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WO2008112865A1 - Dispositif pour empêcher le détachement des membranes fœtales - Google Patents

Dispositif pour empêcher le détachement des membranes fœtales Download PDF

Info

Publication number
WO2008112865A1
WO2008112865A1 PCT/US2008/056809 US2008056809W WO2008112865A1 WO 2008112865 A1 WO2008112865 A1 WO 2008112865A1 US 2008056809 W US2008056809 W US 2008056809W WO 2008112865 A1 WO2008112865 A1 WO 2008112865A1
Authority
WO
WIPO (PCT)
Prior art keywords
disc
delivery
vsd
lumen
leading
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/US2008/056809
Other languages
English (en)
Inventor
Ruben A. Quintero
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
University of South Florida
University of South Florida St Petersburg
Original Assignee
University of South Florida
University of South Florida St Petersburg
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 University of South Florida, University of South Florida St Petersburg filed Critical University of South Florida
Publication of WO2008112865A1 publication Critical patent/WO2008112865A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00637—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for sealing trocar wounds through abdominal wall
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00646—Type of implements
    • A61B2017/00659—Type of implements located only on one side of the opening

Definitions

  • This invention relates to surgical tools. More particularly, it relates to a modified Amplatz delivery system having applications in fetal therapy.
  • Endoscopic fetal surgery requires that an opening be made in the myometrium, chorion, and amnion with a trocar. Detachment of the fetal membranes from the uterine wall can occur during such surgery. Accordingly, there is a need for a device that prevents fetal membrane detachment in patients undergoing endoscopic fetal surgery.
  • the novel VSD-fetal membrane attachment device for preventing fetal membrane detachment in patients undergoing endoscopic fetal surgery includes a delivery plunger, a trocar sheath, a delivery sheath, and a VSD device that is deployed from the delivery sheath by retracting the delivery sheath while maintaining the delivery plunger against movement. More particularly, the novel VSD-fetal membrane attachment device includes a delivery plunger, a trocar sheath having a lumen, a delivery sheath having a lumen and said delivery sheath ensleeved within a lumen of the trocar, and a VSD device ensleeved within the lumen of the delivery sheath
  • the VSD device has a waist, a leading disc at a first end of the waist and a trailing disc at a second end of the waist.
  • the leading disc and the trailing disc are radially contracted when the VSD device is ensleeved within the lumen of the delivery sheath.
  • the leading disc and the trailing disc are radially expanded under an inherent bias when the VSD device is expelled from the lumen of the delivery sheath.
  • the leading disc is adapted to overlie an amnion when the leading disc is radially expanded.
  • the trailing disc is adapted to overlie a myometrium when the trailing disc is radially expanded.
  • the device prevents fetal membrane detachment in patients undergoing endoscopic fetal surgery. Moreover, the device facilitates use of multiple ports, larger ports, or multiple, larger ports thereby allowing performance of more complicated endoscopic fetal procedures.
  • the VSD device is expelled from the lumen of the delivery sheath when the delivery plunger is held against movement and the delivery sheath is retracted in a proximal-to-distal direction.
  • the delivery plunger has an externally-threaded leading end.
  • the trailing disc has an internally threaded aperture that is engaged by the delivery plunger leading end. The delivery plunger leading end is disengaged from the trailing disc after the trailing disc is radially expanded.
  • a valve closes the internally threaded aperture when the delivery plunger leading end is disengaged from the internally threaded aperture.
  • Fig. 1 is a perspective view of a novel VSD-fetal membrane attachment device prior to deployment of the VSD device
  • Fig. 2 is a perspective view of the apparatus depicted in Fig. 1 when the VSD device is partially deployed;
  • Fig. 3 is a perspective view of the apparatus depicted in Fig. 3 when the VSD device is fully deployed;
  • a novel VSD-fetal membrane attachment device is denoted as a whole by the reference numeral 10.
  • Device 10 prevents fetal membrane detachment in patients undergoing endoscopic fetal surgery. Use of this device facilitates the use of multiple ports, larger ports, or multiple, larger ports thereby allowing performance of more complicated endoscopic fetal procedures.
  • Device 10 includes delivery plunger 12, trocar sheath 14, delivery sheath 16, and VSD device 18.
  • Amnion 20 is a thin membrane forming a closed sac containing amniotic fluid about the fetus.
  • Chorion 22 is an outer embryonic membrane associated with the formation of the placenta.
  • Myometrium 24 is the smooth muscular wall of the uterus.
  • VSD device 18 is partially deployed in Fig. 2 and fully deployed in Fig. 3.
  • Leading disc 18b and waist 18c are visible in Fig. 2 and trailing disc 18a is visible in Fig. 3.
  • the leading and trailing discs are radially contracted when housed within the lumen of the delivery sheath and said discs are radially expanded when expelled from said lumen.
  • Delivery plunger 12 performs the function of pushing VSD device 18 from the lumen of delivery sheath 16. More particularly, the delivery sheath is retracted while plunger 12 is held in place. The discs 18a, 18b of VSD device 18 deploy under their inherent bias upon exiting said delivery sheath lumen.
  • Delivery plunger 12 is retracted after full deployment of the VSD device by a rotational motion 12a as indicated in Fig. 3. More particularly, the leading end of delivery plunger 12 is externally threaded and trailing disc 18a has a central aperture that is internally threaded for screwthreaded engagement with the leading end of the delivery plunger. This screwthreaded engagement ensures that the delivery plunger and VSD device 18 will remain connected to one another until the VSD device is fully deployed. After trailing disc 18a is radially expanded, the physician unscrews the delivery plunger from the internally threaded central aperture. A valve then closes the internally threaded central aperture.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Gynecology & Obstetrics (AREA)
  • Pregnancy & Childbirth (AREA)
  • Reproductive Health (AREA)
  • Cardiology (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif d'attache de membrane VSD-fœtale pour empêcher le détachement de membranes fœtales chez des patients subissant une chirurgie fœtale endoscopique comprenant un plongeur d'administration, une gaine de trocart, une gaine d'administration et un dispositif VSD déployé à partir de la gaine d'administration en rétractant la gaine d'administration tout en maintenant le plongeur d'administration en place. Le VSD a des disques radialement contractés lorsqu'il est logé dans la lumière de la gaine d'administration qui se dilatent radialement sous leur sollicitation inhérente lorsque le VSD est déployé depuis la lumière de la gaine d'administration. Un disque d'attaque recouvre l'amnios et un disque de fuite recouvre le myomètre.
PCT/US2008/056809 2007-03-13 2008-03-13 Dispositif pour empêcher le détachement des membranes fœtales Ceased WO2008112865A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US89455107P 2007-03-13 2007-03-13
US60/894,551 2007-03-13

Publications (1)

Publication Number Publication Date
WO2008112865A1 true WO2008112865A1 (fr) 2008-09-18

Family

ID=39760030

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2008/056809 Ceased WO2008112865A1 (fr) 2007-03-13 2008-03-13 Dispositif pour empêcher le détachement des membranes fœtales

Country Status (1)

Country Link
WO (1) WO2008112865A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011063094A3 (fr) * 2009-11-18 2011-10-06 University Of Miami Dérivation foetale
US20160287228A1 (en) * 2015-03-31 2016-10-06 Ruben Quintero Amnio opening occlusion device

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030073979A1 (en) * 2001-10-15 2003-04-17 Wendy Naimark Medical device for delivering patches

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030073979A1 (en) * 2001-10-15 2003-04-17 Wendy Naimark Medical device for delivering patches

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
DEPREST ET AL.: "Fetoscopic surgery: Encouraged by clinical experience and boosted by instrument innovation", SEMINARS IN FETAL & NEONATAL MEDICINE, vol. 11, 2006, pages 398 - 412, XP005725959 *

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011063094A3 (fr) * 2009-11-18 2011-10-06 University Of Miami Dérivation foetale
US8734379B2 (en) 2009-11-18 2014-05-27 Ruben A. Quintero Fetal shunt
US20160287228A1 (en) * 2015-03-31 2016-10-06 Ruben Quintero Amnio opening occlusion device

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