CN107997830A - 刚性耳鼻喉工具 - Google Patents

刚性耳鼻喉工具 Download PDF

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CN107997830A
CN107997830A CN201711059181.5A CN201711059181A CN107997830A CN 107997830 A CN107997830 A CN 107997830A CN 201711059181 A CN201711059181 A CN 201711059181A CN 107997830 A CN107997830 A CN 107997830A
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pipe
sleeve
distal end
conductive coil
passage
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A.戈瓦里
V.格里纳
Y.阿加维
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Biosense Webster Israel Ltd
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Abstract

本发明题为“刚性耳鼻喉工具”。本发明提供了一种装置,该装置包括包封管腔的刚性管,该刚性管被配置成插入人类患者的腔体中。沟槽形成在管的远侧端部中,并且绝缘布线的导电线圈在沟槽中缠绕。套筒覆盖刚性管以便完全包封导电线圈。

Description

刚性耳鼻喉工具
技术领域
本发明整体涉及外科手术工具,并且具体地涉及在患者体内时受到追踪的刚性外科手术工具。
背景技术
在工具诸如ENT(耳、鼻和喉)工具被插入患者体内的外科手术过程中,追踪工具的插入部分是重要的。以下专利和专利申请提供了用于执行此类追踪的方法。
Chang等人的美国专利申请2006/0004286描述了用于执行图像引导介入和外科手术过程的系统,所述图像引导介入和外科手术过程包括用于治疗窦炎和鼻旁窦、耳、鼻或喉的其它疾病的各种过程。
Silverstein等人的美国专利申请2012/0143029描述公开了用于帮助将针插入患者体内的引导系统。引导系统可具有成像设备,该成像设备包括用于产生内部身体部分目标诸如脉管的图像的探针。该探针包括一个或多个传感器。传感器感测与针有关的可检测的特性,诸如包括在针中的磁体的磁场。
Greenburg等人的美国专利申请2012/0226100描述了用于扩展支气管镜的视觉能力和工作通道的系统。该系统包括探针,该探针在支气管镜的远侧末端处具有光学和/或追踪能力,并且该探针能够被推进通过标准支气管镜的工作通道。
Dinger、III等人的美国专利申请2014/0066901描述了用于治疗解剖开口诸如鼻旁窦的器械。本申请涉及用于对治疗部件定位的图像引导导航系统。
Ben-Haim等人的美国专利6,321,109描述了在身体中挖掘组织的方法。本专利涉及感测导管的尖端的瞬时位置的位置感测设备。该位置传感器被表述为感测由发射器生成的交流(AC)磁场的交流(AC)磁场接收器。
Makower等人的美国专利申请2008/0275483描述了与图像引导或导航系统和手持设备结合使用的导航设备。
Chang等人的美国专利8,721,591描述了用于扩张鼻旁窦口的装置。该装置可包括为电磁位置传感器的传感器。
Rosenberg的美国专利5,071,409描述了包括用于感测活塞在汽缸内的位置的位置传感器的柱塞。位置传感器可为由柱塞承载的磁芯的形式。
发明内容
本发明的实施方案提供了一种装置,包括:
刚性管,该刚性管包封管腔,该刚性管被配置成插入人类患者的腔体中;
沟槽,该沟槽形成于管的远侧端部中;
绝缘布线的导电线圈,该绝缘布线的导电线圈在沟槽中缠绕;和
套筒,该套筒覆盖刚性管以便完全包封导电线圈。
在公开的实施方案中,该装置包括通道和一个或多个导体,所述通道连接到沟槽并且形成于管上,所述一个或多个导体放置于连接到导电线圈的端部的通道。通常,套筒被配置成覆盖通道以便完全包封一个或多个导体。远侧端部可被倒角,并且套筒连接到经倒角的远侧端部,使得套筒的外部表面和经倒角的远侧端部形成连续平滑表面。
在另一个公开的实施方案中,将柄部连接到管的近侧端部。通常,柄部包括电路,该电路连接到导电线圈以便接收其中生成的信号。
根据本发明的实施方案,还提供了一种方法,包括:
提供包封管腔的刚性管,该刚性管被配置成插入人类患者的腔体中;
在管的远侧端部中形成沟槽;
使绝缘布线的导电线圈在沟槽中缠绕;以及
用套筒覆盖刚性管以便完全包封导电线圈。
通过以下结合附图对本公开实施方案的详细描述,将更全面地理解本公开,其中:
附图说明
图1是根据本发明的实施方案的ENT(耳、鼻和喉)系统的示意图;并且
图2和图3分别是根据本发明的实施方案的ENT抽吸工具和所述工具的管远侧部分横截面的示意图。
具体实施方式
综述
由于端部在敏感区域诸如眼睛、视神经和大脑附近,因此追踪在ENT过程中使用的ENT(耳、鼻和喉)工具的远侧端部是重要的。发明人已经发现,尽管可通过将追踪传感器附接到ENT工具的近侧端部以及将矢量添加到近侧端部位置来追踪远侧端部,但是在实施过程中,错误与使生成的远侧端部值不可接受的添加的矢量相关联。
本发明的实施方案形成了具有磁追踪传感器(在这种情况下内置于工具中的单个线圈)的刚性ENT工具。工具通常是刚性抽吸工具,但是本文所描述的概念能够应用于其它刚性工具诸如切割器和抓紧器。
将圆形沟槽切入到基本工具的远侧端部中,并且线圈在沟槽中缠绕。还从圆形沟槽最多至工具的近侧端部切割通道。将线圈连接到近侧端部的导体定位在通道中。然后由金属套筒覆盖通道和沟槽,使得基本工具外表面返回到基本工具外表面初始的非凹进形式。
详细描述
现在参考图1,图1是根据本发明的实施方案的ENT(耳、鼻和喉)系统20的示意图。在以下描述中,假设系统20用于对患者22执行鼻窦过程,并且在该过程期间使用抽吸工具21。如下面更详细描述的,工具21在工具21的远侧末端处包括磁性传感器32,并且在该过程期间通过磁追踪系统23追踪该传感器。为了使追踪是有效的,在系统20中,使患者22的CT(计算机断层摄影术)图像和磁追踪系统23的参照系对准。使用的对准方法可包括在本领域中已知的任何对准方法。
虽然CT图像通常可包括磁共振成像(MRI)图像或荧光图像,但是在本文的描述中,以举例的方式,图像被假设为包括荧光CT图像,
在窦过程之前和期间,包括在磁追踪系统中的磁性辐射器组件24被定位在患者的头部附近。组件24包括磁场辐射器26,该磁场辐射器被固定在适当位置,并且将交变正弦磁场传输到患者22的头部位于的区域30中。以举例的方式,组件24的辐射器26被布置成围绕患者22的头部的大致马蹄形。然而,组件24的辐射器的另选构型对于本领域的普通技术人员来说将是显而易见的,并且所有此类构型都被假设为包括在本发明的范围内。由加利福尼亚州钻石吧的Biosense Webster(Biosense Webster,of Diamond Bar,CA)生产的系统使用与本文所描述的追踪系统类似的追踪系统,用于在受磁场照射的区域中找到线圈的位置和取向。
抽吸工具21包括在工具的近侧端部处的探针柄部52,并且抽吸工具还包括在工具的远侧端部处的刚性管60。柄部52允许医师54操纵该工具。挠性管材59连接到柄部52,该管材准许流体通过管60的管腔34排出。此外,将电缆缆线36连接到柄部52,该电缆缆线使得能够将电力传递到柄部中的元件,以及使得能够从柄部传送源自传感器32的信号。
包括辐射器26的系统20的元件由系统处理器40控制。处理器还被配置成接收源自传感器32的信号,并且处理信号以导出用于传感器的位置和取向值。处理器40可安装在控制台50中,该控制台包括操作控制件58,该操作控制件通常包括小键盘和/或指向设备,诸如鼠标或轨迹球。控制台50经由线缆和/或无线地连接到辐射器。医师54使用操作控制件58以与处理器交互,同时使用系统20执行ENT过程。在执行该过程时,处理器可在屏幕56上呈现该过程的结果。
处理器40使用存储在存储器42中的软件来操作系统20。例如,软件可以电子形式通过网络下载到处理器40,或另选地或除此之外,该软件可被提供和/或存储在非暂态有形介质(诸如,磁存储器、光学存储器或电子存储器)上。
处理器40尤其使用该软件来操作组件24的磁性辐射器26,并且分析从传感器32接收的信号。如上面所表述的,辐射器将不同频率的正弦交变磁场传输到区域30中,该区域包括患者22的头部,并且来自辐射器的场感应传感器32中的信号。
图2和图3分别是根据本发明的实施方案的ENT抽吸工具21和工具的刚性管60的远侧部分横截面的示意图。如图2所示,刚性的不可弯曲的管60形成为工具21的远侧端部。管60固定地附接到壳体74,该壳体74通常包封耦接到传感器32的电路82,并且形成柄部52的部分。该电路通常包括前置放大器,该前置放大器接收来自传感器32的信号,并且将信号转化成可经由电缆缆线36传送到处理器40的形式,而不会将噪声引入到信号中。管状流体连接件80也固定地附接到壳体74,并且该连接件连接到管材59(图1),并且被配置成使得在ENT过程期间体液可通过管60的管腔34和连接件80排出,而不会泄漏到壳体74中。
为了有效地操作,管60必须满足多个有时冲突的约束。由于管60充当抽吸设备,所以管60的内部管腔应尽可能地大,并且管腔不应具有可能阻止管腔中材料的流动的内部障碍物。然而,由于将在内部过程中对患者使用管,所以管的外部尺寸应尽可能地小以便减少由管进入患者而引起的任何创伤。此外,也减少创伤的可能性,管的外表面应平滑,没有压痕或隆起。由于将在外科手术中使用管,所以可接触患者的管的表面应是生物相容性的,并且管自身应能够例如在高压釜中进行杀菌。
图3示出了如何构造管60以满足上面列出的约束。管60包括圆柱形生物相容性导线管90(本文也称为管90),该圆柱形生物相容性导线管90包封管腔34。圆形沟槽92形成于导线管的远侧末端处的导线管的外部表面94中。通道96形成于外部表面中,从沟槽92通向壳体74。以举例的方式,在图3所示的实施方案中,通道96形成为螺旋通道,但是在其它实施方案中,通道可为形成于外部表面中将沟槽92连接到壳体74的任何方便的形状(包括直线)。
绝缘布线的线圈98在沟槽92中缠绕,该线圈充当传感器32。将线圈的端部连接到放置在通道96中且将线圈的端部连接到电路82的一对绝缘导体100。在一个实施方案中,布线具有约40μm的直径,沟槽具有约100μm的深度,并且通道具有约100μm直径的半圆形横截面。
一旦已经如上所述形成线圈98和导体100并且对线圈98和导体100进行定位,通道96和沟槽92就被刚性圆柱形生物相容性金属套筒102覆盖,使得完全包封通道和沟槽的导体。套筒通常与管90的外表面过盈配合。在一个实施方案中,由不锈钢或钛构造套筒和管90,并且在将套筒插入到管90上之后,两者被焊接在一起。如图3所示,然后导线管90的远侧末端104可被倒角,使得管60的外部表面形成连续、平滑和未凹进表面,管60的外部表面包括套筒102的外部表面和导线管90的外部远侧部分,即,经倒角的远侧末端104。
在公开的实施方案中,套筒102具有3.57mm的外径和3.4mm的内径,并且导线管90具有3.4mm的外径和3.1mm的内径。
虽然上面的描述已整体提及抽吸工具,但是应当理解,本文所描述的概念加上必要的变更可应用于其它基于管的工具,以及其它工具诸如剃刀和微型清创器。
应当理解,以举例的方式引用上面描述的实施方案,并且本发明不限于上文具体示出和描述的内容。相反,本发明的范围包括上文描述的各种特征的组合和子组合,以及本领域技术人员在阅读前述描述时将会想到的且未在现有技术中公开的各种特征的变型和修改。

Claims (12)

1.一种装置,包括:
刚性管,所述刚性管包封管腔,所述刚性管被配置成插入人类患者的腔体中;
沟槽,所述沟槽形成于所述管的远侧端部中;
绝缘布线的导电线圈,所述绝缘布线的导电线圈在所述沟槽中缠绕;和
套筒,所述套筒覆盖所述刚性管以便完全包封所述导电线圈。
2.根据权利要求1所述的装置,并且包括通道和一个或多个导体,所述通道连接到所述沟槽并且形成于所述管上,所述一个或多个导体放置在连接到所述导电线圈的端部的所述通道中。
3.根据权利要求2所述的装置,其特征在于,所述套筒被配置成覆盖所述通道以便完全包封所述一个或多个导体。
4.根据权利要求3所述的装置,其特征在于,所述远侧端部被倒角,并且其中所述套筒连接到经倒角的远侧端部使得所述套筒的外部表面和经倒角的远侧端部形成连续平滑表面。
5.根据权利要求1所述的装置,并且包括柄部,所述柄部连接到所述管的近侧端部。
6.根据权利要求5所述的装置,其特征在于,所述柄部包括电路,所述电路连接到所述导电线圈以便接收其中生成的信号。
7.一种方法,包括:
提供包封管腔的刚性管,所述刚性管被配置成插入人类患者的腔体中;
在所述管的远侧端部中形成沟槽;
使绝缘布线的导电线圈在所述沟槽中缠绕;以及
用套筒覆盖所述刚性管以便完全包封所述导电线圈。
8.根据权利要求7所述的方法,并且包括在所述管上形成连接到所述沟槽的通道,并且将连接到所述导电线圈的端部的一个或多个导体放置在所述通道中。
9.根据权利要求8所述的方法,其特征在于,所述套筒被配置成覆盖所述通道以便完全包封所述一个或多个导体。
10.根据权利要求9所述的方法,其特征在于,所述远侧端部被倒角,并且其中所述套筒连接到经倒角的远侧端部使得所述套筒的外部表面和经倒角的远侧端部形成连续平滑表面。
11.根据权利要求7所述的方法,并且包括柄部,所述柄部连接到所述管的近侧端部。
12.根据权利要求11所述的方法,其特征在于,所述柄部包括电路,所述电路连接到所述导电线圈以便接收其中生成的信号。
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