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WO1995011637A1 - Prothese de la vessie - Google Patents

Prothese de la vessie Download PDF

Info

Publication number
WO1995011637A1
WO1995011637A1 PCT/BE1994/000074 BE9400074W WO9511637A1 WO 1995011637 A1 WO1995011637 A1 WO 1995011637A1 BE 9400074 W BE9400074 W BE 9400074W WO 9511637 A1 WO9511637 A1 WO 9511637A1
Authority
WO
WIPO (PCT)
Prior art keywords
prosthesis according
bladder prosthesis
liquid container
bladder
reflux means
Prior art date
Application number
PCT/BE1994/000074
Other languages
English (en)
Inventor
André LEONARD
Paul Brusseleers
Original Assignee
Sure, Besloten Vennootschap Met Beperkte Aansprakelijkheid
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 Sure, Besloten Vennootschap Met Beperkte Aansprakelijkheid filed Critical Sure, Besloten Vennootschap Met Beperkte Aansprakelijkheid
Priority to EP94929418A priority Critical patent/EP0737049A1/fr
Priority to AU78491/94A priority patent/AU7849194A/en
Publication of WO1995011637A1 publication Critical patent/WO1995011637A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/042—Urinary bladders

Definitions

  • the present invention concerns a bladder prosthesis.
  • both ureters are implanted in an isolated small bowel segment, of which one end is provided as urostoma on the skin.
  • the present invention aims to solve the above-mentioned problem by making use of an i plantable bladder prosthesis.
  • the invention concerns a bladder prosthesis with optimum characteristics during and after the implantation.
  • the invention concerns a bladder prosthesis, consisting of a liquid container with at least one entry and at least one exit, characterized in that the liquid container has a shape which is anatomically adapted to the shape of the pelvis.
  • the prosthesis preferably has a shape which makes it possible for it to be situated convex over the sigmoid.
  • the bladder prosthesis according to the invention preferably also has a front side which is formed according to the shape of the pubis.
  • the liquid container will preferably consist of at least one virtual basic space, as well as of at least one virtual side space extending sideways upward as of the basic space and connected onto the latter.
  • the bladder prosthesis according to the invention has two side spaces connected symmetrically onto the basic space, which extend to the left and to the right respectively of the basic space.
  • each of the entries of the bladder prosthesis is provided with anti-reflux means, whereby these anti-reflux means mainly consist of a chamber, whether or not virtual, in which the above-mentioned entry is provided on the one hand, and whereby this chamber is connected to the above-mentioned liquid container on the other hand.
  • anti-reflux means a cysto- ureteral reflux can be avoided, as a result of which infections in the ureters are excluded and a pressure build-up in the actual bladder becomes possible, which is necessary to generate the required stimuli which indicate that the bladder is filled.
  • the use of anti-reflux means in the form of chambers, which are preferably but not necessarily virtual, is among other things advantageous in that it is not necessary to provide mechanical valves or such, which may fail.
  • each of the anti-reflux means consist of chambers formed of two parallel walls which are designed such that, after the implant, they are situated against or almost against one another.
  • Such anti-reflux means are advantageous in that they require little space thanks to their flatness, in that they cannot fail and in that they offer an optimal anti-reflux action.
  • the invention also aims, according to its most preferred embodiments, a bladder prosthesis which also has the following characteristics:
  • Another aim of the invention is to provide a prosthetic model of a bladder which is designed to make an insitu reconstruction of the urinary tract possible while retaining the normal voiding and continence.
  • figure 1 represents a bladder prosthesis according to the invention
  • figure 2 represents the bladder prosthesis of figure 1 after the implantation
  • figures 3 to 7 represent sections according to lines III-III to VII-VII from figure 2 to a larger scale
  • figure 8 shows a section according to line VIII-VIII from figure 1 to a larger scale
  • figure 9 is a schematic representation of the pressing together of certain parts of the bladder prosthesis after the implantation
  • figure 10 shows yet another bladder prosthesis according to the invention
  • figure 11 shows a view to a larger scale of the part which is indicated in figure 10 with Fll
  • figure 12 shows yet another variant of the bladder prosthesis according to the invention.
  • the bladder prosthesis 1 mainly consists of a liquid container 2 with at least one, but in this embodiment two entries 3 and 4, and an exit 5.
  • the liquid container 2 as represented in figures 1 to 7 has a shape which is anatomically adapted to the shape of the human pelvis, i.e. which is made according to the topographic anatomic proportions of the pelvis.
  • the bladder prosthesis 1 preferably also has a shape which makes it possible for it to be situated convex over the sigmoid.
  • it preferably has a front side 6 which is formed according to the shape of the pubis.
  • the liquid container 2 may have a rounded apical angle 7 at the bottom directed towards the back upon which the exit 5 is provided.
  • the liquid container 2 is preferably made like a bladder, in other words a container with a flexible wall 8.
  • the liquid container 2 is preferably made such that it functions as a virtual space.
  • the liquid container 2 is made of bio-compatible synthetic material, it is preferably thin-walled and consists of very flexible material.
  • the wall 8 mainly consists of thin-walled silicone sheets or another synthetic material.
  • silicone sheets By these "silicone sheets” is meant that the wall 8 is built up of different layers which are formed by means of several successive immersions in a silicone bath, whereby the silicone is cured at each stage. The final product is in fact a single silicone wall.
  • the use of thin-walled silicone sheets results in the creation of a so-called "flat-shaped bladder” whose sheets touch when the bladder is empty. In vivo, there will be at the most a thin film of urine between the sheets.
  • the use of a thin-walled liquid container 2 offers the advantage that the intra-abdominal pressure is sufficient to empty this container without a considerable residue staying behind.
  • the use of a flexible and thin-walled material for the wall 8 also has for a result that the bladder prosthesis 1, if necessary, will easily adjust to the surface and configuration of the pelvis which it has to occupy, irrespective of the shape, sex or age of the patient.
  • the bladder prosthesis 1 is evenly thin-walled, whereby it is whether or not provided with a rough outer surface, as will be described hereafter.
  • the space which is surrounded by the liquid container 2 is so to say composed of at least one virtual basic space 9, as well as of at least one, but as represented in figures 1 to 7 preferably two virtual side spaces 10 and 11 extending sideways upward as of the basic space 9 and connected onto the latter.
  • the two side spaces 10 and 11 are preferably situated in a symmetrical manner on both sides of the basic space 9.
  • the side spaces 10-11 may narrow towards the top, whereas they gradually merge into the basic space 9 towards the bottom.
  • the parts of the wall 8 which surround the side spaces 10-11 are preferably designed such that each of the side spaces 10-11 can be pressed flat together, which implies that the opposite wall parts can be put together, without any folds arising, over their entire or almost entire surface.
  • every entry 3-4 is provided with anti-reflux means 12 which mainly consist of a - whether or not virtual - chamber 13 in which the above-mentioned entry 3, 4 respectively, is provided on the one hand, and whereby this chamber 13 is connected to the above-mentioned liquid container 2 on the other hand.
  • every chamber 13 provides a free passage, meaning that no valves or such are mounted therein.
  • the anti-reflux means 12 preferably consist of chambers 13 which are formed of two mainly parallel wall parts 14-15 which are designed such that they will be situated flat against one another or almost against one another after the implantation.
  • the chambers 13 of the anti-reflux means 12 can be connected onto the liquid container 2 via a constriction 16.
  • Said constriction 16 may consist of a groove, as represented in detail in figure 8.
  • the above-mentioned chambers 13 may have the shape of triangular wings, whereby one side 17 of the thus formed triangle is connected onto the liquid container 2 and whereby the accompanying entry, 3 or 4 respectively, is provided on the angular point 18 opposite said side 17.
  • the wall, in particular the above-mentioned wall parts 14 and 15, of the chambers 13 of the anti-reflux means 12 is preferably provided with a reinforcement, such as a cast- in synthetic reinforcement or texture 19.
  • the above-mentioned anti-reflux means 12 preferably open into the liquid container 2 at a distance L3 under the top end 20 of this liquid container 2, but at least at a distance of for example five centimetres from the exit 5.
  • the anti-reflux means 12 preferably open into these side spaces 10-11, in particular in their lower half. They are hereby provided on the sides 21 of the side spaces 10-11 directed towards the inside.
  • the anti-reflux means 12 will be designed as ileal wings.
  • the entries 3 and 4 are preferably equipped with connecting pieces 22 and 23 for the ureters 24 and 25.
  • the above-mentioned connecting pieces 22 and 23 preferably consist of fine or coarse synthetic material.
  • a material which is fit for a good incorporation and epithelialisation for example a material made of or based on PTFE (polytetrafluoroethylene) or Dacron.
  • the connecting pieces 22-23 can be cast onto the wall material of the chambers 13 without any problems, fused to it or attached to it according to another method.
  • a connecting piece 26 can be provided at the exit 5, preferably also made of any of the above-mentioned materials. It can be made such that an attachment to the urethra 27 becomes possible. As a result, a normal depletion of the bladder prosthesis 1 becomes possible, as the sphincter can work normally in this case.
  • the whole preferably forms a bi- valvular system which can fold entirely together when empty.
  • the working of the bladder prosthesis from figures 1 to 9 is mainly as follows: during the implantation, the ureters 24 and 25 are connected onto the entries 3 and 4 via the connecting pieces 22 and 23 and the urethra 27 via the connecting piece 26.
  • anti-reflux means 12 are situated low on the inside offers the prime advantage that almost the entire length of the ureters 24-25 can be preserved, so that they remain available should other operations be required afterwards, such as the replacement of the bladder prosthesis by another one.
  • the specific shape offers the advantage that the above-mentioned.wall parts 14 and 15 are also pressed flat together, which promotes the good working of the anti-reflux means 12.
  • the wall parts 14 and 15 which are pressed together make it possible for the urine from the ureters 24 and 25 to trickle in between, but the urine cannot flow back. The flowing back is also prevented by means of the constriction 16.
  • the invention also concerns other shapes of bladder prostheses 1 which are adapted to the shape of the pelvis.
  • anti-reflux means 12 as represented in the invention can also be used for other bladder prostheses while still remaining within the scope of the invention.
  • each of the anti- reflux means 12 mainly consists of a preferably bladder- shaped chamber 13 onto which the ureter in question, 24 and 25 respectively, is connected directly or indirectly, whereby this chamber 13 is also connected to the above- mentioned liquid container 2 via a constriction 16.
  • This also offers the advantage that no mechanical valves or such, which may fail, need to be provided.
  • Such bladder-shaped chambers 13 also offer the advantage that they function as an ileal element. This means that urine from the ureters 24 and 25, which as is known is supplied drop by drop to the bladder, is collected in the chambers 13 and can go from there through the constrictions 16 into the liquid container 2 without any problems, but that the urine collected in this container, thanks to the presence of the constrictions 16, and thanks to the shape of the prosthesis resulting from the presence of the chambers 13, can hardly or not at all flow back into these chambers 13 and thus into the ureters 24 and 25.
  • the chambers 13 are situated to the left and to the right of the top side, but it is clear that they can also open lower into the liquid container 2 as in the embodiment of figures 1 to 9.
  • the liquid container 2 When expanded, the liquid container 2 in this case has a mainly rounded triangular section, whereby the apical angle is situated in the centre at the bottom, where the exit 5 is also situated.
  • the shape of the bladder prosthesis 1 which is represented in figure 10 has for a result that the prosthesis folds together when it is emptied, as indicated by means of the arrows A.
  • This shape offers the advantage that the bladder prosthesis 1 so to say rests on the pelvis and thus is optimally supported. It is clear that the entries 3-4 and the exit 5 can be provided with the above-mentioned connecting pieces 22- 23-26 in an analogous manner.
  • the walls of the chambers 13 are preferably made in one piece with the wall 8 of the liquid container 2, in the first as well as in the second embodiment, which results in a very simple construction which weighs little and is ideal for an implantation.
  • the wall 8 of the liquid container 2, and possibly also of the chambers 13, may be provided with a course outer surface 30, in particular a carved surface.
  • a course outer surface 30, in particular a carved surface is provided.
  • the invention also concerns a bladder prosthesis 1 with only one entry 3 or 4. It is indeed possible for the ureters 24 and 25 to be linked, so that only one end of a ureter is coupled to the bladder prosthesis 1.
  • a connecting piece 32 can be provided which makes it possible for both the ureters 24 and 25 to be connected onto one entry 33.
  • a T-shaped connecting piece 32 made of the same material as the connecting pieces 22 and 23.
  • the liquid container 2 in this case merely has one entry 33, with the accompanying anti- reflux means 12, whereby the latter preferably consist of a chamber 13 as mentioned above.
  • all characteristics mentioned in the description of the embodiment of figure 10 also apply to the embodiment of figure 12.
  • the prosthesis can also be used to create an aesthetic, so-called continent urostoma with a minimum of morbidity, whereby the appropriate discharge means are then provided at the exit 5.

Landscapes

  • Health & Medical Sciences (AREA)
  • Urology & Nephrology (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Pulmonology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne une prothèse de la vessie consistant en un réservoir de liquide (2) épousant la forme du pelvis et présentant au moins deux admissions (3,4) et au moins une sortie (5).
PCT/BE1994/000074 1993-10-29 1994-10-26 Prothese de la vessie WO1995011637A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP94929418A EP0737049A1 (fr) 1993-10-29 1994-10-26 Prothese de la vessie
AU78491/94A AU7849194A (en) 1993-10-29 1994-10-26 Bladder prosthesis

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
BE9301202 1993-10-29
BE9301202A BE1008232A3 (nl) 1993-10-29 1993-10-29 Blaasprothese.

Publications (1)

Publication Number Publication Date
WO1995011637A1 true WO1995011637A1 (fr) 1995-05-04

Family

ID=3887518

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/BE1994/000074 WO1995011637A1 (fr) 1993-10-29 1994-10-26 Prothese de la vessie

Country Status (4)

Country Link
EP (1) EP0737049A1 (fr)
AU (1) AU7849194A (fr)
BE (1) BE1008232A3 (fr)
WO (1) WO1995011637A1 (fr)

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000056246A1 (fr) * 1999-03-18 2000-09-28 Helmut Wassermann Systeme artificiel de derivation urinaire
EP1020165A3 (fr) * 1999-01-13 2000-10-25 CareMed Medical Produkte Aktiengesellschaft Vessie artificielle implantable
WO2006025950A1 (fr) * 2004-08-30 2006-03-09 Boston Scientific Scimed, Inc. Procede et dispositif de scellement uretral
US7131996B2 (en) 1999-03-18 2006-11-07 Helmut Wasserman Artificial urinary diversion device
WO2007039160A1 (fr) * 2005-10-03 2007-04-12 Antonio Sambusseti Piece concue pour remplacer une partie de paroi d'une vessie a la suite du cystectomie
WO2007039159A1 (fr) * 2005-10-03 2007-04-12 Antonio Sambusseti Prothese vesicale artificielle orthotopique et procede de production de celle-ci
JP2008253797A (ja) * 1999-03-18 2008-10-23 Helmut Wassermann 人工排尿装置
WO2009077047A1 (fr) * 2007-12-18 2009-06-25 Antonio Sambusetti Endoprothèse de vessie artificielle orthotopique de type poche
DE10046027B4 (de) * 1999-03-19 2011-05-19 Wassermann, Helmut, Prof. Künstliches Harnableitungssystem
WO2012120326A1 (fr) 2011-03-09 2012-09-13 Pinzi Novello Structure de vessie artificielle
ITMI20121804A1 (it) * 2012-10-24 2014-04-25 Gianni Cancarini Protesi vescicale
ITMI20130799A1 (it) * 2013-05-15 2014-11-16 Antonio Sambusseti Endoprotesi ortotopica di vescica artificiale con migliorate proprieta' antireflusso

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL7416695A (nl) * 1973-12-28 1975-07-01 Rhone Poulenc Sa Inplantbare kunstblaas.
US4044401A (en) * 1975-08-04 1977-08-30 Jacques Guiset Artificial bladder
FR2347031A1 (fr) * 1976-04-05 1977-11-04 Anvar Vessie artificielle implantable, et procede pour sa fabrication
EP0393714A2 (fr) * 1989-04-20 1990-10-24 Donald P. Griffith Prothèse de vessie
WO1993016659A1 (fr) * 1992-02-28 1993-09-02 Mayo Foundation For Medical Education And Research Vessie artificielle

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL7416695A (nl) * 1973-12-28 1975-07-01 Rhone Poulenc Sa Inplantbare kunstblaas.
US4044401A (en) * 1975-08-04 1977-08-30 Jacques Guiset Artificial bladder
FR2347031A1 (fr) * 1976-04-05 1977-11-04 Anvar Vessie artificielle implantable, et procede pour sa fabrication
EP0393714A2 (fr) * 1989-04-20 1990-10-24 Donald P. Griffith Prothèse de vessie
WO1993016659A1 (fr) * 1992-02-28 1993-09-02 Mayo Foundation For Medical Education And Research Vessie artificielle

Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1020165A3 (fr) * 1999-01-13 2000-10-25 CareMed Medical Produkte Aktiengesellschaft Vessie artificielle implantable
DE19912472B4 (de) * 1999-03-18 2011-03-17 Wassermann, Helmut, Prof. Künstliches Harnableitungssystem
US7131996B2 (en) 1999-03-18 2006-11-07 Helmut Wasserman Artificial urinary diversion device
WO2000056246A1 (fr) * 1999-03-18 2000-09-28 Helmut Wassermann Systeme artificiel de derivation urinaire
JP2008253797A (ja) * 1999-03-18 2008-10-23 Helmut Wassermann 人工排尿装置
US7479161B1 (en) 1999-03-18 2009-01-20 Helmut Wassermann Artificial urinary diversion system
DE10046027B4 (de) * 1999-03-19 2011-05-19 Wassermann, Helmut, Prof. Künstliches Harnableitungssystem
WO2006025950A1 (fr) * 2004-08-30 2006-03-09 Boston Scientific Scimed, Inc. Procede et dispositif de scellement uretral
US8105317B2 (en) 2004-08-30 2012-01-31 Boston Scientific Scimed, Inc. Urethral sealing method and device
WO2007039160A1 (fr) * 2005-10-03 2007-04-12 Antonio Sambusseti Piece concue pour remplacer une partie de paroi d'une vessie a la suite du cystectomie
US7972385B2 (en) 2005-10-03 2011-07-05 Antonio Sambusseti Patch for replacement of a portion of bladder wall following partial cystectomy
WO2007039159A1 (fr) * 2005-10-03 2007-04-12 Antonio Sambusseti Prothese vesicale artificielle orthotopique et procede de production de celle-ci
WO2009077047A1 (fr) * 2007-12-18 2009-06-25 Antonio Sambusetti Endoprothèse de vessie artificielle orthotopique de type poche
WO2012120326A1 (fr) 2011-03-09 2012-09-13 Pinzi Novello Structure de vessie artificielle
ITMI20121804A1 (it) * 2012-10-24 2014-04-25 Gianni Cancarini Protesi vescicale
ITMI20130799A1 (it) * 2013-05-15 2014-11-16 Antonio Sambusseti Endoprotesi ortotopica di vescica artificiale con migliorate proprieta' antireflusso

Also Published As

Publication number Publication date
AU7849194A (en) 1995-05-22
BE1008232A3 (nl) 1996-02-20
EP0737049A1 (fr) 1996-10-16

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