CN103142338B - Duodenum casing for treating diabetes implanted under endoscope - Google Patents
Duodenum casing for treating diabetes implanted under endoscope Download PDFInfo
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- CN103142338B CN103142338B CN201310099662.4A CN201310099662A CN103142338B CN 103142338 B CN103142338 B CN 103142338B CN 201310099662 A CN201310099662 A CN 201310099662A CN 103142338 B CN103142338 B CN 103142338B
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- diabetes
- sleeve
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- casing
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- 206010012601 diabetes mellitus Diseases 0.000 title claims abstract description 21
- 210000001198 duodenum Anatomy 0.000 title abstract description 8
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical group [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 claims abstract description 15
- 239000007788 liquid Substances 0.000 claims abstract description 6
- 230000002183 duodenal effect Effects 0.000 claims description 17
- HZEWFHLRYVTOIW-UHFFFAOYSA-N [Ti].[Ni] Chemical compound [Ti].[Ni] HZEWFHLRYVTOIW-UHFFFAOYSA-N 0.000 claims description 6
- 229920000642 polymer Polymers 0.000 claims description 5
- 230000001174 ascending effect Effects 0.000 claims description 4
- 239000000203 mixture Substances 0.000 claims description 4
- 238000007789 sealing Methods 0.000 claims description 4
- 208000001072 type 2 diabetes mellitus Diseases 0.000 abstract description 5
- 229910001000 nickel titanium Inorganic materials 0.000 abstract description 4
- 230000009286 beneficial effect Effects 0.000 abstract description 2
- 229920000249 biocompatible polymer Polymers 0.000 abstract description 2
- 238000004873 anchoring Methods 0.000 abstract 3
- 238000001727 in vivo Methods 0.000 abstract 1
- 239000002994 raw material Substances 0.000 abstract 1
- 238000001356 surgical procedure Methods 0.000 abstract 1
- 208000008589 Obesity Diseases 0.000 description 5
- 238000010586 diagram Methods 0.000 description 5
- 238000002347 injection Methods 0.000 description 5
- 239000007924 injection Substances 0.000 description 5
- 230000000968 intestinal effect Effects 0.000 description 5
- NOESYZHRGYRDHS-UHFFFAOYSA-N insulin Chemical compound N1C(=O)C(NC(=O)C(CCC(N)=O)NC(=O)C(CCC(O)=O)NC(=O)C(C(C)C)NC(=O)C(NC(=O)CN)C(C)CC)CSSCC(C(NC(CO)C(=O)NC(CC(C)C)C(=O)NC(CC=2C=CC(O)=CC=2)C(=O)NC(CCC(N)=O)C(=O)NC(CC(C)C)C(=O)NC(CCC(O)=O)C(=O)NC(CC(N)=O)C(=O)NC(CC=2C=CC(O)=CC=2)C(=O)NC(CSSCC(NC(=O)C(C(C)C)NC(=O)C(CC(C)C)NC(=O)C(CC=2C=CC(O)=CC=2)NC(=O)C(CC(C)C)NC(=O)C(C)NC(=O)C(CCC(O)=O)NC(=O)C(C(C)C)NC(=O)C(CC(C)C)NC(=O)C(CC=2NC=NC=2)NC(=O)C(CO)NC(=O)CNC2=O)C(=O)NCC(=O)NC(CCC(O)=O)C(=O)NC(CCCNC(N)=N)C(=O)NCC(=O)NC(CC=3C=CC=CC=3)C(=O)NC(CC=3C=CC=CC=3)C(=O)NC(CC=3C=CC(O)=CC=3)C(=O)NC(C(C)O)C(=O)N3C(CCC3)C(=O)NC(CCCCN)C(=O)NC(C)C(O)=O)C(=O)NC(CC(N)=O)C(O)=O)=O)NC(=O)C(C(C)CC)NC(=O)C(CO)NC(=O)C(C(C)O)NC(=O)C1CSSCC2NC(=O)C(CC(C)C)NC(=O)C(NC(=O)C(CCC(N)=O)NC(=O)C(CC(N)=O)NC(=O)C(NC(=O)C(N)CC=1C=CC=CC=1)C(C)C)CC1=CN=CN1 NOESYZHRGYRDHS-UHFFFAOYSA-N 0.000 description 4
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 3
- 239000008280 blood Substances 0.000 description 3
- 210000004369 blood Anatomy 0.000 description 3
- 208000012696 congenital leptin deficiency Diseases 0.000 description 3
- 238000005516 engineering process Methods 0.000 description 3
- 239000003629 gastrointestinal hormone Substances 0.000 description 3
- 239000008103 glucose Substances 0.000 description 3
- 210000003405 ileum Anatomy 0.000 description 3
- 210000001630 jejunum Anatomy 0.000 description 3
- 208000001022 morbid obesity Diseases 0.000 description 3
- 101800000224 Glucagon-like peptide 1 Proteins 0.000 description 2
- DTHNMHAUYICORS-KTKZVXAJSA-N Glucagon-like peptide 1 Chemical compound C([C@@H](C(=O)N[C@@H]([C@@H](C)CC)C(=O)N[C@@H](C)C(=O)N[C@@H](CC=1C2=CC=CC=C2NC=1)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CCCCN)C(=O)NCC(=O)N[C@@H](CCCNC(N)=N)C(N)=O)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CCCCN)NC(=O)[C@H](C)NC(=O)[C@H](C)NC(=O)[C@H](CCC(N)=O)NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC=1C=CC(O)=CC=1)NC(=O)[C@H](CO)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](CC(O)=O)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](CC=1C=CC=CC=1)NC(=O)[C@@H](NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](C)NC(=O)[C@@H](N)CC=1N=CNC=1)[C@@H](C)O)[C@@H](C)O)C(C)C)C1=CC=CC=C1 DTHNMHAUYICORS-KTKZVXAJSA-N 0.000 description 2
- 102000004877 Insulin Human genes 0.000 description 2
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- 102100040918 Pro-glucagon Human genes 0.000 description 2
- 238000002651 drug therapy Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 230000002496 gastric effect Effects 0.000 description 2
- 239000007943 implant Substances 0.000 description 2
- 229940125396 insulin Drugs 0.000 description 2
- 208000020442 loss of weight Diseases 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 230000007246 mechanism Effects 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 235000020824 obesity Nutrition 0.000 description 2
- 230000001225 therapeutic effect Effects 0.000 description 2
- 210000000515 tooth Anatomy 0.000 description 2
- 229910000990 Ni alloy Inorganic materials 0.000 description 1
- 206010033307 Overweight Diseases 0.000 description 1
- 206010058046 Post procedural complication Diseases 0.000 description 1
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 229910001069 Ti alloy Inorganic materials 0.000 description 1
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 1
- 230000003187 abdominal effect Effects 0.000 description 1
- 238000012084 abdominal surgery Methods 0.000 description 1
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- 239000000956 alloy Substances 0.000 description 1
- 230000003796 beauty Effects 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 230000037396 body weight Effects 0.000 description 1
- 210000004913 chyme Anatomy 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 230000037213 diet Effects 0.000 description 1
- 235000005911 diet Nutrition 0.000 description 1
- 230000002124 endocrine Effects 0.000 description 1
- 238000002474 experimental method Methods 0.000 description 1
- 230000008713 feedback mechanism Effects 0.000 description 1
- 230000030136 gastric emptying Effects 0.000 description 1
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- 230000002427 irreversible effect Effects 0.000 description 1
- 238000002357 laparoscopic surgery Methods 0.000 description 1
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- 108090000765 processed proteins & peptides Proteins 0.000 description 1
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- 210000002784 stomach Anatomy 0.000 description 1
- 238000011477 surgical intervention Methods 0.000 description 1
- 239000010936 titanium Substances 0.000 description 1
- 230000017105 transposition Effects 0.000 description 1
Abstract
The invention discloses a duodenum casing for treating diabetes implanted under an endoscope. The duodenum casing comprises an anchoring part and a pipeline, wherein the anchoring part consists of two parallel nitinol rings and a casing extension expanding part; the pipeline into which liquid or gas can be injected is arranged on the tube wall of the casing of which the two ends are communicated with each other; the two nitinol rings are arranged on a triangular tooth-shaped structure of the anchoring part; and the nitinol rings are used for opening the opening of the casing extension expanding part. The duodenum casing has the beneficial effects that nitinol and a biocompatible polymer are taken as raw materials, so that the duodenum casing can be well implanted in vivo directly under the endoscope by using relevant appliances for treating type 2 diabetes. The duodenum casing can be taken out of the endoscope in time without surgery when not necessary.
Description
Technical field
The present invention relates to a kind of medical apparatus and instruments.
Technical background
At present, the annual neopathy rate of diabetes has reached 6.7% in China, the height in big city (Shanghai 10%).Within 2025, will reach 2-3 hundred million people.The operative treatment domestic, the major measure of international treatment diabetes has Drug therapy and carried out in recent years, operation method comprises abdominal and laparoscopic surgery etc." gastric bypass operation " art formula in operation has become the goldstandard for the treatment of, the therapeutic effect Drug therapy that can match in excellence or beauty.Because operation can cause irreversible damage to have again some contingent complication to occur to human body, so that the restriction to some extent of carrying out.
In to the retrieval of prior art, find:
[1] .KeithS.Gersin, MD, JenniferE.Keller, MD, Dimitrios Stefanidis, Deng people at IEEE Surgical Innovation, 14 (4): 275-278,2007 write articles " Duodenal-Je junal Bypass Sleeve:A Totally Endoscopic Device for the Treatment of Morbid Obesity " (duodenum _ jejunum detour sleeve pipe: treat morbid obesity endoscopic assistance completely for one).
[2]. the Liu Jingquan of Shanghai Communications University, the people such as Mei Jiabing in " a kind of duodenal sleeve and preparation method thereof " patent of applying for 2012.5.10 day, the patent No.: 201210145497.Thereby above two kinds of technology are all to adopt polymer sleeve pipe to insert duodenum to allow the food that enters gastric not contact duodenal wall directly to arrive jejunum and reach the MO effect for the treatment of.
Although second method is that sleeve outer wall is improved,, above two kinds of technology still have some shortcomings part.As: in above two kinds of prior aries: be 1, all that to treat morbid obesity be object.2, the polymer sleeve pipe adopting is all again the tube of the same length, does not meet the needs of individuation state of an illness treatment.
In the second prior art, only improve between cover outer tube layer and intestinal wall and adhered to, do not paid close attention to contingent adhesion between internal surface of sleeve pipe and inwall and reverse so that cause ileac severe complication.Do not design and illustrate for the vital part-anchor portion of sleeve pipe.
After proximal small bowel is bypassed, there will be thing followed intestinal Hormone change.This theoretical foundation is a non-obese diabetes rat experiment, and its result shows, bypass proximal small bowel and do not change diet and body weight can directly be improved diabetes, and the fluctuation of intestinal hormonal readiness can obviously be detected.
Unabsorbed food arrives ileum in advance, excite negative feedback mechanism, i.e. so-called " ileum lock " effect, cause neural and endocrine mechanism activation, intestinal hormone discharges, thereby has increased the sensitivity of tissue to insulin, has amplified insulin function, thereby both improved blood glucose, again can loss of weight.
Make the chyme concentrating be sent to distal small bowel, thereby cause food absorption to reduce and gastric emptying, and can promote to lose weight the secretion of ileum GLP-1 (glucagon-like peptide _ 1) and PYY (gut hormone peptide), thereby reach the object of controlling blood glucose.
Obesity companion type 2 diabetes mellitus is accepted loss of weight operative treatment has become common recognition.But, for Normal-weight or the overweight patient with type 2 diabetes mellitus, can carry out operative treatment, therapeutic effect is how, still has dispute.
In the selection of non-obesity diabetics modus operandi, at present also without desirable art formula.Someone applies the not high or slightly higher diabetics of sleeve shape stomach excision+jejunum transposition operative treatment BMI (Body Mass Index), result shows, there is patient's blood glucose of 86.9% to obtain control, and preserve the integrity of intestinal, reduce the complication of nutrition aspect, but anastomotic stoma is more, postoperative complication incidence rate is higher.
About opportunity of operation, research finds, patient's sick time is longer, and the age is larger, and the probability of recovery from illness is less, and therefore surgical intervention is early quite important to curing diabetes.
Summary of the invention
In view of this, the present invention proposes a kind of duodenal sleeve of not only having worshipped operative treatment diabetes principle and mechanism but also being different from prior art middle sleeve structure.The invention provides a kind of sleeve pipe that can treat diabetes at medical field a kind of technology that can not only solve prior art middle sleeve outer wall and intestinal wall adhesion and can solve again problem that mutual adhesion between inwall and inwall causes distortion to cause blocking and can also simulate well human body intestinal canal function after implanting is also provided simultaneously.
In order to achieve the above object, the technical solution used in the present invention is:
Under scope, insert the duodenal sleeve that is used for the treatment of diabetes, comprise that two nitinol rings arranged side by side and sleeve pipe continuity expand that have on the anchor portion of portion's composition and the tube wall of the sleeve pipe that two ends communicate can filling liquid or the pipeline of gas, two nitinol rings are arranged in anchor portion triangular tooth structure, and the oral area that nitinol ring makes sleeve pipe continue the portion of expanding struts.
Described pipeline is linear type or helical form.
Described linear type or helical form are at least one end ring shapes in two ends.
The far-end sealing of pipeline, the other end is provided with check valve, and check valve is circumscribed with ascending pipe,
The end that sleeve pipe continues the portion of expanding is provided with dentation.
The edge that sleeve pipe continues the dentation of the end of the portion of expanding is provided with the rope band of being made up of polymer filament.
On two corresponding sidewalls of helical form sleeve pipe, respectively there is a radiopaque strip.
The diameter of titanium-nickel wire ring is 5-6cm, titanium-nickel wire diameter 0.008-012cm, two ring spacing 0.5cm.
The serpentine pipe diameter 0.2-0.3cm of spiral pipe, tube pitch is from 1.5-3cm.
Beneficial effect of the present invention: material of the present invention is that Nitinol and biocompatible polymer are that material can well directly use related equipment just can implant to treat type 2 diabetes mellitus under scope.If, when unnecessary, can under scope, take out in time again, do not need operation.
Brief description of the drawings
Fig. 1 is the overall structure schematic diagram of the embodiment of the present invention 1.
Fig. 2 is the Nitinol anchor portion schematic diagram of the embodiment of the present invention 1.
Fig. 3 is the sleeve portion schematic diagram of the embodiment of the present invention 1.
Fig. 4 is one-way cock schematic diagram on the embodiment of the present invention 1 serpentine pipe.
Fig. 5 is the overall structure schematic diagram of the embodiment of the present invention 2.
Detailed description of the invention
Embodiment 1: as Figure 1-Figure 4;
Under scope, insert the duodenal sleeve that is used for the treatment of diabetes, it be by the continuity of nitinol ring 3 (alloy of nickel and titanium also claims memorial alloy) and sleeve pipe expand on the anchor portion of portion's composition and a tube wall by one can injection liquid gas the sleeve pipe 1 that forms of helical pipe 2.The far-end sealing of helical pipe 2, injection end is communicated with check valve 4 by ascending pipe 41.
Described have the continuity of Nitinol and sleeve pipe to expand the anchor portion of portion's composition be by two diameter 5.5cm titanium-nickel wire rings, 0.1 centimetre of titanium-nickel wire diameter, two ring spacing 0.5cm get up swollen cannula end most 5 barb places (left end of Fig. 1) parallel series.
The far-end of sleeve pipe is ring pipe 5, has so individual supporting role.
Swollen most 5 barbs of sleeve pipe, are the structures that the circular distal of sleeve pipe is made into 5 triangular tooths, and the rope band that edge is made up of polymer filament forms.
Described have can injection liquid gas helical pipe sleeve pipe, 60 centimetres of its length >, its concrete length can be determined according to conditions of patients.4.0 centimetres of diameters, its end expands 5.5 centimetres of section diameters and gradually travels to 4.0 centimetres downwards.1.0 centimetres of ministers divide a word with a hyphen at the end of a line.
Helical pipe that can injection liquid gas on described sleeve pipe, is the helical pipe that casing wall exists between two-layer, 0.3 centimetre of serpentine pipe diameter, and tube pitch is from 1.5 centimetres.Play the each ring of not-go-end, on the ring of cannula end, connect a unidirectional injection valve 4 to 0.2 centimetre, external footpath always, the ascending pipe 41 that length is 90 centimetres.
On two corresponding sidewalls of described screw shell, respectively there is a radiopaque strip.
Nitinol ring makes sleeve pipe be fixed on duodenal bulb.
This shows under gastroscope and implant duodenal sleeve treatment type 2 diabetes mellitus just for the optimum selection of this kind of situation, is also this class patient's Gospel.
Embodiment 2: as shown in Figure 5;
Pipe box on sleeve pipe is linear, one end sealing, and the other end is provided with check valve, and principle is as in Example 1.
Claims (9)
1. under scope, insert the duodenal sleeve that is used for the treatment of diabetes, it is characterized in that, comprise that two nitinol rings arranged side by side and sleeve pipe continuity expand the anchor portion of portion's composition and the sleeve pipe that two ends communicate, on the tube wall of sleeve pipe, having can filling liquid or the pipeline of gas, two nitinol rings are arranged in anchor portion triangular tooth structure, and the oral area that nitinol ring makes sleeve pipe continue the portion of expanding struts.
2. under scope as claimed in claim 1, insert the duodenal sleeve that is used for the treatment of diabetes, it is characterized in that, described pipeline is linear type or helical form.
3. under scope as claimed in claim 2, insert the duodenal sleeve that is used for the treatment of diabetes, it is characterized in that, described linear type or helical form are at least one end ring shapes in two ends.
4. under scope as claimed in claim 3, insert the duodenal sleeve that is used for the treatment of diabetes, it is characterized in that, the far-end sealing of pipeline, the other end is provided with check valve, and check valve is circumscribed with ascending pipe.
5. under scope as claimed in claim 4, insert the duodenal sleeve that is used for the treatment of diabetes, it is characterized in that, the end that sleeve pipe continues the portion of expanding is provided with dentation.
6. under scope as claimed in claim 5, insert the duodenal sleeve that is used for the treatment of diabetes, it is characterized in that, the edge that sleeve pipe continues the dentation of the end of the portion of expanding is provided with the rope band of being made up of polymer filament.
7. under scope as claimed in claim 6, insert the duodenal sleeve that is used for the treatment of diabetes, it is characterized in that, on two corresponding sidewalls of helical form sleeve pipe, respectively have a radiopaque strip.
8. under the scope as described in one claim as any in claim 1-7, insert the duodenal sleeve that is used for the treatment of diabetes, it is characterized in that, the diameter of titanium-nickel wire ring is 5-6cm, titanium-nickel wire diameter 0.008-0.12cm, two ring spacing 0.5cm.
9. under scope as claimed in claim 8, insert the duodenal sleeve that is used for the treatment of diabetes, it is characterized in that, the serpentine pipe diameter 0.2-0.3cm of spiral pipe, tube pitch is from 1.5-3cm.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310099662.4A CN103142338B (en) | 2013-03-26 | 2013-03-26 | Duodenum casing for treating diabetes implanted under endoscope |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310099662.4A CN103142338B (en) | 2013-03-26 | 2013-03-26 | Duodenum casing for treating diabetes implanted under endoscope |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN103142338A CN103142338A (en) | 2013-06-12 |
| CN103142338B true CN103142338B (en) | 2014-09-10 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201310099662.4A Expired - Fee Related CN103142338B (en) | 2013-03-26 | 2013-03-26 | Duodenum casing for treating diabetes implanted under endoscope |
Country Status (1)
| Country | Link |
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| CN (1) | CN103142338B (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109833128A (en) * | 2019-03-11 | 2019-06-04 | 曲梅花 | Rats and mice Duodenum-jejunum built-in cannula |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101843536A (en) * | 2010-04-09 | 2010-09-29 | 张发明 | Duodenal sleeve and conveyor thereof |
| US7981163B2 (en) * | 2003-12-09 | 2011-07-19 | Gi Dynamics, Inc. | Intestinal sleeve |
| CN201987704U (en) * | 2010-12-06 | 2011-09-28 | 北京畅想天行医疗技术有限公司 | Duodenum-jejunum built-in cannula |
| CN203303203U (en) * | 2013-03-26 | 2013-11-27 | 巴克 | Duodenum cannula capable of being placed into body under endoscope for treating diabetes |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7025791B2 (en) * | 2002-12-02 | 2006-04-11 | Gi Dynamics, Inc. | Bariatric sleeve |
| US20110004146A1 (en) * | 2009-07-01 | 2011-01-06 | E2 Llc | Systems and Methods for Treating of Obesity and Type 2 Diabetes |
-
2013
- 2013-03-26 CN CN201310099662.4A patent/CN103142338B/en not_active Expired - Fee Related
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7981163B2 (en) * | 2003-12-09 | 2011-07-19 | Gi Dynamics, Inc. | Intestinal sleeve |
| CN101843536A (en) * | 2010-04-09 | 2010-09-29 | 张发明 | Duodenal sleeve and conveyor thereof |
| CN201987704U (en) * | 2010-12-06 | 2011-09-28 | 北京畅想天行医疗技术有限公司 | Duodenum-jejunum built-in cannula |
| CN203303203U (en) * | 2013-03-26 | 2013-11-27 | 巴克 | Duodenum cannula capable of being placed into body under endoscope for treating diabetes |
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| Publication number | Publication date |
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| CN103142338A (en) | 2013-06-12 |
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