WO2023002106A1 - Device and method for support and retention of tissue - Google Patents

Device and method for support and retention of tissue Download PDF

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Publication number
WO2023002106A1
WO2023002106A1 PCT/FR2022/051380 FR2022051380W WO2023002106A1 WO 2023002106 A1 WO2023002106 A1 WO 2023002106A1 FR 2022051380 W FR2022051380 W FR 2022051380W WO 2023002106 A1 WO2023002106 A1 WO 2023002106A1
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WO
WIPO (PCT)
Prior art keywords
radial
axial
wedging
support
annular surface
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Application number
PCT/FR2022/051380
Other languages
French (fr)
Inventor
Laila MIFTAH EL KHEIR
Tijani Gharbi
Original Assignee
Tissueaegis
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 Tissueaegis filed Critical Tissueaegis
Publication of WO2023002106A1 publication Critical patent/WO2023002106A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
    • A01N—PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF; BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES; PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
    • A01N1/00—Preservation of bodies of humans or animals, or parts thereof
    • A01N1/02—Preservation of living parts
    • A01N1/0236—Mechanical aspects
    • A01N1/0263—Non-refrigerated containers specially adapted for transporting or storing living parts whilst preserving, e.g. cool boxes, blood bags or "straws" for cryopreservation

Definitions

  • the invention relates to a device for supporting and retaining human, animal or artificial tissue taken for a transplant or for an ex vivo experiment, and a method for supporting and retaining the tissue.
  • the invention applies in particular to the support and retention of a tissue such as a corneal graft, without limitation, with a view to its subsequent excision (e.g. along a diameter equal to or greater than 13 mm), analysis, storage and/or transport.
  • US 5019084 A describes a corneal support intended to be used both in a cornea storage system and in a cornea cutting system.
  • the support includes a passage which passes through the openings of a base element and a cap whose shape makes it possible to bring a cutting device into contact with a predetermined part of the corneal material.
  • the support makes it possible to orient said predetermined part radially so as to limit astigmatism, and also makes it possible to shrink the periphery of the corneal material during storage so as to reduce the swelling of said material due to the absorption of liquid.
  • the annular support disclosed in US 5019084 A is such that the cornea is arranged on a radially inner face of a generally axial wall of the base element, which has a generally L-shaped radial section. , of generally P-shaped radial section, covers the radially outer face of said wall so as to retain the base element radially by snap-fastening.
  • a major drawback of the support presented in US 5019084 A lies in particular in the retention of the tissue by radial snapping of the base element inside the cap, this radial retention of the cornea being able to prove insufficient to support safely and durably the fabric without damaging it.
  • An object of the present invention is to provide a device for supporting and retaining a human, animal or artificial tissue taken for a transplant or an ex vivo experiment, in particular a corneal graft, the device having an axis of revolution and, around said axis, an annular geometry configured in particular to allow excision of the supported and retained tissue, the device comprising:
  • - support means capable of supporting the tissue, comprising a first annular surface capable of receiving a peripheral zone of the tissue and facing a first axial side of the device, and
  • this device is such that the support means comprise a second annular surface facing a second axial side of the device axially opposite to said first axial side, the retaining means being adapted to abut axially against the second annular surface to immobilize the tissue.
  • the retaining means may comprise at least one radial locking element adapted to abut axially and radially against an annular shoulder that said second annular surface has, and preferably said at least one element radial lock includes a radial flange ending in a cylindrical axial edge.
  • each radial blocking element included in the retaining means thus makes it possible to obtain said abutment which is both axial and radial, via this shoulder.
  • the retaining means may comprise:
  • wedging means facing said first axial side and capable of wedging the peripheral zone of the fabric against said first annular surface
  • the wedging means comprising: an annular wedging portion configured to match the shape of said first annular surface by wedging the peripheral zone of the fabric, and circumferentially spaced apart axial abutment lugs configured to receive in axial and radial abutment said at least one radial locking element;
  • the blocking means possibly comprising in one piece: said at least one radial blocking element which comprises preferably a radial annular collar ending in a cylindrical axial edge, and axially opposite, an operating member which is axially connected to said at least one radial blocking element by connecting elements and which is capable of directing axially and angularly said at least one radial blocking element to bring it axially against said second annular surface and radially against said axial abutment lugs, the operating member preferably comprising axial studs integral with an operating ring.
  • the retaining means thus separately comprise said means for wedging the fabric and said locking means of the latter which cooperate mutually in abutment being respectively turned towards two opposite axial sides of the device.
  • the first annular surface of the support means can be formed on a radially outer face of said support means.
  • this support for the tissue on the radially outer face of the support means unlike the support for the cornea in US 5019084 A which is produced by the radially inner face of the base element, makes it possible to facilitate the positioning of the fabric on the support without risking damaging it.
  • the support means according to the invention may comprise a support ring (and preferably consist of this ring) having a radially outer face which comprises:
  • said first annular surface which comprises a radially outer rim extending radially inwards by an annular ramp rising up to a radially inner annular edge of the support ring, said ramp being for example frustoconical to support a graft dome-shaped cornea, said flange comprising on its axial thickness a plurality of circumferentially spaced radial notches which cooperate respectively with a plurality of said axial abutment lugs included in the wedging means, and
  • said annular wedging portion may comprise, radially from the outside inwards, a first radial section and a second oblique section respectively parallel to said rim and to said ramp of the support ring, and
  • said axial abutment lugs may end at right angles with a radial free end extending radially inwards, the radial free end being separated from said first radial section of the annular wedging portion by an axial height defined by respective thicknesses of said peripheral zone of the fabric, said flange of the support ring and said at least one radial blocking element of the blocking means formed by a radial annular collar.
  • said connecting elements may comprise axial pillars axially connecting said maneuvering member to said at least one radial blocking element, which is formed of a radial annular collar ending in a cylindrical axial edge adapted to bear against said annular shoulder support means, and
  • said radial annular flange may comprise a plurality of notches respectively adapted to cooperate with said plurality of axial abutment lugs, when assembling the locking means on the wedging means.
  • the invention also aims to provide a method for supporting and retaining a human, animal or artificial tissue taken for a transplant or an ex vivo experiment, in particular a corneal graft, which can advantageously be implemented by a device according to the invention as defined above and which also overcomes the aforementioned drawbacks.
  • This method of supporting and retaining comprises: a) positioning the fabric on support means configured to support it, so that a peripheral zone of the fabric is applied to a first annular surface of the means of support, said first annular surface having an axis of revolution and, around said axis, an annular geometry allowing excision of the supported and retained tissue, the tissue thus positioned defining a first axial side, and b) positioning of retaining means retaining the fabric positioned in a) on the support means, so that the retaining means surround the peripheral zone of the fabric and come into abutment with the support means.
  • this method is such that the support means comprise a second annular surface facing a second axial side axially opposite said first axial side, the retaining means abutting axially against the second annular surface to immobilize the tissue.
  • step b) may comprise the sub-steps: b1) wedging, by wedging means that comprise the retaining means, of a peripheral zone of the fabric against said first annular surface of the support means , with an angular immobilization of the wedging means radially against said support means; then b2) axial and radial abutment of at least one radial blocking element comprised by the retaining means against said second annular surface, by reversible blocking towards said second axial side of the wedging means with respect to the support means , by guiding axially and angularly by an operating member said at least one radial blocking element axially against said second annular surface and radially against the wedging means.
  • sub-step b1) can be implemented by maneuvering axially and angularly a wedging ring forming the wedging means, to guide said ring against a support ring forming the support means; and sub-step b2) can be implemented by maneuvering an operating member of a radial collar ending in a cylindrical axial edge and forming said at least one radial blocking element, to guide the collar axially against said second annular surface and radially against circumferentially spaced axial lugs that the wedging ring comprises, so as to angularly immobilize a locking ring comprising the said operating member and the said at least one radial locking element against and radially inside the ring jamming.
  • FIG. 1 is an exploded side and perspective view of a device according to a preferred embodiment of the invention.
  • FIG. 2 is a side and perspective view of the device of FIG. 1 in the assembled support and retaining position.
  • FIG. 3 is an elevational view of the assembled device of Figure 2.
  • FIG. 4 is a sectional view of the device along the plane IV-IV of Figure 3.
  • FIG. 5 is an enlarged sectional view of the device corresponding to the medallions of Figures 2 and 4.
  • FIG. 6 is a view from below and in perspective of the second annular surface of the support means of the device illustrated in FIGS. 1 to 5.
  • FIG. 7 is a top and perspective view showing the positioning of the fabric on the support means, in a first step of the method of assembling the device according to the invention.
  • FIG. 8 is a top and perspective view showing the supply of the wedging means of the fabric to the support means, in a second step of the method of assembling the device according to the invention.
  • FIG. 9 is a top and perspective view showing the wedging of the fabric against the support means, at the end of this second step of the method of assembling the device according to the invention.
  • FIG. 10 is a top and perspective view showing the bringing into axial and radial abutment of the locking means against the support means and the wedging means, in a third step of the method of assembling the device according to the invention.
  • FIG. 11 is a view from above and in perspective showing the bringing into angular abutment of the locking means against the support means and the wedging means, in a last step of the method of assembling the device according to the invention.
  • the device 1 for supporting and retaining the fabric 2 shown in Figure 1 has an annular geometry around an axis of revolution X forming the axis of symmetry of the device 1 once assembled.
  • the device 1 comprises a support ring 10 for the fabric 2 and means 20 for retaining the fabric on the support ring 10.
  • the retaining means 20 are adapted to enclose a peripheral zone 2a of the fabric 2 and cooperate in abutment with the ring support 10 to immobilize the tissue 2.
  • the tissue 2 is a corneal graft, it being recalled that the present description extends to any type of human, animal or artificial tissue supported and retained in particular with a view to transplant.
  • the support ring 10 and the retaining means 20 can be made of any metallic (for example steel or titanium) or non-metallic biocompatible materials.
  • axial and “axially” is meant the reference to an axial direction parallel to the axis of revolution X common to the support ring 10 and to the various parts of the means of retainer 20 and of the assembled device 1, the relevant direction of this axial direction being defined by the reference to one or the other of first and second sides 3 and 4.
  • the support ring 10 comprises, on a first axial side 3 of its outer circumference, extending radially inwards a radially outer axial edge 11 of the ring 10, a first annular surface 12 (facing downwards in the figures 4-5 and upwards in Figure 6) comprising a first radial edge 12a extending radially inwards by a ramp 12b whose inclination defines in this example a frustoconical surface, particularly well suited to the geometry of the zone peripheral 2a of a corneal graft in the shape of a dome (i.e. of hemispherical cap) that this zone 2a marries once positioned on the support ring 10 (see FIGS. 4-5).
  • the ramp 12b ends with a terminal radial edge 12c whose axial end 12d defines the inner circumference of the ring 10.
  • the support ring 10 comprises, in a second axial side 4 opposite its circumference, extending radially inwardly the radially outer axial edge 11 of the ring 10, a second annular surface 13 (turned upwards in the figures 4-5 and downwards in FIG. 6) comprising a second radial edge 13a extending radially inwards by an annular shoulder 13b, then by an inclined section 13c parallel to the ramp 12b itself terminating in the axial end 12d (see Figure 6).
  • the radially outer axial flange 11 of the ring 10 comprises, over the entire axial thickness of the flange 11, a plurality of radial notches 14 in an arc of a circumferentially spaced circle substantially, which are each U-shaped with rounded radial edges 14a and curvilinear bottom 14b.
  • the retaining means 20 comprise, facing the first side 3, a wedging ring 20A of the peripheral zone 2a of the fabric 2 against the first annular surface 12 and, facing towards the second side 4, a locking ring 20B to reversibly lock the wedging ring 20A against the support ring 10.
  • the wedging ring 20A comprises (see Figures 1 and 5) a circumferential portion 21 of radial section generally in the shape of a rectangular trapezium, of which a radially internal oblique section 21a forming an annular wedging portion extends radially frustoconically inwards and axially towards the first side 3 from a radial section 21b facing the second side 4, to press the peripheral zone 2a of the fabric 2 against the first annular surface 12, and of which a radially cylindrical axial face outer 21c extends from a radial edge 21d of the ring 20 facing the first side 3.
  • the wedging ring 20A further comprises axial tabs 22 for abutment in an arc of a circumferentially spaced circle which are designed, on the one hand, to come inside the radial notches 14 respectively designed to receive them. so as to wedge the peripheral zone 2a of the fabric 2 with sufficient tightness and, on the other hand, to receive in axial and radial abutment one end 23 of the locking ring 20B, as described below.
  • each axial leg 22 extends axially towards the second side 4 the radially outer cylindrical face 21c of the ring 20A, ending in a radial free end 22a curved at a right angle radially inwards, which forms a hook for abutting the end 23 of the locking ring 20B.
  • the locking ring 20B comprises in one piece:
  • a radial locking collar 24 (i.e. annular and continuous, it being specified that it could be in a discontinuous variant) ending in a cylindrical axial edge 25 towards the first side 3, which defines with the collar 24 the functional end 23 of the locking ring 20B allowing said abutment, and
  • studs 26 for operating ring 20B which extend towards the second side 4 from a circumferential portion 27 forming an operating ring, which is axially connected to collar 24 by connecting elements 28 such as axial pillars, the studs 26 being designed so that an operator axially and angularly directs the flange 24 to bring it axially against the second annular surface 13 and radially against the axial tabs 22.
  • the cylindrical axial edge 25 is designed to bear against the annular shoulder 13b of the support ring 10, and the flange 24 has a plurality of notches 24a in an arc of a circle and with rounded edges (each notch 24a, visible in Figures 1 and 10-11, is radially shallower than each notch 14 and of curvilinear width slightly greater than the curvilinear width of each tab 22) respectively designed to cooperate in angular abutment with the tabs axial 22, when assembling the locking ring 20B with rotation on the wedging ring 20A.
  • an operator brings (in the direction of arrow A in Figure 7) the tissue 2, such as a corneal graft , towards and on the support ring 10 by positioning it there so that the peripheral zone 2a of the fabric 2 is applied to the first annular surface 12 radially set back from the notches 14.
  • the operator guides the ring 20A axially and angularly against the radially outer axial edge 11 of the ring 10 by first tilting it slightly around the fabric 2, so that the tabs 22 of the ring 20A then come to wedge themselves inside the notches 14 and the curved radial end 22a is brought to the side of the second annular surface 13 without damaging the fabric 2, which provides an axial play with respect to the rim 11 of the ring 10 allowing the reversible blocking of the ring 20A by the ring 20B, as explained below.
  • the operator then guides the ring 20B axially and angularly, by grasping it by its maneuvering studs 26, following for example the following sequence:

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Abstract

The invention relates to a device for support and retention of human, animal or artificial tissue that has been removed for the purposes of a graft or of an ex vivo experiment, and to a method for support and retention of said tissue. The device has an annular geometry about an axis of revolution, and it comprises: support means (10) for supporting the tissue, these means having a first annular surface (12) which is able to receive a peripheral zone of the tissue (2a) and is directed towards a first axial side (3) of the device, and retention means (20A, 20B) which are able to retain the tissue on the support means and which are adapted to enclose the peripheral zone of the tissue and to cooperate in abutment with the support means. These support means (10) comprise a second annular surface (13) directed towards a second axial side (4) of the device axially opposite the first axial side (3), the retention means (20B) being adapted to abut axially against the second annular surface in order to immobilize the tissue.

Description

DISPOSITIF ET PROCEDE DE SUPPORT ET DE RETENUE D'UN TISSU DEVICE AND METHOD FOR SUPPORTING AND RETAINING FABRIC
Description Description
Domaine technique Technical area
[0001] L’invention concerne un dispositif de support et de retenue d’un tissu humain, animal ou artificiel prélevé en vue d’une greffe ou d’une expérience ex vivo, et un procédé de support et de retenue du tissu. L’invention s’applique notamment au support et à la retenue d’un tissu tel qu’un greffon de cornée, à titre non limitatif, en vue de son excision ultérieure (e.g. suivant un diamètre égal ou supérieur à 13 mm), de son analyse, de son stockage et/ou de son transport. The invention relates to a device for supporting and retaining human, animal or artificial tissue taken for a transplant or for an ex vivo experiment, and a method for supporting and retaining the tissue. The invention applies in particular to the support and retention of a tissue such as a corneal graft, without limitation, with a view to its subsequent excision (e.g. along a diameter equal to or greater than 13 mm), analysis, storage and/or transport.
Technique antérieure Prior technique
[0002] Il est connu de supporter un greffon de cornée dans un dispositif approprié notamment en vue de l’excision et du stockage du greffon, un tel dispositif étant notamment conçu pour réduire les risques d’endommagement de la zone périphérique fragile du greffon lors de sa manipulation. [0002] It is known to support a corneal graft in a suitable device, in particular with a view to excision and storage of the graft, such a device being in particular designed to reduce the risk of damage to the fragile peripheral zone of the graft during of its manipulation.
[0003] On peut par exemple citer US 5019084 A, qui décrit un support de cornée destiné à servir à la fois dans un système de stockage de cornée et dans un système de découpe de cornée. Le support comporte un passage qui passe par les ouvertures d'un élément de base et d'un capuchon dont la forme permet d'amener un dispositif de découpe en contact avec une partie prédéterminée de la matière cornéenne. Le support permet d'orienter radialement ladite partie prédéterminée de manière à limiter l'astigmatisme, et permet également le rétrécissement de la périphérie de la matière cornéenne pendant le stockage de façon à diminuer le gonflement de ladite matière dû à l 'absorption de liquide. [0003] Mention may be made, for example, of US 5019084 A, which describes a corneal support intended to be used both in a cornea storage system and in a cornea cutting system. The support includes a passage which passes through the openings of a base element and a cap whose shape makes it possible to bring a cutting device into contact with a predetermined part of the corneal material. The support makes it possible to orient said predetermined part radially so as to limit astigmatism, and also makes it possible to shrink the periphery of the corneal material during storage so as to reduce the swelling of said material due to the absorption of liquid.
[0004] Plus précisément, le support annulaire divulgué dans US 5019084 A est tel que la cornée est disposée sur une face radialement interne d’une paroi globalement axiale de l’élément de base, lequel présente une section radiale globalement en L. Le capuchon, de section radiale globalement en P, recouvre la face radialement externe de ladite paroi de sorte à retenir radialement l’élément de base par encliquetage. [0005] Un inconvénient majeur du support présenté dans US 5019084 A réside notamment dans la retenue du tissu par encliquetage radial de l’élément de base à l’intérieur du capuchon, cette retenue radiale de la cornée pouvant s’avérer insuffisante pour supporter de manière sûre et durable le tissu sans l’abîmer. [0004] More specifically, the annular support disclosed in US 5019084 A is such that the cornea is arranged on a radially inner face of a generally axial wall of the base element, which has a generally L-shaped radial section. , of generally P-shaped radial section, covers the radially outer face of said wall so as to retain the base element radially by snap-fastening. [0005] A major drawback of the support presented in US 5019084 A lies in particular in the retention of the tissue by radial snapping of the base element inside the cap, this radial retention of the cornea being able to prove insufficient to support safely and durably the fabric without damaging it.
Exposé de l’invention Disclosure of Invention
[0006] Un but de la présente invention est de proposer un dispositif de support et de retenue d’un tissu humain, animal ou artificiel prélevé en vue d’une greffe ou d’une expérience ex vivo, en particulier un greffon de cornée, le dispositif présentant un axe de révolution et, autour dudit axe, une géométrie annulaire configurée notamment pour permettre une excision du tissu supporté et retenu, le dispositif comprenant : An object of the present invention is to provide a device for supporting and retaining a human, animal or artificial tissue taken for a transplant or an ex vivo experiment, in particular a corneal graft, the device having an axis of revolution and, around said axis, an annular geometry configured in particular to allow excision of the supported and retained tissue, the device comprising:
- des moyens de support aptes à supporter le tissu, comportant une première surface annulaire apte à recevoir une zone périphérique du tissu et tournée vers un premier côté axial du dispositif, et - support means capable of supporting the tissue, comprising a first annular surface capable of receiving a peripheral zone of the tissue and facing a first axial side of the device, and
- des moyens de retenue aptes à retenir le tissu sur les moyens de support, qui sont adaptés pour enserrer la zone périphérique du tissu et coopérer en butée avec les moyens de support, qui remédie au moins aux inconvénients précités. - Retaining means capable of retaining the fabric on the support means, which are adapted to enclose the peripheral zone of the fabric and cooperate in abutment with the support means, which at least overcomes the aforementioned drawbacks.
[0007] A cet effet, ce dispositif selon l’invention est tel que les moyens de support comprennent une seconde surface annulaire tournée vers un second côté axial du dispositif axialement opposé audit premier côté axial, les moyens de retenue étant adaptés pour buter axialement contre la seconde surface annulaire pour immobiliser le tissu. To this end, this device according to the invention is such that the support means comprise a second annular surface facing a second axial side of the device axially opposite to said first axial side, the retaining means being adapted to abut axially against the second annular surface to immobilize the tissue.
[0008] On notera que cette mise en butée axiale qui caractérise la coopération entre moyens de support et moyens de retenue selon l’invention se distingue de la retenue exclusivement radiale enseignée par US 5019084 A, et permet ainsi d’améliorer de manière significative la fiabilité de la retenue du tissu supporté pour éviter de le faire tomber, tout en le préservant de manière optimale, comme détaillé ci-dessous. [0009] Selon une autre caractéristique de l'invention, les moyens de retenue peuvent comprendre au moins un élément radial de blocage adapté pour buter axialement et radialement contre un épaulement annulaire que présente ladite seconde surface annulaire, et de préférence ledit au moins un élément radial de blocage comprend une collerette radiale se terminant par un bord axial cylindrique. It will be noted that this axial abutment which characterizes the cooperation between support means and retaining means according to the invention differs from the exclusively radial restraint taught by US 5019084 A, and thus makes it possible to significantly improve the reliable restraint of the supported tissue to prevent it from falling, while optimally preserving it, as detailed below. According to another characteristic of the invention, the retaining means may comprise at least one radial locking element adapted to abut axially and radially against an annular shoulder that said second annular surface has, and preferably said at least one element radial lock includes a radial flange ending in a cylindrical axial edge.
[0010] On notera que le ou chaque élément radial de blocage inclus dans les moyens de retenue permet ainsi d’obtenir ladite mise en butée qui est à la fois axiale et radiale, via cet épaulement. It will be noted that the or each radial blocking element included in the retaining means thus makes it possible to obtain said abutment which is both axial and radial, via this shoulder.
[0011] Selon un mode préférentiel de réalisation de l’invention, les moyens de retenue peuvent comprendre : [0011] According to a preferred embodiment of the invention, the retaining means may comprise:
- des moyens de coincement tournés vers ledit premier côté axial et aptes à coincer la zone périphérique du tissu contre ladite première surface annulaire, les moyens de coincement comprenant : une portion annulaire de coincement configurée pour épouser la forme de ladite première surface annulaire en y coinçant la zone périphérique du tissu, et des pattes axiales de mise en butée circonférentiellement espacées configurées pour recevoir en butée axiale et radiale ledit au moins un élément radial de blocage ; et - wedging means facing said first axial side and capable of wedging the peripheral zone of the fabric against said first annular surface, the wedging means comprising: an annular wedging portion configured to match the shape of said first annular surface by wedging the peripheral zone of the fabric, and circumferentially spaced apart axial abutment lugs configured to receive in axial and radial abutment said at least one radial locking element; and
- des moyens de blocage réversible tournés vers ledit second côté axial et aptes à bloquer réversiblement les moyens de coincement par rapport aux moyens de support, les moyens de blocage pouvant comprendre d’un seul tenant : ledit au moins un élément radial de blocage qui comprend de préférence une collerette annulaire radiale se terminant par un bord axial cylindrique, et axialement à l’opposé, un organe de manoeuvre qui est axialement relié audit au moins un élément radial de blocage par des éléments de liaison et qui est apte à diriger axialement et angulairement ledit au moins un élément radial de blocage pour l’amener axialement contre ladite seconde surface annulaire et radialement contre lesdites pattes axiales de mise en butée, l’organe de manoeuvre comprenant de préférence des plots axiaux solidaires d’une bague de manoeuvre. - reversible blocking means facing said second axial side and capable of reversibly blocking the wedging means with respect to the support means, the blocking means possibly comprising in one piece: said at least one radial blocking element which comprises preferably a radial annular collar ending in a cylindrical axial edge, and axially opposite, an operating member which is axially connected to said at least one radial blocking element by connecting elements and which is capable of directing axially and angularly said at least one radial blocking element to bring it axially against said second annular surface and radially against said axial abutment lugs, the operating member preferably comprising axial studs integral with an operating ring.
[0012] On notera que selon ce mode de réalisation, les moyens de retenue comprennent ainsi séparément lesdits moyens de coincement du tissu et lesdits moyens de blocage de ces derniers qui coopèrent mutuellement en butée en étant respectivement tournés vers deux côtés axiaux opposés du dispositif. [0012] It will be noted that according to this embodiment, the retaining means thus separately comprise said means for wedging the fabric and said locking means of the latter which cooperate mutually in abutment being respectively turned towards two opposite axial sides of the device.
[0013] Selon une autre caractéristique générale de l'invention, la première surface annulaire des moyens de support peut être formée sur une face radialement externe desdits moyens de support. According to another general characteristic of the invention, the first annular surface of the support means can be formed on a radially outer face of said support means.
[0014] On notera que ce support du tissu sur la face radialement externe des moyens de support, contrairement au support de la cornée dans US 5019084 A qui est réalisé par la face radialement interne de l’élément de base, permet de faciliter le positionnement du tissu sur le support sans risquer de l’abîmer. [0014] It will be noted that this support for the tissue on the radially outer face of the support means, unlike the support for the cornea in US 5019084 A which is produced by the radially inner face of the base element, makes it possible to facilitate the positioning of the fabric on the support without risking damaging it.
[0015] Avantageusement, les moyens de support selon l’invention peuvent comprendre une bague de support (et de préférence être constitués de cette bague) présentant une face radialement externe qui comprend : Advantageously, the support means according to the invention may comprise a support ring (and preferably consist of this ring) having a radially outer face which comprises:
- ladite première surface annulaire, laquelle comporte un rebord radialement externe se prolongeant radialement vers l’intérieur par une rampe annulaire s’élevant jusqu’à un bord annulaire radialement interne de la bague de support, ladite rampe étant par exemple tronconique pour supporter un greffon de cornée en forme de dôme, ledit rebord comportant sur son épaisseur axiale une pluralité d’encoches radiales circonférentiellement espacées qui coopèrent respectivement avec une pluralité desdites pattes axiales de mise en butée comprises dans les moyens de coincement, et - said first annular surface, which comprises a radially outer rim extending radially inwards by an annular ramp rising up to a radially inner annular edge of the support ring, said ramp being for example frustoconical to support a graft dome-shaped cornea, said flange comprising on its axial thickness a plurality of circumferentially spaced radial notches which cooperate respectively with a plurality of said axial abutment lugs included in the wedging means, and
- ladite seconde surface annulaire dans une zone de ladite face radialement externe axialement opposée et en regard dudit rebord. - Said second annular surface in a zone of said radially outer face axially opposite and facing said flange.
[0016] Selon une autre caractéristique de l'invention, dans lesdits moyens de coincement : According to another characteristic of the invention, in said wedging means:
- ladite portion annulaire de coincement peut comporter, radialement de l’extérieur vers l’intérieur, une première section radiale et une seconde section oblique respectivement parallèles audit rebord et à ladite rampe de la bague de support, et- said annular wedging portion may comprise, radially from the outside inwards, a first radial section and a second oblique section respectively parallel to said rim and to said ramp of the support ring, and
- lesdites pattes axiales de mise en butée peuvent se terminer à angle droit par une extrémité libre radiale s’étendant radialement vers l’intérieur, l’extrémité libre radiale étant séparée de ladite première section radiale de la portion annulaire de coincement par une hauteur axiale définie par des épaisseurs respectives de ladite zone périphérique du tissu, dudit rebord de la bague de support et dudit au moins un élément radial de blocage des moyens de blocage formé par une collerette annulaire radiale. - said axial abutment lugs may end at right angles with a radial free end extending radially inwards, the radial free end being separated from said first radial section of the annular wedging portion by an axial height defined by respective thicknesses of said peripheral zone of the fabric, said flange of the support ring and said at least one radial blocking element of the blocking means formed by a radial annular collar.
[0017] Selon une autre caractéristique de l'invention, dans lesdits moyens de blocage : According to another characteristic of the invention, in said blocking means:
- lesdits éléments de liaison peuvent comprendre des piliers axiaux reliant axialement ledit organe de manoeuvre audit au moins un élément radial de blocage, lequel est formé d’une collerette annulaire radiale se terminant par un bord axial cylindrique adapté pour venir en appui contre ledit épaulement annulaire des moyens de support, et - said connecting elements may comprise axial pillars axially connecting said maneuvering member to said at least one radial blocking element, which is formed of a radial annular collar ending in a cylindrical axial edge adapted to bear against said annular shoulder support means, and
- ladite collerette annulaire radiale peut comporter une pluralité d’entailles respectivement adaptées pour coopérer avec ladite pluralité des pattes axiales de mise en butée, lors de l’assemblage des moyens de blocage sur les moyens de coincement. - said radial annular flange may comprise a plurality of notches respectively adapted to cooperate with said plurality of axial abutment lugs, when assembling the locking means on the wedging means.
[0018] L’invention a également pour but de proposer un procédé de support et de retenue d’un tissu humain, animal ou artificiel prélevé en vue d’une greffe ou d’une expérience ex vivo, en particulier un greffon de cornée, qui peut avantageusement être mis en oeuvre par un dispositif selon l’invention tel que défini ci-dessus et qui remédie également aux inconvénients précités. [0018] The invention also aims to provide a method for supporting and retaining a human, animal or artificial tissue taken for a transplant or an ex vivo experiment, in particular a corneal graft, which can advantageously be implemented by a device according to the invention as defined above and which also overcomes the aforementioned drawbacks.
[0019] Ce procédé de support et de retenue selon l’invention comprend : a) un positionnement du tissu sur des moyens de support configurés pour le supporter, de manière qu’une zone périphérique du tissu soit appliquée sur une première surface annulaire des moyens de support, ladite première surface annulaire présentant un axe de révolution et, autour dudit axe, une géométrie annulaire permettant une excision du tissu supporté et retenu, le tissu ainsi positionné définissant un premier côté axial, et b) un positionnement de moyens de retenue retenant le tissu positionné en a) sur les moyens de support, pour que les moyens de retenue enserrent la zone périphérique du tissu et viennent en butée avec les moyens de support. [0019] This method of supporting and retaining according to the invention comprises: a) positioning the fabric on support means configured to support it, so that a peripheral zone of the fabric is applied to a first annular surface of the means of support, said first annular surface having an axis of revolution and, around said axis, an annular geometry allowing excision of the supported and retained tissue, the tissue thus positioned defining a first axial side, and b) positioning of retaining means retaining the fabric positioned in a) on the support means, so that the retaining means surround the peripheral zone of the fabric and come into abutment with the support means.
[0020] Selon l’invention, ce procédé est tel que les moyens de support comprennent une seconde surface annulaire tournée vers un second côté axial axialement opposé audit premier côté axial, les moyens de retenue butant axialement contre la seconde surface annulaire pour immobiliser le tissu. According to the invention, this method is such that the support means comprise a second annular surface facing a second axial side axially opposite said first axial side, the retaining means abutting axially against the second annular surface to immobilize the tissue.
[0021] Avantageusement, l’étape b) peut comprendre les sous-étapes : b1) un coincement, par des moyens de coincement que comprennent les moyens de retenue, d’une zone périphérique du tissu contre ladite première surface annulaire des moyens de support, avec une immobilisation angulaire des moyens de coincement radialement contre lesdits moyens de support; puis b2) une mise en butée axiale et radiale d’au moins un élément radial de blocage que comprennent les moyens de retenue contre ladite seconde surface annulaire, par un blocage réversible vers ledit second côté axial des moyens de coincement par rapport aux moyens de support, en guidant axialement et angulairement par un organe de manoeuvre ledit au moins un élément radial de blocage axialement contre ladite seconde surface annulaire et radialement contre les moyens de coincement. [0021] Advantageously, step b) may comprise the sub-steps: b1) wedging, by wedging means that comprise the retaining means, of a peripheral zone of the fabric against said first annular surface of the support means , with an angular immobilization of the wedging means radially against said support means; then b2) axial and radial abutment of at least one radial blocking element comprised by the retaining means against said second annular surface, by reversible blocking towards said second axial side of the wedging means with respect to the support means , by guiding axially and angularly by an operating member said at least one radial blocking element axially against said second annular surface and radially against the wedging means.
[0022] Encore plus avantageusement, la sous-étape b1) peut être mise en oeuvre en manoeuvrant axialement et angulairement un anneau de coincement formant les moyens de coincement, pour guider ledit anneau contre une bague de support formant les moyens de support ; et la sous étape b2) peut être mise en oeuvre en manoeuvrant un organe de manoeuvre d’une collerette radiale se terminant par un bord axial cylindrique et formant ledit au moins un élément radial de blocage, pour guider axialement la collerette contre ladite seconde surface annulaire et radialement contre des pattes axiales circonférentiellement espacées que comprend l’anneau de coincement, de manière à immobiliser angulairement une bague de blocage comprenant ledit organe de manoeuvre et ledit au moins un élément radial de blocage contre et radialement à l’intérieur de l’anneau de coincement. Even more advantageously, sub-step b1) can be implemented by maneuvering axially and angularly a wedging ring forming the wedging means, to guide said ring against a support ring forming the support means; and sub-step b2) can be implemented by maneuvering an operating member of a radial collar ending in a cylindrical axial edge and forming said at least one radial blocking element, to guide the collar axially against said second annular surface and radially against circumferentially spaced axial lugs that the wedging ring comprises, so as to angularly immobilize a locking ring comprising the said operating member and the said at least one radial locking element against and radially inside the ring jamming.
Brève description des dessins Brief description of the drawings
[0023] D’autres caractéristiques, avantages et détails de la présente invention ressortiront à la lecture de la description suivante de plusieurs exemples de réalisation de l’invention, donnés à titre illustratif et non limitatif en relation avec les dessins joints, parmi lesquels : Fig. 1 Other characteristics, advantages and details of the present invention will become apparent on reading the following description of several embodiments of the invention, given by way of non-limiting illustration in relation to the attached drawings, among which: Fig. 1
[0024] [fig. 1] est une vue latérale et en perspective éclatée d’un dispositif selon un mode préférentiel de réalisation de l’invention. [0024] [fig. 1] is an exploded side and perspective view of a device according to a preferred embodiment of the invention.
Fig. 2 [0025] [fig. 2] est une vue latérale et en perspective du dispositif de la figure 1 en position assemblée de support et de retenue. Fig. 2 [0025] [fig. 2] is a side and perspective view of the device of FIG. 1 in the assembled support and retaining position.
Fig. 3 Fig. 3
[0026] [fig. 3] est une vue en élévation du dispositif assemblé de la figure 2. [0026] [fig. 3] is an elevational view of the assembled device of Figure 2.
Fig. 4 [0027] [fig. 4] est une vue en coupe du dispositif selon le plan IV-IV de la figure 3. Fig. 4 [0027] [fig. 4] is a sectional view of the device along the plane IV-IV of Figure 3.
Fig. 5 Fig. 5
[0028] [fig. 5] est une vue agrandie en coupe du dispositif correspondant aux médaillons des figures 2 et 4. [0028] [fig. 5] is an enlarged sectional view of the device corresponding to the medallions of Figures 2 and 4.
Fig. 6 [0029] [fig. 6] est une vue de dessous et en perspective de la seconde surface annulaire des moyens de support du dispositif illustré aux figures 1 à 5. Fig. 6 [0029] [fig. 6] is a view from below and in perspective of the second annular surface of the support means of the device illustrated in FIGS. 1 to 5.
Fig. 7 Fig. 7
[0030] [fig. 7] est une vue de dessus et en perspective montrant le positionnement du tissu sur les moyens de support, dans une première étape du procédé d’assemblage du dispositif selon l’invention. [0030] [fig. 7] is a top and perspective view showing the positioning of the fabric on the support means, in a first step of the method of assembling the device according to the invention.
Fig. 8 Fig. 8
[0031] [fig. 8] est une vue de dessus et en perspective montrant l’amenée des moyens de coincement du tissu vers les moyens de support, dans une deuxième étape du procédé d’assemblage du dispositif selon l’invention. [0032] [fig. 9] est une vue de dessus et en perspective montrant le coincement du tissu contre les moyens de support, au terme de cette deuxième étape du procédé d’assemblage du dispositif selon l’invention. [0031] [fig. 8] is a top and perspective view showing the supply of the wedging means of the fabric to the support means, in a second step of the method of assembling the device according to the invention. [0032] [fig. 9] is a top and perspective view showing the wedging of the fabric against the support means, at the end of this second step of the method of assembling the device according to the invention.
Fig. 10 Fig. 10
[fig. 10] est une vue de dessus et en perspective montrant l’amenée en butée axiale et radiale des moyens de blocage contre les moyens de support et les moyens de coincement, dans une troisième étape du procédé d’assemblage du dispositif selon l’invention. [fig. 10] is a top and perspective view showing the bringing into axial and radial abutment of the locking means against the support means and the wedging means, in a third step of the method of assembling the device according to the invention.
[0033] [0033]
Fig. 11 Fig. 11
[0034] [fig. 11] est une vue de dessus et en perspective montrant l’amenée en butée angulaire des moyens de blocage contre les moyens de support et les moyens de coincement, dans une dernière étape du procédé d’assemblage du dispositif selon l’invention. [0034] [fig. 11] is a view from above and in perspective showing the bringing into angular abutment of the locking means against the support means and the wedging means, in a last step of the method of assembling the device according to the invention.
Description détaillée detailed description
[0035] Le dispositif 1 de support et de retenue du tissu 2 illustré à la figure 1 présente une géométrie annulaire autour d’un axe de révolution X formant axe de symétrie du dispositif 1 une fois assemblé. Le dispositif 1 comprend une bague de support 10 du tissu 2 et des moyens de retenue 20 du tissu sur la bague de support 10. Les moyens de retenue 20 sont adaptés pour enserrer une zone périphérique 2a du tissu 2 et coopérer en butée avec la bague de support 10 pour immobiliser le tissu 2. Dans les figures jointes, le tissu 2 est un greffon de cornée, étant rappelé que la présente description s’étend à tout type de tissu humain, animal ou artificiel supporté et retenu notamment en vue d’une greffe. The device 1 for supporting and retaining the fabric 2 shown in Figure 1 has an annular geometry around an axis of revolution X forming the axis of symmetry of the device 1 once assembled. The device 1 comprises a support ring 10 for the fabric 2 and means 20 for retaining the fabric on the support ring 10. The retaining means 20 are adapted to enclose a peripheral zone 2a of the fabric 2 and cooperate in abutment with the ring support 10 to immobilize the tissue 2. In the attached figures, the tissue 2 is a corneal graft, it being recalled that the present description extends to any type of human, animal or artificial tissue supported and retained in particular with a view to transplant.
[0036] La bague de support 10 et les moyens de retenue 20 peuvent être réalisés en tous matériaux biocompatibles métalliques (par exemple en acier ou en titane) ou non métalliques. Dans la présente description, on entend par « axial(e) » et « axialement » la référence à une direction axiale parallèle à l’axe de révolution X commun à la bague de support 10 et aux différentes parties des moyens de retenue 20 et du dispositif 1 assemblé, le sens concerné de cette direction axiale étant défini par la référence à l’un ou l’autre de premier et second côtés 3 et 4. [0036] The support ring 10 and the retaining means 20 can be made of any metallic (for example steel or titanium) or non-metallic biocompatible materials. In the present description, by "axial" and "axially" is meant the reference to an axial direction parallel to the axis of revolution X common to the support ring 10 and to the various parts of the means of retainer 20 and of the assembled device 1, the relevant direction of this axial direction being defined by the reference to one or the other of first and second sides 3 and 4.
[0037] La bague de support 10 comprend, en un premier côté axial 3 de sa circonférence externe, prolongeant radialement vers l’intérieur un rebord axial radialement externe 11 de la bague 10, une première surface annulaire 12 (tournée vers le bas aux figures 4-5 et vers le haut à la figure 6) comportant un premier bord radial 12a se prolongeant radialement vers l’intérieur par une rampe 12b dont l’inclinaison définit dans cet exemple une surface tronconique, particulièrement bien adaptée à la géométrie de la zone périphérique 2a d’un greffon de cornée en forme de dôme (i.e. de calotte hémisphérique) que cette zone 2a épouse une fois positionnée sur la bague de support 10 (voir figures 4-5). La rampe 12b se termine par un bord radial terminal 12c dont l’extrémité axiale 12d définit la circonférence interne de la bague 10. The support ring 10 comprises, on a first axial side 3 of its outer circumference, extending radially inwards a radially outer axial edge 11 of the ring 10, a first annular surface 12 (facing downwards in the figures 4-5 and upwards in Figure 6) comprising a first radial edge 12a extending radially inwards by a ramp 12b whose inclination defines in this example a frustoconical surface, particularly well suited to the geometry of the zone peripheral 2a of a corneal graft in the shape of a dome (i.e. of hemispherical cap) that this zone 2a marries once positioned on the support ring 10 (see FIGS. 4-5). The ramp 12b ends with a terminal radial edge 12c whose axial end 12d defines the inner circumference of the ring 10.
[0038] La bague de support 10 comporte, en un second côté axial 4 opposé de sa circonférence, prolongeant radialement vers l’intérieur le rebord axial radialement externe 11 de la bague 10, une seconde surface annulaire 13 (tournée vers le haut aux figures 4-5 et vers le bas à la figure 6) comportant un second bord radial 13a se prolongeant radialement vers l’intérieur par un épaulement annulaire 13b, puis par un tronçon incliné 13c parallèle à la rampe 12b se terminant lui-même par l’extrémité axiale 12d (voir figure 6). The support ring 10 comprises, in a second axial side 4 opposite its circumference, extending radially inwardly the radially outer axial edge 11 of the ring 10, a second annular surface 13 (turned upwards in the figures 4-5 and downwards in FIG. 6) comprising a second radial edge 13a extending radially inwards by an annular shoulder 13b, then by an inclined section 13c parallel to the ramp 12b itself terminating in the axial end 12d (see Figure 6).
[0039] Comme illustré aux figures 1 et 6, le rebord axial radialement externe 11 de la bague 10 comporte, sur toute l’épaisseur axiale du rebord 11, une pluralité d’encoches radiales 14 en arc de cercle circonférentiellement espacées sensiblement, qui sont chacune en forme de U à bords radiaux arrondis 14a et à fond 14b curviligne. As illustrated in Figures 1 and 6, the radially outer axial flange 11 of the ring 10 comprises, over the entire axial thickness of the flange 11, a plurality of radial notches 14 in an arc of a circumferentially spaced circle substantially, which are each U-shaped with rounded radial edges 14a and curvilinear bottom 14b.
[0040] Comme notamment illustré aux figures 1 et 4-5, les moyens de retenue 20 comprennent, tourné vers le premier côté 3, un anneau de coincement 20A de la zone périphérique 2a du tissu 2 contre la première surface annulaire 12 et, tournée vers le second côté 4, une bague de blocage 20B pour bloquer réversiblement l’anneau de coincement 20A contre la bague de support 10. [0041] L’anneau de coincement 20A comprend (voir figures 1 et 5) une portion circonférentielle 21 de section radiale globalement en forme de trapèze rectangle, dont une section oblique radialement interne 21a formant portion annulaire de coincement s’étend de manière tronconique radialement vers l’intérieur et axialement vers le premier côté 3 à partir d’une section radiale 21 b tournée vers le second côté 4, pour plaquer la zone périphérique 2a du tissu 2 contre la première surface annulaire 12, et dont une face axiale cylindrique radialement externe 21c s’étend à partir d’un bord radial 21 d de la bague 20 tourné vers le premier côté 3. As illustrated in particular in Figures 1 and 4-5, the retaining means 20 comprise, facing the first side 3, a wedging ring 20A of the peripheral zone 2a of the fabric 2 against the first annular surface 12 and, facing towards the second side 4, a locking ring 20B to reversibly lock the wedging ring 20A against the support ring 10. The wedging ring 20A comprises (see Figures 1 and 5) a circumferential portion 21 of radial section generally in the shape of a rectangular trapezium, of which a radially internal oblique section 21a forming an annular wedging portion extends radially frustoconically inwards and axially towards the first side 3 from a radial section 21b facing the second side 4, to press the peripheral zone 2a of the fabric 2 against the first annular surface 12, and of which a radially cylindrical axial face outer 21c extends from a radial edge 21d of the ring 20 facing the first side 3.
[0042] L’anneau de coincement 20A comprend en outre des pattes axiales 22 de mise en butée en arc de cercle circonférentiellement espacées qui sont conçues, d’une part, pour venir à l’intérieur des encoches radiales 14 respectivement conçues pour les recevoir de sorte à coincer la zone périphérique 2a du tissu 2 avec un serrage suffisant et, d’autre part, pour recevoir en butée axiale et radiale une extrémité 23 de la bague de blocage 20B, comme décrit ci-après. [0042] The wedging ring 20A further comprises axial tabs 22 for abutment in an arc of a circumferentially spaced circle which are designed, on the one hand, to come inside the radial notches 14 respectively designed to receive them. so as to wedge the peripheral zone 2a of the fabric 2 with sufficient tightness and, on the other hand, to receive in axial and radial abutment one end 23 of the locking ring 20B, as described below.
[0043] Comme illustré aux figures 2-3 et 5, chaque patte axiale 22 prolonge axialement vers le second côté 4 la face radialement externe 21c cylindrique de l’anneau 20A, en se terminant par une extrémité libre radiale 22a recourbée à angle droit radialement vers l’intérieur, qui forme un crochet de mise en butée de l’extrémité 23 de la bague de blocage 20B. As illustrated in Figures 2-3 and 5, each axial leg 22 extends axially towards the second side 4 the radially outer cylindrical face 21c of the ring 20A, ending in a radial free end 22a curved at a right angle radially inwards, which forms a hook for abutting the end 23 of the locking ring 20B.
[0044] Comme illustré notamment aux figures 1, 4 et 10, la bague de blocage 20B comprend d’un seul tenant : As illustrated in particular in Figures 1, 4 and 10, the locking ring 20B comprises in one piece:
- une collerette radiale de blocage 24 (i.e. annulaire et continue, étant précisé qu’elle pourrait être en variante discontinue) se terminant par un bord axial 25 cylindrique vers le premier côté 3, qui définit avec la collerette 24 l’extrémité fonctionnelle 23 de la bague de blocage 20B permettant ladite mise en butée, et- a radial locking collar 24 (i.e. annular and continuous, it being specified that it could be in a discontinuous variant) ending in a cylindrical axial edge 25 towards the first side 3, which defines with the collar 24 the functional end 23 of the locking ring 20B allowing said abutment, and
- deux plots axiaux 26 de manoeuvre de la bague 20B qui s’étendent vers le second côté 4 à partir d’une portion circonférentielle 27 formant bague de manoeuvre, laquelle est axialement reliée à la collerette 24 par des éléments de liaison 28 tels que des piliers axiaux, les plots 26 étant conçus pour qu’un opérateur dirige axialement et angulairement la collerette 24 pour l’amener axialement contre la seconde surface annulaire 13 et radialement contre les pattes axiales 22. - two axial studs 26 for operating ring 20B which extend towards the second side 4 from a circumferential portion 27 forming an operating ring, which is axially connected to collar 24 by connecting elements 28 such as axial pillars, the studs 26 being designed so that an operator axially and angularly directs the flange 24 to bring it axially against the second annular surface 13 and radially against the axial tabs 22.
[0045] Comme illustré à la figure 5, le bord axial cylindrique 25 est conçu pour venir en appui contre l’épaulement annulaire 13b de la bague de support 10, et la collerette 24 comporte une pluralité d’entailles 24a en arc de cercle et à bords arrondis (chaque entaille 24a, visible aux figures 1 et 10-11 , est radialement moins profonde que chaque encoche 14 et de largeur curviligne légèrement supérieure à la largeur curviligne de chaque patte 22) respectivement conçues pour coopérer en butée angulaire avec les pattes axiales 22, lors de l’assemblage de la bague de blocage 20B avec rotation sur l’anneau de coincement 20A. As illustrated in Figure 5, the cylindrical axial edge 25 is designed to bear against the annular shoulder 13b of the support ring 10, and the flange 24 has a plurality of notches 24a in an arc of a circle and with rounded edges (each notch 24a, visible in Figures 1 and 10-11, is radially shallower than each notch 14 and of curvilinear width slightly greater than the curvilinear width of each tab 22) respectively designed to cooperate in angular abutment with the tabs axial 22, when assembling the locking ring 20B with rotation on the wedging ring 20A.
[0046] On voit à la figure 5 que la face axialement interne (i.e. tournée vers le premier côté 3) de l’extrémité libre radiale recourbée 22a est séparée de la face axialement interne (i.e. tournée vers le second côté) de la section radiale 21 b de la portion annulaire de coincement 21a, par une hauteur axiale H égale à la somme des épaisseurs axiales respectives de la zone périphérique 2a du tissu 2, du rebord radialement externe 11 de la bague de support 10 et de la collerette 24. We see in Figure 5 that the axially internal face (i.e. facing the first side 3) of the curved radial free end 22a is separated from the axially internal face (i.e. facing the second side) of the radial section 21b of the annular wedging portion 21a, by an axial height H equal to the sum of the respective axial thicknesses of the peripheral zone 2a of the fabric 2, of the radially outer rim 11 of the support ring 10 and of the flange 24.
[0047] Pour assembler le dispositif 1 en y retenant le tissu 2, on peut avantageusement mettre en oeuvre les étapes suivantes. To assemble the device 1 by retaining the fabric 2 therein, the following steps can advantageously be implemented.
[0048] Dans une étape initiale illustrée à la figure 7 et dont le résultat est visible à la figure 8, un opérateur amène (dans le sens de la flèche A à la figure 7) le tissu 2, tel qu’un greffon de cornée, vers et sur la bague de support 10 en l’y positionnant de manière que la zone périphérique 2a du tissu 2 soit appliquée sur la première surface annulaire 12 radialement en retrait des encoches 14. In an initial step illustrated in Figure 7 and the result of which is visible in Figure 8, an operator brings (in the direction of arrow A in Figure 7) the tissue 2, such as a corneal graft , towards and on the support ring 10 by positioning it there so that the peripheral zone 2a of the fabric 2 is applied to the first annular surface 12 radially set back from the notches 14.
[0049] Dans une étape suivante illustrée à la figure 8 et dont le résultat est visible à la figure 9, l’opérateur amène l’anneau de coincement 20A vers et contre la zone périphérique 2a du tissu 2 contre la première surface annulaire 12 (dans le sens de la flèche B à la figure 8), en faisant tourner légèrement l’anneau 20A pour l’immobiliser angulairement radialement contre la bague de support 10. Plus précisément, l’opérateur guide axialement et angulairement l’anneau 20A contre le rebord axial radialement externe 11 de la bague 10 en le faisant d’abord légèrement basculer autour du tissu 2, pour que les pattes 22 de l’anneau 20A viennent ensuite se caler à l’intérieur des encoches 14 et que l’extrémité radiale recourbée 22a soit amenée du côté de la seconde surface annulaire 13 sans endommager le tissu 2, ce qui ménage un jeu axial par rapport au rebord 11 de la bague 10 permettant le blocage réversible de l’anneau 20A par la bague 20B, comme expliqué ci-après. In a next step illustrated in Figure 8 and the result of which can be seen in Figure 9, the operator brings the wedging ring 20A towards and against the peripheral zone 2a of the fabric 2 against the first annular surface 12 ( in the direction of the arrow B in FIG. 8), by slightly rotating the ring 20A to immobilize it angularly radially against the support ring 10. More precisely, the operator guides the ring 20A axially and angularly against the radially outer axial edge 11 of the ring 10 by first tilting it slightly around the fabric 2, so that the tabs 22 of the ring 20A then come to wedge themselves inside the notches 14 and the curved radial end 22a is brought to the side of the second annular surface 13 without damaging the fabric 2, which provides an axial play with respect to the rim 11 of the ring 10 allowing the reversible blocking of the ring 20A by the ring 20B, as explained below.
[0050] Comme illustré aux figures 10-11, l’opérateur guide ensuite axialement et angulairement la bague 20B, en la saisissant par ses plots de manoeuvre 26, suivant par exemple la séquence suivante : As illustrated in Figures 10-11, the operator then guides the ring 20B axially and angularly, by grasping it by its maneuvering studs 26, following for example the following sequence:
- amener axialement la collerette 24 de la bague 20B (dans le sens de la flèche C à la figure 10), pour que la collerette 24 soit positionnée à proximité immédiate de l’extrémité libre radiale 22a de chaque patte 22 de l’anneau 20A, - bring the collar 24 of the ring 20B axially (in the direction of the arrow C in FIG. 10), so that the collar 24 is positioned in the immediate vicinity of the radial free end 22a of each tab 22 of the ring 20A ,
- guider angulairement la bague 20B en la faisant tourner par rapport aux pattes 22, pour amener dans une position angulaire déterminée les entailles 24a de la collerette 24 circonférentiellement en regard des pattes 22, - guider axialement, par simple poussée exercée sur la bague 20B suivant cette position angulaire ainsi obtenue, la collerette 24 pour l’amener contre l’épaulement 13b de la bague 10, avec les entailles 24a qui reçoivent les pattes 22, puis - angularly guide the ring 20B by rotating it relative to the lugs 22, to bring the notches 24a of the flange 24 circumferentially opposite the lugs 22 into a determined angular position, - guide axially, by simple pushing exerted on the following ring 20B this angular position thus obtained, the flange 24 to bring it against the shoulder 13b of the ring 10, with the notches 24a which receive the lugs 22, then
- faire légèrement tourner la bague 20B par rapport aux pattes 22 (dans le sens de la flèche D à la figure 11), de manière que les pattes 22 sortent des entailles 24a de sa collerette 24 en appuyant radialement ces pattes 22, pour bloquer axialement et radialement la bague 20B via sa collerette 24 contre l’épaulement 13b de la bague 10, et angulairement contre l’anneau 20A. - Slightly rotate the ring 20B relative to the lugs 22 (in the direction of arrow D in Figure 11), so that the lugs 22 come out of the notches 24a of its collar 24 by pressing these lugs 22 radially, to block axially and radially the ring 20B via its collar 24 against the shoulder 13b of the ring 10, and angularly against the ring 20A.

Claims

Revendications Claims
[Revendication 1] Dispositif (1) de support et de retenue d’un tissu (2) humain, animal ou artificiel prélevé en vue d’une greffe ou d’une expérience ex vivo, en particulier un greffon de cornée, le dispositif présentant un axe de révolution (X) et, autour de l’axe (X), une géométrie annulaire configurée notamment pour permettre une excision du tissu (2) supporté et retenu, le dispositif (1) comprenant : [Claim 1] Device (1) for supporting and retaining a human, animal or artificial tissue (2) removed for the purpose of a transplant or an ex vivo experiment, in particular a corneal graft, the device having an axis of revolution (X) and, around the axis (X), an annular geometry configured in particular to allow excision of the tissue (2) supported and retained, the device (1) comprising:
- des moyens de support (10) aptes à supporter le tissu (2), comportant une première surface annulaire (12) apte à recevoir une zone périphérique du tissu (2a) et tournée vers un premier côté axial (3) du dispositif (1), et - support means (10) able to support the fabric (2), comprising a first annular surface (12) able to receive a peripheral zone of the fabric (2a) and facing a first axial side (3) of the device (1 ), and
- des moyens de retenue (20) aptes à retenir le tissu (2) sur les moyens de support (10), qui sont adaptés pour enserrer la zone périphérique du tissu (2a) et coopérer en butée avec les moyens de support (10), dans lequel les moyens de support (10) comprennent une seconde surface annulaire (13) tournée vers un second côté axial (4) du dispositif (1) axialement opposé audit premier côté axial (3), les moyens de retenue (20) étant adaptés pour buter axialement contre la seconde surface annulaire (13) pour immobiliser le tissu (2). - retaining means (20) capable of retaining the fabric (2) on the support means (10), which are adapted to grip the peripheral zone of the fabric (2a) and cooperate in abutment with the support means (10) , wherein the support means (10) comprise a second annular surface (13) facing a second axial side (4) of the device (1) axially opposite to said first axial side (3), the retaining means (20) being adapted to abut axially against the second annular surface (13) to immobilize the tissue (2).
[Revendication 2] Dispositif (1) selon la revendication 1, dans lequel les moyens de retenue (20) comprennent au moins un élément radial de blocage (23) adapté pour buter axialement et radialement contre un épaulement annulaire (13b) que présente ladite seconde surface annulaire (13), et de préférence dans lequel ledit au moins un élément radial de blocage (23) comprend une collerette radiale (24) se terminant par un bord axial cylindrique (25). [Claim 2] Device (1) according to Claim 1, in which the retaining means (20) comprise at least one radial blocking element (23) adapted to abut axially and radially against an annular shoulder (13b) which the said second annular surface (13), and preferably wherein said at least one radial blocking element (23) comprises a radial flange (24) terminating in a cylindrical axial edge (25).
[Revendication 3] Dispositif (1) selon la revendication 2, dans lequel les moyens de retenue (20) comprennent : [Claim 3] A device (1) according to claim 2, wherein the retaining means (20) comprises:
- des moyens de coincement (20A) tournés vers ledit premier côté axial (3) et aptes à coincer la zone périphérique du tissu (2a) contre ladite première surface annulaire (12), les moyens de coincement (20A) comprenant : une portion annulaire de coincement (21a) configurée pour épouser la forme de ladite première surface annulaire (12) en y coinçant la zone périphérique du tissu (2a), et des pattes axiales (22) de mise en butée circonférentiellement espacées configurées pour recevoir en butée axiale et radiale ledit au moins un élément radial de blocage (23) ; et - wedging means (20A) facing said first axial side (3) and capable of wedging the peripheral zone of the fabric (2a) against said first annular surface (12), the wedging means (20A) comprising: an annular portion wedging (21a) configured to match the shape of said first annular surface (12) by wedging the peripheral area of the fabric (2a) therein, and circumferentially spaced apart axial abutment lugs (22) configured to receive in axial and radial abutment said at least one radial locking element (23); and
- des moyens de blocage réversible (20B) tournés vers ledit second côté axial (4) et aptes à bloquer réversiblement les moyens de coincement (20A) par rapport aux moyens de support (10), les moyens de blocage (20B) comprenant d’un seul tenant : ledit au moins un élément radial de blocage (23) qui comprend de préférence une collerette radiale (24) se terminant par un bord axial cylindrique (25), et axialement à l’opposé, un organe de manoeuvre (26) qui est axialement relié audit au moins un élément radial de blocage (23) par des éléments de liaison (28) et qui est apte à diriger axialement et angulairement ledit au moins un élément radial de blocage (23) pour l’amener axialement contre ladite seconde surface annulaire (13) et radialement contre lesdites pattes axiales (22) de mise en butée, l’organe de manoeuvre (26) comprenant de préférence des plots axiaux solidaires d’une bague de manoeuvre (27). - reversible locking means (20B) facing said second axial side (4) and able to reversibly lock the wedging means (20A) relative to the support means (10), the locking means (20B) comprising a single piece: said at least one radial locking element (23) which preferably comprises a radial flange (24) ending in a cylindrical axial edge (25), and axially opposite, an operating member (26) which is axially connected to said at least one radial blocking element (23) by connecting elements (28) and which is capable of axially and angularly directing said at least one radial blocking element (23) to bring it axially against said second annular surface (13) and radially against said axial abutment lugs (22), the operating member (26) preferably comprising axial studs integral with an operating ring (27).
[Revendication 4] Dispositif (1) selon une des revendications précédentes, dans lequel la première surface annulaire (12) des moyens de support (10) est formée sur une face radialement externe desdits moyens de support (10). [Claim 4] Device (1) according to one of the preceding claims, in which the first annular surface (12) of the support means (10) is formed on a radially outer face of the said support means (10).
[Revendication 5] Dispositif (1) selon une des revendications précédentes, dans lequel les moyens de support (10) comprennent une bague de support présentant une face radialement externe qui comprend : [Claim 5] Device (1) according to one of the preceding claims, in which the support means (10) comprise a support ring having a radially outer face which comprises:
- ladite première surface annulaire (12), laquelle comporte un rebord radialement externe (12a) se prolongeant radialement vers l’intérieur par une rampe (12b) annulaire s’élevant jusqu’à un bord annulaire radialement interne (12c) de la bague de support, ladite rampe (12b) étant par exemple tronconique pour supporter un greffon de cornée (2) en forme de dôme, ledit rebord (12a) comportant sur son épaisseur axiale une pluralité d’encoches radiales (14) circonférentiellement espacées qui coopèrent respectivement avec une pluralité desdites pattes axiales (22) de mise en butée comprises dans les moyens de coincement (20A), et - ladite seconde surface annulaire (13) dans une zone de ladite face radialement externe axialement opposée et en regard dudit rebord (12a). - said first annular surface (12), which comprises a radially outer edge (12a) extending radially inwards by an annular ramp (12b) rising as far as a radially inner annular edge (12c) of the support, said ramp (12b) being for example frustoconical to support a corneal graft (2) in the form of a dome, said flange (12a) comprising on its axial thickness a plurality of circumferentially spaced radial notches (14) which cooperate respectively with a plurality of said axial abutment lugs (22) included in the wedging means (20A), and - said second annular surface (13) in a zone of said radially outer face axially opposite and facing said rim (12a).
[Revendication 6] Dispositif (1) selon les revendications 3 et 5, dans lequel dans les moyens de coincement (20A) : [Claim 6] Device (1) according to claims 3 and 5, wherein in the wedging means (20A):
- ladite portion annulaire de coincement (21a) comporte, radialement de l’extérieur vers l’intérieur, une première section radiale (21b) et une seconde section oblique (21a) respectivement parallèles audit rebord (12a) et à ladite rampe (12b) de la bague de support (10), et - said annular wedging portion (21a) comprises, radially from the outside inwards, a first radial section (21b) and a second oblique section (21a) respectively parallel to said rim (12a) and to said ramp (12b) the support ring (10), and
- lesdites pattes axiales (22) de mise en butée se terminent à angle droit par une extrémité libre radiale (22a) s’étendant radialement vers l’intérieur, l’extrémité libre radiale (22a) étant séparée de ladite première section radiale (21b) de la portion annulaire de coincement (21a) par une hauteur axiale (H) définie par des épaisseurs respectives de ladite zone périphérique du tissu (2a), dudit rebord (12a) de la bague de support (10) et dudit au moins un élément radial de blocage (23) des moyens de blocage (20B) formé par une collerette radiale (24). - said axial abutment lugs (22) terminate at right angles in a radial free end (22a) extending radially inwards, the radial free end (22a) being separated from said first radial section (21b ) of the annular wedging portion (21a) by an axial height (H) defined by respective thicknesses of said peripheral zone of the fabric (2a), of said flange (12a) of the support ring (10) and of said at least one radial blocking element (23) of the blocking means (20B) formed by a radial collar (24).
[Revendication 7] Dispositif (1) selon la revendication 6, dans lequel dans les moyens de blocage (20B) : [Claim 7] Device (1) according to claim 6, in which in the locking means (20B):
- lesdits éléments de liaison (28) comprennent des piliers axiaux reliant axialement ledit organe de manoeuvre (26) audit au moins un élément radial de blocage (23), lequel est formé d’une collerette radiale (24) se terminant par un bord axial cylindrique (25) adapté pour venir en appui contre ledit épaulement annulaire (13b) des moyens de support (10), et - said connecting elements (28) comprise axial pillars axially connecting said maneuvering member (26) to said at least one radial locking element (23), which is formed by a radial collar (24) terminating in an axial edge cylindrical (25) adapted to bear against said annular shoulder (13b) of the support means (10), and
- ladite collerette radiale (24) comporte une pluralité d’entailles (24a) respectivement adaptées pour coopérer avec ladite pluralité des pattes axiales (22) de mise en butée, lors de l’assemblage des moyens de blocage (20B) sur les moyens de coincement (20A). - said radial flange (24) comprises a plurality of notches (24a) respectively adapted to cooperate with said plurality of axial lugs (22) for abutment, during the assembly of the locking means (20B) on the means of wedging (20A).
[Revendication 8] Procédé de support et de retenue d’un tissu (2) humain, animal ou artificiel prélevé en vue d’une greffe ou d’une expérience ex vivo, en particulier un greffon de cornée, le procédé comprenant : a) un positionnement du tissu (2) sur des moyens de support (10) configurés pour le supporter, de manière qu’une zone périphérique du tissu (2a) soit appliquée sur une première surface annulaire (12) des moyens de support (10), ladite première surface annulaire (12) présentant un axe de révolution (X) et, autour dudit axe (X), une géométrie annulaire permettant une excision du tissu (2) supporté et retenu, le tissu (2) ainsi positionné définissant un premier côté axial (3), et b) un positionnement de moyens de retenue (20) retenant le tissu (2) positionné en a) sur les moyens de support (10), pour que les moyens de retenue (20) enserrent la zone périphérique du tissu (2a) et viennent en butée avec les moyens de support (10), dans lequel les moyens de support (10) comprennent une seconde surface annulaire (13) tournée vers un second côté axial (4) axialement opposé audit premier côté axial (3), les moyens de retenue (20) butant axialement contre la seconde surface annulaire (13) pour immobiliser le tissu (2). [Claim 8] A method of supporting and retaining a human, animal or artificial tissue (2) removed for the purpose of a transplant or an ex vivo experiment, in particular a corneal graft, the method comprising: a) positioning the fabric (2) on support means (10) configured to support it, so that a peripheral area of the fabric (2a) is applied to a first annular surface (12) of the support means (10), said first annular surface (12) having an axis of revolution (X) and, around said axis (X), an annular geometry allowing excision of the tissue (2) supported and retained, the fabric (2) thus positioned defining a first axial side (3), and b) a positioning of retaining means (20) retaining the fabric (2) positioned in a) on the support means (10) , so that the retaining means (20) encloses the peripheral area of the fabric (2a) and comes into abutment with the support means (10), in which the support means (10) comprise a second annular surface (13) turned towards a second axial side (4) axially opposite said first axial side (3), the retaining means (20) abutting axially against the second annular surface (13) to immobilize the fabric (2).
[Revendication 9] Procédé selon la revendication 8, dans lequel l’étape b) comprend les sous-étapes : b1) un coincement, par des moyens de coincement (20A) que comprennent les moyens de retenue (20), d’une zone périphérique du tissu (2a) contre ladite première surface annulaire (12) des moyens de support (10), avec une immobilisation angulaire des moyens de coincement (20A) radialement contre lesdits moyens de support (10); puis b2) une mise en butée axiale et radiale d’au moins un élément radial de blocage (23) que comprennent les moyens de retenue (20) contre ladite seconde surface annulaire (13), par un blocage réversible vers ledit second côté axial (4) des moyens de coincement (20A) par rapport aux moyens de support (10), en guidant axialement et angulairement par un organe de manoeuvre (26) ledit au moins un élément radial de blocage (23) axialement contre ladite seconde surface annulaire (13) et radialement contre les moyens de coincement (20A). [Claim 9] Method according to claim 8, in which step b) comprises the sub-steps: b1) wedging, by wedging means (20A) which comprise the retaining means (20), of a zone peripheral of the fabric (2a) against said first annular surface (12) of the support means (10), with an angular immobilization of the wedging means (20A) radially against the said support means (10); then b2) axial and radial abutment of at least one radial blocking element (23) which the retaining means (20) comprise against said second annular surface (13), by reversible blocking towards said second axial side ( 4) wedging means (20A) relative to the support means (10), by guiding axially and angularly by an operating member (26) said at least one radial blocking element (23) axially against said second annular surface ( 13) and radially against the wedging means (20A).
[Revendication 10] Procédé selon la revendication 9, dans lequel : b1) est mise en oeuvre en manoeuvrant axialement et angulairement un anneau de coincement formant les moyens de coincement (20A), pour guider ledit anneau contre une bague de support formant les moyens de support (10) ; et b2) est mise en oeuvre en manoeuvrant un organe de manoeuvre (26) d’une collerette radiale (24) se terminant par un bord axial cylindrique (25) et formant ledit au moins un élément radial de blocage (23), pour guider axialement la collerette (24) contre ladite seconde surface annulaire (13) et radialement contre des pattes axiales (22) circonférentiellement espacées que comprend l’anneau de coincement (20A), de manière à immobiliser angulairement une bague de blocage (20B) comprenant ledit organe de manoeuvre (26) et ledit au moins un élément radial de blocage (23) contre et radialement à l’intérieur de l’anneau de coincement (20A). [Claim 10] Method according to claim 9, in which: b1) is implemented by maneuvering axially and angularly a wedging ring forming the wedging means (20A), to guide the said ring against a support ring forming the carrier (10); and b2) is implemented by operating an operating member (26) of a radial collar (24) terminating in a cylindrical axial edge (25) and forming said at least one radial blocking element (23), for guiding the collar (24) axially against said second annular surface (13) and radially against tabs circumferentially spaced axial (22) that the wedging ring (20A) comprises, so as to angularly immobilize a locking ring (20B) comprising the said operating member (26) and the said at least one radial locking element (23) against and radially inside the wedging ring (20A).
PCT/FR2022/051380 2021-07-22 2022-07-08 Device and method for support and retention of tissue WO2023002106A1 (en)

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FRFR2107936 2021-07-22
FR2107936A FR3125386B1 (en) 2021-07-22 2021-07-22 Device and method for supporting and retaining tissue.

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5019084A (en) 1986-08-06 1991-05-28 Minnesota Mining And Manufacturing Company Corneal holder
GB2433031A (en) * 2005-12-07 2007-06-13 Philip Douglas Weston Cornea retaining device for keratoplasty
CN208001979U (en) * 2018-01-30 2018-10-26 广东博与再生医学有限公司 A kind of artificial cornea conserving case
WO2020056392A1 (en) * 2018-09-14 2020-03-19 University Of Miami Dual-chamber vial for corneal graft preservation

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5019084A (en) 1986-08-06 1991-05-28 Minnesota Mining And Manufacturing Company Corneal holder
GB2433031A (en) * 2005-12-07 2007-06-13 Philip Douglas Weston Cornea retaining device for keratoplasty
CN208001979U (en) * 2018-01-30 2018-10-26 广东博与再生医学有限公司 A kind of artificial cornea conserving case
WO2020056392A1 (en) * 2018-09-14 2020-03-19 University Of Miami Dual-chamber vial for corneal graft preservation

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FR3125386A1 (en) 2023-01-27

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