CN201691972U - Cavity fistula aperture stopper - Google Patents
Cavity fistula aperture stopper Download PDFInfo
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- CN201691972U CN201691972U CN2010201309946U CN201020130994U CN201691972U CN 201691972 U CN201691972 U CN 201691972U CN 2010201309946 U CN2010201309946 U CN 2010201309946U CN 201020130994 U CN201020130994 U CN 201020130994U CN 201691972 U CN201691972 U CN 201691972U
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- sticking patch
- hole
- fistula
- shutoff
- cavity
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Abstract
The utility model relates to a cavity fistula aperture stopper, belonging to a medical surgical auxiliary appliance. Inwards concave thin shell patches (4 and 6) are made by selecting flexible and elastic medical material, are made into streamline shapes and can cover the fistula aperture on the surface of the cavity wall from the two ends of the fistula aperture. Equidirectional excursion less than the minimum proper clamping thickness of the cavity wall is kept between the clamping points of the edge parts of the two patches for the cavity wall. Axle hole connecting pairs (2, 3, 5 and 7) which are respectively connected with the inner sides of the patches and provided with conical surfaces are mutually connected by utilizing fistula aperture space, and the fistula aperture is properly and effectively stopped. A conduit (8) provides placing and taking-out guide channels which are used for deforming the connected patches and are respectively placed at the two ends of the fistula aperture, and a flexible tube (18) transfers or expands an operation space. Fistula aperture finishing devices (20, 21, 22 and 23) are used for finishing the fistula aperture so as to ensure that the fistula aperture is tightly matched with a connecting shaft (5) of the two patches and strengthen the stoppage.
Description
Technical field
The invention belongs to medical science surgical intervention auxiliary treatment apparatus, relate generally to safe, reliable and effective shutoff, the improvement aspect cavity fistula hole shutoff device architecture and using method thereof are realized in cavity fistula hole.
Background technology
As known in the industry, big difficulty can be brought to treatment in cavity fistula hole.Usually at first selected expectant treatment in the past, by Comprehensive Treatments such as antiinflammatory, environment control, enriched nutritives, expectation spontaneous recovery.For when expectant treatment is invalid, also can only select second operation to repair the fistula mouth, the fistula mouth after the repairing still has the risk of fistula again.
In the treatment of comparatively simple with multiple intestinal fistula, stifled fistula is important measures, makes the temporary close of fistula mouth, recovers the intestinal seriality, and intestinal contents is no longer excessive, reduces body fluid and loses; Create a clean relatively growing environment simultaneously, be beneficial to the growth healing of place, fistula hole tissue, effectively shortened treatment time, can comparatively fast recover the function of intestinal again.But remain at present some problems that affecting the treatment in stifled fistula: levy narrowly such as used equipment and adaptation of methods, therapeutic effect is imprecise, is subjected to interference factor many, easily causes than severe complications.
In current treatment, the fistula hole characteristics according to different often are divided into two parts to stifled fistula: stifled outward method and interior stifled method respectively have its characteristics.
Outer stifled method commonly used has:
1, adhesive glue is stifled outward is suitable for the short and not thick fistula of caliber of fistula, but requires no intestinal juice in the fistula, otherwise it is loose frangible to solidify the back colloid, and adhesive force is not strong.
2, to be suitable for fistulization more straight and complete for the pipe plug method, and shortcoming is: can bring discomfort to patient when pipe matter is hard, and the easy kinking of softish pipe and influence the obstruction effect.
3, intracavity support pipe plug is put into sealing fistula internal orifice in enteric cavity with scope.Shortcoming: intestinal tube wriggling is subjected to obvious influence, and to adhere to the then stifled fistula of pine not tight with intestinal wall, and tension then makes the intestinal wall overtension influence fistula mouth to heal.
4, hydrostatic(al) process is from the water filling in enteric cavity of fistula mouth, makes intestinal juice not excessive to fistula and flow to far-end intestinal tube, shortcoming: the essential long-time bed of patient, and to put the pipe place and still have a small amount of leakage and influence the healing of fistula mouth, the inflow abdominal cavity causes infection.
5, two chambeies, two capsule pipe plugs are inserted head end in the fistula mouth, inflate or water filling makes sacculus fill up the obstruction internal orifice by inner chamber, again collar extension place sacculus are filled up the obstruction collar extension, shortcoming: complex structure uses inconvenience, is difficult for grasping Optimum.
Interior stifled method commonly used has:
Be suitable for labial fistula, shortcoming is blocked the fistula mouth in the method two-layer pressurization inside and outside the fistula mouth that sheet rubber is added button or fixture: because inside and outside pressurization is arranged, fistula mouth edge is downright bad because of pressurized, and the fistula mouth is enlarged; Also still have part intestinal juice to leak outside after stopping up, the erosion of fistula mouth surrounding skin is so that can not block up again.
In addition, at intestinal perforation, gastric fistula in the damaged treatment of hollow organs such as recto-vaginal fistula, also is faced with following problems:
Especially penetration hole diameter reaches far-end when perforation more greatly in intestinal perforation, shutoff easily cause anastomotic stoma infect, hemorrhage, complication such as intestinal fistula, and can only go the first phase fistulation, the second phase is gone anastomosis again.
The expectant treatment of can only going ahead of the rest in recto-vaginal fistula treatment: adopt antiinflammatory, nutrition, topical remedy's flushing etc. to promote the healing of fistula mouth or the row second operation is repaired the fistula mouth through expectant treatment is invalid, treatment time is long, and the patient is misery.After being difficult to shutoff or shutoff failure, the intestinal of can only going excision intestinal anastomosis, fistula hole kposthesis or row first phase fistulation, go the second stage of anastomosis formula again, in the art, the postoperative misery that also is difficult to avoid to take place complication such as anastomotic stricture, hemorrhage, infection, fistula and stands second operation.
Usually at first select expectant treatment in gastric fistula treatment, by antiinflammatory, press down Comprehensive Treatments expectation spontaneous recoverys such as acid, nutrition, and through the invalid second operation repairing fistula mouth of also can only selecting of expectant treatment, the fistula mouth after the repairing has the risk of fistula again.
Summary of the invention
The cavity fistula hole stopper and the using method thereof that the purpose of this invention is to provide safer, reliable shutoff cavity fistula hole, the technical problem that solve are the technical schemes that proposes to be applicable to cavity fistula hole stopper and using method thereof.
The present invention program's particular content is, cavity fistula hole stopper comprises, can be from two ends, fistula hole, in chamber wall mode around continuous sealing, the appropriate clamping fistula hole, cover fully and treat shutoff fistula hole path, successive two plugging parts in surface, limit the coupling components of plugging part fixed position, connect the parts of above-mentioned parts.Wherein, described plugging part is made with medical, the implantable intravital material of flexible elastic force; The shell shape sticking patch that two parts are the corresponding mutually unanimity in edge portion position, concave surface is relative, and be respectively equipped with the coupling components that fixedly links with it; Between two sticking patch, the joining position of each coupling components and sticking patch, this sticking patch clamping part bit position unanimity that corresponds to each other relatively; Correspond to each other between the coupling components of two sticking patch and link.
Like this, material in the medical flexible elastic force implantable is suitable for use as the body shutoff, also brings convenience to executing patient's operation; The shell shape of indent can reduce the contact area between sticking patch and the chamber wall when guaranteeing that edge portion and respective chamber wall seal contact strength continuously, reduce the direct stimulation to the chamber wall, is easy to form the structural strength of sticking patch itself; Also be convenient to sticking patch the plugging action in fistula hole is concentrated on the edge of sticking patch, guarantee to contact with the driving fit of chamber wall on every side of fistula hole path; Edge portion position is corresponding consistent, can be respectively inside and outside the wall of chamber, two ends, fistula hole, form clamping to chamber wall around the fistula hole path, inside and outside space of position, fistula hole and its chamber, place wall all isolated; Concave surface relatively, the shell shape can also reduce and take operative site is spatial, reduces the influence to surgical environments.
Coupling components makes sticking patch operating position in use, two ends, fistula hole be coupled to each other fixing by mutual cooperation; The relative corresponding mutually unanimity of sticking patch clamping part bit position that joins of each coupling components can guarantee the correct relative position between the sticking patch of both sides, keeps clip position and suitable distance between the two sticking patch edge portions, in order to keep correct clamp position.
Therefore, use the product of this programme, be easy to form the isolation of fistula hole and its place cavity lane interior or exterior space, reach the effect in shutoff fistula hole, can be treatment cavity fistula hole necessary environmental condition is provided.Thereby realized purpose of the present invention, solved the technical problem that the present invention proposes.
Sticking patch of the present invention is in the shutoff operating position, relative position between the 2 sticking patch edge portion respective clamp points allows the skew that direction is consistent, but its distance in shutoff face direction all should guarantee less than, treat the thickness of clamping place chamber wall after shutoff fistula vestibule wall is by appropriate clamping.
In two patch size to some extent under the situation of difference, two sticking patch edge portions formed clamp position when the direction of relativity shift is consistent everywhere, inevitable presenting between two contains and the mutual relation that is contained; Containing under the clamp position, the cavity of clamping place certainly leads to bending, and this result will help the stable holding to the chamber wall; Especially to continuing the chamber wall of wriggling state, contain the state clamping stability, surpass the on all four para-position clamping stability of size; And the stability of maintenance clip position, the reliable shutoff that has just kept sticking patch; When the sticking patch that is positioned at inside cavity slightly hour, chamber wall bending meeting makes the sticking patch of sealed condition to the skew of cavity lateral direction, can reduce the shutoff sticking patch to the mobile resistance of cavity content.But maximum position offset amount between the respective clamp point then can't form the appropriate clamping to the chamber wall in case surpass this qualification between two sticking patch, so must qualification to this side-play amount be set with this.
Connection between the coupling components that correspondence of the present invention links; Be axle with the hole between no gap is close-fitting connects, its axis is vertical mutually with sticking patch shutoff face.Because the coupling components of axle, hole shape links with two sticking patch respectively, it is that omnibearing location connects that no gap between the axis hole closely cooperates, can limit the correct operating distance between the edge portion that two sticking patch are used for clamping, guarantee the mutual alignment relation of determining between two sticking patch; Axis and the coupling components that the orthogonal axis hole form of sticking patch shutoff face cooperates also are convenient to utilize the passage in fistula hole itself, set up from the relation of the fixed clamp between the sticking patch of fistula hole two ends shutoff, thus the connection and the location of realizing two sticking patch.
Connection between the coupling components that correspondence of the present invention links contains the taper-face ring platform and the annular groove matching pair of the tight resilient connection in no gap; The axis of the conical surface is vertical mutually with sticking patch shutoff face, or the axis that connects with axis hole overlaps.
Resilient engagement is to set up the axis hole have taper-face ring platform and the annular groove architecture basics of operability that closely cooperates, and is convenient to form the resistance that inserts when reducing to assemble, increases the package assembly of removing required drive and difficulty when connecting cooperation; Have the tight axis hole in the no gap of the conical surface and cooperate, can make to be engaged in that to connect subsidiary axial location more reliable.Axis normal sticking patch shutoff face can satisfy two sticking patch and be connected and fixed and form the needs of clamping duty; Conical surface axis promptly is the axis that axis hole connects, and is the certainty when cooperating the connection form to unite use with above-mentioned axis hole.
The close-fitting connection in no gap of the present invention is included in the end face that connection holes is positioned at the sticking patch outside, limits between axle and hole axially connecting of relative position.In this way, define axle and cooperate, also just define relative position axial between the axle of hole, promptly can guarantee two operating position and clamping gaps between the sticking patch at the axis hole of the outside, hole endface position.
Shell shape sticking patch of the present invention is made the mild streamline shape of variation; Coupling components all or major part be positioned at the inboard of two shell sticking patch; Or the coupling components that correspondence links made one, its two ends fixedly link with two sticking patch are inboard respectively.
Like this, though coupling components is positioned at the shell inboard, because the flexible elastic force of sticking patch itself, can be under deformation state, be positioned at the coupling components of sticking patch inboard separately by patient's clamping, the connection that can achieve fully between the coupling components cooperates, and recovers the preceding original state of sticking patch part strain then, just can make it to become the connection duty of shutoff.
Corresponding coupling components for two sticking patch is integrated, directly keep at its two ends with the sticking patch inboard be fixedly connected, make two sticking patch that can separate to connect to become can not be split whole the time, can pass through deformation operation too, make it enter the user mode of shutoff; Connecting becomes whole pattern, the simplification that also can bring structure and content of operation simultaneously.
Mild streamline shape itself can reduce the axial overall dimension of sticking patch, thereby reduces the influence to the cavity overflow section, helps reducing to the mobile resistance of place cavity content, reduces the spacial influence to surgical environments.Built-in location connects secondary setting or directly links in the inboard, can significantly reduce the sticking patch duty in the size for the treatment of shutoff cavity wall thickness direction.The two combination then can reduce the bulk of the vertical shutoff face direction of stopper to greatest extent, helps keeping sticking patch correct operating position in cavity.Connect whole pattern secondary or that directly fixedly link simultaneously in built-in location, also reduced sticking patch inside and outside spatial taking of cavity in the inboard.Reduced most possibly on the whole stopper implant after to the spacial influence of internal body.
Cavity fistula of the present invention hole stopper also is furnished with different apertures, has cylinder hole axle matching pair and the coaxial with it subsidiary hole device of repairing of circular hole cutting that links.Stopper of the present invention also is furnished with and treats the suitable conduit of shutoff fistula hole dimension.
Repair the cylinder hole axle matching pair of hole device, can guarantee under the guiding that the cylinder hole axle cooperates, the coaxial with it correct cutting that links, forms between the subsidiary two cutting cutting edges of cutting cooperates, with finishing fistula hole; What be equipped with different apertures repaiies the hole device to adapt to different fistula hole finishing needs.The aperture of standard helps the formation of fistula hole and sticking patch coupling components outer surface and closely cooperates, and strengthens the plugging effect of sticking patch to the fistula hole.
The conduit suitable with treating shutoff fistula hole dimension then can assist the patient to protect the fistula hole, provides to allow the escape way of sticking patch by the fistula hole, makes sticking patch pass through the fistula hole more conveniently, is placed in the shutoff operating position of sticking patch; Or by the protection of conduit, assist to take out the sticking patch that has been seated to block-up position, reduce the further damage of operation process as much as possible to the fistula hole; If conduit is made with transparent material, with the observation that is more conducive in patient's operation.Certainly, for the fistula hole of needs finishing,, should be the correct foundation of selecting to be suitable for sticking patch and conduit in the size after repairing hole device finishing.
Conduit of the present invention is made by the transparent flexible pipe for medical purpose of toughness, and has the piston supporting with its internal diameter, or has and supporting piston of its internal diameter and the push rod that links with piston.
The toughness flexible pipe executes for adapting to that the art environment space is narrow and small, the patient can't or during inconvenient local operation hard conduit, shift the operation technique space, provide different azimuth or remote operated may.The flexible pipe for medical purpose that toughness is transparent then is a kind of selection that adapts to this environment, and piston and push rod are the conducting parts with the supporting operation of flexible pipe.
Flexible pipe of the present invention contains at one section medical transmission liquid filling between sticking patch and the piston.
Because the incompressible and suitable shape ability of liquid, the difformity that both can adapt to flexible pipe, also can finish the transmission of power and motion, it is a kind of transferring elements of flexibility, can bear in pipe inner carrier and pipe between the sticking patch, along the power in path, flexible pipe place or the transmission of moving, the realization related surgical is operated.Because of liquid is medical character, so can not cause harmful effect, flow to the liquid of intracavity to human body, can normally excrete along human body natural's tract.The present invention repaiies the tail end of hole device with its hole axle matching pair idol part, respectively with flexible pipe with place the flexible link rod within the flexible pipe to link.Like this, after the tail end of hole axle matching pair idol part and flexible pipe and flexible link rod link, can change operation and repair the position that the patient of hole device is subjected to the art position relatively; Simplify other structure of repairing the hole device, reduce to repair the axial dimension of hole device; Implement the operation that to carry out in vivo to finish by interior facility and the flexible coupler tool peeped.
Coupling components of the present invention is located at the different parts that sticking patch need be kept corresponding edge portion's grip strength and/or shell respective strengths.When sticking patch is non-circular shape or required patch size when increasing, be positioned at the single coupling components at center, often be difficult to keep or keep comprehensively sticking patch edge portion or the grip strength of whole shell self everywhere.And be positioned at the coupling components of same sticking patch different parts, and just might be to reduce distance or the cantilever support radius between shell edge portion and location coupling components, tram when guaranteeing the sticking patch sealed condition and shape make and form reliable clamp position between two sticking patch.
The using method of cavity fistula of the present invention hole stopper is included in and performs under the condition of preparing before the fistula hole shutoff art, and according to treating that shutoff fistula hole selects the sticking patch of corresponding size, shape and clamping thickness for use, sticking patch is laid in the opsition dependent requirement, by the fixing sticking patch of shutoff requirement.Wherein, described laying with fixing sticking patch comprises that 1. by the handling capacity for the treatment of shutoff fistula hole, distortion places fistula hole far-end sticking patch; 2. will be out of shape the major part of far-end sticking patch and pass the fistula hole, rest on fistula hole near-end with near position but need to keep its coupling components union end; 3. by being connected into, coupling components connects subsidiary requirement, the near-end sticking patch that distortion cooperates with the far-end sticking patch, and the coupling components that connects two sticking patch becomes to connect secondary; 4. send into the far-end sticking patch as yet not by the part in fistula hole, keep the correct coupled position of two sticking patch, progressively recover the correct block-up position of being deformed into of near-end sticking patch; 5. according to need by near the chamber wall the massage shutoff position, adjust the far-end sticking patch to the tram.
Like this, because the flexible elastic force material of sticking patch can satisfy the requirement of required various distortion in the operation; Sending into and the connecting of coupling components among the operation, the distortion of sticking patch correctly is connected with recovery, shutoff process, sticking patch is able under controllable state, by the fistula hole near-end at patient place, enters within the closed cavity that patient's inconvenience directly entered, was positioned at fistula hole far-end; Thereby finished laying, connect and fixing of far and near two ends sticking patch, be formed on the covering and the shutoff at two ends, fistula hole.The content of using method part in the object of the invention is achieved, has solved the relevant art problem that is proposed.
Connection sticking patch of the present invention, be after selecting sticking patch, pass the fistula hole before, connect the coupling components of two sticking patch; The concrete grammar that connects is that (1) digs the sticking patch of coupling components periphery to the direction in the two sticking patch outside respectively, makes its direction along vertical sticking patch shutoff face, by the edge portion of sticking patch middle part to sticking patch, gathers successively around the axis at vertical sticking patch shutoff face middle part; (2) coupling components of connection two sticking patch; After this preceding method that continues passes the fistula hole and finishes and connects corresponding contents afterwards; Described corresponding coupling components is the sticking patch of one, then directly uses the method for " preceding method passes the fistula hole and finishes and connects corresponding contents afterwards ".
At first set up the connection between two sticking patch, the integral body to sticking patch in being convenient to operate is controlled; Along vertical shutoff face axially, two sticking patch are gathered with deflation far away to its outside respectively, can prolong the length of sticking patch at coupling direction, make the patient be held part beyond two sticking patch coupling components respectively, be convenient to connect the operation of two coupling components; Meanwhile, also make the connected body that connects back two sticking patch, sticking patch radially, just the radial direction in fistula hole is dwindled the size of sticking patch, for the far-end sticking patch is got ready by the fistula hole.Like this, both shifted to an earlier date, and the connection of having set up two sticking patch at an easy rate, again owing to set up connecting relation between two sticking patch in advance, the patient can be by to the holding of near-end sticking patch, and control far-end sticking patch passes the operation in the process of fistula hole; And this connection is with regard to the connection between the distance end sticking patch that has directly formed the poroid attitude of this stopper shutoff fistula.
Obviously, the sticking patch when being one for corresponding coupling components connects because structure itself has been set up the one of far and near end sticking patch in advance, and above-mentioned method content all about " connection " is promptly unnecessary; So, this method does not have the said method content of " connection " operation, the using method of sticking patch when corresponding exactly coupling components is one.That is, under the condition of before performing fistula hole shutoff art, preparing, according to treating that shutoff fistula hole selects the sticking patch of corresponding size, shape and clamping thickness for use; Press fistula hole handling capacity distortion far-end sticking patch, be out of shape the near-end sticking patch simultaneously by the needs of being convenient to hold; Send the far-end sticking patch to penetrate the installation site of fistula hole, recover its block-up position that is deformed into of near-end sticking patch to its shutoff; Massage respective cavities to sticking patch on demand and all be in correct block-up position; Finishing the shutoff of integral type sticking patch lays.
After this preceding method that continues of the present invention passes the fistula hole and finishes and connects corresponding contents afterwards, and be that following step replaces: (3) select the conduit of corresponding radial dimension for use according to the size for the treatment of shutoff fistula hole; (4) will connect the nearly far-end that nearly far-end of two sticking patch or corresponding coupling components are the sticking patch of one, the catheter end section is filled in distortion successively, the far-end sticking patch is positioned at or the position of this end port of adjacent pipes; (5) conduit should be inserted fistula hole by end, to this pipe end concordant with fistula hole far-end end face or a little exceed; (6) will manage interior far-end sticking patch from catheter proximal end and release gradually, arrive at block-up position until it; (7) be subjected to the position in art fistula hole relatively at catheter proximal end fixing this moment of sticking patch, slowly pull out conduit, make the near-end sticking patch of still staying in the pipe deviate from conduit gradually along fistula axially bored line direction; (8) accurately the process that the sticking patch distortion recovers is rapidly deviate from control, remove to sticking patch remain fixing or sticking patch is entered other obstruction of duty; (9) massage shutoff place chamber wall, adjustment sticking patch position according to need, to correctly finishing the shutoff operation.
Like this, conduit can keep the deformed shape after sticking patch is turned up, gathers, dwindles radial dimension, is convenient to the patient when being subjected to art fistula hole comparatively narrow and small, lays observation and operation in the sticking patch, if conduit is made with transparent material, can make patient's observation more directly perceived with operation; By the elasticity of sticking patch, it can be placed within the conductor string hole in distortion, and after the constraint of having removed conduit, return to the shape of duty; The sticking patch that control is still stayed in the pipe is breaking away from the process that conduit constraint back shape is recovered, and is to guarantee that sticking patch lays on request and reduces the further damage to the fistula hole, the needs that minimizing is subjected to the art misery.
Of the present inventionly select the method for sticking patch for use, comprise at first and treat shutoff fistula hole that take into account its coupling components and the finishing back close-fitting requirement in aperture, fistula hole when selecting sticking patch for use, the described cycle and taking corresponding operation that postpones then continues to repair hole device finishing by the fistula hole.Repair the fistula hole and select corresponding sticking patch for use, help, form the state that is sealed and matched, to strengthen plugging effect place, fistula hole in the cooperation place of fistula hole and coupling components.
The using method of cavity fistula of the present invention hole stopper also comprises the removing method of the sticking patch of having finished shutoff: 1. after the whole preparations that perform before removing the sticking patch art, select for use with by the consistent conduit of shutoff fistula hole dimension; 2. with light and slow maneuver, the part of the shell around patient's near-end sticking patch is dug to the sticking patch outside, it is gathered successively around the axis of the vertical shutoff face in sticking patch middle part; 3. will gather sticking patch and fill in conduit; 4. hold the fixing position of having filled in the interior sticking patch of pipe with respect to the fistula hole in addition from conduit, pushing catheter is to the fistula hole, and far-end is concordant with fistula hole distal surface to managing, and fixing conduit at this moment is with respect to the position in fistula hole; 5. in the catheter proximal end tube outside pipe near-end or proximal tube the tractive sticking patch, until far-end sticking patch edge portion is all drawn in conduit; 6. take out conduit, sticking patch promptly all breaks away from the fistula hole, finishes the taking-up of sealed condition sticking patch.
Like this, the conduit that the position is fixed almost can bear when taking out sticking patch, and outwards whole resistances of tractive sticking patch process take out process operation power to being subjected to the effect at art position thereby shift, and reduce the damage of operation to the fistula hole as possible, finish the taking-up of sticking patch.
The described method of the inventive method by the catheter installation sticking patch, also comprise the flexible pipe for medical purpose of selecting for use after caliber and aperture, fistula hole or the finishing that aperture, fistula hole is consistent, toughness is transparent, and have the piston supporting, or have and supporting piston of its internal diameter and the push rod that links with piston with inner diameter; Be furnished with piston or hold concurrently and the flexible pipe of push rod substitutes conduit in the said method with described, and continue to use correlation method by the catheter installation sticking patch; Just substitute conduit with the flexible pipe of being furnished with piston or double and push rod in operation, with piston or piston and the input conducting parts of push rod that link thereof as operational power and motion.
The method of above-mentioned " substitute conduit, with piston or piston and the input block of push rod as power and motion that link thereof " is, with flexible pipe distal ports far away, method is packed into successively as described above, and distortion is back, the nearly far-end sticking patch or the one sticking patch of coupled situation at the flexible pipe inner carrier; By being subjected to art fistula hole site to insert the requirement of having sent into the intravital flexible pipe far-end of operation receiveing person pipe end section, peep under the assistance of observing with operating apparatus interior, send flexible pipe to go into operative site in operation receiveing person's body, with the bending of interior specula tool packed into sticking patch, piston or hold concurrently and with the link flexible pipe of push rod of piston, the pipe end that flexible pipe is equipped with sticking patch inserts the fistula hole, to concordant with fistula hole far-end end face or have a little to exceed.
Promote piston or push rod that piston joins, the far-end sticking patch is pushed out near block-up position in will managing; The position in the relative fistula of fixing sticking patch this moment hole, axially pull out the flexible pipe distal ports slightly along the fistula hole, make the patient can be by instrument, clamping coupled situation sticking patch is exposed between fistula hole near-end and the flexible pipe far-end, the coupling components between the inside and outside sticking patch of connecting tube, or continue in the mode of flexible pipe near-end with the relative fistula of fixed piston hole site, continue stationary pipes interior this moment of near-end sticking patch position; Under the fixed state of relative position, slowly pull out flexible pipe between coupling components in keeping far-end sticking patch and fistula hole and fistula hole, the near-end sticking patch of still staying in the pipe is deviate from gradually along fistula axially bored line direction; Accurately the process that the sticking patch distortion recovers is rapidly deviate from control, releasing is to the clamping of point of attachment between the sticking patch of two ends, fistula hole, extract the clamping utensil out, or remove before this to other of sticking patch fixing with restriction, make the two ends sticking patch become the shutoff coupled situation, massage shutoff place chamber wall according to need, adjust the sticking patch position,, take out flexible pipe to correctly finishing shutoff.
Like this, to the patient can't or during inconvenient local operation hard conduit, or narrow and small the executing in the art environment in space in vivo can be shifted patient's working place by toughness flexible pipe, piston, prolongs patient's arm, finishes the operation technique of shutoff; Around here, all the other contents are all consistent with the using method that adopts conduit.
The present invention selects flexible elastic force medical material for use, makes that outward appearance is streamlined, shape is consistent, can place the indent shell sticking patch for the treatment of chamber, two ends, shutoff fistula hole wall surface; The relative position of two sticking patch edge portions in shutoff face, between the bite allows to keep skew in the same way, and its side-play amount will guarantee less than the minimum suitably clamping thickness of chamber wall; Have by respectively with two sticking patch link, be built in two sticking patch inboards, with axis hole closely cooperate, axial limiting idol part cooperates the location connection pair that forms, or the integrative-structure that fixedly links with whole coupling components in the sticking patch inboard.Can realize effective shutoff, can reduce again being held the excessive injury at position to cavity fistula hole; Cavity fistula hole stopper takes up room less in chamber wall thickness direction, a little less than the cavity content is flowed and is subjected to the influence of cavity wriggling, and can keep somewhere in the body.Repair the hole device and help setting up and the close-fitting regular fistula of coupling components hole, strengthened the plugging effect of sticking patch.Conduit provides the escape way that passes through the fistula hole when allowing sticking patch to lay and take out, and reduces the further damage of operation process to the fistula hole as much as possible; Be placed within conduit or the flexible pipe with sticking patch connection distortion back or with the distortion of one pattern sticking patch, by with the supporting piston of pipe or hold concurrently and with the piston push rod that links, and medical transmission liquid, can shift or expand operative space, improved the operating characteristics of stopper effectively.The invention scheme has been created and has been helped forming operative treatment assistive device and the using method thereof that cavity fistula hole edge is treated environment, and brings new approaches, the new method of cavity fistula hole expectant treatment, and prognosis is obviously improved.Design concept is original, and its exquisiteness simple in structure is made easily, and is with low cost, is applicable to the hole shutoff of multiple fistula to the ill.
Description of drawings
Fig. 1 is the sticking patch structural representation that is used for fresh intestinal perforation shutoff;
Fig. 2 is that the conduit of packing into after the sticking patch assembling distortion in the operation places the user mode sketch map in fistula hole;
Fig. 3 is with the fixing open fistula of the sticking patch shutoff hole surgical state sketch map of nose end axle tail;
Fig. 4 is the twin columns sticking patch sealed condition sketch map that is used for irregularly shaped fistula hole;
Fig. 5 inserts the fistula hole with the conduit of being furnished with piston to prepare to release sticking patch surgical state sketch map;
Fig. 6 is that Fig. 5 far-end sticking patch is pushed out end of conduit surgical state sketch map;
Fig. 7 is that the toughness flexible pipe inserts fistula hole preparation release sticking patch surgical state sketch map;
Fig. 8 is that Fig. 7 far-end sticking patch is released hose end surgical state sketch map;
Fig. 9 is that Fig. 7 sticking patch is all released flexible pipe shutoff fistula hole surgical state sketch map;
Figure 10 repaiies hole device working state structure sketch map;
Figure 11 is an one sticking patch shutoff working state structure sketch map.
The specific embodiment
The invention will be further described below in conjunction with drawings and Examples.
Drawing parts title or the connotation that code name represents in the accompanying drawing is: the suitable clamping thickness s distance of 14 tails of 1 chamber wall, 2 ring platform 3 annular grooves, 4 sticking patch 56 sticking patch, 7 hole 8 conduits, 9 chamber 10 barrier films, 11 chamber 12 subcutaneous tissue, 13 epidermises, 15 folders, 16 pistons, 17 push rods, 18 flexible pipes, 19 normal saline, 20 swing handles, 21 rears, 22 broach shells, 23 cutter heads, 24 circular holes, 25 square columns, 26 square holes, 27 connecting column α cone angle d chamber walls promptly the position of 2 sticking patch respective clamp chamber wall points in the distance of shutoff face direction.
First embodiment is used for the stopper that intestinal perforation is repaired, and heavily about 12 grams are that material forming is made with the elasticity medical silica-gel, as Fig. 1 and Figure 10.
The affected part is fresh perforation, out-of-shape, about 10 millimeters of major diameter, about 5 millimeters of enteric cavity wall 1 thickness.Use is repaiied the hole device and is trimmed to the about 10 millimeters circular hole of diameter, and bore edges is made it complete necrosis with the electric knife calcination, reduces inflammatory exudation.
This routine used stopper is the circular shell disc of two indents; Its middle inside is respectively and co-axial cylinder of disc and frustum, is recessed scrobicular ring between edge week and middle part; The disc outer shape is more smooth spherical crown.Two disc inboards place the two ends in fistula hole relatively, respectively under the poroid attitude of shutoff fistula, 18 millimeters of its far-end sticking patch 4 outline diameters, and 22 millimeters of near-end sticking patch 6 outline diameters, sticking patch edge contouring is slick and sly arc.The inner face of the cylinder axis 5 at far-end sticking patch middle part is an annular sphere, also can be made into to have the plane that cone angle is 150 degree chamferings; The inner center of cylinder is shaped on blind hole.Also be shaped on the conical surface annular grooves 3 that cone angle is 150 degree in the axle head section, promptly annular groove up and down the side be all the awl point inwardly or with axle in the consistent conical surface of chamfer direction.The middle part frustum of near-end sticking patch is shaped on the blind hole 7 with the coupling of far-end sticking patch axle, and blind hole closely cooperates for zero-clearance with axle.In blind hole, be shaped on far-end sticking patch axle on annular groove for the taper-face ring platform 2 that tight no gap cooperates, encircle the axial location of platform, according to encircling platform and after annular groove cooperates in the hole, two sticking patch edge portions can be kept 5 millimeters intestinal wall, and the requirement when being the clamping thickness d and being 4 millimeters is determined.
This example finishing fistula hole repair the hole device, referring to Figure 10.The broach shell 22 of repairing the hole device is made the cylindrical shell that circular hole 24, proximal segment are made the stepped hole of square hole 26 for distal ports, cooperates for the step column knife bar that cylinder, rear 21 are shaped on screw thread for square column, cutter head 23 with stage casing 25.The cylindrical section end of cutter head is a wedge-like, and shoulder forms cooperating of cutting cutting edge with broach shell circular hole port in the cylindrical section.The square cylinder in knife bar stage casing is slidingly matched with the square hole section of broach shell.When knife bar penetrates the contiguous broach shell circular hole of broach shell, cutter head port, the thread segment of knife bar rear can partly stretch out broach shell near-end, be the square hole outer end, and be positioned at the broach shell near-end, by the screw-internal thread fit of spacing swing handle 20 through holes in broach shell square hole outer face.More than be stated as the main contents of this routine stopper structure.
The user mode of stopper sticking patch is pressed into the blind hole that near-end sticking patch middle part has the taper-face ring platform for far-end sticking patch middle part being had the cylinder of annular groove, embeds the conical surface annular groove of far-end sticking patch cylinder until the taper-face ring platform that makes the near-end sticking patch.At this moment, can form appropriate clamping to chamber wall 1 between two sticking patch edge portion inboards.
Forming normal clamping gap in this example is 4 millimeters.Under the naturalness, because of the thickness of sticking patch edge portion is arranged, 4 millimeters of the difference deficiencies of far-end sticking patch outer rim and near-end sticking patch inner edge radial dimension as long as correct centering connects, can be accomplished the in the same way skew of far-end sticking patch to near-end sticking patch edge portion, promptly keep all to bias internal.Under the naturalness, as long as correct centering connects, when two sticking patch change at vertical shutoff face direction relative position, 2 millimeters of the minimal fitting gap deficiencies that between its edge portion, may form.That is to say, as long as the annular groove of sticking patch, ring platform are in vertical sticking patch shutoff face direction, the Position Design of sticking patch edge portion bite or select properly and considers that it is 4 millimeters appropriate clamping that the distortion elastic force of sticking patch itself, this routine sticking patch can be realized chamber, affected part wall formation thickness relatively separately.
The confined state of repairing the hole device is that knife bar is inserted broach shell, and after being threaded end knife bar stretches out, the external part that screws in the knife bar thread segment with knob gets final product.
During use, confined state is repaiied the hole device carve the fistula hole that shape cutter head column body segment stretched into and passed out-of-shape, shutoff to be performed operation, broach shell is stayed the nearside of chamber, place, fistula hole wall, all the time guaranteeing under the state consistent of knife bar center with the respective center in fistula hole, rotate swing handle, because the restriction of broach shell end face is reclaimed through threaded engagement pulling knife bar, cutting edge until the cutter head shoulder surpasses the broach shell port, finishes the finishing cutting to the fistula hole.It is 10 millimeters that this example is selected the diameter of cutter head cylinder for use.
This example is 10 millimeters fistula hole by the finishing back aperture, and selecting for use the sticking patch middle part to connect with the cylinder diameter of axle is 10 millimeters and by the requirement that 5 millimeters chamber walls is 4 millimeters of suitable clamping thickness, selects to have corresponding conical surface annular groove and the sticking patch that encircles the platform axial location.
When laying sticking patch, the far-end sticking patch is turned over to its outside, and gather around the sticking patch axis, become proximate column.By treat shutoff, and the intestinal fistula hole place of having repaired shaping send into the intestinal intracavity gradually, should clamp the axle root at far-end sticking patch middle part this moment with operating forceps.Entered the far-end sticking patch of cavity, because of elasticity itself, can be in the process that is admitted to, in cavity, around the fistula hole, launch gradually.Because of cylinder axis by the operating forceps clamping, enter far-end sticking patch within the enteric cavity major part just removing in the middle part of axle and the sticking patch this moment.With by the cylinder of operating forceps clamping, link with the near-end sticking patch middle part blind hole socket joint that turns up equally after being out of shape, make its annulated column cooperate socket with annular groove.Unclamp the operating forceps of clamp column axon, continue to be fed into the part that the far-end sticking patch does not pass the fistula hole as yet, keep the formed pair that connects of the ring platform connected and annular groove and cylinder axis and blind hole to place among the fistula hole, the near-end sticking patch is launched, be covered in fistula hole intestinal outer wall on every side, massage this intestinal, confirm that two sticking patch are all on board, and intestinal is resetted.So far, finished the operation technique of laying sticking patch.At this moment, this routine sticking patch user mode is in vertical shutoff face direction, just the thickness of the axis direction of coupling components is 15 millimeters.
Since 4 millimeters of work radial dimension difference less thaies between the given two sticking patch retaining parts, in clamping face, two sticking patch edge portion retaining part centers, clamp position, also 2 millimeters of less thaies of position offset s between the two ends sticking patch edge portion respective chamber wall bite of correctly laying, be significantly less than 4 millimeters of the suitable clamping thickness of this routine intestinal wall, therefore this routine sticking patch can be realized correct clamping, also meets the present invention program's specification requirement.
After finishing aforesaid operations, also should check the sealed condition of stopper immediately, whether it is excessive to confirm that intestinal contents has or not, check by folder intestinal wall part blood fortune well, has or not ischemia to cause that color is dark, blackening, has or not situations such as enterokinesia is limited.After all obtaining sure affirmation, expression clamping appropriateness, shutoff is normal, then finishes whole operations of operation occluding member.
Find that clamping is loose excessively if check, then cut the near-end sticking patch mashed, keep the far-end sticking patch that is positioned at enteral with the operating forceps clamping, change near-end sticking patch edge portion relative blind hole Huan Tai position and more be partial to the sticking patch of sticking patch inboard, or the relative near-end sticking patch of blind hole taper-face ring platform edge portion, more be partial to the sticking patch in the sticking patch outside, like this, after the two sticking patch socket joints, can increase chucking power with less clamping gap.If the clamping tension, then opposite, select for use the ring platform relatively its edge portion side direction skew or sticking patch edge portion in sticking patch encircle the sticking patch of platform relatively to the skew of the sticking patch outside, to increase the clamping gap after the assembling, reduce the chucking power between two sticking patch.
Above-mentioned between sticking patch edge portion and the ring platform, adjusting at vertical shutoff face direction relative position, can realize by the ring platform of selecting same sticking patch edge portion, diverse location for use, also can also be by selecting for use same Huan Tai position, difform sticking patch edge portion to realize, such as the curvature or the curvature of shell disc curved surface itself or the mild streamline shape of shell disc that change sticking patch edge portion curved surface; The variation of two aspects all can bring sticking patch edge portion and the variation that connects relative position between the locating ring platform.It more than is the narration that situation is mainly adjusted in this routine stopper use.
Treat that place, shutoff fistula hole inflammation disappears, the state of an illness no longer needs the shutoff of stopper, then the near-end sticking patch is cut mashed removing, and the far-end sticking patch of enteral then can be filled in intestinal, is discharged by anus subsequently treating.
This kind novel therapeutic scheme has effectively been avoided in intestinal perforation therapeutic process in the past, the intestinal of can only going excision intestinal anastomosis or row first phase fistulation, go the limitation of the second stage of anastomosis formula again, thereby avoided the misery of complication such as anastomotic stricture, hemorrhage, infection, fistula, short bowel syndrome and second operation, shorten operating time simultaneously, reduce the wound surface area, shorten treatment time, reduce medical expense.
This example is because blind hole and the far-end sticking patch cylinder axis of near-end sticking patch, and conical surface annular groove cooperates with the no gap elastic force that encircles between the platform, fixed the connecting relation between two sticking patch; Cover simultaneously all fistula holes and the elasticity that had of the shell shape sticking patch itself of chamber wall on every side thereof, can guarantee to form lasting, fixed chucking power, and keep the shutoff that the fistula hole is located in its edge portion.The fistula hole is trimmed to after the circle, is convenient to cooperate comparatively closely with the cylinder axis formation at far-end sticking patch middle part, has further strengthened the plugging effect to place, fistula hole.
Because the difference of two ends sticking patch edge portion radial position, the clamping direction of two ends sticking patch can be located intestinal wall direction oblique with this, makes this place's intestinal wall bending, and two sticking patch integral body axially to a little skew of the cavity outside, can reduce the influence to the enteral passage at it slightly; And the far-end sticking patch is contained the location by the near-end sticking patch, has further strengthened clamping stability.
Because the streamline-shaped of sticking patch; Also, all be placed between two sticking patch owing to connect subsidiary taper-face ring platform and annular groove and axle and blind hole as the two ends sticking patch; Make assembling back stopper less at the overall dimension of vertical intestinal length direction.Reduced the mobile resistance of intestinal contents has also been reduced the influence of sealed condition stopper to shutoff place environment on the one hand.Also owing to select the medical flexible elasticity material for use, has the compatibility with operation receiveing person's body tissue, can not produce rejection, stopper can be placed in the body long term, make it might be under body surgical wound closed state, be retained within the body,, realize the operation purpose with dimension its plugging action that continues that continues.
Owing to select the medical flexible elasticity material for use, the two ends sticking patch relatively, the shell shape of sticking patch indent and the cross section profile of edge portion circular arc, reduced the pessimal stimulation that the chamber wall is held the position, help keeping normal condition, help by the treatment in shutoff affected part by shutoff position intestinal wall.
Simultaneously, according between taper-face ring and the edge portion inboard at the difference of the relative axial position radial dimension different with sticking patch inner cylinder axle, complete sticking patch can be shaped on specification different product multiple to be selected and accessory, the selection when needing for different shutoff.
Second embodiment is the stopper that is used for labial fistula or fistula irregular symptom, sees Fig. 3.Manhole 7 is made at the middle part of this routine near-end sticking patch, the axial dimension lengthening of far-end sticking patch cylindrical shaft 5, pass until the through hole of its tail 14 by the near-end sticking patch, axle still keeps zero-clearance to closely cooperate with the manhole of near-end sticking patch, and the two all is not provided with ring platform and annular groove.During use, the clamping gap between the sticking patch of two ends increases to and can hold the epidermis 13 that comprises adjacent body surface skin layer, the thickness of subcutaneous tissue 12, and promptly the axle rear should have enough length.The far-end sticking patch cylinder axis tail that will stretch out at corresponding site, is fixed in the near-end of near-end sticking patch through hole with titanium folder 15, can finish the fixing operation of stopper.The body of locating because of the fistula hole has been open state, and the patient can observe the shutoff situation at any time, also can to change the mode of titanium folder clip position, regulate sticking patch clamping dynamics at any time, to satisfy the shutoff requirement according to needs.
Adopt this routine method for blocking, can also in time remove the titanium folder as required, open the near-end sticking patch, check the affected part at any time.This moment, the sealed condition of stopper can be with the motion campaign of abdominal part because of generations such as breathings, and the unlikely intestinal tube wall pressure that causes is compeled tension, and ischemic necrosis enlarges fistula.All the other situations all are consistent with last example, and just for satisfying the requirement of clamping, the corresponding increasing of the size of sticking patch is to increase the ability of sticking patch clamping.Other corresponding situation all is consistent with last example.
The application of this device can make the shutoff zone sealed condition of remaining valid; And can according to disease progression at any time adjusting device significantly reduced the fistula mouth and be subjected to corrosive factor to best sealed condition; But and free position, early-stage feeding recovers function of intestinal canal; Thereby avoided, in the shutoff process in the past because of not timely adjustment sealed condition, and the fistula mouth expansion that easily causes, long-term bed, deficiency such as dosage is big, treatment time is long.
The 3rd embodiment is used for the long situation of fistula hole shape, and the length radial dimension in fistula hole is respectively 15 * 5 millimeters, and the user mode of suitable sticking patch as shown in Figure 4.
This routine two ends sticking patch is made corresponding microscler non-circular shape, and its cylinder axis and blind hole also increase to 2 respectively, and the relative position that is positioned at each sticking patch corresponds to each other.All the other structures are all consistent with first example with using method.Connect subsidiary number owing to increased, the sticking patch edge portion bite that can guarantee to increase length all is in adjacent connection duplicate invoice and connects among the scope of supporting with constant intensity everywhere, makes its elastic force that has be enough to satisfy requirement to the place's clamping of respective chamber wall; Because patch shapes and fistula hole adapt, can finish shutoff again to non-circular fistula hole.
For adapting to the shutoff needs in big fistula hole are set up the subsidiary situation that connects, should connect subsidiary position according to setting up toward contact, near finishing fistula hole or the finishing fistula hole chamber wall is to guarantee correctly laying of sticking patch, any passage of blocking-up fistula hole and place cavity 9 interior or exterior spaces.
The 4th embodiment, usable condition and sticking patch selected all routine identical with first just adopts conduit to insert sticking patch, Fig. 5, Fig. 6 are seen in the signal of mode of operation, specifically execute the art process as after.According to select external diameter of pipe for use be 10 millimeters to the fistula hole after the finishing, have the conduit 8 of supporting piston 16.After connecting selected sticking patch, two sticking patch and gathering around axis of turning up are respectively filled in conduit one end section successively, make the far-end sticking patch be positioned at the position of closing on catheter port; Should end with conduit, insert the fistula hole, concordant with fistula hole far-end end face or slightly exceed to this pipe end; Promote piston from catheter proximal end, release far-end sticking patch in the pipe gradually, until this sticking patch near all opening; Position from the relative fistula of pipe internal fixation piston hole, pull out conduit slightly, make the patient can be by instrument, clamping coupled situation sticking patch is exposed between fistula hole near-end and the conduit pipe end, in the connecting tube between the near-end sticking patch and the outer far-end sticking patch of pipe, have the ring platform, annular groove, spool with the pair that connects of blind hole; Under fixing,, the near-end sticking patch of still staying in the pipe is deviate from fully along connecting countershaft to slowly pulling out conduit as the front clamp state; Or the position in the relative fistula of fixed piston hole, pull out conduit to near-end sticking patch and all deviate from; Accurately the process that the sticking patch distortion recovers is rapidly deviate from control, releasing is to the clamping of point of attachment between the sticking patch of both sides, extract the clamping utensil out, to connect pair delivers in the fistula hole, make the both sides sticking patch by the elastic force of self, recovery distortion separately to greatest extent, until the duty that enters normal clamping, finish the main operation of shutoff operation.Other situation is all identical with first example.
Owing to used conduit, the process of inserting sticking patch is become be easy to control, the accuracy of operation improves, and the damage stimulation that the fistula hole is located reduces, and has improved the operating performance of stopper.
The 5th example stopper is used for the treatment of recto-vaginal fistula, patient 38 years old, because of the cervical cancer pelvic cavity shifts temporary dwelling palace neck cancer radical correction, the postoperative patient healing is preferable, and postoperative recovered diet on the 5th day, can flow out the fraction of thickness band stink when finding defecation from vagina, do bowel radiography and turn out to be rectum vagina Fistula, can find apart from vaginal orifice 3 centimeters vagina right side wall barrier films 10 the about 8 millimeters irregular small gap of a diameter is arranged with colposcope, congestion and edema is obvious, inflammation is heavier, about 10 millimeters of place, fistula hole sidewall thickness.
This example promptly connects axle, hole, ring platform and the annular groove of two shutoff sticking patch after selecting corresponding stopper sticking patch 4 and 6 for use, two sticking patch are joined together; Turn over to its outside and gather in the shape that connects secondary axis from edge portion respectively by the two ends sticking patch, plug feed in the grass tube 8, sterilizes to the aseptic condition lower seal, can be referring to Fig. 2.For ease of operation with use, can be in advance with conduit and sticking patch all by size, column diameter, the different sizes such as clamping thickness that are suitable for the chamber wall make, assemble complete respectively, and the labelling relevant parameter is selected for use during in order to use in the conduit outside.
It is 10 millimeters, the about 15 millimeters conduit of pipe range that this example is selected external diameter for use.The about 8-10 millimeter of sticking patch cylinder axis diameter, two sticking patch overall profile diameters are respectively 23 and 28 millimeters, wall suitable clamping thickness d in chamber, affected part is 7 millimeters, the duty sticking patch connect countershaft to overall dimension be 15 millimeters.
During operation, simultaneously the both sides cavity is strutted with colposcope and rectoscope, conduit one end that the patient will seal off earlier is 9 insertion fistula holes from vagina side chamber, hold intestinal wall concordant in addition to this pipe end and fistula hole, abolish pararectal space 11 inner tube seal dissepiments, reuse pincers or tweezer will be managed from the vagina side and be held seal dissepiment to abolish in addition, hold rectum side sticking patch to go in the pararectal space in addition from managing interior release, after observing this side sticking patch and entering rectum fully, conduit is slowly withdrawn from from the vagina side, exposes fully until this side sticking patch, and be attached on the vagina sidewall, inspection stopper and two side are all adhered to well, and no content flows mutually, then installs.
If sticking patch is laid tension, mistake is loose or other is uncomfortable, the connection cylinder between two sticking patch can be cut off, and takes out the sticking patch of having removed connection from the both sides cavity respectively, selects suitable sticking patch again, lay again as stated above.
Keep somewhere intravital processing for stopper and can be divided into following several situation: if sticking patch can't take out the time because sticking patch material therefor and tissue have the compatibility, can not produce rejection, can place for a long time in the body; Or when the operative treatment that continues, take out.If conditions of patients is not suitable for second operation or the patient is reluctant to be treated surgically once more,, can not produce rejection because sticking patch material therefor and tissue have the compatibility yet, then still can place in the body for a long time.
Remove the situation of having laid sticking patch for needs, can also select conduit suitable with the fistula hole, suitable length for use, patient's nearside sticking patch is turned up and fill in conduit one end, should hold conduit to insert the fistula hole, extremely concordant with fistula hole far-end, hold the interior outwards tractive of pipe to place the interior sticking patch of pipe from other, turn up and enter conduit until the distally sticking patch, finally all drawn in, taken out conduit, finished laying the releasing work of sticking patch.This operation can reduce when implement taking out sticking patch relatively to being subjected to the further infringement in art fistula hole, and can take out whole sticking patch.
For the fistula hole of cavity, the expectant treatment of in the past can only going ahead of the rest in the treatment: adopt antiinflammatory, topical remedy's flushing etc. to promote the healing of fistula mouth; Or through expectant treatment is invalid the row second operation is repaired the fistula mouth.So the therapeutic process time is long, and patient's impression is comparatively painful.The application of this device can change therapeutic process and deficiency in the past, increases the weight of thereby can in early days the shutoff of fistula mouth be avoided infection, and the fistula mouth more to enlarging, does not shorten the second operation time.
The 6th embodiment is the stopper of treatment gastric fistula, sees Fig. 7-9.The patient, the male, 41 years old, because of the splenectomy of liver cirrhosis portal hypertension row add esophagus and stomach at the bottom of blood vessel from disconnected art, the 5th day influent stream of postoperative food back is found to flow out food from peritoneal cavity drainage tube, makees gastroscope and confirms gastric fistula.The fistula mouth is positioned at the stomach bottom, about 10 millimeters of diameter, slit-like, 15 millimeters of this place's wall thickness.Select the size of corresponding sticking patch and coupling spindle thereof.This example alternative with the transparent polyethylene flexible pipe 18 of 12 millimeters of external diameters, 700 millimeters long and with the supporting piston 16 of inner diameter, with the piston near-end push rod 17 that links.
During operation technique, the distal ports of the flexible pipe of packing into after in advance sticking patch being out of shape by the precedent mode pushes against the piston in this flexible pipe to the piston far-end and contacts with sticking patch near-end in the flexible pipe; Send the end that flexible pipe is equipped with sticking patch to enter gastric by the oral cavity, end is kept somewhere outside the oral cavity in addition; Under gastroscope monitors, flexible pipe is equipped with insert the fistula hole after the end bending of sticking patch with interior specula tool gripper clamp and locates, to pipe end exceed the stomach outer wall a little; From flexible pipe in addition end extract out in the flexible pipe push rod and join piston, in pipe, fill with normal saline 19, drain this section inner air tube, reinstall again push rod and join piston; Inwardly exert pressure through push-rod piston external, by releasing in the flexible pipe, make its overwhelming majority outside the far-end of coat of the stomach fistula hole, launch to reset the far-end sticking patch of flexible pipe far-end; By the filling tightness of flexible pipe and near-end sticking patch, suitably tractive pipe far-end sticking patch shows that so that certain tension force to be arranged its far-end sticking patch puts in place; Keeping push rod this moment relatively under the constant situation in fistula hole site, flexible pipe is slowly withdrawed from, discharge the near-end sticking patch that still is positioned at pipe gradually, make the near-end sticking patch correctly be attached to the gastral cavity inwall; When sticking patch was deviate from, transmission liquid also flow to gastric thereupon in the pipe, because of liquid is medical character, so can not cause harmful effect to human body; For checking plugging effect, also need simultaneously, be sure of that no liquid flows out from peritoneal cavity drainage tube, finish shutoff shutoff, flexible pipe can be extracted out from gastric, finish operation place, fistula hole to the gastric water filling.
Usually at first selected expectant treatment in the gastric fistula treatment, by antiinflammatory, press down Comprehensive Treatments expectation spontaneous recoverys such as acid, nutrition, and through the invalid second operation repairing fistula mouth of also can only selecting of expectant treatment, the risk of fistula takes place in fistula mouth after the repairing in addition again in the past.The application of this device can be avoided abdominal, utilize human body natural's tract use in the technology of peeping finish shutoff, and not influenced by local inflammation, complete operation reduces dosage and treatment time at any time.
By flexible pipe, under the cooperation of assistive device, enlarge and shifted the segment space of enforcement operation, prolonged patient's arm, solved the difficulty of implementing shutoff at narrow and small position.
The situation of the 7th embodiment is identical with last example, just coat of the stomach fistula hole shape irregular.At this moment, can use the hole device of repairing that links with flexible coupling components to revise it.With flexible coupling components link repair hole device part-structure and precedent basic identical, but only keep necessary the guiding broach shell of length and cooperating of knife bar place, promptly reduce the length of square hole 26 and square column 25, referring to Figure 10, do not establish operation knob, knife bar does not have the thread segment of tail end yet, and its axial length is shortened dramatically; At the tail end of broach shell and knife bar, fixedly link with flexible pipe and the flexible link rod that is positioned at pipe respectively.
The concrete operations of repairing the fistula hole are as follows: compliant member is connected an end of repairing the hole device, send into gastric by the oral cavity, the end in addition of flexible pipe and flexible link rod is kept somewhere outside the mouth.Under gastroscope monitors, repair the broach shell that the hole device has cutter head with the clamping of interior specula tool gripper clamp, approach the fistula hole of gastral cavity, flexible link rod in the operation pipe stretches into its cutter head and exceeds the fistula hole, keeps broach shell in the center of the near-end in fistula hole, the end in addition of flexible coupling components in the tractive operation receiveing person mouth outer flexible tube, cutter head and broach shell are finished the cutting in fistula hole is repaired, after finishing is satisfied, take out this device.Other situation and the last example of operative treatment are consistent.
In this example and last example, by flexible pipe, under the cooperation of assistive device, enlarge and shifted the segment space of enforcement operation, prolonged patient's arm, solved the difficulty of implementing shutoff at narrow and small position.
The 8th embodiment is the stopper of treatment esophageal fistula, still referring to Fig. 7-9.The patient, the male 23 years old, because of eating sulphuric acid by mistake to burn of esophagus, makees gastroscope and shows that there are 20 millimeters irregular breaches of a diameter in the esophagus stage casing, 20 millimeters of this place's wall thickness.Select to connect about 20 millimeters of subpost body diameter, about 40 millimeters of sticking patch diameter, connect back two sticking patch and be about 20 millimeters at thickness direction, select about 500 millimeters long for use, the flexible pipe 18 of corresponding internal diameter, be furnished with piston 16 in the pipe, deliver to the esophageal injury place by the oral cavity, it is crooked and deliver in the fistula mouth with the gripper clamp of gastroscope the hose end of sticking patch will to be housed, at manipulation in vitro piston near-end, the far-end sticking patch that makes normal saline in the flexible pipe will be positioned at the body inner flexible tube is released, tractive flexible pipe to the inside, and sticking patch does not have retraction, then the far-end sticking patch puts in place, flexible pipe is slowly withdrawed from, the near-end sticking patch is released again, and then two sticking patch all are attached on the interior lateral wall of esophagus, at last flexible pipe is extracted out complete operation.
The 9th embodiment is used for the one stopper that intestinal fistula is repaired, as Figure 11.Its basic condition and first example are identical, and just the structure of stopper is the one pattern.That is, the sticking patch inboard of far and near end is fixedly linked by a columniform connecting column 24, makes one.The plurality of specifications size can be arranged, in order to selecting for use.
In operation technique, directly be out of shape two sticking patch, make the far-end sticking patch by the fistula hole, or select corresponding pipe for use, after directly distortion is packed into, under the guiding of conduit, pass through the fistula hole.Other situations of operation all are consistent with the various situations of the foregoing description.
This example has been simplified corresponding operation technique because the simplification of structure has reduced cost of manufacture.But select for use for the sticking patch in the operation, need comparatively accurately and to judge, when the improper shutoff of correcting before this, must be in pairs, two sticking patch of integral replacing just.
Claims (9)
1. cavity fistula hole stopper, comprise and, to cover fully and to treat shutoff fistula hole path, successive two plugging parts in surface in chamber wall mode around continuous sealing, the appropriate clamping fistula hole from two ends, fistula hole, limit the coupling components of plugging part fixed position, connect the parts of above-mentioned parts; It is characterized in that: described plugging part is made with medical, the implantable intravital material of flexible elastic force, the shell shape sticking patch (4,6) that two parts are the corresponding mutually unanimity in edge portion position, concave surface is relative, and be respectively equipped with the coupling components that fixedly links with it, this coupling components by: ring platform (2), annular groove (3), axle (5), hole (7) constitute; Between two sticking patch, the joining position of each coupling components and sticking patch, this sticking patch clamping part bit position unanimity that corresponds to each other relatively; Correspond to each other between the coupling components of two sticking patch and link.
2. cavity fistula hole stopper according to claim 1, it is characterized in that: described sticking patch is in the shutoff operating position, relative position between the 2 sticking patch edge portion respective clamp points allows the skew that direction is consistent, but its distance (s) in shutoff face direction all should guarantee less than, treat the thickness (d) of clamping place chamber wall after shutoff fistula vestibule wall is by appropriate clamping.
3. cavity fistula hole stopper as claimed in claim 1 or 2 is characterized in that: the connection between the coupling components that described correspondence links is an axle with the hole between no gap is close-fitting connects, its axis is vertical mutually with sticking patch shutoff face; It contains the taper-face ring platform (2) and annular groove (3) matching pair of the tight resilient connection in no gap; The axis of the conical surface is vertical mutually with sticking patch shutoff face.
4. as cavity fistula hole stopper as described in the claim 3, it is characterized in that: the connection between described coupling components, contain the taper-face ring platform (2) and annular groove (3) matching pair of the tight resilient connection in no gap, the axis of the conical surface is vertical mutually with sticking patch shutoff face, or the axis that connects with axis hole overlaps; Its close-fitting connection in no gap is included in the end face that connection holes is positioned at the sticking patch outside, limits between axle and hole axially connecting of relative position, and this connects by axle tail (14), folder (15) formation; Its shell shape sticking patch (4,6) is made and is changed mild streamline shape, the inboard that coupling components all is positioned at two shell sticking patch; Or the coupling components that correspondence links made a connecting column (27), its two ends fixedly link with two sticking patch are inboard respectively.
5. cavity fistula hole stopper according to claim 1 is characterized in that: also be furnished with and treat the conduit (8) that shutoff fistula hole dimension is suitable.
6. as cavity fistula hole stopper as described in the claim 5, it is characterized in that: described conduit is made by the transparent flexible pipe for medical purpose of toughness (18); And have the piston supporting (16), or have and supporting piston of its internal diameter and the push rod (17) that links with piston with its internal diameter; Push rod with piston links is provided with one section medical transmission liquid normal saline (19) in the corresponding confined space within flexible pipe.
7. cavity fistula hole stopper according to claim 1, it is characterized in that: also be furnished with different apertures, have by square column (25), the cylinder hole axle matching pair that square hole (26) constitutes and coaxial with it link by cutter head (23), the subsidiary hole device of repairing of cutting that circular hole (24) constitutes.
8. as cavity fistula hole stopper as described in the claim 7, it is characterized in that: the described tail end of repairing the hole device with its hole axle matching pair idol part, respectively with flexible pipe (18) with place the flexible push rod (17) within the flexible pipe to link.
9. cavity fistula hole stopper according to claim 1, it is characterized in that: described location coupling components is located at the different parts that sticking patch need be kept corresponding shell edge portion's grip strength and/or shell respective strengths.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2010201309946U CN201691972U (en) | 2009-09-25 | 2010-02-02 | Cavity fistula aperture stopper |
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN200910178235.9 | 2009-09-25 | ||
| CN200910178235 | 2009-09-25 | ||
| CN2010201309946U CN201691972U (en) | 2009-09-25 | 2010-02-02 | Cavity fistula aperture stopper |
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| Publication Number | Publication Date |
|---|---|
| CN201691972U true CN201691972U (en) | 2011-01-05 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2010201309946U Expired - Fee Related CN201691972U (en) | 2009-09-25 | 2010-02-02 | Cavity fistula aperture stopper |
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| CN (1) | CN201691972U (en) |
Cited By (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103110471A (en) * | 2013-03-12 | 2013-05-22 | 南方医科大学 | Praeternaturalis anus controller for enterostomy |
| CN103479405A (en) * | 2013-10-05 | 2014-01-01 | 王学建 | Skull base surgical rebuilding device |
| CN103505254A (en) * | 2013-10-05 | 2014-01-15 | 王学建 | Skull base coloboma reestablishment device |
| CN103841903A (en) * | 2011-06-17 | 2014-06-04 | 库拉希尔公司 | Devices and methods for fistula treatment |
| CN105407813A (en) * | 2013-06-20 | 2016-03-16 | 库拉希尔公司 | Enteroatmospheric fistula treatment devices |
| US9993235B2 (en) | 2008-09-04 | 2018-06-12 | Curaseal Inc. | Enteric fistula treatment devices |
| CN111000600A (en) * | 2019-12-17 | 2020-04-14 | 先健科技(深圳)有限公司 | Occluders and Occlusion Systems |
| CN111317516A (en) * | 2018-12-14 | 2020-06-23 | 杭州唯强医疗科技有限公司 | A plugging device capable of monitoring intracavity pressure |
| CN111743710A (en) * | 2020-07-07 | 2020-10-09 | 中国人民解放军东部战区总医院 | Device, use method and early warning method for intestinal air fistula assisted recovery |
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2010
- 2010-02-02 CN CN2010201309946U patent/CN201691972U/en not_active Expired - Fee Related
Cited By (12)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9993235B2 (en) | 2008-09-04 | 2018-06-12 | Curaseal Inc. | Enteric fistula treatment devices |
| CN103841903A (en) * | 2011-06-17 | 2014-06-04 | 库拉希尔公司 | Devices and methods for fistula treatment |
| CN103841903B (en) * | 2011-06-17 | 2017-06-09 | 库拉希尔公司 | Devices and methods for fistula treatment |
| CN107137114A (en) * | 2011-06-17 | 2017-09-08 | 库拉希尔公司 | The device and method treated for fistula |
| CN103110471A (en) * | 2013-03-12 | 2013-05-22 | 南方医科大学 | Praeternaturalis anus controller for enterostomy |
| CN105407813A (en) * | 2013-06-20 | 2016-03-16 | 库拉希尔公司 | Enteroatmospheric fistula treatment devices |
| CN103479405A (en) * | 2013-10-05 | 2014-01-01 | 王学建 | Skull base surgical rebuilding device |
| CN103505254A (en) * | 2013-10-05 | 2014-01-15 | 王学建 | Skull base coloboma reestablishment device |
| CN111317516A (en) * | 2018-12-14 | 2020-06-23 | 杭州唯强医疗科技有限公司 | A plugging device capable of monitoring intracavity pressure |
| CN111000600A (en) * | 2019-12-17 | 2020-04-14 | 先健科技(深圳)有限公司 | Occluders and Occlusion Systems |
| CN111000600B (en) * | 2019-12-17 | 2022-03-22 | 先健科技(深圳)有限公司 | Occluders and Occlusion Systems |
| CN111743710A (en) * | 2020-07-07 | 2020-10-09 | 中国人民解放军东部战区总医院 | Device, use method and early warning method for intestinal air fistula assisted recovery |
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