal length, a plurality of perimetral alignments of external superficial accidents (12), which are axially and equally spaced relatively to each other; and a retaining means (20) having a lock portion (21) fittable around the tubular body (10), between any two consecutive external superficial accidents (12), in a way to restrain said retaining means (20) from moving axially in relation to the tubular body (10), and a stop portion (22) projecting radially outwardly and fittable against the external face of the thoracic cage said tubular body (101 being adjustable to the thickness of the wall of the patient's thorax, the portion of the tubular body (10') projecting beyond the retaining means (201 being removable after the mounting of said retaining means (201 in the tubular body (101. 2. The prosthesis, according to claim 1, characterized in that the portion of the peripheral external edge (11) is selectively and elastically deformable to reduce its radial dimension when introduced inside the thoracic cage of the patient. 3. The prosthesis, according to claim 2, characterized in that the portion of the peripheral external edge (11) takes the form of a continuous flange.
4. The prosthesis, according to claim 3, characterized in that the portion of the peripheral external edge (11) takes the form of a flange with a substantially elliptical contour with a smaller shaft slightly projecting outwardly from the contour of the transversal section of the tubular body (10).
5. The prosthesis, according to claim 1, characterized in that the external superficial accidents (12) are defined by respective perimetral projecting ridges.
6. The prosthesis, according to claim 1, characterized in that the tubular body (10) is cylindrical.
7. The prosthesis, according to claim 1, characterized in that the tubular body (10) is made of silicone.
8. The prosthesis, according to claim 1, characterized in that the retaining means (20) takes the form of a ring with its internal contour defining the lock portion (21) and dimensioned to fit, by elastic deformation, around the tubular body (10), between two consecutive external superficial accidents (12), and with an external contour defining the stop portion and being larger than the contour of the opening for introducing the tubular body (10) in the thoracic cage.
9. A method for the implantation of prosthesis for thoracostomy, characterized in that it comprises the following steps:
- Making in the patient's thorax and close to the bottom (B) of the thoracic cage an incision (I) with a dimension sufficient to allow the subsequent resection of only one rib portion R, defining an opening in said thoracic cage;
- Introducing, through said opening, one of the open ends of a tubular body with a length substantially larger than the total thickness of the thoracic cage and seating the edge of said end against the internal face of the severed edges of said rib R, so as to restrain said tubular body (10) from moving axially outwardly from the thoracic cage;
Mounting around the portion of the tubular body, which is projected outwardly from the thoracic cage, a retaining means (20) restrained from axial movements relatively to the tubular body (10) and seated against the external face region of the thoracic cage which surrounds said opening for introducing the tubular body (10); and
- Cutting the portion of the tubular body (10) located externally to the retaining means (20), in order to adjust the prosthesis according to the wall thickness of the patient's thorax.
PCT/BR1996/000070 1996-12-20 1996-12-20 A prosthesis for thoracostomy and method for its implantation WO1998027878A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/BR1996/000070 WO1998027878A1 (en) 1996-12-20 1996-12-20 A prosthesis for thoracostomy and method for its implantation

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/BR1996/000070 WO1998027878A1 (en) 1996-12-20 1996-12-20 A prosthesis for thoracostomy and method for its implantation

Publications (1)

Publication Number Publication Date
WO1998027878A1 true WO1998027878A1 (en) 1998-07-02

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PCT/BR1996/000070 WO1998027878A1 (en) 1996-12-20 1996-12-20 A prosthesis for thoracostomy and method for its implantation

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090205651A1 (en) * 2008-02-19 2009-08-20 Portaero, Inc. One-piece pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
EP3103405A1 (en) * 2015-06-08 2016-12-14 Innovations for Heart and Vessels Sp. z o.o. Device for providing access into heart interior

Citations (8)

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Publication number Priority date Publication date Assignee Title
US3459175A (en) * 1966-04-08 1969-08-05 Roscoe E Miller Medical device for control of enemata
US3856021A (en) * 1973-10-01 1974-12-24 A Mcintosh Device for treatment of bloat of ruminants
US4269184A (en) * 1980-02-28 1981-05-26 Montgomery William W Silicone tracheal cannula
EP0363873A2 (en) * 1988-10-11 1990-04-18 CO PHARMA CORPORATION S.r.l. Device for fastening a catheter to a cranial theca for performing an external cerebrospinal fluid drainage
US5092850A (en) * 1990-11-29 1992-03-03 Buma Shelley J Catheter with adjustable external locking bolster
EP0542428A1 (en) * 1991-10-14 1993-05-19 Dexide, Inc. Trocar instrument
EP0577400A1 (en) * 1992-06-30 1994-01-05 Ethicon Inc. Flexible endoscopic surgical port
DE9405489U1 (en) * 1994-04-02 1995-08-03 Neumann Kurt Medical sluice device as a connection opening of the body outside to the inner structures or body cavities

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3459175A (en) * 1966-04-08 1969-08-05 Roscoe E Miller Medical device for control of enemata
US3856021A (en) * 1973-10-01 1974-12-24 A Mcintosh Device for treatment of bloat of ruminants
US4269184A (en) * 1980-02-28 1981-05-26 Montgomery William W Silicone tracheal cannula
EP0363873A2 (en) * 1988-10-11 1990-04-18 CO PHARMA CORPORATION S.r.l. Device for fastening a catheter to a cranial theca for performing an external cerebrospinal fluid drainage
US5092850A (en) * 1990-11-29 1992-03-03 Buma Shelley J Catheter with adjustable external locking bolster
EP0542428A1 (en) * 1991-10-14 1993-05-19 Dexide, Inc. Trocar instrument
EP0577400A1 (en) * 1992-06-30 1994-01-05 Ethicon Inc. Flexible endoscopic surgical port
DE9405489U1 (en) * 1994-04-02 1995-08-03 Neumann Kurt Medical sluice device as a connection opening of the body outside to the inner structures or body cavities

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090205651A1 (en) * 2008-02-19 2009-08-20 Portaero, Inc. One-piece pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US20090205646A1 (en) * 2008-02-19 2009-08-20 Portaero, Inc. Flexible pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US20090205650A1 (en) * 2008-02-19 2009-08-20 Portaero, Inc. Variable length pneumostoma management system for treatment of chronic obstructive pulmonary disease
US8430094B2 (en) * 2008-02-19 2013-04-30 Portaero, Inc. Flexible pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US8453638B2 (en) * 2008-02-19 2013-06-04 Portaero, Inc. One-piece pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US8474449B2 (en) * 2008-02-19 2013-07-02 Portaero, Inc. Variable length pneumostoma management system for treatment of chronic obstructive pulmonary disease
EP3103405A1 (en) * 2015-06-08 2016-12-14 Innovations for Heart and Vessels Sp. z o.o. Device for providing access into heart interior

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