NL1024218C2 - Device for treating fistulas. - Google Patents

Description

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Brief indication: Device for handling fistulas.

DESCRIPTION

The invention relates to a device for treating fistulas, in particular perianal fistulas in a patient, comprising an elongated probe provided with a first end and a second end, which probe with its first end via the external outside into the skin Located in the fistula channel, entrance of the fistula into the fistula channel can be brought in the direction of the internal, opening of the fistula for guiding a drainage thread through the fistula channel.

Such a device is known, for example, from Spanish Patent No. ES-2116914 A1. It is proposed in this patent specification to introduce an elongated probe with its first free passage into the fistula channel with the aid of an aid. After removal of the probe via the anus, a cutting tool provided with a drainage wire is attached to the device extending from the internal anal opening of the fistula. By subsequently withdrawing the aid through the fistula channel in the direction of the external fistula opening, on the one hand the tissue immediately around the fistula channel is surgically removed by the cutting tool, while on the other hand a drainage thread is pulled through the thus created surgically passage.

The drainage wire thus provided remains for some time in the operationally treated fistula channel 25 for the purpose of the healing process.

The device proposed in ES-2116914 A1 requires surgery, which treatment can often be so painful for the patient that it must be performed under general anesthesia.

Another painful, surgical treatment involves stretching the fistula channel with the aid of clamps for passing on a drainage wire, a wire end of which is threaded through the 1024218

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internal, anal fistula opening and the anus connected or cross-linked I

with the wire extending out of the external fistula opening. This I too

treatment preferably takes place under general anesthesia. Moreover, I

the use of clamps damage the wall of the fistula channel I

5, which complicates the healing process. I

It is an object of the invention to obviate the above drawbacks I

and a device for treating fistulas and in particular I

to provide perianal fistulas, which painless treatment without I

anesthesia. I

According to the invention, the drainage wire is on the I

second end of the elongated probe. With this embodiment I

surgical treatment is no longer necessary. The drainage wire I

is thus passed through the elongated probe through the external fistula opening I

passed through the fistula channel. Through the probe through the internal, anal I

15 fistula opening and pulling the anus out of the patient's body, I

the two wire ends (one wire end extending from the anus and the I

other threaded end extending from the external fistula opening) with each other I

be connected or knotted. I

This embodiment does not require surgical treatment I

I under general anesthesia and is also much less painful for the patient. I

In a more specific and highly functional embodiment

I, the drainage wire is permanent at the second end of the elongated I

I probe confirmed. More in particular, the drainage wire is permanently on I

I glued, welded or clamped the second end of the elongated probe. I

These embodiments guarantee a certain connection to the probe and I

I prevent accidental disconnection of the drainage wire from the probe. I

In addition, the outer diameter of the second end of the probe can thus be I

I remain limited, which damages the wall of the fistula channel I

I prevents the probe from passing through the fistula channel. I

In the clamped embodiment, the second end is of the I

I elongated probe partially hollow for receiving the I

I 1 02 42 1 8 I

P

3 drainage wire. A good, secure attachment of the dralnage wire to the second, hollow end of the probe is hereby guaranteed in that, according to the invention, the hollow, second end of the elongated probe is partially compressed, for example by means of a punching technique.

A flexible treatment procedure can be achieved by designing the elongated probe according to the invention at least partially flexibly. The elongated probe can herein be made of a plastic material.

However, in order to be able to manipulate the probe somewhat well through the fistula channel, in a specific embodiment the plastic probe may have a slight rigidity, or may for instance be made of a metal.

The insertion of the elongated probe through the fistula channel can be somewhat facilitated in that in one embodiment the elongated probe narrows toward the first end.

More specifically, the first end is button-shaped.

The invention will now be explained in more detail with reference to a drawing, which drawing successively shows:

Figure la-1d schematically the steps of treating a fistula with a device according to the invention;

Figure 2 schematically a first embodiment of a device for treating fistulas according to the invention.

In Figure 1a, the lower body 1 of a patient is disclosed who suffers from a perianal fistula 2. The perianal fistula 2 has an internal fistula opening 2a which is in contact with the intestinal tract 3 and an external fistula opening 2b which opens onto the skin surface.

To treat this perianal fistula, a method is proposed with the present invention, which on the one hand is 102421 8

4 I

patient is perceived as considerably less painful and also without I

anesthesia can be performed. I

The treatment involves it via the external fistula I

opening 2b inserting an elongated probe 4 provided with a first I

5 furthest end 4a and a second end 4b. The end 4b is connected to an I

drainage wire 5, which through the elongated probe 4 is thus passed through I

the fistula channel 2 is fed. I

During treatment, the elongated probe 4 is passed through the I

internal fistula opening 2a and the anus 3 by the treating physician from the I

Body 1 can be removed as shown in figure 1c. I

To this end, the probe 4 can be made of a flexible I

material, for example of a plastic, so as to ensure maneuverability I

of the elongated probe 4 in the rectum of the patient

to make. I

On the other hand also the introduction of the probe 4 by the I

fistula channel 2, the elongated probe 4 serves only I

possess rigidity in the elongated direction. In addition, an I

specific embodiment the elongated probe 4 is made of I

a plastic material or, for example, as a metal bar. I

If, as shown in Figure 1c, the elongated I

If the probe 4 has been removed from the body 1, the two I

ends 5a and 5b respectively of the drainage wire 5 connected to each other I

for example by means of a node 5c, as shown in I

Figure 1d. The presence of a drainage thread 5 through the fistula channel I

2 guarantees that the I remains open for a certain time

fistula channel 2, in order to prevent inflammation etcetera. This I

the latter benefits the healing process considerably. I

According to the invention, the drainage wire 5 with its I

first end 5a fixedly connected to the end 4b of the elongated I

30 probe 4. The mounting can for example be a line or welding technique I

(this latter technique is very suitable in the elongated probe 4 of I

1024218 I

5, a plastic 1s manufactured). On the other hand, the drainage wire can also be permanently clamped at the end 4b of the probe 4. For this purpose the end 4b can be hollow, in which cavity the end 5a of the drainage wire 5 can be received. By subsequently pressing or punching the hollow end 4b 5 with the aid of a suitable tool, the end 5a of the drainage wire 5 is clamped in the probe 4, which detaches the drainage wire 5 during the insertion of the probe 4 and the drainage thread 5 through the fistula channel 4.

The wire 5 can for example be a Seton wire.

Figure 2 shows yet another embodiment of an elongated probe 4 provided with a hollow end 4b in which the end 5a of the drainage wire 5 is received. The end 4b is then pressed shut by means of a clamping or punching technique, so that the threaded end 5a is clamped in the probe 4.

As can clearly be seen in figures 1a-1d and 2, the probe 4 has a smaller diameter when viewed from the end 4b in the direction of the free end 4a.

On the other hand, the free end 4a of the elongated probe 4 is button-shaped, whereby during the insertion of the probe 4 through the fistula channel 2 the wall of the fistula channel 2 is slightly slightly stretched (without however damaging the tissue) in order to To facilitate insertion of the probe 4.

It will be clear that with this probe otherwise painful surgical treatments are unnecessary. Moreover, with the aid of the device according to the invention, a fistula treatment can no longer be carried out under general anesthesia. The latter considerably reduces the inconvenience for the patient, while moreover the fistula treatment no longer has to be performed in a hospital, but can optionally be carried out by a doctor at the patient's home.

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Claims (12)

Device for treating fistulas, in particular perianal fistulas in a patient, comprising an elongated probe provided with a first end and a second end, which probe lies with its first end over the external bumps in the skin, Input of the fistula 1 into the fistula channel, which can be brought in the direction of the internal fistula located in the body for guiding a drainage wire through the fistula channel, characterized in that the drainage wire attached to the second end of the elongated probe 1s. I Device according to claim 1, characterized in that the drainage wire is permanently attached to the second end of the elongated probe. I 3. Device as claimed in claim 2, characterized in that the drainage wire is permanently glued to the second end of the elongated probe. I Device as claimed in claim 2, characterized in that the drainage wire is permanently welded to the second end of the elongated probe. I 5. Device as claimed in claim 2, characterized in that the drainage wire is permanently clamped at the second end of the elongated probe. I 6. Device as claimed in claim 5, characterized in that the second end of the elongated probe is partially hollow for receiving the drainage wire. I 7. Device as claimed in claim 6, characterized in that the hollow, second end of the elongated probe is partially compressed, for example by means of a punching technique. I 8. Device as claimed in one or more of the foregoing claims, characterized in that the elongated probe is at least partially flexible. I 1024218 Device according to claim 8, characterized in that the elongated probe is made of a plastic material. 10. Device as claimed in claim 9, characterized in that the plastic probe has a rigid core, for instance manufactured from a metal. Device according to one or more of the preceding claims, characterized in that the elongated probe narrows in the direction of the first end. 12. Device as claimed in one or more of the foregoing claims, characterized in that the first end is designed in the form of a button. 15 1024218