JP2012506297A - 組織アブレーションシステム - Google Patents
組織アブレーションシステム Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
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- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/042—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating using additional gas becoming plasma
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00559—Female reproductive organs
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00791—Temperature
- A61B2018/00797—Temperature measured by multiple temperature sensors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00791—Temperature
- A61B2018/00821—Temperature measured by a thermocouple
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00898—Alarms or notifications created in response to an abnormal condition
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
- A61B2018/122—Generators therefor ionizing, with corona
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/147—Electrodes transferring energy by capacitive coupling, i.e. with a dielectricum between electrode and target tissue
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3983—Reference marker arrangements for use with image guided surgery
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Abstract
Description
定義
プラズマ。一般に、この開示は、「プラズマ」および「イオン化ガス」という用語を交互に使用する。プラズマは、中性ガスの電子が、それらの分子または原子から剥離される、または「イオン化」される、物質の状態から成る。そのようなプラズマは、電界の印加により、または高温により形成することができる。中性ガスでは、電気伝導度は、存在しないか、または非常に低い。中性ガスは、電界が破壊値に達するまで、誘電体または絶縁体としての機能を果たし、電子なだれプロセスにおいて、原子から電子を遊離させ、したがってプラズマを形成する。そのようなプラズマは、可動電子および正イオンを提供し、かつ電流を支持し、スパークまたはアークを形成することができる導体としての機能を果たす。それらの低い質量により、プラズマ内の電子は、電界に応じて、より正常な正イオンよりも迅速に加速し、したがって、バルク電流を送電する。
Claims (32)
- 組織に高周波電流を送達するための装置であって、
支持端と、作業端と、内部チャンバと、前記内部チャンバの少なくとも一部分を囲繞し、かつ前記作業端に配置される外面を有する、薄い誘電体壁とを有する、本体と、
前記内部チャンバに非伝導性ガスを送達するように接続される、ガス入口と、
前記内部チャンバおよび/または前記ガス入口に曝露される表面を有する、第1の電極構造と、
組織に接触するように適合される表面を有する、第2の電極構造と、
前記第1および第2の電極構造にわたって高周波電圧を印加するように接続される、高周波電力供給であって、前記電圧は、前記チャンバ内の前記非伝導性ガスの中でプラズマを開始するために、および前記誘導体壁を横断して組織の中へ前記プラズマ内で電流を容量的に結合するために十分である、高周波電力供給と
を備える、装置。 - 前記誘電体壁は、セラミック、ガラス、およびポリマから成る群より選択される、剛体材料を含む、請求項1に記載の装置。
- 前記剛体材料は、円筒形外面を有する管に形成される、請求項2に記載の装置。
- 前記誘電体壁は、0.002inから0.1inの範囲の厚さを有する、請求項2に記載の装置。
- 前記誘電体壁は、シリコーンを含む、適合材料を含む、請求項1に記載の装置。
- 前記誘電体壁は、0.03inから0.004inの範囲の厚さを有する、請求項5に記載の装置。
- 前記適合材料は、膨張性構造に形成される、請求項5に記載の装置。
- 前記適合材料を支持する枠をさらに備える、請求項5に記載の装置。
- 前記枠は、前記誘電体壁を開放および閉鎖するように、拡張および収縮させることができる、請求項8に記載の装置。
- 前記本体の前記支持端に接続されるシャフトをさらに備える、請求項1に記載の装置。
- 前記シャフトは、前記非伝導性ガスを前記本体の前記チャンバに送達するように前記ガス入口を延長する、管腔を有する、請求項10に記載の装置。
- 前記シャフトは、前記非伝導性ガスを前記本体の前記チャンバから除去するための少なくとも第2の管腔を含み、それによって、前記チャンバを通る非伝導性ガスの連続流を維持することができる、請求項11に記載の装置。
- 前記第1の電極は、少なくとも部分的に前記第1の管腔の中にある、請求項12に記載の装置。
- 前記第2の電極は、少なくとも部分的に前記シャフトの外面上に配置される、請求項13に記載の装置。
- 前記内部チャンバは、0.01mlから100mlの範囲の容量を有する、請求項1に記載の装置。
- 前記高周波電力供給は、500V(rms)から2500V(rms)の範囲の電圧を送達するように構成される、請求項1に記載の装置。
- 近位端と、遠位端とを有する、シャフトと、
前記シャフトの前記遠位端の近傍に配置されるエネルギーアプリケータであって、前記アプリケータは、内面と、外面とを有する、誘電体壁を含む、エネルギーアプリケータと、
前記アプリケータの前記誘電体壁の前記内面にガスを送達するための前記シャフト内のガス流路と、
前記ガス流路内のガスに曝露される、第1の電極構造と、
前記シャフトの外面上の第2の電極構造と
を備え、
前記第1および第2の電極にわたる高周波電圧の印加は、前記誘電体壁の前記外面が、前記第2の電極構造にも接触する組織に係合する時に、前記流路内の非伝導性ガスの中でプラズマを開始する、電気外科的アブレーションプローブ。 - 前記誘電体壁は、セラミック、ガラス、およびポリマから成る群より選択される、剛体材料を含む、請求項17に記載のプローブ。
- 前記剛体材料は、円筒形外面を有する管に形成される、請求項18に記載のプローブ。
- 前記誘電体壁は、0.002inから0.1inの範囲の厚さを有する、請求項18に記載のプローブ。
- 前記誘電体壁は、シリコーンを含む、適合材料を含む、請求項17に記載のプローブ。
- 前記誘電体壁は、0.03inから0.004inの範囲の厚さを有する、請求項21に記載のプローブ。
- 前記適合材料は、膨張性構造に形成される、請求項21に記載のプローブ。
- 前記アプリケータは、前記適合材料を支持する枠を備える、請求項21に記載のプローブ。
- 前記枠は、前記誘電体壁を開放および閉鎖するように、拡張および収縮させることができる、請求項24に記載のプローブ。
- 前記シャフトは、前記エネルギーアプリケータの近位端に接続される、請求項17に記載のプローブ。
- 前記ガス流路は、前記非伝導性ガスを前記本体の前記チャンバに送達するように前記シャフトの長さを延長する、管腔を備える、請求項26に記載のプローブ。
- 前記シャフトは、前記非伝導性ガスを前記本体の前記チャンバから除去するための少なくとも第2の管腔を含み、それによって、前記チャンバを通る非伝導性ガスの連続流を維持することができる、請求項27に記載のプローブ。
- 前記第1の電極は、少なくとも部分的に前記第1の管腔の中にある、請求項28に記載のプローブ。
- 前記第1の電極は、少なくとも部分的に前記アプリケータ内に配置される、請求項29に記載のプローブ。
- 前記アプリケータは、0.01mlから100mlの範囲の容量を伴う、前記ガス流路の一部分を形成する内部チャンバを有する、請求項17に記載のプローブ。
- 前記電極は、500V(rms)から2500V(rms)の範囲の電圧によって駆動されるように構成される、請求項17に記載のプローブ。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US19687008P | 2008-10-21 | 2008-10-21 | |
US61/196,870 | 2008-10-21 | ||
PCT/US2009/060703 WO2010048007A1 (en) | 2008-10-21 | 2009-10-14 | Tissue ablation systems |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2012506297A true JP2012506297A (ja) | 2012-03-15 |
JP5579726B2 JP5579726B2 (ja) | 2014-08-27 |
Family
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2011533235A Active JP5579726B2 (ja) | 2008-10-21 | 2009-10-14 | 組織アブレーションシステム |
Country Status (8)
Country | Link |
---|---|
US (2) | US8372068B2 (ja) |
EP (1) | EP2349044B1 (ja) |
JP (1) | JP5579726B2 (ja) |
CN (1) | CN102245118B (ja) |
BR (1) | BRPI0919902B8 (ja) |
CA (1) | CA2741453C (ja) |
IL (1) | IL212462A (ja) |
WO (1) | WO2010048007A1 (ja) |
Cited By (3)
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JP2016101492A (ja) * | 2014-11-07 | 2016-06-02 | オヴェスコ エンドスコピー アーゲー | スペーサを備えるプラズマ外科手術装置 |
JP2020520282A (ja) * | 2017-05-16 | 2020-07-09 | メガダイン・メディカル・プロダクツ・インコーポレーテッドMegaDyne Medical Products, Inc. | 電気外科用器具の延長アタッチメント |
JP2022040065A (ja) * | 2020-08-26 | 2022-03-10 | ジャイラス メディカル リミテッド | 電気手術デバイス |
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US8382753B2 (en) | 2013-02-26 |
IL212462A (en) | 2014-04-30 |
BRPI0919902B8 (pt) | 2021-06-22 |
EP2349044B1 (en) | 2019-09-04 |
US8372068B2 (en) | 2013-02-12 |
US20100100094A1 (en) | 2010-04-22 |
IL212462A0 (en) | 2011-06-30 |
EP2349044A1 (en) | 2011-08-03 |
CA2741453A1 (en) | 2010-04-29 |
JP5579726B2 (ja) | 2014-08-27 |
EP2349044A4 (en) | 2013-05-15 |
US20100100091A1 (en) | 2010-04-22 |
CN102245118B (zh) | 2015-04-15 |
CN102245118A (zh) | 2011-11-16 |
CA2741453C (en) | 2017-04-18 |
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