IMPLANTABLE INFUSION DEVICES AND METHODS
20230014979 · 2023-01-19
Inventors
Cpc classification
A61M2025/009
HUMAN NECESSITIES
A61M5/158
HUMAN NECESSITIES
A61M2205/3569
HUMAN NECESSITIES
A61M2005/14208
HUMAN NECESSITIES
A61M2205/192
HUMAN NECESSITIES
A61M2205/3317
HUMAN NECESSITIES
A61M5/1723
HUMAN NECESSITIES
A61M2205/3337
HUMAN NECESSITIES
International classification
A61M5/158
HUMAN NECESSITIES
A61M5/168
HUMAN NECESSITIES
Abstract
Infusion devices and methods are provided for a drug delivery system and can include an infusion needle (1) having a tip end (2) and a drive unit (D) coupled to the infusion needle and arranged for advancing the tip end of the infusion needle to penetrate any fibrosis when the infusion device is implanted in a patient's body. The infusion needle and drive unit are designed for implantation in a patient's body. Other components of the drug delivery system may be part of the implantable infusion device or, alternatively, be for extracorporal use cooperating with the implanted infusion device. Preferably, the infusion needle can be advanced and retracted with each infusion cycle. Furthermore, upon each advancement and/or retraction, the needle may be moved laterally so as to vary the injection site. Needle (1) and drive unit (D) are preferably disposed within a body (15), with the infusion needle being arranged for penetrating a self-sealing penetration membrane (18).
Claims
1.-134. (canceled)
135. An infusion device implantable in a patient's body, the infusion device comprising: a body implantable in the patient's body and having an outer wall, an infusion needle disposed within the body of the infusion device and having a tip end, and a drive unit coupled to the infusion needle which advances and retracts the tip end of the infusion needle to penetrate any fibrosis surrounding the infusion device, when the infusion device is implanted in the patient's body, said infusion needle and drive unit being implantable in the patient's body, the drive unit being operable when implanted in the patient's body, wherein the infusion needle is disposed within the body of the infusion device with the tip end of the infusion needle being arranged for penetrating a penetration area in the outer wall, and wherein the drive unit further comprises an apparatus coupled to the infusion needle that laterally moves the tip end of the infusion needle within the body of the infusion device for variation of the injection site in the penetration area of the outer wall.
136. The infusion device of claim 135, wherein the infusion needle has a tube-like body closed at the tip end and having a laterally arranged delivery exit port.
137. The infusion device of claim 135, wherein a reservoir is coupled to the infusion needle.
138. The infusion device of claim 137, wherein at least a section of a periphery of the reservoir is made from a flexible material permitting volume changes of the reservoir by deformation of the flexible material as infusion liquid is filled into or drawn out of the reservoir.
139. The infusion device of claim 138, wherein the flexible material comprises a polymer membrane.
140. The infusion device of any of claim 139, wherein drawing of liquid from the reservoir causes a negative pressure in at least part of the reservoir.
141. The infusion device of any of claim 140, wherein the reservoir comprises a gas chamber and a liquid chamber, said chambers being separated by the polymer membrane.
142. The infusion device of claim 137, wherein the reservoir has an injection port for refilling the reservoir.
143. The infusion device of claim 142, wherein the injection port comprises a material which is self-sealing in respect of penetrations caused by a replenishing needle.
144. The infusion device of claim 137, wherein the infusion needle is disposed within a body of the device with the tip end of the infusion needle arranged for passing through an outer wall of said body and the reservoir is separate from the body of the device for remote implantation within a patient's body.
145. The infusion device of claim 137, wherein the infusion needle is disposed within a body of the device with the tip end of the infusion needle arranged for passing through an outer wall of said body and the reservoir is part of or is contained within the body of the device.
146. The infusion device of claim 145, wherein at least a section of a periphery of the reservoir at least partially constitutes the outer wall of the body of the device.
147. The infusion device of claim 137, wherein a pump is coupled to the reservoir for pumping infusion liquid from the reservoir to the infusion needle.
148. The infusion device of claim 147, wherein the pump comprises a valve device having a first and a second valve member, each of said first and second valve members having a smooth surface facing each other so as to form a sealing contact between the first and second valve members and further having different liquid channels that can be brought into alignment by displacement of the two smooth surfaces relative to one another while maintaining the sealing contact.
149. The infusion device of claim 148, wherein the first and second valve members are made from a ceramic material.
150. The infusion device of claim 147, wherein the pump is a membrane type pump.
151. The infusion device of claim 150, wherein the membrane type pump comprises a membrane displaceable by a piston as the piston moves, the piston being coupled to the valve device so as to slidably displace the first and second valve members relative to one another as the piston moves.
152. The infusion device of claim 147, wherein the infusion needle is disposed within a body of the device with the tip end of the infusion needle arranged for passing through an outer wall of said body and the pump is separate from the body of the device for remote implantation within a patient's body.
153. The infusion device of claim 147, wherein the infusion needle is disposed within a body of the device with the tip end of the infusion needle arranged for passing through an outer wall of said body and the pump is contained in the body of the device.
154. The infusion device of claim 135, wherein a reservoir is coupled to the infusion needle and a pump is coupled to the reservoir for pumping infusion liquid from the reservoir to the infusion needle, and wherein at least one motor is provided for actuation of at least one of the pump the drive unit and any other energy consuming part of the infusion device.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0050]
[0051]
[0052]
[0053]
[0054]
[0055]
[0056]
[0057]
DETAILED DESCRIPTION OF THE DRAWINGS
[0058]
[0059] Tube 4 penetrates the skin 100 and is attached to an extracorporal pump P. Pump P is schematically shown and can be designed in many ways. In the embodiment shown in
[0060] In the infusion device shown in
[0061] The fit between the outer surface of needle 1 and the inner surface of tube 4 should be sufficiently tight to prevent any fibrosis from growing in.
[0062] It should be noted that the force acting on needle 1 to advance the same may be calculated as the product of the actual pressure and the cross section of needle 1. Since the cross section of a typical infusion needle is relatively small, high pressure will have to be exerted in order to penetrate any fibrosis and to overcome the counteracting forces of return springs 5 and 7. It is therefore advantageous to construct drive unit D such that two strictly separated chambers are formed in front of and behind the drive unit. Thus, when the chamber behind drive unit D is kept at low pressure, such as ambient pressure, the force acting on needle 1 would correspond to the product of the actual pressure and the entire cross section of drive unit D and, thus, be substantially higher.
[0063] This is shown in
[0064] For instance, chamber 9b could be filled with a compressible gas. In that case, return spring 5 could be dispensed with as the compressed air would already create a needle retraction force.
[0065] It is, however, difficult to securely seal a gas chamber. Therefore, second chamber 9b is instead filled with liquid, such as the infusion liquid, and the liquid may be urged into a flexible volume 12. The flexible volume 12 could be of simple balloon type so as to fill up without exerting any strong counter force. Alternatively, the flexible volume 12 may comprise a gas chamber separated from the liquid of second chamber 9b by a flexible membrane. Again, return spring 5 could be dispensed with in this case.
[0066] Instead of the flexible volume 12, a conduit 13 may connect second chamber 9b with reservoir R. Thus, when needle 1 is advanced, liquid will be dispelled from second chamber 9b through conduit 13 into reservoir R, and as needle 1 is retracted by means of return spring 5, liquid will be drawn from reservoir R through conduit 13 back into second chamber 9b.
[0067] Clearly, pump P and reservoir R may be implanted into the patient's body along with drive unit D and needle 1, either remote thereof or as a single unit, if desired.
[0068]
[0069] The other wall portion 16b is rigid to provide some stability for the individual components contained within body 15. A window area 17 is formed in rigid wall portion 16b and a penetration membrane 18 is sealingly press fitted in window area 17. Penetration membrane 18 is made from a self-sealing material in respect of penetrations resulting from infusion needle 1, which infusion needle is arranged for penetrating window area 17.
[0070] Needle 1 is connected to a piston 8 separating a first chamber 9a in front of piston 8 and a second chamber 9b behind piston 8, as discussed above in reference to
[0071] The pressure in first chamber 9a is increased by means of a pump P comprising a piston 10 formed as a unitary piece with an actuator 11 in the form of a manually actuated push button. A return spring 20 serves to urge piston 10 into its initial position shown in
[0072] The infusion device shown in
[0073] The infusion device shown in
[0074] In addition to the advancing and retracting capabilities of drive unit D, the drive unit of the infusion device shown in
[0075] The principle of guide structure 28 will now be described in more detail in relation to
[0076] It should be noted that all components of the infusion device shown in
[0077]
[0078]
[0079] A pump P driven by a motor M connects a reservoir R with an infusion needle 1 mounted on a drive unit D within a body 15 so as to penetrate upon advancement a penetration membrane 17 of body 15. A fluid conduit 4 is long enough to compensate for the advancement of infusion needle 1. While drive unit D may be activated hydraulically by forces generated by pump P, similar to the embodiments discussed above, a separate motor may be provided to actuate drive unit D. Alternatively, motor M may be designed to actuate drive unit D and any movement of drive unit D may cause pump P to pump.
[0080] Although the embodiment shown in
[0081] Motor M is wirelessly controlled by a control unit C from outside the patient's body. Control unit C determines the time period between infusion cycles as well as the amount of infusion liquid to be injected into the patient's body upon each infusion cycle. Instead of wireless communication between control unit C and motor M, galvanic contacts may be provided through the skin 100. Also, the control unit C may be implanted along with motor M. In that case, control unit C is preferably programmable from outside the patient's body, either wirelessly or through galvanic contacts, so as to allow proper configuration of the control unit according to changing demands.
[0082] In addition to or instead of control unit C, a pressure sensitive switch for activating motor M may be arranged subcutaneously.
[0083] There are various ways of providing motor M with energy. For instance, energy may be supplied from outside the patient's body either for direct use by motor M and/or for charging an accumulator A, such as a rechargeable battery and/or a capacitor. In the embodiment shown in
[0084] In general, external energy source E may be adapted to create an external field, such as an electromagnetic field, magnetic field or electrical field, or create a wave signal, such as an electromagnetic wave or sound wave signal. For instance, energy transforming device T as shown in
[0085] Instead of an external primary energy source E, an implantable primary energy source E may be used, such as a regular long-life battery instead of accumulator A.
[0086] The energy signal can also be used to transmit control signal of the control unit C by appropriate modulation of the energy signal, regardless of whether the energy is transmitted wirelessly or by wire, the energy signal thereby serving as a carrier wave signal for the digital or analog control signal. More particularly, the control signal may be a frequency, phase and/or amplitude modulated signal.
[0087]
[0088] Pump P includes a pump membrane 47 that can be any kind of membrane. Preferably, membrane 47 is a metal membrane, for example a titanium membrane, or a type of coated plastic material for achieving long lifetime and avoiding diffusion of liquid through membrane 47 over time. An operation device, which in this embodiment is incorporated in the valve pump assembly, includes a cam sleeve 48 which has a cut-out groove with two opposite cam surfaces 49, a cam wheel 50, which rotates in the cut-out groove pushing against cam surfaces 49, and a pump shaft 51 connected to rotary disc 33. Cam wheel 50 is mounted via a cam wheel shaft 52 onto pump shaft 51. Pump shaft 51 rotates because it is connected to rotating disc 33 via a splined shaft 57 that is coupled to corresponding splines in an upper central hole 53 in rotatable disc 33. The described spline coupling allows disc 33 to move somewhat in an axial direction relative to pump shaft 51. Pump shaft 51 is mounted in an encapsulated ball-bearing 54 and is stationary in an axial direction with respect to ball-bearing 54. Several elongated grooves 55 on pump shaft 51 extend past ball-bearing 54 and serve as liquid flow passages between first channel 38 of stationary disc 32 and a pump chamber 56 under membrane 47.
[0089] When motor 34 is rotating, membrane 47 moves up and down. As membrane 47 moves up and down, rotatable disc 33 connects first channel 38 alternately to second and third channels 40 and 41 so that liquid is either transmitted from second channel 40 or third channel 41 to pump chamber 56 or received from pump chamber 52 by second channel 40 or third channel 41, respectively. In
[0090] The particular material selected for discs 32 and 33 is important because the selected material must be able to function using very fine tolerances without such discs sticking to one another over time. There are several materials available on the market that are suitable for this purpose, e. g. ceramic or ceramic mixed with other materials, such as carbon fiber.
[0091]
[0092] Infusion needle 1 is mounted on a turntable which is part of drive unit D. Upon rotation of the turntable, the tip end of infusion needle 1 will move laterally along window 18 which is positioned proximate blood vessel 200. More particularly, infusion needle 1 is mounted on the turntable so as to be axially movable thereon back and forth such that its tip end will pass through window 18 at an inclined angle. Due to the inclination angle, the tip end of infusion needle 1 will not penetrate the opposite boundary of blood vessel 200 when it is advanced through window 18 into blood vessel 200. Holder 90 supports blood vessel 200 during penetration and injection by the needle.
[0093] Again, the interior of body 15 may serve as reservoir R. Alternatively, reservoir R may be provided as a confined chamber either within body 15 or, preferably, with a section of its periphery constituting a part of the outer wall of the body 15. If such peripheral section is made from a flexible material, such flexibility could compensate for any volume changes in reservoir R. However, at least an injection port 61 should be provided to allow for refilling reservoir R.
[0094] A pump P connects reservoir R with an infusion needle 1 which is mounted on a drive unit D for both longitudinal and lateral displacement.
[0095] Pump P is driven by a first motor M and drive unit D is driven by a separate, second motor M. Alternatively, a single motor M may be used to drive both pump P and drive unit D. Also, as described above, actuation of pump P may simultaneously cause actuation of drive unit D. Alternatively, actuation of drive unit D may cause actuation of pump P.
[0096] A long-life battery B is provided to supply the two motors M with energy. Alternatively, an accumulator, such as a rechargeable battery, may be used instead of long-life battery B.
[0097] Furthermore, a control unit C is provided to control the two motors M. In the embodiment shown in
[0098] The infusion device in
[0099] While
[0100] A method of treating a human being or an animal by implanting any one of the above described infusion devices in a patient's body comprises the steps of [0101] cutting the skin, [0102] free-dissecting a proper location for implantation of the infusion device within the patients body, [0103] placing the infusion device at said proper location, and [0104] closing at least the skin after placement of the infusion device.
[0105] Closing the skin may for instance include suturing, taping and other suitable techniques. The infusion device may be placed subcutaneously in the patient's body or within fat tissue or intramuscularly. In case it is placed adjacent a blood vessel (200) for injecting the infusion liquid directly into the circulating blood; the step of free-dissecting a proper location for implantation comprises free-dissecting the respective blood vessel and placing the infusion device adjacent the blood vessel. The blood vessel may then be secured to the infusion device by means of the holder 90 connected to the infusion device.
[0106] Alternatively, the infusion device may be placed within or adjacent the patient's gastro-intestinal or urinary tract. In the case of placing it adjacent the tract, again, it may be secured to the gastro-intestinal or urinary tract by means of a holder connected to the infusion device. As a further alternative, the infusion device may be placed in the patient's thorax or in the patient's abdomen.
[0107] Where the infusion device is placed adjacent a blood vessel or adjacent or within the patient's gastro-intestinal or urinary tract or within the patient's thorax or abdomen, the steps of cutting the skin, free-dissecting the proper location for implantation and placing the infusion device at said proper location may comprise: [0108] where the infusion device is implanted in the patient's thorax or abdomen, inserting a Varess needle or another type of gas inflation needle into the abdomen or thorax cavity and filling the abdomen or thorax cavity with a gas, [0109] cutting a key-hole, [0110] inserting at least one trocar through the key-hole towards the proper location, [0111] advancing one or more medical instruments and a camera through the at least one trocar towards said location, [0112] dissecting said location, and [0113] supplying the infusion device or part thereof to said location through the at least one trocar or through a separate incision in the skin.
[0114] For instance, the reservoir R may be placed in the abdomen or thorax cavity in the way described above. Alternatively, the infusion device or part thereof, such as the reservoir R, may be implanted by open surgery, in which case the thorax or abdominal wall is opened for placing the infusion device at the proper location within the patient's thorax or abdomen and, afterwards, the skin and other layers of tissue are closed, such as by suturing, and are preferably sutured in layers.
[0115] Replenishing of the reservoir R preferably comprises the step of injecting a volume of infusion liquid through an injection port connected to and/or integrated in the periphery of the reservoir.
[0116] One or more of the following elements of the infusion device may be implanted remote from at least drive unit D and infusion needle 1: [0117] motor M for actuation of drive unit D, [0118] energy storage means B to provide motor M with energy, comprising at least one of a battery, a capacitor and a rechargeable battery, [0119] galvanic coupling elements 90 between either external energy source E or energy storage means B and motor M for transmitting energy to motor M in contacting fashion, [0120] wireless coupling elements adapted to connect either motor M or energy storage means B or both to extracorporal primary energy source E for transmitting energy to either motor M or energy storage means B or both in non-contacting fashion, [0121] control unit C for controlling motor M, [0122] wireless energy transmission or receiving means, [0123] the data transmission interface for wirelessly transmitting data from external data processing device 80 to control unit C, [0124] feedback sensor F, [0125] reservoir R for holding the infusion liquid, and [0126] injection port 61 for refilling the reservoir.