WO2008003111A1 - Dispositif pour fermer des ouvertures de manière étanche - Google Patents

Dispositif pour fermer des ouvertures de manière étanche Download PDF

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Publication number
WO2008003111A1
WO2008003111A1 PCT/AT2007/000331 AT2007000331W WO2008003111A1 WO 2008003111 A1 WO2008003111 A1 WO 2008003111A1 AT 2007000331 W AT2007000331 W AT 2007000331W WO 2008003111 A1 WO2008003111 A1 WO 2008003111A1
Authority
WO
WIPO (PCT)
Prior art keywords
suction
tubular element
openings
wall
connectable
Prior art date
Application number
PCT/AT2007/000331
Other languages
German (de)
English (en)
Inventor
Thomas Wild
Ewald Unger
Original Assignee
Medizinische Universität Wien
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 Medizinische Universität Wien filed Critical Medizinische Universität Wien
Publication of WO2008003111A1 publication Critical patent/WO2008003111A1/fr

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
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • 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
    • A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
    • 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
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00278—Transorgan operations, e.g. transgastric
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30—Surgical pincettes without pivotal connections
    • A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3419—Sealing means between cannula and body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/3443—Cannulas with means for adjusting the length of a cannula
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
    • A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
    • A61B2017/3486—Balloon
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
    • A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
    • A61B2017/3488—Fixation to inner organ or inner body tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/005—Auxiliary appliance with suction drainage system
    • 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
    • A61B90/40—Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
    • 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
    • A61F13/00—Bandages or dressings; Absorbent pads
    • 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
    • A61F13/00—Bandages or dressings; Absorbent pads
    • A61F2013/00361—Plasters
    • A61F2013/00365—Plasters use
    • A61F2013/00536—Plasters use for draining or irrigating wounds
    • 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
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/44—Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Portable urination aids; Colostomy devices
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/77—Suction-irrigation systems

Definitions

  • the invention relates to a device for sealing openings of a wall of the intestine against the abdominal cavity and for separating septic areas.
  • vacuum therapy Methods for promoting wound healing have already become known, which are referred to as vacuum therapy and use a vacuum-assisted wound closure or a vacuum seal as a non-invasive active therapy for promoting wound healing.
  • Such methods rely on the exercise of a defined controlled vacuum on the wound surface.
  • Such a method is primarily intended to have a positive effect on local perfusion and granulation tissue proliferation in the wound.
  • extravascular interstitial fluid can be aspirated with such a method.
  • the invention now aims to provide a device of the type mentioned above, with which the healing can be generally accelerated and at the same time the possibility is created in the case of breakthroughs, which were triggered for example by intestinal obstructions, to create an artificial exit at which septic and aseptic areas can be clearly separated.
  • the device according to the invention consists in a particularly advantageous manner in that a tubular element is provided, which has for the encompassing of the opening of the intestinal wall certain elastic edge suction openings and with a suction port or a vacuum source is connectable.
  • a tubular element is provided, the possibility is provided to attach a kind of chimney over the wound, wherein the fact that the edge of this tubular member has suction openings and is connectable to a suction or a vacuum source, the possibility is created, the Edge of this tubular element sealingly applied to the edge of the opening, so that a separation of septic and aseptic areas succeed.
  • the opening formed in this way allows the immediate action on the septic and usually infectious wound, at the same time an artificial exit can be created.
  • the separation of the abdominal space from the septic area formed by the sucked-in rim of the tubular element allows the secretion exiting the fistula to be adequately suctioned, whereby the external wound area itself can be subjected to therapeutic treatment independently of the treatment of the wound itself.
  • the design is such that the tubular element is designed as a bellows, wherein to maintain a tight connection of the front side of the tubular element with advantage the formation is made such that the bellows in the axial direction of the bellows extending channels or at least one chamber which is connected to the suction ports and to the suction port (are).
  • the embodiment is developed in a particularly advantageous manner such that the outer wall of the tubular element is surrounded by a sponge-like or foamed jacket whose pores are in communication with a further suction connection.
  • a wound foam which is designed, for example, as a collagen wound dressing, makes it possible to further improve the seal and to reliably prevent secretions from entering the abdomen from the fistula. Due to the fact that a further suction connection is arranged here, vacuum can also be applied to the wound foam and in this way, if necessary, secretions are sucked off, such a foam can be used to simultaneously introduce healing-promoting active ingredients for the abdomen.
  • a particularly good distribution of the vacuum on the wound foam can be achieved in that the further suction connection for the sponge-like or foamed sheath is designed as a concentric, unrestricted ring distributor as the tubular element.
  • a particularly simple application of the required vacuum and, if necessary, the respectively required pressure can be achieved by arranging the suction connections on or near the end face of the tubular element facing away from the suction openings outside a cover foil extending essentially radially.
  • the substantially radially extending rectangular cover film can be attached, for example, to the abdominal wall and held by applying the adjustable negative pressure in the particular desired position.
  • the entire device is sensibly designed as a disposable device to eliminate the risk of microbial contamination. If necessary, it should also be changed during the therapy, in which case the wound foam should be exchangeable according to the wound care and wound size.
  • the design is advantageously developed such that the two suction connections can be adjusted separately or in combination with adjustable pressure control devices , in particular pressure reducer, are connectable to a Hauptsaugan gleich, wherein preferably the Hauptsaugan gleich via a water trap or a siphon with the suction ports of the device are connectable.
  • a siphon protects the pressure distributor or the corresponding pressure control devices against contamination, wherein the negative pressure for the suction on the intestinal wall, for example, can be applied slightly higher than the negative pressure in the abdominal area.
  • the underpressure in the abdominal cavity is usually maintained at about 125 mm Hg, whereby not only is a particularly secure closure between the septic area and the pressure selected for the end wall suction openings smaller than the pressure applied to the spongy or foamed mantle Abdominal cavity is achieved.
  • the device according to the invention Compared with the previously known vacuum therapy, in which the negative pressure was exerted only on the wound itself, it is possible with the device according to the invention to develop forms of therapy in which the actual wound area or the opening to be treated is available as an artificial intestinal outlet and the surrounding areas can be treated effectively separated from the septic wound therapy of the wound site (fistula), whereupon, after appropriate limitation of the subsequently to be treated in the body Intestinal wall the definitive healing can be started with simultaneous use of the natural source.
  • FIG.l show a cross section through the device according to the invention
  • Figure 2 is a perspective view of the device according to Fig.l from above the side.
  • FIG. 1 shows the device 1 according to the invention, which has a tubular element 2.
  • the tubular element 2 is designed as a bellows and has a cavity 3, which is connected to a suction port 4.
  • the lower end face 5 of the tubular element 2 in this case has suction openings 6 on the circumference, which can be sucked to the edge of an opening of a bowel wall.
  • a sponge-like or foamed material Concentric with the tubular element 2, a sponge-like or foamed material is provided as a jacket 12. This wound foam 12 is connected to a further suction connection 7. On the side facing away from the end face 5 of the tubular element, a cover 8 is provided.
  • a negative pressure can now be intentionally applied, whereby a sealing pressing of the tubular element onto a wall of the intestine succeeds on one side via the suction openings 6, at the same time forming a chimney-like channel 9 which provides an artificial outlet for the intestine formed.
  • a closure lid is referred to, which covers the septic area.
  • the suction connection 7 opens into a vacuum distributor 11, via which the negative pressure is evenly distributed in the wound foam 12. After removal of the lid 10, access to the septic area is made possible, whereas in the radial direction outside of the enveloping circle of the suction holes 6 an aseptic area is formed, whereby via the wound foam 12 corresponding active substances can be introduced for faster healing of this area.
  • the wound foam 12, the lower end wall 5, the cover 10 and the two suction ports 4 and 7 can be seen, wherein the cover film is again denoted by 8 and may have a substantially rectangular outline.
  • the shape of the cover and in particular the size thereof is chosen as a function of the respective location at which the device is to be used. Underneath the end wall 5 of the tubular element is the intestine with the intestinal fistula, whereby a corresponding delimitation of the septic area from the aseptic area is achieved by the edge of the end face 5.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Medical Informatics (AREA)
  • Otolaryngology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • External Artificial Organs (AREA)

Abstract

Dispositif pour fermer des ouvertures dans une paroi intestinale de manière étanche par rapport à la cavité abdominale et pour délimiter des régions septiques, comprenant un élément tubulaire (2) dont le bord destiné à être entouré par l'ouverture de la paroi intestinale comporte des ouvertures d'aspiration (6) et peut être relié à un raccord d'aspiration (4) et/ou à une source de dépression.
PCT/AT2007/000331 2006-07-04 2007-07-03 Dispositif pour fermer des ouvertures de manière étanche WO2008003111A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AT0113506A AT503904B1 (de) 2006-07-04 2006-07-04 Einrichtung zum abdichten von íffnungen
ATA1135/2006 2006-07-04

Publications (1)

Publication Number Publication Date
WO2008003111A1 true WO2008003111A1 (fr) 2008-01-10

Family

ID=38610964

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/AT2007/000331 WO2008003111A1 (fr) 2006-07-04 2007-07-03 Dispositif pour fermer des ouvertures de manière étanche

Country Status (2)

Country Link
AT (1) AT503904B1 (fr)
WO (1) WO2008003111A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2644138A3 (fr) * 2012-03-26 2014-07-02 Covidien LP Dispositif d'accès chirurgical et dispositif de protection de blessure
WO2014109706A1 (fr) * 2013-01-14 2014-07-17 Kirk Promotion Ltd Dispositif d'assistance chirurgicale

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR996531A (fr) * 1949-10-04 1951-12-20 Trocart pour vidange intestinale aseptique
US4723940A (en) * 1983-06-15 1988-02-09 Akuaba B.V. Method and device to perforate, in particular to puncture a membranous member while utilizing vacuum fixation
US5470320A (en) * 1992-04-10 1995-11-28 Tiefenbrun; Jonathan Method and related device for obtaining access to a hollow organ
US20010029956A1 (en) * 1991-11-14 2001-10-18 Argenta Louis C. Wound treatment employing reduced pressure
WO2003028525A2 (fr) * 2001-09-28 2003-04-10 Moenning Stephen P Complexe trocar-canule, canule et procede d'administration de fluides par micromanipulation chirurgicale
US20040116897A1 (en) * 2000-07-12 2004-06-17 Walid Aboul- Hosn Minimally invasive bypass system and related methods
US20050148822A1 (en) * 2003-12-30 2005-07-07 Willis Geoffrey H. Organ manipulator and positioner and methods of using the same
WO2006012992A1 (fr) * 2004-07-29 2006-02-09 Heinrich Peirlberger Adaptateur de lavage/aspiration

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998038944A1 (fr) * 1997-03-05 1998-09-11 Board Of Regents, The University Of Texas System Systeme d'irrigation auto-etanche
DE102004053166B4 (de) * 2004-11-01 2017-04-06 Primed Halberstadt Medizintechnik Gmbh Vakuum-assistiertes Drainagesystem

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR996531A (fr) * 1949-10-04 1951-12-20 Trocart pour vidange intestinale aseptique
US4723940A (en) * 1983-06-15 1988-02-09 Akuaba B.V. Method and device to perforate, in particular to puncture a membranous member while utilizing vacuum fixation
US20010029956A1 (en) * 1991-11-14 2001-10-18 Argenta Louis C. Wound treatment employing reduced pressure
US5470320A (en) * 1992-04-10 1995-11-28 Tiefenbrun; Jonathan Method and related device for obtaining access to a hollow organ
US20040116897A1 (en) * 2000-07-12 2004-06-17 Walid Aboul- Hosn Minimally invasive bypass system and related methods
WO2003028525A2 (fr) * 2001-09-28 2003-04-10 Moenning Stephen P Complexe trocar-canule, canule et procede d'administration de fluides par micromanipulation chirurgicale
US20050148822A1 (en) * 2003-12-30 2005-07-07 Willis Geoffrey H. Organ manipulator and positioner and methods of using the same
WO2006012992A1 (fr) * 2004-07-29 2006-02-09 Heinrich Peirlberger Adaptateur de lavage/aspiration

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2644138A3 (fr) * 2012-03-26 2014-07-02 Covidien LP Dispositif d'accès chirurgical et dispositif de protection de blessure
WO2014109706A1 (fr) * 2013-01-14 2014-07-17 Kirk Promotion Ltd Dispositif d'assistance chirurgicale
AU2014205723B2 (en) * 2013-01-14 2018-05-31 Medicaltree Patent Ltd. Surgical assisting device
JP2021073036A (ja) * 2013-01-14 2021-05-13 メディカルトゥリー・パテント・リミテッド 医療デバイス
EP4248905A3 (fr) * 2013-01-14 2023-12-27 MedicalTree Patent Ltd. Dispositif d'assistance chirurgicale

Also Published As

Publication number Publication date
AT503904B1 (de) 2009-04-15
AT503904A1 (de) 2008-01-15

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