CN204219093U - A kind of degradable spherical faux bladder - Google Patents

Abstract

The utility model provides a degradable spherical artificial bladder, which is a medical in situ implantable degradable spherical artificial bladder lined with the submucosa of the small intestine. The lower layer consists of the artificial ureteral loop and the artificial urethral loop as a mesh pipe structure, the artificial bladder body as a meshed spherical structure, the artificial urethral loop, the artificial ureteral loop, and the artificial bladder body are integrally formed, and the small intestinal submucosa is lined inside the three . The utility model has a reasonable structural design and fully utilizes the advantages of natural-artificial composite materials. The mesh outer support plays a role of mechanical support in the early stage of implantation, facilitates the suture operation of the surgical port, can maintain the bladder storage structure, and plays a temporary storage role. Urine functions and facilitates fixation to pelvic tissues. The utility model is applied in the cystectomy operation to replace the resected diseased bladder, and finally forms an organ similar to the autologous bladder.

Description

A degradable spherical artificial bladder

technical field

The utility model belongs to medical artificial organs, in particular to a degradable spherical artificial bladder, which is suitable for bladder tumors, necrotic and interstitial cystitis, tuberculous bladder contracture and congenital deformities, etc., which need urinary diversion and bladder reconstruction. patient.

Background technique

At present, after total cystectomy for advanced bladder cancer, urinary diversion is necessary, that is, an artificial bladder is used to replace the function of the original bladder. The existing clinical method is to use the patient's own intestinal segment to make a urinary bladder with a capacity of about 300-500ml—artificial bladder, but this method not only destroys the normal structure and function of the patient's digestive tract, but also destroys the intestinal segment structure. It is far from the bladder structure, so there may be many postoperative complications such as intestinal obstruction, abnormal metabolism or nutritional disorders, as well as mucus secretion in the artificial bladder, prone to infection, stone formation, etc., which seriously affect the quality of life of postoperative patients. Therefore, researchers have been looking for a suitable material to make an exogenous artificial bladder.

The small intestinal submucosa (SIS) is a kind of allogeneic tissue obtained from the small intestine of pigs. It is made by removing the mucosal layer, serosal layer and muscular layer of the small intestine to form a membranous tissue with a thickness of 0.1mm. It contains collagen components and some growth factors that promote tissue regeneration. Because it is very close to the extracellular matrix, it is conducive to cell adhesion and growth. After removing cells, SIS is non-immunogenic and has good biocompatibility. Metzger used SIS to conduct xenograft cross-transplantation experiments on 1000 animals, and found no direct rejection. Kropp et al. successively used SIS as a patch in rats and dogs to perform bladder enlargement surgery. Postoperative histological examination revealed that three layers of normal bladder tissue (epithelium, muscular layer, and serosal layer) could be seen at the patch, which were indistinguishable from normal bladder tissue. These experiments suggest that SIS can induce cell migration, proliferation and differentiation after implantation in vivo, and can form a structure similar to bladder, so it is expected to be applied to the construction of artificial bladder.

Contents of the invention

The purpose of this utility model is to provide a degradable spherical artificial bladder, which is a medical in situ implantable degradable spherical artificial bladder lined with small intestinal submucosa, which consists of artificial ureteral loop, artificial bladder body, artificial urethral loop, small intestinal Composed of submucosa, the artificial ureteral loop is a mesh pipe structure with a diameter of 0.6-0.8cm, the artificial urethral loop is a mesh pipe structure with a diameter of 0.8-1.0cm, and the artificial bladder body is a mesh spherical structure with a capacity of 200~300ml. The urethral loop is connected to the artificial ureteral loop and the artificial bladder body respectively, and the small intestinal submucosa is lined inside the artificial ureteral loop, the artificial bladder body and the artificial urethral loop.

The lining of the small intestine submucosa consists of 3 to 6 layers of SIS superimposed at positions perpendicular to each other's fiber directions, and a thicker SIS is formed after cross-linking and compounding. The artificial ureteral loop, artificial bladder body, and artificial urethral loop are made of biodegradable biocompatible polymer materials, such as polyglycolic acid (Poly-Glycolic Acid, PGA), polylactic acid (Ploy-Lactic Acid, PCA), etc. The network structure can elastically deform under pressure, and the volume expands accordingly.

The preparation of acellular small intestinal submucosa (SIS) matrix material is a prior art, and relevant patents have already been made, so we will not describe it in detail here (see patent number: CN200710177285.6).

The beneficial effect of the utility model is that the structural design is reasonable and novel, and the advantages of the natural-artificial composite material are fully utilized, and the mesh outer bracket plays a role of mechanical support in the early stage of implantation. Maintain the structure of the bladder's allantoic storage sac, serve as a temporary urine storage function and facilitate fixation to the tissues in the pelvic cavity. The submucosa lining the porcine small intestine has no obvious immunogenicity, and its composition is very close to the extracellular matrix, which is conducive to cell adhesion and growth, and can induce the migration, proliferation and differentiation of autologous ureteral cells; at the same time, the mesh outer scaffold gradually degrades, and the The utility model is applied in the cystectomy operation to replace the resected diseased bladder, and finally forms an organ similar to the autologous bladder.

Description of drawings

Fig. 1 is the structural representation of the utility model.

Fig. 2 is a structural schematic diagram of a cross-sectional view of the bladder body in the present invention.

Detailed ways

The utility model is further described in conjunction with the accompanying drawings and embodiments.

Example 1

Referring to Fig. 1 and Fig. 2, the purpose of this utility model is to provide a degradable spherical artificial bladder, which is a medical in situ implantable degradable spherical artificial bladder lined with small intestinal submucosa, composed of artificial ureteral loop 1, artificial Bladder body 2, artificial urethral loop 3, small intestine submucosa 4, artificial ureteral loop 1 is a mesh pipe structure with a diameter of 0.6-0.8cm, artificial urethral loop 3 is a mesh pipe structure with a diameter of 0.8-1.0cm, the artificial bladder body 2 is a net-shaped spherical structure with a capacity of 200~300ml. The artificial urethral loop 3 is respectively connected to the artificial ureteral loop 1 and the artificial bladder body 2. The three are integrally formed. The small intestinal submucosa 4 is lined with the artificial ureteral loop 1 and the artificial bladder body 2 And the inner side of artificial urethral loop 3.

The lining of the small intestine submucosa 4 consists of 3 to 6 layers of SIS superimposed at positions perpendicular to each other's fiber directions, and a thicker SIS is formed after cross-linking and compounding. Artificial ureteral loop 1, artificial bladder body 2, and artificial urethral loop 3 are made of biodegradable biocompatible polymer materials, such as polyglycolic acid (Poly-Glycolic Acid, PGA), polylactic acid (Ploy-Lactic Acid, PCA )wait. The network structure can elastically deform under pressure, and the volume expands accordingly.

Example 2

The implantation method of the present utility model is as follows: under general anesthesia or epidural anesthesia, implement total cystectomy to the patient, after hemostasis is complete, put the artificial bladder of the present utility model into the pelvic cavity in situ, after adjusting the appropriate position, Put one end of the 5Fr ureteral stent commonly used in clinical practice into the artificial ureteral loop 1 and the other end into the autologous ureteral stump, and then anastomose the artificial ureteral loop 1 with the autologous ureteral stump. For the SIS layer, the autologous ureteral stump can be properly everted first, and the autologous ureteral mucosa and the SIS layer of the artificial urinary catheter can be sutured intermittently with absorbable sutures, and then the outer frame and the ureteral serosa layer can be sutured with silk thread, so as to facilitate the crawling of migrating cells to the SIS layer. SIS layer. The contralateral ureter was anastomosed in the same way. The artificial urethral loop 3 was inserted into the posterior urethra of the human body by 0.5 cm, and the SIS layer and the urethral submucosa were intermittently sutured with absorbable sutures. Finally, the mesh outer bracket of the artificial bladder body 2 is properly sutured with the tissues around the pelvic cavity to further fix its position in the pelvic cavity, and a 20Fr double-lumen catheter is inserted through the urethra and passed through the anastomotic opening between the artificial urethral loop 3 and the urethral stump . After the artificial bladder was implanted, the abdominal cavity was closed layer by layer to complete the operation.

Claims (3)

1. A degradable spherical artificial bladder, characterized in that it consists of artificial ureteral loop (1), artificial bladder body (2), artificial urethral loop (3), small intestinal submucosa (4), artificial ureteral loop (1) It is a mesh pipe structure with a diameter of 0.6~0.8cm. The artificial urethral loop (3) is a mesh pipe structure with a diameter of 0.8~1.0cm. The artificial bladder body (2) is a mesh spherical structure with a capacity of 200~300ml. Loop (3) connects artificial ureter loop (1) and artificial bladder body (2) respectively, small intestinal submucosa (4) is lined with artificial ureter loop (1), artificial bladder body (2) and artificial urethral loop (3) inside. 2. A degradable spherical artificial bladder according to claim 1, characterized in that the lining of the small intestine submucosa (4) is formed by overlapping 3 to 6 layers of SIS at positions perpendicular to each other's fiber directions, and cross-linking and compounding Thicker sis. 3. A degradable spherical artificial bladder according to claim 1, characterized in that the artificial ureteral loop (1), the artificial bladder body (2), and the artificial urethral loop (3) are made of biodegradable and highly biocompatible Made of molecular material selected from polyglycolic acid or polylactic acid.