DE9405489U1 - Medical lock device as a connection opening from the outside of the body to internal structures or body cavities - Google Patents

Description

Medical lock device as

Connection opening from the outside of the body to

internal structures or body cavities

In addition to the classic surgical incision, minimal connecting openings from the outside of the body to internal structures or body cavities for the passage of liquids, air, CO2/ surgical instruments, optical devices, tissue samples, organs or parts of organs, drains and other supply or drainage systems are becoming increasingly important in medicine.

The indications for such connecting openings from the outside of a human or animal body to internal structures or body cavities are diverse.

For example, to connect the outside of a body to the chest cavity , openings through the chest wall are required to drain fluid accumulations in the chest cavity (pleural effusion) to the outside or to suck out air accumulations in the chest cavity using suction in order to achieve a negative pressure that allows the lungs to expand. Drains are usually inserted for these inlets and outlets.

Thoracoscopic interventions in the chest cavity also require connecting openings or passage openings for access to suitable surgical instruments and optical devices as well as for the removal of tissue samples, organs or parts of organs from the chest cavity.

In the same way, passage openings are also required for the abdominal cavity , including the small pelvis, in order to channel surgical instruments, optical devices, liquids, air, CO ₂ , tissue samples, organs or parts of organs through the abdominal wall. However, passage openings are also often used after operations in the

Drains are inserted into the abdominal cavity and the small pelvis for targeted external drainage of fluids (blood, secretions, etc.) and are led out through the abdominal wall.

Other possible areas of application for locks in this sense are in joint cavities, for example the knee joint and the cranial cavity, especially the ventricular and fluid systems in the skull area.

Known indications also include openings from the outside of the body to hollow organs for supply and drainage to the outside. A common example is a feeding tube, which creates a connection from the stomach as a hollow organ to the outside of the body.

If renal insufficiency is diagnosed, an appropriate opening through the abdominal wall is also required for special drainage when choosing CAPD (Continuous Ambulatory Peritoneal Dialysis) as a treatment option. Other indications for openings through the abdominal wall are abscess formations or cysts that need to be drained to the outside.

Different drains, catheters, trocars and introducers are known in this context.

The disadvantage of the known devices as passage openings through body walls is that they often do not have satisfactory sealing and fixing devices on the outside of the body, are not adjustable for different body wall thicknesses and cannot be provided with a disconnection or closure device on the outside of the body.

The purpose of the medical lock device through body walls according to the invention is therefore to present a lock system from the outside of the body to internal structures or body cavities, which can be adjusted for different body wall thicknesses, whereby a hermetically sealing and skin-friendly sealing and

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A fixing device can be attached. A connection or disconnection device should be provided on the outside of the body on the lock, to which inlet and outlet systems, sealing devices, diameter reduction devices and/or hermetic closure devices can be repeatedly connected or removed.

The problem is solved by the features specified in the characterising part of claim 1.

The advantage of the new lock device is that the external supply or drainage system can be temporarily disconnected for intermittent supply or drainage. It is also possible to carry out a new intervention at a later date by leaving the locks in place or to perform a "second look" using optics.

The entire lock device can be assembled from interchangeable components, thus offering a variable system in which individual components can be manufactured as reusable items and/or disposable items. In combination with a valve cartridge that can be tightly attached to the outer end of the lock, laparoscopic procedures with pneumoperitoneum can be carried out in the usual way. An angle piece for connecting a supply or drainage system or a hermetically sealed closure cap can also be attached to the outer end of the lock.

With the lock according to the invention it is also possible to individually remove long-standing and possibly infectious drains or blocked drains without having to remove the entire lock.

Further advantageous embodiments of the invention are protected in the subclaims. 35

In the following, embodiments of the lock system according to the invention with conceivable variants are described in more detail with reference to drawings.

Show it:

Figure 1 shows a longitudinal section of the lock device through a body wall with the sealing and fixation unit located on the outside of the body, a

Feedthrough sleeve and a valve cartridge that can be screwed onto the outer end,

Figure la an elbow piece which can be connected to the outer end of the locks for a supply or discharge system

device can be screwed on,

Figure Ib a closure cap which is placed on the outer end of the

Locking device can be screwed on and the opening to internal structures or body cavities is hermetic

table closes,

Figure 2 the outer part of the lock device in cross section with the skin adhesive plate and the two-part threaded sleeve that can be fixed on it,

Figure 3 is a plan view of the two-part threaded sleeve which encloses a feedthrough drainage.

Figure 1 shows a longitudinal section of the lock device through a body wall 1. A skin adhesive plate 3, which has a central opening, can be pushed over a bushing 2 protruding from the outside of the body A and can be glued to the outer skin.

The feedthrough sleeve 2 preferably consists of a flexible hose. However, it is also conceivable that the feedthrough sleeve 2 consists of a rigid material, for example plastic or metal. In this case, it is expedient to have a range of feedthrough sleeves 2 of different diameters and/or different lengths available. The skin-friendly adhesive resin known from stoma therapy is particularly suitable for the skin adhesive plate 3.

• *

A two-part threaded sleeve 4 on a correspondingly two-part base plate 5 can be plugged together around the feedthrough sleeve 2, which can be pushed forward to the desired depth, and encloses the feedthrough sleeve 2 in the desired position. By means of an adhesive surface on the underside of the base plate 5, the threaded sleeve 4 is attached at a suitable height around the feedthrough sleeve

2 assembled threaded sleeve 4, which thus creates a connection to the bushing 2, with the skin adhesive plate

3 can be connected.
10

It is conceivable that the adhesion of the two-part threaded sleeve 4 fitted around the bushing 2 against the bushing 2 can be increased with a corresponding profile and/or adhesive surface.

It is also conceivable that, instead of the lead-through sleeve 2, the sealing and fixing device located on the outside of the body A can be combined with a known intracorporeally placeable drainage device - for example a Bülau drainage device or a Robinson drainage device.

The outwardly projecting end of a drainage sleeve 2, which can be fixed to the outer skin in this way and is variably adjustable in length, can be cut off above the attached threaded sleeve 4. The threads 6 on the outside of the two-part threaded sleeve 4 can be completed in their circumference by putting the two halves together around the feed-through sleeve 2, so that further attachments with a corresponding thread can be screwed onto the thread 6 of the threaded sleeve 4.

For example, a valve cartridge 7 can be screwed onto the thread 6 of the threaded sleeve 4 for laparoscopic use with pneumoperitoneum, which in turn has a threaded attachment 8, for example for sealing diameter reduction caps.

Likewise, an angle piece 9 with a corresponding union nut 10 can be screwed onto the thread 6, to which a supply or discharge hose 11 can be connected (see Figure la). It is also conceivable that a drainage system that continues inwards through the bushing 2 can be connected using a corresponding union nut.

It is also within the scope of the invention that the lock opening leading to an internal structure or body cavity can be repeatedly hermetically sealed with a closure cap 12 that can be screwed onto the thread 6 (see Figure Ib).

In a conceivable variant of the lock device according to the invention, an annular air cushion can be inflated in the end region of the bushing 4 located on the inside of the body B and can be connected to a suitable ventilation system that can be guided outwards and controlled from the outside, and that can be equipped with at least one valve. This air cushion, which can be inflated from the outside, in the end region of the busing sleeve 2 prevents the bushing 2 from slipping out, additionally seals the bushing 2 against the body wall on the inside surface B of the body and also cushions the inner end region of the bushing 2 against internal structures (e.g. intestine).

Figure 2 shows a cross-section of the outer part of the lock device. On the inner side of the skin adhesive plate 3 there is an adhesive layer 3a, by means of which a connection to the outer skin can be made. The arrow C points to the central opening through which the bushing 2 can be guided. An adhesive layer 5a on the base plate 5 of the divisible threaded sleeve 4 establishes the connection to a reinforcement plate 13 on the skin adhesive plate 3. Various attachments (eg parts 7, 9, 12 of Figure 1) can be screwed onto the thread 6.

► Figure 3 shows a top view of the threaded sleeve 4 consisting of two parts 4a, 4b, which can be plugged together using two suitable guide webs 15, 16 and the corresponding grooves 15a, 16a on the opposite threaded sleeve parts 4a and 4b. The thread 6 formed on the outer surface of the threaded sleeve 4 runs around the entire circumference. By plugging the two threaded sleeve parts 4a, 4b together, the feedthrough sleeve 2 shown here in a cut-off position can be clamped at a suitable height. A suitable profile on the inner surface of the threaded sleeve 4 or an adhesive surface 14 increases the adhesion between the threaded sleeve 4 and the feedthrough sleeve 2. With a screw-on closure or connection cap (thread 6), the plugged-together threaded sleeve parts 4a, 4b can be prevented from moving apart.

Claims (12)

Protection claims 1. Medical lock device as a connection opening from the outside of the body to internal structures or body cavities, characterized in that an external sealing device consists of a skin adhesive plate (3) which has an opening (C), that the skin adhesive plate (3) has at least one attachment point with which a tight connection can be made with a feed-through sleeve (2) or drainage which can be inserted to different distances through the opening (C) into internal structures or body cavities, and that attachments can be tightly attached to the opening (C) leading to the outside. 2. Lock according to claim 1, characterized in that a tight connection between the skin adhesive plate (3) and a feed-through sleeve that can be inserted from the outside of the body (A) into internal structures or body cavities to different extents (2) or drainage can be produced by means of a sleeve (4) which can be connected on the one hand to the feedthrough sleeve (2) or drainage and on the other hand can be connected to the skin adhesive plate (3) by means of a base plate (5). 3. Lock according to claim 1 or 2, characterized in that the sleeve (4) consists of two parts (4a, 4b) and has an external thread (6) and a base plate (5) which can be plugged together around the bushing (2) or drainage at the set height, whereby in conjunction with a union nut a tight connection to the bushing (2) or drainage can be established, and that the connection between the base plate (5) and the skin adhesive plate (3) can be established by means of an adhesive layer (5a). 4. Lock according to one of claims 1 to 3, characterized in that at least two guide webs (15, 16) are formed on the two threaded sleeve parts (4a, 4b) with corresponding grooves (15a, 16a) on the respective opposite the part (4a or 4b), and that in the case of the pluggable threaded sleeve parts (4a, 4b) the external thread (6) can be extended to form a complete circumference. 5. Lock according to one of claims 1 to 4, characterized in that the adhesion to the lead-through sleeve (2) or drainage can be increased with a suitable profile and/or adhesive layer (14) on the inner surface of the threaded sleeve (4).
10 6. Lock according to one of claims 1 to 5, characterized in that the skin adhesive plate (3) has a reinforcement and/or attachment plate (13) to which - preferably by means of an adhesive connection (5a) - a connecting device, preferably a threaded sleeve (4) - can be attached. 7. Lock according to one of claims 1 to 6, characterized in that the skin adhesive plate (3) has a self-adhesive layer (3a). 8. Lock according to one of claims 1 to 7, characterized in that a projection of the bushing (2) or drainage protruding outside beyond the threaded sleeve (4) can be cut off. 9. Lock according to one of claims 1 to 8, characterized in that add-on parts - in particular a valve cartridge (7), an angle piece (9), a closure cap (12), reducing caps or drains which continue inwards - can be screwed onto the complete thread (6) of the assembled threaded sleeve parts (4a, 4b). 10. Lock according to one of claims 1 to 9, characterized in that the lock system can be used for bushings (2) or drains with different diameters by appropriately determining the diameter of the opening (C) and selecting a threaded sleeve (4) of the right size. 11. Lock according to one of claims 1 to 10, characterized in that an annular, inflatable air cushion can be formed at the inner (B) end of the bushing (2) or drainage with an outwardly directed ventilation system, which has at least one valve and can be controlled from the outside. 12. Lock according to one of claims 1 to 11, characterized in that with the skin protection plate (3), the threaded sleeve (4), the feed-through sleeve (2) or drainage and the various attachments, interchangeable components can be used, which can be designed partly as disposable articles and partly as reusable articles.