JP6672479B2 - レーザ砕石術のための装置及び方法 - Google Patents
レーザ砕石術のための装置及び方法 Download PDFInfo
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- JP6672479B2 JP6672479B2 JP2018558356A JP2018558356A JP6672479B2 JP 6672479 B2 JP6672479 B2 JP 6672479B2 JP 2018558356 A JP2018558356 A JP 2018558356A JP 2018558356 A JP2018558356 A JP 2018558356A JP 6672479 B2 JP6672479 B2 JP 6672479B2
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Classifications
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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
- A61B18/20—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 laser
- A61B18/22—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 laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B18/26—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 laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor for producing a shock wave, e.g. laser lithotripsy
-
- 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
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00057—Light
-
- 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
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
-
- 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
- A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
- A61B2018/00267—Expandable means emitting energy, e.g. by elements carried thereon having a basket shaped structure
-
- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
-
- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00702—Power or energy
- A61B2018/00708—Power or energy switching the power on or off
-
- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00732—Frequency
-
- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00779—Power or energy
- A61B2018/00785—Reflected power
-
- 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
- A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/002—Irrigation
Landscapes
- Health & Medical Sciences (AREA)
- Physics & Mathematics (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Optics & Photonics (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Electromagnetism (AREA)
- Otolaryngology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Vascular Medicine (AREA)
- Surgical Instruments (AREA)
- Laser Surgery Devices (AREA)
- Endoscopes (AREA)
Description
12 内視鏡
14 主ユニット
16 ユーザコントロール
18 コントローラ
20 レーザ
22 シャフト
24 イメージバンドル
25 照明用バンドル
26 ワーキングチャネル
27 照明用バンドル
28 ツール
30 バスケットデバイス
32 シース
34 バスケット
36 バスケットアーム
38 補助デバイス、シース
40 レーザファイバ
42 第1の管
44 第2の管
45 チャネル
46 第1のルーメン
48 第2のルーメン
50 レーザファイバ導入口
52 液体導入口
54 ポスト
56 プロセッサ
58 メモリ
60 検出システム
62 範囲判定機能
64 放射率判定機能
66 画像処理機能
68 ブロック
70 経路
72 結石
86 自動バスケット制御機
90 光学パターン
Claims (11)
- 結石を断片化するための装置であって、前記装置が、
ワーキングチャネルを含む内視鏡であって、前記ワーキングチャネルが、その中に挿通される回収バスケットを有するように構成される、内視鏡と、
レーザファイバと、
少なくとも2つのルーメンを含むシースであって、前記ルーメンのうち第1のルーメンが、前記第1のルーメンを通って延在する前記内視鏡のシャフトを有し、前記ルーメンのうち第2のルーメンが、前記シャフトの外側面に近接するチャネルを備える前記内視鏡の前記シャフトから離隔され、前記第2のルーメンがその中に挿通される前記レーザファイバを有する、シースと、
前記レーザファイバから低エネルギーチェックパルスを送達し、かつ前記低エネルギーチェックパルスの反射を検出するように構成され、並びに前記レーザファイバからの高エネルギーレーザパルスの送達を制御して前記結石を断片化するように構成される、検出フィードバックシステムと、
を備える装置。 - 前記第1のルーメンが、少なくとも部分的に第1の管によって形成され、
前記第2のルーメンが、少なくとも部分的に可撓性を有する管によって形成され、
前記第2のルーメンは前記第1のルーメンに対して近接して配置されており、前記可撓性を有する管は、前記第1の管に対して潰れるように構成される、請求項1に記載の装置。 - 前記第2のルーメンが、前記第2のルーメンの近位端に、実質的に硬質の導入口を備える、請求項1〜2のいずれか一項に記載の装置。
- 前記第2のルーメンの近位端が、レーザファイバ導入口と、前記第2のルーメンにつながる別個の液体導入口との両方を含む、請求項1〜3のいずれか一項に記載の装置。
- 前記検出フィードバックシステムが、前記レーザファイバの端と、前記低エネルギーチェックパルスが当たる対象との間の範囲を検出するように構成される範囲検出システムを含む、請求項1〜4のいずれか一項に記載の装置。
- 前記検出フィードバックシステムが、反射率及び/又は放射率を測定するように構成される、請求項1〜5のいずれか一項に記載の装置。
- 前記検出フィードバックシステムが、画像処理を使用するように構成される、請求項1〜6のいずれか一項に記載の装置。
- 前記検出フィードバックシステムが、
前記回収バスケットの少なくとも一部分の形状、
前記回収バスケットの少なくとも一部分の色、及び
前記回収バスケットの少なくとも一部分の模様、
のうちの少なくとも1つを認識するように構成される、請求項7に記載の装置。 - 前記検出フィードバックシステムが、前記高エネルギーレーザパルスが前記回収バスケットに当たるであろうことを判定する前記検出フィードバックシステムに基づいて、前記高エネルギーレーザパルスの送達を止めるように構成される、請求項1〜8のいずれか一項に記載の装置。
- 前記検出フィードバックシステムが、前記回収バスケットの一部が前記レーザファイバの前方の経路に位置するかどうかを検出するための手段を含む、請求項1〜9のいずれか一項に記載の装置。
- 機器によって読み取り可能な、非一過性のプログラム記憶デバイスであって、
前記非一過性のプログラム記憶デバイスは、動作を実施するための機器によって実行可能な命令のプログラムを有し、前記動作が、
レーザファイバから低エネルギーチェックパルスを送達することと、
前記低エネルギーチェックパルスの反射を検出することと、
検出された前記反射に基づいて、
前記レーザファイバから高エネルギーレーザパルスを送達して結石を断片化するか、又は
前記レーザファイバから異なる低エネルギーチェックパルスを送達するかを判定することと、
を含む非一過性のプログラム記憶デバイス。
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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JP2020035787A JP6942831B2 (ja) | 2016-05-18 | 2020-03-03 | レーザ砕石術のための装置及び方法 |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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PCT/IB2016/052909 WO2017199066A1 (en) | 2016-05-18 | 2016-05-18 | Apparatus for laser lithotripsy |
Related Child Applications (1)
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JP2020035787A Division JP6942831B2 (ja) | 2016-05-18 | 2020-03-03 | レーザ砕石術のための装置及び方法 |
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JP2019522505A JP2019522505A (ja) | 2019-08-15 |
JP6672479B2 true JP6672479B2 (ja) | 2020-03-25 |
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Country Status (6)
Country | Link |
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US (2) | US10646276B2 (ja) |
EP (2) | EP3439570B1 (ja) |
JP (1) | JP6672479B2 (ja) |
CN (2) | CN109152607B (ja) |
ES (1) | ES2778924T3 (ja) |
WO (1) | WO2017199066A1 (ja) |
Cited By (1)
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US11311338B2 (en) | 2016-05-18 | 2022-04-26 | Gyrus Acmi, Inc. | Apparatus for laser lithotripsy |
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USD943743S1 (en) * | 2019-01-15 | 2022-02-15 | Olympus Corporation | Stone retrieval basket for medical device |
US11534189B2 (en) | 2019-03-01 | 2022-12-27 | Gyrus Acmi, Inc. | Surgical basket |
WO2023279055A1 (en) | 2021-07-01 | 2023-01-05 | Gyrus Acmi, Inc. D/B/A Olympus Surgical Technologies America | Biopsy device with loose light conductor |
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CN115177364A (zh) * | 2022-07-20 | 2022-10-14 | 中国人民解放军空军军医大学 | 一种带有反馈系统的铥激光碎石设备 |
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2016
- 2016-05-18 CN CN201680085793.9A patent/CN109152607B/zh active Active
- 2016-05-18 EP EP16726960.4A patent/EP3439570B1/en active Active
- 2016-05-18 US US16/302,147 patent/US10646276B2/en active Active
- 2016-05-18 CN CN202010095463.6A patent/CN111281532B/zh active Active
- 2016-05-18 WO PCT/IB2016/052909 patent/WO2017199066A1/en active Application Filing
- 2016-05-18 ES ES16726960T patent/ES2778924T3/es active Active
- 2016-05-18 EP EP19204014.5A patent/EP3632359A1/en active Pending
- 2016-05-18 JP JP2018558356A patent/JP6672479B2/ja active Active
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- 2020-03-04 US US16/808,491 patent/US11311338B2/en active Active
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11311338B2 (en) | 2016-05-18 | 2022-04-26 | Gyrus Acmi, Inc. | Apparatus for laser lithotripsy |
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EP3632359A1 (en) | 2020-04-08 |
CN109152607B (zh) | 2020-04-24 |
JP2019522505A (ja) | 2019-08-15 |
CN111281532A (zh) | 2020-06-16 |
US20200197094A1 (en) | 2020-06-25 |
US20190282299A1 (en) | 2019-09-19 |
EP3439570B1 (en) | 2019-12-18 |
ES2778924T3 (es) | 2020-08-12 |
US10646276B2 (en) | 2020-05-12 |
CN109152607A (zh) | 2019-01-04 |
CN111281532B (zh) | 2023-06-13 |
US11311338B2 (en) | 2022-04-26 |
EP3439570A1 (en) | 2019-02-13 |
WO2017199066A1 (en) | 2017-11-23 |
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