MANUALLY OPERATED ARTIFICIAL SPHINCTER PARTLY OR COMPLETLY INSERTED AROUND AN INTERNAL HOLLOW ORGAN

Abstract: Manually operated opening and closing compression device which is implanted wholly or partly as a cuff or a ring round tubular organs in animals or humans. Through the cuff or the ring a specially shaped plug is wedged in, whereby the lumen of the tubular organ is compressed and kinked. The invention relates to an opening and closing device for whole or partial implantation round the tubular organs (2) of humans or animals. The tubular organ (2) is compressed by simple wedging in of a plug (4) shaped as an ellipsoid body with an impression round its middle, which is retained by an arc of the cuff (1) or the ring (1). The cuff (1) or the ring (1) encircles the tubular organ (2), wherefore wedging in of the plug (4) into the lumen of the cuff (1) or the ring (1) presses against the tissue round the tubular organ (2), whereby the lumen (3) of the tubular organ is compressed.

Description: Manually operated artificial sphincter partly or completely inserted around an internal hollow organ The invention relates to an i plantable or partly im- plantable manually operated opening and closing device which as a cuff or a ring encircles a tubular organ in animals or humans. The device is of the kind consisting of a dividable ring or cuff which is passed round the tubular organ. A plug in the form of an ellipsoid body with an impression round its middle (hourglass-shaped) can also be introduced into the lumen of the cuff or the ring. The impression can retain the plug in the cuff or the ring, and the wedged in plug compresses the tubular organ. The plug is introduced if the device is only partly implanted in that section of the cuff or the ring which, as an arc, projects externally through two openings . In the known opening and closing devices for the tubular organs of animals and humans, use is either made of a cuff in the lumen of which a pouch is mounted, which is capable of expanding hydraulically, whereby the tubular organ encircled by the cuff is compressed (US Patent No. 3.815.576, US Patent No. 3.863.622, US Patent No. 4.222.377, US Patent No. 4.571.749, US Patent No. 4.634.443, US Patent No. 4.721.509, US Patent No. 4.731.083, EP Patent Application No. 0200286 A2, DE 3.521.602), or a clamping device disposed at the tubular organ, which device compresses the lumen of the tubular organ when an electromagnet is activated (DE 3.139.811 C2) . In principle, the known devices can open and close the tubular organs of animals and humans. However, the hydraulically acting device requires that an expandable pouch is filled and emptied through associated tubes con- nected to a reservoir tank and a pumping device, which at the implantation calls for a major surgical intervention, and consequently increased risk of complications. In use, it has turned out that the complicated system has many malfunctions with consequent reoperations . The device acting by way of an electromagnet is not used in practice . According to the invention there is provided an opening and closing device of the type mentioned in the preamble which does not call for connection to a reservoir tank or a pumping device, whereby the surgical intervention gets less severe, resulting in reduced risk of complications, and which device in use does not offer the same possibility for malfunctions. According to the invention this is achieved by an opening and closing device of the kind mentioned in the preamble which is characterized in that the wall and consequently the lumen of the tubular organ are compressed by simple manual wedging in of an ellipsoid body with an impression round its middle, which as plug is passed along the longitudinal direction of the tubular organ into the lumen of the cuff or the dividable ring. The impression entails that the plug is retained in the cuff or the ring, and additionally serves the purpose that the plug presses against two sites on the tubular organ with a force directed oppositely to that which is exerted by the cuff or the dividable ring, whereby the tubular organ is not only compressed but also kinked. The device can be wholly implanted. But according to the preferred embodiment it is only partly implanted, part of the cuff or the dividable ring forming an arc externally, simultaneously with the cuff or the ring encircling the tubular organ internally. Opening is obtained by simple manual displacement of the plug in the direction out of the lumen of the cuff or the ring along the tubular organ. In the following the invention is explained with reference to the drawing, in which fig. 1 shows a longitudinal section of the opening and closing device in open state, fig. 2 shows the same, but in closed state, two cohering spheres having been pushed into the lumen of the cuff or the dividable ring, and due to the impression they are retained in the lumen of the cuff or the ring, fig. 3 shows two cohering spheres provided with an eye which can be pulled over the cuff or the dividable ring, fig. 4 shows a sketch of the dividable ring with example or snap locks, fig. 5 shows spheres arranged in series with increasing volume for stepwise wedging in of the plug, and fig. 6 shows a sketch of a penis where two cohering spheres have been introduced into the external lumen of the cuff or the ring, whereby the urethra is compressed. The impression between the two cohering spheres retains the plug. Fig. 1 and fig. 2 show the cuff 1 or the dividable ring 1 encircling the walls 2 and the lumen 3 of the tubular organ. Fig. 2 shows wedging in of a plug 4 consisting of two cohering spheres 4 in the external lumen of the cuff 1 or the dividable ring 1, whereby the wall 2 of the tubular organ is compressed, so that the lumen 3 of the tubular organ is compressed and closed. Fig. 3 shows a plug 4 provided with an eye, the lumen 5 of which can encircle the cuff 1 or the dividable ring 1, thus allowing it to rotate into and out of the lumen of the divisible ring 1 or the cuff 1. Fig. 4 shows a sketch of a ring 1 provided with snap locks, where the male part 7 can be pressed into the female part 6. Fig. 6 shows a penis where two cohering spheres 4 are wedged into the external lumen of the cuff 1 or the ring 1, whereby the urethra is compressed. In use, the cuff it is designed to encircle the tubular organ. In case of the partial implantation of the cuff, it is introduced round the tubular organ through a small cleavage which is obtained by minor surgery, whereby two incisions are made, after which the cuff is passed in round the tubular organ and out as a tape through the two incisions. The cuff is closed round the tubular organ, preferably by simple sowing together or by closing with snap locks. In case of the partial implantation of the dividable ring, it is introduced round the tubular organ through a small cleavage which is obtained by minor surgery, whereby two incisions are made, after which a section of the arc of the ring is introduced round the tubular organ, in through one of the incisions and out through the other incision, whereafter the ring is assembled with the remaining ring arc, preferably by means of snap locks (inserted as a "piercing-ring"). In a special embodiment of the cuff according to the invention it is preferably made of a tissue-friendly, im- plantable material which is flexible and essentially non-elastic. In a special embodiment of the ring according to the in- vention, it is preferably made of a tissue-friendly, im- plantable material, such as e.g. pure gold, which also has the advantage of being slightly bacteriostatic. In a special embodiment of the rounded, hourglass-shaped plug according to the invention, it consists of two spheres which have been glued or welded together, at least one of the spheres having a diameter enabling it to be introduced through the lumen of the cuff or the ring. The plug is preferably made of a tissue-friendly mate ¬ rial, which may either be hard or soft and elastic. If also the plug is to be implanted, it will be made of an implantable material. In a second special embodiment of the plug according to the invention, it consists of a chain of spheres or ellipsoid bodies with increasing volume, thus allowing a stepwise wedging in of the plug. The plug is preferably made of a tissue-friendly material, which may either be hard or soft and elastic. If also the plug is to be implanted, it will be made of an implantable material. In a third special embodiment of the plug according to the invention, it consists of two cohering spheres, where the joint between the two spheres is provided with an eye which can encircle the cuff or the ring, thus allowing the spheres to be tilted into and out of the external arc-shaped lumen of the cuff or the ring. The plug is preferably made of a tissue-friendly material, which may either be hard or soft and elastic. If also the plug is to be implanted, it will be made of an implantable material . In a fourth special embodiment of the plug according to the invention, it is an ellipsoid body provided with an eye which can encircle the cuff or the ring, thus allow- ing the ellipsoid body to be tilted into or out of the external arc-shaped lumen of the cuff or the ring. The plug is preferably made of a tissue-friendly material, which may either be hard or soft and elastic. If also the plug is to be implanted, it will be made of an implantable material. A special use of the invention is as artificial sphincter round the urethra for humans and animals. A second special use of the invention is as opening and closing device in the passage between an artery and a vein. A third special use of the invention is as opening and closing device round a colostomy, enterosto y, or uros- tomy in humans and animals. A fourth special use of the invention is as opening and closing device for spermatic cords in humans and animals. The opening and closing device is intended for whole or partial implantation round tubular organs 2 which are easily palpated through the skin of animals and humans. In case of the partial implantation, the cuff 1 or the dividable ring 1 has been introduced through an incision in the skin and further on through a cleavage provided round the tubular organ 2 and the cuff, or the ring has been passed further on out through the skin. Hereafter, the cuff 1 or the ring 1 has been assembled externally so as to form an arc. By wedging in a suitable plug 4 preferably consisting of an ellipsoid body with an impression round its middle, the impression is caught in the arc- shaped part of the cuff 1 or the ring 1, whereby the tissue round the tubular organ 2 is compressed, and as a result the lumen 3 of the tubular organ is closed.

Claims: C l a i s : 1. An opening and closing device for whole or partial implantation round the tubular organs of humans or animals, which opening and closing device comprises a cuff or a dividable ring, c h a r a c t e r i z e d in that the tubular organ is compressed by wedging in a plug (4), which is an ellipsoid body with an impression round its middle, and which is preferably made of a tissue-friendly material, which may be hard or soft and elastic, which plug (4) is retained in that an arc of the cuff (1) or the dividable ring (1) slides down into the impression. 2. The opening and closing device according to claim 1, c h a r a c t e r i z e d in that the cuff is preferably made of a tissue-friendly, implantable material, which is flexible and essentially non-elastic. 3. The opening and closing device according to claim 1, c h a r a c t e r i z e d in that the dividable ring is preferably made of a tissue-friendly, implantable material, such as e.g. pure gold, which also has the advan- tage that the gold is slightly bacteriostatic . 4. The opening and closing device according to claim 1, c h a r a c t e r i z e d in that the plug consists of two spherical parts which have been glued or welded together, at lease one of the spheres having a diameter enabling it to be introduced through the lumen of the cuff or the dividable ring. 5. The opening and closing device according to claim 1, c h a r a c t e r i z e d in that the plug consists of a chain of spheres or ellipsoid bodies with increasing vol- u e, thus allowing a stepwise wedging in of the plug. 6. The opening and closing device according to claim 1, c h a r a c t e r i z e d in that the plug consists of two cohering spherical parts, where the joint between the two spheres is provided with an eye (5) which can encir- cle the cuff (1) or the ring (1), thus allowing the spheres to be tilted into and out of the lumen of the cuff or the ring. 7. The opening and closing device according to claim 1, c h a r a c t e r i z e d in that the plug is provided with an eye (5) which can encircle the cuff (1) or the dividable ring, thus allowing the ellipsoid body (4) to be tilted into and out of the lumen of the cuff (1) or the dividable ring. 8. The opening and closing device according to claims 1, 2, 3, 4, 5, 6 and 7, c h a r a c t e r i z e d in that it can be used as artificial sphincter round the urethra for humans and animals. 9. The opening and closing device according to claims 1, 2, 3, 4, 5, 6 and 7, c h a r a c t e r i z e d in that it can be used as opening and closing device in the passage between an artery and a vein, or as opening and closing device round a colostomy, enterostomy or urostomy in humans and animals. 10. The opening and closing device according to claims 1, 2, 3, 4, 5, 6 and 7, c h a r a c t e r i z e d in that it can be used as opening and closing device for spermatic cords in humans and animals. 11. A method for manual opening and closing of tubular organs (2) in animals and humans, c h a r a c t e r - i z e d in that use is made of an opening and closing device for whole or partial implantation round the tubular organs of animals or humans, which opening and clos- ing device comprises a cuff or a dividable ring, which compresses the tubular organ by wedging in a plug (4), which is an ellipsoid body with an impression round its middle, and which is preferably made of a tissue-friendly material, which may be hard or soft and elastic, which plug (4) is retained in that an arc of the cuff (1) of the dividable ring (1) slides down into the impression.

Inventors: NIEBEN OLE GYRING, NIEBEN, OLE, GYRING
Applicants: NIEBEN OLE GYRING, NIEBEN, OLE, GYRING
Application year: 1998
Main classification: A61F2
IPC codes: A61B17, A61F2