ES2615827T3 - Dispositivo de extracción de tejido con alta frecuencia de oscilación - Google Patents

Dispositivo de extracción de tejido con alta frecuencia de oscilación Download PDF

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ES2615827T3
ES2615827T3 ES10770377.9T ES10770377T ES2615827T3 ES 2615827 T3 ES2615827 T3 ES 2615827T3 ES 10770377 T ES10770377 T ES 10770377T ES 2615827 T3 ES2615827 T3 ES 2615827T3
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tubular component
inner tubular
uterus
proximal
tissue
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Albert Chun-Chi Chin
Roy Hewitt Sullivan
Eric Karl Litscher
William Lucas Churchill
Ronald David Adams
William Harwick Gruber
David Jacobs
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Hologic Inc
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Hologic Inc
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Abstract

Un dispositivo de extracción de tejido (6), que comprende: un tubo exterior (76) alargado con un extremo proximal, un extremo distal (81) y una ventana lateral (89); y un tubo interior (411) alargado, situado dentro del tubo exterior (76) y que puede moverse para abrir y cerrar la ventana lateral (89); el tubo interior (411) que comprende una punta distal (415) con un borde cortante; caracterizado porque dicha punta distal (415) está unida a un vástago proximal (413) que corta el tejido que se extiende en la ventana (89); en el que la punta distal (415) tiene una dureza que excede la dureza del material del vástago proximal (413), en el que la punta distal (415) tiene un diámetro interior uniforme en toda su longitud, y en el que el diámetro interior de la punta distal (415) es menor que un diámetro interior del vástago proximal (413).

Description

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gradualmente de la manera convencional usando obturadores de diámetro creciente. A continuación, se puede lavar el útero de sangre u otros restos que pueden estar presentes por la dispensación de fluido desde el suministro de fluido 9 en el introductor 7 y dicho fluido puede salir del introductor 7 distalmente a través de lúmenes 198-1 y 198-2.
5 La válvula 228 puede estar abierta durante este procedimiento de lavado para que el fluido y todos los restos presentes en el útero puedan salir del útero de manera proximal a través del lumen 196 de la vaina 191 y, posteriormente, puedan salir del introductor 7 pasando proximalmente por el tubo 241, hacia el componente principal 213 del manguito 211, a través del componente lateral 215 del manguito 211 y a través de la válvula 228. Cuando el procedimiento de lavado se ha completado, la válvula 228 se puede cerrar mientras que el fluido puede seguir
10 dispensándose en el útero a través de los lúmenes 198-1 y 198-2, haciendo de este modo que el útero se distienda mediante el fluido. Cuando el útero se ha distendido lo suficiente por dicho fluido, la válvula 228 se puede abrir mientras que el fluido puede seguir dispensándose en el útero. De esta manera, el útero se puede mantener a un grado deseado de distensión mientras que el fluido se hace circular de forma continua en el útero. Con el útero así distendido mediante el fluido, el histeroscopio 8 se puede usar para examinar el interior del útero.
15 Si se detectan anormalidades que se quieren eliminar, el dispositivo de extracción de tejido 6 se puede cargar en el introductor 7, es decir, insertando los extremos distales del componente tubular exterior 76 y el componente tubular interior 77 distalmente a través de la guía de canal del introductor 7 y, a continuación, a través del canal 196 de la vaina 191, con la carcasa 13 permaneciendo externa al paciente. Entonces el dispositivo 6 puede ser manipulado de
20 modo que la ventana 89 del componente tubular exterior 76 puede estar situado en las proximidades del fibroma u otro tejido a tratar. A continuación, la fuente de vacío 392 se puede operar con el fin de hacer que se aplique succión al componente tubular interior 77, extrayendo así el tejido dentro del componente tubular exterior 76 a través de la ventana 89. Además, el motor del conjunto de transmisión motorizado 11 puede estar accionado, de manera que el componente tubular interior 77 gira y oscila al mismo tiempo hacia atrás y adelante en traslación dentro del
25 componente tubular exterior 76, haciendo que el tejido aspirado a través de la ventana 89 se corte. En este punto, el tejido cortado del paciente se puede succionar a través del componente tubular interior 77 mediante la succión antes mencionada y, después, se recoge en el depósito 391. Una vez que los fibromas u otros tejidos a tratar, se han extraído del paciente, la fuente de vacío 392 y el motor se pueden apagar, el dispositivo 6 se puede retirar del introductor 7 y el introductor 7 se puede retirar del paciente. El dispositivo 6 puede estar diseñado para ser un
30 dispositivo de un solo uso. En tal caso, a continuación el dispositivo 6 se puede desconectar del tubo de evacuación 393 y el eje del motor flexible 398-2 y desecharse adecuadamente.
Cabe señalar que, si bien la anterior discusión contempla el uso del introductor 7 para introducir el dispositivo 6 en el útero, se puede insertar el dispositivo 6 por vía transcervical en el útero sin el uso del introductor 7. En tal situación,
35 el fluido puede ser administrado por vía transcervical en el útero mediante un dispositivo dispensador de fluido con el fin de distender el útero y, después, la observación del útero se puede conseguir, por ejemplo, mediante imágenes ultrasónicas utilizando una sonda ultrasónica insertada por vía transcervical en el útero. Dicha sonda ultrasónica puede estar separada del dispositivo 6 o puede estar integrada en el dispositivo 6. Alternativamente las imágenes del útero se pueden realizar mediante resonancia magnética.
40 Aunque se puede variar uno o más de los parámetros de velocidad del movimiento de rotación del componente tubular interior 77, la frecuencia del movimiento de traslación oscilante del componente tubular interior 77, la relación de avance del componente tubular interior 77 (es decir, la relación de la velocidad a la que el componente tubular 77 oscila en traslación respecto a la velocidad en la que gira el componente 77) y la magnitud de succión proporcionada
45 por la fuente de vacío 392, en particular se han logrado buenos resultados en las siguientes condiciones: velocidad de rotación del componente tubular 77 - al menos 1100 rpm, más preferentemente al menos 5000 rpm, incluso más preferentemente aproximadamente 6000 rpm; la frecuencia del movimiento de traslación oscilante del componente tubular 77- al menos 1,5 ciclos/segundo, más preferentemente aproximadamente 2,5 a 4 ciclos/segundo, incluso más preferentemente aproximadamente 2,8 ciclos/segundo; la relación de avance preferentemente menos de 0,25,
50 más preferentemente menos de 0,15 y presiones de vacío en el rango de 200 a 650 mmHg. Preferentemente, los parámetros anteriores se seleccionan para conseguir una frecuencia de extracción de tejido de al menos 1,5 g/min mientras que el componente tubular exterior 76 tiene un diámetro exterior no superior a aproximadamente 3,0 mm
Como se puede apreciar, a medida que se aplica succión en el componente tubular interior 77, parte del líquido de 55 distensión situado en el útero puede incidentalmente ser retirado del útero a través del componente tubular interior
77. Esta pérdida de fluido de distensión del útero puede ser indeseable si interfiere con el mantenimiento del útero en un estado adecuadamente distendido. Preferentemente, el sistema 5 está construido y operado de manera que se retira un volumen no superior a 300 cc/min con un vacío de más de 300 mmHg. Esto puede implicar, por ejemplo, aplicar succión solo en momentos específicos, por ejemplo, solo cuando se acciona el motor para mover el
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El dispositivo 600 puede ser similar en muchos aspectos al dispositivo 6. Una diferencia entre los dos dispositivos puede ser sus respectivos mecanismos para girar y oscilar traslacionalmente el componente tubular interior 77. Más concretamente, el dispositivo 600 puede comprender un eje de transmisión interno 603 fijado a un eje de transmisión 5 externo (no se muestra) de manera que gire con el mismo. El eje de transmisión interno 603 puede comprender una parte proximal 605 y una parte distal 607. Un engranaje de dientes rectos 609 y un engranaje cónico 611 pueden estar montados coaxialmente sobre la parte distal 607 y fijados a la misma para girar con la misma, con el engranaje cónico 611 situado distalmente en relación con el engranaje de dientes rectos 609. Un engranaje de dientes rectos 613 puede estar montado coaxialmente sobre el componente tubular interior 77 y fijado al mismo para girar con el 10 mismo, el engranaje 613 acoplado con el engranaje 609 de manera que la rotación del eje de transmisión interno 603 provoque la rotación del componente tubular interior 77. (La velocidad de rotación del componente tubular interior 77, en comparación con la de eje de transmisión 603, se puede controlar mediante los diámetros relativos de los engranajes 609 y 613). Un engranaje cónico 615, posicionado distalmente en relación con el eje de transmisión interno 603, se puede acoplar con el engranaje cónico 611. Se puede colocar coaxialmente una montura 619 sobre 15 el componente tubular interior 77, estando dicha montura 619 fijada al componente tubular interior 77 facilitando el movimiento de traslación con el mismo, pero permitiendo que el componente tubular 77 gire libremente con el mismo. La montura 619 y engranaje cónico 615 se pueden acoplar entre sí mediante un pivote (no se muestra) que se extiende hacia arriba de la superficie superior 621 del engranaje 615 y una ranura (no se muestra) prevista en la superficie inferior de la montura 619, la ranura de montura 619 recibiendo el pivote en el engranaje cónico 615. La
20 ranura en la montura 619 puede estar orientada perpendicularmente al eje longitudinal del componente tubular interior 77 y puede estar dimensionado adecuadamente de modo que el pivote del engranaje cónico 615 se desplaza hacia atrás y adelante dentro de la ranura de la montura 619 a medida que gira el engranaje cónico 615. De esta manera, la rotación del engranaje cónico 615 puede provocar la oscilación de traslación del componente tubular interior 77.
25 Con referencia ahora a la fig. 11, se muestra una vista en perspectiva fragmentaria de un dispositivo de extracción de tejido alternativo que se puede utilizar en el sistema de extracción de tejido 5. Dicho dispositivo de extracción de tejido está representado generalmente con el número de referencia 700. Algunos aspectos del dispositivo 700 que no son importantes para una comprensión de la invención no se muestran ni se describen en este documento.
30 El dispositivo 700 puede ser similar en muchos aspectos al dispositivo 6. Una diferencia entre los dos dispositivos puede ser sus respectivos mecanismos para girar y oscilar traslacionalmente el componente tubular interior 77. Más concretamente, el dispositivo 700 puede comprender un eje de transmisión interno 703 fijado a un eje de transmisión externo (no se muestra) de manera que gire con el mismo. Un engranaje de dientes rectos 705 y una leva de
35 traslación 707 pueden estar montados coaxialmente sobre el eje de transmisión 703 y fijados al mismo para girar con el mismo, con la leva de traslación 707 situada distalmente en relación con el engranaje de dientes rectos 705. Un engranaje de dientes rectos 711 puede estar montado coaxialmente sobre el componente tubular interior 77 y fijado al mismo para girar con el mismo, el engranaje 711 acoplado con el engranaje 705 de manera que la rotación del eje de transmisión interno 703 origina la rotación del componente tubular interior 77. (La velocidad de rotación del
40 componente tubular interior 77, en comparación con la de eje de transmisión 703, se puede controlar mediante los diámetros relativos de los engranajes 705 y 711). Se puede colocar coaxialmente una montura 713 sobre el componente tubular interior 77, estando dicha montura 713 fijada al componente tubular interior 77 facilitando el movimiento de traslación con el mismo, pero permitiendo que el componente tubular 77 gire libremente dentro de la misma. La montura 713 y la leva de traslación 707 se pueden acoplar entre sí mediante un pivote (no se muestra)
45 que se extiende hacia abajo desde la montura 713 y una ranura en forma de bucle 717 prevista en la leva 707, la ranura 717 recibiendo el pivote en la montura 713. La ranura 717 de la leva 707 puede estar conformada para extenderse desde alrededor del extremo proximal 707-1 de la leva 707 hasta aproximadamente el extremo distal 707-2 de la leva 707 y de nuevo a alrededor del extremo proximal 707-1 de la leva 707 en el curso de una rotación de la leva 707. De esta manera, a media que la leva 707 gira y el pivote se desplaza hacia atrás y adelante dentro de
50 la ranura 717, el componente tubular interior 77 puede oscilar traslacionalmente en consecuencia.
Con referencia ahora a la fig. 12, se muestra una vista en perspectiva fragmentaria de un dispositivo de extracción de tejido alternativo que se puede utilizar en el sistema de extracción de tejido 5. Dicho dispositivo de extracción de tejido está representado generalmente con el número de referencia 800. Algunos aspectos del dispositivo 800 que
55 no son importantes para una comprensión de la invención no se muestran ni se describen en este documento.
El dispositivo 800 puede ser similar en muchos aspectos al dispositivo 6. Una diferencia entre los dos dispositivos puede ser sus respectivos mecanismos para girar y oscilar traslacionalmente el componente tubular interior 77. Más concretamente, el dispositivo 800 puede comprender un eje de transmisión interno 801 fijado a un eje de transmisión
15
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soporte 1145 puede estar conformado para incluir una ranura 1147 en la superficie superior que está conformada de manera complementaria a la ranura 1143, con las ranuras 1143 y 1147 que definen conjuntamente un canal de forma generalmente cilíndrica.
5 El conjunto de transmisión 1015 puede, además, comprender un mecanismo para la transmisión del movimiento de rotación del componente tubular interior 1077. Dicho mecanismo puede comprender un primer motor 1151. El motor 1151, a su vez, puede comprender un primer extremo 1152 con un eje 1153 se extiende desde el mismo. El primer extremo 1152 puede ser recibido dentro de la parte central 1115 de extremo distal 1107 del cuerpo 1105 y puede ser fijada al mismo con tornillos 1156 insertados a través de las aberturas 1120 y dentro de las aberturas
10 complementarias 1157 del primer extremo 1152 del motor 1151. Con el motor 1151 fijado de este modo a extremo distal 1107, el eje 1153 puede extenderse a través de la abertura transversal central 1119 y puede girar libremente dentro de ella. Se pueden utilizar cables 1159 para conectar el motor 1151 a la unidad de control 1010.
Así mismo, el mecanismo anteriormente mencionado para la transmisión del movimiento de rotación del componente
15 tubular interior 1077 puede comprender además un bloque de acoplamiento 1161 y un engranaje 1162. El bloque de acoplamiento 1161, que puede ser una estructura unitaria hecha de un polímero o metal rígido, puede estar conformado para incluir una base distal 1163 y un poste proximal. Dicho poste proximal se extiende proximalmente desde la base 1163. La base 1163 puede estar conformada para incluir una cavidad 1164 accesible desde su extremo distal, en la que el eje 1153 del motor 1151 puede ser recibido y fijado con un tornillo 1165, acoplando de
20 ese modo el eje 1153 con el bloque 1161. El puesto proximal puede estar conformado para incluir una parte distal 1166 de diámetro aumentado y una parte proximal 1167 de diámetro reducido. El engranaje 1162, que puede ser un miembro unitario hecho de un polímero o metal rígido, puede estar conformado para incluir un tubo distal 1168 y una rueda dentada proximal 1169. El tubo 1168 puede estar montado coaxialmente en la parte 1166 del bloque 1161 y acoplado mecánicamente al mismo con un tornillo 1170. La rueda 1169 puede estar situada de manera que una
25 parte de la rueda 1169 se extiende a través de la ranura 1133 para acoplarse con la parte intermedia 1057 del eje 1051. De esta manera, la rotación de la rueda 1169 provoca la rotación del eje 1051. La parte proximal 1167 del poste 1165, que puede extenderse proximalmente a una corta distancia por encima de la rueda 1169, puede estar sentada dentro de un cojinete 1173. Dicho cojinete 1173 está sentado dentro del extremo distal del canal definido conjuntamente por el bloque 1141 y el soporte 1145.
30 El conjunto de transmisión 1015 puede, además, comprender un mecanismo para la transmisión del movimiento de traslación oscilante del componente tubular interior 1077. Dicho mecanismo puede comprender un segundo motor 1181. El motor 1181 puede, a su vez, comprender un primer extremo 1182 con un eje 1183 que se extiende desde el mismo. El primer extremo 1182 puede ser recibido dentro de la parte central 1123 de extremo distal 1109 del cuerpo
35 1105 y puede ser fijada al mismo con tornillos 1186 insertados a través de las aberturas 1129 y dentro de las aberturas complementarias 1187 del primer extremo 1182 del motor 1181. Con el motor 1181 fijado de este modo a extremo distal 1109, el eje 1183 puede extenderse a través de la abertura transversal central 1127 y puede girar libremente dentro de ella. Se puede utilizar un cable 1189 para conectar el motor 1181 a la unidad de control 1010.
40 Así mismo, el mecanismo anteriormente mencionado para transmitir el movimiento de traslación oscilante de componente tubular interior 1077 puede comprender además un bloque de acoplamiento 1191, un perno roscado 1192 y un transporte 1193. El bloque de acoplamiento 1191, que puede ser una estructura unitaria hecha de un polímero o metal rígido, puede estar conformado para incluir una abertura proximal 1194 y una abertura distal 1195. La abertura proximal 1194 puede estar dimensionada para recibir de forma segura el eje 1183 del motor 1181,
45 acoplando así mecánicamente el eje 1183 con el bloque 1191. La abertura distal 1195 puede dimensionarse para recibir de forma segura el extremo proximal del perno roscado 1192, acoplando así mecánicamente el perno 1192 con el bloque 1191. El extremo distal del perno 1192 puede estar sentado dentro de un cojinete 1196 el cual, a su vez, puede ser sentado dentro del extremo proximal del canal definido conjuntamente por el bloque 1141 y el soporte 1145.
50 El transporte 1193, que puede ser una estructura unitaria hecha de un polímero o metal rígido, puede estar conformado para incluir un agujero 1197 y un par de púas 1198 que se extienden hacia arriba. Un collar rígido 1199 puede estar montado de forma fija dentro del orificio 1197 del transporte 1193 mediante un par de tornillos 1200. El collar 1199 puede estar roscado internamente para encajar el perno 1192. De esta manera, a medida que el perno
55 1192 gira, el transporte 1193 se mueve en traslación a lo largo del eje longitudinal del perno 1192, con el movimiento de traslación proximal o distal del transporte 1193 efectuado por la rotación en sentido horario o en sentido contrario a las agujas del reloj, respectivamente, del perno 1192. El transporte 1193 puede estar acoplado mecánicamente para el movimiento de traslación en el eje 1051 con las púas 1198. Dichas púas 1198 se extienden por la ranura 1135 del cuerpo 1105 y se reciben dentro de las ranuras 1071-1 y 1071-2 del conjunto de morcelador 1013.
20
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El conjunto de transmisión 1015 puede comprender además una tapa 1261. La tapa 1261, que puede ser una estructura unitaria hecha de un polímero o metal rígido, puede tener la forma de medio tubo con un extremo proximal 1263 y un extremo distal 1265. La tapa 1261 puede estar dimensionada para complementar las paredes laterales 5 1111 y 1207 de los cuerpos 1105 y 1201, respectivamente. Así mismo, la tapa 1261 puede estar fijada al cuerpo 1105 con un tornillo 1267 insertado a través de una abertura 1269 en la tapa 1261 y en la cavidad correspondiente 1271 del extremo proximal 1109 del cuerpo 1105 y con un tornillo 1273 insertado a través de una abertura 1275 en la tapa 1261 y en la cavidad correspondiente 1277 del extremo distal 1107 del cuerpo 1105. Además, la tapa 1261 puede estar fijada al cuerpo 1201 al unir la tapa 1261 con un bloque 1281 mediante un tornillo 1283 y al unir el
10 bloque 1281 con el extremo distal 1203 del cuerpo 1201 mediante un par de tornillos 1285.
Con referencia de nuevo a la fig. 15, el conjunto de vacío 1009 puede incluir un depósito de recogida de muestras 1291 y una fuente de vacío 1292. El extremo distal de un tubo de evacuación 1293 puede ser insertado con accesorio 1097 y puede estar fijado al mismo con un ajuste de fricción, y el extremo proximal del tubo de evacuación
15 1293 puede estar acoplado a un primer puerto 1294 del depósito 1291. El extremo distal de un tubo 1295 puede estar acoplado a un segundo puerto 1296 del depósito 1291 y el extremo proximal del tubo 1295 puede estar acoplado a la fuente de vacío 1292. De esta manera, la fuente de vacío 1292 se puede utilizar para aplicar succión al dispositivo 1008, y todos los tejidos, líquidos o materiales similares extraídos y succionados a través del dispositivo 1008, se podrán recoger en el depósito 1291.
20 La unidad de control 1010, que se puede acoplar a una fuente de electricidad, como una toma eléctrica de CA, mediante un cable de alimentación (no se muestra), puede incluir electrónica (no se muestra) para controlar el funcionamiento de los motores 1151 y 1181 mediante un cable 1298-1 conectado a los cables 1159 y 1189. Un pedal de pie 1297 puede estar acoplado a la unidad de control 1010 con un cable 1298-2 y puede ser utilizado como
25 un interruptor de alimentación para activar o desactivar selectivamente los motores 1151 y 1181. La unidad de control 1010 puede incluir además un sensor de vacío 1299, que se puede acoplar al depósito 1291 por un tubo 1300, de modo que la presión dentro del depósito 1291 puede ser controlada por la unidad de control 1010. De esta manera, un aumento repentino de la presión de vacío puede indicar que se ha producido una obstrucción.
30 La presencia de una obstrucción se puede indicar a través de una alarma (no se muestra) situada en la unidad de control 1010. La detección de una obstrucción a menudo es una indicación clara de que el funcionamiento ulterior del dispositivo 1008 solo puede agravar la situación de obstrucción y que puede ser necesario interrumpir la extracción de tejido. La unidad de control 1010 se puede configurar para sincronizar el accionamiento del conjunto de transmisión 1015 con el accionamiento de la fuente de vacío 1292. De esta manera, encender el conjunto de
35 transmisión 1015 encenderá la fuente de vacío 1292 al mismo tiempo. Consecuentemente, la fuente de vacío 1292 se puede desactivar siempre que el conjunto de transmisión 1015 esté apagado.
Cuando se utiliza, el extremo distal de un histeroscopio se puede insertar por vía transcervical en un paciente y puede conducirse un fluido adecuado a través del puerto de entrada de fluido del histeroscopio en el útero hasta que 40 el útero se distiende. La observación del útero y la detección de los fibromas u otros tejidos anormales ginecológicos puede entonces llevarse a cabo utilizando el canal de visualización de la histeroscopio. Los extremos distales del componente tubular exterior 1076 y el componente tubular interior 1077 se pueden insertar a través de un canal de trabajo del histeroscopio y dentro del útero, con el resto del sistema 1007 permaneciendo proximal al histeroscopio. El dispositivo 1008 se puede manipular de modo que la ventana 1089 de componente tubular exterior 1076 pueda 45 estar situada en las proximidades proximidad del fibroma u otro tejido a tratar. A continuación, la fuente de vacío 1292 se puede manejar con el fin de originar la succión a aplicar al componente tubular interior 1077, extrayendo de ese modo el tejido en el componente tubular exterior 1076 a través de la ventana 1089. Así mismo, los motores 1151 y 1181 se pueden manejar con el fin de hacer que el componente tubular interior 1077 gire y oscile hacia atrás y adelante al mismo tiempo en traslación dentro del componente tubular exterior 1076, haciendo que el tejido extraído 50 a través de la ventana 1089 se corte. El tejido cortado del paciente se puede succionar a través del componente tubular interior 1077 mediante la succión antes mencionada y, después, se recoge en el depósito 1291. Una vez que los fibromas u otros tejidos a tratar, se han extraído del paciente, la fuente de vacío 1292 y los motores 1151 y 1181 se pueden apagar, el dispositivo 1008 se puede retirar del histeroscopio y el histeroscopio se puede retirar del paciente. El conjunto de morcelador 1013 se puede entonces separar de conjunto de transmisión 1015 y
55 desconectar de la fuente de vacío 1292. El conjunto de morcelador 1013 puede estar diseñado para ser un dispositivo de un solo uso y, en tal caso, puede eliminarse después de ser utilizado en un paciente. Por el contrario, el conjunto de transmisión 1015 puede utilizarse en varios pacientes diferentes antes de su eliminación, con un conjunto de morcelador 1013 diferente preferentemente utilizado con cada paciente.
22
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imagen19
con el número de referencia 1800. Ciertos aspectos del dispositivo 1800 que no son importantes para una comprensión de la invención no se muestran ni se describen en este documento.
El dispositivo 1800 puede ser similar en ciertos aspectos al dispositivo 6. Una diferencia entre los dos dispositivos es
5 que el dispositivo 1800 puede comprender un componente tubular interior 1803 y un componente tubular exterior 1805. El componente tubular interior 1803 y el componente tubular exterior 1805 pueden ser similares al componente tubular interior 77 y el componente tubular exterior 76, respectivamente, del dispositivo 6, excepto que
(i) el componente tubular exterior 1805 puede comprender un puerto 1807 adaptado para recibir un líquido o gel adecuado (por ejemplo, agua, glicina, un gel tixotrópico, etc. ) de un suministro (no se muestra) y (ii) el componente
10 tubular interior 1803 puede tener un diámetro exterior que es aproximadamente de 0,013-0,015 cm (0,005-0,006 pulgadas) menor que el diámetro interior del componente tubular exterior 1805 (en contraste con los 0,005 cm (0,002 pulgadas) del dispositivo 6) para permitir que, el líquido o gel suministrado al componente tubular exterior 1805 a través del puerto 1807, sea suministrado al tejido a tratar a través de una ventana de resección 1809.
15 Un dispositivo de extracción de tejido alternativo al dispositivo 1800 se muestra en la fig. 23. Dicho dispositivo de extracción de tejido alternativo se representa en general con el número de referencia 1900. Ciertos aspectos del dispositivo 1900 que no son importantes para una comprensión de la invención no se muestran ni se describen en este documento.
20 El dispositivo 1900 puede ser similar en muchos aspectos al dispositivo 6. La principal diferencia entre los dos dispositivos es que, mientras que el dispositivo 6 puede comprender un componente tubular exterior 76, el dispositivo 1900 puede comprender un componente tubular exterior 1903. El componente tubular exterior 1903 puede ser similar al componente tubular exterior 76, excepto que el componente tubular exterior 1903 puede estar conformado, además, para incluir un canal 1905 que tiene un puerto de entrada proximal 1907 y un puerto de salida
25 distal 1909. El puerto de entrada 1907 puede ser adaptado para conectarse a un suministro (no se muestra) y recibir un gel o líquido adecuados (por ejemplo, agua, glicina, un gel tixotrópico, etc.). El puerto distal 1909 puede estar situado próximo a una ventana de resección 1911.
25

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US12/432,702 US20090270898A1 (en) 2007-04-06 2009-04-29 Tissue removal device with high reciprocation rate
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US20090270895A1 (en) 2009-10-29
EP3132760A1 (en) 2017-02-22
US20090270897A1 (en) 2009-10-29
AU2010242907B2 (en) 2015-05-21
US20090270898A1 (en) 2009-10-29
CA2760328C (en) 2017-01-17
WO2010127174A1 (en) 2010-11-04
EP3132760B1 (en) 2018-06-13
US20090270812A1 (en) 2009-10-29
WO2010127171A1 (en) 2010-11-04
CA2760328A1 (en) 2010-11-04
CN102438534A (zh) 2012-05-02
US8951274B2 (en) 2015-02-10
US20110034943A1 (en) 2011-02-10
EP2424449B1 (en) 2016-11-16
AU2010242907A1 (en) 2011-09-15
EP2424449A1 (en) 2012-03-07
EP2424449A4 (en) 2015-05-27
CN105726095A (zh) 2016-07-06
CN102438534B (zh) 2016-03-02
ES2687119T3 (es) 2018-10-23

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