JP2017516620A - 骨盤状態の治療のための方法およびデバイス - Google Patents
骨盤状態の治療のための方法およびデバイス 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
- 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
- A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/0507—Electrodes for the digestive system
- A61N1/0514—Electrodes for the urinary tract
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36007—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of urogenital or gastrointestinal organs, e.g. for incontinence control
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- 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
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
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- A—HUMAN NECESSITIES
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- 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
- A61B2018/00273—Anchoring means for temporary attachment of a device to tissue
- A61B2018/00291—Anchoring means for temporary attachment of a device to tissue using suction
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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
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00434—Neural system
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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
- A61B2018/00505—Urinary tract
- A61B2018/00523—Treatment of incontinence
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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
- A61B2018/00571—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
- A61B2018/00773—Sensed parameters
- A61B2018/00791—Temperature
- A61B2018/00815—Temperature measured by a thermistor
-
- 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
-
- 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
- A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
-
- 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
- A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
-
- 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
- A61B2018/1475—Electrodes retractable in or deployable from a housing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/002—Irrigation
Abstract
Description
本出願は、米国仮出願番号第62/002、742号(出願日:2014年5月23日、名称「Method And Device For Treating Pelvic Conditions」)の利益および優先権を主張する。同出願は、米国特許出願シリアル番号第14,030,869号(出願日:2013年9月18日、名称「骨盤神経組織を調整するための装置および方法」、米国特許出願番号第14/285,627号(出願日:2014年5月22日、名称「骨盤神経組織を調整するための装置および方法」、米国特許出願番号第14/030,905号(出願日:2013年9月18日、名称「膀胱機能を調整するための装置および方法」、米国仮特許出願第61,935,753号(出願日:2014年2月4日、名称「求心性神経シグナルにより引き起こされる症状を治療するための装置および方法」に関連する。本明細書中、全文献の全ては、参照により本開示に含まれる。
尿失禁(UI)とは、尿が無意識のうちに漏れることである。尿失禁にはいくつかの種類があり、例えば、切迫性尿失禁(UUI)および緊張性尿失禁(SUI)がある。切迫性尿失禁とは、排尿切迫感を突然感じているときに失禁することである。緊張性尿失禁は、典型的には女性に多く、身体活動、運動、咳、くしゃみ、笑い、持ち上げなどに起因して腹圧が上昇したときに発生する失禁である。混合型尿失禁は、SUIおよびUUIの属性の組み合わせである。
本発明は、予見されるかされないかに依らず多様な医療手術および治療を行うように構成された装置および方法に関する。非限定的な例示目的のため、本発明の装置および方法は、膀胱機能の調節のために非粘膜標的組織(または組織の標的容積)に対する治療法を提供することに適している。一例において、例えば、膀胱壁の三角部領域の内部またはその近隣に配置された求心性神経といった膀胱の選択された部位にエネルギーを送達して除神経し、膀胱機能の調節とを行うことにより、切迫感、失禁、頻数、夜間頻尿、膀胱容量または痛みのうち少なくとも1つの軽減を可能にする。
図面の簡単な説明
ここで、添付図面を参照して、本発明の特定の実施形態について説明する。しかし、本発明は、多数の異なる形態で具現化可能であり、本明細書中に記載される実施形態に限定されるものとして解釈されるべきではなく、これらの実施形態は、本開示が網羅的かつ完全なものとなるように記載されるものであり、本発明の範囲を当業者に詳細に伝達するであろう。添付図面中に示される実施形態の詳細な説明において用いられる用語は、本発明を制限することを意図していない。図面中、類似の参照符号は、類似の要素を指す。
Claims (20)
- 細長形状の器具であって、
近位端のハンドルアセンブリと、
遠位端の吸引ヘッドと、
前記ハンドルアセンブリと前記吸引ヘッドとの間の細長シャフト部位であって、前記細長シャフト部位は、少なくとも1つのカニューレチャンネル、吸引チャンネルおよびスコープチャンネルを含む、細長シャフト部位と、
前記少なくとも1つのカニューレチャンネルのうち1つとスライド可能に関連付けられた少なくとも1つの電極セットであって、前記少なくとも1つの電極セットは、電極およびカニューレを含み、第1の位置と第2の位置との間でスライド可能であり、前記第1の位置において、前記カニューレの遠位端は、前記関連付けられたカニューレチャンネル内に収容され、前記第2の位置において、前記カニューレの前記遠位端は、前記吸引ヘッドの近くの前記関連付けられたカニューレチャンネルの前記遠位端から延びる、少なくとも1つの電極セットと、
を含む、細長形状の器具。 - 前記吸引ヘッドおよび前記細長シャフト部位は、ヒト患者の尿道に挿入されるようなサイズおよび形状にされる、請求項1の細長形状の器具。
- スライド可能に前記スコープチャンネルと関連付けられたスコープをさらに含む、請求項1の細長形状の器具。
- 前記スコープチャンネルの遠位端は、前記吸引ヘッドの吸引面の反対側の前記吸引ヘッドの側部に配置される、請求項1の細長形状の器具。
- 前記吸引ヘッドは、吸引された場合に組織を保持するように配置された複数の吸引アパチャを含む、請求項1の細長形状の器具。
- 前記吸引ヘッドは、平坦面および角度付き面をさらに含み、前記面はそれぞれ、前記複数の吸引アパチャのうち少なくとも1つを規定する、請求項5の細長形状の器具。
- 前記ハンドルアセンブリは、スコープを受容しかつ操作するような形状にされたスライド機構を含む、請求項1の細長形状の器具。
- 前記スライド機構は、スコープ上のフィーチャを受容する切り欠きを含み、前記切り欠きは、前記フィーチャが前記切り欠き内にあるとき、前記スコープの角度方向を前記器具に対して固定する、請求項7の細長形状の器具。
- 前記スライド機構は、第1の位置と第2の位置との間でスライド可能である、請求項7の細長形状の器具。
- 身体の空洞へ挿入される焼灼器具であって、
少なくとも1つのカニューレチャンネル、スコープチャンネルおよび吸引チャンネルを含む細長シャフトと、
前記吸引チャンネルの遠位端において吸引面を規定する吸引ヘッドと、
前記少なくとも1つのカニューレチャンネルのうち1つとスライド可能に関連付けられた少なくとも1つの電極セットであって、前記少なくとも1つの電極セットは、電極およびカニューレを含み、第1の位置と第2の位置との間でスライド可能であり、前記第1の位置において、前記カニューレの遠位端は、前記関連付けられたカニューレチャンネル内に収容され、前記第2の位置において、前記カニューレの前記遠位端は、前記関連付けられたカニューレチャンネルの前記遠位端から延び、前記スコープチャンネルは、非ゼロ角度αにおいて前記吸引面へ延びる、少なくとも1つの電極セットと、
を含む、焼灼器具。 - 前記スコープチャンネルおよび前記カニューレチャンネルは、スコープを前記スコープチャンネルの遠位開口部から前進させた場合に、前記角度αが前記スコープと前記吸引面との間の分離を増加させるように配置される、請求項10の焼灼器具。
- 前記角度αは1〜20度である、請求項10の焼灼器具。
- 前記角度αは5〜15度である、請求項10の焼灼器具。
- 近位端においてハンドルをさらに含む、請求項10の焼灼器具。
- 前記吸引ヘッドは、吸引された場合に組織を保持するように配置された複数の吸引アパチャを含む、請求項10の焼灼器具。
- 前記吸引ヘッドは、平坦面および角度付き面をさらに含み、前記各面はそれぞれ、前記複数の吸引アパチャのうち少なくとも1つを規定する、請求項15の焼灼器具。
- 身体の空洞へ挿入される焼灼器具であって、
前記少なくとも1つのカニューレチャンネルのうち1つとスライド可能に関連付けられた少なくとも1つの電極セットであって、前記少なくとも1つの電極セットは、電極およびカニューレを含み、第1の位置と第2の位置との間でスライド可能であり、前記第1の位置において、前記カニューレの遠位端は、前記関連付けられたカニューレチャンネル内に収容され、前記第2の位置において、前記カニューレの前記遠位端は、前記関連付けられたカニューレチャンネルの前記遠位端から延びる、少なくとも1つの電極セットと、
組織と係合する遠位ヘッドと、
前記遠位ヘッドと関連付けられた位置決めフィーチャであって、前記位置決めフィーチャは、前記スコープチャンネルを通じて配置されたスコープを介して見られるようにして前記遠位ヘッドと解剖学的特徴との間の視覚的参照を容易とする、位置決めフィーチャと、
を含む、焼灼器具。 - 前記位置決めフィーチャは、前記遠位ヘッドの遠位端から延びる輪を含む、請求項17の焼灼器具。
- 前記輪は、膀胱の口上に配置された場合に、前記口が前記輪を通じて目視できるようなサイズにされる、請求項18の焼灼器具。
- 前記位置決めフィーチャおよび前記電極セットは、前記位置決めフィーチャが膀胱口と整合された場合に、前記電極セットから延びる電極が前記口の近位の組織に進入するが口組織には進入しないように、構成および配置される、請求項17の焼灼器具。
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US201462002742P | 2014-05-23 | 2014-05-23 | |
US62/002,742 | 2014-05-23 | ||
PCT/US2015/032298 WO2015179837A1 (en) | 2014-05-23 | 2015-05-22 | Methods and devices for treating pelvic conditions |
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JP2017516620A true JP2017516620A (ja) | 2017-06-22 |
JP2017516620A5 JP2017516620A5 (ja) | 2018-06-21 |
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US (4) | US10058381B2 (ja) |
EP (1) | EP3145427A4 (ja) |
JP (1) | JP2017516620A (ja) |
CN (1) | CN106999242A (ja) |
AU (1) | AU2015263874B2 (ja) |
CA (1) | CA2949962A1 (ja) |
WO (1) | WO2015179837A1 (ja) |
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2019
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Cited By (5)
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CN107582235A (zh) * | 2016-07-07 | 2018-01-16 | 维纳斯概念有限公司 | 用于增强粘膜组织复原的美容设备 |
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JP2022502104A (ja) * | 2018-09-05 | 2022-01-11 | 山東冠龍医療用品有限公司 | 多経路作業カニューレ |
JP7145316B2 (ja) | 2018-09-05 | 2022-09-30 | 山東冠龍医療用品有限公司 | 多経路作業カニューレ |
KR102599677B1 (ko) * | 2018-09-05 | 2023-11-07 | 드래곤 크라운 메디칼 컴퍼니 리미티드 | 멀티 채널 작업 슬리브관 |
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AU2015263874A1 (en) | 2016-12-15 |
WO2015179837A1 (en) | 2015-11-26 |
AU2015263874B2 (en) | 2020-01-30 |
EP3145427A1 (en) | 2017-03-29 |
EP3145427A4 (en) | 2018-01-24 |
US10058381B2 (en) | 2018-08-28 |
US10548662B2 (en) | 2020-02-04 |
US11529189B2 (en) | 2022-12-20 |
US20230070237A1 (en) | 2023-03-09 |
US20180360530A1 (en) | 2018-12-20 |
US20200138511A1 (en) | 2020-05-07 |
CA2949962A1 (en) | 2015-11-26 |
CN106999242A (zh) | 2017-08-01 |
US20150335381A1 (en) | 2015-11-26 |
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