JP2015516182A - 一体型センサーを有する外科器具 - Google Patents
一体型センサーを有する外科器具 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
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- A61B17/29—Forceps for use in minimally invasive surgery
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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
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
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- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
- A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
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- A61B5/4887—Locating particular structures in or on the body
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- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
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- A61B2090/3782—Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument
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- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
Abstract
Description
この出願は、2012年3月6日付けの出願で、表題が"Apparatus for use of blood flow to evaluate risk of tissue dissection device"(組織切開デバイスのリスクを評価するための血流の使用のための装置)である米国仮出願第61/607335号の利益を主張する。該出願の開示全体は参照によりここに組み込まれる。
発明の分野
ヒンジ機構係合の第1ジョーと第1ジョーがヒンジ機構係合で取り付けられる第2ジョーとを含む。第1ジョーは光学送信機を含み、第2ジョーは光学受信機を含む。
I.外科システムの概要
II.機器付き外科器具
A.外科器具
B.機能要素
C.センサー
E.インジケータ
III.外科システム
IV.外科手術方法
101 コントローラ
102A 第1把持ジョー
102B 第2把持ジョー
104 機能要素
402 光学送信機
404 光学受信機
502 組織部分
506 血管
600 超音波ドップラープローブ
606 超音波送受信機
800 外科用はさみ具
804 センサー
900、904 外科用フック
902 ドップラープローブ
1000、1000A 外科システム
1002 外科デバイス
1006 センサー
1014 データ後処理モジュール
1016 構造アーチファクト検出モジュール
1018 警報信号モジュール
1022 GUIモジュール
1024 コンピューティングデバイス
1026 プロセッサ
1028 RCM
1030 外科器具アプリケーション
1032 ディスプレイ
1100、1004 外科器具
1202 データ収集及び処理モジュール
1210 視覚警報ディスプレイ
1212 聴覚警報
1214 スピーカー
Claims (51)
- 機器付き外科デバイスであって、
手術野内で外科施術を実行する外科器具と、
外科器具に連動的に接続されるセンサーにして、構造アーチファクトに対する手術野を監視するセンサーとを備える機器付き外科デバイス。 - 前記外科器具は、捕捉器具、解剖器具、鉗子、クランプ、組織封止器具、クリップ適用具、持針器、骨パンチ、キューレット、トロカール、生検パンチ、はさみ、外科用メス、摘出具、レーザー外科用メス、レーザー焼灼具、電気焼灼具、超音波凝固具、超音波凝結具のうちの一つ又は複数から選択される請求項1に記載の機器付き外科デバイス。
- 前記センサーは、音響ドップラー速度計、磁気流量計、レーザードップラー速度計、パルスオキシメータ、ソノグラフセンサー、光音響センサー、サーモグラフセンサー、及び磁気計のうちの一つ又は複数から選択される請求項1又は2に記載の機器付き外科デバイス。
- 前記センサーは、構造アーチファクトが手術野で検出された場合、警報信号を発生させる請求項1〜3のいずれか1項に記載の機器付き外科デバイス。
- 前記センサーは、手術野で検出された検出構造アーチファクトが前記センサーの所定閾値を超える場合、警報信号を発生させる請求項1〜4のいずれか1項に記載の機器付き外科デバイス。
- 前記センサーに連動的に接続されるインジケータを更に備え、該インジケータは、
警報信号に応答して視覚警報表示を発生させる視覚ディスプレイと、
警報信号に応答して聴覚警報表示を発生させるスピーカと、
警報信号に応答して触覚警報表示を発生させる振動発生器と、
外科器具の作動を停止するために外科器具に連動的に接続される工具ロック要素とのうちの一つ又は複数から選択される請求項1〜5のいずれか1項に記載の機器付き外科デバイス。 - 前記外科器具は、静止切断エッジ、一組のはさみブレード、レーザー、一つ又は複数の電極、超音波発信機、及び一組のジョーのうちの一つ又は複数から選択される機能要素を備える請求項1〜6のいずれか1項に記載の機器付き外科デバイス。
- 前記手術野は、前記機能要素と接するある量の組織を含む請求項1〜7のいずれか1項に記載の機器付き外科デバイス。
- 前記構造アーチファクトは、手術野における血管の存在、血管の寸法、血管を通る血流の速度、血管配向、血管O2飽和血流;神経組織、尿路組織、及びこれらの任意の組み合わせを含む組織タイプ;呼吸器構造、消化器系構造、神経系構造、筋骨格系構造、循環構造、尿路系構造、肝臓、及びこれらの任意に組み合わせを含む構造、のうちの一つ又は複数から選択される請求項1〜8のいずれか1項に記載の機器付き外科デバイス。
- 前記外科器具は、捕捉器具、鉗子、クランプ、及び組織封止器具から選択され、
外科器具の機能要素は、第1ジョー及び第2ジョーを備え、
手術野は、第1ジョーと第2ジョー間に位置する組織であり、
前記センサーは、音響ドップラー速度計、レーザードップラー速度計、及びパルスオキシメータから選択され、
外科器具は、ユーザ入力に応答して第1ジョー及び第2ジョーにより前記組織にかけられる圧力を比例的に調整するコントローラを更に備える請求項1〜9のいずれか1項に記載の機器付き外科デバイス。 - 外科器具の前記機能要素は、レーザー、一つ又は複数の電極、及び超音波送信機から選択されるエネルギー適用器具を更に備える請求項1〜10のいずれか1項に記載の機器付き外科デバイス。
- 前記エネルギー適用器具は、第1ジョー及び/又は第2ジョーに配置された少なくとも一つの電極を備える請求項1〜11のいずれか1項に記載の機器付き外科デバイス。
- 前記少なくとも一つの電極は、前記第1ジョー及び/又は第2ジョーの周囲に配置される請求項1〜12のいずれか1項に記載の機器付き外科デバイス。
- 前記少なくとも一つの電極は、第1ジョー及び/又は第2ジョーの内面上にある請求項1〜13のいずれか1項に記載の機器付き外科デバイス。
- 前記センサーは、光学送信機と光学受信機とを備え、該光学送信機及び光学受信機は、別個の把持ジョーに配置される請求項1〜14のいずれか1項に記載の機器付き外科デバイス。
- 少なくとも一つの光ケーブルが光学送信機及び光学受信機に連動的に接続される請求項15に記載の機器付き外科デバイス。
- 第1光ケーブルが前記光学送信機に接続され、第2光ケーブルが前記光学受信機に接続される請求項16に記載の機器付き外科デバイス。
- 前記センサーは超音波ドップラープローブを備える請求項1〜17のいずれか1項に記載の機器付き外科デバイス。
- 前記外科器具は、外科用はさみを含む請求項1〜18のいずれか1項に記載の機器付き外科デバイス。
- 前記外科器具は、外科用フックを含む請求項1〜19のいずれか1項に記載の機器付き外科デバイス。
- 前記センサーは、外科用フックのベースに一体化された超音波ドップラープローブを備える請求項20に記載の機器付き外科デバイス。
- 患者の手術野内に位置する組織に外科手術を実行するためのシステムであって、
機器付き外科デバイスを備え、該機器付き外科デバイスは、
外科手術を実行する外科器具にして、コントローラに連動的に接続される機能要素を備える外科器具と、
手術野内の前記組織を連続的に監視するセンサーにして、外科器具に連動的に接続されるセンサーと、
前記組織の一つ又は複数の特性を定義するある量の処理データを発生させるため、前記センサーから受信した一つ又は複数の出力を処理するデータ後処理モジュールと、
前記組織内の一つ又は複数の構造アーチファクトを特徴付けるある量のアーチファクトデータを決定するために前記量の処理データを分析する構造アーチファクト検出モジュールと、
前記量のアーチファクトデータを評価し、前記量のアーチファクトデータが所定の閾値条件を超えた場合に、警報信号を発生させる警報信号モジュールと、
前記量の一つ又は複数の構造アーチファクトに応じて警報表示を発生させる警報表示モジュールと、
一つ又は複数のフォームを発生させるGUIモジュールにして、該一つ又は複数のフォームが該システムに対する一つ又は複数の入力を受信し、かつ該システムから一つ又は複数の出力を伝達するGUIモジュールとを備えるシステム。 - 前記外科器具は、捕捉器具、解剖器具、鉗子、クランプ、組織封止器具、クリップ適用具、持針器、骨パンチ、キューレット、トロカール、生検パンチ、はさみ、外科用メス、摘出具、レーザー外科用メス、レーザー焼灼具、超音波凝固具、超音波凝結具、及びこれらの任意の組み合わせから選択される請求項22に記載のシステム。
- 前記機能要素は、一つ又は複数のブレード、クランプ、フック、一つ又は複数のジョー、エネルギー適用器具、及びこれらの任意の組み合わせから選択される請求項22又は23に記載のシステム。
- 前記エネルギー適用器具は、レーザー、超音波送信機、プラズマ源、極低温源、一つ又は複数の電極、及びこれらの任意の組み合わせから選択される請求項24に記載のシステム。
- 前記センサーは、光学センサー、赤外線検出器及び受信機、パルスオキシメータ、超音波プローブ、超音波ドップラープローブ、音響ドップラー速度計、レーザードップラー速度計、光音響センサー、磁気流量計、サーモグラフセンサー、レーダー、ソノグラフセンサー、磁気計、及びこれらの任意の組み合わせから選択される請求項22〜25のいずれか1項に記載のシステム。
- 前記構造アーチファクトは、手術野における血管の存在、血管の寸法、血管を通る血流の速度、血管配向、血管O2飽和血流;神経組織、尿路組織、及びこれらの任意の組み合わせを含む組織タイプ;呼吸器構造、消化器系構造、神経系構造、筋骨格系構造、循環構造、尿路系構造、肝臓、及びこれらの任意に組み合わせを含む構造、のうちの一つ又は複数から選択される請求項22〜26のいずれか1項に記載のシステム。
- 前記所定の閾値条件は、最大血流速度;最大血管径;神経組織、尿路組織、及びこれらの任意の組み合わせを含む組織タイプ;呼吸器構造、消化器系構造、神経系構造、筋骨格系構造、循環構造、尿路系構造、肝臓、及びこれらの任意の組み合わせを含む構造、のうちの一つ又は複数から選択される請求項22〜27のいずれか1項に記載のシステム。
- 前記警報表示は、視覚表示、聴覚表示、振動表示、外科器具の作動停止、及びこれらの任意の組み合わせ、のうちの一つ又は複数から選択される請求項22〜28のいずれか1項に記載のシステム。
- 患者の手術野内に位置する組織に対し外科手術を実行するためのシステムであって、
該システムは機器付き外科デバイスを備え、該機器付き外科デバイスは、
外科手術を実行する外科器具にして、コントローラに連動的に接続される機能要素を備える外科器具と、
手術野内の組織を連続的に監視するセンサーにして、外科器具に連動的に接続されるセンサーとを備え、
該システムはコンピューティングデバイスを備え、該コンピューティングデバイスは、 一つ又は複数のプロセッサと、
外科器具アプリケーションによりエンコードされたCRMとを備え、該外科器具アプリケーションは、一つ又は複数のプロセッサで実行可能な一つ又は複数のモジュールを備え、該モジュールは、
前記センサーから受信した一つ又は複数の出力を処理して、前記組織の一つ又は複数の特性を定義するある量の処理データを発生させるデータ後処理モジュールと、
前記量の処理データを分析して、前記組織内の一つ又は複数の構造アーチファクトを特徴付けるある量のアーチファクトデータを決定する構造アーチファクト検出モジュールと、
前記量のアーチファクトデータを評価し、前記量のアーチファクトデータが所定の閾値条件を超える場合に警報信号を発生させる警報信号モジュールと、
前記量の一つ又は複数の構造アーチファクトに応答して警報表示を発生させる警報表示モジュールと、
一つ又は複数のフォームを発生させるGUIモジュールにして、該一つ又は複数のフォームは、該システムに対する一つ又は複数の入力を受信し、該システムから一つ又は複数の出力を伝達するGUIモジュールとを備えるシステム。 - 前記外科器具は、捕捉器具、解剖器具、鉗子、クランプ、組織封止器具、クリップ適用具、持針器、骨パンチ、キューレット、トロカール、生検パンチ、はさみ、外科用メス、摘出具、レーザー外科用メス、レーザー焼灼具、超音波凝固具、超音波凝結具、及びこれらの任意の組み合わせから選択される請求項30に記載のシステム。
- 前記機能要素は、一つ又は複数のブレード、クランプ、フック、一つ又は複数ジョー、エネルギー適用器具、及びこれらの任意の組み合わせから選択される請求項30又は31に記載のシステム。
- 前記エネルギー適用器具は、レーザー、超音波送信機、プラズマ源、極低温源、一つ又は複数の電極、及びこれらの任意の組み合わせから選択される請求項32に記載のシステム。
- 前記センサーは、光学センサー、赤外線検出器及び受信機、パルスオキシメータ、超音波プローブ、超音波ドップラープローブ、音響ドップラー速度計、レーザードップラー速度計、光音響センサー、磁気流量計、サーモグラフセンサー、レーダー、ソノグラフセンサー、磁気計、及びこれらの任意の組み合わせから選択される請求項30〜33のいずれか1項に記載のシステム。
- 前記構造アーチファクトは、手術野における血管の存在、血管の寸法、血管を通る血流の速度、血管配向、血管O2飽和血流;神経組織、尿路組織、及びこれらの任意の組み合わせを含む組織タイプ;呼吸器構造、消化器系構造、神経系構造、筋骨格系構造、循環構造、尿路系構造、肝臓、及びこれらの任意に組み合わせを含む構造、のうちの一つ又は複数から選択される請求項30〜34のいずれか1項に記載のシステム。
- 前記所定の閾値条件は、最大血流速度;最大血管径;神経組織、尿路組織、及びこれらの任意の組み合わせを含む組織タイプ;呼吸器構造、消化器系構造、神経系構造、筋骨格系構造、循環構造、尿路系構造、肝臓、及びこれらの任意の組み合わせを含む構造、のうちの一つ又は複数から選択される請求項30〜35のいずれか1項に記載のシステム。
- 前記警報表示は、視覚表示、聴覚表示、振動表示、外科器具の作動停止、及びこれらの任意の組み合わせ、のうちの一つ又は複数から選択される請求項30〜36のいずれか1項に記載のシステム。
- 手術野内の組織に対し外科手術を実行する方法であって、
外科器具に連動的に取り付けられるセンサーを備える機器付き外科デバイスにより組織に近付き;
前記センサーを用いて前記組織内の構造アーチファクトを感知し;
構造アーチファクトが所定の閾値条件を超えた場合、前記センサーからインジケータへと警報信号を送信し;
警報信号に応答して前記インジケータを用いて警報表示を発生させる方法。 - 手術野内で組織に対し外科手術を実行する方法であって、
機器付き外科デバイスを準備する工程を含み、該機器付き外科デバイスは、
外科手術を実行する外科器具にして、コントローラに連動的に接続される機能要素を備える外科器具と、
手術野内で前記組織を連続的に監視するセンサーにして、外科器具に連動的に接続されるセンサーとを備え、
該方法は、
前記外科器具を手術野内の組織に隣接配置する工程と、
一つ又は複数の構造アーチファクトを検出するために前記センサーを用いて手術野内の組織を監視する工程と、
一つ又は複数の構造アーチファクトの一つ又は複数の特性が所定の条件を超えた場合に警報信号を発生させる工程と、
前記警報信号に応答して警報表示を発生させる工程とを含む方法。 - 前記外科器具は、捕捉器具、解剖器具、鉗子、クランプ、組織封止器具、クリップ適用具、持針器、骨パンチ、キューレット、トロカール、生検パンチ、はさみ、外科用メス、摘出具、レーザー外科用メス、レーザー焼灼具、超音波凝固具、超音波凝結具、及びこれらの任意の組み合わせから選択される請求項39に記載の方法。
- 前記機能要素は、一つ又は複数のブレード、クランプ、フック、一つ又は複数ジョー、エネルギー適用器具、及びこれらの任意の組み合わせから選択される請求項39又は40に記載の方法。
- 前記エネルギー適用器具は、レーザー、超音波送信機、プラズマ源、極低温源、一つ又は複数の電極、及びこれらの任意の組み合わせから選択される請求項41に記載の方法。
- 前記センサーは、光学センサー、赤外線検出器及び受信機、パルスオキシメータ、超音波プローブ、超音波ドップラープローブ、音響ドップラー速度計、レーザードップラー速度計、光音響センサー、磁気流量計、サーモグラフセンサー、レーダー、ソノグラフセンサー、磁気計、及びこれらの任意の組み合わせから選択される請求項39〜42のいずれか1項に記載の方法。
- 前記構造アーチファクトは、手術野における血管の存在、血管の寸法、血管を通る血流の速度、血管配向、血管O2飽和血流;神経組織、尿路組織、及びこれらの任意の組み合わせを含む組織タイプ;呼吸器構造、消化器系構造、神経系構造、筋骨格系構造、循環構造、尿路系構造、肝臓、及びこれらの任意に組み合わせを含む構造、のうちの一つ又は複数から選択される請求項39〜43のいずれか1項に記載の方法。
- 前記所定の閾値条件は、最大血流速度;最大血管径;神経組織、尿路組織、及びこれらの任意の組み合わせを含む組織タイプ;呼吸器構造、消化器系構造、神経系構造、筋骨格系構造、循環構造、尿路系構造、肝臓、及びこれらの任意の組み合わせを含む構造、のうちの一つ又は複数から選択される請求項39〜44のいずれか1項に記載の方法。
- 前記警報表示は、視覚表示、聴覚表示、振動表示、外科器具の作動停止、及びこれらの任意の組み合わせ、のうちの一つ又は複数から選択される請求項39〜45のいずれか1項に記載の方法。
- 腹腔鏡外科センサーであって、
光学送信機を備える第1ジョーと、
一端部がヒンジ機構係合にて第1ジョーに取り付けられる第2ジョーにして、光学受信機を備える第2ジョーとを備えるセンサー。 - 前記光学送信機は、約750nm〜約1400nmの範囲の波長の光を作り出す少なくとも一つの近赤外LEDを備える請求項47に記載のセンサー。
- 前記近赤外LEDは、約850nm〜約950nmの範囲の波長の光を作り出す請求項48に記載のセンサー。
- 前記光学受信機は、少なくとも一つの光センサーを備える請求項47〜49のいずれか1項に記載のセンサー。
- 前記光学受信機は、フォトダイオードアレイである請求項47〜50のいずれか1項に記載のセンサー。
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WO2013134411A1 (en) | 2013-09-12 |
EP2822484A1 (en) | 2015-01-14 |
US20150066000A1 (en) | 2015-03-05 |
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