WO2009136121A1

WO2009136121A1 - Ring with multiple tubes with bridge and intermediate cavity

Info

Publication number: WO2009136121A1
Application number: PCT/FR2009/050671
Authority: WO
Inventors: Jean-Paul Gilbert Ricol
Original assignee: Compagnie Europeenne D'etude Et De Recherche De Dispositifs Pour L'implantation Par Laparoscopie
Priority date: 2008-04-14
Filing date: 2009-04-10
Publication date: 2009-11-12
Also published as: FR2929843A1

Abstract

The invention relates to an implantable surgical ring (1) for modifying the cross section of flow through a biological part, especially a gastroplasty ring, said ring comprising: at least one support structure (3); and at least one first and one second clamping tube (10, 11) supported by the support structure (3) and designed to be filled with a filling fluid; said ring (1) being characterized in that the first and second clamping tubes (10, 11) are separated from one another by at least one intermediate cavity (20) isolated from said clamping tubes (10, 11) and bounded by a bridge (21) between said clamping tubes (10, 11). - Gastroplasty ring.

Description

MULTI POCKET RING WITH BRIDGE AND INTERMEDIATE CAVITY

TECHNICAL AREA

The present invention relates to the general technical field of surgical implants intended to be implanted in the body of a patient around biological organs constituting a pocket or a duct, and more particularly to the gastric rings to achieve a constriction of the stomach as part of a treatment for obesity.

The present invention more particularly relates to an implantable surgical ring intended to be placed around a biological organ constituting a pocket or a conduit in order to modify the passage section of said biological organ, said ring comprising at least one curvable carrier structure. on itself to form a loop around the biological organ, as well as at least a first clamping pocket and a second clamping pocket supported by the supporting structure and designed to be filled with a filling fluid so that ensure the tightening of the biological organ.

PRIOR ART

It is known to perform surgical procedures on patients with severe obesity who, because of their overweight, are exposed not only to physical discomfort, but also to a psychological burden as well as related diseases, such as the diabetes, cardiovascular diseases, or severe arthritis. In particular, a known technique is to achieve a gastric constriction to reduce the size of the stomach and therefore the intake of food.

For this purpose, it is frequently used to use gastroplasty rings implanted around the patient's stomach in order to reduce its volume as well as the diameter of its passage (stoma).

Generally, such gastroplasty rings comprise a flexible band made of elastomeric material and intended to be closed at both ends by appropriate closing means to enclose the stomach.

In addition, the known rings usually comprise an annular compression chamber located on the inner face of the flexible band and whose volume is adjustable by adding or removing a filling fluid.

Thus, it is possible, from a ring of fixed overall dimensions, to finely adjust the internal diameter of said ring by a radial expansion or retraction of the chamber.

Such implantable rings generally give satisfaction, but nevertheless suffer from a certain number of drawbacks, in particular related to the arrangement of the compression chamber and to its dynamic behavior.

Thus, in the first place, it sometimes happens that during the setting up of the ring, and more particularly during the inflation operations of the compression chamber, the wall of the latter is deformed randomly and poorly controlled. In particular, it may happen that the chamber is displaced to one or other edge of the ring, which has the effect of unbalancing the pressure exerted on the stomach, but also of weakening the membrane constituting the compression chamber in the zone that is the most tensioned by the pressure.

Moreover, some rings of the prior art sometimes show a tendency to frown the membrane constituting the compression chamber which can lead to the pinching of the biological organ and cause damage to the wall of the latter by abrasion. or even necrosis.

Secondly, it turns out that the rings of the prior art, once implanted, are sometimes subject to accidental displacements caused by natural movements of dilatation and contraction of the stomach.

In some cases, these movements can even lead to the expulsion of the ring by sliding or to its turn on itself, so that it becomes inoperative therapeutically and constitutive of discomfort for the patient .

In such a situation, it is then necessary to carry out a new surgical procedure for the replacement and repositioning of the ring, which, naturally, unnecessarily mobilizes hospital means, causes additional inconvenience to the patient, or even exposes the latter to postoperative complications. SUMMARY OF THE INVENTION

The objects assigned to the present invention therefore aim to remedy the aforementioned drawbacks and to propose a novel implantable surgical ring, in particular gastric, whose dynamic behavior is improved and which is particularly respectful of the integrity of the biological tissues on which it acts. .

Another object assigned to the present invention is to provide a new implantable surgical ring which has a simple, compact, lightweight and robust structure.

Another object assigned to the invention is to propose a new surgical ring which has good adaptability to various conditions of use and which is particularly comfortable whatever the chosen setting.

The objects assigned to the invention are achieved by means of an implantable surgical ring intended to be placed around a biological organ constituting a pocket or a conduit in order to modify the passage section of said biological organ, said ring comprising :

at least one supporting structure able to be bent on itself to form a loop around the biological organ; at least one first clamping bag and a second clamping bag supported by the supporting structure and designed to be filled by a filling fluid so as to ensure the tightening of the biological organ, said ring being characterized in that the first and second clamping pockets are separated from each other by at least one intermediate cavity which is isolated from said clamping pockets and delimited by a separate bridge of the supporting structure and connecting the first clamping pocket to the second clamping pocket.

SUMMARY DESCRIPTION OF THE DRAWINGS

Other objects, features and advantages of the invention will appear in more detail on reading the description which follows, and with the aid of the accompanying drawings, provided for purely illustrative and non-limiting purposes, among which:

- Figure 1 illustrates, in a perspective view, a variant of surgical ring according to the invention in closed configuration.

- Figure 2 illustrates, in a cutaway perspective view of material, an alternative embodiment of the surgical ring according to the invention.

- Figure 3 illustrates, in a schematic longitudinal sectional view, the implementation of a surgical ring according to the invention around a biological organ.

- Figure 4 illustrates, in a cutaway perspective view of material, another embodiment of surgical ring embodiment according to the invention. FIG. 5 illustrates a cross section of the surgical ring shown in FIG. 4 as a function of the level of filling of the clamping pockets.

BEST MODE OF REALIZING THE INVENTION

The present invention relates to an implantable surgical ring 1 which is intended to be placed around a biological organ 2 constituting a pocket or a conduit in order to modify the passage section of said biological organ 2.

For this purpose, the surgical ring 1 comprises at least one carrier structure 3 able to be bent on itself to form a loop around said biological organ 2.

More particularly, the carrier structure 3 is advantageously designed to wind geometrically about a mean axis of extension (X-X '), which advantageously coincides, after implantation, with the direction of extension of the conduit or the pocket formed by the biological organ 2, as shown in FIG.

In a particularly preferred manner, said carrier structure 3 is sufficiently flexible to move from an open configuration (not shown) to a closed configuration illustrated in particular in FIGS. 1 and 3, in which said carrier structure 3, and more generally the implantable ring. 1, is closed substantially to its two ends 4, 5 by means of closure means 6, 7 suitable so as to form a closed loop around the mean axis of extension (X-X '). Thus, by trapping the biological organ 2 inside said loop, it is possible to narrow the diameter of its passage section.

Of course, the geometry adopted by the loop formed, in particular after implantation, by the carrier structure is not limited, but it will preferably have a substantially rounded contour, and particularly preferably substantially circular and axis (X- X ').

More generally, the surgical ring 1 according to the invention will preferably have, when in the closed configuration, substantially a geometry of axis revolution (X-X ').

Advantageously, the closing means 6, 7 are designed to cooperate with each other to ensure the locking of the ring 1 in its closed configuration.

By way of example, it is possible to use for this purpose a sleeve 6 fixed on the first end 4 of the ring and intended to receive a rod 7 associated with the second end 5, said rod 7 preferably comprising one or more lugs 7A in order to allow a snap type assembly with the sleeve 6.

In the description which follows, reference will be made, by way of example and for convenience of description, to a gastroplasty ring, or gastric ring, designed to be implanted around the stomach in order to reduce the diameter of the opening. stoma or designed to be implanted around the esophagus. Of course, the invention is not limited to this application and also relates to surgical rings forming artificial sphincters adapted for the treatment of urinary or faecal incontinence, or rings used for the regulation of blood flow.

Depending on its purpose, the surgical ring 1 will of course be adapted to the size, the environment and the sensitivity of the biological organ 2 concerned by the constriction, such as bladder, urethra, intestine, artery, vein, etc.

According to the invention, the surgical ring 1 also comprises a first clamping pocket 10 and a second clamping pocket 11 which are supported by the supporting structure 3 and designed to be filled with a filling fluid so as to ensure the clamping of the biological organ 2.

Thus, advantageously, the first and the second clamping pocket 10, 11 allow the ring 1 to come into contact with the wall of the biological organ 2 and to obtain a flexible constriction of the pneumatic or hydraulic type of said biological organ 2 .

According to an alternative embodiment not shown, said first and second clamping pockets 10, 11 can be located substantially at the same abscissa along the axis (X-X ') and each cover a predetermined angular sector around said extension axis ( X-X '), and in particular to form the angular subdivisions of the same clamping ring.

However, particularly preferably, as is illustrated in the figures, the carrier structure 3 forming a loop which wraps around the mean extension axis (X-X '), the first and second clamping pockets 10, 11 are staggered along said mean extension axis (X-X '). In addition, said first and second clamping pockets are preferably substantially annular, and extend substantially over the entire length of the carrier structure.

In a particularly preferred manner, the first and second clamping pockets 10, 11 are images of one another with respect to a sagittal plane of symmetry π normal to the axis (X-X ') and intersecting the ring 1 , and more particularly the carrier structure 3, in the middle.

Of course, the arrangement and the shape of the first and second clamping pockets 10, 11 are however not limited to a particular embodiment variant.

Advantageously, the arrangement according to the invention gives the ring a particularly stable character once it is implanted, providing it with a double anchor at two distinct contact zones 12, 13.

In addition, the supporting structure 3 preferably fixes the dorsal limit of the ring, the first and second clamping pockets 10, 11 protruding radially from said bearing structure towards the inside of the ring and not exceeding beyond of said limit.

In addition, the carrier structure 3 advantageously has a certain rigidity with respect to its elongation in tension, that is to say with respect to the increase of the perimeter of the loop, so as to provide, when closed on itself, a relatively stable support and substantially invariant to the clamping pockets 10, 11. Moreover, it is remarkable that, within the meaning of the invention, the first clamping pocket 10 and the second clamping pocket 11 can communicate with each other and form the two projecting portions of the same chamber.

According to such an alternative embodiment, said chamber forming a common container for the filling fluid may thus have two distinct protrusions constituting said clamping pockets, and more particularly a first ridge portion 14 and a second ridge portion 15 projecting towards the rim. inside the loop formed by the ring and intended to come into contact with the biological organ 2 respectively at the level of the first contact zone 12 and the second contact zone 13.

According to an important characteristic of the invention, the first and second clamping pockets 10, 11 are separated from each other by at least one intermediate cavity 20 which is isolated from said clamping pockets 10, 11 and delimited by a bridge 21, said bridge 21 being distinct from the supporting structure 3 and connecting the first clamping pocket 10 to the second clamping pocket 11.

Thus, as illustrated in FIGS. 2 to 5, the bridge 21 mechanically connects the first clamping pocket 10 to the second clamping pocket 11 by overhanging the carrier structure 3 and thus spanning an empty separation zone of material. which forms the aforementioned intermediate cavity 20.

Within the meaning of the invention, the intermediate cavity 20 forms a kind of hollow spacer which physically separates the first clamping pocket 10 from the second clamping pocket 11 and which is "isolated" from these, that is to say substantially substantially sealed said clamping pockets, so in particular to avoid any exchange of filling fluid between the interior of said cavity 20 and the inside of the clamping pockets 10, 11.

Advantageously, as will be detailed hereinafter, this particular arrangement, in which a bridge 21 interposed between the two clamping pockets 10, 11 delimits an intermediate cavity forming a "buffer" zone between said clamping pockets, substantially improves the behavior. dynamics of the ring, not only during operations of adjustment of the intensity of the constriction by the practitioner, that is to say during the transfer of fluid from or to the clamping pockets 10, 11 to obtain their inflation and / or deflation, but also when said ring 1, and in particular its clamping pockets 10, 11, once filled with a determined volume of fluid, must adapt temporarily to the various natural movements of the biological organ 2, and in particular to peristaltic contractions.

Thus, the ring according to the invention is particularly stable, while being atraumatic, respectful of biological tissues and limiting the discomfort felt by the patient.

Preferably, the intermediate cavity 20 is free, that is to say advantageously devoid of controlled filling means. In other words, the user does not have the possibility of intervening directly on said intermediate cavity 20, in particular on its configuration or its volume, by deliberately carrying out an active and controlled fluid transfer from an external reservoir to the ring inwardly of said cavity 20 (or vice versa). Preferably, the intermediate cavity 20 freely communicates with the environment of the ring.

In particular, the intermediate cavity 20 may include orifices which put it into direct communication with the outside of the ring, so that said cavity is in a way "left in the open air", that is to say it does not have an inherently tight character and can advantageously adapt freely to variations in pressure and / or internal volume. Preferably, the intermediate cavity 20 is not sealed, so as not to hinder possible spontaneous transfers of fluid necessary for these adaptations.

According to an alternative embodiment not shown, said orifices may be drilled in the thickness of the carrier structure 3. These orifices may also be formed at the end of the intermediate cavity, for example by allowing said cavity to open freely at one end. and / or the other of the ends 4, 5 of the ring, as illustrated in FIG. 2.

The intermediate cavity can therefore advantageously be arranged so as to remain "empty" and passive, and therefore capable of being reconfigured only by motor elements which are foreign to it, such as the clamping pockets 10, 11, and not by its clean inflation level.

Preferably, as illustrated in particular in Figures 2 to 5, the bridge 21 is set back from the first and second clamping pockets 10, 11 so as to mark a depression 22 between them.

In other words, the bridge advantageously delimits a depression 22 open towards the inside of the loop and marked in hollow between the first and second clamping pockets 10, 11, the deck of said bridge 21 being thus, under normal operating conditions, farther from the extension axis (X-X ') than the peak portions 14, 15.

Thus, the bridge 21 makes it possible to physically separate the first and the second contact zone 12, 13 in two disjoint zones, that is to say to ensure a discontinuity of the anchoring of the ring 1 on the biological organ 2 .

This significantly improves the stability of said ring to the extent that, even if said ring just momentarily lost at the first anchor point provided by the first clamping pocket 10, there remains the second anchor point that provides it the second clamping pocket 11 to retain it, and vice versa.

In other words, the separation of the contact zones 12, 13 makes it possible to multiply the retention points of the ring 1 on the member 2 and thus considerably reduce the probability that the kinematic conditions of a displacement of said ring by report to that biological organ are brought together at the same time.

Consequently, the phenomena of displacement or even accidental release of the ring are substantially limited.

Preferably, the bridge 21 extends substantially over the entire length of the faces of the clamping pockets 10, 11 which are opposite one another, on either side of the the intermediate cavity 20, and, according to a preferred embodiment, on the entire inner periphery of the ring 1 about the axis (X-X '). Thus, the bridge deck 21 can substantially follow the circular perimeter of the loop and cover an intermediate cavity 20 of substantially annular shape.

Once the ring is implanted, the depression 22 advantageously forms a mechanical isolation boundary between the first contact zone 12 and the second contact zone 13, that is to say an area in which the contact between the outer surface of the biological organ 2 and the inner surface of the ring 1 is normally interrupted, at least in places, so that the surgical ring 1 has a substantially independent behavior in each of said contact areas 12, 13.

In particular, this advantageously makes it possible to prevent slippage of the ring 1 by breaking the contact in the first contact zone 12 does not lead to an overall sliding of the ring, by continuous extension of the conditions of occurrence of said phenomenon slip dynamics at the second contact zone 13.

By analogy, the structure of the surgical ring 1 according to the invention is similar to that of a catamaran, the floats of which correspond to the clamping pockets 10, 11 which provide, mainly simultaneously and very occasionally individually, the contact with the surface of the biological organ 2.

Furthermore, the arrangement of the bridge 21 and the clamping pockets 10, 11, and more particularly the conformation of the depression 22, are advantageously adapted to prevent the wall of the biological organ 2, which is likely to penetrate into said depression 22, undergoes alteration, in particular by necrosis, due to an abrasion phenomenon and / or pinching. For this purpose, when considering the contour of said depression in a cutting plane transverse to the clamping pockets, and in particular in a cutting plane containing the extension axis (X-X '), the ratio of the width at half height D1 of the depression 22 by the depth P of said depression 22 is preferably substantially between 0.5 (or 50%) and 1 (or 100%).

Thus, the bridge 21 may advantageously form a retaining means against the centrifugal radial penetration of the wall of the biological organ 2 between the clamping pockets 10, 11.

Geometrically, the depth P, that is to say the limit of penetration allowed by the bridge 21, can be considered as the difference between the base radius of a first notional cylinder C1 of axis (X-X ') inscribed in the closed ring, that is to say, tangent to the first and second crest portions 14, 15, and the base radius of a second imaginary second cylinder C2 of the same axis (X-X ') and tangent to the apparent surface of the bridge 21 farthest from said axis (X-X '), that is to say, more particularly, tangent to the bottom of the depression 22, as shown in Figures 3 and 5.

Of course, although the aforementioned proportions may vary within the same ring 1 depending on the inflation level of the clamping pockets 10, 11, said proportions will preferably remain within the indicated range when the ring 1 is in a normal situation. operation, preferably regardless of its setting, or even when the ring 1 is at rest.

Advantageously, the first and second clamping pockets 10, 11 have a certain structural flexibility giving them an atraumatic character. In particular, they are preferably made of a biocompatible elastomeric material, of the silicone type.

Furthermore, the first and second clamping pockets 10, 11 may have a "flange" character at rest, that is to say they may be devoid of shape and / or clean volume in the absence of filling fluid, or still be "semi-rigid", that is to say present a certain intrinsic structural rigidity sufficient to give them at rest a substantially predetermined shape and volume, even in the absence of filling fluid.

Preferably, the first clamping pocket 10 and / or the second clamping pocket 11 have a deformable structure which allows them to expand substantially centripetally radially towards the inside of the loop, and / or respectively their substantially radial centrifugal retraction towards the outside. of the loop.

In other words, the first and / or second clamping pocket 10, 11 are advantageously designed to allow radial displacement of the crest portions 14, 15 with respect to the carrier structure 3, depending on the amount of fluid of the filling injected into said pockets, which allows to adjust the diameter and / or the constriction force exerted by the ring 1 on the biological organ 2.

As such, it is remarkable that within the meaning of the invention the deformable nature of the structure of the first and second clamping pockets 10, 11 can be conferred by the intrinsic elasticity of the material constituting said clamping pockets, for example on embodiments similar to those illustrated in FIGS. 2 and 3, or by means of a mechanical structure comprising a "reserve of deformation ", for example a folded wall at rest and able to unfold when filling the pockets, as is illustrated in Figures 4 and 5.

Preferably, the bridge 21 is movably mounted relative to the supporting structure 3 so as to be able to substantially accompany the expansion, and / or respectively the retraction, of said clamping pockets 10, 11.

Advantageously, the radial mobility of the bridge 21 allows it to freely follow the radial changes of the clamping pockets 10, 11, and thus allows the radial deployment or contraction of said pockets without these movements being upset by said bridge.

As such, it will be noted that the mechanical mobility of the bridge, as well as the communication of the intermediate cavity 20 with the environment of the ring 1 which allows to spontaneously balance the pressure in the cavity 20 with the external pressure , advantageously allow said cavity 20 to be reconfigured without opposing significant resistance, and in particular to be deformed passively by adapting its contour and / or its internal volume according to the deformation stresses imposed on it by the clamping pockets 10, 11 during the variation of their level of inflation.

Advantageously, the capacity of the ring to jointly change the inflation level of the clamping pockets 10, 11, the conformation of the cavity 20, and the position of the bridge 21, gives the ring 1 a large adjustment range, in particular its constriction diameter or resistance to radial expansion, while ensuring that the arrangement of the constituent elements of the ring 1, which ensures a double anchoring, stable and comfortable for the user, is substantially maintained regardless of the setting chosen from the total range, advantageously continuous, allowed.

Furthermore, the bridge 21 advantageously has transverse adjustment means 30 allowing a controlled lateral deflection of the first clamping pocket 10 with respect to the second clamping pocket 11, in a direction substantially parallel to the axis of extension ( X-X ').

More particularly, said transverse adjustment means 30 may comprise, as illustrated in FIGS. 4 and 5, a deformable inflection zone which constitutes, when the bridge 21 is at rest, a transverse deformation reserve capable of open and expand a bit like a hinge.

Preferably, the inflection zone has, in a plane of substantially radial cross section, a "V" profile whose point is oriented towards the supporting structure 3.

Thus, advantageously, as shown in FIG. 5, the bridge 21 forms a kinematic link which limits the mutual distance between the clamping pockets 10, 11, and preferably also their approach, during the expansion and the retraction of the latter, especially under the effect of filling.

Thus, the bridge 21 prevents in particular each clamping bag from moving individually and excessively towards one of the outer lateral edges of the ring, that is to say to drive in a direction substantially parallel to the axis of extension (X-X ') by losing the effectiveness of its support. Therefore, the bridge 21 allows an effective and reproducible control of the dynamic behavior of said clamping pockets 10, 11, both during the adjustment of the filling level, that is to say the pressure and / or the constriction diameter. when said pockets contain a predetermined amount of filling fluid and are subject to the natural expansion and contraction movements of the biological organ 2.

Preferably, the bridge 21 has an intrinsic flexibility and may advantageously be made for this purpose in a biocompatible elastomeric material, of the silicone type.

In addition, the bridge 21 is preferably integral with the wall of the first clamping pocket 10 and / or the wall of the second clamping pocket 11.

In other words, the clamping pockets 10, 11 form advantageously the pillars of the bridge 21.

It is thus possible to obtain, in particular by extrusion or molding, a monobloc openwork structure, therefore lightweight, simple design compact and robust.

Furthermore, the bridge 21 preferably has a relatively small thickness, especially between 0.4 mm and 1.0 mm, which is preferably substantially constant along the deck, that is to say between the point of attaches to the first clamping pocket and the attachment point to the second clamping pocket.

Moreover, the area of the transverse section of the intermediate cavity 22 is preferably smaller than the area of the transverse section of each of the first and second clamping pockets 10, 11, and preferably comprised between 30% and 90% of the area of the transverse section of each of said clamping pockets 10, 11 considered individually.

Thus, especially in the case where the intermediate cavity and the clamping pockets have substantially a geometry of revolution, the volume of the intermediate cavity 22 is preferably less than or equal to the volume of each of the first and second clamping pockets, and preferably between 30% and 90% of the individual volume of the first clamping pocket 10, respectively of the individual volume of the second clamping pocket 11.

As such, it is remarkable that these proportions, although they may vary during the radial deployment of the clamping pockets under the effect of inflation, remain advantageously within the aforementioned ranges, the volume of the intermediate cavity 22 being less than the volume of the first and second clamping pockets 10, 11 when they are in a contracted configuration, which preferably corresponds to their rest state, as is the case in the solid line representation of FIG. 5, and remaining smaller than the volume of said first and second clamping pockets when they are deployed, as shown in dashed lines in this same figure 5.

The establishment and operation of a ring 1 according to the invention will now be described, with reference to the embodiment variant illustrated in Figures 4 and 5.

The ring is first introduced in open form, for example by laparoscopy, then engaged around the biological organ 2. The carrier structure 3 is then curved until it is closed on itself to form a closed loop enclosing the biological organ 2, and kept in the closed position by the engagement of its locking means 6, 7.

In doing so, the peak portions 14, 15 of the first and second clamping pockets 10, 11 bear against the wall of said biological organ 2, respectively at a first and a second contact strip 12 , 13 substantially annular and located at a distance from each other along the extension axis (X-X ').

At rest, that is to say before filling said clamping pockets 10, 11, the latter are in contracted configuration.

In this particular embodiment, their respective walls located opposite each other, on either side of the depression 22, each have a folded zone 25 folded on itself.

The volume of the intermediate cavity 20 is then particularly reduced, the bridge 21 being in close proximity, or even in partial contact with the supporting structure 3, as shown in solid lines in FIG. 5.

When the practitioner inflates the first and second clamping pockets 10, 11, that is to say when he introduces a suitable filling fluid therein, such as air or physiological saline, increase in pressure and / or volume resulting from this injection forces the centripetal radial deployment of said clamping pockets 10, 11.

According to this particular embodiment, this inflation results in a progressive deployment of the portion of the membrane of each pocket of tightening, initially folded on itself at the level of the pleated zone 25, and is accompanied by an "elevation" of the first and second crest portions 14, 15, which progressively move away from the back structure 3 in one direction substantially centripetal radial.

In addition, this elevation is accompanied by some tilting of said peak portions 14, 15 towards the free lateral edges of the ring 1, as illustrated by the arrows in FIG. 5.

Advantageously, the bridge 21 "takes off" from the carrier structure 3 and is driven in centripetal radial displacement by the deformation of the clamping pockets 10, 11 without opposing significant resistance to this movement.

On the other hand, said bridge advantageously maintains a transverse kinematic link between said first and second clamping pockets 10, 11, and therefore opposes a retaining force to the free axial displacement, and especially to the spacing, of said pockets along the axis of extension (X-X ').

Of course, the bridge 21, however, thanks to its transverse adjustment means 30, a necessary axial displacement and sufficient for the proper deployment of the clamping pockets. In particular, as shown in FIG. 5, the inflection zone is deformed elastically, by progressive opening of the branches of the V, to adapt at any moment to the residual width the depression 22 which remains between said pockets of tightening 10, 11.

In other words, the bridge 21 advantageously maintains the first and second clamping pockets 10, 11 substantially grouped and parallel during the radial deployment thereof, and thus allows a regular deployment of the ring 1 until this one reaches its configuration of functional constriction, and for example its maximum constriction configuration shown in dashed lines in FIG. 5.

As such, it is remarkable that the bridge 21 advantageously remains recessed from the peak portions 14, 15 when the clamping pockets 10, 11, in particular when these are deployed at most, that is to say at most near the axis of extension (X-X '), so that the double anchoring of the ring 1 is still operational and retains the latter a good stability.

Moreover, it is remarkable that the deformation reserve offered by the pleated zone 25 advantageously makes it possible to deploy the clamping pockets 10, 11 without having to distend, and consequently to weaken, their respective membrane.

Conversely, when the practitioner deflates the clamping pockets 10, 11 so as to return them from their deployed configuration to their contracted configuration, that is to say so as to increase the constriction diameter of the organ Biological 2, the peak portions 14, 15 "down" towards the carrier structure 3 in a radial centrifugal movement and drive the bridge 21 thereafter, which has the effect of gradually crushing the intermediate cavity 20.

Again, neither the bridge 21 nor the cavity 20 oppose significant resistance to this centrifugal radial movement, so that the first and second clamping pockets 10, 11 can regain, especially by springback, any intermediate position until to their initial contracted position. Advantageously, during this collapse of the clamping pockets 10, 11, the transverse adjustment means 30 act as a return spring which tends to bring the respective walls of the first and second clamping pockets 10 closer to one another, 11 located opposite each other on either side of the depression 22, which facilitates the orderly and progressive folding of the latter until the reconstruction of the folded zones 25.

Thus, the ring 1 according to the invention has a particularly stable and predictable dynamic behavior, and ensures a good user comfort for the patient.

In addition, such a ring has a particularly light and robust structure, which is furthermore little subject to fatigue work of the material, so that the ring 1 has a long life.

Finally, it is remarkable that the ring 1 according to the invention allows a precise, continuous and fine adjustment of the constriction, while permanently maintaining its qualities of comfort and dynamic stability.

POSSIBILITY OF INDUSTRIAL APPLICATION

The invention finds its industrial application in the design and manufacture of surgical rings, and in particular gastric rings.

Claims

Implantable surgical ring (1) intended to be placed around a biological organ (2) constituting a pocket or a conduit in order to modify the passage section of said biological organ (2), said ring comprising:

at least one carrier structure (3) capable of being curved on itself to form a loop around the biological organ (2),

at least a first clamping bag (10) and a second clamping bag (11) supported by the supporting structure (3) and designed to be filled with a filling fluid so as to ensure the clamping of the biological organ (2), said ring (1) being characterized in that the first and second clamping pockets (10, 11) are separated from each other by at least one intermediate cavity (20) which is isolated from said pockets of clamping (10,11) and delimited by a bridge (21) separate from the supporting structure (3) and connecting the first clamping pocket (10) to the second clamping pocket (11).

- Ring according to claim 1 characterized in that the intermediate cavity (20) communicates with the external environment of the ring (1).

- Ring according to claim 1 or 2 characterized in that the intermediate cavity (20) is devoid of active filling means.

- Ring according to one of claims 1 to 3 characterized in that the bridge (21) is arranged behind the first and second pockets of clamping (10, 11) so as to mark a depression (22) between said first and second clamping pockets (10, 11).

5 - ring according to claim 4 characterized in that the ratio of the width at half height (D1) of the depression (22) by the depth (P) of said depression (22) is substantially between 0.5 and 1 .

6 - Ring according to one of the preceding claims characterized in that the first and / or second clamping pocket (10, 11) have a deformable structure allowing their expansion towards the inside of the loop, respectively their retraction to the outside the loop, and in that the bridge (21) is movably mounted relative to the support structure (3) so as to substantially accompany the expansion, respectively the retraction, said clamping pockets (10,11).

7 - Ring according to one of the preceding claims characterized in that the bridge (21) is provided with transverse adjustment means (30) allowing a controlled lateral movement of the first clamping pocket (10) relative to the second pocket clamping (11).

8 - Ring according to claim 7 characterized in that the transverse adjustment means (30) comprise a deformable inflection zone.

9 - Ring according to one of the preceding claims characterized in that the bridge (21) is made of a biocompatible elastomeric material of the silicone type.

10 -Annle according to one of the preceding claims characterized in that the bridge (21) is integral with the wall of the first pocket (10) and / or with the wall of the second clamping pocket (11).

-Annle according to one of the preceding claims characterized in that the volume of the intermediate cavity (20) is less than the volume of each of the first and second clamping pockets (10, 11), and preferably between 30% and 90 % of the individual volume of said clamping pockets (10, 11).

-Annle according to one of the preceding claims characterized in that, the carrier structure (3) forming a loop which winds around a mean axis of extension (X-X '), the first and second clamping pockets (10, 11) are staggered along said middle axis of extension (X-

X ').

-Annle according to one of the preceding claims characterized in that it constitutes a gastroplasty ring for the treatment of obesity.