ES2387026T3 - Dispositivo de fijación envolvente para utilizarse con broncoscopios - Google Patents

Dispositivo de fijación envolvente para utilizarse con broncoscopios Download PDF

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ES2387026T3
ES2387026T3 ES10191689T ES10191689T ES2387026T3 ES 2387026 T3 ES2387026 T3 ES 2387026T3 ES 10191689 T ES10191689 T ES 10191689T ES 10191689 T ES10191689 T ES 10191689T ES 2387026 T3 ES2387026 T3 ES 2387026T3
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bronchoscope
handle
extension
hand
enveloping
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Benny Greenburg
Danny Belcher
Gil Griefner
Heinrich Becker
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SuperDimension Ltd
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SuperDimension Ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00112—Connection or coupling means
    • A61B1/00121—Connectors, fasteners and adapters, e.g. on the endoscope handle
    • A61B1/00128—Connectors, fasteners and adapters, e.g. on the endoscope handle mechanical, e.g. for tubes or pipes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00137—End pieces at either end of the endoscope, e.g. caps, seals or forceps plugs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/0014—Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147—Holding or positioning arrangements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A61B1/0052—Constructional details of control elements, e.g. handles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • A61B1/2676—Bronchoscopes
    • 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
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • 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
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A61B90/53—Supports for surgical instruments, e.g. articulated arms connected to the surgeon's body, e.g. by a belt
    • 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
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A61B90/57—Accessory clamps
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16B—DEVICES FOR FASTENING OR SECURING CONSTRUCTIONAL ELEMENTS OR MACHINE PARTS TOGETHER, e.g. NAILS, BOLTS, CIRCLIPS, CLAMPS, CLIPS OR WEDGES; JOINTS OR JOINTING
    • F16B2/00—Friction-grip releasable fastenings
    • F16B2/20—Clips, i.e. with gripping action effected solely by the inherent resistance to deformation of the material of the fastening
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16B—DEVICES FOR FASTENING OR SECURING CONSTRUCTIONAL ELEMENTS OR MACHINE PARTS TOGETHER, e.g. NAILS, BOLTS, CIRCLIPS, CLAMPS, CLIPS OR WEDGES; JOINTS OR JOINTING
    • F16B2/00—Friction-grip releasable fastenings
    • F16B2/20—Clips, i.e. with gripping action effected solely by the inherent resistance to deformation of the material of the fastening
    • F16B2/22—Clips, i.e. with gripping action effected solely by the inherent resistance to deformation of the material of the fastening of resilient material, e.g. rubbery material
    • F16B2/24—Clips, i.e. with gripping action effected solely by the inherent resistance to deformation of the material of the fastening of resilient material, e.g. rubbery material of metal
    • F16B2/241—Clips, i.e. with gripping action effected solely by the inherent resistance to deformation of the material of the fastening of resilient material, e.g. rubbery material of metal of sheet metal
    • F16B2/243—Clips, i.e. with gripping action effected solely by the inherent resistance to deformation of the material of the fastening of resilient material, e.g. rubbery material of metal of sheet metal internal, i.e. with spreading action

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • General Health & Medical Sciences (AREA)
  • Pathology (AREA)
  • Veterinary Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
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  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Molecular Biology (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Biophysics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pulmonology (AREA)
  • Mechanical Engineering (AREA)
  • Otolaryngology (AREA)
  • Physiology (AREA)
  • Endoscopes (AREA)
  • Surgical Instruments (AREA)
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Abstract

Extensión del mango envolvente para utilizarse con un mango de broncoscopio, la extensión del mangoenvolvente comprendiendo:(a) una capa envolvente flexible provista de disposiciones de sujeción complementarias desplegadas para formaruna funda cónica con el fin de sostener el mango del broncoscopio, y(b) un bucle manual asociado a la capa envolvente flexible y configurado para recibir la mano de un usuario ypermitir la suspensión de la funda cónica de la mano del usuario.

Description

Dispositivo de fijación envolvente para utilizarse con broncoscopios
CAMPO Y ANTECEDENTES DE LA INVENCIÓN
[0001] La presente invención se refiere a un broncoscopio y, en particular, se refiere a un sistema de accesorios para utilizarse cuando se realizan procesos quirúrgicos utilizando un broncoscopio.
[0002] El proceso intervencionista más conocido en el campo de la medicina pulmonar (i.e., la medicina del sistema respiratorio) es la broncoscopia, en la que un broncoscopio se introduce en las vías respiratorias a través de la nariz o la boca del paciente. El instrumento comprende un tubo largo y fino que típicamente incluye tres elementos, una disposición de iluminación para iluminar la zona distal de la punto del broncoscopio a través de una fibra óptica conectada a una fuente de luz externa, una disposición de representación de imágenes para obtener una imagen de video procedente de la punta distal del broncoscopio, y un “canal de trabajo” a través del que se introducen los instrumentos de diagnóstico (p.ej., herramientas para una biopsia) y terapéuticos (p. ej., laser, crio o sondas para la eliminación de tejido). La punta distal del broncoscopio es orientable; al girar una palanca colocada en el mango del broncoscopio se activa el mecanismo de orientación desviando la punta en dos direcciones opuestas.
[0003] Los broncoscopios se utilizan de forma habitual en el diagnóstico y el tratamiento de enfermedades como el cáncer de pulmón, la estenosis de las vías respiratorias, y el enfisema. Las realiza un neumólogo experto, también conocido como broncoscopista.
[0004] Las broncoscopias las realizan al menos dos personas, el broncoscopista y como mínimo un ayudante, normalmente una enfermera. Durante un procedimiento típico, el broncoscopista sostiene el mango del broncoscopio con una mano y el tubo del broncoscopio con la otra. Manipula la punta distal del broncoscopio dentro del pulmón girando la palanca de desviación y empujando y tirando el tubo. Cuando la punta ya ha llegado al punto objetivo, se consigue un diagnóstico médico y/o se aplica un tratamiento mediante la introducción de una herramienta de broncoscopio dentro del canal de trabajo y a través de la punta distal del tubo del broncoscopio y realizando el diagnóstico o tratamiento.
[0005] Durante la introducción y operación de la herramienta de broncoscopio, la punta distal del broncoscopio debería mantenerse firme en el punto objetivo. Para realizar estas tareas, a menudo se necesitan tres o cuatro manos, dos para fijar el broncoscopio en el lugar deseado, y una o dos manos más para introducir y activar la herramienta de broncoscopio. La complejidad de esta operación con varias personas requiere una coordinación adecuada entre el médico y el ayudante, y a menudo se reduce la precisión del procedimiento médico, y la necesidad de una ayuda adicional a menudo incrementa los costes.
[0006] Un dispositivo y un procedimiento de importancia particular para la presente invención se describe en la solicitud de patente PCT con número de publicación WO 03/086498 titulada "Endoscope Structure and Techniques for Navigation in Brunched Structure" de Gilboa, que se incorpora aquí completamente como referencia. Esta solicitud de patente describe un procedimiento y un aparato en el que una guía localizable (“LG”), envuelta por una funda, se utiliza para mover una herramienta de broncoscopio hasta una ubicación deseada dentro del pulmón. La combinación de guía/funda se introduce en el pulmón a través del canal de trabajo de un broncoscopio. Cuando la punta de la guía ya se encuentra en el punto objetivo, un bloqueo, que está colocado en el orificio (“puerto de conexión”) del canal de trabajo del broncoscopio, se hace funcionar para prevenir que la funda se deslice o se salga del broncoscopio. La guía después se retira de la funda, dejando la funda en un lugar concreto para guiar una herramienta hasta la ubicación objetivo requerida.
[0007] Por otra parte, cuando el mismo broncoscopio se utiliza en su función primaria para la investigación de los bronquios, el mismo canal de trabajo se utiliza para limpiar la mucosidad de las vías respiratorias, utilizando una bomba de vació conectada un conector especial separado del orificio del canal de trabajo. Para que esta succión funcione correctamente, el orificio del canal de trabajo debe sellarse durante la aplicación de la succión.
[0008] Además, durante el proceso, el médico normalmente necesita intercambiar dos dispositivos diferentes en el puerto de conexión del canal de trabajo del broncoscopio, un precinto y un cierre, y deben intercambiarse según la función que esté realizando el broncoscopio en ese momento.
[0009] Durante el cambio de la guía localizable y las otras herramientas, es necesario introducir la guía o herramienta dentro del extremo libre proximal de la funda. Este paso se ha considerado en cierto modo complicado y difícil de conseguir rápidamente debido a la flexibilidad y la correspondiente inestabilidad mecánica del extremo de la funda. El problema de puede solucionar fácilmente manteniendo el extremo de la funda en una mano y la herramienta en la otra, pero esto de nuevo implica una ayuda adicional durante la realización del proceso.
[0010] Para facilitar que un solo médico pueda utilizar un sistema como el que se describe en la solicitud arriba mencionada, sería preferible permitir que el médico pueda soltar temporalmente su herramienta o dispositivo secundario mediante el canal de trabajo del broncoscopio. Al mismo tiempo, es preferible que el dispositivo sea accesible y pueda utilizarse de forma inmediata, y que no quede suelto.
[0011] Existe por tanto la necesidad de obtener accesorios para utilizarse con un broncoscopio que faciliten que un solo médico pueda utilizar un broncoscopio y las herramientas relacionadas. También sería ventajoso proporcionar un adaptador para el puerto de conexión del canal de trabajo de un broncoscopio, que realice las funciones de sellado y cierre sin que sea necesario remplazarlo durante el proceso. También sería ventajoso proporcionar una disposición según las indicaciones de la publicación de patente PCT que faciliten la introducción de las herramientas dentro de la funda de guía.
RESUMEN DE LA INVENCIÓN
[0012] La presente invención se refiere a una extensión del mango envolvente para utilizar con un mango de broncoscopio, la extensión del mango envolvente comprendiendo:
(a)
una capa envolvente flexible provista de disposiciones de sujeción desplegadas para formar una funda cónica para sostener el mango del broncoscopio, y
(b)
un bucle manual asociado a la capa envolvente flexible y configurado para recibir la mano de un usuario y permitir la suspensión de la funda cónica de la mano del usuario.
[0013] Según otra característica de la presente invención, las disposiciones de sujeción complementarias se implementan como zonas complementarias de una disposición de sujeción Velcro.
[0014] Según otra característica de la presente invención, también se proporciona una banda de suspensión asociada a la capa envolvente flexible y configurada para suspender un accesorio de la funda cónica.
[0015] Según otra característica de la presente invención, la banda de suspensión está configurada con una configuración de sujeción que se puede liberar para formar un bucle de suspensión liberable.
BREVE DESCRIPCIÓN DE LOS DIBUJOS
[0016] La invención se describe a continuación, solo a modo de ejemplo, en referencia a los dibujos adjuntos, en los que:
La figura 1 es una vista lateral de una extensión del mango envolvente, construida y operativa según las indicaciones de la presente invención, en un estado aplanado;
La figura 2 es una vista lateral de la extensión de mango envolvente de la figura 1 en un estado desplegado formando una funda cónica para sostener el mango del broncoscopio;
La figura 3 es una vista lateral que muestra la utilización de la extensión del mango envolvente de la figura 1 con un broncoscopio y un accesorio durante una primera etapa del proceso; y
La figura 4 es una vista lateral que muestra la utilización de la extensión del mango envolvente de la figura 1 con un broncoscopio y un accesorio durante una segunda etapa del proceso.
[0017] Las figuras 1-4 muestran una extensión del mango envolvente 220 para utilizarse con un mango de broncoscopio. En términos generales, la extensión del mango envolvente 220 ayuda al broncoscopista a sostener con una mano el mango del broncoscopio y al mismo tiempo el mango de la herramienta del broncoscopio, y hacer funcionar los dos sin que interfieran entre sí, dejando al mismo tiempo la segunda mano libre para cualquier otra operación que se requiera. Para tal fin, la extensión del mango 220 incluye la capa envolvente flexible 228 provista de disposiciones de sujeción complementarias 224 desplegadas para formar una funda cónica (figura 2) y sostener el mango del broncoscopio como se muestra en las figuras 3 y 4. La extensión del mango 220 también incluye un bucle manual 222 asociado a la capa envolvente flexible 228 y configurado para recibir la mano de un usuario y permitir la suspensión de la funda cónica de la mano del usuario.
[0018] En referencia al ejemplo aquí ilustrado con más detalle, la capa envolvente flexible 228 está implementada preferiblemente como una fina capa de espuma de plástico blanda. El bucle manual 22 está hecho típicamente de un material de espuma similar. Las disposiciones de sujeción complementarias 224 están implementadas preferiblemente como zonas complementarias de una disposición de sujeción Velcro, aunque también se pueden utilizar otras disposiciones de bandas o sujeciones.
[0019] La extensión de mango envolvente 220 incluye también preferiblemente una banda de suspensión adicional 226 asociada a la capa envolvente flexible 228 y configurada para suspender un accesorio desde la funda cónica (ver figura 3). La banda de suspensión adicional 226 está configurada preferiblemente con una configuración se sujeción liberable (por ejemplo, Velcro), para forman un bucle de suspensión liberable. En una implementación particularmente preferida como aquí se muestra, la banda de suspensión adicional 226 está implementada como una extensión de una de las bandas de Velcro de la disposición de sujeción 224.
[0020] Como se ha mencionado anteriormente, la capa envolvente 228 forma una funda cónica diseñada para envolver y fijar el mango del broncoscopio 240. Cuando el broncoscopio se utiliza para la exploración, la herramienta de broncoscopio 242 se instala de forma que cuelga como un bucle 226 como se muestra en la figura 3. Esto permite que el broncoscopista pueda manipular la herramienta de broncoscopio con ambas manos
5 sin que le moleste la herramienta de broncoscopio, aunque también la está sujetando. Cuando la punta del broncoscopio llega al punto objetivo, el broncoscopista pone la palma de su mano dentro del mango 22 de modo que el broncoscopio se sostiene, o descansa sobre el dorso de su mano. Ahora el broncoscopista puede utilizar la herramienta de broncoscopio 242 utilizando sus dedos, como se muestra en la figura 4.
[0021] La implementación aquí mostrada es preferiblemente un accesorio de un solo uso. Otras
10 implementaciones, que utilizan diferentes materiales y diferentes técnicas para acoplar la herramienta de broncoscopio al mango del broncoscopio también están dentro del ámbito de la presente invención. En todo caso, la extensión del mango utiliza principio similares, ya que el mango de la herramienta está suspendido en una posición que no interfiere en la utilización del broncoscopio para explorar el interior de los pulmones, e incluso después de llegar al punto objetivo, deja que el médico utilice la herramienta de broncoscopio con la
15 misma mano sosteniendo al mismo tiempo el mango del broncoscopio.
[0022] Aunque lo aspectos anteriores de la presente invención se han descrito en el contexto de un broncoscopio y herramientas de broncoscopios, se debe considerar que otras aplicaciones que utilizan otro tipo de endoscopio y herramientas de endoscopio, en las que es necesario sostener las herramientas y el mango del endoscopio al mismo tiempo, también están dentro del ámbito de la presente invención.
20 [0023] Se apreciará que las descripciones anteriores están destinadas solo a servir de ejemplo, y que muchas otras realizaciones son posibles dentro del ámbito de la presente invención como se define en las reivindicaciones adjuntas.

Claims (3)

  1. REIVINDICACIONES
    1. Extensión del mango envolvente para utilizarse con un mango de broncoscopio, la extensión del mango envolvente comprendiendo:
    (a)
    una capa envolvente flexible provista de disposiciones de sujeción complementarias desplegadas para formar 5 una funda cónica con el fin de sostener el mango del broncoscopio, y
    (b) un bucle manual asociado a la capa envolvente flexible y configurado para recibir la mano de un usuario y permitir la suspensión de la funda cónica de la mano del usuario.
  2. 2. Extensión de mango según la reivindicación 1, en la que dichas disposiciones de sujeción complementarias están implementadas como zonas complementarias de una disposición de sujeción Velcro.
    10 3. Extensión de mango según la reivindicación 1, comprendiendo además una banda de suspensión adicional asociada a dicha capa envolvente flexible y configurada para suspender un accesorio desde dicha funda cónica.
  3. 4. Extensión de mango según la reivindicación 3, en la que dicha banda de suspensión adicional está configurada con una configuración de sujeción liberable para formar un bucle de suspensión liberable.
ES10191689T 2003-09-15 2004-09-14 Dispositivo de fijación envolvente para utilizarse con broncoscopios Expired - Lifetime ES2387026T3 (es)

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US55034604P 2004-03-08 2004-03-08
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US56494404P 2004-04-26 2004-04-26
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US7892229B2 (en) 2003-01-18 2011-02-22 Tsunami Medtech, Llc Medical instruments and techniques for treating pulmonary disorders
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EP2113189A2 (en) 2009-11-04
EP1667749A2 (en) 2006-06-14
WO2005025635A3 (en) 2007-11-08
US20100198006A1 (en) 2010-08-05
US10383509B2 (en) 2019-08-20
DE602004022432D1 (de) 2009-09-17
US9089261B2 (en) 2015-07-28
US8663088B2 (en) 2014-03-04
EP2113189A3 (en) 2009-12-30
US20150342444A1 (en) 2015-12-03
EP1667749A4 (en) 2008-10-22
US20070276180A1 (en) 2007-11-29
EP2113189B1 (en) 2013-09-04
US8317149B2 (en) 2012-11-27
ATE438335T1 (de) 2009-08-15
ATE556643T1 (de) 2012-05-15
WO2005025635A2 (en) 2005-03-24
EP1667749B1 (en) 2009-08-05
US20100198015A1 (en) 2010-08-05
JP2007519425A (ja) 2007-07-19
IL174255A0 (en) 2006-08-01
ES2432616T3 (es) 2013-12-04

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