BR202020024105U2 - Constructive arrangement applied in fiber optic control device - Google Patents
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00112—Connection or coupling means
- A61B1/00117—Optical cables in or with an endoscope
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00163—Optical arrangements
- A61B1/00165—Optical arrangements with light-conductive means, e.g. fibre optics
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00404—Blood vessels other than those in or around the heart
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/0091—Handpieces of the surgical instrument or device
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B2018/2255—Optical elements at the distal end of probe tips
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Abstract
O seguinte resumo para modelo de utilidade se refere ao desenvolvimento de um dispositivo de controle da fibra ótica, combinado ao sistema de proteção anticontaminação em pregado no tratamento de endolaser para varizes, para tracionamento de fibra ótica em técnica de ablação térmica, que compreende o dispositivo propriamente dito (1), que recebe dois anéis de fixação (2 e 2a) da capa plástica (4), onde dita capa (4) fica acondicionada dentro de uma cápsula de contenção (5) que funciona como um dispensador da capa plástica (4), sendo que esta cápsula (5) é presa no dispositivo propriamente dito (1) por intermédio de uma bucha de fixação (3).
Description
[001] O seguinte relatório descritivo para modelo de utilidade se refere ao desenvolvimento de um dispositivo de controle da fibra ótica, combinado ao sistema de proteção anticontaminação em pregado no tratamento de endolaser para varizes, para tracionamento de fibra ótica em técnica de ablação térmica.[001] The following descriptive report for a utility model refers to the development of an optical fiber control device, combined with the anti-contamination protection system used in the endolaser treatment for varicose veins, for optical fiber traction in thermal ablation technique.
[002] O tratamento da insuficiência venosa dos membros inferiores evoluiu muito nos últimos anos, passando de técnicas clássicas, como a safenectomia cirúrgica, flebectomias1 (BABCOCK, 1907) e ligadura de perfurantes, para técnicas endovasculares ablativas com nítida tendência à desospitalização, ou seja, progrediu-se para procedimentos realizados preferencialmente em ambiente ambulatorial2 (BABCOCK, 1907; SHORTELI; MARKOVIC; DURHAM, 2009)1,2.[002] The treatment of venous insufficiency of the lower limbs has evolved a lot in recent years, going from classic techniques, such as surgical saphenectomy, phlebectomies1 (BABCOCK, 1907) and perforator ligation, to ablative endovascular techniques with a clear tendency to dehospitalization, that is, , progress was made to procedures performed preferably in an outpatient setting2 (BABCOCK, 1907; SHORTELI; MARKOVIC; DURHAM, 2009)1,2.
[003] A Ablação Térmica com Laser Endovenoso (EndoVenous Laser Therapy - EVLT) representa uma das técnicas que mais se consagrou nas últimas décadas para o tratamento da doença venosa. Após o primeiro caso descrito, em 1998, por Boné3’ 4 (1999), diversos aprimoramentos e otimizações foram realizados, evoluindo até as novas indicações presentes neste capítulo. Apesar de o EVLT configurar-se como técnica de escolha para tratamento das veias tronculares do sistema venoso superficial, tanto pela Society for Vascular Surgery (EUA)5 (GLOVICZKI et al., 2011) quanto pela European Society for Vascular Surgery (ESVS)6 (WITTENS et al., 2015), essas mesmas entidades recomendam a flebectomia ambulatorial para tratamento de tributárias varicosas7 (BONÉ, 1999; GLOVICZKI et al., 2011; MULLER, 1966; NAVARRO; MIN; BONÉ, 2001; WITTENS et al., 2015)3'4’5·6’7.[003] Thermal Ablation with Endovenous Laser (EndoVenous Laser Therapy - EVLT) represents one of the most popular techniques in recent decades for the treatment of venous disease. After the first case described, in 1998, by Boné3’ 4 (1999), several improvements and optimizations were carried out, evolving to the new indications present in this chapter. Although the EVLT is configured as the technique of choice for the treatment of trunk veins of the superficial venous system, both by the Society for Vascular Surgery (USA)5 (GLOVICZKI et al., 2011) and by the European Society for Vascular Surgery (ESVS)6 (WITTENS et al., 2015), these same entities recommend outpatient phlebectomy for the treatment of varicose tributaries7 (BONÉ, 1999; GLOVICZKI et al., 2011; MULLER, 1966; NAVARRO; MIN; BONÉ, 2001; WITTENS et al., 2015)3'4'5·6'7.
[004] No contexto brasileiro, sabemos que a rotina da maioria dos serviços é a realização de múltiplas flebectomias em ambiente hospitalar, normalmente sob raquianestesia ou anestesia geral. A opção de escolha, que seria a flebectomia ambulatorial7 (MULLER, 1966), é notadamente subutilizada, além de trazer consigo desvantagens e limitações em casos extensos, com os quais nos deparamos frequentemente nos consultórios e ambulatórios da América Latina. Com essa análise, ao considerar a tendência termoablativa para troncos safênicos, surgiu a ideia da técnica de Ablação Térmica Total Assistida (ATTA), procedimento factível em ambiente ambulatorial. Lança-se mão do endolaser para veias possíveis de serem puncionadas, tratando tributárias (insuficientes ou inestéticas) de todos os calibres, com enfoque minimamente invasivo (MULLER, 1966)7.[004] In the Brazilian context, we know that the routine of most services is to perform multiple phlebectomies in a hospital environment, usually under spinal anesthesia or general anesthesia. The option of choice, which would be outpatient phlebectomy7 (MULLER, 1966), is notably underused, in addition to bringing with it disadvantages and limitations in extensive cases, which we often encounter in clinics and outpatient clinics in Latin America. With this analysis, when considering the thermoablative trend for saphenic trunks, the idea of the technique of Assisted Total Thermal Ablation (ATTA) emerged, a feasible procedure in an outpatient setting. The endolaser is used for veins that can be punctured, treating tributaries (insufficient or unsightly) of all sizes, with a minimally invasive approach (MULLER, 1966)7.
[005] As vantagens das técnicas termoablativas são: período menor de convalescência, menor agressividade aos tecidos perivenosos8 (LIU et al., 2011), resolutividade e durabilidade adequadas9 (WOZNIAK; MLOSEK; CIOSTEK, 2016), maior conforto e comodidade no procedimento ambulatorial10,11 (DO; KELLEY, 2007; YILMAZ et al., 2013), menor risco de sangramento e infecção e possibilidade de realização do procedimento sem a presença do profissional anestesiologista (YILMAZ et al., 2013) 8,9,10,11.[005] The advantages of thermoablative techniques are: shorter period of convalescence, less aggressiveness to perivenous tissues8 (LIU et al., 2011), adequate resolution and durability9 (WOZNIAK; MLOSEK; CIOSTEK, 2016), greater comfort and convenience in the outpatient procedure10 ,11 (DO; KELLEY, 2007; YILMAZ et al., 2013), lower risk of bleeding and infection and possibility of performing the procedure without the presence of an anesthesiologist (YILMAZ et al., 2013) 8,9,10,11 .
[006] Etapa primordial do procedimento, a termoablação, em si gera receios quanto à energia a ser utilizada devido ao temido risco de complicações, como lesões térmicas de pele e outras estruturas perivenosas9, 32 (SHAHID et al., 2015; WOŹNIAK; MLOSEK; CIOSTEK, 2016). Temos que levar em consideração todas as variáveis envolvidas: comprimento de onda do laser a ser usado, modo de entrega da energia, velocidade de tração e tipo de fibra, energia por centímetro linear de veia (LEED), além da potência nominal.[006] The primary step of the procedure, thermoablation, in itself generates fears about the energy to be used due to the feared risk of complications, such as thermal lesions of the skin and other perivenous structures9, 32 (SHAHID et al., 2015; WOŹNIAK; MLOSEK ; CIOSTEK, 2016). We have to take into account all the variables involved: wavelength of the laser to be used, energy delivery mode, pull speed and fiber type, energy per linear centimeter of vein (LEED), in addition to the rated power.
[007] O Laser Diodo de 1470 nm é atualmente reconhecido por reunir as maiores vantagens na termoablação endovenosa, com trabalhos demonstrando melhor perfil de entrega de energia em relação a outros comprimentos de onda33,34,35,36 (AKTAS et al., 2015; ARSLAN et al., 2017; DOGANCI; DEMIRKILIC, 2010; HIROKAWA et al., 2015). Com essas evidências em mãos, somadas à revisão bibliográfica que mostra resultados insatisfatórios em trabalhos que utilizaram comprimentos de onda de 980 e 810 nm14, 18 (PARK et al., 2007; WANG et al., 2018), optamos, na técnica ATTA, pelo comprimento de onda de 1470 nm.[007] The 1470 nm Diode Laser is currently recognized for bringing together the greatest advantages in endovenous thermoablation, with works demonstrating a better energy delivery profile in relation to other wavelengths33,34,35,36 (AKTAS et al., 2015). ; ARSLAN et al., 2017; DOGANCI; DEMIRKILIC, 2010; HIROKAWA et al., 2015). With this evidence in hand, added to the literature review that shows unsatisfactory results in studies that used wavelengths of 980 and 810 nm14, 18 (PARK et al., 2007; WANG et al., 2018), we chose, in the ATTA technique, at a wavelength of 1470 nm.
[008] Os geradores de laser podem entregar a energia luminosa em modo contínuo ou pulsado37 (BOS et al., 2008). A quantificação da energia total por segmento de veia tratada ou de superfície é mais prática de ser feita quando utilizamos o modo contínuo. Portanto, para a técnica ATTA, esse é o modo de escolha.[008] Laser generators can deliver light energy in continuous or pulsed mode37 (BOS et al., 2008). Quantifying the total energy per treated or surface vein segment is more practical when using the continuous mode. So for the ATTA technique, this is the mode of choice.
[009] Para o tratamento dos troncos venosos principais, é ampla a discussão sobre o melhor modo de calcularmos a energia ideal para a efetiva termoablação. Contudo a maneira mais difundida em nosso meio, proposta desde 2005, é o cálculo energético por centímetro linear de veia (Linear Endovenous Energy Density - LEED)38,39,40 (IGNATIEVA et al., 2017; FOKIN et al., 2017; PROEBSTLE TM. et al., 2005). A fórmula utilizada é a seguinte:[009] For the treatment of the main venous trunks, there is a wide discussion about the best way to calculate the ideal energy for effective thermoablation. However, the most widespread way in our country, proposed since 2005, is the energy calculation per linear centimeter of vein (Linear Endovenous Energy Density - LEED)38,39,40 (IGNATIEVA et al., 2017; FOKIN et al., 2017; PROEBSTLE TM. et al., 2005). The formula used is the following:
[010] LEED = E (energia total) / cm linear de veia E = P (potência) x T (tempo)[010] LEED = E (total energy) / linear cm of vein E = P (power) x T (time)
[011] Assim: LEED = P x T / centímetro linear de veia.[011] Thus: LEED = P x T / linear centimeter of vein.
[012] Uma solução para isto foi a criação de um dispositivo de tração mecânica da fibra, que a recua em 1 milímetro a cada clique de um botão rotacional (ATTA Control), objeto do pedido de patente BR 102020018402-4.[012] A solution for this was the creation of a mechanical fiber traction device, which retracts it by 1 millimeter at each click of a rotational button (ATTA Control), object of patent application BR 102020018402-4.
[013] O dispositivo ATTA Control é capaz de tracionar fibra ótica 1 mm por click da engrenagem motora, sendo empregado por profissionais que não têm tanta habilidade para tracionar manualmente a fibra[013] The ATTA Control device is capable of pulling optical fiber 1 mm per click of the motor gear, being used by professionals who are not so skilled at manually pulling the fiber
[014] Em um aperfeiçoamento do dispositivo anterior ATTA Control, foi desenvolvido um dispositivo que não apresenta a engrenagem motora da fibra (ATTA Mini), sendo que o cirurgião é que traciona a fibra ótica manualmente, valendo-se de sua expertise para isto.[014] In an improvement of the previous ATTA Control device, a device was developed that does not have the fiber motor gear (ATTA Mini), and the surgeon pulls the optical fiber manually, using his expertise for this.
[015] Associado ao dispositivo simplificado existe um dispensador que contém uma capa plástica protetora da fibra. Esta capa serve para envolver a fibra e protegê-la contra contaminações de qualquer natureza, seja por microrganismos ou por sujidades variadas.[015] Associated with the simplified device is a dispenser that contains a plastic protective cover for the fiber. This cover serves to envelop the fiber and protect it against contamination of any kind, whether by microorganisms or by various types of dirt.
[016] A caracterização do presente modelo de utilidade é feita por meio de figuras representativas do dispositivo de controle da fibra ótica, combinado ao sistema de proteção anticontaminação, de tal modo que produto possa ser integralmente reproduzido por técnica adequada, permitindo plena caracterização da funcionalidade do objeto pleiteado.[016] The characterization of this utility model is made through representative figures of the fiber optic control device, combined with the anti-contamination protection system, in such a way that the product can be fully reproduced by an appropriate technique, allowing full characterization of the functionality of the claimed object.
[017] A partir das figuras elaboradas que expressam a forma preferencial de se realizar o produto ora idealizado, se fundamenta a parte descritiva do relatório, através de uma numeração detalhada e consecutiva, onde a mesma esclarece aspectos que possam ficar subentendidos pela representação adotada, de modo a determinar claramente a proteção ora pretendida.[017] From the elaborated figures that express the preferential way of realizing the product now idealized, the descriptive part of the report is based, through a detailed and consecutive numbering, where it clarifies aspects that may be implied by the adopted representation, in order to clearly determine the protection sought.
[018] Estas figuras são meramente ilustrativas, podendo apresentar variações, desde que não fujam do inicialmente pleiteado.[018] These figures are merely illustrative, and may present variations, as long as they do not deviate from what was initially claimed.
[019] Neste caso se tem que:
- - a figura 01 mostra uma perspectiva explodida do dispositivo de controle da fibra ótica, associado à capsula dispensador da capa plástica;
- - a figura 02 mostra uma perspectiva do dispositivo de controle da fibra ótica;
- - a figura 03 mostra vistas ortogonais do dispositivo de controle proposto e uma seção A-A.
- - figure 01 shows an exploded perspective of the optical fiber control device, associated with the plastic cover dispenser capsule;
- - figure 02 shows a perspective of the optical fiber control device;
- - Figure 03 shows orthogonal views of the proposed control device and an AA section.
[020] Uma forma preferencial de realização da invenção compreende o dispositivo propriamente dito (1), que recebe dois anéis de fixação (2 e 2a) da capa plástica (4), onde dita capa (4) fica acondicionada dentro de uma cápsula de contenção (5) que funciona como um dispensador da capa plástica (4), sendo que esta cápsula (5) é presa no dispositivo propriamente dito (1) por intermédio de uma bucha de fixação (3) .[020] A preferred embodiment of the invention comprises the device itself (1), which receives two fixing rings (2 and 2a) of the plastic cover (4), where said cover (4) is packaged inside a capsule of containment (5) that works as a dispenser of the plastic cover (4), and this capsule (5) is fastened to the device itself (1) by means of a fixing bush (3).
[021] A fibra ótica (não mostrada) passa por dentro do modelo através de uma passagem (6) no dispositivo propriamente dito (1), atravessa a capa plástica (4) e perpassa a cápsula de contenção (5) pela passagem central (7).[021] The optical fiber (not shown) passes inside the model through a passage (6) in the device itself (1), crosses the plastic cover (4) and passes through the containment capsule (5) through the central passage ( 7).
[022] A passagem (6) do dispositivo propriamente dito (1) é coincidente à passagem central (7) da cápsula de contenção (5), de tal modo que uma fibra ótica inserida na passagem central (7) possa facilmente sair na extremidade (8) através da passagem (6).[022] The passage (6) of the device itself (1) is coincident with the central passage (7) of the containment capsule (5), in such a way that an optical fiber inserted in the central passage (7) can easily exit at the end (8) through the passage (6).
[023] A capa plástica (4) fica acondicionada dentro da cápsula de contenção (5) é desentranhada de dentro dela puxando-se a cápsula para trás, de modo que a fibra fique acondicionada dentro da capa plástica (4) , completamente protegida contra qualquer tipo de contaminação.[023] The plastic cover (4) is packaged inside the containment capsule (5) is removed from inside it by pulling the capsule back, so that the fiber is packaged inside the plastic cover (4), completely protected against any kind of contamination.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| BR202020024105-8U BR202020024105U2 (en) | 2020-11-25 | 2020-11-25 | Constructive arrangement applied in fiber optic control device |
| PCT/BR2021/050500 WO2022109698A1 (en) | 2020-11-25 | 2021-11-17 | Structural arrangement applied to an optical-fibre control device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| BR202020024105-8U BR202020024105U2 (en) | 2020-11-25 | 2020-11-25 | Constructive arrangement applied in fiber optic control device |
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| BR202020024105U2 true BR202020024105U2 (en) | 2022-06-07 |
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| BR202020024105-8U BR202020024105U2 (en) | 2020-11-25 | 2020-11-25 | Constructive arrangement applied in fiber optic control device |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5370675A (en) * | 1992-08-12 | 1994-12-06 | Vidamed, Inc. | Medical probe device and method |
| US6152918A (en) * | 1996-04-05 | 2000-11-28 | Eclipse Surgical Technologies, Inc. | Laser device with auto-piercing tip for myocardial revascularization procedures |
| US5876373A (en) * | 1997-04-04 | 1999-03-02 | Eclipse Surgical Technologies, Inc. | Steerable catheter |
| US6319227B1 (en) * | 1998-08-05 | 2001-11-20 | Scimed Life Systems, Inc. | Automatic/manual longitudinal position translator and rotary drive system for catheters |
| US20040167503A1 (en) * | 1999-08-25 | 2004-08-26 | Cardiofocus, Inc. | Malleable surgical ablation instruments |
| EP1578249A4 (en) * | 2002-06-19 | 2010-04-14 | Angiodynamics Inc | Endovascular treatment device with a protective sleeve |
| EP1581130A2 (en) * | 2002-10-31 | 2005-10-05 | CoolTouch, Incorporated | Endovenous closure of varicose veins with mid infrared laser |
| WO2005004737A1 (en) * | 2003-06-30 | 2005-01-20 | Candela Corporation | Endovascular treatment of a blood vessel using a light source |
| WO2005044124A1 (en) * | 2003-10-30 | 2005-05-19 | Medical Cv, Inc. | Apparatus and method for laser treatment |
| US20070219550A1 (en) * | 2006-01-27 | 2007-09-20 | Mark Thompson | Device and system for surgical dissection and/or guidance of other medical devices into body |
| DE102009000685B4 (en) * | 2009-02-06 | 2018-10-25 | Sirona Dental Systems Gmbh | Laser Handpiece |
| FR3059888A1 (en) * | 2016-12-08 | 2018-06-15 | Philippe Rochon | ENDOVENOUS TREATMENT DEVICE WITH GUIDED SOFT WIRED ELEMENT |
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2020
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| Date | Code | Title | Description |
|---|---|---|---|
| B03A | Publication of a patent application or of a certificate of addition of invention [chapter 3.1 patent gazette] |