JP2012179371A - 組織除去のための装置 - Google Patents
組織除去のための装置 Download PDFInfo
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Abstract
【解決手段】組織除去装置は、ガイドワイヤを一部、または全て除去することによって、所定位置に引き入れられる。または、組織除去装置14は、神経保護部材6と共に、または同時に神経孔を横切り配置することができ、それらは任意でガイドワイヤに連結して所定位置に引き入れることもできる。さらには、神経保護部材6および組織除去装置14は、単一の装置に統合することもできる。
【選択図】図61
Description
本出願は、2004年10月15日に出願した米国仮出願第60/619、306号、2004年10月28日に出願した米国出願第60/622、865号、2005年5月16日に出願した米国出願第60/81、719号、2004年5月16日に出願した米国出願第60/681、864号、および2004年5月27日に出願した米国出願第60/685、190号の便益を請求し、それぞれは、参照によってそのままここに組み入れられる。
である。配置カバー436は硬質でよく、例えば組織除去装置300および/または組織保護バリア528が拡張するのを防止できる。組織除去装置300および/または組織保護バリア528は、例えば一体化または取り付けられた機械的拡張装置(例えば膨張バルーン)を具備すること、ならびに/あるいは加熱した時に戻る形状記憶合金で作ることによって手動で拡張することができる。
Claims (5)
- 患者の標的組織変更のための外科的システムであって、当該システムが、
剥脱面と非剥脱面とを具え、少なくとも一部が可撓性の細長い、ガイドワイヤに取付可能な組織剥脱装置であって、前記剥脱面が、侵害軟組織および骨を切断するための少なくとも1のブレードを具える組織剥脱装置と、
遠位端部を有するガイドワイヤとを具え、
前記ガイドワイヤを引っ張ることにより、前記組織剥脱装置の前記剥脱面およびブレードを緊張させた状態で侵害組織を横切るように引いて、切断により組織を除去できるように、前記組織剥脱装置が前記ガイドワイヤに取り付けられる構成となっており、前記組織剥脱装置の可撓性部分が標的組織と非標的組織の間の湾曲面に沿って通るときに、前記患者の体の外に延びる前記ガイドワイヤの遠位端部を引っ張ることにより、遠位部の張力を加えて、前記剥脱面を前記標的組織に押しつけ、切断により組織を除去できることを特徴とするシステム。 - 前記組織剥脱装置が、前記ガイドワイヤを前記組織剥脱装置に連結する小穴を具えることを特徴とする請求項1に記載のシステム。
- 患者の脊椎内の標的組織を変更するためのシステムであって、当該システムが、
少なくとも一部が可撓性の細長い、ガイドワイヤに取付可能な組織剥脱装置と、
前記組織剥脱装置の可撓性部分が前記標的組織と非標的組織の間の湾曲経路に沿って通り、組織変更の処置中に前記組織剥脱装置の両端部またはその近傍に張力を加えて前記組織剥脱装置の可撓性部分を前記標的組織に押しつけることができるように、前記組織剥脱装置を患者の外側から患者の脊椎の神経孔を通るように進めるためのガイドワイヤと、
前記組織剥脱装置の可撓性部分に沿って配置された剥脱面であって、侵害軟組織および骨を切断するための少なくとも1のブレードを具える剥脱面とを具え、
前記剥脱面を前記標的組織に押しつけて組織を切断で除去すべく、前記患者の体の外に延びる前記ガイドワイヤの遠位端部より、前記ガイドワイヤを引っ張ることにより、前記組織剥脱装置およびブレードを緊張させた状態で侵害組織を横切るように引いて、切断により組織を除去することができるように、前記組織剥脱装置がその遠位端部で前記ガイドワイヤに取付可能となっており、
前記システムがさらに、前記可撓性部分に沿って配置される非剥脱面であって、前記剥脱面が前記標的組織に面するときに、前記非標的組織に面する非剥脱面を具えることを特徴とするシステム。 - 前記非剥脱面が、これに連結される潤滑層を具えることを特徴とする請求項3に記載のシステム。
- 患者の脊椎内の標的組織を変更するためのシステムであって、当該システムが、
少なくとも一部が可撓性の細長い、ガイドワイヤに取付可能な組織剥脱装置と、
前記組織剥脱装置の可撓性部分が前記標的組織と非標的組織の間の湾曲経路に沿って通り、組織変更の処置中に前記組織剥脱装置の両端部またはその近傍に張力を加えて前記組織剥脱装置の可撓性部分を前記標的組織に押しつけることができるように、前記組織剥脱装置を患者の外側から患者の脊椎の神経孔を通るように進めるためのガイドワイヤと、
前記組織剥脱装置の可撓性部分に沿って配置された剥脱面とを具え、
前記患者の体の外に延びる前記ガイドワイヤの遠位端部より、前記ガイドワイヤを引っ張ることにより前記組織剥脱装置を配置または作動させて、前記剥脱面を前記標的組織に押しつけることができるように、前記組織剥脱装置がその遠位端部で前記ガイドワイヤに取付可能となっており、
前記システムがさらに、前記可撓性部分に沿って配置される非剥脱面であって、前記剥脱面が前記標的組織に面するときに、前記非標的組織に面する非剥脱面と、
神経刺激能力を用いて前記組織剥脱装置を適切な場所に配置できるようにするために、前記ガイドワイヤを用いて所定位置に引き込まれる神経保護部材に連結される少なくとも1つの電極とを具えることを特徴とするシステム。
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