WO2012007053A1 - Cathéter à longueur ajustable pour diriger des sécrétions biliopancréatiques - Google Patents

Cathéter à longueur ajustable pour diriger des sécrétions biliopancréatiques Download PDF

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Publication number
WO2012007053A1
WO2012007053A1 PCT/EP2010/060294 EP2010060294W WO2012007053A1 WO 2012007053 A1 WO2012007053 A1 WO 2012007053A1 EP 2010060294 W EP2010060294 W EP 2010060294W WO 2012007053 A1 WO2012007053 A1 WO 2012007053A1
Authority
WO
WIPO (PCT)
Prior art keywords
catheter
flexible tube
wall
longitudinal axis
tube
Prior art date
Application number
PCT/EP2010/060294
Other languages
English (en)
Inventor
Mark S. Zeiner
Thomas Edward Albrecht
Mark Steven Ortiz
Michele D'arcangelo
Alessandro Pastorelli
Michael J. Stokes
Christopher J. Hess
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/EP2010/060294 priority Critical patent/WO2012007053A1/fr
Publication of WO2012007053A1 publication Critical patent/WO2012007053A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/0003—Apparatus for the treatment of obesity; Anti-eating devices
    • A61F5/0013—Implantable devices or invasive measures
    • A61F5/0076—Implantable devices or invasive measures preventing normal digestion, e.g. Bariatric or gastric sleeves
    • 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
    • A61M27/002—Implant devices for drainage of body fluids from one part of the body to another
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M2025/0175—Introducing, guiding, advancing, emplacing or holding catheters having telescopic features, interengaging nestable members movable in relations to one another

Definitions

  • 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, pulmonary disease, and accidents.
  • metabolic disorders such as morbid obesity and related co-morbidities, such as diabetes, heart disease, stroke, pulmonary disease, and accidents.
  • the known system comprises a conduit having a first end which diverts bile 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, wherein the length of the conduit at the first end is adjustable and can be shortened by trimming the conduit prior to insertion into a patients body or by pulling a filamentous member applied to the conduit so that the latter will shorten in an accordion style.
  • known conduit catheter can be shortened, it cannot be easily stretched or extended and, when shortened, the conduit doesn't maintain a desired shape and internal flow section.
  • known bile conveying catheters cannot adjust the length of the conduit tract along which biliopancreatic fluids are discharged in the intestine.
  • the known bile conveying catheters cannot be used for a differentiated variation of the discharge position of bile and pancreatic fluids.
  • An aim of the present invention is therefore to provide a catheter for diverting biliopancreatic secretions, wherein the catheter has adjustable discharge zones and obviates at least some of the problems and drawbacks discussed in connection with the prior art.
  • a catheter for directing biliopancreatic secretions comprising:
  • first flexible tube having a first longitudinal axis, the first flexible tube having a wall and first outlet holes formed in the wall;
  • one of the first and second flexible tube is slidingly translatable within the other one of the first and second flexible tube.
  • the relative translation of the first and second tube may telescope the catheter, thereby varying the position of the outlet holes.
  • a relative translation of the first and second tube can selectively cover one or more outlet holes, thereby adjusting the position of the bile discharge which takes place only through the open outlet holes.
  • At least one second outlet hole or slot may be formed in the wall of the second flexible tube, so that relative translation of the first and second tube can selectively overlap the second hole or slot with at least one of the first outlet holes.
  • one of the first and second flexible tube is rotatable about the longitudinal axis with respect to the other one of the first and second flexible tube, so that relative rotation of the first and second tube can selectively overlap the second hole or slot with at least one of the first outlet holes.
  • the catheter comprises at least one additional flexible tube telescopically engaging one of the first and second tube to adjust the length of the catheter.
  • a catheter for directing biliopancreatic secretions comprising:
  • first flexible tube having a first longitudinal axis, the first flexible tube having a wall and outlet holes formed in the wall;
  • first tubular adjustable section having a longitudinal axis substantially parallel to the first longitudinal axis, the first tubular adjustable section having a wall and first adjusting holes formed in the wall;
  • a second tubular adjustable section having a longitudinal axis substantially parallel to the first longitudinal axis, the second tubular adjustable section having a wall and second adjusting holes formed in the wall,
  • first and second adjustable sections are independently slidingly within the first flexible tube to selectively align the first and second adjusting holes with the outlet holes of the first flexible tube, thereby selectively adjusting two independent groups of outlet zones for biliopancretic fluid.
  • the first adjustable section may carry bile and the second adjustable section may carry pancreatic secretions.
  • a catheter for directing biliopancreatic secretions comprising a flexible tube having a longitudinal axis and a wall defining an internal passage, the wall comprising stiffening frame segments forming stiffening lines and flexible membrane segments formed between the stiffening lines, wherein the flexible tube can be longitudinally extended and contracted and the stiffening frame segments and flexible membrane segments are configured to elastically resist against kinking and closure of the internal passage.
  • a catheter for directing biliopancreatic secretions comprising:
  • a proximal end portion adapted to be fluid connected to the common bile duct to collect biliopancreatic secretions, - a distal open end adapted to be placed in a location downstream in the gastrointestinal tract,
  • the catheter comprises adjustment activation means connected between a first point and a second point of the catheter and adapted to approximate the first point towards the second point and to move the second point away from the first point.
  • the adjustment activation means can operate a displacement of adjusting sections, telescoping lumens as well as a contracting deformation or extension deformation of a single tube.
  • the adjustment activation means can comprise a linear micromotor, such as a piezoelectric motor, connected to a push-pull rod or a series of a linear micromotors connected to push-pull rods or a linear micromotor engaging longitudinal guide means extending along the catheter longitudinal direction.
  • a linear micromotor such as a piezoelectric motor
  • the adjustment activation means may be remote controlled.
  • a catheter for directing biliopancreatic secretions comprising a flexible tube having a longitudinal axis and a wall defining an internal passage, wherein the wall is folded back on itself to define a coaxial internal and external tubular portion and an annular folding line forming a distal open catheter end, said annular folding line being displaceable by translating the external tubular portion relative to the internal tubular portion.
  • a catheter for directing biliopancreatic secretions comprising a flexible tube having a longitudinal axis and a wall defining an internal passage, wherein a distal end section of the wall is rolled up and can be more or less unrolled to adjust the overall catheter length and the position of its distal open end in the intestinal tract.
  • a catheter for directing biliopancreatic secretions comprising a flexible tube having a longitudinal axis and a wall defining an internal passage, wherein the wall comprises a plurality of modular reversibly connectable tubular segments which can be selectively assembled and disassembled to adjust and obtain the desired catheter length.
  • a catheter for directing biliopancreatic secretions comprising a flexible tube having a longitudinal axis and a wall defining an internal passage, wherein the wall comprises a plurality of tubular segments which are exposure time dependent absorbable and adapted to operate a time dependent catheter length variation.
  • supplementary anchoring means may be provided to anchor the catheter in a location in the Gl tract proximal to the papilla of Vater. This creates a redundant fixation of the catheter to better resist against peristalsis forces.
  • FIG. 1 illustrates a catheter for directing biliopancreatic juices implanted in the Gl tract of a patient
  • Figu re 2 illustrates a detail of a catheter for directing biliopancreatic juices in accordance with an embodiment of the invention
  • FIG. 2A illustrates a detail of a catheter for directing biliopancreatic juices in accordance with a further embodiment of the invention
  • - Figure 3 il lustrates a detai l of a catheter for d irecting biliopancreatic juices in accordance with a further embodiment of the invention
  • - Figure 4A illustrates a detail of a catheter for directing biliopancreatic juices in accordance with a further embodiment of the invention
  • FIG. 4B is a schematic side view of a portion of the catheter in figure 4A in an extended configuration
  • FIG. 4C is a schematic side view of a portion of the catheter in figure 4A in a retracted configuration
  • FIG. 5 illustrates a detail of a catheter for di recting bi liopancreatic juices in accordance with a further embodiment of the invention
  • FIG. 6A illustrates a catheter for directing biliopancreatic juices in accordance with a further embodiment of the invention
  • FIG. 6B shows a detail of the catheter in figure 6A
  • FIG. 6C illustrates a detail of the catheter in figure 6A and an adjustment tool in accordance with an embodiment of the invention
  • Figu re 7 is a longitudinal sectional view of a detail of a catheter for d irecting biliopancreatic juices in accordance with a further embodiment of the invention.
  • Figu re 8 illustrates a detail of a catheter for directing biliopancreatic juices in accordance with a further embodiment of the invention
  • FIG. 9 illustrates a detail of a catheter for d i recti ng biliopancreatic juices in accordance with a further embodiment of the invention.
  • FIG. 1 0 illustrates a catheter for directing biliopancreatic juices and supplementary anchoring means in accordance with a further embodiment of the invention
  • FIG. 1 1 illustrates supplementary anchoring means in accordance with a further embodiment of the invention.
  • figure 1 is a partial view of the abdominal cavity of a patient, depicting the gastrointestinal tract with the esophagus 1 , stomach 2, duodenum 3, jejunum 4, ileum 5, colon 6, as well as the hepatic-biliary system with the liver, the biliary tree 7 with gall bladder 8, the pancreatic duct 9 and the mayor duodenal papilla of Vater 10 through which the bile and pancreatic fluid normally enter the duodenum 3.
  • Figure 1 shows further a catheter 1 1 for modifying the location at which biliopancreatic secretions interact with nutrients and with the intestinal wall in a gastrointestinal tract.
  • the catheter 1 1 comprises a proximal end portion 22 adapted to be fluid connected to the common bile duct 7 to collect biliopancreatic secretions and a distal end portion 17 adapted to be placed in a location downstream in the gastrointestinal tract, that is to say in a location significantly distal to the papilla of Vater, such as in the distal section of the duodenum 3, in the jejunum 4 or ileum 5.
  • the catheter proximal end portion 22 may have only one proximal open end 15 which can be arranged and anchored (e.g.
  • the proximal end portion 22 may be bifurcated or Y-shaped and define a proximal open bile end 15 intended and adapted to be inserted in the bile duct 7 proximal to the junction point with the pancreatic duct 9, and a proximal open pancreatic end 1 5' intended and adapted to be inserted in the pancreatic duct 7.
  • a Y-shaped proximal end portion 22 allows to collect bile and pancreatic juices separately and to keep them isolated or mix them further distally in the catheter 1 1.
  • the catheter distal end portion 17 forms one or more bile outlet openings 13 and the catheter 1 1 is adapted to adjust the position in which the biliopancreatic juices are released through the outlet openings 13 into the intestine 3, 4, 5.
  • the catheter 1 1 comprises a first outer flexible tube 12 having a first longitudinal axis and first outlet holes 13 formed in the flexible tube wall and a second inner flexible tube 14 having a second longitudinal axis substantially parallel to the first longitudinal axis, wherein the second flexible tube 14 is slidingly translatable within the outer flexible tube 12 or vice versa so that a relative translation of the first 12 and second tube 14 may telescope the catheter 1 1 , thereby adjusting the position of the outlet holes 13.
  • a relative translation of the first 12 and second tube 14 can selectively cover (and obstruct) one or more outlet holes 13, thereby adjusting the position of the bile discharge which takes place only through the free outlet holes 13.
  • At least one second outlet hole or slot 18 may be formed in the wall of the second flexible tube 14, so that relative translation of the first 12 and second tube 14 can selectively overlap the second hole or slot 18 with at least one of the first outlet holes 13.
  • one of the first 12 and second flexible tube 14 (particularly the inner tube 14) may be rotatable about the longitudinal axis with respect to the other one of the first 12 and second flexible tube 14 for selectively overlapping the second hole or slot 18 with at least one of the first outlet holes 13. This allows a high number of combinations of free and obstructed outlet holes 13 and, accordingly, a versatile adaptability and variation of the bile discharge position and length in the intestine 3, 4, 5.
  • the catheter 1 1 may comprise at least one additional flexible tube 19 which is telescopically attached to one of the first 12 and second tube 14 for an additional variation of the length of the catheter 1 1.
  • the relative translation of the additional telescoping tube 19 is adapted to effect a coarse length adjustment of catheter 1 1
  • the relative movement between the outer tube 12 and inner tube 14 is adapted to effect a fine adjustment of the bile discharge position and discharge space extension.
  • the catheter 1 1 comprises a first outer flexible tube 12 having a first longitudinal axis and first outlet holes 13 formed in the flexible tube wall.
  • a first 20 and second tubular adjustable section 21 having both longitudinal axes substantially parallel to the first longitudinal axis of outer tube 12 are received inside the proximal end portion 17 of the outer tube 12 and the first and second adjustable sections 20, 21 are independently slidingly within the outer flexible tube 12 to selectively open and obstruct at least two different groups of the bile outlet holes 13.
  • the first tubular adjustable section 20 forms first adjusting holes in a wall adjacent the wall of outer tube 12 and the second tubular adjustable section 21 forms second adjusting holes in a wall adjacent the wall of outer tube 12, so that a translation of the first and second adjustable sections 20, 21 within the outer flexible tube 12 selectively overlaps the first and second adjusting holes with the bile outlet holes 13 of the outer tube 12, thereby selectively setting two independent groups of outlet zones for biliopancretic secretions.
  • the first adjustable section 20 may be fluid connected with a bile collecting end 15 of the proximal end portion 22 of the catheter 1 1 and, thus, carry bile
  • the second adjustable section 21 may be fluid connected with a pancreatic secretions collecting end 15' of the proximal end portion 22 of the catheter 1 1 and, thus, carry pancreatic secretions. I n this way, it is possible to collect bile and pancreatic fluids isolated from one another and to dispense them independently in adjustable positions and spaces inside the intestine 3, 4, 5.
  • Figures 4A to 4C illustrate an embodiment, in which the catheter 1 1 comprise a flexible tube 23 having a longitudinal axis and a wall 24 defining an internal passage 25.
  • the wall 24 comprises stiffening frame segments 26 which form stiffening lines and flexible membrane segments 27 formed between the stiffening lines.
  • the flexible tube 23 can be longitudinally extended and contracted and the stiffening frame segments 26 and flexible membrane segments 27 are configured to elastically resist against kinking and closure of the internal passage 25.
  • the stiffening frame segments may comprise preformed folding lines in the tube wall 24, a helical wound stiffening wire, e.g. made of stainless steel, NiTi alloy, polyurethane, or a helical interwoven stiffening filament, such as a cylindrical, helically wound biaxial braid, also known as "Chinese finger trap" structure.
  • a helical wound stiffening wire e.g. made of stainless steel, NiTi alloy, polyurethane
  • a helical interwoven stiffening filament such as a cylindrical, helically wound biaxial braid, also known as "Chinese finger trap" structure.
  • the catheter 1 1 comprises a group of concentrically telescopically assembled tube sections 28, 28', 28" connected between the proximal end portion 22 and a distal end 16 and translatable to each other to adjust the overall length of the catheter 1 1 .
  • the adjustment of the catheter length and or the adjustment of the opening and closure of a plurality of bile outlet holes 13 can be accomplished at the time of insertion of the catheter 1 1 based on the patients anatomy or, alternatively or additionally, the bile discharge position in the intestine may be adjusted post surgically as a step of a therapy optimization or therapy adaption.
  • the catheter 1 1 comprises adjustment activation means connected between a first point 29 and a second point 30 of the catheter 1 1 and adapted to approximate the first point 29 towards the second point 30 and/or to move the second point 30 away from the first point 29.
  • adjustment activation means are only schematically illustrated in figure 5, they can be analogously integrated in all other illustrated and described exemplary embodiments and my accomplish a relative displacement of adjusting sections, telescoping lumens as well as a contracting deformation or extension deformation of a single tube of catheter 1 1.
  • the adjustment activation means can comprise a linear micromotor 31 , such as a piezoelectric motor, connected to a push-pull rod 32 or a series of a linear micromotors 31 connected to push-pull rods 32 or a linear micromotor engaging and adapted to travel along a longitudinal guide rail extended in the catheter 1 1 longitudinal direction.
  • a piezoelectric motor may have a reciprocating expanding lateral piezo member pushing on two clutching piezo members mounted inside a tubular housing and electrified in sequence to grip the push-pull rod 32 which is then moved in a linear direction.
  • An exemplary, non limiting example of such a piezoelectric motor is the P-652- series PILine® ultrasonic motor linear slides.
  • the adjustment activation means may be remote controlled, e.g. by means of wireless RF signal communication between an extracorporeal control unit 33 and a local controller 34 associated with the adjustment actuating means.
  • the catheter 1 1 comprises a flexible tube 39 having a longitudinal axis and a wall defining an internal passage 40, wherein a distal end portion 17 of the wall is rolled up and can be more or less unrolled to adjust the overall catheter length and the position of its distal open end 16 (which is formed by the roll).
  • the length adjustment of tube 39 can be accomplished extracorporeal ⁇ before deployment of the catheter 1 1 or endoluminally by means of an endoscope and a grasper or pusher 42 which can be inserted through an instrument channel 43 and comprises a embracement portion adapted to hold and move the rolled portion allowing it to slide inside the embracement portion.
  • the flexible tube 39 may be configured to be elastically biased in a rolled, i.e. shortened, configuration and comprises locking means, such as one or more clips, adapted prevent the tube 39 from rolling back, thereby holding it in a partially o completely rolled out configuration.
  • Figure 7 shows an embodiment, in which the catheter 1 1 comprises a flexible tube 44 having a longitudinal axis and a wall defining an internal passage 45, wherein the wall comprises a plurality of modular reversibly connectable tubular segments 46 which can be selectively assembled (e.g. by shape coupling, interference coupling, snap fit) and disassembled to adjust and obtain the desired catheter length.
  • the individual modular segments 46 may be made of different materials for different requirements, such as absorbable materials, radio opaque materials, materials with radio opaque coating or additives (e.g. barium sulfate) or ultrasound opaque coating so that the catheter or selected portions of the catheter can be localized by ultrasound or radiography.
  • Figure 8 illustrates an embodiment in which the catheter 1 1 , particularly the distal end portion 17 comprises a plurality of tubular segments 47 which have different exposure time dependent absorbability characteristics, ada pted to operate a preset time dependent catheter length variation.
  • Figure 9 illustrate an embodiment, in which the catheter 1 1 comprises a flexible tube 35 having a longitudinal axis and a wall defining an internal passage 36, wherein the wall is folded back on itself to define a coaxial internal 37 and external tubular portion 38 and an annular folding line forming a distal open catheter end 16, said annular folding line being displaceable by translating the external tubular portion 38 relative to the internal tubular portion 37.
  • the catheter 1 1 may have a series outlet openings spaced in the longitudinal direction and individually activatable micro valves associated to each outlet opening and adapted to selectively open and close the outlet openings, thereby adjusting the bile discharge position and space in the intestine.
  • Various means such as bile collecting stents or catheter anchoring stents can be provided for connecting the proximal end 15 of the catheter 1 1 in fluid communication with the bile duct 7.
  • supplementary anchoring means may be provided to anchor the catheter 1 1 in a location in the Gl tract proximal to the papilla of Vater 10. This creates a redundant fixation of the catheter 1 1 to better resist against peristalsis forces.
  • Figure 10 shows a gastric coil 48 which can elastically deform from an extended configuration adapted for transoral or transnasal transportation thereof into the stomach 2, to an arched or circular configuration adapted to shape connect with the stomach 2 such as to provide an anchor for a pull resistant anchoring wire 49 which is connected to the catheter 1 1.
  • the anchoring wire 49 can be connected, e.g. by means of T-tags, to a previously created plication 50 in the stomach wall.
  • the catheter 1 1 may be made of any material that may be absorbable by the body such as polyglycolated resins, polygalactic acid materials, and other similar materials or nonabsorbable materials such as silicone, polyethylene, polypropylene, butylated rubber, latex, and the like.
  • the catheter 1 1 can be installed endoluminally, e.g. transorally, in the intestine and the proximal end 15 of of the catheter 1 1 may be inserted in the papilla of Vater using e.g. an ERCP (Endoscopic Retrograde Cholangio Pancreatography) like technique.
  • the ERCP procedure involves passing a flexible endoscope through the mouth, esophagus, and stomach into the duodenum near the papilla of Vater 10. The doctor then passes the catheter 1 1 through a channel in the endoscope and out into view in the duodenum and inserts it into the papilla of Vater.
  • the present invention further contemplates the possibility of placing the catheter 1 1 in the intestine and introducing the catheter proximal end 15 in the papilla of Vater 10 by laparoscopically accessing the abdominal space, translu menally accessing the duodenum near the papilla of Vater and placing the catheter 1 1 through the duodenum i n th e desi red position with i n th e i ntesti ne an d , from i n sid e th e d uod en u m , laparoscopically introducing the conduit proximal end 15 into the papilla of Vater.
  • the system and methods of the described invention can achieve a selective variation of the location and space at which enzymatic fluids interact with the intestinal wall and with nutrients from food fluids in the Gl tract.
  • less nutrients from the food fluids will be absorbed by the body, the effectiveness of enzyme and emulsifying reagent reacting with the food fluids will be decreased, and more of the food fluids will be excreted resulting in a weight loss.
  • the altered contact space and time between the biliopancreatic juices and the intestinal wall acts on the physiological signaling mechanism of the patient, thereby influencing d iabetes and other comorbidities of obesity.

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  • Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Otolaryngology (AREA)
  • Anesthesiology (AREA)
  • Ophthalmology & Optometry (AREA)
  • Child & Adolescent Psychology (AREA)
  • Obesity (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Vascular Medicine (AREA)
  • Hematology (AREA)

Abstract

L'invention porte sur un cathéter (11) pour diriger des sécrétions biliopancréatiques, lequel cathéter comprend un premier tube souple (12) ayant un premier axe longitudinal, le premier tube souple (12) ayant une paroi et des premiers trous de sortie (13) formés dans la paroi, et un second tube souple (14) ayant un second axe longitudinal sensiblement parallèle au premier axe longitudinal, l'un du premier et du second tube souple pouvant coulisser en translation à l'intérieur de l'autre du premier et du second tube souple.
PCT/EP2010/060294 2010-07-16 2010-07-16 Cathéter à longueur ajustable pour diriger des sécrétions biliopancréatiques WO2012007053A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/EP2010/060294 WO2012007053A1 (fr) 2010-07-16 2010-07-16 Cathéter à longueur ajustable pour diriger des sécrétions biliopancréatiques

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2010/060294 WO2012007053A1 (fr) 2010-07-16 2010-07-16 Cathéter à longueur ajustable pour diriger des sécrétions biliopancréatiques

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WO2012007053A1 true WO2012007053A1 (fr) 2012-01-19

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Cited By (1)

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Publication number Priority date Publication date Assignee Title
US10449075B2 (en) 2015-12-15 2019-10-22 Steven Sounyoung Yu Biliary diversion catheter

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WO1997011724A1 (fr) * 1995-09-27 1997-04-03 Biocon Oy Implant biodegradable en materiau a base de polymere et son procede de fabrication
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