JP2009039546A - 物品を移植する方法、システムおよびキット - Google Patents
物品を移植する方法、システムおよびキット Download PDFInfo
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- 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
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/06—Body-piercing guide needles or the like
- A61M25/0662—Guide tubes
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3431—Cannulas being collapsible, e.g. made of thin flexible material
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3439—Cannulas with means for changing the inner diameter of the cannula, e.g. expandable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
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- Media Introduction/Drainage Providing Device (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
- Prostheses (AREA)
- External Artificial Organs (AREA)
- Materials For Medical Uses (AREA)
Abstract
【解決手段】遠位末端が中実組織の標的部位に隣接して存在するように、放射状に拡張可能なスリーブ10を経皮的に挿入する工程;該放射状に拡張可能なスリーブ10を通って、カニューレ30および拡張器のアセンブリを導入する工程であって、ここで、該スリーブの直径は、拡張される;該拡張器を該カニューレ30から取り外して、開放管腔を該組織標的部位に残す工程;および該物品60を、該カニューレ管腔を通って、該組織標的部位へと前進させる工程。
【選択図】図7
Description
(1.発明の分野)
本発明は、一般に、医療方法、装置およびキットに関する。さらに特定すると、本発明は、移植可能品(例えば、皮下薬剤挿入物)を中実組織(solid tissue)位置に経皮的に送達する方法、システムおよびキットに関する。
移植片を注入する装置および方法は、特許文献1で記述されており、これは、上でさらに詳細に述べている。本発明の方法で使用するのに適当な型の放射拡張拡張器は、特許文献2および特許文献3で記述されており、そして本願の譲渡人であるInnerDyne,Inc.(Sunnyvale,California)から、STEP(登録商標)の名で、市販されている。他の関連特許には、特許文献4;特許文献5;特許文献6;特許文献7;特許文献8;特許文献9;および特許文献10が挙げられる。
本発明によれば、中実組織に物品を移植するための改良方法、システムおよびキットが提供される。これらの物品は、通常、薬剤送達向けであり、典型的には、薬剤の制御放出向けの薬剤送達挿入物またはレザバであるが、また、他の目的(例えば、近接照射療法シード、ペースメーカーおよび他の刺激装置およびリード、ポンプ、変換器および他の診断装置およびモニタ装置、センサなど)向けであり得る。本発明の方法およびシステムは、患者の皮膚の表面から、皮膚の下、典型的には、中実組織(例えば、筋肉)内、腹膜(例えば、腹膜後)の下などの標的部位へと組織路を形成して放射状に拡張することにより、特徴付けられる。この組織路は、好ましくは、その全長にわたって、実質的に一定の管腔直径まで放射状に拡張され、この拡張は、この薬剤挿入物または他の物品の導入前に、起こる。この組織路を放射状に拡張することは、一般に、大口径のコアリング針または大直径の外套針を使用するよりも、患者に外傷を与えにくく、この物品を導入する前に組織路を完全に拡張すると、米国特許第5,304,119号で記述されたようなシステム(この場合、この物品は、それ自体、前進するとき、機械的に経路を開く)を使って起こり得る物品に対する損傷のリスクが回避される。
上記に加えて、本発明は、以下を提供する。
(項目1) 中実組織に物品を移植する方法であって、該方法は、以下の工程を包含する:
その遠位末端が中実組織の標的部位に隣接して存在するように、放射状に拡張可能なスリーブを経皮的に挿入する工程;
該放射状に拡張可能なスリーブを通って、カニューレおよび拡張器のアセンブリを導入する工程であって、ここで、該スリーブの直径は、拡張される;
該拡張器を該カニューレから取り外して、開放管腔を該組織標的部位に残す工程;および
該物品を、該カニューレ管腔を通って、該組織標的部位へと前進させる工程。
(項目2) 前記スリーブ挿入工程が、前記スリーブおよび針のアセンブリを前記組織へと前進させる工程を包含し、ここで、該針の鋭い遠位先端が、まず、該組織を通って前進するように、該スリーブから遠位に配置されている、項目1に記載の方法。
(項目3) 前記拡張可能スリーブが、非弾性フィラメントのメッシュから形成された管状編組を含み、該フィラメントが、拡張するにつれて、軸方向に短縮される、項目1に記載の方法。
(項目4) 前記アセンブリ導入工程が、前記中実組織に前記物品を受容する開口部を作成するために、前記スリーブの前記遠位末端から遠位に配置された組織に、前記拡張器のテーパ付き遠位末端を貫入させる工程を包含する、項目1に記載の方法。
(項目5) 前記カニューレ管腔が、2mm〜20mmの範囲の直径を有する、項目1に記載の方法。
(項目6) 前記挿入工程が、前記スリーブを筋肉内または皮下的に導入する工程を包含する、項目1に記載の方法。
(項目7) 前記物品が、移植片であり、該移植片が、エストロゲン、プロゲステロンおよびテストステロンからなる群から選択される薬剤を放出する、項目6に記載の方法。
(項目8) 中実組織に物品を移植する改良方法であって、該方法は、組織路が形成され拡張されて該物品の前進を可能にする形式であり、改良点は、以下の工程を包含する:
該組織路を放射状に拡張して、実質的に一定の直径を有する管腔を形成する工程;および
該管腔が実質的に完全に拡張した後、該管腔を通って、該物品を前進させる工程。
(項目9) 前記放射状拡張工程が、
その遠位末端が中実組織の標的部位に隣接して存在するように、放射状に拡張可能なスリーブを経皮的に挿入する工程;
該放射状に拡張可能なスリーブを通って、カニューレおよび拡張器のアセンブリを導入する工程であって、ここで、該スリーブは、放射状に拡張されている;および
該拡張器を該カニューレから取り外して、前記実質的に一定の直径の管腔を該組織標的部位に残す工程、
を包含する、項目8に記載の改良方法。
(項目10) 前記スリーブ挿入工程が、前記スリーブおよび針のアセンブリを前記組織へと前進させる工程を包含し、ここで、該針の鋭い遠位先端が、まず、該組織を通って前進するように、該スリーブから遠位に配置されている、項目9に記載の方法。
(項目11) 前記拡張可能スリーブが、非弾性フィラメントのメッシュから形成された管状編組を含み、該フィラメントが、拡張するにつれて、軸方向に短縮される、項目9に記載の方法。
(項目12) 前記アセンブリ導入工程が、前記中実組織に前記物品を受容する開口部を作成するために、前記スリーブの前記遠位末端から遠位に配置された組織に、前記拡張器のテーパ付き遠位末端を貫入させる工程を包含する、項目9に記載の方法。
(項目13) 前記カニューレ管腔が、2mm〜20mmの範囲の直径を有する、項目9に記載の方法。
(項目14) 前記挿入工程が、前記スリーブを筋肉内または皮下的に導入する工程を包含する、項目9に記載の方法。
(項目15) 前記物品が、移植片であり、該移植片が、エストロゲン、プロゲステロンおよびテストステロンからなる群から選択される薬剤を放出する、項目14に記載の方法。
(項目16) 以下の部分を含む、キット:
放射状に拡張可能なスリーブ;
カニューレ;
拡張器;および
項目1に記載の方法に従った使用説明書。
(項目17) さらに、移植する物品を含む、項目16に記載のキット。
(項目18) 前記物品が、医薬移植片を含有する、項目17に記載のキット。
(項目19) 薬剤送達品を患者に移植するためのシステムであって、該システムは、以下の部分を含む:
放射状に拡張可能なスリーブであって、該スリーブは、狭い直径形状から大きな直径形状まで拡張可能であり、そして崩壊不可能管腔を提供する;および
薬剤送達品であって、該薬剤送達品は、該崩壊不可能管腔を通ってそれを送達可能にする周辺寸法を有し、ここで、該管腔は、その中に該物品がないとき、その大きな直径形状まで完全に開いたままにできる、
システム。
(項目20) さらに、カニューレ、および該カニューレの管腔で取り外し可能に受容された拡張器のアセンブリを含み、ここで、該アセンブリが、該スリーブを通って前進されて該スリーブを放射状に拡張するように、構成されており、ここで、該拡張器が、該スリーブを通る前記崩壊不可能管腔を残すように、該カニューレから取り外すことができる、項目19に記載のシステム。
図1を参照すると、放射状に拡張可能なスリーブ10および針12が図示されており、これらは、本発明の方法およびシステムで使用され得る。スリーブ10は、近位末端16および遠位末端18を有する管状鞘14を含む。近位末端16は、その近位方向で、放射状に外向きにテーパが付けられ、そしてハンドル20に固定されている。このハンドルの開口部(図示せず)は、近位末端16の拡張直径と整列しており、そして開口部と整列された差込みフィッティング22を含む。管状鞘14は、以下でさらに詳細に記述するように、このカニューレおよび拡張器のアセンブリを受容して鞘を放射状に拡張できる任意の材料を含有し得る。代表的な実施態様では、この鞘は、米国特許第5,431,676号(その完全な開示内容は、本明細書中で参考として援用されている)で一般に記述されているように、弾性膜で被覆された非弾性編組を含む。適当な拡張可能スリーブ10は、STEP(登録商標)システムの一部として、InnerDyne,Inc.(Sunnyvale,California)から市販で得られる。
Claims (1)
- 明細書に記載の発明。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/112,102 US6245052B1 (en) | 1998-07-08 | 1998-07-08 | Methods, systems, and kits for implanting articles |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2000558873A Division JP4746182B2 (ja) | 1998-07-08 | 1999-06-29 | 物品を移植する方法、システムおよびキット |
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JP2009039546A true JP2009039546A (ja) | 2009-02-26 |
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JP2000558873A Expired - Fee Related JP4746182B2 (ja) | 1998-07-08 | 1999-06-29 | 物品を移植する方法、システムおよびキット |
JP2008234050A Pending JP2009039546A (ja) | 1998-07-08 | 2008-09-11 | 物品を移植する方法、システムおよびキット |
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JP2000558873A Expired - Fee Related JP4746182B2 (ja) | 1998-07-08 | 1999-06-29 | 物品を移植する方法、システムおよびキット |
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US (5) | US6245052B1 (ja) |
EP (1) | EP1094862B1 (ja) |
JP (2) | JP4746182B2 (ja) |
AT (1) | ATE302632T1 (ja) |
DE (1) | DE69926895T2 (ja) |
ES (1) | ES2247815T3 (ja) |
WO (1) | WO2000002616A1 (ja) |
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US6063060A (en) * | 1998-06-15 | 2000-05-16 | Moenning; Stephen P. | Minimally invasive medical apparatus for dispensing a biologically active compound and an associated medical procedure for dispensing a biologically active compound |
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US20050119613A1 (en) * | 2000-02-23 | 2005-06-02 | Moenning Stephen P. | Fluid delivery trocar-cannula complex, fluid delivery accessory, and method for delivering fluids during minimally invasive surgery |
US20060025749A1 (en) * | 2000-02-23 | 2006-02-02 | Moenning Stephen P | Trocar-cannula complex, cannula and method for delivering fluids during minimally invasive surgery |
US6783513B2 (en) * | 2001-05-17 | 2004-08-31 | Stephen P. Moenning | Body cavity access assembly and an associated medical procedure for dispensing a liquid |
US20020173747A1 (en) * | 2001-05-17 | 2002-11-21 | Moenning Stephen P. | Body cavity access assembly and an associated medical procedure for dispensing a bilogically active compound |
MXPA04002885A (es) * | 2001-09-28 | 2005-06-20 | P Moenning Stephen | Complejo de trocar-canula, canula y metodos para suministrar fluidos durante cirugia minimamente. |
-
1998
- 1998-07-08 US US09/112,102 patent/US6245052B1/en not_active Expired - Lifetime
-
1999
- 1999-06-29 ES ES99932071T patent/ES2247815T3/es not_active Expired - Lifetime
- 1999-06-29 WO PCT/US1999/014761 patent/WO2000002616A1/en active IP Right Grant
- 1999-06-29 EP EP99932071A patent/EP1094862B1/en not_active Expired - Lifetime
- 1999-06-29 DE DE69926895T patent/DE69926895T2/de not_active Expired - Lifetime
- 1999-06-29 JP JP2000558873A patent/JP4746182B2/ja not_active Expired - Fee Related
- 1999-06-29 AT AT99932071T patent/ATE302632T1/de not_active IP Right Cessation
-
2001
- 2001-03-30 US US09/823,934 patent/US6589225B2/en not_active Expired - Lifetime
-
2003
- 2003-05-07 US US10/431,215 patent/US20030199809A1/en not_active Abandoned
-
2008
- 2008-05-06 US US12/115,762 patent/US7914512B2/en not_active Expired - Fee Related
- 2008-09-11 JP JP2008234050A patent/JP2009039546A/ja active Pending
-
2011
- 2011-02-22 US US13/031,851 patent/US20110144622A1/en not_active Abandoned
Also Published As
Publication number | Publication date |
---|---|
US7914512B2 (en) | 2011-03-29 |
DE69926895T2 (de) | 2006-06-08 |
WO2000002616A1 (en) | 2000-01-20 |
US6589225B2 (en) | 2003-07-08 |
EP1094862B1 (en) | 2005-08-24 |
ATE302632T1 (de) | 2005-09-15 |
EP1094862A1 (en) | 2001-05-02 |
US20080208165A1 (en) | 2008-08-28 |
US20110144622A1 (en) | 2011-06-16 |
DE69926895D1 (de) | 2005-09-29 |
US20030199809A1 (en) | 2003-10-23 |
JP2002520100A (ja) | 2002-07-09 |
JP4746182B2 (ja) | 2011-08-10 |
ES2247815T3 (es) | 2006-03-01 |
EP1094862A4 (en) | 2002-01-02 |
US20020002360A1 (en) | 2002-01-03 |
US6245052B1 (en) | 2001-06-12 |
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