JPWO2021101951A5 - - Google Patents
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本明細書に説明される主題の他のシステム、デバイス、方法、特徴、および利点が、以下の図および詳細な説明の検討に応じて、当業者に明白であろう、または明白となるであろう。全てのそのような付加的システム、方法、特徴、および利点が、本説明内に含まれ、本明細書に説明される主題の範囲内であり、付随の請求項によって保護されることを意図している。例示的実施形態の特徴は、請求項にそれらの特徴の明確な列挙がない場合に、添付される請求項を限定するものとしていかようにも解釈されるべきではない。
本発明は、例えば、以下の項目を提供する。
(項目1)
インプラントを送達するためのシステムであって、前記システムは、送達デバイスを備え、前記送達デバイスは、
外側管状部材の遠位端領域内に位置する撮像デバイスを備える外側管状部材と、
前記外側管状部材内の内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される管腔を有する第1の伸長管状部材と、管腔を有する第2の伸長管状部材と、前記内側管状部材の縦方向軸に略垂直である平面を画定する少なくとも1つの支持体とを備える、内側管状部材と、
前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記第2の伸長管状部材の管腔内で摺動可能に前進可能である1つまたはそれを上回る構造と
を備える、システム。
(項目2)
前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を用いて前記外側管状部材と解放可能に結合される近位制御デバイス
をさらに備え、
前記近位制御デバイスは、前記内側管状部材および前記外側管状部材を並行して縦方向に移動させるように構成される、項目1に記載のシステム。
(項目3)
前記インプラントをさらに備え、前記インプラントは、前立腺部尿道を少なくとも部分的開放状態に維持するように構成される、項目1に記載のシステム。
(項目4)
前記インプラントは、第1および第2のリング形構造と、前記第1および第2のリング形構造の間に延在する相互接続とを備える本体を有する、項目3に記載のシステム。
(項目5)
前記1つまたはそれを上回る構造は、
前記インプラントの近位部分と解放可能に結合するように構成される伸長把持器部材と、
前記インプラントの遠位部分と解放可能に結合するように構成される遠位制御部材と
を備える、項目1に記載のシステム。
(項目6)
前記遠位制御部材は、前記インプラントの遠位部分と解放可能に結合するように構成される保定器を備え、前記インプラントは、前記保定器と解放可能に結合するように構成される遠位係合部材を備える、項目5に記載のシステム。
(項目7)
前記保定器と結合され、前記保定器からの前記インプラントの遠位部分の解放を可能にするためにユーザによって操作可能である近位端を有する伸長部材をさらに備える、項目6に記載のシステム。
(項目8)
前記保定器は、管状であり、前記遠位制御部材に沿って摺動するように適合される、項目7に記載のシステム。
(項目9)
伸長アンカ部材をさらに備える、項目1に記載のシステム。
(項目10)
前記伸長アンカ部材は、膀胱壁に接触するように構成されるアンカを備える、項目9に記載のシステム。
(項目11)
前記内側管状部材は、少なくとも2つの支持体を含む、項目1に記載のシステム。
(項目12)
前記少なくとも2つの支持体はそれぞれ、約3~約6インチだけ分離される、項目11に記載のシステム。
(項目13)
前記少なくとも1つの支持体は、前記内側管状部材に固定して取り付けられる、項目1に記載のシステム。
(項目14)
前記少なくとも1つの支持体は、前記第1の伸長管状部材に固定して取り付けられる、項目1に記載のシステム。
(項目15)
前記第2の伸長管状部材は、前記少なくとも1つの支持体に対して移動可能である、項目1に記載のシステム。
(項目16)
前記第1の伸長管状部材はさらに、潤滑性ライナを備える、項目1に記載のシステム。
(項目17)
前記第1の伸長管状部材は、ハイポチューブ、編組材料、およびポリマー押出物から成る群から選択される材料から作製される、項目1に記載のシステム。
(項目18)
前記内側管状部材は、ハイポチューブ、編組材料、およびポリマー押出物から成る群から選択される材料から作製される、項目1に記載のシステム。
(項目19)
前記少なくとも1つの支持体は、レーザ切断された金属板、成型されたプラスチック構成要素、または押出された材料である、項目1に記載のシステム。
(項目20)
インプラントの送達を撮像する方法であって、前記方法は、
患者の尿道内で送達デバイスを前進させることであって、前記送達デバイスは、外側管状部材の遠位端領域内に位置する撮像デバイスを備える外側管状部材と、前記外側管状部材内の内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される管腔を有する第1の伸長管状部材と、管腔を有する第2の伸長管状部材と、前記内側管状部材の縦方向軸に略垂直である平面を画定する少なくとも1つの支持体とを備える、内側管状部材と、前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記第2の伸長管状部材の管腔内で摺動可能に前進可能である1つまたはそれを上回る構造とを備え、前記外側管状部材、内側管状部材、および1つまたはそれを上回る構造は、それぞれ、前記患者の外側の近位制御デバイスと結合される、ことと、
前記近位制御デバイスおよび前記1つまたはそれを上回る構造に対して前記内側管状部材を縦方向に後退させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと
を含む、方法。
(項目21)
前記尿道は、前記前立腺部尿道であり、前記方法はさらに、
前記内側管状部材が、縦方向に後退されている間、並行して、(a)前記近位制御デバイスに対して前記外側管状部材を縦方向に後退させ、(b)前記外側管状部材の遠位端領域と関連付けられる撮像デバイスを用いて前記少なくとも部分的に展開されたインプラントを撮像することを含む、項目20に記載の方法。
(項目22)
前記送達デバイスから前記インプラントを解放することをさらに含む、項目20に記載の方法。
(項目23)
前記外側管状部材は、前記内側管状部材と同一の率において縦方向に後退される、項目21に記載の方法。
(項目24)
前記近位制御デバイスに対して前記内側管状部材を回転させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと、
前記内側管状部材が、回転されている間、並行して、(a)前記外側管状部材を前記近位制御デバイスに対して回転的に固定された位置に維持し、(b)前記撮像デバイスを用いて前記少なくとも部分的に展開されたインプラントを撮像することと
をさらに含む、項目21に記載の方法。
(項目25)
前記外側管状部材の遠位端領域における照明デバイスを用いて前記インプラントを照明することをさらに含む、項目20に記載の方法。
(項目26)
前記内側管状部材は、少なくとも2つの支持体を含む、項目20に記載の方法。
(項目27)
前記少なくとも2つの支持体はそれぞれ、約3~約6インチだけ分離される、項目26に記載の方法。
(項目28)
前記少なくとも1つの支持体は、前記内側管状部材に固定して取り付けられる、項目20に記載の方法。
(項目29)
前記少なくとも1つの支持体は、前記第1の伸長管状部材に固定して取り付けられる、項目20に記載の方法。
(項目30)
前記第2の伸長管状部材は、前記少なくとも1つの支持体に対して移動可能である、項目20に記載の方法。
(項目31)
前記第1の伸長管状部材はさらに、潤滑性ライナを備える、項目20に記載の方法。
(項目32)
前記第1の伸長管状部材は、ハイポチューブ、編組材料、およびポリマー押出物から成る群から選択される材料から作製される、項目20に記載の方法。
(項目33)
前記内側管状部材は、ハイポチューブ、編組材料、およびポリマー押出物から成る群から選択される材料から作製される、項目20に記載の方法。
(項目34)
インプラントを送達するためのシステムであって、前記システムは、送達デバイスを備え、前記送達デバイスは、
外側管状部材の遠位端領域と関連付けられる撮像デバイスを備える外側管状部材と、
前記外側管状部材内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される管腔を有する第1の伸長管状部材と、管腔と連通する遠位端領域内の開口部を有する第2の伸長管状部材とを備える、内側管状部材と、
前記インプラントの展開を引き起こすために、前記第2の伸長管状部材の管腔内で摺動可能に前進可能である1つまたはそれを上回る構造であって、前記1つまたはそれを上回る構造は、前記インプラントの遠位部分と解放可能に結合するように構成される保定器を備え、前記保定器は、前記第2の伸長管状部材の管腔内で近位に延在する伸長部材に結合され、前記伸長部材は、前記開口部から外に通過し、その中に戻るように通過し、前記保定器が近位方向に移動することを防止するループを形成する、1つまたはそれを上回る構造と
を備える、システム。
(項目35)
前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を用いて前記外側管状部材と解放可能に結合される近位制御デバイスをさらに備え、
前記近位制御デバイスは、前記内側管状部材および前記外側管状部材を並行して縦方向に移動させるように構成される、項目34に記載のシステム。
(項目36)
前記撮像デバイスは、前記外側管状部材の遠位端領域内に位置する、項目34に記載のシステム。
(項目37)
前記1つまたはそれを上回る構造は、
前記インプラントの近位部分と解放可能に結合するように構成される伸長把持器部材と、
前記インプラントの遠位部分と解放可能に結合するように構成される遠位制御部材と
を備える、項目34に記載のシステム。
(項目38)
前記保定器は、前記インプラントの遠位部分と解放可能に結合するように構成され、前記インプラントは、前記保定器と解放可能に結合するように構成される遠位係合部材を備える、項目34に記載のシステム。
(項目39)
前記インプラントは、前記伸長把持器部材と解放可能に結合するように構成される近位係合部材を備える、項目34に記載のシステム。
(項目40)
前記近位制御デバイスは、前記遠位制御部材が、前記インプラントの遠位部分と解放可能に結合されている間、前記遠位制御部材に対して前記内側管状部材を回転させ、縦方向に移動させるように構成される、項目35に記載のシステム。
(項目41)
前記近位制御デバイスは、前記外側管状部材を回転させることなく、前記内側管状部材を回転させるように構成される、項目40に記載のシステム。
(項目42)
前記伸長部材は、前記保定器からの前記インプラントの遠位部分の解放を可能にするためにユーザによって操作可能である近位端を有する、項目38に記載のシステム。
(項目43)
前記保定器は、管状であり、前記遠位制御部材に沿って摺動するように適合される、項目40に記載のシステム。
(項目44)
前記遠位制御部材は、前記インプラントの遠位部分を受容するように適合される陥凹を備える、項目38に記載のシステム。
(項目45)
前記保定器は、前記インプラントの遠位部分が、前記陥凹内に受容されている間、前記陥凹を露出するように移動可能である、項目42に記載のシステム。
(項目46)
前記保定器は、スロットを備える、項目45に記載のシステム。
(項目47)
前記伸長把持器部材は、インプラントの前記近位部分と解放可能に結合するように構成される陥凹を備える、項目37に記載のシステム。
(項目48)
前記システムは、前記陥凹が、前記第1の内側管腔によって拘束されていないとき、前記インプラントの近位部分が、前記伸長把持器部材の陥凹から自由に解放するように構成される、項目47に記載のシステム。
(項目49)
前記伸長部材は、前記第2の伸長管状部材の管腔の中に前記ループを引動し、前記保定器からの前記インプラントの遠位部分の解放を可能にするためにユーザによって操作可能である近位端を有する、項目34に記載のシステム。
(項目50)
前記伸長部材は、ニチノール、ケブラ、ステンレス鋼、縫合糸、および液晶ポリマーから成る群から選択される材料から作製される、項目34に記載のシステム。
(項目51)
前記伸長部材は、架張可能材料から作製される、項目34に記載のシステム。
(項目52)
インプラントの送達を撮像する方法であって、前記方法は、
患者の尿道内で送達デバイスを前進させることであって、前記送達デバイスは、外側管状部材の遠位端領域と関連付けられる撮像デバイスを備える外側管状部材と、前記外側管状部材内の内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される管腔を有する第1の伸長管状部材と、管腔と連通する遠位端領域内の開口部を有する第2の伸長管状部材とを備える、内側管状部材と、前記インプラントの展開を引き起こすために、前記第2の伸長管状部材の管腔内で摺動可能に前進可能である1つまたはそれを上回る構造であって、前記1つまたはそれを上回る構造は、インプラントの遠位部分と解放可能に結合するように構成される保定器を備え、前記保定器は、前記第2の伸長管状部材の管腔内で近位に延在する伸長部材に結合され、前記伸長部材は、前記開口部から外に通過し、その中に戻るように通過し、前記保定器が近位方向に移動することを防止するループを形成する、1つまたはそれを上回る構造とを備え、前記外側管状部材、内側管状部材、および1つまたはそれを上回る構造は、それぞれ、前記患者の外側の近位制御デバイスと結合される、ことと、
前記近位制御デバイスおよび前記1つまたはそれを上回る構造に対して前記内側管状部材を縦方向に後退させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと、
前記伸長部材を近位方向に引動することによって前記送達デバイスから前記インプラントを解放することであって、前記ループは、前記第2の伸長管状部材の管腔の中に抜去され、前記保定器は、近位方向に移動される、ことと
を含む、方法。
(項目53)
前記尿道は、前記前立腺部尿道であり、前記方法はさらに、
前記内側管状部材が、縦方向に後退されている間、並行して、(a)前記近位制御デバイスに対して前記外側管状部材を縦方向に後退させ、(b)前記外側管状部材の遠位端領域と関連付けられる撮像デバイスを用いて前記少なくとも部分的に展開されたインプラントを撮像することを含む、項目51に記載の方法。
(項目54)
前記撮像デバイスは、前記外側管状部材の遠位端領域内に位置する、項目51に記載の方法。
(項目55)
前記外側管状部材は、前記内側管状部材と同一の率において縦方向に後退される、項目53に記載の方法。
(項目56)
前記近位制御デバイスに対して前記内側管状部材を回転させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと、
前記内側管状部材が、回転されている間、並行して、(a)前記外側管状部材を前記近位制御デバイスに対して回転的に固定された位置に維持し、(b)前記撮像デバイスを用いて前記少なくとも部分的に展開されたインプラントを撮像することと
をさらに含む、項目53に記載の方法。
(項目57)
前記外側管状部材の遠位端領域における照明デバイスを用いて前記インプラントを照明することをさらに含む、項目51に記載の方法。
(項目58)
前記保定器は、管状であり、前記第2の伸長管状部材に沿って摺動するように適合される、項目51に記載の方法。
(項目59)
前記第2の伸長管状部材は、前記インプラントの遠位部分を受容するように適合される陥凹を備える、項目51に記載の方法。
(項目60)
前記保定器は、前記インプラントの遠位部分が、前記陥凹内に受容されている間、前記陥凹を露出するように移動可能である、項目51に記載の方法。
(項目61)
前記保定器は、スロットを備える、項目51に記載の方法。
(項目62)
インプラントを送達するためのシステムであって、前記システムは、送達デバイスを備え、前記送達デバイスは、
第1および第2の管腔と、遠位端とを備える外側管状部材と、
前記第2の管腔を通して延在する少なくとも1つの伸長部材に搭載される撮像モジュールであって、前記撮像モジュールは、前記少なくとも1つの伸長部材の遠位前進に応じて、前記外側管状部材の遠位端の遠位に位置付けられるように構成される、撮像モジュールと、
外側管状部材の前記第1の管腔内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される、内側管状部材と
を備える、システム。
(項目63)
前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記内側管状部材内で摺動可能に前進可能である1つまたはそれを上回る構造と、
前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を用いて前記外側管状部材と解放可能に結合される近位制御デバイスと
をさらに備え、
前記近位制御デバイスは、前記内側管状部材および前記外側管状部材を並行して縦方向に移動させるように構成される、項目62に記載のシステム。
(項目64)
前記インプラントは、前立腺部尿道を少なくとも部分的開放状態に維持するように構成される、項目62に記載のシステム。
(項目65)
前記インプラントは、第1および第2のリング形構造と、前記第1および第2のリング形構造の間に延在する相互接続とを備える本体を有する、項目64に記載のシステム。
(項目66)
前記1つまたはそれを上回る構造は、
前記インプラントの近位部分と解放可能に結合するように構成される伸長把持器部材と、
前記インプラントの遠位部分と解放可能に結合するように構成される遠位制御部材と
を備える、項目63に記載のシステム。
(項目67)
前記遠位制御部材は、前記インプラントの遠位部分と解放可能に結合するように構成される保定器を備え、前記インプラントは、前記保定器と解放可能に結合するように構成される遠位係合部材を備える、項目66に記載のシステム。
(項目68)
前記インプラントは、前記伸長把持器部材と解放可能に結合するように構成される近位係合部材を備える、項目66に記載のシステム。
(項目69)
前記外側管状部材の遠位端領域はさらに、照明デバイスを備える、項目62に記載のシステム。
(項目70)
前記撮像モジュールは、カメラと、光源とを備える、項目62に記載のシステム。
(項目71)
前記光源は、少なくとも1つのLEDである、項目70に記載のシステム。
(項目72)
前記撮像モジュールは、少なくとも2つの伸長部材に搭載される、項目62に記載のシステム。
(項目73)
前記撮像モジュールは、少なくとも3つの伸長部材に搭載される、項目62に記載のシステム。
(項目74)
前記撮像モジュールは、前記外側管状部材の遠位端の約0cm~約5cm遠位に位置付けられるように構成される、項目62に記載のシステム。
(項目75)
インプラントの送達を撮像する方法であって、前記方法は、
患者の尿道内で送達デバイスを前進させることであって、前記送達デバイスは、第1および第2の管腔と、遠位端とを備える外側管状部材と、前記第2の管腔を通して延在する少なくとも1つの伸長部材に搭載される撮像モジュールと、前記第1の管腔を通して延在し、インプラントの少なくとも一部を格納する内側管状部材と、前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記内側管状部材内で摺動可能に前進可能である1つまたはそれを上回る構造とを備え、前記外側管状部材、内側管状部材、および1つまたはそれを上回る構造は、それぞれ、前記患者の外側の近位制御デバイスと結合される、ことと、
前記近位制御デバイスおよび前記1つまたはそれを上回る構造に対して前記内側管状部材を縦方向に後退させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと、
前記外側管状部材の遠位端を越えて遠位に前記撮像モジュールを延在させることと、
前記少なくとも部分的に展開されたインプラントを撮像することと
を含む、方法。
(項目76)
前記尿道は、前記前立腺部尿道である、項目74に記載の方法。
(項目77)
前記送達デバイスから前記インプラントを解放することをさらに含む、項目74に記載の方法。
(項目78)
前記外側管状部材は、前記内側管状部材と同一の率において縦方向に後退される、項目74に記載の方法。
(項目79)
前記近位制御デバイスに対して前記内側管状部材を回転させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと、
前記内側管状部材が、回転されている間、並行して、(a)前記外側管状部材を前記近位制御デバイスに対して回転的に固定された位置に維持し、(b)前記撮像デバイスを用いて前記少なくとも部分的に展開されたインプラントを撮像することと
をさらに含む、項目74に記載の方法。
(項目80)
前記インプラントは、第1および第2のリング形構造と、前記第1および第2のリング形構造の間に延在する相互接続とを備える本体を有し、前記第2のリング形構造は、前記第1のリング形構造の近位にある、項目74に記載の方法。
(項目81)
前記撮像モジュールは、前記外側管状部材の遠位端の遠位に延在された後、前記第2のリング形構造の設置を可視化することができる、項目74に記載の方法。
(項目82)
撮像した後、前記送達デバイスから前記インプラントを解放するステップをさらに含む、項目81に記載の方法。
(項目83)
前記撮像モジュールは、前記外側管状部材の遠位端から約0cm~約5cm遠位に延在される、項目74に記載の方法。
(項目84)
インプラントを送達するためのシステムであって、前記システムは、送達デバイスを備え、前記送達デバイスは、
外側管状部材と、
前記外側管状部材内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される、内側管状部材と、
前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記内側管状部材内で摺動可能に前進可能である1つまたはそれを上回る構造と、
回転アダプタを備える近位制御デバイスであって、前記近位制御デバイスは、前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を用いて前記外側管状部材と解放可能に結合される、近位制御デバイスと、
前記回転アダプタに結合される撮像デバイスと
を備え、
前記近位制御デバイスは、前記内側管状部材および前記外側管状部材を並行して縦方向に移動させるように構成される、システム。
(項目85)
インプラントをさらに備える、項目84に記載のシステム。
(項目86)
前記インプラントは、第1および第2のリング形構造と、前記第1および第2のリング形構造の間に延在する相互接続とを備える本体を有する、項目85に記載のシステム。
(項目87)
前記1つまたはそれを上回る構造は、
前記インプラントの近位部分と解放可能に結合するように構成される伸長把持器部材と、
前記インプラントの遠位部分と解放可能に結合するように構成される遠位制御部材と
を備える、項目85に記載のシステム。
(項目88)
前記遠位制御部材は、前記インプラントの遠位部分と解放可能に結合するように構成される保定器を備え、前記インプラントは、前記保定器と解放可能に結合するように構成される遠位係合部材を備える、項目87に記載のシステム。
(項目89)
前記インプラントは、前記伸長把持器部材と解放可能に結合するように構成される近位係合部材を備える、項目87に記載のシステム。
(項目90)
前記近位制御デバイスは、前記遠位制御部材が、前記インプラントの遠位部分と解放可能に結合されている間、前記遠位制御部材に対して前記内側管状部材を回転させ、縦方向に移動させるように構成される、項目87に記載のシステム。
(項目91)
前記近位制御デバイスは、前記外側管状部材を回転させることなく、前記内側管状部材を回転させるように構成される、項目90に記載のシステム。
(項目92)
前記保定器と結合され、前記保定器からの前記インプラントの遠位部分の解放を可能にするためにユーザによって操作可能である近位端を有する伸長部材をさらに備える、項目88に記載のシステム。
(項目93)
前記保定器は、管状であり、前記遠位制御部材に沿って摺動するように適合される、項目92に記載のシステム。
(項目94)
前記遠位制御部材は、前記インプラントの遠位部分を受容するように適合される陥凹を備える、項目87に記載のシステム。
(項目95)
前記保定器は、前記インプラントの遠位部分が、前記陥凹内に受容されている間、前記陥凹を露出するように移動可能である、項目94に記載のシステム。
(項目96)
前記外側管状部材の遠位端領域はさらに、照明デバイスを備える、項目84に記載のシステム。
(項目97)
前記内側管状部材の遠位端領域は、ある分離距離だけ前記外側管状部材の遠位端領域の遠位にあり、前記近位制御デバイスは、前記分離距離を変化させることなく、前記外側管状部材および内側管状部材を並行して縦方向に移動させるように構成される、項目84に記載のシステム。
(項目98)
前記内側管状部材の近位端は、前記回転アダプタと結合される、項目84に記載のシステム。
(項目99)
前記回転アダプタは、遠位構成要素と、摺動構成要素と、ばねと、近位構成要素とを備え、前記撮像デバイスは、前記摺動構成要素に結合される、項目84に記載のシステム。
(項目100)
前記摺動構成要素は、環状溝を備え、前記撮像デバイスは、前記環状溝に結合される、項目99に記載のシステム。
(項目101)
前記ばねは、前記遠位構成要素と前記摺動構成要素との間に位置する、項目99に記載のシステム。
(項目102)
前記ばねは、前記摺動構成要素と前記近位構成要素との間に位置する、項目99に記載のシステム。
(項目103)
前記回転アダプタは、電気を伝導する、項目84に記載のシステム。
(項目104)
前記回転アダプタはさらに、電気を伝導する電気板またはリングを備える、項目84に記載のシステム。
(項目105)
前記摺動構成要素は、電気を伝導する電気板またはリングを含む、項目99に記載のシステム。
(項目106)
前記回転アダプタは、光源に電気的に接続される、項目84に記載のシステム。
(項目107)
前記光源は、前記内側管状部材の遠位端または前記内側管状部材内で摺動可能に前進可能な前記1つまたはそれを上回る構造の遠位端上に搭載される、項目106に記載のシステム。
(項目108)
前記回転アダプタは、前記撮像デバイスに電気的に接続される、項目84に記載のシステム。
(項目109)
前記撮像デバイスは、前記内側管状部材の遠位端に対して縦方向に前進することが可能である、項目84に記載のシステム。
(項目110)
前記撮像デバイスは、前記内側管状部材の遠位端に対して縦方向に後退することが可能である、項目84に記載のシステム。
(項目111)
インプラントの送達を撮像する方法であって、前記方法は、
患者の尿道内で送達デバイスを前進させることであって、前記送達デバイスは、外側管状部材と、前記外側管状部材内にあり、インプラントの少なくとも一部を格納する内側管状部材と、前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記内側管状部材内で摺動可能に前進可能である1つまたはそれを上回る構造と、撮像デバイスとを備え、前記外側管状部材、内側管状部材、1つまたはそれを上回る構造、および撮像デバイスは、それぞれ、前記患者の外側の近位制御デバイスと結合され、前記近位制御デバイスは、前記撮像デバイスに結合される回転アダプタを備える、ことと、
前記近位制御デバイスおよび前記1つまたはそれを上回る構造に対して前記内側管状部材を縦方向に後退させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと、
前記内側管状部材の遠位端に対して前記撮像デバイスを縦方向に移動させることと、
前記撮像デバイスを用いて前記少なくとも部分的に展開されたインプラントを撮像することと
を含む、方法。
(項目112)
前記尿道は、前記前立腺部尿道である、項目111に記載の方法。
(項目113)
前記送達デバイスから前記インプラントを解放することをさらに含む、項目111に記載の方法。
(項目114)
前記外側管状部材は、前記内側管状部材と同一の率において縦方向に後退される、項目111に記載の方法。
(項目115)
前記近位制御デバイスに対して前記内側管状部材を回転させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと、
前記内側管状部材が、回転されている間、並行して、(a)前記外側管状部材を前記近位制御デバイスに対して回転的に固定された位置に維持し、(b)前記撮像デバイスを用いて前記少なくとも部分的に展開されたインプラントを撮像することと
をさらに含む、項目111に記載の方法。
(項目116)
前記外側管状部材の遠位端領域における照明デバイスを用いて前記インプラントを照明することをさらに含む、項目111に記載の方法。
(項目117)
前記インプラントは、第1および第2のリング形構造と、前記第1および第2のリング形構造の間に延在する相互接続とを備える本体を有し、前記第2のリング形構造は、前記第1のリング形構造の近位にある、項目111に記載の方法。
(項目118)
前記撮像デバイスは、部分的展開後、前記第2のリング形構造の設置を可視化することができる、項目117に記載の方法。
(項目119)
撮像した後、前記送達デバイスから前記インプラントを解放するステップをさらに含む、項目111に記載の方法。
(項目120)
前記撮像デバイスは、前記インプラントの部分的展開後、前記第2のリング形構造に対して近位に抜去される、項目117に記載の方法。
(項目121)
前記撮像デバイスは、前記インプラントの部分的展開後、前記第2のリング形構造に対して遠位に前進される、項目117に記載の方法。
(項目122)
前記撮像デバイスは、前記内側管状部材の遠位端に対して縦方向に前進される、項目117に記載の方法。
(項目123)
前記撮像デバイスは、前記内側管状部材の遠位端に対して縦方向に後退される、項目117に記載の方法。
(項目124)
インプラントを送達するためのシステムであって、前記システムは、送達デバイスを備え、前記送達デバイスは、
外側管状部材と、
前記外側管状部材内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される、内側管状部材と、
前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記内側管状部材の管腔内で摺動可能に前進可能である1つまたはそれを上回る構造と、
前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を通して前記外側管状部材と解放可能に結合される近位制御デバイスであって、前記近位制御デバイスは、引動ワイヤと、アクチュエータとを備え、前記アクチュエータは、回転可能車輪と、延在部と、ラッチと、レッジとを備え、前記引動ワイヤは、前記外側管状部材の少なくとも一部を通して延在し、前記回転可能車輪は、前記引動ワイヤを巻回および巻解するように適合され、筐体内に位置し、前記延在部は、第1および第2の側を有し、前記筐体から延在し、前記ラッチは、前記延在部内に格納され、前記延在部の第1の側から第2の側に摺動可能であり、前記レッジは、前記筐体上に配置され、前記ラッチに摩擦して係合するように適合される、近位制御デバイスと
を備える、システム。
(項目125)
前記回転可能車輪の周囲に前記引動ワイヤを巻回することは、前記外側管状部材の偏向をもたらす、項目124に記載のシステム。
(項目126)
前記回転可能車輪から前記引動ワイヤを巻解することは、前記外側管状部材の直線化をもたらす、項目124に記載のシステム。
(項目127)
前記延在部は、前記筐体の少なくとも一部を回転させることによって、第1の位置から第2の位置に移動可能である、項目124に記載のシステム。
(項目128)
前記延在部が、前記第1の位置にあるとき、前記回転可能車輪は、前記引動ワイヤを巻回または巻解することが可能である、項目127に記載のシステム。
(項目129)
前記第1の位置において、前記延在部は、前記外側管状部材の遠位端から離れるように角度付けられる、項目127に記載のシステム。
(項目130)
前記延在部が、前記第2の位置にあるとき、前記回転可能車輪は、前記引動ワイヤを巻回または巻解することが可能ではない、項目127に記載のシステム。
(項目131)
前記第2の位置において、前記延在部は、前記外側管状部材の遠位端に向かって角度付けられる、項目127に記載のシステム。
(項目132)
前記ラッチは、前記延在部が、前記第2の位置にあるとき、前記レッジによって摩擦して係合される、項目130に記載のシステム。
(項目133)
前記延在部はさらに、戻り止めにおいて終端するパドルを備える、項目124に記載のシステム。
(項目134)
前記ラッチは、前記パドルに沿って摺動可能である、項目133に記載のシステム。
(項目135)
前記レッジは、前記筐体の右側上に位置する、項目124に記載のシステム。
(項目136)
前記延在部は、前記筐体の左側に取り付けられる、項目124に記載のシステム。
(項目137)
前記引動ワイヤは、前記外側管状部材の管腔を通して延在する、項目124に記載のシステム。
(項目138)
前記引動ワイヤは、前記外側管状部材の側壁に結合されるかまたはその中に埋設される、項目124に記載のシステム。
(項目139)
前記引動ワイヤの遠位端は、前記外側管状部材の遠位端領域において前記外側管状部材に固着される、項目124に記載のシステム。
(項目140)
インプラントを送達する方法であって、前記方法は、
(a)患者の尿道内で送達デバイスを前進させることであって、前記送達デバイスは、外側管状部材と、前記外側管状部材内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される、内側管状部材と、前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記内側管状部材の管腔内で摺動可能に前進可能である1つまたはそれを上回る構造と、前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を通して前記外側管状部材と解放可能に結合される近位制御デバイスであって、前記近位制御デバイスは、引動ワイヤと、アクチュエータとを備え、前記アクチュエータは、回転可能車輪と、延在部と、ラッチと、レッジとを備え、前記引動ワイヤは、前記外側管状部材の少なくとも一部を通して延在し、前記回転可能車輪は、前記引動ワイヤを巻回および巻解するように適合され、筐体内に位置し、前記延在部は、第1および第2の側を有し、前記筐体から延在し、前記ラッチは、前記延在部内に格納され、前記延在部の第1の側から第2の側に摺動可能であり、前記レッジは、前記筐体上に配置され、前記ラッチに摩擦して係合するように適合される、近位制御デバイスとを備える、ことと、
(b)前記近位制御デバイスおよび前記1つまたはそれを上回る構造に対して前記内側管状部材を縦方向に後退させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと、
(c)前記送達デバイスから前記インプラントを解放することと
を含み、
前記外側管状部材は、ステップ(a)、(b)、または(c)のうちの少なくとも1つの間に、またはステップ(a)および(b)または(b)および(c)の間に、前記回転可能車輪の周囲に前記引動ワイヤを巻回することによって偏向され、前記外側管状部材は、前記外側管状部材が偏向された後、前記ラッチを前記レッジと摩擦して係合させることによって、偏向位置に係止される、方法。
(項目141)
前記外側管状部材は、前記前進させるステップ(a)の間に偏向され、前記偏向位置に係止される、項目140に記載の方法。
(項目142)
前記外側管状部材は、ステップ(a)と(b)との間に偏向され、前記偏向位置に係止される、項目140に記載の方法。
(項目143)
前記外側管状部材は、前記後退させるステップ(b)の間に偏向され、前記偏向位置に係止される、項目140に記載の方法。
(項目144)
前記外側管状部材は、ステップ(b)と(c)との間に偏向され、前記偏向位置に係止される、項目140に記載の方法。
(項目145)
前記外側管状部材は、前記解放するステップ(c)の間に偏向され、前記偏向位置に係止される、項目140に記載の方法。
(項目146)
前記延在部は、前記筐体の少なくとも一部を回転させることによって、第1の位置から第2の位置に移動可能である、項目140に記載の方法。
(項目147)
前記延在部が、前記第1の位置にあるとき、前記回転可能車輪は、係止解除され、前記引動ワイヤを巻回または巻解することが可能である、項目146に記載の方法。
(項目148)
前記延在部が、前記第2の位置にあるとき、前記回転可能車輪は、係止され、前記引動ワイヤを巻回または巻解することが可能ではない、項目146に記載の方法。
(項目149)
前記ラッチは、前記延在部が、前記第2の位置にあるとき、前記レッジによって摩擦して係合される、項目146に記載の方法。
(項目150)
前記レッジから前記ラッチを係脱させることによって、前記外側管状部材を前記偏向位置から係止解除するステップをさらに含み、前記延在部は、前記第1の位置に戻る、項目146に記載の方法。
(項目151)
前記引動ワイヤは、前記外側管状部材の管腔を通して延在する、項目140に記載の方法。
(項目152)
前記引動ワイヤは、前記外側管状部材の側壁に結合される、またはその中に埋設される、項目140に記載の方法。
(項目153)
前記引動ワイヤの遠位端は、前記外側管状部材の遠位端領域において前記外側管状部材に固着される、項目140に記載の方法。
(項目154)
インプラントを送達するためのシステムであって、前記システムは、送達デバイスを備え、前記送達デバイスは、
外側管状部材の遠位端領域と関連付けられる撮像デバイスを備える外側管状部材と、
前記外側管状部材内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される管腔を有する第1の伸長管状部材と、管腔と連通する遠位端領域内の開口部を有する第2の伸長管状部材とを備える、内側管状部材と、
前記インプラントの展開を引き起こすために、前記第2の伸長管状部材の管腔内で摺動可能に前進可能である1つまたはそれを上回る構造であって、前記1つまたはそれを上回る構造は、前記インプラントの遠位部分と解放可能に結合するように構成される保定器を備え、前記保定器は、近位制御デバイスまで近位に延在する第3の伸長管状部材に結合される、1つまたはそれを上回る構造と
を備える、システム。
(項目155)
前記近位制御デバイスは、前記第3の伸長管状部材を近位に抜去するように適合される、項目154に記載のシステム。
(項目156)
前記保定器は、前記インプラントの遠位部分と解放可能に結合するように構成され、前記インプラントは、前記保定器と解放可能に結合するように構成される遠位係合部材を備える、項目154に記載のシステム。
(項目157)
前記近位制御デバイスは、前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を通して前記外側管状部材と解放可能に結合され、
前記近位制御デバイスは、前記内側管状部材および前記外側管状部材を並行して縦方向に移動させるように構成される、項目154に記載のシステム。
(項目158)
前記1つまたはそれを上回る構造は、
前記インプラントの近位部分と解放可能に結合するように構成される伸長把持器部材と、
前記インプラントの遠位部分と解放可能に結合するように構成される遠位制御部材と
を備える、項目154に記載のシステム。
(項目159)
前記伸長部材は、前記保定器からの前記インプラントの遠位部分の解放を可能にするためにユーザによって操作可能である近位端を有する、項目154に記載のシステム。
(項目160)
インプラントを送達する方法であって、前記方法は、
患者の尿道内で送達デバイスを前進させることであって、前記送達デバイスは、外側管状部材の遠位端領域と関連付けられる撮像デバイスを備える外側管状部材と、前記外側管状部材内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される管腔を有する第1の伸長管状部材と、管腔と連通する遠位端領域内の開口部を有する第2の伸長管状部材とを備える、内側管状部材と、前記インプラントの展開を引き起こすために、前記第2の伸長管状部材の管腔内で摺動可能に前進可能である1つまたはそれを上回る構造であって、前記1つまたはそれを上回る構造は、前記インプラントの遠位部分と解放可能に結合するように構成される保定器を備え、前記保定器は、近位制御デバイスまで近位に延在する第3の伸長管状部材に結合される、1つまたはそれを上回る構造とを備える、ことと、
前記近位制御デバイスおよび前記1つまたはそれを上回る構造に対して前記内側管状部材を縦方向に後退させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと、
前記第3の伸長管状部材を近位方向に抜去することによって、前記送達デバイスから前記インプラントを解放することであって、前記保定器は、近位方向に移動される、ことと
を含む、方法。
(項目161)
前記保定器は、前記第2の伸長管状部材に沿って摺動するように適合される、項目160に記載の方法。
(項目162)
前記第2の伸長管状部材は、前記インプラントの遠位部分を受容するように適合される陥凹を備える、項目160に記載の方法。
(項目163)
前記保定器は、前記インプラントの遠位部分が、前記陥凹内に受容されている間、前記陥凹を露出するように移動可能である、項目160に記載の方法。
(項目164)
インプラントを送達するためのシステムであって、前記システムは、送達デバイスを備え、前記送達デバイスは、
外側管状部材と、
前記外側管状部材内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される、内側管状部材と、
前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記内側管状部材内で摺動可能に前進可能である1つまたはそれを上回る構造と、
前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を通して前記外側管状部材と解放可能に結合される近位制御デバイスであって、前記近位制御デバイスは、前記内側管状部材および前記外側管状部材を並行して縦方向に移動させるように構成され、前記近位制御デバイスは、近位取っ手部分に対して移動可能である移動可能取っ手部分を備え、前記移動可能取っ手部分は、前記近位取っ手部分の内面に結合される戻り止めを受容するように構成される溝を備える、近位制御デバイスと
を備える、システム。
(項目165)
前記戻り止めは、前記近位取っ手部分の遠位区分の内面上に位置する、項目164に記載のシステム。
(項目166)
前記戻り止めは、偏向可能である、項目164に記載のシステム。
(項目167)
前記近位取っ手部分はさらに、第1の端部と、第2の端部とを有するステントを備え、前記ステントの第1の端部は、前記近位取っ手部分の内面に取り付けられ、前記ステントは、前記第2の端部において前記戻り止めにおいて終端する、項目164に記載のシステム。
(項目168)
前記近位取っ手部分は、前記移動可能取っ手部分の周囲で回転可能である、項目164に記載のシステム。
(項目169)
前記近位取っ手の回転は、前記溝から前記戻り止めを取り外すことができる、項目164に記載のシステム。
(項目170)
インプラントをさらに備える、項目164に記載のシステム。
(項目171)
インプラントを送達する方法であって、前記方法は、
患者の尿道内で送達デバイスを前進させることであって、前記送達デバイスは、外側管状部材と、前記外側管状部材内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される、内側管状部材と、前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記内側管状部材内で摺動可能に前進可能である1つまたはそれを上回る構造と、前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を通して前記外側管状部材と解放可能に結合される近位制御デバイスであって、前記近位制御デバイスは、前記内側管状部材および前記外側管状部材を並行して縦方向に移動させるように構成され、前記近位制御デバイスにおける機構は、前記外側管状部材が前記内側管状部材に対して回転することを防止する、近位制御デバイスとを備える、ことと、
前記近位制御デバイスおよび前記1つまたはそれを上回る構造に対して前記内側管状部材を縦方向に後退させ、少なくとも部分的に、前記内側管状部材から前記インプラントを展開することと、
前記送達デバイスから前記インプラントを解放することと
を含む、方法。
(項目172)
前記近位制御デバイスは、近位取っ手部分に対して移動可能である移動可能取っ手部分を備え、前記機構は、前記近位取っ手部分の内面に結合される戻り止めを受容するように構成される前記移動可能取っ手部分上の溝を備える、項目171に記載の方法。
(項目173)
前記戻り止めは、偏向可能である、項目172に記載の方法。
(項目174)
前記戻り止めは、前記近位取っ手部分の遠位区分の内面上に位置する、項目172に記載の方法。
(項目175)
前記近位取っ手部分はさらに、第1の端部と、第2の端部とを有するステントを備え、前記ステントの第1の端部は、前記近位取っ手部分の内面に取り付けられ、前記ステントは、前記第2の端部において前記戻り止めにおいて終端する、項目172に記載の方法。
(項目176)
前記近位取っ手部分は、前記移動可能取っ手部分の周囲で回転可能である、項目172に記載の方法。
(項目177)
前記近位取っ手の回転は、前記溝から前記戻り止めを取り外すことができる、項目172に記載の方法。
(項目178)
前記外側管状部材が前記内側管状部材に対して回転することを可能にするために、前記機構を解放するステップをさらに含む、項目172に記載の方法。
(項目179)
前記機構を解放することは、前記溝から前記戻り止めを除去することを含む、項目178に記載の方法。
(項目180)
前記戻り止めは、前記移動可能取っ手部分の周囲の前記近位取っ手部分の回転によって前記溝から除去される、項目179に記載の方法。
Other systems, devices, methods, features, and advantages of the subject matter described herein will be or will become apparent to those skilled in the art upon consideration of the following figures and detailed description. Dew. It is intended that all such additional systems, methods, features and advantages be included within this description, be within the scope of the subject matter described herein, and be protected by the accompanying claims. ing. The features of the exemplary embodiments should not be construed in any way as limiting the appended claims in the absence of a clear recitation of those features in the claims.
The present invention provides, for example, the following items.
(Item 1)
A system for delivering an implant, the system comprising a delivery device, the delivery device comprising:
an outer tubular member comprising an imaging device located within a distal end region of the outer tubular member;
an inner tubular member within the outer tubular member, the inner tubular member comprising: a first elongate tubular member having a lumen adapted to store at least a portion of an implant; and a second elongated tubular member having a lumen. an elongated tubular member; and at least one support defining a plane substantially perpendicular to a longitudinal axis of the inner tubular member;
one or more structures slidably advanceable within the lumen of the second elongate tubular member to cause deployment of the implant from within the inner tubular member;
A system equipped with.
(Item 2)
a proximal control device coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member using a coupling mechanism;
Furthermore,
2. The system of item 1, wherein the proximal control device is configured to longitudinally move the inner tubular member and the outer tubular member in parallel.
(Item 3)
2. The system of item 1, further comprising the implant, the implant configured to maintain the prostatic urethra at least partially open.
(Item 4)
4. The system of item 3, wherein the implant has a body comprising first and second ring-shaped structures and an interconnect extending between the first and second ring-shaped structures.
(Item 5)
The one or more structures are:
an elongated grasper member configured to releasably couple with a proximal portion of the implant;
a distal control member configured to releasably couple with a distal portion of the implant;
The system according to item 1, comprising:
(Item 6)
The distal control member includes a retainer configured to releasably couple with the distal portion of the implant, and the implant includes a distal engagement configured to releasably couple with the retainer. The system according to item 5, comprising a mating member.
(Item 7)
7. The system of item 6, further comprising an elongate member coupled to the retainer and having a proximal end operable by a user to enable release of the distal portion of the implant from the retainer.
(Item 8)
8. The system of item 7, wherein the retainer is tubular and adapted to slide along the distal control member.
(Item 9)
The system of item 1 further comprising an elongated anchor member.
(Item 10)
10. The system of item 9, wherein the elongated anchor member comprises an anchor configured to contact a bladder wall.
(Item 11)
2. The system of item 1, wherein the inner tubular member includes at least two supports.
(Item 12)
12. The system of item 11, wherein the at least two supports are each separated by about 3 to about 6 inches.
(Item 13)
The system of item 1, wherein the at least one support is fixedly attached to the inner tubular member.
(Item 14)
2. The system of item 1, wherein the at least one support is fixedly attached to the first elongated tubular member.
(Item 15)
2. The system of item 1, wherein the second elongate tubular member is movable relative to the at least one support.
(Item 16)
2. The system of item 1, wherein the first elongated tubular member further comprises a lubricious liner.
(Item 17)
2. The system of item 1, wherein the first elongate tubular member is made from a material selected from the group consisting of hypotubes, braided materials, and polymeric extrudates.
(Item 18)
2. The system of item 1, wherein the inner tubular member is made from a material selected from the group consisting of hypotubes, braided materials, and polymeric extrudates.
(Item 19)
The system of item 1, wherein the at least one support is a laser cut metal sheet, a molded plastic component, or an extruded material.
(Item 20)
A method of imaging delivery of an implant, the method comprising:
advancing a delivery device within the patient's urethra, the delivery device comprising: an outer tubular member comprising an imaging device located within a distal end region of the outer tubular member; and an inner tubular member within the outer tubular member. wherein the inner tubular member includes a first elongate tubular member having a lumen adapted to store at least a portion of an implant; a second elongate tubular member having a lumen; at least one support defining a plane substantially perpendicular to a longitudinal axis of the member; and a second elongated tubular member for causing deployment of the implant from within the inner tubular member. one or more structures slidably advanceable within the lumen of the member, the outer tubular member, the inner tubular member, and the one or more structures each being external to the patient. coupled with a proximal control device of;
longitudinally retracting the inner tubular member relative to the proximal control device and the one or more structures to at least partially deploy the implant from the inner tubular member;
including methods.
(Item 21)
The urethra is the prostatic urethra, and the method further comprises:
While the inner tubular member is being longitudinally retracted, in parallel (a) longitudinally retracting the outer tubular member relative to the proximal control device; 21. The method of item 20, comprising imaging the at least partially deployed implant with an imaging device associated with a distal region.
(Item 22)
21. The method of item 20, further comprising releasing the implant from the delivery device.
(Item 23)
22. The method of item 21, wherein the outer tubular member is longitudinally retracted at the same rate as the inner tubular member.
(Item 24)
rotating the inner tubular member relative to the proximal control device to at least partially deploy the implant from the inner tubular member;
While the inner tubular member is being rotated, in parallel: (a) maintaining the outer tubular member in a rotationally fixed position relative to the proximal control device; and (b) controlling the imaging device. imaging the at least partially deployed implant using
The method according to item 21, further comprising:
(Item 25)
21. The method of item 20, further comprising illuminating the implant using a lighting device in a distal end region of the outer tubular member.
(Item 26)
21. The method of item 20, wherein the inner tubular member includes at least two supports.
(Item 27)
27. The method of item 26, wherein the at least two supports are each separated by about 3 to about 6 inches.
(Item 28)
21. The method of item 20, wherein the at least one support is fixedly attached to the inner tubular member.
(Item 29)
21. The method of item 20, wherein the at least one support is fixedly attached to the first elongated tubular member.
(Item 30)
21. The method of item 20, wherein the second elongate tubular member is movable relative to the at least one support.
(Item 31)
21. The method of item 20, wherein the first elongated tubular member further comprises a lubricious liner.
(Item 32)
21. The method of item 20, wherein the first elongated tubular member is made from a material selected from the group consisting of hypotubes, braided materials, and polymeric extrudates.
(Item 33)
21. The method of item 20, wherein the inner tubular member is made from a material selected from the group consisting of hypotubes, braided materials, and polymeric extrudates.
(Item 34)
A system for delivering an implant, the system comprising a delivery device, the delivery device comprising:
an outer tubular member comprising an imaging device associated with a distal end region of the outer tubular member;
an inner tubular member within the outer tubular member, the inner tubular member communicating with the lumen and a first elongated tubular member having a lumen adapted to store at least a portion of an implant; a second elongate tubular member having an opening in the distal end region;
one or more structures slidably advanceable within a lumen of the second elongate tubular member to cause deployment of the implant, the one or more structures comprising: a retainer configured to releasably couple with a distal portion of the implant, the retainer being coupled to an elongate member extending proximally within a lumen of the second elongate tubular member; , one or more structures in which the elongated member passes out of and back into the opening to form a loop that prevents proximal movement of the retainer. and
A system equipped with.
(Item 35)
further comprising a proximal control device coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member using a coupling mechanism;
35. The system of item 34, wherein the proximal control device is configured to longitudinally move the inner tubular member and the outer tubular member in parallel.
(Item 36)
35. The system of item 34, wherein the imaging device is located within a distal end region of the outer tubular member.
(Item 37)
The one or more structures are:
an elongated grasper member configured to releasably couple with a proximal portion of the implant;
a distal control member configured to releasably couple with a distal portion of the implant;
The system according to item 34, comprising:
(Item 38)
Item 34, wherein the retainer is configured to releasably couple with a distal portion of the implant, and the implant includes a distal engagement member configured to releasably couple with the retainer. system described in.
(Item 39)
35. The system of item 34, wherein the implant comprises a proximal engagement member configured to releasably couple with the elongate grasper member.
(Item 40)
The proximal control device rotates and longitudinally moves the inner tubular member relative to the distal control member while the distal control member is releasably coupled to the distal portion of the implant. 36. The system of item 35, wherein the system is configured to:
(Item 41)
41. The system of item 40, wherein the proximal control device is configured to rotate the inner tubular member without rotating the outer tubular member.
(Item 42)
39. The system of item 38, wherein the elongate member has a proximal end that is operable by a user to enable release of the distal portion of the implant from the retainer.
(Item 43)
41. The system of item 40, wherein the retainer is tubular and adapted to slide along the distal control member.
(Item 44)
39. The system of item 38, wherein the distal control member comprises a recess adapted to receive a distal portion of the implant.
(Item 45)
43. The system of item 42, wherein the retainer is movable to expose the recess while a distal portion of the implant is received within the recess.
(Item 46)
46. The system of item 45, wherein the retainer comprises a slot.
(Item 47)
38. The system of item 37, wherein the elongated grasper member comprises a recess configured to releasably couple with the proximal portion of an implant.
(Item 48)
The system is configured such that a proximal portion of the implant freely releases from a recess of the elongate grasper member when the recess is not constrained by the first inner lumen. The system described in item 47.
(Item 49)
The elongate member has a proximal end that is operable by a user to pull the loop into the lumen of the second elongate tubular member and enable release of the distal portion of the implant from the retainer. 35. The system of item 34, having a terminal end.
(Item 50)
35. The system of item 34, wherein the elongated member is made from a material selected from the group consisting of Nitinol, Kevlar, stainless steel, suture, and liquid crystal polymer.
(Item 51)
35. The system of item 34, wherein the elongated member is made from a stretchable material.
(Item 52)
A method of imaging delivery of an implant, the method comprising:
advancing a delivery device within the patient's urethra, the delivery device comprising: an outer tubular member comprising an imaging device associated with a distal end region of the outer tubular member; and an inner tubular member within the outer tubular member. the inner tubular member includes a first elongated tubular member having a lumen adapted to receive at least a portion of an implant; and a first elongated tubular member having an opening in a distal end region communicating with the lumen. an inner tubular member comprising: two elongated tubular members; and one or more structures slidably advanceable within the lumen of the second elongated tubular member to cause deployment of the implant. wherein the one or more structures include a retainer configured to releasably couple with a distal portion of the implant, the retainer disposed within the lumen of the second elongated tubular member. an elongate member extending proximally within the opening, the elongate member being passed out of the opening and back into the opening to prevent proximal movement of the retainer; the outer tubular member, the inner tubular member, and the one or more structures are each coupled to a proximal control device external to the patient. ru, and,
longitudinally retracting the inner tubular member relative to the proximal control device and the one or more structures to at least partially deploy the implant from the inner tubular member;
releasing the implant from the delivery device by proximally pulling the elongate member, the loop being withdrawn into the lumen of the second elongate tubular member, and the retainer being removed; , moved in a proximal direction, and
including methods.
(Item 53)
The urethra is the prostatic urethra, and the method further comprises:
While the inner tubular member is being longitudinally retracted, in parallel (a) longitudinally retracting the outer tubular member relative to the proximal control device; 52. The method of item 51, comprising imaging the at least partially deployed implant with an imaging device associated with the distal region.
(Item 54)
52. The method of item 51, wherein the imaging device is located within a distal end region of the outer tubular member.
(Item 55)
54. The method of item 53, wherein the outer tubular member is longitudinally retracted at the same rate as the inner tubular member.
(Item 56)
rotating the inner tubular member relative to the proximal control device to at least partially deploy the implant from the inner tubular member;
While the inner tubular member is being rotated, in parallel: (a) maintaining the outer tubular member in a rotationally fixed position relative to the proximal control device; and (b) controlling the imaging device. imaging the at least partially deployed implant using
The method of item 53, further comprising:
(Item 57)
52. The method of item 51, further comprising illuminating the implant using a lighting device in a distal end region of the outer tubular member.
(Item 58)
52. The method of item 51, wherein the retainer is tubular and adapted to slide along the second elongate tubular member.
(Item 59)
52. The method of item 51, wherein the second elongated tubular member comprises a recess adapted to receive a distal portion of the implant.
(Item 60)
52. The method of item 51, wherein the retainer is movable to expose the recess while a distal portion of the implant is received within the recess.
(Item 61)
52. The method of item 51, wherein the retainer comprises a slot.
(Item 62)
A system for delivering an implant, the system comprising a delivery device, the delivery device comprising:
an outer tubular member comprising first and second lumens and a distal end;
an imaging module mounted on at least one elongate member extending through the second lumen, the imaging module configured to distally advance the outer tubular member in response to distal advancement of the at least one elongate member; an imaging module configured to be positioned distal to the distal end;
an inner tubular member within the first lumen of an outer tubular member, the inner tubular member being adapted to store at least a portion of an implant;
A system equipped with.
(Item 63)
one or more structures slidably advanceable within the inner tubular member to cause deployment of the implant from within the inner tubular member;
a proximal control device coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member using a coupling mechanism;
Furthermore,
63. The system of item 62, wherein the proximal control device is configured to longitudinally move the inner tubular member and the outer tubular member in parallel.
(Item 64)
63. The system of item 62, wherein the implant is configured to maintain the prostatic urethra at least partially open.
(Item 65)
65. The system of item 64, wherein the implant has a body comprising first and second ring-shaped structures and an interconnect extending between the first and second ring-shaped structures.
(Item 66)
The one or more structures are:
an elongated grasper member configured to releasably couple with a proximal portion of the implant;
a distal control member configured to releasably couple with a distal portion of the implant;
The system according to item 63, comprising:
(Item 67)
The distal control member includes a retainer configured to releasably couple with the distal portion of the implant, and the implant includes a distal engagement configured to releasably couple with the retainer. 67. The system of item 66, comprising a mating member.
(Item 68)
67. The system of item 66, wherein the implant comprises a proximal engagement member configured to releasably couple with the elongated grasper member.
(Item 69)
63. The system of item 62, wherein the distal end region of the outer tubular member further comprises a lighting device.
(Item 70)
63. The system of item 62, wherein the imaging module comprises a camera and a light source.
(Item 71)
71. The system of item 70, wherein the light source is at least one LED.
(Item 72)
63. The system of item 62, wherein the imaging module is mounted on at least two elongated members.
(Item 73)
63. The system of item 62, wherein the imaging module is mounted on at least three elongate members.
(Item 74)
63. The system of item 62, wherein the imaging module is configured to be positioned about 0 cm to about 5 cm distal of the distal end of the outer tubular member.
(Item 75)
A method of imaging delivery of an implant, the method comprising:
advancing a delivery device within the patient's urethra, the delivery device comprising: an outer tubular member having first and second lumens and a distal end; and extending through the second lumen. an imaging module mounted on at least one elongate member for deploying the implant from within the inner tubular member; one or more structures slidably advanceable within the inner tubular member to cause the outer tubular member, the inner tubular member, and the one or more structures to each include: coupled to a proximal control device external to the patient;
longitudinally retracting the inner tubular member relative to the proximal control device and the one or more structures to at least partially deploy the implant from the inner tubular member;
extending the imaging module distally beyond the distal end of the outer tubular member;
imaging the at least partially deployed implant;
including methods.
(Item 76)
75. The method according to item 74, wherein the urethra is the prostatic urethra.
(Item 77)
75. The method of item 74, further comprising releasing the implant from the delivery device.
(Item 78)
75. The method of item 74, wherein the outer tubular member is longitudinally retracted at the same rate as the inner tubular member.
(Item 79)
rotating the inner tubular member relative to the proximal control device to at least partially deploy the implant from the inner tubular member;
While the inner tubular member is being rotated, in parallel: (a) maintaining the outer tubular member in a rotationally fixed position relative to the proximal control device; and (b) controlling the imaging device. imaging the at least partially deployed implant using
75. The method of item 74, further comprising:
(Item 80)
The implant has a body comprising first and second ring-shaped structures and an interconnect extending between the first and second ring-shaped structures, the second ring-shaped structure comprising: 75. The method of item 74, proximal to the first ring-shaped structure.
(Item 81)
75. The method of item 74, wherein the imaging module is capable of visualizing installation of the second ring-shaped structure after being extended distal to the distal end of the outer tubular member.
(Item 82)
82. The method of item 81, further comprising releasing the implant from the delivery device after imaging.
(Item 83)
75. The method of item 74, wherein the imaging module extends from about 0 cm to about 5 cm distal from the distal end of the outer tubular member.
(Item 84)
A system for delivering an implant, the system comprising a delivery device, the delivery device comprising:
an outer tubular member;
an inner tubular member within the outer tubular member, the inner tubular member being adapted to store at least a portion of an implant;
one or more structures slidably advanceable within the inner tubular member to cause deployment of the implant from within the inner tubular member;
a proximal control device comprising a rotational adapter, the proximal control device coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member using a coupling mechanism; a proximal control device,
an imaging device coupled to the rotation adapter;
Equipped with
The system, wherein the proximal control device is configured to longitudinally move the inner tubular member and the outer tubular member in parallel.
(Item 85)
85. The system of item 84, further comprising an implant.
(Item 86)
86. The system of item 85, wherein the implant has a body comprising first and second ring-shaped structures and an interconnect extending between the first and second ring-shaped structures.
(Item 87)
The one or more structures are:
an elongated grasper member configured to releasably couple with a proximal portion of the implant;
a distal control member configured to releasably couple with a distal portion of the implant;
86. The system according to item 85, comprising:
(Item 88)
The distal control member includes a retainer configured to releasably couple with the distal portion of the implant, and the implant includes a distal engagement configured to releasably couple with the retainer. 88. The system of item 87, comprising a mating member.
(Item 89)
88. The system of item 87, wherein the implant comprises a proximal engagement member configured to releasably couple with the elongated grasper member.
(Item 90)
The proximal control device rotates and longitudinally moves the inner tubular member relative to the distal control member while the distal control member is releasably coupled to the distal portion of the implant. 88. The system of item 87, wherein the system is configured to:
(Item 91)
91. The system of item 90, wherein the proximal control device is configured to rotate the inner tubular member without rotating the outer tubular member.
(Item 92)
89. The system of item 88, further comprising an elongate member coupled to the retainer and having a proximal end operable by a user to enable release of the distal portion of the implant from the retainer.
(Item 93)
93. The system of item 92, wherein the retainer is tubular and adapted to slide along the distal control member.
(Item 94)
88. The system of item 87, wherein the distal control member comprises a recess adapted to receive a distal portion of the implant.
(Item 95)
95. The system of item 94, wherein the retainer is movable to expose the recess while a distal portion of the implant is received within the recess.
(Item 96)
85. The system of item 84, wherein the distal end region of the outer tubular member further comprises a lighting device.
(Item 97)
The distal end region of the inner tubular member is distal to the distal end region of the outer tubular member by a separation distance, and the proximal control device controls the outer tubular member without changing the separation distance. and the inner tubular member in a parallel longitudinal direction.
(Item 98)
85. The system of item 84, wherein a proximal end of the inner tubular member is coupled to the rotational adapter.
(Item 99)
85. The system of item 84, wherein the rotational adapter comprises a distal component, a sliding component, a spring, and a proximal component, and the imaging device is coupled to the sliding component.
(Item 100)
100. The system of item 99, wherein the sliding component comprises an annular groove and the imaging device is coupled to the annular groove.
(Item 101)
100. The system of item 99, wherein the spring is located between the distal component and the sliding component.
(Item 102)
100. The system of item 99, wherein the spring is located between the sliding component and the proximal component.
(Item 103)
85. The system of item 84, wherein the rotating adapter conducts electricity.
(Item 104)
85. The system of item 84, wherein the rotating adapter further comprises an electrical plate or ring that conducts electricity.
(Item 105)
100. The system of item 99, wherein the sliding component includes an electrical plate or ring that conducts electricity.
(Item 106)
85. The system of item 84, wherein the rotation adapter is electrically connected to a light source.
(Item 107)
107. The system of item 106, wherein the light source is mounted on a distal end of the inner tubular member or of the one or more structures slidably advanceable within the inner tubular member. .
(Item 108)
85. The system of item 84, wherein the rotational adapter is electrically connected to the imaging device.
(Item 109)
85. The system of item 84, wherein the imaging device is advanceable longitudinally relative to the distal end of the inner tubular member.
(Item 110)
85. The system of item 84, wherein the imaging device is retractable longitudinally relative to the distal end of the inner tubular member.
(Item 111)
A method of imaging delivery of an implant, the method comprising:
advancing a delivery device within the patient's urethra, the delivery device comprising: an outer tubular member; an inner tubular member within the outer tubular member housing at least a portion of the implant; one or more structures slidably advanceable within the inner tubular member to cause deployment of the implant from within, the outer tubular member, the inner tubular member; one or more structures and an imaging device are each coupled to a proximal control device external to the patient, the proximal control device comprising a rotational adapter coupled to the imaging device;
longitudinally retracting the inner tubular member relative to the proximal control device and the one or more structures to at least partially deploy the implant from the inner tubular member;
vertically moving the imaging device relative to the distal end of the inner tubular member;
imaging the at least partially deployed implant using the imaging device;
including methods.
(Item 112)
112. The method according to item 111, wherein the urethra is the prostatic urethra.
(Item 113)
112. The method of item 111, further comprising releasing the implant from the delivery device.
(Item 114)
112. The method of item 111, wherein the outer tubular member is longitudinally retracted at the same rate as the inner tubular member.
(Item 115)
rotating the inner tubular member relative to the proximal control device to at least partially deploy the implant from the inner tubular member;
While the inner tubular member is being rotated, in parallel: (a) maintaining the outer tubular member in a rotationally fixed position relative to the proximal control device; and (b) controlling the imaging device. imaging the at least partially deployed implant using
The method of item 111, further comprising:
(Item 116)
112. The method of item 111, further comprising illuminating the implant using a lighting device in a distal end region of the outer tubular member.
(Item 117)
The implant has a body comprising first and second ring-shaped structures and an interconnect extending between the first and second ring-shaped structures, the second ring-shaped structure comprising: 112. The method of item 111, proximal to the first ring-shaped structure.
(Item 118)
118. The method of item 117, wherein the imaging device is capable of visualizing installation of the second ring-shaped structure after partial deployment.
(Item 119)
112. The method of item 111, further comprising releasing the implant from the delivery device after imaging.
(Item 120)
118. The method of item 117, wherein the imaging device is withdrawn proximal to the second ring-shaped structure after partial deployment of the implant.
(Item 121)
118. The method of item 117, wherein the imaging device is advanced distally relative to the second ring-shaped structure after partial deployment of the implant.
(Item 122)
118. The method of item 117, wherein the imaging device is advanced longitudinally relative to the distal end of the inner tubular member.
(Item 123)
118. The method of item 117, wherein the imaging device is longitudinally retracted relative to the distal end of the inner tubular member.
(Item 124)
A system for delivering an implant, the system comprising a delivery device, the delivery device comprising:
an outer tubular member;
an inner tubular member within the outer tubular member, the inner tubular member being adapted to store at least a portion of an implant;
one or more structures slidably advanceable within the lumen of the inner tubular member to cause deployment of the implant from within the inner tubular member;
a proximal control device coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member through a coupling mechanism, the proximal control device comprising: a pull wire; an actuator, the actuator comprising a rotatable wheel, an extension, a latch, and a ledge, the pull wire extending through at least a portion of the outer tubular member, and the rotatable wheel , adapted to wind and unwind the pull wire and located within a housing, the extension having first and second sides and extending from the housing, the latch being , retracted within the extension and slidable from a first side to a second side of the extension, the ledge being disposed on the housing and frictionally engaging the latch. a proximal control device adapted to
A system equipped with.
(Item 125)
125. The system of item 124, wherein wrapping the pull wire around the rotatable wheel results in deflection of the outer tubular member.
(Item 126)
125. The system of item 124, wherein unwinding the pull wire from the rotatable wheel results in straightening of the outer tubular member.
(Item 127)
125. The system of item 124, wherein the extension is movable from a first position to a second position by rotating at least a portion of the housing.
(Item 128)
128. The system of item 127, wherein the rotatable wheel is capable of winding or unwinding the pull wire when the extension is in the first position.
(Item 129)
128. The system of item 127, wherein in the first position, the extension is angled away from the distal end of the outer tubular member.
(Item 130)
128. The system of item 127, wherein the rotatable wheel is not capable of winding or unwinding the pull wire when the extension is in the second position.
(Item 131)
128. The system of item 127, wherein in the second position, the extension is angled toward a distal end of the outer tubular member.
(Item 132)
131. The system of item 130, wherein the latch is frictionally engaged by the ledge when the extension is in the second position.
(Item 133)
125. The system of item 124, wherein the extension further comprises a paddle terminating in a detent.
(Item 134)
134. The system of item 133, wherein the latch is slidable along the paddle.
(Item 135)
125. The system of item 124, wherein the ledge is located on the right side of the housing.
(Item 136)
125. The system of item 124, wherein the extension is attached to the left side of the housing.
(Item 137)
125. The system of item 124, wherein the pull wire extends through a lumen of the outer tubular member.
(Item 138)
125. The system of item 124, wherein the pull wire is coupled to or embedded in a sidewall of the outer tubular member.
(Item 139)
125. The system of item 124, wherein a distal end of the pull wire is secured to the outer tubular member at a distal end region of the outer tubular member.
(Item 140)
A method of delivering an implant, the method comprising:
(a) advancing a delivery device within the patient's urethra, the delivery device comprising an outer tubular member and an inner tubular member within the outer tubular member, the inner tubular member being an implant. an inner tubular member adapted to at least partially retract and slidably advanceable within a lumen of the inner tubular member to cause deployment of the implant from within the inner tubular member; a proximal control device coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member through a coupling mechanism; The position control device includes a pull wire and an actuator, the actuator including a rotatable wheel, an extension, a latch, and a ledge, the pull wire extending through at least a portion of the outer tubular member. the rotatable wheel extends and is adapted to wind and unwind the pull wire and is located within a housing, the extension having first and second sides and extending from the body, the latch is retracted within the extension and is slidable from a first side to a second side of the extension, and the ledge is disposed on the housing. , a proximal control device adapted to frictionally engage the latch; and
(b) longitudinally retracting the inner tubular member relative to the proximal control device and the one or more structures to at least partially deploy the implant from the inner tubular member;
(c) releasing the implant from the delivery device;
including;
During at least one of steps (a), (b), or (c), or during steps (a) and (b) or (b) and (c), the outer tubular member deflected by wrapping the pull wire around a rotatable wheel, and the outer tubular member is deflected by frictionally engaging the latch with the ledge after the outer tubular member is deflected. How to be locked into position.
(Item 141)
141. The method of item 140, wherein the outer tubular member is deflected during the advancing step (a) and locked in the deflected position.
(Item 142)
141. The method of item 140, wherein the outer tubular member is deflected between steps (a) and (b) and locked in the deflected position.
(Item 143)
141. The method of item 140, wherein the outer tubular member is deflected during the retracting step (b) and locked in the deflected position.
(Item 144)
141. The method of item 140, wherein the outer tubular member is deflected between steps (b) and (c) and locked in the deflected position.
(Item 145)
141. The method of item 140, wherein the outer tubular member is deflected during the releasing step (c) and locked in the deflected position.
(Item 146)
141. The method of item 140, wherein the extension is movable from a first position to a second position by rotating at least a portion of the housing.
(Item 147)
147. The method of item 146, wherein when the extension is in the first position, the rotatable wheel is unlocked and the pull wire can be wound or unwound.
(Item 148)
147. The method of item 146, wherein when the extension is in the second position, the rotatable wheel is locked and is not capable of winding or unwinding the pull wire.
(Item 149)
147. The method of item 146, wherein the latch is frictionally engaged by the ledge when the extension is in the second position.
(Item 150)
147. The method of item 146, further comprising unlocking the outer tubular member from the deflected position by disengaging and disengaging the latch from the ledge, and wherein the extension returns to the first position. .
(Item 151)
141. The method of item 140, wherein the pull wire extends through a lumen of the outer tubular member.
(Item 152)
141. The method of item 140, wherein the pull wire is coupled to or embedded in a sidewall of the outer tubular member.
(Item 153)
141. The method of item 140, wherein a distal end of the pull wire is secured to the outer tubular member at a distal end region of the outer tubular member.
(Item 154)
A system for delivering an implant, the system comprising a delivery device, the delivery device comprising:
an outer tubular member comprising an imaging device associated with a distal end region of the outer tubular member;
an inner tubular member within the outer tubular member, the inner tubular member communicating with the lumen and a first elongated tubular member having a lumen adapted to store at least a portion of an implant; a second elongate tubular member having an opening in the distal end region;
one or more structures slidably advanceable within a lumen of the second elongate tubular member to cause deployment of the implant, the one or more structures comprising: a retainer configured to releasably couple with a distal portion of the implant, the retainer being coupled to a third elongate tubular member extending proximally to a proximal control device; one or more structures and
A system equipped with.
(Item 155)
155. The system of item 154, wherein the proximal control device is adapted to proximally withdraw the third elongated tubular member.
(Item 156)
Item 154, wherein the retainer is configured to releasably couple with a distal portion of the implant, and the implant includes a distal engagement member configured to releasably couple with the retainer. system described in.
(Item 157)
the proximal control device is coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member through a coupling mechanism;
155. The system of item 154, wherein the proximal control device is configured to longitudinally move the inner tubular member and the outer tubular member in parallel.
(Item 158)
The one or more structures are:
an elongated grasper member configured to releasably couple with a proximal portion of the implant;
a distal control member configured to releasably couple with a distal portion of the implant;
155. The system of item 154, comprising:
(Item 159)
155. The system of item 154, wherein the elongate member has a proximal end that is operable by a user to enable release of the distal portion of the implant from the retainer.
(Item 160)
A method of delivering an implant, the method comprising:
advancing a delivery device within the patient's urethra, the delivery device comprising: an outer tubular member comprising an imaging device associated with a distal end region of the outer tubular member; and an inner tubular member within the outer tubular member. wherein the inner tubular member has a first elongated tubular member having a lumen adapted to receive at least a portion of an implant and an opening in a distal end region communicating with the lumen. an inner tubular member comprising a second elongate tubular member; one or more inner tubular members slidably advanceable within a lumen of the second elongate tubular member to cause deployment of the implant; a structure, the one or more structures comprising a retainer configured to releasably couple with a distal portion of the implant, the retainer proximally to a proximal control device; one or more structures coupled to an extending third elongated tubular member;
longitudinally retracting the inner tubular member relative to the proximal control device and the one or more structures to at least partially deploy the implant from the inner tubular member;
releasing the implant from the delivery device by proximally withdrawing the third elongate tubular member, the retainer being moved proximally;
including methods.
(Item 161)
161. The method of item 160, wherein the retainer is adapted to slide along the second elongate tubular member.
(Item 162)
161. The method of item 160, wherein the second elongated tubular member comprises a recess adapted to receive a distal portion of the implant.
(Item 163)
161. The method of item 160, wherein the retainer is movable to expose the recess while a distal portion of the implant is received within the recess.
(Item 164)
A system for delivering an implant, the system comprising a delivery device, the delivery device comprising:
an outer tubular member;
an inner tubular member within the outer tubular member, the inner tubular member being adapted to store at least a portion of an implant;
one or more structures slidably advanceable within the inner tubular member to cause deployment of the implant from within the inner tubular member;
a proximal control device coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member through a coupling mechanism, the proximal control device being coupled to the inner tubular member and the one or more structures; and configured to longitudinally move the outer tubular member in parallel, the proximal control device comprising a movable handle portion movable relative to the proximal handle portion, the movable handle portion being , a proximal control device comprising a groove configured to receive a detent coupled to an inner surface of the proximal handle portion;
A system equipped with.
(Item 165)
165. The system of item 164, wherein the detent is located on an inner surface of a distal section of the proximal handle portion.
(Item 166)
165. The system of item 164, wherein the detent is deflectable.
(Item 167)
The proximal handle portion further includes a stent having a first end and a second end, the first end of the stent being attached to the inner surface of the proximal handle portion, and the stent having a first end and a second end. 165. The system of item 164, wherein the second end terminates in the detent.
(Item 168)
165. The system of item 164, wherein the proximal handle portion is rotatable about the movable handle portion.
(Item 169)
165. The system of item 164, wherein rotation of the proximal handle can remove the detent from the groove.
(Item 170)
165. The system of item 164, further comprising an implant.
(Item 171)
A method of delivering an implant, the method comprising:
advancing a delivery device within the patient's urethra, the delivery device comprising an outer tubular member and an inner tubular member within the outer tubular member, the inner tubular member including at least a portion of the implant; an inner tubular member adapted to store the implant; and one or more slidably advanceable within the inner tubular member to cause deployment of the implant from within the inner tubular member. a proximal control device coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member through a coupling mechanism, the proximal control device coupled to the inner tubular member and the one or more structures; configured to longitudinally move the inner tubular member and the outer tubular member in parallel, a mechanism in the proximal control device preventing rotation of the outer tubular member relative to the inner tubular member; a proximal control device;
longitudinally retracting the inner tubular member relative to the proximal control device and the one or more structures to at least partially deploy the implant from the inner tubular member;
releasing the implant from the delivery device;
including methods.
(Item 172)
The proximal control device includes a movable handle portion that is movable relative to the proximal handle portion, and the mechanism is configured to receive a detent coupled to an inner surface of the proximal handle portion. 172. The method of item 171, comprising a groove on the movable handle portion.
(Item 173)
173. The method of item 172, wherein the detent is deflectable.
(Item 174)
173. The method of item 172, wherein the detent is located on an inner surface of a distal section of the proximal handle portion.
(Item 175)
The proximal handle portion further includes a stent having a first end and a second end, the first end of the stent being attached to the inner surface of the proximal handle portion, and the stent having a first end and a second end. 173. The method of item 172, wherein terminating in the detent at the second end.
(Item 176)
173. The method of item 172, wherein the proximal handle portion is rotatable about the movable handle portion.
(Item 177)
173. The method of item 172, wherein rotation of the proximal handle can remove the detent from the groove.
(Item 178)
173. The method of item 172, further comprising releasing the mechanism to allow rotation of the outer tubular member relative to the inner tubular member.
(Item 179)
179. The method of item 178, wherein releasing the mechanism includes removing the detent from the groove.
(Item 180)
180. The method of item 179, wherein the detent is removed from the groove by rotation of the proximal handle portion about the movable handle portion.
Claims (23)
外側管状部材と、
前記外側管状部材内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される、内側管状部材と、
前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記内側管状部材の管腔内で摺動可能に前進可能である1つまたはそれを上回る構造と、
前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を通して前記外側管状部材と解放可能に結合される近位制御デバイスであって、前記近位制御デバイスは、引動ワイヤと、アクチュエータとを備え、前記アクチュエータは、回転可能車輪と、延在部と、ラッチと、レッジとを備え、前記引動ワイヤは、前記外側管状部材の少なくとも一部を通して延在し、前記回転可能車輪は、前記引動ワイヤを巻回および巻解するように適合され、筐体内に位置し、前記延在部は、第1および第2の側を有し、前記筐体から延在し、前記ラッチは、前記延在部内に格納され、前記延在部の第1の側から第2の側に摺動可能であり、前記レッジは、前記筐体上に配置され、前記ラッチに摩擦して係合するように適合される、近位制御デバイスと
を備える、システム。 A system for delivering an implant, the system comprising a delivery device, the delivery device comprising:
an outer tubular member;
an inner tubular member within the outer tubular member, the inner tubular member being adapted to store at least a portion of an implant;
one or more structures slidably advanceable within the lumen of the inner tubular member to cause deployment of the implant from within the inner tubular member;
a proximal control device coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member through a coupling mechanism, the proximal control device comprising: a pull wire; an actuator, the actuator comprising a rotatable wheel, an extension, a latch, and a ledge, the pull wire extending through at least a portion of the outer tubular member, and the rotatable wheel , adapted to wind and unwind the pull wire and located within a housing, the extension having first and second sides and extending from the housing, the latch being , retracted within the extension and slidable from a first side to a second side of the extension, the ledge being disposed on the housing and frictionally engaging the latch. A system comprising: a proximal control device; and a proximal control device adapted to.
外側管状部材と、
前記外側管状部材内にある内側管状部材であって、前記内側管状部材は、インプラントの少なくとも一部を格納するように適合される、内側管状部材と、
前記内側管状部材内からの前記インプラントの展開を引き起こすために、前記内側管状部材内で摺動可能に前進可能である1つまたはそれを上回る構造と、
前記内側管状部材および前記1つまたはそれを上回る構造と結合され、結合機構を通して前記外側管状部材と解放可能に結合される近位制御デバイスであって、前記近位制御デバイスは、前記内側管状部材および前記外側管状部材を並行して縦方向に移動させるように構成され、前記近位制御デバイスは、近位取っ手部分に対して移動可能である移動可能取っ手部分を備え、前記移動可能取っ手部分は、前記近位取っ手部分の内面に結合される戻り止めを受容するように構成される溝を備える、近位制御デバイスと
を備える、システム。 A system for delivering an implant, the system comprising a delivery device, the delivery device comprising:
an outer tubular member;
an inner tubular member within the outer tubular member, the inner tubular member being adapted to store at least a portion of an implant;
one or more structures slidably advanceable within the inner tubular member to cause deployment of the implant from within the inner tubular member;
a proximal control device coupled to the inner tubular member and the one or more structures and releasably coupled to the outer tubular member through a coupling mechanism, the proximal control device being coupled to the inner tubular member and the one or more structures; and configured to longitudinally move the outer tubular member in parallel, the proximal control device comprising a movable handle portion movable relative to the proximal handle portion, the movable handle portion being , a proximal control device comprising a groove configured to receive a detent coupled to an inner surface of the proximal handle portion.
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2020
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- 2020-11-18 WO PCT/US2020/060989 patent/WO2021101951A1/en unknown
- 2020-11-18 AU AU2020387396A patent/AU2020387396A1/en active Pending
- 2020-11-18 CN CN202080080158.8A patent/CN114786629A/en active Pending
- 2020-11-18 JP JP2022528612A patent/JP2023502997A/en active Pending
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