WO2012007051A1 - A bile draining catheter and method for diverting bile from the gallbladder in the intestine - Google Patents

A bile draining catheter and method for diverting bile from the gallbladder in the intestine Download PDF

Info

Publication number
WO2012007051A1
WO2012007051A1 PCT/EP2010/060289 EP2010060289W WO2012007051A1 WO 2012007051 A1 WO2012007051 A1 WO 2012007051A1 EP 2010060289 W EP2010060289 W EP 2010060289W WO 2012007051 A1 WO2012007051 A1 WO 2012007051A1
Authority
WO
WIPO (PCT)
Prior art keywords
bile
catheter
according
portion
distal
Prior art date
Application number
PCT/EP2010/060289
Other languages
French (fr)
Inventor
Thomas Edward Albrecht
Michael J. Stokes
Mark Steven Ortiz
Alessandro Pastorelli
Taylor Aronhalt
Original Assignee
Ethicon Endo-Surgery, Inc.
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 Ethicon Endo-Surgery, Inc. filed Critical Ethicon Endo-Surgery, Inc.
Priority to PCT/EP2010/060289 priority Critical patent/WO2012007051A1/en
Publication of WO2012007051A1 publication Critical patent/WO2012007051A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F5/00Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/0003Apparatus for the treatment of obesity; Anti-eating devices
    • A61F5/0013Implantable devices or invasive measures
    • A61F5/0076Implantable devices or invasive measures preventing normal digestion, e.g. Bariatric or gastric sleeves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M27/00Drainage appliances for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002Implant devices for drainage of body fluids from one part of the body to another

Abstract

A catheter (6) for draining bile to a target location in the intestinal tract (1) comprises an external surface (7) facing radially outward, a proximal bile capturing portion (8) configured for placement in a biliary flow path (2) and a distal end (9) configured for placement in a target location in the intestinal tract (1), wherein the bile capturing portion (8) is located on the external surface (7) and adapted to capture bile from a radially external side of the catheter (6).

Description

"A BILE DRAINING CATHETER AND METHOD FOR DIVERTING BILE FROM THE

GALLBLADDER IN THE INTESTINE"

DESCRIPTION

The present invention relates, in general, to devices and methods for surgically influencing the digestion of a patient with the aim to treat metabolic disorders, such as morbid obesity and related co-morbidities, such as diabetes, heart disease, stroke and pulmonary disease. Numerous non-operative therapies for morbid obesity have been tried in the past with virtually no permanent success.

Surgical methods of treating morbid obesity, such as open, laparoscopic and endoluminal gastric bypass surgery aiming to permanent malabsorption of the food , have been increasingly used with greater success. However, current methods for performing a gastric bypass involve time-consuming and highly dexterity dependent surgical techniques as well as significant and generally highly invasive modifications of the patients gastrointestinal anatomy. These procedures are reserved only for the severely obese patients because they have a number of significant complications, including the risk of death. In order to avoid the drawbacks of gastric bypass surgery and to influence the digestion of a patient in a more specific and aimed way, the present invention focuses on methods and devices for primarily influencing and modifying the entero-hepatic bile cycling rather than the digestive tract itself. To this end, the following possible approaches and mechanisms of action on the entero- hepatic bile cycling are contemplated:

- modification of the entero-hepatic bile cycling frequency, particularly bile cycle acceleration;

- modification of the physiological signaling triggered by the contact and interaction of the bile with the food in the intestine and by the contact of the bile with the intestinal wall;

- modification of the food absorbability by modifying the contact space and time between the bile and the food or chime in the intestine as well as by an aimed separation of the bile from the food.

A known minimally invasive bypass system and method for modifying the location at which bile and pancreatic secretions interact with nutrients in a gastrointestinal tract has been discussed in US 2005085787 A1 . The known system comprises a conduit having a first end wh ich diverts bi le and pancreatic secretions from the ampulla of Vater to a location downstream in the gastrointestinal tract and a second end attached to the ampulla of Vater. The known device can divert only the amount of bile which has been released through the sphincter of ODDI and the flow rate of bile through the known conduit would not be sufficient to obtain a significant acceleration of the bile cycling compared to the natural entero-hepatic bile cycling velocity.

Moreover, known conduit catheters tend to be displaced by the peristalsis of the intestinal tract so that the distal end of the catheter is frequently relocated far away from the target position intended by the surgeon.

In view of the drawbacks of the known art, there is a need to provide a minimally invasive device and method of diverting bile from the biliary tree including the gallbladder into a section of the small intestine significantly distally from the papilla of Vater, in which the bile is captured more efficiently and faster.

There is a further need to increase the flow rate of the diverted bile towards the target location in the small intestine.

There is a yet further need to provide methods and devices for diverting bile from the biliary tree into a target location of the small intestine, which obviate undesired relocations of a bile release portion from the target location.

At least part of the above identified needs are met by a catheter for draining bile, the catheter comprising an external surface facing radially outward, a proximal bile capturing portion configured for placement inside a biliary duct and a distal end configured for placement in a target location in an intestinal tract, wherein the bile capturing portion is located on the external surface and adapted to capture bile from a radially external side of the catheter. This provides an increased bile capturing surface compared to an open tubular end and makes it possible to capture and drain more efficiently and more completely the bile present in the biliary tree.

I n accordance with an aspect of the invention, the bile capturing portion comprises a drainage wire coated with a bile attracting agent, such as a bile acid sequestrant adapted to exchange anions for bile acids, thereby sequestering bile acids and attracting the bile onto the drainage wire.

I n accordance with a further aspect of the invention , the bile capturing portion has a multifilament fibrous structure, such as wicking, adapted to attract and drain bile by capillary action.

In accordance with a further aspect of the invention, at least the bile capturing portion forms a plurality of externally open channels extending in a longitudinal direction of the catheter. Such externally open channels can capture and completely receive the bile and convey it distally without isolation from the external environment.

In accordance with a yet further aspect of the invention, the catheter comprises at least one capillary bile conveying duct in fluid communication with the bile capturing portion and adapted to convey the captured bile by capillary action.

In accordance with a further aspect of the invention, the catheter comprises at least one bile conveying duct in fluid communication with the bile capturing portion and deformable in a milking manner by external pressure. In this way, the intestinal peristalsis and chime movement acting on the catheter is transformed in a pumping movement which increases the flow rate of the diverted bile.

In accordance with a yet further aspect of the invention, the catheter comprises at least one bile conveying duct in fluid communication with the bile capturing portion, wherein the bile conveying duct is made from or internally coated with a moisture repellent material which prevents the bile from adhering to the duct wall and, thus, reduces the flow resistance.

In accordance with an aspect of the invention, the catheter comprises tensioning means acting on the distal catheter end, thereby preventing the catheter from bundling up and obviating the risk of dislocation of the distal catheter end away from the intended target location.

I n accordance with an aspect of the invention , the tensioning means comprises an expandable enlarged perimeter portion formed near the distal catheter end, the enlarged perimeter portion forming a peristalsis force application surface so that the catheter is tensioned distally.

In accordance with a further aspect of the invention, the tensioning means comprises an expandable space frame connected near the distal catheter end, the space frame forming a peristalsis force application surface so that the catheter is tensioned distally. The space frame causes the body to apply a tensioning force on the catheter, while letting the chime pass through, thereby obviating undesired accumulation of chime or stool at the catheter end.

In accordance with a yet further aspect of the invention, the tensioning means comprises a flexible stripe connected near the distal catheter end, the stripe forming a peristalsis force application surface so that the catheter is tensioned distally.

Accordingly, the invention provides also a method for diverting biliary fluid within a body, the method comprising the steps of inserting a flexible catheter in the intestinal tract, connecting a proximal catheter end in fluid communication with the bile duct, placing a distal catheter end in a target position distally in the intestinal tract; tensioning the catheter by applying a distal pulling force on the distal catheter end.

These and other aspects and advantages of the present invention shall be made apparent from the accompanying drawings and the description thereof, which illustrate embodiments of the invention and, together with the general description of the invention given above, and the detailed description of the embodiments given below, serve to explain the principles of the present invention.

- Figure 1 illustrates a method and catheter for draining bile from the biliary tree to a target location of the small intestine in accordance with an embodiment of the invention;

- Figure 2 is an enlarged view of a detail of the catheter in figure 1 ;

- Figure 3 is a cross-sectional view of a bile capturing portion of a catheter for draining bile in accordance with an embodiment;

- Figure 4 illustrates a method and catheter for draining bile in accordance with a further embodiment of the invention;

- Figure 5 illustrates a method and catheter for draining bile in accordance with a further embodiment of the invention;

- Figure 6 illustrates a distal end of a catheter for draining bile in accordance with a further embodiment of the invention;

- Figure 7 illustrates a distal end of a catheter for draining bile in accordance with a further embodiment of the invention;

- Figures 8 to 14 illustrate supplementary anchoring means for anchoring a bile drain catheter in the Gl tract.

Referring to the drawings where like numerals denote like anatomical structures and components throughout the several views, figure 1 depicts a portion of small intestine 1 and part of the biliary duct 2 with gall bladder 3, the pancreatic duct 4 and the mayor duodenal papilla of Vater 5 through which the bile and pancreatic fluid normally enter the duodenum. Figure 1 shows further a catheter 6 for draining bile from the biliary tree 2 to a target location further distally in the small intestine 1 .

The catheter 6 comprises an external surface 7 facing radially outward, a proximal bile capturing portion 8 configured for placement inside the biliary duct 2 and a distal end 9 configured for placement in a target location in the intestinal tract 1 , wherein the bile capturing portion 8 is located on the external surface 7 and adapted to capture bile from a radially external side of the catheter 6. This provides an increased bile capturing surface compared to an open tubular end and makes it possible to capture and drain more efficiently and more completely the bile present in the biliary tree.

In accordance with an embodiment (Figure 1 ), the bile capturing portion 8 comprises a drainage wire 10 coated with a bile attracting agent, such as a bile acid sequestrant adapted to exchange anions for bile acids, thereby sequestering bile acids and attracting the bile onto the drainage wire 10. Examples for bile acid sequestrants are polymeric compounds adapted to serve as ion exchange resins. The bile attracting coating causes part of the bile to cover the surface of the drainage wire 10 and, due to the surface tension of the bile, the remaining not actively sequestered bile will adhere to the sequestered bile and, hence, be captured by the catheter.

In accordance with an embodiment, the bile capturing portion 8 or the previously described drainage wire 10 can have a multifilament fibrous structure, such as wicking, adapted to attract and drain bile by capillary action.

As illustrated in figure 1 , the drainage wire 10 may extend from the proximal bile capturing portion 8 further distally and form also a bile conveying duct of the catheter, adapted to convey bile without isolating it from the external environment. The catheter 6 may further comprise a bile release portion 1 1 attached to the drainage wire 10 and adapted to detach and shed the bile from the drainage wire 10. The bile release portion 1 1 can comprise a sleeve made from or coated with moisture repellent material (e.g. PTFE) or inert material and inserted over a distal end portion of the drainage wire 10.

In accordance with a further embodiment (Figure 3), the bile capturing portion 8 forms a plurality of externally open channels 12 which extend in a longitudinal direction of the catheter 6. Such externally open channels 12 can capture and completely receive the bile and convey it distally without isolation from the external environment. Also in th is embodiment, the externally open channels 12 may extend from the proximal bile capturing portion 8 further distally and form also a bile conveying duct of the catheter, adapted to convey bile without isolating it from the external environment.

It is further contemplated that the catheter forms a plurality of longitudinally extending channels having at least one tubular bile conveying tract extending inside the catheter isolated from the external environment (not illustrated) and at least one laterally open bile capturing tract formed in the external surface 7 of the catheter 6 exposed to the external environment (as shown in figure 3).

The catheter 6 may further comprise at least one bile conveying d uct 13 in fluid communication with the bile capturing portion 8. The bile conveying duct 13 may be capillary and adapted to convey the captured bile by capillary action.

In accordance with a further embodiment, the bile conveying duct 1 3 is deformable in a milking manner by external pressure. In this way, the intestinal peristalsis and chime movement acting on the catheter 6 is transformed in a pumping movement which increases the flow rate of the diverted bile. In accordance with a yet further embodiment, the bile conveying duct 13 is made from or internally coated with a moisture repellent material which prevents the bile from adhering to the duct wall and, thus, reduces the flow resistance. Advantageously, the moisture repellent material, such as polytetrafluoroethylene can be deposited on the internal surface of the bile conveying duct, using a hot-filament chemical vapour deposition (HFCVD), such as to obtain a nano-scale thickness layer. Together with the moisture repellent agent, antibacterial or biologically active molecules, such as enzymes or DNA, may be deposited to biologically influence the bile before discharging it in the target location of the small intestine.

The moisture repellent bile conveying duct in fluid communication with the above described bile capturing portion tends to suck the bile into the catheter 6 and propel it quickly distally through it.

The present invention also addresses the problem of undesired dislocation of a bile drain catheter from the intended target location, as well as the undesired bundling up and related risk of kinking and clogging of the catheter lumen. In order to obviate these phenomena, it is proposed to equip the catheter with tensioning means acting on a distal catheter end.

In the following, exemplary advantageous embodiments of such catheter tensioning means will be described in connection of the above disclosed bile draining catheter 6. On the basis of the present disclosure, those skilled in the art will appreciate the synergistic effect of the combination of the described bile capturing and propelling features and the catheter tensioning features, which optimize bile capturing, bile conveying and bile flow path determination.

In accordance with an embodiment (Figure 1 ), the tensioning means can comprise a ballast mass 14 attached to the catheter 6 near its distal end 9 to tension the catheter by gravity and to provide an inertial resistance against displacement of the catheter distal end 9. Moreover, the ballast mass 14 causes the distal catheter end 9 to have more weight for an easier insertion into the gastrointestinal tract.

In accordance with an alternative embodiment (Figures 4 and 5), the tensioning means comprises a (preferably expandable) enlarged perimeter portion 15 formed near the distal catheter end 9 and adapted to form a peristalsis force application surface so that the catheter 6 is tensioned distally.

The enlarged perimeter portion 15 may have a substantially truncated cone shape and can have enlarged longitudinal slots 16 through which bile may be discharged in the intestine. For this purpose, the slots 16 can be fluid connected to the bile conveying duct 13 of the catheter 6. Also the proximal bile capturing portion 8 could be shaped as an enlarged perimeter portion with longitudinal slots forming the above described externally open channels 12.

Advantageously, the enlarged perimeter portion 15 is expandable from a radially compressed configuration which enables transoral introduction in the intestinal tract. For instance, the enlarged perimeter portion 15 could be compressed within a sheath (not shown in the figures) and adapted to elastically expand upon removal of the sheath.

In accordance with an alternative embodiment, the enlarged perimeter portion 15 can comprise an expandable balloon or a temperature dependent expanding frame, e.g. made from a shape memory material. The frame is annealed in a e.g. coiled enlarged shape and subsequently longitudinally straightened and compressed in a stressed shape, and expands to its relaxed enlarged shape upon exposure to the body temperature. The frame may be fabricated from a NiTi - alloy, such as Nitinol.

The catheter is transorally inserted in the intestine. The proximal bile capturing portion is then connected in fluid communication with a bile flow, for instance inside the bile duct 2 or inside a bile collecting chamber formed by a bile collecting stent 17 (Figure 5), which has been previously placed and anchored in the duodenum at the papilla of Vater 5. Then the distal end 9 of the catheter is placed in the intended target location in the intestine and the enlarged perimeter portion 1 5 is expanded to tension the catheter 6 distally, thereby maintaining its intended position.

In accordance with a further embodiment (Figure 6), the tensioning means comprises an expandable space frame 18 connected near the distal catheter end 9. The space frame 18 causes the body to apply a tensioning force on the catheter 6, while allowing the chime flow to pass through the frame, so that an undesired accumulation of chime or stool at the distal catheter end 9 is avoided.

The expandable space frame 18 can be substantially cone shaped, dome shaped or pyramid shaped. In accordance with an embodiment, the expandable space frame 18 is made from a shape memory material. The frame is annealed in the enlarged shape and subsequently longitudinally straightened and compressed in a stressed shape, and expands to its relaxed enlarged shape upon exposure to the body temperature. The shape memory material can be a NiTi - alloy, such as Nitinol.

The introduction of the catheter in the body and the expansion of the space frame 18 can be accomplished using the same method described in connection with the catheter with expandable enlarged perimeter portion 15 (Figures 4, 5).

In accordance with a yet further embodiment, the tensioning means comprises a flexible stripe 19 connected to the catheter 6 near the distal end 9 and forming a peristalsis force application surface so that the catheter 6 is tensioned distally. During endoluminal, e.g. transoral, introduction of the catheter 6 in the intestinal tract, the flexible stripe 19 can be wrapped around the catheter end 9. When the stripe 19 is helicoidally wrapped from the distal catheter end in a proximal direction, it will remain wrapped during insertion of the catheter in a distal direction and subsequently unwrap due to peristalsis and chime flow acting in the distal direction. Once unwrapped, the comparatively great surface area of the stripe 19 will cause the stripe to be dragged distally by the flow of bowel contents, thereby tensioning the catheter 6.

As can be readily appreciated from the foregoing description, the invention provides also a general method for diverting biliary fluid within a body. According to this method, a flexible catheter is inserted in the intestinal tract, a proximal catheter end is connected in fluid communication with the bile duct, a distal catheter end is placed in a target position distally in the intestinal tract and the catheter is tensioned by applying a distal pulling force on the distal catheter end.

In accordance with a further embodiment, a system for draining bile is proposed, the system comprising the bile draining catheter 6 and supplementary anchoring means which are connected with the catheter 6 and adapted to anchor the latter in a location in the Gl tract, preferably at a distance from the proximal bile capturing portion 8 and proximal (upstream) to the papilla of Vater 5. The supplementary anchoring means provide a supplementary fixation of the catheter 6 to better resist against peristalsis forces.

Figure 8 shows an embodiment, in which the catheter 6 can be anchored to the intestinal wall by means of a submucosal band 20 inserted in the intestinal wall and extending all around it such as to form an anchoring ring which creates a bottleneck portion in the intestinal wall, adapted to engage a corresponding annular anchoring groove 21 formed in an annular anchoring portion 22 adapted to allow the intestinal contents to pass through and to which the catheter 6 may be connected by means of an anchoring wire 23.

Figure 9 illustrates a yet further exemplary embodiment, in which the catheter 6 can be anchored in the G l tract by means of a gastric stent 24 and an attached elastically expandable (possibly shape memory) arch 25 adapted to create a shape connection with the stomach 26.

Figure 10 illustrates a yet further exemplary embodiment, in which the catheter 6 can be anchored in the Gl tract by means of one or more T-tags 27 fired from the inside of the intestine in the intestinal wall, thereby forming fixation points. The T-tags 27 are directly connected with the bile draining catheter 6 by a pull resistant anchoring wire 23 or, alternatively, the T-tags 27 are connected to a ring shaped anchoring stent 28 which in turn is connected to the catheter 6 by an anchoring wire 23.

Figures 1 1 and 1 1A illustrate a yet further exemplary embodiment, in which the catheter 6 can be anchored in the Gl tract by means of an annular anchoring portion 29 having a plurality of anchoring barbs 30. The barbs 30 are movable, e.g. rotatable, from a rest position in which the barbs 30 are contained within the encumbrance of the anchoring portion 29 to enable unobstructed endoluminal transport of the anchoring portion 29, to a working position in which the barbs 30 protrude radially outward, thereby piercing the lumen wall and, hence, anchoring the anchoring portion 29 thereto. Also in this embodiment, the catheter 6 is connected to the anchoring portion 29 by a pull resistant anchoring wire 23.

In a further exemplary embodiment, illustrated in figures 12 - 12C, the catheter 6 can be anchored in the Gl tract by means of a tubular or annular anchoring portion 31 having one or more anchoring holes 32 intended to face adjacent intestinal wall portions and adapted to allow these intestinal wall portions to be pulled into the holes 32 and fixed thereto. An endoluminal suction device 33 may be provided for sucking the lumen wall portions from inside the tubular anchoring portion 31 and pulling them in the anchoring holes 32, as well as means and methods for creating a permanent (mushroom head type) swelling of the lumen wall portion, preventing it from withdrawal from the anchoring holes 32. Such means and methods for creating a permanent swelling of the lumen wall portion may comprise the submucosal injection of a swelling agent or sclerosant agent or insertion of a plastic bead, e.g. Poly(methyl methacrylate) PMMA, in the tissue portions which have been previously pulled through the anchoring holes 32. For instance, absolute ethanol may be injected in the tissue portion to induce rapid dehydration and scar formation. The bile draining catheter 6 is connected or connectable to the anchoring portion 31 , e.g. by a pull resistant anchoring wire 23.

The described supplementary anchoring means can be endoluminally, particularly transorally inserted in the Gl tract and affixed thereto. Alternatively, the supplementary anchoring means are positioned and fixated laparoscopically by creating a laparoscopic access port in the abdominal wall and accessing the duodenum transluminally through an enter ostomy performed in the duodenal wall.

The same laparoscopic approach and access port may be used for introd ucing and positioning the catheter 6 in the intestine and for connecting its proximal bile capturing portion 8 in the bile duct 2, as well as for connecting the catheter 6 with the supplementary anchoring means.

Figure 13 shows a gastric coil 34 which can elastically deform from an extended configuration adapted for transoral or transnasal transportation thereof into the stomach 26, to an arched or circular configuration adapted to shape connect with the stomach 26 such as to provide an anchor for a pull resistant anchoring wire 23 which is connected to the catheter 6.

Alternatively, the catheter 6 may be anchored to a previously created plication 35 in the stomach wall. The plication can be created , using an endoscopic procedure or a laparoscopic procedure, and a flexible smooth anchoring wire 23 extending between the catheter 6 and the plication may be connected to the plication by means of a clip, a staple, a suture or a T-tag.

The described catheter, system and methods can achieve a an alteration of the contact space and time between the biliopancreatic juices and the intestinal wall, as well as an acceleration of the entero-hepatic bile cycling and, hence, effect the physiological signaling mechanism of the patient, thereby influencing diabetes and other co-morbidities of obesity. O n th e basi s of the present disclosure, those skilled in the art will appreciate the advantageous effects of the proposed catheter, system and methods for efficiently capturing and rapidly propelling bile or biliopancreatic secretions to a target location in the small intestine.

Although preferred embodiments of the invention have been described in detail, it is not the intention of the applicant to limit the scope of the claims to such particular embodiments, but to cover all modifications and alternative constructions falling within the scope of the invention.

Claims

1. A catheter (6) for draining bile to a target location in the intestinal tract (1 ), the catheter (6) comprising an external surface (7) facing radially outward, a proximal bile capturing portion (8) configured for placement in a biliary flow path (2) and a distal end (9) configured for placement in a target location in the intestinal tract (1 ), wherein the bile capturing portion (8) is located on the external surface (7) and adapted to capture bile from a radially external side of the catheter (6).
2. A catheter (6) according to claim 1 , wherein said bile capturing portion (8) comprises a drainage wire (10) coated with a bile attracting agent.
3. A catheter (6) according to claim 2, wherein said bile attracting agent comprises a bile acid sequestrant adapted to exchange anions for bile acids, thereby sequestering bile acids and attracting the bile onto the drainage wire (10).
4. A catheter (6) according to claim 1 or 2, wherein said bile capturing portion (8) comprises a drainage wire (10) having a multifilament fibrous structure adapted to drain bile by capillary action.
5. A catheter (6) according to claim 2 or 4, wherein the drainage wire (10) extends from the proximal bile capturing portion (8) distally and forms a bile conveying duct adapted to convey bile without isolating it from the external environment.
6. A catheter (6) according to claim 5, comprising a bile release portion (1 1 ) attached to the drainage wire (10) and adapted to detach and shed the bile from the drainage wire (10).
7. A catheter (6) according to claim 6, in which the release portion (1 1 ) comprises a sleeve containing moisture repellent material, said sleeve being inserted over a distal end portion of the drainage wire (10).
8. A catheter (6) according to claim 1 , in which said bile capturing portion (8) forms a plurality of externally open channels (12) extending in a longitudinal direction of the catheter (6).
9. A catheter (6) according to claim 8, in which the externally open channels (12) extend from the proximal bile capturing portion (8) further distally and form a bile conveying duct adapted to convey bile without isolating it from the external environment.
10. A catheter (6) according to any one of the preceding claims, in which the proximal bile capturing portion (8) is in fluid communication with at least one bile conveying duct (13) extending inside the catheter (6) isolated from the external environment.
11. A catheter (6) according to claim 10, in which the bile conveying duct (13) is capillary.
12. A catheter (6) according to claim 10, in which the bile conveying duct (13) is deformable in a milking manner by external pressure.
13. A catheter (6) according to claim 10, in which the bile conveying duct (13) comprises an internal surface of moisture repellent material.
14. A catheter (6) according to any one of the preceding claims, comprising tensioning means acting on the distal catheter end (9).
15. A catheter (6) according to claim 14, in which the tensioning means comprise a ballast mass (14) attached to the catheter (6) near its distal end (9).
16. A catheter (6) according to claim 14, in which the tensioning means comprise an expandable enlarged perimeter portion (15) formed near the distal catheter end (9), said enlarged perimeter portion (15) forming a peristalsis force application surface.
17. A catheter (6) according to claim 14, in which the tensioning means comprise an expandable space frame (18) connected to the catheter (6) near the distal end (9).
18. A catheter (6) according to claim 14, in which the tensioning means comprise a flexible stripe (19) connected to the catheter (6) near the distal end (9) and forming a peristalsis force application surface.
19. A system for draining bile to a target location in the intestinal tract (1 ), the system comprising the catheter (6) according to any one of the preceding claims and supplementary anchoring means, said supplementary anchoring means being connected with the catheter (6) and having an anchoring portion positioned at a distance proximal to the proximal bile capturing portion (8), in which said anchoring portion is adapted to anchor the system in a location in the Gl tract.
20. A catheter (6) for draining bile to a target location in the intestinal tract (1 ), the catheter (6) comprising:
- a proximal bile capturing portion (8) configured for placement in a biliary flow path (2),
- a distal end (9) configured for placement in a target location in the intestinal tract (1), - tensioning means acting on the distal catheter end (9) and adapted to pull the distal catheter end (9) distally, thereby longitudinally tensioning the catheter (6).
21. A method for diverting biliary fluid within a body, the method comprising the steps of:
- inserting a flexible catheter in the intestinal tract,
- connecting a proximal catheter end in fluid communication with a bile flow,
- placing a distal catheter end in a target position in the intestinal tract, said target position being distal to the bile flow; and
- tensioning the catheter by applying a distal pulling force on the distal catheter end.
PCT/EP2010/060289 2010-07-16 2010-07-16 A bile draining catheter and method for diverting bile from the gallbladder in the intestine WO2012007051A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/EP2010/060289 WO2012007051A1 (en) 2010-07-16 2010-07-16 A bile draining catheter and method for diverting bile from the gallbladder in the intestine

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2010/060289 WO2012007051A1 (en) 2010-07-16 2010-07-16 A bile draining catheter and method for diverting bile from the gallbladder in the intestine

Publications (1)

Publication Number Publication Date
WO2012007051A1 true WO2012007051A1 (en) 2012-01-19

Family

ID=43033033

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2010/060289 WO2012007051A1 (en) 2010-07-16 2010-07-16 A bile draining catheter and method for diverting bile from the gallbladder in the intestine

Country Status (1)

Country Link
WO (1) WO2012007051A1 (en)

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040220682A1 (en) * 2003-03-28 2004-11-04 Gi Dynamics, Inc. Anti-obesity devices
US20050049718A1 (en) * 2002-11-01 2005-03-03 Valentx, Inc. Gastrointestinal sleeve device and methods for treatment of morbid obesity
US20050085787A1 (en) 2003-10-17 2005-04-21 Laufer Michael D. Minimally invasive gastrointestinal bypass
US20070282454A1 (en) * 2006-05-30 2007-12-06 Boston Scientific Scimed Inc. Anti-obesity diverter structure
US20070282453A1 (en) * 2006-05-30 2007-12-06 Boston Scientific Scimed Inc. Anti-obesity stent
US20070282452A1 (en) * 2006-05-30 2007-12-06 Boston Scientific Scimed, Inc. Anti-obesity dual stent
US20090187206A1 (en) * 2006-05-26 2009-07-23 Binmoeller Kenneth F Conformationally-Stabilized Intraluminal Device for Medical Applications
US20100191167A1 (en) * 2006-03-02 2010-07-29 Lytn Gastrointestinal implant and methods for use

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050049718A1 (en) * 2002-11-01 2005-03-03 Valentx, Inc. Gastrointestinal sleeve device and methods for treatment of morbid obesity
US20040220682A1 (en) * 2003-03-28 2004-11-04 Gi Dynamics, Inc. Anti-obesity devices
US20050085787A1 (en) 2003-10-17 2005-04-21 Laufer Michael D. Minimally invasive gastrointestinal bypass
US20100191167A1 (en) * 2006-03-02 2010-07-29 Lytn Gastrointestinal implant and methods for use
US20090187206A1 (en) * 2006-05-26 2009-07-23 Binmoeller Kenneth F Conformationally-Stabilized Intraluminal Device for Medical Applications
US20070282454A1 (en) * 2006-05-30 2007-12-06 Boston Scientific Scimed Inc. Anti-obesity diverter structure
US20070282453A1 (en) * 2006-05-30 2007-12-06 Boston Scientific Scimed Inc. Anti-obesity stent
US20070282452A1 (en) * 2006-05-30 2007-12-06 Boston Scientific Scimed, Inc. Anti-obesity dual stent

Similar Documents

Publication Publication Date Title
US7125413B2 (en) Endoscopic fundoplication devices and methods for treatment of gastroesophageal reflux disease
EP2068719B1 (en) System for anchoring stomach implant
CN1713870B (en) Satiation device
US7935073B2 (en) Methods of treatment using a bariatric sleeve
EP2397113B1 (en) Satiation devices
JP5024902B2 (en) Intragastric bag for the treatment of obesity
US8137301B2 (en) Bariatric sleeve
US6946002B2 (en) Intragastric stent for duodenum bypass
US20050273060A1 (en) Obesity treatment and device
US7083629B2 (en) Overtube apparatus for insertion into a body
CN101077312B (en) Endoscopic gastric restriction methods and devices
US8784500B2 (en) Devices and methods for retaining a gastro-esophageal implant
US7695446B2 (en) Methods of treatment using a bariatric sleeve
US9687334B2 (en) Intestinal sleeves and associated deployment systems and methods
US20120316603A1 (en) Tissue fastening devices and processes that promote tissue adhesion
US9044300B2 (en) Gastrointestinal prostheses
US9149614B2 (en) Systems and methods for treatment of obesity and type 2 diabetes
US20110040230A1 (en) Minimally invasive gastrointestinal bypass
EP1682010B1 (en) System for tissue approximation and fixation
US8087413B2 (en) Attenuation of environmental parameters on a gastric lumen
US8206456B2 (en) Restrictive and/or obstructive implant system for inducing weight loss
US7708752B2 (en) Implant system and method for bulking tissue
US8182441B2 (en) Methods and devices for intragastric support of functional or prosthetic gastrointestinal devices
US7314489B2 (en) Method and apparatus to facilitate nutritional malabsorption
US20090276055A1 (en) Method for gastric volume reduction surgery

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 10732984

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase in:

Ref country code: DE

122 Ep: pct app. not ent. europ. phase

Ref document number: 10732984

Country of ref document: EP

Kind code of ref document: A1