WO2022063788A1 - Anse pouvant être assemblée pourvue d'une caméra pour l'ablation chirurgicale à haute fréquence de tissus malades - Google Patents

Anse pouvant être assemblée pourvue d'une caméra pour l'ablation chirurgicale à haute fréquence de tissus malades Download PDF

Info

Publication number
WO2022063788A1
WO2022063788A1 PCT/EP2021/075965 EP2021075965W WO2022063788A1 WO 2022063788 A1 WO2022063788 A1 WO 2022063788A1 EP 2021075965 W EP2021075965 W EP 2021075965W WO 2022063788 A1 WO2022063788 A1 WO 2022063788A1
Authority
WO
WIPO (PCT)
Prior art keywords
snare
sling
loop
camera
distal end
Prior art date
Application number
PCT/EP2021/075965
Other languages
German (de)
English (en)
Inventor
Johannes Roth
Original Assignee
Johannes Roth
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 Johannes Roth filed Critical Johannes Roth
Publication of WO2022063788A1 publication Critical patent/WO2022063788A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00482—Digestive system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • A61B2018/141—Snare

Definitions

  • the present invention relates to a snare for high-frequency surgical removal of diseased tissue from hollow body organs and for removing all types of foreign bodies from hollow body organs, the snare consisting of two adaptable halves and a camera being located on one snare half.
  • Loops for high-frequency surgical removal of diseased tissue from hollow body organs and for removing all types of foreign bodies from hollow body organs are known from the prior art and are, for example, in DE 20 2010 005 677 U1, DE 2009 036 158 A1 and EP2 959 855 B1.
  • So-called polypectomy snares are used to remove polyps (also called adenomas) and also foreign bodies from hollow body organs, in particular from the entire gastrointestinal tract.
  • the diseased tissue is usually removed using the so-called mucosectomy technique.
  • the diseased tissue (polyp) is first lifted after being injected with a NaCl solution.
  • the polypectomy snare is then guided over the polyp to the base, with healthy raised tissue also being introduced into the snare in order to achieve safe removal in healthy (in sano) areas.
  • the tissue to be removed is separated from the surrounding healthy tissue using high-frequency surgical current application and then recovered. Removal of such polyps is necessary because malignant tumors develop from these polyps over the years.
  • large polyps can lead to acute bleeding, but over a longer period of time it can also lead to chronic anemia.
  • the present invention is based on the problem that the polypectomy loops used according to the current state of the art (FIG. 1) have a loop (a) that is already completely closed when the loop is extended (FIG. 1), so that both a polyp as well as a foreign body must be introduced into this closed snare opening in order to separate the polyp or to recover the foreign body.
  • the diseased tissue is located in an unfavorable place in the intestine, such as in the flexures of the large intestine or in the very tortuous course of the sigmoid.
  • Another example is when, for example, there is a foreign body in the upper gastrointestinal tract such as in the fundus of the stomach or in the duodenum.
  • the view of the rear (dorsal) side through the polyp is also limited due to the already mentioned different growth configurations, such as size or cauliflower-like growth, but also due to the anatomical location in the intestine, such as growth around intestinal folds itself not given.
  • the object of the present invention is to provide a sling with which the aforementioned disadvantages are eliminated.
  • the object of the present invention is to provide a sling that also makes it possible to see the dorsal area of a sling.
  • a further object is to provide a snare that enables the polyp or foreign body to be grasped and completely removed in one step, regardless of the shape.
  • the present invention provides a snare for high-frequency surgical removal of diseased tissue from hollow body organs and for removal of all types of foreign bodies from hollow body organs, characterized in that the snare consists of two separate halves, a first snare half and a second snare half, consists, wherein the first and the second sling halves can be adapted to form a completely connected sling by closing these two halves; and wherein a camera is additionally located on at least one half of the sling, via which a corresponding camera image can be transmitted to a monitor.
  • the sling according to the invention is particularly characterized in that it has primarily two separate halves (left and right) in the first step of opening.
  • These primarily separated two halves of the newly developed polypectomy snare can, for example, in the case of a polyp with a peduncle, be grasped directly on the left and right of its pedicle. The snare is then tightened further until the two ends connect, in order to then carry out the ablation. As a result, the entire closed polypectomy snare no longer has to be laboriously guided over the head of the polyp.
  • a partial removal of the polyp head with the aforementioned negative consequences or the complete failure of such a removal is thus significantly minimized or no longer takes place. This significantly reduces the removal time.
  • Foreign bodies can also be grasped directly (frontally) without first having to be inserted laterally into the opening of the primarily closed polypectomy snare (e.g. when retrieving a battery).
  • the camera makes it possible on the one hand to provide a better visual view, in particular of the dorsal area of a polyp, for example, and on the other hand to facilitate the joining of the snare halves to form a snare.
  • the snare according to the invention allows the tissue to be removed to be separated from the healthy surrounding tissue and recovered by means of high-frequency surgical current application after connecting the snare halves and then tightening the snare.
  • the sling according to the invention comprises appropriate elements that enable the application of current.
  • first sling half and the second sling half can be moved independently of one another and/or the first sling half and the second sling half can be releasably connected to one another in order to form a sling.
  • first snare half and the second snare half can be magnetically connected to one another in order to form a snare.
  • the magnetic elements can be permanent magnetic elements or magnetic elements that can be activated, such as electromagnets. If electromagnets are used, this is referred to as an electromagnetic connection within the meaning of the invention.
  • the first snare half and the second snare half can preferably be connected to one another magnetically or electromagnetically in order to form a snare.
  • the first snare half preferably has a first magnet, for example a permanent magnet or electromagnet, which is arranged at the distal end of the first snare half. This magnet can contact the distal end of the second snare half to form a snare.
  • the second loop half preferably has a substance at the distal end that can enter into a detachable connection with the first magnet. This substance can consist, for example, of iron, cobalt, nickel and/or alloys containing the aforementioned metals.
  • the first snare half has a first magnet disposed at the distal end of the first snare half and the second snare half has a second magnet disposed at the distal end of the second snare half, the first and second magnets being so configured that they connect to form a noose.
  • Distal ends of the snare halves are the ends that form a snare by bringing them together and connecting (connecting).
  • the distal end of one snare half is magnetic or electromagnetic.
  • the distal end of the other half of the loop is included equipped with an element that allows interaction with the magnetic or electromagnetic end to form a loop.
  • this end contains iron, cobalt, nickel, alloys containing these metals, or a substance that interacts with a magnet or electromagnet.
  • the first snare half has a hook at the distal end and the second snare half has a loop at the distal end, the hook and the loop being connectable to one another to form a snare.
  • Cylindrical thickenings are preferably present at the distal ends of the two halves of the snare, one end being open in the shape of a cup, so that the other end can fit into it with a precise fit.
  • the cylindrically shaped ends of the two halves of the snare preferably have magnetic properties in order to ensure a precise connection.
  • the camera is arranged at the distal end of a snare half.
  • the camera preferably has a resolution of at least 10,000 pixels, preferably 20,000 pixels and more preferably 30,000 pixels.
  • the camera comprises an image sensor which has dimensions of 1.5 mm ⁇ 1.5 mm or smaller, preferably has dimensions of 1.0 mm ⁇ 1.0 mm or smaller.
  • the snare for the high-frequency surgical removal of diseased tissue from hollow body organs and for the removal of all types of foreign bodies from hollow body organs consists of two separate halves (left and right), which only become a completely connected one as these two halves increasingly close Adapt sling.
  • Cylindrical thickenings are preferably present at the ends of the two halves of the sling, one end being open in the shape of a cup, so that the other end can fit into it with a precise fit.
  • the cylindrically shaped ends of the two halves of the snare also preferably have magnetic properties in order to ensure the precise connection. More preferably, there is also a camera at one end of the sling, via which a corresponding camera image can be transmitted to a monitor.
  • FIG. 1 shows the prior art of a polypectomy snare with a closed snare (a);
  • Fig. 2 Invention with the two separate snare halves, first snare half (A) and second snare half (B) and the cylindrical ends (C) and (D) in the open/extended state, with the second snare half (B) at the distal end (D ) is provided with a camera (E);
  • Fig. 3 invention with the two separate snare halves, first snare half (A) and second snare half (B) and the cylindrical ends (C) and (D) in the closed state, with the second snare half (B) at the distal end (D). the camera (E);
  • Fig. 4 invention with the two separate loop halves, first loop half (A) and second loop half (B) and the cylindrical ends (C) and (D) in the open, Fig. 4a, and closed state, Fig. 4b, shown, where the second loop half (B) is provided with the camera (E) at the distal end (D).
  • FIG. 1 shows a polypectomy snare according to the prior art with a closed snare (a).
  • FIG. 2 shows a sling according to the invention with a camera (E) in the open state.
  • a camera (E) is located at the distal end (D) of the second half of the snare.
  • FIG 3 shows the sling according to the invention with a closed sling consisting of the connected sling halves (A) and (B) which are detachably connected to one another via the connections (C) and (D).
  • FIG. 4 shows the enlarged view of the distal ends (C) and (D) of the first snare half (A) and the second snare half (B) in the open state, FIG. 4a, and in the closed state, FIG. 4b
  • Exact connection is necessary so that the circuit is closed in order to then be able to carry out the high-frequency surgical ablation. So that this necessary connection can be made more securely, it makes sense to equip the two cylindrically shaped ends (C, D) with magnetic properties, so that one thickened distal end (D) of the second half of the loop points in the exact direction of the cup-shaped end (Fig. 2- 4 (C)) can be found.
  • the problem of the lack of visibility of the dorsal side of a polyp, but also foreign bodies, is solved with the camera (E) as shown in Fig. 2-4 at the distal end (D) of one half of the snare, here the second half of the snare (B).
  • the camera (E) is arranged at the distal end (D).
  • the examiner can now see exactly how much and which tissue he has wrapped in the snare when removing a polyp. This facilitates complete removals. In particular, this also reduces the risk of perforation due to incorrect entanglement of healthy, non-injected intestinal wall on the dorsal portion of the polyp.
  • a camera (E) When rescuing foreign bodies, a camera (E) is also a relief if it is arranged appropriately on the sling, since it can be seen whether the foreign body has actually been completely grasped.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Plasma & Fusion (AREA)
  • Medical Informatics (AREA)
  • Otolaryngology (AREA)
  • Physics & Mathematics (AREA)
  • Cardiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne une anse pour l'ablation chirurgicale à haute fréquence de tissus malades provenant d'organes creux et pour l'ablation de tous types de corps étrangers présents dans des organes creux. L'invention est caractérisée en ce que l'anse est constituée de deux moitiés séparées, à savoir une première demi-anse (A) et une seconde demi-anse (B), la première demi-anse (A) et la seconde demi-anse (B) pouvant s'adapter pour former une anse complète par fermeture de ces deux moitiés. L'invention est caractérisée par ailleurs en ce qu'au moins une demi-anse (A, B) est pourvue d'une caméra (E) par l'intermédiaire de laquelle une image de caméra correspondante peut être transmise à un moniteur.
PCT/EP2021/075965 2020-09-22 2021-09-21 Anse pouvant être assemblée pourvue d'une caméra pour l'ablation chirurgicale à haute fréquence de tissus malades WO2022063788A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102020005779.9 2020-09-22
DE102020005779 2020-09-22

Publications (1)

Publication Number Publication Date
WO2022063788A1 true WO2022063788A1 (fr) 2022-03-31

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PCT/EP2021/075965 WO2022063788A1 (fr) 2020-09-22 2021-09-21 Anse pouvant être assemblée pourvue d'une caméra pour l'ablation chirurgicale à haute fréquence de tissus malades

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Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080015409A1 (en) * 2006-03-09 2008-01-17 Barlow David E Treatment device for endoscope
DE102009036158A1 (de) 2009-07-28 2011-02-03 Farin, Günter, Dipl.-Ing. Monopolare Polypektomieschlingen
DE202010005677U1 (de) 2010-06-18 2011-10-21 Mtw - Endoskopie W. Haag Kg Polypektomieschlinge
US20120016190A1 (en) * 2010-01-18 2012-01-19 Olympus Medical Systems Corp. Endoscope treatment instrument
US20170348017A1 (en) * 2012-01-06 2017-12-07 University Of Louisville Research Foundation, Inc. Open loop polypectomy system
EP2959855B1 (fr) 2014-06-25 2019-04-10 Günter Farin Boucle de résection électrochirurgicale avec une partie exposée et avec une partie pourvue d'une isolation
US20200001053A1 (en) * 2017-08-25 2020-01-02 Transmural Systems Llc Catheters and manipulators with articulable ends

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080015409A1 (en) * 2006-03-09 2008-01-17 Barlow David E Treatment device for endoscope
DE102009036158A1 (de) 2009-07-28 2011-02-03 Farin, Günter, Dipl.-Ing. Monopolare Polypektomieschlingen
US20120016190A1 (en) * 2010-01-18 2012-01-19 Olympus Medical Systems Corp. Endoscope treatment instrument
DE202010005677U1 (de) 2010-06-18 2011-10-21 Mtw - Endoskopie W. Haag Kg Polypektomieschlinge
US20170348017A1 (en) * 2012-01-06 2017-12-07 University Of Louisville Research Foundation, Inc. Open loop polypectomy system
EP2959855B1 (fr) 2014-06-25 2019-04-10 Günter Farin Boucle de résection électrochirurgicale avec une partie exposée et avec une partie pourvue d'une isolation
US20200001053A1 (en) * 2017-08-25 2020-01-02 Transmural Systems Llc Catheters and manipulators with articulable ends

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