The present invention generally relates to medical systems and apparatus and uses thereof for treating obesity and/or obesity-related diseases, and more specifically, relates to an implantable device used in a medical system to protect tubing from puncture.
Adjustable gastric banding apparatus have provided an effective and substantially less invasive alternative to gastric bypass surgery and other conventional surgical weight loss procedures. Despite the positive outcomes of invasive weight loss procedures, such as gastric bypass surgery, it has been recognized that sustained weight loss can be achieved through a laparoscopically-placed gastric band, for example, the LAP-BAND® (Allergan, Inc., Irvine, Calif.) gastric band or the LAP-BAND AP° (Allergan, Inc., Irvine, Calif.) gastric band. Generally, gastric bands are placed about the cardia, or upper portion, of a patient's stomach forming a stoma that restricts food's passage into a lower portion of the stomach. When the stoma is of an appropriate size that is restricted by a gastric band, food held in the upper portion of the stomach provides a feeling of satiety or fullness that discourages overeating. Unlike gastric bypass procedures, gastric band apparatus are reversible and require no permanent modification to the gastrointestinal tract.
Certain types of gastric band systems may operate through a hydraulic force. The size of the band placed around the stomach may depend on the volume of fluid in the band. An access port may be used to control the amount of fluid in the band. The access port may be located below the surface of an individual's skin. The physician accesses the access port to either increase or decrease the amount of fluid in the band. The physician inserts a long hypodermic needle through the surface of the skin and into the access port. The physician may then deposit or remove fluid from the system to control operation of the gastric band. However, the access port may be under many layers of fat, and may be difficult to locate. If the physician cannot properly locate the access port, the physician may improperly insert the hypodermic needle into the individual's body.
If the physician improperly inserts the hypodermic needle into the individual's body, the hypodermic needle may puncture the tube leading from the access port to the gastric band. The tube contains fluid that may leak causing the gastric band to eventually fail. The entire gastric band system may then need to be removed from the individual's body, or the physician may need to perform an operation to mend the punctured tube.
Generally described herein is an implantable shielding device that protects tubing used in a gastric band system. A protective system placed over the tubing may protect the tube from errant needle sticks.
In one embodiment, the implantable device comprises an access port configured to attach to body tissue, a tube coupled to the access port, and a shielding device coupled to the tube. The shielding device is positioned adjacent to the access port and covers the end of the tube coupled to the access port. The shielding device is made from a puncture resistant material. The shielding device protects the tube from puncture, by blocking the movement of a needle directed towards the tube.
In one embodiment, the shielding device comprises a plurality of individual shields. Each individual shield may have a bell-like shape, a cone-like shape, a cylindrical shape, a bullet-like shape, or a ball and socket shape. The individual shields are positioned adjacent to each other along the tube. Each individual shield may be independently moveable to allow the tube to bend. Portions of adjacent individual shields overlap each other to assure no portion of the tube is exposed to an incoming needle. In addition, multiple different shapes of individual shields may be alternatively placed along the tube.
In one embodiment, the shielding device comprises a coil wrapped around the outer circumference of the tube. The coil is wrapped such that no portion of the tube is exposed to the needle. The coil may include a single wire, or multiple wires wrapped around the tube. In addition, multiple layers of wire may be wrapped over each other around the tube to further assure a needle cannot puncture the tube. Furthermore, the coil may have a size that is small enough to be integrated within the tube, as an alternative to placing it around the tube. The coil may be made from metal or a hard plastic or polymer.
In one embodiment, the shielding device has a flattened disk-like shape and is coupled to the access port. The flattened disk extends outward from the access port in a radial dimension to cover a portion of the tube. The shielding device may comprise multiple flattened disks extending outward from the access port, or a half-disk shape extending from the access port in a direction towards the tube. In addition, the shielding device may have multiple layers of material pressed together, or sandwiched together to increase puncture resistance. The flattened disk may be a flexible disk, made from a flexible puncture resistant fabric or a hard material such as plastic.
The present invention relates to a shielding device that protects a tube used in a gastric band system. Specifically, the shielding device protects a tube from puncture by a syringe needle inserted near the tube.
As shown in
The gastric band system 10 shown in
If the physician deposits or injects fluid into the fluid chamber 32, the inner bladder's 26 inner diameter 28 decreases, and the band 12 constricts the upper portion 22 of the stomach 24. The constricted upper portion 22 of the stomach 24 reduces the flow of food passing to the lower part of the stomach 24, ideally causing the individual to lose weight over time. If the physician removes fluid from the fluid chamber 32, the inner bladder's 26 inner diameter 28 increases, and band 12 loosens around the upper portion 22 of the stomach 24. The flow of food passing to the lower part of the stomach 24 correspondingly increases.
To adjust the size of the inner bladder 26, the physician may need to repeatedly insert a syringe needle 36 into the individual's body 20 to add or remove fluid from the gastric band system 10. Also, the physician may need to insert a syringe needle 36 on a periodic basis to adjust the size of the inner bladder 26, or to assure the fluid pressure is sufficient in the gastric band system 10. As such, it is important that the physician be able to easily identify and locate the precise position of the septum 30.
When the physician attaches the access port 16 to the muscle wall 38, the physician also passes the tube 14 inside the individual's body 20 to connect to the inner bladder 26. It is important that the tube 14 remains flexible to allow the physician to easily manipulate the tube 14 during insertion. Accordingly, the tube 14 may be made of a durable, flexible material such as silicone or other equivalent material.
A drawback to fixing the access port 16 to the muscle wall 38 is that the position of the septum 30 may change over time relative to the surface 42 of the skin 43. The amount of fat 44 located around the access port 16 may vary, shifting the position of the access port 16 relative to the surface 42 of the skin 43. In this situation, the physician may not be able to detect the exact position of the septum 30. Therefore, it may be difficult for the physician to repeatedly determine the exact position of the septum 30 over an extended period of time, if the patient's weight is changing. A physician can place a mark on the skin 43 to indicate the position of the septum 30, however, the mark may deviate from the septum 30 over time. To properly locate the septum 30, the physician can also palpate the area around the access port 16 to generally feel where the septum 30 is located. However, even a skilled physician may not correctly determine the precise location of the septum 30 because it may be under many layers of fat 44.
The physician may therefore incorrectly insert the syringe needle 36 through the skin 43 and contact the muscle wall 38. Although this result would be painful, another problem would occur if the syringe needle 36 penetrated the tube 14. As discussed above, the tube 14 is typically made from a soft, flexible material such as silicone, which may be easily penetrated by a syringe needle 36. If the tube 14 is punctured, the pressurized fluid in the tube 14 would leak out into the individual's body 20. The gastric band system 10 would then be inoperable, and the physician would either need to surgically remove the gastric band system 10 or perform an operation to mend the punctured tube 14. To alleviate the problem of a punctured tube 14, the shielding device 18 may be placed over a portion of the tube 14 located adjacent to the access port 16. In one embodiment, the shielding device 18 is placed completed around the tube 14 so that the tube 14 is protected from all sides.
The operation of the shielding device 18 is shown in
In an alternative operation, the shielding device 18 may be composed of a puncture resistant material that merely resists penetration by a needle 36. The puncture resistant material may deform when contacted by a needle 36, but the energy required to pass through the shielding device 18 and contact the tube 14 may be great. The physician will notice the increased resistance and realize the needle 36 is not contacting the septum 30.
The individual shields 46 are spaced along the tube 14 equidistantly, at regular intervals from each other. However, the spacing between the individual shields 46 may vary in different embodiments. In the embodiment shown in
Referring back to
However, in one embodiment, the individual shields 46 may be fixed to the tube 14 in another manner. For example, each individual shield 46 may be fixed to a flexible sleeve (not shown), and the flexible sleeve may be slid over the tube 14. The flexible sleeve may be directly attached to the access port housing 34 or glued to the outer surface 72 of the tube 14. The flexible sleeve may allow the shielding device 18 to be entirely disengaged from the tube 14 and the access port housing 34 during assembly or disassembly of the gastric band system 10.
The coil 74 is positioned adjacent to the access port housing 34, to leave no gap between the coil 74 and the access port housing 34 for a syringe needle 36 to contact the tube 14. In addition, the tightly wound wraps 76 of the coil 74 are spaced closely, and may contact each other, to leave no gap for a syringe needle 36 to pass through the shielding device 18 and contact the tube 14.
The multiple wraps 76 of the coil 74 allow the shielding device 18 to remain flexible, yet still be comprised from a hard material. A wrap 76 of the coil 74 may rotate relative to an adjacent wrap 76 of the coil 74. The coil 74 may be fixed to the tube 14 directly, through a silicone glue or equivalent means of fixing the coil 74. In addition, a portion of the coil 74 may be coupled directly to the access port housing 34, to further secure the coil 74 in place along the tube 14.
The secondary coil 84 comprises a wire 86 wrapped over the surface of the inner coil 82. The wire 86 of the secondary coil 84 includes wraps positioned close to or in contact with each other. The wire 86 of the secondary coil 84 may have a narrower diameter than a wire 78, 80 of the inner coil 82 to allow the secondary coil 86 to more easily flex when the tube 14 is manipulated. The secondary coil 84 may be placed along the entire length of the inner coil 82 or over a portion of the inner coil 82 adjacent to the access port housing 34. Although
The disk-like or skirt-like shaped shielding device 18 allows the tube 14 to be shielded without any attachment or modification to the tube 14, unlike the embodiment shown in
The cylindrical surface 115 is shaped to wrap around the tube 14, and may grip the tube or may be glued directly to the tube 14. In addition, the cylindrical surface 115 may be slightly larger than the tube 14. The shielding device 18 in this embodiment remains flexible, in part, because of the conical surface 113 positioned between the internal articulating surface 111 and the cylindrical surface 115. A portion of the conical surface 113 may be shaped to extend in a direction away from the surface of the tube 14 with a generally conical shape. One end of the conical surface 113 is positioned near the tube 14 and another end extends away from the tube 14. The end of the conical surface 113 positioned away from the tube 14 transitions to the internal articulating surface 111, which, as discussed above, has a curved shape to conform to a curved or arc shape of the external articulating surface 109.
The shape of the conical surface 113 forms an interior cavity 117 positioned between the tube 14 and the individual shield 46. The interior cavity 117 allows the individual shield 46 to rotate, or articulate around the tube 14 when the tube 14 is flexed. No portion of an adjacent individual shield 46 extends into the interior cavity 117.
When the tube 14 is flexed, the internal articulating surface 111 and the external articulating surface 109 slide with respect to one another and compress or expand a portion of the interior cavity 117. The arc shape of the surfaces 111, 109 aids the sliding motion of the shields 46. In addition, when the tube 14 is flexed, one portion of the external articulating surface 109 slides away from the respective portion of the internal articulating surface 111, and a portion of the external articulating surface 109 slides towards the respective portion of the internal articulating surface 111 simultaneously. The two portions of the external articulating surface 109 may be positioned opposite from one another around the individual shield 46. The external articulating surface 109 and internal articulating surface 111 remain in contact, or remain close to one another when the tube 14 is flexed. This configuration allows for a closely guarded, yet flexible tube 14. The design eliminates the need for spacers between the shields 46 and minimizes any gaps between the shields 46. The sizes or particular shapes of the individual shields 46 in this embodiment may be varied to produce alternative, equivalent results. The individual shields 46 may be firmly fixed to the tube 14 in any manner discussed previously in this application.
The rotation of the spherical housing portion 125 is limited by the narrow portion 123, which is positioned between the external spherical surface 121 and the spherical housing portion 125. The narrow portion 123 serves as a transition point between the external spherical surface 121 and the housing portion 125. If the individual shield 46 rotates too far in one direction, a portion of the spherical housing portion 125 will contact the narrow portion 123, preventing further movement.
The individual shields 46 additionally remain flexible around the tube 14 because the ball and socket shape forms a ball cavity 119, within the interior of the individual shield 46. The ball cavity 119 provides an area of movement for the individual shield 46, similar to the internal cavity 117 shown in
Similar to the embodiment shown in
Although
In light of the shielding device 18 embodiments disclosed above, the shielding device 18 may be used in a gastric band system 10 that utilizes various components different from those discussed above. For example, a physician may insert the syringe needle to fill a pump reservoir, or maintain a fluid pressure in a mechanical pump system. In addition, a physician may insert a probe near the access port 16 to measure a local property of the gastric band system 10. The shielding device 18 will still serve to protect the tube 14 from puncture in these systems that differ from the gastric band system 10 disclosed above.
The terms “a,” “an,” “the” and similar referents used in the context of describing the invention (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. Recitation of ranges of values herein is merely intended to serve as a shorthand method of referring individually to each separate value falling within the range. Unless otherwise indicated herein, each individual value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention otherwise claimed. No language in the specification should be construed as indicating any non-claimed element essential to the practice of the invention.
Groupings of alternative elements or embodiments of the invention disclosed herein are not to be construed as limitations. Each group member may be referred to and claimed individually or in any combination with other members of the group or other elements found herein. It is anticipated that one or more members of a group may be included in, or deleted from, a group for reasons of convenience and/or patentability. When any such inclusion or deletion occurs, the specification is deemed to contain the group as modified thus fulfilling the written description of all Markush groups used in the appended claims.
Certain embodiments of this invention are described herein, including the best mode known to the inventors for carrying out the invention. Of course, variations on these described embodiments will become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventor expects skilled artisans to employ such variations as appropriate, and the inventors intend for the invention to be practiced otherwise than specifically described herein. Accordingly, this invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the invention unless otherwise indicated herein or otherwise clearly contradicted by context.
Specific embodiments disclosed herein may be further limited in the claims using consisting of and/or consisting essentially of language. When used in the claims, whether as filed or added per amendment, the transition term “consisting of” excludes any element, step, or ingredient not specified in the claims. The transition term “consisting essentially of” limits the scope of a claim to the specified materials or steps and those that do not materially affect the basic and novel characteristic(s). Embodiments of the invention so claimed are inherently or expressly described and enabled herein.
In closing, it is to be understood that the embodiments of the invention disclosed herein are illustrative of the principles of the present invention. Other modifications that may be employed are within the scope of the invention. Thus, by way of example, but not of limitation, alternative configurations of the present invention may be utilized in accordance with the teachings herein. Accordingly, the present invention is not limited to that precisely as shown and described.
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