JP2012000443A - 「自動経管組織目標設定固定デバイス及び方法」 - Google Patents
「自動経管組織目標設定固定デバイス及び方法」 Download PDFInfo
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Abstract
【解決手段】自動ばね荷重機構が利用される内視鏡、あるいは内視鏡カメラ誘導経管介入向け組織貫通装置が教示される。組織固定、付加、および吻口の創出が含まれる様々な変更例および利用例が説明される。本発明の一実施形態では、本発明は圧縮ガス室、コイルばね、あるいは捩りばねのような構成部材が含まれるプレバイアスデバイスによって組織貫通デバイスの自動操作が可能となる。
【選択図】図1
Description
本発明は内視鏡あるいは内視鏡検査法、あるいは自動化された、例えば、外科措置ならびに特に組織固定における利用が含まれる様々な変更と用途が伴われるばね荷重機構が利用される内視鏡、あるいは内視鏡カメラ誘導経管介入向けの組織貫通デバイスに関する。
内視鏡および内視鏡カメラ誘導介入には外科代替および経皮誘導措置上の利点がいくつかある。内視鏡あるいは内視鏡カメラが採用される介入により代替措置の人的影響の回避がある程度可能である。
本発明により上述の技術ニーズが解決可能であると同時に、先行技術に優るいくつかの利点が提供される。本発明によるこれらの技術に利用可能な装置の提供によって追加技術項目の遂行能力に関するニーズが解決される。
(項目1)
基端側端部および末端側端部をもつほぼ空洞の円筒状中央部材および上記中央部材の末端側端部に取付けられる脚部材が含まれ、該脚部材の少なくとも一部分に、該部材の拡大される末端側半径、上記中央部材の末端側部分に取付けられる縫合線、拡大具部材、上記中央部材を貫通して同軸で並べられる末端側部分、上記拡大具の基端側部分廻りに同軸で並べられて上記中央部材の基端側方向への移動防止に対応される押出具部材、ならびに、該装置の少なくとも一部分の末端側方向押し込みに選択的に対応されるプレバイアスデバイスの創出が可能に対応される装置。
(項目2)
さらに上記装置を包囲する外側スリーブが含まれ、上記外側スリーブが内視鏡に取付くよう対応される項目1の装置。
(項目3)
上記プレバイアスデバイスに圧縮ガス室、コイルばねおよび捩りばねから構成される群から選択される部材が含まれる項目1の装置。
(項目4)
さらに上記拡大具部材の基端側部分に接続されるロープが含まれる項目1の装置。
(項目5)
組織の貫通に対応する貫通部材が通行可能に対応されるほぼ空洞の中央部材ならびに上記中央部材の末端側部分に接続される第1脚部材が含まれ、上記第1脚部材により上記中央部材の末端側半径の拡大が生まれるよう対応されかつ上記拡大による上記装置の末端側方向への移動が抑制されるよう対応される装置。
(項目6)
上記第1脚部材により自動拡大および手動拡大から構成される群から選択される拡大半径生成技術が採用される項目5の装置。
(項目7)
上記第1脚部材が上記貫通部材の末端側移動に応答して半径が拡大するよう対応される項目5の装置。
(項目8)
上記第1脚部材に形状記憶合金が含まれる項目5の装置。
(項目9)
上記第1脚部材に、末端側部分に接続される第1端部ならびに上記装置の上記半径の拡大に先立ってほぼ基端側に拡大する第2端部が含まれる項目5の装置。
(項目10)
上記第1脚部材に、末端側部分に接続される第1端部ならびに上記装置の上記半径の拡大に先立ってほぼ末端側に拡大する第2端部が含まれる項目5の装置。
(項目11)
上記第1脚部材が包囲さや部の基端側移動に応答して半径が拡大するよう対応される項目5の装置。
(項目12)
さらに、上記中央部材の基端側部分に接続される第2脚部材が含まれ、上記第2脚部分により上記装置の基端半径の拡大が生まれるよう対応されかつ上記拡大により上記装置の末端方向への移動が抑制されるよう対応される項目5の装置。
(項目13)
上記第2脚部材が包囲さや部の基端側移動に応答して半径が拡大するよう対応される項目12の装置。
(項目14)
上記第2脚部材が1本以上のゴムバンドによって半径が拡大するよう対応される項目12の装置。
(項目15)
上記中央部材がステントで対応される項目5の装置。
(項目16)
上記中央部材が拡大可能であるよう対応される項目5の装置。
(項目17)
上記中央部材にメッシュおよびウェブからなる群から選定される構造が含まれる項目5の装置。
(項目18)
さらに上記中央部材に形状記憶合金メッシュが含まれる項目17の装置。
(項目19)
さらに上記中央部材に接続されるとともに半径方向内側に向けられたつまみが含まれ、上記つまみにより軸基端側方向の力が半径方向外側方向の力に変換されるよう対応される項目5の装置。
(項目20)
さらに上記中央部材の基端部分に接続されるロープが含まれる項目5の装置。
(項目21)
上記ロープが感知器に接続されて対応される項目20の装置。
(項目22)
上記感知器が、カメラ、電磁感知器、ナノメーター感知器、pH検知棒、ならびに内肛内容物サンプリング用探知棒から構成される群から選定される項目21の装置。
(項目23)
上記ロープが治療搬送デバイスに接続され対応される項目20の装置。
(項目24)
上記治療搬送デバイスが、薬物搬送デバイス、化学療法搬送デバイス、治療作動デバイス、光線力学的治療デバイス、放射性同位元素封入デバイス、放射性同位元素搬送デバイス、熱搬送デバイス、高周波搬送デバイス、放射性同位元素容器、熱搬送デバイス、光化学剤搬送デバイス、無線周波数搬送デバイス、刺激電極棒デバイス、ペースメーカーならびに神経刺激器から構成される群からから選定される項目23の装置。
(項目25)
上記装置が内視鏡およびエコー内視鏡からなる群から選定されるデバイスと一緒に利用されて対応される項目5の装置。
(項目26)
内肛構造への組織の固定段階が含まれ、上記組織が、上記内肛構造を貫通して少なくとも上記組織中に貫通するよう対応される項目5の装置の利用によって固定されかつ上記組織が上記内肛構造の少なくとも1領域に関連してほぼ定位置に保持される方法。
(項目27)
上記組織に第2内肛構造が含まれる項目26の方法。
(項目28)
上記内肛構造に膀胱、子宮、導管構造、気管支気管樹、静脈、動脈および腸の一部分から構成される群から選定される組織が含まれる項目26の方法。
(項目29)
上記第2内肛構造に膀胱、子宮、導管構造、気管支気管樹、静脈、動脈および腸の一部分から構成される群から選定される組織が含まれる項目27の方法。
(項目30)
外側さや部によって取り囲まれる開放可能な組織アンカー付きの貫通部材、装置の軸方向前方への貫通部材のプレバイアス用プレバイアス手段、上記の予めバイアスをかけた貫通部材が解放されて上記貫通部材が装置の軸方向前方に突き出る解放手段、および内視鏡の通路の入口ポートで上記貫通部材が固定されて設けられる留め金が含まれる組織固定装置。
(項目31)
上記プレバイアス手段に上記外側さや部の露出部分の調節が可能なように対応される外側スリーブが含まれる項目30によるデバイス。
(項目32)
上記プレバイアス手段に組織層の貫通深さの正確な調節が可能に対応される調節スリーブが含まれる項目30によるデバイス。
(項目33)
上記プレバイアス手段に、上記貫通部材に接続および切断可能であるばねが含まれ、かつ、上記ばねが上記貫通部材から切断されている場合に上記貫通部材が手動制御されるよう対応される上記項目30によるデバイス。
(項目34)
上記ばねがコイルばねである項目33によるデバイス。
(項目35)
上記貫通部材にサンドブラストによって処理される末端側部分が含まれる項目30によるデバイス。
(項目36)
上記貫通部材に、上記貫通部材が装置の軸方向前方に突き出る場合に上記貫通部材を包囲する上記外側さや部の末端側部分を通過して突き出る末端側部分が含まれる項目30によるデバイス。
(項目37)
上記外側さや部が上記内視鏡の通路を上記貫通部材と独立して移動可能である項目30によるデバイス。
(項目38)
上記装置がエコー内視鏡に利用されるよう対応される項目30によるデバイス。
(項目39)
上記留め金にねじ留め金が含まれる項目30によるデバイス。
本発明は、ここで説明される特定の方法論、混合物、材料、製作技術、用途、および応用法は変化し得るものであり、これらに限定されない点が理解されなくてはならない。また、ここで使用される用語も特定の実施例が説明される目的でのみ使用されると同時に、本発明の範囲が限定されることは意図されていない点も理解されなくてはならない。ここに使用される通りかつ付録の特許請求項中にある単数型式の表現には、他に文脈によりはっきりと指示されない限り複数の引用が含まれる点が特記されなくてはならない。このように、例えば、「縫合線」の言及には1本以上の縫合線に関して言及されると同時に、これらの技術に熟練した人々にとっての既知相当のものが含まれる。本発明に関連して使用可能である材料にはステンレススチール、その他のスチール外科用合金、様々な生物共生プラスチックおよびエラストマーおよびその他の従来材料のようなものが含まれ得る。一般に、アレルギー反応あるいは炎症が引き起こされる結果があえて望まれる場合を除き、これらの可能性のある材料の使用は避けられることが大切である。
(特許文献1)米国特許第6,228,039号(特許文献2)米国特許第6,638,213号、(特許文献3)米国特許第6,614,595号、(特許文献4)米国特許第6,520,908号、
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US10/822,138 US20050228413A1 (en) | 2004-04-12 | 2004-04-12 | Automated transluminal tissue targeting and anchoring devices and methods |
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JP2010272069A Pending JP2012000443A (ja) | 2004-04-12 | 2010-12-06 | 「自動経管組織目標設定固定デバイス及び方法」 |
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EP (2) | EP1755462B1 (ja) |
JP (2) | JP2007532200A (ja) |
AT (1) | ATE501675T1 (ja) |
DE (1) | DE602005026934D1 (ja) |
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Also Published As
Publication number | Publication date |
---|---|
ATE501675T1 (de) | 2011-04-15 |
WO2005099591A3 (en) | 2007-01-25 |
EP1755462B1 (en) | 2011-03-16 |
EP1755462A2 (en) | 2007-02-28 |
EP2389877A3 (en) | 2012-01-25 |
WO2005099591A2 (en) | 2005-10-27 |
DE602005026934D1 (de) | 2011-04-28 |
EP2389877A2 (en) | 2011-11-30 |
JP2007532200A (ja) | 2007-11-15 |
US20050228413A1 (en) | 2005-10-13 |
EP1755462A4 (en) | 2009-07-01 |
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