JP6417433B2 - 医療デバイス - Google Patents
医療デバイス Download PDFInfo
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- JP6417433B2 JP6417433B2 JP2017018836A JP2017018836A JP6417433B2 JP 6417433 B2 JP6417433 B2 JP 6417433B2 JP 2017018836 A JP2017018836 A JP 2017018836A JP 2017018836 A JP2017018836 A JP 2017018836A JP 6417433 B2 JP6417433 B2 JP 6417433B2
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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
- A61B1/012—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
- A61B1/015—Control of fluid supply or evacuation
-
- 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
- A61B1/012—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
-
- 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
- A61B1/303—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 vagina, i.e. vaginoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/42—Gynaecological or obstetrical instruments or methods
-
- 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
- A61B18/042—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating using additional gas becoming plasma
-
- 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
-
- 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
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
-
- 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
- A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/42—Gynaecological or obstetrical instruments or methods
- A61B2017/4216—Operations on uterus, e.g. endometrium
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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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00184—Moving parts
- A61B2018/00196—Moving parts reciprocating lengthwise
-
- 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
- A61B2018/00559—Female reproductive organs
-
- 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
- A61B2018/00571—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
-
- 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
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00601—Cutting
-
- 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
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
-
- 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
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/02—Details of sensors specially adapted for in-vivo measurements
- A61B2562/0247—Pressure sensors
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- General Health & Medical Sciences (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Optics & Photonics (AREA)
- Pathology (AREA)
- Radiology & Medical Imaging (AREA)
- Plasma & Fusion (AREA)
- Otolaryngology (AREA)
- Gynecology & Obstetrics (AREA)
- Reproductive Health (AREA)
- Pregnancy & Childbirth (AREA)
- Surgical Instruments (AREA)
- Endoscopes (AREA)
Description
他の実施形態においては、圧力センサは使い捨てであってもよい。第2チャネルは、0.5mm2よりも大きな、しばしば1.0mm2よりも大きな断面積を有してもよい。
本発明の第3の態様においては、子宮内の類線維腫またはポリープを切除するための方法は、子宮鏡の伸長部の先端部を子宮内に経頸管的に導入するステップを含む。器具の切除端部が伸長部の先端部から延びるように、子宮鏡の湾曲したチャネル内において切除器具を前進させる。器具の切除端部は器具が湾曲したチャネル内に留まっている間に類線維腫またはポリープに係合する。湾曲は、有利には、切除端部が係合している間に切除器具シャフトがチャネルに対して軸方向変位することに対する抵抗を提供する。抵抗は、しかしながら、湾曲チャネルが所望の回転を大幅に阻止しない程度である。
図17〜22の任意の実施形態においては、図17〜22に示す圧力リリーフ弁の位置において膨張オフ軸線チャンバ550と連通する圧力センサを設けることができる。
320 作動チャネル(第3チャネル)
322 使い捨てアダプタ構成要素
325 本体
328 シャフト部分
355A 非直線部(基端部)
355B 直線チャネル部
356A 湾曲した軸線
356B 直線軸線
360 基端面
Claims (16)
- 子宮腔にアクセスするための改良型のシステムであって、
シャフト部分に結合された本体を有する子宮鏡であって、前記シャフト部分が患者の子宮腔に経頸管的に延びるように構成される、子宮鏡と、
前記本体から前記シャフト部分の先端部まで延びる第1チャネル、第2チャネル及び第3チャネルと、
前記第1チャネルの基端部に結合可能な流体源と、
前記第2チャネルの基端部に着脱可能に結合された圧力センサと、
前記第3チャネルを通して導入するように構成された組織切除プローブと、を含み、
前記第3チャネルは、前記シャフト部分を長手方向に貫通する直線チャネル部と、前記本体を貫通する基端部を有し、
前記組織切除プローブは、細長いシャフトアセンブリを有し、前記シャフトアセンブリは、内腔を有する外部スリーブと、前記内腔内で往復動することができる内部スリーブを有し、前記外部スリーブは、金属材料を含み、
前記第3チャネルの基端部は、前記本体の基端面において、前記本体の中を通って前記本体の基端面まで延長された前記直線チャネル部の中心線からオフセットされ、
前記第3チャネルの基端部は、前記第3チャネル内における前記組織切除プローブの回転を可能にする一方で、前記第3チャネル内における前記組織切除プローブの軸方向摺動に対して選択したレベルの抵抗を付与するように構成される、システム。 - 前記第3チャネルの基端部は、前記基端面において、前記本体の中を通って前記基端面まで延長された前記直線チャネル部の中心線から2mm〜5mmの範囲内の距離だけオフセットされる、請求項1に記載のシステム。
- 前記第3チャネルの直線チャネル部の中心線は、直線である、請求項1に記載のシステム。
- 前記第3チャネルの基端部の中心線は、前記直線チャネル部の中心線と斜めの角度で交差する、請求項1に記載のシステム。
- 前記第3チャネルの基端部は、非線形中心線を有する、請求項1に記載のシステム。
- 前記非線形中心線は、4cm〜8cmの範囲内の長さにわたって延びる、請求項5に記載のシステム。
- 前記第3チャネルの基端部の非線形中心線は、湾曲する、請求項5に記載のシステム。
- 前記非線形中心線は、150mm〜900mmの範囲内の半径を有する、請求項7に記載のシステム。
- 前記圧力センサは使い捨てである、請求項1に記載のシステム。
- 更に、前記流体源に接続された制御部を含み、前記制御部は、前記第1チャネルから子宮腔への流れを0ml/分〜750ml/分の流量で選択的に制御するように適合される、請求項1に記載のシステム。
- 前記制御部は、前記圧力センサに接続され、子宮腔内の圧力を0KPa(0mmHg)〜19.998KPa(150mmHg)の任意のレベルに選択的に制御するように適合される、請求項10に記載のシステム。
- 前記制御部は、前記第3チャネルを通過する前記子宮腔からの流れを0ml/分〜750ml/分の任意の流量で選択的に制御するように適合される、請求項10に記載のシステム。
- 前記第2チャネルは、0.5mm2よりも大きい断面積を有する、請求項1に記載のシステム。
- 前記第2チャネルは、1.0mm2よりも大きい断面積を有する、請求項13に記載のシステム。
- 更に、前記本体内の圧力リリーフ弁を含む、請求項1に記載のシステム。
- 更に、前記本体に着脱式に結合可能な使い捨てアダプタ構成要素を有し、前記アダプタ構成要素は、前記組織切除プローブが前記第3チャネル内に配置されていても配置されていなくても、前記第3チャネルの基端部をシールするように構成される、請求項1に記載のシステム。
Applications Claiming Priority (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201261589168P | 2012-01-20 | 2012-01-20 | |
US61/589,168 | 2012-01-20 | ||
US201261635803P | 2012-04-19 | 2012-04-19 | |
US61/635,803 | 2012-04-19 | ||
US201261659312P | 2012-06-13 | 2012-06-13 | |
US61/659,312 | 2012-06-13 |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2014553516A Division JP6122874B2 (ja) | 2012-01-20 | 2013-01-22 | 医療デバイスおよび方法 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2018190308A Division JP6697524B2 (ja) | 2012-01-20 | 2018-10-05 | 医療デバイス |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2017080529A JP2017080529A (ja) | 2017-05-18 |
JP6417433B2 true JP6417433B2 (ja) | 2018-11-07 |
Family
ID=48799751
Family Applications (5)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2014553516A Active JP6122874B2 (ja) | 2012-01-20 | 2013-01-22 | 医療デバイスおよび方法 |
JP2017018836A Active JP6417433B2 (ja) | 2012-01-20 | 2017-02-03 | 医療デバイス |
JP2018190308A Active JP6697524B2 (ja) | 2012-01-20 | 2018-10-05 | 医療デバイス |
JP2020077421A Active JP7191888B2 (ja) | 2012-01-20 | 2020-04-24 | 医療デバイス |
JP2021200922A Active JP7185751B2 (ja) | 2012-01-20 | 2021-12-10 | 医療デバイス |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2014553516A Active JP6122874B2 (ja) | 2012-01-20 | 2013-01-22 | 医療デバイスおよび方法 |
Family Applications After (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2018190308A Active JP6697524B2 (ja) | 2012-01-20 | 2018-10-05 | 医療デバイス |
JP2020077421A Active JP7191888B2 (ja) | 2012-01-20 | 2020-04-24 | 医療デバイス |
JP2021200922A Active JP7185751B2 (ja) | 2012-01-20 | 2021-12-10 | 医療デバイス |
Country Status (8)
Country | Link |
---|---|
US (4) | US9439677B2 (ja) |
EP (2) | EP2804550B1 (ja) |
JP (5) | JP6122874B2 (ja) |
CN (2) | CN108354664B (ja) |
AU (5) | AU2013209409B2 (ja) |
CA (3) | CA3187927A1 (ja) |
ES (1) | ES2677145T3 (ja) |
WO (1) | WO2013110073A1 (ja) |
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