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1. (WO1990006717) TECHNIQUE FACILITANT L'ENDOSCOPIE
Note: Texte fondé sur des processus automatiques de reconnaissance optique de caractères. Seule la version PDF a une valeur juridique

Claims

1. A method for inserting an instrument into the large intestine of a mammal, in which
at least a portion of a flexible liner is emplaced to form within the intestine an inner tube within an outer tube, said inner tube defining a lumen lying within the intestine and having a distal end accessible via the anal opening from outside the body of the mammal, and
thereafter said instrument is passed into said lumen via its said distal end.

2. The method of claim 1 wherein said flexible liner is emplaced by eversion.

3. The method of claim 1 wherein said eversion is achieved by
folding one end of said liner back upon itself to form said inner and outer tubes connected along an
annular fold, and
introducing said fold into the anal opening.

4. The method of claim 1 further comprising pressurizing the space enclosed between said inner and outer tubes.

5. The method of claim 4 in which said space is pressurized at low pressures no greater than 10 pounds per square inch, preferably less than 3 pounds per square inch.

6. The method of claim 1 in which said inner and outer tubes are collapsed against each other prior to said instrument being passed into said lumen.

7. The method of claim 6 wherein said tubes are collapsed by reducing the pressure in the space enclosed between said tubes.

8. The method of claim 1 further comprising passing a proximal tip of said instrument through said lumen and beyond a proximal end of said emplaced flexible liner.

9. The method of claim 1 wherein, prior to eversion, said inner tube is at least partially gathered on a storage device, and during eversion the withdrawal of portions of said liner from said storage device is aided by applying mechanical force to said inner liner to free it from said storage device.

10. The method of claim 9 wherein said
mechanically applied force is applied only
intermittently.

11. The method of claim 10 wherein said space is subjected to varying pressure in coordination with said intermittently applied mechanical force.

12. The method of claim 11 wherein said pressure is decreased when said mechanical force is being applied.

13. The method of claim 9 wherein said storage device comprises an internal passage and an external wall supporting said liner, and said force is mechanically applied by means of a tool passed via said storage device passage.

14. The method of claim 13 wherein said force is mechanically applied by inflating a balloon against a wall of the liner.

15. Apparatus for inserting an instrument into the large intestine of a mammal, comprising
an elongate evertible liner,
a liner support chamber having a proximal port and a distal port,
said liner having its two ends attached
respectively at said ports, and
a pressurizer for increasing the pressure within said chamber to cause said liner to be everted,
said liner comprising a material characterized by having a wall thickness to diameter ratio and a zero strain elasticity modulus whose product is less than 4.0 lb/inch2, preferably less than 1.0 lb/inch2, and a wall thickness to diameter ratio and a 100% strain modulus of elasticity whose product is greater than 0.5 lb/inch2, preferably greater than 2.0 lb/inch2.

16. The apparatus of claim 15 wherein said liner comprises polyurethane or latex.

17. The apparatus of claim 15 wherein said liner is at least sufficiently long to reach proximally beyond the sigmoid flexure when said liner is fully everted within the large intestine.

18. The apparatus of claim 15 wherein said liner is at least sufficiently long to reach proximally beyond the splenic flexure when said liner is fully everted within the large intestine.

19. The apparatus of claim 15 wherein said liner is at least 12 inches long when said liner is fully everted within the large intestine.

20. The apparatus of claim 15 wherein said liner is at least 30 inches long when said liner is fully everted within the large intestine.

21. The apparatus of claim 15 wherein said distal port is configured to receive a leading end of said instrument.

22. The apparatus of claim 15 further comprising means for sealing said distal port during eversion.

23. Apparatus for inserting an instrument into the large intestine of a mammal, comprising
an elongate evertible liner,
a liner support chamber having a proximal port and a distal port,
opposite ends of said liner being attached
respectively to said ports,
at least a portion of said liner being gathered in the space between said ports,
said liner defining a lumen between said ports, and
a rigid guide tube lying within said lumen and between said ports to provide an unobstructed passage for said instrument within at least a portion of said lumen.

24. The apparatus of claim 23 wherein a portion of said liner is gathered along and supported by the outside wall of said guide tube.

25. The apparatus of claim 24 further comprising a mechanism located in the vicinity of one end of the guide tube for contacting the liner and aiding withdrawal of the liner from the guide tube.

26. The apparatus of claim 25 wherein said mechanism comprises a roller whose outer surface contacts the liner and a support for the roller, the support having a structure for permitting the roller to turn when the liner is being withdrawn from the guide tube, while resisting the turning of the roller when the liner is being moved in the opposite direction.

27. The apparatus of claim 23 wherein said tube is straight, and colinear with both of said ports.

28. Apparatus for inserting an instrument into the intestine of a mammal, comprising
an elongate evertible liner,
a liner support chamber,
said chamber having a distal port and a proximal port,
a tube extending distally from said distal port,
said liner having its opposite ends attached respectively to said ports,
the end of said liner attached to said distal port being everted over and gathered along said tube, and
a pressurizer for increasing the pressure within said liner during eversion to aid the gathered portion of said liner to slide along and be released from said tube.

29. The apparatus of claim 15, 23, or 28 further comprising means for selectively depressurizing said liner while said liner is everted.

30. The apparatus of claim 15, 23, or 28 further comprising a walled passage connected to said distal port for bridging the distance from said distal port to the anal sphincter of the mammal.

31. The apparatus of claim 15, 23, or 28 further comprising a walled passage connected to said distal port for bridging the distance from said distal port to the anal sphincter of the mammal, said walled passage having walls made of a pliable material.

AMENDED CLAIMS
[received by the International Bureau
on 10 May 1990 (10.05.90);
original claims 1,5,14 and 15 amended;
new claims 32-35 added; other claims unch.anged (3 p.ages)]

1. (Amended) A method for inserting an instrument into the large intestine of a mammal, comprising
emplacing at least a portion of a flexible liner [is emplaced] to form within the intestine an inner tube within an outer tube, said inner tube defining a lumen lying within the intestine and having a distal end accessible via the anal opening from outside the body of the mammal, and during emplacing.
preventing said instrument from entering said lumen more than an insubstantial amount , and
thereafter passing said instrument [is passed] into the intestine through said lumen via its said distal end and causing a portion of said instrument to pass beyond a proximal end of said lumen.

5. (Amended) The method of claim 4 in which said space is pressurized at [low] pressures no greater than 10 pounds per square inch [ , preferably less than 3 pounds per square inch] .

14. (Amended) The method of claim [13] 9_ wherein said storage device comprises an internal passage and an external wall supporting said liner, and said force is mechanically applied by inflating a balloon against a wall of [the] said liner.

15. (Amended) Apparatus for inserting an instrument into the large intestine of a mammal, comprising
an elongate evertible liner,
a liner support chamber having a proximal port and a distal port,
said liner having its two ends attached respectively at said ports, and
a pressurizer for increasing the pressure within said chamber to cause said liner to be everted,
said liner comprising a material characterized by having a wall thickness to diameter ratio and a zero strain elasticity modulus whose product is less than 4.0 lb/inch2 [, preferably less than 1.0 lb/inch2,] and a wall thickness to diameter ratio and a 100% strain modulus of elasticity whose product is greater than 0.5 lb/inch2 [,preferably greater than 2.0 lb/inch2].

Please add the following new claims 32-35:
—32. The method of claim 5 in which said space is pressurized at pressures less than 3 pounds per square inch. —

—33. The apparatus of claim 15 in which said liner material is characterized by having a wall thickness to diameter ratio and a zero strain elasticity modulus whose product is less than 1.0 lb/inch . —

—34. The apparatus of claim 15 in which said liner material is characterized by having a wall thickness to diameter ratio and a 100% strain modulus of elasticity whose product is greater than 2.0 lb/inch2. —

—35. A method for inserting an instrument into the large intestine of a mammal, comprising
emplacing at least a portion of a flexible liner to form within the intestine an inner tube within an outer tube, said inner tube defining a lumen lying within the intestine and having a distal end accessible via the anal opening from outside the body of the mammal, said emplacing proceeding without passing said instrument substantially into said intestine, and
only thereafter passing said instrument substantially into the intestine through said lumen via its said distal end. —