FISTULECTOMY METHOD OF FORMING A FISTULA BETWEEN A FIRST DUCT AND A SECOND DUCT

• US 20100099947A1
• Filed: 12/24/2009
• Published: 04/22/2010
• Est. Priority Date: 08/28/2006
• Status: Active Grant

• Current Assignee: Olympus Corporation
• Original Assignee: Olympus Medical Systems Corporation (Olympus Corporation)
• Inventors: Sato, Masatoshi, Shiono, Junji, Mizunuma, Akiko, Mikkaichi, Takayasu, Suzuki, Takayuki, Kaji, Kunihide
• Granted Patent: US 8,876,699 B2
• Time in Patent Office: Days
• US Class Current: 600/104
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00179 for off-axis viewing
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61B 2017/1103 Approximator
• CPC Class Codes: A61B 2017/1117 adapted for discharge after necrotisation, e.g. by evacuation, expulsion or excretion
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/4416 : related to combined acquisition of different diagnostic modalities, e.g. combination of ultrasound and X-ray acquisitions
• CPC Class Codes: A61B 8/445 : Details of catheter construction

Abstract

A fistulectomy method of forming a fistula between a first duct and a second duct is provided. The method including: inserting an insertion portion of an endoscope having a channel into the first duct; inserting a treatment instrument into the channel; feeding a distal end of the treatment instrument into the second duct through the first duct; discharging a first magnet from the distal end of the treatment instrument to the second duct; pulling the treatment instrument from the second duct; discharging a second magnet to the first duct; and attaching the first magnet and the second magnet magnetically when the first and second ducts are between the first and second magnets.

Claims

1. A fistulectomy method of forming a fistula between a first duct and a second duct, comprising:

inserting an insertion portion of an endoscope having a channel into the first duct;

inserting a treatment instrument into the channel;

feeding a distal end of the treatment instrument into the second duct through the first duct;

discharging a first magnet from the distal end of the treatment instrument to the second duct;

pulling the treatment instrument from the second duct;

discharging a second magnet to the first duct; and

attaching the first magnet and the second magnet magnetically when the first and second ducts are between the first and second magnets.

2. The fistulectomy method according to claim 1, wherein:

the distal end of the treatment instrument is arranged with a needle-like shape member that is able to discharge the first magnet to the inner side of the second duct; and

feeding the distal end of the treatment instrument into the second duct through the first duct also includes inserting the needle-like Shape member to the wall surface of the first and second ducts

3. The fistulectomy method according to claim 1, wherein discharging a first magnet from the distal end of the treatment instrument to the second duct includes keeping the first magnet inside the second duct.

4. The fistulectomy method according to claim 1, wherein discharging a first magnet from the distal end of the treatment instrument to the second duct includes keeping a cord-like member coupled with the first magnet inside the first duct.

5. The fistulectomy method according to claim 4, wherein attaching the first magnet and the second magnet magnetically when the first and second ducts are between the first and second magnets includes operating the cord-like member using the endoscope and magnetically attaching the first magnet to the second magnet.

6. The fistulectomy method according to claim 1, wherein the treatment instrument comprises:

a puncture needle having a needle tube at a distal end;

a side hole provided in the needle tube;

a magnet provided to allow access from the side hole;

a stylet which is detachable at a proximal end of the needle tube and discharges the magnet from the side hole by insertion.

7. The fistulectomy method according to claim 6, wherein the magnet includes a cord-like member extending to a proximal side of the needle tube of the puncture needle.

8. The fistulectomy method according to claim 7, wherein:

the treatment instrument further comprises a sheath provided on an outer side of the puncture needle, and

the cord-like member is set on an inner side of the sheath.

9. The fistulectomy method according to claim 7, wherein the cord-like member is set on an outer side of the puncture needle.

10. The fistulectomy method according to claim 7, wherein:

the treatment instrument further comprises a sheath provided on an outer side of the puncture needle, and

the cord-like member is set between an inner side of the sheath and an outer side of the needle tube of the puncture needle.

11. The fistulectomy method according to claim 6, wherein the magnet includes a supporting point portion swivel with a marginal portion of the side hole as a supporting point when discharged from the side hole.

12. The fistulectomy method according to claim 6, wherein the magnet includes an inclined surface portion on a proximal end which moves in the direction to discharge the magnet from the side hole when the stylet comes to contact.