WO2013004267A1 - Cathéter, en particulier destiné à diriger des sécrétions biliopancréatiques - Google Patents

Cathéter, en particulier destiné à diriger des sécrétions biliopancréatiques Download PDF

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Publication number
WO2013004267A1
WO2013004267A1 PCT/EP2011/061115 EP2011061115W WO2013004267A1 WO 2013004267 A1 WO2013004267 A1 WO 2013004267A1 EP 2011061115 W EP2011061115 W EP 2011061115W WO 2013004267 A1 WO2013004267 A1 WO 2013004267A1
Authority
WO
WIPO (PCT)
Prior art keywords
catheter
anchor
end portion
distal end
discharge port
Prior art date
Application number
PCT/EP2011/061115
Other languages
English (en)
Inventor
Alessandro Pastorelli
Mark Steven Ortiz
Christopher J. Hess
Michele D'arcangelo
David A. Dalessandro
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/EP2011/061115 priority Critical patent/WO2013004267A1/fr
Publication of WO2013004267A1 publication Critical patent/WO2013004267A1/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
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • 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
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A61F2002/072—Encapsulated stents, e.g. wire or whole stent embedded in lining
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable

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.
  • 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 conduit catheter extends inside the intestine and tends to bundle up and 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.
  • the known endoluminal conduit in order to follow the winding path of the intestine, the known endoluminal conduit must have a significant length which undesirably increases the flow resistance and decreases the flow rate of the bile to the distal target location in the Gl tract. Accordingly, the known conduit is not suitable to obtain a significant acceleration of the bile cycling compared to the natural entero-hepatic bile cycling velocity.
  • a further issue of the prior art catheters applied to the Gl tract is their tendency to be clogged by an undesired backflow of intestinal contents which may lead to partial or complete obstruction of the artificially created flow path and increase the risk of infection.
  • an aim of the invention is to provide a catheter for intra-abdominal diversion of bodily fluids, particularly for the diversion of biliopancreatic secretions from a biliary tree to a target section of the small intestine, which catheter has improved anchoring and position preserving capabilities.
  • a further aim of the invention is to provide a catheter for intra-abdominal diversion of bodily fluids which is less subject to backflow of contents into the catheter.
  • a yet further aim of the invention is to provide a catheter for intra-abdominal diversion of bodily fluids having a reduced risk of leakage of bodily fluids or intestinal contents into the abdominal cavity.
  • At least part of the described aims are ach ieved by a catheter for directing biliopancreatic secretions, the catheter comprising an elongate tubular wall extending between a proximal end portion and a distal end portion of the catheter, the proximal end portion having a proximal anchor or stent adapted to anchor the proximal end portion within a biliary tree and the distal end portion having a distal anchor adapted to anchor the distal end portion within the intestine, in which the distal end portion is T-shaped and the distal anchor extends transversally, preferably substantially perpendicularly to a longitudinal direction of the catheter at the distal end portion.
  • the catheter can be translumenally extended in the abdominal cavity and the T- shaped distal end portion can be inserted through an enterotomy in the small bowel and assures a reliable anchoring and positioning of the catheter without any risk of displacement with respect to the planned position.
  • the distal anchor or stent may be expandable from a reduced size collapsed or compacted shape to an expanded shape. This facilitates the insertion of the collapsed distal catheter end through a small otomy in a target section of the small bowel and its subsequent expansion and reliable anchoring thereto.
  • the distal anchor may comprise an expandable metallic stent or an inflatable anchoring portion.
  • the distal anchor may be configured to circumferentially fully engage the wall of the hollow organ to which it is intended to be anchored such as to provide a leak tight sealing interface between the distal end portion of the catheter and the hollow organ , e.g. the intestine.
  • the distal anchor may comprise a sealing agent, e.g. an adhesive, provided on an external surface of the distal anchor (e.g. within folds of a collapsed inflatable anchoring portion) intended to adhere to an internal surface of the hollow organ at the anchoring site.
  • a sealing agent e.g. an adhesive
  • the distal end portion of the catheter may comprise a unilateral valve device adapted to prevent a back flow into the distal end portion, thereby reducing the risk of clogging of the catheter e.g. due to the formation of a plug of chime or stool penetrated through a discharge port into the distal catheter end portion.
  • both opposite free ends of the transversal catheter may be provided with a unilateral valve, e.g. with a duckbill valve, so that there is always one valve oriented in the direction of flow (trailing valve through which the fluid can exit the catheter), while the oppositely oriented valve (leading valve) is shut through the external pressure exerted by the flow of chime in the intestine.
  • a unilateral valve e.g. with a duckbill valve
  • the T-shaped distal end portion of the catheter forms a guide surface adapted to orient the transverse anchor in the direction of a flow acting upon it and a discharge port is formed on a trailing end of the anchor facing downstream said flow.
  • the distal end portion may comprise a hinge which allow rotation of the transverse anchor about the longitudinal axis of the catheter at the distal end.
  • FIG. 1 illustrates an intra-abdominally extended catheter for directing biliary fluid from the bile duct to a target section of intestine in the Gl tract of a patient;
  • FIG. 2 illustrates an intra-abdominally extended catheter for directing biliary fluid from a branch of the biliary tree within the liver to a target section of intestine in the Gl tract of a patient;
  • Fig u re 3 i ll ustrates an intra-abdominally extended catheter for directing biliopancreatic fluid from the bile duct and from the pancreatic duct to a target section of intestine in the Gl tract of a patient;
  • FIG. 4 illustrates a distal end portion of a catheter in accordance with an embodiment
  • FIG. 5 illustrates a distal end portion of a catheter in accordance with a further embodiment
  • FIG. 6 illustrates a collapsed distal end portion of a catheter in accordance with a further embodiment
  • FIG. 7 illustrates the distal end portion of the catheter in figure 6 deployed and insufflated inside a target section of small intestine.
  • figure 1 is a partial view of the abdomi nal 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 an elongate tubular wall 17 defining an internal fluid channel 25 and extending between a proximal end portion 12 and a distal end portion 13.
  • the proximal end portion 12 is intended to be fluid connected to the common bile duct 7 to collect biliopancreatic secretions, while the distal end portion 13 is intended 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 12 may have only one proximal open end 14 which can be arranged and anchored (e.g.
  • the proximal end portion 12 may be bifurcated or Y-shaped and define a proximal open bile end 14 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 14' intended and adapted to be inserted in the pancreatic duct 7.
  • a Y-shaped proximal end portion 12 would allow to collect bile and pancreatic juices separately and to keep them isolated or mix them further distally in the catheter 1 1 .
  • the proximal end portion 1 3 may be anchored e.g. by means of a metallic expandable stent 1 5 with in a section of the bile d uct (Figs. 1 and 3) or, alternatively, the proximal end portion 13 may be anchored e.g. by means of a so- called "pig-tail end" within a branch of the biliary tree inside the liver (Fig. 2).
  • the catheter distal end portion 13 forms one or more bile discharge ports 16 or openings through which the bodily fluid, e.g. biliopancreatic juices, are released from the catheter 1 1 into the target location, particularly in the intestine.
  • bodily fluid e.g. biliopancreatic juices
  • the distal end portion 13 is generally T-shaped and forms an elongate anchor 18 which extends transversally, preferably substantially perpendicularly to a longitudinal axis 19 or leg portion 34 of the catheter 1 1 at the distal end portion 13.
  • the catheter 1 1 can be translumenally extended in the abdominal cavity and the T- shaped distal end portion 13 can be inserted through an otomy 22 in the small bowel and assures a reliable anchoring and positioning of the catheter 1 1 without any risk of displacement with respect to the planned position.
  • the distal anchor 18 may be configured as an elastically flexible or rigid tube or as a stent which is expandable from a reduced size collapsed or compacted shape to an expanded shape. This facilitates the insertion of the collapsed distal catheter end portion 13 through a small incision in a target section of the small bowel and its subsequent expansion and reliable anchoring thereto.
  • the anchor 1 8 may comprise an expandable metallic wire mesh stent 20 which, in its expanded configuration is substantially rigid or elastically deformable and adapted to follow within certain limits the peristalsis movements of the intestine.
  • An external surface 21 of the anchor 18 may be adapted to permanently and intimately adhere to the tissue (e.g. the wall of the jejunum) adjacent the otomy 22 in order to seal the otomy 22 from inside the intestine and prevent leakage and spillage of intestinal contents into the abdominal cavity.
  • a sealing agent e.g. an adhesive
  • a sealing agent may be provided on the external surface 21 , particularly inside folds 36 formed by the external surface 21 in the collapsed or compacted state of the anchor 18.
  • the sealing agent inside the folds 36 cannot be easily wiped off or rinsed away during insertion and positioning of the catheter 1 1 and will be exposed in the interface between the anchor 18 and the tissue of the target organ only after expansion of the anchor 18 and aperture of the folds 36.
  • the anchor 18 is inflatable from the com pacted or collapsed shape to the expanded shape and comprises an insufflating chamber 23 adapted to be filled with an insufflating fluid, e.g. saline solution, and in fluid communication with an insufflating channel 24 extending inside the tubular wall 17 separate from a fluid channel 25 of the catheter 1 1 .
  • the insufflating fluid can be injected in the insufflating channel 24 by means of a syringe or by pumping from a fluid reservoir.
  • the inflatable anchor is easier to remove from the anchoring site and less subject to harboring of bacteria due to the absence of exposed metal wire.
  • the anchor 18 may have a generally tubular shape with the above said external surface 21 intended to adhere from inside to the organ to which the distal end portion 13 is anchored, and an internal surface 26 defining a transverse channel 27 which allows the passage of fluids flowing through the organ , e.g. intestinal content.
  • the fluid channel 25 of the catheter opens into the transverse channel 27.
  • the distal end portion 13 has in its reduced size collapsed state a shape adapted for insertion thereof in the target position and, when expanded or inflated, the distal end portion 13 takes the above said T- shape adapted to assure anchoring and, possibly, to engage and seal the tissue surrounding the otomy 22.
  • a unilateral valve device 28 may be provided at the distal discharge port 16 which allows the bile flow from the catheter 1 1 into the intestine while preventing chime or stool to flow back from the intestine into the catheter.
  • both opposite free ends of the transversal anchor 18 may be provided with a unilateral valve, e.g. with a duckbill valve made of a flexible collapsible material or with any other suitable type of valve (e.g. flapper valve etc.), so that there is always one valve oriented in the direction of flow.
  • a trailing valve 28' allows fluid to exit the catheter, while an oppositely oriented leading valve 28" is hold shut by the external pressure exerted by the flow of chime in the intestine.
  • the T-shaped distal end portion 13, particularly the anchor 18 forms a guide surface 29 adapted to orient the anchor 18 in the direction of a flow (arrow 30) acting upon it and the discharge port 16 is formed on a trailing end 31 of the anchor 18 facing downstream said flow.
  • the guide surface 29 may be advantageously formed on the anchor 18 which has a trailing portion 32 extending from a leg portion 34 (tubular wall 17) of the T-shaped distal end portion 1 3 and having a trailing length, and a leading portion 33 extending from the leg portion 34 in an opposite direction with respect to the trailing portion 32 and having a leading length, in which the trailing length is greater than the leading length.
  • a diameter of the trailing portion 32 may be greater than a diameter of the leading portion 33.
  • the outer surface of the trailing portion 32 is greater than the outer surface of the leading portion 33 so that the flow 30 of intestinal content acting on the outer surfaces of both the trailing and leading portion 32, 33 of the anchor 18 orient the anchor 18 with its trailing portion 32 downstream.
  • the distal end portion 13 may comprise a hinge 35 which allows rotation of the anchor 18 with respect to the leg portion 34 about the longitudinal axis 19 of the catheter distal end 13.
  • the tubular wall 17 is preferably flexible to facilitate the implantation of the catheter 1 1 and to better follow the physiological structures to which the catheter 1 1 is applied.
  • the tubular wall 17 of the catheter may be grafted at least partially in silicone, polyethylene, polypropylene, butylated rubber, latex and the like, and may comprise an inner coating of PTFE or Dacron (Polyethylene terephthalate) or including particles, fibers or film sections of PTFE or Dacron (Polyethylene terephthalate) to provide a low friction and inert biocompatible surface for the biliary fluid to flow through.
  • the tubular wall 17 may be additionally reinforced with a metal or plastic wire mesh, e.g . with a braided wire mesh , which can be coextruded together with or incorporated and encapsulated in the tubular wall 17 base material (e.g. polyethylene).
  • a metal or plastic wire mesh e.g . with a braided wire mesh , which can be coextruded together with or incorporated and encapsulated in the tubular wall 17 base material (e.g. polyethylene).
  • the catheter 1 1 can be implanted by open surgery or laparoscopically.
  • the biliary duct 7 is transected and an IR guide wire is inserted under fluoroscopy into the biliary tree towards the liver or gallbladder and acts as a guide rail for the proximal end portion 12 of the catheter 1 1 .
  • the proximal end portion 12 of the catheter 1 1 is inserted over the guide wire into the biliary duct 7 and anchored inside the latter e.g. by expanding a metallic stent 15. Then the guide wire is removed and an enterotomy 22 is performed in a target section of the intestine at a planned bile delivery location.
  • the T-shaped distal end portion 1 3 is inserted through the enterotomy 22 in the intestine and anchored thereto by closing the enterotomy around the leg portion 34 of the distal end portion 1 3 by means of a suture. Additionally, one or more stay sutures can be placed on the tissue of the intestine and over the transverse anchor 1 8 to hold it i n place.
  • the anchor 1 8 is expandable, it is inserted through the enterotomy in a compacted collapsed state and subsequently expanded to prevent undesired withdrawal and, possibly, to provide an anti-leak seal between the distal end portion 13 and the intestinal wall.
  • the biliary duct 7 is transected and an IR guide wire is inserted under fluoroscopy in the bile duct 7 up to a branch of the biliary tree within the liver as a guide rail for the proximal end portion 12 of the catheter 1 1.
  • FIG. 3 illustrates a further embodiment in which the proximal end portion 12 of the catheter 1 1 comprises a Y-shaped bifurcation with a biliary portion intended to be arranged inside the biliary duct upstream the junction with the pancreatic duct, and a pancreatic portion intended to be arranged inside the pancreatic duct.
  • the biliary tree can be reached by translumenal access to the duodenum at the papilla of Vater and the proximal end portion 12 of the catheter 1 1 can be introduced through the papilla of Vater 10 in the common bile duct, using e.g. an ERCP (Endoscopic Retrograde Cholangio Pancreatography) like technique.
  • ERCP Endoscopic Retrograde Cholangio Pancreatography
  • the catheters and methods of the invention provide an improved anchoring and positioning of the catheter, reduce the risk of backflow of intestinal content into the catheter as well as the risk of leakage of bodily fluids or intestinal contents into the abdominal space.

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  • Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Transplantation (AREA)
  • Obesity (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Pulmonology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Child & Adolescent Psychology (AREA)
  • Prostheses (AREA)
  • Nursing (AREA)

Abstract

L'invention concerne un cathéter (11) pour diriger des sécrétions biliopancréatiques, le cathéter (11) comprenant une paroi tubulaire allongée (17) définissant un canal de fluide interne (25) et s'étendant entre une partie d'extrémité proximale (12) et une partie d'extrémité distale (13) du cathéter (11), la partie d'extrémité proximale (12) ayant un moyen de fixation proximal conçu pour fixer la partie d'extrémité proximale (12) à l'intérieur d'un arbre biliaire et la partie d'extrémité distale (13) ayant un ancrage distal allongé (18) conçu pour ancrer la partie d'extrémité distale (13) à l'intérieur d'un intestin, la partie d'extrémité distale (13) étant en forme de T et l'ancrage allongé (18) s'étendant de manière transversale à une direction longitudinale (19) du cathéter au niveau de la partie d'extrémité distale (13).
PCT/EP2011/061115 2011-07-01 2011-07-01 Cathéter, en particulier destiné à diriger des sécrétions biliopancréatiques WO2013004267A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/EP2011/061115 WO2013004267A1 (fr) 2011-07-01 2011-07-01 Cathéter, en particulier destiné à diriger des sécrétions biliopancréatiques

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2011/061115 WO2013004267A1 (fr) 2011-07-01 2011-07-01 Cathéter, en particulier destiné à diriger des sécrétions biliopancréatiques

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WO2013004267A1 true WO2013004267A1 (fr) 2013-01-10

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20010003985A1 (en) * 1997-03-06 2001-06-21 Lafontaine Daniel M. System and method for percutaneous coronary artery bypass
US20020123786A1 (en) * 2001-03-02 2002-09-05 Ventrica, Inc. Methods and devices for bypassing an obstructed target vessel by placing the vessel in communication with a heart chamber containing blood
EP1508312A1 (fr) * 2003-08-20 2005-02-23 Ethicon Endo-Surgery, Inc. Dispositif facilitant la malabsorption nutritionnelle
US20050085787A1 (en) 2003-10-17 2005-04-21 Laufer Michael D. Minimally invasive gastrointestinal bypass
WO2008142696A1 (fr) * 2007-05-24 2008-11-27 Inverthis Ltd. Dispositif de pontage et système et procédé d'administration

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20010003985A1 (en) * 1997-03-06 2001-06-21 Lafontaine Daniel M. System and method for percutaneous coronary artery bypass
US20020123786A1 (en) * 2001-03-02 2002-09-05 Ventrica, Inc. Methods and devices for bypassing an obstructed target vessel by placing the vessel in communication with a heart chamber containing blood
EP1508312A1 (fr) * 2003-08-20 2005-02-23 Ethicon Endo-Surgery, Inc. Dispositif facilitant la malabsorption nutritionnelle
US20050085787A1 (en) 2003-10-17 2005-04-21 Laufer Michael D. Minimally invasive gastrointestinal bypass
WO2008142696A1 (fr) * 2007-05-24 2008-11-27 Inverthis Ltd. Dispositif de pontage et système et procédé d'administration

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