JP6923665B2 - 基準マーキングによる高周波アブレーション処置の位置精度を改善する方法及びシステム - Google Patents
基準マーキングによる高周波アブレーション処置の位置精度を改善する方法及びシステム Download PDFInfo
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- JP6923665B2 JP6923665B2 JP2019546214A JP2019546214A JP6923665B2 JP 6923665 B2 JP6923665 B2 JP 6923665B2 JP 2019546214 A JP2019546214 A JP 2019546214A JP 2019546214 A JP2019546214 A JP 2019546214A JP 6923665 B2 JP6923665 B2 JP 6923665B2
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
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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
- A61B18/148—Probes or electrodes therefor having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0085—Brain, e.g. brain implants; Spinal cord
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/04—Centrally acting analgesics, e.g. opioids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00004—(bio)absorbable, (bio)resorbable, resorptive
-
- 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
- A61B2018/00005—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
-
- 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
- A61B2018/00005—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
- A61B2018/00023—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids closed, i.e. without wound contact by the fluid
-
- 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
- A61B2018/00059—Material properties
- A61B2018/00071—Electrical conductivity
- A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
-
- 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
- A61B2018/00107—Coatings on the energy applicator
- A61B2018/00154—Coatings on the energy applicator containing and delivering drugs
-
- 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
- A61B2018/00434—Neural system
-
- 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
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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
- A61B2018/00636—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
- A61B2018/0072—Current
-
- 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
- A61B2018/00744—Fluid flow
-
- 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
- A61B2018/00791—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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00904—Automatic detection of target tissue
-
- A—HUMAN NECESSITIES
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- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3925—Markers, e.g. radio-opaque or breast lesions markers ultrasonic
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3933—Liquid markers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3937—Visible markers
- A61B2090/3941—Photoluminescent markers
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3966—Radiopaque markers visible in an X-ray image
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3987—Applicators for implanting markers
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3991—Markers, e.g. radio-opaque or breast lesions markers having specific anchoring means to fixate the marker to the tissue, e.g. hooks
Description
Claims (17)
- 患者の標的神経に対して行われる高周波アブレーション処置の位置精度を改善するシステムであって、
外径、近位端、及び遠位端を有するプローブであって、前記プローブは、近位端に配置される電気絶縁部分と、遠位端に配置される標的神経にエネルギーを送達するための導電部分とを含む、該プローブと、
標的神経に隣接した患者の体内へのプローブの遠位端の挿入を容易にするためのイントロデューサであって、前記イントロデューサは、内径、近位端、及び遠位端を有し、プローブの露出した前記導電部分は、標的神経へのエネルギー送達中に前記イントロデューサの遠位端を越えて延び、プローブの外径及びイントロデューサの内径はルーメンを画定する、該イントロデューサと、
標的神経に伝わる神経信号伝達をブロックするのに十分な量で供給される薬剤と、
標的神経に隣接して配置されるように前記システムから前記患者の体内に送達される基準マーカーとを含むことを特徴とするシステム。 - 請求項1に記載のシステムであって、
前記患者の体内への前記イントロデューサの挿入を容易にするためのオブチュレータを含んでいることを特徴とするシステム。 - 請求項1または2に記載のシステムであって、
前記標的神経は、脊髄神経または末梢神経であることを特徴とするシステム。 - 請求項1または3に記載のシステムであって、
前記基準マーカーは、超音波不透過性、X線不透過性または蛍光性であることを特徴とするシステム。 - 請求項1〜4のいずれか1項に記載のシステムであって、
前記イントロデューサは、前記標的神経に前記薬剤を送達することを特徴とするシステム。 - 請求項1〜5のいずれか1項に記載のシステムであって、
前記基準マーカーは、前記イントロデューサの外面に配置されることを特徴とするシステム。 - 請求項1〜6のいずれか1項に記載のシステムであって、
前記基準マーカーは、前記イントロデューサを通過する前記基準マーカーの送達によって前記標的神経に隣接して配置されることを特徴とするシステム。 - 請求項1〜7のいずれか1項に記載のシステムであって、
前記基準マーカーは、前記標的神経に送達されるまで前記イントロデューサ内に収容されることを特徴とするシステム。 - 請求項8に記載のシステムであって、
前記基準マーカーは、前記基準マーカーを前記患者の体内に送達するための体内配置用の展開針内に収容され、
前記展開針は、前記展開針の開口端が前記イントロデューサの前記遠位端に配置されて前記標的神経に隣接するように、前記イントロデューサの前記近位端から前記イントロデューサ内に挿入され、
前記展開針はロッドを含み、
前記ロッドは前記展開針の前記開口端から前記基準マーカーを体内配置するように操作されることを特徴とするシステム。 - 請求項1〜9のいずれか1項に記載のシステムであって、
前記基準マーカーは、固体材料から形成されることを特徴とするシステム。 - 請求項1〜10のいずれか1項に記載のシステムであって、
前記基準マーカーは1以上の付属物を含み、
前記付属物は、前記基準マーカーを前記標的神経または前記標的神経に隣接した組織に固定することを特徴とするシステム。 - 請求項1〜5のいずれか1項に記載のシステムであって、
前記基準マーカーは、液状ポリマーとして前記標的神経に隣接して注入され、
前記液状ポリマーは、前記標的神経に隣接して配置された後に硬化することを特徴とするシステム。 - 請求項12に記載のシステムであって、
前記液状ポリマーはシリンジ内に収容され、
前記イントロデューサは、前記標的神経に隣接した前記液状ポリマーの注入を容易にするために前記シリンジを受容することを特徴とするシステム。 - 請求項1〜13のいずれか1項に記載のシステムであって、
前記基準マーカーは非生分解性であることを特徴とするシステム。 - 請求項1〜5のいずれか1項に記載のシステムであって、
前記基準マーカーは非生分解性の金属であることを特徴とするシステム。 - 請求項1〜13のいずれか1項に記載のシステムであって、
前記基準マーカーは生分解性であることを特徴とするシステム。 - 請求項1〜16のいずれか1項に記載のシステムであって、
前記薬剤はシリンジ内に収容され、
前記イントロデューサは、前記標的神経への前記薬剤の送達を容易にするために前記シリンジを受容することを特徴とするシステム。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/US2017/019603 WO2018156160A1 (en) | 2017-02-27 | 2017-02-27 | Method and system for improving location accuracy of a radiofrequency ablation procedure via fiducial marking |
Publications (3)
Publication Number | Publication Date |
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JP2020508169A JP2020508169A (ja) | 2020-03-19 |
JP2020508169A5 JP2020508169A5 (ja) | 2020-04-30 |
JP6923665B2 true JP6923665B2 (ja) | 2021-08-25 |
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JP2019546214A Active JP6923665B2 (ja) | 2017-02-27 | 2017-02-27 | 基準マーキングによる高周波アブレーション処置の位置精度を改善する方法及びシステム |
Country Status (7)
Country | Link |
---|---|
US (1) | US20200229862A1 (ja) |
EP (1) | EP3585291A1 (ja) |
JP (1) | JP6923665B2 (ja) |
KR (1) | KR20190121772A (ja) |
AU (2) | AU2017400540A1 (ja) |
MX (1) | MX2019009923A (ja) |
WO (1) | WO2018156160A1 (ja) |
Family Cites Families (16)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8882755B2 (en) | 2002-03-05 | 2014-11-11 | Kimberly-Clark Inc. | Electrosurgical device for treatment of tissue |
US20070156136A1 (en) | 2002-03-05 | 2007-07-05 | Neil Godara | Methods of treating the sacroiliac region of a patient's body |
US20060259026A1 (en) | 2005-05-05 | 2006-11-16 | Baylis Medical Company Inc. | Electrosurgical treatment method and device |
US7306596B2 (en) * | 2004-05-26 | 2007-12-11 | Baylis Medical Company Inc. | Multifunctional electrosurgical apparatus |
US20090024124A1 (en) * | 2005-07-14 | 2009-01-22 | Lefler Amy | Methods for treating the thoracic region of a patient's body |
US8043287B2 (en) | 2002-03-05 | 2011-10-25 | Kimberly-Clark Inc. | Method of treating biological tissue |
US7819869B2 (en) | 2004-11-15 | 2010-10-26 | Kimberly-Clark Inc. | Methods of treating the sacroilac region of a patient's body |
US7258688B1 (en) | 2002-04-16 | 2007-08-21 | Baylis Medical Company Inc. | Computerized electrical signal generator |
US7329414B2 (en) | 2002-05-03 | 2008-02-12 | Biopsy Sciences, Llc | Biodegradable polymer for marking tissue and sealing tracts |
US20050283148A1 (en) * | 2004-06-17 | 2005-12-22 | Janssen William M | Ablation apparatus and system to limit nerve conduction |
ES2539578T3 (es) * | 2005-08-10 | 2015-07-02 | C.R. Bard, Inc. | Dispositivo de biopsia de múltiples muestras e inserción única con diversos sistemas de transporte |
WO2013154776A2 (en) * | 2012-04-13 | 2013-10-17 | Covidien Lp | Energy delivery device and methods of use |
US9486275B2 (en) * | 2010-12-30 | 2016-11-08 | Avent, Inc. | Electrosurgical apparatus having a sensor |
US10272269B2 (en) * | 2012-11-13 | 2019-04-30 | Silk Road Medical, Inc. | Devices and methods for endoluminal delivery of either fluid or energy for denervation |
EP2991717A4 (en) * | 2013-05-02 | 2016-12-07 | Douglas C Harrington | DEVICES AND METHODS FOR DETECTION AND TREATMENT OF AORTICO-RENAL GANGLION |
US9949652B2 (en) * | 2013-10-25 | 2018-04-24 | Ablative Solutions, Inc. | Apparatus for effective ablation and nerve sensing associated with denervation |
-
2017
- 2017-02-27 WO PCT/US2017/019603 patent/WO2018156160A1/en active Application Filing
- 2017-02-27 KR KR1020197024613A patent/KR20190121772A/ko unknown
- 2017-02-27 AU AU2017400540A patent/AU2017400540A1/en not_active Abandoned
- 2017-02-27 MX MX2019009923A patent/MX2019009923A/es unknown
- 2017-02-27 EP EP17711829.6A patent/EP3585291A1/en active Pending
- 2017-02-27 US US16/486,868 patent/US20200229862A1/en active Pending
- 2017-02-27 JP JP2019546214A patent/JP6923665B2/ja active Active
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2023
- 2023-08-31 AU AU2023222938A patent/AU2023222938A1/en active Pending
Also Published As
Publication number | Publication date |
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KR20190121772A (ko) | 2019-10-28 |
AU2023222938A1 (en) | 2023-09-21 |
US20200229862A1 (en) | 2020-07-23 |
JP2020508169A (ja) | 2020-03-19 |
AU2017400540A1 (en) | 2019-08-15 |
WO2018156160A1 (en) | 2018-08-30 |
MX2019009923A (es) | 2019-09-26 |
EP3585291A1 (en) | 2020-01-01 |
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