JP2001514921A5 - - Google Patents
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- JP2001514921A5 JP2001514921A5 JP2000509360A JP2000509360A JP2001514921A5 JP 2001514921 A5 JP2001514921 A5 JP 2001514921A5 JP 2000509360 A JP2000509360 A JP 2000509360A JP 2000509360 A JP2000509360 A JP 2000509360A JP 2001514921 A5 JP2001514921 A5 JP 2001514921A5
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- 239000000523 sample Substances 0.000 description 43
- 210000003195 Fascia Anatomy 0.000 description 13
- 238000001816 cooling Methods 0.000 description 9
- 210000001519 tissues Anatomy 0.000 description 9
- 210000003932 Urinary Bladder Anatomy 0.000 description 4
- 239000012530 fluid Substances 0.000 description 3
- 238000010438 heat treatment Methods 0.000 description 3
- 210000001215 Vagina Anatomy 0.000 description 2
- 206010021639 Incontinence Diseases 0.000 description 1
- 208000005392 Spasm Diseases 0.000 description 1
- 230000004913 activation Effects 0.000 description 1
- 230000005540 biological transmission Effects 0.000 description 1
- 239000012141 concentrate Substances 0.000 description 1
- 230000000875 corresponding Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 238000007789 sealing Methods 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 230000001629 suppression Effects 0.000 description 1
- 230000001702 transmitter Effects 0.000 description 1
Description
【特許請求の範囲】
【請求項1】 患者身体の膣内由来の筋膜にエネルギーを印加するための経膣的なプローブであって、該筋膜は膣壁によって該膣から分離されており、
該プローブは、
近位端および遠位端を有するプローブ本体であって、該膣内への導入を可能にするために選択された長さおよび断面を有する、プローブ本体と、
該プローブ本体に取り付けられた複数のエネルギー伝達要素であって、該膣壁を介して該筋膜を加熱し、攣縮するために十分な熱エネルギーを伝達し得、それによって、該攣縮した筋膜は、失禁を抑止する、伝達要素と、
該複数の伝達要素の間に配列された冷却システムであって、該筋膜が該複数のエネルギー伝達要素によって加熱される場合、最高安全温度以下にて該プローブに隣接する該膣壁を維持するように適合される、冷却システムと
を備えた、プローブ。
【請求項2】 前記複数のエネルギー伝達要素が、前記膣壁に対して係合し得る側方的に配向した複数の電極表面を有する複数の電極を含み、該複数の電極表面が前記冷却システムと結合され、それによって、該複数の電極表面からの電流束が前記筋膜を治療学的に加熱する間、該複数の電極表面が、該係合した膣壁を冷却し得る、請求項1に記載のプローブ。
【請求項3】 失禁を抑止するために処置温度にて前記電流束が前記筋膜を加熱し、攣縮する間、前記冷却システムが前記膣壁を最高安全組織温度以下にて維持し得る、請求項2に記載のプローブ。
【請求項4】 前記複数の電極が電極アレイを含み、前記複数の電極表面が複数の電極表面セグメントを含む、請求項2または3に記載のプローブ。
【請求項5】 前記複数の電極表面セグメントが、前記膣壁を介して前記筋膜内に電流束を指向するように実質的に平らである組み合わされた電極表面を規定する、請求項4に記載のプローブ。
【請求項6】 前記複数の電極表面セグメントが複数のバイポーラ電極対を含み、該複数のバイポーラ電極対が、各々の対の該複数の電極表面セグメントの間で前記膣壁を介して前記筋膜内に電流束を指向するように適合される、請求項4に記載のプローブ。
【請求項7】 前記対の前記複数の電極表面セグメントが前記プローブ本体に沿って分離され、そして前記冷却システムが該対の該分離された複数のバイポーラ電極セグメントの間に配置される前記係合した膣壁を冷却するように適合される、請求項6に記載のプローブ。
【請求項8】 前記筋膜と前記プローブとを整列させることを容易にするために前記電極表面に隣接して配置された超音波変換器をさらに備えた、請求項1〜7に記載のプローブ。
【請求項9】 前記プローブから前記超音波変換器の視野内に膨張可能な針をさらに含み、該針は、前記筋膜の温度をモニターする温度センサーに結合される、請求項8に記載のプローブ。
【請求項10】 前記複数のエネルギー伝達要素に結合したコントロールシステムをさらに含み、該コントロールシステムは前記筋膜を前記処置温度まで加熱するために該複数のエネルギー伝達要素を選択的に活性化するように配列され、それによって、前記冷却システムが該複数のエネルギー伝達要素と該筋膜との間に配置される前記膣壁を最高安全組織温度未満に維持する間、失禁が抑止される、請求項1〜9に記載のプローブ。
【請求項11】 前記コントロールシステムが前記冷却システムに動作可能に関連付けられ、該コントロールシステムが前記筋膜の加熱を開始する前に前記膣壁の予備冷却に効果を与えるように配列される、請求項10に記載のプローブ。
【請求項12】 前記コントロールシステムに結合され、前記膣壁および前記筋膜の少なくとも1つの温度を測定するように適合された温度センサーをさらに備え、前記冷却システムが前記膣壁を最高安全組織温度未満に維持する間、該コントロールシステムは、標的組織を処置温度まで加熱するために該温度に応答して前記複数のエネルギー伝達要素を選択的に活性化するように適合される、請求項10に記載のプローブ。
【請求項13】 前記制御装置が、前記複数のエネルギー伝達要素を断続的に活性化するように適合される、請求項10に記載のプローブ。
【請求項14】 前記複数のエネルギー伝達要素が複数の電極表面セグメントを含み、前記冷却システムが前記膣壁への傷害を抑止する間、前記制御装置が、前記筋膜を加熱し、縮小するためにRF電流を用いて前記複数の電極表面セグメントを断続的に活性化するように適合される、請求項10に記載のプローブ。
【請求項15】 前記制御装置が、代替性の複数の電極表面セグメントの間にバイポーラ電流を駆動するように配列され、前記筋膜の重なり合う標的ゾーンを加熱する、請求項14に記載のプローブ。
【請求項16】 請求項2に記載のプローブを含むプローブシステムであって、
前記筋膜が膀胱壁によって膀胱から分離された骨盤支持組織を含み、
該プローブシステムは、
近位端、遠位端、および該遠位端付近の第二のプローブ電極を有する第二のプローブと、
それらの間で該骨盤支持組織を加熱し、縮小するために、該第二のプローブの電極および該第二のプローブに結合した電源とをさらに備えている、プローブシステム。
【請求項17】 前記第二のプローブが、前記膀胱内への経尿道的挿入のために適合され、かつ、該膀胱内に導電性流体を封着するために該流入ポートの近位のシーリングメンバーを有する流体流入ポートを前記遠位端付近に有し、それによって、前記第二のプローブ電極が該導電性流体によって前記膀胱壁に電気的に結合される、請求項16に記載のプローブシステム。
【請求項18】 前記第二のプローブが、前記プローブ本体に機械的に結合され、それによって、該第二のプローブ電極の電極表面が前記複数の電極表面に向かって配向される、請求項16に記載のプローブシステム。
【請求項19】 前記複数の電極表面の間の前記組織を圧縮する前記複数の電極を機械的に結合するクランプ構造をさらに備えた、請求項16に記載のプローブシステム。
【請求項20】 前記プローブが、前記筋膜を加熱するために前記膣壁を介して超音波エネルギーを集中させるために適合された超音波伝達装置を備えた、請求項1および11〜13に記載のプローブ。
【請求項21】 前記制御装置が、前記伝達装置から前記標的組織内に前記超音波エネルギーを指向するように適合され、それによって前記膣壁の温度を約45℃以下に制限する間、該標的組織を約60℃以上まで加熱する、請求項20に記載のプローブ。
【請求項22】 複数の加熱電極が幅を規定し、幅の約1/3から約5倍の範囲内の分離距離によって分離される、請求項2に記載のプローブ。
【請求項1】 患者身体の膣内由来の筋膜にエネルギーを印加するための経膣的なプローブであって、該筋膜は膣壁によって該膣から分離されており、
該プローブは、
近位端および遠位端を有するプローブ本体であって、該膣内への導入を可能にするために選択された長さおよび断面を有する、プローブ本体と、
該プローブ本体に取り付けられた複数のエネルギー伝達要素であって、該膣壁を介して該筋膜を加熱し、攣縮するために十分な熱エネルギーを伝達し得、それによって、該攣縮した筋膜は、失禁を抑止する、伝達要素と、
該複数の伝達要素の間に配列された冷却システムであって、該筋膜が該複数のエネルギー伝達要素によって加熱される場合、最高安全温度以下にて該プローブに隣接する該膣壁を維持するように適合される、冷却システムと
を備えた、プローブ。
【請求項2】 前記複数のエネルギー伝達要素が、前記膣壁に対して係合し得る側方的に配向した複数の電極表面を有する複数の電極を含み、該複数の電極表面が前記冷却システムと結合され、それによって、該複数の電極表面からの電流束が前記筋膜を治療学的に加熱する間、該複数の電極表面が、該係合した膣壁を冷却し得る、請求項1に記載のプローブ。
【請求項3】 失禁を抑止するために処置温度にて前記電流束が前記筋膜を加熱し、攣縮する間、前記冷却システムが前記膣壁を最高安全組織温度以下にて維持し得る、請求項2に記載のプローブ。
【請求項4】 前記複数の電極が電極アレイを含み、前記複数の電極表面が複数の電極表面セグメントを含む、請求項2または3に記載のプローブ。
【請求項5】 前記複数の電極表面セグメントが、前記膣壁を介して前記筋膜内に電流束を指向するように実質的に平らである組み合わされた電極表面を規定する、請求項4に記載のプローブ。
【請求項6】 前記複数の電極表面セグメントが複数のバイポーラ電極対を含み、該複数のバイポーラ電極対が、各々の対の該複数の電極表面セグメントの間で前記膣壁を介して前記筋膜内に電流束を指向するように適合される、請求項4に記載のプローブ。
【請求項7】 前記対の前記複数の電極表面セグメントが前記プローブ本体に沿って分離され、そして前記冷却システムが該対の該分離された複数のバイポーラ電極セグメントの間に配置される前記係合した膣壁を冷却するように適合される、請求項6に記載のプローブ。
【請求項8】 前記筋膜と前記プローブとを整列させることを容易にするために前記電極表面に隣接して配置された超音波変換器をさらに備えた、請求項1〜7に記載のプローブ。
【請求項9】 前記プローブから前記超音波変換器の視野内に膨張可能な針をさらに含み、該針は、前記筋膜の温度をモニターする温度センサーに結合される、請求項8に記載のプローブ。
【請求項10】 前記複数のエネルギー伝達要素に結合したコントロールシステムをさらに含み、該コントロールシステムは前記筋膜を前記処置温度まで加熱するために該複数のエネルギー伝達要素を選択的に活性化するように配列され、それによって、前記冷却システムが該複数のエネルギー伝達要素と該筋膜との間に配置される前記膣壁を最高安全組織温度未満に維持する間、失禁が抑止される、請求項1〜9に記載のプローブ。
【請求項11】 前記コントロールシステムが前記冷却システムに動作可能に関連付けられ、該コントロールシステムが前記筋膜の加熱を開始する前に前記膣壁の予備冷却に効果を与えるように配列される、請求項10に記載のプローブ。
【請求項12】 前記コントロールシステムに結合され、前記膣壁および前記筋膜の少なくとも1つの温度を測定するように適合された温度センサーをさらに備え、前記冷却システムが前記膣壁を最高安全組織温度未満に維持する間、該コントロールシステムは、標的組織を処置温度まで加熱するために該温度に応答して前記複数のエネルギー伝達要素を選択的に活性化するように適合される、請求項10に記載のプローブ。
【請求項13】 前記制御装置が、前記複数のエネルギー伝達要素を断続的に活性化するように適合される、請求項10に記載のプローブ。
【請求項14】 前記複数のエネルギー伝達要素が複数の電極表面セグメントを含み、前記冷却システムが前記膣壁への傷害を抑止する間、前記制御装置が、前記筋膜を加熱し、縮小するためにRF電流を用いて前記複数の電極表面セグメントを断続的に活性化するように適合される、請求項10に記載のプローブ。
【請求項15】 前記制御装置が、代替性の複数の電極表面セグメントの間にバイポーラ電流を駆動するように配列され、前記筋膜の重なり合う標的ゾーンを加熱する、請求項14に記載のプローブ。
【請求項16】 請求項2に記載のプローブを含むプローブシステムであって、
前記筋膜が膀胱壁によって膀胱から分離された骨盤支持組織を含み、
該プローブシステムは、
近位端、遠位端、および該遠位端付近の第二のプローブ電極を有する第二のプローブと、
それらの間で該骨盤支持組織を加熱し、縮小するために、該第二のプローブの電極および該第二のプローブに結合した電源とをさらに備えている、プローブシステム。
【請求項17】 前記第二のプローブが、前記膀胱内への経尿道的挿入のために適合され、かつ、該膀胱内に導電性流体を封着するために該流入ポートの近位のシーリングメンバーを有する流体流入ポートを前記遠位端付近に有し、それによって、前記第二のプローブ電極が該導電性流体によって前記膀胱壁に電気的に結合される、請求項16に記載のプローブシステム。
【請求項18】 前記第二のプローブが、前記プローブ本体に機械的に結合され、それによって、該第二のプローブ電極の電極表面が前記複数の電極表面に向かって配向される、請求項16に記載のプローブシステム。
【請求項19】 前記複数の電極表面の間の前記組織を圧縮する前記複数の電極を機械的に結合するクランプ構造をさらに備えた、請求項16に記載のプローブシステム。
【請求項20】 前記プローブが、前記筋膜を加熱するために前記膣壁を介して超音波エネルギーを集中させるために適合された超音波伝達装置を備えた、請求項1および11〜13に記載のプローブ。
【請求項21】 前記制御装置が、前記伝達装置から前記標的組織内に前記超音波エネルギーを指向するように適合され、それによって前記膣壁の温度を約45℃以下に制限する間、該標的組織を約60℃以上まで加熱する、請求項20に記載のプローブ。
【請求項22】 複数の加熱電極が幅を規定し、幅の約1/3から約5倍の範囲内の分離距離によって分離される、請求項2に記載のプローブ。
Applications Claiming Priority (15)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/910,371 US6081749A (en) | 1997-08-13 | 1997-08-13 | Noninvasive devices, methods, and systems for shrinking of tissues |
US08/910,775 US6480746B1 (en) | 1997-08-13 | 1997-08-13 | Noninvasive devices, methods, and systems for shrinking of tissues |
US08/910,369 US6035238A (en) | 1997-08-13 | 1997-08-13 | Noninvasive devices, methods, and systems for shrinking of tissues |
US7141898P | 1998-01-14 | 1998-01-14 | |
US7141998P | 1998-01-14 | 1998-01-14 | |
US7142298P | 1998-01-14 | 1998-01-14 | |
US7132398P | 1998-01-14 | 1998-01-14 | |
US08/910,371 | 1998-01-14 | ||
US08/910,369 | 1998-01-14 | ||
US08/910,775 | 1998-01-14 | ||
US60/071,323 | 1998-01-14 | ||
US60/071,418 | 1998-01-14 | ||
US60/071,422 | 1998-01-14 | ||
US60/071,419 | 1998-01-14 | ||
PCT/US1998/016754 WO1999008614A1 (en) | 1997-08-13 | 1998-08-12 | Noninvasive devices, methods, and systems for shrinking of tissues |
Publications (2)
Publication Number | Publication Date |
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JP2001514921A JP2001514921A (ja) | 2001-09-18 |
JP2001514921A5 true JP2001514921A5 (ja) | 2006-01-05 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2000509360A Pending JP2001514921A (ja) | 1997-08-13 | 1998-08-12 | 組織収縮のための非侵襲性デバイス、方法、およびシステム |
Country Status (8)
Country | Link |
---|---|
US (6) | US6216704B1 (ja) |
EP (1) | EP1003432B1 (ja) |
JP (1) | JP2001514921A (ja) |
AT (1) | ATE326913T1 (ja) |
AU (1) | AU732188B2 (ja) |
CA (1) | CA2300152A1 (ja) |
DE (1) | DE69834644T2 (ja) |
WO (1) | WO1999008614A1 (ja) |
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