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WO2012007047A1 - Dispositif et procédé destinés à détourner la bile de la vésicule biliaire dans l'intestin - Google Patents

Dispositif et procédé destinés à détourner la bile de la vésicule biliaire dans l'intestin Download PDF

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Publication number
WO2012007047A1
WO2012007047A1 PCT/EP2010/060275 EP2010060275W WO2012007047A1 WO 2012007047 A1 WO2012007047 A1 WO 2012007047A1 EP 2010060275 W EP2010060275 W EP 2010060275W WO 2012007047 A1 WO2012007047 A1 WO 2012007047A1
Authority
WO
WIPO (PCT)
Prior art keywords
bile
gallbladder
intestine
valve
lumen
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/EP2010/060275
Other languages
English (en)
Inventor
Michael J. Stokes
Michele D'arcangelo
Alessandro Pastorelli
Christopher J. Hess
Mark S. Zeiner
Mark Steven Ortiz
Manoel Galvao Neto
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.)
Ethicon Endo Surgery Inc
Original Assignee
Ethicon Endo Surgery Inc
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 Ethicon Endo Surgery Inc filed Critical Ethicon Endo Surgery Inc
Priority to PCT/EP2010/060275 priority Critical patent/WO2012007047A1/fr
Priority to CN201080068039.7A priority patent/CN103118607B/zh
Publication of WO2012007047A1 publication Critical patent/WO2012007047A1/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
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/0003—Apparatus for the treatment of obesity; Anti-eating devices
    • A61F5/0013—Implantable devices or invasive measures
    • A61F5/0076—Implantable devices or invasive measures preventing normal digestion, e.g. Bariatric or gastric sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002—Implant devices for drainage of body fluids from one part of the body to another
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0649—Coils or spirals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B2017/1139—Side-to-side connections, e.g. shunt or X-connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/22—Valves or arrangement of valves
    • A61M39/24—Check- or non-return valves

Definitions

  • the present invention relates, in general, to devices and methods for surgically influencing the digestion of a patient with the aim to treat metabolic disorders, such as morbid obesity and related co-morbidities, such as diabetes, heart disease, stroke and pulmonary disease. Numerous non-operative therapies for morbid obesity have been tried in the past with virtually no permanent success.
  • An aim of the present invention is therefore to provide a minimally invasive device and method to alter the entero-hepatic bile cycling by one-directional directing bile from the gallbladder in a section of the small intestine, preferably significantly distally from the papilla of Vater.
  • This aim is achieved by a method of diverting bile from a gallbladder to a portion of an intestine, the method comprising the steps of:
  • a desired portion of intestine which may be distal to the papilla of Vater, e.g. a distal duodenum portion, a jejunum portion or an ileum portion, while obviating the risk of chime backflow in the gallbladder.
  • the method comprises the steps of:
  • the method comprises the steps of:
  • the portion of biliary tree can be the gallbladder or a section of the bile duct.
  • the aim of the invention is further achieved by a device for diverting bile from a gallbladder to a portion of an intestine, the device having:
  • a proximal portion adapted to be attached to a first lumen of the biliary tree
  • a bile conduit portion connected with at least one of the proximal and distal portions and adapted to define a flow path between the first and second lumen, - a one-way valve arranged in the flow path of the bile conduit portion and adapted to prevent a flow from the second lumen to the first lumen.
  • the device comprises an anastomosis device adapted to directly attach a gallbladder to a portion of small intestine, wherein the anastomosis device defines a flow path between the gall bladder and the portion of small intestine and a one-way valve is arranged in the flow path and adapted to prevent flow from the intestine in the gall bladder.
  • FIG. 1 illustrates a method and device for diverting bile from a gallbladder to a portion of an intestine in accordance with an embodiment of the invention
  • FIG. 2 illustrates a detail of a device for diverting bile from a gallbladder to a portion of an intestine in accordance with an embodiment of the invention
  • FIG. 3A and 3B illustrate a method and device for diverting bile from a gallbladder to a portion of an intestine in accordance with a further embodiment
  • FIG. 4A and 4B illustrate components of a device for diverting bile from a gallbladder to a portion of an intestine in accordance with a further embodiment
  • FIGS. 4C to 4F show single method steps for diverting bile from a gallbladder to a portion of an intestine, using the device in figure 4A and 4B;
  • FIGS. 5A and 5B are two side views of a unidirectional valve in accordance with an embodiment of the invention.
  • FIG. 6 is a perspective view of an anastomosis device with a unidirectional valve in accordance with an embodiment of the invention
  • FIGS. 7A and 7B are longitudinal cross-sectional views of an anastomosis device with an unidirectional valve in an open and closed configu ration in accordance with an embodiment of the invention
  • FIG. 9A is a perspective view of an anastomosis device with an integrated unidirectional valve in accordance with a further embodiment of the invention
  • - Figure 9B is a radial cross-sectional view of the anastomosis device in figure 9A;
  • FIG. 10 illustrates a method and device for diverting bile from a gallbladder to a portion of an intestine in accordance with a further embodiment involving a one-way valve arranged at a distal end of a bile conduit catheter inside the intestine;
  • FIG. 1 1 illustrates a method and device for diverting bile from a gallbladder to a portion of an intestine in accordance with a further embodiment involving a one-way valve arranged in an intermediate tract of a bile conduit catheter outside the gallbladder and outside the intestine;
  • FIG. 12 illustrates a method and device for diverting bile from a gallbladder to a portion of an intestine in accordance with a further embodiment
  • FIG. 13A and 13B illustrate a method and device for diverting bile from a gallbladder to a portion of an intestine in accordance with a yet further embodiment.
  • figure 1 is a partial view of the abdominal cavity of a patient, depicting the gastrointestinal tract with the esophagus 1 , stomach 2, duodenum 3, jejunum 4, ileum 5, colon 6, as well as the hepatic-biliary system with the liver, the bile duct 7 with gall bladder 8, the pancreatic duct 9 and the mayor duodenal papilla of Vater 10 through which the bile and pancreatic fluid normally enter the duodenum 3.
  • Figure 1 shows further a device 1 1 for directing bile from the gallbladder in the intestine, bypassing the papilla of Vater 10.
  • the device 1 1 comprises a first portion 12 adapted to be attached to a first lumen 13 of the biliary tree 7 and a second portion 14 adapted to be attached to a second lumen 15 of a portion of intestine 3, 4, 5, in which the expression "biliary tree” is intended to include the bile duct 7 and also the gallbladder 8.
  • the device 1 1 comprises further a bile conduit portion 16 connected with at least one of the first 12 and second portion 14 and adapted to define a flow path between the first lumen 13 and the second lumen 15, as well as a unidirectional valve 17 arranged in the flow path of the bile conduit portion 16 and adapted to prevent a flow from the second lumen 15 to the first lumen 13 or, in other words, to prevent a back flow of small bowel contents in the gallbladder 8.
  • the device 1 1 comprises an anastomosis device adapted to directly attach the gallbladder 8 to a portion of small intestine 3, 4 , 5, wherein the anastomosis device defines the flow path between the gall bladder 8 and the portion of small intestine and the one-way valve 17 is connected to the anastomosis device and adapted to prevent flow from the intestine 3, 4, 5 into the gall bladder 8.
  • the anastomosis device comprises a tissue clamping coil 18 formed from a shape memory alloy wire annealed in a coil shape and subsequently longitudinally straightened in a stressed shape, the clamping coil 18 having a proximal pointed tip 19 adapted to pierce through a lumen wall and the clamping coil 18 being configured to regain its original tightly coiled shape upon exposure to the body temperature, thereby clamping the first 13 and second tissue portion 15 between adjacent spires.
  • the clamping coil 18 may be annealed in a flattened coil shape, in a tapered coil shape or in a cylindrical coil shape and subsequently forcedly straightened, e.g. rectilinear shape or in an elongated coiled shape having a distance between adjacent spires.
  • the shape memory alloy of the clamping coil 18 may comprise a NiTi alloy, such as for example Nitinol.
  • the clamping coil 1 8 may be deployed using an endoluminal or laparoscopic anastomosis instrument 20 comprising an elongate member 21 with a distally open recess 22 configured to receive the clamping coil 18 in its stressed shape, as well as a proximally (doctor's side) actuatable dispensing member slidingly received in the elongate member 21 and coupled to the recess 22 to distally dispense the clamping coil 18.
  • the instrument 20 may further comprise a grasper 23 with two opposing grasping jaws.
  • the grasper 23 is movable distally from the elongate member 21 distal end and can be actuated by a grasper control mechanism (not illustrated) coupled to the grasping jaws through the elongate member 21 to effect opening and closing thereof.
  • a grasper control mechanism (not illustrated) coupled to the grasping jaws through the elongate member 21 to effect opening and closing thereof.
  • D u ri n g i m pl antation of th e d evice 1 1 , th e a n astomos is i n stru m ent 20 ca n be laparoscopically inserted through a trocar proximal (with respect to the surgeon) to the second lumen 15 of the intestine.
  • a trocar proximal with respect to the surgeon
  • an enter ostomy may be formed in the jejunum 4 distal to the desired target location for the anastomosis with the gallbladder 8 and the instrument 20 is inserted through the ostomy in the jejunum 4 and advanced retrograde up the jejunum.
  • the grasper 23 jaws are closed to form a piercing tip and the grasper 23 is distally advanced through the tissue wall of the second lumen 15 (jejunal wall). Then the grasper 23 jaws are opened to grasp the tissue wall of the first lumen 13 of the gall bladder 8. The grasper 23 is then drawn proximally to approximate and juxtapose the lumen walls 13, 15 and the clamping coil 18 is distally dispensed through the walls of the approximated lumens. Then the clamping coil 18 relaxes into its coiled shape with at least one spire (first portion 12) on the distal side of the first lumen 13 and another spire (second portion 14) on the proximal side of the second lumen 80.
  • the fully relaxed clamping coil 18 then forms the anastomosis attachment, so that healing will occur between the two lumen walls.
  • the lumen walls are then cut through in the center opening of the annular clamping coil 18 to create patency.
  • the unidirectional valve 17 is inserted laparoscopically or endolumenally to the anastomosis site and attached to the clamping coil 18, e.g. inserted in the center opening of the coil 18 and connected thereto by snap fit, press-fit or shape connection.
  • the anastomosis device may comprise a woven tube 24 of wire constructed from a shape memory alloy, e.g. a TiNi alloy, having outer loops or ends adapted to thermally deform and evert when inserted into the walls of adjacent first 13 and second lumen 15 at the anastomotic site.
  • a shape memory alloy e.g. a TiNi alloy
  • the ends of the tube 24 form petals in a manner which clamps the first 13 and second lumen 15 in apposition.
  • the woven tube 24 can be endoluminally or laparoscopically deployed by means of an elongate applicator (not illustrated) which comprises a canula with a distal end designed to allow the woven tube 24 to be slipped over the canula and pulled longitudinally causing the woven tube 24 to become longer and smaller in diameter.
  • an elongate applicator not illustrated
  • a canula with a distal end designed to allow the woven tube 24 to be slipped over the canula and pulled longitudinally causing the woven tube 24 to become longer and smaller in diameter.
  • the applicator further comprises an outer sleeve adapted to be pushed over the woven tube 24 to provide a smooth surface for inserting the applicator through the walls of the approximated second (intestinal) lumen 15 and first (gallbladder) lumen 13, and to be retracted from the woven tube 24 to expose the latter, so that heat from the body causes the tube 24 to contract longitudinally and evert to clamp the lumen walls and produce the anastomosis.
  • the anastomosis between the gallbladder 8 and the selected portion of intestine 3,4,5 may be accomplished by mounting the woven tube 24 on the applicator, covering the woven tube 24 by a retractable sheath, inserting the applicator intraluminally, e.g. transorally, into the intestine to the anastomotic site, approximating the gallbladder 8 into close apposition to the intestine at the anastomotic site, piercing a wall of the intestinal lumen 15 and a wall of the gallbladder lumen 13, retracting the sheath and deploying the woven tube 24.
  • the unidirectional valve 17 is inserted laparoscopically or endolumenally to the anastomosis site and attached to the reverted tube 24, e.g. by snap fit, press-fit or shape connection.
  • the anastomosis device comprises two pressure rings 40, 41 connectable to each other in a clamping relationship, for example by snap fit, press fit, magnetic attraction or screw connection, and adapted to connect the first 13 and second lumen 15 in anastomosis.
  • the unidirectional valve 17 is formed on or connected with at least one of the first 40 and second pressure ring 41 .
  • the bile conduit portion 16 comprises an elongate flexible tube, such as a catheter, extending between the first portion 12 and the second portion 14 and having a length which is sufficient to fluid connect the first portion 12 and the second portion 14 without significantly approximating the second (intestinal) lumen 15 to the first (gallbladder) lumen 13.
  • This arrangement obviates the need to anastomose the selected portion of intestine directly to the gallbladder and allows both anatomical structures to remain in their natural anatomical position.
  • a single path catheter 25 is extended from inside the gallbladder 8 translumenally into the small intestine, e.g. the jejunum 4 or ileum 5, and the unidirectional valve 17 is attached to a distal end 26 of catheter 25 to prevent backflow of chime from the intestine towards the gallbladder 8.
  • the unidirectional valve 17 may be arranged in an intermediate tract 27 of the catheter 25, so that the valve 17 can be positioned outside the gallbladder 8 and outside the intestine 3, 4, 5. This makes it possible to use a unidirectional valve having greater dimensions without risking obstruction of the intestine or excessive reduction of the bile flow section inside the valve 25.
  • the conduit portion 16 can comprise a multi lumen tube (not illustrated) or a multiple path catheter 28 forming a closed loop ( Figure 12) with a first perforated tract 29 adapted to be placed inside the gallbladder 8 and a second perforated tract 30 adapted to be placed inside the intestine 3, 4, 5, and a first 31 and second bile flow tract 32 extending between the perforated tracts, so that bile can enter the catheter 28 through the first perforated tract 29 and flow either direction towards the second perforated tract 30 through which it can flow in the intestine.
  • a first unidirectional valves 1 7 can be arranged in the first bile flow tract 31 and a second unidirectional valve 17' can be arranged in the second bile flow tract 32.
  • the two parallel bile flow tracts 31 , 32 provide a fluid communication redundancy which assures the desired bile diversion also in case of clogging of one flow tract.
  • Figure 13A illustrates an exemplary embodiment in which the proximal catheter end is placed in the bile duct 7 rather than directly in the gallbladder 8.
  • the catheter 25 tip may be deployed translumenally by means of a needle introducer, as schematically shown in Figure 13B.
  • the unidirectional valve 17 may comprise a one-way check valve 34 comprising a valve housing 35 defining a flow section and a shutter 36, e.g. a ball shutter, biased by a spring element 37 in a closed position in which the flow section is sh ut and a flow prevented .
  • the shutter 36 is displaceable by a predetermined bile pressure on the gallbladder side of the valve 34 to an opening position in which the flow section is at least partially free to allow a flow through the valve.
  • a possible pressure increase on the intestinal side of valve 34 would push the shutter 36 even more in its closed position, preventing a backflow of chime from the intestine towards the gallbladder or biliary tree.
  • valve housing, shutter and spring element are fabricated of a biologically compatible material, such as titanium , stainless steel or polycarbide material , e.g. Poly(methyl methacrylate).
  • the valve 34 can be formed on or connectable to the previously described anastomosis devices or incorporated in or attached to the previously described flexible elongated catheters.
  • the unidirectional valve 17 may comprise a flexible tube 38 which defines internally a flow section and has a proximal open end 42 intended to be connected in fluid communication with the gallbladder 8 and a flattened distal open end 39 intended to be arranged in fluid communication with the intestine 3, 4, 5.
  • the flattened distal end 39 is elastically biased in a rolled up or folded configuration in which the flow section is shut and adapted to roll out or unfold, thereby opening the flow section, in response to a given fluid pressure acting on the proximal open end 42.
  • An increase of the pressure on the distal end 39 will cause the latter to flatten or fold even more, thereby holding the internal flow section shut and preventing a backflow of chime from the intestine 3, 4, 5 in the gallbladder 8.
  • the flexible tube 38 may comprise an elastic spring member incorporated in the tube wall or acting on the tube wall to bias the distal end 39 in the rolled up or folded configuration.
  • the flexi ble tu be 38 can be formed on or con nectable to the previously described anastomosis devices or incorporated in or attached to the previously described flexible elongated catheters.
  • the unidirectional valve 17 may comprise a tubular body 43 with an external surface 44.
  • the external surface 44 forms a peripheral annular cavity 45 adapted to receive an anastomosis device or a rim of an anastomotic lumen to connect the unidirectional valve 17 to the anastomosis between the gallbladder 8 and the intestine 3, 4, 5 or to the anastomosis ring device.
  • the tubular body 43 may be elastically deformable to allow radial deformation thereof during insertion into the anastomotic lumen and or into the anastomosis ring device and subsequent elastic radial expansion to accomplish a shape fit or interference fit between both components.
  • the unidirectional valve 17 may comprise a duckbill valve shutter 46, as illustrated in figures 4B, 5A and 5B.
  • the duckbill valve shutter can be manufactured from a synthetic elastomer and is shaped like the beak of a duck with a flattened end which elastically retains its flattened shape.
  • the flattened end opens to permit the bile to pass through the valve 17 in the intestine.
  • the flattened end returns to its flattened shape, thereby preventing backflow from the intestine into the gallbladder.
  • the duckbill valve shutter 46 can be formed on or connectable to the previously described anastomosis devices or incorporated in or attached to the previously described flexible elongated catheters.
  • the unidirectional valve 1 7 may comprise a valve body 47 defining a flow section and a flap 48 elastically biased in a closing position in which the flap 48 shuts the flow section and prevents a flow.
  • the flap 48 is displaceable by a predetermined bile pressure on the gallbladder side of the valve body 47 to an opening position in which the flow section is at least partially free to allow a flow through the valve.
  • a possible pressure increase on the intestinal side of valve body 47 would push the flap 48 even more in its closed position, preventing a backflow of chime from the intestine towards the gallbladder or biliary tree.
  • the unidirectional valve 17 comprises a valve body 49 forming a support grate 50 for a flexible diaphragm 51 and a flow section extending through the support grate 50.
  • the flexible diaphragm 51 is supported to rest elastically against the support grate 50 on a distal side (intestinal side) of the valve body 49 thereby shutting the flow section and preventing a flow through the valve body 49.
  • the diaphragm 51 is liftable from the support grate 50 by a predetermined bile pressure on a proximal (gallbladder) side of the valve body 49 to an opening position in which the flow section is at least partially free to allow a flow through the valve body.
  • a possible pressure increase on a second (intestinal) side of the valve body 49 pushes the diaphragm 51 against the support grate 50, preventing a backflow of chime from the intestine towards the gallbladder or biliary tree.
  • the support grate 50 has a conical, pyramide or generally tapered shape with a convex tapered end 52 facing the first side of the valve body 49 and a cavity 53 facing the second side of the valve body 49 and the diaphragm 51 is fixed in the cavity 53 and elastically deflectable towards the second side of the valve body 49.
  • the valve body 49 can be formed on or con nectable to the previously described anastomosis devices or incorporated in or attached to the previously described flexible elongated catheters.
  • Figures 8A and 8B illustrate a further embodiment, wherein the unidirectional valve 17 comprises a valve body 54 having a proximal plate 55 and a distal plate 56.
  • the proximal plate 55 forms a central shutter portion 57 and an external passage portion 58 with one or more passage openings arranged radially outside the shutter portion 57.
  • the distal plate 56 forms a central passage opening 59 and an external pressure portion 60 with a pressure area greater than the sectional area of the passage opening 59.
  • the proximal 55 and distal plate 56 are arranged and shaped in a manner that the central shutter portion 57 of the proximal plate 55 elastically engages the distal plate 56 and closes the central passage opening 59 from a proximal side of the valve body 54.
  • Figures 9A and 9B illustrate a yet further exemplary embodiment of the unidirectional valve, configured as a double sided flapper valve based on substantially the same concept described in connection with Figure 6.
  • the disclosed device and method for directing bile from the gallbladder in a portion of intestine obtain the aims of the invention.
  • the described device and method make it possible to aimedly alter the entero-hepatic bile cycling and contact space between bile and food and the small bowel, while preventing the risk of backflow of chime from the intestine to the gallbladder.
  • the described methods for directing bile from the gallbladder in the intestine may be performed at least partially transumbilically using a multiple port access device and procedural steps described and illustrated in US2010/0081883A1 , as well as at least partially transvaginal ⁇ using devices and procedures described and illustrated in US2010/0081864A1 .
  • the complete content of these cited publications is herein incorporated by reference.

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Abstract

La présente invention concerne un dispositif (11) destiné à détourner la bile d'une vésicule biliaire (8) vers une partie d'un intestin (3, 4, 5), comprenant une première partie (12) conçue pour être fixée à une première lumière (13) de l'arbre biliaire et de la vésicule biliaire (7, 8), une seconde partie (14) conçue pour être fixée à une seconde lumière (15) d'une partie de l'intestin (3, 4, 5), une partie de canal biliaire (16) connectée à la première (12) et/ou la seconde partie (14) et conçue pour définir une voie de circulation entre la première lumière (13) et la seconde lumière (15), une valve unidirectionnelle (17) disposée dans la voie de circulation de la partie de canal biliaire (16) et conçue pour empêcher une circulation de la seconde lumière (15) vers la première lumière (13).
PCT/EP2010/060275 2010-07-16 2010-07-16 Dispositif et procédé destinés à détourner la bile de la vésicule biliaire dans l'intestin Ceased WO2012007047A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/EP2010/060275 WO2012007047A1 (fr) 2010-07-16 2010-07-16 Dispositif et procédé destinés à détourner la bile de la vésicule biliaire dans l'intestin
CN201080068039.7A CN103118607B (zh) 2010-07-16 2010-07-16 将胆汁从胆囊引导至肠内的装置

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2010/060275 WO2012007047A1 (fr) 2010-07-16 2010-07-16 Dispositif et procédé destinés à détourner la bile de la vésicule biliaire dans l'intestin

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US20100304576A1 (en) * 2009-05-27 2010-12-02 Commissariat A L'energie Atomique Et Aux Energies Alternatives Chamber, device and method for annealing a semi-conductor material of ii-vi type
EP3005993A3 (fr) * 2014-10-10 2016-05-04 Rex Medical, L.P. Système et procédé de pontage gastrique
WO2018053477A1 (fr) * 2016-09-19 2018-03-22 Boston Scientific Scimed, Inc. Endoprothèse de drainage anastomotique
US10449075B2 (en) 2015-12-15 2019-10-22 Steven Sounyoung Yu Biliary diversion catheter
CN114587469A (zh) * 2016-07-25 2022-06-07 维兰德.K.沙马 磁性吻合装置和递送系统
KR20240047053A (ko) * 2022-10-04 2024-04-12 인제대학교 산학협력단 트렁크 타입 복수배액용 배액관 유닛
KR20240047032A (ko) * 2022-10-04 2024-04-12 인제대학교 산학협력단 덕빌 타입 복수배액용 배액관 유닛

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CN107648725A (zh) * 2017-10-08 2018-02-02 刘锦春 一种内置引流管
CN109589189B (zh) * 2018-11-30 2020-12-01 陕西省人民医院 一种oddis括约肌仿生装置
RU2746438C1 (ru) * 2019-12-25 2021-04-14 Федеральное государственное бюджетное образовательное учреждение высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации Способ наложения арефлюксного билиодигестивного анастомоза при доброкачественных заболеваниях внепеченочных протоков
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