DE19647873A1 - Insert for indicating position of tumor or other diseased structures - Google Patents

Insert for indicating position of tumor or other diseased structures

Info

Publication number
DE19647873A1
DE19647873A1 DE19647873A DE19647873A DE19647873A1 DE 19647873 A1 DE19647873 A1 DE 19647873A1 DE 19647873 A DE19647873 A DE 19647873A DE 19647873 A DE19647873 A DE 19647873A DE 19647873 A1 DE19647873 A1 DE 19647873A1
Authority
DE
Germany
Prior art keywords
hüllkanüle
characterized
element
device according
thread
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
DE19647873A
Other languages
German (de)
Inventor
Andreas Melzer
Axel Winkel
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
MRI DEVICES DAUM GMBH, 19061 SCHWERIN, DE
Original Assignee
Daum GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Daum GmbH filed Critical Daum GmbH
Priority to DE19647873A priority Critical patent/DE19647873A1/en
Publication of DE19647873A1 publication Critical patent/DE19647873A1/en
Application status is Withdrawn legal-status Critical

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3904Markers, e.g. radio-opaque or breast lesions markers specially adapted for marking specified tissue
    • A61B2090/3908Soft tissue, e.g. breast tissue

Abstract

The system of indicating the position of diseased structure in the human body uses a hollow needle in the end of which an indicator element (1) is mounted. A wire (4) is attached to the indicating element and runs up through the needle. The indicating element is in the form of a short tube section which is mounted inside the end of the needle. The needle and element are bevelled forming a sharp point to facilitate the needle being pushed into the body. When the section is near the diseased part, it is pushed out of the needle by a third tube section (3) which also fits inside the needle. It is hooked behind the diseased section while the needle is withdrawn. A knot is tied in the wire just outside the body.

Description

Die Vorrichtung betrifft eine Vorrichtung nach dem Oberbegriff des Anspruches 1. The device relates to a device according to the preamble of claim 1.

Derzeit werden eine Reihe von Lokalisierungselementen für perkutane Markierungen von Tumoren und anderen anatomischen Strukturen angeboten. Currently, a number of localization elements for percutaneous markers of tumors and other anatomical structures are offered. Alle diese Elemente haben drahtartige Verbindungsteile, die nach der Markierung außen aus dem Körper hervorstehen. All these elements have wire-like connecting members that protrude after labeling the outside of the body. Dadurch wird ein Abdecken des herausstehenden Endes schwierig und der Transport des Patienten in den Operationssaal muß meist unmittelbar erfolgen. This one covering the protruding end of the difficult and transporting the patient to the operating room must be immediately most. Ein Verrutschen des Lokalisationselementes ist die Gefahr. Slipping of the localization element is the danger.

Die Erfindung hat das Ziel, dieses Problem zu lösen. The invention aims to solve this problem.

Die Erfindung ist in den folgenden Figuren dargestellt: The invention is illustrated in the following figures:

Fig. 1 Querschnitt durch ein distales Ende der Lokalisierungsvorrichtung, Fig. 1 cross section through a distal end of the locating device,

Fig. 2 Ablauf der Lokalisation, Fig. 2 expiry of localization,

Fig. 3 vergrößerte Darstellung des distalen Endes der Lokalisationsvorrichtung von Fig. 2. Fig. 3 are enlarged view of the distal end of the localization device of FIG. 2.

Fig. 1 zeigt die erfinderische Vorrichtung im Querschnitt des distalen Endes. Fig. 1, the inventive apparatus in cross section, of the distal end. In der Hohlnadel 2 befindet sich das Lokalisationselement. In the hollow needle 2 is the localization element. Am Lokalisationselement ist ein Lokalisationsfaden angebracht, der in proximaler Richtung durch ein Antriebsröhrchen hindurch verläuft. On localization element is a localization thread is attached, which runs in the proximal direction by a drive tube therethrough. Fig. 2 zeigt die Anwendung in 6 Schritten: Fig. 2 shows the application in 6 steps:

  • a) die Vorrichtung wird seitlich an der Läsion positioniert a) the device is positioned on the lesion side
  • b) durch Vorschieben des Antriebsröhrchens oder Zurückziehen der Hohlnadel gelangt das Lokalisationselement in das freie Gewebe b) by advancing the drive tube or retraction of the hollow needle reaches the localization element in the free fabric
  • c, d, e) durch Zurückziehen der Hohlnadel und des Antriebsröhrchens sowie durch Zurückziehen des Fadens 4 dreht sich das Lokalisationselement aus der axialen Richtung radial heraus c, d, e) by retraction of the hollow needle and the drive tube as well as by retraction of the thread 4, the localization member rotates from the axial direction radially out
  • f) nach vollständigem Entfernen des Antriebsröhrchens und der Hohlnadel liegt das Lokalisationselement senkrecht zur Läsion frei. f) after complete removal of the drive tube and the hollow needle is the localization element perpendicular to the lesion free. Nun kann der Faden extrakorporal verknotet werden, so daß dieser in einer gewissen Spannung zwischen dem Lokalisationselement und dem Knoten fest im Gewebe positioniert ist. the thread can be tied extracorporeally now, so that it is positioned in a certain voltage between the localization element and the node detects in the tissue.

Fig. 3 zeigt den distalen Teil der Vorrichtung der Fig. 2c in vergrößerter Darstellung. Fig. 3 shows the distal portion of the apparatus of Fig. 2c in an enlarged view.

Verbindet man das Lokalisierungselement mit einem chirurgischen Faden oder einem feinen Stahldrahtgeflechtfaden, so kann das herausstehende Ende an die Haut angelegt und mit einem sterilen Pflaster abgedeckt werden. By connecting the locator member with a surgical thread or a fine steel wire yarn, the protruding end can be applied to the skin and covered with a sterile patch. Der Eingriff ist ambulant bei Patienten durchführbar, die erst am nächsten oder sogar erst Tage später zur Operation kommen. The surgery is outpatient basis in patients who come only days later for surgery until the next or even. Bei einem anderen Anwendungsfall, der Entfernung von kleinen tumorverdächtigen Arealen aus der Lunge, gibt es bisher nur wenige Versuche, Tumorlokalisationen mit den bestehenden Systemen durchzuführen, siehe z. In another application, the removal of small lesions suspected areas of the lungs, there are only a few attempts to perform tumor sites with existing systems. See, B. den Artikel von Geaurceau "The required technique for localization of lungnodules during thoracoscopic resection" aus der Zeitschrift "Chest". As the article by Geaurceau "The technique required for localization of lungnodules during thoracoscopic resection" from the journal "Chest".

Diese Technik beinhaltet jedoch das Problem, daß der Draht bei Atmung verschieblich ist, dh aus der Brusthöhle hinein- und herausgeschoben wird und daß, wenn während der Operation die eine Lungenhälfte, in der sich der Lokalisierungshaken befindet, nicht mehr beatmet wird und zusammenfällt, der ganze Draht in den Brustraum hineinrutschen kann. However, this technique involves the problem that the wire in breathing is displaceable, that is, screwing in from the chest cavity and pushed out and that, if one half of the lung in which the locating hook is located is not ventilated during surgery and coincides, the can slip in whole wire into the chest cavity. Hier ist ebenfalls ein Lokalisierungshaken mit angebrachtem Faden dazu geeignet, über ein Reservoir entsprechend Faden freigeben zu können, um erstens die Atemverschieblichkeit zu kompensieren und zweitens beim Zusammenfallen der Lunge ein Verschwinden des Fadens zu verhindern. Here is also a locating hook with attached suture adapted to release over a reservoir in accordance with thread to first, to compensate for the Atemverschieblichkeit and secondly to prevent disappearance of the yarn upon the collapse of the lung.

Bezugszeichenliste LIST OF REFERENCE NUMBERS

1 1

Lokalisationselement localization element

2 2

Hohlnadel cannula

3 3

Antriebsröhrchen drive tube

4 4

Lokalisationsfaden localization thread

5 5

Läsion lesion

Claims (7)

1. Vorrichtung zum Lokalisieren krankhafter und anderer Strukturen innerhalb des menschlichen Körpers, dadurch gekennzeichnet , daß diese über eine Markierungsvorrichtung über eine scharfgeschliffene Hohlnadel in den Körper eingestochen werden kann und im Vergleich zur Hohlnadel ein kurzes distal gelegenes Lokalisationselement aufweist, welches an einem Faden befestigt ist, der durch ein Antriebsröhrchen zum proximalen Vorrichtungsende verläuft und durch Anschieben durch das Antriebsröhrchen oder Rückziehen der Hohnadel distal aus der Hohlnadel herausgeschoben werden kann. 1. A device for locating pathological and other structures within the human body, characterized in that it can be inserted via a marking device with a sharpened hollow needle in the body and having in comparison to the hollow needle a short distally located localization element, which is attached to a string which extends to the proximal end of the device by a drive tube and can be pushed out by pushing through the drive tubes or retraction of the hollow needle distally out of the hollow needle.
2. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, daß sich das Markierungs- bzw. Lokalisationselement beim Zurückziehen der Hüllkanüle und vollständigem Entfernen derselben durch leichtes Ziehen am Lokalisationsfaden aus der axialen Richtung verschiebt und sich innerhalb des Gewebes verankert. 2. Device according to claim 1, characterized in that the marker or localization member upon retraction of the Hüllkanüle and complete removal shifts the same by pulling gently on the localization of the thread from the axial direction and anchored within the tissue.
3. Vorrichtung nach Anspruch 1 und 2, dadurch gekennzeichnet, daß der Faden aus Formgedächtnismetall, geflochtenem Stahldraht, chirurgischen monophilen oder polyphilen Nahtmaterial besteht oder aus einer Kombination von diesen. 3. Device according to claim 1 and 2, characterized in that the thread of a shape memory metal, braided steel wire, monofilaments or surgical Polyphilic suture material, or a combination of these.
4. Vorrichtung nach Anspruch 1 bis 3, dadurch gekennzeichnet, daß sich in der Hüllkanüle eine zweite, den Faden und das Markierungselement umschließende Hüllkanüle, die z. 4. Device according to claim 1 to 3, characterized in that in the Hüllkanüle a second thread and the marking element enclosing Hüllkanüle which z. B. aus weichen Kunststoffmaterial besteht, befindet und daß nach Herausziehen der Hüllkanüle das Markierungselement mit der weichen Kunststoffhülle verbleibt, so daß das komplette Markierungselement herausgezogen und über die Hüllkanüle neu plaziert werden kann, wenn die elastische Hüllkanüle zurückgezogen ist. B. consists of soft plastic material, located, and that after withdrawal of the Hüllkanüle the marking element with the soft plastic envelope remains, can be such that the complete marking element is pulled out and re-placed on the Hüllkanüle when the elastic Hüllkanüle is withdrawn.
5. Vorrichtung nach Anspruch 1 bis 4, dadurch gekennzeichnet, daß das Markierungselement aus einem Kunststoffhohlkörper besteht, der zur besseren Darstellung und Auffindbarkeit im Kernspintomographen mit einer paramagnetischen Substanz gefüllt ist. 5. Device according to claim 1 to 4, characterized in that the marking element consists of a hollow plastic body filled to better illustrate and discovery in magnetic resonance imaging with a paramagnetic substance.
6. Vorrichtung nach Anspruch 1 bis 5, dadurch gekennzeichnet, daß das Markierungselement mit dem Faden und/oder der Hüllkanüle eine elektrische Spule bildet, die durch entsprechende Kontaktstellen dazu verwendet werden kann, daß das Markierungselement ein entsprechendes Hochfrequenzsignal sendet, so daß im kernspintomographischen Bild eine den entsprechenden Sequenzen angepaßte Darstellung des Lokalisationselementes erfolgt. 6. Device according to claim 1 to 5, characterized in that the marking element is an electrical coil with the yarn and / or the Hüllkanüle that can be used by appropriate contact points to the fact that the marking element sends a corresponding high frequency signal so that in the MRI image takes place adapted to the corresponding sequences representation of the localization element.
7. Methode zur Anwendung der Vorrichtung nach den Ansprüchen 1 bis 5, dadurch gekennzeichnet, daß die Vorrichtung in das Gewebe eingestochen wird, bis dieses seitlich an der zu lokalisierenden Stelle positioniert ist und Zurückziehen der Hüllkanüle und Zurückziehen des Fadens sowie Herausziehen der Hüllkanüle und des Antriebsröhrchens und Zurückziehen des Fadens, bis das Lokalisationselement senkrecht zum Faden verankert ist und Verknoten des Fadens extrakorporal, so daß das Lokalisationselement und der Knoten durch eine gewisse Spannung im Faden verbunden sind und nicht mehr depositioniert werden können. 7. Method for using the device according to claims 1 to 5, characterized in that the device is inserted into the tissue until it is positioned at the locating point laterally and retracting the Hüllkanüle and retraction of the yarn and pulling out the Hüllkanüle and drive tube and retraction of the thread until the localization element is vertically anchored to the yarn and knotting of the suture outside the body, so that the localization element and the nodes are connected by a certain tension in the yarn and can not be depositioniert. Anstelle des Knotens kann auch ein Stopper verwendet werden, der auf den Faden geklemmt wird. Also, a stopper may be used instead of the node which is clamped on the thread.
DE19647873A 1996-11-19 1996-11-19 Insert for indicating position of tumor or other diseased structures Withdrawn DE19647873A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
DE19647873A DE19647873A1 (en) 1996-11-19 1996-11-19 Insert for indicating position of tumor or other diseased structures

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE19647873A DE19647873A1 (en) 1996-11-19 1996-11-19 Insert for indicating position of tumor or other diseased structures

Publications (1)

Publication Number Publication Date
DE19647873A1 true DE19647873A1 (en) 1998-05-20

Family

ID=7812143

Family Applications (1)

Application Number Title Priority Date Filing Date
DE19647873A Withdrawn DE19647873A1 (en) 1996-11-19 1996-11-19 Insert for indicating position of tumor or other diseased structures

Country Status (1)

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DE (1) DE19647873A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001010324A1 (en) * 1999-08-04 2001-02-15 Cbyon, Inc. Spinal fiducial implant and method

Citations (22)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4572198A (en) * 1984-06-18 1986-02-25 Varian Associates, Inc. Catheter for use with NMR imaging systems
US4774948A (en) * 1986-11-24 1988-10-04 Markham Charles W Marking and retraction needle having retrievable stylet
US4799495A (en) * 1987-03-20 1989-01-24 National Standard Company Localization needle assembly
US4931059A (en) * 1986-11-24 1990-06-05 Markham Charles W Needle/stylet combination
EP0395997A1 (en) * 1989-05-05 1990-11-07 Becton Dickinson and Company Electrically insulated breast lesion localization device
US4986279A (en) * 1989-03-01 1991-01-22 National-Standard Company Localization needle assembly with reinforced needle assembly
US4989608A (en) * 1987-07-02 1991-02-05 Ratner Adam V Device construction and method facilitating magnetic resonance imaging of foreign objects in a body
US5018530A (en) * 1989-06-15 1991-05-28 Research Corporation Technologies, Inc. Helical-tipped lesion localization needle device and method of using the same
US5059197A (en) * 1989-04-15 1991-10-22 Urie Robert G Lesion location device
US5127916A (en) * 1991-01-22 1992-07-07 Medical Device Technologies, Inc. Localization needle assembly
US5158565A (en) * 1990-10-10 1992-10-27 Dlp, Inc. Localization needle assembly
US5158084A (en) * 1989-11-22 1992-10-27 Board Of Regents, The University Of Texas System Modified localization wire for excisional biopsy
DE4216694A1 (en) * 1991-05-31 1992-12-03 Norbert Heske Biopsy sample cannula - has inner solid needle enclosed in tubular outer needle and sheath forming guide needle
US5195540A (en) * 1991-08-12 1993-03-23 Samuel Shiber Lesion marking process
US5197482A (en) * 1989-06-15 1993-03-30 Research Corporation Technologies, Inc. Helical-tipped lesion localization needle device and method of using the same
US5290266A (en) * 1992-08-14 1994-03-01 General Electric Company Flexible coating for magnetic resonance imaging compatible invasive devices
US5307808A (en) * 1992-04-01 1994-05-03 General Electric Company Tracking system and pulse sequences to monitor the position of a device using magnetic resonance
US5318025A (en) * 1992-04-01 1994-06-07 General Electric Company Tracking system to monitor the position and orientation of a device using multiplexed magnetic resonance detection
DE4306277A1 (en) * 1993-03-01 1994-09-08 Leibinger Gmbh Surgical marking instrument
EP0673621A1 (en) * 1994-03-18 1995-09-27 Schneider (Europe) Ag A medical appliance for use in magnetic resonance imaging procedures
DE19500157A1 (en) * 1994-11-04 1996-05-09 Norbert Heske Hollow cannula for intracorporeal tissue examination of plastic
US5556410A (en) * 1993-09-27 1996-09-17 M3 Systems, Inc. Surgical needle with stress-relocation means

Patent Citations (22)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4572198A (en) * 1984-06-18 1986-02-25 Varian Associates, Inc. Catheter for use with NMR imaging systems
US4774948A (en) * 1986-11-24 1988-10-04 Markham Charles W Marking and retraction needle having retrievable stylet
US4931059A (en) * 1986-11-24 1990-06-05 Markham Charles W Needle/stylet combination
US4799495A (en) * 1987-03-20 1989-01-24 National Standard Company Localization needle assembly
US4989608A (en) * 1987-07-02 1991-02-05 Ratner Adam V Device construction and method facilitating magnetic resonance imaging of foreign objects in a body
US4986279A (en) * 1989-03-01 1991-01-22 National-Standard Company Localization needle assembly with reinforced needle assembly
US5059197A (en) * 1989-04-15 1991-10-22 Urie Robert G Lesion location device
EP0395997A1 (en) * 1989-05-05 1990-11-07 Becton Dickinson and Company Electrically insulated breast lesion localization device
US5018530A (en) * 1989-06-15 1991-05-28 Research Corporation Technologies, Inc. Helical-tipped lesion localization needle device and method of using the same
US5197482A (en) * 1989-06-15 1993-03-30 Research Corporation Technologies, Inc. Helical-tipped lesion localization needle device and method of using the same
US5158084A (en) * 1989-11-22 1992-10-27 Board Of Regents, The University Of Texas System Modified localization wire for excisional biopsy
US5158565A (en) * 1990-10-10 1992-10-27 Dlp, Inc. Localization needle assembly
US5127916A (en) * 1991-01-22 1992-07-07 Medical Device Technologies, Inc. Localization needle assembly
DE4216694A1 (en) * 1991-05-31 1992-12-03 Norbert Heske Biopsy sample cannula - has inner solid needle enclosed in tubular outer needle and sheath forming guide needle
US5195540A (en) * 1991-08-12 1993-03-23 Samuel Shiber Lesion marking process
US5307808A (en) * 1992-04-01 1994-05-03 General Electric Company Tracking system and pulse sequences to monitor the position of a device using magnetic resonance
US5318025A (en) * 1992-04-01 1994-06-07 General Electric Company Tracking system to monitor the position and orientation of a device using multiplexed magnetic resonance detection
US5290266A (en) * 1992-08-14 1994-03-01 General Electric Company Flexible coating for magnetic resonance imaging compatible invasive devices
DE4306277A1 (en) * 1993-03-01 1994-09-08 Leibinger Gmbh Surgical marking instrument
US5556410A (en) * 1993-09-27 1996-09-17 M3 Systems, Inc. Surgical needle with stress-relocation means
EP0673621A1 (en) * 1994-03-18 1995-09-27 Schneider (Europe) Ag A medical appliance for use in magnetic resonance imaging procedures
DE19500157A1 (en) * 1994-11-04 1996-05-09 Norbert Heske Hollow cannula for intracorporeal tissue examination of plastic

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001010324A1 (en) * 1999-08-04 2001-02-15 Cbyon, Inc. Spinal fiducial implant and method

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OM8 Search report available as to paragraph 43 lit. 1 sentence 1 patent law
8139 Disposal/non-payment of the annual fee
8170 Reinstatement of the former position
8139 Disposal/non-payment of the annual fee
8127 New person/name/address of the applicant

Owner name: MRI DEVICES DAUM GMBH, 19061 SCHWERIN, DE