• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    Lega for perianal fistulas. The invention describes a new curette (1a, 1b, 1c) to carry out the curettage of a perianal fistula in a simpler and more effective way. The new curette (1a, 1b, 1c) has an essentially cylindrical shape with an abrasive outer surface (2) and comprises two holes (3) located at its ends, its size being such that it can traverse the entire perianal fistula conduit by pulling by means of threads fixed to said holes (3). The invention also encompasses a set of legras (1a, 1b, 1c) of increasing size that can be used together for the curettage of a perianal fistula. (Machine-translation by Google Translate, not legally binding)
    公开号:ES2547496A1
    申请号:ES201430292
    申请日:2014-03-04
    公开日:2015-10-06
    发明作者:Francisco Javier PEREZ LARA；Arminda FERRER BERGES；Horacio OLIVA MUÑOZ
    申请人:Servicio Andaluz de Salud；
    IPC主号:
    专利说明:

    DESCRIPTION

    Legra for perianal fistulas

    OBJECT OF THE INVENTION 5

    The present invention belongs to the field of medicine, and more specifically to the surgical treatment of perianal fistulas.

    The object of the present invention is a new legra to carry out the curettage of a perianal fistula in a more simple and effective way.

    BACKGROUND OF THE INVENTION

    The perianal fistula is an abnormal connection between the internal surface of the anal canal and the skin that surrounds the perianal region, has an incidence of 1.1 to 2.2 per 10,000 inhabitants and year and constitutes a pathology that often causes great discomfort and it can significantly reduce the patient's quality of life, since they can be irritating due to the drainage of pus, as well as the discomfort of some fistulas from passing fecal material through their light. In addition, the recurrent abscesses they produce can cause short-term morbidity, such as pain and infection, which can become systemic.

    Currently, the treatment of perianal fistulas is surgical, there are two large groups of surgical techniques, techniques that include the sphincter section and sphincter preservation techniques. 25

    The techniques of the first group have higher cure rates than those of the second group but as a counterpart they also have higher rates of faecal incontinence, therefore they can only be used in simple fistulas (which due to their low situation cross small amount of muscle tissue sphincter) and consist of fistulotomy or fistulectomy. 30 A fistulotomy consists of the section of all external and internal sphincter muscles that are below the sphincter path. A fistulectomy is the resection of the path from the external fistulous orifice to the internal fistulous orifice that also involves the section of all external and internal sphincter musculature that is below the sphincterian path. 35

    Higher fistulas require more complex treatments with partial sphincter sections and an increased risk of incontinence and variable success rates (but clearly lower than simple fistulas). In these cases of complex fistula is very important, the technique used is used, carry out the curettage and resection of the largest amount of fibrous tissue along the entire path, however the surgical instruments that we have today On this day, there is no legra capable of lysing all the fibrotic tissue of the path, since the legras are not able to adapt to the path, most of the time curvilinear, of the fistulas.

    Currently, instruments called 10 legras are used to carry out the curettage. A conventional legra is an instrument that has a handle, an elongated portion for introduction into the fistula duct, and a rounded but endowed portion located at its distal end to scrape the internal surface of the fistula duct. Fig. 1 shows an example of conventional legra.
     fifteen
    These instruments have the important disadvantage that they are not usually able to adapt to the path of a fistula, which often has curvilinear sections. As a consequence, the results of the curettage carried out by means of this type of instruments are not suitable. Proper curettage is of the utmost importance, since it seems likely that the results of the treatment of complex fistulas are directly proportional to the amount of fibrotic tissue that can be resected along the entire path of the fistula.

    DESCRIPTION OF THE INVENTION
     25
    The present invention solves the above problems thanks to a new legra design completely different from those known so far. The slogans of the present invention consist of small pieces that, with the help of threads to pull through one or the other end of the fistula duct, can completely cross said duct. This makes it possible to adequately achieve even curvilinear or internal revolt areas 30 of the fistula, unlike conventional legras that only allow access to the interior of the fistula in a limited way.

    The invention describes a slogan for the treatment of perianal fistulas having an essentially cylindrical shape with an abrasive outer surface and holes 35 located at its ends, its size being such that it can pass through the entire fistula duct
    perianal pulling by means of threads that are fixed to the holes.

    As used herein, the term "essentially cylindrical" encompasses not only strictly cylindrical shapes, but also shapes that deviate slightly from said cylindrical shape, fundamentally small changes in diameter, although staying close to a cylindrical shape that allows it to slide longitudinal along the fistula duct.

    As used herein, an "abrasive" surface refers to a surface provided with protrusions, spikes, spikes, spikes ..., generally referred to as 10 protuberances, which have an essentially radial shape such that, when the legra of the invention travels longitudinally along the fistula duct, "scrape" or "scratch" the inner surface of said duct.

    As for the size, as mentioned above, it must allow the legra 15 to pass longitudinally along the entire fistula duct, entering at one end and exiting at the opposite end. Taking into account the usual internal diameter of several fistulas studied, and according to the tests performed by the inventors of the present application, a suitable size for this comprises a length of less than 15 mm and a diameter of less than 10 mm. twenty

    In addition, normally the roughness of the abrasive outer surface is greater the larger the diameter of the woodgrain. That is, the larger the diameter or thickness of the legra, the greater the length of the protuberances that protrude radially from its surface. This makes it possible to manufacture several legras of different sizes that can be used depending on the size of the fistula to be treated, or successively as will be described below. The inventors of the present application have developed the legra of the invention in three sizes that have proven useful in the various tests performed.

    A preferred embodiment describes a slogan having a diameter between 1.5 mm and 2.5 mm and an abrasive outer surface with protuberances between 0.1 and 0.4 mm. This letter can be used as the first letter in a successive curettage treatment.

    Another preferred embodiment describes a legra having a diameter between 2.5 mm and 4 mm and an abrasive outer surface with protuberances between 0.5 mm and 0.8 mm. It can be used as a second curette in a successive curettage treatment.

    Another preferred embodiment describes a legra having a diameter between 4 mm and 6 mm and an abrasive outer surface with protuberances between 1.0 mm and 1.4 mm. It can be used as a third curette in a successive curettage treatment.
     5
    Finally, the present invention is also directed to a set of legras for the treatment of perianal fistulas comprising:
     a) a legra with a diameter of between 1.5 mm and 2.5 mm and an abrasive outer surface with protuberances between 0.1 and 0.4 mm
     b) a slogan with a diameter between 2.5 mm and 4 mm and an abrasive outer surface 10 with protuberances between 0.5 mm and 0.8 mm
     c) a legra with a diameter between 4 mm and 6 mm and an abrasive outer surface with protuberances between 1.0 mm and 1.4 mm

    This set of letters allows to carry out a method of curettage of the perianal fistula 15 by successively passing through the fistula the first legra successively, followed by the second legra, and finally the third legra. An example of the method of using the slogans of the present invention will be described in more detail later in this document.
     twenty
    BRIEF DESCRIPTION OF THE FIGURES

    Fig. 1 shows an example of legra in accordance with the prior art.

    Figs. 2a-2c show respectively three examples of legras that can constitute a set of legras for the successive curettage of a perianal fistula.

    Fig. 3 schematically shows the mode of use of a letter according to the present invention.
     30
    PREFERRED EMBODIMENT OF THE INVENTION

    Fig. 1 shows an example of legra (100) according to the prior art. As can be seen, it comprises a proximal handle from which an elongated rod protrudes at the distal end of which there is an element of living edges to "scrape" the inner surface of the fistula duct. Obviously, in fistulas with curved or broken ducts the
    This legra's ability to reach its entire interior surface is limited.

    Figs. 2a-2c show three examples of legra (1a, 1b, 1c) according to the present invention. These are three legras (1a, 1b, 1c) made of a hypoallergenic metallic material that can be used together to make a progressive curettage of the fistula duct to be treated.

    The first legra (1a) is the finest of the three, with an essentially cylindrical shape with an approximate diameter of 2 mm and an abrasive surface (2) provided with protuberances similar to those of a sandpaper. In addition, it has holes (3) located at its ends. 10

    The second legra (1b) is somewhat thicker than the previous one, with an approximate diameter of 3 mm and an abrasive surface (2) having protrusions of approximately 0.6 mm in length. It also has holes (3) at its ends.
     fifteen
    The third legra (1c) is the thickest of the three, with an approximate diameter of 5 mm and an abrasive surface (2) provided with protrusions of approximately 1.2 mm in length. It also has holes (3) at its ends.

    Next, an example of the operation of curettage is described briefly in this set 20 of three letters in a successive and orderly manner. Note that this is only an example, and that in general it would be possible to use only one or two slogans depending on each particular case.

    First, a guide is channeled through the path of the fistula duct, and then this guide is used to pass a silk thread along the entire duct. The silk thread is tied to one of the holes (3) of the first legra (1a), the finest, and the opposite end of the thread is pulled to pass the first legra (1a) through the entire duct. This has been schematically represented in Fig. 3, where it is seen how the thread completely crosses the fistula duct, so that when the legra 30 (1a) is attached to said thread it is enough to pull one end and another successively , as indicated by the arrows, to pass the legra (1a) through the duct. This process is repeated successively so that the legra (1a) runs through the duct successively in both directions until a situation in which it passes easily is reached. It is then interpreted that the curettage of the innermost part of the fibrous duct has been performed correctly. 35

    Then, the operation is repeated with the second legra (1b), which has a larger diameter and greater protuberances, until it passes through the fistula duct easily.

    Finally, the operation is repeated again with the third letter (1c). After passing it repeatedly in both directions, successively achieving the fibrous layers of the duct, a situation is again reached in which the legra (1c) passes easily. This means that a tunnel of about 5 mm in diameter has been carved out, so it can be concluded that the fibrous tissue of the duct has been resected.

    Finally, the concrete technique to be used is performed (mucous advance flap, 10 sealed with fibrin, sealed with platelets, plug, ...), with the guarantee that the duct has been completely curettage. You can even simply close the internal hole as a definitive treatment without applying any other complementary technique.

     fifteen
    权利要求:
    Claims (8)
    [1]

    1. Legra (1a, 1b, 1c) for perianal fistulas, characterized in that it has an essentially cylindrical shape with an abrasive outer surface (2) and comprises holes (3) located at its ends, its size being such that it can pass through the entire duct of the perianal fistula by pulling by means of threads fixed to said holes (3).

    [2]
    2. Legra (1a, 1b, 1c) according to claim 1, having a length of less than 15 mm and a diameter of less than 10 mm.
     10
    [3]
    3. Legra (1a, 1b, 1c) according to any of the preceding claims, which is made of a hypoallergenic metallic material.

    [4]
    4. Legra (1a, 1b, 1c) according to any of the preceding claims, wherein the roughness of the abrasive outer surface (2) is greater the larger the diameter. fifteen

    [5]
    5. Legra (1a) according to claim 4, having a diameter between 1.5 mm and 2.5 mm and an abrasive outer surface (2) with protuberances between 0.1 and 0.4 mm.

    [6]
    6. Legra (1b) according to claim 4, which has a diameter between 2.5 mm and 4 20 mm and an abrasive outer surface (2) with protuberances between 0.5 mm and 0.8 mm.

    [7]
    7. Legra (1c) according to claim 4, having a diameter between 4 mm and 6 mm and an abrasive outer surface (2) with protrusions between 1.0 mm and 1.4 mm.
     25
    [8]
    8. Set of legras (1a, 1b, 1c) for perianal fistulas comprising:
     - a letter (1a) according to claim 5;
     - a letter (1b) according to claim 6; Y
     - a letter (1c) according to claim 7;
    to carry out a curettage procedure of a perianal fistula by successively passing a thread through the fistula the legra (1a), followed by the legra (1b), and finally the legra (1c).
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    同族专利:
    公开号 | 公开日
    WO2015132439A1|2015-09-11|
    ES2547496B1|2016-07-14|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    US5643305A|1994-11-18|1997-07-01|Al-Tameem; Moshin|Device for excision of a fistula|
    ES2116914B1|1996-05-14|1999-03-01|Palazon Hernandez Jesus Maria|PERIANAL FISTULES RESECTOR.|
    AU5694101A|2001-04-11|2002-10-28|Tasci Ihsan|Device for excision of a fistula|
    NL1024218C2|2003-09-03|2005-03-07|Stichting Sint Annadal|Device for treating fistulas.|WO2020136305A1|2018-12-28|2020-07-02|Servicio Andaluz De Salud|Device for the curettage of fistulous tracts|
    法律状态:
    2016-07-14| FG2A| Definitive protection|Ref document number: 2547496 Country of ref document: ES Kind code of ref document: B1 Effective date: 20160714 |
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    申请号 | 申请日 | 专利标题
    ES201430292A|ES2547496B1|2014-03-04|2014-03-04|LEGRA FOR PERIANAL FISTLES|ES201430292A| ES2547496B1|2014-03-04|2014-03-04|LEGRA FOR PERIANAL FISTLES|
    PCT/ES2015/070157| WO2015132439A1|2014-03-04|2015-03-04|Curette for fistulas|
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