WO2023128892A1

WO2023128892A1 - Lesion recovery apparatus

Info

Publication number: WO2023128892A1
Application number: PCT/TR2021/051568
Authority: WO
Inventors: Şenol Pi̇şki̇n; Mehmet TOKAÇ; Ayhan DİNÇKAN
Original assignee: İsti̇nye Üni̇versi̇tesi̇
Priority date: 2021-12-28
Filing date: 2021-12-28
Publication date: 2023-07-06

Abstract

Invention relates to a lesion recovery apparatus (100) providing removal of thrombus (400) occurring in any vessel (artery or vein) or liver (200) portal vein (300) in field of medicine. Invention is characterised in comprising main body (10) in ring form going into any vessel (artery or vein) or liver (200) portal vein (300) and provides incising thrombus (400) from liver (200) portal vein (300) or any vessel surface and collection thereof, arm (30) connected to main body (10) and providing manually holding lesion recovery apparatus (100) and pushing of it into liver (200) portal vein (200) or any vessel, directing and pulling back thereof, diastole membrane (20a) or systole membrane (20b) located on rear surface of main body (10) and providing prevention of blood flowing out or reduction during proceeding or stopping of lesion recovery apparatus (100) inside liver (200) portal vein (300) or any vessels.

Description

Lesion recovery apparatus

The Field of the Invention

Invention relates to a lesion recovery apparatus used for removing thrombus occurring in any vessel (artery or vein) and cleaning of thrombus by means of accessing difficult to access areas in vessel joints during transplantation of liver, kidney or other organs in the field of medicine.

The invention particularly relates to a lesion recovery apparatus designed specifically for patient based on clinic view and used directly in open operations and capable to access areas difficult to access in vein or artery joints and incising and cleaning thrombus.

Background of the Invention

Thrombus layers develop inside vein by time and due to various diseases and said thrombus layers cause reduction in vein lumen diameter. This prevents blood flowing and restricts organ perfusions. This case causes bigger problems in organ transplantations. For that reason, cleaning such obstructing layers is important. Thrombus layers are connected to surface in general and need to be incised from vein for removal. In addition, such narrowing cases continue up to far points inaccessible manually by surgeon in most cases.

In particular, primary treatment of chronic liver failure is liver transplantation. A successful liver transplantation needs assurance of adequate blood flowing in all veins providing blood in liver. Main vein feeding liver is portal vein. About 10-15% of patients planned to have liver transplantation because of chronic liver failure have portal vein thrombus of various level. Some of those thrombi can be easily cleaned during operation while some are advanced thrombi and can not be cleaned and patients lose their chance for liver transplantation.

Lesions occurring inside vein are cleaned by means of instruments such as dissection tweezers used during operation in the related art. However, in the related art it is not likely to reach the required distance in the vein by devices and in general part of the lesion remains therein.

During search of literature, document numbered CN109998634 is encountered as an example. Said document relates to a system providing removal of foreign agents such as thrombus, Thrombus parts, blood clots, blood lipid plaques and atherosclerotic agents in veins. Said system basically comprises thrombus removal device and operating part. Thrombus removal device and operating arm are connected by means of rear catheter.

Another example from the related art is the document numbered JP2019519342. Said document relates to a mechanic thrombectomy apparatus comprising a rolling distal inversion tube configured to hold and remove a thrombus material and inverted on distal end. Said apparatus comprises a mechanic thrombus dismantler to remove thrombus from blood vein, a catheter having flexible, proximal, distal and distal tip openings and a flexible tube.

Another example from the related art is the document numbered US2013018410. Said document relates to a thrombus removing device. Said thrombus removing device comprises a shaft having distal tip and a proximal tip, a casing having a distal tip and a proximal tip, and a winding bobbin combined at an end near distal end of shaft and placed into a lumen.

Another example from the related art is the document numbered CN210228259. Said document relates to a device capable to facilitate holding and removing thrombus in blood veins (stones or foreign objects in gall or urinary paths). In said device thrombus caught by use of soft bobbin by help of wire or strip to go into surface of a thrombus.

Another example from the related art is the document numbered EP2515991. Said document relates to a device for removing a thrombus (clot) from vascular structure of a live subject. Said thrombus removal device comprises primary and secondary ring shape parts. Primary ring shaped part slides on a guide wire placed on a vascular structure. Particularly, said apparatuses fail to be solution for easy to use and efficiency in respect to incising the thrombus and removal from vein by surgeon during open vein or organ transplantation operations.

As a result, because of the existence of the said problems mentioned above and inadequacy of solutions, it has been necessary to make a development in the related art.

Purpose of the Invention

This present invention relates to a lesion recovery apparatus eliminating above mentioned disadvantages and providing new advantages in the related art.

Primary purpose of the invention is to present a lesion recovery apparatus designed specifically for patient specific based on clinical images and used directly in open operations and capable to access areas difficult to access in vessel joints and incising and cleaning thrombus.

Another purpose of the invention is to provide a lesion recovery apparatus designed based on clinical images specific to patient and fast manufacture before operation for surgeries.

A further purpose of the invention is to provide a lesion recovery apparatus of convenient for mass production, low cost, light and high resistance by production in standard sizes too in addition to patient specific manufacture.

Another purpose of the invention is to increase operation chances of patients by providing cleaning of advanced level thrombus which can not be cleaned manually during operation by surgeon.

Another purpose of the invention is to remove limited thrombus from vein walls inside portal vein, superior mesenteric vein and splenic vein in pancreas posterior inaccessible by conventional thrombus cleaning methods and thus cleaning thereof.

In order to achieve all of the purposes described above and elicited from the detailed description, the invention is a lesion recovery apparatus providing removal of thrombus occurring in any vessels (artery or vein) or liver portal vein in field of medicine and comprising a main body in ring form incising thrombus from liver portal vein or any vein surface and collecting them by entering into any veins (artery or vein) or liver,

- an arm connected to main body and providing manual holding of lesion recovery apparatus and pushing of it into liver portal vein or any veins, directing and pulling back of it.

The structural and characteristic features and all advantages of the invention will be understood better in the figures given below and the detailed description by reference to the figures. Therefore, the assessment should be made based on the figures and taking into account the detailed descriptions.

Brief Description of the Drawings

Figure 1a is a perspective view of the lesion recovery apparatus of the invention in a disassembled position.

Figure 1 b is a perspective view of an alternative embodiment of the lesion recovery apparatus of the invention in a disassembled position.

Figure 2a is a side view of the lesion recovery apparatus of the invention in a disassembled position.

Figure 2b: is a side view of an alternative embodiment of lesion recovery apparatus of the invention in a demounted position.

Figure 3: is another perspective view of the lesion recovery apparatus of the invention in a demounted position.

Figure 4: is a perspective view of the lesion recovery apparatus of the invention.

Figure 5: is a side view of an alternative embodiment of the lesion recovery apparatus of the invention

Figure 6: is a detailed side view of an alternative embodiment of the lesion recovery apparatus of the invention in a demounted position.

Figure 7: is a side view of anther embodiment of the lesion recovery apparatus of the invention

Figure 8: is an illustrative view of the lesion recovery apparatus of the invention inside liver portal vein.

Figure 9: is an illustrative perspective view of the lesion recovery apparatus of the invention. Description of Part References

10. Main body

11. Inlet mouth

20a. Diastole membrane

21a. Diastole membrane foliar (Diastole membrane leaflet)

20b. Systole membrane

21 b. Systole membrane foliar (Systole membrane leaflet)

30. Arm

100. Lesion recovery apparatus

200. Liver

300. Portal vein

400. Thrombus

500. Forceps

Detailed Description of the Invention

In this detailed description, the preferred alternatives of the lesion recovery apparatus (100) being subject of this invention have been disclosed solely for the purpose of better understanding of the subject and described in a manner not causing any restrictive effect.

Figures 1 a and 1 b show demounted views of lesion recovery apparatus (100) of the invention. Accordingly, lesion recovery apparatus (100) in its basic form comprises a main body (10) incising thrombus (400) from liver (200) portal vein (300) or any vein surface by entering into any veins (artery or vein) or liver (200) portal vein (300) and collecting them by entering into any veins (artery or vein) or liver, diastole membrane (20a) provided on rear surface of main body (10) and preventing or reducing flow of blood outside during proceeding of lesion recovery apparatus (100) into liver (200) portal vein (300) or any veins or stopping therein and similar to closed position form of cardiac valves (diastole) or systole membrane (20b) similar to open position of cardiac valves, an arm (30) connected to main body (10) and providing manual holding of lesion recovery apparatus (100) and pushing of it into liver (200) portal vein (300) or any veins, directing and pulling back of it. Main body (10) shown in figures 2a and 2b is in ring form and made from solid material. Main body (10) can be produced specific to person or in standard size according to patient’s liver (200) portal vein (300) or any vessel size. Main body (10) goes into any vessels (artery or vein) or liver (200) portal vein (300) and provides incising thrombus (400) from liver (200) portal vein (300) or any vessel surface and collection thereof. Due to the manufacture of the main body (10) from hard material, its structural strength is preserved during incision, collection of thrombus (400) and traverse (proceeding). Inlet mouth (11 ) at front end of main body (10) is shaped in an inclined form and the main body (10) can easily go into any vessel (artery or vein) or liver (200) portal vein (300) and the forward motion (proceeding) is provided.

Diastole membrane (20a) similar to closed position form of cardiac valve or systole membrane (20b) similar to open position form of cardiac valves are placed onto rear surface of main body (10).

Diastole membrane (20a) shown in figures 3 and 4 is in a structure similar to the closed position form (diastole) of cardiac valves and contains diastole membrane foliars (leaflets) (21 a) capable to open and close in a flexible structure. Said diastole membrane (20a) is located on the rear surface of main body (10) and provides prevention of blood flowing out or reduction during proceeding or stopping of lesion recovery apparatus (100) inside liver (200) portal vein (300) or any vessels. Diastole membrane foliar (leaflet) (21 a) on diastole membrane (20a) surface is opened by means of preferably forceps (500) to provide cleaning of thrombus (400) inside main body (10) and closes during taking thrombus (400) and thus grasps thrombus (400) and prevents its going into main body (10). Also diastole membrane foliar (21 a) prevents pushing of thrombus (400) into liver (200) portal vein (300) or any vessel while thrombus (400) is pulled from the main body by forceps (500) and while pushing lesion recovery apparatus (100) into vessel. Said forceps (500) are operation tweezers or tongs.

In an alternative embodiment of the invention, systole membrane (20b) can be used instead of diastole membrane (20a) as shown in figures 5 and 6. Systole membrane (20b) is of structure similar to open position of cardiac valves (systole) and contain systole membrane foliar (21 b) capable to open and close in a flexible structure. Said systole membrane (20b) is located on rear surface of main body (10) and provides prevention of blood flowing out or reduction during proceeding or stopping of lesion recovery apparatus (100) inside liver (200) portal vein (300) or any vessel. Systole membrane foliar (21 b) on systole membrane (20b) surface is opened by means of preferably forceps (500) to provide cleaning of thrombus (400) inside main body (10) and closes during taking thrombus (400) and thus grasps thrombus (400) and prevents its going into main body (10). Also systole membrane foliar (21 b) prevents pushing of thrombus (400) into liver (200) portal vein (300) or any vessel while thrombus (400) is pulled from main body by forceps (500) and while pushing lesion recovery apparatus (100) into vein.

Diastole membrane (20a) and systole membrane (20b) can be produced specific to person or in standard size according to patient’s liver (200) portal vein (300) or any vessel size.

Arm (30) connected to main body provides manually holding lesion recovery apparatus (100) and pushing of it into liver (200) portal vein (200) or any vessel, directing and pulling back thereof. Arm (30) can be produced specific to person or in standard size according to patient’s liver (200) portal vein (300) or any vessel size. Arm (30) is of a curved structure and thickness of end of the arm (30) connected to main body (10) equals to thickness of main body (10). Thus, stress densities are reduced and also the blockage of thrombus (400) is prevented. Rear end of arm (30) is at the same axis as central axis of main body (10). With its curved structure, the arm (30) is durable and at the same time, ergonomics for holding and advancing are provided.

In an alternative embodiment of the invention as shown in figure 7 main body (10) and arm (30) can be produced in uniform structure (in one piece) specific to person or in standard size according to patient’s liver (200) portal vein (300) or any vessel size. In such case said arm (30) is of flat structure longitudinally. On main body (10) diastole membrane (20a) or systole membrane (20b) are not used.

Figure 8 shows view of lesion recovery apparatus (100) of invention inside liver (200) portal vein (300). Lesion recovery apparatus (100) of the invention goes into any veins (artery or vein) or liver (200) portal vein (300) and provides incising thrombus (400) from liver (200) portal vein (300) or any vessel surface and collection thereof as shown in figure 9.

Claims

8 CLAIMS

1. A lesion recovery apparatus (100) providing removal of thrombus (400) occurring in any vessels (artery or vein) or liver (200) portal vein (300) in field of medicine characterized by comprising; main body (10) in ring form going into any vessels (artery or vein) or liver (200) portal vein (300) and provides incising thrombus (400) from liver (200) portal vein (300) or any vessel surface and collection thereof,

- arm (30) connected to main body (10) and providing manually holding lesion recovery apparatus (100) and pushing of it into liver (200) portal vein (300) or any veins, directing and pulling back thereof.

2. The lesion recovery apparatus (100) according to claim 1 characterized by comprising diastole membrane (20a) located on rear surface of said main body (10) and preventing blood flowing out or reducing during lesion recovery apparatus (100) proceeding into liver (200) portal vein (300) or any vessel or stopping and similar to closed position form (diastole) of cardiac valves.

3. The lesion recovery apparatus (100) according to claim 2 characterized by comprising diastole membrane foliar (21 a) in flexible structure on diastole membrane (20a) surface capable of opening to provide cleaning of thrombus (400) inside main body (10) and closing during taking thrombus (400) and thus grasping thrombus (400) and preventing its going into main body (10).

4. The lesion recovery apparatus (100) according to claim 1 characterized by comprising systole membrane (20b) located on rear surface of said main body (10) and preventing blood flowing out or reducing during lesion recovery apparatus (100) proceeding into liver (200) portal vein (300) or any vein or stopping and similar to open position form (systole) of cardiac valves.

5. The lesion recovery apparatus (100) according to claim 4 characterized by comprising systole membrane foliar (21 b) in flexible structure on systole membrane (20b) surface capable of opening to provide cleaning of thrombus (400) inside main body (10) and closing during taking thrombus (400) and thus grasping thrombus (400) and preventing its going into main body (10). 9 The lesion recovery apparatus (100) according to claim 1 characterized by comprising an inlet mouth (11 ) in sloped (sharped) structure located on front end of said main body (10) and providing main body (10) going into any vessel (artery or vein) or liver (200) portal vein (300) and proceeding therein. The lesion recovery apparatus (100) according to claim 1 characterized by said arm (70) being in flat structure longitudinally or curved structure in a manner the rear end being on same axis as main body (10) central axis.