• 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:
    Device (1) to cause ischemia in the uterus (2) during medical interventions, characterized in that it comprises: - A laparoscopic cuff (3) of paracervical uterine ischemia that has a curved shape adapted to the contour of the uterus (2), and is made of recoverable flexible material to tend to surround the uterus (2) once placed, comprising first means of hook in its distal area (30) to configure a closed loop (31) once placed, - a balloon (32) arranged along the laparoscopic sleeve (3) to contact the uterine vessels (20), and provided with inflation means at sufficient pressure to cause the ischemia to be pressed against them, and - an abdominal access port (5) for insertion of the laparoscopic sleeve (3). (Machine-translation by Google Translate, not legally binding)
    公开号:ES2727024A1
    申请号:ES201930129
    申请日:2019-02-18
    公开日:2019-10-11
    发明作者:Zambrano Miguel Angel Rodriguez
    申请人:Zambrano Miguel Angel Rodriguez；
    IPC主号:
    专利说明:

    [0001] DEVICE TO CAUSE ISCHEMIA IN THE UTERUS DURING INTERVENTIONS
    [0002]
    [0003]
    [0004]
    [0005] The present invention relates to a device for causing ischemia in the uterus during medical interventions.
    [0006]
    [0007]
    [0008]
    [0009] Currently, surgical interventions on the uterus with abdominal access (from laparoscopic abdominal surgery), even the simplest ones, require a laborious and complicated preparation by the surgeon, since the tissues and structures surrounding the uterus, and arteries uterine, they must be prepared and must be accessed through them in many cases, preparation that is not simple and also takes many times longer than the intervention itself.
    [0010]
    [0011] Therefore, blood flow is often not properly interrupted, and these interventions (myomas removal, hysterectomies, etc.) are performed with bleeding.
    [0012]
    [0013] This drawback is solved with the use of the device of the invention.
    [0014]
    [0015]
    [0016]
    [0017] The device for causing ischemia in the uterus during medical interventions of the invention has a configuration that allows simple and rapid placement around the uterus without having to manipulate or damage the surrounding structures, and has means for producing ischemia, blocking blood flow and allowing the operation to be performed without bleeding, which facilitates the operation itself and the subsequent recomposition of the affected tissues and structures, with minimal aggressiveness.
    [0018]
    [0019] According to the invention, the device comprises:
    [0020] -A laparoscopic cuff (suitable to access the abdomen through a laparoscopic port) to cause uterine ischemia, paracervical -that is, it has a curved shape adapted to the contour of the uterus-, and is made of flexible material recoverable in shape to pass through a port of laparoscopy and once inserted through it tend to surround the uterus; the sleeve comprising first coupling means in its distal area to configure a closed loop once placed,
    [0021] - a balloon arranged along the laparoscopic cuff to contact the uterine vessels, and provided with inflation means at sufficient pressure to cause uterine ischemia when constricting them, and
    [0022] -the mentioned abdominal access port, for insertion of the laparoscopic cuff and paracervical placement.
    [0023]
    [0024] In this way, a simple laparoscopy incision is made to place an abdominal access port (through a trocar for example), and you simply have to insert the cuff through it thanks to its flexibility, also manipulating the port so that this movement -in coordination with the recovery of the paracervical shape of the cuff thanks to its flexible configuration recoverable in shape - get around the uterus and uterine vessels until the first means of engagement close the loop made around the uterus, adjusting the contact or pressure against the uterus simply by tensioning the cuff from the outside and fixing its position. Subsequently, it is only necessary to give the balloon sufficient pressure (pneumatic or through fluid) to block irrigation, a pressure that is usually equal to or greater than 200 mmHg.
    [0025]
    [0026] But in addition to this advantage, the following additional advantages derived from the proposed configuration have been found:
    [0027] -Less less skilled personnel can safely perform these interventions, without risk of damage to the uterine arteries with the placement of vascular clips, and in case of subtitle hysterectomies it helps to preserve the ureter and avoid damage to it.
    [0028] -in laparoscopic myomectomies, due to its complete ischemic power, it will allow the complete removal of them without bleeding, making the subsequent rapid suture unnecessary, being able to perform it in a slower and safer way since there is no active bleeding.
    [0029]
    [0030] Figure 1 shows a view of the device of the invention.
    [0031]
    [0032] Figure 2 shows a view of the device of the invention in a variant where the laparoscopic sleeve comprises a sectioning wire whose end incorporates the electric piercing tip, the wire comprising an insulating jacket of breakable material in case of pulling the thread.
    [0033]
    [0034] Figure 3 shows a view of the use of the device of the invention, where the electric tip of the sleeve is accessing the peritoneum
    [0035]
    [0036] Figures 4 to 6 show the placement of the cuff around the uterus. In a detail of Fig. 6, it is also appreciated how the balloon is placed around the uterine vessels and the uterus together, but still without swelling the balloon to constrict them
    [0037]
    [0038] Figure 7 shows the filling of the laparoscopic cuff balloon to produce ischemia of the uterus. In the detail similar to that of Figure 6, it can be seen how the balloon is swollen, constricting the vessels against the uterus and producing ischemia.
    [0039]
    [0040] Figure 8 shows a view similar to that of Figure 7, where the first means of engagement of the distal area of the sleeve comprise a narrowing to fit in the recess or extreme perimeter step of the trocar.
    [0041]
    [0042]
    [0043]
    [0044] The device (1) for causing ischemia in the uterus (2) during medical interventions of the invention comprises:
    [0045] -A laparoscopic cuff (3) of paracervical uterine ischemia that has a curved shape adapted to the contour of the uterus (2), and is made of flexible material recoverable in shape to tend to surround the uterus (2) once placed (see figs 4 to 6), comprising first coupling means in its distal area (30) (see figs. 1 and 2) to configure a closed loop (31) once placed (see figs 4 to 7),
    [0046] -a balloon (32) (see detail of figs 1, 2, 6 and 7) arranged along the laparoscopic sleeve (3) to contact the uterine vessels (20), and provided with inflation means to sufficient pressure (> 200 mmHg for example) to cause ischemia when pressed against them, and
    [0047] -A abdominal access port (5) for insertion of the laparoscopic sleeve (3).
    [0048]
    [0049] The balloon (32) will cover at least the area of the uterine vessels (20), but most preferably said balloon (32) is arranged along the entire laparoscopic cuff (3), to cover the entire contour of the uterus (2) ) and block irrigation in the main and secondary or branched uterine vessels.
    [0050]
    [0051] It is envisaged that the laparoscopic sleeve (3) most preferably comprises a reinforcement (33) (see detail of fig 1 and 2) on the contact face with the tip (50) of the access port (5), since when inserting the sleeve (3) rubbing with the port (5) (for example, with the tip of a trocar) could puncture, tear or damage it. In addition, the reinforcement (33) can cooperate in maintaining the flexible recoverable shape of the sleeve (3). Said reinforcement (33) ideally comprises an outer flat flat wall of the sleeve (3), the balloon (32) being arranged on the inside (the one that is in contact with the organ), so as to produce an effective irrigation blockage.
    [0052]
    [0053] On the other hand, the access port (5) preferably comprises a trocar, since it is a usual element in this technical field, with the particularity that said trocar will preferably also comprise coupling means complementary to the first coupling means of the distal area (30) of the sleeve (3) to close the loop. For example, the first hooking means can comprise an extreme configuration of the sleeve (3) in the form of a hook (36) (see figs 1, 2, 4 and 6), since in the direction of advancement it has a soft and slightly aggressive configuration with the surrounding structures, while the complementary hooking means arranged in the trocar can be for example a recess (61) or an extreme perimeter step for engaging the hook-shaped end configuration (36), or an end eyelet, not shown , for insertion of the extreme hook-shaped configuration (36). Likewise, the first coupling means may comprise an extreme configuration of the sleeve (3) in the form of a narrowing (36a), while the complementary coupling means arranged in the trocar could also be a recess (61), perimeter step or extreme groove for fitting the narrowing (36a), or the one end eyelet, not shown, for insertion of the narrowing (36a).
    [0054] Additionally, it is provided that the laparoscopic sleeve (3) may comprise an electric piercing tip (37) for access to the peritoneum (88) (see fig. 3). Thus, by inserting the sleeve (3) and accessing the inside of the peritoneum (88) an electric shock will cooperate in the drilling and cauterization of the hole. Said electric tip (37) is connected to a first external source (7) through a conductor (38) integrated in the sleeve (3).
    [0055]
    [0056] It is also provided that the device (1) can comprise a laparoscopic disconnecting wire (39) (insertable by the port (5)), arranged parallel to the laparoscopic sleeve (3) and connected to the first coupling means in its distal area for also be placed around the uterus (2) in the form of a loop and an external puller (40) (it can be the outside of the thread itself (39)) to section the uterus (2) in hysterectomy interventions. In this way pulling the handle (40) the uterus (2) is sectioned during a hysterectomy, with ease and minimal aggressiveness. Ideally, the disconnecting wire (39) is made of electrically conductive material (a wire, for example) connected to a second outdoor source (41) to cause cauterization of the wound during the section of the uterus (2). The electric piercing tip (37) can be arranged at the end of the wire (39) disconnector made of electrically conductive material, the wire (39) comprising an insulating jacket (35) of breakable material in case of pulling the wire (39 ), so that with a single first external source (7) of electrical energy both functions are obtained (perforation and cauterization during the section of the uterus).
    [0057]
    [0058] Finally, indicate that the sleeve (3) is ideally materialized in elastomer suitable for intra-abdominal use, such as silicone.
    [0059]
    [0060] Sufficiently described the nature of the invention, as well as the manner in which it is carried out in practice, it should be noted that the provisions indicated above and represented in the attached drawings are subject to modifications in detail as long as they do not alter the fundamental principle.
    权利要求:
    Claims (13)
    [1]
    1. -Device (1) to cause ischemia in the uterus (2) during medical interventions, characterized in that it comprises:
    -A laparoscopic cuff (3) of paracervical uterine ischemia that has a curved shape adapted to the contour of the uterus (2), and that is made of flexible material recoverable in shape to tend to surround the uterus (2) once placed, comprising some first hooking means in its distal zone (30) to configure a closed loop (31) once placed,
    - a balloon (32) arranged along the laparoscopic sleeve (3) to contact the uterine vessels (20), and provided with inflation means at sufficient pressure to cause the ischemia to be pressed against them, and
    -A abdominal access port (5) for insertion of the laparoscopic sleeve (3).
    [2]
    2. Device (1) for causing ischemia in the uterus (2) during medical interventions according to claim 1 characterized in that the balloon (32) is arranged along the entire laparoscopic sleeve (3).
    [3]
    3. Device (1) for causing ischemia in the uterus (2) during medical interventions according to any of the preceding claims characterized in that the laparoscopic sleeve (3) comprises a reinforcement (33) on the face of contact with the tip (50) of the access port (5).
    [4]
    4. -Device (1) for causing ischemia in the uterus (2) during medical interventions according to claim 3 characterized in that the reinforcement (33) comprises a flat outer wall of the sleeve (3), the balloon (32) being arranged by the interior part.
    [5]
    5. Device (1) for causing ischemia in the uterus (2) during medical interventions according to any of the preceding claims characterized in that the access port (5) comprises a trocar.
    [6]
    6. Device (1) for causing ischemia in the uterus (2) during medical interventions according to claim 5 characterized in that the trocar comprises a coupling means complementary to the first coupling means of the distal area (30) of the sleeve (3) .
    [7]
    7. Device (1) for causing ischemia in the uterus (2) during medical interventions according to claim 6 characterized in that the first coupling means comprise an extreme configuration of the sleeve (3) in the form of a hook (36) or narrowing (36a) ; while the complementary coupling means arranged in the trocar are selected from:
    - a groove disposed at the end of said trocar to fit said narrowing (36a),
    -a recess (61) or extreme perimeter step for fitting the hook-shaped end configuration (36) or the narrowing (36a), or
    - An extreme eyelet for insertion of the extreme hook-shaped configuration (36) or the narrowing (36a).
    [8]
    8. Device (1) for causing ischemia in the uterus (2) during medical interventions according to any of the preceding claims characterized in that the laparoscopic sleeve (3) comprises an electric piercing tip (37) for access to the peritoneum (88).
    [9]
    9. Device (1) for causing ischemia in the uterus (2) during medical interventions according to claim 8 characterized in that the electric tip (37) is connected to a first external source (7) through an integrated conductor (38) in the sleeve (3).
    [10]
    10. Device (1) for causing ischemia in the uterus (2) during medical interventions according to any of the preceding claims characterized in that it comprises a laparoscopic disconnecting wire (39) arranged parallel to the laparoscopic sleeve (3) and attached to the first means of hook to close around the uterus (2) in the form of a loop and to an external handle (40) to section the uterus (2) in hysterectomy interventions.
    [11]
    11. Device (1) for causing ischemia in the uterus (2) during medical interventions according to claim 10, characterized in that the disconnecting wire (39) is made of electrically conductive material connected to a second outdoor source (41).
    [12]
    12. -Device (1) to cause ischemia in the uterus (2) during medical interventions according to claim 11 characterized in that the electric piercing tip (37) is arranged at the end of the wire (39) disconnector made of electrically conductive material ; the thread (39) comprising an insulating jacket (35) of breakable material in case of pulling the thread (39).
    [13]
    13.-Device (1) for causing ischemia in the uterus (2) during medical interventions according to any of the preceding claims characterized in that the sleeve (3) is materialized in silicone suitable for intra-abdominal use
    5
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    同族专利:
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    引用文献:
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    US20090318950A1|2006-07-24|2009-12-24|Yossi Gross|Fibroid treatment apparatus and method|
    US20100185220A1|2007-05-23|2010-07-22|Ic Therapeutics, Inc.|Apparatus and methods for controlled ischemic conditioning|
    WO2011013127A2|2009-07-27|2011-02-03|Fibro Control, Inc.|Structures for occluding the uterine artery|
    CN104116540A|2013-04-27|2014-10-29|耿桂启|Temporary in vitro uterine artery blocker|
    RU2661701C1|2017-02-09|2018-07-19|федеральное государственное автономное образовательное учреждение высшего образования "Российский университет дружбы народов" |Method of laparoscopic treatment of nodular forms of adenomyosis|
    法律状态:
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