JP2008119523A - 骨処置器具および骨処置方法 - Google Patents
骨処置器具および骨処置方法 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1477—Needle-like probes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
- A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00071—Electrical conductivity
- A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00107—Coatings on the energy applicator
- A61B2018/00142—Coatings on the energy applicator lubricating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
- A61B2018/00654—Sensing and controlling the application of energy with feedback, i.e. closed loop control with individual control of each of a plurality of energy emitting elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00755—Resistance or impedance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00791—Temperature
- A61B2018/00797—Temperature measured by multiple temperature sensors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00875—Resistance or impedance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1435—Spiral
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3925—Markers, e.g. radio-opaque or breast lesions markers ultrasonic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/002—Irrigation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
- A61M5/142—Pressure infusion, e.g. using pumps
Abstract
【解決手段】本発明は、骨腫瘍に挿入されるように適合される、遠位末端構造(294)を有する器具(286)、および器具中の導管を含むシステムを提供し、この骨腫瘍において、遠位末端構造(294)は、腫瘍組織を切除するために活性化され得、そしてこの導管は、切除用の構造が腫瘍に挿入された場合に、液体を腫瘍に供給し得る。遠位末端構造(294)をRF電流供給源のような活性化デバイスに連結するための第1の連結構造、および導管を液体供給源に連結するための第2の連結構造も含まれる。
【選択図】なし
Description
本発明は、骨上または骨内で、疼痛を生じる腫瘍を待機的に処置するためのシステムを含む。このシステムは、骨腫瘍に挿入されるように適合された、遠位末端構造を有する器具(この骨腫瘍において、その構造が、腫瘍組織を切除するために活性化され得る)、および切除用の構造が、腫瘍に挿入された場合に、液体を腫瘍に供給し得る、器具中の導管を含む。遠位末端構造をRF電流供給源のような活性化デバイスに連結するための第1の連結構造、および導管を液体供給源に連結するための第2の連結構造も含まれる。
本発明は、疼痛を引き起こす骨上または骨内の腫瘍を待期的に処置するためのシステムを提供する。より一般的には、本発明のシステムは、腫瘍の少なくとも一部を切除し、そして/または腫瘍に関連する神経組織(例えば、冒された骨を覆う骨膜鞘)を脱神経させるのに十分なエネルギーを送達することによって、骨腫瘍および損傷(例えば、類骨骨腫、転移性癌または骨髄腫)のサイズおよび/または疼痛を減少させるために設計される。
(1)疼痛を引き起こす骨腫瘍を待機的に処置するためのシステムであって、該骨腫瘍は、(i)骨膜の下の緻密骨領域の外側に、(ii)少なくとも部分的に、緻密骨領域内に、または(iii)骨の海綿状の領域内に存在し得、該システムは:
前記チップが腫瘍組織を切除するように活性化され得る、該骨腫瘍に挿入されるために適合した遠位末端構造を有する装置、
該チップが、腫瘍中に挿入される場合、液体を該腫瘍に供給し得る、前記器具における導管、
該遠位末端構造を活性化デバイスに連結するための、第1の連結構造、および
該導管を該液体の供給源に連結するための、第2の連結構造
を含む、システム。
(2)項目1に記載のシステムであって、前記器具が、遠位末端を有するプローブ、および、配備された場合、前記遠位末端構造を形成する、該プローブ内の引っ込められた位置から、該プローブの遠位末端から伸長する配備された位置まで移動可能な、少なくとも1つの電極を含む、システム。
(3)項目2に記載のシステムであって、前記器具が、複数の、湾曲し配備され得る電極を含み、該配備が、前記腫瘍内で、実質的に2次元的な表面広がりまたは3次元的な体積を、規定する、配備された電極のアレイを生成するために有効である、システム。
(4)骨の緻密領域の外側表面または内側表面上の骨腫瘍の処置で使用するための、項目3に記載のシステムであって、前記電極が、配備された場合、前記腫瘍によって囲まれる緻密骨の領域の表面の一部と同一の広がりを有する、2次元的広がりを規定するアレイを生成する、システム。
(5)項目3に記載のシステムであって、前記電極は、配備された場合、前記遠位チップを含む3次元的体積を形成する、システム。
(6)項目3に記載のシステムであって、前記電極は、配備された場合、前記遠位チップにおいて収束する3次元体積を形成する、システム。
(7)項目3に記載のシステムであって、前記電極が、前記腫瘍中に挿入される場合に、該腫瘍内に、選択された幾何学的構造を規定するように、位置づけの前に、該電極の少なくとも1つの曲率が形作られ得る、システム。
(8)項目3に記載のシステムであって、少なくとも1つの前記電極が、前記導管の一部を形成する針である、システム。
(9)項目1に記載のシステムであって、前記第1の連結構造が、前記導管を電解質液体のレザバと連結させるように適合されている、システム。
(10)項目1に記載のシステムであって、前記第1の連結構造が、前記導管を熱硬化性ポリマー液体のレザバまたは熱可塑性ポリマー液体のレザバに連結するように適合されている、システム。
(11)項目1に記載のシステムであって、前記第1の連結構造が、前記導管を化学療法剤液体のレザバに連結するように適合されている、システム。
(12)項目11に記載のシステムであって、前記第2の連結構造が、RF電流の供給源に前記遠位末端構造を連結するように適合されている、システム。
以下の用語は、本明細書において他に示されない限り、与えられた意味を有する。
本発明の切除システムは、一般的に、骨腫瘍内に挿入されるように適合された遠位端切除構造、およびこの機器内の導管(この導管を通って、液体が腫瘍に供給され得る)を有する機器またはデバイスを備える。遠位端構造は、腫瘍に関連する疼痛の緩和のために、腫瘍を切除するように活性化可能である。機器内の接続構造、または機器に装着可能な接続構造は、機器に活性化デバイスを作動可能に接続し、そして液体レザバを機器内の導管に接続するために設計される。1つの一般的な実施形態において、機器は、目的の骨領域にもたれて配置されるかまたは隣接して配置される遠位端を有するプローブまたは他の細長アクセス部材、ならびにこのプローブから腫瘍内にまたは腫瘍へと展開可能であり得る1つ以上の展開可能な電極または他の活性化可能なワイヤもしくは針から形成される。電極は、展開された場合、代表的に、選択された幾何学的構成(例えば、平面)、または活性化された場合に、腫瘍組織を光学的に切除するように設計された容積形成構成を有する。アセンブリ、および特に、本発明の切除機器は、ここで、図面を参照して記載される。
この節は、本発明の別の局面に従って、上記のシステムを、骨上および骨内の腫瘍に関連する疼痛の待期療法において使用するための方法を記載する。この方法の最初の工程において、処置作業者(例えば、医師)は、疼痛性骨腫瘍の位置を見つける。これは、従来、疼痛領域を触診し、そして必要に応じて、公知の画像化技術(例えば、X線像、コンピューター連動断層撮影、MRI、シンチグラフィ、または超音波画像化)を使用して目的の1つ以上の特定の腫瘍領域を位置付けし、必要に応じて腫瘍損傷の程度をマッピングすることにより行われる。
Claims (1)
- 明細書に記載の発明。
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US26129701P | 2001-01-11 | 2001-01-11 |
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JP2002555683A Division JP4111829B2 (ja) | 2001-01-11 | 2002-01-11 | 骨処置器具 |
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JP2008119523A true JP2008119523A (ja) | 2008-05-29 |
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JP2002555683A Expired - Fee Related JP4111829B2 (ja) | 2001-01-11 | 2002-01-11 | 骨処置器具 |
JP2008032479A Pending JP2008119523A (ja) | 2001-01-11 | 2008-02-13 | 骨処置器具および骨処置方法 |
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JP2002555683A Expired - Fee Related JP4111829B2 (ja) | 2001-01-11 | 2002-01-11 | 骨処置器具 |
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US (2) | US6622731B2 (ja) |
EP (1) | EP1363700A4 (ja) |
JP (2) | JP4111829B2 (ja) |
AU (1) | AU2002245243B2 (ja) |
CA (1) | CA2434151C (ja) |
WO (1) | WO2002054941A2 (ja) |
Cited By (6)
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JP2010042155A (ja) * | 2008-08-13 | 2010-02-25 | Olympus Medical Systems Corp | 内視鏡用処置具 |
JP2013520269A (ja) * | 2010-02-26 | 2013-06-06 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | 組織識別能力を持つ介入的な切除デバイス |
JP2015505310A (ja) * | 2011-12-30 | 2015-02-19 | カイバー メディカル, インコーポレイテッド | 活性薬剤を評価するための移植可能なデバイスおよび方法 |
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JP2017127498A (ja) * | 2016-01-20 | 2017-07-27 | 日本ライフライン株式会社 | 焼灼用針装置、高周波焼灼治療システムおよび化学焼灼治療システム |
JP2018153654A (ja) * | 2008-09-26 | 2018-10-04 | リリーバント メドシステムズ、インコーポレイテッド | 骨の内部を通って器具を誘導するためのシステムおよび方法 |
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- 2002-01-11 US US10/044,081 patent/US6622731B2/en not_active Expired - Fee Related
- 2002-01-11 AU AU2002245243A patent/AU2002245243B2/en not_active Ceased
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2003
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Also Published As
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EP1363700A2 (en) | 2003-11-26 |
US7108696B2 (en) | 2006-09-19 |
US20040059328A1 (en) | 2004-03-25 |
AU2002245243B2 (en) | 2007-03-22 |
WO2002054941A2 (en) | 2002-07-18 |
CA2434151C (en) | 2009-12-22 |
US20020133148A1 (en) | 2002-09-19 |
JP2004523272A (ja) | 2004-08-05 |
WO2002054941A9 (en) | 2003-12-18 |
US6622731B2 (en) | 2003-09-23 |
WO2002054941A3 (en) | 2003-09-18 |
JP4111829B2 (ja) | 2008-07-02 |
EP1363700A4 (en) | 2005-11-09 |
CA2434151A1 (en) | 2002-07-18 |
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