JP2010514541A - 前立腺の疾患を治療するための侵襲性が最小である方法及びデバイス - Google Patents
前立腺の疾患を治療するための侵襲性が最小である方法及びデバイス Download PDFInfo
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Abstract
【解決手段】シャフトは、膀胱内で膨張させたバルーン又は他の構造によって固定され、エネルギ源はアブレーションエネルギを尿道から半径方向外方に差し向けることができ、前記エネルギ源は、前立腺組織の所定の容積を除去するため、移動される。
【選択図】図1
Description
12 シャフト
14 遠位端
16 近位端
18 ハブ
20 エネルギ送出領域
22 エネルギ源
24 バルーンアンカー
26 バルーン膨張源
28 注入/フラッシング源
30 吸引(負圧)源
32 通気源
34 送出ポート
36 第2ポート
38 追加のポート
B 膀胱
BN 膀胱頚部
P 前立腺
U 尿道
Claims (35)
- 前立腺組織の切除を行うための方法において、
エネルギ源を尿道内に位置決めする工程と、
エネルギを前記エネルギ源から前立腺内の尿道の壁に向かって半径方向外方に差し向ける工程と、
前記エネルギ源を移動し、前記内腔を取り囲む組織の所定の容積を除去する工程とを含む、方法。 - 請求項1に記載の方法において、更に、
アンカーを尿道の遠位端の膀胱内で膨張する工程を含み、前記エネルギ源は、前記アンカーに対して位置決めされている、方法。 - 請求項2に記載の方法において、
前記アンカー及び前記エネルギ源はカテーテル組立体に取り付けられており、前記カテーテル組立体は、前記エネルギ源を前記カテーテル組立体に対して軸線方向に並進させ及び/又は回転させるとき、定置のままである、方法。 - 請求項3に記載の方法において、
前記アンカーは、膨張されたとき、膀胱のほぼ全容積を占有し、安定性を向上する、方法。 - 請求項1に記載の方法において、
前記エネルギを差し向ける工程は、組織にアブレーションを加えるため、高周波電流を搬送する導電性流体を送出する工程を含む、方法。 - 請求項2に記載の方法において、
前記送出工程は、導電性流体のプラズマを発生する工程を含む、方法。 - 請求項1に記載の方法において、
前記アブレーションエネルギを差し向ける工程は、高圧流体流を送出し、組織を切除する工程を含む、方法。 - 請求項1に記載の方法において、
前記エネルギを差し向ける工程は、レーザーエネルギ送出し、組織にアブレーションを加える工程を含む、方法。 - 請求項1に記載の方法において、
前記エネルギを差し向ける工程は、電極を組織と係合させ、高周波エネルギを送出し、組織にアブレーションを加える工程を含む、方法。 - 請求項1に記載の方法において、更に、
エネルギを半径方向外方に差し向けるとき、加圧ガスを導入し、尿道を膨張する工程を含む、方法。 - 請求項1に記載の方法において、更に、
尿道を吸引し、アブレーション生成物を除去する工程を含む、方法。 - 請求項11に記載の方法において、更に、
尿道にフラッシングを施し、アブレーション生成物の除去を補助する工程を含む、方法。 - 請求項12に記載の方法において、
前記吸引及び前記フラッシングは、前記エネルギ源を支持するデバイスで実施される、方法。 - 請求項1に記載の方法において、
前記エネルギ源を移動する工程は、回転、回転揺動、並進、及び並進揺動のうちの少なくとも一つを含む、方法。 - 請求項13に記載の方法において、
前記エネルギ源を移動する工程は、更に、組織を除去するとき、前記エネルギ源を組織に向かって半径方向に前進する工程を含む、方法。 - 請求項14に記載の方法において、
前記エネルギ源を半径方向に前進する工程は、プラズマ源の円筒形アレイを膨張する工程を含む、方法。 - 前立腺の治療を行うための方法において、
尿道を通してシャフトを前進する工程と、
前記シャフトに連結されたアンカーを膀胱内で膨張させ、前記シャフトを尿道内で安定させる工程と、
前記シャフトに設けられた治療デバイスを賦勢し、尿道を拡大し及び/又は前立腺を減量し、前記治療デバイスの位置は前記アンカーによって決定される、工程とを含む、方法。 - 請求項17に記載の方法において、
前記アンカーを膨張する工程は、バルーンを膨張させ、尿道のほぼ全容積を占有する工程を含む、方法。 - 請求項17に記載の方法において、
前記治療デバイスを賦勢する工程は、安定させたシャフトから、機械的エネルギ、振動エネルギ、熱エネルギ、光エネルギ、及び電気エネルギのうちの少なくとも一つを前立腺組織に加える工程を含む、方法。 - 請求項17に記載の方法において、更に、
前記治療デバイスを前記シャフトに対して移動し、尿道の所定の表面領域を治療する工程を含む、方法。 - 請求項20に記載の方法において、
前記所定の表面領域は全体に円筒形である、方法。 - 請求項21に記載の方法において、
前記治療デバイスはエネルギ流又はエネルギの周方向バンドを放出し、前記移動は、軸線方向並進及び/又は軸線方向揺動を含む、方法。 - 請求項22に記載の方法において、
前記移動は、更に、回転及び/又は回転揺動を含む、方法。 - 前立腺切除デバイスにおいて、
近位端及び遠位端を持つシャフトと、
膀胱内に固定するための、前記遠位端の近くの膨張可能なアンカーと、
前記シャフトに前記アンカーの手前に設けられた、前記アンカーが膀胱内にあるときに尿道内に位置決めされる、エネルギを半径方向外方に送出するための少なくとも一つのエネルギ源とを含む、デバイス。 - 請求項24に記載のデバイスにおいて、更に、
前記エネルギ源を取り囲む尿道を加圧して尿道を膨張させ、組織をノズルから離間するため、前記シャフト内に設けられた内腔を含む、デバイス。 - 請求項25に記載のデバイスにおいて、更に、
前記ノズルの周囲の尿道を吸引し、アブレーション生成物を除去するため、前記シャフト内に設けられた内腔を含む、デバイス。 - 請求項26に記載のデバイスにおいて、更に、
尿道を流体でフラッシングし、アブレーション生成物の除去を補助するため、前記シャフト内に設けられた内腔を含む、デバイス。 - 請求項27に記載のデバイスにおいて、
前記シャフトは、幅が1mm乃至10mmであり、長さが15cm乃至25cmである、デバイス。 - 請求項24に記載のデバイスにおいて、
前記エネルギ源は、エネルギを前立腺の様々な領域に選択的に差し向けるため、前記シャフトに対して移動自在である、デバイス。 - 請求項29に記載のデバイスにおいて、
前記エネルギ源は、前記シャフトに対し、並進、回転、揺動、及び/又は回転揺動するようになっている、デバイス。 - 請求項24に記載のデバイスにおいて、
前記エネルギ源は高圧流体イジェクタを含む、デバイス。 - 請求項24に記載のデバイスにおいて、
前記エネルギ源はレーザーエネルギ源を含む、デバイス。 - 請求項32に記載のデバイスにおいて、
前記エネルギ源は、更に、レーザーエネルギを反射するためのミラーを含む、デバイス。 - 請求項24に記載のデバイスにおいて、
前記エネルギ源は導電性流体源及び高周波エネルギ源を含む、デバイス。 - 請求項24に記載のデバイスにおいて、
前記エネルギ源は、尿道壁に当てて位置決めできる電極を含む、デバイス。
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WO2008083407A1 (en) | 2008-07-10 |
EP3510959A1 (en) | 2019-07-17 |
US20090018533A1 (en) | 2009-01-15 |
JP2013144168A (ja) | 2013-07-25 |
EP2099375A4 (en) | 2012-07-18 |
EP3868323B1 (en) | 2023-09-06 |
EP4238519A2 (en) | 2023-09-06 |
JP2015155024A (ja) | 2015-08-27 |
JP5369336B2 (ja) | 2013-12-18 |
EP2810613B1 (en) | 2019-03-20 |
EP3510959B1 (en) | 2021-03-03 |
EP3868323A1 (en) | 2021-08-25 |
EP2099375A1 (en) | 2009-09-16 |
ES2721915T3 (es) | 2019-08-06 |
ES2858596T3 (es) | 2021-09-30 |
EP2810613A1 (en) | 2014-12-10 |
ES2959025T3 (es) | 2024-02-19 |
EP2099375B1 (en) | 2014-09-24 |
JP6140512B2 (ja) | 2017-05-31 |
US7882841B2 (en) | 2011-02-08 |
EP4238519A3 (en) | 2023-11-29 |
EP3868323C0 (en) | 2023-09-06 |
JP6268125B2 (ja) | 2018-01-24 |
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