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1. US20110137252 - DEVICE FOR PROVIDING A PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

Anmerkung: Text basiert auf automatischer optischer Zeichenerkennung (OCR). Verwenden Sie bitte aus rechtlichen Gründen die PDF-Version.

[ EN ]

Claims

1. A device for creating a percutaneous endoscopic gastrostomy, with
a handle for handling the device,
a puncturing cannula to puncture the stomach, which comprises a proximal end part and a distal end part, the distal end piece being a needle tip,
and a insertion cannula, which has a proximal and a distal end part for the insertion of a wire into the stomach, the wire being passed through the insertion cannula,
wherein
the puncturing cannula is designed as an outer cannula that encloses an insertion cannula, while the insertion cannula is designed as an inner cannula enclosed by the puncturing cannula, and the insertion cannula is guided longitudinally in the puncturing cannula, and
the handle comprises an already integrated or attachable rotating wire spool, on which a wire is wound up, which is to be inserted into the stomach.
2. The device according to claim 1, wherein the handle comprises a distal end part and a proximal end part, wherein the proximal end part of the puncturing cannula is attached to the distal end part of the handle.
3. The device according to claim 1, wherein a slider is conducted longitudinally in the handle, the slider having a distal end part and a proximal end part, the proximal end part of the insertion cannula is attached to the slider.
4. The device according to claim 3, wherein the slider is conducted longitudinally between a first position and a second position in the handle, when in the first position the distal end of the insertion cannula is withdrawn into the puncturing cannula, and in the second position, the distal end of the insertion cannula is advanced into the puncturing cannula.
5. The device according to claim 4, wherein locking means are provided on the handle and the slider to secure the slider in the first position against accidental displacement.
6. The device according to claim 5, wherein the locking means have a locking clip that can be placed on the handle, which holds the slider in the first position.
7. The device according to claim 6, wherein the locking clip has a nose, which engages a recess of the slider, when the locking clip is placed on the handle.
8. (canceled)
9. The device according to claim 1, wherein the wire spool is rotatably mounted on the handle.
10. The device according to claim 9, wherein the wire spool and the slider are connected to each other in such a way that, when advancing the slider into the handle, the wire spool is rotated in order to unwind the wire.
11. The device according to claim 9, wherein the wire spool is designed as a gear and the slider, at least over a part of its length, is designed as a rack, said gear and rack being positively coupled.
12. The device according to claim 9, wherein the wire spool that is rotatably mounted to the handle is attached so it can be detached.
13. The device according to claim 9, wherein the handle comprises a housing part that, at least partially, surrounds the wire spool and in which is arranged the wire spool.
14. The device according to claim 13, wherein the housing part comprises side walls, that, at least partially, encompass the wire spool, wherein the wire spool comprises an axle that is snapped into the recesses of the side walls.
15. The device according to claim 3, wherein a clamping device is provided for the wire that can be adjusted between a position releasing the wire and a position clamping the wire, wherein the clamping device interacts with the slider such that the clamping device releases the wire, when the slider is pushed forward into the second position.
16. The device according to claim 15, wherein the clamping device has a first and a second clamping part, between which the wire is conducted.
17. The device according to claim 16, wherein one of the two clamp parts is fixed to the slider and the other of the two clamp parts is attached to the slider in movable manner, the movable clamping part having a lug, which during the advancement of the slider to the second position hits a stop, which is provided on the handle so that the movable clamping part is pushed back to release the wire.
18. The device according to claim 1, wherein the device comprises a stylet for feeding the wire into the insertion cannula, wherein the stylet is conducted longitudinally in the slider so that the stylet can be advanced into the insertion cannula.
19. The device according to claim 18, wherein the length of the stylet is sized such that the stylet projects from the insertion cannula when the stylet is inserted into the slider.
20. The device according to claim 18, wherein a clamping device is provided for the wire, which presses the wire resting against the stylet down against the stylet.
21. The device according to claim 20, wherein the clamping device comprises one or more clamping members which are resiliently biased against the stylet when the stylet is inserted into the slider.
22. The device according to claim 21, wherein the clamping parts of the clamping device are lips provided on the slider, which are radially oriented inwardly in a recess of the slider for receiving the stylet.
23. The device according to claim 18, wherein the mandrel comprises a longitudinal groove for receiving the wire.
24. The device according to claim 12, wherein the mandrel has a distal handle, which protrudes from the slider when the stylet is inserted into the slider.
25. The device according to claim 24, wherein the handle of the stylet is snapped in the handle, when the stylet is inserted into the slider.
26. The device according to claim 1, wherein the wire is a double-wire, which forms a loop at the distal end.
27. The device according to claim 7, wherein the wire spool is is mounted in a rotatable manner on an attachment piece, which can be placed on the handle.
28. The device according to claim 27, wherein the attachment piece can be locked on the handle.
29. The device according to claim 28, wherein the attachment piece comprises clamping elements which encircle the proximal end piece of the handle when attachment piece is placed on the handle.
30. The device according to claim 27, wherein the slider has a passage, which extends from the proximal end part of the slider up to the insertion cannula.
31. The device according to claim 30, wherein the attachment piece comprises a hollow cylindrical body through which the wire is conducted, characterized in that the hollow cylindrical body extends into the passage of the slider when the attachment piece is placed on the handle element.
32. The device according to claim 30, wherein the passage in the slider is closed by a valve body of a valve, the valve being configured such that upon the placement of the attachment pieces on the handle, the valve body is opened by the hollow cylindrical body of the attachment pieces.
33. The device according to claim 27, wherein the attachment piece has a wire brake, which secures the wire on the wire spool against accidental unwinding.