JP6174672B2 - 動静脈(av)フィステルを作るためのシステムおよび方法 - Google Patents
動静脈(av)フィステルを作るためのシステムおよび方法 Download PDFInfo
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
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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
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
- A61M1/3655—Arterio-venous shunts or fistulae
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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
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
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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
- A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
- A61B18/082—Probes or electrodes therefor
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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
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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
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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
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
- A61M25/09041—Mechanisms for insertion of guide wires
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
- A61N7/02—Localised ultrasound hyperthermia
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- A—HUMAN NECESSITIES
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- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1139—Side-to-side connections, e.g. shunt or X-connections
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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
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
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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
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
- A61B2018/00386—Coronary vessels
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- 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
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- A61B2018/00601—Cutting
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- 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
- A61B2018/00619—Welding
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- A—HUMAN NECESSITIES
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- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00714—Temperature
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/0091—Handpieces of the surgical instrument or device
- A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
- A61B2018/00922—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device by switching or controlling the treatment energy directly within the hand-piece
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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
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1425—Needle
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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
- A61B2018/1475—Electrodes retractable in or deployable from a housing
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- Hematology (AREA)
- Mechanical Engineering (AREA)
- Dentistry (AREA)
- Electromagnetism (AREA)
- Radiology & Medical Imaging (AREA)
- Pathology (AREA)
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Description
Claims (8)
- 近位端、遠位端、および開口が設けられた表面を有する第1の部分、
前記第1の部分に旋回可能に連結された非伸縮性の第2の部分であって、第1の部分の管腔および第1の身体管腔を通って、第2の身体管腔に送達されるように構成された、第2の部分、
前記第1の部分とは別体で前記第1の部分に連結された第1のエネルギー送達部分、
前記第2の部分とは別体で前記第2の部分に連結された第2のエネルギー送達部分であって、第1のエネルギー送達部分に直接接合して対向する第2のエネルギー送達部分、および、
前記第2の部分を、前記第2の身体管腔の壁から離れて配された第1の位置から、前記第2の身体管腔の壁に隣接する第2の位置まで移動させるように構成されたアクチュエータであって、前記第1の部分と第2の部分との間に切断および溶接を実施するのに十分な圧力およびエネルギーを適用するためのアクチュエータを備え、
前記アクチュエータは前記第2の部分に備えられるシャフトに連結され、該シャフトは第1の部分の管腔内に摺動可能に位置づけられ、前記第2の部分は前記第1の部分の表面に対向し、前記第2の位置において前記第2の部分の長さ寸法が前記第1の部分の開口の長さ寸法以上であり、かつ前記第2の位置において前記第2の部分が前記開口を横切って延びることを特徴とする装置。 - 前記装置が第1の構造であるときに、前記第1の部分と非伸縮性の前記第2の部分は第1の距離だけ離れるように構成され、前記装置が第2の構造であるときに、前記第1の部分と前記第2の部分は第2の距離だけ離れるように構成され、前記第1の距離は前記第2の距離とは異なる、請求項1に記載の装置。
- 前記第1の部分は、前記第1の部分の軸に対し交差する角度で前記第1の身体管腔の壁と係合するように構成された遠位端部を含む、請求項1に記載の装置。
- 非伸縮性の前記第2の部分は、前記第2の部分の軸に対し交差する角度で前記第2の身体管腔の壁と係合するように構成された表面を含む、請求項1に記載の装置。
- 前記第1の部分は第1の表面を有し、前記第2の部分は第2の表面を有し、第1の表面と第2の表面は実質的に平行または同一平面上にある、請求項1に記載の装置。
- 前記第1のエネルギー送達部分または前記第2のエネルギー送達部分の少なくとも一方の温度を制御するように構成されたフィードバック制御デバイスをさらに備える、請求項1に記載の装置。
- 非伸縮性の前記第2の部分は、第1の構造と第2の構造との間で移動可能であり、前記第2の部分は、前記第1の構造で第1の横方向の寸法を有し、前記第2の構造で第2の横方向の寸法を有する、請求項1に記載の装置。
- 前記シャフトは、前記第2の部分が前記第1の部分から離れるように移動すると、一方向に前記第2の部分を付勢するように構成される、請求項1に記載の装置。
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
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US35490310P | 2010-06-15 | 2010-06-15 | |
US61/354,903 | 2010-06-15 | ||
US201161480486P | 2011-04-29 | 2011-04-29 | |
US61/480,486 | 2011-04-29 |
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JP2013515482A Division JP5864064B2 (ja) | 2010-06-15 | 2011-06-15 | 動静脈(av)フィステルを作るためのシステムおよび方法 |
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JP2016093528A JP2016093528A (ja) | 2016-05-26 |
JP6174672B2 true JP6174672B2 (ja) | 2017-08-02 |
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JP2013515482A Active JP5864064B2 (ja) | 2010-06-15 | 2011-06-15 | 動静脈(av)フィステルを作るためのシステムおよび方法 |
JP2015250535A Active JP6174672B2 (ja) | 2010-06-15 | 2015-12-22 | 動静脈(av)フィステルを作るためのシステムおよび方法 |
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JP2013515482A Active JP5864064B2 (ja) | 2010-06-15 | 2011-06-15 | 動静脈(av)フィステルを作るためのシステムおよび方法 |
Country Status (6)
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US (5) | US9445868B2 (ja) |
EP (1) | EP2582306B1 (ja) |
JP (2) | JP5864064B2 (ja) |
AU (1) | AU2011268411B2 (ja) |
CA (1) | CA2804524C (ja) |
WO (1) | WO2011159802A1 (ja) |
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US20140094791A1 (en) | 2014-04-03 |
US9439728B2 (en) | 2016-09-13 |
EP2582306A4 (en) | 2017-04-26 |
AU2011268411B2 (en) | 2014-11-27 |
WO2011159802A1 (en) | 2011-12-22 |
JP2013528472A (ja) | 2013-07-11 |
US20110306993A1 (en) | 2011-12-15 |
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EP2582306A1 (en) | 2013-04-24 |
JP2016093528A (ja) | 2016-05-26 |
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