CN110251229A - 传送能量的装置及相关使用方法 - Google Patents

传送能量的装置及相关使用方法 Download PDF

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CN110251229A
CN110251229A CN201910385117.9A CN201910385117A CN110251229A CN 110251229 A CN110251229 A CN 110251229A CN 201910385117 A CN201910385117 A CN 201910385117A CN 110251229 A CN110251229 A CN 110251229A
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actuation component
medical instrument
backstopping assembly
leg
distal
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曼·明·恩古耶恩
埃里克·卡尔·利斯谢尔
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Boston Scientific Scimed Inc
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Abstract

本发明涉及传送能量的装置及相关使用方法。本发明公开一种医疗器械。该医疗器械可包括细长部件，其具有至少部分地在细长部件的近端和远端之间延伸的腔。医疗器械还可包括多个连接至细长部件的远侧部分的腿部，和连结至多个腿部中的每一个并位于细长部件的远端的远侧的远侧端片。医疗器械还可包括连接至远侧端片并在多个腿部之间延伸穿过腔的促动部件。促动部件的往复运动可配置成使多个腿部从第一位置可逆地移至第二位置。医疗器械还可包括连接至促动部件并配置成限制促动部件的运动的止挡部件。

Description

传送能量的装置及相关使用方法
本申请是于2014年6月5日提交的、申请号为201480032297.8、名为《传送能量的装置及相关使用方法》的申请的分案申请。
相关申请的交叉引用
根据《美国法典》35卷§119，本专利申请要求于2013年6月6日提交的美国临时专利申请第61/831,997号的优先权，并根据《美国法典》35卷§120要求于2014年6月4日提交的美国非临时专利申请第14/295,745号的优先权，其全部内容通过引用合并在此。
技术领域
本发明大体涉及用于传送热能至壁的装置和方法。更特别地，本发明涉及治疗肺部系统和气道的装置和方法。更特别地，本发明涉及治疗具有阻塞性肺病至少一种症状的肺的内科和外科装置及方法。本发明还涉及以可控方式传送能量至肺的气道组织的装置和方法。
背景技术
传送能量至壁的装置通常用来治疗医疗病情。一种此类病情是慢性阻塞性肺病(COPD)，其是一种可导致肺气道阻塞从而限制气流进出肺部的进行性疾病。因此，患有慢性阻塞性肺病的患者可能呼吸困难。可能有许多因素是慢性阻塞性肺病的原因，诸如平滑肌收缩，过多粘液产生，气道壁由于炎症而变厚，以及气道周围结构的改变。更特别地，位于此类患者肺气道壁内的气道平滑肌(ASM)过度且不合适的收缩可能是慢性阻塞性肺病的促成因素。因此，减少过多的气道平滑肌可针对慢性阻塞性肺病的治疗提供治疗益处。已研发出微创技术来成功地减少和/或消除过多的气道平滑肌。
用于减少(例如，收缩或减量(debulking))过多的气道平滑肌的微创技术的实例涉及使用导管传送热能至气道壁。为了实施该治疗，导管定位在气道内的期望位置处。使导管末端上的电极阵列扩张以接触气道壁。通过紧握导管的手柄来手动扩张电极使其达到期望的扩张量。在一些实施方式中，治疗可能涉及损伤肺部系统气道中的神经组织以降低平滑肌组织的静息张力(resting tone)。
使用常规的微创技术可能仍然不是最理想的。例如，由于压挤手柄太多可能使电极过扩张，导致可能损伤电极及邻近的身体组织。另外，使用者可能无法施加足够的压力至手柄，导致电极不接触气道壁或者不能均匀地传送热能至气道壁。
因此，已知的、用来减轻慢性阻塞性肺病至少一种症状的微创技术仍然存在缺点。
发明内容
本发明涉及以可控方式传送热能至人体组织壁以执行某些医疗手术(包括一般手术和外科手术)的医疗器械。
在本发明的一个方面，医疗器械可包括细长部件，其具有至少部分地在细长部件的近端和远端之间延伸的腔。医疗器械还可包括多个连接至细长部件的远侧部分的腿部，和连结至多个腿部中的每一个并位于细长部件的远端的远侧的远侧端片。医疗器械还可包括连接至远侧端片并在多个腿部之间延伸穿过腔的促动部件。促动部件的往复运动可配置成使多个腿部从第一位置可逆地移至第二位置。医疗器械还可包括连接至促动部件并配置成限制促动部件的运动的止挡部件。
本发明的各种实施方式还可包括以下方面中的一个或多个：其中止挡部件可配置成限制促动部件沿细长部件的纵轴线的运动；其中止挡部件的至少一部分可设置在远侧端片内；其中止挡部件可界定配置成容纳促动部件的一部分的腔；其中促动部件还可包括设置在促动部件的远端的凸出物，凸出物可配置成压缩止挡部件；其中凸出物可以是附装至促动部件的远端的盘状物，其中盘状物的宽度可大于止挡部件的腔的宽度；其中盘状物可接合止挡部件的远端以限制促动部件的运动；支撑物围绕促动部件设置并连结至止挡部件，支撑物可配置成支撑止挡部件的近端；其中止挡部件可形成在多个腿部中的每一个的至少一端；其中止挡部件可设置在多个腿部的近侧；其中止挡部件可设置在促动部件的两个部分之间；其中多个腿部可在第一位置紧缩，并在第二位置配置成从纵轴线向外弓；并且其中止挡部件可在多个腿部位于第一位置时处于第一形态，在多个腿部位于第二位置时处于第二形态。
在另一方面，本发明可涉及具有细长部件的医疗器械，细长部件具有在细长部件的近端和远端之间延伸的腔。医疗器械还可包括多个从细长部件的远端延伸出的腿部。至少一个腿部可包括用于传送能量的电极，并且多个腿部中的每一个具有远端。医疗器械还可包括连结至多个腿部中的每一个的远端的远侧端片，和连接至远侧端片并在多个腿部之间延伸穿过腔的促动部件。促动部件可配置成使多个腿部从第一位置可逆地移至第二位置。当近侧力施加至促动部件时，多个腿部可从第一位置移至第二位置，并且当近侧力释放时，多个腿部可从第二位置移至第一位置。医疗器械还可包括连接至促动部件配置成限制促动部件的运动的止挡部件。
本发明的各种实施方式还可包括以下方面中的一个或多个：其中止挡部件的至少一部分可设置在远侧端片内；并且其中促动部件可进一步包括设置在促动部件的远端的凸出物，凸出物可配置成在促动部件向近侧方向移动时接合止挡部件。
在又另一方面中，本发明可涉及使用医疗器械传送能量至体腔壁的方法。该方法可包括将医疗器械插入到体腔中，并向近侧拉动促动部件以使在医疗器械的远端的可扩张部件径向扩张。该方法还可包括通过压缩连接至促动部件的止挡部件来限制可扩张部件的径向扩张，以及经由可扩张部件施加能量至体腔壁。
本发明的各种实施方式还可包括：其中可扩张部件的径向扩张可通过限制促动部件沿医疗器械的纵轴线运动而得到限制；其中止挡部件的至少一部分设置在医疗器械的远侧端片内；并且其中止挡部件可界定配置成容纳促动部件的一部分的腔。
在以下说明中部分提出本发明主题的附加的特性、特征和优势，根据说明部分显而易见的，或者可通过实施本发明而习得。本发明的特性和特征经由权利要求中特别指出的元件和组合可实现并获得。
应当理解，上述总的说明和以下的具体描述都是示范性的，仅用于说明，而并不限制本发明的主题。
附图说明
附图，其包含在本说明书中并构成本说明书的一部分，示出了本发明的示范实施方式，并与说明一起用来解释本发明的原理。
图1是根据本发明一个实施方式的示范医疗器械的示意图；
图2是图1中医疗器械的侧剖面图，描绘了处于未压缩位置的止挡部件；
图3是图1中医疗器械的侧剖面图，描绘了处于压缩位置的止挡部件；
图4是图1中根据本发明一实施方式的医疗器械的侧剖面图；
图5是根据本发明一实施方式的医疗器械的局部立体图；
图6是根据本发明一实施方式的医疗器械的剖面图。
具体实施方式
现在参考本发明的某些示范实施方式，在附图中示出其实例。只要可能，整个附图中将使用相同的附图标记来指代相同或相似的部件。术语“远侧”是指将装置引入到患者体内时距医学专家最远的一端。术语“近侧”是指将装置放置在患者体内时最靠近医学专家的一端。
概述
本发明的实施方式涉及配置成传送一致的热能至人体组织壁的装置及其方法。例如，本发明装置的实施方式可以以可控方式促进热能传送至肺气道壁以减少、收缩、减量或以其他方式消除过多的气道平滑肌(ASM)，从而减轻慢性或可逆性阻塞性肺病(包括但不限于哮喘)的至少一种症状。
示范实施方式
本文中公开的实施方式可连同伸长装置一起使用，伸长装置可以是内窥镜系统，其起到将公开的实施方式引入并传送到患者体内目标部位的装置的作用。然而，应当注意到，本发明实施方式可连同其他引入装置、鞘套或系统一起使用，诸如气管镜、套管针、内窥镜、导管鞘套、腹腔镜、结肠镜、输尿管镜等。
图1是根据本发明用于传送热能至治疗部位的示范医疗器械的示意图。医疗器械10可配置成横越穿过身体的具有壁的窄腔(例如，肺气道)到达治疗部位。
医疗器械10可包括鞘套11，细长部件12可穿过该鞘套11。细长部件12可具有远端20，近端(未示出)，及在远端20和近端之间延伸的腔13。尽管细长部件12可界定单个腔13，但细长部件12可替代地界定多个腔。在一些实施方式中，多个腔可延伸细长部件12的整个长度。在其他实施方式中，可能存在仅部分延伸穿过细长部件12的附加腔。在一些实施方式中，细长部件12可连接或延伸至医疗器械10的其他部分。
而且，细长部件12和鞘套11可具有界定圆形截面的管状结构。细长部件12和鞘套11各自的截面轮廓可在与任何其他的细长装置(例如，气管镜)一起使用时相对容易组装、移除、和/或使用的。或者，细长部件12和鞘套11可具有其他构造，例如但不限于，椭圆形截面轮廓等。
鞘套11可以是柔性的中空部件，具有允许细长部件12穿过其中的尺寸。即，鞘套11的直径可大于细长部件12的直径，但小于气管镜(或其他合适的装置)和体腔(例如气道)两者的直径。特别地，鞘套11的大小可足够紧凑，足以穿过气道，同时仍然允许细长部件12安置在其中。
细长部件12和鞘套11可包含任何合适的柔性和/或生物相容性材料，包括但不限于，金属、聚合物、合金等。在至少一些实施方式中，细长部件12和鞘套11由镍钛诺，硅酮等中的一个或多个制成。根据一个实施方式，该材料可显示出充足的柔性，以机动地穿过体腔并定位在体腔内，而不会对周围组织(例如，气道)造成任何损害。
细长部件12可进一步包括笼状物14，其具有多个连接至细长部件12远侧部分(未示出)的腿部16。在替代实施方式中，笼状物14可由可膨胀、可扩张的部件(例如，球囊)代替。每个腿部16可配置成包括沿腿部16的纵向长度安置的电极。而且，各电极可沿腿部16定位，使得腿部16扩张时电极能够触及诸如气道壁的组织表面以传送能量至治疗部位。然而，各腿部16可进一步包括不止一个电极以传输能量到治疗部位。电极可通过本领域已知的任何合适的手段连接至腿部16。在一些实施方式中，各腿部16可包括导电材料，并且腿部16的端部可覆盖有绝缘材料从而留下裸露的有源区(active region)。
结构上，各腿部16可具有从细长部件12的腔中露出来的近侧部分。在一些实施方式中，各腿部16可具有通过粘合剂(或其他附装结构或材料)联接或以其他方式相互连接的近侧部分，并可形成穿过细长部件12的近侧接合点。各腿部16可具有从细长部件12的远端20连续延伸出的近侧部分，如图1所示。而且，各腿部16的远侧部分可通过本领域已知的各种机构相互连结，诸如钎焊、胶接、焊接、使用附装结构等。
各腿部16可以以大约任何期望的间距或等间距隔开以形成笼状物14。例如，图1可描绘在笼状物14周围以大约九十度间隔隔开的四个腿部16。在具有五个腿部16的实施方式中，例如，腿部16可以以大约七十二度间隔隔开形成笼状物14。因此，在笼状物14周围的腿部16的数量和角度间隔可以依各种要求而定，诸如目标气道的大小、各腿部16与气道壁之间期望的接触等。
各腿部16可具有这样的长度，即，使得笼状物14能够扩张并接触气道壁并且横越穿过狭窄的肺气道。而且，腿部16可具有充足的厚度和模量(modulus)，以便在手术过程中扩张和紧缩时不会断裂或以其他方式塑料变形。
笼状物14可配置成从第一紧缩位置往复移动至第二扩张位置(例如，向外弓出的状态)，反之亦然。笼状物14可配置成从第一位置径向扩张至第二位置。在第二位置，笼状物14可扩张成使得腿部16的弓形部分接触气道的壁表面以传送能量。
构成笼状物14的腿部可由弹性、高抗拉且生物相容性的材料制成，其在径向扩张时不会变形(例如，弹性地)。此类材料的实例可包括但不限于硅酮、超弹性合金、不锈钢、诸如镍钛诺的形状记忆合金等。在一些实施方式中，腿部16可由与细长部件12相同的材料制成，并界定圆形截面轮廓。然而，腿部16可具有其他的界面轮廓，诸如椭圆形、矩形等。
如以上讨论的，各腿部16的远侧部分可联接在一起，并进一步地可由诸如远侧盖或远侧端片18的覆盖物包住。这样，远侧盖18可位于细长部件12的远端20的远侧。远侧盖18的直径可配置成便利将医疗器械10插入到狭窄的肺气道中，而不会伤害气道。于是，远侧盖18可具有防止损伤的构造。此外，远侧盖18可具有一定大小，使得远侧盖18能够进入、穿过并退出气管镜(或其他合适的装置)和狭窄的气道。
远侧盖18可以是中空筒状细长部件，并配置成允许腿部16的远侧部分穿过或进入其中。在一个实施方式中，例如，远侧盖18的远端可闭合。远侧盖18可足够长，足以大致包住腿部16的远侧部分。远侧盖18内部结构的更多细节将会连同随后的附图一起讨论。在一些实施方式中，远侧盖18可以是导电的，具有绝缘罩。
远侧盖18可具有圆形截面轮廓。然而，远侧盖18可具有其他的截面，诸如椭圆形、矩形、多边形、非对称等。
远侧盖18可由柔性的生物相容性材料制成。此类材料的实例可包括但不限于硅酮、诸如镍钛诺的形状记忆合金等。
接下来，诸如拉线的促动部件22可配置成从医疗器械10的近侧部分(未示出)延伸出，穿过细长部件12的腔，在腿部16之间延伸穿过笼状物14，连接腿部16的远侧部分和远侧盖18，并进一步延伸穿过远侧盖18。促动部件22可配置成随着手动或自动地(autonomously)施加到在医疗器械10近侧部分上的促动部件22的力来回移动(即，往复移动)。在一些实施方式中，促动部件22可以是编织的拉线和/或包括多个拉线。
促动部件22可配置成从医疗器械10的近侧部分、穿过笼状物14、朝向远侧盖18延伸的细长线。
促动部件22可由任何合适的生物相容性材料制成。或者，促动部件22可以是杆、细绳、结、或其他的能够往复移动的合适机构。合适的材料的实例可包括但不限于镍钛诺、其他形状记忆合金、不锈钢、硅酮等。
医疗器械10的近侧部分可配置成从诸如气管镜的伸长装置(未示出)的远端露出来。气管镜可用来查看支气管的内部结构。在医疗器械10的极近端(未示出)，可存在配置成手动或自动地压挤的手柄(未示出)。在手柄或其他驱动器处，可存在连结至电外科发电机的插头(未示出)，其可配置成提供电能至医疗器械10。
图2是图1中医疗器械10的剖面图，描绘了处于未激活位置的促动部件22。如图2所示，远侧盖18可包住包括电极的腿部16和促动部件22的远侧部分的一部分。而且，止挡部件201，例如螺旋弹簧，可操作地连接至促动部件22并包住促动部件22。止挡部件201可界定配置成容纳促动部件22远侧部分的腔。止挡部件201可配置成至少限制促动部件22沿细长部件12的纵轴线向近侧方向移动。止挡部件201相当大的部分可设置在远侧盖18内。
当力施加到医疗器械10的手柄上或医疗器械10的手柄上的力释放时，止挡部件201可压缩和扩张。止挡部件201可包括压缩弹簧、螺旋弹簧、碟形垫圈(Bellvillewashers)、可压缩聚合材料、可压缩弹性管、液压或气动囊、可膨胀部件、弹簧片、橡皮筋、海绵等。
止挡部件201可由柔性、弹性、可压缩和/或生物相容性材料制成。此类材料的实例可包括但不限于不锈钢、形状记忆合金、聚合物、其他具有弹性特性的合适材料等。在一些实施方式中，若需要，非弹性材料也可用来构造止挡部件201。
而且，诸如盘状物的凸出物202可设置在促动部件22的最远端。凸出物202可配置成接合止挡部件201的远端以限制促动部件22向例如近侧方向移动。凸出物202的宽度可大于止挡部件201的腔的宽度。在一些实施方式中，凸出物202可固定至腿部16的远端，使得促动部件22被促动时(例如，向近侧方向)，凸出物202和腿部16的远端也向近侧移动。
凸出物202可配置成具有圆形截面轮廓。然而，凸出物202可具有其他的截面和构造，不限于椭圆形、扁圆形、多边形、不规则形等。
止挡部件201的近端可进一步连结或以其他方式可操作地连接至围绕促动部件22设置的支撑物204。支撑物204可配置成支撑止挡部件201的近端并相对于例如腿部16的远端部分固定止挡部件201的近侧位置。这样，经由促动部件22施加到腿部16远端的力通过止挡部件201压缩抵住支撑物204而受到限制，但不受施加至促动部件22的力(例如，通过连接至促动部件22的手柄)的量限制。在一些实施方式中，当施加至手柄的力超过预定界限时，止挡部件201可吸收过剩力以阻止过剩力传递至腿部16的远端。凸出物202和/或支撑物204可由弹性、柔性、传导性、和/或生物相容性材料制成。此类材料的实例可包括但不限于镍钛诺、硅酮、不锈钢、金属、合金等。
支撑物204可以是环形。然而，支撑物204可具有其他形状，诸如圆环，椭圆环，多边形，扁圆形，不规则形等。
支撑物204的近端可进一步连结或以其他方式连接至细长部件，诸如围绕促动部件22设置的间隔物206。间隔物206可配置成大致从腿部16的近侧部分延伸至远侧部分。间隔物206可配置成为防止笼状物14过度扩张提供支撑。
间隔物206可以是圆筒状，并具有环形截面轮廓。然而，在一些实施方式中，间隔物206的截面可取决于促动部件22的截面，因为间隔物206包住或以其他方式围绕促动部件22。间隔物206还可形成在外部支撑腿部16的形状。
间隔物206可由弹性、柔性、和/或生物相容性材料制成。此类材料的实例可包括但不限于镍钛诺、硅酮、不锈钢、聚合物、合金等。
如图2所示，止挡部件201未压缩，并且笼状物14(参照图1)处于第一紧缩位置。
图3是包括处于压缩位置的止挡部件201的医疗器械10的剖面图。当医疗器械10近端上的手柄被拉动或以其他方式激活而向促动部件22施加向近侧的拉力时，凸出物202和促动部件22可移向医疗器械10的近端。结果，凸出物202可推动止挡部件201并压缩止挡部件201使其抵住支撑物204。由于促动部件22向近侧移动，笼状物14可径向向外扩张(例如，笼状物14的近端和远端(未示出)可从第一位置移至第二位置)。在一些实施方式中，腿部16的远端可连接至凸出物202，并随着凸出物202向近侧移动而向近侧移动。在第一位置，笼状物14可紧缩(例如，笼状物14看起来是闭合的，并且腿部16可看起来是从医疗器械10的近端大体笔直地延伸至远侧盖18的远端)。而在第二位置，笼状物14可扩张成使得腿部16径向向外弓。在没有止挡部件201、凸出物202和支撑物204的情况下，例如通过拉动或以其他方式激活医疗器械10的手柄可能施加太多的力至促动部件22，导致由例如笼状物14的过度扩张而造成的对腿部16和/或气道壁的损伤。然而，由于凸出物202仅能压缩止挡部件201固定的量，该固定量由支撑物204限制，可防止腿部16移动超过预定界限。这可帮助避免笼状物14的过度扩张以及腿部16的过度弯曲。而且，由于间隔物206长度固定，腿部16能够以可控方式弯曲。因此，可进一步避免笼状物14的过度扩张，也进一步避免了可能对腿部16和气道造成的损伤。
而且，当医疗器械10的手柄释放时，凸出物202和促动部件22可移向远侧盖18的远端。这种向远侧的移动可解压止挡部件201，导致腿部16从第二位置移至第一位置。即，释放手柄可释放压缩止挡部件201的力，导致止挡部件201释放了储存的任何势能并返回至未压缩位置，所以笼状物14返回至紧缩位置。这样，由于促动部件22可配置成往复移动，腿部16可在第一紧缩位置至第二扩张位置(例如，当促动部件22向近侧移动时，腿部16可从第一位置移至第二位置，并且当促动部件22向远侧移动时，腿部16可从第二位置移至第一位置)之间往复运动。然而，应当注意到，也可以考虑替代的实施方式。在一个替代实施方式中，促动部件22向远侧移动可使腿部16从第一紧缩位置移至第二扩张位置，而促动部件22向近侧移动使腿部16从第二扩张位置移至第一紧缩位置。
图4是医疗器械10的剖面图，描绘了支撑止挡部件201的间隔物206。在图4的实施方式中，止挡部件201可由间隔物206直接支撑。间隔物206可邻近止挡部件201的近端，并直接固定止挡部件201的近侧位置。这样，经由促动部件22施加至腿部16远端的力可受止挡部件201压缩抵住间隔物206和/或止挡部件201的刚度限制，但不受施加至促动部件22(例如，通过连接至促动部件22的手柄)的力的量限制。在一些实施方式中，当施加至手柄的力超出界限时，止挡部件201可吸收过剩力以阻止过剩力传递至腿部16的远端。止挡部件201的弹性也可设定为促动时将触觉信号提供给医师，表明笼状物14完全扩张了。
图5示出示范医疗器械500的另一个实施方式。医疗器械500可大致类似于医疗器械10(参照图1)，但附加或替代地包括与多个腿部516的远端成一体的止挡部件504。腿部516可大致类似于上述腿部16并包括上述腿部16的任何一个或多个特征。在替代实施方式中，止挡部件504可与多个腿部516中每一个腿部的近端(未示出)成一体。每个腿部516可包括沿纵轴线设置的电极。腿部516可以是整体的，并由外径小于工作通道范围的内径的管体切割而成。或者，腿部516可由材料板切割而成并卷起来，或者可通过另一种合适的机构形成。盖(未示出)可延伸越过远侧组件。盖可防止组织进入止挡部件504的压缩空间中并限制止挡部件504的压缩。
促动部件522可从医疗器械500的近端(未示出)延伸至远端。凸出物502可设置在促动部件522的远端。促动部件522和凸出物502可分别大致类似于促动部件22和凸出物202，示于图2中。止挡部件504可以是围绕促动部件522相当大的远侧部分的螺旋弹簧或其他合适的弹性部件，并可在近侧邻近凸出物502。止挡部件504可经由支撑物506整体连结至各腿部516的远端。即，支撑物506可设置在止挡部件504和腿部516之间(例如，支撑物506可位于止挡部件504的近侧，并在腿部516远端的远侧)。支撑物506可大体是筒状或可具有任何其他合适的形状。在替代实施方式中，各单独的腿部516可包括并入到远端部分中的止挡部件(例如，具有四个腿部516的笼状物可包括四个止挡部件，其中至少一个止挡部件并入到各腿部516的端部中)。
向近侧拉动促动部件522时，腿部516可从第一紧缩位置径向向外扩张至第二扩张位置。支撑物506可邻近止挡部件504的近端，并直接固定止挡部件504的近侧位置。这样，经由促动部件522施加至腿部516远端的力可通过止挡部件504压缩抵住支撑物506而被限制，但不受施加至促动部件22(例如，通过连接至促动部件22的手柄)的力的量限制。在一些实施方式中，当施加至手柄的力超过预定界限时，止挡部件504可吸收过剩力以阻止过剩力传递至腿部516的远端。这样，当由腿部516形成的笼状物达到预定扩张界限时，施加至促动部件22的更多的力不会使笼状物进一步扩张。
盖518的远端可配置成支撑止挡部件504和腿部516的远端。盖518可连结或以其他方式连接至细长部件的远端，例如，通过细长连接器519连接至细长部件12(参照图1)。盖518可以是大体U形，C形，或具有另一种合适的构造。
图6示出医疗器械600的另一个实施方式。医疗器械600可包括设置在腿部16近侧并在促动部件602的远侧部分604和近侧部分606之间的止挡部件608。换句话说，止挡部件608的远端可连结至促动部件602远侧部分604的近端，并且止挡部件608的近端可连结至促动部件602近侧部分606的远端。促动部件602可以是任何合适的促动部件，诸如拉线，编织拉线，多个拉线，控制杆等。在一个实施方式中，当促动部件602向近侧移动时，止挡部件608可扩张，导致腿部16扩张至第二扩张位置。止挡部件608的刚度可选择成防止促动部件602向近侧方向过度扩张。当施加至促动部件602的近侧力低于预定界限时，该近侧力可能不足以使止挡部件608扩张，所以远侧部分604、止挡部件608和近侧部分606在保持相互之间的布局大体不变的同时可全部向远侧移动。然而，当近侧力增加时，例如，增加至可另外导致笼状物14和腿部16过度扩张的点时(参照图1)，止挡部件608可扩张。止挡部件608扩张可吸收过剩力，防止过剩力造成笼状物14和腿部16的过度扩张。当促动部件602向远侧方向释放时，止挡部件608可收缩，释放存储的能量，因此使腿部516移至第一紧缩位置。
使用本公开的医疗器械传送能量至气道以治疗肺部的方法可包括许多连续，非连续，同时，非同时，或者替代的步骤。开始，可提供根据本发明主题的原理制造的医疗器械。诸如气管镜的细长装置可通过自然的(诸如，患者的嘴)或外科手术形成的开口插入。要求气管镜横越穿过狭窄的血管(诸如，风管)，随后穿过患者肺部的支气管。其后，可通过气管镜查看并检查作为治疗目标的支气管。在这之后可将医疗器械10的远侧部分插入到气管镜的腔中达到治疗部位区域。在医疗器械10近端的手柄(未示出)可连结至插头(未示出)，该插头可进一步连结至诸如电外科发电机的能量发生器(未示出)。当拉动或以其他方式促动(例如，向近侧移动)手柄或其他促动器时，连接至促动部件22的凸出物202可朝着医疗器械10的近侧部分移动。促动部件22向近侧移动可导致腿部16径向向外弓，使设置在腿部16上的电极能够接触气道壁。同时，可激活电外科发电机，电流可通过插头朝向促动部件22行进。而且，当促动部件22前后移动(即，往复运动)时，电流可从促动部件22传输至凸出物202。由于凸出物202和腿部16接触以及凸出物202和腿部16的传导材料，电流可经由凸出物202传输至各腿部16。当腿部16向外弓抵住壁并电激活时，电能可以以可控方式从腿部16传输至气道壁。
本发明实施方式可用于任何医疗或非医疗环境或用于除气道之外的任何其他应用中，其中能量通过装置施加至壁，这里期望控制腿部扩张抵住壁。另外，在不脱离本发明范围的情况下，前述实施方式的至少某些方面可与实施方式的其他方面相结合或去除。
对本领域技术人员而言，从本文公开的说明书和具体实施方式考虑，本发明的其他实施方式会是显而易见的。说明书和实例仅旨在作为示范，本发明的真实范围和实质由权利要求表明。

Claims (9)

1.一种医疗器械，包括：
轴，其具有至少部分地在所述轴的近端和远端之间延伸的腔；
连结至所述轴的远侧部分的多个腿部；
延伸穿过所述腔并连结至所述多个腿部中至少一个的促动部件，其中所述促动部件的往复运动配置成使所述多个腿部从第一、径向紧缩位置可逆地移至第二、径向扩张位置；以及
连结至所述促动部件并配置成限制所述促动部件的运动的止挡部件，其中所述止挡部件设置在所述多个腿部的近侧；
其中，当所述多个腿部处于所述第一、径向紧缩位置时，向所述促动部件施加第一近侧力使所述多个腿部朝向所述第二、径向扩张位置移动；并且
其中，在所述多个腿部从所述第一、径向紧缩位置移向所述第二、径向扩张位置之后，向所述促动部件施加第二近侧力使所述止挡部件扩张，从而防止所述多个腿部进一步径向扩张。
2.根据权利要求1所述的医疗器械，还包括连结至所述多个腿部中每一个并位于所述轴的远端的远侧的远侧端片，其中所述促动部件连结至所述远侧端片。
3.根据权利要求2所述的医疗器械，其中所述促动部件在所述多个腿部之间延伸。
4.根据权利要求1所述的医疗器械，其中所述止挡部件设置在所述促动部件的远侧部分和近侧部分之间。
5.根据权利要求4所述的医疗器械，其中所述止挡部件的远端连接至所述促动部件的远侧部分的近端，且所述止挡部件的近端连接至所述促动部件的近侧部分的远端。
6.根据权利要求4所述的医疗器械，其中，在所述多个腿部处于所述第一、径向紧缩位置时，当施加至所述促动部件的所述第一近侧力低于预定界限时，所述止挡部件不扩张，使得所述远侧部分、所述止挡部件和所述近侧部分在保持相互之间的布局大体不变的同时全部向近侧移动，并且其中所述第二近侧力高于所述预定界限。
7.根据权利要求1所述的医疗器械，其中，在所述止挡部件扩张之后，释放所述第二近侧力使得所述止挡部件收缩，所述促动部件向远侧移动，并且所述多个腿部移动返回至所述第一、径向紧缩位置。
8.根据权利要求1所述的医疗器械，其中所述止挡部件是弹簧。
9.根据权利要求1所述的医疗器械，其中所述促动部件是拉线、编织拉线、多个拉线或控制杆。
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US9814618B2 (en) 2017-11-14

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