Surgery – Means for introducing or removing material from body for... – Treating material introduced into or removed from body...
Patent
1995-04-25
1998-08-11
Polutta, Mark O.
Surgery
Means for introducing or removing material from body for...
Treating material introduced into or removed from body...
604175, 604164, 604268, A61M 500
Patent
active
057921199
DESCRIPTION:
BRIEF SUMMARY
The invention relates to an implant and a set for providing an artificial gastrostomy port.
Implants of this type are being used for long-time gastrostomy feeding of patients. Long-time gastrostomy feeding is necessary when feeding via the mouth and gullet is no longer possible. This may be caused for example by inoperable tumor obstructions of the upper gastrointestinal tract, but also after extensive oral surgery or due to for example neurogenic swallowing difficulties.
In these cases an implant of the above type can be inserted into a punctured hole extending through the abdominal wall to the stomach, and thereafter liquid food can be fed through the implant.
The implants which are known from the literature or are commercially available all are in the shape of a tube having at its distal end an enlargement provided with at least one opening. When implanted this enlargement is seated within the stomach cavity and secures the implant against withdrawal.
The distal enlargement is followed by a central tubular section which extends through the punctured hole outwards. At its proximal end the tubular section is provided with an opening adapted to be closed for example by a plug. Furthermore an outer flange for securing the implant on the abdominal wall can be provided. For the feeding of the patient the implant is opened at its proximal end and is thereafter connected to a food pump via a tube.
In the distal enlargement there can be provided a one-way valve to prevent backflow of the food or flow of stomach fluids into the implant.
Various techniques have become known to insert the implant into the stomach. For a first implantation it is common to pierce a puncture cannula into the stomach and thereafter to insert a guide thread into the stomach through the puncture cannula. The guide thread is engaged by pliers inserted into the stomach through a gastroscope and is withdrawn together with the gastroscope from the mouth. Thereafter the implant is connected to the guide thread, is drawn into the stomach through the mouth and gullet and is inserted into the punctured hole such that the distally enlarged end of the implant engages the inner abdominal wall surface.
The technique as described is relatively complicated (and awsome for the patient) and generally is used only for first implantations when the surgeon cannot use an already existing cured punctured hole. If however a used implant is to be replaced by a new implant, it is usually sufficient to slightly stretch the implant and thereafter withdraw the implant through the already existing punctured hole fixed against displacements of the tissue layers by fusion and, respectively, adhesion. The new implant can be inserted into the stomach in the opposite sequence. For tensioning a rod adapted to be inserted into the implant can be used for example. Such a stretchable implant has become known e.g. from U.S. Pat. No. 5,007,900.
U.S. Pat. No. 3,961,632 discloses a method enabling a first implantation from the outside. In this method a special implant is drawn over the puncture cannula, and the cannula and the implant are inserted into the stomach. Thereafter the cannula is withdrawn, with the implant remaining in the punctured hole and forming an enlargement at its distal area.
However, this known system is disadvantageous in that it requires specially formed implants. Under certain circumstances withdrawal of the cannula from the implant may cause problems, in particular in view of the fact that the implant is held on the cannula only by friction.
The object of the invention is to provide an implant which can be inserted in a simple manner and without too much strain on the patient. A further object of the invention is to provide a set enabling to produce a gastrostomy port in a gentle manner.
In accordance with the invention an implant is provided with tensioning or pinching means for reversibly reducing the diameter of the implant along its total length. When the implant is in a tensioned or pinched condition, it is freely displaceable through a common troc
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Polutta Mark O.
Snow Bruce E.
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