JP2009537234A - 気管切開の方法およびデバイス - Google Patents
気管切開の方法およびデバイス Download PDFInfo
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- JP2009537234A JP2009537234A JP2009511111A JP2009511111A JP2009537234A JP 2009537234 A JP2009537234 A JP 2009537234A JP 2009511111 A JP2009511111 A JP 2009511111A JP 2009511111 A JP2009511111 A JP 2009511111A JP 2009537234 A JP2009537234 A JP 2009537234A
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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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
- A61M16/0468—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters with valves at the proximal end limiting exhalation, e.g. during speaking or coughing
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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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
- A61M16/0472—Devices for performing a tracheostomy
-
- 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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0475—Tracheal tubes having openings in the tube
- A61M16/0477—Tracheal tubes having openings in the tube with incorporated means for delivering or removing fluids
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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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0434—Cuffs
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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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
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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
- A61M2202/00—Special media to be introduced, removed or treated
- A61M2202/20—Pathogenic agents
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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
- A61M2205/00—General characteristics of the apparatus
- A61M2205/02—General characteristics of the apparatus characterised by a particular materials
- A61M2205/0222—Materials for reducing friction
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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
- A61M2205/00—General characteristics of the apparatus
- A61M2205/02—General characteristics of the apparatus characterised by a particular materials
- A61M2205/0266—Shape memory materials
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- Health & Medical Sciences (AREA)
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- Emergency Medicine (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
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- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Prostheses (AREA)
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Abstract
Description
1 上半身
2 患者
3 頸部
4 気管
5 食道
6 脊柱
7 気管瘻
8 気管瘻スペーサ
9 支持枠
10 外被
11 組織
12 9の端部
13 9の端部
14 固定要素
15 固定要素
16 固定要素
17 固定要素
19 開孔
20 開孔
21 開孔
22 開孔
23 縁部
24 9の内面
25 連結要素
26 弁ユニット
27 26のスリーブ状セクション
28 唇弁
29 唇弁
30 28、29の平坦セクション
31 円周表面
32 連結要素
33 カラー
34 気管切開デバイス
36 切断器具
37 トロカール
38 カバースリーブ
39 37の縁部
40 37の縁部
41 シャフト
42 マガジンセクション
43 誘導セクション
44 把持面
45 カフ
46 コネクタ要素
47 管
48 管誘導要素
49 管誘導曲線
50 誘導要素
51 カテーテル
52 気管壁
A 外周
AD 外径
L 長さ
MLA 中心の長手方向軸
R 方向
WD 壁厚
α 直角度
β 角度
好適な実施形態は、気管切開術を対象としたものであるが、本発明の原理は、その他の分野、特に、例えば結腸を含むその他の種類の造孔術、または、血管を含むその他のアクセスデバイスに対しても適用され得る。
Claims (52)
- 管状支持枠(9)を有する気管瘻スペーサであって、該支持枠(9)は、初期状態(A)から、増大した直径の支持状態(S)へと拡張することができ、端部に固定要素(14〜17)を有する、気管瘻スペーサ。
- 前記支持枠(9)は、初期状態(A)から、増大した直径の支持状態(S)へと自己拡張することができる、請求項1に記載の気管瘻スペーサ。
- 前記支持枠(9)の長さ(L)は、調整可能である、請求項1または2に記載の気管瘻スペーサーサ。
- 前記固定要素(14〜17)は、非外傷性縁部(23)を有する、請求項1から3までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持状態(S)において、前記固定要素(14〜17)は、前記支持枠(9)の中心の長手方向の軸(MLA)に対して横方向に、前記支持枠の外周(A)を越えて突出する、請求項1から4までのいずれか一項に記載の気管瘻スペーサ。
- 2つの固定要素(14、15;16、17)が、前記支持枠(9)の一端部(12;13)に提供される、請求項1から5までのいずれか一項に記載の気管瘻スペーサ。
- 端部(12;13)の前記固定要素(14、15;16、17)は、互いに反対側にあるように配置される、請求項6に記載の気管瘻スペーサ。
- 前記固定要素(14、15;16、17)は、前記支持枠(9)の両端部(12;13)に提供される、請求項1から7までのいずれか一項に記載の気管瘻スペーサ。
- 一端部(12)の前記固定要素(14、15)は、他端部(13)の前記固定要素(16、17)に対して、前記支持枠(9)の前記中心の長手方向軸(MLA)の周りに直角度(α)だけオフセットされている、請求項8に記載の気管瘻スペーサ。
- 固定要素(14〜17)は、開孔(19〜22)を有する、請求項1から9までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠(9)は、気管切開デバイス(34)、または、前記気管瘻スペーサ(8)を介して挿入されるカテーテルを誘導するための、管状誘導要素を有する、請求項1から10までのいずれか一項に記載の気管瘻スペーサ。
- 前記管状誘導要素は、前記支持枠(9)の一端部(12、13)を越えて外部へ伸長する、請求項11に記載の気管瘻スペーサ。
- 前記管状誘導要素は、湾曲しているか、または段部を有する、請求項11または12に記載の気管瘻スペーサ。
- 前記支持枠(9)は、弁ユニットを付与される、請求項1から13までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠(9)は、加湿器を付与される、請求項1から13までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠(9)を通過する、またはそれに挿入される物品を固定するために、連結要素(25)が提供される、請求項1から15までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠(9)は、外被(10)を有する、請求項1から16までのいずれか一項に記載の気管瘻スペーサ。
- 前記外被(10)は、ポリマーで作製される、請求項17に記載の気管瘻スペーサ。
- 前記外被(10)は、医薬活性物質を含有する、請求項17または18に記載の気管瘻スペーサ。
- 前記支持枠の円周面上に開口部を有するリザーバが設けられる、請求項1から19までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠の前記円周面上に一端を有するチャネルが設けられる、請求項1から20までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠(9)は、円形断面を有する、請求項1から21までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠は、長円形断面を有する、請求項1から21までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠は、その断面に凹入を有する、請求項1から23までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠は、その断面に隆起を有する、請求項1から24までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠(9)は、微細繊維で作製された支柱を有する、請求項1から25までのいずれか一項に記載の気管瘻スペーサ。
- 前記微細繊維は、金属で作製される、請求項26に記載の気管瘻スペーサ。
- 前記微細繊維は、形状記憶合金で作製される、請求項27に記載の気管瘻スペーサ。
- 前記支持枠(9)は、合成繊維織物を備える、請求項1から25までのいずれか一項に記載の気管瘻スペーサ。
- 前記微細繊維は、エラストマーで被覆される、請求項1から29までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠(9)の壁厚(WD)は、前記支持状態(S)における外径(AD)の5分の1(1/5)よりも小さい、請求項1から30までのいずれか一項に記載の気管瘻スペーサ。
- 前記支持枠(9)の壁厚(WD)は、前記支持状態(S)における外径(AD)の10分の1(1/10)未満である、請求項1から30までのいずれか一項に記載の気管瘻スペーサ。
- 気管に開口部を形成するステップと、
該気管の該開口部に、拡張可能な直径の気管瘻スペーサを設置するステップと、
を包含する、気管切開方法。 - 前記気管の前記開口部は、針を使用して形成される、請求項33に記載の気管切開方法。
- 前記気管の前記開口部は、ナイフまたはメスによって切断されるか、あるいはトロカールを使用して穿刺される、請求項33に記載の気管切開方法。
- 前記気管の前記開口部を形成するための切開は、該気管に対して横方向に為される、請求項35に記載の気管切開方法。
- 前記気管瘻スペーサが適所に嵌合される前に、皮膚および気管壁を通る前記開口部が、柔軟性のない器具、またはその直径を広げることができる器具を使用して広げられる、請求項33から36までのいずれか一項に記載の気管切開方法。
- 請求項1から37までのいずれか一項に従う、気管瘻スペーサ(8)を気管瘻に挿入するための、気管切開デバイス(34)であって、そのシャフト(41)上に該気管瘻スペーサ(8)が配置され得る切断器具(36)と、該シャフト(41)上でそこに配置された気管瘻スペーサ(8)の上を移動可能なカバースリーブ(38)とを備える、気管切開デバイス(34)。
- 前記切断器具(36)は、円錐形先端を有する、請求項38に記載の気管切開デバイス。
- 前記切断器具(32)は、誘導ワイヤ用のチャネルを有する、請求項38または39に記載の気管切開デバイス。
- 前記切断器具(36)は、針を備える、請求項38から40までのいずれか一項に記載の気管切開デバイス。
- 前記切断器具(36)は、ナイフ、メス、またはトロカール(37)を備える、請求項38から41までのいずれか一項に記載の気管切開デバイス。
- 前記カバースリーブ(38)上にカフ(45)が配置される、請求項38から42までのいずれか一項に記載の気管切開デバイス。
- 前記シャフト(35)は、マガジンセクション(36)を有する、請求項38から43までのいずれか一項に記載の気管切開デバイス。
- 前記シャフト(41)は、誘導セクション(43)を有する、請求項38から44までのいずれか一項に記載の気管切開デバイス。
- 前記シャフトおよび前記カバースリーブは、湾曲している、請求項38から45までのいずれか一項に記載の気管切開デバイス。
- 外形状は、断面において適合され、前記気管の開口部に適合することができる、請求項38から46までのいずれか一項に記載の気管切開デバイス。
- 把持面(44)が提供される、請求項38から47までのいずれか一項に記載の気管切開デバイス。
- 前記気管切開デバイス(34)を前記気管内へ過度に挿入することから保護するために、安全要素が提供される、請求項38から48までのいずれか一項に記載の気管切開デバイス。
- 前記安全要素は、ハウジングである、請求項49に記載の気管切開デバイス。
- 前記安全要素は、接触部である、請求項49に記載の気管切開デバイス。
- 前記安全要素は、前記皮膚を経由して前記気管の中への曲線的な進入を助長するために、前記気管瘻スペーサ(8)の軸方向長さに沿って形成された弓形形状である、請求項49に記載の気管切開デバイス。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US80110406P | 2006-05-18 | 2006-05-18 | |
US60/801,104 | 2006-05-18 | ||
PCT/US2007/012108 WO2007142812A2 (en) | 2006-05-18 | 2007-05-18 | Tracheotomy method and device |
Publications (2)
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JP2009537234A true JP2009537234A (ja) | 2009-10-29 |
JP5191005B2 JP5191005B2 (ja) | 2013-04-24 |
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JP2009511111A Expired - Fee Related JP5191005B2 (ja) | 2006-05-18 | 2007-05-18 | 気管切開の方法およびデバイス |
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US (3) | US7631642B2 (ja) |
EP (1) | EP2023987B1 (ja) |
JP (1) | JP5191005B2 (ja) |
CN (1) | CN101541365A (ja) |
CA (1) | CA2652544A1 (ja) |
WO (1) | WO2007142812A2 (ja) |
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US8985099B2 (en) | 2015-03-24 |
US20100043786A1 (en) | 2010-02-25 |
CN101541365A (zh) | 2009-09-23 |
CA2652544A1 (en) | 2007-12-13 |
US20120145147A1 (en) | 2012-06-14 |
US7631642B2 (en) | 2009-12-15 |
EP2023987A2 (en) | 2009-02-18 |
EP2023987B1 (en) | 2016-11-09 |
EP2023987A4 (en) | 2013-06-26 |
US20080029088A1 (en) | 2008-02-07 |
WO2007142812A3 (en) | 2008-10-16 |
JP5191005B2 (ja) | 2013-04-24 |
WO2007142812A2 (en) | 2007-12-13 |
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