WO2007003532A1 - Dispositif chirurgical pour prelever du tissu sur une structure biologique - Google Patents

Dispositif chirurgical pour prelever du tissu sur une structure biologique Download PDF

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Publication number
WO2007003532A1
WO2007003532A1 PCT/EP2006/063591 EP2006063591W WO2007003532A1 WO 2007003532 A1 WO2007003532 A1 WO 2007003532A1 EP 2006063591 W EP2006063591 W EP 2006063591W WO 2007003532 A1 WO2007003532 A1 WO 2007003532A1
Authority
WO
WIPO (PCT)
Prior art keywords
suction
surgical device
guide wall
suction tube
liquid jet
Prior art date
Application number
PCT/EP2006/063591
Other languages
German (de)
English (en)
Inventor
Andreas Pein
Original Assignee
P + P Medical Gmbh
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 P + P Medical Gmbh filed Critical P + P Medical Gmbh
Priority to EP06777485A priority Critical patent/EP1903956A1/fr
Publication of WO2007003532A1 publication Critical patent/WO2007003532A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3203—Fluid jet cutting instruments
    • A61B17/32037—Fluid jet cutting instruments for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/84—Drainage tubes; Aspiration tips
    • A61M1/85—Drainage tubes; Aspiration tips with gas or fluid supply means, e.g. for supplying rinsing fluids or anticoagulants
    • 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
    • A61B2017/00685—Archimedes screw
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • A61M1/741—Suction control with means for varying suction manually
    • A61M1/7411—Suction control with means for varying suction manually by changing the size of a vent
    • 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
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/08—Lipoids
    • 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
    • A61M25/007—Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked

Definitions

  • the invention relates to a surgical device according to the preamble of claim 1.
  • Such devices are used in particular in plastic surgery, but also for the surgical treatment of disease. These devices are also suitable for the removal of reproductive tissue cells.
  • a device for the removal of tissue cells which consists of a liquid separation device for releasing the tissue parts by means of a liquid jet and a suction device for removing the dissolved tissue cells.
  • the liquid separator consists of a reservoir for the separating liquid, a pressure pump and an injection line.
  • the suction device includes a collecting container for the extracted tissue parts, a suction pump and a suction line.
  • the injection line of the liquid separator and the suction line of the suction device open together in a surgical handpiece.
  • the injection line is arranged axially and within the suction line, so that there is a suction line surrounding the injection line annular.
  • the injection line is equipped at its distal end with an injection nozzle, while the annular suction channel has corresponding suction openings.
  • this surgical device can only be used in an open surgery in which the surgical area remains visible to the surgeon.
  • the drive mechanism for the very long and relatively thin injection line is technically complicated.
  • the surgical handpiece assumes an extensive size, which makes use in the invasive area impossible.
  • the very long and thin injection line is also unable to remain stable under the load of the drive, so there is a risk of bending or shearing.
  • no secure function is guaranteed, which prohibits the use of this device in the very sensitive medical field.
  • the invention is therefore based on the object to increase the performance of a generic surgical device.
  • Claim 1 solved. Further refinement possibilities emerge from the dependent claims 2 to 10.
  • the new surgical device eliminates the disadvantages of the prior art. So the main advantage is that the risk of blockages is largely avoided. This is because oversized adipose tissue cells are reduced to the size required and determined by the size of the suction holes and the suction channel. This special and compared to the previous surgical devices improved crushing of separated fat cells makes it possible that the liquid jet is made even more efficient by increasing the pressure or by a special design of the beam shape. It is expedient to carry out the guide wall provided in the suction as a spiral, which leads to a swirl-like suction flow. With this suction flow additional separation forces are involved in the separation process.
  • the spiral guide wall acts as a screw conveyor, which supports the suction flow, so that the suction performance is improved.
  • rigidly connect the guide wall to the injection cannula it may also be advantageous for certain applications to rigidly attach the guide wall to the inner wall of the suction tube. But it is also possible in principle to execute the guide wall axially parallel in one plane. This simplifies the effort and thus the manufacturing cost of the device.
  • the Blasting head equipped and placed in front of the injection nozzle, wherein the jet head has a baffle for the bundled liquid jet.
  • the baffle With this baffle the bundled liquid jet is transformed according to the requirements of the specific application. Accordingly, the impact surface is executed in its angle of attack and in its shape so that a desired shape of the liquid jet is formed.
  • the desired shape of the liquid jet may be flat or parabolic.
  • FIG. 2 shows a longitudinal section through a suction line in a first embodiment with a swirl-like suction channel
  • FIG. 3 shows a plan view of the suction line according to FIG. 2 with a partial longitudinal section, which is rotated by 90 °, FIG.
  • Fig. 4 is a plan view of the suction line of FIG. 3 with an oval and arranged like a swirl suction and
  • FIG. 5 shows a cross section through a suction line in a second embodiment with an axially parallel guide wall.
  • the surgical device for removing tissue from a biological structure consists of a liquid separation device for separating a biological structure and a corresponding suction device, as known for example from EP 0551 920 B 1. Both the liquid separator and the suction device are now well known and therefore need not be shown.
  • the liquid separation device accordingly consists of a reservoir, a pressure pump and an injection line and the suction device has a collecting container, a suction pump and a suction line.
  • the injection line of the liquid separation device and the suction line of the suction device open together in a surgical handpiece 1.
  • a handle 5 which the suction tube 2 and the Injection cannula 3 unified and the elements for connecting the inner injection cannula 3 with the injection line leading to the liquid pressure pump and the connection of the outer suction tube 2 with the leading to the suction device Suction line has.
  • the handle 5 is a closable by the thumb of the surgeon bypass opening 6, which allows influencing the size of the suction force of the suction flow.
  • the outer suction tube 2 and the inner injection cannula 3 are matched with their diameters so that a sufficient for the removal of tissue parts suction channel remains in the form of an annular channel.
  • the injection nozzle 4 of the inner injection cannula 3 has a cylindrical nozzle bore and is mounted in an axial guide bore of the outer suction tube 2, wherein the injection nozzle 4 protrudes only with a small projection from the guide bore of the outer suction tube 2.
  • the injection nozzle 4 is preceded by a jet head 7 with a groove 8 in the form of a half-shell and a jet head 9 with a baffle 10, wherein the jet head 7 is rigidly connected to the outer suction tube 2.
  • the baffle 10 of the injection nozzle 4 is arranged opposite and in alignment with the exiting liquid jet. Opposite this flight, the baffle 10 is aligned so that the incident bundled liquid jet is dissolved and reshaped.
  • the jet head tip 9 is designed with a separating edge, not shown, which is used for additional mechanical support of the liquid separation beam.
  • the suction tube 2 has a plurality of radial suction openings 11, which are executed in cross-section circular or oval and which form one or more axial rows. In this case, the one or more rows of the suction openings 11 extend in a same axial line, as shown in FIG. 1, or even like a spiral.
  • the suction tube 2 is designed to be interchangeable and rotatable relative to the handle 5 and is therefore equipped with a drive device 12 and a control and regulating unit 13.
  • This drive device 12 and the control unit 13 are spatially used in the handle 5, so that the control unit 13 is easily accessible and operable for the surgeon.
  • the drive device 12 and the control unit 13 is preferably operated electrically, wherein it can also be constructed purely mechanical and manually driven by the operator.
  • the drive device 12 and the control and regulation unit 13 are further designed so that the suction tube 2 is rotatable in two directions of rotation or rotatable within a selected rotation angle range from 0 to 360 ° and steplessly or in stages.
  • the inner injection cannula 3 is equipped with a circumferential and swirl-like oriented guide wall 14, wherein the injection cannula 3 and the guide wall 14 are made in one piece or detachably connected to each other.
  • This swirl-like guide wall 14 extends radially as far as the inner wall of the outer suction tube 2 and axially in one go from the immediate region of the first suction opening 11 to the immediate region behind the last suction opening 11 or into the handle 5.
  • This swirl-like guide wall 14 can axially interrupted and thus executed in several parts, in which case each suction opening 11 is assigned a separate part of the guide wall 14 with at least one turn.
  • the radial adaptation of the guide wall 14 to the inner wall of the outer suction tube 2 is selected with a game so that a slight rotational movement allows and sufficient tightness against the passage of tissue parts are ensured.
  • the slope of the swirl-like guide wall is required so large and the surface of the guide wall 14 so smooth that the transport movement of the material to be sucked is affected by Reihungs manager only as small as possible.
  • the guide wall 14 in the region of all or selected suction openings 11 has a circumferential cutting edge 15 and the corresponding suction openings 11 each have an inner cutting edge 16, which together form a cutting pair.
  • the guide wall 14 may extend like a spiral, as shown in FIGS. 2 to 4, or the guide wall 14 is aligned axially parallel as shown in FIG.
  • additional separation forces are developed, which were simplified in Figs. 2 to 5 and represented symbolized by vectors. The effect of these vectors will be described below together with the operation of the surgical device.
  • the suction tube 2 For removal of fat and connective tissue cells, the suction tube 2 is first pushed with the injection cannula 3 in the region of the fatty tissue cells to be removed and adjusted to the pressure pump of the liquid supply device a required liquid flow. In the same way, by activating the suction pump, a suction flow suitable for the liquid flow is generated, which first sucks its air through the open bypass opening 6. The liquid stream passes through the injection channel 3 and exits under pressure and concentrated from the injection gland 4. While maintaining its bundled shape, the liquid flow passes through the axial groove 11 of the jet head 7 and strikes the baffle 10 of the jet head 9, where it is reshaped depending on the geometry of the baffle 10.
  • This jet of fluid has sufficient force to intelligently pass between the adipose tissue cells and separate the individual adipose tissue cells.
  • the suction flow is passed through the suction openings 11, which now detects the dissolved fatty tissue cells and the working fluid used, deflects in its direction of movement and accelerates in the direction of the suction openings 11.
  • the separated fatty tissue cells enter the swirling suction channel between the inner injection cannula 3 and the outer suction tube 2 and from there into a collecting container.
  • Fat cells with larger dimensions are held up by the then small suction 11 and initially fixed.
  • the separating forces from the sum of the mass forces of the tissue cell and the suction forces from the thrown suction flow, which are symbolized together by the vectors 17, act on the fatty tissue cell. Due to the diagonal due to the spin-like suction Alignment of these separation forces 17, the separation forces 17 disassemble in axially and radially acting separating force components.
  • the axial force components of these separation forces 17 are the opposite separation forces 18, resulting from the axially fixed suction tube 2.
  • the size of the axial force components of the separation forces 17 and the counterpart forces 18 are suitable for correspondingly reducing the oversized fat tissue cells.
  • the control unit 13 is actuated, so that the suction tube 2 is placed in a correspondingly oriented rotation. From this rotation, counter-separation forces 19, which oppose the radial separation force components of the separating forces 17, develop. Thus, the radial separation force components of the separation forces 17 participate in the separation process, so that the sum of the forces acting on the fat tissue cell separation forces has increased. This will shred difficult to separate and absorbable adipose tissue cells. As FIGS. 3 and 4 illustrate, the sum of the separating forces can be further increased if the suction openings 11 are made circular instead of oval, because this increases the effective length of the separating edge involved in the separating process.
  • Fig. 5 illustrates, the sum of the forces acting on the fat cell separating forces is further increased when the suction opening 11 is provided with an inner cutting edge 16 and the guide wall 14 with a circumferential cutting edge 15, so that from the new cutting forces 20th and the corresponding counter-cutting forces 21 of the suction tube 2 results in a new cutting pair. Then additional cutting forces are developed, which also crush the previously not separable and absorbable fat cells to a transportable size.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Vascular Medicine (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • External Artificial Organs (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif chirurgical pour prélever du tissu sur une structure biologique. Les dispositifs chirurgicaux connus possèdent une pièce à main (1) fonctionnelle comprenant une canule d'injection (3) interne et un tuyau d'aspiration (2) externe, un canal d'évacuation étant formé entre la canule d'injection (3) interne et le tuyau d'aspiration (2) externe. Le tuyau d'aspiration (2) présente plusieurs ouvertures d'aspiration (11). L'objectif de l'invention est d'accroître les capacités de ce dispositif chirurgical. A cet effet, chaque ouverture d'aspiration (11) est pourvue d'une arête de séparation, le canal d'aspiration possède une paroi de guidage (14) pour un flux d'aspiration et le tuyau d'aspiration (2) externe est conçu de façon à pouvoir être mis en rotation et entraîné.
PCT/EP2006/063591 2005-06-30 2006-06-27 Dispositif chirurgical pour prelever du tissu sur une structure biologique WO2007003532A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP06777485A EP1903956A1 (fr) 2005-06-30 2006-06-27 Dispositif chirurgical pour prelever du tissu sur une structure biologique

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102005030931A DE102005030931B4 (de) 2005-06-30 2005-06-30 Operationshandstück einer chirurgischen Einrichtung zur Entnahme von Gewebe aus einer biologischen Strukur
DE102005030931.3 2005-06-30

Publications (1)

Publication Number Publication Date
WO2007003532A1 true WO2007003532A1 (fr) 2007-01-11

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ID=36950402

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2006/063591 WO2007003532A1 (fr) 2005-06-30 2006-06-27 Dispositif chirurgical pour prelever du tissu sur une structure biologique

Country Status (3)

Country Link
EP (1) EP1903956A1 (fr)
DE (1) DE102005030931B4 (fr)
WO (1) WO2007003532A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105125258A (zh) * 2010-03-03 2015-12-09 精工爱普生株式会社 流体喷射装置和手术装置

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0315557A1 (fr) * 1987-10-27 1989-05-10 Daniel Le Cam Dispositif de liposuccion
US5460604A (en) * 1993-11-29 1995-10-24 Stryker Corporation Surgical irrigation apparatus
DE10033278A1 (de) * 2000-07-07 2002-01-24 Pein Andreas Medizintech Gmbh Chirurgische Einrichtung zur Entnahme von Gewebezellen aus einer biologischen Struktur
US20030167053A1 (en) * 2000-05-31 2003-09-04 Taufig Ahmmed Ziah Liposuction device
WO2004014460A2 (fr) * 2002-07-12 2004-02-19 Andreas Pein Dispositif chirurgical pour prelever des cellules de tissus dans une structure biologique
DE202004014104U1 (de) * 2004-09-08 2004-12-16 Human Med Ag Chirurgische Einrichtung zur Entnahme von Gewebezellen aus einer biologischen Struktur

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5037431A (en) * 1989-11-03 1991-08-06 The Curators Of The University Of Missouri Surgical liquid lance apparatus
DE4200976C2 (de) * 1992-01-16 1995-08-24 Andreas Pein Vorrichtung zum Trennen einer biologischen Struktur, insbesondere des menschlichen Gewebes
US5782795A (en) * 1995-06-30 1998-07-21 Xomed Surgical Products, Inc. Surgical suction cutting instrument with internal irrigation

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0315557A1 (fr) * 1987-10-27 1989-05-10 Daniel Le Cam Dispositif de liposuccion
US5460604A (en) * 1993-11-29 1995-10-24 Stryker Corporation Surgical irrigation apparatus
US20030167053A1 (en) * 2000-05-31 2003-09-04 Taufig Ahmmed Ziah Liposuction device
DE10033278A1 (de) * 2000-07-07 2002-01-24 Pein Andreas Medizintech Gmbh Chirurgische Einrichtung zur Entnahme von Gewebezellen aus einer biologischen Struktur
WO2004014460A2 (fr) * 2002-07-12 2004-02-19 Andreas Pein Dispositif chirurgical pour prelever des cellules de tissus dans une structure biologique
DE202004014104U1 (de) * 2004-09-08 2004-12-16 Human Med Ag Chirurgische Einrichtung zur Entnahme von Gewebezellen aus einer biologischen Struktur

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105125258A (zh) * 2010-03-03 2015-12-09 精工爱普生株式会社 流体喷射装置和手术装置

Also Published As

Publication number Publication date
DE102005030931B4 (de) 2009-03-05
EP1903956A1 (fr) 2008-04-02
DE102005030931A1 (de) 2007-01-04

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