[go: up one dir, main page]

WO2009147639A2 - Dispositif et procédé de dissection de tissus - Google Patents

Dispositif et procédé de dissection de tissus Download PDF

Info

Publication number
WO2009147639A2
WO2009147639A2 PCT/IB2009/052375 IB2009052375W WO2009147639A2 WO 2009147639 A2 WO2009147639 A2 WO 2009147639A2 IB 2009052375 W IB2009052375 W IB 2009052375W WO 2009147639 A2 WO2009147639 A2 WO 2009147639A2
Authority
WO
WIPO (PCT)
Prior art keywords
cannula
gas
insufflator
pressure
mandrel
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/IB2009/052375
Other languages
English (en)
Other versions
WO2009147639A3 (fr
Inventor
Romeo Bardini
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
Priority claimed from ITPD20080167 external-priority patent/ITPD20080167A1/it
Priority claimed from ITPD20080169 external-priority patent/ITPD20080169A1/it
Application filed by Individual filed Critical Individual
Publication of WO2009147639A2 publication Critical patent/WO2009147639A2/fr
Publication of WO2009147639A3 publication Critical patent/WO2009147639A3/fr
Anticipated expiration legal-status Critical
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
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M13/00—Insufflators for therapeutic or disinfectant purposes, i.e. devices for blowing a gas, powder or vapour into the body
    • A61M13/003—Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00535—Surgical instruments, devices or methods pneumatically or hydraulically operated
    • A61B2017/00544—Surgical instruments, devices or methods pneumatically or hydraulically operated pneumatically
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320044—Blunt dissectors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320044—Blunt dissectors
    • A61B2017/320048—Balloon dissectors

Definitions

  • the present invention relates to a tissue dissection device and method.
  • tissue dissection can be achieved only by means of mechanical or thermo-mechanical dissection, through a mechanical handling of the tissue layers, also known as
  • tissue dissection comprises the steps of:
  • [0004] - arranging a pressure of gas, preferably of CO 2 , through a gas insufflator, preferably of CO 2 , configured to reduce the gas pressure from a value of about 40-50 bar (gas cylinder pressure) to a value of 0.02 - 0.03 bar, in which the gas insufflator implements two reduction drops of the CO 2 gas pressure;
  • object of the invention is a system to insufflate CO 2 into the different types of anatomical tissues in order to obtain a dissection thereof which is easier, bloodless, and rapid.
  • FIG. 1 illustrates a pneumatic scheme of an insufflator configured to reduce the CO 2 gas pressure through two reduction stages (drops) in accordance with an embodiment of the invention
  • FIG. 2 [0010] - Figs. 2, 3, and 4 represent a plastic cannula (A) and a metal mandrel (B) according to embodiments of the invention.
  • the insufflator can comprise:
  • a cab suitable to receive a gas cylinder containing CO 2 gas, preferably at a pressure of about 40-50 bar.
  • a connection system between the gas cylinder and a first pressure reduction assembly preferably in stainless steel, in which such connection system comprises a double supply circuit, as well as manually controlled filters and stop valves;
  • the first pressure reduction assembly (first drop) having a tubing system preferably in stainless steel, as well as manually controlled valves and reducing and stabilizing filters configured to reduce the gas pressure from 40-50 bar to about 3-4 bar;
  • [0015] - a second pressure reduction assembly connected to the first reduction assembly downstream the latter with reference to the gas flow direction and configured to reduce the gas pressure from 3-4 bar to about 0.02 - 0.03 bar;
  • a graduated knob preferably with micrometric graduation, connected to the insufflator, preferably with the second pressure reduction assembly so as to allow a very fine adjustment of the gas (CO 2 ) pressure as a function of the resistance which is given by the different anatomical tissues which are intended to be dissected.
  • the above-mentioned pneumatic manipulator can be connected to the insufflator by means of one or more hoses.
  • the insufflator or the connection system between the insufflator and the pneumatic manipulator are configured to allow a CO 2 gas maximum flow rate of about 2 litres per minute.
  • the tissue dissection insufflator comprises at least two pressure reduction assemblies arranged in series, and preferably at least two parallel circuits in each reduction assembly.
  • insufflation occurs at a constant pressure and with a substantially continuous flow, and with a maximum flow rate, which is preferably limited to 2 litres per minute, in order to conciliate the need to dissect mutually connected tissues, while avoiding side effects, for example, damages to the tissues.
  • the pressure fine adjusting means allow setting different pressure gradients for the dissection of different anatomical districts.
  • the pneumatic manipulator preferably comprises a cannula for insufflation into the tissues during laparoscopic surgery.
  • the cannula can be in plastic material and of a substantially conical, extended shape (preferably with a proximal (outer) diameter of about 0.5 cm and a distal diameter of about 3 mm) and assembled to a metal mandrel .
  • the length of the cannula can be of about 33 cm, and that of the mandrel of 36 cm.
  • the cannula is configured to be connected to the above-mentioned dissection insufflator so as to insufflate CO 2 at a constant, yet adjustable pressure into the tissues during laparoscopic surgery interventions.
  • the plastic cannula can have a length of about 33 cm and a substantially conical shape with proximal diameter of 0.5 cm and distal diameter of 0.3 cm.
  • the wall thickness of the cannula is of about 0.1 cm at the proximal end, and it decreases, preferably gradually, to a wall thickness of about 0,05cm at the cannula distal end.
  • the cannula inner diameter at the proximal end is of about 0.3 cm, and such inner diameter is of about 0.2 cm at the distal end.
  • a connecting portion (for example, of the female luer lock type) is formed at the cannula proximal end, for the connection of the cannula to a plastic hose.
  • a cock is provided for the opening and closure of the CO 2 gas passage.
  • the metal mandrel has a length which is higher than the length of the cannula, e.g., about 36 cm, and a diameter below the diameter of the cannula, for example, about 0.15 cm, in order to be insertable from the proximal side
  • a manual grip portion is formed at the mandrel proximal end, for example, an ovoid metal plate which can have a length of about 2.5 cm and a width of about 2 cm, as well as a thickness of about 0.15 cm, in order to allow handling the mandrel .
  • the mandrel distal end for example, an end length of about 2 cm, has a tapered, preferably conical shape, to make the penetration of the mandrel into the tissue to be dissected easier.
  • the cannula - mandrel kit is preferably used in laparoscopic surgery, for example, by using a method which provides the steps of : [0031] - laparoscopically introducing the cannula via a trocar into a patient's abdominal cavity;
  • the conical shape of the cannula allows an easy penetration into the tissue, and a good maintenance of the insufflation pressure.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention porte sur un dispositif de dissection de tissus qui comprend un manipulateur pneumatique configuré pour être relié à un insufflateur, de façon à insuffler du gaz, de préférence du CO2, à une pression constante mais ajustable dans les tissus, afin de les disséquer durant des interventions chirurgicales.
PCT/IB2009/052375 2008-06-06 2009-06-04 Dispositif et procédé de dissection de tissus Ceased WO2009147639A2 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
ITPD20080167 ITPD20080167A1 (it) 2008-06-06 2008-06-06 Insufflatore di co2 per dissezione tissutale a pressione continua e regolata in chirurgia laparoscopica
ITPD2008A000167 2008-06-06
ITPD20080169 ITPD20080169A1 (it) 2008-06-09 2008-06-09 Cannula per insufflazione di co2 nei tessuti durante chirurgia laparoscopica
ITPD2008A000169 2008-06-09

Publications (2)

Publication Number Publication Date
WO2009147639A2 true WO2009147639A2 (fr) 2009-12-10
WO2009147639A3 WO2009147639A3 (fr) 2010-01-28

Family

ID=41077634

Family Applications (2)

Application Number Title Priority Date Filing Date
PCT/IB2009/052375 Ceased WO2009147639A2 (fr) 2008-06-06 2009-06-04 Dispositif et procédé de dissection de tissus
PCT/IB2009/052374 Ceased WO2009147638A2 (fr) 2008-06-06 2009-06-04 Dispositif et procédé servant à disséquer des tissus

Family Applications After (1)

Application Number Title Priority Date Filing Date
PCT/IB2009/052374 Ceased WO2009147638A2 (fr) 2008-06-06 2009-06-04 Dispositif et procédé servant à disséquer des tissus

Country Status (1)

Country Link
WO (2) WO2009147639A2 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102012009078A1 (de) 2012-05-09 2013-11-14 Karl Storz Gmbh & Co. Kg Insufflationsvorrichtung und Verfahren

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2326734A1 (fr) * 1975-10-04 1977-04-29 Wolf Gmbh Richard Appareil d'insufflation de gaz applicable notamment au remplissage d'une cavite du corps
DE4019239C2 (de) * 1990-06-15 1997-04-10 Walz Elektronik Gmbh Insufflationsgerät
EP0996368B1 (fr) * 1997-07-14 2004-06-23 Applied Medical Resources Corporation Dissecteur pneumatique de tissu a systeme d'evacuation
WO2005035035A1 (fr) * 2003-10-07 2005-04-21 Northgate Technologies Inc. Systeme et procede permettant de fournir une substance a une cavite corporelle
US7331971B2 (en) * 2003-10-31 2008-02-19 Olympus Corporation Living-body tissue removing apparatus
US20080119759A1 (en) * 2006-11-21 2008-05-22 The Cleveland Clinic Foundation Method and apparatus for aspirating bone marrow
US20080249556A1 (en) * 2007-04-06 2008-10-09 Ken Yamatani Dissection apparatus and dissection method

Also Published As

Publication number Publication date
WO2009147638A2 (fr) 2009-12-10
WO2009147639A3 (fr) 2010-01-28
WO2009147638A3 (fr) 2010-02-25

Similar Documents

Publication Publication Date Title
EP2138106B1 (fr) Port d'accès multi-lumières
CA3156682A1 (fr) Systemes et procedes de realisation d'une chirurgie en utilisant la retractation de tension de la loi de laplace pendant la chirurgie
DE69824728T2 (de) Pneumatischer gewebedissektor mit druckentlastungssystem
EP2015829B1 (fr) Améliorations apportées à ou en relation avec des dispositifs pour réaliser des manipulations sur l'utérus
US20140357945A1 (en) Laparoscopic Trocar with Ventriculoperitoneal Shunt Entry Port
US20130165944A1 (en) Apparatus, systems, and methods for removing obstructions in the urinary tract
EP3554598B1 (fr) Pompe technique médicale à désufflation améliorée
US20100185053A1 (en) Transverse surgical tunneling
GB2479176A (en) Adapter for reducing the port size of a trocar seal
EP3603547B1 (fr) Papillotome pour la gastrostomie endoscopique percutanée
EP1561428B1 (fr) Aiguille pneumoperitoneum
WO2014079807A2 (fr) Dispositif formant trocart et son utilisation
US9220532B2 (en) Translumenal peritoneal access and catheter therefor
US10383652B2 (en) Tissue manipulation tool
US8920456B2 (en) Insufflation damper for endoscopic vessel dissector/harvester
EP3845135B1 (fr) Canule ayant de multiples canaux de fonctionnement
WO2009147639A2 (fr) Dispositif et procédé de dissection de tissus
DE102009057374A1 (de) Overtube (Schutzhülle) zum Einführen/Wechseln von Endoskopen und medizinischen Instrumenten
AU2016286171B2 (en) Surgical device
US20140081307A1 (en) Medical Instrument with Suction
WO2009151970A3 (fr) Dispositifs, système et procédés pour des procédures chirurgicales abdominales à invasion minimale
AT507660B1 (de) Chirurgisches instrument
US10426496B2 (en) Method for surgically removing a tumor from a woman's breast
US12434017B2 (en) Surgical insufflation systems and methods for use
EP4295791A1 (fr) Systèmes et procédés de dissection de tissu

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 09757986

Country of ref document: EP

Kind code of ref document: A2

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 09757986

Country of ref document: EP

Kind code of ref document: A2