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WO2007105220A2 - Procédure de chirurgie gastro-intestinale - Google Patents

Procédure de chirurgie gastro-intestinale Download PDF

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Publication number
WO2007105220A2
WO2007105220A2 PCT/IL2007/000338 IL2007000338W WO2007105220A2 WO 2007105220 A2 WO2007105220 A2 WO 2007105220A2 IL 2007000338 W IL2007000338 W IL 2007000338W WO 2007105220 A2 WO2007105220 A2 WO 2007105220A2
Authority
WO
WIPO (PCT)
Prior art keywords
food
small intestine
constrictor
digestive system
stomach
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IL2007/000338
Other languages
English (en)
Other versions
WO2007105220A3 (fr
Inventor
Noam Calderon
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO2007105220A2 publication Critical patent/WO2007105220A2/fr
Anticipated expiration legal-status Critical
Publication of WO2007105220A3 publication Critical patent/WO2007105220A3/fr
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B2017/1135—End-to-side connections, e.g. T- or Y-connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B2017/1139—Side-to-side connections, e.g. shunt or X-connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2002/044—Oesophagi or esophagi or gullets

Definitions

  • the present invention relates generally to surgical intervention in the gastrointestinal system of a patient for the purpose of elimination and control of obesity.
  • Obesity is a major health risk which concerns a substantial proportion of the western population.
  • a common medical treatment to remedy morbid obesity is surgery, which may take several forms.
  • surgical weight loss procedures are either restrictive or malabsorptive, or a combination thereof.
  • Restrictive procedures include constricting the stomach and/or the entrance of the esophagus, to decrease the amount of food allowed in and absorbed in the absorptive parts of the gastric system.
  • Malabsorptive procedures for weight loss generally shorten the length of the active absorptive intestines.
  • the parts of the digestive system that are restricted in such malabsorptive surgical procedures are the stomach and/or the small intestine.
  • the small intestine carries out the major absorptive task of the gastro-intestinal system.
  • the small intestines are divided into three parts, as described in Fig. 1 to which reference is now made.
  • Duodenum 20, is a small part of the small intestine situated at the opening of
  • the duodenum receives secretions from the pancreas and liver.
  • Jejunum 24 consisting of about 40% of the small intestine, runs between the duodenum and ileum 26.
  • the ileum empties into large intestine 28.
  • the native digestive system forms a single channel, in which the flow of food is unidirectional.
  • Fig. 1 is a schematic description of the gastric system showing the stomach, small intestine and connection to the large intestine;
  • Fig. 2 is a schematic description of a side-to-side anastomosis surgical treatment in accordance with one preferred embodiment of the invention;
  • Fig. 3 is a schematic description of an end-to-side anastomosis surgical treatment in accordance with another preferred embodiment of the invention.
  • Fig. 4 is a schematic description of an embodiment implementing two bypasses in the small intestine, one leading to a stoma.
  • the native digestive system is a single path in which the food ingested undergoes digestion as it runs unidirectionally.
  • the present invention provides schemes for making structural changes in the digestive system of an obese patient for the purpose of controllably limiting the amount of food absorbed by the digestive system.
  • the structural schemes of the invention are generally described as forming a diversion of the native digestive tract by connecting two separate points along the tract, and/or implemented to limit the interaction between ingested food and the digestive system. This is achieved, generally, by limiting the amount of digesting tissue exposed to ingested food, and/or shortening the time with which the ingested food interacts with the digestive tissue.
  • a mechanical control unit is implanted in the body for constricting the aperture size of various passages, stomata or alternative pathways thereby imposing a limit to the amount of food digested in the digestive system.
  • a shunt for bypassing a substantial part of the small intestine is provided.
  • the original path, leading to the large intestine is controllably constricted as described in Fig. 2 to which reference is
  • a side-cut is made in the wall of jejunum 24 at site 50 which is connected to an opening of by-pass section 52 of the small intestine. Section 52 connects to ileum 26 at site 54.
  • two constrictors 56 and 58 are disposed along the parts of the small intestine as described in the figure and discussed below.
  • an ileal stoma is provided surgically such that a patient is able to empty at least a part of the digestive track's contents into an external container.
  • a mechanically controlled constrictor manages the dimensions of the aperture, hence the amount of excluded contents.
  • two bypasses can be applied to the same patient.
  • the small intestine's main branch 70 carries food along the small intestine to the large intestine, whereas
  • bypass 72 directs food to the colon.
  • Secondary bypass 74 connects bypass 72
  • Constrictor 82 constricts the small intestine's passage
  • constrictor 84 constricts the other branch, leading to the stoma and/or to the colon.
  • constrictors and constriction control The side-to-side anastomosis as described in Fig. 2, to which reference is
  • constrictor 46 gripping the intestine past the anastomosis.
  • constrictor When the constrictor is activated, i.e. its grip over the intestine is strengthened, ceasing or diminishing flow in the direction of arrow 48. Food can flow in the direction of arrow 50. When the constrictor is relaxed, food can flow
  • a constrictor of the invention is made typically in the form of two parallel linear blocks substantially embracing an organ. Such a constrictor is capable of clenching the digestive organ, thereby blocking its lumen, by drawing the two parallel blocks together. Activating the constrictor is achieved typically by will of the treated patient. Thus, when a patient wishes to cease or diminish the absorptive action of the intestine, the constrictor activation is triggered by signaling.
  • the signaling mechanism is exogenic (external) and can be chosen from any remotely activating physical field. Typical signaling media are electro magnetic fields or magnetic fields, but mechanical force may be used for signaling as well.
  • a receiver of a signal is connected to the actuator of the constrictor.
  • the receiver receives a signal from a transmitter employed by the user/patient.
  • Actual activation of the constrictor is achieved by electrical motor, or a pneumatic actuator.
  • Another possibility is the construction of an artificial constrictor made from an endogenic muscle tissue.
  • the energy for actuating the constrictor may be obtained externally or endogenically.
  • electromagnetic or electric energy or magnetic energy may be supplied by an external source to activate the constrictor.
  • energy may be supplied by piercing the skin to provide electric contact. If the source of energy is endogenic, an implanted battery may be used
  • the external energy is applied only to trigger the actuation of the constrictor.
  • the control over the constrictors is external, such that an external trigger activates or relaxes the constrictor.
  • Another restriction method is that of an internal balloon that inflates inside the lumen of the intestine in order to congest the lumen.
  • a liquid or gas is to be driven into the balloon by a pump thereby causing it to inflate.
  • the activation is effected by a specially designed electronic muscle pacer, such as used today for anal sphincter control, or for activation and maintenance of denervated striated muscles.
  • sensors are attached to the stomach that sense the tension exerted on the walls of the stomach.
  • a change in the volume of the stomach correlates with the tension exerted on the walls of the stomach. Accordingly, a control over the digestive system is imposed so as to automatically counterbalance to amount of food taken in.
  • the control is exerted by the action of one or more of the constrictors operative in connection with the digestive system as described above.

Landscapes

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

Abstract

L'invention concerne un procédé chirurgical et un appareil complémentaire qui permettent de limiter la quantité d'aliments digérés. Selon ce procédé, on utilise des parties de l'intestin grêle pour former des voies alternatives destinées aux aliments ingérés, réduisant de la sorte leur interaction avec les tissus digestifs. On utilise un ou plusieurs éléments d'étranglement pour dévier ou bloquer l'écoulement d'aliments digérés sur une certaine longueur de l'intestin grêle. Le mécanisme d'étranglement qui permet de dévier les aliments ingérés vers d'autres voies du système digestif fait appel à deux blocs qui peuvent être comprimés l'un contre l'autre au-dessus de l'intestin grêle, tandis que l'on insère une barrière mécanique autour des principaux vaisseaux sanguins sur le site de l'étranglement, afin de limiter la pression exercée sur lesdits vaisseaux.
PCT/IL2007/000338 2006-03-15 2007-03-15 Procédure de chirurgie gastro-intestinale Ceased WO2007105220A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US76727606P 2006-03-15 2006-03-15
US60/767,276 2006-03-15

Publications (2)

Publication Number Publication Date
WO2007105220A2 true WO2007105220A2 (fr) 2007-09-20
WO2007105220A3 WO2007105220A3 (fr) 2009-04-09

Family

ID=38509884

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IL2007/000338 Ceased WO2007105220A2 (fr) 2006-03-15 2007-03-15 Procédure de chirurgie gastro-intestinale

Country Status (1)

Country Link
WO (1) WO2007105220A2 (fr)

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6450946B1 (en) * 2000-02-11 2002-09-17 Obtech Medical Ag Food intake restriction with wireless energy transfer
US6558400B2 (en) * 2001-05-30 2003-05-06 Satiety, Inc. Obesity treatment tools and methods
US6656194B1 (en) * 2002-11-05 2003-12-02 Satiety, Inc. Magnetic anchoring devices

Also Published As

Publication number Publication date
WO2007105220A3 (fr) 2009-04-09

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