WO2007038934A1 - Prosthesis for repairing digestive anastomosis dehiscences and abdominal wall deficiencies - Google Patents

Prosthesis for repairing digestive anastomosis dehiscences and abdominal wall deficiencies Download PDF

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Publication number
WO2007038934A1
WO2007038934A1 PCT/DZ2006/000003 DZ2006000003W WO2007038934A1 WO 2007038934 A1 WO2007038934 A1 WO 2007038934A1 DZ 2006000003 W DZ2006000003 W DZ 2006000003W WO 2007038934 A1 WO2007038934 A1 WO 2007038934A1
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WO
WIPO (PCT)
Prior art keywords
prosthesis
digestive
disunions
sutures
treatment
Prior art date
Application number
PCT/DZ2006/000003
Other languages
French (fr)
Inventor
Bourhane Eddine Benelouezzane
Original Assignee
Bourhane Eddine Benelouezzane
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 Bourhane Eddine Benelouezzane filed Critical Bourhane Eddine Benelouezzane
Publication of WO2007038934A1 publication Critical patent/WO2007038934A1/en

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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
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
    • 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
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/003—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in adsorbability or resorbability, i.e. in adsorption or resorption time
    • A61F2250/0031—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in adsorbability or resorbability, i.e. in adsorption or resorption time made from both resorbable and non-resorbable prosthetic parts, e.g. adjacent parts

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The invention concerns a prosthesis characterized in that it is comprised of two oval or circular pieces (1) that are superimposed and joined by two wire-shaped elements (5) inserted in two opposite points situated on the edges of the pieces (2) and (3). Each of the pieces (2) and (3) of the prosthesis consists of a resorbable biocompatible synthetic tissue plate. Piece (2) is lined with non-resorbable synthetic tissue. Piece (2) is to be introduced inside the digestive hole resulting from the dehiscence of the digestive sutures. Piece (3) is then applied to the outer surface of the wound. The prosthesis is provided with fixing openings arranged in pairs (6). The prosthesis comprises a circular thickening on its perimeter. The prosthesis is put in place by surgery or endoscopy. .

Description

PROTHESE DE REPARATION DES DESTINIONS DES ANASTOMOSES DIGESTIVES ET DES DEFICIENCES DE LA PAROI ABDOMINALE. PROSTHESIS FOR REPAIRING DESTINIONS OF DIGESTIVE ANASTOMOSES AND DEFICIENCES OF THE ABDOMINAL WALL.
DESCRIPTIONDESCRIPTION
La présente invention a pour objet une prothèse à usage chirurgical. L'invention se rapporte à une prothèse destinée à être utilisée dans le traitement des désunions de sutures digestives . La prothèse, selon l'invention, est caractérisée en ce qu'elle est constituée de deux pièces ovales fig. (1) ou circulaires fig.The present invention relates to a prosthesis for surgical use. The invention relates to a prosthesis for use in the treatment of disunions of digestive sutures. The prosthesis, according to the invention, is characterized in that it consists of two oval parts fig. (1) or circular fig.
(7) superposées et reliées entre elles par deux éléments filiforme (5a) insérés en deux points opposés situés en périphérie sur les pièces décrites. Chacune des deux pièces principales de la prothèse est une plaque de tissu synthétique bio-compatible; l'une est destinée à être introduite à l'intérieur de la brèche digestive résultant du lâchage des sutures de la paroi du tube digestif la deuxième sera appliquée sur la face externe de cette plaie. II s'ensuit une fixation à la paroi digestive à l'aide de fil chirurgical ou d'agrafes.(7) superimposed and interconnected by two filamentary elements (5a) inserted at two opposite points located peripherally on the parts described. Each of the two main parts of the prosthesis is a bio-compatible synthetic tissue plate; one is intended to be introduced inside the digestive breccia resulting from the release of the sutures of the wall of the digestive tract, the second will be applied to the external face of this wound. It follows a fixation to the digestive wall using surgical wire or staples.
Afin de permettre la fixation de la prothèse chaque pièce (2 ; 3) est munie à sa périphérie d'orifices disposés par paires (βa) . La périphérie de chacune des deux pièces principales présente un épaississement en forme de cerceau (5b) destiné à maintenir l'étalement de celles-ci cet artifice permet de faciliter l'installation de la prothèse.In order to allow the fixation of the prosthesis each piece (2; 3) is provided at its periphery with orifices arranged in pairs (βa). The periphery of each of the two main parts has a hoop-shaped thickening (5b) intended to maintain the spread thereof thereof this device facilitates the installation of the prosthesis.
La pièce destinée à la face superficielle (3) de la brèche est constituée de tissu synthétique à résorption lente connu en pratique chirurgicale.The part intended for the surface face (3) of the gap consists of synthetic tissue with slow resorption known in surgical practice.
La pièce destinée à la face profonde (2) de la plaie digestive est composée de tissu synthétique à résorption lente, elle est renforcée par une fine plaque de matériau biocompatible non résorbable, les matériaux utilisés sont connus en pratique chirurgicale . La plaque de renforcement sus décrite (4) émet des prolongements (6b) qui s'insinueront entre deux orifices de la même paire, cette disposition permet de maintenir l'obturation de la brèche même après la disparition des composants résorbables.The part intended for the deep face (2) of the digestive wound is composed of synthetic fabric slow resorption, it is reinforced by a thin plate of biocompatible non-absorbable material, the materials used are known in surgical practice. The reinforcing plate described above (4) emits extensions (6b) which will creep between two orifices of the same pair, this arrangement makes it possible to maintain the closing of the gap even after the disappearance of the absorbable components.
ETAT DE IA TECHNIQUESTATE OF TECHNICAL AI
En chirurgie digestive, les lâchages de sutures et leur corollaire les fistules digestives post-opératoires représentent une complication grave.In digestive surgery, suture lapses and their corollary post-operative digestive fistulas represent a serious complication.
Cette complication s'observe aussi bien en chirurgie classique qu'en coeliochirurgie et elle peut concerner tous niveaux du tube digestif : œsophage, estomac, duodénum, intestin grêle, colon. Cette pathologie n'a toujours pas bénéficié de solutions ayant pu améliorer le pronostic ni même réduit les difficultés de sa prise en charge.This complication is observed in both conventional surgery and laparoscopic surgery and can affect all levels of the digestive tract: esophagus, stomach, duodenum, small bowel, colon. This pathology has still not benefited from solutions that have improved the prognosis or even reduced the difficulties of its management.
Les méthodes thérapeutiques actuelles utilisées sont les drainages externes, les entérostomies, les exclusions digestives, les résections digestives et parfois la réfection de l'anastomose. En plus d'une efficacité discutable; ces techniques sont souvent de réalisation difficile, elles sont fréquemment accompagnées de complications locales liées aux dispositifs de drainage et aux stomies, et générales (désordres biologiques) qui nécessitent des soins intensifs de durée trop longue et dont le coût est trop élevé.The current therapeutic methods used are external drainage, enterostomies, digestive exclusions, digestive resections and sometimes the repair of the anastomosis. In addition to questionable efficiency; these techniques are often difficult to perform, they are frequently accompanied by local complications related to drainage devices and ostomies, and general (biological disorders) that require intensive care of too long duration and the cost is too high.
La prothèse selon l'invention propose d'effectuer un geste direct sur la plaie digestive; celui-ci consiste à prendre les parois de la brèche entre les deux pièces superposables de la prothèse, nous réaliserons ainsi une fermeture de la brèche par ses deux faces.The prosthesis according to the invention proposes to perform a direct action on the digestive wound; this consists in taking the walls of the breach between the two superimposable parts of the prosthesis, we will thus achieve a closure of the gap by its two faces.
Ce dispositif permet d'éviter les fuites des liquides digestifs et par conséquent la péritonite post-opératoire dont la gravité est connue. Par ailleurs la prothèse rapproche et maintient les berges de la brèche lui permettant ainsi de cicatriser; ce qui représente l'objectif du traitement de cette affection. La technique antérieure connaît une prothèse (Brevet européen n°1057457, inventeur Benelouezzane) Une telle prothèse utilisée surtout en chirurgie biliaire; elle associe une obturation double et un drainage interne de la fistule digestive. La mise en place de cette prothèse est exclusivement chirurgicale, de plus dans cette technique une deuxième intervention chirurgicale dite « d' ablation de matériel » est nécessaire après guérison du patient. L'invention propose une prothèse qui offre la possibilité d'une installation soit chirurgicale, soit par voie endoscopique, celle-ci dispense le patient des contraintes et des risques liés à un acte chirurgical.This device makes it possible to avoid leakage of digestive liquids and consequently postoperative peritonitis whose severity is known. In addition, the prosthesis brings the breasts closer to the breccia, thus allowing it to heal; which is the goal of treating this condition. The prior art knows a prosthesis (European Patent No. 1057457, inventor Benelouezzane) Such a prosthesis used mainly in biliary surgery; it combines a double filling and an internal drainage of the digestive fistula. The placement of this prosthesis is exclusively surgical, moreover in this technique a second surgical operation called "ablation of material" is necessary after healing of the patient. The invention proposes a prosthesis that offers the possibility of either a surgical or endoscopic installation, which exempts the patient from the constraints and risks associated with a surgical procedure.
En outre la prothèse selon l'invention, a l'avantage d'être constituée dans sa majeure partie de tissu résorbable. La partie non résorbable peut être laissée dans l'organisme ou bien retirée par voie endoscopique, ce qui permet également d'éviter au malade la deuxième intervention chirurgicale pour l'ablation de la prothèse. L'invention, selon son principe, peut être appliquée à d'autres pathologies notamment les hernies et les éventrations qui sont des affections dues à une déficience de la paroi abdominale. Bien entendu, l'invention n'est pas limitée au mode de réalisation qui vient d'être décrit et représenté, on pourra y apporter de nombreuses modifications de détail sans sortir pour cela du cadre de l'invention.In addition, the prosthesis according to the invention has the advantage of being composed for the most part of absorbable tissue. The non-absorbable part can be left in the body or removed endoscopically, which also avoids the patient the second surgical procedure for the removal of the prosthesis. The invention, according to its principle, can be applied to other pathologies including hernias and eventrations which are conditions due to a deficiency of the abdominal wall. Of course, the invention is not limited to the embodiment that has just been described and shown, it can make many changes in detail without departing from the scope of the invention.
DESSINSDRAWINGS
L'invention est représentée par les dessins annexés dans lesquels : La figure 1 est une vue en perspective de la prothèse.The invention is represented by the accompanying drawings, in which: FIG. 1 is a perspective view of the prosthesis.
La figure 2 est une vue à plus grande échelle de la pièce qui doit être mise à l'intérieur de l'organe digestif à traiter.Figure 2 is an enlarged view of the part to be placed inside the digestive organ to be treated.
La figure 3 montre la pièce qui doit couvrir la face externe de la plaie. La figure 4 représente l'élément qui sert de doublure dans la pièce interne. La figure 5 objective les éléments filiformes qui servent à réunir les pièces ainsi que les manches servant à la prise de la prothèse au cours des manipulations.Figure 3 shows the part that must cover the outer surface of the wound. Figure 4 shows the element which serves as a lining in the inner part. Figure 5 shows the filiform elements used to join the parts and the sleeves used to hold the prosthesis during handling.
La figure 6 met en évidence la disposition des orifices de fixation de la prothèse.Figure 6 shows the arrangement of the fixing holes of the prosthesis.
La figure 7 est une vue générale du modèle circulaire destiné aux anastomoses portant sur les segments étroits.Figure 7 is a general view of the circular model for anastomoses on narrow segments.
La figure 8 représente le modèle pour traiter les anastomoses termino-latérales . Figure 8 shows the model for treating termino-lateral anastomoses.

Claims

REVENDICATIONS
1-Prothèse pour le traitement des désunions de sutures digestives caractérisée en ce qu'elle est constituée de deux pièces planes, elliptiques ou circulaires superposées et reliées entre elles, l'une destinée a être placée dans le tube digestif en regard de la lésion, et la seconde sera appliquée sur la face externe de la lésion.1-prosthesis for the treatment of disunions of digestive sutures characterized in that it consists of two planar pieces, elliptical or circular superimposed and interconnected, one intended to be placed in the digestive tract opposite the lesion, and the second will be applied to the outer surface of the lesion.
2-Prothèse pour traitement des désunions de sutures digestives , selon la revendication 1 caractérisée en ce que les pièces 1 et 2 sont reliées par deux filaments (5) de 5 à 6 mm de longueur (3) résorbables insérés sur le pourtour de ces pièces principales. 3-Prothèse pour le traitement des désunions de sutures digestives selon la revendication 1 caractérisée en ce que les pièces 1 et 2 sont munies sur leur pourtour d'orifices disposés par paires. 4-Prothèse pour le traitement des désunions de sutures digestives selon la revendication 1 caractérisée en ce que la pièce (1) est composée de tissu synthétique résorbable doublé d'une plaque de matériau biocompatible non résorbable 5-Prothèse pour le traitement des désunions de sutures digestives selon les revendications (3) et (4) caractérisée en ce que la plaque de matériau non résorbable présente des prolongements adjacents aux orifices de fixation.2-prosthesis for treating disunions of digestive sutures, according to claim 1 characterized in that the parts 1 and 2 are connected by two filaments (5) of 5 to 6 mm in length (3) absorbable inserted around the periphery of these parts main. 3-prosthesis for the treatment of disunions of digestive sutures according to claim 1 characterized in that the parts 1 and 2 are provided on their periphery with orifices arranged in pairs. 4-prosthesis for the treatment of disunions of digestive sutures according to claim 1 characterized in that the part (1) is composed of resorbable synthetic fabric lined with a non-resorbable biocompatible material plate 5-Prosthesis for the treatment of disunions sutures digestive system according to claims (3) and (4) characterized in that the non-resorbable material plate has extensions adjacent to the fixing holes.
6-prothèse pour le traitement des désunions de sutures digestives selon la revendication 1 est munie de deux éléments annulaires (6)6-prosthesis for the treatment of disunions of digestive sutures according to claim 1 is provided with two annular elements (6)
7-prothèse pour le traitement des désunions des sutures digestives selon la revendication (1 ; 2 ;3 ; 4 ) présente un modèle elliptique incurvé dont les éléments (5) qui relient les pièces let 2 sont situés sur la grande courbure . 8-prothèse pour le traitement des désunions des sutures digestives selon les revendications (1) et (6) caractérisée en ce que sa mise en place s'effectue par voie chirurgicale et par voie endoscopique. 7-prosthesis for the treatment of disunions digestive sutures according to claim (1; 2; 3; 4) has a curved elliptical model whose elements (5) which connect the pieces let 2 are located on the large curvature. 8-prosthesis for the treatment of disunions digestive sutures according to claims (1) and (6) characterized in that its implementation is performed surgically and endoscopically.
PCT/DZ2006/000003 2005-10-04 2006-10-04 Prosthesis for repairing digestive anastomosis dehiscences and abdominal wall deficiencies WO2007038934A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DZ050369 2005-10-04
DZ050369 2005-10-04

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ITMI20091481A1 (en) * 2009-08-14 2011-02-15 Antonio Sambusseti CONCAVA PLATE (SCAFFOLD) FOR THE REPLACEMENT OF A VESICAL WALL PORTION FOLLOWED BY PARTIAL VESCITECTOMY
FR2953710A1 (en) * 2009-12-16 2011-06-17 Sofradim Production PROSTHETIC COMPRISING A REINFORCED TRELLIS

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6174320B1 (en) * 1994-09-29 2001-01-16 Bard Asdi Inc. Hernia mesh patch with slit
US6383201B1 (en) * 1999-05-14 2002-05-07 Tennison S. Dong Surgical prosthesis for repairing a hernia
US20030130745A1 (en) * 2002-01-07 2003-07-10 Dennis Cherok Implantable prosthesis
US20060025785A1 (en) * 2004-08-02 2006-02-02 Cully Edward H Tissue repair device with a bioabsorbable support member

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6174320B1 (en) * 1994-09-29 2001-01-16 Bard Asdi Inc. Hernia mesh patch with slit
US6383201B1 (en) * 1999-05-14 2002-05-07 Tennison S. Dong Surgical prosthesis for repairing a hernia
US20030130745A1 (en) * 2002-01-07 2003-07-10 Dennis Cherok Implantable prosthesis
US20060025785A1 (en) * 2004-08-02 2006-02-02 Cully Edward H Tissue repair device with a bioabsorbable support member

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ITMI20091481A1 (en) * 2009-08-14 2011-02-15 Antonio Sambusseti CONCAVA PLATE (SCAFFOLD) FOR THE REPLACEMENT OF A VESICAL WALL PORTION FOLLOWED BY PARTIAL VESCITECTOMY
WO2011018300A1 (en) * 2009-08-14 2011-02-17 Antonio Sambusseti Reabsorbable concave plate (scaffold) for the replacement of a portion of bladder wall following partial cystectomy
AP3266A (en) * 2009-08-14 2015-05-31 Antonio Sambusseti Reabsorbable concave plate (scaffold) for the replacement of a portion of bladder wall following partial cystectomy
FR2953710A1 (en) * 2009-12-16 2011-06-17 Sofradim Production PROSTHETIC COMPRISING A REINFORCED TRELLIS
WO2011073225A1 (en) * 2009-12-16 2011-06-23 Sofradim Production Prosthesis comprising a reinforced mesh
US9801704B2 (en) 2009-12-16 2017-10-31 Sofradim Production Prothesis comprising a reinforced mesh

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