U.S. patent number 3,833,940 [Application Number 05/297,746] was granted by the patent office on 1974-09-10 for bile duct endoprothesis.
Invention is credited to Walter Hartenbach.
United States Patent |
3,833,940 |
Hartenbach |
September 10, 1974 |
BILE DUCT ENDOPROTHESIS
Abstract
A bile duct endoprothesis having a metal or plastic cannula for
introduction into the bile duct and having rounded or beveled ends
to aid in insertion and a radially extending portion which serves
as a means for attaching a drain hose to the cannula and also as a
means for insuring against longitudinal displacement of the cannula
after it has been positioned within the bile duct. The cannula has
two discrete end sections which are detachable joined to a push on
frictional type connector that enables easier implantation of the
cannula within a bile duct.
Inventors: |
Hartenbach; Walter (62
Wiesbaden, DT) |
Family
ID: |
5825343 |
Appl.
No.: |
05/297,746 |
Filed: |
October 16, 1972 |
Foreign Application Priority Data
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Nov 17, 1971 [DT] |
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2156994 |
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Current U.S.
Class: |
623/23.64;
604/284; 606/155 |
Current CPC
Class: |
A61F
2/04 (20130101) |
Current International
Class: |
A61F
2/04 (20060101); A61f 001/24 (); A61m 027/00 () |
Field of
Search: |
;3/1,DIG.1
;128/334R,334C,348,349R,35R |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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666,090 |
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Jul 1963 |
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CA |
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115,942 |
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Nov 1969 |
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DK |
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17,717 |
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Aug 1913 |
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FR |
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Other References
Surgical Drains, Catalogue of Catheters & Accessories, American
Cystoscope Makers, Inc., 1960, page 64. .
Bile Duct Tubes, Pearse Type, Vitallium Surgical Appliances
Catalog, Austenal Laboratories, Inc., New York-Chicago, 1948, page
23..
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Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Frinks; Ronald L.
Attorney, Agent or Firm: Hauke, Gifford, Patalidis &
Dumont
Claims
I claim:
1. A bile duct emdoprothesis for restoring the biliary flux into
the duodenum, comprising a cannula of a size which can be
introduced into the bile duct, said cannula being made of material
suitqble for implantation in a bile duct and having rounded free
ends and at least one radial extension for protection against
longitudinal displacements, the cannula comprising two discrete end
sections and a discrete push-on frictional type connector
detachably connecting said end sections together.
2. A bile duct endoprothesis according to claim 1, characterized in
that the cannula is beveled, at least at one free end.
3. A bile duct endoprothesis according to claim 1, characterized in
that the cannula is shaped according to the normal curvature of the
bile duct and is shaped so for at least part of its length.
4. A bile duct endoprothesis according to claim 1, characterized in
that at least one of the end sections is formed to be flexible.
5. A bile duct endoprothesis according to claim 4, characterized in
that the flexible end section is covered by a thin-walled plastic
hose.
6. A bile duct endoprothesis according to claim 4 characterized in
that the flexible end section comprises a tightly wound coil
spring, said connector having a reduced diameter portion and one
end of said flexible end section being disposed over said reduced
diameter portion of said connector and a torroidal end ring carried
by the opposite end of said flexible end section.
7. A bile duct endoprothesis according to claim 4 and in which each
of the end sections comprises tightly wound coil springs each of
which carries a torroidal end ring at one end, said connector
comprising a short connecting piece having reduced diameter
opposite end portions, said end section having ends opposite said
end rings fitting over said end portions, said radial extension
comprising said connecting piece having a radially extending drain
attachment means.
8. A bile duct endoprothesis according to claim 1, characterized in
that the radial extension is formed as a nipple having a
perforation which is in communication with the interior of the
cannula.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention is directed to a bile duct endroprothesis for
restoring the biliary flux into the duodenum.
2. Description of the Prior Art
Irreparable bile duct stenoses which result in deadly bile duct
congestions (cholestases) are caused by carcinoma of the pancreas,
papillocarcinoma, duodenal carcinoma, antral carcinoma, carcinoma
of the bile duct, carcinoma of the gall bladder, carcinoma in the
hilus of the liver, retroperitoneal tumors, chronic pancreatitis,
etc. When these diseases occur, the cases are rare in which
short-term success is achieved by using radical by-pass anastomoses
for restoring the biliary flux. However, in most cases, such
irreparable methods of closing the bile ducts lead to early
disturbances of the total organism resulting in death.
SUMMARY OF THE PRESENT INVENTION
The present invention makes it possible to eliminate irreparable
bile duct stenoses and thus to prolong or save the lives of
patients. For this purpose, the invention provides a bile duct
endoprothesis for restoring the bile flux into the duodenum,
characterized by a metal or plastic cannula which can be introduced
into the bile duct. The cannula has rounded ends and at least one
radial extension for protection against longitudinal
displacements.
After the bile duct has been opened on one side of the stenosis and
after the stenosis has been dilated with a bougie on both sides,
the cannula can be introduced into the bile duct and thus, a safe
and unhindered bile flux is made possible. The radial extension
prevents displacements and thus prevents the prothesis from sliding
out of the bile duct.
To facilitate the introduction of the cannula, not only are its
ends rounded off, but also according to a further development of
the invention, there is provided a beveling at least at one end,
i.e., the cannula is not cut off straight, but beveled, and hence
tapers.
A further development of the invention additionally provides that
the cannula is subdivided into two sections. Both sections can then
be introduced separately during the operation, and hence, they can
be introduced easier. Afterwards, they can be joined, preferably by
means of a detachable push-on connection.
In a further development, the invention proposes that the cannula
is shaped according to the normal curvature of the bile duct or, at
least is shaped so for a part of its length. For this purpose, one
of its sections can be rendered flexible so that the prothesis can
automatically adapt itself to the natural curvature of the bile
duct. According to a further development of the invention, the
flexible section consists of a tightly wound coil spring, one end
of which is attachable to a part of the other section having a
reduced diameter while the other end of the coil spring carries a
toroidal end ring. Likewise, both sections can consist of such coil
springs each having a toroidal end ring and being attachable to a
short connecting piece of a reduced diameter on both sides and
having the radial extension.
The flexible section, especially one formed as coil spring, can be
slightly loose when curved. Therefore, a further development of the
invention provides that the flexible section is covered with a
thin-walled plastic hose. The hose must consist of a material
compatible with body tissue, for example, silicone rubber.
An important development of the invention is characterized in that
the radial extension is formed as a nipple having a perforation
which is in communication with the interior of the cannula. Then,
the nipple not only prevents longitudinal displacements of the
endoprothesis, but simultaneously serves as a means for attachment
with a hose to temporarily drain the bile to the outside and to
administer irrigations.
DESCRIPTION OF THE DRAWINGS
A better understanding of the present invention will be achieved
upon reference to the accompanying drawings in which several
preferred embodiments are illustrated and in which:
FIG. 1 is a side elevational view of a bile duct endroprothesis of
the present invention in the form of a straight cannula;
FIG. 2 is a view similar to FIG. 1 but illustrating a bile duct
endoprothesis of the present invention in the form a bent
cannula;
FIGS. 3a and 3b are side elevational views of other preferred
prothesis of the present invention; and
FIG. 4 illustrates the connecting piece of a prothesis upon which
two flexible sections according to FIG. 3b can be attached.
DESCRIPTION OF SEVERAL PREFERRED EMBODIMENTS
A bile duct endoprothesis of the present invention is illustrated
in FIG. 1 as comprising a rigid cannula 1 made of material that can
be implanted in a bile duct of the human body, i.e., metal or
plastic. At about one-third of its length, a perforated nipple 2 is
mounted on the cannula 1 and has a perforation 3 which is in
communication with the internal boring 4 of the cannula 1. A hose
(not shown) can be pushed on to the nipple 2, and utilized to drain
temporarily the bile to the outside and to administer irrigations.
Simultaneously, the nipple 2 together with the connected hose forms
a radial extension which protects the cannula from longitudinal
displacements.
At the ends of the cannula 1, there are bevels 5 which facilitate
the insertion into the bile duct. Roundness of the outer surfaces
prevents injuries.
FIG. 2 illustrates another preferred embodiment of the present
invention which differs from the prothesis according to FIG. 1 in
that the cannula 1 is bent at 6 for adapting itself to the natural
form of the bile duct.
Another preferred form of the endoprothesis of the present
invention is depicted in FIGS. 3a and 3b as comprising rigid
section 7 and a flexible section 8. The rigid section 7 is formed
of a metal cannula 14 and has a nipple 2 and a bevel 5 similar to
that of the embodiments of FIGS. 1 and 2. At the end opposite to
the bevel 5, there is disposed a connecting piece 9 of reduced
diameter on which the flexible section 8 can be pushed so that
clamping and tightening is effected. The flexible section 8
includes a tightly wound elastic metal wire forming an initially
tensioned toroidal coil spring with the individual turns being
close to each other. A toroidal end ring 10 preferably made of
metal is pushed on the free end of the flexible section 8 and
fastened there. The roundness of the ring 10 facilitates insertion
of the section 8 into the bile duct.
When a better sealing in the curved state is desired or required, a
thin-walled hose 12 made of silicone rubber is installed to fit
tightly over the coil spring. For a better understanding, the wall
thickness of the hose 12 depicted in FIG. 3b has been
exaggerated.
Depending upon the prevailing conditions, it may be advantageous to
utilize two flexible sections 8 like the one shown in FIG. 3b. In
that case, a center piece 11, as shown in FIG. 4, serves as a
push-on frictional type connector. In conformity with the example
according to FIG. 3a, the center piece 11 is provided with a radial
extension in the form of a nipple 2. Connecting pieces 9 are
provided on both ends for attaching the flexible sections 8.
In order to adapt the endoprothesis to the respective size and the
course of the bile ducts and to the forms of stenosis, it is
advantageous to keep available endoprotheses or their parts of
different lengths, sizes, and curvatures, as well as those which
are rigid and those which are flexible. The length of the complete
prothesis is normally situated in a range between 4 and 7 cm.
For the introduction of the prothesis into the bile duct, the
latter is opened above the stenosis. If the stenosis extends over
the total bile duct, an attempt has to be made to obtain a
passageway at one spot. The part of the stenosed bile duct is
dilated by a bougie until a part of the endoprothesis can be easily
introduced and can then be pushed into the small intestine through
the spot dilated by the bougie. The other part of the endoprothesis
is introduced into the bile ducts in the direction of the liver.
The sections are then snapped together. For gripping both sections,
a special pliers fitted to the form of the cannula 1 can be used. A
hose is pushed onto the nipple 2 of the endoprothesis and conducted
through the skin to the outside. This hose makes it possible to
drain initially the bile and to administer irrigations during the
first weeks. The hose can be drawn off after two or three months.
The surrounding tissue closes the small opening within a few
days.
When the stenosis is located towards the liver, the same applies
correspondingly, except that the stenosis must be dilated by a
bougie in the direction of the liver.
Although I have disclosed several embodiments of the present
invention, it is apparent that many changes and modifications can
be made without departing from the spirit of the invention as
expressed by the scope of the appended claims.
* * * * *