JPH11511991A - 選択対象物を融除するための方法及び装置 - Google Patents
選択対象物を融除するための方法及び装置Info
- Publication number
- JPH11511991A JPH11511991A JP9509547A JP50954797A JPH11511991A JP H11511991 A JPH11511991 A JP H11511991A JP 9509547 A JP9509547 A JP 9509547A JP 50954797 A JP50954797 A JP 50954797A JP H11511991 A JPH11511991 A JP H11511991A
- Authority
- JP
- Japan
- Prior art keywords
- electrode
- antenna
- ablation
- probe
- primary antenna
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
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- A61N1/40—Applying electric fields by inductive or capacitive coupling ; Applying radio-frequency signals
- A61N1/403—Applying electric fields by inductive or capacitive coupling ; Applying radio-frequency signals for thermotherapy, e.g. hyperthermia
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- Surgical Instruments (AREA)
Abstract
Description
Claims (1)
- 【特許請求の範囲】 1.管腔と長手方向軸線とを有する一次アンテナと、前記長手方向軸線に対して 横方向に前記管腔から展延可能な二次アンテナと、を含み、各二次アンテナの少 なくとも遠位端部は一次アンテナよりも構造的に剛性が小さく、一次アンテナは 組織を通して導入されるのに十分に剛性である多重アンテナ装置と、 エネルギ源と、 多重アンテナ装置を前記エネルギ源に結合する少なくとも1のケーブルと、 一次アンテナに結合された冷却要素と、を含む、 ことを特徴とする融除装置。 2.一次アンテナが、二次アンテナの融除面の長さの少なくとも20%の長さの 融除面を有する、 ことを特徴とする請求の範囲第1項に記載の装置。 3.一次アンテナが、二次アンテナの融除面の長さの少なくとも1/3の長さの 融除面を有する、 ことを特徴とする請求の範囲第1項に記載の装置。 4.一次アンテナが、二次アンテナの融除面の長さの少なくとも1/2の長さの 融除面を有する、 ことを特徴とする請求の範囲1項に記載の装置。 5.二本の二次電極が設けられて一次アンテナから横方向に展延し、一次アンテ ナ及び二次アンテナのそれぞれが、融除面の間に融除領域を生成するように融除 面を有する、 ことを特徴とする請求の範囲第1項に記載の装置。 6.三本の二次電極が設けられて一次アンテナから横方向に展延し、一次アンテ ナ及び二次アンテナのそれぞれが、融除面の間に融除領域を生成するように融除 面を有する、 ことを特徴とする請求の判示第1項に記載の装置。 7.一次アンテナの外側の少なくとも一部に該部分を取り囲むようにして位置決 めされた絶縁スリーブを更にを含む、 ことを特徴とする請求の範囲第1項に記載の装置。 8.絶縁スリーブは、一次アンテナの外側に沿って調節可能に移動可能である、 ことを特徴とする請求の範囲第7項に記載の装置。 9.二次アンテナの外側の少なくとも一部に該部分を取り囲むようにして位置決 めされた絶縁スリーブを更に含む、 ことを特徴とする請求の範囲第1項に記載の装置。 10.絶縁スリーブは、二次アンテナの外側に沿って調節可能に移動可能である、 ことを特徴とする請求の範囲第9項に記載の装置。 11.接地パッド電極を更に含み、 一次及び二次アンテナがモノポーラモードで動作する、 ことを特徴とする請求の範囲第1項に記載の装置。 12.一次アンテナ及び二次アンテナが、高周波アンテナである、 ことを特徴とする請求の範囲第1項に記載の装置。 13.冷却要素が、実質的に、一次アンテナが融除エネルギ供給面を有するところ だけで一次アンテナを冷却する、 ことを特徴とする請求の範囲第1項に記載の装置。 14.冷却要素は、冷却媒体を受け入れるように構成された少なくとも1つのチャ ンネルを含む一次アンテナの内側に位置決めされた構造を含む、 ことを特徴とする請求の範囲第1項に記載の装置。 15.冷却媒体は前記チャンネルを通って再循環される、 ことを特徴とする請求の範囲第14項に記載の装置。 16.一次アンテナは開いている、 ことを特徴とする請求の範囲第1項に記載の装置。 17.一次アンテナは閉じている、 ことを特徴とする請求の範囲第1項に記載の装置。 18.冷却要素は一次アンテナの内側に位置決めされている、 ことを特徴とする請求の範囲第1項に記載の装置。 19.冷却要素は、一次アンテナの外側表面に位置決めされている、 ことを特徴とする請求の範囲第1項に記載の装置。 20.冷却要素は、一次アンテナを構成する壁内に位置決めされている、 ことを特徴とする請求の範囲第1項に記載の装置。 21.選択組織対象物内に融除領域を生成する方法であって、 一次アンテナと、一次アンテナに形成された一次アンテナ管腔内に収容され る一本以上の展延可能な二次アンテナと、一次アンテナに結合された冷却要素と 、アンテナに結合されて電磁エネルギを供給するエネルギ源と、を有する融除装 置を準備し、 選択組織対象物内に一次アンテナを挿入し、 少なくとも一本の二次アンテナを一次アンテナ管腔から一次アンテナの長手 方向軸線に対して横方向に選択組織対象物内に前進させ、 一次アンテナの融除面を冷却し、 一次アンテナ融除面又は二次アンテナ融除面の一方又は両方から選択組織対 象物に電磁エネルギを供給し、 選択組織対象物内に融除領域を生成する、 ことを特徴とする方法。 22.それぞれ融除面を有する二本の二次アンテナを一次アンテナから前進させ、 二本の二次アンテナの融除面と一次アンテナ融除面との間に融除領域を形成する 、 ことを特徴とする請求の範囲第21項に記載の方法。 23.一次アンテナの遠位端部から二本の二次アンテナを前進させる、 ことを特徴とする請求の範囲第22項に記載の方法。 24.一次アンテナに形成された別々の開口部から二本の二次アンテナを前進させ る、 ことを特徴とする請求の範囲第22項に記載の方法。 25.一次アンテナから二本の二次アンテナを前進させ、平面を構成する、 ことを特徴とする請求の範囲第22項に記載の方法。 26.一次アンテナから三本の二次アンテナを前進させる、 ことを特徴とする請求の範囲第21項に記載の方法。 27.三本の二次アンテナのそれぞれ及び一次アンテナが、融除面を有し、アンテ ナの融除面の間に融除領域を生成する、 ことを特徴とする請求の範囲第26項に記載の方法。 28.一次アンテナが、二次アンテナの融除面の20%以上の融除面を有する、 ことを特徴とする請求の範囲第21項に記載の方法。 29.一次アンテナが、二次アンテナの融除面の1/3以上の融除面を有する、 ことを特徴とする請求の範囲第21項に記載の方法。 30.一次アンテナが、二次アンテナの融除面の1/2以上の融除面を有する、 ことを特徴とする請求の範囲第21項に記載の方法。 31.一次アンテナ及び二次アンテナが、モノポーラモードで動作する、 ことを特徴とする請求の範囲第21項に記載の方法。 32.融除装置が、バイポーラモードで動作する、 ことを特徴とする請求の範囲第21項に記載の方法。 33.電磁エネルギは高周波エネルギである ことを特徴とする請求の範囲21項に記載の方法。 34.一次アンテナの融除面を、電磁エネルギを選択組織対象物に供給している間 に融除面を妨害しないようにするほど十分に冷却する、 ことを特徴とする請求の範囲第21項に記載の方法。 35.一次アンテナの融除面を、十分に冷却し、一次アンテナの融除面と二次アン テナの融除面との間の選択組織対象物を、一次アンテナを妨害することなく融除 する、 ことを特徴とする請求の範囲第21項に記載の方法。 36.把手と、 把手の遠位端部から延びる電極と、を含み、前記電極は、遠位端部と、管腔 と、冷却媒体流入導管と、冷却媒体流出導管と、を含み、前記冷却媒体流入導管 及び冷却媒体流出導管はともに前記管腔を通って前記電極遠位端部まで延びてお り、前記電極は、前記前記冷却媒体流入導管及び冷却媒体流出導管内を流れる冷 却媒体から隔絶された側壁ポートを更に含み、 前記管腔内に位置決めされ、前記側壁開口部を通って前進後退されるように 構成されたプローブと、 前記プローブにより支持された熱センサと、 前記電極に結合されたエネルギ源と、を更に含む、 ことを特徴とする融除装置。 37.再循環冷却装置は、前記電極遠位端部で閉鎖ルーブを形成している、 ことを特徴とする請求の範囲第36項に記載の装置。 38.前記電極管腔は、冷却媒体から隔絶されたままである注入媒体を受け入れる ように構成されている、 ことを特徴とする請求の範囲第36項に記載の装置。 39.注入媒体は、前記電極管腔の近位端部から前記ポートを経て組織部位に導入 される、 ことを特徴とする請求の範囲第38項に記載の装置。 40.前記プローブに結合された前進及び後退部材を更に含む、 ことを特徴とする請求の範囲第36項に記載の装置。 41.前記プローブの少なくとも一部分は、前記エネルギ源に結合された電極であ る、 ことを特徴とする請求の範囲第36項に記載の装置。 42.2つの熱センサが前記プローブにより支持されている、 ことを特徴とする請求の範囲第36項に記載の装置。 43.第一の熱センサがプローブの遠位端部に位置決めされており、第2の熱セン サがプローブの遠位端部でない位置に位置決めされている、 ことを特徴とする請求の範囲第42項に記載の装置。 44.熱センサは、プローブの遠位端部に位置決めされている、 ことを特徴とする請求の範囲第36項に記載の装置。 45.電極の外側表面の周囲に位置決めされて絶縁スリーブを更に含む、 ことを特徴とする請求の範囲第36項に記載の装置。 46.絶縁スリーブは、電極の長手方向軸線に沿って移動可能である、 ことを特徴とする請求の範囲第45項に記載の装置。 47.電極に形成された第二の側壁ポートを更に含む、 ことを特徴とする請求の範囲第36項に記載の装置。 48.電極管腔内に位置決めされ、第二の側壁ポートを通って前進及び後退される ように構成された第二のプローブと、 第二のプローブにより支持された第二の熱センサと、を含む、 ことを特徴とする請求の範囲第47項に記載の装置。 49.電極に構造的支持を付加するように第一の導管及び第2の導管がつくらてて いる、 ことを特徴とする請求の範囲第36項に記載の装置。 50.プローブは、該プローブがポートから展延されるときに電極を固定位置に保 持するように構成された遠位端部形状を有する、 ことを特徴とする請求の範囲第36項に記載の装置。 51.第一の導管と第二の導管は電極管腔内で互いに隣接して位置決めされている 、 ことを特徴とする請求の範囲第36項に記載の装置。 52.組織部位の測定された温度を所定の温度値と比較し、測定された温度と所定 の温度との差を表す信号を発生する比較器装置を更に含む、 ことを特徴とする請求の範囲第36項に記載の装置。 53.測定された温度を所定の温度以下に維持するために温度差を表す比較器から の信号に応答して電極管腔内を流れる冷却媒体の流量を調節するための流体制御 装置を更に含む、 ことを特徴とする請求の範囲第52項に記載の装置。 54.エネルギ源に結合されたエネルギ出力制御装置を更に含む、 ことを特徴とする請求の範囲第36項に記載の装置。 55.エネルギ出力制御装置は、 組織に加えられるエルルギに基づいて組織のインピーダンス値を測定するた めのインピーダンス測定装置と、 測定された組織のインピーダンス値を所定の最大インピーダンス値と比較し 、測定されたインピーダンス値が所定の最大インピーダンス値を越えている場合 に無効化信号を発生するインピーダンス比較器装置と、 エネルギ源から電極へのエネルギの更なる供給を止めるため無効化信号をエ ネルギ源に伝える伝達装置と、を更に含む、 ことを特徴とする請求の範囲第54項に記載の装置。 56.測定されたインピーダンス値を所定の最大インピーダンス値以下に維持する ためにインピーダンス差を表す比較装置からの信号に応答して電極管腔内を流れ る冷却媒体の流量を調節するための冷却媒体制御装置を更に含む、 ことを特徴とする請求の範囲第55項に記載の装置。 57.把手と、 把手の遠位端部から延びる電極と、を含み、電極は、遠位端部と、管腔と、 冷却媒体流入導管と、冷却媒体流出導管と、を含み、冷却媒体流入導管及び冷却 媒体流出導管はともに管腔を通って電極遠位端部まで延びており、電極は、冷却 媒体流入導管及び冷却媒体流出導管内を流れる冷却媒体から隔絶された側壁ポー トを更に含み、 流入導管に結合された冷却媒体源と、 電極に結合されたエネルギ源と、 選択された組織融除部位の温度を検出するため電極及びエネルギ源に結合さ れた温度センサと、 選択された組織融除部位の温度を所定の温度値と比較し、温度差を表す信号 を発生する比較器装置と、 選択された組織部位の測定された温度を所定の温度以下に維持するために温 度差を表す比較器からの信号に応答して流入導管及び流出導管内を流れる冷却媒 体の流量を調節するための流体制御装置と、を更に含む、 ことを特徴とする融除装置。 58.冷却媒体流入導管及び冷却媒体流出導管は、電極遠位端部で閉鎖ルーブを形 成している、 ことを特徴とする請求の範囲第57項に記載の装置。 59.電極の外側表面の周囲に位置決めされて絶縁スリーブを更に含む、 ことを特徴とする請求の範囲第57項に記載の装置。 60.絶縁スリーブは、電極の長手方向軸線に沿って移動可能である、 ことを特徴とする請求の範囲第45項に記載の装置。 61.電極管腔内に位置決めされ、絶縁スリーブポートを通って絶縁スリーブに前 進及び後退されるように構成された第のプローブを含む、 ことを特徴とする請求の範囲第57項に記載の装置。 62.プローブに結合された前進及び後退部材を更に含む、 ことを特徴とする請求の範囲第57項に記載の装置。 63.前記プローブの少なくとも一部分は、エネルギ源に結合された電極である、 ことを特徴とする請求の範囲第61項に記載の装置。 64.センサはプローブにより支持されている、 ことを特徴とする請求の範囲第57項に記載の装置。 65.熱センサはプローブの遠位端部に位置決めされている、 ことを特徴とする請求の範囲第64項に記載の装置。 66.2つの熱センサがプローブにより支持されている、 ことを特徴とする請求の範囲第61項に記載の装置。 67.第一の熱センサがプローブの遠位端部に位置決めされており、第2の熱セン サがプローブの遠位端部でない位置に位置決めされている、 ことを特徴とする請求の範囲第61項に記載の装置。 68.電極に形成された第二の側壁ポートを更に含む、 ことを特徴とする請求の範囲第57項に記載の装置。 69.電極に構造的支持を付加するように第一の導管及び第二の導管がつくらてて いる、 ことを特徴とする請求の範囲第57項に記載の装置。 70.プローブは、該プローブがポートから展延されるときに電極を固定位置に保 持するように構成された遠位端部形状を有する、 ことを特徴とする請求の範囲第61項に記載の装置。 71.第一の導管と第二の導管は電極管腔内で互いに隣接して位置決めされている 、 ことを特徴とする請求の範囲第57項に記載の装置。 72.選択組織対象物内に融除領域を生成する方法であって、 把手と、電極と、を含み、該電極は、遠位端部と、管腔と、電極内を流れる 冷却媒体から隔絶された側壁ポートと、を含み、管腔内に位置決めされ、側壁開 口部を通って前進後退されるように構成されたプローブと、前記プローブにより 支持された熱センサと、を更に含む融除装置を準備し、 選択組織対象物内に電極を挿入し、 電磁エネルギ供給面に隣接して組織インターフェースを形成し、 プローブの遠位端部を開口部から選択組織対象物内に前進させ、電極電磁エ ネルギ供給面の少なくとも一部を冷却し、 電極電磁エネルギ供給面から選択組織対象物に電磁エネルギを供給し、 選択組織対象物内の部位の温度を測定し、 選択組織対象物に融除領域を生成する、 ことを特徴とする方法。 73.熱センサを選択融除領域の周囲に位置決めする、 ことを特徴とする請求の範囲第72項に記載の方法。 74.熱センサを、電極と、選択融除領域の周囲との間に位置決めする、 ことを特徴とする請求の範囲第72項に記載の方法。 75.電極から電磁エネルギを供給している間に選択融除領域内の2以上の位置で 温度を測定する、 ことを特徴とする請求の範囲第72項に記載の方法。 76.電極から電磁エネルギを供給している間に選択融除領域内で調節可能に温度 を測定する、 ことを特徴とする請求の範囲第72項に記載の方法。 77.第二のセンサがプローブにより支持されている、 ことを特徴とする請求の範囲第72項に記載の方法。 78.センサはプローブの遠位端部に位置決めされており、第二のセンサがプロー ブの遠位端部と電極の外側表面との間でプローブに位置決めされている、 ことを特徴とする請求の範囲第72項に記載の方法。 79.注入媒体を開口部を通して導入する、 ことを特徴とする請求の範囲第72項に記載の方法。 80.注入媒体を冷却媒体から隔絶させる、 ことを特徴とする請求の範囲第79項に記載の方法。 81.電磁エネルギを選択組織部位に供給している間に組織インターフェースを5 0℃を越える温度に加熱する、 ことを特徴とする請求の範囲第72項に記載の方法。 82.プローブの展延された遠位端部が電極を選択位置に固定する、 ことを特徴とする請求の範囲第72項に記載の方法。 83.センサで選択組織部位の温度を測定し、 センサで測定した選択組織部位の温度を所定の温度値と比較し、測定された 温度と所定の温度値との差を表す信号を発生し、 測定された温度が所定の温度を越えている場合には更なる電磁エネルギの供 給を止める信号を電極に結合された電磁エネルギ源に伝える、ことを更に含む、 ことを特徴とする請求の範囲第72項に記載の方法。 84.センサで選択組織部位のインピーダンスを測定し、 センサで測定した選択組織部位のインピーダンスを所定のインピーダンス値 と比較し、測定されたインピーダンスと所定のインピーダンス値との差を表す信 号を発生し、 測定されたインピーダンスが所定のインピーダンスを越えている場合には更 なる電磁エネルギの供給を止める信号を電極に結合された電磁エネルギ源に伝え る、ことを更に含む、 ことを特徴とする請求の範囲第72項に記載の方法。 85.センサで選択組織部位の温度を測定し、 センサで測定した選択組織部位の温度を所定の温度値と比較し、 測定された温度と所定の温度値との差に基づいて電極内を流れる冷却流体の 流量を調節する、ことを更に含む、 請求の範囲第72項に記載の方法。 86.電極内を流れる冷却流体の流量は、1〜50ml/分である、 ことを特徴とする請求の範囲第72項に記載の方法。
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PCT/US1996/013409 WO1997006855A2 (en) | 1995-08-15 | 1996-08-15 | Apparatus for ablation of a selected mass |
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JP9509503A Pending JP2000500033A (ja) | 1995-08-15 | 1996-08-15 | 選択対象物を融除するための方法及び装置 |
JP9509548A Pending JPH11511992A (ja) | 1995-08-15 | 1996-08-15 | 選択対象物を融除するための方法及び装置 |
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1996
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- 1996-08-15 EP EP03076237A patent/EP1344497A1/en not_active Withdrawn
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- 1996-08-15 KR KR1019970702468A patent/KR100243744B1/ko not_active IP Right Cessation
- 1996-08-15 WO PCT/US1996/013300 patent/WO1997006740A2/en active IP Right Grant
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- 1996-08-15 DE DE69634051T patent/DE69634051T2/de not_active Expired - Lifetime
- 1996-08-15 JP JP9509548A patent/JPH11511992A/ja active Pending
- 1996-08-15 AU AU70079/96A patent/AU7007996A/en not_active Abandoned
- 1996-08-15 AU AU68512/96A patent/AU6851296A/en not_active Abandoned
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2001
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Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2001353164A (ja) * | 2000-04-27 | 2001-12-25 | Biosense Webster Inc | 切除カテーテル |
JP4559660B2 (ja) * | 2000-04-27 | 2010-10-13 | バイオセンス・ウェブスター・インコーポレーテッド | 切除カテーテル |
JP2014503231A (ja) * | 2010-11-04 | 2014-02-13 | パーフィント ヘルスケア プライベート リミテッド | センサーシステム |
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