WO2022166903A1 - 一种吻合装置 - Google Patents

一种吻合装置 Download PDF

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Publication number
WO2022166903A1
WO2022166903A1 PCT/CN2022/075107 CN2022075107W WO2022166903A1 WO 2022166903 A1 WO2022166903 A1 WO 2022166903A1 CN 2022075107 W CN2022075107 W CN 2022075107W WO 2022166903 A1 WO2022166903 A1 WO 2022166903A1
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Prior art keywords
channel
bracket
anastomotic device
stent
subsection
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PCT/CN2022/075107
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English (en)
French (fr)
Inventor
孙思予
王晟
韦建宇
沈正华
李常青
冷德嵘
周友琴
张凯
Original Assignee
南微医学科技股份有限公司
中国医科大学附属盛京医院
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Publication of WO2022166903A1 publication Critical patent/WO2022166903A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus

Definitions

  • the present disclosure relates to the field of medical devices, and in particular, to an anastomosis device.
  • Gallstones can enter the common bile duct through the cystic duct and become common bile duct stones.
  • the stones in the common bile duct are incarcerated in the ampulla through the sphincter of Oddi and cause pancreatitis, which is called biliary pancreatitis.
  • pancreatitis which is called biliary pancreatitis.
  • gallbladder duodenal fistula or gallbladder colon fistula large stones enter the intestine through the fistula and cause intestinal obstruction called gallstone intestinal obstruction. Stones and long-term inflammatory stimulation can induce gallbladder cancer.
  • the treatment plan of gallbladder removal can be adopted for the treatment of gallstones, but the removal of the gallbladder has the following disadvantages: 1. It is easy to cause indigestion and reflux gastritis; 2. The problem of bile duct damage after cholecystectomy; 3. The gallbladder after cholecystectomy The incidence of common duct stones increased.
  • Another method is to perform percutaneous gallbladder puncture under the guidance of ultrasound, then expand the puncture needle and insert the cholecystoscope into the gallbladder. Under the direct vision of the cholecystoscope, the stones are crushed by ultrasound, and the crushed stones are sucked out, but the residual rate is still very high. , at this stage, the in vitro gravel is only crushed but not discharged.
  • the anatomy of the bile duct has its particularity, which is completely different from the anatomical structure of the urinary system. Broken stones can easily cause bile duct blockage, which is more harmful to the patient than if no treatment is given.
  • endoscopic ultrasonography has been used to dispose of an enterobiliary anastomosis stent in the duodenum, anastomosis the duodenum with the gallbladder, and then perform gastroscopic lithotripsy.
  • this procedure is used to dispose of the enterobiliary anastomosis stent in the duodenum. It requires endoscopic ultrasonography to pass through the cardia, stomach and pylorus to reach the duodenum. Stent placement is difficult and the learning curve is long. Endoscopy doctors to promote, limit the development of this surgery.
  • the purpose of the present disclosure is to provide an anastomotic device, which has a small structural size and is easy to be inserted into an implanter, thereby reducing the difficulty of use.
  • the present disclosure provides an anastomosis device, which includes a first bracket and a second bracket;
  • the first bracket has a first channel
  • the second bracket is provided with a second channel, and the second bracket is connected with the first bracket;
  • the second bracket is located outside the first channel, and the first channel is in communication with the second channel; or, at least part of the second bracket is accommodated in the first channel.
  • At least one membrane flap is disposed in the second channel, and the membrane flap is used to unidirectionally lead the second channel from the distal end of the second stent to the proximal end of the second stent.
  • the distal end of the second stent is connected to the proximal or distal end of the first stent.
  • the distal end of the second stent abuts against the distal end of the first stent through the first channel, and the second stent accommodated in the first channel is matched with the first channel.
  • the second bracket accommodated in the first channel is an interference fit with the first channel.
  • the valve includes a plurality of sub-valve bodies
  • the plurality of sub-lobe bodies are arranged at annular intervals around the axis direction of the first channel.
  • the second stent includes a first subsection and a second subsection that are arranged in sequence from the distal end to the proximal end, and the second subsection is connected to the first subsection;
  • the first sub-section and the second sub-section respectively have a hollow first inner cavity and a second inner cavity, and the first inner cavity communicates with the second inner cavity and forms a second channel.
  • a first valve is disposed in the first lumen, and a second valve is disposed in the second lumen.
  • the second valve flap is located at an end of the second subsection remote from the first subsection.
  • first valve and the second valve each include four sub-valve bodies.
  • At least one valve is disposed in the second channel, and the valve is disposed in the first lumen or in the second lumen.
  • an end of the first subsection away from the second subsection is provided with a first abduction portion, and the first abduction portion is used for connecting with the first bracket.
  • the first flared portion is a first annular outer edge extending out of the first subsection in a direction perpendicular to the axis of the second channel.
  • both ends of the first bracket are respectively provided with a second outreach portion and a third outreach portion.
  • both the second flared portion and the third flared portion are second annular outer edges formed by flared around the axis of the first channel.
  • the outer circumference of one of the second annular outer edges is curled toward its center to form an annular space that accommodates the distal end of the second stent.
  • the outer peripheries of the two second annular outer edges are curled toward their center to form annular spaces, one of which is used to accommodate the distal end of the second stent.
  • both the first support and the second support include a frame body and a membrane body covering the frame body.
  • both the inner peripheral surface or the outer peripheral surface of the first channel and the second channel are covered with a membrane body.
  • the anastomotic device further includes a drainage tube connected to the proximal end of the second stent.
  • the anastomotic device includes a first bracket and a second bracket; the first bracket has a first channel; the second bracket has a second channel, and the second bracket is connected with the first bracket; wherein, the second bracket is located outside the first channel, and the second bracket is located outside the first channel.
  • a channel communicates with the second channel; or, at least part of the second bracket is accommodated in the first channel.
  • the anastomotic device has a small structure and is easy to be loaded into the implanter, thereby reducing the difficulty of use.
  • the two ends of the first stent are respectively used to be accommodated in the patient's gallbladder and stomach, and abut against the gallbladder wall and the stomach wall respectively, so as to pass through the first channel or the second The channel connects the gallbladder to the stomach.
  • the anastomotic device includes a first bracket and a second bracket, and the second bracket is assembled with the first bracket, such a structure is conducive to reducing the structural size of the anastomotic device , so that the anastomotic device can be easily loaded into the implanter, so as to reduce the difficulty of use, and can leave a larger installation space for the valve, thereby improving the anti-reflux effect.
  • FIG. 1 is a schematic structural diagram of an anastomotic device in an embodiment of the disclosure
  • FIG. 2 is a cross-sectional view of an anastomotic device according to an embodiment of the disclosure
  • FIG. 3 is a schematic view of the installation of the anastomotic device in the embodiment of the present disclosure
  • FIG. 4 is a schematic structural diagram of a second bracket from a first perspective in an embodiment of the disclosure.
  • FIG. 5 is a schematic structural diagram of a second bracket from a second perspective in an embodiment of the disclosure.
  • FIG. 6 is a cross-sectional view of a second bracket from a third perspective in an embodiment of the disclosure.
  • FIG. 7 is a cross-sectional view of a second bracket from a fourth angle of view according to an embodiment of the disclosure.
  • FIG. 8 is a schematic structural diagram of a first bracket from a first perspective in an embodiment of the disclosure.
  • FIG. 9 is a schematic structural diagram of a first bracket from a second perspective in an embodiment of the disclosure.
  • FIG. 10 is a cross-sectional view of a first bracket in an embodiment of the disclosure.
  • FIG. 11 is a schematic diagram of the installation of the first bracket in the embodiment of the disclosure.
  • FIG. 13 is a schematic structural diagram of a drainage tube in another embodiment of the disclosure.
  • Icons 200 - anastomotic device; 210 - first stent; 211 - first channel; 10 - gallbladder; 20 - stomach; 220 - second stent; 221 - second channel; 224-second segment; 225-first lumen; 226-second lumen; 227-first valve; 228-second valve; 229-first abduction; 231-first annular outer 232 - subvalve body; 212 - second abduction; 213 - third abduction; 214 - second annular outer edge; 215 - annular space; 230 - drainage tube; 30 - duodenum.
  • horizontal does not imply that a component is required to be absolutely horizontal or overhang, but rather may be slightly inclined.
  • horizontal only means that its direction is more horizontal than “vertical”, it does not mean that the structure must be completely horizontal, but can be slightly inclined.
  • the terms “arranged”, “installed”, “connected” and “connected” should be understood in a broad sense, for example, it may be a fixed connection, It can also be a detachable connection, or an integral connection; it can be a mechanical connection or an electrical connection; it can be a direct connection, or an indirect connection through an intermediate medium, or the internal communication between the two components.
  • the meanings of the above terms in the present disclosure can be understood according to the situation.
  • Gallstones can enter the common bile duct through the cystic duct and become common bile duct stones.
  • the stones in the common bile duct are incarcerated in the ampulla through the sphincter of Oddi and cause pancreatitis, which is called biliary pancreatitis.
  • Cholecystoduodenal fistula or cholecystocolonic fistula large stones enter the intestine through the fistula and cause intestinal obstruction, which is called gallstone intestinal obstruction. Stones and long-term inflammatory stimulation can induce gallbladder cancer.
  • the treatment plan of gallbladder removal can be adopted for the treatment of gallstones, but the removal of the gallbladder has the following disadvantages: 1. It is easy to cause indigestion and reflux gastritis; 2. The problem of bile duct damage after cholecystectomy; 3. The gallbladder after cholecystectomy The incidence of common duct stones increased.
  • gallbladder preservation there is a traditional laparotomy, in which the gallbladder is incised to remove the gallbladder and then the gallbladder is sutured. This technique removes stones under the naked eye, leaving a "blind area", and tiny stones cannot be found, which increases the residual rate of stones in the gallbladder.
  • blind stone removal Another method is to perform percutaneous gallbladder puncture under the guidance of ultrasound, then expand the puncture needle and insert the cholecystoscope into the gallbladder. Under the direct vision of the cholecystoscope, the stones are crushed by ultrasound, and the crushed stones are sucked out, but the residual rate is still very high. , at this stage, the in vitro gravel is only crushed but not discharged.
  • the anatomy of the bile duct has its particularity, which is completely different from the anatomical structure of the urinary system. Broken stones can easily cause bile duct blockage, which is more harmful to the patient than if no treatment is given.
  • endoscopic ultrasonography has been used to dispose of an enterobiliary anastomosis stent in the duodenum, anastomosis the duodenum with the gallbladder, and then perform gastroscopic lithotripsy.
  • this procedure is used to dispose of the enterobiliary anastomosis stent in the duodenum. It requires endoscopic ultrasonography to pass through the cardia, stomach and pylorus to reach the duodenum. Stent placement is difficult and the learning curve is long. Endoscopy doctors to promote, limit the development of this surgery. If endoscopic ultrasonography is used to perform gastrobiliary anastomosis in the stomach through the cardia, the difficulty of the operation is greatly reduced and the success rate is high.
  • FIGS. 1 and 2 show the structure of the anastomotic device in the embodiment of the present disclosure
  • FIG. 3 shows the installation state of the anastomotic device in the gallbladder and the stomach in the embodiment of the present disclosure. ;
  • This embodiment provides an anastomosis device 200, which includes a first bracket 210 and a second bracket 220;
  • the first bracket 210 has a first channel 211; the second bracket 220 has a second channel 221, and the second bracket 220 is connected to the first bracket 210;
  • the second bracket 220 is located outside the first channel 211 , and the first channel 211 and the second channel 221 communicate with each other; or, at least part of the second bracket 220 is accommodated in the first channel 211 .
  • at least part of the second bracket 220 is accommodated in the first channel 211, and the distal end of the second bracket 220 is connected to the first bracket 210 and accommodated in the first channel
  • the axis of the second channel 221 of 211 coincides with the axis of the first channel 211 .
  • At least one membrane flap 222 is provided in the second channel 221 , and the membrane flap 222 is used for unidirectional conduction in the direction from the distal end of the second stent 220 to the proximal end of the second stent 220 The second channel 221 .
  • the two ends of the first stent 210 are respectively used to be accommodated in the patient's gallbladder 10 and stomach 20, and abut against the walls of the gallbladder 10 and the stomach 20, respectively.
  • a channel 211 is used to communicate the gallbladder 10 with the stomach 20 .
  • the working principle of the anastomotic device 200 is as follows:
  • the anastomotic device 200 includes a first stent 210 and a second stent 220; wherein, the first stent 210 has a first channel 211, and two ends of the first stent 210 are respectively used to be accommodated in the patient's gallbladder 10 and stomach 20 , and abut with the wall of the gallbladder 10 and the wall of the stomach 20 respectively, so as to connect the gallbladder 10 and the stomach 20 through the first channel 211; and the second bracket 220 has a second channel 221, and at least one membrane flap is arranged in the second channel 221 222, the membrane flap 222 is used for unidirectionally leading the second channel 221 from the distal end of the second stent 220 to the proximal end of the second stent 220; the distal end of the second stent 220 is used for connecting with the first stent 210,
  • the axis of the first channel 211 coincides with the axis of the second channel 221 .
  • the membrane flap 222 of the second stent 220 is used to unidirectionally conduct the second channel 221 from the distal end of the second stent 220 to the proximal end of the second stent 220 , that is, the first stent 210 is connected with the second stent 220 At this time, the second channel 221 can be unidirectionally led from the gallbladder 10 to the stomach 20 through the valve, thereby preventing food residues or gastric acid in the stomach 20 from refluxing into the gallbladder 10, thereby avoiding serious infection accidents.
  • the anastomotic device 200 includes the first bracket 210 and the second bracket 220, and the second bracket 220 and the first bracket 210 are assembled in a manner, such a structure is beneficial to reduce the
  • the structural size of the anastomotic device 200 is convenient to install the anastomotic device 200 into the implanter, so as to reduce the difficulty of use, and to allow a larger installation space for the valve 222, thereby improving the anti-reflux effect.
  • distal end and proximal end
  • front end of the anastomotic device 200 in the relative position in FIG.
  • distal can be understood as the front end portion of a part or component relatively close to the gallbladder 10
  • proximal end can be understood as the rear end part of a part or component relatively close to the stomach 20.
  • both ends of the first stent 210 can be accommodated in the patient's gallbladder 10 as the distal end of the first stent 210 and abut against the wall of the gallbladder 10 .
  • the first bracket 210 and the second bracket 220 when the first bracket 210 and the second bracket 220 are installed, the first bracket 210 and the second bracket 220 both include a frame body and a film body covering the frame body. Leakage occurs at the abutment between the anastomotic device 200 and the gallbladder 10 or the stomach 20 , or prevents leakage at the formed channel connecting the gallbladder 10 and the stomach 20 .
  • the inner peripheral surface or the outer peripheral surface of the first channel 211 and the second channel 221 can also be covered with membranes to prevent leakage at the channel connecting the gallbladder 10 and the stomach 20 .
  • the distal end of the second stent 220 may be connected to the proximal end or the distal end of the first stent 210 .
  • the distal end of the second bracket 220 abuts against the distal end of the first bracket 210 through the first channel 211 , and the second bracket 220 accommodated in the first channel 211 is matched with the first channel 211 .
  • the second bracket 220 accommodated in the first channel 211 is in an interference fit with the first channel 211 .
  • the function of the membrane flap 222 is to unidirectionally lead the second channel 221 from the distal end of the second stent 220 to the proximal end of the second stent 220 .
  • One-way conduction of the second channel 221 is ensured. Therefore, in this embodiment, when disposing the membrane flaps 222 , a method of disposing a plurality of membrane flaps 222 at intervals in the second channel 221 may be adopted.
  • the membrane flaps 222 are disposed in the second channel 221 at intervals, and the two membrane flaps 222 are used for unidirectional communication in the direction from the distal end of the second stent 220 to the proximal end of the second stent 220
  • the second channel 221 ; and, the membrane valve 222 includes a plurality of sub-valve bodies 232 ; the plurality of sub-valve bodies 232 are arranged at annular intervals around the axis direction of the first channel 211 .
  • both membrane flaps 222 can play the role of restricting the flow of fluid from the gallbladder 10 to the stomach 20;
  • the two flaps 222 and the second channel 221 together form a cavity, the fluid entering the second channel 221 from the gallbladder 10 can flow into the stomach 20 after entering the cavity, and the food residues in the stomach 20 Or gastric acid, even after entering the cavity through the membrane flap 222 at the proximal end of the second stent 220, it will be restricted in the cavity or return to the stomach 20 under the action of the flow restriction of the other membrane flap 222. Therefore, through the arrangement of the two membrane flaps 222, it can play the role of double protection, thereby preventing the food residue or gastric acid in the stomach 20 from refluxing into the gallbladder 10, thereby avoiding serious infection accidents.
  • FIGS. 4 to 7 illustrate the structure of the second stent in the embodiment of the present disclosure.
  • the second stent 220 when the second stent 220 is disposed, the second stent 220 includes a structure from the distal end to the proximal end.
  • the first subsection 223 and the second subsection 224 are arranged in sequence in the direction of the end, and the second subsection 224 is connected with the first subsection 223; and the first subsection 223 and the second subsection 224 respectively have a hollow first subsection
  • a first membrane flap 227 may be arranged in the first lumen 225
  • a second membrane flap 228 may be arranged in the second inner cavity 226 .
  • the first membrane flap 227 and the second membrane flap 228 are arranged, the first membrane flap 227 and the Both the second valve flaps 228 are used for unidirectionally leading the second channel 221 from the distal end of the second stent 220 to the proximal end of the second stent 220 , that is, the first valve valve 227 and the second valve valve 228 are both used for the The direction from the gallbladder 10 to the stomach 20 leads to the second channel 221 unidirectionally.
  • the first valve 227 and the second valve 228 can be arranged at intervals In the second channel 221, the first valve 227, the second valve 228 and the second channel 221 can jointly form a cavity, so as to play the role of double-layer anti-reflux.
  • both the first inner cavity 225 and the second inner cavity 226 may be cylindrical inner cavities extending along the axis direction of the second channel 221 , and the first inner cavity 225 may be a cylindrical inner cavity.
  • the inner diameter is greater than the inner diameter of the second lumen 226
  • the area of the first valve 227 is greater than the area of the second valve 228 . In this way, the first valve 227 and the second valve 228 are opposite to the second channel 221 .
  • the effect of restricting the flow is different, and the purpose is to enable the first valve 227 to restrict the fluid in the cavity from flowing into the gallbladder 10 through the first valve 227, while the fluid in the cavity can be restricted.
  • the cavity can be drained through the second flap 228 , ie, the fluid located in the cavity can flow back into the stomach 20 .
  • the second membrane flap 228 When the second membrane flap 228 is disposed, the second membrane flap 228 is located at one end of the second subsection 224 away from the first subsection 223 . It should be noted that, in this embodiment, when the second subsection 224 is provided, the second subsection 224 is located outside the first channel 211 and in the stomach 20; while in other embodiments of the present disclosure, the second subsection 224 is located outside the first channel 211 and in the stomach 20. The subsection 224 may also be located within the first channel 211 .
  • the distal end of the second bracket 220 is used to pass through the first channel 211 and the first bracket 210 at the gallbladder One end of the 10 abuts, and the second bracket 220 accommodated in the first channel 211 is in an interference fit with the first channel 211, so as to improve the connection between the first bracket 210 and the second bracket 220 in this way
  • the end of the first sub-section 223 away from the second sub-section 224 is provided with a first abduction part 229
  • the first outreach portion 229 is used for abutting with one end of the first stent 210 located in the gallbladder 10 .
  • the first flared portion 229 may be a first annular outer edge 231 extending radially outward of the first lumen 225 , and the outer diameter of the
  • the first sub-section 223 and the second sub-section 224 are arranged in sequence from the distal end of the second bracket 220 to the proximal end, the distal end of the second bracket 220 passes through the first channel 211 and the After the distal end of a stent 210 abuts, the first sub-section 223 is an interference fit with the first channel 211 ; secondly, since the first lumen 225 and the second lumen 226 both extend along the axis of the second channel 221 Therefore, the first subsection 223 and the second subsection 224 are both cylindrically extending along the axial direction of the second channel 221; therefore, the outer diameter of the first subsection 223 and the inner diameter of the first channel 211 Therefore, by making the outer diameter of the first annular outer edge 231 larger than the outer diameter of the first sub-portion 223, the first annular outer edge 231 can be located at a distance from the first bracket 210.
  • the second channel 221 is provided with a first valve 227 and a second valve 228 at intervals, and when the first valve 227 and the second valve are arranged
  • both the first valve 227 and the second valve 228 include a plurality of sub-valve bodies 232, and the plurality of sub-valve bodies 232 are arranged at annular intervals around the axis direction of the first channel 211, and the plurality of sub-valve bodies 232 are formed by a plurality of sub-valve bodies 232.
  • the second channel 221 protrudes from the distal direction to the proximal end direction, so as to play a role of restricting the flow in the second channel 221 .
  • first valve 227 and the second valve 228 each include four sub-valve bodies 232 , and since the four sub-valve bodies 232 are arranged annularly spaced around the axis of the first channel 211 , such a configuration In this way, a cross-shaped opening can be formed, and through this arrangement, the second channel 221 can be unidirectionally led from the distal end of the second stent 220 to the proximal end of the second stent 220 .
  • FIGS. 8 to 10 illustrate the structure of the first stent in the embodiment of the present disclosure.
  • the two ends of the first stent 210 to connect with the wall of the gallbladder 10 and the stomach 20
  • the walls are in contact with each other, so both ends of the first bracket 210 are respectively provided with a second outreach portion 212 and a third outreach portion 213, and one of the second outreach portion 212 and the third outreach portion 213 is used for In abutment with the wall of the gallbladder 10 , the other of the second flared portion 212 and the third flared portion 213 is used to abut against the wall of the stomach 20 .
  • the second abduction portion 212 may be located in the gallbladder 10 and abut against the wall of the gallbladder 10, and the third abduction portion 213 may be located in the stomach 20 and abut against the wall of the stomach 20;
  • the abduction portion 213 is located in the gallbladder 10 and abuts against the wall of the gallbladder 10, and the second abduction portion 212 is located in the stomach 20 and abuts against the wall of the stomach 20; thus, in the process of using the first stent 210, the first stent
  • the end of the first stent 210 provided with the second abduction portion 212 can be used as the distal end of the first stent 210
  • the end of the first stent 210 with the third abduction portion 213 can also be used as the distal end of the first stent 210 .
  • the second abduction portion 212 and the third abduction portion 213 are provided so that the second abduction portion 212 and the third outer portion can abut against the wall of the gallbladder 10 and the wall of the stomach 20 respectively.
  • the third flared portions 213 are each a second annular outer edge 214 formed by flared around the axis of the first channel 211 .
  • the outer circumference of one of the second annular outer edges 214 is curled toward its center to form a receiving
  • the annular space 215 at the distal end of the second bracket 220 increases the abutment area with the distal end of the second bracket 220 in this way, so as to improve the installation stability of the second bracket 220 .
  • the first flared portion 229 is the first annular outer edge 231 extending outward along the radial direction of the first lumen 225
  • the first bracket 210 is used for connecting with the second bracket 220 .
  • the second annular outer edge 214 abutting on the distal end is an annular space 215 formed by curling, so the annular space 215 has a shape adapted to the first annular outer edge 231 to increase the contact area.
  • the annular space 215 is formed by curling, its cross-sectional profile has a certain radian.
  • the cross-section of the first annular outer edge 231 has the same shape as the annular space.
  • the radian of the space 215 is adapted so that the distal end of the second bracket 220 is in the shape of a bell mouth.
  • the end of the first stent 210 provided with the second outreach portion 212 can be used as the distal end of the first stent 210
  • the end of the first bracket 210 provided with the third outreach portion 213 can also be used as the distal end of the first bracket 210 .
  • the outer peripheries of the two second annular outer edges 214 can be curled toward their center to form annular spaces 215 , wherein one annular space 215 is used to accommodate the distal end of the second stent 220 .
  • FIGS. 3 , 11 and 12 illustrate the steps of installing the anastomotic device in the embodiment of the present disclosure.
  • the working process of the anastomotic device 200 is as follows:
  • the first stent 210 is placed through the implanter so that the first part of the first stent 210 is located in the gallbladder 10, the other end of the first stent 210 is located in the stomach 20, and the first stent 210 is located in the stomach 20.
  • the two second annular outer edges 214 are respectively in contact with the wall of the gallbladder 10 and the wall of the stomach 20; at this time, the end of the first bracket 210 located in the gallbladder 10 is the distal end of the first bracket 210, and the first bracket 210 is located in the stomach
  • One end in 20 is the proximal end of the first bracket 210;
  • the second stent 220 is placed through the implanter so that the first annular outer edge 231 at the distal end of the second stent 220 is located in and abuts against the annular space 215 at the distal end of the first stent 210, and the proximal end of the second stent 220 is located in the stomach 20; and the part of the second stent 220 located in the first channel 211 is in an interference fit with the first channel 211;
  • first bracket 210 and the second bracket 220 are assembled into a whole, and the anastomotic device 200 is unidirectionally conducted from the gallbladder 10 to the stomach 20, so as to play the role of preventing gallbladder reflux in the stomach 20;
  • the first stent 210 and the second stent 220 are taken out, and the stones in the gallbladder 10 are taken out through the fistula tract; or the second stent 220 is taken out, The stones in the gallbladder 10 are taken out through the first channel 211 of the first stent 210 , and then the first stent 210 is taken out.
  • FIG. 13 shows the structure of the drainage tube in other embodiments of the present disclosure; in other embodiments of the present disclosure, the anastomotic device 200 may further include a second bracket 220 and a second bracket 220 .
  • the proximal end of the drainage tube 230 is connected to the drainage tube 230; the distal end of the drainage tube 230 is connected to the proximal end of the second stent 220, and the proximal end of the drainage tube 230 can extend into the duodenum 30 through the pylorus, so that in this way , to prevent the food in the stomach from refluxing into the gallbladder, and the drainage tube 230 can also be provided with small holes, through which the bile can easily flow out of the body and help digestion.
  • the above-mentioned method of disposing at least one membrane flap 222 in the second channel 221 may be adopted or the The method of disposing the drainage tube 230 in the above content can also be a combination of disposing at least one valve 222 in the second channel 221 and disposing the drainage tube 230 to avoid serious infection accidents.

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Abstract

一种吻合装置，其包括第一支架(210)以及第二支架(220)；第一支架(210)具备第一通道(211)；第二支架(220)具备第二通道(221)，第二支架(220)与第一支架(210)连接；其中，第二支架(220)位于第一通道(211)外，且第一通道(211)与第二通道(221)导通；或，第二支架(220)的至少部分容置于第一通道(211)内。该吻合装置的结构尺寸小，且便于装入置入器中，从而能够降低使用的难度。

Description

一种吻合装置
相关申请的交叉引用
本公开要求于2021年02月05日提交中国专利局的申请号为“CN 202110164162.9”名称为“一种吻合装置”的中国专利申请的优先权，其全部内容通过引用结合在本公开中。
技术领域
本公开涉及医疗器械领域，具体而言，涉及一种吻合装置。
背景技术
胆结石可通过胆囊管进入胆总管内成为胆总管结石，胆总管的结石通过Oddi括约肌嵌顿于壶腹部导致胰腺炎，称为胆源性胰腺炎，因结石压迫引起胆囊炎症并慢性穿孔，可造成胆囊十二指肠瘘或胆囊结肠瘘，大的结石通过瘘管进入肠道引起肠梗阻称为胆石性肠梗阻，结石及长期的炎症刺激可诱发胆囊癌。
目前治疗胆结石可以采取切除胆囊的治疗方案，但切除胆囊存在以下弊病：1.容易引起消化不良和返流性胃炎；2.胆囊切除术后导致胆管损伤的问题；3.胆囊切除术后胆总管结石的发生率增高。
而对于保胆取石有传统的开腹，切开胆囊取出结石后再将胆囊缝合。此术式在肉眼下取石，留有“盲区”，微小结石不能发现，从而使胆囊内结石残留率增高，被称为“盲人”取石，残留率高，创伤大、恢复慢。
另一种方式在超声波引导下，先作经皮胆囊穿刺，然后扩大穿刺针道并插入胆囊镜至胆囊，在胆囊镜直视下用超声波将结石粉碎，并将粉碎结石吸出依然残留率极高，此阶段体外碎石只碎石不排石。加之胆道的解剖有其特殊性，完全不同于泌尿系统的解剖结构，震碎的结石极易造成胆管堵塞，比不治疗给患者造成的身体危害更大。
最近几年，经超声内镜在十二指肠处置入肠胆吻合支架，将十二指肠与胆囊吻合，然后再进行胃镜取石的手术是比较先进和前沿的新“保胆取石”术。但此术式在十二指肠处置入肠胆吻合支架，需要超声内镜通过贲门、胃及幽门才能到达十二指肠，进行支架置入，手术难度大，学习曲线长，很难向普通内镜医生推广，限制此术式的发展。
发明内容
本公开的目的在于提供一种吻合装置，该吻合装置的结构尺寸小，且便于装入置入器中，从而能够降低使用的难度。
本公开提供一种吻合装置，其包括第一支架以及第二支架；
第一支架具备第一通道；
第二支架具备第二通道，第二支架与第一支架连接；
其中，第二支架位于第一通道外，且第一通道与第二通道导通；或，第二支架的至少部分容置于第一通道内。
在可选的实施方式中，第二通道内设置有至少一个膜瓣，膜瓣用于由第二支架的远端至第二支架的近端的方向单向导通第二通道。
在可选的实施方式中，第二支架的远端与第一支架的近端或远端连接。
在可选的实施方式中，第二支架的远端穿过第一通道与第一支架的远端抵接，且容置于第一通道内的第二支架与第一通道配合。
在可选的实施方式中，容置于第一通道内的第二支架与第一通道过盈配合。
在可选的实施方式中，膜瓣包括多个子瓣体；
多个子瓣体均绕第一通道的轴线方向环形间隔设置。
在可选的实施方式中，第二支架包括由远端至近端的方向依次设置的第一分部及第二分部，第二分部与第一分部连接；
第一分部及第二分部分别具备中空的第一内腔及第二内腔，第一内腔与第二内腔连通并形成第二通道。
在可选的实施方式中，第一内腔中设置有第一膜瓣，第二内腔中设置有第二膜瓣。
在可选的实施方式中，第二膜瓣位于第二分部远离第一分部的一端。
在可选的实施方式中，第一膜瓣及第二膜瓣均包括四个子瓣体。
在可选的实施方式中，第二通道内设置有至少一个膜瓣，膜瓣设置于第一内腔中或设置于第二内腔中。
在可选的实施方式中，第一分部远离第二分部的一端设置有第一外展部，第一外展部用于与第一支架连接。
在可选的实施方式中，第一外展部为沿垂直于第二通道的轴线的方向向第一分部外延伸的第一环形外缘。
在可选的实施方式中，第一支架的两端分别设置有第二外展部及第三外展部。
在可选的实施方式中，第二外展部及第三外展部均为绕第一通道的轴线外展而形成的第二环形外缘。
在可选的实施方式中，其中一个第二环形外缘的外周朝自身中心的方向卷曲以形成容纳第二支架的远端的环形空间。
在可选的实施方式中，两个第二环形外缘的外周朝自身中心的方向卷曲以形成环形空间，其中一个环形空间用于容纳第二支架的远端。
在可选的实施方式中，第一支架及第二支架均包括架体以及覆于架体的膜体。
在可选的实施方式中，第一通道及第二通道的内周面或外周面均覆有膜体。
在可选的实施方式中，吻合装置还包括与第二支架的近端连接的引流管。
本公开实施方式的有益效果包括：
该吻合装置包括第一支架及第二支架；第一支架具备第一通道；第二支架具备第二通道，第二支架与第一支架连接；其中，第二支架位于第一通道外，且第一通道与第二通道导通；或，第二支架的至少部分容置于第一通道内。该吻合装置的结构尺寸小，且便于装入置入器中，从而能够降低使用的难度。在采用该吻合装置实施胃胆吻合手术时，第一支架的两端分别用于容置于患者的胆囊内及胃内，并分别与胆囊壁及胃壁抵接，以通过第一通道或第二通道将胆囊与胃连通。
在使用的过程中，由于该吻合装置包括第一支架及第二支架，且采用的是第二支架与第一支架组装而成的方式，进而这样的结构有利于减小该吻合装置的结构尺寸，以便于将该吻合装置装入置入器中，以降低使用的难度，并能够留出更大的膜瓣安装空间，从而提高防反流的效果。
附图说明
为了更清楚地说明本公开实施方式的技术方案，下面将对实施方式中所需要使用的附图作简单地介绍，应当理解，以下附图仅示出了本公开的某些实施方式，因此不应被看作是对范围的限定，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他相关的附图。
图1为本公开实施方式中吻合装置的结构示意图；
图2为本公开实施方式中吻合装置的剖视图；
图3为本公开实施方式中吻合装置的安装示意图；
图4为本公开实施方式中第二支架第一视角的结构示意图；
图5为本公开实施方式中第二支架第二视角的结构示意图；
图6为本公开实施方式中第二支架第三视角的剖视图；
图7为本公开实施方式中第二支架第四视角的剖视图；
图8为本公开实施方式中第一支架第一视角的结构示意图；
图9为本公开实施方式中第一支架第二视角的结构示意图；
图10为本公开实施方式中第一支架的剖视图；
图11为本公开实施方式中第一支架的安装示意图；
图12为本公开实施方式中第二支架的安装示意图；
图13为本公开其他实施方式中引流管的结构示意图。
图标：200-吻合装置；210-第一支架；211-第一通道；10-胆囊；20-胃；220-第二支架；221-第二通道；222-膜瓣；223-第一分部；224-第二分部；225-第一内腔；226-第二内腔；227-第一膜瓣；228-第二膜瓣；229-第一外展部；231-第一环形外缘；232-子瓣体；212-第二外展部；213-第三外展部；214-第二环形外缘；215-环形空间；230-引流管；30-十二指肠。
具体实施方式
为使本公开实施方式的目的、技术方案和优点更加清楚，下面将结合本公开实施方式中的附图，对本公开实施方式中的技术方案进行清楚、完整地描述，显然，所描述的实施方式是本公开一部分实施方式，而不是全部的实施方式。通常在此处附图中描述和示出的本公开实施方式的组件可以以各种不同的配置来布置和设计。
因此，以下对在附图中提供的本公开的实施方式的详细描述并非旨在限制要求保护的本公开的范围，而是仅仅表示本公开的选定实施方式。基于本公开中的实施方式，本领域普通技术人员在没有作出创造性劳动前提下所获得的所有其他实施方式，都属于本公开保护的范围。
应注意到：相似的标号和字母在下面的附图中表示类似项，因此，一旦某一项在一个附图中被定义，则在随后的附图中不需要对其进行定义和解释。
在本公开的描述中，需要说明的是，术语“中心”、“上”、“下”、“左”、“右”、“竖直”、“水平”、“内”、“外”等指示的方位或位置关系为基于附图所示的方位或位置关系，或者是该公开产品使用时惯常摆放的方位或位置关系，仅是为了便于描述本公开和简化描述，而不是指示或暗示所指的装置或元件必须具有特定的方位、以特定的方位构造和操作， 因此不能理解为对本公开的限制。此外，术语“第一”、“第二”、“第三”等仅用于区分描述，而不能理解为指示或暗示相对重要性。
此外，术语“水平”、“竖直”等术语并不表示要求部件绝对水平或悬垂，而是可以稍微倾斜。如“水平”仅仅是指其方向相对“竖直”而言更加水平，并不是表示该结构一定要完全水平，而是可以稍微倾斜。
在本公开的描述中，还需要说明的是，除非另有明确的规定和限定，术语“设置”、“安装”、“相连”、“连接”应做广义理解，例如，可以是固定连接，也可以是可拆卸连接，或一体地连接；可以是机械连接，也可以是电连接；可以是直接相连，也可以通过中间媒介间接相连，可以是两个元件内部的连通。对于本领域的普通技术人员而言，可以根据情况理解上述术语在本公开中的含义。
胆结石可通过胆囊管进入胆总管内成为胆总管结石，胆总管的结石通过Oddi括约肌嵌顿于壶腹部导致胰腺炎，称为胆源性胰腺炎，因结石压迫引起胆囊炎症并慢性穿孔可造成胆囊十二指肠瘘或胆囊结肠瘘，大的结石通过瘘管进入肠道引起肠梗阻称为胆石性肠梗阻，结石及长期的炎症刺激可诱发胆囊癌。
目前治疗胆结石可以采取切除胆囊的治疗方案，但切除胆囊存在以下弊病：1.容易引起消化不良和返流性胃炎；2.胆囊切除术后导致胆管损伤的问题；3.胆囊切除术后胆总管结石的发生率增高。而对于保胆取石有传统的开腹，切开胆囊取出结石后再将胆囊缝合。此术式在肉眼下取石，留有“盲区”，微小结石不能发现，从而使胆囊内结石残留率增高，被称为“盲人”取石，残留率高，创伤大、恢复慢。另一种方式在超声波引导下，先作经皮胆囊穿刺，然后扩大穿刺针道并插入胆囊镜至胆囊，在胆囊镜直视下用超声波将结石粉碎，并将粉碎结石吸出依然残留率极高，此阶段体外碎石只碎石不排石。加之胆道的解剖有其特殊性，完全不同于泌尿系统的解剖结构，震碎的结石极易造成胆管堵塞，比不治疗给患者造成的身体危害更大。
最近几年，经超声内镜在十二指肠处置入肠胆吻合支架，将十二指肠与胆囊吻合，然后再进行胃镜取石的手术是比较先进和前沿的新“保胆取石”术。但此术式在十二指肠处置入肠胆吻合支架，需要超声内镜通过贲门、胃及幽门才能到达十二指肠，进行支架置入，手术难度大，学习曲线长，很难向普通内镜医生推广，限制此术式的发展。如果超声内镜通过贲门在胃内实施胃胆吻合手术，手术难度大大降低，成功率高，但面临胃内的食物残渣或胃酸反流进入胆囊的问题，容易造成严重的感染事故。
基于上述原因，请参照图1-图3，图1及图2示出了本公开实施方式中吻合装置的 结构，图3示出了本公开实施方式中吻合装置在胆囊及胃中的安装状态；
本实施方式提供一种吻合装置200，其包括第一支架210以及第二支架220；
第一支架210具备第一通道211；第二支架220具备第二通道221，第二支架220与第一支架210连接；
其中，第二支架220位于第一通道211外，且第一通道211与第二通道221导通；或，第二支架220的至少部分容置于第一通道211内。在本实施方式中，采用的是，第二支架220的至少部分容置于第一通道211内的实施方式，并且第二支架220的远端与第一支架210连接，容置于第一通道211的第二通道221轴线与第一通道211的轴线重合。
需要说明的是，在本实施方式中，第二通道221内设置有至少一个膜瓣222，膜瓣222用于由第二支架220的远端至第二支架220的近端的方向单向导通第二通道221。
在采用该吻合装置200实施胃胆吻合手术时，第一支架210的两端分别用于容置于患者的胆囊10内及胃20内，并分别与胆囊10壁及胃20壁抵接，第一通道211用于将胆囊10与胃20连通。
在采用该吻合装置200实施胃胆吻合手术时，该吻合装置200的工作原理是：
该吻合装置200包括第一支架210及第二支架220；其中，第一支架210具备第一通道211，且第一支架210的两端分别用于容置于患者的胆囊10内及胃20内，并分别与胆囊10壁及胃20壁抵接，以通过第一通道211将胆囊10与胃20连通；而第二支架220具备第二通道221，第二通道221内设置有至少一个膜瓣222，膜瓣222用于由第二支架220的远端至第二支架220的近端的方向单向导通第二通道221；第二支架220的远端用于与第一支架210连接，第一通道211的轴线与第二通道221的轴线重合。
由于第二支架220的膜瓣222用于由第二支架220的远端至第二支架220的近端的方向单向导通第二通道221，即，在第一支架210与第二支架220连接时，通过瓣膜能够由胆囊10至胃20的方向单向导通第二通道221，从而能够防止胃20内的食物残渣或胃酸反流进入胆囊10，进而能够避免出现严重的感染事故。在使用的过程中，由于该吻合装置200包括第一支架210及第二支架220，且采用的是第二支架220与第一支架210组装而成的方式，进而这样的结构有利于减小该吻合装置200的结构尺寸，以便于将该吻合装置200装入置入器中，以降低使用的难度，并能够留出更大的膜瓣222安装空间，从而提高防反流的效果。
需要说明的是，在本实施方式中，在采用该吻合装置200实施胃胆吻合手术时，全 文中，需要对术语“远端”、“近端”等进行说明，在这里进行说明仅仅是为了更好的理解本公开，并不能理解为对本公开的限定。一般的，在吻合装置200的使用过程中，吻合装置200的前端部分(以图1中的相对位置，指的是吻合装置200的左端)会伸入胆囊10内，而吻合装置200的后端部分(以图1中的相对位置，指的是吻合装置200的右端)位于胃20内。因此，“远端”可以理解为某个零件或部件相对靠近胆囊10的前端部分，“近端”可以理解为某个零件或部件相对靠近胃20的后端部分。当然了，当没有明确指出是哪个零件或部件的“近端”、“远端”时，默认指代的是整个吻合装置200的近端或远端。并且在使用的过程中，第一支架210两端均可以作为第一支架210的远端容置于患者的胆囊10内并与胆囊10壁抵接。
在本实施方式中，在设置第一支架210及第二支架220时，第一支架210及第二支架220均包括架体以及覆于架体的膜体，通过膜体的设置，能够防止该吻合装置200与胆囊10或胃20的抵接处出现泄漏，或是防止所形成的连通胆囊10和胃20的通道处出现泄漏的情况。而在本公开的其他实施方式中，还可以使得第一通道211及第二通道221的内周面或外周面均覆有膜体，以防止连通胆囊10和胃20的通道处出现泄漏的情况。
基于本实施方式的基础上，第二支架220在与第一支架210连接时，第二支架220的远端可以与第一支架210的近端或远端连接。在本实施方式中，第二支架220的远端穿过第一通道211与第一支架210的远端抵接，且容置于第一通道211内的第二支架220与第一通道211配合。并且，为防止容置于第一通道211内的第二支架220相对于第一通道211滑动，故容置于第一通道211内的第二支架220与第一通道211过盈配合。
基于本实施方式的基础上，在本实施方式中，膜瓣222的作用在于由第二支架220的远端至第二支架220的近端的方向单向导通第二通道221，由此，为保证第二通道221的单向导通，故在本实施方式中，在设置膜瓣222时，可以采用在第二通道221内间隔设置多个膜瓣222的方式。
在本实施方式中，第二通道221内至少间隔地设置有两个膜瓣222，两个膜瓣222用于由第二支架220的远端至第二支架220的近端的方向单向导通第二通道221；并且，膜瓣222包括多个子瓣体232；多个子瓣体232均绕第一通道211的轴线方向环形间隔设置。
需要说明的是，在设置两个膜瓣222时，首先，两个膜瓣222均能够起到限制流体由胆囊10向胃20流动的作用；其次，由于两个膜瓣222间隔地设置在第二通道221内，故两个膜瓣222与第二通道221共同形成容腔，由胆囊10进入至第二通道221的流体 能够在进入容腔后流入胃20中，而胃20中的食物残渣或胃酸，即便是经过第二支架220近端的膜瓣222进入容腔之后，也会在另一个膜瓣222的限流的作用下，被限制在容腔中，或重新回到胃20中；由此，通过两个膜瓣222的设置，能够起到双层防护的作用，从而能够防止胃20内的食物残渣或胃酸反流进入胆囊10，进而能够避免出现严重的感染事故。
请参照图1-图7，图4-图7示出了本公开实施方式中第二支架的结构，在本实施方式中，在设置第二支架220时，第二支架220包括由远端至近端的方向依次设置的第一分部223及第二分部224，第二分部224与所述第一分部223连接；并且第一分部223及第二分部224分别具备中空的第一内腔225及第二内腔226，第一内腔225与第二内腔226连通并形成第二通道221；由于第二通道221内设置有至少一个膜瓣222，故膜瓣222可以设置于第一内腔225中或设置于第二内腔226中。
而在本实施方式中，在设置两个膜瓣222时，可以在第一内腔225中设置有第一膜瓣227，第二内腔226中设置有第二膜瓣228。需要说明的是，由上述内容可知，由于第二通道221内的膜瓣222均用于由第二支架220的远端至第二支架220的近端的方向单向导通第二通道221，即第二通道221内的膜瓣222均用于由胆囊10至胃20的方向单向导通第二通道221，故在设置第一膜瓣227及第二膜瓣228时，第一膜瓣227及第二膜瓣228均用于由第二支架220的远端至第二支架220的近端的方向单向导通第二通道221，即第一膜瓣227及第二膜瓣228均用于由胆囊10至胃20的方向单向导通第二通道221。由此，通过在第一内腔225中设置第一膜瓣227，在第二内腔226中设置第二膜瓣228的方式，能够使得第一膜瓣227与第二膜瓣228间隔地设置在第二通道221内，从而使得第一膜瓣227、第二膜瓣228与第二通道221能够共同形成容腔，以起到双层防反流的作用。
在设置第一内腔225及第二内腔226时，第一内腔225及第二内腔226均可以为沿第二通道221的轴线方向延伸的圆柱形内腔，第一内腔225的内径大于第二内腔226的内径，且第一膜瓣227的面积大于第二膜瓣228的面积，这样的设置方式，使得第一膜瓣227与第二膜瓣228在对第二通道221内的流体进行限流的过程中，其限流的效果不同，其目的是使得第一膜瓣227能够限制容腔中的流体经第一膜瓣227流入胆囊10，而位于容腔中的流体能够经第二膜瓣228排出容腔，即位于容腔中的流体能够回流至胃20中。
在设置第二膜瓣228时，第二膜瓣228位于第二分部224远离第一分部223的一端。 需要说明的是，在本实施方式中，在设置第二分部224时，第二分部224位于第一通道211外，且位于胃20中；而在本公开的其他实施方式中，第二分部224还可以位于第一通道211内。
请参照图1-图7，在本实施方式中，在第一支架210与第二支架220组装时，采用的是第二支架220的远端穿过第一通道211与第一支架210位于胆囊10内的一端抵接，且容置于第一通道211内的第二支架220与第一通道211过盈配合的方式，以通过这样的方式，提高第一支架210与第二支架220的连接稳定性，而为使得第二支架220的远端能够与第一支架210位于胆囊10内的一端抵接，故，第一分部223远离第二分部224的一端设置有第一外展部229，第一外展部229用于与第一支架210位于胆囊10内的一端抵接。第一外展部229可以为沿第一内腔225的径向向外延伸的第一环形外缘231，且第一环形外缘231的外径大于第一分部223的外径。
需要说明的是，首先，由于第一分部223及第二分部224由第二支架220的远端至近端的方向依次设置，故在第二支架220的远端穿过第一通道211与第一支架210的远端抵接后，第一分部223便与第一通道211过盈配合；其次，由于第一内腔225及第二内腔226均为沿第二通道221的轴线方向延伸的圆柱形内腔，故第一分部223及第二分部224均为沿第二通道221的轴线方向延伸的圆柱形；故，第一分部223的外径与第一通道211的内径差满足过盈配合的公差要求，由此，通过使得第一环形外缘231的外径大于第一分部223的外径，便可使得第一环形外缘231在与第一支架210的远端抵接后，即便是在外力的作用下，沿第一通道211的轴线方向向近端运动，也会由于第一通道211的限制作用，保持与第一支架210的远端抵接的状态。
请参照图1-图7，在本实施方式中，由上述内容可知，第二通道221内间隔地设置有第一膜瓣227及第二膜瓣228，在设置第一膜瓣227及第二膜瓣228时，第一膜瓣227及第二膜瓣228均包括多个子瓣体232，多个子瓣体232均绕第一通道211的轴线方向环形间隔设置，且多个子瓣体232均由第二通道221的远端方向至近端方向凸出，以在第二通道221内起到限流的作用。
而在本实施方式中，第一膜瓣227及第二膜瓣228均包括四个子瓣体232，且由于四个子瓣体232均绕第一通道211的轴线方向环形间隔设置，故这样的设置方式，能够形成十字型的开口，通过这样的设置方式，能够由第二支架220的远端至第二支架220的近端的方向单向导通第二通道221。
请参照图1-图10，图8-图10示出了本公开实施方式中第一支架的结构，在本实施 方式中，为使得第一支架210的两端能够与胆囊10壁及胃20壁抵接，故第一支架210的两端分别设置有第二外展部212及第三外展部213，且第二外展部212及第三外展部213两者中的一个用于与胆囊10壁抵接，第二外展部212及第三外展部213两者中的另一个用于与胃20壁抵接。即，在使用的过程中，可以使得第二外展部212位于胆囊10内并与胆囊10壁抵接，第三外展部213位于胃20内并与胃20壁抵接；或使得第三外展部213位于胆囊10内并与胆囊10壁抵接，第二外展部212位于胃20内并与胃20壁抵接；由此，在使用第一支架210的过程中，第一支架210设置有第二外展部212的一端可以作为第一支架210的远端，也可以使得第一支架210设置有第三外展部213的一端作为第一支架210的远端。
在设置第二外展部212及第三外展部213，为使得第二外展部212及第三外部能够分别与胆囊10壁及胃20壁抵接，故，第二外展部212及第三外展部213均为绕第一通道211的轴线外展而形成的第二环形外缘214。
由于第二支架220的远端用于穿过第一通道211与第一支架210位于胆囊10内的一端抵接，故其中一个第二环形外缘214的外周朝自身中心的方向卷曲以形成容纳第二支架220的远端的环形空间215，从而通过这样的方式增加与第二支架220的远端抵接的面积，以提高第二支架220的安装稳定性。
需要说明的是，由上述内容可知，第一外展部229为沿第一内腔225的径向向外延伸的第一环形外缘231，而第一支架210用于与第二支架220的远端抵接的第二环形外缘214为卷曲形成的环形空间215，故环形空间215具备与第一环形外缘231相适应的形状，以增加接触的面积。并且由于环形空间215为卷曲而成，故其截面轮廓具备一定的弧度，由此，为增加第一环形外缘231与环形空间215的接触面积，故第一环形外缘231的截面具备与环形空间215相适应的弧度，由此，使得第二支架220的远端呈喇叭口的形状。
基于上述描述，由上述内容可知，在本实施方式中，在使用第一支架210的过程中，第一支架210的设置有第二外展部212的一端可以作为第一支架210的远端，也可以使得第一支架210的设置有第三外展部213的一端作为第一支架210的远端。由此，可以将两个第二环形外缘214的外周朝自身中心的方向卷曲以形成环形空间215，其中一个环形空间215用于容纳第二支架220的远端。
请参照图1-图12，图3、图11及图12示出了本公开实施方式中吻合装置的安装步骤，该吻合装置200的工作过程如下：
经超声内镜钳道，通过置入器放置第一支架210，并使得第一支架210的第一位于胆囊10内，第一支架210的另一端位于胃20内，并且使得第一支架210的两个第二环形外缘214分别与胆囊10壁和胃20壁抵接；此时，位于第一支架210位于胆囊10内的一端即为第一支架210的远端，第一支架210位于胃20内的一端为第一支架210的近端；
通过置入器放置第二支架220，并使得第二支架220远端的第一环形外缘231位于第一支架210远端的环形空间215内并与其抵接，而第二支架220的近端位于胃20内；而第二支架220位于第一通道211内的部分则与第一通道211过盈配合；
由此，第一支架210与第二支架220组装为一体，且该吻合装置200由胆囊10至胃20的方向单向导通，以起到胃20胆防反流的作用；
在经过一定的周期后，待胆囊10与胃20之间的瘘道形成之后，取出第一支架210及第二支架220，通过瘘道将胆囊10内的结石取出；或取出第二支架220，通过第一支架210的第一通道211将胆囊10内的结石取出，随后将第一支架210取出。
请参照图13，并结合图1-图12，图13示出了本公开其他实施方式中引流管的结构；在本公开的其他实施方式中，该吻合装置200还可以包括与第二支架220的近端连接的引流管230；引流管230的远端与第二支架220的近端连接，而引流管230的近端则可以通过幽门伸入十二指肠30内，从而通过这样的方式，防止胃内食物反流到胆囊内，并且引流管230上还可以设置小孔，通过小孔可以方便胆汁流出体内，帮助消化。
需要说明的是，基于上述内容，在防止胃20内的食物残渣或胃酸反流进入胆囊10内时，可以采用上述内容中的在第二通道221内设置有至少一个膜瓣222的方式或采用上述内容中的设置引流管230的方式，也可以将在第二通道221内设置有至少一个膜瓣222与设置引流管230相结合的方式，以避免出现严重的感染事故。
以上仅为本公开的实施方式而已，并不用于限制本公开，对于本领域的技术人员来说，本公开可以有各种更改和变化。凡在本公开的精神和原则之内，所作的任何修改、等同替换、改进等，均应包含在本公开的保护范围之内。

Claims (20)

  1. 一种吻合装置，其特征在于，包括：
    第一支架(210)，所述第一支架(210)具备第一通道(211)；以及
    第二支架(220)，所述第二支架(220)具备第二通道(221)，所述第二支架(220)与所述第一支架(210)连接；
    其中，所述第二支架(220)位于所述第一通道(211)外，且所述第一通道(211)与所述第二通道(221)导通；或，所述第二支架(220)的至少部分容置于所述第一通道(211)内。
  2. 根据权利要求1所述的吻合装置，其特征在于：
    所述第二通道(221)内设置有至少一个膜瓣(222)，所述膜瓣(222)用于由所述第二支架(220)的远端至所述第二支架(220)的近端的方向单向导通所述第二通道(221)。
  3. 根据权利要求2所述的吻合装置，其特征在于：
    所述第二支架(220)的远端与所述第一支架(210)的近端或远端连接。
  4. 根据权利要求3所述的吻合装置，其特征在于：
    所述第二支架(220)的远端穿过所述第一通道(211)与所述第一支架(210)的远端抵接，且容置于所述第一通道(211)内的所述第二支架(220)与所述第一通道(211)配合。
  5. 根据权利要求4所述的吻合装置，其特征在于：
    容置于所述第一通道(211)内的所述第二支架(220)与所述第一通道(211)过盈配合。
  6. 根据权利要求2所述的吻合装置，其特征在于：
    所述膜瓣(222)包括多个子瓣体(232)；
    多个所述子瓣体(232)均绕所述第一通道(211)的轴线方向环形间隔设置。
  7. 根据权利要求1-6中任意一项所述的吻合装置，其特征在于：
    所述第二支架(220)包括由远端至近端的方向依次设置的第一分部(223)及第二分部(224)，所述第二分部(224)与所述第一分部(223)连接；
    所述第一分部(223)及所述第二分部(224)分别具备中空的第一内腔(225)及第二内腔(226)，所述第一内腔(225)与所述第二内腔(226)连通并形成所述第二通道(221)。
  8. 根据权利要求7所述的吻合装置，其特征在于：
    所述第一内腔(225)中设置有第一膜瓣(227)，所述第二内腔(226)中设置有第二膜瓣(228)。
  9. 根据权利要求8所述的吻合装置，其特征在于：
    所述第二膜瓣(228)位于所述第二分部(224)远离所述第一分部(223)的一端。
  10. 根据权利要求8所述的吻合装置，其特征在于：
    所述第一膜瓣(227)及所述第二膜瓣(228)均包括四个子瓣体(232)。
  11. 根据权利要求7所述的吻合装置，其特征在于：
    所述第二通道(221)内设置有至少一个膜瓣(222)，所述膜瓣(222)设置于所述第一内腔(225)中或设置于所述第二内腔(226)中。
  12. 根据权利要求7所述的吻合装置，其特征在于：
    所述第一分部(223)远离所述第二分部(224)的一端设置有第一外展部(229)，所述第一外展部(229)用于与所述第一支架(210)连接。
  13. 根据权利要求12所述的吻合装置，其特征在于：
    所述第一外展部(229)为沿垂直于所述第二通道(221)的轴线的方向向所述第一分部(223)外延伸的第一环形外缘(231)。
  14. 根据权利要求3所述的吻合装置，其特征在于：
    所述第一支架(210)的两端分别设置有第二外展部(212)及第三外展部(213)。
  15. 根据权利要求14所述的吻合装置，其特征在于：
    所述第二外展部(212)及所述第三外展部(213)均为绕所述第一通道(211)的轴线外展而形成的第二环形外缘(214)。
  16. 根据权利要求15所述的吻合装置，其特征在于：
    其中一个所述第二环形外缘(214)的外周朝自身中心的方向卷曲以形成容纳所述第二支架(220)的远端的环形空间(215)。
  17. 根据权利要求16所述的吻合装置，其特征在于：
    两个所述第二环形外缘(214)的外周朝自身中心的方向卷曲以形成环形空间(215)，其中一个所述环形空间(215)用于容纳所述第二支架(220)的远端。
  18. 根据权利要求1所述的吻合装置，其特征在于：
    所述第一支架(210)及所述第二支架(220)均包括架体以及覆于所述架体的膜体。
  19. 根据权利要求1所述的吻合装置，其特征在于：
    所述第一通道(211)及所述第二通道(221)的内周面或外周面均覆有膜体。
  20. 根据权利要求1所述的吻合装置，其特征在于：
    所述吻合装置(200)还包括与所述第二支架(220)的近端连接的引流管(230)。
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