JP2007503911A - 内部身体領域に空洞を生成するためのデバイスおよび関連する方法 - Google Patents
内部身体領域に空洞を生成するためのデバイスおよび関連する方法 Download PDFInfo
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- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/885—Tools for expanding or compacting bones or discs or cavities therein
- A61B17/8852—Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc
- A61B17/8855—Tools for expanding or compacting bones or discs or cavities therein capable of being assembled or enlarged, or changing shape, inside the bone or disc inflatable, e.g. kyphoplasty balloons
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1604—Chisels; Rongeurs; Punches; Stamps
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- A—HUMAN NECESSITIES
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- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
- A61B17/1617—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material with mobile or detachable parts
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1671—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
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- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
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- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
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- A61B2017/00238—Type of minimally invasive operation
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- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
- A61B2017/22034—Gripping instruments, e.g. forceps, for removing or smashing calculi for gripping the obstruction or the tissue part from inside
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2215—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
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- A—HUMAN NECESSITIES
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- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
- A61B2017/320028—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments with reciprocating movements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320044—Blunt dissectors
Abstract
Description
本出願は、2003年9月3日に提出された、「Mechanical Devices for Creating Voids in Interior Body Regions and Related Methods」と題する米国仮出願第60/499、934号の利益を主張する。
本発明は、全体として内部身体領域に腔または空洞を生成するためのツールに関する。詳細には、本発明は、診断目的または治療目的のために骨内に空洞を生成することに関する。
診断および治療の両方の目的のために身体の固形臓器の1つの内部に腔または空洞を形成する低侵襲的方法は、放射線走査技法ならびに他の種類の走査技法によって切開を行う必要なく身体の内部を観察する医師の能力が向上するにつれて、いっそう重要となりつつある。
本発明は、内部身体領域内に空洞を生成するシステムおよび方法を提供する。
本明細書の開示内容を、当業者が本発明を実施できるようにするために詳細に説明し、取り上げているが、本明細書に開示する物理的実施形態は、他の特定の構造で実施することができる本発明を単に例示するものに過ぎない。好ましい実施形態を説明してきたが、詳細は、特許請求の範囲によって定義される本発明を逸脱することなく変更することができる。
(A.キューレット)
図1〜図3に、標的の治療部位に腔または空洞を形成することができるツール10を示す。ツール10は、近位端および遠位端、それぞれ14ならびに16を有するシャフト12を備える。シャフト12は、シャフト12を握って操作し、あらかじめ形成されたアクセス経路を通って骨内に到達させるのを支援するためのハンドル18を含むのが好ましい。ハンドル18は、任意の適した金属、例えば任意の剛体のポリマーまたは金属もしくはそれらの組み合わせで製造し、シャフト12の周りに固定することができる。ハンドル18は、医師によって安全かつ快適に把持されるような大きさおよび形状を有するのが望ましい。
多くの場合において、回転方向と並進方向の両方向に切断することが望ましい。そのような場合、回転切断動作が医師とっての人間工学的で自然な動作を反映するのが好ましい。図4〜図9に、人間工学的で自然な動作を用いて切断用先端部の並進運動、回転運動、または並進と回転の同時運動を可能にする切断用先端部120を有する切断ツール100の実施形態を示す。切断用先端部は、任意の適した生体適合性を有する材料、例えばステンレススチールで製造されている。
図15および図16に、内部身体領域内に空洞を生成するためのツールの代替的実施形態200を示す。この実施形態では、トランク232は、図4〜図9に示す実施形態と比較して先細であり、90°回転されており、これにより、先端部220がシャフト212の軸線Sから90°の角度Aで展開されると、トランクの全幅Wは、シャフト212の軸線Sに垂直となる。
図17および図18に、内部身体領域内に空洞を生成するためのツールの別の代替的実施形態300を示す。この実施形態では、トランク332は、図15および図16の実施形態と同様に先細であるが、円錐形である。
(A. サムホイールの実施形態)
図19〜図22に、空洞形成ツールと共に用いるためのアクチュエータ機構の一実施形態を示す。本アクチュエータ機構は、回転運動を並進運動に変換し、切断用先端部の展開を制御する。例としてであり限定としてではなく、本アクチュエータ機構を、図4〜図9の切断用先端部120の実施形態と共に示す。
図23〜図25に、図19〜図21の実施形態に類似したアクチュエータの実施形態を示す。このアクチュエータは、相互に作用して回転運動を並進運動に変換する一連の歯車を備える。
(A.形状記憶合金)
図26〜図28に、形状記憶合金で形成された切断用先端部720を用いたツールの実施形態700を示す。形状記憶合金の使用により、ヒンジ機構としての小器具をもはや必要とせずに先端部を作動させることが可能となる。小器具は、より安全であり、かつ脊柱内のより高い位置にある小椎体にアクセスすることができる。小器具は、患者に対する侵襲がより少なくかつ外傷の可能性がより低いものでもあり、回復時間をより速くすることができる。
図36に、内部身体領域に空洞を生成するための機械的ツールの代替的実施形態400を示す。シャフト412は、シャフト412の端部上に、鋭利で頑丈な金属のばねを担持している。シャフト412は、ばね420の方向とは逆の方向に回転させることができ、広げるようにして、ばね420に骨(または他の組織)を切断させることができる。ツール400は、カニューレおよびシャフト412よりも先に延び、一回につき短い距離だけ組織内に回転挿入されるばね420と共に、カニューレ(図示せず)を通じて導入されるような大きさおよび形状を有する。次いで、シャフト412を抜去し、任意の捕捉した組織を除去ことができる。組織が捕捉されなかった場合、ツール400が組織内のさらに先へ再導入され、組織除去が再度試みられる。ツール400は、他の機械的ツールによってより適切に切断および/または除去することができるように、組織を弛緩させるために用いることもできる。
記載した種類の2つまたはそれ以上の異なる機械的切断ツールを組み合わせて用い、標的の骨内に所望の大きさおよび形状の腔もしくは空洞を形成することもできる。さらに、1つまたはそれ以上の機械的切断ツールを1つもしくはそれ以上の空洞生成ツールと組み合わせて用い、所望の空洞を形成することができる。骨内に空洞を生成するための拡張可能な構造体は、米国特許第4、969、888号、第5、827、289号、第5、972、015号、第6、235、043号、第6、248、110号、および第6、607、544号に記載されており、それらのすべてが引用により本明細書に組み込まれる。
Claims (3)
- 内部身体領域内に空洞を生成するためのツールであって、
管腔を含むシャフト組立体と、
該シャフトに連結された、骨に接触するための先端部と、
該先端部につながれた、該管腔内で摺動可能なロッドと、
を備えるツール。 - 内部身体領域内に空洞を生成するためのツールであって、
管腔を含むシャフトと、
連結要素によって該シャフトに連結された、骨に接触するための先端部とを備え、該先端部は、たとえ該連結要素が作動不能となった場合でも該先端部が該シャフトに依然としてつながれているように、該シャフトにさらにつながれている、
ツール。 - 内部身体領域内に空洞を生成するためのツールであって、
カニューレと、
ハンドルを有し、かつ該カニューレを通過するような大きさおよび形状を有するシャフトと、
該シャフト上に該ハンドルの遠位に配置され、かつ該シャフトから半径方向に延び、該カニューレ内での該シャフトの前方進行を制限する突起と、
を備えるツール。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US49993403P | 2003-09-03 | 2003-09-03 | |
PCT/US2004/022950 WO2005023085A2 (en) | 2003-09-03 | 2004-07-16 | Devices for creating voids in interior body regions and related methods |
Publications (2)
Publication Number | Publication Date |
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JP2007503911A true JP2007503911A (ja) | 2007-03-01 |
JP4555293B2 JP4555293B2 (ja) | 2010-09-29 |
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JP2006525324A Expired - Fee Related JP4555293B2 (ja) | 2003-09-03 | 2004-07-16 | 内部身体領域に空洞を生成するためのデバイスおよび関連する方法 |
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US (2) | US6923813B2 (ja) |
EP (1) | EP1663029A4 (ja) |
JP (1) | JP4555293B2 (ja) |
KR (1) | KR101132644B1 (ja) |
CN (1) | CN1845709B (ja) |
AU (1) | AU2004270128B2 (ja) |
CA (1) | CA2537048C (ja) |
IL (1) | IL173842A0 (ja) |
MX (1) | MXPA06002541A (ja) |
WO (1) | WO2005023085A2 (ja) |
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JP2010527705A (ja) * | 2007-05-21 | 2010-08-19 | エーオーアイ メディカル インコーポレイテッド | 折れ曲がり式の空洞形成デバイス |
JP2010530256A (ja) * | 2007-06-04 | 2010-09-09 | アーオー テクノロジー アクチエンゲゼルシャフト | カニューレ |
JP2013017610A (ja) * | 2011-07-11 | 2013-01-31 | Ai-Medic:Kk | 手術用穿孔器具 |
JP2015134204A (ja) * | 2010-01-20 | 2015-07-27 | コンベンタス オーソピディックス, インコーポレイテッド | 骨へのアクセスおよび空洞設備のための装置および方法 |
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US7678151B2 (en) | 2000-05-01 | 2010-03-16 | Ek Steven W | System and method for joint resurface repair |
US8361159B2 (en) | 2002-12-03 | 2013-01-29 | Arthrosurface, Inc. | System for articular surface replacement |
US6610067B2 (en) | 2000-05-01 | 2003-08-26 | Arthrosurface, Incorporated | System and method for joint resurface repair |
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- 2004-07-16 AU AU2004270128A patent/AU2004270128B2/en not_active Ceased
- 2004-07-16 CA CA002537048A patent/CA2537048C/en not_active Expired - Fee Related
- 2004-07-16 EP EP04778454A patent/EP1663029A4/en not_active Withdrawn
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Also Published As
Publication number | Publication date |
---|---|
US20050113838A1 (en) | 2005-05-26 |
US20050240193A1 (en) | 2005-10-27 |
WO2005023085A2 (en) | 2005-03-17 |
US6923813B2 (en) | 2005-08-02 |
EP1663029A4 (en) | 2010-06-09 |
CN1845709A (zh) | 2006-10-11 |
AU2004270128B2 (en) | 2010-12-23 |
KR101132644B1 (ko) | 2012-04-02 |
AU2004270128A1 (en) | 2005-03-17 |
IL173842A0 (en) | 2006-07-05 |
CA2537048C (en) | 2010-01-12 |
EP1663029A2 (en) | 2006-06-07 |
WO2005023085A3 (en) | 2005-05-12 |
CN1845709B (zh) | 2012-06-20 |
CA2537048A1 (en) | 2005-03-17 |
KR20060133952A (ko) | 2006-12-27 |
JP4555293B2 (ja) | 2010-09-29 |
MXPA06002541A (es) | 2006-06-20 |
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