CN107126254B - 用于便于部署微波辐射导管的导引器的90度互锁几何结构 - Google Patents
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Abstract
微波消融系统包括:第一插管;套管针,所述套管针能够插入通过第一插管并且构造成有助于将第一插管插入到目标组织中;和微波天线组件,所述微波天线组件构造成与第一插管互锁,所述微波天线组件包括同轴馈线,所述同轴馈线具有形成在其上的辐射段,所述微波天线构造成插入到第一插管中。微波消融系统还包括致动器,所述致动器操作地连接到第一插管或者微波天线组件中的一个。致动器在第一位置和第二位置之间的操作将微波天线组件的辐射段从第一插管的远侧部分暴露出。
Description
技术领域
本公开整体涉及一种微波导管,并且更具体地涉及一种用于便于部署微波辐射导管的导引器的90度互锁几何结构。
背景技术
能够使用电磁场加热以及破坏肿瘤细胞。该治疗可以包括将消融探针插入到已经识别出癌性肿瘤的组织中。一旦适当定位消融探针,则消融探针在位于消融探针周围的组织内感生电磁场。
在治疗诸如癌症的疾病过程中,已经发现在升高温度条件下使得某些类型的肿瘤细胞变性,所述升高温度略微低于通常有损健康细胞的温度。已知治疗方法(诸如温热疗法)加热病变细胞至高于41℃的温度,而与此同时保持毗邻的健康细胞低于发生不可逆细胞破坏的温度。这些方法包括施加电磁场以加热或者消融组织。
已经针对各种用法和应用研发了利用电磁场的装置。通常,应用在消融手术中的设备包括:能量发生源,例如,作为能量源的微波发生器;和手术器械(例如,具有天线组件的微波消融探针),其用于将能量引导到目标组织。通常由具有多个导体的线缆组件操作地联接发生器和手术器械,以将能量从发生器传递到手术器械并且在器械和发生器之间沟通控制、反馈以及识别信号。
使用中存在若干类型的可以用于组织消融用途的微波探针,例如,单极、双极、和螺旋形微波探针。通过多种方法来加热组织以进行热消融,所述多种方法包括从应用表面或者元件进行热传导、由从电极流至地垫的电流进行的离子振荡(基于电流的技术)、光波长吸收、或者在微波消融的情况中由天线电磁场内的水分子引起的介电松弛(基于场的技术)。
由于在微波消融组件中需要各种部件,因此增加了微波消融组件的重量,从而致使难以操纵这种组件。微波消融组件的重量可以限制外科医生在利用微波消融组件的同时使用手术工具的能力,而且还在实施微创手术期间导致外科医生手臂疲劳。因此,需要这样的设备,所述设备将有助于单手致动和操纵导管和手术器械,从而一只手能够实施其它任务,并且需要这样的设备,所述设备将限制所需步骤数量,原因在于每个步骤均导致导管在患者体内移动。
发明内容
本公开的一个方面涉及一种微波消融组件,所述微波消融组件包括:第一插管;套管针,所述套管针能够插入通过第一插管并且构造成便于将第一插管插入到目标组织中;和微波天线组件,所述微波天线组件构造成与第一插管互锁。微波天线组件包括同轴馈线,所述同轴馈线具有形成在其上的辐射段,所述微波天线组件构造成插入到第一插管中。微波消融组件还包括致动器,所述致动器能够操作连接到第一插管或者微波天线组件中的一个,其中,致动器在第一位置和第二位置之间的操作使微波天线组件的辐射段从第一插管的远侧部分暴露出。
微波消融组件可以包括转换头,所述转换头适于将微波天线组件连接到微波传输线缆组件。另外,微波消融组件可以包括多管腔壳体,所述多管腔壳体具有形成在其近端处的衬套,所述衬套限定了通过其中的纵向轴线并且包括流入端口和流出端口,以提供将冷却剂进出多管腔壳体的入口和出口,从而用于冷却微波天线组件。
微波消融组件可以包括第二插管,所述第二插管从多管腔壳体延伸并且与流入端口和流出端口流体连通、且接收微波天线组件,其中,冷却剂流经第二插管并且在微波天线组件上流动。
根据本公开的其它方面,流入端口和流出端口相互平行并且垂直于由衬套限定的纵向轴线。此外。转换头可以包括第一段和第二段,所述第一段适于联接到微波传输线缆组件的远端,而第二段适于联接到同轴馈线的近端。而且,微波消融组件可以包括O形环,所述O形环适于装配在转换头的第二段上,所述第二段适于接收在多管腔壳体的衬套中,使得O形环在连接时形成转换头的第二段和衬套之间的不透流体密封。
根据本公开的其它方面,致动器限定了在其相对表面上的一对凹陷部和用于暴露出流入端口、流出端口和线缆组件的远端的开口。销可以接收在致动器的相对表面上的一对凹陷部中。此外,在锁止心轴组装在致动器上的情况中,可以包含锁止心轴。锁止心轴可以包括本体部分,所述本体部分在其相对表面上限定了一对纵向狭槽,其中,纵向狭槽均分离开第一端部和第二端部。
在本公开的其它方面中,致动器可以包括滑动心轴,所述滑动心轴构造成在锁止心轴内滑动,使得销沿着一对纵向狭槽行进,以锁止在第一端部和第二端部之间。致动器可以包括控制环,所述控制环组装在锁止心轴和滑动心轴的一部分上。控制环可以包括:本体部分;从本体部分延伸的一对相对的伸出件;和构造成和尺寸设计成接收销并且引导销纵向移动的一对相对的细长凸轮表面。
鼻锥可以组装在控制环的一部分上,所述鼻锥具有近端和远端,并且所述远端具有带锁止机构的末端部分,并且所述近端限定了切口分,所述切口分构造成接收通过其中的流出端口。锁止心轴可以包括保持环,所述保持环构造成将鼻锥固定到锁止心轴。形成在第一插管的近侧区域上的壳体可以构造成与鼻锥的锁止机构匹配。
根据本公开的方面,在致动致动器时,滑动心轴和第二插管保持固定并且第一插管沿着滑动心轴的方向被拉动,以暴露出位于其中的微波天线组件的辐射段和第二插管。附加或者替代地,可以沿着滑动心轴的方向拉动锁止心轴、控制环和鼻锥,以暴露出位于其中的微波天线组件的辐射段和第二插管。
此外,为了保持一致,在此描述的方面中的任意一个均可以结合在此描述的其它方面中的任意一个或者所有一起使用。
附图说明
参照附图在下文描述了本公开的各个方面,所述附图作为并且构成本说明书的一部分,其中:
图1是根据本公开各方面的微波传输和辐射部件的透视图;
图2是根据本公开各方面的图1的微波传输和辐射部件的传输头的透视图;
图3是根据本公开各方面的多管腔二次成型流体衬套的截面图;
图4是根据本公开各方面的插入通过图3的多管腔二次成型流体衬套且具有图1的微波辐射段的同轴馈线的透视图;
图5是根据本公开各方面的插入到图3的多管腔二次成型流体衬套且具有图1的微波辐射段的同轴馈线的截面图;
图6是根据本公开各方面的滑动心轴的透视图;
图7是根据本公开各方面的至少组装到图3的多管腔二次成型流体衬套的图6的滑动心轴的截面图;
图8是根据本公开各方面的组装到图1的微波传输和辐射部件的图6的滑动心轴的透视图;
图9是根据本公开各方面的图6的滑动心轴的放大视图,其示出用于接收销的凹陷部;
图10是根据本公开各方面的插入到图6的滑动心轴的凹陷部中的一对销的透视图;
图11是根据本公开各方面的图6的滑动心轴的放大视图,其示出了插入到其中的图10的一对销;
图12是根据本公开各方面的锁止心轴的透视图;
图13是根据本公开各方面的组装到图6的滑动心轴的图12的锁止心轴的放大视图;
图14A是根据本公开各方面的控制环的第一实施例的透视图;
图14B是根据本公开各方面的控制环的第二实施例的透视图;
图15A是根据本公开各方面的图14A的控制环的截面图,所述控制环组装到图12的锁止心轴,其中,控制环处于第一或者部署位置中;
图15B是根据本公开各方面的图14A的控制环的截面图,所述控制环组装到图12的锁止心轴,其中,控制环处于第二或者缩回位置中;
图16A是根据本公开各方面的图14A的控制环的截面图,所述控制环组装到图12的锁止心轴上,其中,控制环处于第二位置中;
图16B是根据本公开各方面的图14A的控制环的截面图,所述控制环组装到图12的锁止心轴上,其中,控制环处于第一位置中;
图17是根据本公开各方面的控制环的放大视图,所述控制环组装到锁止心轴上,所述锁止心轴组装到滑动心轴上,并且所述滑动心轴组装到微波传输和辐射部件,并且示出了流入和流出端口;
图18是根据本公开各方面的鼻锥的透视图;
图19是根据本公开各方面的图18的鼻锥的透视图,所述鼻锥组装到图14A的控制环上;
图20是根据本公开各方面的鼻锥的一部分的截面图,所述鼻锥连接到锁止心轴的保持环,以将鼻锥固定到锁止心轴;
图21是根据本公开各方面的图18的鼻锥的放大视图,其示出了铰接部件;
图22是根据本公开各方面的手术系统的透视图,所述手术系统包括以参照图1-20描述的方式组装的微波导管和接入通道装置;
图23A是根据本公开各方面的插管的透视图;
图23B是根据本公开各方面的套管针的透视图;
图23C是根据本公开各方面的图23B的套管针的透视图,所述套管针插入在图23A的插管内;
图23D是根据本公开各方面的图23B的套管针的透视图,所述套管针完全插入在图23A的插管内;和
图24是根据本公开各方面的图23D的插管/套管针组件的透视图,所述插管/套管针组件安装到图18的鼻锥和图1的微波辐射段。
具体实施方式
本公开涉及一种微波导管,所述微波导管以90度角度或者以大体垂直构造连接到接入通道装置。通过使用90度转换头以及多管腔二次成型流体衬套,使得能够实施90度转换几何结构,所述多管腔二次成型流体衬套具有可以基本相互平行的流入端口和流出端口。当操纵这种装置时,微波导管和接入通道装置之间的90度连接或者90度互锁几何结构减小了施加到外科医生手和臂上的负荷和压力。另外,微波导管和接入通道装置之间的90度连接或者90度互锁几何结构使得插管能够与套管针快速分离,使得能够轻易地将接入通道装置放置在目标位置处。而且,微波导管和接入通道装置之间的90度连接或者90度互锁几何结构使得能够在不需要导丝或者预先建立的接入路径的情况下将细长非刚性微波辐射导管如针一样放置到目标组织中,用于在开放、腹腔镜或者经皮手术期间热消融。
参照附图描述了微波消融系统和部件的实施例。在附图中,相同的附图标记可以表示类似或者相同的元件。如图所示并且如在此描述中使用的那样,术语“近侧”指的是更接近用户的设备部分或者设备部件,而术语“远侧”指的是更远离用户的设备部分或者设备部件。
本说明书可以使用短语“在一个实施例中”、“在多个实施例中”、“在一些实施例中”或者“在其它实施例中”,所述短语均可以指的是根据本公开的相同或者不同实施例中的一个或者多个。
当在本描述中使用时,“微波”通常指的是处于300兆赫兹(MHz)(3×108周期/秒)至300千兆赫(GHz)(3×1011周期/秒)的频率范围内的电磁波。当在本描述中使用时,“消融手术”通常指的是任何消融手术,诸如,例如微波消融、射频(RF)消融或者微波或者RF消融辅助切除。当在此使用时,“传输线”通常指的是能够用于将信号从一个地点传播到另一个信号的任何传输介质。当在本说明书中使用时,“流体”通常指的是液体、气体或者液体和气体。术语“冷却剂”可以与术语“流体”互换使用。
现在详细参照本公开的实施例。尽管将描述本公开的特定示例性实施例,但是应当理解的是其并不旨在将本公开的实施例局限于描述的实施例。相反,参照本公开的实施例旨在涵盖包括在由附属权利要求限定的本公开的实施例的精神和范围内的替代方案、修改方案和等效方案。
初始参照图1,微波传输和辐射部件100包括微波传输线缆组件102,所述微波传输线缆组件102经由转换头110连接到微波天线组件108。微波天线组件108包括馈线106和辐射段106a,所述辐射段106a位于微波天线组件的远侧部分处并且与同轴馈线106电通信。转换头110可以称作90度转换头110。微波传输线缆组件102具有近端101和远端103。近端101可以具有弹簧偏压的联接元件104。弹簧偏压的联接元件104可以联接到壳体2212(图22),用于联接到微波发生器。微波天线组件108具有近端105和远端107。在一些实施例中,微波传输线缆组件102具有第一直径并且同轴馈线106具有第二直径,第一直径大于第二直径。转换头110允许在微波传输线缆组件102和微波天线组件108的同轴馈线106之间建立90度连接,如将参照图2在下文详细描述的那样。
如图2所示,转换头110由第一段111和第二段113形成。第一和第二段111、113相互垂直并且它们之间形成90度角度。第一和第二段111、113形成90度互锁几何结构。第一段111联接到同轴馈线106的近端105。第二段113经由管状构件118联接到微波传输线缆组件102的远端103。90度同轴线缆连接件(未示出但是包括在转换头110中)使得微波传输线缆组件102和同轴馈线106之间能够电连接。第一段111还包括围绕其一部分轴向定位的O形环115。O形环115虽然没有接触第二段113,但是确保在转换头110与多管腔衬套结合成一体时液密,如参照图3在下文描述的那样。
如图3所示,多管腔衬套300包括本体部分或者衬套310。本体部分310具有近端301和远端303。本体部分310限定了上本体部分311和下本体部分313。上本体部分311限定了室312并且下本体部分313容纳插管314。室312与插管314流体连通。插管314限定了通过其中的纵向轴线“X”。
插管314可以由刚性或者柔性材料形成。在特定实施例中,可以采用刚性(例如,钢或者陶瓷)和柔性(例如,聚合物材料)的组合。此外,插管314可以预先弯曲或者成形以抵达患者生理机能内的所需位置。而且,插管314可以采用一对或者多对转向金属丝,从而使得插管能够沿着一个或者多个方向铰接。通过使用柔性材料使得插管314能够前进以及导航,以适当放置被容纳在其中的辐射段106,如将在下文描述的那样。
多管腔衬套300包括流入端口320和流出端口330。流入端口320还可以称作流体进入端口,而流出端口330还可以称作流体返回端口。流入端口320限定了通过其中的流入管腔322,而流出端口330限定了通过其中的流出管腔332。流入和流出端口320、330分别提供流体或者冷却剂进入到多管腔衬套300的本体部分310中的入口以及离开多管腔衬套300的本体部分310的出口,以冷却图1的微波传输和辐射部件100的同轴馈线106和辐射段106a。
流入端口320基本平行于流出端口330。因此,流入端口320的流入管腔322也基本平行于流出端口330的流出管腔332。流入和流出端口320、330可以基本垂直于由插管314限定的纵向轴线“X”。流入和流出端口320、330具有大体圆形开口。然而,本领域中的技术人员可以设想到用于流入和流出端口320、330的多种几何形状开口。流入端口320与本体部分310的上本体部分311相互配合,而流出端口330与本体部分310的下本体段313相互配合。流入端口320与室312流体连通,而流出端口330与插管314流体连通。插管314延伸超过本体部分310的下本体部分313的远端。流入和流出管腔322、332的直径大于插管314的直径。室312的直径大于流入和流出端口320、330的直径。
参照图4,示出了微波传输和辐射部件100以及多管腔二次成型流体衬套300的组装视图400。微波传输和辐射部件100插入到多管腔衬套300中。插管314接收微波传输和辐射部件100的同轴馈线106和辐射段106a。O形环115(图2)定位在室312中(图3),以将转换头110的第二段113毗邻多管腔衬套300的近端301固定在区域410处。
插管314和多管腔衬套300限定了通过其中的纵向轴线“X”。微波传输线缆组件102限定了延伸通过其中的纵向轴线“Y”。纵向轴线“X”基本垂直于纵向轴线“Y”。因此,多管腔衬套300组装成相对于微波传输线缆组件102成90度。结果,转换头110的90度互锁几何结构使得能够相对于微波传输线缆组件102以90度放置或者定位多管腔衬套300。
参照图5,转换头110的第一段111插入多管腔衬套300的本体部分310的室312中或者接收在室312内。转换头110的第二段113毗邻多管腔衬套300的近端301固定在区域410处。转换头110的第二段113经由O形环115密封室312。O形环115位于上本体部分311的近端301处并且位于室312中。O形环115周向接合室312的内表面,以形成其紧密密封。
另外,截面图500示出了连接构件120,用于将微波传输线缆组件102的端部118联接到同轴馈线106。连接构件120完全定位在转换头110的第二段113内。
在图5中,流入端口320基本平行于流出端口330。流入和流出端口320、330可以基本平行于微波传输线缆组件102。因此,微波传输线缆组件102、流入端口320和流出端口330皆基本垂直于多管腔衬套300和同轴馈线106。同轴馈线106延伸达插管314的一段长度。插管314与流入端口320和流出端口330两者流体连通,使得冷却剂沿着同轴馈线106并在形成在同轴馈线106的远侧部分上的辐射段106a周围流动。
参照图6,示出了致动器,诸如例如滑动心轴600,所述滑动心轴600包括具有近侧部分601和远侧部分603的本体部分610。近侧部分601例如限定了穹顶状部分612。本体部分610还限定了开口620以及一对凹陷部630。凹陷部630定位在本体部分610的远侧部分603的相对侧上。凹陷部630相对于开口620偏移。偏移可以是90度偏移。一对凹陷部630中的每一个均包括孔632。本体部分610由第一本体段614和第二本体段616限定,所述第一本体段614和所述第二本体段616结合形成本体部分610。滑动心轴600的远侧部分603还限定了孔618。孔618构造成允许同轴插管314通过其中,如参照图7在下文讨论的那样。
滑动心轴600的细长本体部分610组装在多管腔衬套300上和转换头110上。转换头110的第二段113、流入端口320和流出端口330延伸通过本体部分610的开口620(图6)。转换头110的第一段111和第二段113至少部分包封在滑动心轴600内。心轴600的本体部分610的穹顶状部分612固定毗邻转换头110的第二段113。多管腔衬套300的插管314延伸通过滑动心轴600的孔618。插管314限定了纵向轴线“X”,所述纵向轴线“X”延伸通过多管腔衬套300和滑动心轴600。
参照图8,示出了微波传输和辐射部件100和多管腔二次成型流体衬套300以及滑动心轴600的组装视图800。微波传输和辐射部件100插入到多管腔衬套300中,使得同轴馈线106和辐射段106a被接收在插管314内。然后,滑动心轴600组装在多管腔衬套300上。插管314和多管腔衬套300以及滑动心轴600限定了通过其中的纵向轴线“X”。微波传输线缆组件102限定了延伸通过其中的纵向轴线“Y”。纵向轴线“X”基本垂直于纵向轴线“Y”。因此,滑动心轴600和多管腔衬套300组装成相对于微波传输线缆组件102成90度。
在图9中,凹陷部630为限定在滑动心轴600的本体部分610的远侧部分603处的圆形凹陷部。在图9示出的实施例中,呈现了在滑动心轴600的另一侧上的类似凹陷部630(未示出)。因此,一对凹陷部630限定在本体部分610的远侧部分603的径向相对的表面上。凹陷部630均构造成接收图10中示出的一对销1010、1020。第一销1010包括第一段1011和第二段1013。第二销1020与第一销1010类似,但是相对于第一销1010示出处于倒置构造中。第二销1020包括第一段1021和第二段1023。第二销1020还包括延伸远离第一段1021杆1025。第一段1021限定了包围杆1025的环形凹陷部1027。杆1025构造成接收在凹陷部630的孔632内,以将第二销1020固定到滑动心轴600的凹陷部630。如能够理解的那样,如图11所示并且根据下文所述的实施例所述,弹簧(未示出)可以接收在环形凹陷部1027内,以当销1010、1020接收在凹陷部630内时推动销1010和1020离开滑动心轴600的本体部分610。
参照图12,锁止心轴1200包括具有近端1201和远端1203的本体部分1205。远端1203包括保持环1210。本体部分1205包括开口1250,用于接收流入端口320、流出端口330和微波传输线缆组件102(图13)。本体部分1205还包括一对纵向狭槽1220。如图12所示,纵向狭槽1220使得第一圆端1222与第二圆端1224分离开。一对纵向槽1220和它们的相应第一和第二圆端1222、1224构造成接收销1010、1020(图10),如将在下文更加详细描述的那样。远端1203还可以限定用于接收插管314(图13)的孔1215,馈线106和辐射段106a已经插入到所述插管314中。纵向狭槽1220还可以称作凸轮表面。第一和第二圆端1222、1224可以具有相等的尺寸。
本体部分1205还包括开口或者切口1230。开口1230延伸达一段长度的本体部分1205,使得流入端口320、流出端口330和微波传输线缆组件102的远端103容纳在其中(图16B)。开口1230可以从一对纵向狭槽1220偏离。偏离可以为90度偏移。
参照图13,组装的视图1300示出了滑动心轴600,所述滑动心轴600组装在接收于锁止心轴1200中的多管腔衬套300上,使得滑动心轴600的销1010、1020接合锁止心轴1200的相应纵向狭槽1220。销1010、1020沿着它们的相应纵向狭槽1220滑动,使得销1010、1020从第一圆端1222和第二圆端1224行进或者在第一圆端1222和第二圆端1224之间行进。诸如弹簧(未示出)的偏压装置强制销1010、1020离开滑动心轴600的本体部分610并且与圆端1222接合,如图13所示。
参照图14A,示出了诸如控制环1400A的致动器并且包括本体部分1410,所述本体部分1410具有近端1401和远端1403。近端1401具有一对伸出件1430,所述一对伸出件1430从本体部分1410向外延伸。一对伸出件1430限定了第一臂段1432和第二臂段1434。第一臂段1432基本垂直于本体部分1410或者限定通过本体部分1410的纵向轴线“Z”。第二臂部分1434例如为弯曲部分。一对伸出件1430形成了用于手动操纵的手柄构件。本体部分1410还限定了开口或者切口1420,用于将流入端口320、流出端口330和微波传输线缆组件102接收或者容纳在其中(图17)。控制环1400A还限定了通过其中的管道或者通道1450。控制环1400A的内表面可以包括一个或者多个止动件1460。
参照图14B,控制环1400B包括具有近端1401’和远端1403’的本体部分1410’。近端1401’具有:第一对伸出件1430’,所述第一对伸出件1430’从本体部分1410’向外延伸;和第二对伸出件1440’,所述第二对伸出件1440’从本体部分1410向外延伸。第一和第二对伸出件1430’、1440’可以基本垂直于本体部分1410’或者限定通过本体部分1410的纵向轴线“Z”。第一和第二对伸出件1430’、1440’可以形成用于手动操纵的手柄构件。本体部分1410’还限定了开口或者切口1420’,用于将流入端口320、流出端口330和微波传输线缆组件102接收或者容纳在其中(图17)。控制环1400B还限定了通过其中的通道1450’。控制环1400B的内表面可以包括一个或者多个止动件1460’。
滑动心轴600和控制臂1400A在此皆描述为致动器。本领域中的技术人员将意识到的是根据本公开,这两个致动器可以单独或者一起操作并且它们可以作用在在此描述的组件的不同部件上。
现在参照图15A和15B描述容纳同轴馈线106和辐射段106a的插管314的部署。图15A是根据本公开的方面的组装到图12的锁止心轴1200和图11的滑动心轴600上的图14A的控制环1400A的截面图1500A,其中,插管314处于部署位置中。
图15A,控制环1400A组装到或者安装在锁止心轴1200上,使得滑动心轴600的销1010、1020沿着锁止心轴1200的带沟槽开口1220行进。开口1420(图14A)可以延伸达控制环1400A的本体部分1410的较大长度。在部署位置中,滑动心轴600位于由锁止心轴1200限定的区域1550的下部分中,并且销1010、1020靠近控制环1400A的远端1403位于第二圆端1224内。销1010、1020的第二段1013、1023(图10)分别是突出构件,使得当将销下按到锁止心轴600的凹陷部630中,它们允许滑动心轴600经由带沟槽开口1220相对于锁止心轴1200移动并且防止从锁止心轴1200移除滑动心轴600。
图15B是根据本公开的方面的组装到图12的锁止心轴1200和图11的滑动心轴600的图14A的控制环1400A的截面图,其中,插管314处于缩回位置中。
在缩回位置中,滑动心轴600位于由锁止心轴1200限定的区域1550的上部分中。在这两个构造中,转换头110保持固定到滑动心轴600内的多管腔衬套300,并且插管314相对于锁止心轴1200移动。在缩回位置中,销1010、1020位于第一圆端1222或者控制环1400A的近端1401处。
另外,因为控制环1400A安装到锁止心轴1200上,所以控制环1400A还相对于滑动心轴600移动。因此,当将保持力“A”施加到滑动心轴并且致动力“C”被施加到控制环1400A的一对伸出件1430使得滑动心轴600不移动时,控制环1400A沿着方向“B”移动。该移动导致通过比较图15B的缩回位置与图15A的部署位置得到的变化。在这个过渡中,销1010、1020沿着它们相应纵向狭槽1220在第一圆端1222和第二圆端1224之间行进。滑动心轴600接合区域1550内的锁止心轴1200的内表面1525。因此,锁止心轴1200选择性地将滑动心轴600锁止在延伸位置和缩回位置之间。结果,插管314可以基于滑动心轴600和控制环1400A以及锁止心轴1200的相对移动而延伸和缩回。
图16A示出了组装到图12的锁止心轴1200的图14A的控制环1400A的替代视图,其中,插管314和滑动心轴600处于缩回位置中。类似地,图16B示出了组装到图12的锁止心轴1200上的图14A的控制环1400A的替代视图,其中,插管314位于部署位置中。图16A和16B示出了流入端口320、流出端口330、和延伸通过锁止心轴1200的开口1230(图12)和控制环1400A的开口1420(图14A)的微波传输线缆组件102。另外,流入端口320、流出端口330和微波传输线缆组件102的远端103在由锁止心轴1200的开口1230和控制环1400A的开口1420限定的区域内移动(当在延伸和缩回位置之间过渡时)。
如参照图16A和16B在上文所述,流入端口320、流出端口330和微波传输线缆组件102的远端103在由锁止心轴1200的开口1230(图12)和控制环1400A的开口1420限定的区域内移动(当在延伸和缩回位置之间过渡时)。开口1230和1420相互重叠。图17还提供了位于锁止心轴1200内的滑动心轴600和控制环1400A的替代透视图。
图18示出了连接到锁止心轴1200的鼻锥1800。鼻锥1800包括本体部分1810,所述本体部分1810限定了上本体段1811和下本体段1813。上本体段1811包括切口段1815。本体部分1810具有形成在下本体段1813上的远侧部分1820。远侧部分1820具有孔1830。
参照图19,上本体部分1811构造成接收锁止心轴1200的远端1203(图12)和控制环1400A的远端1403(图17)。上本体部分1811的切口段1815构造成包围流出端口330。插管314延伸通过鼻锥1800的远侧部分1820的孔1830。因此,孔1830被适配和尺寸设计成接收插管314。
如图20所示,鼻锥1800在其内表面2012上包括凹陷部2010,用于接收锁止心轴1200的保持环1210。凹陷部2010是沿着鼻锥1800的内表面2012限定的环形凹陷部。保持环1210与凹陷部2010相互作用,以将鼻锥1800固定到锁止心轴1200。
在图21中,锁止机构2110示出定位在鼻锥1800的远侧部分1820的平坦表面2112的远端2114上。锁止机构2110构造成与参照图23A至23D在下文描述的套管针/插管组件相互匹配。
图22示出了完全组装的微波消融组件2200,所述微波消融组件2200包括壳体2212,所述壳体2212覆盖用于连接到微波发生器的弹簧偏压的联接元件104。微波传输线缆组件102可以包括覆盖件,所述覆盖件具有狭槽2214,第一流体流动通道2216和第二流体流动通道2218通过所述狭槽2214离开。第一流体流动通道2216连接到流入端口320,第二流体流动通道连接到流出端口330。虽然未示出,但是微波发生器可以包括流体源并且使得能够通过壳体2212连接流体源、
参照图23A至24描述了微波消融组件2200的插入和部署。图23A示出了刚性插管2310,所述刚性插管2310包括连接到具有远侧部分2314的轴2312的壳体2316。壳体2316包括狭槽2318,用于接收锁止机构2318或者2110。图23B示出了套管针2320,所述套管针2320包括连接到具有远侧末端2324的轴部分2322的保持构件2326。保持构件2326包括锁止机构2328。现在参照图23C和23D,套管针2320的锁止机构2328与插管2310的壳体2316的狭槽2318匹配。锁止机构2328将套管针2320固定到插管2310。套管针2320因此可释放联接到插管2310。远侧末端2324可以是相对尖锐末端,以刺穿组织。
通常,临床医生在实施例如肝消融手术时,将需要一系列图像来识别肿瘤或者病变的位置,以用于消融。一旦被识别,则临床医生将寻求将如图23D所示的插管2310和套管针2320组件放置在肿瘤或者病变附近。可以通过各种技术来实施这种放置,所述各种技术包括荧光镜检查、超声、MRI和CT成像技术、它们单独或者组合一个或者多个导航技术(诸如,电磁导航)。一旦将插管2310和套管针2320组件定位在患者体内的肿瘤或者病变附近的所需位置中,则可以移除套管针2320。插管2310保持在准备接收微波消融组件220的位置中或者适当实施一个或者多个预处理活检的位置。
微波消融组件2200然后可以放置在插管2310内肿瘤或者病变附近的所需位置处,并且经由鼻锥1800上的锁止机构2110和插管2310的壳体2316上的狭槽2310固定到插管2310上。然而,为了保护插管314内馈线106和辐射段106a,插管314没有从插管2310部署。为了部署容纳有馈线106并且更加具体地辐射段106a的插管314,控制环1400A和锁止心轴1200必须相对于滑动心轴600压缩。通过锁止心轴在滑动心轴600(优选地保持固定)上相对移动,插管2310相对于插管314缩回,从而暴露出插管314并且更加具体暴露出容纳在其中的辐射段106a。
图24示出了延伸超过插管2310的远端的插管314。在这个位置中,已经缩回插管2310,从而暴露出插管314和微波辐射组件2200的辐射段106a。通过克服由销1020、1030施加的保持力将压力施加在控制环1400a上,暴露出了插管314(图14A),从而允许控制环1400a和锁止心轴1200(图12)相对于滑动心轴600移动(图6)。在这个位置中,微波组件2210处于实施消融的位置中。
如在此所述,在本公开的优选实施例中,当插管314以及更加具体来说辐射段106a部署至手术部位或者目标时,滑动心轴600、多管腔壳体300和微波传输和辐射部件100保持固定在空间中(或者保持固定)。当辐射段106a部署至手术部位或者目标时,沿着远离手术部位的方向拉动锁止心轴1200、控制环1400A和鼻锥1800。
本公开使得能够在各种介入手术类型中从非射频透明接入管腔(诸如插管2310)放置插管314,所述插管314可以具有柔性并且包括辐射段106a。这些介入手术包括经皮放置(与刚性活检装备类似)、开放手术(钢针状)、腹腔镜手术(手助放置)。通过使用插管2310和套管针2320,通向特定处理部位的接近路径能够与能量输送装置约束分离开。还可以设想的是在此描述的方法和装置使得能够建立血管通路,因此能够利用可转向的导丝放置柔性构造的插管314。而且,还可以设想利用插管314的混合手术,所述插管314部分具有刚性而部分具有柔性。
根据本公开的另一个方面,预期有接近途径,其中,在放置插管2310和移除套管针2320之后,插管314(可以包括可转向导丝或者可以利用可转向导丝插入通过柔性引导护套)能够以4维自由度延伸接入路径。
本发明的系统和方法通过使得在接入通道放置期间的临床医生需要和与能量输送有关的临床医生需要分离开而改进工作流程。通过与微波消融组件2200分离开使用插管2310和套管针2320,临床医生在放置插管2310的同时不必处理微波消融组件2200的约束。移除对微波线缆、流体管路、装置重量、手柄长度等的关注大大改进了临床医生专注于将插管2310放置在目标部位处或者附近的能力,并且还允许更加便捷地为放置部位成像(例如,通过荧光镜或者CT成像)。而且,因为在插管2310插入步骤期间没有采用微波和流体元件部分,所以通过节省装置内的空间,套管针2320和插管2310可以“搭载”其它能力,诸如EM导航传感器、温度传感器、装置固定特征件和其它诊断能力。
根据本公开,插管2310可以具有小于用于放置微波消融部件的现有装置的直径规格或者French尺寸。实际上,插管2310可以是用于扩大开口尺寸以接收微波消融组件2200的一系列插管中的一根。
装置、包含这种装置的系统和使用所述装置和所述系统的方法的详细实施例如在此描述。然而,这些详细实施例仅仅为本公开的示例,可以以各种形式实施所述详细实施例。因此,在此公开的具体结构和功能细节并不理解为限制,而仅仅为权利要求的基础和代表性基础,用于允许本领域中的技术人员在适当的详细结构中以各种方式采用本公开。
尽管已经在附图中示出了本公开的若干实施例,但是不应当理解为本公开局限于此,原因在于本公开的范围如本领域所允许的那样宽泛并且应当同样解读说明书。还可以设想上述实施例的任何组合并且所述组合均处于附属权利要求的范围内。因此,上述描述不应当理解为限制,而仅仅作为特定实施例的解释。本领域中的技术人员将设想处于附属权利要求范围内的其它修改方案。
Claims (20)
1.一种微波消融组件,包括:
第一插管;
套管针,所述套管针能够插入通过第一插管并且构造成便于将第一插管插入到目标组织中;
微波天线组件,所述微波天线组件构造成在套管针从第一插管移除后固定至第一插管,微波天线组件包括同轴馈线,所述同轴馈线具有形成在其上的辐射段,微波天线组件构造成插入第一插管中;和
致动器,所述致动器能够操作连接到第一插管或者微波天线组件中的一个,
其中,致动器在第一位置和第二位置之间的操作使微波天线组件的辐射段从第一插管的远侧部分露出。
2.根据权利要求1所述的微波消融组件,其还包括转换头,所述转换头适于将微波天线组件连接到微波传输线缆组件。
3.根据权利要求2所述的微波消融组件,其还包括多管腔壳体,所述多管腔壳体具有形成在其近端处的衬套,所述衬套限定了通过其中的纵向轴线,并且包括流入端口和流出端口,以提供冷却剂进出多管腔壳体的各入口和出口,从而冷却微波天线组件。
4.根据权利要求3所述的微波消融组件,其还包括第二插管,所述第二插管从多管腔壳体延伸、与流入端口和流出端口流体连通、并且接收微波天线组件,其中,冷却剂流经第二插管并且在微波天线组件上流动。
5.根据权利要求3所述的微波消融组件,其中,流入端口和流出端口相互平行并且垂直于由衬套限定的纵向轴线。
6.根据权利要求3所述的微波消融组件,其中,转换头包括第一段和第二段,第一段适于联接到微波传输线缆组件的远端,而第二段适于联接到同轴馈线的近端。
7.根据权利要求6所述的微波消融组件,其还包括O形环,所述O形环适于装配在转换头的第二段上,转换头的第二段适于接收在多管腔壳体的衬套中,使得O形环在连接时形成转换头的第二段和衬套之间的不透流体密封。
8.根据权利要求2所述的微波消融组件,其中,致动器限定:
位于其相对表面上的一对凹陷部:和
用于露出流入端口、流出端口和线缆组件的远端的开口。
9.根据权利要求8所述的微波消融组件,其还包括接收在致动器的相对表面上的所述一对凹陷部中的销。
10.根据权利要求9所述的微波消融组件,其还包括锁止心轴,其中,所述锁止心轴组装在致动器上。
11.根据权利要求10所述的微波消融组件,其中,锁止心轴还包括本体部分,所述本体部分在其相对表面上限定了一对纵向狭槽。
12.根据权利要求11所述的微波消融组件,其中,纵向狭槽均将其第一端部和其第二端部分离开。
13.根据权利要求12所述的微波消融组件,其中,致动器包括滑动心轴,所述滑动心轴构造成在锁止心轴内滑动,使得销沿着所述一对纵向槽行进,以在第一端部和第二端部之间锁止。
14.根据权利要求13所述的微波消融组件,其中,所述致动器还包括控制环,所述控制环组装在滑动心轴和锁止心轴的一部分上。
15.根据权利要求14所述的微波消融组件,其中,控制环包括:本体部分;从本体部分延伸的一对相对的伸出件;和构造成和尺寸设计成接收销并且引导销纵向移动的一对相对的细长凸轮表面。
16.根据权利要求15所述的微波消融组件,其中,鼻锥组装在控制环的一部分上,鼻锥具有近端和远端,鼻锥的远端具有带锁止机构的末端部分,并且鼻锥的近端限定了切口部,切口部构造成接收通过其中的流出端口。
17.根据权利要求16所述的微波消融组件,其包括保持环,所述保持环形成在锁止心轴上并且构造成将鼻锥固定到锁止心轴。
18.根据权利要求17所述的微波消融组件,其还包括壳体,所述壳体形成在第一插管的近侧区域上并且构造成与鼻锥的锁止机构匹配。
19.根据权利要求15所述的微波消融组件,其中,在致动器致动时,滑动心轴和第二插管保持固定,并且第一插管沿着滑动心轴的方向被拉动,以露出位于其中的微波天线组件的辐射段和第二插管。
20.根据权利要求19所述的微波消融组件,其中,锁止心轴、控制环和鼻锥沿着滑动心轴的方向被拉动,以露出位于其中的微波天线组件的辐射段和第二插管。
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2020
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CN107126254A (zh) | 2017-09-05 |
US20210007802A1 (en) | 2021-01-14 |
US10813692B2 (en) | 2020-10-27 |
US20170245930A1 (en) | 2017-08-31 |
EP3210563A1 (en) | 2017-08-30 |
CN110946649A (zh) | 2020-04-03 |
EP3210563B1 (en) | 2018-12-19 |
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