JP5686772B2 - マイクロ波アンテナアセンブリおよびそれを使用する方法 - Google Patents
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- 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
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- 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
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- 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
- A61B18/149—Probes or electrodes therefor bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
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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
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B2018/1807—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using light other than laser radiation
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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
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
- A61B2018/183—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves characterised by the type of antenna
- A61B2018/1838—Dipole antennas
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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
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
- A61B2018/183—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves characterised by the type of antenna
- A61B2018/1853—Monopole antennas
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Description
(技術分野)
本開示は、一般に、医療/外科用切除(アブレーション)アセンブリ、およびそれらの使用の方法に関する。より詳細には、本開示は、組織の診断および処置のために組織中への直接挿入のための形態であるマイクロ波アンテナアセンブリおよびそれを用いる方法に関する。
癌のような疾患の処置では、特定のタイプの癌細胞は、高められた温度(これは、健常細胞に対しては通常有害である温度よりはわずかに低い)で変性することが見出されている。温熱療法として一般に知られるこれらのタイプの処置は、代表的には、電磁放射線を利用して疾患細胞を41℃を超える温度に加熱し、その一方、隣接健常細胞を不可逆的な細胞破壊が起こらない、より低い温度に維持する。組織を加熱するために電磁放射線を利用するその他の手順はまた、組織の切除および凝固を含む。このようなマイクロ波切除手順、例えば、月経過多のために実施されるような手順は、代表的には、標的にされた組織を切除および凝固するために行われ、それを変性または殺傷する。電磁放射治療を利用する多くの手順およびデバイスのタイプは当該技術分野で公知である。このようなマイクロ波治療は、代表的には、前立腺、心臓、および肝臓のような組織および器官の処置で用いられる。
本開示は、第1の状態にある間、さらなる導入具またはカテーテルを必要とすることなく、組織中への直接挿入のための構造的に頑丈であるデバイスであり、第2の状態で、切除の明確に規定される領域または容量で制御可能でかつ予測可能な加熱パターンを生成し得るマイクロ波アンテナを形成するデバイスを記載する。
近位端および遠位端ならびにそれらの間で規定される内部管腔を有する細長いシャフト;
この細長いシャフトの内部管腔内に少なくとも部分的に配置される伝導性部材であって、この伝導性部材の遠位端がこの細長いシャフトの遠位端に少なくとも部分的に接する第1の位置から、この伝導性部材の遠位端がこの細長いシャフトの遠位端に対して間隔を置かれる第2の位置までこの細長いシャフトの遠位端に対して選択的に展開可能である伝導性部材;および
この細長いシャフトとこの伝導性部材との間に配置される第1の誘電性材料;を備え、
ここで、この伝導性部材の一部分が、この細長いシャフトの遠位端の遠位方向にあり、そして組織を貫通するように適合される、マイクロ波アンテナアセンブリ。
近位端および遠位端ならびにそれらの間で規定される内部管腔を有する細長いシャフト;
この細長いシャフトの内部管腔内に少なくとも部分的に配置される伝導性部材であって、この伝導性部材の遠位端がこの細長いシャフトの遠位端に少なくとも部分的に接する第1の状態から、この伝導性部材の遠位端がこの細長いシャフトの遠位端に対して間隔を置かれる第2の状態までこの細長いシャフトの遠位端に対して選択的に展開可能である伝導性部材;および
この細長いシャフトとこの伝導性部材との間に配置される第1の誘電性材料;を備え、
ここで、この伝導性部材の一部分が、この細長いシャフトの遠位端の遠位方向にあり、そして組織を貫通するように適合される、マイクロ波アンテナアセンブリ。
その中に規定される管腔を有する細長いシャフト;
この細長いシャフトの管腔内に部分的に配置される伝導性部材であって、その遠位端に組織を貫通するような形態の幾何学的形状を含む伝導性部材;
この細長いシャフトとこの伝導性部材の少なくとも一部分との間に配置される第1の誘電性材料;および
この伝導性部材の少なくとも一部分を覆う第2の誘電性材料を備え、
ここで、この細長いシャフト、この伝導性部材、この第1の誘電性材料およびこの第2の誘電性材料の少なくとも1つが、導入具の遠位端に対して、この伝導性部材の遠位端がこの導入具の遠位端に少なくとも部分的に接する第1の状態からこの伝導性部材の遠位端がこの導入具の遠位端に対して間隔を置かれる第2の状態まで選択的に展開するような形態である、マイクロ波アセンブリ。
第1の状態にあるマイクロ波アンテナアセンブリを処置されるべき組織の領域に進行する工程であって、それによって、電気外科的エネルギー送達装置の遠位部分が、貫通の間に組織中に経路を規定する工程と;
この電気外科的エネルギー送達装置の遠位部分を第2の状態に展開する工程であって、それによって、この電気外科的エネルギー送達装置の展開された遠位部分が所定の形態に付勢される工程と;
この組織の領域を電気外科用エネルギーで処置する工程と;
この電気外科用エネルギー送達装置の展開された遠位部分をこの第1の状態に退却する工程と;
この電気外科用エネルギー送達装置をこの組織から引き抜く工程、とを包含する、方法。
本明細書に開示されるマイクロ波アンテナアセンブリの実施形態は、ここで、描写する図面を参照して詳細に説明され、図面では、同様の参照番号は、類似または同一の要素を識別する。本明細書で用いられ、そして伝統的であるように、用語「遠位」は、使用者から最も遠い部分をいい、そして用語「近位」は、使用者に最も近い部分をいう。さらに、「上」、「下」、「前方」、「後方」などのような用語は、姿の配向または構成要素の方向をいい、そして単に便宜上、説明のために用いられる。
マイクロ波アンテナアセンブリは、近位端および遠位端ならびにそれらの間の管腔を有する細長いシャフト、この細長いシャフトの内部管腔内に少なくとも部分的に配置される伝導性部材であって、この伝導性部材の遠位端が上記細長いシャフトの遠位端に少なくとも部分的に接する第1の状態から、この伝導性部材の遠位端が上記細長いシャフトの遠位端に対して間隔が置かれた第2の状態まで上記細長いシャフトの遠位端に対して選択的に展開可能である伝導性部材、および上記細長いシャフトと上記伝導性部材との間に配置される第1の誘電性材料を備え、ここで、上記伝導性部材の一部分は、上記細長いシャフトの遠位端の遠位方向にあり、そして組織を貫通するように適合されている。
12 細長いシャフト
14 伝導性部材
16 導入具
18 ハンドル
19 接近スロット
20 冷却アセンブリ
21 冷却シース
22 冷却流体サプライ
24 冷却流体戻り
26 電気外科用エネルギーコネクター
27 電気外科用エネルギー送達供給源
29 セレクター
31 位置決定手段
36 遠位先端部分
Claims (18)
- マイクロ波アンテナアセンブリであって、以下:
管腔をその中に画定する導入具;
外側コンダクター内に同軸に位置決めされる内側コンダクターを含む可撓性のマイクロ波伝導性ケーブルであって、第1の誘電性材料が該内側コンダクターと該外側コンダクターとの間に位置決めされ、該可撓性のマイクロ波伝導性ケーブルは、組織に隣接する該内側コンダクターの遠位端を位置決めするために該導入具内に位置決め可能であり、該内側コンダクターがその遠位端に、該組織を貫通するように構成された幾何学的形状を有する遠位先端部分を含む、マイクロ波伝導性ケーブル;および
該内側コンダクターの遠位端の少なくとも一部を覆う第2の誘電性材料を備え、該内側コンダクターの遠位先端部分が該第2の誘電性材料を超えて延びる、マイクロ波アンテナアセンブリ。 - 前記内側コンダクターの遠位端が、前記導入具の遠位端の遠位にある、請求項1に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターの遠位先端部分の幾何学的形状が、該内側コンダクターの遠位端の前記導入具の管腔への退却を妨げる、請求項1に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターの遠位先端部分の幾何学的形状が、前記導入具の遠位端と選択的に係合する、請求項1に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターの前記導入具に対する相対位置を決定するための少なくとも1つのセンサーをさらに備える、請求項1に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターを少なくとも部分的に取り囲む冷却チャンバーをさらに備え、該冷却チャンバーが該内側コンダクターの遠位端に冷却流体を供給する、請求項1に記載のマイクロ波アンテナアセンブリ。
- 前記外側コンダクター、前記内側コンダクター、前記第1の誘電性材料、および前記第2の誘電性材料の少なくとも1つが、前記導入具の遠位端に対し、該内側コンダクターの遠位端が該導入具の遠位端に少なくとも部分的に接する第1の状態から、該内側コンダクターの遠位端が該導入具の遠位端に対して間隔を置かれる第2の状態まで選択的に展開するように構成されている、請求項1に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターが、前記第2の状態にあるとき、前記導入具の遠位端と連結する、請求項7に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターが、前記第2の状態にあるとき、所定の形態に付勢される、請求項7に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターの遠位端が、組織貫通の間に組織中に経路を画定する、請求項7に記載のマイクロ波アンテナアセンブリ。
- 前記経路が、機械的に生成される、請求項10に記載のマイクロ波アンテナアセンブリ。
- 前記経路が、前記内側コンダクターの幾何学的形状および組織へのエネルギーの印加によって画定される、請求項10に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターが、高周波エネルギーまたはマイクロ波エネルギーの少なくとも1つを供給するエネルギー供給源に連結するように適合されている、請求項12に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターが、前記第1の状態に配置されるとき、高周波エネルギーを供給するように構成されている、請求項13に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターが、前記第2の状態にあるとき、マイクロ波エネルギーを供給するように構成されている、請求項14に記載のマイクロ波アンテナアセンブリ。
- 前記内側コンダクターが、該内側コンダクターが前記第1の状態に配置されるとき高周波エネルギーを、そして該内側コンダクターが前記第2の状態にあるときマイクロ波エネルギーを供給するように構成されている、請求項15に記載のマイクロ波アンテナアセンブリ。
- 前記第2の誘電性材料が、高い温度プロフィールを有する非粘着性外表面を有するPTFE収縮物の形態である、請求項7に記載のマイクロ波アンテナアセンブリ。
- 前記第2の誘電性材料の外径が、前記内側コンダクターの遠位端の近位端と円滑な遷移を形成し、前記第1の状態と前記第2の状態との間の該内側コンダクターの移動を容易にする、請求項17に記載のマイクロ波アンテナアセンブリ。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US11/529,823 US8068921B2 (en) | 2006-09-29 | 2006-09-29 | Microwave antenna assembly and method of using the same |
US11/529,823 | 2006-09-29 |
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JP2007256540A Division JP5145001B2 (ja) | 2006-09-29 | 2007-09-28 | マイクロ波アンテナアセンブリおよびそれを使用する方法 |
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JP2012228570A JP2012228570A (ja) | 2012-11-22 |
JP5686772B2 true JP5686772B2 (ja) | 2015-03-18 |
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JP2007256540A Expired - Fee Related JP5145001B2 (ja) | 2006-09-29 | 2007-09-28 | マイクロ波アンテナアセンブリおよびそれを使用する方法 |
JP2012170073A Expired - Fee Related JP5686772B2 (ja) | 2006-09-29 | 2012-07-31 | マイクロ波アンテナアセンブリおよびそれを使用する方法 |
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US (3) | US8068921B2 (ja) |
EP (1) | EP1905375B1 (ja) |
JP (2) | JP5145001B2 (ja) |
AU (1) | AU2007219344B2 (ja) |
CA (1) | CA2604318C (ja) |
DE (1) | DE602007007859D1 (ja) |
ES (1) | ES2348679T3 (ja) |
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US9333032B2 (en) | 2016-05-10 |
JP2012228570A (ja) | 2012-11-22 |
US8068921B2 (en) | 2011-11-29 |
AU2007219344A1 (en) | 2008-04-17 |
ES2348679T3 (es) | 2010-12-10 |
CA2604318A1 (en) | 2008-03-29 |
JP2008086774A (ja) | 2008-04-17 |
DE602007007859D1 (de) | 2010-09-02 |
EP1905375B1 (en) | 2010-07-21 |
AU2007219344B2 (en) | 2012-02-02 |
US20160249981A1 (en) | 2016-09-01 |
CA2604318C (en) | 2016-09-06 |
EP1905375A1 (en) | 2008-04-02 |
US20120041433A1 (en) | 2012-02-16 |
US20080082093A1 (en) | 2008-04-03 |
JP5145001B2 (ja) | 2013-02-13 |
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