CN1657021A - 被植入时有平面轮廓的外科用可植入调整的带 - Google Patents
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Abstract
一种有一已展开形状和一未展开形状的可植入的外科手术装置。该装置包括一细长的可弯曲的气囊部分和一细长的可弯曲的基本上不可伸长的带部分。该带部分有一远端、一近端和一在其间的纵轴线。该带部分沿其一个内表面附接在气囊部分上。当该装置处在其未展开形状中时,该带部分的至少一部分有一垂直于纵轴线截取的凹形截面。
Description
发明领域
本发明具有在常规的内窥镜和开孔的外科器械中的用途以及在机器人辅助的外科手术中的用途。本发明还涉及可调整的外科用可植入的带,如用于治疗肥胖的胃带。
发明背景
世界上患肥胖病的人口比例持续增加。严重肥胖的人患心脏病、中风、糖尿病、肺病和意外疾病的风险增大。由于肥胖病对病人生活的影响,正在研究治疗肥胖病的方法。
用于肥胖病的许多非手术疗法的试验实际上未获得持久的成功。饮食指导、行为矫正、栓拢病人的颌部以及药物疗法都试验过,但不能改善状况。也采用过通过非外科方法如使用胃气囊***体内以填充胃的机械装置来治疗该病,但是,此类装置不能长期使用,因为它们常常产生严重刺激,需要定期取出,因而中断治疗。因此,医学界已研究治疗肥胖病的外科途径。
治疗肥胖病的大多数外科手术通常可分为防止吸收食物(吸收障碍)或约束胃而使病人觉得饱了(胃约束)。最普通的吸收障碍和胃约束技术是胃旁路。在该技术的变化中,胃被水平地分为两个隔开的囊,上囊食物容量小。该上囊通过小口连接在小肠或空肠上,这导致通过大大缩小的可用胃来处理食物。因为食物旁路掉许多肠道,所以吸收的食物量大大减小。
上述手术有许多缺点。通常上述手术在敞开的外科手术环境中进行。当前的最小侵害技术难以为外科医生掌握,并有许多附带缺点。同时,病人对这样一种不易可逆的剧烈的手术有高度的不舒适感。此外,所有吸收障碍技术对病人带来风险和副作用,包括营养不良和倾倒综合症。
因此,许多病人和医生宁可采用胃约束手术来治疗肥胖症。最普通的手术之一是植入一可以调整的胃带。一种可以调整的胃带的例子可以在下列美国专利中找到:Kuzmak的No.4,592,339;Kuzmak的RE36176;Jacobson的No.6,102,922和Vincent的No.5,601,604;所有这些专利均参考合并于此。按照当前的实践,一条胃带操作地安置而围绕病人的胃。这将胃分成两部分而其间有一口。上部分或上囊相当小,而下部分相当大。胃的隔开的小部分有效地成为病人的新胃,只需极少食物就使病人感觉饱了。
一旦置于胃的周围,该胃带的两端就彼此扣紧而该胃带通过在胃带上方折褶一部分胃壁和用置于其间的缝合线封闭该折褶的组织,由此防止该带滑动和防止围绕的口膨胀。先有技术的胃带能够通过参照图5和图6来最好地描述。先有技术的胃带101包括一个可以弯曲的基本上不可伸长的部分120,其上附接一个可以膨胀的部分110。可膨胀的部分110与一远的注射部位成流体连通。将注射流体注入该可膨胀的壳体的内部或从其移去,这用于在植入期间或之后调整该口的尺寸。通过扩大该口,病人可以吃较多食物而不感觉饱,但不会很快减少重量。通过减小该口的尺寸,发生相反的情况。医生有规律地调整该口的尺寸,以调整减重的速度。
对于大多数胃带,如从图5所见,带101的可以弯曲的基本上不可伸长的部分120在置入体内之前有一平面矩形轮廓。但是,如从图6所见,当其植入到胃111的周围,该部分120拉紧而变形,这使其表面弯曲而变成凸形轮廓。这在该带上产生潜在的尖锐点121。这也是一个修整和觉察的品质问题。因此,需要一种当植入时不会弯曲太多的可调整的胃带。
发明概要
按照本发明,提供一种有一已展开形状和一未展开形状的可植入的外科用装置。该装置包括一个细长的可以弯曲的可以膨胀的气囊部分和一个细长的可以弯曲的基本上不可伸长的带部分。该带部分有一远端、一近端和一在其间的纵轴线。当该装置处在其未展开形状中时,该带部分的至少一部分有一垂直于纵轴线截取的凹形截面。
附图简述
本发明的新颖特点特别列举在附属的权利要求书中。但是,结合附图参考下列描述可最好地理解本发明本身的组织构造和操作方法以及其它目的和优点,附图中:
图1是按照本发明制造的装置1的透视图;
图2是沿线2-2截取的图1中所示装置的截面图;
图3是装置1处在未展开位置的透视图;
图4是沿线4-4截取的图3中所示装置的截面图;
图5是类似于图2的装置的视图,但表示一种先有技术的装置101;
图6是带101的截面图,但表示其处在已展开的位置。
发明详述
现在参照附图,其中在所有图中相同的标号表示同一元件,如上所述,图5中示出一种先有技术的在上述有关参考文献中描述的那种类型的可以调整的胃带。装置101包括一个细长的可以弯曲的可以膨胀的部分(或者称为气囊部分)110和一个细长的可以弯曲的和基本上不可伸长的带部分120。图5表示该装置处于未展开形状,而带部分120具有直线截面的轮廓。
但是,如上所述,并如从图6中所见,一旦装置101安置在胃111的周围,而胃带的两端彼此扣紧,那么带部分120拉紧而变形,这导致其表面弯曲而取一凸出轮廓。这在带上产生潜在的尖锐点121,它们也是一个需要修整和已觉察的品质问题。因此,需要一种当植入和取凹形轮廓时不会弯曲的可以调整的胃带。
现在参照图1,图示一种按照本发明制造的可植入的外科装置1。该装置包括一个细长的可以弯曲的可以膨胀的气囊部分10。气囊部分可以用该技术的专业人员已知的各种材料包括硅酮和聚尿烷制成。装置1还包括一个细长的可以弯曲的和基本上不可伸长的带部分20。该带部分有一远端22、一近端24和一在其间的纵轴线26。带部分20可以用该技术的专业人员已知的各种材料包括硅酮和聚尿烷制成。该带部分沿其内表面28(示于图2中)附接在气囊部分上。可膨胀的或气囊部分10可以用该技术的专业人员已知的各种方法包括采用硅酮胶粘剂而附接在带部分20上。这两部分也可以整体地制成一个部件。
带部分的远端和近端最好包括将这两端附接在一起的机构。有各种将带的远端和近端附接在一起的机构。许多机构描述于共同申请和共同转让的美国专利申请书顺序号:2003年9月30日申请的No.60/483,353;2003年9月30日申请的No.60/507,916以及2003年9月30日申请的No.60/507,625中,其公开内容参考合并于此。图1表示带22的远端包括一个带切口32的插头30。插头30将***带20的近端24上的槽(未示出)中。插头30也包括缝合孔34和36,其中之一与带20的近端24上的缝合孔38对准。在插头30***该槽中后,外科医生愿意有带的最终位置,然后常常将端部22和24缝合在一起,以便将带更好地固定在位置中。但是,许多替代的锁紧机构如上述参考文献中描述的,并不需要使用缝合线。
图示的可膨胀的部分10通过流体管线52与注射口50成流体连通。但是,可膨胀部分10也可以流体地连接在一植入液池如与远距离控制的带一起使用的。这种带描述于2002年9月24日颁布的美国专利No.6,453,907中,该专利参考合并于此。注射口50为医学领域中熟知的类型,不仅用于胃带,也用于进入血管输送药物。在将装置1植入病人体内后,注射口刚巧附接在病人皮肤下方,因此可用注射器将流体注入该可膨胀的部分和从其退出。流体管线52能与可膨胀的部分10形成一体或可以是一独立部件。
装置1有一带有图1中所示的未展开形状的未展开位置。这是该装置在***病人体内之前的形状和位置。装置1也有一个在图3中示出的带一展开形状的已展开位置。该带的已展开位置是当该带围绕病人身体的一部分如胃或食管时的位置。图3表示该带的两端22和24已用插头和槽及缝合线附接在一起。
图2表示当装置1处在其未展开位置时可膨胀部分10和带部分20的截面图。如从该图看到的,当该装置处在其未展开形状中时,带部分20有一垂直于纵轴线26截取的凹形截面。带部分20模制在目前形状中,其优点可参照图4看到。图4表示当装置1处在其未展开形状中时可膨胀部分10和带部分20的截面图。如从该图看到的,处在其未展开状态中的带20的凹面性质使其当该装置处在已展开状态中时取一基本上直线的截面或平面轮廓。将该图与图6比较,其中,当带在其未展开状态中有一平面轮廓时,该带在其已展开状态中采取一凹面轮廓。因此,上述装置有一当植入时拉紧和变形的带部分20,但使其表面弯曲而取一平面轮廓。这消除了任何潜在的点锐点或一个需要修整的和已觉察的品质问题。
该技术的专业人员容易清楚,上述发明对其它类型的可植入带有同等可应用性。例如带已用于医治大便失禁。一种此类带描述于美国专利No.6,461,292中,后者参考合并于此。带也可用于医治小便失禁。一种此类带描述于美国专利申请书2003/0105385中,后者参考合并于此。带已可以用于医治胃灼热和/或酸反流。一种此类带描述于美国专利No.6,470,892中,后者参考合并于此。带已可用于医治阳萎。一种此类带描述于美国专利申请书2003/0114729中,后者参考合并于此。
虽然此处已示出和描述了本发明的优选实施例,但该技术的专业人员将会清楚,此类实施例只作为例子提供。该技术的专业人员可以进行各种更换、变化和替代而不偏离本发明。例如,该技术的专业人员将会清楚,此处的公开内容同样可用于机器人辅助的外科手术。此外,应当理解,上述每种结构有一功能,而此种结构可称为进行该功能的机构。因此,期望本发明仅受所附权利要求书的范围和精神的限制。
Claims (13)
1.一种有一已展开形状和一未展开形状的可植入的外科装置,所述装置包括:
a.一个细长的可弯曲膨胀的部分;以及
b.一个有一远端、一近端和一在其间的纵轴线的细长的可弯曲的和基本上不可伸长的带部分,所述带部分沿其内表面附接在所述可膨胀的部分上,其中,当所述装置处在其未展开的形状中时,所述带部分的至少一部分有一沿垂直于所述纵轴线截取的凹形截面。
2.权利要求1的装置,其特征在于,所述可膨胀的部分和所述带部分被整体制成一个部件。
3.权利要求1的装置,其特征在于,处于其已展开形状的所述带部分有一垂直于所述纵轴线截取的基本上平面的截面。
4.权利要求1的装置,其特征在于,所述带部分至少部分由硅酮和聚尿烷中的至少一种制成。
5.权利要求1的装置,其特征在于,还包括一种用于将所述带的所述远端和近端附接在一起的机构。
6.权利要求1的装置,其特征在于,还包括一个与所述可膨胀的部分成流体连通的注射口。
7.一种有一已展开形状和一未展开形状的可植入的外科手术装置,所述装置包括:
a.一个有一远端、一近端和一在其间的纵轴线的细长的可弯曲的带部分,其中,当所述装置处在于未展开形状时,所述带部分的至少一部分有一垂直于所述纵轴线而截取的凹形截面;以及
b.一个用于将所述带的所述远端和近端附接在一起的机构。
8.权利要求7的装置,其特征在于,所述带部分在其已展开形状中有一垂直于所述纵轴线截取的基本上平面的截面。
9.权利要求7的装置,其特征在于,所述带部分至少部分由硅酮和聚尿烷中的至少一种形成。
10.一种有一展开形状和一未展开形状的可植入的外科手术装置,所述装置包括:
a.一个细长的可弯曲膨胀的部分;
b.一个有一远端、一近端和一在其间的纵轴线的细长的可弯曲的和基本上不可伸长的带部分,所述带部分沿其一个内表面附接在所述可膨胀的部分上,其中当所述装置处在其未展开的形状时,所述带部分的至少一部分有一垂直于所述纵轴线的凹形截面;
c.一个用于将该带的所述远端和近端附接在一起的机构;以及
d.一个与所述可膨胀的部分成流体连通的注射口。
11.权利要求10的装置,其特征在于,所述可膨胀的部分和所述带部分整体制造成一个部件。
12.权利要求10的装置,其特征在于,所述带部分在其已展开形状中有一垂直于所述纵轴线截取的基本上平面的截面。
13.权利要求10的装置,其特征在于,所述带部分至少部分由硅酮和聚尿烷中的至少一种制成。
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US10/784416 | 2004-02-20 | ||
US10/784,416 US7311716B2 (en) | 2004-02-20 | 2004-02-20 | Surgically implantable adjustable band having a flat profile when implanted |
Publications (2)
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CN1657021A true CN1657021A (zh) | 2005-08-24 |
CN100548237C CN100548237C (zh) | 2009-10-14 |
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US (1) | US7311716B2 (zh) |
EP (1) | EP1574189B1 (zh) |
JP (1) | JP4948771B2 (zh) |
CN (1) | CN100548237C (zh) |
AT (1) | ATE430538T1 (zh) |
AU (1) | AU2005200281B2 (zh) |
BR (1) | BRPI0500589B8 (zh) |
CA (1) | CA2497523C (zh) |
DE (1) | DE602005014298D1 (zh) |
ES (1) | ES2325406T3 (zh) |
MX (1) | MXPA05002017A (zh) |
RU (1) | RU2392903C2 (zh) |
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- 2005-02-18 AT AT05250951T patent/ATE430538T1/de not_active IP Right Cessation
- 2005-02-18 CN CNB2005100093327A patent/CN100548237C/zh not_active Expired - Fee Related
- 2005-02-18 EP EP05250951A patent/EP1574189B1/en not_active Expired - Fee Related
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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CN105451692A (zh) * | 2013-08-05 | 2016-03-30 | 乔凡尼·莱斯蒂 | 用于可勘探胃部胃旁路的设备 |
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AU2005200281B2 (en) | 2011-09-08 |
RU2392903C2 (ru) | 2010-06-27 |
ATE430538T1 (de) | 2009-05-15 |
CA2497523A1 (en) | 2005-08-20 |
CA2497523C (en) | 2012-09-11 |
JP4948771B2 (ja) | 2012-06-06 |
US7311716B2 (en) | 2007-12-25 |
CN100548237C (zh) | 2009-10-14 |
MXPA05002017A (es) | 2005-10-19 |
ES2325406T3 (es) | 2009-09-03 |
EP1574189B1 (en) | 2009-05-06 |
BRPI0500589A (pt) | 2006-05-02 |
US20050187566A1 (en) | 2005-08-25 |
AU2005200281A1 (en) | 2005-09-08 |
DE602005014298D1 (de) | 2009-06-18 |
BRPI0500589B8 (pt) | 2021-06-22 |
EP1574189A1 (en) | 2005-09-14 |
JP2005230554A (ja) | 2005-09-02 |
RU2005104538A (ru) | 2006-07-27 |
BRPI0500589B1 (pt) | 2015-11-24 |
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