Internal tissue may bleed during a non-invasive surgical procedure, making blood loss and visibility important concerns. During some procedures, a hemostatic agent may be applied to the affected bodily tissue to stop the bleed, at least until a more robust method can be used to permanently stop the bleed. These agents are often delivered as powders. Many of these powders are known to agglomerate, or have agglomerative properties, making it more difficult to propel the powder through a lumen of an endoscope for delivery to a treatment site inside the body. For example, the lumen may become blocked by the material. As a result, some effective of hemostatic agents may have disadvantages, for example, by requiring continuous delivery.
Implementations of the present disclosure relate to exemplary delivery devices, methods, and systems. Numerous implementations of the present disclosure are now described.
One implementation of this disclosure is a device. The device may comprise a flow chamber including an inlet port for receiving a fluid flow in the flow chamber, and an outlet port for exiting a material from the flow chamber. A formation portion of the flow chamber may form a suspension of the material. A collection portion of the flow chamber may direct the suspension toward the outlet port. In some implementations, an amount of the material may collect in the collection portion adjacent the outlet port. The device may comprise an insertion port for permitting insertion of the material into the flow chamber, and/or a pusher operable to move the amount of material through the outlet port.
In some implementations, the outlet port may be in communication with an exit lumen, and an end of the pusher may be movable through a portion of the exit lumen. The formation portion may include a semi-spherical surface defining a volume in which the fluid flow expands, and a semi-frustoconical surface that funnels the suspension towards the collection portion. In some implementations, the pusher may be biased toward the outlet port by a resilient element, and the device may comprise a stopper that holds the resilient element in a compressed position. The stopper may be moveable to release the resilient element. For example, the stopper may be movable between a first position to compress the resilient element, and a second position to release the resilient element. In other implementations, the pusher may, alternatively, be biased away from the outlet port by the resilient element.
The device may comprise a cap operable with the insertion port to permit insertion of a material in the flow chamber when the cap is disengaged with the insertion port, and seal the insertion port when engaged therewith. The cap may not extend into the flow chamber. Alternatively, the cap may have a protrusion that extends into the formation portion of the flow chamber. The protrusion may have an exterior surface contoured to create, with the fluid flow, at least one of a vortex and a turbulent flow in the flow chamber. In other implementations, the device may comprise an impeller mounted in the flow chamber to create and sustain a vortex in the flow chamber when the fluid flow is received therein.
An end of the pusher may be shaped to push a predetermined amount of the material through the outlet port. The flow chamber may be contained in a body of the device, and the pusher may be an elongated rigid body that extends through an opening in the body. For example, the pusher may extend through a reaction chamber in the body. In some implementations, the device may further comprise an engaging structure mounted on the pusher in the reaction chamber, and a resilient element mounted around the pusher between the engaging structure and an internal surface of the reaction chamber. A stopper may be mounted on the pusher outside of the reaction chamber to hold the resilient element in a compressed position when, for example, the stopper is placed against an exterior surface of the body.
Another implementation of this disclosure is a device comprising: a body defining a flow chamber with an inlet port for receiving a fluid flow in the flow chamber; an insertion port on the body for receiving a material in the flow chamber; and an outlet port on the body for exiting the material from the flow chamber. The fluid flow may form a suspension of the material in the flow chamber. An amount of the material may collect in the flow chamber adjacent the outlet port. In some implementations, the fluid flow is operable with an interior surface of the flow chamber to push the amount of material through the outlet port.
In some implementations, the device may further comprise a cap operable to permit insertion of the material in the flow chamber through the insertion port when the cap is disengaged from the body, and seal the insertion port when the cap is engaged with the body. The cap may have a protrusion that extends into the flow chamber to alter the fluid flow in the flow chamber. The protrusion may have an exterior surface contoured to create, with the fluid flow, at least one of a vortex and a turbulent flow in the flow chamber.
The device may comprise an impeller mounted in the flow chamber to create and sustain, with the fluid flow, a vortex in the flow chamber. Implementations of the vortex may be used to push the amount of the material through the outlet port.
In other implementations, the device may further comprise a pusher operable to push the amount of the material through the outlet port. For example, an end of the pusher may be shaped to push a predetermined amount of the material through the outlet port. The pusher may be operable through an opening in the body. In some implementations, the pusher may extend through a reaction chamber in the body, wherein the device further comprises an engaging structure mounted on the pusher in the reaction chamber, and a resilient element mounted around the pusher between the engaging structure and an internal surface of the reaction chamber. The engaging structure may seal the reaction chamber. In some implementations, the body may have a handle portion. The device may further comprise a sheath extending distally from the outlet port. The pusher may be operable to push the amount of material into the sheath, and a distal end of the sheath may include at least one opening configured to distribute the amount of material. The at least one opening may be moveable between an open position and a closed position.
Another implementation of this disclosure is a method of operating a device, which may include a flow chamber with an inlet port and an outlet port. This method may comprise inserting a material into the flow chamber; receiving a fluid flow in the flow chamber through the inlet port; forming a suspension of the material in the flow chamber with the fluid flow; directing a portion of the suspension through the outlet port, wherein an amount of the material collects adjacent the outlet port; and pushing the amount of material through the outlet port.
According to this implementation, the device may include a pusher that may be biased toward the outlet port by a resilient element. In some implementations, the pusher may include a stopper that holds the resilient element in a compressed position, and the pushing step may comprise moving the stopper to fire the pusher through the outlet port. Alternatively, the device may include a pusher that may be biased away from the outlet port by a resilient element, and the pushing step may comprise compressing the biasing element with the pusher. In other implementations, inserting the material in the flow chamber may comprise disengaging a cap from the insertion port to permit insertion of the material in the flow chamber. The method may further comprise engaging the cap with the insertion port to seal the flow chamber.
Another implementation of this disclosure is a device comprising: a body defining a flow chamber with an inlet port for receiving a fluid flow in the flow chamber; an outlet port on the body for exiting the material from the flow chamber; and a sheath including a proximal end attached to the outlet port, and a distal end including at least one sealed opening configured to be unsealed to exit the material. The fluid flow may form a suspension of the material in the flow chamber. An amount of the material may collect in the flow chamber adjacent the outlet port, and the fluid flow may be operable with an interior surface of the flow chamber to push the amount of the material through the outlet port and into the sheath. The at least one sealed opening may include a removable plug or cap. The device may comprise an insertion port for permitting insertion of the material into the flow chamber, and/or a pusher operable to move the amount of material through the outlet port.
It may be understood that both the foregoing summary and the following detailed descriptions are exemplary and explanatory only, neither being restrictive of the inventions claimed below.
The accompanying drawings are incorporated in and constitute a part of this specification. These drawings illustrate implementations of the present disclosure that, together with the written descriptions, serve to explain the principles of this disclosure.
Implementations of the present disclosure are now described with reference to numerous exemplary delivery devices and methods. Some implementations are described with reference to a non-invasive surgical procedure, wherein the delivery device is used with a fluid flow to deliver a material to a treatment site inside a body. For example, an exemplary delivery device may use a fluid flow (e.g., a flow of compressed gas, like air) to deliver a hemostatic powder to the treatment site through a lumen of the endoscope. Any reference to a particular procedure, such as a non-invasive surgical procedure; a particular agent, such as a hemostatic powder; or a particular fluid, such as air, is provided for convenience and not intended to limit the present disclosure unless claimed. Accordingly, the concepts disclosed herein may be utilized for any analogous device, method, or system—medical or otherwise.
The directional terms “proximal” and “distal,” and their respective initials “P” and “D,” are used to describe relative components and features of the present disclosure. Proximal refers to a position closer to the exterior of the body or a user, whereas distal refers to a position closer to the interior of the body or further away from the user. Appending the initials P or D to an element number signifies its proximal or distal location. Unless claimed, these directional terms and initials are provided for convenience and not intended to limit the present disclosure to a particular direction or orientation. As used herein, the terms “comprises,” “comprising,” or like variation, are intended to cover a non-exclusive inclusion, such that a device or method that comprises a list of elements does not include only those elements, but may include other elements not expressly listed or inherent thereto. Unless stated otherwise, the term “exemplary” is used in the sense of “example” rather than “ideal.”
Implementations of the present disclosure describe a delivery device 10, such as device 10 of
A section view of device 10 is provided in
Chamber 30 of
For example, in some implementations, formation portion 36 may include surfaces that cause the fluid flow to assume various flow patterns, such as laminar flow, turbulent flow, vortex flow, or the like. These flow patterns may be used in formation portion 36 to form the suspension. For example, formation portion 36 may cause the fluid flow to form a vortex in chamber 30 that is useful for creating and maintaining the suspension. Collection portion 32 may include surfaces that move (e.g., funnel) a portion of the suspension through exit lumen 26 and out of outlet port 24. Collection portion 32 may also concentrate an amount of the material from the suspension at a location adjacent lumen 26. Accordingly, as in
Formation portion 36 of
The material is inserted in flow chamber 30 by operation of cap 40. In
The respective funneling and circulating surfaces 34, 33 of flow chamber 30 are, in some implementations, configured to form a suspension of the material in formation portion 36, and direct the suspension toward collection portion 32. For example, a portion of the material inserted through port 23 may be continually mixed by fluid flow FF3 to form and maintain the suspension, while other portions of the material are directed towards collection portion 32 by fluid flows FF1 and FF2. Collection portion 32 of
In one solution to this problem, disclosed herein, pusher 60 is operable in collection portion 32 to push an amount of the material into and/or through exit lumen 26, unblocking lumen 26, and allowing said amount of the material to be delivered to a treatment site. As shown in
In implementations of this disclosure, a biasing mechanism 70 may be operable with pusher 60. Some types of mechanisms 70 may, for example, fire pusher 60 through the collection portion 32 (e.g.,
An exemplary biasing mechanism 70 is depicted in
Numerous alternative implementations are now described with reference to device 10 of
Some alternative implementations are illustrated in
Another exemplary implementation of device 110 is depicted in
A device 210 is depicted in
Other implementations are depicted in
Other alternative implementations of this disclosure are depicted in
Flow chamber 430 includes a center support 439 with a material holding portion 439A, an impeller support portion 439B, and an end support section 439C. Material holding portion 439A may be configured to receive the material. For example, as in
Impeller support section 439B provides a surface or axle for impeller 434 to rotate upon. In
Still other implementations are depicted in
A step 502 of method 500 may comprise receiving the fluid flow in flow chamber 30 through inlet port 28. For example, the fluid flow may be compressed air that originates from a source, such that step 502 includes the intermediate step of activating the source. A step 504 may comprise forming, with formation portion 36, a suspension of the material in flow chamber 30 with the fluid flow. For example, step 504 may include moving the fluid flow across funneling surface 34 and/or circulating surface 33 to create a fluid flow (e.g., laminar, turbulent, vortex, or the like), and using said fluid flow to form the suspension.
Once the suspension is formed, then a step 506 may comprise directing, with a collection portion 32 of the flow chamber 30, a portion of the suspension through the outlet port 28, wherein an amount of the material may collect adjacent port 28. For example, collection portion 32 is described as having a semi-cylindrical surface aligned with exit lumen 26. If the material is agglomerative, then this surface may collect an amount of material from the suspension as it moves toward collection portion 32 and/or into exit lumen 26. In some implementations, these amounts of material may accumulate in collection portion 32, blocking exit lumen 26. Thus, another step 508 may comprise operating pusher 60 to push the amount of material through exit lumen 26.
Implementations of method 500 may be modified for use with any device 10, 110, 210, etc., disclosed herein. For example, the formation step 504 may be modified to accommodate the elongated protrusion 144 of cap 140 (
Still other implementations may be realized by omitting or combining the features of the various delivery devices disclosed herein. For example, a cap 40 has been described with respect to device 10, yet may be omitted from device 10 if the material is otherwise placed or sealed inside of flow chamber 30, as may occur of the device 10 is intended for single-use. Any device disclosed herein may include pusher 60, which may be operable with biasing mechanism 70, 170, or like mechanisms; or omit pusher 26, as with device 310, wherein flow chamber 330 is configured to move the suspension through exit lumen 326. Although described with reference to device 410, impeller 434 may be used with any disclosed device. For example, any of flow chambers 30, 130, 230, or 330 may be modified to accommodate impeller 434 for the purpose of forming, maintaining, and/or directing the suspension, with or without the aid of a pusher.
Another implementation of the present disclosure may include device 10 described above; and a sheath 600 including a sheath lumen 602 extending between the proximal end distal ends of sheath 600, and a distal end opening 603 at the distal end of sheath 600. In
Over time, the material from chamber 30 may block outlet port 24. Device 10 may be operable to unblock outlet port 24. As shown in
As shown in
All or portions of plug 606 and cap 607 may be made of a dissolvable material. For example, plug 606 and/or cap 607 may be made of a water soluble material configured to dissolve when exposed to the fluid for a period of time, disrupting the friction fit, and allowing plug 606 and/or cap 607 to automatically separate from the lumen 602. Plug 606 and/or cap 607 may be configured to dissolve when contacting certain bodily tissues, such as when being pushed against the mucosa. Plug 606 or cap 607 also may be ejected from lumen 602 by second fluid flow FF2 once the friction fit has been disrupted. As shown in
Another exemplary sheath 610 is depicted in
Various means for operating valve 614 are contemplated. Second fluid flow FF2 may be used to operate valve 614. For example, valve 614 may be biased toward the closed position, and then pushed open by second fluid flow FF2. Additional components may be used to operable valve 614. For example, sheath 610 may located in a retaining catheter with a working channel (e.g., similar to working channel 638 of
Yet another sheath 620 is depicted in
Additional openings may be provided to modify the spread patterns. For example, another sheath 630 is depicted in
As also shown in
Another sheath 640 is shown in
As shown in
Flaps 645 are distal-facing in
As shown in
While principles of the present disclosure are disclosed herein with reference to illustrative implementations for particular applications, the disclosure is not limited thereto. Those having ordinary skill in the art and access to the teachings provided herein will recognize additional modifications, applications, aspects, and substitution of equivalents all fall in the scope of the implementations disclosed herein. Accordingly, the present disclosure is not to be considered as limited by the foregoing description.
This application is a continuation of and claims the benefit of priority of U.S. Nonprovisional application Ser. No. 16/650,664, filed Sep. 4, 2019, which is a continuation of and claims the benefit of priority Nonprovisional Patent application Ser. No. 15/637,743, filed on Jun. 29, 2017, which claims the benefit of priority of U.S. Provisional Patent Application No. 62/357,425, filed on Jul. 1, 2016. Each of the above-mentioned applications is herein incorporated by reference in its entirety.
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Child | 17884150 | US | |
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