Single stroke dispensing method

PATENT DESCRIPTION

Additional patent to patent No. - Filed: 09.03.74 (P. 169399)

Priority; 31.01.74 United States of America

The application was announced: 01.04.75

Patent description published: 17.04.1979

Int. Cl.² A61M 31/00 A61M 25/00

DO AND FLAW?

Ur-ędu Pałówerteweęo

Creator of the invention Patent holder: Population Research Incorporated, Minneapolis (USA) «

The method of introducing the substance into the fallopian tube and the device for introducing the substance into the fallopian tube and

The subject of the invention is a method of introducing substances into the fallopian tube channels, especially for the purpose. sterilization, in which this substance is first placed in the uterine cavity. The invention also relates to a device for introducing substances into the fallopian tubes.

Bilateral cut of the fallopian tubes is a common surgery to sterilize a woman. This plollega procedure involves cutting 4 fallopian tubes ligation. For periodic sterilization of the woman, mid-device devices such as inserts and wires are used. These measures also include inserts that are inserted into the fallopian tube canals to prevent the egg from descending into the uterus through the canal. Such inserts may, however, be moved or fall out without the knowledge of a woman. There is therefore no certainty as to the effectiveness of such devices.

It is also known to place inserts on the wall of the uterus for transient sterilization, and more specifically to prevent the descent of eggs from the fallopian tubes into the uterus and the entry of sperm from the uterine cavity into the fallopian tubes. Contraceptives of this kind are not completely effective because it is possible for the egg to bypass the uterus and enter the uterus.

They are also known for example from the publication Corf-. man et al., "Obfetetrics and Gynecology", vol. 2,7, no. pp. 88101-883, June 11976, useful tests, especially for the purpose of temporary sterilization, introduction of materials directly into the fallopian tubes with the help of elongated syringes inserted inside the cervix, and filled with a predetermined amount of substance getting to their anterior tip by pulling back of the syringe plunger. A rubber ball rested against the isthmus of the uterus is used to allow the front tip of the syringe to be pushed into the corner and attached to it before the substance is injected through the syringe plunger into the appropriate fallopian tube.

(According to another similar procedure known from U.S. Patent No. 2,407,8512 and U.S. Patent No. 3,809,967. North, fallopian tubes are clogged by inserting the tip of the flexible extension of the mixing syringe into the uterine cavity through the vagina and cervix, and placing it blindly, or under the X-ray apparatus, opposite the uterine tip of one of the fallopian tubes and then injecting into the fallopian tube of a liquid mixture of elastomer with catalyst causing it to harden with this flexible extension and by activating the syringe. With such direct injection of material into the fallopian tube, the success of the procedure depends largely on how the device tip is positioned opposite the uterine tip of the fallopian tube.

Due to the wide range of sizes and shapes of uterine cavities encountered in practice, the probability of successful recognition when the instrument tip has taken exactly the desired position is small even if the procedure is performed under an X-ray apparatus. The number of successful treatments is not satisfactory. The use of this method, due to the difficulty of pointing the device to the end of the fallopian tube, requires carefully trained personnel. This method is time consuming, because the cumbersome procedure of positioning the tip of the device opposite the end of the fallopian tube must be carried out for each fallopian tube separately, i.e. twice. During the whole procedure, the patient is exposed to X-rays, which is not desirable due to the speed of their operation.

iZne is finally known from the Rakshit publication "Calcutta Med. J. ", 65, no. 3 *, March 1968, as well as from the publication "Humań Sterilizatiom", published by Ralph Rechart, 1971, pp. 213 to 2żli, introduction of certain amounts of the substance intended to block the fallopian tubes simply into the uterine cavity by means of a needle and syringe in the hope that a sufficient amount of the substance itself enters the fallopian tubes. The uterine cavity is then emptied. In a large percentage of patients, the fallopian tubes do not become blocked or become blocked.

It is also known from the publication of Hefnawi et al., "Amer. J. Obst. and Gynecology ”, vol. 99, No. 3, pp. 421 to 4217, direct injection of elastomeric substances into the fallopian tubes, exposed by abdominal incision, to block them. This type of procedure requires major surgery with all its side effects and the dangers it brings.

(In addition, catheters are known, according to German Patent Nos. 161649) 2 and 161649 (3, for introducing plastics into the body cavities for the purpose of forming an elastic formation corresponding to the shape of the body cavity, intended for diagnostic purposes. The catheter tube is equipped with an expandable bag, which after introducing the catheter into the body cavity is expanded to such an extent that the material injected into the body cavity cannot squeeze through it and that the fcater cannot accidentally slide out of it. Similarly, the tube, known from the advertisement description of Germany No. 1Γ769 902, is equipped with an expanding fastening bar and acting as a bar catheter, introduced into the body of the body *, which, sticking to the wall of the body cavity in the range of the hole leading to it, protects the tube against accidental slipping out her.

Also known is a pistol for introducing substances, especially liquid medicines, according to German Patent No. 2 0372 (1 (1, containing a reservoir for receiving said sulhstameja, whose bottom, side walls and main part with a borehole are displaced relative to each other, similar to is in the piston-cylinder system, and in addition the handle and actuating lever, pivotably mounted in this handle and causing the extrusion of a certain amount of substance by causing a relative movement between the bottom of the tank and its side wall, the tank dino being connected to the handle and the main part of the tank being moved relative to the bottom of the tank by means of an actuating lever. The connecting member, placed between the bottom of the tank and the handle, has a knife edge that cuts the side wall of the main part of the tank during its movement.

An injection catheter is also known, according to German Patent No. 1 4916124, which has an external catheter tube and an internal batter tube disposed therein, with a needle attached to the front end of the inner catheter tube that pierces the diaphragm closing the front end of the external catheter tube exerting infiltration on the rear end of the inner catheter tube.

The purpose of the invention is to develop a method and apparatus enabling particularly simple, fast and reliable introduction of a certain amount of substance into both fallopian tube channels at the same time, regardless of the shape and size of the uterus occurring in individual. cases. This object according to the invention is achieved by the fact that the substance is pumped from the uterine cavity to the canals of the fallopian tubes by means of an expanded balloon introduced into the uterine cavity_xmonths.

The method of introducing substances into the fallopian tubes, through the uterine cavity, especially for sterilization, in which the substance is placed in the uterine cavity, according to the invention, is characterized by the substance being pumped from the uterine cavity to the fallopian tubes through a tensioned balloon introduced into Maicica cavity.

Preferably, the uterine cavity is practically completely filled with an expanded balloon, while the pressure of the expanded balloon can be maintained against the inner wall of the uterus.

The expanded balloon is introduced into the uterus through a hole in the neck of the maicica, then the balloon is partially expanded, keeping it firmly pressed against the inner wall of the uterine cavity within the opening in the cervix, with the substance injected into the space between the partially expanded balloon and the uterus, then the balloon expands completely.

Partial expansion of the balloon, injection of the substance and full expansion of the balloon are carried out in iodine work stroke.

Preferably, the sound pressure of the balloon used to expand the balloon is limited.

The device for introducing substances into the fallopian tube canals through the uterine cavity, containing a dosing device, equipped with a part discharged into the uterus and intended for introducing the substance into the uterine cavity, according to the invention is characterized in that the part introduced into the uterus is equipped with an expandable balloon with the help of a relaxing device to displace the uterine cavity into the fallopian tubes.

The expansion device is coupled to the supply device, so that the introduction of the substance into the mud is followed by partial expansion of the balloon, and the extrusion of the substance from the uterine cavity into the jiajod canal can occur as a result of further expansion of the bailon, acting as a pressure pump.

The balloon can be expanded to. practically completely filling the uterine cavity.

The dispensing device includes a sequential control device connected to the expansion device and the feeding device to allow for partial automatic expansion of the balloon, introduction of substances into the uterine cavity and further expansion of the balloon.

The control device is equipped with technical means for shrinking the balloon after extruding sulbstanstan from the uterine cavity into the fallopian tubes.

The sequential control device is equipped with a single, continuously movable actuator.

The expansion device has a pressure system that allows the fluid to be delivered under a predetermined pressure to the expanded balloon.

The pressure system has a pressure limiter limiting the pressure in the balloon under pressure to the level of a predetermined maximum pressure. With the help of a pressure limiter, the maximum pressure in the balloon, and the same and the filling of the uterine cavity with a balloon are fixed in such a way that the substance is injected into the fallopian tube channels, and not forced through them.

The pressure system is equipped with a control unit that maintains a substantially constant pressure in the expanding balloon.

The expansion device includes a reservoir for supplying the balloon with fluid intended for its expansion and an actuation device for forcing fluid from the reservoir to the balloon to expand the balloon in the uterine cavity.

The dispensing device has a tubular catheter extending in the longitudinal direction, which is provided with a through hole passing through the catheter and terminated at one end with an outlet opening leading into the interior of the uterine cavity.

The device according to the invention is equipped with a housing comprising a first and a second chamber, in which a reservoir with a fluid supply and a substance supply reservoir is located. They are connected respectively with a through hole for fluid and a through hole for substances, which reach up to the part entering the uterine cavity. The through-hole for the substance is connected to the hole in the needle intended to pierce the tank to supply the substance.

A first drive device is connected to the actuator which, depending on the position of the actuator, is connected; fluid under pressure into a balloon to fill the uterine cavity.

The first power unit is equipped with a locking device; which locks the power unit in the event of a predetermined pressure in the balloon.

The device housing has a plurality of teeth facing the first drive assembly engaging with the locking device in the event of a predetermined pressure.

The locking device comprises a body provided with a protrusion and a spring for introducing a protrusion between adjacent teeth in the event of a predetermined pressure.

The actuator is coupled to a second drive assembly introducing the substance into the uterine cavity when the actuator is displaced.

The apparatus according to the invention has a first and a second toothed driving arrangement coupling the first or second drive assembly to the actuating device.

[Preferably, the device has a second reservoir for feeding a second substance and a mixing device for mixing both of these substances prior to their introduction into the uterine cavity. The mixing device has the form of a mixing head, adjacent to the front of the balloon and provided with channels for receiving, mixing these substances and introducing the mixture into the uterine cavity.

i On the front of the catheter there is a head for separating and introducing the substance into the uterine cavity.

The dispensing system is equipped with a bumper with the help of which the part introduced into the uterine cavity is kept at a distance from the bottom of the madrid.

Preferably, the head has an extended bumper in contact with the uterus cavity that maintains the exit holes at a distance from the bottom of the uterus. .

The balloon has a tubular shape and is made of flexible smooth material with low surface tension and with substantially the same ability to expand.

The balloon is made of a material with sufficient flexibility to allow it to take the shape of a uterus cavity. Preferably the balloon is made of latex rubber or soft and flexible plastic.

In contrast to known methods in which the substance is introduced into the uterine cavity and left to run, or attempted to inject the substance directly into the fallopian tubes by means of a device inserted into and directed to the uterus, in the solution according to the invention the amount of substance introduced into the uterus cavity into the fallopian tubes by expanding the balloon coating, which acts on the substance like a pressure pump. Thanks to the tern, it is not necessary to point the device precisely in the uterine cavity and make sure that the substance is actually pumped into the fallopian tubes. In this case, the expanded balloon is used not only, as is known, to seal the uterine cavity or vaginal tract, and also to secure the position of the device, but it is also an active element forfashed for forcing, in a forced way, substances from the uterine cavity into both fallopian tubes at the same time. Due to the insensitivity of the device to changes in position, its orientation in the uterine cavity does not have to be supervised under the X-ray apparatus. *

Preferably, the uterine cavity is virtually completely filled with an expanded balloon while maintaining firm pressure of the expanded balloon against the inner wall of the uterus. Thanks to this, the possibility of leaving residues of substances in the uterine cavity is largely excluded. In addition, you can easily dose the amount of substance introduced into the oviducts.,

Preferably, the balloon is expanded into the uterine cavity through the opening in the cervix, after which the balloon partially expands, maintaining its firm pressure against the inner wall of the uterus in the area of ​​the opening in the cervix, whereby the substance is injected into the space between the partially expanded balloon and at the bottom of the uterus, and then this balloon completely expands. The substance contacts the maCicy wall only to a small extent.

In order to enable particularly rapid introduction of substances into the fallopian tubes and to minimize the residence time of the substance in the uterine cavity, partial balloon expansion, dosing of the substance and full expansion of baloUU are carried out in one working stroke.

© any fluid used, such as water or air, is used to inflate the balloon. Any chemical or pharmaceutical preparations, ftp, are used as the substance discharged into the fallopian tubes. tissue glue. Liquid tissue glue reacts with mucus of the fallopian tissue, which causes the adhesive to harden and block the fallopian tubes. Preparations causing necrosis of the tissue lining the fallopian tubes are also used. This tftfcśtaije tissue is replaced by scar tissue that closes the fallopian tubes. Such a substance may also be a preparation that facilitates the migration of eggs and "Sperm through the fallopian tubes. You can use substances that widen or open the fallopian tube channels, making pregnancy easier.

The subject of the invention is shown in the embodiments aa of the drawing, in which fig. 1 shows the device for introducing substances into the fallopian tube ducts, in cross section, located in the uterine chamber, fig. 2 - the device in the longitudinal section, fig. 3 - the feeding device in fig. 2 in section along line 84 - 34, Fig. 4 - the device according to the invention with a partially expanded balloon filling the uterine chamber, Fig. 5 - the device according to Fig. 4 with a fully expanded balloon and filling the uterine chamber, Fig. 6 is a second embodiment of the device according to the invention, and Fig. 7 is an enlarged and sectional view of the fragment of the device of Fig. 6, Fig. 1 is a diagram of the female reproductive organ 421. The dispensing device 420 is placed in the reproductive organ to introduce substances such as a pharmaceutical, binding agent or other into the fallopian tubes. The binding agent used is a pressure gauge, isobutio-2-lycanoacrylate, silver nitrate or quinalkrine derivatives. The cyanakryilain pressure gauge is a plastic liquid that hardens or polymerises on contact with a moist agent, thus causing clogging of the fallopian tubes. As a pharmaceutical, any agent that causes periodic blockage or plugging of the fallopian tubes is also used. After a certain period of time, the fallopian tubes become patent again and continue to function.

The reproductive organ consists of an elongated vagina 427 defined by a cylindrical vaginal wall 426. The vagina terminates in the 428 vestibule. The opposite end of the vagina is connected to the pear-shaped 422 uterus with thick flattened walls. The uterus has an inner chamber 439, flattened and triangular. The dimensions of the uterine chamber vary depending on the anatomical features of the woman. The upper prominent part of the uterus, called the bottom of the uterus 436, is connected to the uterus 438. The lower part of the shaft goes into the neck 429, which separates the uterine chamber from the vagina.

On both sides of the uterus are the fallopian tubes 423 and 424 muscled in the shape of trumpets and extending from the upper lateral corners of the uterus to the ovaries not shown. The ovaries are small, irregularly shaped organs located on both sides of the uterus, at the back and below the fallopian tubes.

The fallopian tubes contain 433 and 434 fallopian channels and have a muscular structure and are approximately 12 cm long. The fallopian tubes are divided into a forest, a transition section, and a banking section. The channels allow the egg to pass from the ovary to the uterus chamber. The transitional segment of the fallopian tube is connected to the wall of the uterus in a direct way and shows a slight expansion when connecting to the uterine chamber. The channels are the largest part of the transition section. The walls of the fallopian tubes consist of the serous layer, the muscular layer and the mucous layer. The muscular layer consists of elongated smooth fibers that, during contraction, bring the ends of the fallopian tubes closer to the surface of the ovaries. Numerous blood vessels contained in the muscular layer together with a bunch of muscles form swelling tissue, which after swelling increases the movement of the fallopian tube on the surface of the ovaries. The filling of the fallopian tubes with the pharmaceutical substance of the invention does not inhibit tissue swelling or fallopian tube movements.

The substance dispensing device comprises a tubular catheter 441 of such a length that when the device is placed in the uterus chamber 432, the catheter protrudes slightly from the vagina. The catheter 441 is hollow inside its entire length. The expanded balloon 444 is located at the upper or outer end of the cafeteria. 441. The balloon 444 is a flexible and expandable element. A connector 446, such as a flange or thread, connects the top of the barrel 444 to the catheter 441. A similar connector is attached to the opposite end of the balloon 444, connecting this end to the catheter 441. Kaiteter 441 has several holes 448 allowing flow between the channel 442 and the chamber 449 inside ⁵balloon 444 *

The 444 balloon is a thin tubular element made of a smooth, flexible and flexible material, such as rubber or plastic material, which expands at minimal pressure, advantageous ¹⁰e.g. thin latex rubber with low surface pressure. The low surface pressure allows uniform expansion of the element using relatively low pressure. The material from which the balloon 444 is made; two is expanded to deform the uterus chamber 432, retaining the shape 437, 438. After complete deformation of the uterus chamber 432 with the help of an expanded balloon 444, the balloon 444 evenly adheres to its surface²⁰inner membrane 439.

The upper or outer end of the catheter 441 is closed by means of a head 451 having two ophthalmologic outlet nozzles 452. The elongated tube 453 is connected to the head 451. The tube 453 is longer than the catheter 441 and contains outlet 454 through which the substance flows out 452 outlet apertures, separating the substance in two opposite directions to the upper zone of the uterine chamber 432. Head 451 contains ³⁰bumper 456, the upper surface of which touches the inner wall of the bottom of the uterus. The bumper 456 separates the exit holes 452 from the inner wall of the bottom of the uterus 436.

Figure 2 shows a dispensing device 426 in the shape of an elongated body 457 connected to the end of the catheter 441. Body 457 includes a first chamber 458 in which an elongated cylindrical tank 459 'is provided, provided with a neck 461 facing forward and connected to a through tube. 462. flight 462 incl. ⁴⁰a channel connected to the channel 442 of the catheter 441 thus allowing fluid flow from the reservoir 459 through channel 442 to the chamber 449 of the expandable balloon, thereby enabling its expansion. The other end of tank 459 is⁴⁵closed by a piston 463 holding the fluid in chamber 464.

The reservoir 459 includes an opening 466 located directly in front of the piston 463 to allow sterilant to flow into the chamber 464. ⁵⁰ Near the piston 463 there is a drive assembly 467 actuating the piston 463 inside the tank 459. The drive assembly 466 is connected to the piston 468 located near the body 457. ⁱⁿ

The body 457 includes a second chamber 469 adjacent to the chamber 458. A passage tube 471 is mounted in the body 457 and connects the ruin 453 to the chamber 469. Tube 471 is terminated with an elongated needle 472 inserted into chamber 469. On ⁶⁰opposite the end of the tube 471, a plug 473 is mounted closing the end of the catheter 441 and connecting the tube 453 "which precedes the head 451. The chamber 469 has an elongated shape and is open to the upper part of the body 457, as shown in Fig. 1. Cylindrical tank 474 is located in chamber 469 at needle extension 472. The front end of Tank 474 includes a pierced pole 476 located on the needle extension 472 * The open end of tank 474 includes a movable piston 477 for sucking in substance 478 into tank 474.

The second drive unit 479 is connected to Tank 474 and piston 468. Piston 468 is intended for introducing substances into the fallopian tubes with one stroke. The rear body portion 457 includes outer and opposed positioned flanges 481 and 482 serving as handles when actuating piston 468. Piston 468 includes an opening 483 for placing pin 483A bringing piston 468 into a working position. The 483A pin prevents unintentional starting of the device. The drive assembly 467 is a mechanism that transmits pressure to actuate piston 463 in reservoir 459 and transmits fluid pressure to balloon 444 and causes it to expand. The drive assembly 467 includes a size cylinder. extensible 484 sliding on which the body 486 is located. The opposite end of the cylinder 484 is connected to the head 487 including a central bore 488 allowing access to the cylinder 484.

The outer end of piston 483 includes a cone 489 for accommodating the conical end of the head 487. The bore 488 is located in the extension of the screw 491 screwed into the body 486. The position of the screw 491 relative to the body 486 is changed by using a tool such as a lead screw extending along the 488 bore. Two springs 492 and 493 move cylinder 484 and body 486 in opposite directions, as a result of which the first drive assembly 467 is deflected in its elongated position. Spring. 492 rests against head 487. Spring 493 is opus on screw 491. Appropriate positioning of screw 491 regulates tension on spring 493, which deflects head 467 and body 486 in opposite directions. Screw 491 allows fine adjustment of spring tension 493 depending on spring changes and enables fluid pressure in chamber 449 to be adjusted. Washer 494 containing a central hole for needle tip u * is located between springs 492 and 493. The spring 492 is weaker than the spring 493. The weaker spring 492 presses the pin with a small force ^ here 0.14 — ± 21 kg / cm², as a result of which the washer 494 rests on the head 487, thereby providing the court with partial expansion of the balloon 444, at a predetermined maximum pressure. The maximum pressure fest determined by the pressure specific to the 493 spring allows the device to be used with various shapes and sizes of the uterus, as the 493 spring is adjusted depending on the anatomical differences of the uterus.

Expandable cylinder 484 and body 486 are connected to a pin 496 extending along an elongated groove 497 in the expansion cylinder 484. Groove 497 allows the 484 extension cylinder to move relative to body 486, as springs 492 and 494 are pressed

The pin 509 is pushed outwards through the spring 512, at the base of the opening 508. Cylinder 484 has an opening 513 located in front of the projection 510. With spring pressure 492 and 493, the body 486 shifted is positioned relative to the element 484 until the projection 510 is opposite the opening 513 and then the spring 512 compresses. * protrusion 510 through hole 513 lead it to meshing with one of the teeth 511, thus blocking the propulsion unit forward movement and limiting the pressure in balloon 444.

/ Second drive unit 479 moves tank 474 towards needle 472 and pushes piston 477 into tank, thus allowing substance 478 to flow through needle 472 into tube 453. Substance flows through tube 453 to head 451 and is introduced in two opposite directions, to the upper part of the uterine chamber 432. Figure 2 shows a second drive assembly 479 in the form of an elongated sliding-plunger piston 514 along the opening 515 in the body 457. Piston 514 includes a front portion 516 adapted to connect to piston 477. The opposite end of the piston 514 includes a transverse channel 517, in which channel 517 there is a ruichome element 518 comprising a semicircular recess 519 on the side of the actuator 468. The opposite end of the drive member 518. slides along the side wall of the chamber 457 forming part of the passage 515 / holding the element 518, so that it remains connected to the actuator 468 as long as it is opposite the recess 521. The drive member 518 is then pressed against the recess 521, as a result of which actuator 468 continues to move forward and piston 514 remains on its interface.

The metering device 420 is connected to a reservoir located in the chamber 469. The actuator 468 is locked in a fixed position by a bolt 483A passing through the opening 483. The bolt 483A is connected to the end of the body 457 thus enabling the actuator to move inside the body.

The expanded balloon 444 is introduced into the vagina 427 and through the cervix 431 into the uterus chamber 432, as shown in Figure 1.

The expanded balloon 444 remains contracted, allowing it to enter the uterine chamber. The catheter 441 is inserted into the uterine chamber until the head 451 contacts the bottom of the uterus 436.

It is known that the uteri have different sizes, shapes and positions, so that the swellable balloon can be positioned asymmetrically * relative to the oviducts 423 and 424. FIG. 1 shows the spring-loaded balloon 444 occupying the central position in the uterus chamber 432. In some cases, this element may take position inclined by a certain angle, close to the side wall in the uterine chamber. The 420 dispensing device allows the substance to be effectively introduced into both fallopian tubes, regardless of the location of the swellable balloon in the uterus chamber 432.

After removing the bolt 483A from the opening 483, the piston 468 can be moved in the chamber 457 to expand the balloon 444 and introduce the substance into the mafoica chamber 432, after which the balloon 444 is fully expanded and the substance is forced into the fallopian tubes. Flanges 481, 482 are used as support for the fingers of the hand, so that pressure on the actuator 468 can be applied.

Figure 4Γ shows the actuator 468 shifted within the body 457 by a small distance enabling the piston 463 to move within the reservoir 459, thereby expanding the balloon 444, so that it seals the bottom of the uterus chamber 432 tightly. The balloon 444 is then widened so that it adheres tightly to the inner wall of membrane 439. Pinion system 501 connects actuator 468 to first drive assembly 467 to transfer movement of actuator 468 to first drive assembly 467, as a result of which piston 463 is moved inside chamber 464. Element ^ 518 connects piston 514 to actuator 468 so that front portion 516 of the actuator introduces piston 477 into tank 474, moving the entire tank forward. Needle 472 pierces washer 476 and is introduced into the reservoir containing substance 478. Locking system 501 is opposite the recess 506 in body 457, thus enabling the driving system 501 to move to the right as shown in Figure 4, resulting in remote from actuator 468. As a result of further operation, device 468 presses piston 514 moving piston 477-to tank 474. The pharmaceutical substance 478 is forced through tubes 471 and 453 into the head 451 and inserted in two opposite directions through the channel 452 into the upper part of the uterus chamber 432.

Fig. 5 shows device 468 after further displacement, as a result of which projection 591 is connected to the rear of the body 486. During this time, the driving arrangement 591 passes from Recess 596 to recess 593. Device 468 moves in the body 457 increasing the pressure in chamber 464. , which causes the balloon 444 to expand further. The expanded balloon 444 pushes the pharmaceutical substance from the upper part of the uterine chamber into the fallopian tubes. Balloon 444 is expanded until it is reached_spressure about 0.57 at. A different pressure may also be used depending on the characteristics of the springs 492, 493 and the adjustment of the bolt 491. The spring pressure causes the sleeve body 484 to move until the projection 519 is opposite the opening 513, with the spring 512 pressing the projection 519 through the opening 513 to the space between the two teeth 511 that the projection engages in thereby preventing further movement of the device 468 in the body 457. After locking device 468 with locking device 507, the pressure in chamber 449 is limited to the minimum prescribed clearance from spring characteristics 492 and 493.

Moving device 468 from the position shown in Fig. 4 to the position of Fig. 5, above 100247

14 results in displacement of the post-scraper system element 518 from recess 519 to recess 521 thereby stopping the movement of the piston 514 introducing the pharmaceutical substance into the uterine chamber 432. Further movement of the device 488 causes an increase in pressure in the chamber 449, thereby pushing the pharmaceutical substance out of the uterus chamber 432 to fallopian tubes. 'Substance ejection will be stopped when the balloon 444 is fully expanded, as shown in Figure 5. The substance poise in the fallopian tubes because the pressure exerted is not so high as to cause it to flow to other parts of the body.

The device 468 is then removed from the chamber 457 and the element 591 of the gravel system is located in the recess 583 and connects the body 586 to the piston 468. The projection 510 of the bolt 507 is displaced with teeth 511, as a result of which the piston 463 is withdrawn from the chamber 464. Glare in the chamber shrinks and fluid flows back from chamber 449 to chamber 464, and the balloon 444 returns to its contracted position. This minimizes the removal of the device from the patient's uterus.

By the use of Cyanofilignate Binding agents, channels 433, 434 are permanently closed. Binding agents, such as cyanoacrylates, cause the formation of fibers which, after some time, close channels 433 and 434. Binding agents are polymerized under the influence of an environment containing hydroxyl ions, such as water: Cells adjacent to the binding agent are damaged and are eventually replaced with tissue fibrous. Other binders polymerize under the influence of body temperature or other factors:

In the method according to the invention, the expanded element is first placed in the uterine chamber as illustrated in Fig. 11. The device 468 is then activated in chamber 457. The first drive system 467 and the second 479¹ they in turn cause the balloon 444 to expand, which fills the lower part of the uterine chamber and closes it tightly. The piston 514 presses the piston 477 "which feeds the reservoir onto the needle 472 and pushes the substance 478 out of the reservoir in two opposite directions into the uterine chamber, over the partially expanded balloon 444, as shown in Fig. 4. Further movement of the device 468 extends the balloon 444 completely, then fills the ventricular chamber 432. The 468 device moves until the bolt 507 locks into one of the teeth 511, which stops the balloon 444 from expanding. The balloon 444 is subjected to a predetermined maximum pressure to avoid excessive pressure on the uterine wall. Balloon expansion 444 pushes the substance into the 433 and 434 fallopian tubes. Retracting the device 468 from the body 457 causes a decrease in pressure in the balloon 444, which returns to its original position, after which the device can be removed from the uterine chamber and vagina.

Figs. 6 and 7 show inins an embodiment of the 420A metallurgy device inserted into the female reproductive organ, similar to the Mg device. 1 to 5, whereby the relevant elements have the same designations with the addition of the letter A.

The 420A dosing device introduces a mixed binary pharmaceutical substance ⁵ at the end of the catheter to the upper part of the uterus chamber 432A, and after expanding the balloon 444A further into the fallopian tubes. '

Head 651 mounted on catheter 441A includes transverse channels with outlet holes¹⁰ mi 652 directing the pharmaceutical substance in both directions of the upper part of the uterine chamber 432A. Rulriki 653 and 654 are combined with head 651, in which there is a kamora 655 connected to channel 652. Substance supplied through pipes 653 and 654¹⁵ is mixed in chamber 655 and then discharged in two directions 652.

Chamber 457A includes two chambers 656 located next to chamber 458A, in which there is a reservoir 657 containing center 660. Piston 661 is ²⁰ slidly mounted in Żagiomilek 657, and piston 662 in tank 659.

Piston 514A of the second drive system 479A includes a forked end formed by pins 663 and 664. Pin 663 is mounted in tank 657 and actuates piston 661, and pin 664 located in tank 659 actuates piston 662. Tubes 653, 654 are terminated with needles 666 and 667 set in extension of tank ends 657 and 659.

⁵⁰ After starting a single 468A device. the 647 A system initially expands the 444 A balloon, which seals the bottom of the 432A uterus chamber tightly. Further movement of the 468A device, activates the second system 479A moving the pins 663, 664. Piston 514Λ³⁵ moves forward and feeds tanks 657 and 658 to needles 666 and 667, respectively. Pins 663, 664 connected to pistons 661, 662 push the same amount of substance through the tube 654, 653 into mixing chamber 655, resulting in a mixture of⁴⁰ wlera * about 5-0% of each substance. The 668 mixture is introduced into the upper part of the mosquito uterus with two streams of approximately equal quantity until the piston 514A comes to a stop. Further flies of the 468A device⁴⁵ causes balloon 444A to expand. which pushes the substance into the fallopian tubes.

Substances 658 and 660 are substances that, when mixed, harden to form a semi-rigid plastic material. This mixtureⁱⁿ It may be susceptible to humidity or body temperature that causes hardening. The reaction of this mixture occurs only after a certain period of time has elapsed so that it can be introduced into the fallopian tubes before stwardnde⁵⁵ tangible measure. Two-component substances may consist of two parts of epoxy compounds, two parts of a prisoner agent, RTF sffillkom or a polymer constituting the product known under the trade name Dow Corning Silaśtic 382 Me⁶⁰ dical Elastome and 'Medioai Fluid. Other types of miscible and curing agents may also be used. In addition, the ratio of both components can be changed by increasing the size of one of the tanks. For example, you can mix two parts of the first agent with one part of the second.

by using tanks of the right size in body 457A.

As an introduced substance, an agent that promotes the flow of eggs, or sperm in the fallopian tubes and uterus can be used. Such a substance may also contain a substance that facilitates the extension of the fallopian tubes to facilitate fertilization. Many chemical agents used to treat fallopian tubes to facilitate fertilization are known. *