RU2011142301A - Направляющая система с механизмом аспирации - Google Patents

Направляющая система с механизмом аспирации Download PDF

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RU2011142301A
RU2011142301A RU2011142301/14A RU2011142301A RU2011142301A RU 2011142301 A RU2011142301 A RU 2011142301A RU 2011142301/14 A RU2011142301/14 A RU 2011142301/14A RU 2011142301 A RU2011142301 A RU 2011142301A RU 2011142301 A RU2011142301 A RU 2011142301A
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catheter
proximal
catheter guide
inner diameter
distal
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RU2011142301/14A
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RU2538237C2 (ru
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Джон Й. ЧАНГ
Эрик ГОЛДФАРБ
Серена СВЕЙ
Мэй Й. ПАДЕР
Майкл Дж. ГОТТСМАН
Ричард Р. НЬЮХОСЕР
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Аккларент, Инк.
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/24—Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3415—Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
    • A61M25/0041—Catheters; Hollow probes characterised by the form of the tubing pre-formed, e.g. specially adapted to fit with the anatomy of body channels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M25/0054—Catheters; Hollow probes characterised by structural features with regions for increasing flexibility
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/008—Strength or flexibility characteristics of the catheter tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0097—Catheters; Hollow probes characterised by the hub
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00—Dilators with or without means for introducing media, e.g. remedies
    • A61M29/02—Dilators made of swellable material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3478—Endoscopic needles, e.g. for infusion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00738—Aspects not otherwise provided for part of the tool being offset with respect to a main axis, e.g. for better view for the surgeon
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/24—Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
    • A61B2017/246—Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers for cleaning of the nose
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/345—Cannulas for introduction into a natural body opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3454—Details of tips
    • A61B2017/346—Details of tips with wings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/005—Auxiliary appliance with suction drainage system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/06—Head
    • A61M2210/0681—Sinus (maxillaris)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0074—Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0082—Catheter tip comprising a tool

Abstract

1. Катетер-проводник для направленного введения одного или нескольких гибких устройств в полость придаточной пазухи пациента и осуществления аспирации с помощью катетера-проводника, при этом катетер-проводник включает:удлиненный ствол катетера, приспособленный для введения в ноздрю пациента, при этом ствол катетера включает:проксимальную часть;изогнутую дистальную часть, более гибкую по сравнению с проксимальной частью; ипросвет, проходящий продольно через проксимальную и дистальную части; ивтулку в сборе, соединенную с проксимальной частью ствола катетера, при этом втулка в сборе включает:внутреннюю камеру, сообщающуюся по текучей среде с просветом ствола катетера;обратный клапан, размещенный во внутренней камере, при этом клапан имеет отверстие, предназначенное для создания герметичного уплотнения вокруг устройства, продвигаемого через клапан;аспирационный порт для соединения механизма аспирации с втулкой; ивентиляционное отверстие.2. Катетер-проводник по п.1, в котором просвет включает:первый внутренний диаметр в проксимальной части ствола, при этом первый внутренний диаметр имеет достаточную величину, чтобы обеспечить возможность проксимального проведения аспирации через ствол катетера в то время, как баллонный катетер находится в просвете проксимальной части; ивторой внутренний диаметр в дистальной части, имеющий меньший размер по сравнению с первым внутренним диаметром.3. Катетер-проводник по п.1, в котором проксимальный внешний профиль катетера больше дистального внешнего профиля.4. Катетер-проводник по п.3, в котором катетер включает конусообразный переход между проксимальным внешним пр�

Claims (34)

1. Катетер-проводник для направленного введения одного или нескольких гибких устройств в полость придаточной пазухи пациента и осуществления аспирации с помощью катетера-проводника, при этом катетер-проводник включает:
удлиненный ствол катетера, приспособленный для введения в ноздрю пациента, при этом ствол катетера включает:
проксимальную часть;
изогнутую дистальную часть, более гибкую по сравнению с проксимальной частью; и
просвет, проходящий продольно через проксимальную и дистальную части; и
втулку в сборе, соединенную с проксимальной частью ствола катетера, при этом втулка в сборе включает:
внутреннюю камеру, сообщающуюся по текучей среде с просветом ствола катетера;
обратный клапан, размещенный во внутренней камере, при этом клапан имеет отверстие, предназначенное для создания герметичного уплотнения вокруг устройства, продвигаемого через клапан;
аспирационный порт для соединения механизма аспирации с втулкой; и
вентиляционное отверстие.
2. Катетер-проводник по п.1, в котором просвет включает:
первый внутренний диаметр в проксимальной части ствола, при этом первый внутренний диаметр имеет достаточную величину, чтобы обеспечить возможность проксимального проведения аспирации через ствол катетера в то время, как баллонный катетер находится в просвете проксимальной части; и
второй внутренний диаметр в дистальной части, имеющий меньший размер по сравнению с первым внутренним диаметром.
3. Катетер-проводник по п.1, в котором проксимальный внешний профиль катетера больше дистального внешнего профиля.
4. Катетер-проводник по п.3, в котором катетер включает конусообразный переход между проксимальным внешним профилем и дистальным внешним профилем.
5. Катетер-проводник по п.1, в котором фрагмент проксимальной части выполнен из нержавеющей стали.
6. Катетер-проводник по п.1, в котором часть наконечника изогнутой дистальной части обладает гибкостью, что позволяет ей растягиваться при прохождении через нее гибкого устройства.
7. Катетер-проводник по п.6, в котором часть наконечника изогнутой дистальной части выполнена из пебакса.
8. Катетер-проводник по п.6, в котором катетер включает фрагмент из нейлона, расположенный проксимально относительно конечной части изогнутой дистальной части, выполненной из пебакса.
9. Катетер-проводник по п.1, дополнительно включающий наконечник в форме скошенного конуса.
10. Катетер-проводник по п.1, дополнительно содержащий наконечник с крыльями.
11. Катетер-проводник по п.1, в котором клапан образует герметичное уплотнение вокруг гибкого баллонного катетера, продвигаемого через катетер-проводник.
12. Катетер-проводник по п.1, в котором втулка в сборе имеет поверхность для захвата, позволяющую хирургу пальцами одной руки ухватить втулку в сборе и закрыть вентиляционное отверстие.
13. Катетер-проводник по п.1, в котором вентиляционное отверстие содержит канал, проходящий от внешней поверхности втулки к внутренней поверхности втулки, при этом канал проходит проксимально от внутренней поверхности к внешней поверхности под углом относительно продольной оси катетера-проводника.
14. Катетер-проводник по п.1, в котором аспирационный порт имеет наклон проксимально относительно продольной оси катетера-проводника.
15. Катетер-проводник для направленного введения одного или нескольких гибких устройств в полость придаточной пазухи пациента и осуществления аспирации с помощью катетера-проводника, при этом катетер-проводник включает:
удлиненный ствол катетера, приспособленный для введения в ноздрю пациента, при этом ствол катетера включает:
проксимальную часть;
изогнутую дистальную часть, более гибкую по сравнению с проксимальной частью; и
просвет, проходящий продольно через проксимальную и дистальную части;
обратный клапан, размещенный внутри просвета проксимальной части, при этом клапан имеет отверстие, предназначенное для создания герметичного уплотнения вокруг устройства, продвигаемого через клапан;
аспирационный порт, расположенный вдоль проксимальной части ствола, для соединения механизма аспирации с катетером-проводником; и
вентиляционное отверстие, размещенное вдоль проксимальной части ствола.
16. Катетер-проводник по п.15, в котором просвет включает:
первый внутренний диаметр в проксимальной части ствола, при этом первый внутренний диаметр имеет достаточную величину, чтобы обеспечить возможность проксимального проведения аспирации через ствол катетера в то время, как баллонный катетер находится в просвете проксимальной части; и
второй внутренний диаметр в дистальной части, размер которого меньше первого внутреннего диаметра.
17. Система для выполнения операции на придаточной пазухе или в полости придаточной пазухи, при этом система включает:
катетер-проводник, включающий:
удлиненный ствол катетера, приспособленный для введения в ноздрю пациента, при этом ствол катетера включает:
проксимальную часть;
изогнутую дистальную часть, более гибкую по сравнению с проксимальной частью; и
просвет, проходящий продольно через проксимальную и дистальную части; и
втулку в сборе, соединенную с проксимальной частью ствола катетера, при этом втулка в сборе включает:
внутреннюю камеру, сообщающуюся по текучей среде с просветом ствола катетера;
обратный клапан, размещенный во внутренней камере, при этом клапан имеет отверстие, предназначенное для создания герметичного уплотнения вокруг устройства, продвигаемого через клапан;
аспирационный порт для подключения аспирационного механизма с втулкой; и
вентиляционное отверстие; и
гибкое устройство, приспособленное для введения через катетер-проводник в полость придаточной пазухи для выполнения операции на придаточной пазухе или в полости придаточной пазухи.
18. Система по п.17, в которой гибкое устройство представляет собой гибкий баллонный катетер, используемый для дилатации отверстия, ведущего в полость придаточной пазухи.
19. Система по п.18, дополнительно включающая проволочный проводник, по которому продвигается баллонный катетер.
20. Система по п.19, в которой проволочный проводник имеет подсветку, обеспечивающую трансиллюминацию придаточной пазухи.
21. Система по п.18, дополнительно включающая насос для надувания баллонного катетера.
22. Система по п.18, дополнительно включающая ирригационный катетер, вводимый через катетер-проводник после дилатации и предназначенный для промывания полости придаточной пазухи.
23. Система по п.15, в которой просвет катетера-проводника включает:
первый внутренний диаметр в проксимальной части ствола, при этом первый внутренний диаметр имеет достаточную величину, чтобы обеспечить возможность проксимального проведения аспирации через ствол катетера в то время, как баллонный катетер находится в стволе проксимальной части; и
второй внутренний диаметр в дистальной части, размер которого меньше первого внутреннего диаметра.
24. Система по п.15, в которой часть наконечника изогнутой дистальной части катетера-проводника обладает гибкостью, что позволяет ей растягиваться при прохождении через нее гибкого устройства.
25. Система по п.15, в которой катетер-проводник дополнительно содержит наконечник в форме скошенного конуса.
26. Система по п.15, в которой клапан катетера-проводника образует герметичное уплотнение вокруг гибкого баллонного катетера, продвигаемого по катетеру-проводнику.
27. Способ введения гибкого устройства в полость придаточной пазухи включает:
вводят катетер-проводник в полость черепа пациента, где гибкое устройство может быть предварительно размещено внутри катетера-проводника или введено в катетер-проводник во время введения катетера-проводника в полость черепа пациента или после этого;
создают проксимально направленную всасывающую силу в катетере-проводнике вокруг гибкого устройства с помощью аспирационного механизма, присоединенного к катетеру-проводнику;
продвигают гибкое устройство вперед за пределы дистального конца катетера-проводника в полость придаточной пазухи.
28. Способ по п.27, в котором в качестве гибкого устройства используют баллонный дилатационный катетер.
29. Способ по п.28, дополнительно включает выполнение баллонной дилатации при помощи баллонного катетера для осуществления дилатации отверстия придаточной пазухи.
30. Способ по п.29, в котором при дилатации отверстия осуществляют дилатацию естественного устья придаточной пазухи.
31. Способ по п.29, дополнительно включающий создание искусственного отверстия, ведущего в полость придаточной пазухи, при этом дилатация отверстия предполагает дилатацию по меньшей мере одного из двух отверстий: искусственного отверстия или естественного устья придаточной пазухи.
32. Способ по п.28, в котором используют гибкое устройство, представляющее собой проволочный проводник; при этом проволочный проводник продвигают вперед за пределы дистального конца катетера-проводника в полость придаточной пазухи до введения баллонного катетера, при этом баллонный катетер продвигают по проволочному проводнику.
33. Способ по п.27, в котором используют катетер-проводник, имеющий гибкую дистальную часть, при этом продвигают гибкое устройство по дистальной части, что вызывает растяжение дистальной части.
34. Способ по п.27, в котором используют катетер-проводник, включающий втулку в сборе, имеющую проксимальный конец, при этом присоединяют вспомогательное устройство к втулке в сборе.
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WO2010108017A1 (en) 2010-09-23
CA2755321A1 (en) 2010-09-23
US10524814B2 (en) 2020-01-07
US11207087B2 (en) 2021-12-28
EP2408505A1 (en) 2012-01-25
AU2010226594B2 (en) 2015-12-03
JP2012520749A (ja) 2012-09-10
CN102361663B (zh) 2015-04-01
US20220142663A1 (en) 2022-05-12
RU2538237C2 (ru) 2015-01-10
US20160324535A1 (en) 2016-11-10
BRPI1012540A2 (pt) 2016-03-29
JP5855562B2 (ja) 2016-02-09
US20200046392A1 (en) 2020-02-13
MX2011009837A (es) 2011-10-19
US20100241155A1 (en) 2010-09-23
AU2010226594A1 (en) 2011-10-20
CN102361663A (zh) 2012-02-22

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