Fistula plugs and apparatuses and methods for fistula plug delivery

摘要

Described are methods and apparatuses for delivering fistula plugs into fistulae having at least a primary fistula opening, a secondary fistula opening, and a fistula tract extending therebetween. Illustratively, some inventive methods involve delivering a fistula plug into a fistula tract through a primary fistula opening and toward a secondary fistula opening, while others involve delivering a fistula plug into a fistula tract through a secondary fistula opening and toward a primary fistula opening. In certain aspects, a fistula plug is pushed and/or pulled through a fistula tract along a guidewire or other plug-guiding device, potentially protected by a protective delivery device such as a sheath, capsule or other suitable delivery vehicle.

主权项

1. A method of treating an enterocutaneous fistula in a patient, the fistula having at least a primary fistula opening in a bowel wall, a secondary fistula opening in skin of the patient, and a fistula tract extending therebetween, the method comprising:
advancing an endoscope into the alimentary canal of the patient from a natural body opening of the patient; providing a first wire through the endoscope, the first wire having a distal portion; advancing a second wire through the fistula tract from the secondary fistula opening to and out of the primary fistula opening to position a distal portion of the second wire in the alimentary canal; joining the distal portion of the second wire with the distal portion of the first wire; withdrawing the first wire back out of the alimentary canal so as to leave the second wire emplaced in the patient; associating a fistula plug assembly comprising a fistula plug with at least a portion residing in a protective housing having a rounded tip with the second wire; and pulling the second wire to pull the fistula plug assembly through the bowel of the patient, through the primary fistula opening, and into the fistula tract.