JP2003510159A5

JP2003510159A5 -

Info

Publication number: JP2003510159A5
Application number: JP2001527716A
Authority: JP
Filing date: 2000-09-29
Publication date: 2005-06-09

Claims

In the treatment of benign prostatic hyperplasia in human men,
Inserting a flexible ultrasound probe into the long urethra, distal and proximal ends;
Extending the ultrasound probe to a site adjacent to the enlarged prostate lobe;
Providing ultrasonic vibration to a proximal end of the ultrasonic probe such that the ultrasonic vibration generates a plurality of nodules and antinodes along the entire length of the ultrasonic probe;
Perforating ultrasonically through the urethral wall tissue using the ultrasonic probe; and
Inserting the ultrasound probe into the interior of a human male prostate;
Reducing the enlarged prostate lobe tissue by causing cavitation in the enlarged prostate lobe prostate tissue;
A treatment method characterized by comprising:

2. The method of claim 1, wherein the step of reducing the tissue is performed by deflecting the ultrasound probe toward the prostate while substantially leaving the urethra intact.

The treatment method according to claim 1, further comprising a step of removing the tissue during treatment.

The treatment method according to claim 1, wherein the ultrasonic probe directly contacts the enlarged prostate lobe.

The treatment method according to claim 1, further comprising applying suction for removing the tissue destroyed by the cavitation during treatment.

The treatment method according to claim 1, further comprising the step of monitoring the position of the ultrasonic probe using ultrasonic waves.

The treatment method according to claim 6, wherein the ultrasonic wave used for monitoring the position of the ultrasonic probe is supplied by one ultrasonic probe inserted into the rectum of the human male.

The treatment method according to claim 1, wherein the tissue destruction treatment is performed without heat action.

The method according to claim 1, further comprising the step of removing prostate tissue without destroying the urethra.

The treatment method according to claim 1, further comprising a step of monitoring a temperature of the ultrasonic probe.

2. The method according to claim 1, further comprising the step of monitoring the frequency and amplitude of the ultrasonic vibration, and automatically terminating the delivery of the ultrasonic vibration once the set frequency and amplitude values become excessive. Treatment methods.

The method of claim 1, further comprising monitoring the amount of tissue removed by monitoring movement caused by echoes in the probe and monitoring voids created by the probe.

The treatment method according to claim 1, wherein the frequency of the ultrasonic vibration is in a range of 20 kHz to 80 kHz.

The method according to claim 1, wherein the amplitude of the ultrasonic vibration is in the range of 150 to 250 microns.

The ultrasonic probe vibrates in a direction transverse to the long axis of the ultrasonic probe, and the distal end of the ultrasonic probe does not substantially move along the long axis of the probe. Item 2. The treatment method according to Item 1.

The treatment method according to claim 1, wherein the flexible probe can be bent and deflected during operation without affecting the ability to cause cavitation.

In ultrasonic therapy equipment,
An ultrasonic probe having an ultrasonic tip;
A suction sheath surrounding the ultrasound probe;
Have
The ultrasonic treatment apparatus, wherein the suction sheath forms a suction port at a distal end and is movable in an axial direction relative to the ultrasonic probe.

The ultrasonic probe has at least one flow path on an outer surface of the ultrasonic probe and at least one flow path extending from a proximal end of the ultrasonic probe to a position adjacent to an ultrasonic tip of the ultrasonic probe. The ultrasonic therapeutic apparatus according to claim 17, further comprising:

The ultrasonic therapy apparatus according to claim 18, wherein the suction port communicates with at least one of the flow paths.

The ultrasonic therapy apparatus according to claim 18, wherein the ultrasonic probe includes a plurality of flow paths.

The ultrasonic therapy apparatus according to claim 18, wherein at least one of the flow paths is formed by spirally winding an outer peripheral surface of the ultrasonic probe.

The ultrasonic therapy apparatus according to claim 17, wherein the ultrasonic probe includes an irrigation passage.

The ultrasonic therapy apparatus according to claim 22, wherein the irrigation passage is located in the center of the ultrasonic probe.

23. The ultrasonic therapy apparatus according to claim 22, wherein the irrigation passage includes at least one lumen on one side surface of the ultrasonic probe.

The ultrasonic therapy apparatus according to claim 17, further comprising a flexible optical fiber observation device attached to the suction sheath.

18. The ultrasonic treatment apparatus according to claim 17, wherein the suction sheath is made of a flexible and elastic material, and the suction sheath has a bonding wire so that the joint-like movement can be controlled.

27. The ultrasonic therapy apparatus according to claim 26, wherein the probe is deflected when the suction sheath is controllably articulated.

The ultrasonic therapy apparatus according to claim 17, wherein the suction port is a side groove located on one side of the suction sheath.

A method for treating a human male prostate,
Inserting a medical device through the perineum of the human male;
Advancing at least a portion of the medical device into the human male prostate;
Treating the prostate of the human male with the medical device;
Have
A method of treating the prostate of the human male using ultrasound.

30. The method of claim 29, comprising inserting at least a portion of the medical device through a prostate sac of the prostate of the human male.

32. The method of claim 30, wherein the prostate of the human male is treated to reduce prostate tissue.

31. The treatment method according to claim 30, further comprising the step of ultrasonically drilling the prostate sac before inserting at least a part of the treatment device through the prostate sac.

30. The treatment method according to claim 29, further comprising the step of extracting the treatment device through the perineum of the human male.

In the treatment of benign prostatic hyperplasia in human men,
Providing an ultrasonic probe;
Inserting the ultrasonic probe into the enlarged prostate lobe of the human male;
Reducing the enlarged prostate lobe tissue by cavitation of the enlarged prostate lobe prostate tissue;
A treatment method characterized by comprising:

Inserting the ultrasound probe into the urethra of the human male;
Drilling ultrasonically through the urethral wall tissue adjacent to the enlarged prostate lobe using the ultrasound tip prior to inserting the tip of the ultrasound probe into the prostate lobe;
35. The method of claim 34, comprising:

35. The treatment method according to claim 34, further comprising the step of sucking tissue destroyed by cavitation.

Inserting the ultrasound probe through the perineum of the human male;
Drilling ultrasonically through the prostate sac using the ultrasound probe prior to inserting the ultrasound tip into the prostate lobe;
35. The method of claim 34, comprising:

Inserting the ultrasound probe into the human male across the urethra;
Prior to inserting the ultrasound tip into the interior of the prostate lobe, using the ultrasound tip, ultrasonically drilling through the prostate membrane;
35. The method of claim 34, comprising:

The treatment method according to claim 34, wherein the frequency of the ultrasonic probe is in a range of 20 kHz to 80 kHz.

40. The treatment method of claim 39, wherein the amplitude of energy supplied to the ultrasound probe is in the range of 150 microns to 250 microns.

35. The treatment method according to claim 34, wherein the ultrasonic probe vibrates in a direction across a long axis of the probe.

In the treatment of benign prostatic hyperplasia in human men,
Inserting a medical device into the enlarged prostatic lobe of the human male;
Reducing the enlarged prostate lobe tissue while maintaining the reduced tissue temperature within normal body temperature ± 7 ° C .;
Have
The treatment method, wherein the tissue is removed hemostatically.

43. The treatment method according to claim 42, wherein the reduction of the tissue is performed using ultrasound.

44. The treatment method according to claim 43, wherein the ultrasound reduces the tissue by cavitation.

Inserting the medical device into the urethra of the human male;
Inserting the medical device through urethral wall tissue adjacent to the enlarged prostate lobe prior to inserting the medical device into the prostate lobe;
45. A method according to claim 44, comprising:

Inserting the medical device through the human male perineum;
Inserting the medical device through a prostate sac prior to inserting the medical device into the prostate lobe;
43. A method according to claim 42, comprising:

Inserting the medical device across the urethra into the human male;
Inserting the medical device through a prostate sac prior to inserting the medical device into the prostate lobe;
43. The treatment method according to claim 42, comprising:

Extracting the medical device;
Filling the cavity created by the device with an adhesive to plug the cavity;
43. The treatment method according to claim 42, comprising:

In ultrasonic therapy equipment,
Having an ultrasonic probe having an ultrasonic tip;
The ultrasonic probe has at least one flow path on an outer surface of the ultrasonic probe, and the at least one flow path is located at a position adjacent to the ultrasonic tip from a proximal end of the ultrasonic probe. Ultrasonic therapy device characterized by being extended to.

50. The ultrasonic therapy apparatus according to claim 49, wherein the ultrasonic probe includes a plurality of flow paths.

50. The ultrasonic therapy apparatus according to claim 49, wherein the at least one flow path is formed by spirally winding an outer peripheral surface of the ultrasonic probe.

A suction sheath surrounding the ultrasound probe;
The ultrasonic therapy apparatus according to claim 49, wherein the suction sheath forms a suction port at a distal end, and the suction port communicates with at least one flow path.

53. The ultrasonic therapy apparatus according to claim 52, wherein the suction sheath is movable in the axial direction with respect to the ultrasonic probe.

53. The ultrasonic therapy apparatus according to claim 52, wherein the suction sheath is formed of a flexible and elastic material, and includes a bonding wire so that the joint-like movement can be controlled.

55. The ultrasonic therapy apparatus of claim 54, wherein the suction sheath can be used to bend the ultrasonic probe.

52. The ultrasonic therapy apparatus according to claim 51, wherein the ultrasonic probe has an irrigation passage.

57. The ultrasonic therapy apparatus according to claim 56, wherein the irrigation passage is located in the center of the ultrasonic probe.

57. The ultrasonic therapy apparatus according to claim 56, wherein the irrigation passage includes at least one lumen on one side surface of the ultrasonic probe.

50. The ultrasonic therapy apparatus according to claim 49, comprising a flexible optical fiber observation device attached to the probe.

50. The ultrasonic therapy apparatus according to claim 49, wherein the suction port is a side groove located on one side surface of the suction sheath.

An ultrasonic probe,
Having an elongated shaft with a long axis having a recess,
The ultrasonic probe according to claim 1, wherein the recessed portion is in contact with a flat surface at one end.

51. The ultrasonic probe of claim 50, wherein the flat surface is approximately 90 degrees with respect to the long axis of the elongated shaft.

An ultrasonic medical device,
  A probe having a distal end and a proximal end and an axial length therebetween;
  The probe which tapers from the proximal end of the probe to the distal end of the probe The diameter of the
  Have
  The probe has a transverse ultrasonic vibration along at least a portion of the axial length of the probe. An ultrasonic medical device characterized by being capable of supporting movement.

The probe is characterized by having a small cross-sectional profile. 64. The ultrasonic medical device according to claim 63.

Move axially inward and outward relative to the distal end of the suction sheath. 64. The ultrasonic medical device according to claim 63, further comprising a probe tip capable of Place.

The probe tip is ball-shaped from the distal end of the probe The ultrasonic medical device according to claim 65, wherein the ultrasonic medical device is a protrusion.

The probe includes a groove for sucking material from a treatment site. 64. The ultrasonic medical device according to claim 63.

The probe is at least part of the axial length of the probe. 64. The ultrasonic medical device according to claim 63, wherein the ultrasonic medical device vibrates in a direction across the axis.

The transverse ultrasonic vibration of the probe is the axial length of the probe. 64. The method of claim 63, further comprising providing a plurality of antinodes along at least a portion of the length. Sonic medical device.

The antinode is along at least a portion of the axial length of the probe. 70. The ultrasonic medical device according to claim 69, wherein the ultrasonic medical device is a point of only the maximum transverse ultrasonic vibration.

64. The probe comprises a titanium alloy. The described ultrasonic medical device.

The probe's flexibility allows the probe to move like a joint 64. The ultrasonic medical device of claim 63, wherein:

A medical device,
  A flexible probe having a distal end and a proximal end and an axial length therebetween;
  A probe tip extending from the distal end of the probe;
  Have
  The probe has a transverse ultrasonic vibration along at least a portion of the axial length of the probe. A medical device characterized in that it can contract to support movement.

The flexible probe has a small cross-sectional profile. 74. The medical device of claim 73, wherein

The probe tip is axially inward with respect to the distal end of the suction sheath 74. The medical device of claim 73, wherein the medical device is movable outwardly and outwardly.

The probe tip is a bow from the distal end of the flexible probe. The medical device according to claim 73, wherein the medical device is a lug-shaped protrusion.

The flexible probe includes a groove for aspirating material from the treatment site. 74. The medical device of claim 73.

The flexible probe has a small axial length of the flexible probe. The medical device according to claim 73, wherein the medical device vibrates in a direction crossing at least a part thereof.

The transverse ultrasonic vibration of the flexible probe is A plurality of antinodes are provided along at least a portion of the axial length. 73. The medical device according to 73.

The antinode is at least one of the axial lengths of the flexible probe. 80. The medical device of claim 79, wherein the medical device is a point of maximum transverse ultrasonic vibration along the portion.

The flexible probe comprises a titanium alloy. Item 74. The medical device according to Item 73.

The probe's flexibility allows the probe to move like a joint 74. The medical device of claim 73, wherein