WO2005020823A1 - Device for treating fistulas - Google Patents

Device for treating fistulas Download PDF

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Publication number
WO2005020823A1
WO2005020823A1 PCT/NL2004/000584 NL2004000584W WO2005020823A1 WO 2005020823 A1 WO2005020823 A1 WO 2005020823A1 NL 2004000584 W NL2004000584 W NL 2004000584W WO 2005020823 A1 WO2005020823 A1 WO 2005020823A1
Authority
WO
WIPO (PCT)
Prior art keywords
fistula
probe
elongated probe
patient
drainage thread
Prior art date
Application number
PCT/NL2004/000584
Other languages
French (fr)
Inventor
Cornelius Gerardus Maria Ignatius Baeten
Original Assignee
Stichting Sint Annadal
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Stichting Sint Annadal filed Critical Stichting Sint Annadal
Priority to EP04774891A priority Critical patent/EP1673016A1/en
Publication of WO2005020823A1 publication Critical patent/WO2005020823A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06166—Sutures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00641—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closing fistulae, e.g. anorectal fistulae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06019—Means for attaching suture to needle by means of a suture-receiving lateral eyelet machined in the needle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06028—Means for attaching suture to needle by means of a cylindrical longitudinal blind bore machined at the suture-receiving end of the needle, e.g. opposite to needle tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06033—Means for attaching suture to needle using adhesives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/06085—Needles, e.g. needle tip configurations having a blunt tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains

Definitions

  • the invention relates to a device for treating fistulas, in particular a patient's perianal fistulas, which device comprises an elongated probe having a first end and a second end, which probe can be inserted into the entrance of the fistula channel with its first end via the external opening of the fistula in the patient's skin, in the direction of the internal opening of the fistulas inside the patient's body, for the purpose of passing a drainage thread through the fistula channel .
  • a device is known, for example from Spanish patent No. ES-2116914 Al. In said patent it is proposed to insert an elongated probe into the fistula channel with its first, free end, using an auxiliary device.
  • a cutting tool provided with a drainage thread is attached to the auxiliary device that projects from the. - interior, anal opening of the fistula.
  • the tissue directly surrounding the fistula channel is surgically removed by the cutting tool on the one hand, whilst on the other hand a drainage thread is pulled through the passage that has thus been surgically created.
  • the drainage thread thus provided remains behind in the surgically treated fistula channel for some time to contribute to the healing process.
  • the device proposed in ES-2116914 Al requires surgery, which surgery generally causes the patient so much pain that it must be performed under anaesthesia.
  • Another painful surgical treatment is stretching the fistula channel by means of clamps for the purpose of passing a drainage thread therethrough, one end of which thread is connected or tied to the thread end that projects from the external fistula opening via the internal, anal fistula opening and the anus.
  • This treatment is preferably carried out under anaesthesia.
  • the use of clamps may cause damage to the wall of the fistula channel, which interferes with the healing process.
  • the object of the invention is to obviate the above drawbacks and to provide a device for the treatment of fistulas, in particular perianal fistulas, which enables a painless treatment that can be carried out without anaesthesia.
  • the drainage thread is attached to the second end of the elongated probe.
  • surgery is no longer required.
  • the drainage thread is thus passed through the fistula channel by the elongated probe via the external fistula opening.
  • the two thread ends one thread end extending from the anus and the other end extending from the external fistula opening
  • the drainage thread is permanently attached to the second end of the elongated probe.
  • the drainage thread is permanently glued, welded or clamped to the second end of the elongated probe.
  • These embodiments guarantee a secure connection with the probe and prevent the drainage thread from unexpectedly becoming detached from the probe.
  • the external diameter of the second end of the probe can thus remain within bounds, which prevents the wall of the fistula channel from being damaged upon passage of the probe through the fistula channel.
  • the second end of the elongated probe is partially hollow for receiving the drainage thread. A correct, secure attachment of the drainage thread to the second, hollow end of the probe is thus guaranteed in that the hollow second end of the elongated probe is according to the invention partially closed, for example by means of a punching technique.
  • the elongated probe is at least partially flexible.
  • the elongated probe may be made of a plastic material in that case.
  • the plastic probe may exhibit a certain degree of rigidity, or be made of a metal, for example, in order to enable manipulation of the probe through the fistula channel.
  • the insertion of the elongated probe into the fistula channel can be slightly facilitated in that the elongated probe narrows in the direction of the first end in one embodiment. More specifically, the first end is knob-shaped.
  • Fig. la-Id schematically show the steps of the treatment of a fistula, using a device according to the invention
  • Fig. 2 schematically shows a first embodiment of a device according to the invention for treating fistulas.
  • Fig. la shows the lower part of the body 1 of a patient suffering from a perianal fistula 2.
  • the perianal fistula 2 has an internal fistula opening 2a, which is in contact with the intestinal canal 3, and an external fistula opening 2b in the patient's skin.
  • a method is proposed which on the one hand is considerably less painful for the patient and which on the other hand can be carried out without anaesthesia.
  • the treatment comprises the insertion of an elongated probe 4 having a first distal end 4a and a second end 4b via the external fistula opening 2b.
  • the doctor attending the patient will remove the elongated probe 4 from the body 1 via the internal fistula opening 2a and the anus 3, as is shown in Fig. lc.
  • the probe 4 may be made of a flexible material, for example a plastic, so as to make it possible to manoeuvre the elongated probe 4 in the patient's rectum.
  • the elongated probe 4 In order to make it possible on the other hand to pass the probe 4 through the fistula channel 2, the elongated probe 4 must exhibit a certain degree of rigidity in longitudinal direction.
  • the elongated probe 4 may to that end be made of a plastic material, or be configured as a metal rod, for example.
  • the two ends 5a and 5b, respectively, of the drainage thread 5 may be interconnected, for example by tying them together in a knot 5c, as is shown in Fig. Id.
  • the presence of a drainage thread 5 in the fistula channel 2 ensures that the fistula channel 2 will remain open for some time, thus preventing inflammations and the like. The latter has a very beneficial effect on the healing process.
  • the drainage thread 5 is fixedly connected to the end 4b of the elongated probe 4 with its first end 5a.
  • a glueing or welding technique may be used for this purpose (the latter technique is very suitable if the elongated probe 4 is made of a plastic material).
  • the drainage thread may also be permanently clamped to the end 4b of the probe 4.
  • Said end 4b may be hollow for that purpose, for receiving the end 5a of the drainage thread 5.
  • the thread 5 may be a Seton thread, for example.
  • Fig. 2 shows an embodiment of an elongated probe 4 having a hollow end 4b, into which the end 5a of the drainage thread 5 has been inserted. The end 4b has subsequently been closed by means of a clamping or punching technique, thus clamping down the wire end 5a in the probe 4. As is clearly shown in Figs. la-Id and Fig. 2, the diameter of the probe 4 decreases from the end 4b in the direction of the free end 4a.
  • the free end 4a of the elongated probe 4 is knob-shaped, as a result of which the wall of the fistula channel 2 is slightly stretched (without causing damage to the tissue, however) upon insertion of the probe 4 into the fistula channel 2, so as to facilitate insertion of the probe 4.
  • the need for otherwise painful surgical treatments is obviated by using this probe.
  • the treatment of a fistula no longer needs to take place under anaesthesia when using the device according to the invention. The latter alleviates the patient's discomfort to a significant extent, whilst in addition the treatment of a fistula no longer needs to take place in a hospital, but can also be carried out at the patient's home by the family doctor.

Abstract

The invention relates to a device for treating fistulas, in particular a patient's perianal fistulas, which device comprises an elongated probe having a first end and a second end, which probe can be inserted into the entrance of the fistula channel with its first end via the external opening of the fistula in the patient's skin, in the direction of the internal opening of the fistulas inside the patient's body, for the purpose of passing a drainage thread through the fistula channel. The object of the invention is to provide a device for the treatment of fistulas, in particular perianal fistulas, which enables a painless treatment that can be carried out without anaesthesia, and to that end the drainage thread is attached to the second end of the elongated probe. This embodiment obviates the need for surgical treatment. The drainage thread is thus passed through the fistula channel, via the external fistula opening, by the elongated probe. By removing the probe from the patient's body via the internal, anal fistula opening and the anus, the two thread ends (one thread end projecting from anus and the other thread end extending from the external fistula opening) can be connected or tied together. This embodiment does not require surgery under anaesthesia, and in addition it is much less painful for the patient.

Description

Device for treating fistulas.
DESCRIPTION The invention relates to a device for treating fistulas, in particular a patient's perianal fistulas, which device comprises an elongated probe having a first end and a second end, which probe can be inserted into the entrance of the fistula channel with its first end via the external opening of the fistula in the patient's skin, in the direction of the internal opening of the fistulas inside the patient's body, for the purpose of passing a drainage thread through the fistula channel . Such a device is known, for example from Spanish patent No. ES-2116914 Al. In said patent it is proposed to insert an elongated probe into the fistula channel with its first, free end, using an auxiliary device. After removal of the probe via the anus, a cutting tool provided with a drainage thread is attached to the auxiliary device that projects from the. - interior, anal opening of the fistula. By subsequently withdrawing the auxiliary device through the fistula channel in the direction of the external fistula opening, the tissue directly surrounding the fistula channel is surgically removed by the cutting tool on the one hand, whilst on the other hand a drainage thread is pulled through the passage that has thus been surgically created. The drainage thread thus provided remains behind in the surgically treated fistula channel for some time to contribute to the healing process. The device proposed in ES-2116914 Al requires surgery, which surgery generally causes the patient so much pain that it must be performed under anaesthesia. Another painful surgical treatment is stretching the fistula channel by means of clamps for the purpose of passing a drainage thread therethrough, one end of which thread is connected or tied to the thread end that projects from the external fistula opening via the internal, anal fistula opening and the anus. This treatment, too, is preferably carried out under anaesthesia. In addition, the use of clamps may cause damage to the wall of the fistula channel, which interferes with the healing process. The object of the invention is to obviate the above drawbacks and to provide a device for the treatment of fistulas, in particular perianal fistulas, which enables a painless treatment that can be carried out without anaesthesia. According to the invention, the drainage thread is attached to the second end of the elongated probe. When this embodiment is used, surgery is no longer required. The drainage thread is thus passed through the fistula channel by the elongated probe via the external fistula opening. By withdrawing the probe from the patient's body via the internal, anal fistula opening and the anus, the two thread ends (one thread end extending from the anus and the other end extending from the external fistula opening) can be connected or tied together. This embodiment does not require surgery under anaesthesia and is much less painful for the patient. In a more specific, very functional embodiment, the drainage thread is permanently attached to the second end of the elongated probe. More in particular, the drainage thread is permanently glued, welded or clamped to the second end of the elongated probe. These embodiments guarantee a secure connection with the probe and prevent the drainage thread from unexpectedly becoming detached from the probe. In addition, the external diameter of the second end of the probe can thus remain within bounds, which prevents the wall of the fistula channel from being damaged upon passage of the probe through the fistula channel. In the clamped embodiment, the second end of the elongated probe is partially hollow for receiving the drainage thread. A correct, secure attachment of the drainage thread to the second, hollow end of the probe is thus guaranteed in that the hollow second end of the elongated probe is according to the invention partially closed, for example by means of a punching technique. A smooth treatment can be obtained if according to the invention the elongated probe is at least partially flexible. The elongated probe may be made of a plastic material in that case. In a specific embodiment, however, the plastic probe may exhibit a certain degree of rigidity, or be made of a metal, for example, in order to enable manipulation of the probe through the fistula channel. The insertion of the elongated probe into the fistula channel can be slightly facilitated in that the elongated probe narrows in the direction of the first end in one embodiment. More specifically, the first end is knob-shaped. The invention will now be explained in more detail with reference to a drawing, in which: Figs. la-Id schematically show the steps of the treatment of a fistula, using a device according to the invention; Fig. 2 schematically shows a first embodiment of a device according to the invention for treating fistulas. Fig. la shows the lower part of the body 1 of a patient suffering from a perianal fistula 2. The perianal fistula 2 has an internal fistula opening 2a, which is in contact with the intestinal canal 3, and an external fistula opening 2b in the patient's skin. For the treatment of said perianal fistula, using the present invention, a method is proposed which on the one hand is considerably less painful for the patient and which on the other hand can be carried out without anaesthesia. The treatment comprises the insertion of an elongated probe 4 having a first distal end 4a and a second end 4b via the external fistula opening 2b. In the course of the treatment, the doctor attending the patient will remove the elongated probe 4 from the body 1 via the internal fistula opening 2a and the anus 3, as is shown in Fig. lc. To that end, the probe 4 may be made of a flexible material, for example a plastic, so as to make it possible to manoeuvre the elongated probe 4 in the patient's rectum. In order to make it possible on the other hand to pass the probe 4 through the fistula channel 2, the elongated probe 4 must exhibit a certain degree of rigidity in longitudinal direction. In a specific embodiment, the elongated probe 4 may to that end be made of a plastic material, or be configured as a metal rod, for example. Once the elongated probe 4 has been removed from the patient's body 1 via the anus 3, as is shown in Fig. lc, the two ends 5a and 5b, respectively, of the drainage thread 5 may be interconnected, for example by tying them together in a knot 5c, as is shown in Fig. Id. The presence of a drainage thread 5 in the fistula channel 2 ensures that the fistula channel 2 will remain open for some time, thus preventing inflammations and the like. The latter has a very beneficial effect on the healing process. According to the invention, the drainage thread 5 is fixedly connected to the end 4b of the elongated probe 4 with its first end 5a. A glueing or welding technique may be used for this purpose (the latter technique is very suitable if the elongated probe 4 is made of a plastic material). On the other hand, the drainage thread may also be permanently clamped to the end 4b of the probe 4. Said end 4b may be hollow for that purpose, for receiving the end 5a of the drainage thread 5. By subsequently closing the hollow end 4b by means of a suitable tool, for example a punch, the end 5a of the drainage thread 5 is clamped down in the probe 4, which prevents the drainage thread 5 from becoming detached upon insertion of the probe 4 and the drainage thread 5 into the fistula channel 4. The thread 5 may be a Seton thread, for example. Fig. 2 shows an embodiment of an elongated probe 4 having a hollow end 4b, into which the end 5a of the drainage thread 5 has been inserted. The end 4b has subsequently been closed by means of a clamping or punching technique, thus clamping down the wire end 5a in the probe 4. As is clearly shown in Figs. la-Id and Fig. 2, the diameter of the probe 4 decreases from the end 4b in the direction of the free end 4a. On the other hand, the free end 4a of the elongated probe 4 is knob-shaped, as a result of which the wall of the fistula channel 2 is slightly stretched (without causing damage to the tissue, however) upon insertion of the probe 4 into the fistula channel 2, so as to facilitate insertion of the probe 4. It will be apparent that the need for otherwise painful surgical treatments is obviated by using this probe. In addition, the treatment of a fistula no longer needs to take place under anaesthesia when using the device according to the invention. The latter alleviates the patient's discomfort to a significant extent, whilst in addition the treatment of a fistula no longer needs to take place in a hospital, but can also be carried out at the patient's home by the family doctor.

Claims

1. A device for treating fistulas, in particular a patient's perianal fistulas, which device comprises an elongated probe having a first end and a second end, which probe can be inserted into the entrance of the fistula channel with its first end via the external opening of the fistula in the patient's skin, in the direction of the internal opening of the fistulas inside the patient's body, for the purpose of passing a drainage thread through the fistula channel, characterized in that the drainage thread is attached to the second end of the elongated probe.
2. A device according to claim 1, characterized in that the drainage thread is permanently attached to the second end of the elongated probe.
3. A device according to claim 2, characterized in that the drainage thread is permanently glued to the second end of the elongated probe.
4. A device according to claim 2, characterized in that the drainage thread is permanently welded to the second end of the elongated probe.
5. A device according to claim 2, characterized in that the drainage thread is permanently clamped to the second end of the elongated probe.
6. A device according to claim 5, characterized in that the second end of the elongated probe is partially hollow so as to receive the drainage thread.
7. A device according to claim 6, characterized in that the hollow second end of the elongated probe is partially closed, for example by means of a punching technique.
8. A device according to any one or more of the preceding claims, characterized in that the elongated probe is at least partially flexible.
9. A device according to claim 8, characterized in that the elongated probe is made of a plastic material.
10. A device according to claim 9, characterized in that the plastic probe has a rigid core, for example made of a metal.
11. A device according to any one or more of the preceding claims, characterized in that the elongated probe narrows in the direction of the first end.
12. A device according to any one or more of the preceding claims, characterized in that the first end is knob-shaped.
PCT/NL2004/000584 2003-09-03 2004-08-19 Device for treating fistulas WO2005020823A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP04774891A EP1673016A1 (en) 2003-09-03 2004-08-19 Device for treating fistulas

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL1024218A NL1024218C2 (en) 2003-09-03 2003-09-03 Device for treating fistulas.
NL1024218 2003-09-03

Publications (1)

Publication Number Publication Date
WO2005020823A1 true WO2005020823A1 (en) 2005-03-10

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Country Status (3)

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EP (1) EP1673016A1 (en)
NL (1) NL1024218C2 (en)
WO (1) WO2005020823A1 (en)

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US7645229B2 (en) 2003-09-26 2010-01-12 Armstrong David N Instrument and method for endoscopic visualization and treatment of anorectal fistula
US7897167B2 (en) 2005-06-21 2011-03-01 Cook Incorporated Implantable graft to close a fistula
WO2011151659A2 (en) 2011-03-21 2011-12-08 Keighleycolo Ltd A device
US8317823B2 (en) 2001-07-26 2012-11-27 Cook Biotech Incorporated Bodily lumen closure apparatus and method
US8535349B2 (en) 2007-07-02 2013-09-17 Cook Biotech Incorporated Fistula grafts having a deflectable graft body portion
WO2014023962A2 (en) 2012-08-09 2014-02-13 Keighleycolo Limited A device
NL2009404C2 (en) * 2012-09-03 2014-03-04 Medishield B V SETON FOR TREATMENT OF A FISTLE, METHOD FOR FORMING A CLOSED LOOP FROM A SETON, AND THE MELT CLAMP THEREFOR.
CN103705210A (en) * 2012-09-28 2014-04-09 上海众仁生物医药科技有限公司 Measuring operative line with probe and latch
US8764791B2 (en) 2004-01-21 2014-07-01 Cook Medical Technologies Llc Implantable graft to close a fistula
CN104127210A (en) * 2014-08-14 2014-11-05 李春穴 Anal fistula seton surgery device
CN104665883A (en) * 2015-03-18 2015-06-03 王辉 Seton for complex anal fistula
US9113851B2 (en) 2007-08-23 2015-08-25 Cook Biotech Incorporated Fistula plugs and apparatuses and methods for fistula plug delivery
WO2015132439A1 (en) * 2014-03-04 2015-09-11 Servicio Andaluz De Salud Curette for fistulas
US9149262B2 (en) 2006-06-21 2015-10-06 Cook Biotech Incorporated Fistula grafts and related methods and systems useful for treating gastrointestinal fistulae
US9226736B2 (en) 2005-04-29 2016-01-05 Cook Biotech Incorporated Volumetric grafts for treatment of fistulae and related methods and systems
US9492149B2 (en) 2007-11-13 2016-11-15 Cook Biotech Incorporated Fistula grafts and related methods and systems useful for treating gastrointestinal and other fistulae
US9538996B2 (en) 2006-01-31 2017-01-10 Cook Biotech Incorporated Fistula grafts and related methods and systems for treating fistulae
US9861517B2 (en) 2001-07-26 2018-01-09 Cook Medical Technologies Llc Vessel closure member, delivery apparatus, and method of inserting the member
WO2018015073A1 (en) * 2016-07-20 2018-01-25 Queen Mary University Of London Surgical tool
CN107754030A (en) * 2017-11-22 2018-03-06 上海中医药大学附属龙华医院 A kind of self-retaining medicated thread and preparation method thereof
US9956315B2 (en) 2005-04-29 2018-05-01 Cook Biotech Incorporated Fistula graft with deformable sheet-form material
WO2018109494A1 (en) * 2016-12-16 2018-06-21 Xiros Limited Medical probe, assembly and method
US10143457B2 (en) 2007-04-06 2018-12-04 Cook Biotech Incorporated Fistula plugs having increased column strength and fistula plug delivery apparatuses and methods

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