WO2002004066A1 - Electrode enfouie dans un corps - Google Patents

Electrode enfouie dans un corps Download PDF

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Publication number
WO2002004066A1
WO2002004066A1 PCT/JP2001/005507 JP0105507W WO0204066A1 WO 2002004066 A1 WO2002004066 A1 WO 2002004066A1 JP 0105507 W JP0105507 W JP 0105507W WO 0204066 A1 WO0204066 A1 WO 0204066A1
Authority
WO
WIPO (PCT)
Prior art keywords
conductor
hole
beak
electrode
electrode according
Prior art date
Application number
PCT/JP2001/005507
Other languages
English (en)
Japanese (ja)
Inventor
Tsuyoshi Shoji
Yoshitaka Oku
Original Assignee
Wada, Hiromi
Ohnaka, Kenji
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Wada, Hiromi, Ohnaka, Kenji filed Critical Wada, Hiromi
Priority to AU2001266336A priority Critical patent/AU2001266336A1/en
Publication of WO2002004066A1 publication Critical patent/WO2002004066A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode

Definitions

  • the present invention belongs to an implantable electrode in the body, and is particularly suitably used as a thoracoscopic implantable, diaphragm-based pacing electrode by electrical stimulation.
  • Diaphragmatic pacing which provides functional electrical stimulation of the phrenic nerve, is primarily central alveolar hypoventilation syndrome (a syndrome of hypercapnia despite normal pulmonary function; when sleeping) Hypoventilation worsens, meaning that it cannot take in oxygen and produce carbon dioxide) and high myelinjury (
  • the ventilator interferes with the functions of the mouth, such as vocalization and eating, and is not portable and has a limited range of action.
  • the heart pacemaker it is not as widespread as the heart pacemaker.
  • the electrode implantation procedure involves thoracotomy. It can be considered invasive (stress on the human body).
  • one object of the present invention is to solve this problem and to provide an electrode which can be implanted in the body in a minimally invasive manner, in particular, a diaphragm pacing electrode which can be implanted in a minimally invasive manner under thoracoscopy. Disclosure of the invention
  • an implantable electrode provides an electrode including a conductor and a rubber insulator covering the conductor, wherein the insulator is
  • a gripper having a through-hole capable of gripping a nerve, and having an opening formed on one side of a radial cross section of the through-hole;
  • An upper beak that extends forward from the upper edge of the opening, has a thicker tip, and has a small hole formed at the tip,
  • the conductor passes through the extension, and the lower end is exposed outside the end of the extension, and the upper end is exposed in the through hole.
  • a thin wire such as a thread is passed through a small hole, and the thread is pulled inside the body to open the upper and lower beaks.
  • the beak is used as a guide to move the opening of the grasping part to the nerve, the nerve is inserted into the through hole from the opening, and the upper and lower beaks are fixed to each other by fixing means such as clips. And can grasp nerves. Since the insulator is made of rubber, the opening and closing of the upper and lower bills and the expansion and contraction of the opening are performed by elastic deformation of the insulator.
  • the nerve can be stimulated by applying a current to the lower end of the conductor that extends outside from the end of the extension.
  • thoracoscopic surgery is widely used as a surgical technique for various thoracic diseases.
  • the nerve can be grasped only by fixing the upper and lower beaks to each other by a fixing means such as a clip, so that neither sewing nor touching the electrode is required. Therefore, it is minimally invasive. Since it is an easy procedure for a thoracic surgeon who is experienced in thoracoscopic surgery to perform electrode implantation, it is suitable for various treatments such as diaphragm pacing if clinical application is possible.
  • the sheet serves as a non-slip for the above-mentioned clip or other fixing means, and the fixing means is It is preferable because it does not come off from the beak.
  • the beaks maintain a predetermined shape even during the work of inserting the nerve, so that the nerve penetrates the nerve. It is preferable because it is easy to fit into the hole or fix the upper and lower beaks to each other by the fixing means.
  • the shape of the conductor is such that the conductor is exposed from the base of the beak upward through the thick portion of the grip portion to the inside of the through hole from the extension portion, and is folded back to the bottom of the beak along the wall surface of the through hole. Preferably it is extended. This allows the nerve to be in contact with the nerve at any position on the wall of the through-hole, and electrical connection is ensured.
  • FIG. 1 is a perspective view showing the implanted electrode of the embodiment
  • FIG. 2 is a longitudinal sectional view of the electrode
  • FIG. 3 is a rear view of the electrode
  • FIG. 4 is a front view of the electrode
  • FIG. Fig. 6 shows the electrode of the embodiment.
  • diaphragm base is Dara off showing the time course one single longitudinal carbon dioxide partial pressure (paC0 2).
  • FIG. 1 is a perspective view showing an implantable electrode according to the embodiment
  • FIG. 2 is a longitudinal sectional view
  • FIG. 3 is a rear view
  • FIG. 4 is a front view.
  • the electrode 1 is composed of two conductors 2 and 2 and a silicon rubber insulator 3 covering the conductors 2 and 2.
  • the conductor 2 is formed by soldering a three-piece platinum wire having a diameter of 0.03 mm and a stainless steel wire.
  • the insulator 3 is composed of a gripper 4, an extension 5, an upper beak 6, and a lower beak 7.
  • the grip portion 4 has a through hole 41 having a thickness of 2 mm, a width of 7 mm, and an inner diameter similar to that of a nerve such as the phrenic nerve, for example, a diameter of about 3 mm.
  • An opening 42 is formed on one side of the radial cross section.
  • the extension portion 5 has an outer diameter of 2 mm and extends to a length of 300 mm from a position different from the opening 42 of the grip portion 4.
  • the upper beak 6 extends 5 mm forward with a thickness of 1 mm from the upper edge of the opening 42, has a tip approximately 2 mm thick, and has a small hole 61 having a diameter of 0.5 mm formed at the tip. ing.
  • a sheet 62 made of reticulated silicon is embedded in the lower surface of the upper beak 6.
  • the lower beak 7 extends forward with a substantially uniform thickness of 0.5 mm from the lower edge of the opening 42, and a lower sheet is embedded with a sheet 71 of the same quality as the sheet 62. .
  • the conductor 2 passes through the extension 5 in the length direction, and its lower end is exposed to the outside from the end of the extension 5 and is connected to the connector 8.
  • the upper end of the conductor 2 passes through the thick part of the gripper 4 so as to bypass the through-hole 41, reaches the base of the beak 6, and then goes out into the through-hole 41 to be folded. Then, along the inner periphery of the through hole 41, it reaches near the base of the lower beak 7.
  • the platinum wire portion is located on the upper side
  • the stainless steel wire portion is located on the lower side, and both are joined near a boundary between the grip portion 4 and the extension portion 5.
  • the stainless steel wire portion is formed into a thread-like shape and Teflon-coated, and has a diameter of 0.25 mm.
  • the conductors 2 and 2 are separated from each other so as not to short-circuit each other, and the interval between the platinum wire portions exposed in the through holes 41 is
  • the thread color edge 3 may be formed by integrally molding the grip portion 4, the extension portion 5, and the upper and lower beaks 6 and 7 by a normal rubber molding technique, or may fuse the respective components after separate molding.
  • integral molding fix the conductors 2 and 2 in a mold and pour the rubber.
  • separate molding the gripping portion 4 is processed into a circular cross section with a silicon rubber sheet and a small hole for passing the conductor 2 is formed. Then, the conductive wire 2 is passed through a silicon tube, and the tube is heat-softened to form an extended portion 5, which is thermally fused to the grip portion 4.
  • the nerve can be gripped by moving 42 and inserting the nerve into the through-hole 41 from the opening 42, and then fixing the upper and lower beaks 6 and 7 to each other with a clip. All of these operations are performed under thoracoscopy.
  • the grasped nerve contacts the platinum wire portion of the conducting wire 2 in the through hole 4 1.
  • the insulator 3 is made of silicon rubber, the opening and closing of the upper and lower bills 6 and 7 and the expansion and contraction of the opening 42 are performed by the elastic deformation of the insulator 3. However, since the sheet 61 is provided on the lower surface of the upper beak 6, it is not excessively deformed. Since the upper end of the wire 2 exposed inside the through hole is in contact with the nerve, connect the connector to a nerve stimulator outside the body. Can stimulate nerves.
  • An example of the above-mentioned clip is a rig clip ERCA, which is released by Johnson & Johnson Corporation.
  • the top end of the upper beak 6 is formed to be thick, and the lower end of the lower beak 7 is provided with a sheet 71. It stops. Therefore, there is no need to worry about the clip coming off during nerve stimulation.
  • Micro connector A-2P manufactured by Unique Medical Inc. is exemplified as connector-18.
  • the shape of the conductor is not limited to the above-described conductor 2, and the upper end of the conductor 2 may protrude directly from the extension 5 into the through hole 41 as shown in the cross-sectional view of FIG. 5, or may be replaced with a wire.
  • a foil may be used and this may be lined with the wall surface of the through hole 41.
  • ketamine hydrochloride as a general anesthetic (trade name for intramuscular injection of keiyaral, manufactured by Sankyo)
  • Intramuscular injection of 10 mg / kg transfer to the operating table, and blood sampling from right femoral artery Then measure spontaneous breathing and blood gas partial pressure in room air.
  • Shaving the forelimbs (forelimbs) (shaving), securing intravenous lines (starting infusion), intravenous pentobarbital salt (trade name Nembutal, manufactured by Dainippon Pharma Co., Ltd.) 10 mg / kg intravenously Injected and introduced.
  • Anesthesia was maintained by inhalation of an inhaled anesthetic, Yaguchi Tan (Flosen, trade name, manufactured by Takeda Pharmaceutical). 2. Orally intubate the endotracheal tube and start artificial respiration. In the supine position (back up), the stomach was shaved to expose the right femoral artery, an arterial line was inserted, and blood pressure, heart rate, and blood gas were monitored. Blood gas from bilateral lung ventilation was collected from the arterial line and measured.
  • an electrode can be implanted under thoracoscopy.
  • the indication of diaphragm paging has spread to cases that cannot withstand general surgical invasion, and has been used in many patients with ventilatory insufficiency who had been tied to a ventilator and had become bedridden. This may include withdrawing from ventilators, closing tracheal incisions, and opening the way for return to social activity.
  • Electrode stimulation is expected to be applied not only to the phrenic nerve but also to multiple organs in the future.

Landscapes

  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Electrotherapy Devices (AREA)

Abstract

L'invention concerne une électrode qui comprend un conducteur (2) et un isolant en caoutchouc (3) recouvrant le conducteur. Le diélectrique comprend une pièce de retenue (4) à trou de passage pouvant généralement fixer une nervure, et présente une ouverture pratiquée sur un côté du trou de passage selon une section transversale radiale. Le conducteur comprend également une pièce de prolongement (5) s'étendant de l'autre côté de la pièce de retenue; une mâchoire supérieure (6) s'étendant vers l'avant depuis le bord supérieur de l'ouverture et présentant une pointe plus épaisse dans laquelle est ménagé un trou; et une mâchoire inférieure (7) s'étendant vers l'avant depuis le bord inférieur de l'ouverture. Le conducteur traverse l'intérieur de la pièce de prolongement. L'extrémité inférieure du conducteur est exposée à l'air libre à partir de l'extrémité de la pièce de prolongement, et l'extrémité supérieure est exposée jusqu'à l'intérieur du trou de passage, ce qui donne une électrode enfouie dans un corps avec une contrainte de faible intensité, notamment une électrode de stimulation de diaphragme enfouie avec une contrainte de faible intensité sous un pleuroscope.
PCT/JP2001/005507 2000-07-12 2001-06-27 Electrode enfouie dans un corps WO2002004066A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2001266336A AU2001266336A1 (en) 2000-07-12 2001-06-27 Body-buried electrode

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2000-210660 2000-07-12
JP2000210660A JP4169460B2 (ja) 2000-07-12 2000-07-12 体内埋め込み電極

Publications (1)

Publication Number Publication Date
WO2002004066A1 true WO2002004066A1 (fr) 2002-01-17

Family

ID=18706894

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2001/005507 WO2002004066A1 (fr) 2000-07-12 2001-06-27 Electrode enfouie dans un corps

Country Status (3)

Country Link
JP (1) JP4169460B2 (fr)
AU (1) AU2001266336A1 (fr)
WO (1) WO2002004066A1 (fr)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9227053B2 (en) 2008-05-02 2016-01-05 Medtronic, Inc. Self expanding electrode cuff
US8340785B2 (en) * 2008-05-02 2012-12-25 Medtronic, Inc. Self expanding electrode cuff
KR101158775B1 (ko) 2010-11-16 2012-06-22 연세대학교 산학협력단 나노 와이어와 커프를 활용한 신경 소자
KR101658222B1 (ko) * 2014-10-31 2016-09-20 인하대학교 산학협력단 신경 자극을 위한 전극 어레이

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1986000234A1 (fr) * 1984-06-21 1986-01-16 Medtronic, Inc. Procede et appareil de stimulation du diaphragme
JPH07328130A (ja) * 1994-06-13 1995-12-19 Nippon Sogo Igaku Kenkyusho:Kk 生体内部刺激用電極セット

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1986000234A1 (fr) * 1984-06-21 1986-01-16 Medtronic, Inc. Procede et appareil de stimulation du diaphragme
JPH07328130A (ja) * 1994-06-13 1995-12-19 Nippon Sogo Igaku Kenkyusho:Kk 生体内部刺激用電極セット

Also Published As

Publication number Publication date
JP4169460B2 (ja) 2008-10-22
AU2001266336A1 (en) 2002-01-21
JP2002017872A (ja) 2002-01-22

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