JP4652004B2 - 内視鏡的粘膜切除装置 - Google Patents
内視鏡的粘膜切除装置 Download PDFInfo
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- JP4652004B2 JP4652004B2 JP2004282281A JP2004282281A JP4652004B2 JP 4652004 B2 JP4652004 B2 JP 4652004B2 JP 2004282281 A JP2004282281 A JP 2004282281A JP 2004282281 A JP2004282281 A JP 2004282281A JP 4652004 B2 JP4652004 B2 JP 4652004B2
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
- A61B10/0266—Pointed or sharp biopsy instruments means for severing sample
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
- A61B10/0283—Pointed or sharp biopsy instruments with vacuum aspiration, e.g. caused by retractable plunger or by connected syringe
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
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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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00269—Type of minimally invasive operation endoscopic mucosal resection EMR
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/30—Surgical pincettes without pivotal connections
- A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B2017/32004—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes having a laterally movable cutting member at its most distal end which remains within the contours of said end
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/32007—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with suction or vacuum means
-
- 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
- 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
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
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- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Pathology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Optics & Photonics (AREA)
- Radiology & Medical Imaging (AREA)
- Surgical Instruments (AREA)
- Endoscopes (AREA)
Description
(1)胃腸管から組織サンプルを採取する方法であって、
真空源を用意するステップと、
前記胃腸管に有孔組織ストッパーを配置するステップと、
前記胃腸管の前記有孔組織ストッパーに対して組織を吸引するステップと、
前記有孔組織ストッパーに対して吸引された前記組織から組織サンプルを切除するステップとを含むことを特徴とする方法。
(2)更に、前記組織ストッパーを第1の位置から第2の位置に変移させるステップを含むことを特徴とする実施態様(1)に記載の方法。
(3)前記組織ストッパーを変移させる前記ステップが、前記組織ストッパーを変形させるステップを含むことを特徴とする実施態様(2)に記載の方法。
(4)前記切除するステップが、高周波エネルギーを供給するステップを含むことを特徴とする実施態様(1)に記載の方法。
(5)更に、前記組織ストッパーの少なくとも一部に高周波極を設けるステップを含むことを特徴とする実施態様(4)に記載の方法。
(6)更に、前記組織ストッパーの内側に内視鏡を配置するステップを含むことを特徴とする実施態様(1)に記載の方法。
(7)医療装置であって、
内部を通る組織を受容するための側面開口を備えた外面を含む本体と、
組織を切断するためにエネルギーを受け取るように適合され、かつ前記側面開口を介して延在する組織を切断するために前記側面開口の長さを横断するように適合された、前記側面開口の内側に配置されたカッターと、
前記側面開口及び前記カッターの内側に配置された、前記側面開口を介して組織を吸引するために真空を伝える少なくとも1つの開口を有する組織ストッパーとを含むことを特徴とする医療装置。
(8)前記組織ストッパーが、真空を伝えるための複数の貫通開口を含むことを特徴とする実施態様(7)に記載の医療装置。
(9)前記組織ストッパーが変形可能であることを特徴とする実施態様(7)に記載の医療装置。
(10)前記組織ストッパーが導電部分を含むことを特徴とする実施態様(7)に記載の医療装置。
(11)前記組織ストッパーが高周波回路の1つの極を含むことを特徴とする実施態様(7)に記載の医療装置。
(12)前記本体が内視鏡を受容できる大きさの通路を含むことを特徴とする実施態様(7)に記載の医療装置。
(13)前記カッターが、前記側面開口の両側に配設されたスロットにスライド可能に係合するように支持された切断要素を含むことを特徴とする実施態様(7)に記載の医療装置。
(14)更に、前記切断要素を受容するための少なくとも1つの剪断スロットを含むことを特徴とする実施態様(7)に記載の医療装置。
(15)更に、針ガイドを含むことを特徴とする実施態様(7)に記載の医療装置。
(16)医療装置であって、
内部を通る組織を受容するための側面開口を備えた外側を向いた外面と、
組織を切断するために高周波エネルギーを受け取るように適合されたカッターと、
前記側面開口の内側に配設された、前記側面開口を介して組織を吸引するために真空を伝える少なくとも1つの開口を有する組織ストッパーとを含むことを特徴とする医療装置。
(17)前記医療装置が、内部を通過可能に内視鏡を受容するように適合されていることを特徴とする実施態様(16)に記載の医療装置。
(18)前記医療装置が、内部を通過できるように内視鏡を受容するように適合されていることを特徴とする実施態様(17)に記載の医療装置。
(19)前記医療装置が、前記組織ストッパーの内側に内視鏡を受容できるように適合されていることを特徴とする実施態様(16)に記載の医療装置。
22、82 内視鏡の先端部
24、84 内視鏡
26 切断支持体
28、88 円錐部材
30 開口した先端部
32、112 処置用通路
34、94 組織受容用の開口
36、96 組織のためのストッパープレート
38、98 支持構造
40、100 ガイド用のスロット
42、102 絶縁性のスリーブ
44、104 切断要素
46 スライドブロック
48 接地線
50、110 剪断スロット
52 代替の切断要素
54 尖端部分
56、116 シース
58、118 注入針
86 オーバーチューブ
90 開口した外側端部
92 管状部分
97 導電性のグリッド
99 グリッド開口
114 組織
200 電気焼灼発生器
201 真空ポンプ
203 接地パッド
204 吸気路
205 高周波エネルギー経路
Claims (12)
- 医療装置であって、
側面開口を備えた外面を含む本体であって、前記側面開口は、この側面開口を通して組織を受容するためのものである、本体と、
組織を切断するためのエネルギーを受け取るように適合され、かつ前記側面開口を介して延在する組織を切断するために前記側面開口の長さを横断するように適合された、前記側面開口の内側に配置されたカッターと、
前記側面開口及び前記カッターの内側に配置された、前記側面開口を介して組織を吸引するために真空を伝える少なくとも1つの貫通開口を有する、変形可能な組織ストッパーと、
を含む、医療装置。 - 前記組織ストッパーが、真空を伝えるための複数の貫通開口を含む、請求項1に記載の医療装置。
- 前記組織ストッパーが、導電部分を含む、請求項1または2に記載の医療装置。
- 前記組織ストッパーが、高周波回路の1つの極を含む、請求項1〜3のいずれかに記載の医療装置。
- 前記本体が、内視鏡を受容できる大きさの通路を含む、請求項1〜4のいずれかに記載の医療装置。
- 前記カッターが、前記側面開口の両側に配設されたスロットにスライド可能に係合するように支持された切断要素を含む、請求項1〜5のいずれかに記載の医療装置。
- 前記側面開口の両側に配設されたスロットは、前記切断要素が前記側面開口内をスライドできるよう互いに向って開口している、請求項6に記載の医療装置。
- 前記スロットは、前記切断要素の両端に取り付けられた電線をガイドするように適合されている、請求項6または7に記載の医療装置。
- 更に、前記切断要素を受容するための少なくとも1つの剪断スロットを含む、請求項1〜8のいずれかに記載の医療装置。
- 更に、針ガイドを含む、請求項1〜9のいずれかに記載の医療装置。
- 前記カッターは、組織を切断するための高周波エネルギーを受け取るように適合されている、請求項1〜10のいずれかに記載の医療装置。
- 前記医療装置が、前記組織ストッパーの内側に内視鏡を受容できるように適合されている、請求項5に記載の医療装置。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/673,954 US7186252B2 (en) | 2003-09-29 | 2003-09-29 | Endoscopic mucosal resection device and method of use |
Publications (2)
Publication Number | Publication Date |
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JP2005103268A JP2005103268A (ja) | 2005-04-21 |
JP4652004B2 true JP4652004B2 (ja) | 2011-03-16 |
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Application Number | Title | Priority Date | Filing Date |
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JP2004282281A Expired - Fee Related JP4652004B2 (ja) | 2003-09-29 | 2004-09-28 | 内視鏡的粘膜切除装置 |
Country Status (8)
Country | Link |
---|---|
US (1) | US7186252B2 (ja) |
EP (1) | EP1518498B1 (ja) |
JP (1) | JP4652004B2 (ja) |
KR (1) | KR20050031446A (ja) |
CN (1) | CN100459942C (ja) |
AU (1) | AU2004214626A1 (ja) |
CA (1) | CA2482740C (ja) |
DE (1) | DE602004010756T2 (ja) |
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KR20050031446A (ko) | 2005-04-06 |
JP2005103268A (ja) | 2005-04-21 |
EP1518498B1 (en) | 2007-12-19 |
US20050070890A1 (en) | 2005-03-31 |
CA2482740C (en) | 2013-01-08 |
US7186252B2 (en) | 2007-03-06 |
AU2004214626A1 (en) | 2005-04-14 |
DE602004010756T2 (de) | 2008-12-11 |
EP1518498A1 (en) | 2005-03-30 |
DE602004010756D1 (de) | 2008-01-31 |
CN1628615A (zh) | 2005-06-22 |
CA2482740A1 (en) | 2005-03-29 |
CN100459942C (zh) | 2009-02-11 |
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