[go: up one dir, main page]

WO2018010034A1 - Dispositif d'utilisation de soutien pendant la colonoscopie, en particulier permettant de fixer et, de préférence, d'étanchéifier un endoscope dans la zone du canal anal et/ou du rectum - Google Patents

Dispositif d'utilisation de soutien pendant la colonoscopie, en particulier permettant de fixer et, de préférence, d'étanchéifier un endoscope dans la zone du canal anal et/ou du rectum Download PDF

Info

Publication number
WO2018010034A1
WO2018010034A1 PCT/CH2017/000071 CH2017000071W WO2018010034A1 WO 2018010034 A1 WO2018010034 A1 WO 2018010034A1 CH 2017000071 W CH2017000071 W CH 2017000071W WO 2018010034 A1 WO2018010034 A1 WO 2018010034A1
Authority
WO
WIPO (PCT)
Prior art keywords
endoscope
tubular body
balloon
rectum
proximal
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/CH2017/000071
Other languages
German (de)
English (en)
Inventor
Polat BASTÜRK
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.)
Ileri Atilay
Original Assignee
Ileri Atilay
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 Ileri Atilay filed Critical Ileri Atilay
Publication of WO2018010034A1 publication Critical patent/WO2018010034A1/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
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147—Holding or positioning arrangements
    • A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/01—Guiding arrangements therefore
    • 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
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00082—Balloons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/31—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the rectum, e.g. proctoscopes, sigmoidoscopes, colonoscopes
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A61M25/1009—Balloons anchored to a disc or plate

Definitions

  • Device for the supportive use in a coloscopic examination in particular for fixing and preferably sealing an endoscope in the region of the
  • the present invention relates to a device for supporting use in a colonoscopic examination, in particular for fixing and preferably sealing an endoscope in the region of the anal canal and / or the rectum.
  • the invention further relates to a method for fixing and preferably sealing an endoscope in the region of the anal canal and / or end-use using such a device.
  • the colonoscopy is used for the continuous visualization of the mucous membrane of the large intestine to the end of the small intestine as well as for the detection of polyps, neoplasms and conspicuous mucous membrane areas, which may need to be removed during the colonoscopic examination and subsequently biopsied.
  • colonoscopes For this purpose, special, flexible endoscopes, so-called colonoscopes, also called colonoscopes, are used.
  • Coloscopes typically consist of a flexible tube with optics that is pushed into the intestine via the anus.
  • the hose has only low restoring forces and serves to transmit power between the examiner and the optics at the distal end of the hose.
  • the hose also houses fiber optic cables for illumination, image transmission cables and cables, channels for rinsing water and suction and a working channel for auxiliary equipment such as pliers, syringe needle, clips and slings.
  • the colonoscope With the aid of the colonoscope, a doctor can thus look at the inside of the colon, remove tissue samples if necessary or carry out minor surgical procedures, such as the removal of tissue growth or the removal of intestinal polyps.
  • the intestine is inflated via the media line of the endoscope usually to fully unfold the intestinal wall.
  • the endoscope In order to be able to make targeted and safe interventions on the intestinal wall, it is also necessary for the endoscope to assume a stable position relative to the intestinal wall. If there are findings in the rectum or distal signum, the optimal positioning of the endoscope due to insufficient inflatability and fixation difficulties may be difficult. In such situations, a colonoscopic examination without additional assistance by another person is difficult to perform.
  • US 2014/018625 A1 discloses a colonoscope which has a tube, on the outside of which a balloon device is arranged.
  • the balloon assembly is attached externally, such as by adhesive.
  • the balloon device is smaller as the pipe or just as long.
  • US 2008/033246 AI generally relates to a system for introducing an endoscope. At the distal end balloons are arranged, which are inflatable or generally expandable for fixing in the patient's body. The supply of the fluid for expansion takes place via lines in the interior of the device.
  • US 2009/062837 AI discloses a tube as a shell for an endoscope. At the end of the tube, a balloon device is provided, which fixes the endoscope in the tube.
  • the hose is flexible.
  • US 2015/105621 A1 describes a catheter with an outer tube, which is partially inflatable in order to be fixed in the patient's body.
  • US 2014/128677 AI describes a simple colonoscope.
  • the US 2014/107692 AI relates to an insert into a body opening, in which a balloon catheter is inserted, one balloon device for fixing in the patient's body and another for expanding the body vessel (lumen) is used.
  • the object of the present invention is to avoid the abovementioned disadvantages, above all to provide an alternative to the manual fixation of the endoscope and, furthermore, preferably also an alternative to the manual sealing of the endoscope in the area of the anal canal and / or rectum.
  • a device for assisting use in a colonoscopic examination in particular for fixing and preferably also sealing an endoscope in the region of the anal canal and / or the rectum, which has an at least partially insertable into the anal canal and / or the rectum, tubular body having.
  • the tubular body At the distal end of the body, i. at that end, which is first inserted into the anal canal and / or rectum, the tubular body has a distal opening.
  • a proximal opening is provided in the region of the proximal end.
  • the tubular body Body has at least one inflatable with a fluid balloon device.
  • the balloon device is designed in such a way that its volume is increased by the inflation, so that a positive or frictionally engaged contact is produced on the one hand with the intestinal wall and on the other hand with the guided endoscope through the overpressure generated during inflation.
  • the inflatable balloon device is rigidly connected to the tubular body.
  • the force or frictional contact of the balloon device thus functions similarly as in Doppelbailonendoskopen for small bowel examination, but in which a double-balloon device is fixed directly to the endoscope.
  • the present device allows the use or retrofitting of a conventional ready existing endoscope without integrated balloon device and even the subsequent use or insertion of the device into the anal canal and / or intestine during an already ongoing endoscopic examination.
  • the inflatable balloon device is further formed as a seal to an outer annular gap between the intestinal wall and in the state in which an endoscope passed through the tubular body and the device is inserted into the anal canal and / or the rectum the outside of the tubular body and an inner annular gap between the outside of the endoscope and the inside of the tubular body gas-tight seal.
  • the balloon device may be similar to the balloon or cuff of an endobrachial tube, which fulfills the same two functions to reduce the risk of aspiration, namely to fix the tube on the one hand in the trachea and on the other hand to seal the gap between the tube and trachea, so that only way into the lungs via the tube leads.
  • the balloon device may according to an advantageous embodiment have a fluid-inflatable outer balloon member on the outside of the tubular body and at least one fluid-inflatable inner balloon member on the inside of the tubular body.
  • the distal balloon element has the advantage that only a single balloon element is necessary, on the one hand a fixation and preferably also sealing of the tubular body opposite to the intestinal wall and on the other hand to effect a fixation and preferably also sealing against the guided endoscope.
  • the at least one outer balloon element and / or the at least one inner balloon element are preferably likewise arranged in the region of the distal end of the tubular body.
  • the at least one outer balloon element and / or the at least one inner balloon element are arranged on another portion of the tubular body, in particular in the region of the proximal end of the tubular body and in a Nittelab steel of the tubular body with respect to its longitudinal axis.
  • not only an outer and inner balloon element is provided, but corresponding a plurality of balloon elements, which are arranged at different ümfangs- and / or axial position with respect to the longitudinal axis of the tubular body on the inner and or outer side.
  • the inflatable balloon device in particular the outer, the inner and / or the distal balloon element may be circumferentially or circumferentially formed.
  • the balloon device in particular the outer, the inner and / or the distal balloon element may be annular, toroidal or hollow cylinder shaped. It is also conceivable that the balloon device, in particular the outer, the inner and / or the distal balloon element is formed on the outer side or inner side or at the distal end of the tubular body as a peripheral circumferential balloon cuff.
  • the balloon device in particular the outer, the inner and / or the distal balloon element at least in the inflated state tubular or kisaenförmig or cuboid is formed in order to achieve at least a fixing of the device relative to the intestinal wall and with respect to the guided or passed through endoscope.
  • two or three cushion, cuboid and / or tubular balloon elements are arranged on the outside and the inside of the tubular body in order to effect at least one fixation, albeit not sealing the endoscope relative to the intestinal wall.
  • more than three balloon elements are circumferentially arranged on the inside and outside of the tubular body.
  • the at least one balloon device, the at least one inner, the at least one outer or the at least one distal balloon element consists of an inflatable flexible (plastic) sheath.
  • the at least one balloon device which occupies at least one inner, the at least one outer or the at least one distal balloon element in the inflated state one of the shapes or geometries described above, and in the uninflated state collapsed significantly smaller volume compared to the inflated state, so that on the one hand the device can be easily introduced into the anal canal and / or rectum and on the other hand, an endoscope easily through the tubular body.
  • the balloon device in particular the outer and the inner or the distal balloon element, at least one Have supply line.
  • the at least one lead is guided on the outside of the device and / or at least so long that the proximal end of the lead is in the inserted state of the device outside the body.
  • a valve in particular a check valve, is arranged to control the supply and possibly the discharge of the fluid, in particular to prevent uncontrolled discharge of the fluid.
  • a disposable syringe can be used, which can preferably be connected to a corresponding connection element at the distal end of the supply line.
  • air or water, in particular deionized water, or a saline solution come into consideration as the fluid.
  • the device may have a proximal, proximal end of the tubular body.
  • plate-shaped, plate-shaped or funnel-shaped extension preferably a proximal end plate, a having proximal end plate or a proximal end funnel in the sense of a stop.
  • the proximal extension in this respect represents a cross-sectional broadening of the device transverse to the longitudinal axis of the tubular body which exceeds the cross-section of the tubular body and the anus expanded by the tubular body such that the device only inserts into the body at most the length of the tubular body leaves until the proximal extension in the area of the anus rests on the outside of the body.
  • the proximal extension in a first direction transversely, in particular perpendicular to the longitudinal axis of the tubular body have a greater extent than in a second direction transversely, in particular perpendicular to the longitudinal axis of the tubular body and transversely, in particular perpendicular to the first direction
  • the proximal extension may have an asymmetrical, in particular elliptical or rectangular cross-section in a plane transverse, in particular perpendicular to the longitudinal axis of the tubular body.
  • This asymmetrical configuration in the cross section of the proximal extension is preferably adapted to the anatomical conditions of the buttocks / jaws and thereby causes in cooperation with the buttocks advantageously an anti-rotation of the device relative to its longitudinal axis.
  • the proximal extension is mirror-symmetrical with respect to a mirror axis perpendicular to the longitudinal axis of the tubular body.
  • the proximal enlargement relative to the tubular body is slidably disposed along the longitudinal axis of the tubular body.
  • the proximal extension is connected by means of a thread or a latching connection device displaceable with the tubular body along its longitudinal axis. This makes it possible, on the one hand, to determine whether the device can only be inserted into the anal canal or, moreover, into the area of the rectum.
  • the device has a longitudinal slot over its entire length, in particular parallel to the longitudinal axis of the tubular body.
  • the longitudinal slot thus extends both over the tubular body and over the possibly existing proximal enlargement.
  • the device is laterally applied to an endoscope by a temporary widening of the longitudinal slot or by a temporary widening of the body in the circumferential direction.
  • the device for this purpose is made of a material that allows a temporary widening of the longitudinal slot.
  • the device is also conceivable, however, for the device to be multi-part, in particular two-part, and to comprise approximately a hinge device, for example a film hinge which extends along the longitudinal axis of the tubular body.
  • the longitudinal slot also means an interruption of a peripheral circulating balloon device.
  • the Balloon device for example, a circumferentially encircling, interrupted in the region of the longitudinal slot balloon ring, Ballontorus, balloon tube or a corresponding balloon cuff, in which the interruption is closed sealingly in the inflated state.
  • the tubular body may be designed to be substantially resistant to bending transversely with respect to at least one axis, in particular perpendicularly to its longitudinal axis. As a result, the introduction into the body is particularly facilitated. Alternatively or additionally, at least the distal end of the tubular body may be semi-flexible.
  • materials for the device are in particular plastics and / or metal into consideration. Metal is particularly suitable for multiple use of the device and is particularly easy to clean and sterilize. Plastic is preferably used when the device is designed as a disposable article.
  • the device has on the inside of the tubular body, in particular in the region of the proximal end or the proximal opening at least one mark, the rotational position relative to the longitudinal axis of the tubular body relative to Patients marked.
  • This marking can be used advantageously by the examining person to orient themselves within the intestine and, when a finding is found, to refer this to the marking.
  • - if present - on the inside of the proximal extension, in particular in the area adjacent to the proximal end or the proximal Opening of the tubular body such a rotation position marker is provided.
  • the device can be designed for fixing and preferably sealing a proctoscope or a rectoscope or, in addition to fixing and optionally sealing, can also be used as a proctoscope or rectoscope.
  • the invention thus also relates to the use of the device according to the invention as a proctoscope or rectoscope or for performing a proctoscopy or rectoscopy.
  • provision may be made for the endoscope to be withdrawn from the patient after the endoscopic examination has ended, while the device according to the invention still remains in the anal canal and / or rectum and, after removal of the endoscope, serves to carry out proctoscopy or rectoscopy.
  • the device is first introduced without endoscope into the anal canal and / or rectum before the actual endoscopic examination to perform a proctoscopy or rectoscopy, and only then introduced the endoscope through the device into the body of the patient to perform a colonoscopy.
  • the invention further relates to an endoscope device with an endoscope, in particular a colonoscope, and with a previously described inventive device, wherein the endoscope is passed through the tubular body of the device or can be passed.
  • the present invention relates to a method for fixing and optionally sealing an endoscope in the region of the anal canal and / or rectum of a patient with Help a Vorrichtving described above.
  • the method may include the following steps: a) introducing an endoscope, in particular a colon in the anal canal and / or rectum, wherein prior to insertion of a device according to the invention on the endoscope, preferably via the distal end of the endoscope or - if present - on a slot of the device is placed; b) subsequently introducing the device into the anal canal and / or rectum by pushing the device into the anal canal and / or rectum via the endoscope towards the distal end of the endoscope; c) inflating the balloon device by means of a fluid, or a) simultaneously introducing a device according to the invention together with an endoscope, in particular with a colonoscope, into the anal canal and / or rectum, the device being guided onto
  • Device is placed; b) inflating the balloon device by means of a fluid. or (a) imports of an endoscope, in particular a colon, into the anal canal and / or rectum; b) placing a device according to the invention on a proximal, not yet introduced section of the endoscope over a longitudinal slot of the device;
  • proximal extension is positioned relative to the tubular body prior to insertion into the body of the patient, i. the maximum insertion depth of the device according to the invention is set or limited before insertion.
  • Fig. La is a perspective view of a first exemplary embodiment of the inventive device
  • Fig. Lb is a detail view of a longitudinal section through the
  • Fig. La Fig. Lc-lh is a schematic representation of various alternative embodiments of the
  • Fig. 2 is a schematic representation of the arrangement of a
  • FIG. 1a shows a perspective view of a second exemplary embodiment of the device according to the invention
  • 4a-b is a schematic representation of various alternative embodiments of a length-adjustable device according to the invention.
  • Fig. 5 is a plan view of the inventive
  • FIGS. 1 a, 1 b, 2 and 5 show a first exemplary embodiment of a device 10 according to the invention, which serves both for fixing and sealing an endoscope 22 in the region of the anal canal 40 and / or rectum 41.
  • the device has a tubular body 11 with a distal opening 12 at its distal end 13 and a proximal opening 14 in the region of its proximal end 15. Subsequent to the proximal end 15 of the tubular body 11 - in the proximal direction - the device 10 further comprises a plate-like proximal extension 30.
  • an endoscope 22 can be passed through the tubular body 11 via the proximal opening 14 in the direction of the distal end 13 and out of the distal opening 12.
  • the length of the tubular body 11 is selected so that the distal end 13 of the tubular body 11 comes to lie in the region of the rectal 41, while the proximal end 15 is in the region of the anal canal 40.
  • the endoscope 22 can be introduced simultaneously with the device 10 or, alternatively, subsequently, ie after insertion of the device 10.
  • a fixation of the guided through the device 10 endoscope 22 in the region of the anal canal 40 and / or rectum 41 and on the other hand preferably at the same time to achieve a gas-tight seal of the present embodiment to be examined Enddarm Anlagens 41 has the tubular Body 11 on a fluid inflatable balloon device 16.
  • the balloon device 16 comprises a circumferentially encircling annular or toroidal distal balloon element 16.3 of a flexible plastic sheath, which is arranged in the region of the distal end 13 of the tubular body 11 and can be inflated with a fluid.
  • FIGS. 1a, 1b and 2 show the distal balloon element 16.3 in the inflated state.
  • the balloon device 16.3 In the uninflated state, the balloon device 16.3 is collapsed so that the device 10 with the distal end 13 can be easily inserted into the anal canal 40 into the rectal region 41 ahead. If the balloon element 16.3 inflated, its volume increases such that due to the overpressure and the increase in volume a force or frictional contact on the one hand with the intestinal wall 43 and on the other hand with a through the tubular body 11th guided endoscopes 22 is formed (see Fig. 2). Since the distal balloon element 16.3 is fixedly connected to the tubular body 11 (see Fig.
  • the device 10 is fixed on the one hand non-positively relative to the intestinal wall 43 and on the other hand non-positively relative to the endoscope 22, which in turn the endoscope 22 - mediated by the Device 10 - can be fixed. Due to the special annular or toroidal configuration of the distal balloon element 16.3 this simultaneously acts as a seal, on the one hand the outer annular gap 51 between the intestinal wall 43 and the outside 11.1 of the tubular body 11 and on the other hand an inner annular gap 52 between the outside 22.1 of the endoscope 22 and the inner side 11.2 of the tubular body 11 closes gas-tight. By means of this gas-tight closure, the region beyond the balloon device 16 can be inflated with air via a corresponding media channel 22.
  • a supply line 17 for inflating the balloon device 16 and the distal balloon element 16.3 in the present embodiment via a supply line 17, in which also a check valve 18 is arranged.
  • the supply line is formed at least so long that it protrudes in the inserted state of the device 10 from the anus 42 and can be connected for pumping via a connection element 17.1, for example with a disposable syringe.
  • the valve 17 can be configured such that the balloon device 16 can also be pumped out again with the aid of the disposable syringe and thus the entire device 10 can be unblocked.
  • the balloon device 16 may also have other balloon elements and balloon element configurations.
  • Fig. Lc shows a possible embodiment of the balloon device 16, which has approximately in the middle of the tubular body 11 on the outside 11. l of the body 11, an outer balloon member 16.1 and the opposite on the inside 11.2 of the tubular body 11, a corresponding inner balloon member 16.2 , Both the inner and the outer balloon element 16.1, 16.2 are formed in the present embodiment as a hollow cylindrical balloon body, which are each circumferentially fixed to the inner side 11.2 and outer side 11.1 of the tubular body 11.
  • 1 d shows a further embodiment variant in which, in addition to the annular or toroidal distal balloon element 16. 3 -as shown in the embodiment according to FIG. 1-an outer, circumferentially encircling, hollow-cylindrical balloon element 16. 1 in the area is additionally provided on the outside of the tubular body 11 the proximal end 15 of the body 11 is arranged.
  • the non-positive fixation of the device 10 of the endoscope 22 is additionally increased compared to the embodiment according to FIG. Fig. Le shows an alternative embodiment variant of the balloon device 16, which - similar to the embodiment of FIG. Lc - an outer and an inner balloon element 16.1, 16.2 has, however, differ in their size and shape.
  • Both balloon elements 16.1, 16.2 are peripherally circumferentially arranged in the region of the distal end 13 of the body 11 on the outside or inside.
  • the outer balloon element 16.1 is, similar to in Fig. L, formed in a hollow cylindrical shape.
  • the inner balloon member 16.2 is annular, similar to the distal balloon member 16.3 in Fig. La, formed.
  • Fig. Lf shows a further variant of a possible arrangement and embodiment of the balloon device 16. This differs from the embodiment variant according to FIG. 1 in that the outer balloon element 16.1 is not arranged at the distal end 13 of the tubular body 11, but approximately centrally with respect to the longitudinal extension of the body 11 on its outer side 11.1.
  • Lg shows a further embodiment variant of the balloon device 16, which has a plurality of outer and a plurality of inner balloon devices 16.1, 16.2.
  • two hollow-cylindrical outer balloon elements 16.1 on the outside 11.1 in the area of the distal end 13 or of the proximal end 15 and correspondingly two inner balloon elements 16.2 on the inside 11.2 are respectively arranged peripherally circumferentially.
  • FIG. 1 h shows a simplified schematic representation of an embodiment variant of the balloon device 16, which merely serves to fix the device 10 and the endoscope 22 relative to the intestinal wall 43.
  • a plurality of outer, cuboid balloon means circumferentially disposed at the proximal end 13 of the body and correspondingly opposite a plurality of inner, cuboid balloon elements 16.1 on the proximal inner side of the body 11.
  • Between the outer and inner balloon elements 16.1, 16.2 is in each case a distance, so that these Balloon device 16 does not seal the bowel area beyond the device 10 even in the inflated state due to the gap gaps. It is also conceivable that the distance is chosen so small that touch the outer and inner balloon elements 16.1, 16.2 in the inflated state, so close the gap gaps in the inflated state and so a gas-tight closure of the anal canal can be achieved.
  • FIG. 3 shows a second possible embodiment of the device 10 according to the invention, which in contrast to the first exemplary embodiment according to FIG. 1a has a longitudinal slot 19 along the longitudinal axis of the tubular body 11 over the entire length of the device 10. Since the device 10 is formed in the present embodiment of plastic, the longitudinal slot 19 can be widened in the circumferential direction, so that the entire device 10 can be laterally applied to an endoscope. This is achieved in an advantageous manner that the device 10 can also later applied during an endoscopy already taking place on a still located outside of the body portion of the endoscope and introduced via the endoscope into the rectum.
  • the balloon device 16 in the present embodiment is a not completely closed annular body or torus, but closes in the inflated state at the front ends, so that a gas-tight closure of the anal canal can be achieved.
  • FIGS. 4 a and 4 b show one embodiment of a length-adjustable device 10 in which the tubular body 11 can be displaced relative to the proximal extension 30 along the longitudinal axis of the tubular body 11.
  • This length adjustment is used in an advantageous Heise to adjust the maximum insertion depth of the entire device 10.
  • the length adjustability is realized by way of a thread 21 between a neck or collar section 31 of the proximal extension 30 and the tubular body 11.
  • a latching device 20 is provided, which permits different latching positions of the proximal extension 30 relative to the body 11 in the direction of the longitudinal axis of the tubular body 11.
  • FIG. 1a shows the plan view of the inventive device according to FIG. 1a on the proximal end 15 in the direction of the distal end 13.
  • the proximal extension 30 has an asymmetrical, in particular elliptical, cross section, ie in one first direction y perpendicular to the longitudinal axis of the tubular body 11 has a greater extent than in a second direction x perpendicular to the longitudinal axis of the tubular body 11 and perpendicular to the first direction y.
  • asymmetrical configuration in the cross section of the proximal extension 30 is adapted to the anatomical conditions of the buttocks / jaws and thereby advantageously causes a rotation of the device relative to its longitudinal axis of the tubular body 11, whereby the fixation of the endoscope is additionally reinforced.
  • Fig. 5 shows on the inside of the proximal extension 30 in the region adjacent to the proximal opening 14 of the tubular body 11, a rotational position marker 35 with respect to the longitudinal axis of the tubular body 11. This marking can be used advantageously by the examiner to orient themselves within the intestine and refer to mark 35 if a finding is made. Due to the anti-rotation by means of the elliptical configuration of the proximal extension 30, this rotation position marker remains unchanged relative to the patient.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Physics & Mathematics (AREA)
  • Pathology (AREA)
  • Optics & Photonics (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Endoscopes (AREA)

Abstract

La présente invention concerne un dispositif (10) de fixation et, de préférence, d'étanchéité d'un endoscope (22), en particulier destiné à une utilisation en tant que rectoscope dans la zone du canal anal (40) et/ou du rectum (41), comprenant un corps tubulaire (11) insérable, au moins partiellement, dans le canal anal (40 ) et/ou dans le rectum (41), pourvu d'une ouverture distale (12), à l'extrémité distale (13) du corps (11) et d'une ouverture proximale (30), dans la zone de l'extrémité proximale (15) du corps (11), ledit corps (11) comportant au moins un dispositif à ballonnet (16) gonflable par un fluide, d'une part, pour fixer par liaison de force le corps (11) par rapport à la paroi intestinale dans la zone du canal anal (40) et/ou du rectum (41) et, d'autre part, pour fixer par liaison de force un endoscope guidé par rapport au corps (11) à travers le corps tubulaire (11). L'invention concerne en outre un procédé de fixation et, de préférence, d'étanchéité d'un endoscope (22) dans la zone du canal anal (40) et/ou du rectum (41) d'un patient au moyen d'un tel dispositif (10).
PCT/CH2017/000071 2016-07-14 2017-07-10 Dispositif d'utilisation de soutien pendant la colonoscopie, en particulier permettant de fixer et, de préférence, d'étanchéifier un endoscope dans la zone du canal anal et/ou du rectum Ceased WO2018010034A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
EP16179506 2016-07-14
EP16179506.7 2016-07-14

Publications (1)

Publication Number Publication Date
WO2018010034A1 true WO2018010034A1 (fr) 2018-01-18

Family

ID=56497560

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CH2017/000071 Ceased WO2018010034A1 (fr) 2016-07-14 2017-07-10 Dispositif d'utilisation de soutien pendant la colonoscopie, en particulier permettant de fixer et, de préférence, d'étanchéifier un endoscope dans la zone du canal anal et/ou du rectum

Country Status (1)

Country Link
WO (1) WO2018010034A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110270003A (zh) * 2019-07-15 2019-09-24 温州医科大学附属第一医院 内窥镜引导下球囊导管
CN111820856A (zh) * 2020-07-22 2020-10-27 复旦大学附属中山医院 一种结直肠内镜手术肛门辅助固定装置
CN113456132A (zh) * 2021-07-19 2021-10-01 南通市第一人民医院 一种自动开合式肠道保护器
CN113633250A (zh) * 2021-06-22 2021-11-12 桐乡市第一人民医院 一种术中肠镜肠壁固定装置
CN115624311A (zh) * 2022-10-31 2023-01-20 江西省肿瘤医院(江西省第二人民医院、江西省癌症中心) 一种新型可调可视扩肛器

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080033246A1 (en) 2006-08-01 2008-02-07 Raifu Matsui Endoscopic insertion aid, endoscopic system, and method of inserting insertion portion of endoscope into body cavity by use of endoscopic insertion aid
US20090062837A1 (en) 2007-08-29 2009-03-05 Christoph Gasche Outer tube for natural orifice surgery
US20140018625A1 (en) 2012-07-10 2014-01-16 University Hospitals Of Cleveland Colonoscope closure device
US20140107692A1 (en) 2012-10-17 2014-04-17 Olympus Medical Systems Corp. Method of treating a lumen region of a subject
US20140128677A1 (en) 2012-07-30 2014-05-08 Janet Lenart Enema and Coloscopy Aide
US20150105621A1 (en) 2008-11-07 2015-04-16 Ashkan Farhadi Endoscope Accessory

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080033246A1 (en) 2006-08-01 2008-02-07 Raifu Matsui Endoscopic insertion aid, endoscopic system, and method of inserting insertion portion of endoscope into body cavity by use of endoscopic insertion aid
US20090062837A1 (en) 2007-08-29 2009-03-05 Christoph Gasche Outer tube for natural orifice surgery
US20150105621A1 (en) 2008-11-07 2015-04-16 Ashkan Farhadi Endoscope Accessory
US20140018625A1 (en) 2012-07-10 2014-01-16 University Hospitals Of Cleveland Colonoscope closure device
US20140128677A1 (en) 2012-07-30 2014-05-08 Janet Lenart Enema and Coloscopy Aide
US20140107692A1 (en) 2012-10-17 2014-04-17 Olympus Medical Systems Corp. Method of treating a lumen region of a subject

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110270003A (zh) * 2019-07-15 2019-09-24 温州医科大学附属第一医院 内窥镜引导下球囊导管
CN110270003B (zh) * 2019-07-15 2024-05-17 南京康友医疗科技有限公司 内窥镜引导下球囊导管
CN111820856A (zh) * 2020-07-22 2020-10-27 复旦大学附属中山医院 一种结直肠内镜手术肛门辅助固定装置
CN113633250A (zh) * 2021-06-22 2021-11-12 桐乡市第一人民医院 一种术中肠镜肠壁固定装置
CN113456132A (zh) * 2021-07-19 2021-10-01 南通市第一人民医院 一种自动开合式肠道保护器
CN115624311A (zh) * 2022-10-31 2023-01-20 江西省肿瘤医院(江西省第二人民医院、江西省癌症中心) 一种新型可调可视扩肛器

Similar Documents

Publication Publication Date Title
DE10126062B4 (de) Haube für ein Endoskop
EP2185061B1 (fr) Fourreau de trocart, trocart, obturateur et rectoscope pour chirurgie endoscopique transluminale par les voies naturelles
DE19815598B4 (de) Flexibles Zugangsrohr mit Stülpschlauchsystem
EP3272386B1 (fr) Drainage par éponge sous vide
DE19624826C2 (de) Gewebeextraktionsvorrichtung
EP2676597B1 (fr) Enveloppe d'endoscope, agencement d'endoscope et procédé de mise à disposition d'un agencement d'endoscope
WO2018010034A1 (fr) Dispositif d'utilisation de soutien pendant la colonoscopie, en particulier permettant de fixer et, de préférence, d'étanchéifier un endoscope dans la zone du canal anal et/ou du rectum
EP1034010B1 (fr) Dispositif d'aide a l'insertion endoscopique
EP1083821A1 (fr) Gaine protectrice utilisee lors de la sterilisation d'endoscopes souples
DE69024876T2 (de) Uteruszugangsvorrichtung mit automatischer Oberflächenregelung
DE202009017988U1 (de) Chirurgisches Instrument
DE102011102686A1 (de) Anastomosegerät und Verfahren zum Einführen eines Anastomosegerätes in ein Körperlumen
EP2986228B1 (fr) Dispositif de prélèvement d'échantillons
EP2368500A1 (fr) Rétracteur chirurgical et utilisation dans le cadre d'une opération thoracoscopique
EP2903494B1 (fr) Système d'endoscopie et de biopsie à usage unique
DE102009057374A1 (de) Overtube (Schutzhülle) zum Einführen/Wechseln von Endoskopen und medizinischen Instrumenten
EP0626824B1 (fr) Dispositif pour extractions transanales de matieres de resection
DE102012203908B3 (de) Instrumentensystem für die minimalinvasive Chirurgie in der Single-Port-Technik
DE202011101205U1 (de) Anastomosegerät
WO2014118172A1 (fr) Cathéter muni d'un système de positionnement
DE102010051502A1 (de) Ballon-Laparoskop
DE202019102209U1 (de) Endoskopiesystem umfassend ein Endoskop mit einem flexiblen Schaft
EP3409221B1 (fr) Système d'instrument pour chirurgie à invasion minimale dans le tissu d'un patient
DE69837853T2 (de) Ausrichtbare endoskopische chirurgische vorrichtung
DE102010049568A1 (de) Schlauchanordnung für ein Endoskop

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: 17751002

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 17751002

Country of ref document: EP

Kind code of ref document: A1