APPLICATION DEVICE WITH A URETERIC TRAYS AND AN INTRODUCER COMPONENT FOR INTRODUCING THE URETERIC TRAYS, INTRODUCER COMPONENT AND APPLICATION DEVICE

Description

[0001] The invention relates to an application device comprising a ureteral stent, which comprises a ureteral stent base body and a receiving body connected to the ureteral stent base body by at least one connecting element of the ureteral stent, as well as an insertion component for holding the ureteral stent and for guiding the ureteral stent through a patient's ureter along a flexible guide element. Further aspects of the invention relate to an insertion component for such an application device and an application device.

[0002] To insert ureteral stents, a guidewire is often inserted through a urethra, bladder, and ureter into a patient's kidney. The ureteral stent can then be positioned over the guidewire using an introducer. Once the ureteral stent is positioned, the introducer and guidewire are removed. Removing the guidewire typically causes a change in shape, usually a rolling movement, at one or both ends of the ureteral stent. This change in shape prevents the ureteral stent from accidentally slipping out and thus serves to secure it in the patient's urinary system.

[0003] To avoid cystoscopy for removing the ureteral stent, the stent can be equipped with a magnet at its distal end, which can be magnetically connected to a catheter, particularly a Tiemann catheter, which has an end that attracts the magnet. The magnetic force acting between the magnet and the end of the catheter is sufficient to remove the ureteral stent, which is coupled to the catheter via the magnet, in a very short time using the catheter.

[0004] DE 697 31 027 T2 discloses a stent for implantation into a ureter between a bladder and a kidney to prevent the backflow of urine into the kidney. The stent comprises an elongated tubular body with a bladder end portion and a kidney end portion, fluid paths in the kidney end portion and across at least part of the tubular body, means at the kidney end portion and at the bladder end portion for curving the ends of the stent so that they are retained in the renal pelvis and bladder, and means for suppressing the flow of urine from the bladder to the kidney via the stent. The stent comprises either no passage or a passage in the bladder end portion that is closed after implantation of the stent, the bladder end portion forming the suppression means.

[0005] DE 10 2015 001 505 A1 describes a device that, from the outside, looks somewhat like a bladder catheter, but is composed of a sheath tube part and a tip part, which is arranged at the bladder-side end of the sheath tube part via a guide wire located centrally in the sheath tube part in such a way that, by actuating the guide wire on the handle element, the tip part can be extended translationally from the sheath tube part and rotated relative to the sheath tube part, so that the tip part, in its extended working position, releases a gripping part attached to the guide wire and having elastically deformable gripping arms, wherein the latter, when the gripping part is rotated, grasp and wind up pulling threads or thread loops that are arranged externally at the distal end region of the double-J ureteral stent. US 2015 / 182362 A1 discloses an application device according to the preamble of claim 1.US 2010 / 160848 A1 discloses a ureteral stent comprising an elongate member having a first portion and a second portion coupled to the first portion. The first portion of the elongate member is configured to be disposed within a kidney of a patient. The second portion, which has a sidewall defining a lumen, is configured to deliver fluid from a first location on the sidewall of the second portion to a second location on the sidewall of the second portion by capillary action. The second portion of the elongate member is configured to be disposed within at least one of a bladder and a ureter of the patient.US 6 258 098 B1 shows a stent assembly comprising an elongated stent having a distal end; a ferromagnetic element having a length substantially shorter than the length of the stent; and a tether, one part of which is connected to the ferromagnetic element and the other part of which is connected to the distal end of the stent.

[0006] The object of the present invention is to provide an application device, an insertion component and an application device of the type mentioned at the outset, by means of which a simplified alignment of a ureteral stent during its insertion in the direction of a kidney can be achieved.

[0007] This object is solved by the subject matter of independent patent claim 1. Advantageous developments of the invention are disclosed by the features of the dependent patent claims, the following description and the figures.

[0008] A first aspect of the invention relates to an application device having a ureteral stent, which comprises a ureteral stent base body and a receiving body connected to the ureteral stent base body by means of at least one connecting element of the ureteral stent, as well as having an insertion component for holding the ureteral stent and for guiding the ureteral stent through a ureter of a patient along a flexible guide element.

[0009] According to the invention, the ureteral stent can be displaced by means of the insertion component in opposite directions of movement along the flexible guide element, and the insertion component is designed to guide the ureteral stent base body and the receiving body during displacement in the respective directions of movement. This is advantageous because the ureteral stent and thus the ureteral stent base body and the receiving body can thus be displaced together by means of the insertion component relative to the flexible guide element and in opposite directions of movement, thus enabling particularly precise orientation and thus alignment of the ureteral stent during its insertion toward the patient's kidney.When moving in the respective opposite directions of movement, the ureteral stent can be pulled forwards and backwards in the urethra, bladder, ureter or kidney using the insertion component.

[0010] The ureteral stent can also be referred to as a ureteral stent. The ureteral stent base can also be referred to as a stent, a medical implant for keeping vessels or hollow organs open. The insertion component can also be referred to as a "pusher." The guide element can preferably be designed as a guide wire, i.e., a wire for guiding the application device. In principle, a design of the guide element as a plastic wire or a plastic tube is also conceivable. The guide element can be inserted into a patient's kidney via a urethra, a bladder, and the ureter. The ureteral stent, together with the insertion component, can then be inserted into the kidney along the guide element and thus passed through the ureter.The ureteral stent can be held to the insertion component via the flexible guide element, whereby the flexible guide element can be guided through both the ureteral stent and the insertion component. The insertion component also includes a recess for inserting and holding the receiving body. This is advantageous because the receiving body can be arranged in the recess in a particularly space-saving manner, and the recess also makes it easy to prevent any unwanted falling out of the receiving body. The recess can thus form a receptacle for the receiving body.The insertion component further comprises at least two tube sections into which the flexible guide element can be inserted, as well as at least one connecting region connecting the at least two tube sections to one another, wherein the at least two tube sections and the at least one connecting region delimit the recess. This is advantageous because the insertion component thus has an outer contour which makes the insertion component particularly suitable for insertion into respective channels of the urinary system, such as the urethra or ureter. Due to the possibility of inserting the flexible guide element into the tube sections, the insertion component can be inserted particularly securely along the flexible guide element and, for example, into the patient's bladder, to name just one example.The tube sections can have respective tube passage openings through which the flexible guide element can be passed. According to the invention, a first tube section of the at least two tube sections is designed as the proximal end of the insertion component, into which, at least when the ureteral stent is held on the insertion component, a distal base body end of the ureteral stent base body facing the receiving body is inserted at least partially. This is advantageous because the insertion of the distal base body end provides a particularly captive, releasable attachment of the distal base body end and thus of the ureteral stent base body to the insertion component. The distal base body end can also be referred to as the distal end of the ureteral stent base body.Overall, the distal end of the main body and the proximal end of the insertion component (pusher) can be in contact with each other when the ureteral stent is held on the insertion component. The proximal end of the respective element of the application device is understood to be the end closest to the body center, while the distal end is understood to be the element of the application device further away from the body center. Furthermore, the first, proximal tube section of the insertion component has a first tube through-opening whose diameter decreases toward the receiving body such that it is approximately equal to or equal to a diameter of a through-opening of the receiving body.However, it is also possible for a tube to be arranged in the first, proximal tube section of the insertion component, wherein the tube has a tube through-opening whose diameter decreases toward the receiving body, such that this diameter is approximately equal to or equal to a diameter of a through-opening in the receiving body. Furthermore, it is possible for the tube to have a tube through-opening whose diameter is approximately equal to or equal to a diameter of a through-opening in the receiving body. The aforementioned embodiments ensure safe and easy passage and mobility of the guide element within the through-openings of the ureteral stent base body, the insertion component, and the receiving body.By appropriately adjusting the diameters, it is possible to reliably prevent the guide element from striking the end face of the receiving body, for example, and thus prevent the guide element from being pushed further through the insertion component and the receiving body. Finally, a proximal end region of the first, proximal tube section of the insertion component is funnel-shaped to accommodate the distal end of the base body. It is also possible for the funnel shape to be formed by a proximal end region of the tube arranged in the first, proximal tube section of the insertion component. The funnel shape facilitates docking and securing the distal ureteral stent base body to the proximal end of the insertion component.

[0011] The insertion component can particularly preferably be designed to keep the ureteral stent base body and the receiving body spaced apart from one another, in particular at a constant distance from one another, regardless of displacement in the opposite directions of movement. This advantageously prevents any collision and, for example, any resulting tilting of the receiving body relative to the ureteral stent base body during insertion toward the kidney, thereby avoiding complications during insertion of the ureteral stent. In other words, any relative movement between the ureteral stent base body and the receiving body during displacement can be avoided.

[0012] The insertion component, which can also be referred to as an insertion aid, can preferably be designed as a single piece, thus making the insertion component particularly easy to handle. In particular, this eliminates the need for any additional mechanism to detach the insertion component from the ureteral stent after its intended placement in the urinary system.

[0013] In an advantageous development of the invention, the receiving body has ferromagnetic properties. In other words, the receiving body can be designed as a ferromagnet, at least in part. This allows the receiving body to be attracted by a magnet, which can be attached to a catheter, in particular a Tiemann catheter, or which can be part of the catheter. Alternatively, the receiving body can also be designed as a magnetic body, at least in part, and thus be magnetic itself. Both the magnetic attractability and the magnetic design facilitate the removal of the ureteral stent, especially since the receiving body can then be quickly connected to the catheter (Tiemann catheter) and removed, in particular pulled out, from the urinary system due to the corresponding magnetic forces.

[0014] In a further advantageous development of the invention, the ureteral stent base body, together with the receiving body, can be rotated relative to the flexible guide element using the insertion component. This is advantageous because it can further improve the orientation and thus the alignment of the ureteral stent during its insertion. The insertion component can, in particular, be designed to hold the ureteral stent base body and the receiving body in such a way that they can be rotated synchronously, i.e., without any rotational offset, using the insertion component.

[0015] In a further advantageous embodiment of the invention, the at least one connecting element is designed to be flexible or flexible. This is advantageous because, upon subsequent removal of the ureteral stent, the receiving body can be pulled particularly easily toward a catheter, in particular a Tiemann catheter. The connecting element can be deformed with particularly little force, thereby facilitating the establishment of a magnetic connection between the receiving body and the catheter.

[0016] In a further advantageous development of the invention, the at least one connecting element is tensioned by means of the insertion component when the ureteral stent is held on the insertion component. This is advantageous because the ureteral stent is thus held particularly securely on the insertion component. Thus, it can be provided in a particularly advantageous manner that the insertion component is clamped in regions between the receiving body and the ureteral stent base body via the connecting element, whereby unintentional detachment of the ureteral stent from the insertion component can be particularly advantageously prevented. In other words, the connecting element can be held under mechanical tension via the insertion component when the ureteral stent is held on the insertion component.

[0017] In a further advantageous development of the invention, the at least one connecting element is designed as a thread element or a wire element. This is advantageous because the connecting element takes up very little space and thus does not unnecessarily complicate the insertion of the ureteral stent toward the kidney. Furthermore, the design of the connecting element as a thread element or a wire element allows for particularly simple deformation of the connecting element, so that the connecting element does not impede a magnetic coupling between the receiving body and a catheter for removing the ureteral stent.

[0018] InIn a further advantageous development of the invention, the distal base body end, which has been inserted at least partially, can be held in an insertion position by means of the guide element on the first tube section when the ureteral stent is held on the insertion component. The distal base body end is designed to deform independently from the insertion position into a home position of the distal base body end when the guide element is released from the ureteral stent base body, thereby moving out of the first tube section. The guide element can thus hold the distal base body end in the insertion position.This is advantageous because the distal end of the base body can be inserted into the urethra, for example, with particularly low resistance in its insertion position. It can deform from the insertion position to the home position without the need for additional aids and thus, so to speak, independently when the guide element is released from the ureteral stent base body, i.e., pulled out of the ureteral stent base body and thus separated from the ureteral stent base body, in particular, spaced apart. As a result of the deformation from the insertion position to the home position, the distal end of the base body can move independently out of the first tube section.In other words, the guide element can hold the distal base body end, which has been inserted at least in part, in the insertion position when the ureteral stent is held on the insertion component, wherein the distal base body end is designed to deform independently from the insertion position into the basic position when the guide element is released from the ureteral stent base body and to thereby move out of the first tube section.

[0019] In the basic position, the distal end of the base body can preferably have a greater radial extension than in the insertion position. This can prevent the ureteral stent base body, which has been guided through the ureter, for example, from undesirably slipping out or sliding in its basic position. The ureteral stent base body can therefore be held securely in the ureter. In contrast to the insertion position, the distal end of the base body can preferably be twisted in the basic position. The same can also apply to a proximal end of the ureteral stent base body opposite the distal end of the base body. In other words, it can be provided that the proximal end of the base body opposite the distal end of the base body can also deform independently from its insertion position to its basic position. The proximal end of the base body can also preferably be twisted in its basic position.In particular, the two opposing base body ends of the ureteral stent base body can each be twisted in a J-shape in their respective basic position. In their respective insertion position, the opposing base body ends can each be stretched and pre-tensioned compared to the basic position. The distal base body end and / or the proximal base body end can be deformed together from the insertion position to the basic position by releasing the guide element from the ureteral stent base body. By means of the guide element, the distal base body end and / or the proximal base body end can be held pre-tensioned in the insertion position. The distal base body end and / or the proximal base body end can be preferably twisted together when deformed from the insertion position to the basic position.

[0020] In a further advantageous development of the invention, the distal end of the base body is designed to pull the receiving body out of the recess via the at least one connecting element when it is moved out of the first tube section and by deformation from the insertion position into the basic position. This is advantageous because the receiving body can thus be detached from the insertion component without further aids by deforming the distal end of the base body and via the connecting element. When moving out of the first tube section, the distal end of the base body can be supported on the first tube section during its deformation from the insertion position into the basic position and can thereby move the receiving body out of the recess via the at least one connecting element.

[0021] In particular, the flexible guide element can initially be pulled out at least from the first tube section, allowing the distal end of the base body to deform from the insertion position to the home position and thus move independently out of the first tube section. The distal end of the base body can be supported on the first tube section and, in doing so, pull the receiving body out of the recess via the connecting element. The distal end of the base body can thus move automatically out of the first tube section due to the deformation from the insertion state to the home position.

[0022] In further advantageous embodiments of the application device according to the invention, the first, proximal tube section of the insertion component can have a constriction in a proximal end region, wherein an inner diameter of the constriction is smaller than an outer diameter of the distal end of the ureteral stent base body. It is also possible for the first, proximal tube section of the insertion component to be tapered in a proximal end region such that the inner diameter of the constriction is smaller than the outer diameter of the distal end of the ureteral stent base body. This ensures, according to the invention, that the distal end of the ureteral stent base body cannot penetrate, or cannot penetrate excessively, into the insertion component. This can reliably prevent difficulties when separating the two elements from one another.

[0023] InIn further advantageous embodiments of the application device according to the invention, the recess in the insertion component can have at least one bevel and / or at least one step in the end region facing the first tube section, such that a diameter of the recess increases in the region of the bevel or step. The aforementioned bevel or step can also be formed by a distal end region of the tube arranged in the first, proximal tube section of the insertion component. The formation of such a bevel or step facilitates the sliding of the receiving body out of the recess when the guide element is pulled out of the ureteral stent base body, the insertion component, and the receiving body.

[0024] InIn a further advantageous embodiment of the application device according to the invention, at least one notch or marginal recess for receiving and guiding the connecting element is formed in a proximal end region of the first, proximal tube section of the insertion component. For example, the ends of a thread- or wire-shaped connecting element are brought together and at least partially held in the notch. Such a construction advantageously prevents the ureteral stent or the distal end of the ureteral stent base body from inadvertently detaching from the proximal end of the insertion component.

[0025] In a further advantageous development of the invention, the at least one connecting region is deformable between a release position, in which the at least two pipe sections are tilted relative to one another by means of the at least one connecting region and the recess for releasing the receiving body is thereby widened at least in some regions, and a holding position, in which the recess for holding the receiving body is narrowed compared to the release position. This is advantageous because the deformation of the connecting region from the holding position to the release position enables the receiving body to slide out of the recess more easily. Thus, while the receiving body can be held captively in the recess in the holding position, the receiving body can be guided out of the recess in a particularly simple manner in the release position.As a result of the deformation of the connecting region from the holding position to the release position, the respective center axes of the pipe sections can tilt relative to each other and thereby form an angle with each other. In the non-tilted state, the respective center axes of the pipe sections can be oriented parallel or coaxially to each other. The at least one connecting region can, in particular, be elastically deformable between the holding position and the release position.

[0026] In a further advantageous development of the invention, the at least one connecting region can be held in the holding position by means of the guide element when the ureteral stent is held by means of the insertion component and when the guide element is inserted into the at least two tube sections, wherein an elastic deformation of the at least one connecting region from its holding position to its release position can be blocked by means of the inserted guide element. This is advantageous because, accordingly, the elastic deformation of the connecting region from its holding position to its release position can be brought about simply by releasing the guide element from the insertion component. Accordingly, the release of the guide element from the insertion component can also simultaneously assist the release of the ureteral stent, i.e. the ureteral stent base body and the receiving body, from the insertion component.

[0027] For example, at least one connecting area can be subjected to a mechanical preload in the holding position by means of the flexible guide element. By removing the flexible guide element from the first tube section, the mechanical preload can be released, allowing the connecting area to deform independently and elastically from the holding position to the release position.

[0028] The inserted guide element can thus prevent the elastic deformation of the connecting area from its holding position to its release position. The inserted guide element can accordingly keep the connecting area tensioned in its holding position.

[0029] In a further advantageous embodiment of the application device according to the invention, the connecting element, when the ureteral stent is held on the insertion component, is guided at least partially along an outer surface of the proximal end of the insertion component. Such an arrangement of the connecting element is advantageously simple to manufacture.

[0030] In a further advantageous embodiment of the application device according to the invention, it comprises a mounting sleeve, wherein the mounting sleeve is designed such that an inner diameter of the mounting sleeve is equal to or greater than an outer diameter of the insertion component. Such a mounting sleeve serves to fix the receiving body in the recess of the insertion component. In particular, before the guide element is passed through the corresponding through-openings of the insertion component and the receiving body, the receiving body can thus be securely held or fixed in the recess.

[0031] A second aspect of the invention relates to an insertion component for an application device according to the first aspect of the invention. The features presented in connection with the application device according to the first aspect of the invention and their advantages apply accordingly to the insertion component according to the second aspect of the invention, and vice versa.

[0032] A third aspect of the invention relates to an application device comprising an application device according to the first aspect of the invention and the flexible guide element on which the ureteral stent and the insertion component are received. The features presented in connection with the application device according to the first aspect of the invention and the insertion component according to the second aspect of the invention, as well as their advantages, apply accordingly to the application device according to the third aspect of the invention, and vice versa. The flexible guide element can, in particular, be guided through respective through-openings of the ureteral stent base body and the receiving body, as well as through the insertion component.

[0033] Further features of the invention emerge from the claims, the exemplary embodiments, and the drawings. The features and combinations of features mentioned above in the description, as well as the features and combinations of features mentioned below in the exemplary embodiments, can be used not only in the respective specified combinations, but also in other combinations without departing from the scope of the invention.

[0034] It shows: Fig. 1 is a schematic perspective view of an application device comprising an application device and a flexible guide element on which a ureteral stent and an insertion component of the application device are guided and displaceable; Fig. 2 is a schematic side view of the application device, showing mutually opposite directions of movement along which the ureteral stent can be displaced translationally and relative to the flexible guide element using the insertion component, and showing mutually opposite directions of rotation in which the ureteral stent can be rotated relative to the flexible guide element using the insertion component; Fig.3a-e each show schematic plan views of a patient's urinary system, illustrating the insertion of the flexible guide element towards a kidney of the urinary system, subsequent placement of the ureteral stent over the guide element by means of the insertion component, removal of the guide element and the insertion component, and a desired position of the ureteral stent during its intended use; Fig. 4 shows a schematic perspective view of the insertion component, with a connecting region of the insertion component in a release position; Fig. 5 shows a schematic side view of the insertion component; Fig. 6 shows a schematic perspective view of a distal base body end of a ureteral stent base body of the ureteral stent and a receiving body of the ureteral stent, which is connected to the distal base body end via a connecting element of the ureteral stent;7 shows a schematic side view of the distal end of the base body and of the receiving body connected to the distal end of the base body via the connecting element; Figs. 8a-c show schematic representations of various examples of the insertion component of the application device not according to the invention; and Figs. 9a-b show schematic representations of the application device according to the invention.

[0035] In the following figures, the same reference numerals refer to identical or comparable features of the different embodiments of the application device 10.

[0036] Fig. 1 and Fig. 2Each shows different views of an application device 100, which comprises an application device 10 and a flexible guide element 110. A ureteral stent 20 and an insertion component 50 of the application device 10 can be arranged on the flexible guide element 110, which can be designed, for example, as a guide wire.

[0037] The ureteral stent 20 comprises a ureteral stent base body 30 and a receiving body 40 connected to the ureteral stent base body 30 by means of at least one connecting element 22 of the ureteral stent 20. In this case, the at least one connecting element 22 is designed to be flexible or flexible and is configured as a thread element. However, an alternative design of the connecting element 22 as a wire element is also conceivable. It can be seen that, when the ureteral stent 20 is held on the insertion component 50, the connecting element 22 is at least partially guided on an outer surface of a proximal end of the insertion component 50.

[0038] The insertion component 50 of the application device 10 serves to hold the ureteral stent 20 and to guide the ureteral stent 20, for example, by means of a Fig. 3a to Fig. 3e recognizable ureter HL of a patient's urinary system along the flexible guide element 110. The urinary system is in Fig. 3awithout the application device 100 or without the application device 10 and comprises a urethra HR, a bladder BL, ureters HL and kidneys NI.

[0039] In order to insert the ureteral stent 20 into the urinary system, the flexible guide element 110 (here: guide wire) can first be inserted via the urethra HR, the bladder BL and one of the ureters HL into one of the kidneys NI, as shown in Fig. 3b is recognizable.

[0040] Fig. 3cshows how the ureteral stent 20 can subsequently be pushed by means of the insertion component 50 along the guide element 110 through the bladder BL in the direction of the left ureter HL in the drawing plane and thus in the direction of the left kidney NI in the drawing plane. To enable this, the guide element 110 is inserted, on the one hand, into a base body through-opening 31 associated with the ureteral stent base body 30 and, on the other hand, into a receiving body through-opening 42 associated with the receiving body 40. In addition, the guide element 110 is guided through respective tube through-openings 62, 72 of the insertion component 50, while the ureteral stent 20 is held on the insertion component 50.

[0041] Based on Fig. 3d it can be seen how the guide element 110 is removed as soon as the ureteral stent 20 is partially inserted into the (left) kidney NI on the one hand and partially inserted into the bladder BL on the other hand. Fig. 3e Finally, FIG. 1 shows a predetermined position of the ureteral stent 20 for its intended use. For the intended use of the ureteral stent 20, opposing ends of the ureteral stent base body 30 are each twisted in a J-shape in their respective basic position 36, thereby preventing undesired slippage of the ureteral stent 20 within the urinary system.

[0042] The ureteral stent 20 can be displaced translationally within the urinary system in opposite directions of movement R1, R2 by means of the insertion component 50. The opposite directions of movement R1, R2 are in Fig. 2by oppositely directed, straight arrows. The insertion component 50 is also designed to guide the ureteral stent base body 30 and the receiving body 40 during displacement along the guide element 110 and within the urinary system in the respective directions of movement R1, R2. Furthermore, the ureteral stent base body 30 together with the receiving body 40 can be rotated synchronously and relative to the flexible guide element 110 in opposite directions of rotation D1, D2 using the insertion component 50. The directions of rotation D1, D2 are in Fig. 2 illustrated by curved arrows pointing in opposite directions.

[0043] Based on Fig. 1 and Fig. 2 It can also be seen that the at least one connecting element 22 (here: thread) is tensioned by means of the insertion component 50 when the ureteral stent 20 is held on the insertion component 50.

[0044] By looking at Fig. 1 , Fig. 4 and Fig. 5 It is particularly clearly visible that the insertion component 50 comprises a recess 52 for inserting and holding the receiving body 40. The recess 52 serves as a receptacle for the receiving body 40. The insertion component 50 comprises two tube sections, namely a first tube section 60 and a second tube section 70, into which the flexible guide element 110 can be inserted, as in connection with Fig. 3c has already been described. The insertion component 50 further comprises a connecting region 80, which connects the tube sections 60, 70 to one another. The two tube sections 60, 70 and the connecting region 80 together delimit the recess 52, as can be seen in particular from Fig. 4 and Fig. 5 is recognizable.

[0045] The first tube section 60 is designed in the present case as the proximal end of the insertion component 50, into which - with the ureteral stent 20 held on the insertion component 50 (see Fig. 1 ) - a distal base body end 32 of the ureteral stent base body 30 facing the receiving body 40 is partially inserted. The guide element 110, which is guided through the insertion component 50, as well as through the receiving body 40 and through the ureteral stent base body 30, holds the partially inserted distal base body end 32 taut, in particular stretched, in an insertion position 34. In addition, the first tube section 60, into which the distal base body end 32 is inserted, can also contribute to keeping the distal base body end 32 taut. The first tube section 60 can therefore at least support the holding of the distal base body end 32 - with the ureteral stent 20 held on the insertion component 50 - in the insertion position 34. The distal base body end 32 is designed to move independently from the insertion position 34 into the basic position 36, which in Fig. 3e and particularly evident in Fig. 6 and Fig. 7can be seen, to deform the distal end of the base body 32 and thereby move independently out of the first tube section 60. In the basic position 36 of the distal end of the base body 32, the latter is relaxed compared to the insertion position 34. By looking at Fig. 2 , in which the insertion position 34 of the distal base body end 32 is particularly clearly visible, and Fig. 7 , which shows the basic position 36 of the distal base body end 32, it can be seen that the distal base body end 32 is rotated in its basic position 36 and in contrast to the insertion position 34 and thus has a greater radial extension than in the insertion position 34. The basic position 36 prevents the undesired slipping of the ureteral stent base body 30 and thus of the entire ureteral stent 20 within the urinary system.

[0046] The distal base body end 32 is designed to pull the receiving body 40 out of the recess 52 via the connecting element 22 when it moves (independently) out of the first tube section 60 and is deformed from the inserted position 34 into the basic position 36. For this purpose, the flexible guide element 110 can initially be pulled out at least from the first tube section 60 and thus from the first tube passage opening 62, whereby the distal base body end 32 deforms elastically and thus independently from the inserted position 34 into the basic position 36 and thereby moves independently out of the first tube section 60. During the deformation, the distal base body end 32 can be supported on the first tube section 60 and can pull the receiving body 40 out of the recess 52 via the connecting element 22.The distal base body end 32 is thus designed to pull the receiving body 40 out of the recess 52 via the connecting element 22 when it is removed from the first tube section 60 and by deforming from the insertion position 34 into the basic position 36.

[0047] In order to facilitate the withdrawal of the receiving body 40 from the recess 52, the connecting area 80 is between a Fig. 4 and Fig. 5 shown release position 84, in which the two pipe sections 60, 70 are tilted relative to each other by means of the connecting area 80 and thereby the recess 52 is partially widened to release the withdrawal of the receiving body 40, and a Fig. 1 in Fig. 2 shown holding position 86, in which the recess 52 for holding the receiving body 40 is narrowed compared to the release position 84, elastically deformable.

[0048] As long as the flexible guide element 110 (guide wire) is guided through the two tube passage openings 62, 72 of the respective tube sections 60, 70 of the insertion component 50 as well as through the base body passage opening 31 and the receiving body passage opening 42, the flexible guide element 110 prevents the elastic deformation of the connecting region 80 from its holding position 86 into its release position 84 and in particular keeps the connecting region 80 prestressed in the holding position 86. However, as soon as the flexible guide element 110 is completely pulled out at least from the base body through-opening 31 and the first pipe through-opening 62, the flexible guide element 110 no longer counteracts the elastic deformation of the connecting region 80 from its holding position 86 into its release position 84, whereby the connecting region 80 can independently deform elastically from the holding position 86 into the release position 84.Due to the resulting tilting of the two pipe sections 60, 70, the recess 52 is widened, as can be seen particularly clearly in . Fig. 4 and Fig. 5 is recognizable.

[0049] Thus, when the ureteral stent 20 is held by means of the insertion component 50 and when the guide element 110 is inserted into the tube sections 60, 70, the connecting region 80 is held pretensioned in the holding position 86 by means of the guide element 110, wherein the elastic deformation of the connecting region 80 from its holding position 86 into its release position 84 can be blocked by means of the inserted guide element 110, as long as the guide element 110 is inserted in particular into the first tube through-opening 62 of the first tube section 60 and into the main body through-opening 31 of the ureteral stent main body 30.

[0050] In summary, the insertion component 50 enables the movement of the ureteral stent 20 (i.e., the ureteral stent base body 30 and the receiving body 40, which is coupled to the ureteral stent base body 30 via the connecting element 22), the rotational movements D1, D2, as well as the translational movements along the different movement directions R1, R2 relative to the flexible guide element 110 (guide wire). Thus, positioning of the ureteral stent 20 is possible by pulling it forward and back, as well as by rotating the ureteral stent 20 during its insertion into the urinary system.

[0051] The insertion component 50, which can also be referred to as an insertion aid, serves to position the ureteral stent 20. The insertion component 50 requires no additional mechanism and, in particular, no special movements are required to detach the ureteral stent 20 from the insertion component 50 after it has been positioned. Due to the special design of the insertion component 50, it is sufficient to pull the flexible guide element 110 out of the ureteral stent 20 and out of the insertion component 50 in order to thereby detach the ureteral stent 20 from the insertion component 50.

[0052] The connection between the insertion component 50 (pusher) and the ureteral stent 20 can be released independently, in particular without any movement specifically intended for this purpose, when the flexible guide element 110 is pulled out.

[0053] The connection between the ureteral stent 20 and the insertion component 50 can be released in particular by a resilient movement of the distal base body end 32 from its insertion position 34 to its basic position 36 and by a further resilient movement of the connecting region 80 from its holding position 86 to its release position 84, wherein the connecting region 80 can be assigned to the proximal end of the insertion component 50.

[0054] When the flexible guide element 110 is inserted, the connecting region 80 initially undergoes a reversible change in shape, whereby the connecting region 80 is thereby tensioned and deformed from the release position 84 into the holding position 86. InIn the holding position 86, the receiving body 40 fits better in the recess 52 of the insertion component 50 than in the release position 84. The opposite deformation of the connecting region 80 from the holding position 86 back into the release position 84 can be achieved by pulling the flexible guide element 110 out at least from the base body through-opening 31 and the first tube through-opening 62. In the release position 84, compared to the holding position 86, the receiving body 40 can be removed more easily from the recess 52 (which is widened in the release position 84 of the connecting region 80). The distal base body end 32 also undergoes a reversible change in shape from the home position 36 to the insertion position 34 by inserting the flexible guide element 110 into the base body through-opening 31.The independent, opposite and thus reversible elastic deformation of the distal base body end 32 from the insertion position 34 into the home position 36 occurs by pulling the guide element 110 out at least from the base body through-opening 31. This reversible elastic deformation from the insertion position 34 into the home position 36 causes the receiving body 40 to be pulled out via the connecting element 22 using the distal base body end 32.

[0055] The Fig. 8a to 8c show schematic representations of various embodiments of the insertion component 50 of the application device 10. In Fig. 8a1 shows an insertion component 50 with a receiving body 40 inserted into the recess 52. It can be seen that the recess 52 has a bevel 88 in the end region facing the first tube section 60, such that a diameter of the recess 52 continuously increases outwards in the region of the bevel 88. The bevel 88 facilitates withdrawal of the receiving body 40 from the recess 52 by means of the distal end 32 of the ureteral main body 30 (not shown here). Furthermore, it can be seen that the connecting element 22 is thread-shaped and is arranged to extend through a corresponding opening in the receiving body 40.

[0056] In Fig. 8bA further embodiment of the insertion component 50 is shown with the receiving body 40 inserted into the recess 52. It can be seen that the first, proximal tube section 60 of the insertion component 50 has a constriction 92 in a proximal end region, wherein an inner diameter of the constriction 92 is smaller than an outer diameter of the distal end 32 of the ureteral stent base body 30 (not shown here). Furthermore, it can be seen that the proximal end of the proximal tube section 60 is funnel-shaped. Fig. 8c1 shows a further embodiment of the insertion component 50 with the receiving body 40 inserted into the recess 52. It can be seen that here the first, proximal tube section 60 of the insertion component 50 is tapered in a proximal end region, such that the inner diameter of the constriction 92 is smaller than the outer diameter of the distal end 32 of the ureteral stent base body 30 (not shown here). These configurations prevent the distal end 32 of the ureteral stent base body 30 from penetrating the insertion component, or from penetrating excessively, thus potentially leading to difficulties in detaching the distal end 32 from the insertion component 50.

[0057] The Fig. 9a and 9b show schematic representations of the insertion component 50 of the application device 10 according to the invention.

[0058] In Fig. 9a1 shows an insertion component 50 with a receiving body 40 inserted into the recess 52. It can be seen that, according to this exemplary embodiment, a tube 94 is arranged in the first, proximal tube section 60 of the insertion component 50, the tube 94 having a tube through-opening 96 whose diameter is approximately the same as or equal to a diameter of the through-opening 42 of the receiving body 40. In addition, the tube 94 has a bevel 88 at its distal end, which leads to an expansion of the diameter of the recess 52. The bevel 88 runs at a 45° angle over a length of approximately half the diameter of the tube 94. The proximal end of the tube 94 is funnel-shaped for receiving the distal end 32 of the ureteral main body 32.Furthermore, it can be seen that the proximal end region of the proximal tube section 60 has a notch 98 for inserting and holding the thread-like connecting element 22, in particular for receiving the two ends of the thread-like connecting element 22. The two ends of the thread-like connecting element 22 are fastened to the distal end 32 of the ureteral main body 32. The application device 10 according to this exemplary embodiment also has a mounting sleeve 90, wherein the mounting sleeve 90 is designed such that an inner diameter of the mounting sleeve 90 is equal to or greater than an outer diameter of the insertion component 50. The mounting sleeve 90 serves to fix the receiving body 40 in the recess 52 of the insertion component 50 before the guide element 110 (not shown here) is passed through the corresponding passage openings 72, 96, 42 of the insertion component 50, the tube 94 and the receiving body 40.The receiving body 40 can thus be securely held or fixed in the recess 52.

[0059] The Fig. 9b The embodiment of the insertion component 50 shown corresponds to that shown in Fig. 9a described and illustrated embodiment. In contrast to the previously described insertion component, the bevel 88 formed in the distal region of the tube 94 extends over the entire diameter of the tube 94. The bevel 88 in turn serves to expand the diameter of the recess 52 in the radial outward direction. Furthermore, it can be seen that in the Fig. 9a and 9b The proximal end of the illustrated introducer components 50 is also rounded. This configuration results in an advantageous atraumatic tip design of the introducer component 50.

Claims

1. An application device (10) with a ureteral stent (20), which includes a ureteral stent base body (30) and a receiving body (40) connected to the ureteral stent base body (30) by means of at least one connection element (22) of the ureteral stent (20), as well as with an introduction component (50) for retaining the ureteral stent (20) and for guiding the ureteral stent (20) through a ureter (HL) of a patient along a flexible guide element (110), wherein the ureteral stent (20) is displaceable along the flexible guide element (110) in movement directions (R1, R2) opposite to each other by means of the introduction component (50), and the introduction component (50) is formed to guide the ureteral stent base body (30) and the receiving body (40) in displacing in the respective movement directions (R1, R2), and the introduction component (50) includes a recess (52) for introducing and retaining the receiving body (40), wherein the introduction component (50) includes at least two pipe sections (60, 70), into which the flexible guide element (110) can be introduced, as well as at least one connection area (80) connecting the at least two pipe sections (60, 70) to each other, wherein the at least two pipe sections (60, 70) and the at least one connection area (80) delimit the recess (52), and a first pipe section (60) of the at least two pipe sections (60, 70) is formed as a proximal end of the introduction component (50), into which a distal base body end (32) of the ureteral stent base body (30) facing the receiving body (40) is introduced at least in certain areas at least with the ureteral stent (20) retained on the introduction component (50), characterized in that a tube (94) is arranged in the first, proximal pipe section (60) of the introduction component (50), wherein the tube (94) comprises a tube passage opening (96), the diameter of which decreases towards the receiving body (40) such that it is approximately equal to or equal to a diameter of a passage opening (42) of the receiving body (40), or the tube (94) comprises a tube passage opening (96), the diameter of which is approximately equal to or equal to a diameter of a passage opening (42) of the receiving body (40), and a proximal end area of the tube (94) is formed funnel-shaped for receiving the distal base body end (32), and / or a distal end area of the tube (94) comprises at least one slant (88) and / or at least one step, such that a diameter of the recess (52) increases in the area of the slant (88) or step.

2. The application device (10) according to claim 1, characterized in that the receiving body (40) has ferromagnetic characteristics.

3. The application device (10) according to claim 1 or 2, characterized in that the ureteral stent base body (30) is rotatable in relation to the flexible guide element (110) in common with the receiving body (40) based on the introduction component (50).

4. The application device (10) according to any one of the preceding claims, characterized in that the at least one connection element (22) is formed pliable or flexible.

5. The application device (10) according to any one of the preceding claims, characterized in that the at least one connection element (22) is tensioned by means of the introduction component (50) with the ureteral stent (20) retained on the introduction component (50).

6. The application device (10) according to claim 4 or 5, characterized in that the at least one connection element (22) is formed as a thread element or as a wire element.

7. The application device (10) according to claim 1, characterized in that the distal base body end (32) introduced at least in certain areas can be retained on the first pipe section in an introduction position by means of the guide element (110) with the ureteral stent (20) retained on the introduction component (50), wherein the distal base body end (32) is formed to autonomously deform from the introduction position (34) into a basic position (36) of the distal base body end (32) with the guide element (110) detached from the ureteral stent base body (30) and to thereby move out of the first pipe section (60).

8. The application device (10) according to any one of claims 1 or 7, characterized in that the distal base body end (32) is formed, upon movement thereof out of the first pipe section (60) and by the deformation from the introduction position (34) into the basic position (36), to extract the receiving body (40) out of the recess (52) via the at least one connection element (22).

9. The application device (10) according to any one of claims 1 or 7 to 8, characterized in that the first, proximal pipe section (60) of the introduction component (50) comprises a constriction (92) in a proximal end area, wherein an internal diameter of the constriction (92) is smaller than an external diameter of the distal end (32) of the ureteral stent base body (30), or that the first, proximal pipe section (60) of the introduction component (50) is formed tapering in a proximal end area such that the internal diameter of the constriction (92) is smaller than the external diameter of the distal end (32) of the ureteral stent base body (30).

10. The application device (10) according to any one of claims 1 or 7 to 9, characterized in that the first, proximal pipe section (60) of the introduction component (50) comprises a first pipe passage opening (62), the diameter of which decreases towards the receiving body (40), such that it is approximately equal to or equal to a diameter of a passage opening (42) of the receiving body (40).

11. The application device (10) according to claim 1, characterized in that the recess (52) comprises at least one slant (88) and / or at least one step in the end area facing the first pipe section (60), such that a diameter of the recess (52) increases in the area of the slant (88) or step.

12. The application device (10) according to any one of claims 1 or 7 to 11, characterized in that at least one notch (98) or peripheral recess for receiving and guiding the connection element (22) is formed in a proximal end area of the first, proximal pipe section (60) of the introduction component (50).

13. The application device (10) according to any one of claims 1 or 7 to 12, characterized in that the at least one connection area (80) is deformable between a release position (84), in which the at least two pipe sections (60, 70) are tilted in relation to each other by means of the at least one connection area (80) and thereby the recess (52) is expanded at least in certain areas for releasing the receiving body (40), and a retaining position (86), in which the recess (52) is constricted compared to the release position (84) for retaining the receiving body (40).

14. The application device (10) according to claim 13, characterized in that the at least one connection area (80) can be retained in the retaining position (86) based on the guide element (110) with the ureteral stent (20) retained by means of the introduction component (50) as well as with the guide element (110) introduced into the at least two pipe sections (60, 70), wherein an elastic deformation of the at least one connection area (80) from the retaining position (86) thereof into the release position (84) thereof can be blocked by means of the introduced guide element (110).

15. The application device (10) according to any one of the preceding claims, characterized in that the connection element (22) is at least partially guided on an outer surface of the proximal end of the introduction component (50) with the ureteral stent (20) retained on the introduction component (50); or characterized in that the application device (10) includes a mounting sleeve (90), wherein the mounting sleeve (90) is formed such that an internal diameter of the mounting sleeve (90) is equal to or larger than an external diameter of the introduction component (50).

16. An introduction component (50) for an application device (10) according to any one of claims 1 to 15.

17. An application apparatus (100), which includes an application device (10) according to any one of claims 1 to 15 as well as a flexible guide element (110), on which the ureteral stent (20) as well as the introduction component (50) are received.