JP5676446B2 - 副鼻洞口ファインダ - Google Patents
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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
- A61B1/233—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 for the nose, i.e. nasoscopes, e.g. testing of patency of Eustachian tubes
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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
- A61B17/24—Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
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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
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
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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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
- A61B2017/22042—Details of the tip of the guide wire
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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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
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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
- A61B2017/320044—Blunt dissectors
- A61B2017/320048—Balloon dissectors
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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
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
- A61M29/02—Dilators made of swellable material
- A61M2029/025—Dilators made of swellable material characterised by the guiding element
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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
- A61M25/10—Balloon catheters
- A61M25/1002—Balloon catheters characterised by balloon shape
Description
本出願は、2008年7月30日に出願された仮出願第61/084,965号の利益を請求し、その内容は参照により組み込まれる。
本発明は、概して、医療デバイス、システム、及び方法に関し、より具体的には、副鼻腔口を特定し、膨張させるための方法及びデバイスに関する。
(1) 遠位端、近位端、前記遠位端と前記近位端との間に位置する湾曲領域、及び内部チャネルを有するシャフトと、
前記内部チャネル内に移動可能に実装された伸張可能かつ格納可能なガイドワイヤと、
前記ガイドワイヤに接合したプローブ先端と、を備える、副鼻洞口ファインダ。
(2) 前記ガイドワイヤは、前記プローブ先端が前記遠位端に隣接する格納位置と、前記プローブ先端が前記遠位端から離れる伸張位置との間で可逆的に移動可能である、実施態様1に記載の副鼻洞口ファインダ。
(3) 前記プローブ先端は、着脱可能かつ互換性がある、実施態様1に記載の副鼻洞口ファインダ。
(4) 前記シャフト又は前記ガイドワイヤのうちの少なくとも1つと連結した膨張可能なバルーンを更に備える、実施態様1に記載の副鼻洞口ファインダ。
(5) 前記シャフトの前記近位端に接合したハンドルを更に備える、実施態様1に記載の副鼻洞口ファインダ。
(6) 前記シャフトは、外部シース及び内部要素を更に備え、前記内部チャネルは、前記内部要素を通って延在する、実施態様1に記載の副鼻洞口ファインダ。
(7) 内部要素は、硬質材料を備え、前記外部シースは、弾力性材料を備える、実施態様6に記載の副鼻洞口ファインダ。
(8) 内部要素は、取り外し可能であり、かつ互換性がある、実施態様6に記載の副鼻洞口ファインダ。
(9) 前記ガイドワイヤに機械的に連結した作動装置要素を更に備える、実施態様1に記載の副鼻洞口ファインダ。
(10) 前記シャフトの前記近位端と連結したハンドルと、
前記ハンドル上に位置し、前記ガイドワイヤに機械的に連結した作動装置要素と、を更に備える、実施態様1に記載の副鼻洞口ファインダ。
(12) 前記シャフトは、管状内側シース及び管状外側シースを更に備え、前記内側シースは、前記外側シース内に位置付けられ、前記内部チャネルは、前記内側シースを通って延在する、実施態様10に記載の副鼻洞口ファインダ。
(13) 前記内部シースは、前記外側シースに対して伸張可能かつ格納可能である、実施態様12に記載の副鼻洞口ファインダ。
(14) 前記シャフトは、前記内部チャネルと連通するスロットを更に備え、前記スロットは、前記ガイドワイヤが前記スロットを通って前記内部チャネル内に挿入されて、前記内部チャネルから取り外されるのを可能にするように構造化及び構成される、実施態様1に記載の副鼻洞口ファインダ。
(15) 前記外側シースは、第1のスロットを含み、前記内側シースは、第2のスロットを含み、前記第1及び第2のスロットは、前記第1及び第2のスロットが相互に整合されるときに、前記ガイドワイヤが前記第1及び第2のスロットを通って前記内部チャネル内に挿入されて、前記内部チャネルから取り外されるのを可能にするように構造化及び構成される、実施態様14に記載の副鼻洞口ファインダ。
(16) 前記シャフトは、前面部分及び前記前面部分に接合された背面部分を更に備え、前記前面及び背面部分は、管状形状を画定し、前記内部チャネルは、前記前面部分と前記背面部分との間に位置する、実施態様1に記載の副鼻洞口ファインダ。
(17) 前記前面部分は、スロットを更に備え、前記スロットは、前記内部チャネルと連通し、前記スロットは、前記ガイドワイヤが前記スロットを通って前記内部チャネル内に挿入されて、前記内部チャネルから取り外されるのを可能にするように構造化及び構成される、実施態様16に記載の副鼻洞口ファインダ。
(18) 遠位端、近位端、及び前記遠位端と前記近位端との間の湾曲領域を有する細長いシャフトと、
前記近位端に接合されたハンドルと、
前記シャフト及び前記ハンドルを通って延在する長手方向の内部チャネルと、
前記内部チャネル内に移動可能に実装された伸張可能かつ格納可能なガイドワイヤと、
前記ガイドワイヤの端部に接合したプローブ先端と、
前記ハンドルと関連付けられ、前記ガイドワイヤに機械的に連結した作動装置要素であって、前記ガイドワイヤは、前記作動装置要素の調節に従って伸張可能かつ格納可能である、作動装置要素と、を備える、副鼻洞口ファインダ。
(19) 前記ガイドワイヤは、前記プローブ先端が前記遠位端に隣接する格納位置と、前記プローブ先端が前記遠位端から離れる伸張位置との間で可逆的に移動可能である、実施態様18に記載の副鼻洞口ファインダ。
(20) 前記プローブ先端は、着脱可能であり、互換性がある、実施態様18に記載の副鼻洞口ファインダ。
(22) 内部要素は、硬質材料を備え、前記外部シースは、弾力性材料を備える、実施態様21に記載の副鼻洞口ファインダ。
(23) 内部要素は、取り外し可能で、互換性がある、実施態様21に記載の副鼻洞口ファインダ。
(24) 前記作動装置要素は、前記ハンドル上のスロット内に摺動可能に実装される、実施態様18に記載の副鼻洞口ファインダ。
(25) 前記シャフトは、細長い管状内側シース及び細長い管状外側シースを更に備え、前記内側シースは、前記外側シース内に位置付けられ、前記長手方向の内部チャネルは、前記内側シースを通って延在する、実施態様24に記載の副鼻腔口ファインダ。
(26) 前記内部シースは、前記外側シースに対して伸張可能かつ格納可能である、実施態様25に記載の副鼻洞口ファインダ。
(27) 前記外側シースは、第1のスロットを含み、前記内側シースは、第2のスロットを含み、前記第1及び第2のスロットは、前記第1及び第2のスロットが相互に整合されるときに、前記ガイドワイヤが前記第1及び第2のスロットを通って前記内部チャネル内に挿入されて、前記内部チャネルから取り外されるのを可能にするように構造化及び構成される、実施態様25に記載の副鼻洞口ファインダ。
(28) 前記シャフトは、前記長手方向の内部チャネルと連通する長手方向のスロットを更に備え、前記スロットは、前記ガイドワイヤが前記スロットを通って前記内部チャネル内に挿入されて、前記内部チャネルから取り外されるのを可能にするように構造化及び構成される、実施態様18に記載の副鼻洞口ファインダ。
(29) 前記長手方向スロットは、横方向領域を含む、実施態様28に記載の副鼻洞口ファインダ。
(30) 前記シャフトは、前面部分及び前記前面部分に接合した背面部分を更に備え、前記前面及び背面部分は、管状形状を画定し、前記内部チャネルは、前記前面部分と前記背面部分との間に位置する、実施態様18に記載の副鼻洞口ファインダ。
(32) 副鼻腔口を特定する方法であって、
遠位端、近位端、前記遠位端と前記近位端との間に位置する湾曲領域、及び内部チャネルを備えるシャフトと、前記内部チャネル内に移動可能に実装された伸張可能かつ格納可能なガイドワイヤと、前記ガイドワイヤに接合したプローブ先端と、を有する副鼻洞口ファインダを提供する工程と、
前記副鼻洞口ファインダの前記シャフトを患者の副鼻腔内に挿入する工程と、
前記シャフトの前記遠位端の位置を調節する工程と、
前記標的口が特定されるまで、前記ガイドワイヤ及び前記プローブ先端の位置を調節する工程と、を含む、方法。
(33) 前記ガイドワイヤ及び前記プローブ先端を前記調節された位置に置いたまま前記副鼻腔から前記シャフトを引き出す工程を更に含む、実施態様32に記載の方法。
(34) 前記ガイドワイヤに沿って外科用デバイスを前記標的口に導入する工程を更に含む、実施態様33に記載の方法。
(35) 上顎洞の自然口を特定し、膨張させるデバイスであって、
細長いシャフトであって、
実質的に硬質の近位部分と、
湾曲遠位部分と、
前記湾曲遠位部分の端部における非外傷性遠位先端であって、前記湾曲遠位部分は、鼻腔内への前記遠位部分の通過が上顎洞口内又はその付近に前記非外傷性遠位先端を位置付けるのを可能にするような寸法及び形状を有する、非外傷性遠位先端と、
前記シャフトの少なくとも一部を通過する膨張ルーメンと、を備える、細長いシャフトと、
前記膨張ルーメンと流体連通にある前記シャフトの前記遠位部分と連結する少なくとも1つの拡張可能な拡張器と、を備える、デバイス。
(36) 前記拡張可能な拡張器は、膨張可能なバルーンを備える、実施態様35に記載のデバイス。
(37) 前記バルーンの少なくとも一部分は、前記シャフトの前記遠位部分内の曲線に近位に配置される、実施態様36に記載のデバイス。
(38) 前記バルーンは、前記シャフトに沿って、前記曲線の近位から前記曲線の遠位に延在する、実施態様37に記載のデバイス。
(39) 前記拡張器は、2つのバルーンを備え、一方は、前記シャフトの前記遠位部分の曲線に近位に配置され、他方は前記曲線に遠位に配置される、実施態様36に記載のデバイス。
(40) 前記バルーンは、前記シャフトの前記湾曲遠位部分の内側曲率半径から離れて外側に非対称的に拡張する、実施態様36に記載のデバイス。
(42) 前記非外傷性遠位先端は、前記上顎洞口を特定するときに、触覚フィードバックを強化させるための球形状の先端を備える、実施態様35に記載のデバイス。
(43) 上顎洞の自然口を特定し、膨張させるデバイスであって、
細長い内側シャフトであって、
実質的に硬質の近位部分と、
湾曲遠位部分と、
前記湾曲遠位部分の端部における非外傷性遠位先端であって、前記湾曲遠位部分は、鼻腔内への前記遠位部分の通過が上顎洞口内又はその付近に前記非外傷性遠位先端を位置付けるのを可能にするような寸法及び形状を有する、非外傷性遠位先端と、を備える、細長い内側シャフトと、
前記内側シャフトの上に摺動可能に配置され、膨張ルーメンを含む外側シャフトと、
前記膨張ルーメンと流体連通にある前記シャフトの前記遠位部分と連結する少なくとも1つの拡張可能な拡張器と、を備える、デバイス。
(44) 前記内部シャフトに沿って前記外側シャフトを前進させ、かつ格納させるための作動装置を有するハンドルを更に備える、実施態様43に記載のデバイス。
(45) 前記拡張器は、膨張可能なバルーンを備える、実施態様43に記載のデバイス。
(46) 前記非外傷性遠位先端は、前記上顎洞口を特定するときに、触覚フィードバックを強化させるための球形状の先端を備える、実施態様43に記載のデバイス。
(47) 上顎洞の自然口を特定し、膨張させるための方法であって、
上顎洞デバイスの湾曲遠位部分を鼻腔内に前進させる工程であって、前記上顎洞デバイスの近位部分は、実質的に硬質である、工程と、
前記上顎洞の前記自然口を通して前記遠位部分の非外傷性遠位端を通過させ、触覚フィードバックを使用して前記口を通る前記遠位端の通過を確認する工程と、
前記上顎洞の自然口を膨張させるために前記上顎洞デバイスの前記湾曲遠位部分に連結した少なくとも1つの拡張可能な拡張器を膨張させる工程と、を含む、方法。
(48) 前記非外傷性遠位端を通過させ、触覚フィードバックを使用する工程は、前記デバイスの球形状の遠位先端を用いて感知する工程を含む、実施態様47に記載の方法。
(49) 前記膨張工程前に前記上顎洞デバイスの外側シャフトを前記デバイスの内側シャフトに沿って前進させる工程を更に含み、前記拡張可能な拡張器は、前記外側シャフトに連結される、実施態様47に記載の方法。
(50) 前記拡張可能な拡張器を膨張させる工程は、少なくとも1つの膨張可能なバルーンを膨張させる工程を含む、実施態様47に記載の方法。
前記上顎洞口内に位置する第1のバルーンを膨張させる工程と、
前記副鼻腔内の前記上顎洞の外側に位置する第2のバルーンを膨張させる工程と、を含む、実施態様47に記載の方法。
(52) 前記拡張可能な拡張器を膨張させる工程は、前記自然口を形成する粘膜の下の骨の再構成又は損傷をもたらす、実施態様47に記載の方法。
(53) 前記拡張可能な拡張器を膨張させる工程は、前記副鼻腔口付近の副鼻腔内の解剖学的領域の膨張又は解剖学的構造体の動作のうちの少なくとも1つをもたらす、実施態様47に記載の方法。
(54) 前記解剖学的領域は、漏斗及び中鼻道からなる群から選択される、実施態様53に記載の方法。
(55) 前記解剖学的構造体は、鉤状突起、中鼻甲介、及び前篩骨蜂巣からなる群から選択される、実施態様53に記載の方法。
(56) 前記膨張工程前に、前記副鼻腔の鉤状突起を格納するために、前記上顎洞デバイスを引く工程を更に含む、実施態様47に記載の方法。
Claims (13)
- 遠位端、近位端、及び前記遠位端と前記近位端との間の湾曲領域を有する細長いシャフトと、
前記近位端に接合されたハンドルと、
前記シャフト及び前記ハンドルを通って延在する長手方向の内部チャネルと、
前記内部チャネル内に移動可能に実装された伸張可能かつ格納可能なガイドワイヤと、
前記ガイドワイヤの端部に接合したプローブ先端と、
前記ハンドルと関連付けられ、前記ガイドワイヤに機械的に連結した作動装置要素であって、前記ガイドワイヤは、前記作動装置要素の調節に従って伸張可能かつ格納可能である、作動装置要素と、を備え、
前記作動装置要素は、前記ハンドル上のスロット内に摺動可能に実装され、
前記ガイドワイヤは、前記プローブ先端が前記遠位端に隣接する格納位置と、前記プローブ先端が前記遠位端から離れる伸張位置との間で可逆的に移動可能である、副鼻洞口ファインダ。 - 前記プローブ先端は、着脱可能であり、互換性がある、請求項1に記載の副鼻洞口ファインダ。
- 前記シャフトは、細長い外部シース及び細長い内部要素を更に備え、前記長手方向の内部チャネルが、前記内部要素を通って延在する、請求項2に記載の副鼻洞口ファインダ。
- 内部要素は、硬質材料を備え、前記外部シースは、弾力性材料を備える、請求項3に記載の副鼻洞口ファインダ。
- 内部要素は、取り外し可能で、互換性がある、請求項3に記載の副鼻洞口ファインダ。
- 前記シャフトは、細長い管状内側シース及び細長い管状外側シースを更に備え、前記内側シースは、前記外側シース内に位置付けられ、前記長手方向の内部チャネルは、前記内側シースを通って延在する、請求項1に記載の副鼻腔口ファインダ。
- 前記内部シースは、前記外側シースに対して伸張可能かつ格納可能である、請求項6に記載の副鼻洞口ファインダ。
- 前記外側シースは、第1のスロットを含み、前記内側シースは、第2のスロットを含み、前記第1及び第2のスロットは、前記第1及び第2のスロットが相互に整合されるときに、前記ガイドワイヤが前記第1及び第2のスロットを通って前記内部チャネル内に挿入されて、前記内部チャネルから取り外されるのを可能にするように構造化及び構成される、請求項6に記載の副鼻洞口ファインダ。
- 前記シャフトは、前記長手方向の内部チャネルと連通する長手方向のスロットを更に備え、前記スロットは、前記ガイドワイヤが前記スロットを通って前記内部チャネル内に挿入されて、前記内部チャネルから取り外されるのを可能にするように構造化及び構成される、請求項1に記載の副鼻洞口ファインダ。
- 前記長手方向スロットは、横方向領域を含む、請求項9に記載の副鼻洞口ファインダ。
- 前記シャフトは、前面部分及び前記前面部分に接合した背面部分を更に備え、前記前面及び背面部分は、管状形状を画定し、前記内部チャネルは、前記前面部分と前記背面部分との間に位置する、請求項1に記載の副鼻洞口ファインダ。
- 前記前面部分は、スロットを更に備え、前記スロットは、前記内部チャネルと連通し、前記スロットは、前記ガイドワイヤが前記スロットを通って前記内部チャネル内に挿入されて、前記内部チャネルから取り外されるのを可能にするように構造化及び構成される、請求項11に記載の副鼻洞口ファインダ。
- 前記シャフト又は前記ガイドワイヤのうちの少なくとも1つと連結した膨張可能なバルーンを更に備える、請求項1に記載の副鼻洞口ファインダ。
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JP6920578B2 (ja) | 2016-03-02 | 2021-08-18 | パナソニックIpマネジメント株式会社 | 映像ストリーミング装置、映像編集装置および映像配信システム |
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KR101653180B1 (ko) | 2016-09-01 |
AU2009276553A1 (en) | 2010-02-04 |
CN102112040A (zh) | 2011-06-29 |
CN102112040B (zh) | 2015-04-01 |
AU2009276553B2 (en) | 2015-02-05 |
JP2011529743A (ja) | 2011-12-15 |
KR20110055564A (ko) | 2011-05-25 |
US20140343498A1 (en) | 2014-11-20 |
US20170347869A1 (en) | 2017-12-07 |
ES2700863T3 (es) | 2019-02-19 |
US20100030113A1 (en) | 2010-02-04 |
WO2010014799A1 (en) | 2010-02-04 |
RU2011107229A (ru) | 2012-09-10 |
EP2306886B1 (en) | 2018-10-31 |
US11116392B2 (en) | 2021-09-14 |
US9750401B2 (en) | 2017-09-05 |
CA2732769A1 (en) | 2010-02-04 |
US10271719B2 (en) | 2019-04-30 |
EP2664350A1 (en) | 2013-11-20 |
US8979888B2 (en) | 2015-03-17 |
US20190167089A1 (en) | 2019-06-06 |
MX2011001099A (es) | 2011-03-15 |
RU2500337C2 (ru) | 2013-12-10 |
EP2306886A1 (en) | 2011-04-13 |
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