JP4588977B2 - 新生物を治療するアブレーション液を供給するための装置 - Google Patents
新生物を治療するアブレーション液を供給するための装置 Download PDFInfo
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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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
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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
- A61B2090/3937—Visible markers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0082—Catheter tip comprising a tool
- A61M2025/0096—Catheter tip comprising a tool being laterally outward extensions or tools, e.g. hooks or fibres
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
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Description
この出願は、2001年11月7日に出願された仮特許出願第60/348,301号、および2001年2月28日出願の仮特許出願第60/272,119号に由来する優先権を主張するものである。これら出願の全体の内容を、本明細書の一部として本願に援用する。
本発明は、病巣を治療するための外科用装置に関し、特に、病巣をアブレートする酢酸等のアブレーション液を供給する装置に関する。
肝細胞性癌を治療する現在の一つの方法は、高周波エネルギー形態の電気外科用エネルギーを使用することである。一連の電極を悪性腫瘍に配置し、発電機を駆動してエネルギーを電極に印加し、該電極は組織を加熱して腫瘍を破壊する。このような装置の一例は、RITAメディカルシステムズ社が販売しているものであり、該装置は種々の構成で提供される電極アレイを有し、これら電極はそれらを拘束する管から外側に湾曲している。しかし、RFエネルギーを印加することは、癌組織をアブレートするために常に充分な訳ではないことが文献に示されている。従って、患者は、病巣が充分にアブレートされるまで追加のRFエネルギー照射を受けるために、繰返し医者の所に戻らなければならない。これは、処置の費用が嵩むだけでなく、治療が長引いて頻繁な通院を特徴とする患者に悪い精神的影響を与える可能性がある。臨床的欠点に加えて、RFエネルギーの利用は資本を要する装置、即ち、電気外科用エネルギーを印加および制御するためのRF発電機が必要とされるので、高価である可能性がある。
本出願の出願人と共通の出願人に譲渡された、2001年2月28日の出願になる同時継続の仮出願第60/272,119号は、エタノール、酢酸、または他のアブレーション液を供給するための器具を開示しており、これは上記で述べた多回数の針穿刺および限定されたアブレーション領域を有利に回避する。この出願を、本明細書の一部として本願に援用する。この仮出願第60/272,119号に開示された器具は、大きな腫瘍をアブレートするための大きな治療領域を提供し、多回数の針穿刺を回避し、治療に必要な時間を減少し、外科処置を単純化する。加えて、該方法はより均一な治療領域を提供し、また同じ供給針を異なる大きさの病巣のために適合することができるように、治療領域を変化させる能力を提供する。
好ましくは、内部管70は金属で構成され、内部管70の回転を阻止するために、ポケット43に受け入れられる平らな(スエージ加工された)領域を有する。内部管70は、その中を通って延びるルーメンを有しており、その近位端において、好ましくは、摩擦嵌合により管90に連結されており、管90のルーメンとの液体流通を提供する。枝管(液体供給部材)80は、好ましくは、かしめ(クリンピング)、または、樹脂ポッティングによって内部管70の遠位端に取付けられており、内部管70の軸線方向の移動が枝管を軸線方向に移動させるようになっている。この結合部位には、枝管80の接続部をシールして液体漏れを防止するために、更に接着剤または半田が使用される。内部管70のスエージ加工された領域72(図7Bに示されている)は、枝管80のための棚74を形成する。内部管70は、アブレーション液を供給するために、枝管の中のルーメンと液体流通している。従って、可撓性プラスチック管90(図3)は、支持管70と液体流通して該支持管に液体を供給し、次いで、該支持管は枝管80に液体を供給する。プランジャ半型36は、上記のようにプランジャ半型34と同じであり、内部管70およびプラスチック管90を収容するために、プランジャ半型34のポケットおよびリブ(例えば図3のポケット40およびリブ48)と協働する同一のポケットおよびリブを有する。
針(細長い部材)50は、プランジャ半型36のリブおよび溝44b,45bとそれぞれ協働する、プランジャ半型34のリブ44aおよび溝45aの中に設置されており、開口部25aを通して手術部位へのアクセスを可能にするのに十分な距離だけ、ハウジング12から外側に向けて、ハウジング12の遠位方向に延びている。針50は、その中に内部管70および枝管80を摺動可能に収容するように寸法決めされ、構成されたルーメンを有している。
この第一の展開位置において、第一のプランジャ半型14のインジケータドット38が窓26の近位部分に現れ、枝管80a〜80cがそれらの第一の位置に展開されたことの視覚的表示をユーザに提供する。同様に、プランジャ半型36のインジケータドットがハウジング半型16の窓に現れる。
なお、インジケータドットは窓26の中央部分にあり、プランジャ30が更に前進されて、枝管80を更に第二の展開位置へ移動させたことを示す。この位置において、枝管80a〜80cは、針5030dの長手方向軸線に対して更に大きな角度で、且つ直線状の枝管80dに対してより大きな角度で延びる。従って、酢酸が枝管80a〜80cを通して注入されるときには、図14Cの球よりも大きな空間を占める四つの交差する球体が形成され、これはより大きな治療領域を形成する。
加えて、装置300には、図25の皮膚パッチと整列させるための配向矢印、および/または図23および図24の配向構造を設けることができる。
Claims (11)
- 病巣を治療するための液体を供給する外科用装置において、
遠位チップ、および、側壁に形成された複数の開口部を有する細長い部材を備え、前記複数の開口部は、前記細長い部材の外面において周方向に離間して配置されており、
さらに、前記細長い部材に移動可能に配置された複数の液体供給部材を備え、前記病巣に液体を供給するために、各々の液体供給部材が、一つのルーメン、および、前記ルーメンと連通した少なくとも一つの開口部を有しており、
さらに、前記液体供給部材の近位端で前記液体供給部材を保持し、かつ、前記液体供給部材と流通する内部管と、
前記内部管を保持するように構成された管保持プレートと、
前記管保持プレートから遠位方向に軸方向に間隔を隔てられてハウジング内に配置され、かつ、前記細長い部材を保持するように構成された針保持プレートとを備え、
前記複数の液体供給部材が前記細長い部材の側壁に形成された開口部の角度間隔と異なる角度間隔になるように、前記管保持プレートと前記針保持プレートは、互いに角度をなして組み立てられており、
さらに、前記液体供給部材に動作可能に結合されたアクチュエータを備え、前記アクチュエータは、前記細長い部材内の後退位置から、前記側壁のそれぞれの開口部を貫通し、かつ、前記細長い部材に対して半径方向に延びる第一の展開位置に、前記液体供給部材を移動させるための第一の位置へと駆動可能であり、かつ、前記アクチュエータは、前記第一の展開位置から前記細長い部材に対して更に半径方向に延びた第二の展開位置に、前記液体供給部材を移動させるための第二の位置へと駆動可能であり、前記液体供給部材は、保持部材によって前記第一の展開位置、および、前記第二の展開位置に保持されるようになっており、
前記アクチュエータは、前記複数の液体供給部材を、その後退位置、前記第一の展開位置、および、前記第二の展開位置の間で移動させるように軸方向に摺動可能であり、
前記保持部材は、前記装置の内部に配置されている、
ことを特徴とする外科用装置。 - 請求項1に記載の装置において、前記液体供給部材は、前記開口部を通して展開可能であることを特徴とする装置。
- 請求項2に記載の装置において、前記細長い部材の遠位チップは、組織を貫通するように構成された鋭利なチップであることを特徴とする装置。
- 請求項2に記載の装置において、前記保持部材は、前記アクチュエータに装着されたタブを含んでおり、前記タブは、ハウジング内に形成された複数の凹部の一つと係合するようになっており、前記アクチュエータは、前記ハウジング内に摺動可能に収容されるようになっており、前記装置は、更に、前記細長い部材の中に摺動可能に装着された支持管を備え、前記支持管に前記複数の液体供給部材が連結されることを特徴とする装置。
- 請求項2に記載の装置において、前記液体供給部材の遠位端は、前記第一の展開位置、および、前記第二の展開位置において、前記細長い部材の遠位チップから遠位方向に延びないことを特徴とする装置。
- 請求項2に記載の装置において、前記複数の液体供給部材の一つは、前記細長い部材の長手方向軸線と実質的に整列した展開位置に延びることが可能であり、前記長手方向軸線に対して或る角度で半径方向に延びることが可能な他の前記液体供給部材の直径よりも小さい直径を有することを特徴とする装置。
- 請求項2に記載の装置であって、更に、前記複数の液体供給部材の位置を表示するための視認可能なインジケータを備えることを特徴とする装置。
- 請求項2に記載の装置において、前記液体供給部材における少なくとも一つの開口部は前記部材の側壁に形成され、前記側壁には複数の開口部が含まれることを特徴とする装置。
- 請求項7に記載の装置において、前記視認可能なインジケータは、前記液体供給部材が前記後退位置、前記第一の展開位置または前記第二の展開位置に展開されたかどうかを表示するために、前記ハウジングの窓を通して見えるインジケータを備えることを特徴とする装置。
- 請求項7に記載の装置において、前記視認可能なインジケータは、前記装置の近位端に、前記液体供給部材の半径方向での配向を表示するためのマーキングを含み、前記マーキングは、前記装置が貫通する皮膚装着パッチと整列可能であることを特徴とする装置。
- 請求項2に記載の装置であって、更に、前記細長い部材に摺動可能に装着された深さインジケータを備えることを特徴とする装置。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US27211901P | 2001-02-28 | 2001-02-28 | |
US34830101P | 2001-11-07 | 2001-11-07 | |
PCT/US2002/005462 WO2002067796A1 (en) | 2001-02-28 | 2002-02-22 | Apparatus for delivering ablation fluid to treat neoplasms |
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JP2005506101A JP2005506101A (ja) | 2005-03-03 |
JP2005506101A5 JP2005506101A5 (ja) | 2005-12-22 |
JP4588977B2 true JP4588977B2 (ja) | 2010-12-01 |
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JP2002567171A Expired - Fee Related JP4588977B2 (ja) | 2001-02-28 | 2002-02-22 | 新生物を治療するアブレーション液を供給するための装置 |
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US (3) | US6905480B2 (ja) |
EP (1) | EP1370186B1 (ja) |
JP (1) | JP4588977B2 (ja) |
CN (1) | CN100336489C (ja) |
AU (1) | AU2002250170B2 (ja) |
CA (1) | CA2435416C (ja) |
DE (1) | DE60208780T2 (ja) |
ES (1) | ES2257539T3 (ja) |
WO (1) | WO2002067796A1 (ja) |
Cited By (1)
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WO2022202314A1 (ja) | 2021-03-23 | 2022-09-29 | テルモ株式会社 | 医療器具 |
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2002
- 2002-02-22 DE DE60208780T patent/DE60208780T2/de not_active Expired - Lifetime
- 2002-02-22 CA CA2435416A patent/CA2435416C/en not_active Expired - Fee Related
- 2002-02-22 AU AU2002250170A patent/AU2002250170B2/en not_active Ceased
- 2002-02-22 ES ES02719064T patent/ES2257539T3/es not_active Expired - Lifetime
- 2002-02-22 US US10/081,695 patent/US6905480B2/en not_active Expired - Lifetime
- 2002-02-22 EP EP02719064A patent/EP1370186B1/en not_active Expired - Fee Related
- 2002-02-22 JP JP2002567171A patent/JP4588977B2/ja not_active Expired - Fee Related
- 2002-02-22 CN CNB028056418A patent/CN100336489C/zh not_active Expired - Fee Related
- 2002-02-22 WO PCT/US2002/005462 patent/WO2002067796A1/en active IP Right Grant
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2022202314A1 (ja) | 2021-03-23 | 2022-09-29 | テルモ株式会社 | 医療器具 |
Also Published As
Publication number | Publication date |
---|---|
ES2257539T3 (es) | 2006-08-01 |
DE60208780D1 (de) | 2006-04-06 |
US20040204683A1 (en) | 2004-10-14 |
JP2005506101A (ja) | 2005-03-03 |
CN1494399A (zh) | 2004-05-05 |
US6905480B2 (en) | 2005-06-14 |
WO2002067796A1 (en) | 2002-09-06 |
EP1370186B1 (en) | 2006-01-18 |
US7331947B2 (en) | 2008-02-19 |
DE60208780T2 (de) | 2006-08-10 |
CA2435416A1 (en) | 2002-09-06 |
US20040147902A1 (en) | 2004-07-29 |
US7344518B2 (en) | 2008-03-18 |
CN100336489C (zh) | 2007-09-12 |
EP1370186A1 (en) | 2003-12-17 |
CA2435416C (en) | 2012-11-13 |
AU2002250170B2 (en) | 2006-08-10 |
US20020151867A1 (en) | 2002-10-17 |
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