WO2016166466A1

WO2016166466A1 - Passive connector between two adjacent stomas

Info

Publication number: WO2016166466A1
Application number: PCT/FR2016/050844
Authority: WO
Inventors: Régis Logier; Jean-Pierre Sozanski; Jean-Robert NZAMUSHE LEPAN MABLA
Original assignee: Centre Hospitalier Regional Universitaire De Lille
Priority date: 2015-04-14
Filing date: 2016-04-12
Publication date: 2016-10-20
Also published as: FR3034984A1; FR3034984B1

Abstract

The present invention relates to a connector for adjacent stomas (S1; S2), of the type comprising a base (7), which has a stoma passage able to surround the two stomas, and a collector (1) mounted in a leaktight manner on the first face of the base (7), in the area of said passage, the second face (73) of said base (7) being able to be placed on the abdominal wall of a patient, said collector comprising a collection chamber (133) able to communicate with the upstream stoma (S1), an outlet conduit (5) able to be connected to the downstream stoma (S2), and a flow conduit (132) which connects said collection chamber (133) to said outlet conduit (5). According to the invention, said device has the characteristic of being free of pump-forming means and of comprising a guide element (34), which extends into said collection chamber (133) and connects the latter to said flow conduit (132), and at least one volume-reducing element (36), which limits the volume of said collection chamber (133).

Description

PASSIVE CONNECTOR BETWEEN TWO RECOMBINED STOMIES

The present application relates to a passive connector allowing the passage of the alimentary bolus between two stomas.

The document WO 2014/122378 describes an active device for circulating a flow of alimentary bolus between two stomas. This device comprises one or two sealed collectors which are mounted on an ostomy or both depending on the spacing of the latter. This device comprises pump means, external, mounted on the patient's abdomen and which can be activated by the latter. The pump means can reinject the food bolus flowing naturally from the upstream stoma, under the effect of intestinal contractions, to the stoma downstream, at a distance from the latter.

The presence of the pump means weighs down the device of the invention which is mounted, for example, by means of a belt on the abdomen of the patient.

These pump means also generate noise and sometimes require the intervention of the patient to operate.

Moreover, the presence of the pump means prevents the use of the device in the shower, for example.

WO 03/032878 A1 discloses a stoma connecting device which has no pump means but which has a pocket attached to the abdominal wall of the patient by means of an adhesive element which surrounds the two stomas. This type of device generates several disadvantages: a large amount of food bolus always stagnates on the surface of the skin of the abdominal wall of the patient; only the bolus layer exceeding the height of the downstream stoma actually flows into it. The collar of the outlet tube which holds the latter in the downstream stoma, moreover, tends to cause irritation problems. In addition, the withdrawal of the outlet tube requires an additional operation after removal of the bag, this operation can be painful if the downstream stoma is irritated. Furthermore, JP Hei 5-212071 A1 discloses a device without pump means but which comprises a housing covering the two stomas. This casing is attached to the abdominal wall of the patient by means of an adhesive base. To reduce the area of contact between the bolus and the skin of the patient, this document recommends the use of a filling that fills the housing and which comprises a U-shaped channel connecting the two stomas. This device must be made to measure for each patient because the size and the gap between the stomas are not standard. In addition, sealing is difficult to ensure.

An object of the present invention is to provide a device which has at least one of the aforementioned drawbacks with reference to the prior art.

Another object of the present invention is to provide an approximated stoma connection device that is simple to manufacture, inexpensive and can be adapted to all sizes and configurations of stomas.

The present invention therefore proposes a close ostomy connector of the type comprising a pedestal which has a stoma passage capable of surrounding the two stomas and a collector, sealingly mounted on the first face of the pedestal, at said passage, the second face. said base being adapted to be mounted on the abdominal wall of a patient, said manifold comprising a collection chamber adapted to communicate with the upstream stoma, an outlet duct adapted to be connected to the downstream stoma and a flow duct which connects said collection chamber to said outlet conduit.

Typically according to the invention, said device is free of pump means, said collection chamber and said flow conduit are shaped to allow the passage of the naturally expelled food bolus at the upstream stoma to said outlet conduit, the device comprises a guiding element which extends into said collection chamber and connects it to said flow duct, the device further comprises at least one volume-reducing element which limits the volume of said collection chamber, and said volume reducing member connects said guide member and at least one member selected from the inner surface of said manifold and the outer surface of said outlet conduit. It is indeed the merit of the Applicant that to have found that the flow of food bolus out of the upstream stoma was sufficient to circulate without external energy input to the downstream stoma, if the path of the bowl between the two stomas is short enough, especially. The device of the invention can be used when the patient's intestine has already sufficiently recovered from its function; thus, in a first step, one can consider the use of the device of the prior art comprising pump means and that of the present invention, when the patient can get up and / or his bowel is functional again.

The guide element facilitates the passage of the food bolus into the flow conduit. It is preferably made of anallergic material; it can be silicone.

The volume-reducing volume-limiting element of said collection chamber makes it possible to adapt the device to any form, configuration and stoma size approximated. It also makes it possible to easily limit the collection chamber to the only upstream stoma, when it connects the guide element to the wall of the collector and to the wall of the outlet pipe or the pipe equipping it as later exposed. . The reducing element is preferably elastically deformable which makes it possible to ensure the tightness of the collection chamber.

Advantageously, said guide element is preferably elastically deformable allowing its adaptation to the upstream stoma and can provide a slight suction effect that sucks the food bolus to the flow conduit thus avoiding stagnation of the food bolus around the upstream stoma .

According to one embodiment, the dimensions of said collection chamber and of said flow duct, in particular their height, allow the flow of the food bolus expelled naturally to said outlet duct. The term "height" is defined as the dimension extending substantially perpendicular to the mean plane of the base.

The shape of the collector and the various conduits is not limiting of the invention. According to a particular embodiment, said collection chamber extends exclusively above said upstream stoma. A collection chamber with small dimensions avoids the stagnation of the bolus in the skin of the patient's abdomen. The collection chamber does not extend above the downstream stoma, the food bowl can not emerge from the stoma downstream in the collection chamber.

The outlet duct may comprise a nozzle and a flexible tube mounted on said nozzle. The nozzle may extend into the collection chamber in the direction of the base; the tube can thus be inserted into the patient's intestine through the downstream stoma. The length of the tube avoids any risk of reflux of the food bolus from the downstream stoma. The nozzle prevents any contact between the stoma and the flexible tube that plunges into the intestine.

Advantageously, the device comprises a washing tube which passes through the wall of said manifold and communicates with said collection chamber and valve means to allow or not the communication of said collection chamber with the outside of said manifold via said tube.

The tube can thus allow the washing of the collection chamber and all the conduit taken by the food bowl. This avoids the risk of irritation of the skin of the patient's abdomen and unpleasant odors that may occur despite the tightness of the collector.

Advantageously, the device comprises scraping means of the food bolus in said flow duct.

According to a particular embodiment of these scraping means, they comprise a propeller rotatably mounted in said flow duct and possibly means for rotating said propeller.

The present invention, its structure, its characteristics and the various advantages that it affords will appear better on reading the following description of two embodiments, presented as explanatory and nonlimiting examples and with reference to the appended drawings. on which ones :

FIG. 1 is a schematic cross-sectional view of a first embodiment of the invention;

FIG. 2 is a schematic cross-sectional view of a second embodiment; and FIG. 3 is a schematic cross-sectional view of an alternative embodiment of the second embodiment.

With reference to FIG. 1, the device comprises a single collector 1 which allows a sealed connection to the upstream and downstream stomia S1 and S2. This device is adapted for close ostomies that can be covered by the collector 1. The collector 1 is mounted on a base 7. The base 7 has an opening 72 which surrounds the stoma S1 and S2, when the device is mounted on the abdomen of a patient. The collector 1 has a collection chamber or collecting housing 133 which is disposed above the opening 72 above. The collector 1 also comprises comprises an inlet duct 3 and an outlet duct 5 which open into the collection housing 133 and into the flow duct 132. The flow duct 132 connects the inlet duct 3 to the duct 3. outlet duct 5. In the embodiment shown, the flow duct is substantially horizontal and substantially perpendicular to the outlet and inlet ducts 3 and 5 which are themselves vertical. The end of the outlet duct 5 which opens into the collection chamber 133 forms a nozzle 51 on which is mounted a flexible tube TS. The flexible tube TS immersed in the patient's intestine, beyond the downstream stoma S2. The nozzle 51 and the flexible tube TS pass through the collection chamber 133.

As shown in FIG. 1, the device comprises a base 7 which comprises a flexible sheet 71. The flexible sheet 71 has an attachment face 73 which is adhesive and adhered to the skin of the abdomen of a patient. The collector 1 is fixed on the second face of the sheet 71.

The operation of the device shown in FIG. 1 is the following. The flexible tube TS is mounted on the nozzle 51. The flexible tube TS is introduced into the downstream stoma S2 and the protective film is removed from the adhesive face of the flexible sheet 71. Collector 1 is glued on top of the two stomas S1 and S2. When the intestine of the patient under the effect of his natural contractions, advances the bolus, the bolus comes out at the level of the stoma S1 with a certain flow. The path of the food bowl is represented by the gray arrows.

The Applicant has demonstrated that the bolus could without external energy input, climb in the flow conduit 132 through the inlet duct 3 and then flow, particularly because of the gravity, in the outlet duct 5 and the flexible tube TS.

The connector 1 thus makes it possible to connect the two stomies S1 and S2 in a purely passive manner. The device is thus inexpensive and can be regularly changed for hygiene reasons.

A second embodiment will now be described with reference to FIG. 2. The elements in common with the first embodiment are referenced identically.

The second embodiment comprises a guiding cone or guiding funnel 34, made of a flexible material, for example, made of silicone. In the embodiment shown, the guide cone 34 forms the inlet duct 3. Flexible tubes 36 are inserted between two opposite walls so as to reduce the volume of the collection chamber 133. These flexible tubes are made of hypoallergenic material. . These flexible tubes 36 are supported on the one hand on the inner surface of the manifold 1 and on the other hand, on the guide cone 34 and / or the nozzle 51 and / or the flexible tube TS. They make it possible by reducing the volume of the collection chamber 133 to avoid the stagnation of the food bolus in the collection chamber 133; the food bolus being acidic, it is likely to irritate the skin of the patient.

The collector 1 also comprises a washing tube 8 equipped with valve means 81. The washing tube 8 passes through the wall of the collector 1 and opens into the collection chamber 133. When the valve means 81 are closed, the collection chamber remains sealed and the food bowl can flow through the conduit only. 5. When opening the tap means, it is possible to inject water or physiological saline in the collection chamber 133, to pass it in the flow conduit 132 and the outlet duct 5. The device can thus be cleaned without discomfort for the patient and without the need to remove the collector 1.

The operation of the second embodiment is identical to that described with reference to the first embodiment.

An alternative embodiment will now be described with reference to FIG. 3. The elements in common are referenced identically. With reference to FIG. 3, the device of the invention comprises a propeller 120 mounted in the flow conduit 132. This propeller 120 is horizontal is used to scrape the food bowl (which contains solid pieces) in the flow conduit 132 to facilitate its expulsion through the outlet duct 5. The propeller 120 is rotatably mounted about a vertical rod 121 which protrudes out of the connector 1, which remains sealed. By actuating this rod 121, the patient can himself rotate the propeller 120. In the variant shown, an electric motor 123 rotates the propeller 120.

Claims

Claims:

1. An ostomy connector (S1; S2) of the type having a pedestal (7) having an ostomy passage capable of surrounding the two stomas and a collector (1) sealingly mounted on the first face of the pedestal (7) at the level of said passage, the second face (73) of said base (7) being adapted to be mounted on the abdominal wall of a patient, said collector comprising a collection chamber (133) able to communicate with the upstream stoma (S1), an outlet duct (5) adapted to be connected to the downstream stoma (S2) and a flow duct (132) which connects said collection chamber (133) to said outlet duct (5), characterized in that said device is free of pump means, in that said collection chamber (133) and said flow duct (132) are shaped to allow passage of naturally expelled food bolus at the upstream stoma (S1) to said delivery duct output (5), in that it comprises an element of g uidage (34) extending into said collection chamber (133) and connecting the same to said flow conduit (132), comprising at least one volume reducing member (36) which limits the volume of said collection chamber (33), and in that said volume-reducing member (36) connects said guide member (34) and at least one member selected from the inner surface of said manifold (1) and the outer surface of said duct output (5; 51).

2. Device according to claim 1, characterized in that said guide element is preferably elastically deformable.

3. Device according to claim 1 or 2, characterized in that the dimensions of said collection chamber (133) and said flow duct (132), in particular their height, allow the flow of the food bolus expelled naturally to said duct output (5).

4. Device according to any one of claims 1 to 3, characterized in that said collection chamber (133) extends exclusively above said upstream stoma (S1).

5. Device according to any one of the preceding claims, characterized in that said outlet duct (5) comprises a nozzle (51) and a flexible tube mounted on said nozzle (51).

6. Device according to any one of the preceding claims, characterized in that it comprises a washing tube (8) which passes through the wall of said manifold (1) and communicates with said collection chamber (133) and means tap (81) to allow or not the communication of said collection chamber (133) with the outside of said manifold (1) via said tube (8).

7. Device according to any one of the preceding claims, characterized in that it comprises scraping means (120) of the food bolus in said flow conduit (132).

8. Device according to claim 7, characterized in that said scraping means (120) of the food bowl comprises a propeller rotatably mounted in said flow conduit (132) and means for rotating said propeller (121; 123).