WO2007051339A1 - Systeme d'amenee de liquides a l'interieur du corps - Google Patents

Systeme d'amenee de liquides a l'interieur du corps Download PDF

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Publication number
WO2007051339A1
WO2007051339A1 PCT/CH2006/000616 CH2006000616W WO2007051339A1 WO 2007051339 A1 WO2007051339 A1 WO 2007051339A1 CH 2006000616 W CH2006000616 W CH 2006000616W WO 2007051339 A1 WO2007051339 A1 WO 2007051339A1
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WO
WIPO (PCT)
Prior art keywords
implant
filling device
filling
valve
channel
Prior art date
Application number
PCT/CH2006/000616
Other languages
German (de)
English (en)
Inventor
Georg Cramm
Original Assignee
Müller, Daniel
Daetwyler, Peter
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 Müller, Daniel, Daetwyler, Peter filed Critical Müller, Daniel
Publication of WO2007051339A1 publication Critical patent/WO2007051339A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C17/00—Devices for cleaning, polishing, rinsing or drying teeth, teeth cavities or prostheses; Saliva removers; Dental appliances for receiving spittle
    • A61C17/02—Rinsing or air-blowing devices, e.g. using fluid jets or comprising liquid medication
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/0247—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/22—Valves or arrangement of valves
    • A61M39/26—Valves closing automatically on disconnecting the line and opening on reconnection thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/142—Pressure infusion, e.g. using pumps
    • A61M5/14244—Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body
    • A61M5/14276—Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body specially adapted for implantation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C19/00—Dental auxiliary appliances
    • A61C19/06—Implements for therapeutic treatment
    • A61C19/063—Medicament applicators for teeth or gums, e.g. treatment with fluorides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0089—Implanting tools or instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M2039/0205—Access sites for injecting media
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/0247—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A61M2039/025—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body through bones or teeth, e.g. through the skull
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/0247—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A61M2039/0261—Means 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/0247—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A61M2039/0276—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body for introducing or removing fluids into or out of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/0247—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A61M2039/0282—Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body with implanted tubes connected to the port
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2209/00—Ancillary equipment
    • A61M2209/04—Tools for specific apparatus
    • A61M2209/045—Tools for specific apparatus for filling, e.g. for filling reservoirs

Definitions

  • the present invention relates to a feeding device (a "port") for supplying a fluid inside the body according to the preamble of claim 1 and to a filling device cooperating therewith according to the preamble of claim 11.
  • the invention is also directed to a combination and method of operation of the invention both devices.
  • a controlled liquid into the body, in particular in a container located inside the body.
  • An example is the delivery of insulin to an insulin pump implanted in the body.
  • the insulin pump usually has an insulin reservoir, which must be replenished at regular intervals.
  • it is customary to inject the insulin through the abdominal wall into the container.
  • implants are known which ensure permanent access through the abdominal wall to the abdominal cavity.
  • Such an implant is e.g. in US 5,100,392.
  • Such implants are disadvantageous because they hinder the patient in his daily activities and pose a high risk of infection.
  • Another example is the introduction of dialysis fluid into the body in kidney patients.
  • US 4,412,825 teaches to direct a fluid through a channel in a tooth into the body interior.
  • the channel is closed to the outside world simply by a plugged into the channel plug.
  • the plug To fill a liquid, the plug must be removed and the channel opened. There is always a latent risk of infection.
  • This task will solved by a feeder according to claim 1.
  • the invention is further directed to a combination of the feeding device according to the invention and the filling device according to the invention.
  • This object is achieved by a method according to claim 16.
  • this method can be a non-therapeutic method for filling a container located in the interior of the body.
  • a delivery device for delivering a fluid to a predetermined location in a human or animal body, comprising: an implant for anchoring the device in a hard body tissue, in particular a bone, wherein the implant one from a body exterior to a body inside through the implant hin-. through extending channel; and a catheter adjacent to the interior of the body to direct the fluid to the predetermined location.
  • a valve is arranged, which selectively opens or closes the channel towards the inside of the body.
  • a fastening means for releasably securing a filling device is present in the channel, which is designed such that the filling device in a first position sealingly attachable to the implant, in which it does not open the valve and rinsing a allows the exterior of the body-facing portion of the valve.
  • Such a port has a number of advantages.
  • the proposed port reduces the risk of infection considerably compared to a passage through a soft body tissue, as known from the prior art, owing to the better structural compatibility between implant and hard body tissue.
  • An additional reduction of the risk of infection results from the possibility of flushing the outer area of the valve and the adjacent channel area prior to filling. This ensures that no germs can get inside the body through the port. This solves the interface problem in an elegant way.
  • the port is designed so that the inlet device can purposely open the valve after rinsing.
  • the fastening means is preferably designed to allow a movement of at least a part of the filling device from the first position to a second position. It remains preferably in the entire area over which this part of the filling device is moved, the filling device sealingly connected to the implant. In the second position, the filling device is then arranged so that it opens the valve.
  • the fastening means is preferably designed to allow a movement of at least a part of the filling device from the first position to a second position. It remains preferably in the entire area over which this part of the filling device is moved, the filling device sealingly connected to the implant. In the second position, the filling device is then arranged so that it opens the valve.
  • the sealing of the filling device on the implant can be done in various ways, for example via a known O-ring seal, a lip seal or (less preferably) by a sealing paste. Especially elegant However, the sealing is reliably performed by the channel having a region which widens conically towards the outside of the body and forms a sealing surface for the filling device.
  • the implant has an internal thread to attach the filling device by screwing a filling screw on the implant.
  • the valve is then arranged relative to the internal thread so that the filling device does not yet open the valve in the first position.
  • the filling device preferably opens the valve by screwing the filling screw beyond the first position into a second position into the internal thread.
  • the internal thread on a length which ensures that such screwing between the first and the second position is possible, and the valve is arranged and designed so that a suitably designed filling device, the valve in this position opens.
  • valve has a closure element which can be pressed by the filling screw and thereby opens the valve.
  • valve for example, a closure element which is rotatably mounted on the actual valve body and opens the valve by rotation.
  • an edge is formed, for example in the form of a recess or a projection, and the filler plug has a complementary edge, for example in the form of an eccentric nose.
  • the filling screw and the closure element do not yet touch, or they are just touching each other in a manner in which the closure element is just not yet rotated by the filling screw. By further screwing the filling screw this takes the closure element with and rotates, whereby the valve is opened.
  • the fastening can take place instead of by screwing in, for example, by a bayonet closure with two different locking positions.
  • a combination of the above-described conical sealing surface with an internal thread is particularly advantageous because it allows the use of a special, two-piece filling device with filler neck and guided therein filler plug, as described in more detail below.
  • the valve comprises in a very simple and effective embodiment a spring-loaded ball which is pressed by the spring force against an annular sealing surface.
  • a spring-loaded ball which is pressed by the spring force against an annular sealing surface.
  • the valve may also comprise a pin on which a sealing surface is formed.
  • the use of a solenoid valve is possible in which the spring is replaced by a magnet.
  • the valve can in principle also be designed as a septum, which is pierced by a suitable cannula on the filling device. However, such a closure will often fail to meet the longevity and security requirements of the port.
  • the filling device can flush the outside of the valve, in a position in which the filling device is fixed to the port.
  • the position and configuration of the fastening means relative to the valve will also depend on the nature of the valve and the consequent configuration of the filling device.
  • a detachable cover is preferably present, which is designed similarly to the filling device, that cooperates with the same fastening and sealing means as the filling device.
  • the cover may have a screw which is suitable for being screwed into the internal thread of the implant in order to fix the cover to the implant.
  • the cover may have a conically widening de outer surface which is suitable to be used sealingly in a conically widening region of the channel.
  • the cover is formed in two parts, wherein the conical outer surface is formed on an insert part, through which the screw is guided.
  • the catheter is preferably attached to the implant in a manner that on the one hand forms a tight connection with the implant, but on the other hand can be easily replaced. This is ensured, in particular, when the catheter has a radially widened and preferably conically shaped catheter end and the delivery device has a clamping body which can be screwed into the implant, by means of which the catheter end can be pressed sealingly against a sealing element surrounding the catheter.
  • the conical surface of the catheter end preferably points towards the outside of the body.
  • This type of seal is from other applications, e.g. from the vacuum technique, known and finds e.g. in the known Swagelok® compounds application.
  • one or more conduit means for energy may also be passed through between the inside of the body and the body outside through the supply device.
  • the energy may be, for example, electrical currents or optical signals.
  • electrical currents these serve, for example, to make measurements in the body to perform stimulation, or to provide power to an electrically operated device arranged inside the body.
  • one or more electrical lines are advantageously led through the feed device.
  • the conduit ends advantageously on contacts which are arranged on an area of the supply device facing towards the outer side of the body.
  • the contacts can be covered.
  • Other types of conductive means may include, for example, one or more optical fibers to guide light through the delivery device.
  • a transmitter for measuring the flow rate through the filling catheter in the body is also available, which is connected to the conduit means. In this way can be determined online while filling the flow through the delivery catheter.
  • the implant is a dental implant that is anchored in the jaw.
  • the feeder is then a "dental port".
  • the port is particularly accessible, visually does not disturb and is well protected.
  • the catheter is then routed through the mandible.
  • the implant may also be an implant for another easily accessible bone, e.g. a bone located behind an ear, act.
  • the implant can perform other functions, e.g. wear a prosthesis, such as an ear prosthesis.
  • an existing prosthesis can also be adapted by means of the invention for the further purpose of supplying fluid and optionally energy into the body.
  • the catheter is preferably designed especially for laying through the mandible into the abdominal cavity and for connection to an insulin pump.
  • this embodiment relates to the design of the catheter material, which must be biocompatible for the various types of tissue throughout the implant-pump region and must have sufficient flexibility and stability.
  • An example of a suitable material is titanized PVC.
  • the embodiment also relates to the length and the cross-section of the catheter, which must be chosen so that no excessive pressure drop across the length of the catheter takes place, so that an insulin solution may possibly reach the pump alone by generating a slight negative pressure in the pump. Accordingly, the catheter must also be designed so that a negative pressure does not lead to a local compression and closure of the catheter.
  • the invention also includes, in particular, the combination of a so adapted dental port with an insulin pump.
  • the invention further relates to an insertion device for introducing a fluid into the delivery device described above.
  • the filling device has a fastening means (which is complementary to the fastening means of the delivery device) for releasable attachment to the implant of the delivery device.
  • This is designed so that the filling device can be fastened in a first position in a sealing manner on the implant in which it does not open the valve, and in that the filling device has means for flushing a body-side facing the area of the valve.
  • this brings a number of hygienic benefits.
  • a variety of configurations are possible, as described below.
  • the filling device preferably has at least two fluid channels, wherein one of the fluid channels for supplying fluid to the outer region of the valve (and thus the adjacent portion of the channel in the implant) is used, and wherein another fluid channel for discharging the fluid during the rinsing process serves.
  • the attachment means may preferably be adapted to allow movement of at least a portion of the filling device from the first position to a second position, wherein the filling device is sealingly connected to the implant in the entire area over which this part of the filling device is moved, and wherein in the second position, the filling device is arranged so that it opens the valve.
  • a controlled supply of the liquid is possible after rinsing.
  • a variety of configurations are possible, e.g. a two-stage bayonet closure or a screw through which the fluid channels are guided. Preferred embodiments will be described below.
  • the filling device preferably has a conically widening outer surface which, together with a conically widening region of the channel in the implant, forms a seal of the filling device against the implant. This achieves a very efficient seal, which is important for the flushing process.
  • the filling device is constructed in two parts. It has an insert body ("filler neck") for sealing support on the implant, through which a filler screw is guided, which is adapted to be screwed into an internal thread in the channel of the implant. The insert screw is preferably guided sealingly in the insert body.
  • the means for flushing the body-facing side portion of the valve then preferably comprise at least two fluid channels, which are passed through the filling device, that they end in the screwed state near the valve in the channel of the implant.
  • holes can be provided in the filling screw or in the insert body.
  • the filler plug may have a smooth-walled cylindrical portion which is adapted to be guided in a smooth-walled cylindrical portion of a bore of the insert body. This initially creates a sealing effect between these parts.
  • the smooth-walled cylindrical portion of the filling screw and / or the bore can then be present at least one groove extending in the axial direction. This forms a fluid channel for the supply or discharge of liquid to the outer region of the valve.
  • the task is to specify a defined first position, can be flushed in, without the valve is opened accidentally.
  • a spacer element for example, a slotted disc is advantageously provided, which can be applied in a blocking position on the insert body, in which it prevents screwing the filler plug beyond the first position.
  • the supply device additionally comprises conduction means for energy, for example for electrical or optical energy, means for supplying and / or reading out the energy can also be present at the filling device.
  • the feeder has one or more electrical leads connected to electrical contacts on the body exterior of the feeder, one or more electrical contacts may be provided on the feeder, such as one or more electrical contacts after attachment of the feeder to the feeder Touch feeder. The same applies to optical contacts.
  • the invention also relates to a method for supplying a fluid to a predetermined location in a human or animal body by means of a delivery device according to the invention and a corresponding filling device.
  • the method comprises the following steps:
  • FIG. 1 is a schematic side sectional view of a feed device
  • 2 is a schematic partial side sectional view of an old ma tive embodiment of a feeding device
  • Fig. 3 is a schematic representation of the delivery device in the mouth of a patient
  • FIG. 4 shows a schematic representation of the connection from the supply device to an insulin pump
  • 5A and 5B are schematic sketches of a possible surgical technique in establishing a connection between the delivery device and the insulin pump;
  • 6A to 6C are schematic side sectional views of an implant with refilling device inserted therein in three different positions;
  • FIG. 7A and 7B are schematic representations of a first variant of the channel guide in the refilling device.
  • 8A and 8B are schematic representations of a second variant of the channel guide in the refilling device.
  • a feeding device according to a first embodiment of the present invention is shown.
  • This dental port comprises a dental implant 100 with a main body 101.
  • the main body has a continuous channel which extends essentially vertically in FIG. 1 and which widens increasingly toward the top.
  • a clamp body 102 is screwed, in which a check valve 106 is arranged.
  • the check valve comprises a ball which is pressed by a coil spring against an annular sealing surface on the clamping body. Pressing the ball against the spring force away from the sealing surface (downwards in FIG. 1) opens the valve. This can be done by mechanical pressure or a sufficiently high fluid pressure. In this way, the valve 106 opens or closes the channel downwards, that is, towards the inside of the body.
  • a Filling catheter 104 guided into the channel.
  • the filling catheter terminates in a truncated cone-shaped thickening of the catheter itself, or the end of the filling catheter is surrounded by a frusto-conical ring.
  • the thickening or the ring is pressed by the clamping body 102 down against a clamping ring 103, which in turn abuts against the inner wall of the main body 101, whereby the filling catheter 104 is sealingly secured in the implant 100.
  • the channel in the main body widens upwards (that is to say in the direction of the oral cavity, ultimately also towards the outer side of the body) over two conical wall sections 110 and 111.
  • An insert 107 which has conical outer surfaces which abut the conical wall sections 110, 111 of the main body, is inserted into the widening opening.
  • an insert screw 108 is inserted, which is substantially smooth-walled in the region of the insert and has an external thread only near its lower end. This external thread engages in the internal thread present in the channel.
  • the insert screw 108 is dimensioned so that it presses the insert 107 into its seat formed by the conical wall sections 110, 111 in the screwed-in state.
  • a cylinder head is formed on the insert grave, which abuts against a shoulder in the bore of the insert.
  • the insert 107 is sealingly fixed in the base body 101 and ensures a secure, tight closure of the channel.
  • the insert 107 projects slightly above the base body 101 upwards.
  • An attachment 200 which includes a crown 201 and a carrier 202 connected thereto, is pushed onto this projecting region.
  • a threaded pin 204 is screwed in a laterally disposed internal thread 203 in the carrier 202. In the screwed-in state, this threaded pin engages in a recess in the insert 107 and thus holds the attachment 200 on the insert 107.
  • the filling catheter 104 is led out laterally obliquely downward from the main body 101 'of the implant.
  • the implant 100 preferably replaces a cutting or canine tooth with the attachment 200, since it is particularly well adapted to these teeth in the form and because these teeth experience a comparatively low load.
  • the threaded pin 204 comes to lie inwards (towards the tongue) so as not to impair the appearance.
  • Typical dimensions are as follows: outer diameter of the implant approx. 4 mm, length approx. 13 mm; Outer diameter of the catheter approx. 1.2 mm, inner diameter approx. 0.5 mm; Thickening of the catheter end on the clamp body to approx. 2 to 2.5 mm. Of course, these dimensions may vary within certain limits.
  • the base body 101, the clamping body 102 and the clamping ring 103 from a titanium-based alloy such. Ti-6AI-4V to manufacture.
  • the main body 101 can also be hypoallergenic coated in a known manner.
  • the exterior of the upper third of the body 101 is preferably polished so that the oral sulcus epithelium can attach. In this way, a proven and proven ingrowth of the implant results.
  • the valve-side end of the insert screw 108 may be antiseptically coated, e.g. with a chlorhexidine-silver sulfadiazine coating.
  • the filling catheter 104 is preferably made of titanized PVC, wherein the coating advantageously takes place in a nanotechnological process.
  • the titanium-containing layer combines with the plastic to form a new composite material that has the flexibility of the underlying plastic. A separation of this covalent layer is possible only by destruction of the plastic structure in itself. This avoids possible problems such as cracks, erosion, delamination, etc.
  • the titanium coating also prevents the absorption of phthalates and other additives in the human body. Such a coating is particularly advantageous in the outlet rich of the catheter from the implant; however, it preferably extends over the entire length of the catheter. This choice of material allows the mandibular bone to grow up to the catheter, so that the catheter in the dandruff is well-fed and well-fed.
  • the material is also haemocompatible and has a high long-term stability. However, the use of other flexible and biocompatible materials, as known in the art, is also possible.
  • connection of the filling catheter with the implant is detachable, so that the catheter can be easily replaced if necessary. This can be minimally invasive by inserting a new catheter along the existing catheter.
  • FIG. 3 shows a delivery device as it is arranged in the mouth of a patient.
  • the implant 100 is inserted in the mandible 300 and grown together with it.
  • the gingiva 310 envelops the edge of the crown and thus provides a natural protection against germs. It also creates a natural transition between soft and hard body tissue.
  • the device is easily accessible and accessible in the mouth. In addition, a visual check is easily possible at any time.
  • the implantation technique required for anchoring has long been known and proven.
  • the filling catheter 104 is guided through the mandible 300 and preferably exits at its rear edge. In this way, the catheter is well protected from stress.
  • FIG. 4 illustrates an exemplary application example in which the filling catheter 104 is guided to an insulin pump 400. Recognizable are the exit point 301 of the tooth nerve and the exit point 302 of the filling catheter 104 at the rear edge of the mandible. At the insulin pump 400, a flexible delivery catheter 500 is present.
  • Implantable insulin pumps are known in the art and are available, for example, from Medtronic Diabetes, Northridge, CA (USA). You have one internal reservoir from which it controls, for example, according to a specified program or on external initiative, insulin into the surrounding tissue. Typically, such a reservoir holds 10 to 30 ml of insulin solution, which is sufficient for up to several months of operation without refilling. Frequently, a filling of the reservoir is provided by the generation of negative pressure, so that when filled through a cannula through the abdominal wall, as practiced in the prior art, the insulin solution is automatically drawn into the reservoir. For use with a feeder according to the present invention, this type of filling is also advantageous.
  • the filling program is preferably adapted to the specific conditions of the filling via the long filling catheter 104 (eg by taking into account the relatively small flow rate through such a catheter and the higher pressure loss over its length).
  • the control of the pump 400 in particular the control of the filling, preferably takes place contactlessly via radio frequency signals.
  • the insulin pump preferably has a titanium sheath, resulting in good biocompatibility.
  • a flexible delivery catheter known from US 2004/0049169 can be used as the delivery catheter 500.
  • a major advantage of such a flexible delivery catheter is that ingrowth and consequent scar tissue formation and fibrin fiber formation by the delivered insulin is largely avoided.
  • the delivery catheter 500 can also be designed in another way.
  • FIGS. 5A and 5B show how the filling catheter 104 can be advantageously connected to the insulin pump 400.
  • the dental implant is fixed according to known implantation techniques.
  • a small incision is made and the mandible prepared for the laying of the catheter.
  • the filling catheter is then guided through the implant and the mandible to the exit site. From its exit point, the filling catheter is then subcutaneously up to the Muscular fascia pocket performed (subcutaneous tunneling).
  • the muscle fascia pocket was previously prepared by a small incision at the costal margin for receiving the insulin pump. Now the pump is connected to the filling catheter and inserted.
  • the delivery device of the present invention makes it possible to completely dispense with injecting insulin solution through sensitive regions such as the abdominal wall.
  • the associated infection risk is drastically reduced by the present invention.
  • the risk of infection after the end of the surgical procedures for anchoring the implant also decreases in time.
  • FIGS 6A to 6C illustrate how a liquid can be introduced through the delivery device of Figure 1.
  • a filling device 600 is provided. This has a filler neck 601, which is used instead of the insert 107 in the upper opening of the channel in the base body 101.
  • the filler neck 601 is located on conical outer wall portions 602 and 603 sealingly against the conical wall portions 110 and 111 of the channel.
  • a continuous vertical bore is present in the filler neck 601 .
  • a filler plug 620 is arranged in this .
  • This has a cylinder head 628 and an adjacent smooth-walled, cylindrical portion 621 which extends through the bore of the filler neck 601 therethrough.
  • an O-ring 608 is also arranged in an annular recess in the filler neck, which surrounds the cylindrical portion sealing.
  • the filling screw 620 has an external thread 624, which extends into the internal thread of the implant main body
  • the filling screw 620 is in a ner shown initial position in which it just reached the internal thread.
  • the filling screw 620 has along its cylindrical portion 621 two parallel and axially extending grooves 622, 623 in its outer wall. These form together with the bore of the filler neck in each case a liquid channel. In the position of Fig. 6B, these two channels communicate with horizontal bores 604, 605 in the filler neck, which in turn lead to hoses 606, 607 attached to the filler neck.
  • the outside area of the valve 106 and the adjacent area of the implant 100 can be flushed with liquid by supplying liquid into the area of the valve via the first fluid channel of the filling device (bore 604, groove 622) and via the second fluid channel (Groove 623, bore 605), the liquid is discharged again. This is indicated in FIG. 6B by two arrows. As a result, any invaded saliva or invading germs are removed.
  • the liquid may be a special rinse solution, e.g. Saline solution or a disinfectant solution, or the same type of liquid as is subsequently filled.
  • the spacer 630 is removed.
  • the filler plug 620 is screwed in until it pushes in the ball of the valve.
  • the displaced during screwing liquid can flow through the second fluid channel of the filling device (groove 623, bore 605).
  • the finally assumed position is shown in FIG. 6C. Now, the liquid supplied through the first fluid channel of the filling device (groove 623, bore 605) can reach the filling catheter 104 through the opened valve.
  • the filler neck 601 and the filler plug 620 are preferably made of a corrosion resistant metal such as stainless steel or titanium or a plastic such as PEEK (polyetheretherketone).
  • the transition from the horizontal bores 604, 605 to the grooves 622, 623 is preferably in a manner as shown in Figs. 7A and 7B.
  • Each of the horizontal holes terminates in a semi-annular groove 625, 626 in the bore of the filler neck. These grooves can be seen in the sectional view of FIG. 7B.
  • Each of the semi-annular grooves extends around the filler plug 620 in an angular range of just under 180 °.
  • each of the two grooves 622, 623 of the filling screw 620 communicates with one of the two semi-annular grooves 625, 626. This ensures that two continuous fluid channels are formed in almost every screw position.
  • FIGS. 8A and 8B An alternative to this is shown in FIGS. 8A and 8B.
  • the first horizontal bore 604 terminates in a circumferential annular groove 627 in the bore of the filler neck, which is seen in the sectional view of Fig. 8B.
  • This annular groove extends completely around the filler plug 620 and communicates with the groove 622 in the filler plug. In this way, regardless of the screw position, a continuous first fluid channel is present.
  • the second fluid channel is directly through holes in the filler neck trained.
  • fluid guides are possible, e.g. a guide through a central hole in the filler plug or a guide that runs completely through the filler neck.
  • the illustrated port system of delivery device and filling device can be easily modified so that it can be used in other places than in the mandible.
  • the implant can be shaped differently in order to be implanted in another bone, which is easily accessible from the outside of the body.
  • the implant is covered only by a relatively thin layer of skin and on the other hand, an implant at this point has little aesthetic disturbing effect.
  • an already existing prosthesis can be suitably adapted in this way to introduce a fluid into the body, e.g. an ear prosthesis.
  • the proposed port system can be used wherever a fluid, i. a liquid or gas controlled to be supplied to a place inside the body, e.g. for rinses, for dialysis, etc.
  • a fluid i. a liquid or gas controlled to be supplied to a place inside the body, e.g. for rinses, for dialysis, etc.
  • electrical lines, optical fibers o.a. It is possible to inject energy into the body via the port or to read signals from there.
  • the present invention thus represents a flexibly usable and easily adaptable to specific requirements port system, which creates an optimal interface to the body interior and highest hygienic to be able to speak.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pulmonology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Biophysics (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Vascular Medicine (AREA)
  • Prostheses (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)

Abstract

L'invention concerne un système d'orifice qui permet d'apporter un fluide à l'intérieur du corps. Ce système comprend un dispositif d'amenée auquel est adapté un dispositif de remplissage (600). Le dispositif d'amenée comprend un implant (100) dans lequel un canal continu est formé, ainsi qu'un cathéter (104) adjacent à ce canal. Une soupape (106) est disposée dans le canal. Un moyen de fixation garantit que le dispositif de remplissage (600) puisse être fixé sur l'implant (100) de telle sorte qu'une partie extérieure de la soupape (106) puisse d'abord être rincée avant le remplissage. L'invention indique des modes de réalisation spécialement conçus dans de but. L'implant (100) est de préférence un implant dentaire. Le système d'orifice convient en particulier pour amener de l'insuline à une pompe à insuline implantée.
PCT/CH2006/000616 2005-11-04 2006-11-01 Systeme d'amenee de liquides a l'interieur du corps WO2007051339A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH1767/05 2005-11-04
CH01767/05A CH698841B1 (de) 2005-11-04 2005-11-04 System zum Zuführen von Flüssigkeiten ins Körperinnere.

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WO2007051339A1 true WO2007051339A1 (fr) 2007-05-10

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Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7244051B2 (en) 2003-04-09 2007-07-17 Schott Ag Light-generating apparatus having a reflector
EP2092943A1 (fr) * 2008-02-21 2009-08-26 Universität Bern Accès implantable pour le retrait et/ou le retour de fluides
EP2095788A1 (fr) * 2008-02-29 2009-09-02 Pharmaco-Kinesis Corporation Appareil médicamenteux de dent artificielle pour contrôler, réguler et détecter et libérer des agents médicaux dans le corps
EP2286849A1 (fr) 2009-08-21 2011-02-23 Cendres & Métaux S.A. Accès vasculaire implantable
WO2012093277A3 (fr) * 2010-10-25 2012-11-01 Vladila Bogdan Constantin Traitement cellulaire électromagnétique
WO2012165987A3 (fr) * 2010-10-25 2013-04-04 Vladila Bogdan Constantin Implant dentaire et ensemble d'éléments et de dispositifs médicaux pour en accélérer l'ostéo-intégration
US9174037B2 (en) 2010-06-04 2015-11-03 Cendres + Mataux SA Implanted access port
WO2016023998A1 (fr) * 2014-08-15 2016-02-18 Schlee, Markus Système pour le nettoyage in situ d'implants dentaires
US9333331B2 (en) 2010-11-08 2016-05-10 Cendres+Metaux Sa Method for implanting an access port
CN111134879A (zh) * 2020-01-17 2020-05-12 上海臻威医疗器械有限公司 口腔种植手术用引导装置
FR3100706A1 (fr) * 2019-09-13 2021-03-19 Roux Freres Energie Prothèse dentaire de raccordement d’un organe intracorporel à un dispositif extracorporel

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DE102012022227A1 (de) * 2012-11-14 2014-05-15 Urs Brodbeck Behandlungselement zur Verwendung mit einem Dental-Implantat-Teil, Behandlungssystem und Verfahren zur Reinigung eines Dental-Implantat-Teils

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US4021921A (en) * 1974-10-18 1977-05-10 Detaille Louis J Device for treating the pulp-canals of a tooth
US4412825A (en) * 1981-09-17 1983-11-01 Tokarz Richard D Medical entry connector for teeth bearing animals
US20050256540A1 (en) * 2004-02-26 2005-11-17 Silver Theodore A Apparatus and method for movement of electricity or fluid into and out of the body

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Publication number Priority date Publication date Assignee Title
US4021921A (en) * 1974-10-18 1977-05-10 Detaille Louis J Device for treating the pulp-canals of a tooth
US4412825A (en) * 1981-09-17 1983-11-01 Tokarz Richard D Medical entry connector for teeth bearing animals
US20050256540A1 (en) * 2004-02-26 2005-11-17 Silver Theodore A Apparatus and method for movement of electricity or fluid into and out of the body

Cited By (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7244051B2 (en) 2003-04-09 2007-07-17 Schott Ag Light-generating apparatus having a reflector
US8845573B2 (en) 2008-02-21 2014-09-30 Universitaet Bern Implantable access for removal and/or return of fluids
EP2092943A1 (fr) * 2008-02-21 2009-08-26 Universität Bern Accès implantable pour le retrait et/ou le retour de fluides
WO2009103758A2 (fr) * 2008-02-21 2009-08-27 Universitaet Bern Accès implantable pour le prélèvement et/ou le retour de liquides
WO2009103758A3 (fr) * 2008-02-21 2009-10-29 Universitaet Bern Accès implantable pour le prélèvement et/ou le retour de liquides
EP2095788A1 (fr) * 2008-02-29 2009-09-02 Pharmaco-Kinesis Corporation Appareil médicamenteux de dent artificielle pour contrôler, réguler et détecter et libérer des agents médicaux dans le corps
US8926591B2 (en) 2009-08-21 2015-01-06 Cendres + Metaux Sa Implantable vascular access
WO2011020873A1 (fr) 2009-08-21 2011-02-24 Cendres + Métaux Sa Accès vasculaire implantable
EP2286849A1 (fr) 2009-08-21 2011-02-23 Cendres & Métaux S.A. Accès vasculaire implantable
US9174037B2 (en) 2010-06-04 2015-11-03 Cendres + Mataux SA Implanted access port
WO2012093277A3 (fr) * 2010-10-25 2012-11-01 Vladila Bogdan Constantin Traitement cellulaire électromagnétique
WO2012165987A3 (fr) * 2010-10-25 2013-04-04 Vladila Bogdan Constantin Implant dentaire et ensemble d'éléments et de dispositifs médicaux pour en accélérer l'ostéo-intégration
US9333331B2 (en) 2010-11-08 2016-05-10 Cendres+Metaux Sa Method for implanting an access port
WO2016023998A1 (fr) * 2014-08-15 2016-02-18 Schlee, Markus Système pour le nettoyage in situ d'implants dentaires
CN107106265A (zh) * 2014-08-15 2017-08-29 赛福马有限责任公司 用于现场清洗种植牙的系统
EP3179957B1 (fr) * 2014-08-15 2020-10-28 Zyfoma GmbH Système pour le nettoyage in situ d'implants dentaires
US10864061B2 (en) 2014-08-15 2020-12-15 Zyfoma Gmbh System for the in situ cleaning of dental implants
FR3100706A1 (fr) * 2019-09-13 2021-03-19 Roux Freres Energie Prothèse dentaire de raccordement d’un organe intracorporel à un dispositif extracorporel
CN111134879A (zh) * 2020-01-17 2020-05-12 上海臻威医疗器械有限公司 口腔种植手术用引导装置
CN111134879B (zh) * 2020-01-17 2021-08-03 上海臻威医疗器械有限公司 口腔种植手术用引导装置

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