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WO2018078589A1 - Dispositif d'anastomose par compression et mécanisme de positionnement et de raccordement de ce dernier - Google Patents

Dispositif d'anastomose par compression et mécanisme de positionnement et de raccordement de ce dernier Download PDF

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Publication number
WO2018078589A1
WO2018078589A1 PCT/IB2017/056702 IB2017056702W WO2018078589A1 WO 2018078589 A1 WO2018078589 A1 WO 2018078589A1 IB 2017056702 W IB2017056702 W IB 2017056702W WO 2018078589 A1 WO2018078589 A1 WO 2018078589A1
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WO
WIPO (PCT)
Prior art keywords
rod
coupling
male coupling
conical
female coupling
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/IB2017/056702
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English (en)
Spanish (es)
Inventor
Cristóbal Adolfo ABELLO MUNARRIZ
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Individual
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Individual
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Publication of WO2018078589A1 publication Critical patent/WO2018078589A1/fr
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound

Definitions

  • the present invention relates to devices for anastomosis of tubular ducts, and with mechanisms for inserting and connecting said devices.
  • the present invention relates to devices for anastomosis of tubular organs, such as, esophagus, stomach, and intestines.
  • the prior art discloses devices for anastomosis of hollow anatomical structures, such as intestines, stomach and esophagus, such as those disclosed in US 8,709,025 B2 and US 6,030,392.
  • US 8,709,025 B2 discloses a device for anastomosis of tubular organs, such as intestines, stomach, esophagus, etc., wherein the tubular organ to which the anastomosis is to be made has two ends separated by a gap.
  • the device comprises an inner ring and an outer ring, the outer ring is made of an elastic material; wherein each ring is sewn to a separate tubular organ end. The ends of each separate tubular organ are sewn to the outer surface of a ring.
  • the outer ring surrounds the tubular organ, then the outer ring and the end of the tubular organ to which it is sewn are turned so that the tubular organ is connected within the outer ring. Then, the outer ring and the inner ring, and the adventitia of the ends of the tubular organ attached to the rings are assembled.
  • the inner ring has an upper portion used for anastomosis, a middle section used for connection, and a low section used for insertion. The diameter of the middle section is smaller than the diameter of the lower section, and the upper section. He
  • the outer ring has holes in its periphery in which the suture is anchored by gluing a section of tubular organ.
  • the outer ring has a prominent ring towards the center.
  • the prominent ring is coupled with the middle section of the inner ring.
  • the lower section of the inner ring used for insertion includes beards that prevent the inner and outer rings from separating after they have been connected.
  • US 8,709,025 B2 requires an invasive operation to be installed, for example, in the case of an anastomosis of an esophagus, it is carried out around the esophagus in which the thyroid gland, the carotid artery, the vocal cords and the trachea, which must be manipulated to execute the anastomosis.
  • document US 2009/0012543 Al discloses a device for anastomosis of two parts of blood vessels, or for anastomosis of two parts of tubular organs.
  • the device includes a first attachable unit and a second attachable unit.
  • Each unit is connected to a part of the blood vessel, in addition, the attachable units are connected to each other.
  • Each attachable unit has a through hole that defines a longitudinal axis.
  • each unit has a receiving unit that grabs the blood vessel, the receiving unit includes a surface with sharp projections that penetrate the walls of the blood vessel without piercing it.
  • the attachable units are preferably manufactured in titanium or in another partially or completely resorbable material.
  • the first attachable unit is cylindrical, and has a rear section, and a front section of a diameter larger than the rear section. The surface with sharp projections is arranged on the inside of the rear section.
  • axial extensions are arranged in the first unit, for example, tabs.
  • the second unit is also cylindrical, and has at its front edge, guides in which the axial extensions of the first unit are inserted.
  • the device of US 2009/0012543 for anastomosis of tubular organs is installed by an invasive operation.
  • the walls of the tubular organ there is a risk that the walls will weaken and cause an injury to the organ.
  • the organ is a intestine
  • the lesion in the wall of the intestine can become an intestinal ischemia and later a peritonitis.
  • the state of the art discloses devices for anastomosis of tubular organs that need invasive operations, for example in the case of an esophageal anastomosis, where incisions are made in the neck and must make their way between important anatomical parts, such as the Thyroid gland, jugular artery, vocal cords, and trachea to make the anastomosis of the esophagus.
  • incisions are made in the neck and must make their way between important anatomical parts, such as the Thyroid gland, jugular artery, vocal cords, and trachea to make the anastomosis of the esophagus.
  • they need to be attached to the walls of the tubular organs by sutures or sharp projections that can weaken said walls.
  • the present invention corresponds to a device for compression anastomosis, and a mechanism for positioning and connecting the device.
  • the device comprises a female coupling with a through conical housing that communicates its distal end with its proximal end, where the smaller diameter of the through conical housing is located towards the proximal end; and a male coupling with a conical protuberance, which has its largest diameter at the distal end, and which includes a through hole that communicates its distal end with its proximal end.
  • the conical protuberance is operatively coupled to the through conical housing of the female coupling.
  • the mechanism comprises two malleable stems one with a distal end connected to the female coupling and the other with a proximal end connected to the male coupling of the device. Also, the mechanism can conform to the first rigid rod with a first radially arranged end, the first end is connected to the female coupling, and the second rigid rod with a first radially arranged end, the first end is connected to the male coupling.
  • the second rigid rod is connected to the first rigid rod by means of an axis that is located in the medial zone of each rod.
  • the mechanism and the device make it possible to make the anastomosis of an esophagus of a neonate by introducing one of the couplings with one of the malleable stems through the mouth of the neonate, and introducing the other coupling with the other stem through an incision made in the stomach of the neonate, thus, avoiding making invasive incisions in the neck and thorax.
  • FIG. 1 corresponds to a cross-section of a male coupling (4) and a female coupling (5) in one embodiment of a device for compression anastomosis.
  • FIG. 2 corresponds to a cross-section of a male coupling (4) and a female coupling (5) when they are already coupled in an embodiment of a device for compression anastomosis, forming areas of total ischemia (A), partial ischemia ( B) and non ischemia (C).
  • A total ischemia
  • B partial ischemia
  • C non ischemia
  • FIG. 3 corresponds to a detailed view of a procedure of anastomosis of the esophagus of a newborn, showing a modality of a device for compression anastomosis, and a mechanism for positioning and connecting the device.
  • FIG. 4 corresponds to a side view of an embodiment of the mechanism for positioning and connecting a compression anastomosis device having malleable stems.
  • FIG. 5 corresponds to an embodiment of the mechanism for positioning and connecting a compression anastomosis device where the stems of the mechanism for positioning and connecting a compression anastomosis device are arranged inside sleeves.
  • FIG. 6 corresponds to a modality of the mechanism for positioning and connecting a compression anastomosis device that has rigid stems.
  • the present invention corresponds to a device for compression anastomosis (hereinafter device), and a mechanism for positioning and connecting a device for compression anastomosis (hereinafter mechanism).
  • the device for compression anastomosis comprising:
  • proximal means a near point according to a reference.
  • distal means a remote point according to a reference.
  • a tubular organ eg esophagus, intestines, stomach, etc.
  • the head is taken as a reference, with the points closest to the head being proximal and the points away from the head being distal.
  • the device serves to make the compression anastomosis of a duct (1) which can be a tubular organ (e.g. esophagus, intestines, stomach, etc.), or a synthetic duct (e.g. hoses, ducts, etc.).
  • a duct which can be a tubular organ (e.g. esophagus, intestines, stomach, etc.), or a synthetic duct (e.g. hoses, ducts, etc.).
  • the conduit (1) has a proximal connection (2), a distal connection (3) and a wide gap that separates the proximal connection (2) and the distal connection (3).
  • a gap is an irregular breakage or opening between two objects.
  • the proximal connection (2) of the conduit (1) is connected to the distal end of the female coupling (5), and the proximal end of the male coupling (4) is connected to a distal connection (3) of the duct (1).
  • the proximal connection (2) is communicated with the distal connection (3) of the conduit (1), thus closing the wide gap that separates the proximal connection (2) and the distal connection (3).
  • the male coupling (4) consists of two parts along its longitudinal axis.
  • the first part (8) of the male coupling (4) consists of a cylindrical section located at the distal end of the male coupling (4)
  • the second part (9) of the male coupling (4) consists of a conical protuberance (7) that extends axially from the first part, between the medial and proximal region of the male coupling (4).
  • the male coupling (4) has as its only section a conical protuberance (7).
  • the first part (8) of the male coupling (4) the cylindrical section may have a length between 3mm and 10mm, between 3mm and 4mm, between 5mm and 6mm, between 7mm and 8mm, between 8mm and 9mm.
  • the second part (9) of the male coupling (4) the conical protuberance (7) can have a length between 3mm and 10mm, between 3mm and 4mm, between 5mm and 6mm, between 7mm and 8mm, between 8mm and 9mm.
  • the cone angle of the conical protrusion (7) of the male coupling (4) may be 5 or 30 °, between 5 ° and 10 °, between 10 ° and 15 °, between 15 ° and 20 °, between 20 ° and 25 °, between 25 ° and 30 °.
  • the external diameter of the male coupling (4) can be between 4mm and 30mm, between 4mm and 6mm, between 6mm and 8mm, between 8mm and 12mm, between 12mm and 15mm, between 15mm and 18mm, between 18mm and 20mm.
  • the conical protuberance (7) of the male coupling (4) has a stepped outer surface (10).
  • stepped form is a change of section on a surface.
  • a stepped shape may be a 90 ° section change; a section change with groove with chamfer-shaped edges; a spike-shaped section change; a change of section in circular form; a change of section in semicircular form and combinations of the previous ones.
  • a spike shape can be a triangular, or trapezoidal section with angles less than 90 °.
  • the stepped shape (10) of the conical protuberance (7) of the male coupling (4) when connected to the through conical housing (6) of the female coupling (5) forms a bolt coupling system and tube that uses an interference fit.
  • the bolt and tube coupling system uses friction between two parts without the use of an additional fixing element.
  • the stepped shape (10) favors the bolt and tube coupling system.
  • the steps of the stepped surface (10) are deformed plastically, and thus, strengthen the interference fit of the conical protuberance (7) and the conical through housing (6).
  • the stepped shape (10) of the conical protuberance (7) of the male coupling (4) has a spike shape.
  • the spike shape is the shape where more plastic deformation is achieved in the steps, which improves the coupling between the male coupling (4) and the female coupling (5)
  • the stepped form (10) of the conical protuberance (7) of the male coupling (4) has a step located at its proximal end.
  • the stepped form (10) of the conical protuberance (7) of the male coupling (4) has two steps.
  • the stepped shape (10) of the conical protuberance (7) of the male coupling (4) has between three and five steps.
  • ischemia pressure is the force necessary to obstruct blood flow through tissue.
  • the stepped shape (10) of the conical protuberance (7) of the male coupling (4) has a circular section change.
  • the stepped shape (10) of the conical protuberance (7) of the male coupling (4) has a semicircular section change.
  • the stepped shape (10) of the conical protuberance (7) of the male coupling (4) has a groove section change with chamfered edges.
  • the circular, semicircular and chamfered edges in the stepped form (10) have the purpose of facilitating the force that must be applied to couple the male coupling (4) and the female coupling (5).
  • the stepped form (10) of the conical protuberance (7) of the male coupling (4) has four steps.
  • One step has a semicircular section and the others have a triangular section.
  • the step with semicircular section is located at the proximal end of the male coupling (4).
  • the step with semicircular section in the proximal end allows to reduce the force necessary to couple the male coupling (4) to the female coupling (5).
  • the remaining three steps They will have a spike shape and will give more resistance so that the male coupling does not separate
  • the edges of the male coupling (4) and the female coupling (5) are rounded and / or chamfered.
  • Roundings and chamfers are used to reduce the risk of perforation or laceration to the tubular organ.
  • the female coupling (5) is cylindrical in shape.
  • the cylindrical shape makes it easier to insert and move the female coupling (5) into the duct (1).
  • the external diameter of the female coupling (5) can be between 5mm and 30mm, between 5mm and 8mm, between 8mm and 12mm, between 12mm and 15mm, between 15m and 18mm, between 18mm and 25mm, between 25mm and 30mm.
  • the female coupling (5) has a conical through housing (6).
  • the angle of taper of the conical housing of the female coupling (5) may be between 6 and 35 °, between 6 and 12 °, between 12 ° and 17 °, between 18 ° and 22 °, between 22 ° and 28 °, between 28 ° and 35 °.
  • the through conical housing (6) the female coupling (5) has a rough internal surface.
  • the through conical housing (6) the female coupling (5) has concentric grooves axially distributed on its inner surface.
  • the through conical housing (6) the female coupling (5) has concentric grooves axially distributed on its inner surface.
  • the conical protuberance (7) of the male coupling (4) has a smooth surface.
  • the shape of the internal surface with grooves of the conical through housing (6) of the female coupling (5), as well as the stepped shape (10) serve to improve the interference fit.
  • the conical angle of the conical protuberance (7) of the male coupling (4) is not the same, as the conic angle of the through conical housing (6) of the female coupling (5).
  • the difference in these conicity angles generates a contact pressure gradient between the male coupling (4) and the coupling female (5) over the duct (1).
  • the contact pressure gradient decreases in the distal direction of the duct (1).
  • the contact pressure gradient that occurs at the proximal end of the male coupling (4) and at the distal end of the Female coupling (5) generates in the duct tissue (1) a total ischemia (A).
  • Ischemia (C) is not generated in the distal region of the male coupling (4) and proximal of the female coupling (5).
  • the contact pressure is sufficient to achieve total ischemia (A).
  • Total ischemia (A) cuts off the blood flow to this area of the duct (1), which occurs after approximately eight hours, tissue necrosis.
  • the contact pressure is sufficient to achieve a partial ischemia (B).
  • partial ischemia (B) a process of scarring and tissue sealing is promoted, and therefore the union of the proximal connection (2) with the distal connection (3) of the duct (1).
  • the female coupling (5) and the male coupling (4) are made of a biocompatible material.
  • biocompatible material shall be understood as a material that complies with ISO-10993: "Biological Evaluation of Medical Devices”.
  • Some materials are: Polyaryl ether ketone (PAEK), polyether ether ketone (PEEK), high density polyethylene (HDPE), Ultra High Molecular Weight Polyethylene (UHMWPE), polymethylmethacrylate (PMMA), Polysulfones (PSU), Polyetherimide (PEI), polyphenylsulfone (PPSU) and polyphenylene sulfide (PPS, for its acronym in English) its acronym in English), Commercially Pure Titanium (ASTM F67), Titanium alloys ASTM B265 (standard specification of titanium and titanium in the form of a band, sheet and plate) and AISI 316L Stainless Steel, Acrylonitrile butadiene styrene (ABS) in English) medical grade, polycarbonate, polyamide, polyester, polyvinylchloride (PVC), absorbable materials such as polyprop
  • the male coupling (4) and the female coupling (5) are made of Acrylonitrile Butadiene Styrene (ABS), or an acrylic material.
  • ABS Acrylonitrile Butadiene Styrene
  • the male coupling (4) and the female coupling (5) can be manufactured by 3D printing, preferably high definition, or rapid prototyping.
  • the material of the male coupling (4) and the female coupling (5) is selected from PAEK, PEEK, Polysulfones (PSU), Polyetherimide (PEI). ), polyphenylsulfone (PPSU) and polyphenylene sulfide (PPS).
  • the male coupling (4) and the female coupling (5) can be manufactured by plastic injection, machining (eg milling, turning), die cutting, molding (e.g. broken molding) and combinations of the above
  • the female coupling (5) has a first magnet (11) located in its proximal region.
  • the male coupling (4) has a second magnet (12) located in its medial region.
  • the first magnet (11) and the second magnet (12) have opposite polarity, thus, the magnets generate a force that attracts the male coupling (4) to the female coupling (5).
  • the first magnet (11) of the female coupling (5) and the second magnet (12) of the male coupling (4) are in the form of a washer.
  • the male coupling (4) and the female coupling (5) are made of a magnetizable material.
  • the male coupling (4) and the female coupling (5) are magnetized with opposite polarities to generate attraction between them.
  • the male coupling (4) and the coupling Female (5) can be made of ferromagnetic stainless steel, magnetizable titanium, and magnetizable biocompatible materials.
  • the first magnet (11) of the male coupling (4) and the second magnet (12) of the female coupling (5) are selected from alnico, flexible, ceramic, super magnets, earth magnets rare, temporary magnets and natural magnets.
  • the male coupling (4) and the female coupling (5) have a heating means.
  • the heating medium increases the temperature of the male coupling (4) and the female coupling (5) when the proximal connection (2) and the distal connection (3) are found.
  • the heating of the male coupling (4) and the female coupling (5) melts the ends of the proximal connection (2) and the distal connection (3).
  • the melted ends of the proximal connection (2) and the distal connection (3) are joined by fusion.
  • fusion fusion will be understood when similar or different materials are heated so that a physical and / or chemical bond between said materials occurs.
  • the heating means may be an electrical resistor, inductors, graphite electrodes and a combination thereof.
  • an eyelet is located at the proximal end of the female coupling (5), a thread is connected to the eyelet.
  • the wire extends from the female coupling (5) to the proximal mouth of the duct (1).
  • the thread allows the female coupling (5) and the male coupling (4) to be recovered after the anastomosis of the duct, pulling the thread and removing both parts through the proximal mouth of the duct (1).
  • the first rod (14) pushes in the distal direction the female coupling (5) in the middle of the proximal connection (2)
  • the second rod (15) pushes in the proximal direction the male coupling (4) in the middle of the distal connection (3) thus connecting the male coupling (4) and the female coupling (5).
  • the first rod (14) and the second rod (15) are malleable.
  • the malleable stems serve to give better control of the male coupling (4) and female coupling (5) and are better molded to the tubular organs.
  • a malleable rod is a cylinder, wire or bar with a rigidity that allows it to be folded with the hands.
  • the conduit (1) is an esophagus, a bowel, colon, or stomach.
  • the proximal connection (2) belongs to a section of the conduit (1) comprised from the wide gap to the mouth of the proximal end.
  • the mouth of the proximal end of the canal (1) may be the mouth of a person.
  • the distal connection (3) belongs to a section of the duct (1) comprised from the wide gap to the incision of the distal end.
  • the mouth of the distal end may be an incision in the stomach of the person.
  • the first rod (14) is connected to the female coupling (5) at the distal end of the first rod (14).
  • the second rod (15) is connected to the male coupling (4) at the proximal end of the second rod (15).
  • the first rod (14) pushes the female coupling (5) through the duct (1), from the duct mouth (1) to the proximal connection (2) where the gap is located.
  • the second rod (15) pushes the male coupling (4) through the duct (1), from the incision in the stomach to the distal connection (3), where the gap is located.
  • the first rod (14) and the second rod (15) exert a force that plastically deforms the conical protuberance (7) of the male coupling (4) against the through conical housing (6) of the female coupling (5), and in turn generates the pressure gradient described above, thereby completing the anastomosis of the duct (1).
  • a first guide (16) is inserted at the distal end of the first rod (14) which is inserted into the through conical housing (6) of the female coupling (5) ; and at the proximal end of the second rod (15) is located a second guide (17) that is inserted into the through hole (29) of the male coupling (4).
  • the female coupling (5) is connected to the first rod (14) by means of an adhesive (18).
  • the second rod (15) is connected by means of an adhesive (18) to the male coupling (4).
  • the adhesive (18) must be soft, for example, a pressure sensitive adhesive.
  • the adhesives can be acrylics (Ethyl Cyanoacrylate, Alkoxyethyl Cyanoacrylate, polyacrylates), epoxides, polyurethanes, hydrogels, silicone gel, silicone, modified and anaerobic silanes, phenolic resin adhesives, polyamides, heat cured rubber adhesives, unsaturated polyester , hotmelts, solvent based adhesives, water based adhesives, contact adhesives, dispersion adhesives, plastisol adhesives, pressure adhesives (PSA) and adhesive waxes.
  • acrylics Ethyl Cyanoacrylate, Alkoxyethyl Cyanoacrylate, polyacrylates
  • epoxides polyurethanes
  • hydrogels silicone gel
  • silicone modified and anaerobic silanes
  • phenolic resin adhesives polyamides
  • heat cured rubber adhesives unsaturated polyester
  • hotmelts solvent based adhesives
  • solvent based adhesives water based adhesives
  • contact adhesives dis
  • the first rod (14) has a plunger (19) at the distal end.
  • the second rod (15) has a plunger (19) at the proximal end.
  • a plunger is a piece that moves inside a duct and serves to facilitate the thrust of an object.
  • the piston (19) of each rod has a paraboloid shape.
  • Each paraboloid has its vertex pointed towards the medial zone of the stem where the plunger (19) is located.
  • the paraboloid has a flat face opposite its vertex.
  • the first cylindrical guide (16) protrudes from the flat face of the piston (19) of the first rod (14).
  • the second cylindrical guide (17) protrudes from the flat face of the plunger (19) of the second rod (15).
  • the plunger (19) is cylindrical in shape.
  • the plunger (19) may have a circular, oval, elliptical, oblong and cross-sectional cross-section.
  • the plunger (19) and the first rod (14) are two different parts.
  • the piston (19) and the second rod (15) are two different pieces.
  • the plunger (19) and the first rod (14) are joined by welding.
  • the piston (19) and the second rod (15) are joined by welding
  • the piston (19) and the first rod (14) can be joined by adhesives, threaded fasteners (e.g. bolts, screws, prisoners and studs), rivets, nails, by interference.
  • the piston (19) and the second rod (15) can be joined by the same means.
  • a plunger (19) and the first rod (14) form a monolithic body.
  • a plunger (19) and the second rod (15) form a monolithic body.
  • the first rod (14) has a plunger (19) at the distal end.
  • the plunger (19) is connected by means of an adhesive (18) at its distal end with the female coupling (5).
  • the second rod (15) has a plunger (19) at the proximal end.
  • the plunger (19) is connected by means of an adhesive (18) at its proximal end with the male coupling (4).
  • the first rod (14) has a plunger (19) at the distal end. From the piston (19) the first cylindrical guide (16) of the first rod (14) protrudes at the distal end.
  • the first cylindrical guide (16) of the first rod (14) is connected to the female coupling (5).
  • the second rod (15) has a plunger (19) at the proximal end. From the piston (19) a second cylindrical guide (17) of the second rod (15) protrudes at the proximal end. The second cylindrical guide (17) of the second rod (15) is connected to the male coupling (4).
  • first cylindrical guide (16) of the first rod (14) is rigid.
  • second cylindrical guide (17) of the second rod (15) is rigid.
  • first cylindrical guide (16) of the first rod (14) is malleable.
  • second cylindrical guide (17) of the second rod (15) is malleable
  • the first cylindrical guide (16) and the second cylindrical guide (17) have a diameter smaller than the internal diameter of the through hole (29) of the male coupling (4) and the smaller diameter of the through conical coupling (6) of the female coupling (5).
  • the diameter of the first cylindrical guide (16) and the diameter of the second cylindrical guide (17) have a tolerance that results in an interference fit.
  • the tolerance of the diameters of the first cylindrical guide (16) and the second cylindrical guide (17) can be, for example, from -0.06 mm and +0 mm for diameters from 0 mm to 3 mm, -0.07 mm and +0.001 mm for diameters from 6 mm to 10 mm, -0.08 mm and +0.001 mm for diameters from 6 mm to 10 mm.
  • the first rod (14) can be guided by the tubular organ without the need for a jacket.
  • the second rod (15) can be guided by the tubular organ without the need for a jacket. Referring to FIG. 5, in another embodiment of the invention, the first rod
  • first rod (14) and the second rod (15) have a rectangular section change along the entire longitudinal axis.
  • the change of rectangular section serves to decrease the weight of the first rod (14) and the second rod (15).
  • the change of rectangular section favors the malleability of the first rod (14) and the second rod (15).
  • the first rod (14) has a first support plate (22) located at its proximal end.
  • the second rod (15) has a second support plate (23) located at its distal end.
  • the support plate serves to support the fingers. Also, the support plate facilitates the pushing of the rod through the conduit (1).
  • the first rod (14) has a first end (24) arranged radially, the first end (24) is connected to the female coupling (5), and;
  • the second rod (15) has a first end (25) arranged radially, the first end (25) is connected to the male coupling (4),
  • the second rod (15) is connected to the first rod (14) by means of an axis (26) that is located in the medial zone of each rod;
  • the shaft (26) allows the first rod (14) to move radially with respect to the second rod (15).
  • the first rod (14) and the second rod (15) are rigid.
  • an incision is made near the proximal connection (2) of the duct (1).
  • an incision is made near the distal connection (3) of the duct (1).
  • the incision of the proximal connection (2) serves as input for the first rod (14).
  • the incision of the distal connection (3) serves as an input for the second stem (15).
  • the first rod (14) pushes in the distal direction the female coupling (5) in the middle of the proximal connection (2).
  • the second rod (15) pushes in the proximal direction the male coupling (4) in the middle of the distal connection (3) thus connecting the male coupling (4) and the female coupling (5).
  • the first rigid rod (14) is connected to the female coupling (5) at the first end (24) by means of an adhesive (18).
  • the second rod (15) is connected to the male coupling (4) at the first end (25) by means of an adhesive (18).
  • the first rigid rod (14) is connected to the female coupling (5) at the first end (24) by means of an adhesive (18).
  • the second rod (14) is connected to the male coupling (4) at the first distal end (24) by means of the second cylindrical guide (17).
  • the first rigid rod (14) is connected to the female coupling (5) at the first end (24) by means of the first cylindrical guide (16).
  • the second rod (15) is connected to the male coupling (4) at the first end (25) by means of the second cylindrical guide (17).
  • the use of the first cylindrical guide (16) and the second cylindrical guide (17) serves to have greater control over the male coupling (4) and the female coupling (5).
  • the first rigid rod (14) has a grip handle at the second end (27).
  • the second rigid rod (15) has a grip handle at the second end (28).
  • the first rigid rod (14) has a curved grip handle at its second end (27).
  • the second rigid rod (15) has a curved grip handle at its second end (28).
  • the curved grip handle serves to improve the grip and ergonomics of the first rod (14) and the second rod (15).
  • the curved shape of the grip handle has a semicircular section with a radius greater than 100mm.
  • the curved shape of the grip handle may be a truncated elliptical section, truncated oval, parabolic, conical, truncated, hyperbolic, truncated horseshoe and combinations of the foregoing.
  • the first rigid rod (14) has at its second end (27) a ring for a finger.
  • the second rigid rod (15) has at its second end (28) a ring for one finger. The rings improve the grip and ergonomics of the first rod (14) and the second rod (15).
  • the first rod (14) is formed of:
  • first diagonal section connected to the first prismatic section and located at the opposite end of the first protuberance, where the first diagonal section is the medial region of the first stem (14); Y a first grip handle connected to the first diagonal section, the first grip handle is located at the second end (27) of the first rod (14);
  • the second rod (15) consists of:
  • the second grip handle is located at the second end (28) of the second rod
  • the first rod (14) and the second rod (15) have a hole in their medial region, in the holes a fixing means is provided that secures the first rod (14) and second rod (15 ).
  • the fixing means can be rivets, screws, pins, studs and combinations thereof.
  • the first rigid rod (14) and the second rigid rod (15) can be cylindrical.
  • first rod (14) and the second rod (15) are square, rectangular, triangular, elliptical, polygonal, oblong and combinations of the foregoing.
  • the first rod (14) and the second rod (15) have a length between 10mm and 10mm. Preferably, they have a length between 100mm and 300mm. In one embodiment of the invention, the first rod (14) and the second rod (15) are made of 304 stainless steel.
  • the first rod (14) and the second rod (15) may be of a biocompatible material, for example, 316 stainless steel, 316 Lvm stainless steel, Titanium T ⁇ 6A14V Grade 5, Titanium T ⁇ 6A14V ELI Grade 23.
  • Example 1 Device for compression anastomosis of the esophagus of a newborn and mechanism to position and connect the device.
  • a device for compression anastomosis and a mechanism (13) were designed and constructed to position and connect the device.
  • the device was used for anastomosis of the esophagus of a newborn, the device consisted of the following parts:
  • the mechanism (13) has the following parts:
  • the piston (19), the first rod (14) and the first cylindrical guide (16) form a monolithic body and are made of 304 stainless steel.
  • the piston (19), the second rod (15) and the second cylindrical guide (17) form a monolithic body and are made of 304 stainless steel.
  • Example 2 Mechanism with shirts to position and connect a device for compression anastomosis.
  • Example 3 In the third example the device was used for the anastomosis of a bowel.
  • the separated parts of the intestine are in parallel, the mechanism (13) enters through a small incision that is made to each intestine laterally. Then join them.
  • the mechanism (13) consists of the following parts.
  • the first rigid rod (14) and the first cylindrical guide (15) form a monolithic body and are made of 304 stainless steel.
  • the second rigid rod (14) and the second cylindrical guide (16) form a monolithic body and are made of 304 stainless steel.

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

Abstract

La présente invention concerne un dispositif d'anastomose par compression et un mécanisme de positionnement et de raccordement de ce dernier. Le dispositif comprend un raccord femelle comportant un logement conique traversant qui fait communiquer son extrémité distale avec son extrémité proximale; le plus petit diamètre du logement conique traversant se trouvant en direction de l'extrémité proximale; et un raccord mâle pourvu d'une protubérance conique, qui présente son plus grand diamètre dans l'extrémité distale et qui comporte une perforation traversante qui fiat communiquer son extrémité distale avec son extrémité proximale. La protubérance conique se couple de manière fonctionnelle au logement conique traversant du raccord femelle. Pour se part, le mécanisme comprend deux tiges malléables respectivement par rapport à une extrémité distale accouplée au raccord femelle et à une extrémité proximale accouplée au raccord mâle du dispositif. Le mécanisme peut également avoir la première tige rigide qui comporte une première extrémité disposée radialement, la première extrémité s'accouplant au raccord femelle, et la seconde tige rigide qui comprend une première extrémité disposée radialement, la première extrémité s'accouplant au raccord mâle. La seconde tige rigide s'accouple à la seconde tige rigide au moyen d'un axe qui se situe dans la zone médiane de chaque tige.
PCT/IB2017/056702 2016-10-31 2017-10-27 Dispositif d'anastomose par compression et mécanisme de positionnement et de raccordement de ce dernier Ceased WO2018078589A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CO16003711 2016-10-31
CONC2016/0003711 2016-10-31

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WO2018078589A1 true WO2018078589A1 (fr) 2018-05-03

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4598712A (en) * 1984-02-16 1986-07-08 Carlo Rebuffat Circular anastomosis
US4907591A (en) * 1988-03-29 1990-03-13 Pfizer Hospital Products Group, Inc. Surgical instrument for establishing compression anastomosis
US4931057A (en) * 1988-03-29 1990-06-05 Pfizer Hospital Products Group, Inc. Compression anastomosis coupling assembly
US6666873B1 (en) * 2002-08-08 2003-12-23 Jack L. Cassell Surgical coupler for joining tubular and hollow organs

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4598712A (en) * 1984-02-16 1986-07-08 Carlo Rebuffat Circular anastomosis
US4907591A (en) * 1988-03-29 1990-03-13 Pfizer Hospital Products Group, Inc. Surgical instrument for establishing compression anastomosis
US4931057A (en) * 1988-03-29 1990-06-05 Pfizer Hospital Products Group, Inc. Compression anastomosis coupling assembly
US6666873B1 (en) * 2002-08-08 2003-12-23 Jack L. Cassell Surgical coupler for joining tubular and hollow organs

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