JP4966195B2 - 光ファイバー画像化カテーテル - Google Patents
光ファイバー画像化カテーテル Download PDFInfo
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- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
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- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
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- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00096—Optical elements
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- A61B1/00103—Constructional details of the endoscope body designed for single use
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- A61B1/00119—Tubes or pipes in or with an endoscope
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- A61B1/00131—Accessories for endoscopes
- A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
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- 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
- A61B1/00163—Optical arrangements
- A61B1/00165—Optical arrangements with light-conductive means, e.g. fibre optics
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- A61B1/0052—Constructional details of control elements, e.g. handles
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- A61B1/012—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 characterised by internal passages or accessories therefor
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- A61B1/012—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 characterised by internal passages or accessories therefor
- A61B1/018—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 characterised by internal passages or accessories therefor for receiving instruments
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- A61B1/05—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 combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
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- A61B1/0607—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 with illuminating arrangements for annular illumination
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- A61B1/07—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 with illuminating arrangements using light-conductive means, e.g. optical fibres
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- A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
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- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3937—Visible markers
Description
本発明は、医療用デバイスに関し、特に、造影能を有する光ファイバーカテーテルに関する。
内視鏡は、患者の内部体腔の像を提供し得るための、造影能を有する外科手術用機器の構成要素である。消化(GI)管または他の内部体腔において行われる最小侵襲性の外科手術手順は、内視鏡の助けにより達成される。内視鏡は、他の医療用カテーテル/器具が通過し得る1つ以上の作業チャネルを備える。代表的には、内視鏡は、体腔内の目的の領域に到達するために使用され、その後、外科手術用カテーテルのような別の器具が、内視鏡の作業チャネルを通って延ばされて、いくつかの所望の手順を行う。しかし、内視鏡は、代表的には、通過しなければならない体腔または身体の管腔に対して比較的大きい直径を有する。
本発明は、単一の光ファイバーまたは光ファイバーの束を使用する、造影能を有するより小さな直径のデバイスである。一実施形態において、造影能を有する光ファイバーまたは光ファイバーの束は、操縦可能なカテーテルの管腔を通って軸方向に受容される。このようなカテーテルは、代表的には、単一のステアリングケーブルを備え、この遠位端部は、カテーテルの遠位端部に取り付けられている。ステアリングケーブルの近位端部を操作することによって、外科医は、カテーテルの遠位端部を曲げ、それによって、カテーテルを操縦することができる。しかし、単一のステアリングケーブルを有する操縦可能なカテーテルは、一方向にのみ曲がり得る。従って、三次元空間においてあらゆる所望の方向にカテーテルを曲げるために、カテーテルは、一方向の屈曲が、所望の方向に向くように、軸方向に回転されなければならない。その結果、光ファイバーを組み込んだ操縦可能なカテーテルは、ファイバーをねじったり損傷したりする可能性のある、度重なるトルクに供される。
図1〜図3は、本発明に従って形成した、操縦可能な画像化カテーテル10を示す。カテーテル10は、近位端部14と遠位端部16とを有する細長のカテーテル管12を備える。カテーテル10は、その唯一の機能が造影である、造影専用カテーテルであっても、造影機能に加えて、診断/治療機能も有する、任意の診断/治療用カテーテル(例えば、バルーンカテーテル、ステント送達カテーテル、括約筋切開カテーテルなど)であってもよい。図2、図2A、図2Bおよび図3を具体的に参照すると、4本のステアリングケーブル18が、カテーテル管12の周囲に、等間隔で配置されており、そして、このケーブル18は、近位端部14から遠位端部16までを実質的にカテーテル管12の長さに沿って延びている。カテーテル管12のステアリングケーブル18は、カテーテル管の遠位端部16の動きを制御する。カテーテル10はまた、近位端部22と遠位端部24とを有する光ファイバーケーブル20を備え、このケーブル20は、少なくとも部分的に、カテーテル管12の長さに沿って延びている。この目的のために、図1に示されるような、例示される実施形態は、カテーテル管12および光ファイバーケーブル20を受容し、そして組み合せるように構成されたブレークアウトユニット21を備える。明らかなように、この実施形態においては、カテーテル12の外壁は、開口部19を備え、この開口部19を通って、光ファイバーケーブル20がカテーテル管12内に入り、そして、カテーテル管12を通って、カテーテル管12内を延びる。光ファイバーケーブル20は、近位端部22から遠位端部24へと照射光を伝達し、そしてまた、遠位端部24から近位端部22へと像を伝達するように構成される。図2に最も良く示されるような、例示される実施形態において、光ファイバーケーブル20は、1以上の中心に延びる干渉性造影ファイバー(coherent imaging fiber)20aと、この1以上の造影ファイバー20aをほぼ取り囲む、1以上の周囲に延びる照射ファイバー20b(干渉性でなくてもよい)とを備える。さらに、対物レンズ25が、1以上の造影ファイバー20aの遠位端部に取り付けられている。
Claims (25)
- 操縦可能な画像化カテーテルであって、以下:
近位端部と遠位端部とを有する細長のカテーテル管;
少なくとも1本のステアリングケーブルであって、実質的に該カテーテル管の該近位端部から該遠位端部までを該カテーテル管に沿って延び、該カテーテル管の遠位端部の動きを制御する、少なくとも1本のステアリングケーブル;および
近位端部と遠位端部とを有する光ファイバーケーブルであって、該光ファイバーケーブルは、実質的に該カテーテル管の該近位端部から該遠位端部までを該カテーテル管に沿って延び、そして、該遠位端部から該近位端部まで像を伝達する間に、該近位端部から該遠位端部まで照射光を伝達する、光ファイバーケーブルを備え、
該操縦可能な画像化カテーテルの直径は、約1mmと約4.5mmとの間であり;
該光ファイバーケーブルは、レンズおよび1つ以上の造影ファイバーを備え;そして
該1つ以上の造影ファイバーの最も外側の半径が該レンズの最も外側の半径より大きい、画像化カテーテル。 - さらに、前記光ファイバーケーブルの遠位端部に対物レンズを備える、請求項1に記載のカテーテル。
- 4本のステアリングケーブルを、前記カテーテル管の周囲に沿ってほぼ等角に備える、請求項1に記載のカテーテル。
- 前記カテーテル管が、該管を通って延びる複数の管腔を規定し、該管腔のうちの1つが、前記光ファイバーケーブルを受容する、請求項1に記載のカテーテル。
- 前記管腔のうちの1つが、測定プローブを受容する、請求項4に記載のカテーテル。
- 前記管腔のうちの1つが、切断デバイスを受容する、請求項4に記載のカテーテル。
- 前記カテーテル管が、前記光ファイバーケーブルから分離可能なように構成される、請求項1に記載のカテーテル。
- 前記カテーテル管が、前記近位端部付近よりも、前記遠位端部付近で、より大きな可撓性を有する、請求項1に記載のカテーテル。
- 前記光ファイバーケーブルが、光生検を行うために使用される、請求項1に記載のカテーテル。
- 前記光ファイバーケーブルの外面が、滑らかな材料でコーティングされている、請求項1に記載のカテーテル。
- 前記滑らかな材料が、親水性コーティングである、請求項10に記載のカテーテル。
- 前記カテーテル管の外面が、滑らかな材料でコーティングされている、請求項1に記載のカテーテル。
- 前記滑らかな材料が、親水性コーティングである、請求項12に記載のカテーテル。
- 前記光ファイバーケーブルが、前記カテーテル管と一体に形成されている、請求項1に記載のカテーテル。
- 操縦可能な画像化カテーテルであって、以下:
近位端部と遠位端部とを有する細長のカテーテル管;
少なくとも1本のステアリングケーブルであって、実質的に該カテーテル管の該近位端部から該遠位端部までを該カテーテル管に沿って延び、該カテーテル管の遠位端部の動きを制御する、少なくとも1本のステアリングケーブル;および
近位端部と遠位端部とを有する光ファイバーケーブルであって、該光ファイバーケーブルは、実質的に該カテーテル管の該近位端部から該遠位端部までを該カテーテル管に沿って延び、そして、該遠位端部から該近位端部まで像を伝達する間に、該近位端部から該遠位端部まで照射光を伝達する、光ファイバーケーブルを備え、
該カテーテル管は、該遠位端部付近に屈曲を集中させるように、該近位端部付近よりも、該遠位端部付近でより大きな可撓性を有し;
該光ファイバーケーブルは、レンズおよび1つ以上の造影ファイバーを備え;そして
該1つ以上の造影ファイバーの最も外側の半径が該レンズの最も外側の半径より大きい、画像化カテーテル。 - 前記カテーテル管の遠位端部から約1〜2インチが、該カテーテル管の残りの部分よりも大きな可撓性を有するように構成される、請求項15に記載のカテーテル。
- 前記カテーテル管の遠位端部付近と近位端部付近とが、異なるデュロメーター等級を有する材料から形成される、請求項15に記載のカテーテル。
- 前記カテーテル管が、前記光ファイバーケーブルから分離可能なように構成される、請求項15に記載のカテーテル。
- 前記光ファイバーケーブルが、前記カテーテル管と一体に形成される、請求項15に記載のカテーテル。
- 前記カテーテル管が、該管を通って延びる複数の管腔を規定し、該管腔のうちの1つが、前記光ファイバーケーブルを受容する、請求項15に記載のカテーテル。
- 操縦可能な画像化カテーテルであって、以下:
近位端部と遠位端部とを有する細長のカテーテル管;
少なくとも2本のステアリングケーブルであって、実質的に該カテーテル管の該近位端部から該遠位端部までを該カテーテル管に沿って延び、該カテーテル管の遠位端部の動きを制御する、少なくとも2本のステアリングケーブル;および
近位端部と遠位端部とを有する光ファイバーケーブルであって、該光ファイバーケーブルは、実質的に該カテーテル管の該近位端部から該遠位端部までを該カテーテル管に沿って延び、そして、該遠位端部から該近位端部まで像を伝達する間に、該近位端部から該遠位端部まで照射光を伝達する、光ファイバーケーブルを備え、
該操縦可能な画像化カテーテルの直径は、約1mmと約4.5mmとの間であり;
該光ファイバーケーブルは、レンズおよび1つ以上の造影ファイバーを備え;そして
該1つ以上の造影ファイバーの最も外側の半径が該レンズの最も外側の半径より大きい、画像化カテーテル。 - 操縦可能な画像化カテーテルであって、以下:
近位端部と遠位端部とを有する細長のカテーテル管;
少なくとも3本のステアリングケーブルであって、実質的に該カテーテル管の該近位端部から該遠位端部までを該カテーテル管に沿って延び、該カテーテル管の遠位端部の動きを制御する、少なくとも3本のステアリングケーブル;および
近位端部と遠位端部とを有する光ファイバーケーブルであって、該光ファイバーケーブルは、実質的に該カテーテル管の該近位端部から該遠位端部までを該カテーテル管に沿って延び、そして、該遠位端部から該近位端部まで像を伝達する間に、該近位端部から該遠位端部まで照射光を伝達する、光ファイバーケーブルを備え、
該操縦可能な画像化カテーテルの直径は、約1mmと約4.5mmとの間であり;
該光ファイバーケーブルは、レンズおよび1つ以上の造影ファイバーを備え;そして
該1つ以上の造影ファイバーの最も外側の半径が該レンズの最も外側の半径より大きい、画像化カテーテル。 - 前記光ファイバーケーブルがさらに:
遠位端部および近位端部を有する第1の管であって、前記レンズおよび前記1つ以上の造影ファイバーと重なり合い、そして該第1の管の近位端部が前記カテーテル管の近位端部から実質的に遠位方向で終結する、第1の管;
該第1の管および該1つ以上の造影ファイバーの実質的長さの両方の上にわたって延びる第2の管;
該第2の管を同軸で取り囲む照射ファイバー;および
該照射ファイバーの長さを取り囲む保護管、を備える、請求項1に記載のカテーテル。 - 前記第1の管の外側半径が、前記1つ以上の造影ファイバーの外側半径と同じである、請求項23に記載のカテーテル。
- 前記1つ以上の造影ファイバーの遠位部分の半径が、前記1つ以上の造影ファイバーの近位部分の半径より小さい、請求項1に記載のカテーテル。
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2004
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-
2005
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- 2005-03-23 EP EP10185028.7A patent/EP2319388B1/en active Active
- 2005-03-23 EP EP10185036.0A patent/EP2329760B1/en active Active
- 2005-08-09 AU AU2005287330A patent/AU2005287330B2/en not_active Expired - Fee Related
- 2005-08-09 EP EP05814825.5A patent/EP2112900B1/en not_active Not-in-force
- 2005-08-09 JP JP2007525784A patent/JP4966195B2/ja active Active
- 2005-08-09 EP EP16206739.1A patent/EP3175785A1/en not_active Withdrawn
- 2005-08-09 WO PCT/US2005/028524 patent/WO2006033721A1/en active Application Filing
- 2005-08-09 CA CA002575678A patent/CA2575678A1/en not_active Abandoned
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2011
- 2011-03-07 US US13/041,520 patent/US20110213206A1/en not_active Abandoned
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2013
- 2013-10-16 US US14/055,580 patent/US9215970B2/en not_active Expired - Fee Related
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EP2417898A1 (en) | 2012-02-15 |
EP2319388B1 (en) | 2015-10-28 |
EP2329760A1 (en) | 2011-06-08 |
EP2319388A1 (en) | 2011-05-11 |
US10058236B2 (en) | 2018-08-28 |
US20060030753A1 (en) | 2006-02-09 |
US20110213206A1 (en) | 2011-09-01 |
US20140046129A1 (en) | 2014-02-13 |
EP3175785A1 (en) | 2017-06-07 |
EP3266365A1 (en) | 2018-01-10 |
US7922654B2 (en) | 2011-04-12 |
AU2005287330A1 (en) | 2006-03-30 |
AU2005287330B2 (en) | 2011-06-09 |
EP2112900B1 (en) | 2015-01-07 |
EP2112900A1 (en) | 2009-11-04 |
EP2417898B1 (en) | 2016-12-28 |
JP2008508987A (ja) | 2008-03-27 |
EP2329760B1 (en) | 2017-06-28 |
US20160073857A1 (en) | 2016-03-17 |
US9215970B2 (en) | 2015-12-22 |
WO2006033721A1 (en) | 2006-03-30 |
CA2575678A1 (en) | 2006-03-30 |
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