WO2005087146A2 - Gastric implant for treating obesity - Google Patents

Gastric implant for treating obesity Download PDF

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Publication number
WO2005087146A2
WO2005087146A2 PCT/FR2005/000508 FR2005000508W WO2005087146A2 WO 2005087146 A2 WO2005087146 A2 WO 2005087146A2 FR 2005000508 W FR2005000508 W FR 2005000508W WO 2005087146 A2 WO2005087146 A2 WO 2005087146A2
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WO
WIPO (PCT)
Prior art keywords
strip
pocket
implant
pipe
gastric implant
Prior art date
Application number
PCT/FR2005/000508
Other languages
French (fr)
Other versions
WO2005087146A3 (en
Inventor
Jean Cady
Charles De Seguin Des Hons
Jean-Michel Fabre
Gilles Fourtanier
Jacques Louis Hubert Domergue
Original Assignee
Dedienne Sante
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 Dedienne Sante filed Critical Dedienne Sante
Priority to EP05733028A priority Critical patent/EP1720496A2/en
Publication of WO2005087146A2 publication Critical patent/WO2005087146A2/en
Publication of WO2005087146A3 publication Critical patent/WO2005087146A3/en

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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
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/0003—Apparatus for the treatment of obesity; Anti-eating devices
    • A61F5/0013—Implantable devices or invasive measures
    • A61F5/005—Gastric bands
    • A61F5/0066—Closing devices for gastric bands
    • 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
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/0003—Apparatus for the treatment of obesity; Anti-eating devices
    • A61F5/0013—Implantable devices or invasive measures
    • A61F5/005—Gastric bands
    • A61F5/0053—Gastric bands remotely adjustable
    • A61F5/0056—Gastric bands remotely adjustable using injection ports
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132—Tourniquets
    • A61B17/135—Tourniquets inflatable

Definitions

  • the present invention relates to a gastric implant for the treatment of obesity, in particular obesity known as "morbid” obesity.
  • Such an implant is commonly called “gastric ring” or “gastroplasty ring”. It is known to treat the pathological obesity of a patient by placing a gastric implant in the form of a ring around the stomach of this patient.
  • Such an implant makes it possible to form a pocket of limited dimensions on the upper part of the stomach, communicating with the rest of the stomach through an opening of restricted section, commonly called “stoma”.
  • a known gastric implant comprises a flexible band comprising an inflatable pocket on one of its faces and means for closing the implant in the form of a ring, an implantable chamber containing an inflation liquid for this pocket, and a pipe. connecting this pocket to this implantable chamber.
  • the band is placed around the patient's stomach so that the inflatable bag is located on the internal face of the ring thus formed, then the ends of the band are joined together to maintain this band in position.
  • the implantable chamber allows the supply or withdrawal of inflation liquid to adjust the section of the opening delimited by the ring according to the progress of the patient.
  • the means for closing the band in the form of a ring exist in particular in the form of latching systems, as described in document WO-A-94/27504, comprising a passage in which one end of the band is engaged and locks , or interpenetration systems locked by a threaded pin, or sutures, as described in document WO-A-86/04498.
  • the existing implants have the drawback of being difficult to install and of inducing a non-negligible risk of deterioration during this installation, in particular at the level of the connection of the pipe to the inflatable pocket when this pipe must be engaged. through an interlocking passage.
  • These implants also have the disadvantage of allowing only one ring diameter, or a reduced number of ring diameters, and thus not allow this diameter to be adapted to the specific needs of the patient.
  • the closure systems of these implants have the further disadvantage of not allowing, once locked, a reopening of the strip for the repositioning of the implant, without damaging or risking damaging the implant, which is a certain constraint. for the practitioner.
  • the removal of the implant after treatment of the patient is not easy.
  • Document FR-A-2 827 756 describes a lake usable in endoscopic surgery, having the general shape of a strip and having ends provided with easily removable attachment means, in particular complementary self-gripping bands. This document does not belong to the field of gastric implants and the lakes which it describes is not comparable to a gastric implant.
  • Document US-A-5,527,355 describes a tubular implant for treating an aneurysm and a retaining band for this implant, which can be closed by various means, in particular by complementary self-gripping bands. This document does not belong to the field of gastric implants and the implant which it describes is not comparable to a gastric implant. The present invention aims to remedy all of the drawbacks of existing gastric implants.
  • the device concerned comprises, in a manner known per se: - a flexible band comprising an inflatable pocket on one of its faces and means for closing it in the form of a ring; - An implantable chamber containing an inflation liquid of this pocket, and - a pipe connecting said pocket to this implantable chamber.
  • said closing means comprise complementary hook-and-loop surfaces placed respectively on the two end portions of the strip. Thanks to these complementary hook-and-loop surfaces, the implant is easy to place, without risk, or with a reduced risk, of damaging the implant.
  • the implant can be easily repositioned by simple separation of said surfaces and then reapplication of these surfaces one against the other, and the separation of these surfaces allows the implant to be removed after treatment with the same ease.
  • the strip may comprise, on its side comprising the pocket, a gradual transition between the end of the pocket and the end portion of the strip comprising the self-gripping surface, allowing the strip to be closed according to numerous diameters possible ring, without forming a substantial detachment capable of injuring the gastric wall.
  • the strip may however also have a recess between the end of the pocket and the end portion of the strip comprising the self-gripping surface, forming a stop zone against which the other end of the strip abuts after being put in place.
  • a precise closing diameter of the strip is thus defined.
  • an end zone of the strip comprises at least one means defining an engagement passage of the other end of the strip, this means making it possible to maintain said self-supporting surfaces. -aggripantes in engagement with each other. Maintaining engagement of these surfaces is thus ensured in particular during inflation of said pocket.
  • One end of the strip may be in the form of a rounded point, of so as to facilitate the engagement of this end in said means defining a passage, without this end being aggressive for the surrounding tissues.
  • the pipe may, at the time of implantation placement, not be connected to the implantable chamber and present a pointed terminal part, in rod or in pallet at its end intended to be connected to this chamber.
  • This end portion facilitates the engagement of the pipe in said means defining a passage, thereby helping to reduce the risk of deterioration of the implant.
  • This end part is, after the band has been put in place, sectioned and then the pipe is connected to the chamber.
  • the strip may include at least one means defining a housing for receiving and retaining the pipe against the strip. This means eliminates the risk of pulling on the pipe that could damage the pipe at its connection to the pocket.
  • This means defining a housing for receiving and retaining the pipe against the strip may in particular consist of a pair of slightly flexible projections, delimiting said housing between them and forming a clip ring for the pipe.
  • Figure 1 is a perspective view according to a first embodiment, after placement around a stomach, this stomach being fictitiously shown transparently for clarity of the drawing;
  • Figure 2 is a perspective view of a strip it comprises;
  • Figure 3 is a view of this strip in longitudinal section;
  • Figure 4 is one of this side strip, before inflation of a chamber it comprises;
  • Figure 5 is a view similar to Figure 4, after inflation of the chamber;
  • Figure 6 is a partial perspective view of the two ends of the strip, according to a second embodiment, before assembly of these ends;
  • Figure 7 is a view similar to Figure 6, after assembly of the ends of the strip;
  • Figure 8 is a side view of the strip;
  • Figure 9 is a view of the top strip, according to a third embodiment;
  • FIG. 1 represents a gastric implant 1 of treatment of obesity, in particular obesity known as "morbid", placed around a stomach 100.
  • this implant 1 makes it possible to form a pocket 101 of limited dimensions on the upper part of the stomach 100, communicating with the rest 102 of the stomach through an opening 103 of restricted section, commonly called "stoma". The filling of this pocket 101 gives the patient more quickly the feeling of satiety.
  • the implant 1 comprises a flexible strip 2, suitable for being placed around the stomach 100, comprising an inflatable pocket 3 on one of its faces, an implantable chamber 4 and a pipe 5 connecting the pocket 3 to this implantable chamber 4.
  • the strip 2 and the pocket 3 are made in one piece, in particular in silicone, the pocket 3 being delimited by the strip 2 on the one hand and by a deformable membrane 10 on the other hand.
  • the strip 2 At one of its ends, the strip 2 comprises an elongated boss 11 projecting longitudinally and transversely relative to the rest of the strip. This boss 11 and the strip 2 are crossed by the pipe 5, which opens into the pocket 3.
  • the part of the boss 11 protruding from the strip 2 forms a recess 12 with the part of the strip 2 along which the pocket is located. 3, this step delimiting a transverse end face.
  • this protruding part of the boss 11 comprises a coating 13 forming part of a pair of complementary Velcro® type hook-and-loop coatings, for example a coating having pins forming hooks.
  • the opposite end of the strip 2 comprises, on the side opposite to that on which the pocket 3 is located, the other covering 14 of said pair of complementary hook-and-loop coverings, that is to say the covering comprising fibers. in the example considered.
  • the implantable chamber 4 comprises a container 15 containing an inflating liquid from the pocket 3 and a membrane 16 which can be pierced by the needle of a syringe allowing, percutaneously, to introduce into the container 15, or to withdraw, inflating liquid from the bag 3.
  • the pipe 5 is formed by a tube made of flexible material, in particular silicone. It connects the pocket 3 to the implantable chamber 4. As shown in FIGS. 1, 4 and 5, the strip 2 is maintained in its circular position by the arrival of the covering 13 in cooperation with the covering 14.
  • the transverse face delimited by the recess 12 comes in the immediate vicinity of the opposite end of the strip 2, defining a precise position for closing the strip 2, and therefore a precise diameter of the gastric band thus formed.
  • the bag 3 can then be more or less inflated by means of the liquid contained in the chamber 4, in order to adjust the section of the "stoma" 102 according to the needs and the evolution of the patient. Thanks to these coatings 13 and 14, the implant 1 is easy to put in place, without risk, or with a reduced risk, of deterioration.
  • the implant 1 can be easily repositioned by simple separation of said coatings 13, 14 then reapplication of these coatings one against the other, and the separation of these coatings makes it possible to remove the implant 1 after treatment with the same ease.
  • the end of the strip 2 opposite to that comprising the boss 11 has a loop 17 making it possible to ensure perfect retention of the coatings 13 and 14.
  • the loop 17 can be removably connected to the strip 2 at at least one of its ends, to allow the engagement of the pipe 5 through it, or the pipe 5 can be separable from the container 15, for the same purpose.
  • the end of the strip 2 comprising the boss 11 forms a progressive recess 12 with the protruding part of this boss, such that the strip has a transverse face inclined on the side opposite to this protruding part.
  • the strip 2 can thus be closed in the form of a ring according to a plurality of possible positions of the ends of this strip relative to each other, thus allowing adjustment of the diameter of the ring that this strip 2 forms once closed.
  • the pipe 5 is fixed along the boss 11, and the strip 2 comprises, beyond the covering 14, a loop or an open clip ring 18 suitable for receiving the pipe 5 after engagement of this pipe through the passer-by 17.
  • the latter in this case comprises lateral extensions 17a, projecting from the longitudinal side opposite to the strip 2, which provide reinforced lateral support for the boss 11 by this passer-by 17.
  • Figures 11 to 13 show that, to facilitate its engagement in the passer-by 17 and before its connection to the chamber 4, the end of the pipe 5 not connected to the strip 2 can have an end 5a of tapered shape (cf. figure 11), an end 5b in the form of a rod, increasing its rigidity (cf. FIG. 12), or an end 5c in the form of a pallet (cf. FIG. 13). These ends are sectioned once the engagement of the pipe 5 is carried out in the passage 17, then the sectioned end of this pipe is connected to the chamber 4.
  • the invention thus provides a gastric implant which can be put in place without risk of deterioration, or at least greatly reducing this risk, which can be implemented, if necessary, according to several possible diameters, which can be easily repositioned, and which can be easily removed after treatment of the patient. It goes without saying that the invention is not limited to the embodiment described above by way of example but that it extends to all the embodiments covered by the claims appended hereto.

Abstract

The inventive gastric implant (1) comprises according to methods known per se: an elastic strip (2) provided with an inflatable pocket (3) on one face thereof and means in the form of a ring for closing said pocket, an implantable chamber (4) containing a fluid for inflating the pocket and a conduit (5) connecting the pocket (3) to said implantable chamber (4). The invention is characterised in that said closing means comprises additional self-adhesive surfaces (13, 14) placed on two end portions of the strip (2), respectively.

Description

IMPLANT GASTRIQUE DE TRAITEMENT DE L'OBESITE La présente invention concerne un implant gastrique de traitement de l'obésité, notamment de l'obésité dite "morbide". Un tel implant est couramment dénommé "anneau gastrique" ou "anneau de gastroplastie". II est connu de traiter l'obésité pathologique d'un patient en plaçant un implant gastrique sous forme d'anneau autour de l'estomac de ce patient. Un tel implant permet de former une poche de dimensions limitées sur la partie supérieure de l'estomac, communiquant avec le reste de l'estomac par une ouverture de section restreinte, couramment dénommée "stoma". Un implant gastrique connu comprend une bande souple comportant une poche gonflable sur l'une de ses faces et des moyens pour sa fermeture de l'implant sous forme d'anneau, une chambre implantable contenant un liquide de gonflage de cette poche, et une conduite reliant cette poche à cette chambre implantable. La bande est mise en place autour de l'estomac du patient de telle sorte que la poche gonflable soit située sur la face interne de l'anneau ainsi formé puis les extrémités de la bande sont assemblées l'une à l'autre pour maintenir cette bande en position. La chambre implantable permet l'apport ou le retrait de liquide de gonflage pour ajuster la section de l'ouverture délimitée par l'anneau en fonction de l'évolution du patient. Les moyens pour la fermeture de la bande sous forme d'anneau existent notamment sous forme de systèmes à enclenchement, comme décrit dans le document WO-A-94/27504, comprenant un passage dans lequel est engagé et se verrouille une extrémité de la bande, ou de systèmes à interpénétration verrouillés par une broche filetée, ou de sutures, comme décrit dans le document WO-A-86/04498. Les implants existants ont pour inconvénient d'être guère aisés à mettre en place et d'induire un risque non négligeable de détérioration lors de cette mise en place, notamment au niveau du raccordement de la conduite à la poche gonflable lorsque cette conduite doit être engagée au travers d'un passage à enclenchement. Ces implants ont également pour inconvénient de n'autoriser qu'un diamètre d'anneau, ou un nombre réduit de diamètres d'anneau, et de ne pas permettre ainsi d'adapter ce diamètre aux besoins spécifiques du patient. Les systèmes de fermeture de ces implants ont de plus pour inconvénient ne pas permettre, une fois verrouillés, une réouverture de la bande en vue du repositionnement de l'implant, sans détériorer ou risquer de détériorer l'implant, ce qui est une contrainte certaine pour le praticien. En outre, le retrait de l'implant après traitement du patient n'est guère facile. Le document FR-A-2 827 756 décrit un lacs utilisable en chirurgie endoscopique, ayant la forme générale d'une bandelette et ayant des extrémités pourvues de moyens d'accrochage aisément amovibles, en particulier de bandes auto-aggripantes complémentaires. Ce document n'appartient pas au domaine des implants gastriques et le lacs qu'il décrit n'est pas assimilable à un implant gastrique. Le document US-A-5,527,355 décrit un implant tubulaire de traitement d'un anévrisme et une bande de maintien de cet implant, pouvant être refermée par différents moyens, notamment par des bandes auto-aggripantes complémentaires. Ce document n'appartient pas au domaine des implants gastriques et l'implant qu'il décrit n'est pas assimilable à un implant gastrique. La présente invention vise à remédier à l'ensemble des inconvénients des implants gastriques existants. Son objectif principal est donc de fournir un implant gastrique du type précité, pouvant être mis en place sans risquer de détériorer l'implant, ou tout au moins en réduisant fortement ce risque de détérioration. Un autre objectif de l'invention est de fournir un implant pouvant être mis en place selon de nombreux diamètres possibles, et pouvant être facilement repositionné. Un autre objectif encore de l'invention est de fournir un implant pouvant être facilement retiré après traitement du patient. Le dispositif concerné comprend, de manière connue en soi : - une bande souple comportant une poche gonflable sur l'une de ses faces et des moyens pour sa fermeture sous forme d'anneau ; - une chambre implantable contenant un liquide de gonflage de cette poche, et - une conduite reliant ladite poche à cette chambre implantable. Selon l'invention, lesdits moyens de fermeture comprennent des surfaces auto-agrippantes complémentaires placées respectivement sur les deux portions d'extrémité de la bande. Grâce à ces surfaces auto-agrippantes complémentaires, l'implant est facile à mettre en place, sans risque, ou avec un risque réduit, de détériorer l'implant. L'implant peut être facilement repositionné par simple séparation desdites surfaces puis réapplication de ces surfaces l'une contre l'autre, et la séparation de ces surfaces permet de retirer l'implant après traitement avec la même facilité. La bande peut comprendre, sur son côté comportant la poche, une transition progressive entre l'extrémité de la poche et la portion d'extrémité de la bande comportant la surface auto-aggripante, permettant à la bande d'être refermée selon de nombreux diamètres d'anneau possibles, sans former de décrochement substantiel susceptible de blesser la paroi gastrique. La bande peut toutefois également présenter un décrochement entre l'extrémité de la poche et la portion d'extrémité de la bande comportant la surface auto- aggripante, formant une zone d'arrêt contre laquelle vient buter l'autre extrémité de la bande après mise en place. Un diamètre de fermeture précis de la bande est ainsi défini. Selon une forme de réalisation possible de l'invention, une zone d'extrémité de la bande comprend au moins un moyen définissant un passage d'engagement de l'autre extrémité de la bande, ce moyen permettant d'assurer le maintien desdites surfaces auto-aggripantes en prise l'une avec l'autre. Le maintien en prise de ces surfaces est ainsi assuré en particulier lors du gonflage de ladite poche. Une extrémité de la bande peut être en forme de pointe arrondie, de manière à faciliter l'engagement de cette extrémité dans ledit moyen définissant un passage, sans pour autant que cette extrémité soit agressive pour les tissus environnants. La conduite peut, au moment de la mise en place de l'implant, ne pas être raccordée à la chambre implantable et présenter une partie terminale pointue, en tige ou en palette au niveau de son extrémité destinée à être raccordée à cette chambre. Cette partie terminale permet de faciliter l'engagement de la conduite dans ledit moyen définissant un passage, contribuant ainsi à réduire le risque de détérioration de l'implant. Cette partie terminale est, après mise en place de la bande, sectionnée puis la conduite est raccordée à la chambre. La bande peut comprendre au moins un moyen définissant un logement de réception et de rétention de la conduite contre la bande. Ce moyen permet d'éliminer le risque d'exercice d'une traction sur la conduite susceptible de détériorer la conduite au niveau de son raccordement à la poche. Ce moyen définissant un logement de réception et de rétention de la conduite contre la bande peut notamment consister en une paire de saillies légèrement souples, délimitant ledit logement entre elles et formant un anneau de clipage de la conduite. L'invention sera bien comprise, et d'autres caractéristiques et avantages de celle-ci apparaîtront, en référence au dessin schématique annexé, représentant, à titre d'exemples non limitatifs, plusieurs formes de réalisation possibles de l'implant gastrique qu'elle concerne. La figure 1 en est une vue en perspective selon une première forme de réalisation, après mise en place autour d'un estomac, cet estomac étant fictivement représenté de manière transparente pour la clarté du dessin ; la figure 2 est une vue en perspective d'une bande qu'il comprend ; la figure 3 est une vue de cette bande en coupe longitudinale ; la figure 4 est une de cette bande de côté, avant gonflage d'une chambre qu'elle comprend ; la figure 5 est une vue similaire à la figure 4, après gonflage de la chambre ; la figure 6 est une vue partielle, en perspective, des deux extrémités de la bande, selon une deuxième forme de réalisation, avant assemblage de ces extrémités ; la figure 7 est une vue similaire à la figure 6, après assemblage des extrémités de la bande ; la figure 8 est une vue de la bande, de côté ; la figure 9 est une vue de la bande de dessus, selon une troisième forme de réalisation ; la figure 10 en est une vue de côté, et les figures 11 à 13 sont des vues de dessus de la partie terminale d'une conduite qu'il comprend, selon trois variantes de réalisation. Par simplification, les parties ou éléments d'une forme de réalisation qui se retrouvent de manière identique ou similaire dans une autre forme de réalisation seront identifiés par les mêmes références numériques et ne seront pas à nouveau décrits La figure 1 représente un implant gastrique 1 de traitement de l'obésité, notamment de l'obésité dite "morbide", mis en place autour d'un estomac 100. Comme cela est représenté, cet implant 1 permet de former une poche 101 de dimensions limitées sur la partie supérieure de l'estomac 100, communiquant avec le reste 102 de l'estomac par une ouverture 103 de section restreinte, couramment dénommée "stoma". Le remplissage de cette poche 101 donne au patient plus rapidement le sentiment de satiété. L'implant 1 comprend une bande souple 2, propre à être mise en place autour de l'estomac 100, comportant une poche gonflable 3 sur l'une de ses faces, une chambre implantable 4 et une conduite 5 reliant la poche 3 à cette chambre implantable 4. Comme le montrent plus particulièrement les figures 2 et 3, la bande 2 et la poche 3 sont réalisées en une pièce, notamment en silicone, la poche 3 étant délimitée par la bande 2 d'une part et par une membrane déformable 10 d'autre part. À l'une de ses extrémités, la bande 2 comprend un bossage allongé 11 faisant saillie longitudinalement et transversalement par rapport au reste de la bande. Ce bossage 11 et la bande 2 sont traversés par la conduite 5, laquelle débouche dans la poche 3. La partie du bossage 11 dépassant de la bande 2 forme un décrochement 12 avec la partie de la bande 2 le long de laquelle se trouve la poche 3, ce décrochement délimitant une face transversale d'extrémité. Sur sa face située du côté de la poche 3, cette partie dépassante du bossage 11 comprend un revêtement 13 faisant partie d'une paire de revêtements auto- agrippants complémentaires de type Velcro ®, par exemple un revêtement présentant des picots formant des crochets. L'extrémité opposée de la bande 2 comprend, du côté opposé à celui sur lequel se trouve la poche 3, l'autre revêtement 14 de ladite paire de revêtements auto-agrippants complémentaires, c'est-à-dire le revêtement comprenant des fibres dans l'exemple considéré. L'extrémité libre du bossage 11 est par ailleurs en forme de pointe arrondie, de manière à faciliter l'engagement de cette extrémité autour de l'estomac 100 sans pour autant que cette extrémité soit agressive pour les tissus environnants. La chambre implantable 4 comprend un récipient 15 contenant un liquide de gonflage de la poche 3 et une membrane 16 pouvant être transpercée par l'aiguille d'une seringue permettant, par voie percutanée, d'introduire dans le récipient 15, ou de retirer, du liquide de gonflage de la poche 3. La conduite 5 est formée par un tube en matériau souple, notamment en silicone. Elle relie la poche 3 à la chambre implantable 4. Comme le montrent les figures 1 , 4 et 5, la bande 2 est maintenue dans sa position circulaire par la venue du revêtement 13 en coopération avec le revêtement 14. La face transversale délimitée par le décrochement 12 vient à proximité immédiate de l'extrémité opposée de la bande 2, définissant une position précise de fermeture de la bande 2, et donc un diamètre précis de l'anneau gastrique ainsi formé. La poche 3 peut alors être plus ou moins gonflée au moyen du liquide contenu dans la chambre 4, afin de régler la section du "stoma" 102 en fonction des besoins et de l'évolution du patient. Grâce à ces revêtements 13 et 14, l'implant 1 est facile à mettre en place, sans risque, ou avec un risque réduit, de détérioration. L'implant 1 peut être facilement repositionné par simple séparation desdits revêtements 13, 14 puis réapplication de ces revêtements l'un contre l'autre, et la séparation de ces revêtements permet de retirer l'implant 1 après traitement avec la même facilité. Dans la forme de réalisation représentée sur les figures 6 à 8, l'extrémité de la bande 2 opposée à celle comportant le bossage 11 présent un passant 17 permettant d'assurer le parfait maintien en prise des revêtements 13 et 14. Le passant 17 peut être relié amoviblement à la bande 2 au niveau d'au moins une de ses extrémités, pour permettre l'engagement de la conduite 5 à travers lui, ou la conduite 5 peut être séparable du récipient 15, dans le même but. Dans cette même forme de réalisation, l'extrémité de la bande 2 comportant le bossage 11 forme un décrochement 12 progressif avec la partie dépassante de ce bossage, tel que la bande présente une face transversale inclinée du côté opposé à cette partie dépassante. La bande 2 peuvent ainsi être refermée sous forme d'anneau selon une pluralité de positions possibles des extrémités de cette bande l'une par rapport à l'autre, permettant ainsi un réglage du diamètre de l'anneau que forme cette bande 2 une fois refermée. Dans la forme de réalisation représentée sur les figures 9 et 10, la conduite 5 est fixée le long du bossage 11, et la bande 2 comporte, au-delà du revêtement 14, un passant ou un anneau ouvert de clipage 18 propre à recevoir la conduite 5 après engagement de cette conduite au travers du passant 17. Ce dernier comprend dans ce cas des extensions latérales 17a, faisant saillie du côté longitudinal opposé à la bande 2, qui réalisent un maintien latéral renforcé du bossage 11 par ce passant 17. Les figures 11 à 13 montrent que, pour faciliter son engagement dans le passant 17 et avant son raccordement à la chambre 4, l'extrémité de la conduite 5 non reliée à la bande 2 peut présenter une extrémité 5a de forme effilée (cf. figure 11), une extrémité 5b en forme de tige, augmentant sa rigidité (cf. figure 12), ou une extrémité 5c en forme de palette (cf. figure 13). Ces extrémités sont sectionnées une fois réalisé l'engagement de la conduite 5 dans le passant 17, puis l'extrémité sectionnée de cette conduite est raccordé à la chambre 4. L'invention fournit ainsi un implant gastrique pouvant être mis en place sans risque de détérioration, ou tout au moins en réduisant fortement ce risque, pouvant être mis en place, le cas échéant, selon plusieurs diamètres possibles, pouvant être facilement repositionné, et pouvant être facilement retiré après traitement du patient. Il va de soi que l'invention n'est pas limitée à la forme de réalisation décrite ci-dessus à titre d'exemple mais qu'elle s'étend à toutes les formes de réalisations couvertes par les revendications ci-annexées. The present invention relates to a gastric implant for the treatment of obesity, in particular obesity known as "morbid" obesity. Such an implant is commonly called "gastric ring" or "gastroplasty ring". It is known to treat the pathological obesity of a patient by placing a gastric implant in the form of a ring around the stomach of this patient. Such an implant makes it possible to form a pocket of limited dimensions on the upper part of the stomach, communicating with the rest of the stomach through an opening of restricted section, commonly called "stoma". A known gastric implant comprises a flexible band comprising an inflatable pocket on one of its faces and means for closing the implant in the form of a ring, an implantable chamber containing an inflation liquid for this pocket, and a pipe. connecting this pocket to this implantable chamber. The band is placed around the patient's stomach so that the inflatable bag is located on the internal face of the ring thus formed, then the ends of the band are joined together to maintain this band in position. The implantable chamber allows the supply or withdrawal of inflation liquid to adjust the section of the opening delimited by the ring according to the progress of the patient. The means for closing the band in the form of a ring exist in particular in the form of latching systems, as described in document WO-A-94/27504, comprising a passage in which one end of the band is engaged and locks , or interpenetration systems locked by a threaded pin, or sutures, as described in document WO-A-86/04498. The existing implants have the drawback of being difficult to install and of inducing a non-negligible risk of deterioration during this installation, in particular at the level of the connection of the pipe to the inflatable pocket when this pipe must be engaged. through an interlocking passage. These implants also have the disadvantage of allowing only one ring diameter, or a reduced number of ring diameters, and thus not allow this diameter to be adapted to the specific needs of the patient. The closure systems of these implants have the further disadvantage of not allowing, once locked, a reopening of the strip for the repositioning of the implant, without damaging or risking damaging the implant, which is a certain constraint. for the practitioner. In addition, the removal of the implant after treatment of the patient is not easy. Document FR-A-2 827 756 describes a lake usable in endoscopic surgery, having the general shape of a strip and having ends provided with easily removable attachment means, in particular complementary self-gripping bands. This document does not belong to the field of gastric implants and the lakes which it describes is not comparable to a gastric implant. Document US-A-5,527,355 describes a tubular implant for treating an aneurysm and a retaining band for this implant, which can be closed by various means, in particular by complementary self-gripping bands. This document does not belong to the field of gastric implants and the implant which it describes is not comparable to a gastric implant. The present invention aims to remedy all of the drawbacks of existing gastric implants. Its main objective is therefore to provide a gastric implant of the aforementioned type, which can be put in place without risking damaging the implant, or at least by greatly reducing this risk of deterioration. Another objective of the invention is to provide an implant which can be put in place according to many possible diameters, and which can be easily repositioned. Yet another object of the invention is to provide an implant which can be easily removed after treatment of the patient. The device concerned comprises, in a manner known per se: - a flexible band comprising an inflatable pocket on one of its faces and means for closing it in the form of a ring; - An implantable chamber containing an inflation liquid of this pocket, and - a pipe connecting said pocket to this implantable chamber. According to the invention, said closing means comprise complementary hook-and-loop surfaces placed respectively on the two end portions of the strip. Thanks to these complementary hook-and-loop surfaces, the implant is easy to place, without risk, or with a reduced risk, of damaging the implant. The implant can be easily repositioned by simple separation of said surfaces and then reapplication of these surfaces one against the other, and the separation of these surfaces allows the implant to be removed after treatment with the same ease. The strip may comprise, on its side comprising the pocket, a gradual transition between the end of the pocket and the end portion of the strip comprising the self-gripping surface, allowing the strip to be closed according to numerous diameters possible ring, without forming a substantial detachment capable of injuring the gastric wall. The strip may however also have a recess between the end of the pocket and the end portion of the strip comprising the self-gripping surface, forming a stop zone against which the other end of the strip abuts after being put in place. A precise closing diameter of the strip is thus defined. According to a possible embodiment of the invention, an end zone of the strip comprises at least one means defining an engagement passage of the other end of the strip, this means making it possible to maintain said self-supporting surfaces. -aggripantes in engagement with each other. Maintaining engagement of these surfaces is thus ensured in particular during inflation of said pocket. One end of the strip may be in the form of a rounded point, of so as to facilitate the engagement of this end in said means defining a passage, without this end being aggressive for the surrounding tissues. The pipe may, at the time of implantation placement, not be connected to the implantable chamber and present a pointed terminal part, in rod or in pallet at its end intended to be connected to this chamber. This end portion facilitates the engagement of the pipe in said means defining a passage, thereby helping to reduce the risk of deterioration of the implant. This end part is, after the band has been put in place, sectioned and then the pipe is connected to the chamber. The strip may include at least one means defining a housing for receiving and retaining the pipe against the strip. This means eliminates the risk of pulling on the pipe that could damage the pipe at its connection to the pocket. This means defining a housing for receiving and retaining the pipe against the strip may in particular consist of a pair of slightly flexible projections, delimiting said housing between them and forming a clip ring for the pipe. The invention will be clearly understood, and other characteristics and advantages thereof will appear, with reference to the appended schematic drawing, representing, by way of nonlimiting examples, several possible embodiments of the gastric implant that it concerned. Figure 1 is a perspective view according to a first embodiment, after placement around a stomach, this stomach being fictitiously shown transparently for clarity of the drawing; Figure 2 is a perspective view of a strip it comprises; Figure 3 is a view of this strip in longitudinal section; Figure 4 is one of this side strip, before inflation of a chamber it comprises; Figure 5 is a view similar to Figure 4, after inflation of the chamber; Figure 6 is a partial perspective view of the two ends of the strip, according to a second embodiment, before assembly of these ends; Figure 7 is a view similar to Figure 6, after assembly of the ends of the strip; Figure 8 is a side view of the strip; Figure 9 is a view of the top strip, according to a third embodiment; Figure 10 is a side view, and Figures 11 to 13 are top views of the end portion of a pipe it comprises, according to three alternative embodiments. For simplification, the parts or elements of an embodiment which are found in an identical or similar manner in another embodiment will be identified by the same reference numerals and will not be described again. FIG. 1 represents a gastric implant 1 of treatment of obesity, in particular obesity known as "morbid", placed around a stomach 100. As shown, this implant 1 makes it possible to form a pocket 101 of limited dimensions on the upper part of the stomach 100, communicating with the rest 102 of the stomach through an opening 103 of restricted section, commonly called "stoma". The filling of this pocket 101 gives the patient more quickly the feeling of satiety. The implant 1 comprises a flexible strip 2, suitable for being placed around the stomach 100, comprising an inflatable pocket 3 on one of its faces, an implantable chamber 4 and a pipe 5 connecting the pocket 3 to this implantable chamber 4. As shown more particularly in FIGS. 2 and 3, the strip 2 and the pocket 3 are made in one piece, in particular in silicone, the pocket 3 being delimited by the strip 2 on the one hand and by a deformable membrane 10 on the other hand. At one of its ends, the strip 2 comprises an elongated boss 11 projecting longitudinally and transversely relative to the rest of the strip. This boss 11 and the strip 2 are crossed by the pipe 5, which opens into the pocket 3. The part of the boss 11 protruding from the strip 2 forms a recess 12 with the part of the strip 2 along which the pocket is located. 3, this step delimiting a transverse end face. On its face situated on the side of the pocket 3, this protruding part of the boss 11 comprises a coating 13 forming part of a pair of complementary Velcro® type hook-and-loop coatings, for example a coating having pins forming hooks. The opposite end of the strip 2 comprises, on the side opposite to that on which the pocket 3 is located, the other covering 14 of said pair of complementary hook-and-loop coverings, that is to say the covering comprising fibers. in the example considered. The free end of the boss 11 is moreover in the shape of a rounded point, so as to facilitate the engagement of this end around the stomach 100 without this end being aggressive for the surrounding tissues. The implantable chamber 4 comprises a container 15 containing an inflating liquid from the pocket 3 and a membrane 16 which can be pierced by the needle of a syringe allowing, percutaneously, to introduce into the container 15, or to withdraw, inflating liquid from the bag 3. The pipe 5 is formed by a tube made of flexible material, in particular silicone. It connects the pocket 3 to the implantable chamber 4. As shown in FIGS. 1, 4 and 5, the strip 2 is maintained in its circular position by the arrival of the covering 13 in cooperation with the covering 14. The transverse face delimited by the recess 12 comes in the immediate vicinity of the opposite end of the strip 2, defining a precise position for closing the strip 2, and therefore a precise diameter of the gastric band thus formed. The bag 3 can then be more or less inflated by means of the liquid contained in the chamber 4, in order to adjust the section of the "stoma" 102 according to the needs and the evolution of the patient. Thanks to these coatings 13 and 14, the implant 1 is easy to put in place, without risk, or with a reduced risk, of deterioration. The implant 1 can be easily repositioned by simple separation of said coatings 13, 14 then reapplication of these coatings one against the other, and the separation of these coatings makes it possible to remove the implant 1 after treatment with the same ease. In the embodiment shown in FIGS. 6 to 8, the end of the strip 2 opposite to that comprising the boss 11 has a loop 17 making it possible to ensure perfect retention of the coatings 13 and 14. The loop 17 can be removably connected to the strip 2 at at least one of its ends, to allow the engagement of the pipe 5 through it, or the pipe 5 can be separable from the container 15, for the same purpose. In this same embodiment, the end of the strip 2 comprising the boss 11 forms a progressive recess 12 with the protruding part of this boss, such that the strip has a transverse face inclined on the side opposite to this protruding part. The strip 2 can thus be closed in the form of a ring according to a plurality of possible positions of the ends of this strip relative to each other, thus allowing adjustment of the diameter of the ring that this strip 2 forms once closed. In the embodiment shown in FIGS. 9 and 10, the pipe 5 is fixed along the boss 11, and the strip 2 comprises, beyond the covering 14, a loop or an open clip ring 18 suitable for receiving the pipe 5 after engagement of this pipe through the passer-by 17. The latter in this case comprises lateral extensions 17a, projecting from the longitudinal side opposite to the strip 2, which provide reinforced lateral support for the boss 11 by this passer-by 17. Figures 11 to 13 show that, to facilitate its engagement in the passer-by 17 and before its connection to the chamber 4, the end of the pipe 5 not connected to the strip 2 can have an end 5a of tapered shape (cf. figure 11), an end 5b in the form of a rod, increasing its rigidity (cf. FIG. 12), or an end 5c in the form of a pallet (cf. FIG. 13). These ends are sectioned once the engagement of the pipe 5 is carried out in the passage 17, then the sectioned end of this pipe is connected to the chamber 4. The invention thus provides a gastric implant which can be put in place without risk of deterioration, or at least greatly reducing this risk, which can be implemented, if necessary, according to several possible diameters, which can be easily repositioned, and which can be easily removed after treatment of the patient. It goes without saying that the invention is not limited to the embodiment described above by way of example but that it extends to all the embodiments covered by the claims appended hereto.

Claims

REVENDICATIONS 1 - Implant gastrique (1), comprenant : - une bande souple (2) comportant une poche gonflable (3) sur l'une de ses faces et des moyens (13, 14) pour sa fermeture sous forme d'anneau ; - une chambre implantable (4) contenant un liquide de gonflage de cette poche (3), et - une conduite (5) reliant ladite poche (3) à cette chambre implantable (4) ; implant gastrique caractérisé en ce que lesdits moyens de fermeture comprennent des surfaces auto-agrippantes complémentaires (13, 14) placées respectivement sur les deux portions d'extrémité de la bande (2). 2 - Implant gastrique (1) selon la revendication 1 , caractérisé en ce que la bande (2) comprend, sur son côté comportant la poche (3), une transition progressive (12) entre l'extrémité de la poche (3) et la portion d'extrémité (11) de la bande (2) comportant la surface auto-aggripante (13). 3 - Implant gastrique (1) selon la revendication 1 , caractérisé en ce que la bande (2) présente au moins un décrochement (12) entre l'extrémité de la poche (3) et la portion d'extrémité (11) de la bande (2) comportant la surface auto-aggripante (13), formant une zone d'arrêt contre laquelle vient buter l'autre extrémité de la bande (2) après mise en place. 4 - Implant gastrique (1) selon l'une des revendications 1 à 3, caractérisé en ce qu'une zone d'extrémité de la bande (2) comprend au moins un moyen (17) définissant un passage d'engagement de l'autre extrémité de la bande (2). 5 - Implant gastrique (1) selon l'une des revendications 1 à 4, caractérisé en ce qu' au moins une extrémité (11) de la bande (2) est en forme de pointe arrondie. 6 - Implant gastrique (1) selon l'une des revendications 1 à 5, caractérisé en ce que la conduite (5) n'est pas, au moment de la mise en place de l'implant (1), raccordée à la chambre implantable (4) et en ce qu'elle présente une partie terminale (5a, 5b, 5c) pointue, en tige ou en palette au niveau de son extrémité destinée à être raccordée à cette chambre (4). 7 - Implant gastrique (1) selon l'une des revendications 1 à 6, caractérisé en ce que la bande (2) comprend au moins un moyen (18) définissant un logement de réception et de rétention de la conduite (5) contre la bande (2). 8 - Implant gastrique selon la revendication 7, caractérisé en ce que le moyen définissant un logement de réception et de rétention de la conduite (5) contre la bande (2) consiste en une paire de saillies légèrement souples, délimitant ledit logement entre elles et formant un anneau (18) de clipage de la conduite (5). CLAIMS 1 - Gastric implant (1), comprising: - a flexible band (2) comprising an inflatable pocket (3) on one of its faces and means (13, 14) for closing it in the form of a ring; - an implantable chamber (4) containing an inflation liquid for this pocket (3), and - a pipe (5) connecting said pocket (3) to this implantable chamber (4); gastric implant characterized in that said closure means comprise complementary self-gripping surfaces (13, 14) placed respectively on the two end portions of the strip (2). 2 - Gastric implant (1) according to claim 1, characterized in that the strip (2) comprises, on its side comprising the pocket (3), a gradual transition (12) between the end of the pocket (3) and the end portion (11) of the strip (2) comprising the self-gripping surface (13). 3 - Gastric implant (1) according to claim 1, characterized in that the strip (2) has at least one recess (12) between the end of the pocket (3) and the end portion (11) of the strip (2) comprising the self-gripping surface (13), forming a stop zone against which the other end of the strip (2) abuts after installation. 4 - Gastric implant (1) according to one of claims 1 to 3, characterized in that an end zone of the strip (2) comprises at least one means (17) defining an engagement passage of the other end of the strip (2). 5 - Gastric implant (1) according to one of claims 1 to 4, characterized in that at least one end (11) of the strip (2) is in the shape of a rounded point. 6 - Gastric implant (1) according to one of claims 1 to 5, characterized in that the pipe (5) is not, at the time of the introduction of the implant (1), connected to the chamber implantable (4) and in that it has a pointed end portion (5a, 5b, 5c), in rod or in pallet at its end intended to be connected to this chamber (4). 7 - Gastric implant (1) according to one of claims 1 to 6, characterized in that the strip (2) comprises at least one means (18) defining a housing for receiving and retaining the pipe (5) against the band (2). 8 - gastric implant according to claim 7, characterized in that the means defining a housing for receiving and retaining the pipe (5) against the strip (2) consists of a pair of slightly flexible projections, delimiting said housing therebetween and forming a ring (18) for clipping the pipe (5).
PCT/FR2005/000508 2004-03-04 2005-03-03 Gastric implant for treating obesity WO2005087146A2 (en)

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EP05733028A EP1720496A2 (en) 2004-03-04 2005-03-03 Gastric implant for treating obesity

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FR0402249 2004-03-04
FR0402249A FR2867062B1 (en) 2004-03-04 2004-03-04 GASTRIC IMPLANT

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1986004498A1 (en) 1985-02-01 1986-08-14 Astra Meditec Aktiebolag Surgical device
WO1994027504A1 (en) 1993-05-27 1994-12-08 Inamed Development Company Universal gastric band
US5527355A (en) 1994-09-02 1996-06-18 Ahn; Sam S. Apparatus and method for performing aneurysm repair
FR2827756A1 (en) 2001-07-25 2003-01-31 Patrick Rat Snare and associated applicators used in endoscopic surgery comprises bandage circumscribing esophagus to form closed loop

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4706914A (en) * 1986-07-25 1987-11-17 Minnesota Mining And Manufacturing Company Attaching assembly

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1986004498A1 (en) 1985-02-01 1986-08-14 Astra Meditec Aktiebolag Surgical device
WO1994027504A1 (en) 1993-05-27 1994-12-08 Inamed Development Company Universal gastric band
US5527355A (en) 1994-09-02 1996-06-18 Ahn; Sam S. Apparatus and method for performing aneurysm repair
FR2827756A1 (en) 2001-07-25 2003-01-31 Patrick Rat Snare and associated applicators used in endoscopic surgery comprises bandage circumscribing esophagus to form closed loop

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FR2867062A1 (en) 2005-09-09
FR2867062B1 (en) 2006-05-12
EP1720496A2 (en) 2006-11-15
WO2005087146A3 (en) 2006-01-12

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