JP5380410B2 - カテーテル位置表示装置 - Google Patents
カテーテル位置表示装置 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
- A61B5/74—Details of notification to user or communication with user or patient ; user input means
- A61B5/742—Details of notification to user or communication with user or patient ; user input means using visual displays
- A61B5/743—Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
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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
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
- A61B5/062—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body using magnetic field
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/065—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6851—Guide wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/74—Details of notification to user or communication with user or patient ; user input means
- A61B5/742—Details of notification to user or communication with user or patient ; user input means using visual displays
-
- 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
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J15/00—Feeding-tubes for therapeutic purposes
- A61J15/0003—Nasal or oral feeding-tubes, e.g. tube entering body through nose or mouth
- A61J15/0007—Nasal or oral feeding-tubes, e.g. tube entering body through nose or mouth inserted by using a guide-wire
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J15/00—Feeding-tubes for therapeutic purposes
- A61J15/0026—Parts, details or accessories for feeding-tubes
- A61J15/0069—Tubes feeding directly to the intestines, e.g. to the jejunum
-
- 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
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
-
- 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
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/107—Visualisation of planned trajectories or target regions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
-
- 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
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B2090/363—Use of fiducial points
-
- 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
- A61B2090/3983—Reference marker arrangements for use with image guided surgery
-
- 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
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M2025/0166—Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
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- Otolaryngology (AREA)
- Radiology & Medical Imaging (AREA)
- Oral & Maxillofacial Surgery (AREA)
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Description
本発明は人体におけるカテーテルおよびコイル位置の発信方法に関し、特に、挿入時および体内および/または体内の経路での使用時にカテーテルの先端位置を継続的に判定する方法に関する。
本明細書においては、理解しやすいように、経腸栄養カテーテルの誘導および載置、さらには作業中のメンテナンスについて、例を挙げて説明する。しかし、ここで説明する技術および機器は、人体および動物の他の部分における同様の載置においても有効であることは、当業者にとって明らかであろう。カテーテルは、多種多様な目的のために使用されるとともに、多種多様なタイプがある。本発明による、人体での使用例は、中心静脈カテーテルの位置決め分野においても適用できる。
・投薬のタイプ
・注入する溶液のオスモル濃度およびpH
・必要な治療の期間
・二次的危険要素および持病
・患者の年齢、活動、仕事、生活様式
・将来的な静脈注射の必要性および長期的な病気の予後
・現在の利用可能度、アクセスする静脈の状態(特に手足の末梢静脈)
・患者の神経性疾患歴、静脈またはリンパ系に影響のある手術歴、血液疾患歴、血栓歴およびこれまでの静脈注射の使用歴など
・現在の患者の診断および治療の希望
本発明は、おおむね、対象患者の体に挿入されるカテーテルにおいて使用する、信号エネルギーを発信するコイルの位置を表示する方法であり、前記方法は、少なくとも二つの信号エネルギー検出器を有するとともに前記対象患者の体の所定の位置または部分に対して位置決めされたコイル位置測定手段を使用する工程と、前記コイル位置測定手段よる位置測定結果を表示する工程と含み、前記位置測定結果は、前記位置測定手段に対して臨床医が前記対象患者の体の内部において、前記対象患者の体の所定の位置または部分に対する前記コイルと前記カテーテルの位置を判定するために使用する。
(a) 対象患者の体の所定の目印に対して位置付けされた、少なくとも一つの受信コイルの位置を示す少なくとも一つの基準信号を受信する工程と、
(b) 対象患者の体に挿入した発信コイルから少なくとも一つの指示信号を受信する工程と、
(c) 所定の目印に伴う基準データを検索する工程と、
(d) 基準データから引き出した基準画像を表示する工程と、
(e) 対象患者の体上または上方の少なくとも二つの受信コイルの位置の相対位置を示す指示信号によって表されるデータを生成する工程と、
(f) 指示データが表す図を表示する工程と、
(g) 指示信号の変化を受信した後、工程(e)と(f)を繰り返す工程とからなる。
(a) 検出装置の所定の領域を対象患者の体の所定の目印上に載置する工程と、
(b) カテーテル、スチレット、ガイドワイヤ又は発信コイルを埋め込んだコイル位置表示装置を対象患者の体に挿入する工程と、
(c) 所定の部位または部分の図形表示、もしくは、基準画像の表示をモニタ上で見る工程と、
(d) モニタ上で発信コイルの図形表示を見る工程と、
(e) 図形表示の相対位置の表示を利用して、対象患者の体の中でカテーテルを操縦する工程と、を備えてなる。
前記ワイヤの束は、
可撓性チューブの位置決めを制御するように構成された所定の堅さを有する第1のワイヤと、
発信コイルとプロセッサとの間で信号を伝送するように構成された第2のワイヤと、
第2のワイヤを第1のワイヤに固定する為の手段とを備えている。
図1は、先端/遠位端の近傍に、米国特許5,099,845号に説明するものと類似した装置によって検出することができる信号を発するために使用するコイルを有する1ルーメンカテーテルを示す図である。この特許は、マイクロニックスPty Ltd.による特許であると共に、本明細書内で引用して参照している。上記の特許の引用は、当業者共通の一般的知識として入っている明細書の内容を認めるためのものと解釈してはならない。
Claims (9)
- プロセッサと、
前記プロセッサに作用的に接続される表示装置と、
前記プロセッサに作用的に接続され、対象の所定の位置の上に置かれるように構成される検出装置と、
前記プロセッサに作用的に接続されるコイルであって、前記コイルがカテーテルの中に挿入されるように構成されるコイルと、
メモリ装置であって、
(a)前記対象の正中線を表す所定の第1線に関する情報と、
(b)前記対象の横隔膜を表す所定の第2線に関する情報と、
(c)前記コイルが前進させられている間又は前記カテーテルから引き出されている間、前記プロセッサによって実行されるときに、前記表示装置、前記検出装置、前記コイル及び前記メモリ装置と協働して前記プロセッサに以下の(a)〜(e)の処理、すなわち、
(a)前記対象の正中線を表す前記所定の第1線と、前記対象の横隔膜を表す前記所定の第2線と、を表示する処理と、
(b)食道部分における、前記コイルから前記検出装置までの第1距離を示す第1値を決定及び表示する処理と、
(c)胃部分における、前記コイルから前記検出装置までの第2距離を示す第2値を決定及び表示する処理と、
(d)幽門部分における、前記コイルから前記検出装置までの第3距離を示す第3値を決定及び表示する処理と、
(e)十二指腸部分における、前記コイルから前記検出装置までの第4距離を示す第4値を決定し表示する処理と、
を実行させる命令と、を記憶する前記メモリ装置と、
を備えるカテーテル位置表示装置。 - 前記命令は、前記プロセッサによって実行されるときに、前記コイルが前進させられている間又は前記カテーテルから引き出されている間、前記検出装置、前記コイル及び前記メモリ装置と協働して前記プロセッサに前記対象体内を通った経路を記録する処理を実行させることを特徴とする請求項1記載のカテーテル位置表示装置。
- 前記経路がX−Y位置を含むことを特徴とする請求項2記載のカテーテル位置表示装置。
- 前記所定の第1線と前記所定の第2線が、前記対象の剣状胸骨結合部を表す点において交差することを特徴とする請求項1ないし3のいずれか1項に記載のカテーテル位置表示装置。
- 前記コイルが電磁信号を発信することを特徴とする請求項1ないし4のいずれか1項に記載のカテーテル位置表示装置。
- 前記コイルに接続された終端部を有する複数のワイヤを含み、該複数のワイヤが、スチレット及びガイドワイヤのうちの少なくとも1つであることを特徴とする請求項1ないし5のいずれか1項に記載のカテーテル位置表示装置。
- 前記検出装置が、前記コイルから電磁信号を受信する複数の受信コイルを備えていることを特徴とする請求項1ないし6のいずれか1項に記載のカテーテル位置表示装置。
- 前記命令は、前記プロセッサによって実行されるときに、前記コイルが前進させられている間又は前記カテーテルから引き出されている間、前記表示装置、前記検出装置、前記コイル及び前記メモリ装置と協働して前記プロセッサに前記コイルの移動方向を示す矢印を生成し表示する処理を実行させることを特徴とする請求項1ないし7のいずれか1項に記載のカテーテル位置表示装置。
- 前記命令は、前記プロセッサによって実行されるときに、前記コイルが前進させられている間又は前記カテーテルから引き出されている間、前記表示装置、前記検出装置、前記コイル及び前記メモリ装置と協働して前記プロセッサに、空腸部分における、前記コイルから前記検出装置までの第5距離を示す第5値を決定させ表示する処理を実行させることを特徴とする請求項1ないし8のいずれか1項に記載のカテーテル位置表示装置。
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AUPQ9592 | 2000-08-23 | ||
AUPQ9592A AUPQ959200A0 (en) | 2000-08-23 | 2000-08-23 | Catheter locator apparatus and method of use |
AUPR5250A AUPR525001A0 (en) | 2001-05-24 | 2001-05-24 | Catheter locator apparatus and method of use |
AUPR5250 | 2001-05-24 |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2002520893A Division JP2004505748A (ja) | 2000-08-23 | 2001-08-23 | カテーテル位置表示装置およびその使用法 |
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JP2011045726A JP2011045726A (ja) | 2011-03-10 |
JP5380410B2 true JP5380410B2 (ja) | 2014-01-08 |
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JP2002520893A Pending JP2004505748A (ja) | 2000-08-23 | 2001-08-23 | カテーテル位置表示装置およびその使用法 |
JP2010212975A Expired - Lifetime JP5380410B2 (ja) | 2000-08-23 | 2010-09-24 | カテーテル位置表示装置 |
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JP2002520893A Pending JP2004505748A (ja) | 2000-08-23 | 2001-08-23 | カテーテル位置表示装置およびその使用法 |
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US (7) | US20040087877A1 (ja) |
EP (3) | EP2380550A3 (ja) |
JP (2) | JP2004505748A (ja) |
AU (3) | AU8370301A (ja) |
CA (1) | CA2420676C (ja) |
WO (1) | WO2002015973A1 (ja) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11944344B2 (en) | 2018-04-13 | 2024-04-02 | Karl Storz Se & Co. Kg | Guidance system, method and devices thereof |
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EP2380550A3 (en) | 2000-08-23 | 2012-10-31 | Micronix Pty Ltd | Catheter locator apparatus and method of use |
US20090165784A1 (en) * | 2007-12-28 | 2009-07-02 | Tyco Healthcare Group Lp | Lubricious intubation device |
US20060116658A1 (en) * | 2004-11-30 | 2006-06-01 | Kimberly-Clark Worldwide, Inc. | Multi-lumen stoma measuring device and method for using same |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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US11944344B2 (en) | 2018-04-13 | 2024-04-02 | Karl Storz Se & Co. Kg | Guidance system, method and devices thereof |
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EP2380550A3 (en) | 2012-10-31 |
US10058268B2 (en) | 2018-08-28 |
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US20170143235A1 (en) | 2017-05-25 |
AU2001283703B2 (en) | 2006-05-25 |
AU8370301A (en) | 2002-03-04 |
US20100097373A1 (en) | 2010-04-22 |
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