CN102892456B

CN102892456B - Resectoscope gas-bag system

Info

Publication number: CN102892456B
Application number: CN201080066769.3A
Authority: CN
Inventors: E·H·贡达伊; L·J·格朗斯
Original assignee: SANOVAS LLC
Current assignee: SANOVAS LLC
Priority date: 2010-05-13
Filing date: 2010-05-13
Publication date: 2016-01-13
Anticipated expiration: 2030-05-13
Also published as: EP2569045A4; AU2010352872A1; AU2010352872B2; CA2797861A1; CN102892456A; CA2797861C; EP2569045A1; WO2011142758A1

Abstract

Disclose resectoscope gas-bag system, it usually comprises the conduit with at least one air bag, air bag has the outer wall on band excision, non-slip surface, described surface is for excising undesired physiological substances, such as tissue or tumor, also comprise pump, this pump provides fluid repeatedly to exit to described air bag and inflate in a pulsed fashion.In a particular embodiment, pump comprises processor, based on the change of set up frequency or volume, controls the pulse supply of fluid.In certain embodiments, this system comprises the adapter of band key, and use this adapter, this pump identifies airbag types, and in some cases, this system-computed cavity interior diameter and density.In certain embodiments, the cell parts of this conduit comprises multiple balloon segment, and in some cases, the plurality of balloon segment can be inflated separated from one anotherly.

Description

Resectoscope gas-bag system

Technical field

The present invention relates to the System and method for excising undesired physiological substances, the tissue growth in all chambers in this way on health of this undesired physiology's material and tumor.More specifically, the present invention relates to the balloon catheter with removal surface, it operates in a pulsed fashion, with minimal damage excision target material.

Background technology

Undesired and/or life-threatening physiological substances is removed from bodily cavity chamber interior, such as organ, blood vessel, joint combine and structure, hole and all kinds of body lumen, the operation that right and wrong are usually shown in the plurality of medical specialty and subject of such as pulmonology, cardiology, urology, gynecology, gastroenterology, neurological, otolaryngology, plastic surgery and general surgery.Therefore, taken various instruments and methods to carry out these operations, these are generally known in the prior art.

One of most important factor is hemorrhage in such a process.In current known a lot of surgical operations, the prevalence of hemorrhage and caused tissue is the result that technology was excised and removed to scratch, wound and invasive.Much such technology emits the danger of blood vessel or the tube chamber perforation wherein carrying out performing the operation, and causes the severe complication of surgeon and patient.In addition, a lot of patient disease is not simply by these surgical healings, because there is not the treatment form of intervention, minimally-invasive, these methods not effectively, safety and repeatable, and/or the instrument the adopted feedback that lacks suitable observability, physiological measurements and/or necessity guarantee to perform the operation safe, effective and repeatable.Therefore, the treatment of newtype is needed.

The instrument generally used in various types of medical operating is inflatable bladders conduit, has much dissimilar, is used to the function performing various necessity.Such as, these aerating gasbags be often used in control or stop hemorrhage, keep instrument to put in place or to prevent or auxiliary other flows in health chamber or movement.Such as, via being held in place with a lot of urological catheters of urethra sidewall contact, via contacting with fornix vaginae sidewall, a lot of department of obstetrics and gynecology instrument is held in place, Ink vessel transfusing air bag is often used in Bleeding control, aerating gasbag and is sometimes used to control to inject cystic duct and detects the adverse current of the contrast agent that cholelithiasis exists and recently, balloon catheter has been used to discharge congestion of nasal sinus in general surgery cholecystectomy process.

An application-specific of such conduit is pulmonary carcinoma.In all types of cancer, pulmonary carcinoma has minimum survival rate, because caused by pulmonary carcinoma more than 1/3rd in the death caused due to cancer.Annual worldwide diagnoses out the new patient more than 1,500,000.The most common cause of the death of lung cancer patient is airway obstruction.In cancer patient, in all patients 1/3rd have just started and other 1/3rd long-term, occur that main airway blocks, and this causes and suffocates, bleed in a large number and infect.These complication are the most common causes of the death of lung cancer patient.

Use intervention bronchoscopy to be used for lung cancer therapy and add the quality of life of the patient standing chronic obstructive pulmonary disease (COPD) and survival rate and the obstructive co-morbidity relevant to cancer with caused airway obstruction.Therefore, balloon catheter has been conventionally used in various endoscope and the flexible bronchoscope with rigidity for expanding, as clogging to stop blooding and being kept putting in place by instrument as intervention fixing device and prevent the retrogressing of these instruments under countercurrent pressure.

Based on the needs of the aforesaid treatment for the newtype for removing undesired physiological substances in health chamber, achieve, inflatable bladders conduit can be used further to excise as intervention instrument and remove such material-such as endolymph obturator and tumor and Endovascular Occlusion-in various applications, the pulmonology of such as above-mentioned intervention medical speciality, cardiology, urology, gynecology, gastroenterology, neurological, otolaryngology and general surgery.Compare by the method and apparatus of the other types used (such as machinery, laser, electric cautery, cryotherapy etc.), use balloon catheter to present simply in this way, safety, highly effective and not expensive Therapeutic Method.

Therefore, the air bag that suggested new classification is for this object, disclosed in the european patent application No.EP1913882 such as applied for by Karakoca.This equipment have employed the balloon catheter with hardened surface, and it can be inserted into health chamber.After this equipment is inserted into, air bag is inflated, and this air bag is movable in the chamber thus veined surface performs scraper action on undesired physiological substances.In this way, targeting substance has been excised.

But, this particular instrument and use its method to be limited by several inferior position and shortcoming.One of sixty-four dollar question of this resectoscope air bag is, by striking off with the hardened surface being positioned at air bag outside, that is, by by before and after air bag and/or in rotary moving, removes undesired physiological substances.This motion mechanism may cause scratch and wound.In addition, hardened surface adds that scraper action may lack the complication that necessary degree of accuracy prevents the hemorrhage of such as affected anatomical structure and structural perforation and so on sometimes.Further, the amount of moment of torsion required on air bag and back and forth active force can cause equipment fault, is particularly attached to conduit part at air bag.

Another inferior position of this resectoscope air bag is, its hardened surface is the discrete thin film be positioned at outside air bag.This thin film has the extension characteristics different from air bag, and adversely affects the performance of balloon catheter.May need to check this balloon catheter in advance in vitro before use.Additionally, under the friction stree of operation, this air bag is tear-away and block or jeopardize the safety of the health chamber wherein expanding air bag further.

Another problem of this resectoscope air bag is that this air bag also lacks accuracy, because this air bag shortage is accurately measured wherein, it is provided the physiologic measurement and feedback that can help Results and effect by the size of the environment used.Such as, surgeon has no idea to know the diameter of affected health chamber (close to obturator wherein or away from obturator wherein) itself.Similarly, surgeon has no idea to know the cavity interior diameter that wherein there is undesired tissue growth or tumor, and further, have no idea to regulate exactly when this tissue growth or tumor cut time this diameter over time.Owing to there is no mechanism for measuring chamber cavity body interior diameter in different time points, and specifically, measure this diameter as where time to time change, the amount of pressure that is provided to air bag can not be regulated suitably and prevent complication by this and accelerate to treat.

Be with this device-dependent problem, doctor has no idea the intraarticular space between measurement two articulation structures, soleplate or surfaces.

Another relevant issues of this equipment are, the density that surgeon has no idea to understand health chamber is that surgeon does not know the density of tissue growth or tumor itself yet close to obturator or different from obturator.Owing to there is not the mechanism of the density for measuring chamber or obstruction, surgery degree of accuracy may be helped, minimize potential complication and accelerates operation by the pressure controlled suitably in air bag.

Another relevant issues of this equipment are, this equipment has no idea to identify the type of the balloon catheter being connected to pump.As a result, this air bag can unexpectedly excessively be inflated, and therefore, this air bag can break.

Another inferior position of this resectoscope air bag is, this air bag comprises structure that is single, monomer, this means only whole air bag to be inflated as a whole.This causes some deficiencies, comprising: can not measure cavity interior diameter not existing together, and comprises the physiological substances of health chamber itself (close/away from obturator) and obstruction; Can not accurately locate needs maximum pressure part (multiple) thus exactly and excise this obturator methodically; Specific region can not be clogged thus Bleeding control; Cut material can not be caught thus it is drawn out from health chamber; Also has the trend of air bag slip and movement.

Another deficiency of this equipment is, this equipment can not by according to being desirably optimally placed.Such as, the integral diameter of this balloon catheter needs rigidity or the soft endoscope with service aisle.Except the fact that such endoscope not easily obtains, endoscope is independent cavity equipment.As a result, can not seal wire be used, by rigidity or soft endoscope or rigidity or soft endoscope other together with endoscope, they are guided to health chamber.Similarly, this equipment does not have ability and is linearly transmitted along catheter configurations by air bag, and this can optimize air bag placement and repeatability.Finally, this equipment does not comprise for the material (such as radiography material) in its position of outer logo.Therefore, the position of air bag easily can not be identified via outside imaging modalities (such as actinogram or ultra sonic imaging).Each of these shortcomings makes can not accurately locate this air bag as desired.

Another inferior position of this resectoscope air bag is, have no idea for doctor illumination light, non-thermal illumination light and air bag are provided before, hope from air bag forward direction air bag, along the visual feedback of air bag side or air bag rear region, optimize Results and effect.

The further deficiency of this resectoscope air bag is derived from such fact: it is the single cavity equipment that near-end is blocked.As a result, when air bag is inflated, it does not allow fluid (such as air or blood) to flow to near-end from distal end of catheter.This is very important in the application of intervention pulmonology, if wherein there is airway obstruction situation, suction is crucial.Similarly, in the application of intervention cardiology, in the operation of vessel segment (vesselsegment), the by-pass flow of blood is allowed to be important.

Another deficiency of this equipment is, it does not have ability transmission can help to excise the low temperature agent of undesired physiological substances or the energy of various ways.As a result, the energy of low temperature agent or the such as various ways of radio frequency, ultrasonic and electrosurgical energy and so on can not be provided thus perform melt, dry, burn, excise, divest and/or tissue modification thus optimize hemostasis and excision.

The further deficiency of these balloon catheters is, medicine, support, physiological substances, nano-particle or the correlation technique of having no idea to provide localization to transmit are to balloon surface.Therefore, the means of supply medical science, treatment and rehabilitation process can not be provided this equipment to provide.

Therefore, it is desirable that a kind of resectoscope gas-bag system, for removing less desirable physiological substances, and does not cause the unnecessary damage for affected health chamber of the result as the scraper action being used to excise this material.It is also contemplated that have the resectoscope gas-bag system of controlled rate for inflation and venting.It is further desirable that, do not need the resectoscope gas-bag system of the discrete thin film being fixed to air bag outside.It is also contemplated that by endoscope, by endoscope or via actinogram or the manageable resectoscope gas-bag system of ultra sonic imaging.It is also contemplated that a kind of resectoscope gas-bag system, this system can provide physiological feedback to determine the cavity interior diameter and density wherein with undesired physiology's material and to be adjacent to or away from the intraarticular spacing between the cavity interior diameter of the position of such material and density, two articulation structures and the type of balloon catheter that connects.It is also contemplated that a kind of resectoscope gas-bag system, this system can also provide the size and performance metric that are structured in intravital balloon catheter.It is further desirable that a kind of resectoscope gas-bag system, this system can be positioned bodily cavity indoor best and can accurately locate the specific region providing maximum inflation.It is also contemplated that a kind of resectoscope gas-bag system, this system can provide light and visualization capability, low temperature agent and various forms of energy to help surgical technic and medicine and relevant material and deliver to anatomic points.It is further desirable that a kind of resectoscope gas-bag system, this system allows fluid to flow to far-end from catheter proximal end.

Summary of the invention

Therefore, the object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, this system does not need scraper action mechanism.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, and this system does not adopt the separating film be fixed to outside air bag.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, this system provides physiological feedback, can determine wherein to have the diameter in the cavity of these physiological substances and contiguous and away from the health chamber of this material itself from these feedbacks, and correspondingly scalable is provided to pressure and the stream of air bag.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, this system provides physiological feedback, can determine the intraarticular space between two articulation structures, soleplate or surfaces from this physiological feedback, and correspondingly scalable is provided to pressure and the stream of air bag.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, this system provides physiological feedback, can determine wherein to have the density in the cavity of these physiological substances and contiguous and away from the health chamber of this material itself from these feedbacks, and correspondingly scalable is provided to pressure and the stream of air bag.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, and this system can identify the type of the balloon catheter being connected to pump.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, and wherein have can by the different section of inflating independently for this cell parts.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, and this system also has at least one additional via except the path of the fluid for inflating this air bag.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, and this system can make this air bag be transmitted along this conduit.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, the outside imaging of this system supplymentary.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, and this system provides the visual pattern of bodily cavity indoor.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, and this system can transfer its energy to target area.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, and low temperature agent can be passed to target area by this system.

Another object of the present invention is to provide a kind of resectoscope conduit system for removing less desirable physiological substances, and medicine, support, nano-particle and similar substance can be passed to target area by this system.

In order to overcome the deficiencies in the prior art and the object listed by realization and at least some in advantage, the present invention includes the method with resectoscope gas-bag system excision physiological substances, the method comprises to be inserted in the health chamber with the physiological substances wanting cut by conduit, this conduit comprises at least one air bag of the outer wall with band removal surface, by accommodating fluid wherein, to make the removal surface of air bag, this physiological substances is touched to this airbag aeration, come repeatedly to exit to this air bag and inflate by a pulsed fashion fluid being provided to this air bag, thus this venting repeated and inflation make this removal surface excise this physiological substances.

In certain embodiments, the step of airbag aeration is comprised with electropneumatic pump accommodating fluid to this air bag, and this air bag repeatedly to be exitted and the step of inflating is controlled by this electropneumatic pump based on set up change in volume or frequency at least in part.In some cases, the method also comprises the airbag types detecting and be inserted into the conduit of health chamber, the step wherein controlled airbag aeration based on detected airbag types at least in part, and under specific circumstances, the step of repeatedly exitting to air bag and inflate comprises the density of determining physiological substances or the diameter in physiology's chamber, and regulates the amount of the fluid being provided to air bag at least in part based on determined density or diameter.

In certain embodiments, at least one air bag comprises multiple balloon segment, and comprises the step of airbag aeration and inflating at least one balloon segment independent of at least one other balloon segment.

The present invention also comprises resectoscope gas-bag system, comprise the conduit of at least one air bag with tool outer wall, this outer wall comprises the removal surface for excising physiological substances, also comprise by providing fluid to the pump of airbag aeration wherein, wherein this pump provides fluid repeatedly to exit to air bag and inflate at least one air bag in a pulsed fashion.

In certain embodiments, in specific favourable embodiment, this pump is electropneumatic pump.In certain embodiments, this pump comprises processor, and the pulse that this processor controls fluid based on set up frequency provides, and in other embodiments, this pump comprises processor, and this processor controls the pulse supply of fluid based on the change in volume set up in air bag.

In certain embodiments, the present invention also comprises the adapter connecting the conductive pipe to pump, and wherein this adapter is air bag mark adapter, and use this adapter, this pump identifies this air bag.In certain embodiments, this adapter comprises air bag marking plate and key, and when conduit is connected to this pump, this marking plate of this bond orientation, uses this marking plate to identify this air bag to make this pump.In some cases, this pump electric light ground identifies this air bag by this marking plate, and in other cases, this pump motor tool ground identifies this air bag by this marking plate.In a particular embodiment, this pump comprises air bag profile data corresponding to air bag and processor, and this processor is at least in part based on the fluid supply of this air bag profile data control flow check to air bag.Air bag profile data also can comprise the correction data for dissimilar tissue.

In certain embodiments, this pump comprises for making at least one at least one sensor measured and processor, and based on this, at least one measurement and air bag profile data calculate the density of the physiological substances in physiology chamber to this processor at least in part.In certain embodiments, this at least one sensor comprises the sensor of the pressure of the fluid determining to export to air bag and determines to export to the sensor of flowing of fluid of air bag, and in some cases, this pump controls the fluid supply to air bag based on calculated density at least in part.

Similarly, in certain embodiments, this pump comprises for making at least one at least one sensor measured and processor, and based on this, at least one measurement and air bag profile data calculate the diameter in physiology chamber to this processor at least in part.In certain embodiments, this at least one sensor comprises the sensor of the pressure of the fluid determining to export to air bag and determines to export to the sensor of flowing of fluid of air bag, and in some cases, this pump controls the fluid supply to air bag based on calculated diameter at least in part.

In a particular embodiment, this system also comprises the adapter connecting the conductive pipe to this pump, wherein this adapter is air bag mark adapter, use this adapter, this pump identifies air bag, and this pump comprises the air bag profile data corresponding to this air bag, and this pump comprises processor, the change of volume in desired frequency or air bag determined at least in part by this processor based on these disposition of gasbag data, and this pump controls the fluid supply to air bag based on determined frequency or change in volume at least in part.

In certain embodiments, this at least one air bag comprises multiple balloon segment, and conduit comprises multiple cavity, and by this multiple cavity, this pump accommodating fluid, to this balloon segment, is inflated to make this pump pair at least one balloon segment be separated with at least one other balloon segment.

In specific advantageous embodiment, this system also comprises accommodating fluid at least one external cavity to this at least one balloon segment and internal cavity.In certain embodiments, internal cavity comprises air or body fluid passage, and in certain embodiments, at least one seal wire is placed in internal cavity.In specific embodiment in these embodiments, this system also comprises at least one passage connecting internal cavity and gasbag outer surface, for transmitting medical science or therapeutic agent to this physiology's chamber.In certain embodiments, this conduit comprises imaging device hole, also comprises and is placed in this conduit and exits the fibre bundle in described hole, for checking this physiology's chamber.For multiple object, some cavitys can be used.Such as, put in place once this conduit is inserted under the help of seal wire, then internal cavity can be used to be used for visual.

In a particular embodiment, this pump comprises vacuum source, uses this vacuum source, and by the passage in internal chamber, cut material is discharged by this pump from body lumen.In certain embodiments, this pump comprises the vacuum source of being discharged from air bag by fluid.

In certain embodiments, this system also comprise for energy supply energy source and be molded in conduit for by energy from energy source conduct to this physiology's chamber at least one lead-in wire.

In specific favourable embodiment, this fluid is air.In certain embodiments, this fluid is cryogen.

In specific advantageous embodiment, this system comprises the mesh be molded in this conduit, and wherein removal surface comprises the texturizing surfaces being positioned at gasbag ektexine that this mesh produces.In other embodiments, the outer wall of this air bag comprises the multiple inflatable chamber providing removal surface.In other embodiment, this system also comprises the spring lead being mounted to this gasbag ektexine, and wherein removal surface comprises this spring lead, and in some cases, and this system also comprises and is connected to this spring lead and arrives energy source wherein for providing energy.

In certain embodiments, this air bag has the first and second ends, and this system also comprises and is installed as at least one imaging labelling (marker) adjacent with at least one air bag end, in some cases, imaging labelling comprises radiography ring (radio-opaquering).

Accompanying drawing explanation

Fig. 1 is front according to resectoscope gas-bag system of the present invention, partial schematic diagram.

Fig. 2 A is front, the partial schematic diagram of the balloon catheter of the system of Fig. 1.

Fig. 2 B is end, the partial cross section diagram of the air bag of the inflation of the system of Fig. 2 A.

Fig. 2 C is the partial cross section diagram of the air bag of the venting of the system of Fig. 2 A.

Fig. 3 A is front, the partial schematic diagram of the balloon catheter of Fig. 2 A adopting multiple balloon segment.

Fig. 3 B is the side view of the air bag of the conduit of Fig. 3 A, and the air bag of centre is inflated.

Fig. 3 C is the side view of the air bag of the conduit of Fig. 3 A, and the air bag of centre is deflated.

Fig. 3 D is the partial cross section figure of the balloon catheter of Fig. 3 A.

Fig. 3 E is the side view of the air bag of the conduit of Fig. 3 A, and balloon segment is separated spatially.

Fig. 3 F is the partial cross section figure of the balloon catheter of Fig. 3 E.

Fig. 4 A is side, the partial schematic diagram of the balloon catheter of the Fig. 1 with energy delivery assembly.

Fig. 4 B is side, the partial schematic diagram of the balloon catheter of Fig. 4 A.

Fig. 5 is the side view of the balloon catheter of Fig. 1, has the spring lead being mounted to air bag.

Fig. 6 A is side, the partial schematic diagram of the balloon catheter of the Fig. 1 with imaging device.

Fig. 6 B is the end diagram of the imaging device of Fig. 6 A.

Fig. 7 A-F be just in body lumen by the side of the balloon catheter of Fig. 1 that operates, partial cross section figure.

Fig. 8 is the block diagram of the pneumatic member of the pump that Fig. 1 is shown.

Fig. 9 is the block diagram of the soft copy of the pump that Fig. 1 is shown.

Figure 10 A illustrates the front panel of the pump of Fig. 1.

Figure 10 B illustrates the graphic software platform of the front panel of Figure 10 A.

Figure 10 C illustrates the front panel of the remote controller of the pump of Figure 10 A.

Figure 11 A illustrates the front panel of the pump of Fig. 1.

Figure 11 B illustrates the rear board of the pump of Figure 11 A.

Figure 11 C illustrates the front panel of the remote controller of the pump of Figure 11 A.

Figure 12 A-B is the flow chart of the operation of the resectoscope gas-bag system that Fig. 1 is shown.

Figure 13 is the example that volume relative current moves the typical curve of time response before and after correcting.

Detailed description of the invention

According to the basic module of an embodiment of resectoscope gas-bag system of the present invention shown in Fig. 1.As used in this specification, term " top ", " bottom ", " on ", " under ", " up ", " in below ", " on ", " beneath ", " at top ", " below ", " upwards ", " downwards ", " on ", D score, "front", "rear", " back ", " forward " and " backward " refer to that these orientations are not necessary for realizing object of the present invention with the object mentioned during orientation shown in the accompanying drawings.

This system 20 comprises fluid source (22), such as has electropneumatic pump of control in its front portion, and doctor or assistant can control this system (and remote control unit) from these controls, and this will hereafter further describe.Balloon catheter (24) is connected to pump (22), this pump (22) accommodating fluid, and such as gas, liquid or its mixture are to balloon catheter.Under specific circumstances, this pump (22) is supplied cryogen thus is helped particular procedure further, and such as tumor is dry.

As shown in Fig. 2 A-B, this balloon catheter (24) comprises to be made up of polythene material and to have the conduit (26) of 1.8mm external diameter and about 1.2 to 3 meters of length.Be positioned at the flexible part (28) with about 5-10mm length of conduit (24) far-end as safe end (tip).As a result, when conduit (24) is inserted into by the available open of body lumen, it will bend and can not pierce through cavity wall.

The cell parts (30) that rubber or other suitable materials are made be positioned at conduit (24) proximate distal ends or be positioned at other expect, along conduit (24) preset distance part.Air bag (30) has various sizes and diameter, and this can be selected to the application-specific being applicable to using this equipment.Generally, such air bag can have the length and 2.5,5,10,15,20,30 or the diameter of 50mm of 5,10,15,20,30 or 50mm.Various variable balloon size allows balloon catheter (24) in the body lumen of various diameter and size, such as has larger and less bronchus, hole and the blood vessel of all types of tumors and the tissue that will be treated.This pump (22) provides the air of about 2 atmospheric pressure, thus can be complete size by such airbag aeration, between 2.5mml to 50mml.

In specific favourable embodiment, air bag (30) comprises imaging labelling (32), is such as positioned at end or the radiography ring near end.。Can select and place such labelling suitably thus reflect the relevant ripple of each image mode (e.g., x-ray), thus allowing to use such mode to help the accurate location of air bag (30).

Referring to Fig. 2 B, show the cross section of air bag (30), this air bag is coating is stamped flexible removal surface (34), and flexible removal surface such as can comprise the fiber mesh on the surface being fixed to this air bag (30).In specific favourable embodiment, removal surface (34) comprises the ingredient as air bag and the thick texturizing surfaces of the about 0.2mm be incorporated therein in molding process.In these cases, by meticulous, fiber mesh being attached in bag material and making removal surface (34), this mesh is made up of lycra, polyurethane, synthesis spring or other suitable materials.The cross point of mesh base parts produces towards outside, less knot or pit, and this creates microshock in inflation/deflation cyclic process described below on tumor tissues (or by other cut physiological substances).In other embodiments, have employed size (dimensional) surface texture in the surperficial substrate being encapsulated in air bag (30) or inflatable cave (sinus).This dipping (impregnated) structure in the surperficial substrate of air bag can imitate mesh-like structure, block (bump), ridge etc.

Back referring to Fig. 2 A, balloon catheter (24) comprises internal chamber branch (breakout) Y and ties (40) and help the introducing of seal wire, air by-pass, drug delivery or visual guiding.The near-end of the internal cavity (42) after Y knot (40) is eventually with Luer connector (44) termination.External cavity is at its near-end to be with key connector (46) termination, and band key connector (46) comprises key (48) and air bag marking plate (50).

Y knot (40) is for several object.First, independent, the internal cavity (42) of conduit (24) are brought to suitable connector by it, such as above-mentioned Luer connector (44), thus independently path is provided, two-way air flue such as between the far-end and near-end of balloon catheter (24), when air bag is inflated, this is important for application-specific (that is, bronchoscopy).In addition, this Y tie (40) also comprise valve-off (not shown) be provided for this air bag (30) stop venting.Such as, this can be used to, when require it leave aerating gasbag reach long period section thus treatment chronic hemorrhage time.

As mentioned above, conduit (24) the air bag marking plate (50) of band key is terminated at near-end.The object of this adapter is detected catheter (24) identify the particular type of the balloon catheter used electronically when during conduit is inserted into pump (22).This key (48) orientation connector (46) and marking plate (50), make it possible to by using electric light or electromechanical means to identify airbag types by pump (22).

Can be characterized by the air bag (30) of each type used together with pump (22), and air bag profile data is registered in enquiry form.By identifying the type of air bag (30) be connected with pump (22), suitable profile data can be searched and for guarantee can suitable pressure, volume, flow and the sequential adjustment of manipulation balloon (30) safely and effectively.With suitable pressure together with flow measurement (as described further below), air bag profile data is comprised in enquiry form, allows to make suitable tissue density and is similar to.This air bag profile data and by the cavity diameter that is similar to and tissue density, and any user command, the inflation that the air capacity thus realize being used to regulate pump (22) to be passed to air bag (30) is expected and discharge quantity.

As shown in FIG. 2 C, it illustrates the cross section of the conduit (26) of the far-end that the air bag (30) of venting and removal surface (34) are positioned at.In a particular embodiment, the internal cavity (42) of conduit (26) is extended by the flexible part of catheter tip (28) and in distal openings.As mentioned above, in a particular application, such as bronchoscopy, this internal cavity (42), as path, allows air bidirectionally to move freely from the every one end of air bag (30) when air bag is inflated.In addition, this internal cavity (42) can be used as the device of positioning gasbag conduit (24) exactly, because when being inserted in body lumen by the balloon catheter (24) of venting, this internal cavity can be used as the guiding of seal wire (63).In other application, such as when treating coronary heart disease, the by-pass prot (not shown) of internal cavity can be provided and this internal cavity (42) after this gets clogged by the correct position after the near-end of air bag (30), thus the branch's knot for it is not necessary.

The external cavity (60) of conduit (26) is used to be inflated and venting air bag (30) by the hole (62) be arranged in conduit outer wall (64).These external cavities get clogged at the far-end of air bag (30), thus the air be intended to for inflating and exit can not be overflowed.

In specific advantageous embodiment, as illustrated in figs. 3 a-b, balloon catheter (24) comprises many bladder configurations (70) at its far-end.This structure can comprise, such as, and nearly balloon segment (72), center sleeve section (74) and balloon segment (76) far away.At the near-end of conduit (24), Y knot (40) brings another cavity (78), its nearly balloon segment (72) providing fluid to be extremely separated with center sleeve section (74) and balloon segment far away (76).This additional cavity (78) is connected to another band key adapter (80) being similar to band key and connecting (46).In this way, center sleeve section (74) is inflated independent of near and far air bag (72,76) and exits.

The near and far balloon segment of separation is adopted to play different object in this way.First, can inflate near and far balloon segment (72,76) reaches a certain amount of, this amount be suitable for conduit (24) stably to remain on will be removed organize whereabouts, cyclically center sleeve (74) is inflated and exitted simultaneously and excise undesired physiological substances, as shown in Fig. 3 B-C.By doing like this, can prevent air bag (30) movable or migration and may cause for body lumen itself in operation process, this is when chamber stands very big return pressure and to insert that requirement reaches in the application of the time period of prolongation at balloon catheter be very important.In addition, by near and far air bag (72,76) inflation, can prevent cut material from entering health chamber, but, the tissue that is released can be caught thus simply remove.Finally, by adopting multiple, independently inflatable bubble or pit in this way, can more selectively and accurately clog health chamber different piece, measure its cavity interior diameter and density and the tissue that hinders of excision.

Fig. 3 D illustrates how to use external cavity to come these three air bags (72,74,76) inflation and venting.As mentioned above, internal cavity (42) is used to guide for air by-pass and/or seal wire.Lower cavity (82) has inflation/deflation hole (84) along in the catheter wall of conduit (24) length only on the position at center sleeve (74) place, and upper chamber (86) only comprises inflation/deflation hole (88) in the position near and far air bag (72,76) place along catheter length.It should be noted, comprise additional cavity by further separate external cavity and place inflation/deflation hole along conduit (24) length at correct position, near and far balloon segment (72,76) also can independent of being inflated each other/exitting.Similarly, also can add additional balloon section, increase stand-alone terminal by increasing number of cavities and tying (40) near-end at Y, additional balloon section can similarly independent of being inflated each other.

Although balloon segment is illustrated as being adjacent one another are in Fig. 3 A-3C, in other embodiments, as indicated in figure 3e, different balloon segment can be separated each other spatially.Balloon segment can separatedly reach, such as, and about 1cm distance, but depend on application-specific, this interval can be greater or lesser.By being separated balloon segment in this way, hole (90) can be provided in the catheter to other cavitys (92).

As shown in fig.3f, cavity (92) and hole (90) can be used to transmit, such as, and medical medicine.In this way, along with near and far air bag (72,76) keeps being inflated and center sleeve excises undesired physiological substances (as described further below), medicine is comprised in target location and distributes equably.But it should be noted, in other embodiments, such as medicine, nano-particle etc., disperseed by multiple distal tip or by the mouth in bladder sidewall.Therefore, medicine that can be such via the release systematically and/or through putting into practice.

Can use cavity (92) and hole (90) transmit any amount of things help to open chamber, circulation, air-breathing, breathing, help blockage decomposition or be affected region internal stimulus treatment, such things comprises air, aspirate, medicine, biomaterial, biological reagent, nano-particle, solution, stem cell and gene therapy and support (stent) and shelf (scaffold).Specifically, this equipment can be used for dispose in the reparation of target area, process and treatment and (pro-generative) medium and/or catalytic materials are progenesised in implantation, comprise biomaterial, nano-particle material and/or physiology's material, structure, support and similar equipment and medium, comprise, such as, bone morphogenetic protein, microcrystal nanometer granule, collagen, softening GUSUIPIAN, calcio structure, polyglycolic acid, polylactic acid and hyaluronic acid.Can this equipment be used similarly configure and implant the material of inertia, nonelastic and semihard, such as, such as PEEK, pottery, cobalt chromium, titanium and rustless steel, and for implanting enhancing structure in anatomical structure, along anatomical structure and/or around this anatomical structure, this enhancing structure can be configured then impregnated, compression, or fill with inert material afterwards before insertion, this inert material comprises, such as, polymethyl methacrylate, sclerotin, polyethylene, polypropylene, latex and PEEK.

In addition, in the some of them of these many balloon embodiment, above-mentioned imaging labelling (e.g., developing ring) can be positioned at each balloon segment place or each balloon segment close, thus helps the use of specific image mode to help the accurate location of air bag.

As shown in Figure 4 A, in specific favourable embodiment, the flexible conduit (100) with electric lead (103) and electrode (104) is used to transfer its energy to the physiological substances place of processed expectation.As shown in Figure 4 B, use access hole (106) that electrocautery electrode (104) is introduced into target location.Electrode (104) is molded in flexible conduit (100), and is electrically connected to wire (103), and wire to be also molded in conduit (100) and to be electrically insulated from each other.The far-end of wire (103) and then be connected to must the energy generation apparatus of energy (108) for providing, such as, such as, suitable electrosurgery unit.

Electrode (104) is made up of suitable spring metal, this spring metal the inside cavity of conduit (26) be straight, not excessive be pushed out by access hole (106) time, rebound its original-shape.Pushing and releasing conduit (100) by tying (40) place at Y, configuring this electrode.Desirably by rotary pneumatic ductus bursae (26) gradually air bag (30) is inflated and exitted, electrode (104) is placed on desired locations.It should be noted, one pole (electrode is remotely connected) and bipolar (two electrodes are all placed) all may be utilized.In this way, the energy of various forms and type, such as radio frequency and electrosurgery energy, can be provided to that execution is melted, burns, excised, cortex divests and/or tissue modification thus optimize hemostasis and excision in a 360 manner.Similar energy delivery system can be built for ultrasonic transmission.

In specific advantageous embodiment, the present invention, in the surface along bladder configurations or the surface in bladder configurations, also comprises insulant and insulation barrier and completely cuts off to the relevant adverse effect of multi-form energy that is hot, ultrasonic and that transmitted by above-mentioned balloon catheter (24) to make this air bag.Therefore, under the pressure of energy transfer process (multiple), air bag (30) protected avoiding becomes venting or damages by other.

As shown in Figure 5, in a particular embodiment, in cylinder mode, straight, steel spring line (110) are arranged on air bag (30).Wire termination is fixed to balloon catheter (24) at the near-end (112) of air bag (30), thus they do not move relative to conduit (26).In far-end (114), line (110) is not fixed and is distally extended into the passage be arranged in balloon catheter (26).Therefore, when air bag (30) is inflated, spring wire (110) is by inflating shape that is stressed thus formation air bag (30).In this way, by making the end of spring wire (110) isolated from one another and by Y knot (40), wire (103) being provided to outside, provide as air bag (30) arranges another means of removal surface, these means also can be used to as electric cautery provides one pole or bipolar electrode.

In certain embodiments, as shown in FIG, be conducted through access hole (122) by imaging fiber light beam (120), or (124) directed come imaging peripheral region.At the near-end of balloon catheter (26), Y knot (40) provides path by port (126) and/or (128).As depicted in figure 6b, imaging fiber bundle (120) is by the coherent fibre bundle (130) for throwing light on be positioned at the coherent imaging fibre bundle (132) of core and lens (not shown) is made.Also can use two independently to restraint, one for illumination and another is for imaging (not shown).At the far-end of fibre bundle (120), imaging coherent optical-fiber independent of lighting fiber (not shown) and, by suitable optical element (not shown), be interfaced to imaging sensor, such as CMOS or CCD.Similarly, lighting fiber is interfaced to light source (not shown).But, it should be noted, also can adopt other light sources, such as light emitting diode.Be also to be noted that imaging sensor (nowadays at obtainable CCD or CMOS of 2mm size) can be positioned at the end (not shown) of imaging catheter assembly, eliminate the needs for coherent imaging light, because this increasing picture quality and decreasing cost.

By this way, doctor can be provided illumination light, non-thermal illumination light and feed back for before air bag (30), along the direct vision of air bag both sides and/or air bag Background Region.Imaging sensor and illumination optical device have ability linearly or rotatably to be passed through and/or is passed around air bag (30), thus allows visual for 360 ° of area for treatment.

The operation of air bag (30) usually can be described referring to Fig. 7 A-F.First, referring to Fig. 7 A, after endoscope, x-ray and/or ultrasonic appearance test, select balloon catheter, and the equipment be deflated is inserted into the position in body lumen.This measure by using the service aisle of endoscope to complete or as mentioned above, along being inserted into the wire of health before and the internal cavity near-end of the seal wire of health outside being inserted conduit has come.Conduit is connected to pump (its assembly and operation will be described in more detail below), and now, the type of the balloon catheter be inserted into determined by this pump.

Then referring to Fig. 7 B, under about 2 atmospheric air pressures, by pump (type of its known connected air bag), set time amount is reached to airbag aeration, and measure flowing (press the inflation button on pump doctor after).Then this pump calculates the initial approximation of tissue density in tumor tissues and openings of sizes, and shows result for being confirmed by doctor.Along with this pump of operation, these data are continually updated and show.

As shown in Fig. 7 C-D, when the pulse button on pump is pressed, based on the parameter of user's input or the default parameters based on pump selection, air bag is deflated in a looping fashion and inflates, and parameter is the diameter made based on characteristic and the system of specific air bag (its result as above-mentioned air bag marking plate is identified) and/or density measure.In this way, the pulse mode of pump makes air bag beat according to the change in volume in expected frequency and air bag, and the periodicity producing air bag size repeats to increase and reduce.

Therefore, the removal surface of air bag repeatedly touches tissue growth, tumor or other undesired blockages to create microshock on it.Be deflated along with air bag and inflate, removal surface creates just in time enough interference with one heart and fixes on undesired physiological substances, and compression stress excites and friction, thus promote compression stress to exhaust and wear and tear to draw it to decompose and excision, thus with non-damaging manner excision targeting physiological substances.Damaged and remove along with organizing, air bag is inflated to larger initial diameter, and these steps repeat until all undesired organize cut.

Therebetween, pump monitors gasbag pressure and air-flow constantly, and correspondingly upgrades graphic software platform, as described in detail below.This points out to doctor, and when stop pulse pattern also discharges the tissue got loose.

Referring to Fig. 7 E, once tumor and/or tissue damage, air bag is deflated (by pressing the release button on pump), and air bag, through the position of undesired tissue, be inserted into health chamber further far.

As illustrated in fig. 7f, then air bag is again inflated (by pressing the inflation button on pump) and is gently proximally drawn, and the tissue got loose is moved together with fragment to the point that tweezers or suction pump can be used to remove.In many bladder configurations, remove fragment by one of available cavity.

Such as, optimize that 360 ° of cavitys decompose blockages, point to unblock, an application-specific that is clean and spall-catcher relates to and in series use four bubbles.First, all four bubbles are inflated and carry out point unblocking to cavity.Then, bubble far away is fully inflated, and in bubble far away abandoned completely and in nearly bubble partly exitted.When balloon catheter is retracted, in nearly bubble be preferably inflated, the rotation of nearly bubble in starting, and therefore fragment by cut from cavity inner wall.Once be retracted on the bubble far away inflated completely and be comprised in middle far away and nearly bubble, fragment is captured.

If any being necessary, these steps are repeated many times, until all undesired organizing all are removed.Generally, this operation between 5-45 minute, will depend on the density of tumor or undesired tissue.

Hereafter the pump (22) of the operation controlling above-mentioned resectoscope air bag will be described.Fig. 8 illustrates the Pneumatic assembly of pump and the block diagram of operation.This pump comprises air compressor (232) and head tank (233), such as Festo model C RVZS-0.1, and can achieve up to 10 atmospheric continuous.Air pressure in groove (233) is monitored by microcontroller (254) constantly, and this microcontroller further describes at the electronic component (Fig. 9) hereafter in conjunction with pump.When groove pressure drop is lower than 4-5 atmospheric pressure, this microcontroller exports (252) initialization compressor (232) via the signal of telecommunication and operates.Select the size of groove (233) thus when there is no compressor operation, at least one operation (procedure) can be completed.This microcontroller calculate and display channel (233) in air capacity, this to user display whether exist enough air to complete this operation.Check valve (234), such as Festo model H-1/8-A/1, be positioned between compressor (232) and groove (233), thus prevent by the air return that compresses in compressor (232).But, in another change of pump (22), do not comprise above-mentioned compressor and head tank, and alternatively provide air or the carbon dioxide of compression from external source (such as air drain or in situations in the surgery room usual visible operation locular wall).

From air groove (233) by Compressed Gas first by pressure regulator (238), this actuator exports (0V-10V) signal (246) via the analog electrical that microcontroller produces and carrys out electric control, thus with accurate pressure, air being provided to air bag, this pressure can be arranged by doctor and change.But any pressure higher than the upper limit of used specific air bag will produce caution signals.As mentioned above, depend on application, can use different balloon catheters, this can identify via key adapter.Therefore, the pressure of dissimilar air bag, volume and flow behavior to be comprised in enquiry form thus to optimize the operation of air bag and guarantee the performance that they are consistent.

Therefore, prescribe a time limit when pressure is set higher than on air bag, the detection for air-flow will make pump stop and producing warning, and then doctor must take specific action to carry out this situation of override.Similarly, if there is no gasbag pressure, generation is also warned, because this may mean that air bag is punctured by the detection of air-flow.Be also to be noted that pump is inoperation also if conduit is not connected.In addition, when first time takes out from encapsulation, the operation of air bag can be different from its normal operating, and before requiring to use in vivo, first they practised.Therefore, the setting of pump and preparatory function allow this inconsistent.

In specific favourable embodiment, vacuum source (239), such as Festo model VN-05-L-T3-PQ2-VQ2-R01-B, is also included in pump, thus air bag can be exitted in a consistent manner rapidly.This assembly also helps to obtain higher frequency in burst mode operation process.Via electrical output signal (247), open and close vacuum source (239) by microcontroller.

Using two by the electromagnetic valve of Microprocessor S3C44B0X---venting valve (240) and charging valve (241) control inflation and the venting of air bag.By keeping the time that air pressure is constant, use the ON/OFF activity time section from the gasbag pressure of lookup table data, flowing and bulk properties and by-pass valve control (240,241), obtain suitable airbag aeration size.Respectively by the venting signal of telecommunication (248) and the inflation signal of telecommunication (249) (produced by above-mentioned microcontroller), control venting valve (240) and charging valve (241).

The pressure regulator (243) of the pressure regulator (242) being used in the input of groove (233), the output being positioned at actuator (238) and be positioned at the pressure regulator (244) of air bag output, continues to monitor air pressure by microcontroller.These pressure regulators, can be such as Festo model SDET-22T-D10-G14-U-M12, be supplied to the analog electrical signal (0V-10V) that microcontroller and the proportional pressure that is positioned at these actuators (242,243,244) place change to input (250,251,252).Before being passed to air bag, gas flows through electric flowmeter (245) (such as Festo model SFET-F010-L-WQ6-B-K1) and filter (246).Effusion meter (245) provides analog electrical signal to input (254) to microcontroller, and it indicates the air stream flowing into air bag.

Pressure regulator (244) and effusion meter (245), and known balloon size, provide necessary feedback and come, via tangential force and degree of depth resistance determination tumor size and resistance, therefrom to make the determination about the diameter of cavity and the density of tumor.Use these parameters, necessary suitable pressure made by microcontroller and sequential regulates, maximize the effectiveness of air bag, there is provided for affect and measure with the physiology in impregnable region, and the data point and designator that are relevant to anatomy and pathological specific dimensions and density feature in cavity are provided, help doctor determine safely and transmit treatment.

In this way, air pressure is strictly monitored and is maintained 2 atmospheric pressure thus avoid balloon rupture.Electronically and under software, higher air input pressure (up to 10 atmospheric pressure) is reduced and is adjusted to 2 atmospheric pressure.But, via operator commands, under specific circumstances, can increase or reduce the pressure being passed to air bag.

In certain embodiments, one or more temperature sensor is also adopted, before low temperature and/or heat treatment mode apply, in applying and after applying, lasting physiological temperature reading is made to intravital tissue, tumor, thin film or other cavity inner tissues and/or equipment (no matter being organic or inorganic).In certain embodiments, this system for or body in low temperature or Equipment for Heating Processing makes lasting temperature reading and evaluate temperature, rate of temperature change and thrust the degree of depth of energy of cavity inner tissue, thus help to control low temperature or the distribution of heat treatment mode and/or the control of application, thus optimizing tissue amendment and/or cut.

Fig. 9 illustrates the assembly of electronic component and the block diagram of operation of pump (22).This microcontroller (254) is risc processor and is positioned at the cardia of electronic component.What be connected to microcontroller (254) by the suitable signal of telecommunication is general static state, dynamically and flash memories (255), question blank (256) and for the interface (257) with external device communication for firmware and data.This interface can be used to come by USB (universal serial bus) (USB) (258) programming, upgrade, diagnose and/or control.The interface for remote control hand-held unit (278) hereafter further described also is set up by interface circuit (257).In addition, pump comprises real time date time integrated circuit (not shown).

Digital simulation (D to A) transducer is used to control to provide air pressure to the pressure regulator of air bag.D to A transducer (268) produces the analog electrical signal (269) from 0V to 10V proportional with desired pressure.A series of analog digital (A to D) transducer (270) allows microcontroller (254) to read the pressure signal (250) at compressed air groove (233) place, the pressure signal (251) of the output of pressure regulator (238), the pressure signal (252) of air bag output and the air-flow (254) to air bag.

With suitable interface circuit (275) another a series of numeral export allow microcontroller (254) with control signal (253) control compressor (232) (ON/OFF(opening/closing)), with control signal (247) control vacuum source (239) (ON/OFF), with control signal (248) control pressure-releasing electromagnetic valve (240) (opening/closing) and with control signal (249) control inflate electromagnetic valve (241).

A series of input circuit (276) is connected to the switch be positioned on pump (22) front panel, thus input user controls, and this will hereafter further describe.In addition, microcontroller (254) is interfaced to front panel LCD display by display driving circuit (277), also will be described below.

As shown in FIG. 10A, in a particular embodiment, pump (22) comprises along the bottom of graphical LCD display panel (264) and the form of side is the user control button of soft keyboard (263).The function of control knob (263) is displayed on LCD (264) and goes up and depend on the pattern of pump and change.Button (263) can be used to input the pattern of setting, display setting, call collected data or increase/reduce frequency and pressure.Except soft key function, graphical LCD display (264) also show the setting of pump, pressure, frequency and slamp value, warning, such as event, data and elapsed time and so on other information and doctor is carried out performing the operation and collect any other useful information of surgical data, as shown in Figure 10 B.

The front panel of pump (22) comprises the pattern that release button (259), inflation button (260) and pulse button (261) change operating pumps (22).Front panel also comprises On/Off switch (265) and emergency stop push button (266), and it is by closing charging valve (241) and opening venting valve (240) and start the air-flow that vacuum source (239) stops to air bag.Also be included on the front panel of pump (22), one or more key socket (multiple) (267) of the above-mentioned band key adapter (multiple) of balloon catheter.

In a particular embodiment, the front panel of pump (22) also comprises the interface (210) of handheld remote controller (278), as previously mentioned.This handheld remote controller (278), is illustrated in Figure 10 C, can be positioned at sterile field, and can hardwired ground, or be easy to obtain communication technology (such as infrared or radio frequency (that is, bluetooth)) wirelessly, be connected to pump (22).Similar with the front panel of pump (22), remote controllers (278) have three push-in type buttons (259,260,261) for venting, inflation and Pulse Width Control.Remote controllers (278) also have (ready) lamp (262) of awaiting orders, and represent that suitable being ready to receives order.

As shown in Figure 11 A-C, in another change of pump (22), do not comprise compressor, compressed air groove and vacuum source.Namely use vacuum source can quickly to air bag deflation, and sufficient for generation frequency also makes it useful by the elasticity of fiber mesh and latex balloon.As illustrated in figure 11 a, the front panel of this equipment comprises pump On/Off switch (215), airbag types selector knob (216), air bag out connector (217), balloon inflation/deflation speed select push-in type press button (218) and speed L(low), in M() and H(high) indicator LED(219).As shown in Figure 11 B, rear board comprises the input of VAC power supply (220), pressure control knob (221), compressed air input connector (222) and remote control connections (223).Gasbag pressure scale is positioned at the top of this unit.

The operation of this system will be described referring to Figure 12 A-B.Initialization step comprises setting and operational diagnostics test on all intrawares, intraware comprises pressure transducer, effusion meter, electromagnetic valve etc., and show any warning, if or problem do not detected, then to await orders instruction (step 300) to user display system.

Upon initialization, pump opens venting valve and cuts out charging valve to guarantee is not having air pressure and flowing (step 302) to the output of balloon catheter.Then this system reads interior groove pressure (step 304).If pressure too low (decision box 306), this system is by display available air volume and wait for that user confirms to start compressor (step 308).Alternatively, if inner compressor is unavailable, by read porch air pressure and show warning to connect external compression air.

Then this system will show message and etc. balloon catheter to be connected.When air bag is connected, detects (step 310) by electric light or electro-mechanical devices and show message authentication airbag types (step 312) to user.If user confirms (decision box 314), then system will show this air bag of message authentication to user should tested (step 316), and if user confirms (decision box 318), then test this air bag and check (step 320) in advance.Then this system will show message (step 322) to user, and once receive the confirmation (decision box 324) from user, will from front panel, remote controllers or serial line interface scan command (step 326).In the process of before Dynamic System and simultaneously wait command, receiving emergency stop command will cause the Rapid degassing of air bag.

Each " inflation " order (order 330) by based on connected airbag types to airbag aeration recruitment (step 332).By open charging valve reach the scheduled volume time exit simultaneously valve keep close, complete the inflation that this is cumulative.In this way, this air bag is inflated the size reached desired by user.Alternatively, push down and keep inflation button will in a continuous manner to airbag aeration.

When inflating, the flow velocity (ml/sec) (step 332) of measurement gas.After this charging valve of closedown, record cavity pressure, and make approximate (step 334) of volume V based on desired air law (V=nRT/P) and enquiry form.Herein, T be assumed to be 310 ° of K constant (body temperature can be recorded and also input this equation), R be gas constant, n is number of moles of gas, proportional with the flow velocity recorded, and P is the pressure recorded.Along with the inflation that each increases, V is recalculated, and display relative volume change (V2-V1) (step 336).From air bag mark, be aware of the shape of air bag and use from the data of question blank, also calculate and show the relative change (D2-D1) of air bag diameter.As shown in Figure 13, graphically can illustrate that general volume flows time characteristic data relatively by form.The typical characteristics performance curve (400) of air bag is converted into (translatedto) actual linear properties (401).

Similarly, by open abandon valve reach setting-up time section simultaneously charging valve keep closing, each " venting " order (ordering 340) exits (step 342) to air bag progressively.

When pump receives " pulse " order (order 350), based on parameters, this air bag is carried out inflating and exitting (step 352, decision box 354, step 356, decision box 358) in a pulsed fashion, and it is preferential that this comprises inflation.In pulse mode, this aspect of inflation/deflation circulation can be set as required.This pump has the feature controlling this function based on the change (dilatation) of volume or the priority of frequency.Because air pressure is maintained at constant value (that is, 2 atmospheric pressure), spend airbag aeration to expecting that the time of size changes due to the different size of airbag types and volume.Therefore, when dilatation is preferential, used specific air bag is calculated and arranges minimum and maximum frequency, thus maximizes the dilatation between inflation and deflation status.When frequency is preferential, specific air bag is calculated and minimum and maximum dilatation is set, thus maximizing the frequency of inflation/deflation circulation.

For each inflation/deflation cycle calculations dilatation and/or frequency, and correspondingly upgrade display.If in this pulse mode process, " inflation " button is pressed, and when air bag is in inflated condition, this pulse mode is stopped.Similarly, if in this pulse mode process, " venting " button is pressed, and when air bag is in deflation status, this pulse mode is stopped.

If user is intended for pulse mode and changes and arrange frequency and/or dilatation, be positioned at up/down soft key on LCD display floater to complete this measure (order 360, step 362-364) by pressing.User also can press and be positioned at soft key input state on display floater and arrange display (ordering 370, step 372-374).This comprise screen to arrange and input initialization data to system, and in operation process, show accumulated data.

It should be noted, in all states of the operation of pump, vacuum source is opened and closed to realize exitting faster and the circulation of higher inflation/deflation.

It should be noted, although sometimes with reference to using tumor and tissue to describe described embodiment, native system also can be used in other application.Similarly, although with reference to impulse interference wave machine described herein braking to describe the present invention, such action is not uniqueness.That is, as required, except pulse, the action of other mechanism can be adopted, such as along the Linear-moving of the air bag of conduit, and rotate.When the plaque excision in such as ENT application and mucosa resection, useful especially during such motion.

Can usefully adopt another example of said system to be, with minimal damage mode recover joint space, highly with the reparation of the decompression in the compression joint in function.Decompression air bag comprises various shape and size and solves and copy in the mankind and other body of mammals the wider anatomic joint size found, comprises spine, knee, shoulder, buttocks, ankle, elbow, wrist, hands, finger, foot, toe, jaw, rib, clavicle and relevant joint.The application in this field will be the method for minimal damage, adopt intervertebral process distance piece, comprise unique shape, scale air bags structure, when inflated, have the ability processing joint between decompress(ion) cone.Under endoscope, actinogram and/or ultrasonic visualization, guide via less otch and/or via line, this bladder configurations can be inserted into.Then, this air bag distance piece can be inflated to provide the necessary decompress(ion) processing (interspinousprocess) between cone.As a result, current material and the frequent appreciable stress shielding of method and failure mode is used to be alleviated.This method is widely used in a lot of joints in human body and body of mammals.

Said system can be used to the minimal damage therapeutic intervention that Minor articulus merges (FacetJointfusion).Via endoscope/or cryptoscope visual under line guide and then inflate, imitate the air bag of unique dimensions shape of the articular surface of Minor articulus to be used to Minor articulus.The mesh like surface of the grinding of air bag is with one heart and rapidly by pulse thus the micro-grinding produced in articular cartilage, and then ablation energy is applied to the conduction ridge (conductiveridge) on the outer surface top of air bag, causes the decompress(ion) of articular surface and decorticate.By creating compression to airbag aeration and/or clogging any hemorrhage via applying electrosurgical energy, electrosurgical energy is transmitted via the conduction ridge being positioned at air bag outer surface top.Then, air bag is rotated and decorticates further and joint space is broadened.Then air bag is deflated, and then promotes implant to be inserted in key space inertia implant, nail or other bone conduction things and bone to create to intervene coordinate and promote fusion along venting conduit and/or seal wire.The little key of configuration that repeatedly also comprises of this operation substitutes implant.This operation has wider application in the broad range of joint fusion and crucial substitute.

It should be understood that above-mentioned is illustrative and non-limiting, and those skilled in the art can make a lot of apparent change without departing from the spirit of the invention.Therefore, mainly reference should be made to claims, instead of above-mentioned description, determine scope of the present invention.

Claims

1. a resectoscope gas-bag system, comprising:

Balloon catheter, described balloon catheter comprises the air bag that at least one has outer wall, and described outer wall comprises the removal surface for excising physiology's material; With

Pump, described pump comes described airbag aeration by providing fluid to described air bag;

Wherein, described pump provides fluid with set up frequency at least one air bag described in a pulsed fashion thus repeatedly makes described removal surface to excise described physiology's material to described air bag deflation and inflation with the described frequency set up.

2. a resectoscope gas-bag system, comprising:

Wherein, described pump provides fluid at least one air bag described in a pulsed fashion, change in volume in the described air bag set up with generation, wherein, in the described air bag set up, change in volume remains unchanged, thus repeatedly makes described removal surface to excise described physiology's material to described air bag deflation and inflation.

3. system as claimed in claim 1 or 2, it is characterized in that, described pump comprises electropneumatic pump.

4. system as claimed in claim 1 or 2, is characterized in that, also comprise adapter, and described adapter is by described tubes connection to described pump, and wherein said adapter is air bag mark adapter, and use described adapter, described pump identifies described air bag.

5. system as claimed in claim 4, it is characterized in that, described adapter comprises:

Air bag marking plate; With

Key, when described tubes connection is to described pump, marking plate described in described bond orientation thus described pump uses described marking plate to identify described air bag.

6. system as claimed in claim 5, it is characterized in that, described pump identifies described air bag from described marking plate electric light.

7. system as claimed in claim 5, it is characterized in that, described pump identifies described air bag to electromechanical from described marking plate.

8. system as claimed in claim 4, it is characterized in that, described pump comprises:

Corresponding to the air bag profile data of described air bag; With

Processor, described processor is based in part on described air bag profile data and controls to described air bag accommodating fluid.

9. system as claimed in claim 8, it is characterized in that, described pump comprises:

For making at least one sensor that at least one is measured; With

Processor, described processor calculates the density of the physiological substances in physiology's chamber at least in part based at least one measurement described and described air bag profile data.

10. system as claimed in claim 9, it is characterized in that, at least one sensor described comprises the sensor determining the pressure exporting described air bag to, and determines the sensor of flowing of the fluid exporting described air bag to.

11. systems as claimed in claim 9, is characterized in that, described pump supplies based on the fluid of calculated density domination to described air bag at least in part.

12. systems as claimed in claim 8, it is characterized in that, described pump comprises:

For making at least one sensor that at least one is measured; With

Processor, described processor calculates the diameter in physiology's chamber based at least one measurement described and described air bag profile data at least in part.

13. systems as claimed in claim 12, it is characterized in that, at least one sensor described comprises the sensor determining the pressure exporting described air bag to, and determines the sensor of the fluid flowing exporting described air bag to.

14. systems as claimed in claim 12, is characterized in that, described pump supplies based on the fluid of calculated diameter control to described air bag at least in part.

15. systems as claimed in claim 1 or 2, is characterized in that, also comprise by described tubes connection to the adapter of described pump, wherein:

Described adapter is air bag mark adapter, and use described adapter, described pump identifies described air bag;

Described pump comprises the air bag profile data corresponding to described air bag;

Described pump comprises processor, and described processor is at least in part based on the change in volume in described air bag profile data determination expected frequency or described air bag; And

Described pump controls to supply to the fluid of described air bag based on determined frequency or change in volume at least in part.

16. systems as claimed in claim 1 or 2, is characterized in that:

At least one air bag described comprises multiple balloon segment;

And

Described conduit comprises multiple cavity, and by described cavity, described pump provides fluid to described balloon segment, thus described pump and at least one other described in balloon segment discretely balloon segment described at least one is inflated.

17. systems as claimed in claim 1 or 2, is characterized in that, also comprise:

For providing at least one external cavity of fluid at least one balloon segment; With

Internal cavity.

18. systems as claimed in claim 17, it is characterized in that, described internal cavity comprises fluid passage.

19. systems as claimed in claim 17, is characterized in that, also comprise at least one seal wire being placed in described internal cavity.

20. systems as claimed in claim 17, is characterized in that, also comprise at least one passage connecting described internal cavity and described gasbag outer surface, for transmitting medicine or therapeutic agent to physiology's chamber.

21. systems as claimed in claim 17, it is characterized in that, described conduit comprises imaging device hole, also comprises and is placed in described conduit and exits the fibre bundle in described hole, for checking physiology's chamber.

22. systems as claimed in claim 17, is characterized in that, also comprise:

For providing the energy source of energy; With

Be overmolded at least one lead-in wire in described conduit, for energy is guided to physiology's chamber from described energy source.

23. systems as claimed in claim 17, it is characterized in that, also comprise at least one passage, connect the outer surface of described internal cavity and described air bag, wherein said pump comprises vacuum source, use described vacuum source, the material under excision is discharged from physiology's chamber by described passage and described internal cavity by described pump.

24. systems as claimed in claim 1 or 2, is characterized in that, also comprise the mesh be molded in described conduit, and wherein said removal surface comprises the texturizing surfaces being positioned at described gasbag ektexine that described mesh produces.

25. systems as claimed in claim 1 or 2, it is characterized in that, the outer wall of described air bag comprises the multiple inflatable chamber providing described removal surface.

26. systems as claimed in claim 1 or 2, it is characterized in that, also comprise the multiple spring wires being mounted to described gasbag ektexine, wherein said removal surface comprises described spring wire.

27. systems as claimed in claim 26, is characterized in that, also comprise and are connected to described spring wire for providing the energy source of energy to it.

28. systems as claimed in claim 1 or 2, it is characterized in that, described air bag has the first and second ends, also comprises at least one the imaging labelling be arranged in described air bag two ends near at least one end.

29. systems as claimed in claim 28, is characterized in that, at least one imaging labelling described comprises radiography ring.

30. systems as claimed in claim 1 or 2, it is characterized in that, described fluid is cryogen.

31. systems as claimed in claim 1 or 2, it is characterized in that, described fluid is gas.

32. systems as claimed in claim 1 or 2, it is characterized in that, described pump also comprises the vacuum source of being discharged from described air bag by described fluid.

33. systems as claimed in claim 1 or 2, it is characterized in that, described removal surface comprises the mesh of the outer wall being fixed to described air bag.