WO2002083012A1 - Device for excision of a fistula - Google Patents
Device for excision of a fistula Download PDFInfo
- Publication number
- WO2002083012A1 WO2002083012A1 PCT/TR2001/000015 TR0100015W WO02083012A1 WO 2002083012 A1 WO2002083012 A1 WO 2002083012A1 TR 0100015 W TR0100015 W TR 0100015W WO 02083012 A1 WO02083012 A1 WO 02083012A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- guide
- fistula
- spherical
- shaft
- fixing
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00305—Constructional details of the flexible means
- A61B2017/00309—Cut-outs or slits
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00305—Constructional details of the flexible means
- A61B2017/00314—Separate linked members
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2905—Details of shaft flexible
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
- A61B2017/320032—Details of the rotating or oscillating shaft, e.g. using a flexible shaft
-
- 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
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
Definitions
- the present invention pertains to a surgical instrument for excising and removing a fistulous tract from the canal, and in particular, for treating anal f ⁇ stulae by performing a minimally invasive operation in an efficient manner and within a short time.
- Anal fistulae can be divided into two categories: simple (which can be treated with fistulectomy) and complicated (where fistulectomy is contraindication).
- Simple fistulae can be easily treated by performing fistulectomy and then letting the secondary healing.
- Treatment methods employed for treating complicated fistulae include application of seton or performing periodic surgical operations to incise the fistulous tract. Said methods take a long time, cause many difficulties for the patient, and most of the time, turn out to be unsuccessful.
- Treatment of a fistula requires to open the bleeding tissue to the fistulous tract for the purpose of removing dead tissues from the fistulous tract, removing the secreting mucosa, and moving the granulation tissue to fill the tract.
- the foregoing objects can be achieved by performing fistulectomy on a simple fistula, but fistulectomy is not performed on complicated fistulae, otherwise it will cause anal insufficiency. Therefore, the seton method is employed for incising the muscle tissue in stages within a long time and for letting it heal. Seton is applied for the expectation that the granulation will develop thanks to the excite starting when the living tissue is incised and then will fill the fistulous tract. This method is not necessarily successful for al cases, and can lead to a particular loss of continence. Therefore, the present device is significantly needed to treat such kind of fistulae.
- the present device incises the dead tissues and fibrous structures having developed secretory epithelium from the fistulous tract, and removes them from the environment.
- the edge of the fistulous tract is equipped with viable tissues which activate the excited granulation, so that the granulation starting there fills the fistulous tract and ensures treatment of it.
- the present invention is an instrument capable of overcoming all kind of problems associated with treatment of fistulae. It can be easily used for all perianal fistulae. It turns a risky operation into a simple one especially for complicated fistulae, and ensures them to heal in a short time.
- An operation made by using the present invention will both protect the anatomic and physiological characteristics of the perianal tract, and meet the surgical principles needed for treatment of fistulae.
- the present invention is a device generating an axial circular rotational movement through an electric motor, conveying said movement by means of a spherical shaft or a tubular shaft to its incision end in a manner fully controlled in three dimensions, as directed by its guide, and ensuring the cutting end to incise for the purpose.
- the present invention is a fistulectomy set consisting of cannulation guides, fixing guides, a cutting end, a spherical or tubular shaft , a movement control and stabilization part, a mavement conveying element, and a handle (motor housing).
- Fig.l Fistulectomy performed on an extra-sphincteric fistula and view of an supra-sphincteric fistula.
- Anal fistulae generally begins on the crypts above the dentate line (7), passes through the tissue and ends on the perineum skin (9).
- an inner opening can form on the upper sections of the rectum (10b) or on the sigmoid colon (10c), The more the fistula' sopening in the perineum (13) moves away from the anus (6) , the more the fistulous tract gets complicated.
- No fistulectomy can be performed on fistulae whose tract passes outside the internal sphincter (4) and external sphincter (5).
- the present invention contains a shaft system (36,39) enabling it to proceed along such complicated fistula tract.
- Fig.2 Fistulectomy performed on an supra-sphincteric fistula and view of an extra-sphincteric fistula.
- Supra-sphincteric fistula begins on the perineum (13) at a point far from the anus (6), pierces through the pubo-rectal muscle (11) and ends on the upper section (10b) of the rectum. It cannot be treated with fistulectomy, because the latter will damage the pubo-rectal muscle (11) and give way to incontinence. It is apparent that the present invention is able to incise said fistula in a simple way (10b), from the perineum (9) to the internal opening.
- Fig.3 View of cannulation of the tract by means of the cannula guide (15), beginning on the external opening of the perineum (6) and proceeding up to the internal opening (10) of the rectum (8).
- Fig.4 Schematic views of fistulectomy performateral an extra- sphincteric fistula with pelvic inflamational (4a) and the said f ⁇ stul(4b).
- This figure shows how the present invention is used along a hard guide on an extra-sphincteric fistula causing pelvic inflammation It also shows how the present invention incises a fistula from the fistula opening (9) located in the perineum (13) up to the internal fistula opening (10c) located in the sigmoid colon along a hard guide (29).
- Fig.5 View of the movement of the spherical shaft (36) on the wire (25) and spring (26) guides.
- the end of the wire guide (25) is fixed to the guide end holding apparatus (51) inside the rectum (8).
- the wire guide (25) stabilizes the spring guide (26).
- the spherical shaft (36) uses the spring guide as a directing rail while it operates.
- Fig. 6 View and details of the cannula guide system.
- the present invention designed to facilitate pinpointing a fistula and cannulating the fistula along its soft tissue, run by an electric motor (housed inside the handle (14), containing a directing part (16, 17) at the end of the carmule guide designed for either eccentric rotation (6T) or vibrational movement (6V).
- Fig. 7 View of general use of the present inven'tion.
- Fig. 8 View of movement control guides and incision ends.
- Fig.9 View of the spherical shaft and its details. View of the spherical shaft and its sfctional details(36) rotated by a part located behind it, the special circular protrusions (37) conveying said rotation to next part, the longitudinal canals (38) receiving the rotation conveyed by said protrusions, the central canal (40) serving as a bed for the wire guide (26), and the body.
- Fig.lO View of the spherical shaft (36), tubular shaft (39) and spring guide (26) which are the moving parts of the present invention, and its functional movements.
- Fig.ll View of the movement sliding part.
- this intermediate part (43) slides the axial rotation in parellel with its direction.
- Said intermediate part consists of a part (42) controlling the spherical shaft, a gear (44) ensuring said part to rotate axially, a wheel (45) conveying the axial rotation provided by the electric motor, and a body ensuring said gear and wheel to work in harmony with each other
- Fig.12 View of the details of the guide end holding apparatus, and of the guide tensioning and fixing handle.
- the guide end holding apparatus (51) catches the drop-shaped (27a) or 100 spherical (27b) end of the wire guide thanks to the holding bed (52) located in the center of the holding cap.
- the guide tensioning and fixing handle (46) ensures the operator to place the spring guide (26) on the wire guide (25). It also stabilizes the spring guide after the latter is placed on the wire guide.
- Radiological examination is conducted on the patient by means of fistulography in order to delineaze the shape and direction of the fistula.
- the operator inserts the vibrational cannulation guide or rotational cannulation guide into the fistula's opening in the perineum, and reaches 110 to the other opening of it inside the rectum.
- the fistula is mechanically pinpointed. Then the operator takes the cannulation guide out of the fistula. The operator uses the wire guide to push the fistula forward from its opening in the perineum, along the tract, into the anal canal. Then the operator pushes the fistula along the 115 spring guide up to its end. The ends of both guides are held and fixed with the holding apparatus inserted into the anal canal.
- the spherical articulated shaft having an incision end is attached on the controlling and fixing part attached to the movements sliding part attached to the holding handle.
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2001256941A AU2001256941A1 (en) | 2001-04-11 | 2001-04-11 | Device for excision of a fistula |
PCT/TR2001/000015 WO2002083012A1 (en) | 2001-04-11 | 2001-04-11 | Device for excision of a fistula |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/TR2001/000015 WO2002083012A1 (en) | 2001-04-11 | 2001-04-11 | Device for excision of a fistula |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2002083012A1 true WO2002083012A1 (en) | 2002-10-24 |
WO2002083012A8 WO2002083012A8 (en) | 2005-06-02 |
Family
ID=21619323
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/TR2001/000015 WO2002083012A1 (en) | 2001-04-11 | 2001-04-11 | Device for excision of a fistula |
Country Status (2)
Country | Link |
---|---|
AU (1) | AU2001256941A1 (en) |
WO (1) | WO2002083012A1 (en) |
Cited By (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2007072043A1 (en) * | 2005-12-21 | 2007-06-28 | Meditech Instruments Ltd | Surgical instrument |
GB2450411A (en) * | 2007-06-21 | 2008-12-24 | Peter W Bolton | A rotating surgical cutting device |
WO2011037664A1 (en) * | 2009-09-24 | 2011-03-31 | Gyrus Ent, L.L.C. | Repeatably flexible surgical instrument |
CN103917180A (en) * | 2011-09-05 | 2014-07-09 | Movasu公司 | Minimally invasive surgical instrument having joint section comprising spherical components |
CN104173092A (en) * | 2014-09-12 | 2014-12-03 | 李爱军 | Device for removing tissue |
CN104173094A (en) * | 2014-09-15 | 2014-12-03 | 江苏钱璟医疗器械有限公司 | Anal fistula scalpel |
WO2014204420A3 (en) * | 2013-06-22 | 2015-06-11 | Ihsan Tasci | System for excising anal fistula traces |
WO2015132439A1 (en) * | 2014-03-04 | 2015-09-11 | Servicio Andaluz De Salud | Curette for fistulas |
CN113440202A (en) * | 2021-06-29 | 2021-09-28 | 川北医学院附属医院 | Thread hanging structure for anal fistula disease treatment and elastic thread preparation method thereof |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
SU1421319A1 (en) * | 1986-12-26 | 1988-09-07 | Киевский Медицинский Институт Им.Акад.А.А.Богомольца | Arrangement for dissection of soft tissues |
US5222938A (en) * | 1989-09-15 | 1993-06-29 | Interventional Thermodynamics, Inc. | Method for thermal ablation of hollow body organs |
EP0712609A1 (en) * | 1994-11-18 | 1996-05-22 | Mohsin Al-Tameem | Device for excision of a fistula and method for using same |
US5524635A (en) * | 1992-09-14 | 1996-06-11 | Interventional Technologies Inc. | Apparatus for advancing a guide wire |
EP0836833A2 (en) * | 1996-10-15 | 1998-04-22 | Bristol-Myers Squibb Company | Rotatable surgical burr |
-
2001
- 2001-04-11 AU AU2001256941A patent/AU2001256941A1/en not_active Abandoned
- 2001-04-11 WO PCT/TR2001/000015 patent/WO2002083012A1/en active Application Filing
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
SU1421319A1 (en) * | 1986-12-26 | 1988-09-07 | Киевский Медицинский Институт Им.Акад.А.А.Богомольца | Arrangement for dissection of soft tissues |
US5222938A (en) * | 1989-09-15 | 1993-06-29 | Interventional Thermodynamics, Inc. | Method for thermal ablation of hollow body organs |
US5524635A (en) * | 1992-09-14 | 1996-06-11 | Interventional Technologies Inc. | Apparatus for advancing a guide wire |
EP0712609A1 (en) * | 1994-11-18 | 1996-05-22 | Mohsin Al-Tameem | Device for excision of a fistula and method for using same |
US5643305A (en) | 1994-11-18 | 1997-07-01 | Al-Tameem; Moshin | Device for excision of a fistula |
EP0836833A2 (en) * | 1996-10-15 | 1998-04-22 | Bristol-Myers Squibb Company | Rotatable surgical burr |
Non-Patent Citations (1)
Title |
---|
DATABASE WPI Section PQ Week 198911, 16 April 1989 Derwent World Patents Index; Class P31, AN 1989-083251, XP002185109 * |
Cited By (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2007072043A1 (en) * | 2005-12-21 | 2007-06-28 | Meditech Instruments Ltd | Surgical instrument |
GB2450411A (en) * | 2007-06-21 | 2008-12-24 | Peter W Bolton | A rotating surgical cutting device |
WO2011037664A1 (en) * | 2009-09-24 | 2011-03-31 | Gyrus Ent, L.L.C. | Repeatably flexible surgical instrument |
CN103917180A (en) * | 2011-09-05 | 2014-07-09 | Movasu公司 | Minimally invasive surgical instrument having joint section comprising spherical components |
EP2754402A4 (en) * | 2011-09-05 | 2015-03-04 | Movasu Inc | Minimally invasive surgical instrument having joint section comprising spherical components |
WO2014204420A3 (en) * | 2013-06-22 | 2015-06-11 | Ihsan Tasci | System for excising anal fistula traces |
JP2016526970A (en) * | 2013-06-22 | 2016-09-08 | タシュチュ,イハサン | Methods for anorectal fistula treatment |
US10383653B2 (en) | 2013-06-22 | 2019-08-20 | Ihsan Tasci | System for excising anal fistula traces |
WO2015132439A1 (en) * | 2014-03-04 | 2015-09-11 | Servicio Andaluz De Salud | Curette for fistulas |
CN104173092A (en) * | 2014-09-12 | 2014-12-03 | 李爱军 | Device for removing tissue |
CN104173094A (en) * | 2014-09-15 | 2014-12-03 | 江苏钱璟医疗器械有限公司 | Anal fistula scalpel |
CN113440202A (en) * | 2021-06-29 | 2021-09-28 | 川北医学院附属医院 | Thread hanging structure for anal fistula disease treatment and elastic thread preparation method thereof |
Also Published As
Publication number | Publication date |
---|---|
AU2001256941A1 (en) | 2002-10-28 |
WO2002083012A8 (en) | 2005-06-02 |
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