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
thread
cannula
needle
localization
marking
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Withdrawn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 19061 Schwerin De GmbH
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
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, 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
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, 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
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3904—Markers, e.g. radio-opaque or breast lesions markers specially adapted for marking specified tissue
    • A61B2090/3908—Soft tissue, e.g. breast tissue

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

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. Alle diese Elemente haben drahtartige Verbindungsteile, die nach der Markierung außen aus dem Körper hervorstehen. Dadurch wird ein Abdecken des herausstehenden Endes schwierig und der Transport des Patienten in den Operationssaal muß meist unmittelbar erfolgen. Ein Verrutschen des Lokalisationselementes ist die Gefahr.A number of localization elements are currently being used for percutaneous labeling of tumors and other anatomical structures. All of these elements are wire-like Connecting parts that protrude from the outside of the body after marking. This will make a Covering the protruding end difficult and transporting the patient into the The operating room must usually be done immediately. The localization element slips Danger.

Die Erfindung hat das Ziel, dieses Problem zu lösen.The object of the invention is 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. In der Hohlnadel 2 befindet sich das Lokalisationselement. Am Lokalisationselement ist ein Lokalisationsfaden angebracht, der in proximaler Richtung durch ein Antriebsröhrchen hindurch verläuft. Fig. 2 zeigt die Anwendung in 6 Schritten:
 Fig. 1 shows the inventive device in cross section of the distal end. The localization element is located in the hollow needle 2 . A localization thread is attached to the localization element and runs through a drive tube in the proximal direction. Fig. 2 shows the application in 6 steps:

  • a) die Vorrichtung wird seitlich an der Läsion positionierta) the device is positioned laterally on the lesion
  • b) durch Vorschieben des Antriebsröhrchens oder Zurückziehen der Hohlnadel gelangt das Lokalisationselement in das freie Gewebeb) by pushing the drive tube or pulling back the hollow needle Localization element in the free tissue
  • 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 herausc, d, e) by pulling back the hollow needle and the drive tube and pulling back the thread 4 , the localization element rotates radially out of the axial direction
  • f) nach vollständigem Entfernen des Antriebsröhrchens und der Hohlnadel liegt das Lokalisationselement senkrecht zur Läsion frei. 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.f) after complete removal of the drive tube and the hollow needle that lies Localization element perpendicular to the lesion free. Now the thread can be knotted extracorporeally be so that this in a certain tension between the localization element and the knot is firmly positioned in the tissue.

Fig. 3 zeigt den distalen Teil der Vorrichtung der Fig. 2c in vergrößerter Darstellung. Fig. 3 shows the distal part of the device 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. Der Eingriff ist ambulant bei Patienten durchführbar, die erst am nächsten oder sogar erst Tage später zur Operation kommen. 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. B. den Artikel von Geaurceau "The required technique for localization of lungnodules during thoracoscopic resection" aus der Zeitschrift "Chest".If you connect the localization element with a surgical thread or a fine one Steel wire mesh thread, so the protruding end can be applied to the skin and with a sterile plasters. The procedure can be performed on an outpatient basis for patients who are only on come for surgery next or even days later. In another use case, The removal of small tumor-suspicious areas from the lungs has so far been few Attempts to carry out tumor localizations with the existing systems, see e.g. B. the article by Geaurceau "The required technique for localization of lungnodules during thoracoscopic resection "from the magazine" Chest ".

Diese Technik beinhaltet jedoch das Problem, daß der Draht bei Atmung verschieblich ist, d. h. 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. 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. However, this technique involves the problem that the wire is displaceable when breathing, i.e. H. from the Breast cavity is pushed in and out and that if one during the operation Half of the lung in which the localization hook is located is no longer ventilated and collapses, the whole wire can slide into the chest. Here is also one Localization hook with attached thread suitable for this, via a reservoir corresponding thread to be able to release, firstly to compensate for breathability and secondly when The lungs collapse to prevent the thread from disappearing.  

BezugszeichenlisteReference list

11

Lokalisationselement
Localization element

22nd

Hohlnadel
Hollow needle

33rd

Antriebsröhrchen
Drive tube

44th

Lokalisationsfaden
Localization thread

55

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. Device for localizing pathological and other structures within the human body, characterized in that they can be inserted into the body via a marking device via a sharpened hollow needle and, compared to the hollow needle, has a short distal localization element which is attached to a thread , which runs through a drive tube to the proximal end of the device and can be pushed distally out of the hollow needle by pushing through the drive tube or pulling back the mock 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 marking or Localization element when withdrawing the sheath cannula and completely removing it the same moves from the axial direction by gently pulling on the localization thread 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. Apparatus according to claim 1 and 2, characterized in that the thread Shape memory metal, braided steel wire, surgical monophile or polyphile 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. 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.4. The device according to claim 1 to 3, characterized in that in the cannula second, enclosing the thread and the marking element, the cannula z. B. from there is soft plastic material, and that after pulling out the sheath cannula Marking element with the soft plastic cover remains, so that the complete Marking element can be pulled out and repositioned over the cannula if the elastic cannula 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. Apparatus according to claim 1 to 4, characterized in that the marking element consists of a plastic hollow body, which for better presentation and traceability in Magnetic resonance imaging is filled 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. The device according to claim 1 to 5, characterized in that the marking element with the thread and / or the cannula forms an electrical coil through Appropriate contact points can be used that the marking element Corresponding high-frequency signal sends, so that in the magnetic resonance imaging image  the localization element is adapted to the corresponding sequences. 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. Anstelle des Knotens kann auch ein Stopper verwendet werden, der auf den Faden geklemmt wird.7. Method for using the device according to claims 1 to 5, characterized characterized in that the device is pierced into the tissue until this on the side the position to be located and withdrawing the sheath cannula and Withdrawing the thread and pulling out the sheath cannula and the drive tube and Pull the thread back until the localization element is anchored perpendicular to the thread and knotting the thread extracorporeally so that the localization element and the knot are connected by a certain tension in the thread and can no longer be depositioned can. Instead of the knot, a stopper can also be used, which is on the thread is clamped.
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
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
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 made 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 made 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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8139 Disposal/non-payment of the annual fee
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8127 New person/name/address of the applicant

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