WO2004019793A1 - Panier de capture et de destruction de lithotriteur - Google Patents

Panier de capture et de destruction de lithotriteur Download PDF

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Publication number
WO2004019793A1
WO2004019793A1 PCT/DE2003/002816 DE0302816W WO2004019793A1 WO 2004019793 A1 WO2004019793 A1 WO 2004019793A1 DE 0302816 W DE0302816 W DE 0302816W WO 2004019793 A1 WO2004019793 A1 WO 2004019793A1
Authority
WO
WIPO (PCT)
Prior art keywords
basket
strands
lithotriptor
strand
ring
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/DE2003/002816
Other languages
German (de)
English (en)
Inventor
Raimar Boehlke
Werner Schwarz
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.)
Medi Globe GmbH
Original Assignee
Medi Globe GmbH
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 Medi Globe GmbH filed Critical Medi Globe GmbH
Publication of WO2004019793A1 publication Critical patent/WO2004019793A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop

Definitions

  • the invention relates to a lithotriptor capture and shattering basket, consisting of a plurality of stranded material strands, each of which is formed from a plurality of twisted material wires, in particular metal wires, and optionally has at least one kink region in the basket region, with all stranded material strands at the distal end of the basket are combined with each other in a summarizing area and are received by a sheathing at the proximal end of the basket and are displaceable therein.
  • Lithotriptor baskets and crushing baskets are used for the minimally invasive removal and crushing of stones in hollow organs and organs, especially the bile duct, by individuals or patients. Catchers of various shapes are used in such treatments.
  • lithotriptor collecting baskets and baskets of the type mentioned at the outset are known, for example, from EP 0 391 384 B1, US 6 183 482 A1, US 6 350 266 Bl.
  • lithotriptor catchers designed in this way there are also lithotriptor catchers in which the material wires at the distal end of the catcher each have a loop-shaped configuration, that is to say are not combined with one another in a summary region (see, for example, US Pat. No. 6,099,534, US Pat. No. 174,318 Bl, US 6 280 451 Bl).
  • the invention is therefore based on the object to show a way how to proceed with a lithotriptor catch and smashing basket of the type mentioned, so that it is ensured that in the event of a certain value being exceeded by the lithotriptor catch in question - and -Drümm réelleskorbchen exerted tensile force whose material strand strands do not tear, but rather in a problem-free pulling the lithotriptor catch and -Dishrümm réelleskorb is brought into the respective body opening, into which it was previously introduced, shape.
  • the invention has the advantage that tearing of the strand of material strands of the lithotriptor catch and shattering basket is ruled out in a relatively simple manner in the event that the tensile force exerted on the basket in question with a stone picked up by it exceeds a predetermined value.
  • this value which is below the total tensile strength of all material strand strands, is sufficient to break or tear open the material ring mentioned at precisely this tensile load, so that the material strand strands previously combined with one another at the distal cup end come apart without tearing.
  • the lithotriptor capture and smashing basket according to the invention is thus a safe basket that always enables minimally invasive patient treatment.
  • the material ring expediently has notches for receiving the strand of material strands running from the proximal cup end to the distal cup end. This has the advantage that the individual strand of material strands ge can be held by the relevant material ring in defined desired positions.
  • a material strand positioning ring is arranged in the direction of the proximal cup end, which holds the individual material strand strands at the distal cup end in fixed positions and which is designed such that its tear strength is less than the tear strength of the material ring in question.
  • the stranded material strands are separated in a two-stage manner if a certain predetermined value is exceeded by the tensile force exerted on the lithotriptor catcher basket. First, if this value is exceeded by the tensile force in question, the material strand positioning ring mentioned is disassembled, and then the material ring in question is disassembled.
  • the disassembly of the stranded wire positioning ring for the operator of the lithotriptor trap and shattering basket can be regarded as a warning to the extent that a further increase in the tensile force on the lithotriptor trap and shattering basket in question is likely to result in its strand of material strand be separated at the distal end of the cup.
  • the individual strands of material strand are preferably each connected to a separate holding element at the distal cup end, and all holding elements are covered by the material ring and, if appropriate, by the positioning ring. This has the advantage of a simple yet secure positioning of the strand of material strand at the distal end of the cup.
  • the material lit Strands of material strands are positively and / or positively received in their respective receiving element.
  • the stranded material strands are expediently connected to their receiving elements by a soldered or welded connection. As a result, the material strand strand ends in question are securely connected to their receiving elements.
  • An alternative connection option comprises crimping the relevant strand of material strand.
  • a structurally particularly simple, but nevertheless effective lithotriptor cup construction results according to an expedient development of the present invention in that the positioning ring and the metal ring are formed by a single ring.
  • Fig. 1 shows a partially sectioned side view of a schematic representation of a first embodiment of a lithotriptor capture and shattering basket according to the invention.
  • FIG. 2 shows an enlarged view of a material ring used in the lithotriptor capture and shattering basket according to FIG. 1 along the line of sight II-II entered in FIG. 1.
  • FIG. 3 shows an enlarged sectional view of the summary area at the distal end of the basket of the lithotriptor basket and comminution basket shown in FIG. 1, corresponding to the section line III-III entered there.
  • Fig. 4 shows a schematic representation of a second embodiment of the lithotriptor capture and Shattering basket according to the present invention.
  • FIG. 5 shows in an enlarged view a plan view of a positioning ring used in the lithotriptor catch and shattering basket according to FIG. 4 along the line of sight IV-IV entered in FIG. 4.
  • FIG. 6 shows, in a greatly enlarged view, a schematic illustration of the lithotriptor catch and shattering basket shown in FIG. 4, in which a stone is received, in order to illustrate the mechanism of action that is used according to the invention.
  • Fig. 1 shows a side view and partly in section a schematic representation of a first embodiment of a lithotriptor catch basket 1, hereinafter only briefly called lithotriptor catch basket 1 according to the invention.
  • the lithotriptor basket 1 consists of a plurality of stranded material strands, in the present case four such stranded material strands 2, 3, 4, 5.
  • the stranded material strands 2 to 5 each consist of a plurality of twisted material wires, in particular through metal wires, such as through Stainless steel or titanium wires are formed; if necessary, they can also be formed by plastic strands.
  • the number of material or metal wires in question can correspond, for example, to the number of strands of material 2 to 5; however, it is also possible for each strand of material strand to consist of a larger or smaller number of material wires.
  • the individual strand of material strands 2 to 5 here have in the cup area, that is the area between a distal cup end 6 and a proximal cup end 7, in each case at least one kink area.
  • the material strand strands 2 to 5 are combined with one another at the distal end of the basket 6 in a gathering area 10, and they are received at the proximal end of the basket 7 by a sheath 11 and can be displaced in the longitudinal direction thereof.
  • the material strand strands 2 to 5 are enclosed by at least one material ring 12, which can be made of stainless steel, titanium or high-strength plastic and which is designed and dimensioned such that its tensile strength is lower than the total tensile strength of all material strand strands 2 to 5
  • This design and dimensioning of the material ring 12 ensures that an obstacle which occurs when the lithotriptor basket 1 with a stone therein is pulled to the left according to FIG. 1 and leads to a heavy load on the material strand strands 2 to 5 will not be sufficient to lead to the tearing of individual strands of material strand 2 to 5.
  • the previously considered summary area 10 also includes a cover cap 13 which receives and covers the distal ends of the stranded material strands 2 to 5, which can be made of plastic or rubber, for example, and whose tear strength is also lower than the total tensile strength of all stranded material strands 2 to 5 or is even less than the tensile strength of the material ring 12.
  • the covering cap 13 in question and / or the material ring 12 can or can optionally also be easily formed so elastic that only the individual Materiallitzenstrlinde 2 released to 5 who, without the cap or type of material in question ring tears ⁇ .
  • FIG. 2 shows an enlarged top view of the material ring 12 shown in section in FIG. 1 along the view plane II-II according to FIG. 1. It is clear from FIG. 2 that the material ring 12 on its side facing the proximal end of the basket four Has notches 14, 15, 16 and 17 at equidistant intervals. In these notches 14 to 17, the strand of material strands 2 to 5 lie against the material ring 12 at the distal end of the catcher basket 6, as can be seen from the sectional illustration in FIG. 1.
  • the individual strand of material strands 2 to 5 at the distal cup end each have a separate holding element 34, 35, 36 or 37 are connected, which in the present case has the shape of a right-angled angular part.
  • these holding elements or angular parts 34 to 37 which are made of stainless steel, for example, the associated stranded material strands 2 to 5 are each non-positively and / or positively received.
  • the respective connection is a soldered connection (soft or hard soldering).
  • FIG. 1 shows a schematic side view and partly in section of a second exemplary embodiment of the lithotriptor collecting basket according to the invention. 4, insofar as they correspond to the elements shown in FIG. 1, the same reference numerals are used for the individual elements.
  • the summarizing region 10 in the exemplary embodiment of the lithotriptor collecting basket 1 shown in FIG. 4 points in the direction next to the material ring, which is designated by 18 in FIG. 4 Towards the proximal cup end 7, there is also a separate material strand positioning ring 19 which holds the individual material strand strands 2 to 5 at the distal cup end in fixed positions and which is designed and dimensioned such that its tear strength is lower than the tear strength of the material ring 18.
  • the material strand positioning ring 19 can be configured on its side facing the proximal cup end 7 as illustrated in FIG. 2, that is to say provided with notches 14 to 17 in the surface concerned. However, it is also possible to design the material strand positioning ring 19 in a manner as illustrated in FIG. 5, which shows an enlarged plan view of the material strand positioning ring 19 shown in FIG. 4 along the view plane V-V.
  • the material strand positioning ring 19, as shown in FIG. 5, has four equidistantly spaced latching openings 20, 21, 22, 23 in its inner surface, into which the material strand strands 2 to 5 to a certain extent during the assembly of the lithotriptor basket according to FIG. 4 be snapped into place.
  • the material ring 12 in the first embodiment shown in FIG. Example of the lithotriptor basket according to the invention can be designed in its inner circumference as shown in Fig. 5.
  • Fig. 6 the lithotriptor basket according to the invention shown in Fig. 4 is shown in a schematic view enlarged to illustrate the mechanism of action that is used according to the invention to avoid tearing of the stranded material strands under excessive tensile load.
  • the same reference numerals are used in FIG. 6 for the designation of the individual elements as in FIG. 4.
  • the lithotriptor basket 1 according to FIG. 6 is in a body opening 24 of a body tissue 25 together with one of the stone basket 26 is shown, which is to be pulled with the relevant lithotriptor basket 1 through the tissue opening 24 according to FIG. 6 from right to left.
  • tensile forces occur in the longitudinal direction in the individual material strand strands 2 to 5, which are relative to the material strand strands 2 and 5 are denoted by Pz. It is assumed here that the respective tensile forces are of the same magnitude and are also present in the remaining stranded material strands 3 and 4, although this is not shown in FIG. 6.
  • the tearing or tearing strength of the positioning ring 19 is lower than the tearing or tearing strength of the material ring 18, this material ring 18 becomes the stranded material strands 2 to 5 according to FIG. 6 after the positioning or tearing of the positioning ring 19 stick together.
  • the covering cap 13 surrounding the distal ends of the strand of material strands 2 to 5 will then no longer be able to hold them together, but the relevant strand of material strands 2 to 5 will detach from this covering cap 13 or cause it to tear. This ensures that the relevant strand of material strands 2 to 5 themselves are not torn and thus do not lead to damage to the tissue of the tissue opening or to penetration and entanglement in the tissue in question, as a result of which the lithotriptor basket is withdrawn.
  • the parts of the positioning ring 19, the material ring 18 and the cover cap 13 remaining in the body opening 24 of the body tissue 25 initially remain in the relevant body opening 24 from which the patient then undergoes natural invasive treatment. which are minimally invasively removed or removed with endoscopic foreign body forceps.
  • the tensile strength of the material ring 12 in the exemplary embodiment according to FIG. 1 and the tensile strength of the material ring 18 and the positioning ring 19 in the exemplary embodiment according to FIGS. 4 and 6 are determined by the choice of material and design of the respective ring in such a way that they are lower than one of the total tensile strength of the stranded material strands 2 to 5 strength value corresponding to the respective basket design.
  • the mechanism of action used in the present invention takes into account the fact that the risk of tearing stranded material strands of a lithotriptor basket The larger the stone to be removed is, the larger it is because of the associated greater resistance to a pulling movement of the collecting basket in question.
  • the action mechanism explained above ensures that the material ring 12 or the positioning ring 19 and the material ring 18 only break open when the total pulling force Pg exerted on the respective lithotriptor collecting basket according to the invention exceeds a pulling force value corresponding to this tear resistance value, without any the strand of material strands 2 to 5 breaks. In this way, a safe lithotriptor basket is created, which is free from the problems which, as discussed at the outset, are inherent in the previously known lithotriptor basket.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un panier (1) de capture et de destruction de lithotriteur qui est constitué d'une pluralité de cordons de matière (2 à 5) eux-mêmes respectivement formés d'une pluralité de fils de matière torsadés, notamment de fils métalliques, et présentant dans la zone de panier éventuellement au moins une zone coudée (8, 9). L'ensemble des cordons de matière (2 à 5) est regroupé dans une zone de regroupement (10) à l'extrémité distale (6) du panier de capture et est reçu de manière mobile dans une gaine (11) à l'extrémité proximale (7) du panier de capture. Dans la zone de regroupement (10), les cordons de matière (2 à 5) sont entourés par au moins une bague de matière (12; 18, 19) qui est conçue de façon que sa résistance à la rupture soit inférieure à une valeur de résistance correspondant à la résistance à la rupture globale de l'ensemble des cordons de matière (2 à 5).
PCT/DE2003/002816 2002-08-23 2003-08-22 Panier de capture et de destruction de lithotriteur Ceased WO2004019793A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE10246531.2 2002-08-23
DE2002146531 DE10246531A1 (de) 2002-08-23 2002-08-23 Lithotriptor-Fang- und -Zertrummerungskörbchen

Publications (1)

Publication Number Publication Date
WO2004019793A1 true WO2004019793A1 (fr) 2004-03-11

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PCT/DE2003/002816 Ceased WO2004019793A1 (fr) 2002-08-23 2003-08-22 Panier de capture et de destruction de lithotriteur

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DE (1) DE10246531A1 (fr)
WO (1) WO2004019793A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113133809A (zh) * 2021-04-23 2021-07-20 无锡东峰怡和科技发展有限公司 一次性使用静脉瓣膜刀

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4633871A (en) * 1984-06-18 1987-01-06 Olympus Optical Company, Ltd. Basket forceps assembly
EP0391384A2 (fr) * 1989-04-05 1990-10-10 GIP Medizintechnik GmbH Lithotriteur

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4633871A (en) * 1984-06-18 1987-01-06 Olympus Optical Company, Ltd. Basket forceps assembly
EP0391384A2 (fr) * 1989-04-05 1990-10-10 GIP Medizintechnik GmbH Lithotriteur
US5098441A (en) * 1989-04-05 1992-03-24 Dr. Andreas Lindner Unternehmensberatung Lithotriptor

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113133809A (zh) * 2021-04-23 2021-07-20 无锡东峰怡和科技发展有限公司 一次性使用静脉瓣膜刀

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DE10246531A1 (de) 2004-03-11

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