CN107106235A - 肿瘤消融系统 - Google Patents

肿瘤消融系统 Download PDF

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CN107106235A
CN107106235A CN201680005267.7A CN201680005267A CN107106235A CN 107106235 A CN107106235 A CN 107106235A CN 201680005267 A CN201680005267 A CN 201680005267A CN 107106235 A CN107106235 A CN 107106235A
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antenna
sacculus
microwave
microwave antenna
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C·德鲁玛
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Medtronic PLC
Medtronic Spine LLC
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Kyphon Inc
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Abstract

一种用于肿瘤消融的系统。所述肿瘤消融系统包括微波天线，所述微波天线具有沿其长度的通道。靠近所述微波天线的近端存在两个端口。第一端口是被配置成用于将所述天线连接至能量源的能量端口。第二端口是被配置成用于将所述通道连接至流体递送机构的流体端口。所述系统还包括被配置成用于附接至所述天线的远端的可膨胀球囊。所述通道允许流体从所述流体端口进入球囊内部以使其膨胀。

Description

肿瘤消融系统
背景技术
本发明总体上涉及一种肿瘤消融系统。
相关技术说明
在患有癌症的患者中，脊柱转移瘤是剧痛最常见的原因。脊柱转移瘤还经常伴随有椎体压缩性骨折。
球囊扩张椎体后凸成形术是被设计成通过减少和稳定骨折来修复椎体压缩性骨折的微创手术。复位术是通过将至少一个顺应性球囊插入骨折椎体的中心部位来完成的。仔细地使(多个)球囊膨胀成使得将松质骨朝向皮质壁推出，直到椎体返回到正确高度。在复位术之后，球囊被放气和移除。稳定是通过用骨水泥填充所产生的空洞来完成的。骨水泥变硬，形成内部铸件，从而稳定骨折。
射频消融用于破坏不想要的组织(包括肿瘤)。在射频消融期间，将探针插入不想要的组织中。从探针的一端部署有多个小电极以包围不想要的组织。探针的相对端连接至射频发生器，所述射频发生器发送射频能量穿过电极，导致紧邻的组织变热。一旦不想要的组织在特定时间段达到足够的温度，组织就死亡。肿瘤的射频消融花费大约20-30分钟。
微波消融也用于破坏不想要的组织(包括肿瘤)。在微波消融期间，将探针插入不想要的组织中。探针的另一端连接至微波发生器，所述微波发生器发送微波能量穿过探针的一端并且导致附近的组织变热。一旦不想要的组织在特定时间段达到足够的温度，组织就死亡。肿瘤的微波消融花费大约10-15分钟。然而，发射的微波能量所导致的直接加热造成了加热并因此损害椎体附近的敏感神经通路的风险。
因此，需要一种用于在消融肿瘤时在不对附近神经通路或其他重要器官造成损害的情况下快速修复椎体压缩性骨折的装置和方法。
发明内容
根据本发明，微波天线包括被电介质分离开的内导体和外导体。外导体被屏蔽包围。电介质包括通道，所述通道沿天线的长度延伸并且将天线近端处的流体端口连接至附接至天线远端的可膨胀球囊。流体端口经由管道附接至填充有生理盐水和对比剂的混合物的或仅填充有无菌水的高压注射器。
天线的近端还包括微波端口，所述微波端口帮助将微波发生器附接至微波天线的内导体和外导体以使得能够将微波能量从微波发生器传输至附接至天线的近端的球囊中的流体以及邻近组织。
所述方法包括将患者置于俯卧位置并且在皮肤上切口。外科医生将插管穿过切口插入与有肿瘤的骨头相接触。外科医生引入钻头穿过插管并且在骨头中创造开口并进入肿瘤中。接下来，外科医生插入天线穿过插管以在开口中定位球囊。在开口中有球囊的情况下，外科医生压下高压注射器的柱塞，迫使生理盐水和对比剂进入球囊。生理盐水使球囊膨胀并且挤压肿瘤。在球囊挤压肿瘤的情况下，外科医生接通微波发生器。微波能量加热球囊中的混合物，将热量传导到肿瘤中。一旦热量破坏了肿瘤，就关闭微波发生器。
破坏肿瘤之后，球囊进一步膨胀直到骨折复位。实现复位之后，球囊被放气并且利用骨水泥来填充所产生的空洞以用于稳定。
附图说明
并入本说明书且构成其一部分的附图展示了本发明的优选实施例并且与说明书一起并且用于解释本发明的目的、优点和原理。在附图中：
图1是根据本发明的实施例的用于肿瘤消融和椎体压缩性骨折修复的系统的部分截面正视图，示出了微波天线以及连接至微波天线的近端的高压注射器和微波发生器，其中，球囊附接至所述微波天线的插入骨折椎体中的远端；
图2是在图1中示出的用于肿瘤消融和椎体压缩性骨折修复的系统的微波天线的部分截面平视图，示出了在骨折椎体内部部分地膨胀的球囊；
图3A是用于肿瘤消融和椎体压缩性骨折修复的微波天线的远端的截面视图，示出了生理盐水使球囊膨胀；
图3B是在图3A中示出的天线的放大截面视图。
图3C是在图3A和图3B中示出的天线的替代性实施例的截面视图。
具体实施方式
通过考虑在此公开的本发明的说明书以及实践，本发明的其他实施例对于本领域的技术人员而言将是显而易见的。以下所描述的实施例旨在被认为仅是示例性的，而本发明的实际范围和精神由所附权利要求书来指示。
本发明的以下详细说明被加以描述并且示出在附图中以用于骨折椎体V。然而，应理解的是，本发明可以用于任何骨头中的肿瘤消融以及复位。
如在图1至图3A中所示出的，用于肿瘤消融的系统10包括微波天线20和被配置成用于附接至天线20的远端的球囊50。球囊50以及微波天线20的大部分长度被尺寸设计(sized)并且被配置成用于穿过插管60插入在骨折椎体V中制备的开口中。
如在图3A和3B中所示出的，天线20包括沿天线20的长度延伸的内导体21。内导体21可以由适用于传输微波能量的铜或任何其他导电材料构造而成。天线20进一步包括包围内导体21的电介质层22。电介质层22可以由适用于用作电介质的聚四氟乙烯或任何其他材料构造而成。电介质层22被由铜或任何其他合适的导电材料构造而成的外导体24包围。外导体24被屏蔽25包围以便电绝缘并且热绝缘外导体24。外导体24、内导体21和电介质22形成同轴结构。天线20可以进一步包括在其近端处用于控制天线20移动的手柄26(图1和图2)。
如在图3A中所示出的，内导体21延伸超过电介质层22、外导体24和屏蔽25的远端，使得内导体21在球囊50附接至天线20的远端时延伸进入球囊50。球囊50可以包括附接至球囊50的远端的柔性构件52。替代性地，柔性构件52的远端可以自由浮置。另外的替代方案可以包括附接至球囊50的远端的内导体21。柔性构件52的近端被配置成用于通过键合工艺附接至内导体21的远端。
如在图1和2中所示出的，天线20包括靠近天线20的近端的流体端口30。流体端口30方便了高压注射器34经由管道32的附接。高压注射器34包括筒体35和柱塞36。流体端口30连通通道23(图3A和图3B)或替代性地多个通道23(图C)。通道23穿过电介质层22在天线20的长度上前进并且连通球囊50内部。如此，挤压柱塞36迫使生理盐水38和对比剂离开筒体35穿过管道32、流体端口30和通道23并进入球囊50。球囊50中生理盐水38和对比剂的量的增加导致球囊50膨胀。球囊50的膨胀导致球囊50将压力施加到肿瘤上，确保球囊50与椎体V之间的良好接触。球囊50的继续膨胀导致松质骨朝向骨折椎体V的皮质层向外挤压。使球囊50膨胀直到骨折椎体V实现期望的正确高度。
如在图1和图2中所示出的，天线20包括靠近天线20的近端的能量端口40。能量端口40方便了微波发生器44经由同轴线缆42的附接。能量端口40方便了微波能量从同轴线缆42到内导体21和外导体24的传输。微波能量退出天线20的远端。退出天线20的远端的微波能量加热球囊50内的生理盐水38。被加热的生理盐水38将热量传导至肿瘤。所传导的热量用于破坏肿瘤。微波能量优先地加热生理盐水和对比剂混合物并且因此减少微波能量对邻近重要结构的负面影响。微波消融的直接加热效果被通过传导进行的间接加热所替代。如此，由于大多数微波能量用于加热生理盐水和对比剂混合物，因此本发明将减少微波能量对邻近结构的有害影响。另外，利用消融同时执行球囊膨胀将减少手术的时长并且在骨头变软时可以帮助进行球囊扩张椎体后凸成形手术。被加热的生理盐水38的温度可以经由位于微波天线的远端处或外导体24的远端处的温度探针(未示出)来监测。球囊50内部的温度可以利用温度感测元件(比如RTD、TC、光纤温度计或辐射测量)来监测。
在本发明的优选实施例中，采用以下方式来利用系统10。优选方法包括将患者置于俯卧位置并且在骨折椎体V之上的皮肤上制作小切口。然后，外科医生将插管60穿过切口插入与骨折椎体V相接触。外科医生可以通过握住位于插管60的近端的手柄62来操纵插管60的位置。在适当地对准插管60时，外科医生引入钻头(未示出)穿过插管60并且在骨折椎体V中创造开口并且进入肿瘤。外科医生撤回钻头并且插入天线20穿过插管60，直到将球囊50定位在在骨折椎体V中创造的开口内。在球囊50在开口中的情况下，外科医生压下高压注射器34的柱塞36，迫使生理盐水38和对比剂进入球囊50。生理盐水38使球囊50膨胀，导致球囊50挤压肿瘤。在球囊50挤压肿瘤的情况下，外科医生接通微波发生器44。微波能量加热球囊50中的生理盐水38。生理盐水38将热量传导到肿瘤中。在热量破坏肿瘤之后，关闭微波发生器44。此时，外科医生进一步压下柱塞36，导致球囊50进一步膨胀直到实现骨折椎体V的正确高度。在实现正确高度时，球囊50被放气并且从骨折椎体V中移除，在骨折椎体V中留下了较大的空洞。然后，用聚甲基丙烯酸甲酯(“PMMA”)骨水泥填充骨折椎体V中的空洞。
替代性地，外科医生在施加微波能量期间可以继续复位骨折椎体V。另外，手术的部分或全部可以在骨折椎体V的两侧同时执行。
在以上说明和附图中公开了完全且有效地完成了本发明的目的的肿瘤消融系统。然而，将显而易见的是，可以在不脱离本发明的原理或所附权利要求书的范围的情况下对公开的实施例做出改变和修改。

Claims (10)

1.一种用于肿瘤消融的系统，所述系统包括：
微波天线，所述微波天线具有近端和与所述近端相对的远端，所述微波天线进一步包括沿其长度在所述近端与所述远端之间的通道；
能量端口，所述能量端口靠近所述微波天线的所述近端、被配置成用于将所述天线连接至能量源；
流体端口，所述流体端口靠近所述微波天线的所述近端、被配置成用于将所述通道连接至流体递送机构；以及
可膨胀球囊，所述可膨胀球囊被配置成被附接至所述天线的所述远端，所述通道允许流体进入所述球囊的内部以使其膨胀。
2.如权利要求1所述的系统，进一步包括尺寸设计成允许所述天线从其中穿过的插管。
3.如权利要求1所述的系统，进一步包括将内导体的远端连接至所述球囊的远端的柔性构件。
4.如权利要求1所述的系统，进一步包括连接至所述流体端口的注射器。
5.如权利要求1所述的系统，进一步包括连接至所述能量端口的微波发生器。
6.如权利要求1所述的系统，进一步包括附贴至所述天线的所述近端的手柄。
7.如权利要求1所述的系统，其中，所述球囊包括聚氨酯。
8.如权利要求1所述的系统，进一步包括在所述微波天线的所述近端处的温度探针。
9.如权利要求1所述的系统，其中，所述微波天线的内导体为铜。
10.如权利要求1所述的系统，其中，所述微波天线的电介质为聚四氟乙烯。
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Application publication date: 20170829