CN106102561A - Apparatus and method for the non-intruding monitor of cancerous tumor cell - Google Patents

Apparatus and method for the non-intruding monitor of cancerous tumor cell Download PDF

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Publication number
CN106102561A
CN106102561A CN201580004504.3A CN201580004504A CN106102561A CN 106102561 A CN106102561 A CN 106102561A CN 201580004504 A CN201580004504 A CN 201580004504A CN 106102561 A CN106102561 A CN 106102561A
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China
Prior art keywords
implantable devices
pump
charging
tumor cell
liquid
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Application number
CN201580004504.3A
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Inventor
N·L·约翰逊
S·惠特克
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Plug Kui Ana Medical Treatment Joint-Stock Co
Sequana Medical AG
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Plug Kui Ana Medical Treatment Joint-Stock Co
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Priority claimed from US14/155,079 external-priority patent/US9675327B2/en
Application filed by Plug Kui Ana Medical Treatment Joint-Stock Co filed Critical Plug Kui Ana Medical Treatment Joint-Stock Co
Publication of CN106102561A publication Critical patent/CN106102561A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M27/00Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002Implant devices for drainage of body fluids from one part of the body to another
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/0045Devices for taking samples of body liquids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
    • A61M25/007Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0015Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network characterised by features of the telemetry system
    • A61B5/0022Monitoring a patient using a global network, e.g. telephone networks, internet
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14507Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue specially adapted for measuring characteristics of body fluids other than blood
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/48Other medical applications
    • A61B5/4842Monitoring progression or stage of a disease
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/48Other medical applications
    • A61B5/4848Monitoring or testing the effects of treatment, e.g. of medication
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M2025/0001Catheters; Hollow probes for pressure measurement
    • A61M2025/0002Catheters; Hollow probes for pressure measurement with a pressure sensor at the distal end
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02Holding devices, e.g. on the body
    • A61M2025/0293Catheter, guide wire or the like with means for holding, centering, anchoring or frictionally engaging the device within an artificial lumen, e.g. tube
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M27/00Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002Implant devices for drainage of body fluids from one part of the body to another
    • A61M2027/004Implant devices for drainage of body fluids from one part of the body to another with at least a part of the circuit outside the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06Body-piercing guide needles or the like
    • A61M25/0662Guide tubes
    • A61M25/0668Guide tubes splittable, tear apart
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Hematology (AREA)
  • Anesthesiology (AREA)
  • Medical Informatics (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Pathology (AREA)
  • Ophthalmology & Optometry (AREA)
  • Otolaryngology (AREA)
  • External Artificial Organs (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)

Abstract

Thering is provided the system of a kind of cancerous tumor cell in the body fluid that non-intruding monitor gathers due to ascites, pleural effusion or pericardial effusion, this system includes: implantable pump, has control circuit;Charging and communication system, be configured to periodically charge and with implantable pump communication implantable pump to fetch performance data;And monitoring and control software, be suitable to be used together with ordinary personal computer, for configuring and control implantable pump and charging and the operation of communication system.Implantable pump is configured to be moved to bladder from body cavity by the liquid comprising cancerous tumor cell, so that liquid can be drained, be collected with analysis station and analyze the curative effect of progress or the cancer treatment plans evaluating cancer during urinating.

Description

Apparatus and method for the non-intruding monitor of cancerous tumor cell
Technical field
The application relates to the apparatus and method of the non-intruding monitor of the cancerous tumor cell in internal hydrops.
Background technology
It is chronic poly-that some cancer can result in the pathologic of body fluid in the cavity of such as peritoneum, pleura or pericardium capsule etc Collection.Such cancer may cause chronic ascites, hydrothorax or pericardial effusion, and the chronicest liquid accumulation continues and leads Cause the increase of M & M.
In hydrothorax, by the potential pathology of such as pulmonary carcinoma, breast carcinoma, melanoma, leukemia or lymphoma etc The surplus liquid caused accumulates in pleural space.If do not treated, hydrops may interfere with normal pulmonary function, dramatically increases M & M.
In pericardial effusion, liquid gathers in pericardium capsule and can cause intrapericardial pressure power and the heart of minimizing increased Output.The liquid of excess is commonly due to potential cancer, is such as transferred into the cancer of pericardium, pulmonary carcinoma, breast carcinoma, black Melanoma, leukemia or lymphoma.
Ascites is the most debilitating complication of one, this complication with include liver failure, congestive heart failure Exhaust and some cancer (such as ovarian cancer, breast carcinoma, cancer of pancreas, uterus carcinoma, the intestinal tract including colon cancer, melanin Tumor, leukemia or lymphoma) it is associated in interior many medical condition.Untreated ascites can result in respiratory tract damage, Postcava (vital blood vessel) compressing and spontaneous bacterial peritonitis (life-threatening situation).
The treatment of cancer is typically included in chemotherapy, radiotherapy or the Drug therapy that cancerous area is injected.But, long-pending Liquid can also be caused by treatment of cancer (particularly chemotherapy or radiotherapy).
The patient suffering from cancer and ascites or hydrops (usually being caused) by potential cancer or treatment of cancer typically requires pin Treat while cancer and ascites/both hydrops.Conventional therapy for ascites, hydrothorax or pericardial effusion includes following One of three kinds of methods: 1) external drainage, it constitutes infection risk and the long-term needs punctured more;2) another body cavity it is drained to;Or 3) Drug therapy.There is multiple shortcoming in such method, including high cost, routinely see doctor, poor efficiency and serious the most also Send out the risk of disease.
During treatment cancer, it is necessary that doctor monitors the development of cancerous cell.Conventional method is used to typically require cancer Become tissue and carry out intrusive mood biopsy to analyze cancerous cell.Biopsy is often necessary to deliver to Distance Laboratory for analyzing, and this delays Doctor efficiently and effectively treats the ability of cancer.
Shortcoming in view of above-mentioned prior known systems, it would be desirable to provide for treating by ascites, hydrothorax Or the method and apparatus of non-intruding monitor cancerous tumor cell while the internal hydrops that causes of pericardial effusion.
Summary of the invention
The present invention automatically and independently by the hydrops comprising cancerous tumor cell is moved to bladder without patient by offer The shortcoming that the liquid management system participated in overcomes the prior known systems for monitoring cancerous tumor cell.Via the cancer discharged of urinating The born of the same parents that attenuate are the most analyzed for the progress evaluating treatment of cancer.
For discharging cancerous tumor cell to allow the liquid management system of non-intruding monitor cancerous tumor cell to preferably include: can Implantable pump, has the first controller;Inflow catheter, has and is suitable to be placed on endoceliac arrival end and be configured to coupling To implantable delivery side of pump end, body cavity has the hydrops including cancerous tumor cell;And outflow conduit, have and be configured to couple to The arrival end of implantable pump and be suitable to the port of export being placed in bladder.First controller is preferably programmed to selectivity Ground activates implantable pump will include the liquid arrival end from input pipe of cancerous tumor cell during the predetermined time period Mobile to bladder.
The arrival end of inflow catheter treats such as abdomen in may be adapted to be placed on peritoneal cavity, pleural space or pericardial cavity The disease caused by cancer or treatment of cancer of water, hydrothorax or pericardial effusion etc.
According to one aspect of the present invention, it is provided that the system of a kind of non-intruding monitor for cancerous tumor cell, including by It is configured to from body cavity, the liquid comprising cancerous tumor cell is pumped to the liquid management system of bladder and is configured to analyze row The analysis station of the cancerous tumor cell of excretion during urine.Preferably, liquid management system includes: implantable pump, has the first controller; Inflow catheter, has and is suitable to be placed on endoceliac arrival end and be configured to couple to implantable delivery side of pump end;With And outflow conduit, have and be configured to couple to the arrival end of implantable pump and be suitable to the port of export being placed in bladder. First controller is programmed to optionally activate implantable pump with the liquid by including the cancerous tumor cell suspended from input pipe Arrival end move to bladder.Analysis station could be for analyzing cell to determine the presence or amount of the most normal of cancerous tumor cell Rule system, and may be located remotely from liquid management system and be set or it can the most closely be set.An embodiment In, analysis station is configured to analysis and indicates cancer from the liquid including cancerous tumor cell of bladder drainage to determine in period of urinating It is in progress or for treating the parameter of effect of the program of cancer.
Liquid management system may include that implantable devices (the most implantable pump), controller, battery and transceiver; Charging and communication system, be configured to periodically charge the battery of implantable devices, and with implantable devices communication;With And monitoring and control software, it is suitable for being used together with conventional personal computer, to configure and to control implantable devices and charging and to lead to The operation of communication system.Preferably, software is monitored and controlled can use, so that patient is typically in order to planting only for treatment doctor Enter equipment charge and only mutual with implantable devices by charging and communication system.According to an aspect of the present invention, implantable Equipment is configured to during the predetermined instant of every day incrementally pump liquid so that relatively high flow velocity is little, holds reaching target Amount, and it is configured to the position of periodic variation pump to reduce at non-pumping interim blocking implantable devices Risk.Pump is also programmed in the case of obstruction being detected perform a succession of quick rearward movement and travel forward, Thus remove blocking.Additionally, liquid management system can include being configured to labelling that infecting occurs in detection (such as, temperature, exhale Inhale speed or the increase of ascites viscosity) one or more sensors, and be configured to output based on those sensors to Doctor indicates prediction or one or more sirens of detection of infection.
In a preferred embodiment, implantable devices includes the power-driven machinery gear being arranged to be subcutaneously implanted Pump.This pump has the entrance being coupled to inflow catheter and the outlet being coupled to bladder catheter.According to an aspect of the present invention, should Pump uses and serves as a pair floating gear of positive-displacement pump, wherein drive gear coupling to motor splined shaft with minimize due to Manufacture change or the power consumption of eccentric shaft generation.Inflow catheter includes having the first end and the pipe of the second end, and the first end is configured to Being coupled to pump intake, the second end is configured to be positioned in selected chamber (such as, peritoneum, pleura or pericardium capsule).Inflow catheter Second end includes the multiple wall-through holes allowing the liquid of accumulation to enter conduit.Bladder catheter or outflow conduit (outflow Catheter) including having the first end and the pipe of the second end, the first end is configured to coupled to pump, and the second end is configured to pass through The wall of urinary bladder of patient is inserted and is fixed on the intravesical of patient.Fluid loop farther includes sensor, and this sensor is by cloth Put at monitoring of environmental pressure, pump intake at pressure, pump discharge pressure in pressure, bladder, and alternatively, the temperature of ascites Breathing rate with patient.Inflow catheter and outflow conduit include the adapter being configured to reduce the risk of improper implantation.
Implantable devices farther includes controller, this controller low capacity seal in shell with pump, electronic mechanical, electrical Pond, charge coil and radio transceiver are packaged together.Controller is coupled to pump motor, battery, transceiver and multiple biography Sensor is with that monitor pressure, temperature, humidity, charged state, pump state, patient moving and other environment continuously and and system Relevant parameter.Controller preferably includes processor, is used for storing firmware, implant identification information and system and environment number According to nonvolatile memory, and performing and firmware reproducting periods serves as the volatibility of buffer of result of calculation and instruction Memorizer.Pump motor be arranged to extension use and low-power consumption, and preferably include for position sensing and for Determine the hall effect sensor of direction of rotation (and correspondingly, flow and liquid viscosity).Battery is preferably coupled to sense The long-acting lithium ion of inductive charging circuit or lithium polymer battery, so that battery can use external charging and communication system to carry out Recharge.RF transceiver is preferably used in equipment with to external charging and communication system transmitting system information and from outside Charging and communication system receive information, and this information includes system performance information, order and firmware upgrade.All said modules are excellent Selection of land is arranged in the enclosure, and this shell farther includes filler, and this filler has low-permeability for water, thus reduces water Divide the infiltration in shell.
According to an aspect of the present invention, liquid management system includes external charging and communication system.At preferred embodiment In, charging and communication system include shell, and this shell comprises controller, radio transceiver, inductive charge circuit, power supply and fills Electricity quality (quality-of-charging) indicator.Controller is coupled to inductive charge circuit, power supply, the instruction of charging quality Device, radio transceiver and the depositing of software and implantable devices between the information of transmission will be monitored and controlled for storage Reservoir.Charging and communication system preferably include FPDP (such as USB port) or radio port (such as bluetooth, Zigbee or GPRS), it allows charging and communication system to be coupled to conventional computer (such as personal computer or calculating on knee Machine), this conventional computer is configured to operational monitoring and controls software.In one embodiment, charging and communication system are permissible Including rope, this rope enables a system to be directly coupled to normal power supplies (such as 120V AC wall socket).But, it is further preferred that Charging and communication system include battery powered handpiece (handpiece), and this handpiece can be periodically coupled AC and supply The charging base of electricity, so that handpiece separately can not fetter because of power line to recharge implantable devices from base Patient.In a preferred embodiment, the control circuit of charging and communication system can be configured to lifting and pass through induction charging Circuit is supplied to the power of the motor of implantable devices, to dredge the potential blocking of gear pump.
Liquid management system farther includes software is monitored and controlled, and the doctor of patient the most only be may have access to by it.Should Software is configured on ordinary personal computer or laptop computer run, and enables a physician to configure and monitor fill Electricity and communication system and the operation of implantable devices.If this software can include for controlling and the pump operated trepang being associated Number (such as, every day or the target liq amount that motor activated is to be moved every time, and inflow catheter pressure, bladder pressure, pump pressure Power and the restriction of implant temperature) in the routine of arbitrary parameter.This software can be additionally configured to control implantable devices Operate, in order to avoid in period specific period (such as evening) mobile liquid or postponement pump actuating in the case of patient is sleeping.Example As, this software can be configured to send immediate command to start or stop pump to implantable devices further, or such as when When patient is accessing his or her doctor reverse or operate pump with high-power, with dredging pump or its leading of being associated Pipe.This software can be configured to such as during patient accesses the office of doctor, download from implantable devices collection and The data of storage in charging and communication system.Alternatively, based on download information (breathing rate of such as patient, body temperature with And liquid viscosity), this software can be configured to prediction or the detection reminding doctor to infect.
The system of the anticipated present invention can be avoided usual in itself previously known relevant for solving the apparatus and method of ascites The difficulty of connection.For example, it is desirable to the system and method for the present invention a small amount of ascites will be enable to be moved to bladder and the most generally with Inconvenience that the use of medicine or puncture are associated and complication.Particularly because apparatus and method of the present invention avoids in a large number The repetition of liquid, periodically remove, so when with puncture time, by reduce generate be used for the volume offsetting the liquid being removed The trend of outer ascites.These effects then the elimination that is expected to follow puncture closely and are injected by plasma expander (such as human albumin) and suffer from Needs in person's body, thus cause the substantial amounts of cost savings for patient and healthcare system.Infect and (particularly infecting Commitment) prediction or detection can improve patient's prognosis (outcome) further, and reduce for more expensive treatment The needs of method.Finally, apparatus and method of the present invention is expected to chronic patients with ascites and provides the quality of life improved, it is allowed to this A little patients pursue ratio otherwise by life style motionless for the possible motionless less sitting of sitting, and encouragement preferably meets medical science The diet instructed and exercise plan.
In an alternative embodiment, provide liquid management system general as described above, but be arranged on the contrary to treat by Pleural effusion that cancer or treatment of cancer cause or pericardial effusion.Little surgery selects to can be used for treating these situations, and Great majority in those selections present the notable risk of M & M.Particularly, the system of the present invention can be joined Put for treating pleural effusion or pericardial effusion, and substantially as described above include implantable devices, charging and communication system And software.The difference of the ascites fluid management system of this embodiment and the present invention essentially consists in pump to be had and is coupled to pleura Chamber or the inflow catheter of pericardial cavity, and controller is configured to work under negative pressure.More particularly, inflow catheter has and is joined It is set to be coupled to the first end of pump intake and be configured to the second end being placed in pleural space or pericardial cavity, and includes multiple Wall-through hole, this wall-through hole allows the liquid accumulating in intracavity to enter conduit and do not disturb the normal work of lung or the heart.Since it is desired that Some liquid to lubricate the motion of the organ of these intracavity, so implantable devices be preferably programmed to not pump all from The liquid in chamber.Additionally, implantable devices is programmed to explain and provide cause intracavity during eupnea or cardiomotility The drain of pressure oscillation occurs.
The method additionally providing the liquid management system implanting and operating the present invention.Implantable devices preferably can use Interventional radiology including radiophotography imaging or ultrasound wave carries out subcutaneous placement, and inflow catheter and outflow conduit can So that surgically (or it is highly preferred that minimal invasive procedures) is placed.In a kind of version, inflow catheter can be by Subcutaneous excavation to the position of drain, and flow out conduit can be by subcutaneous fluting to bladder (or peritoneal cavity).Implantable devices is excellent Selection of land uses the RF-coupled of transceiver in implantable devices and charging and communication system to be programmed, and can by coupling The inductive charge circuit of implantation equipment and charging and communication system to provide power to the battery of implantable devices.Hereinafter describe and depend on According to the implantation of the present invention and the extra details of the method for operating system.
According to an aspect of the present invention, it is provided that a kind of method of non-intruding monitor for cancerous tumor cell.The method Including via implantable pump, the body fluid including cancerous tumor cell is pumped to bladder for excretion from the body cavity of the hydrops with body fluid;With And collect from the cancerous tumor cell of bladder drainage for analyzing.Such preparation can such as include receiving urine specimen, transferring urine Sample to doctor, transfer urine specimen to Local or Remote analysis station.The method can also include analyzing cancerous tumor cell to determine The progress of instruction cancer or the parameter of the curative effect of cancer treatment plans, such as, use analysis station to detect the cancer in Urine in Patients Attenuate the existence of born of the same parents or quantity.
Accompanying drawing explanation
The exemplary fluids of the principle structure that Fig. 1 is based on the present invention manages the saturating of the parts at system and exemplary analysis station View.
Fig. 2 A and Fig. 2 B is adapted for the exemplary embodiment of the inflow catheter that the system with the present invention is used together respectively Side view and detailed perspective, wherein Fig. 2 B is corresponding to detail region 2B of Fig. 2 A.
Fig. 3 A and Fig. 3 B is adapted for the of the bladder catheter that ascites treating system with the present invention respectively is used together respectively One embodiment and the side view of the second embodiment and perspective view.
Fig. 4 is the schematic diagram of the electronic unit of the exemplary embodiment of the implantable devices of the present invention.
Fig. 5 A and Fig. 5 B be respectively the implantable devices with the present invention with the shell shown in profile perspective view and Remove the perspective view in the front of the implantable devices of shell and low permeable filler.
Fig. 6 A, Fig. 6 B, Fig. 6 C and Fig. 6 D are the decomposition diagram driving assembly of implantable devices respectively;Upper case Front view and top view;And the perspective view of the manifold (manifold) of the exemplary embodiment of implantable devices.
Fig. 7 A and Fig. 7 B is the top view of the gear pump shell of the implantable devices of Fig. 5 A respectively, and according to the present invention's The top view of the model of the gear pump that principle builds.
Fig. 8 A and Fig. 8 B is perspective view and the top of the handpiece part of the exemplary charging of the present invention and communication system respectively View.
Fig. 9 is the schematic diagram of the electronic unit of the exemplary embodiment of the charging of the present invention and communication system.
Figure 10 is the merit that software is monitored and controlled used in the exemplary embodiment of the liquid management system of the present invention The schematic diagram of energy parts.
Figure 11-Figure 15 be a diagram that the exemplary screen of the various aspects of the user interface of the monitoring and control system of the present invention Curtain sectional drawing.
Detailed description of the invention
The liquid management system of the present invention include for be easy to from need drain body region (such as peritoneum, thoracic cavity or Pericardium capsule) remove the equipment of liquid.Devices disclosed herein may be used for from a body cavity, chronic unnecessary hydrops is drained into Two body cavitys (preferably bladder).Such surplus liquid can gather due to the potential condition of such as cancer etc.According to this The principle of invention, liquid management system can be optimized for treating chronic ascites in the patient and the pleura suffering from cancer Hydrops or pericardial effusion, allow non-intruding monitor cancerous tumor cell simultaneously.Many by comprising cancerous tumor cell at liquid management system Remaining liquid moves to bladder and after period drained liquid of urinating from the first body cavity, cancerous tumor cell can the most analyzed with Evaluate treatment of cancer or the progress of cancer self.
Systematic review
With reference to Fig. 1, it is provided that the liquid management system 10 of the present invention and the general view of the analysis station 45 of the present invention.In FIG, The parts of system not relative or definitely on the basis of be drawn to scale.Liquid management system 10 include implantable devices 20, External charging and communication system 30 and monitoring and control system 40 based on software.In the illustrated embodiment, monitor and control System 40 processed is mounted and operates on the conventional laptop used by the doctor of patient.During patient assessment, Charging and communication system 30 can wirelessly or use cable to be coupled to monitoring and control system 40, and to download, be stored in can Data on implantation equipment 20 are to check, or adjust the operating parameter of implantable devices.Monitoring and control system 40 also may be used To be configured to the data fetched from charging and communication system 30 uploaded and store remote server, in order to afterwards by curing Raw or charging accesses with communication system 30.
Implantable devices 20 includes having the electro-mechanical pump of shell 21 being arranged to be subcutaneously implanted.As hereafter the most in detail Thin description, it is suitable for treatment ascites and discharges cancerous tumor cell to allow the embodiment of the such cell of non-intruding monitor In, implantable devices 20 includes having the ingress port 22 coupleding to peritoneal catheter 23 and the outlet coupleding to bladder catheter 25 The electric drive machinery gear pump of port 24.Peritoneal catheter 23 include having be configured to couple to pump intake 23 the first end and It is configured to the pipe of the second end being positioned in peritoneal cavity.Suffering from the ascites caused by cancer in the patient, health is at abdomen Film chamber generates the accumulation of the liquid including cancerous tumor cell.Bladder catheter 25 includes having and is configured to couple to pump discharge 24 First end and be configured to the wall of urinary bladder of patient and insert and be fixed on intravesical second end of patient.The most real Executing in example, two conduits are all made up of medical grade silica gel and include polyester cuff (cuff) (not shown) at its far-end, with Keep conduit in position.Peritoneal catheter 23 and bladder catheter 25 use and are configured to reduce improper installation and negligent The adapter 26 of risk that disconnects and be coupled to pump case 21, and can comprise additionally in and reduce the risk of improper installation not Same cross section.
Implantable devices 20 is preferably configured as with short (such as 10 seconds) interval (such as, every 10-20 minute) mobile liquid Body.Such short and be spaced frequently and be desired to by preventing the accumulation of the material on the inner chamber of conduit 23 and 25 from overcoming For the blockage problem that in itself previously known ascites diverter is common, and reduce the risk that tissue is grown into.For ascites treating, can The fluid loop of implantation equipment 20 is preferably configured as providing the mean flow rate of about 60ml/ hour, although if desired, high Also it is possible with much lower flow velocity much.As described in detail below, pump time and capacity (include the appearance pumped every day The maximum of amount limits and minimum limit) can be compiled for the requirement use monitoring and control system 40 of concrete patient by doctor Journey.As described further below, the fluid loop of implantable devices 20 includes the pressure monitoring the pressure in peritoneal cavity and bladder Force transducer, so that forbidding entering in bladder by liquid pumping, until determining that bladder has the liquid that sufficient space is extra Body.Comfortable for patient, implantable devices 10 is generally programmed at night or in being included in implantable devices Accelerometer instruction patient does not carries out the when of falling asleep pumping (and therefore unlikely empty bladder).Implantable devices 20 is excellent Selection of land includes multiple single fail safe mechanism, to guarantee that urine will not flow to peritoneal cavity by pump from bladder, thereby reduces Propagate the risk infected.
Again referring to Fig. 1, the external charging of preferred form and communication system 30 include base 31 and handpiece 32.In this enforcement In example, handpiece 32 comprises controller, radio transceiver, inductive charge circuit, battery, charging quality indicator and display Device, and it is removably coupled to base 31, so that its battery to be recharged.Base 31 could be included for routine 120V Power service is converted to transformator and the circuit of suitable DC electric current, in order to charge handpiece 32 when coupleding to base 31. In an alternative embodiment, handpiece 32 can include such circuit and dismountable power line, thereby allows handpiece direct Insert the wall socket of conventional 120V, so that battery to be charged.In a preferred embodiment, implantable devices 20 and handpiece 32 are respective Including the device identifier stored in memory, so that the handpiece 32 to patient's offer is encoded as only with this patient's Specific implantable devices 20 operates together.
Handpiece 32 preferably include there is multifunctional button 34, display 35, (LED does not shows multiple light emitting diode Go out) and the shell 33 of induction coil part 36.Multifunctional button 34 provides to patient and sends Finite Number to implantable devices 20 The ability of purpose order, and display 35 provides the visual confirmation that desired order has been transfused to;It also shows battery status. Induction coil part 36 accommodates the sense recharged with the battery to implantable devices 20 for transmission from the energy of handpiece 32 Answer coil.Three rows, often 2 LED of row can be arranged to by the LED that the material of shell 33 is visual when lighting, and coupled to Inductive charge circuit in control circuit and handpiece 32.As described in further detail below, LED can be arranged to a little Bright be reflected in implantable devices 20 recharge period, between handpiece 32 and implantable devices 20 obtain inductively Degree.Alternatively, LED can be omitted, and provides analog information to indicate quality inductively on display 35.
As described in further detail below, the control circuit being comprised in handheld device 32 coupled to induction charging electricity Road, battery, LED and radio transceiver, and include the memorizer for storing the information from implantable devices 20.Hand-held Part 32 preferably includes FPDP (such as USB port), and this FPDP allows handpiece to access doing of doctor patient It coupled to monitoring and control system 40 during public room.Alternatively, handpiece 32 can include such as meeting bluetooth or IEEE The wireless chip of 802.11 wireless standards, thereby makes handpiece can carry out radio communication with monitoring and control system 40.
Monitoring and control system 40 is intended to mainly be used by doctor, and include be configured to run in conventional laptop meter Software on calculation machine.Software enables the surgeon to configuration, monitors and control charging and communication system 30 and implantable devices 20 Operation.As described in detail below, software can include for configuring and control pump operated routine, such as every day or every Aim parameter that secondary motor activated is to be moved, pump activate between interval and peritoneal cavity pressure, bladder pressure, pump pressure and The restriction of battery temperature.System 40 can also provide instruction via charging and control system 30 to implantable devices 20, to control The operation of implantable devices 20, in order to do not move liquid in specific period (such as, night), or postpone pump when patient falls asleep Activate.System 40 can also such as be configured to send immediate command, to start or stop pump, or inversely to implantable devices Ground or with high power operation pump with dredging pump or the conduit that is associated.The software of system 40 can be additionally configured to download and grasps with pump Make relevant real time data, and the event log of storage during the operation of implantable devices 20.Based on the data downloaded, example As, based on the measurement result being made up of the body temperature of patient, breathing rate and/or liquid viscosity, the software of system 40 can be optional It is configured to selecting alert prediction Xiang doctor or infection detected.Finally, system 40 can be optionally configured as by peace All internet passage receives operation data that are unprocessed or that filter from the handpiece 32 of patient.
Ascites, pleural effusion or pericardial effusion can by such as pulmonary carcinoma, breast carcinoma, the cancer being transferred to pericardium, The cancer of ovarian cancer, cancer of pancreas, uterus carcinoma, intestinal cancer, melanoma, leukemia or lymphoma including colon cancer etc or Person's treatment of cancer causes.In this case, cancerous tumor cell will be present in accumulating in peritoneal cavity, pleural space or pericardial cavity and divides In the excess liq not caused by ascites, pleural effusion or pericardial effusion.
Advantageously, the liquid management system 10 of the present invention allows non-intruding monitor to be pumped to bladder and row from body cavity The cancerous tumor cell being drained during urine.Such method allow the patient to cosily to provide cancerous tumor cell for analyze without The intrusive mood process of such as biopsy etc.Applicant have discovered that the pH level in bladder creates the ring neutralizing cancerous tumor cell Border;Thus cancerous tumor cell is delivered to bladder and may cause the worry of bladder cancer by elimination.
Analysis station 45 is configured with in cancer cell analysis field known technology and analyzes in period of urinating from trouble The cancerous tumor cell of person's excretion.Analysis station 45 receives the urine specimen comprising the liquid including cancerous tumor cell, and liquid is via implantable Equipment 20 is pumped to bladder from the first body cavity.Analysis station 45 can show that analysis result checks for user, or is coupled to It is configured to receive the analytical data comprising display result.Analysis station 45 can include telecommunication circuit, and telecommunication circuit is configured to Wirelessly or use cable analytical data to be transferred to such computer and/or to operational monitoring and control system 40 for doctor The computer that teacher checks.Analysis station 45 can be arranged on the vicinity (such as in same office or hospital) of system 40, or Person can be remotely located as well.As additional benefits, treating physician can check the operation of implantable devices 20 and be used In the urine specimen visiting period analysis cancerous tumor cell independent patient.Analysis station is arranged on the reality near system 40 wherein Executing in example, cancerous tumor cell can be more analyzed than conventional method, and wherein biopsy is generally transported to tele-experimentation Room is for analysis.
Inflow catheter and outflow conduit
With reference to Fig. 2 A and Fig. 2 B, describe the exemplary inflow catheter 50 that the principle according to the present invention constructs.Inflow catheter 50 can be configured in peritoneal cavity (and therefore corresponding to the peritoneal catheter 23 of Fig. 1) or thoracic cavity or pericardial cavity use, and And preferably include medical grade silicone pipe 51, arrival end 52 that this medical grade silicone pipe 51 includes having multiple wall-through hole 53 and The port of export 54.When being configured to be placed in peritoneal cavity, inflow catheter preferably has length L1 of about 40cm, have from Arrival end 52 extends the hole 53 of length L2 of about 24cm.Hole 53 preferably circumferential offset 90 ° and radial deflection are at about 8mm It is arranged, as shown in Figure 2 B between 10mm.In a preferred embodiment, 29 holes 53 are arranged to 4 rows, often row 7, Only extended by a wall of inflow catheter in each position, and there is the size between 2.0 to 2.5mm, inflow catheter 50 The solid-state silica gel plug 55 preferably including the distance that the far-end in chamber is filled about 7-10mm is grown into reduce tissue, and is put Put or be embedded in radiopaque band 56 in conduit, that extend the whole length of conduit, with perspective or X-ray image visual Ground presents conduit.Inflow catheter 50 can also include polyester cuff in the region of facing away from hiatus 53, to promote to adhere to conduit Surrounding tissue, is thereby anchored on appropriate location.
Alternatively, the arrival end 52 of inflow catheter 50 can have coiled arrangement, and atraumatic is most advanced and sophisticated, has distribution On pipe lengths to reduce the hole 53 of the risk of blocking.As further alternative, arrival end 52 can include as U.S. Patent No. 4,657, the part of the diameter disclosed in No. 530, there is expansion or as in U.S. Patent Application Publication Reservoir disclosed in Fig. 9 to Figure 16 of US2009/0318844 (full content both it is all incorporated herein by herein), with Reduce the risk of blocking further.Arrival end 52 can also terminate in duckbill valve, such as such as U.S. Patent No. 4, and 240, No. 434 Shown in, thereby allow conduit by being disconnected from implantable devices 20 by the port of export of conduit and passing through duckbill valve at arrival end Extend rod from the port of export of conduit 50, allow conduit to be cleaned by its original position.
Arrival end 52 can also include polyester cuff, to promote that conduit adheres to neighbouring tissue wall, thereby ensuring that conduit Arrival end rest in situ.The port of export 54 could be included for the port of export of inflow catheter is fixed to implantable devices 20 Adapter.In a preferred embodiment, the far-end of inflow catheter, until cuff of growing into, often can be configured to pass through The 16F of rule strips off sheath (peel-away sheath).Additionally, the length of inflow catheter can be selected to ensure that it is along at the bottom of body cavity Portion stretches, and has enough resistances to twist motion, in order to will not become during implanting or after implanting distortion or Kink.
In one embodiment, inflow catheter 50 can by plastotype for such as Y type with include multiple inflow segment allow from More than one body cavity flows into.Such as, the arrival end of a section can be placed in peritoneal cavity, and the arrival end of another section Can be placed in pleural space or pericardial cavity.In an alternative embodiment, more than one inflow catheter is coupled to plant Enter equipment 20 to allow to flow into from more than one body cavity.Such as, the arrival end of the first inflow catheter can be placed on peritoneum In chamber, and the arrival end of the second inflow catheter can be placed in pleural space or pericardial cavity.One or more valves can be with coupling It is bonded to multiple entry conduit or multiple inflow catheter so that liquid can be sent in response to by the processor of implantable devices 20 The order of valve and be pumped from a chamber or from more than one chamber uniquely.
About Fig. 3 A, describing the first embodiment flowing out conduit 60 of the present invention, it is corresponding to the bladder catheter of Fig. 1 25.Flow out conduit 60 to preferably include to have and include that the arrival end 62 of helical structure 64 and the port of export 63 and polyester are grown into cuff The medical grade silica gel tube 61 of 65.Flow out conduit 60 to include extending to the single outlet at the tip of helical structure 64 from arrival end 62 Single intra-cavity, commonly referred to " pigtail " design.Arrival end 62 can include the arrival end for flowing out conduit, and be fixed to can The adapter of implantation equipment 20, or can have and can be trimmed with the length of applicable particular patient.
When the outflow conduit being configured to act as in ascites treating system, flow out conduit and can have the length of about 45cm Degree L3, has the cuff 65 being placed on the distance away from helical structure 64 about 5 to 6cm length L4.Flow out conduit 60 can be filled It is downloaded to have on the stylet of the helical structure 64 of alignment, and uses less invasive techniques and implanted, wherein use the stylet will The port of export 63 and helical structure 64 pass the wall of urinary bladder of patient.When stylet is removed, helical structure returns to shown in Fig. 3 A Coiled shape.The port of export 63 once flowing out conduit 60 is placed on the intravesical of patient, and the remainder of conduit uses tunnel Technology and implanted, so that the arrival end 62 of conduit can be coupled to implantable devices 20.Helical structure 64 can reduce The port of export 64 will be accidentally withdrawn the risk of bladder, mat before cuff 65 in perivesical organization healing to being enough to merge grow into Outflow conduit is anchored on appropriate location by this.
In a preferred embodiment, flow out conduit be configured to pass through routine strip off sheath.Flow out conduit 60 the most right Twist motion has enough resistances, in order to will not become distortion or kink during implanting or after implanting.The most real Execute in example, inflow catheter 50 and flow out conduit 60 and be preferably different colours, have different profiles (such as, side and circle) or There is different connection features so that they be connected to implantable devices 20 period will not by thick property careless exchange. Selectively, flow out conduit 60 and can include the inside duckbilled of the centre between the arrival end 62 and the port of export 63 of conduit When flowing out conduit and surprisingly being avulsed the pump discharge of implantable devices 20, valve, to guarantee that urine will not flow to peritoneal cavity from bladder In.
In an alternative embodiment, inflow catheter equipment and outflow catheter device can merge one or more anti-infectives Suppress to infect the propagation in body cavity.The example of the anti-infectives that can use can such as include antibacterial material, sterilization Material, one or more antibiotic medicament, antibiotic drip washing material and the coating stoping bacterial adhesion and combinations thereof.
Alternatively, inflow catheter and outflow conduit can be shared wall rather than include single conduit.This layout can be managed Think for ascites treating embodiment because bladder and peritoneal cavity share wall, be thereby easy to the insertion of single double lumen tube.Additionally, Inflow catheter or flow out both conduits or one of can along a part for its length or along its whole length use ribbon Or line braiding or reinforce in catheter interior or the line or the length of ribbon that embed along conduit or integrate.Braiding or line are permissible By the superelastic metal of the most stainless metal, such as Nitinol etc or it is made up of various suitable polymer.
About Fig. 3 B, describing second embodiment flowing out conduit of the present invention, wherein like is had subscript by similar Digital ID.Flow out conduit 60 ' to preferably include and there is arrival end 62 ', the port of export 63 ' and polyester grow into the doctor of cuff 65 ' Treat level silica gel tube 61 '.According to the present embodiment, the port of export 63 ' includes malecot structure 66, illustratively includes four laterally Away from the elastic wings 67 of the dilatation shaft of conduit, will be pulled loose by careless after placement reducing the port of export 63 ' of conduit Risk.Arrival end 62 ' can include the adapter for the arrival end flowing out conduit is fixed to implantable devices 20, or can Can be trimmed to have with the length of applicable particular patient.
It is the most flat that Malecot structure 66 is preferably structured so that the wing 67 is deformed into when stylet is inserted through the chamber of conduit Whole configuration.In this way, flowing out conduit 60 ' can be loaded onto on stylet, and uses less invasive techniques, it is possible to use The port of export 63 ' and malecot structure 66 are passed the wall of urinary bladder of patient by stylet.When stylet is removed, malecot structure The wing 67 return to expansion shape as shown in Figure 3 B.The port of export 63 ' once flowing out conduit 60 ' coupled to the wing of patient Guang, the remaining part of conduit is implanted, so that the arrival end 62 ' of conduit is coupled to implantable with regard to use tunneling technique Equipment 20.Malecot structure 66 can reduce the port of export 63 ' and merge cuff of growing in perivesical organization healing to being enough to The risk of bladder will be inadvertently pulled out before 65 '.As for the embodiment of Fig. 3 A, the outflow conduit of Fig. 3 B can be configured to pass through Conventional strips off sheath, and preferably has enough resistances to twist motion, in order to during implanting or after implantation not Become distortion or kink.
As described previously for ascites treating system, the port of export flowing out conduit is preferably configured to be placed in bladder, And this configuration can be also used for pleural effusion and Pericardial Effusion system.Alternatively, it is used for being designed to treat abdomen The outflow conduit of the system of film hydrops or pericardial effusion can be configured so the port of export and be positioned in peritoneal cavity, so that being drawn Flow to the overflowing liquid in peritoneal cavity such as heavily absorbed by kidney and excrete.For such embodiment, outflow is led Pipe 60 can be similar to the inflow catheter 50 of Fig. 2 and construct, and can have multiple hole by liquid drain to peritoneal cavity. For the treatment of the ascites caused by cancer, pleural effusion and/or pericardial effusion, the port of export flowing out conduit is preferably configured For being arranged in urinary bladder so that cancerous tumor cell by bladder pH level neutralize, urinate period be drained, And it is analyzed in non-intruding mode.
Implantable devices
With reference now to Fig. 4, describe the schematic diagram of the functional device of the implantable devices 20 describing the present invention.Implantable devices 20 include control circuit, illustratively coupled to such as flash memory or Electrically Erasable Read Only Memory via data/address bus Etc nonvolatile memory 71 and the processor 70 of volatile memory 72.Processor 70 be electrically coupled to motor 73, Battery 74, sensor circuit 75, radio transceiver 76 and multiple sensor, including humidity sensor 77, multiple temperature sensing Device 78, accelerometer 79, multiple pressure transducer 80 and respiration rate sensor 81.Sensor circuit 75 is electrically coupled to coil 84, To receive from charging and the energy of communication system 30 transmission, and transceiver 76 coupled to antenna 82, and is similarly configured to With charging and communication system 30 in transceiver communications, as described below.Selectively, conducting channel 75 can also coupled to infrared Light emitting diode 83.Motor 73 can include nonshared control unit, and it is in response to from the command interpretation of processor 70 and activate Motor 73.The all parts described in Fig. 4 are included in the shell that low capacity seals bio-compatible, such as institute in Fig. 5 A Show.
Processor 70 performs to be stored in the firmware in nonvolatile memory 71, and it is in response to by motor 73, sensor The signal that 77-81 and the order received from transceiver 76 generate controls the operation of motor 73.Processor 70 also controls warp By the reception of the message of transceiver 76 and the operation of transmission and sensor circuit 75 so that battery 74 is charged.Additionally, processor 70 Receive by be positioned at motor 73 hall effect sensor produce signal, its for calculate gear pump gear direction and Revolution, and the viscosity of the liquid volume therefore pumped and this liquid, as described below.Processor 70 preferably includes low-power behaviour Operation mode and include internal clocking, so that processor can be devices may wake up periodically to process pumping, pump ticking (tick) Pattern or communication and charge function, and/or be waken up to locate the order that reason transceiver 76 receives from handpiece 32.At one In embodiment, processor 70 includes from Texas Instruments, and Incorporated, Dallas, Texas's is available The member of the MSP430 family of micro controller unit, and the nonvolatile memory described in Fig. 4 can be merged, volatibility is deposited Reservoir and radio transceiver element.Additionally, on processor 70 perform firmware can be configured to directly in response to via Charging and communication system 30 are sent to the order of implantable devices 20.Processor 70 be additionally configured to monitor motor 72 (and Any motor controller being associated) and the operation of sensor 78-81, as described below, and be configured to store reflection can The data of the operation of implantation equipment, including event log and alarm.Therefore, data are reported to charging and communication system, now Then it be wirelessly coupled to implantable devices.In a preferred embodiment, processor 70 is activating before pump generation per second up to 80 journal entries, about 8 journal entries per second when implantable system effectively pumps, and the biggest when not pumping About journal entries.
Nonvolatile memory 71 preferably includes flash memory or EEPROM, and storage is used for the unique of implantable devices 20 Device identifier, the firmware configuration set point data relevant with the operation of implantable devices that will perform on processor 70, with And selectively, will perform on transceiver 76 and/or sensor circuit 75 and single motor controller (if existence) Coding.It is stored in the firmware on nonvolatile memory 71 and set point data can use by controlling and monitoring system 40 warp The new instruction provided by charging and communication system 30 updates.Volatile memory 72 coupled to and supports the behaviour of processor 70 Make, and be stored in the data and event log information collected during the operation of implantable devices 20.Volatile memory 72 is also Serve as buffering, charge and the communicating of communication system 30 with being received from for being sent to.
Transceiver 76 preferably includes RF transceiver and is arranged to charge via antenna 76 with being positioned at and communicate The two-way communication of the similar transceiver circuit in the handpiece 32 of system 30.Transceiver 76 can also include low-power operation mould Formula, so that its message periodically waking up to listen to entrance, and include being assigned to this implantable devices only in response to those The message of unique device identifier.Alternatively, because transceiver 76 only with its charging being associated and communication in handpiece 32 The corresponding transceiver communications of system 30, so transceiver 76 can be configured to only effective at the sensor circuit 75 of implantable devices Time send or receive data.Additionally, transceiver 76 can use encryption routine to guarantee to send from implantable devices or connect by it The message received will not be trapped or forge.
Sensor circuit 75 coupled to coil 84, and is configured to be exposed to the handpiece by charging and communication system 30 During the magnetic field that the corresponding sensor circuit in 32 provides, the battery 74 of implantable devices is recharged.In one embodiment, sensing Circuit 75 coupled to send the optional infrared LED 83 of infrared signal when sensor circuit 75 is effective.Infrared signal can be electrically charged Receive with the handpiece 32 of communication system 30, to assist to position handpiece relative to implantable devices, thereby improve planting Enter magnetic coupling and the energy transmission of equipment.
According to an aspect of the present invention, sensor circuit 75 selectively can be configured not to be only battery 74 and recharge, Also directly under " boosting " pattern or fine motion (jog)/vibrating mode, provide energy to motor 73, with dredging pump.Especially, as Really processor 70 detect motor 73 such as due to protein ascites fluid produce obstruction and stall, then alarm can be deposited Enter memorizer.When next implantable devices 20 communicates with charging and communication system 30, alarm is reported to handpiece 32, and And the option pressing multifunction push key 34 can be provided to patient to apply one period of expected time of arrival from sensor circuit 75 to motor 73 Between overvoltage, with break away from pump block.Alternatively, pressing multifunctional button can make processor 70 perform command set, motor 73 By this command set by fine motion or vibrations, such as, by alternately running, motor inversely and then forward, stifled to destroy Plug.Because such operator scheme can use the energy consumption higher than expection in the normal operation period, so with via sensor circuit 75 energy provided drive motor to be favourable during such program.
Battery 74 preferably include can the lithium ion of extended operation (such as, up to 3 years) or lithium polymer battery, when When being implanted to human body, in order to minimize the demand of second operation for replacing implantable devices 20.At a preferred embodiment In, battery 74 supply the rated voltage of 3.6V, when battery is new the capacity of 150mAh and use after 2 years the most about The capacity of 120mAh.Preferably, battery 74 is configured to provide to motor 73 electric current of 280mA when pumping;At transceiver The electric current of 25mA is provided when communicating with charging and communication system 30;At processor and interlock circuit effectively but when not pumping or communicate The electric current of 8mA is provided;And the electric current of 0.3mA is provided when implantable devices is in low-power mode.It is highly preferred that battery 74 Should be adjusted to allow at least 450mAh during each charging cycle to continue to continue 25 milliseconds in 10 seconds and 1A.
Motor 73 preferably brushless direct-current or there is the spline of one group of floating gear driven as gear pump operation The electricity exchange motor of output shaft, as described below.Motor 73 can include that the definite-purpose motor separated with processor 70 controls Device, to control the operation of motor.Motor 73 can include multiple hall effect sensor, is preferably two or more, with Determine position and the direction of rotation of motor.Owing to implantable devices 20 being likely encountered high humility, so processor 70 is permissible Motor 73 is operated, although having the accuracy of reduction, even if some or all hall effect sensor all loses including programming Spirit.
In a preferred embodiment, motor 73 driving gear pump can produce the nominal flow rate of 150ml/ minute and permissible Pressure head to the 30cm water being in 3000RPM applies the torque of about 1mNm.In the present embodiment, motor is the most selected For respectively at 1000 to 5000RPM driving gears of the flow velocity arriving 260ml/ minute corresponding to 50.Motor preferably has At least at 500mA, in the stall torque of 3mNm of 3V, and more preferably 6mNm, in order to crushing non-solid protein material.As above Described, when directly being powered by sensor circuit 75, motor is the most also supported to start operator scheme, such as at 5V.Electronic Machine 73 preferably can also inversely be driven, as fine motion or the part of vibrations program, to open gear pump.
According to an aspect of the present invention, processor 70 can be programmed, with automatically and periodically wake up and go forward side by side Enter the ticking pattern of pump.In this operator scheme, gear pump somewhat advanced before processor 70 returns to low-power mode, such as 120 °, hall effect sensor record.Preferably, this interval is about every 20 minutes, although it can be used inspection by doctor Survey and control system adjusts.The ticking pattern of this pump is desired to prevent from having the ascites fluid part of high protein content and coagulates Gu and block gear pump, and be desirably in overcome previously known to be designed to treat the implantable system of chronic ascites The blockage problem aspect observed in system is especially advantageous.
Additionally, processor 70 is also programmed to when only operation in the power of battery enter fine motion or vibrating mode, To dredge gear pump.Be similar to when using charging and the handpiece of communication system 30 that implantable devices is charged can boosting Pattern, fine motion or vibrating mode cause motor forward and reverse between the most alternately gear, with crushing or loosening gear pump Or protein accumulation elsewhere in liquid path.Especially, in this operator scheme, if motor is after it is energized A period of time in (such as, 1 second) do not start to rotate, then the direction of motion is by reverse one section of relatively short period of time, and the most again By inversely, so that motor rotates in a desired direction.If motor rotates not yet (such as, because gear pump is by card Live), then direction is again by reverse a period of time (such as, another 10 milliseconds).If motor still cannot advance, the most electronic Time interval between the reverse in machine direction reduces, and to allow motor to play more power, causes the shock motion of gear.As Really motor did not rotated forward more than 4 seconds, then the jog mode operated stops, and alarm is written to event log.If it is electric Motivation cannot rotate forward, then processor 70 introduces the most ticking before being moved by the liquid being ranked at next.The most ticking with Ticking (such as, about 120 ° of forwards of motor reel move) is identical, but in the opposite direction, and be intended to force motor Falling back before rotating forward, it should allow motor to obtain power.
Sensor 77-81 constantly detects humidity, temperature, acceleration, pressure and breathing rate, and to processor 70 Corresponding signal is provided.Especially, humidity sensor 77 is arranged to measure the humidity in implantable devices shell, so that guarantee can The parts of implantation equipment operate in intended operation limits.Humidity sensor 77 be preferably able to highly accurately to sense and It is reported in the humidity in the range of 20% to 100%.One or more temperature sensors 78 can be placed in shell, and supervises Survey the temperature of implantable devices and especially battery 74, with guarantee battery will not during charging overheated, and another or Multiple temperature sensors 78 can be arranged to the liquid that contact enters at entrance 62, and therefore monitors the temperature of liquid Degree, such as, predict for increase based on temperature of liquid or detect infection.Accelerometer 79 is arranged to measure implant Acceleration (preferably along at least two axle) detects the static cycle, such as, determine whether patient falls asleep.This information quilt It is supplied to processor 70, to guarantee that pump does not operates when patient is unsuitable for emptying bladder.
Implantable devices 20 preferably includes multiple pressure transducer 80, and it was constantly supervised in the period that wakes up up of processor Survey.Following about described in Fig. 6 A, the implantable devices of the present invention preferably includes four pressure transducers: be used for measuring source chamber The sensor of the pressure in (such as, peritoneum, pleura or pericardial cavity), for measuring the sensor of ambient pressure, for measuring tooth Sinking chamber (sink cavity) (such as bladder, or for breast measured by the sensor of the pressure in the exit of wheel pump and being used for Film or the peritoneal cavity of pericardium system) in the sensor of pressure.These sensors are preferably configured as consumption at 3V and are less than The absolute pressure between 450mBar and 1300mBar is measured during 50mW.Preferably, pressure at pump discharge and in groove is measured Sensor is placed across duckbill valve, which prevent adverse current and enters gear pump and also allow to calculate based on the pressure drop across duckbill valve Flow velocity.Being placed in the embodiment of the multiple arrival ends in multiple source chamber having, the implantable devices of the present invention is preferably Including additional sensor to measure the pressure in each additional source chamber (such as peritoneal cavity, pleural space or pericardial cavity).
Breathing rate monitor 81 is configured to detect the breathing rate of patient, such as, for breathing based on patient speed The increase of rate is predicted or detects infection.Alternatively, the breathing rate of patient can be based on one or more pressure transducers 80 Output (such as based on the pressure in ambient pressure or source chamber (such as, peritoneum, pleura or pericardial cavity) change) measure, this Planting pressure change is to be caused by periodically compressing the barrier film in this chamber during breathing.
In a preferred embodiment, processor 70 be programmed to only at the pressure of source chamber more than the first predetermined value and the chamber that sinks In pressure less than the second predetermined value time, liquid is pumped into sinking chamber from source chamber.It is placed in multiple source chamber having In the embodiment of multiple arrival ends, processor 70 be programmed to only when the pressure in the pressure in the first source chamber, the second source chamber or Both persons are respectively more than the first predetermined value, the second predetermined value or the first predetermined value and the second predetermined value and in sinking chamber In pressure less than three predetermined values time, by liquid from the first source chamber, the second source chamber or both be pumped into sinking chamber.In order to explain Patient walks to relatively High aititude position from sea level location, and ambient pressure measurement result is used against peritoneum pressure computing differential Value.By this way, the predetermined pressure that pump starts to operate can be reduced, to explain relatively low pressure.Similarly, ambient pressure can Predetermined value is adjusted for for bladder pressure.By this way, the threshold pressure that pumping stops can being reduced, because patient Bladder discomfort may be experienced at low pressure when High aititude position.
With reference now to Fig. 5 A and Fig. 5 B, it is provided that the further detail below of the exemplary embodiment of implantable devices 90.Fig. 5 A In, shell 91 is shown as transparent, although should certainly recognize, shell 91 includes opaque, the plastics of bio-compatible And/or alloy material.In Fig. 5 B, implantable devices is shown as removing the bottom 92 of shell 91 from upper case 93, and does not has There are the bead for preventing moisture from accumulating in a device or epoxy resin packing material.In Fig. 5 A and Fig. 5 B, motor 94 coupling It is bonded to gear pump shell 95, about Fig. 6 and Fig. 7, it will be described in more detail.The electronic component discussed above with respect to Fig. 4 Being disposed on flexible circuit board substrate 96, it is to around extending and being held to support member (member) 97.Coil 98 (corresponding to the coil 84 of Fig. 4) is arranged in the wing lid (flap) of substrate and above and is coupled to wing lid by flex cable portion 101 Electronic component on 100.Support member 97 is fixed to upper case 93 and provides the receiving battery 102 (electricity corresponding to Fig. 4 Pond 74) chamber.The bottom 92 of shell 91 includes for being fixed together inject afterwards on the top 93 of shell 91 and bottom 92 The port 103 of bead/epoxy resin composition, to reduce the space that in shell, moisture can gather.
Shell 91 can also include the feature being designed to reduce the movement of the most implanted implantable pump in the patient, Such as sewing hole is securely by implantable devices and surrounding tissue grappling.Shell 91 additionally can include that polyester is grown into sticking patch, should Polyester sticking patch of growing into is easy to implantable devices and is attached to surrounding tissue afterwards being subcutaneously implanted.
Additionally, implantable devices can merge antiblocking medicine alternatively, and the protein being such as specifically designed for ascites becomes Point enzyme drip washing material, the albumen being specifically designed for urine and lump forming component enzyme drip washing material, chemical leaching surface, prevent The coating that proteinate adheres to, and combinations thereof.If be provided, the most such medicine can be integrated into each yuan of system The inside of part or be coated in its surface.
With reference now to Fig. 6 A to Fig. 6 D, describe the further detail below of gear pump and liquid path.In Fig. 6 A to Fig. 6 D, class Use like element and identify with the same reference numerals from Fig. 5 A to Fig. 5 B.Fig. 6 A is to illustrate to have gear pump shell 95 and top The exploded view of the assembling of the element of the liquid path in the motor 94 of shell 93 and implantable devices.Upper case 93 is preferred Ground includes to be molded or being machined into including that opening and passage are to accommodate entrance female connector 102, outlet female connector 103, pressure Sensor 104a-104d, manifold 105 and the highstrenghtpiston of screw 106 or alloy material.Female connector 102 and 103 is preferably from height Intensity bio-compatible alloy is machined and obtains, and exports female connector 103 and farther include to accept elastomeric duckbill valve 108 Passage 107.Outlet female connector 103 also includes the side recess accepting pressure transducer 104a, and this pressure transducer 104a is arranged use In measuring the pressure at the arrival end flowing out conduit, corresponding to the pressure in the bladder (or peritoneal cavity) of patient.
Referring now also to Fig. 6 B and Fig. 6 C, entrance female connector 102 is placed in opening 110, and it is formed in upper case 93 Passage, this upper case includes the opening 111 for pressure transducer 104b and coupled to the opening 112 of manifold 105.Pressure passes Sensor 104b is arranged for the pressure measured at the port of export of inflow catheter, corresponding to the pressure in peritoneum (or pleura or pericardium) chamber Power.Outlet female connector 103, including duckbill valve 107, is placed in the opening 113 of upper case 93, in order to side recess 108 and opening 114 alignment, to allow the access of the electrical contact to pressure transducer 104a.Opening 113 is formed and includes for pressure transducer The passage 115 of the opening 116 of 104c, and it coupled to the opening 117 of manifold 105.Upper case 93 the most also includes being formed Opening 118 including the passage of the opening 119 for receiving pressure transducer 104d.Pressure transducer 104d measures environment pressure Power, and the input of this sensor is used for being computed as described above pressure reduction.Upper case also includes for accepting adapter 26 (see figure 1) notch 120, coupled to entrance female connector and the inflow catheter of outlet female connector 102 and 103 for retaining and flows out conduit.Top Shell 93 also includes the dimple 121 for accepting manifold 105, and the nail 122 that support member 97 (see Fig. 5 B) is connected to.
As shown in Fig. 6 A and 6D, manifold 105 preferably includes two the single upper cases 93 that pass through that have of mold and incites somebody to action The flexible member of the fluid passage of gear pump is coupled in inlet fluid path footpath and outlet flow passage footpath.First passage includes entrance 124 He Outlet 125, and second channel includes entrance 126 and outlet 127.Entrance 124 coupled to the opening 112 (see Fig. 6 C) of inflow path And export 127 openings 117 coupleding to outflow path.Manifold 105 is configured to simplify the structure of upper case 93 also And avoid the need for improving the manufacturability of implantable devices with complicated non-linear flow path casting or machined components.
With reference now to Fig. 6 A, Fig. 7 A and Fig. 7 B, motor 94 uses matching thread 130 to coupled to gear pump shell 95, with Make the splined shaft 131 of motor 94 through bearing 132.The gear pump of the present invention includes by O-ring seals 135 and plate 136 envelope Close the meshing gear 133 and 134 in gear pump shell 95.Gear pump is self-priming (self-priming).Plate 136 includes The opening 137 and 138 coordinated with outlet 125 and the entrance 126 of manifold 105 respectively.The splined shaft 131 of motor 94 extends into tooth The opening 139 of wheel 133, is connected with the floating of gear 133 to provide.The phase interaction of splined shaft and gear is described below with respect to Fig. 7 B With.
Fig. 7 A depicts the front of the gear pump shell 95 of Fig. 6 A, and includes being adjusted to accept gear 133 and 134 Groove 140, and accept the groove 141 of O-ring seals 135.Gear 133 and 134 is sealed in groove 140, so that flower Key axle 131 is extended by opening 142 and floats in the keyed jointing opening 139 of gear 133.The size of gear 133 and 134 is adjusted Whole to be positioned at groove 140, there is the severe tolerance (such as, 0.2mm) away from groove walls 143, but as long as liquid viscous Degree allows, it is possible to rotate freely.The opening 137 and 138 (see Fig. 6 A) of plate 136 is positioned on the binding site of gear 133 and 134 (the most shown in broken lines), so that rotation (when viewed from above) generation that gear 133 is in the clockwise direction will Liquid is drained in gear pump shell and by the suction of opening 138 drain by opening 137.Similarly, if electric The motivation 94 driving gear 133 (as viewed from above) in the counterclockwise direction, gear pump will be by opening 138 by liquid drain In gear pump shell, thereby make flowing reverse.
Such as described in the simplified model of Fig. 7 B, gear 134 does not has axle, but the most freely its groove 140 Float in point.Splined shaft 131 engages with the keyed jointing opening 139 of gear 133, in order to gear floats on splined shaft 131.Favorably Ground, this layout improves the efficiency of pump and manufacturability, and reduces electricity by reducing the impact manufacturing change and heat effect The power consumption of motivation 94.Especially, manufacturing tolerance or differential thermal expansion cause the motor reel degree of eccentricity or glacing flatness Minor variations will not cause gear mesh groove 140 inside or the binding (bind) to gear 134.On the contrary, the surface of axle 131 Different piece contact with each other during the rotation of axle 131 with keyed jointing opening 139, to transmit revolving force to gear 133 continuously. But, the power of the waste energy that change in shaft eccetricity, manufacturing tolerance or the differential thermal expansion of element cause is reduced.This Outward, this floating arranges that can reduce microparticle material causes the risk of the binding between gear and wall 143, because gear can be with side To mobile to accommodate such microparticle material.
Gear 133 and 134 includes intermeshing salient angle 144, and they clearly replace liquid, substantially when engagement and disengaging On there is no by-pass flow.By this way, volume and the viscosity of the liquid of gear 133 and 134 conveying can be placed in electricity by tracking Motor revolution that in motivation 94, hall effect sensor senses and calculated.As shown in Fig. 7 A and Fig. 7 B further, The groove 140 of gear pump shell 95 includes two that interconnect, substantially circular salient angles.Gear 133 and 134 is protected by this layout Stay about groove walls 143 and appropriate location relative to each other.In a preferred embodiment, the point that two salient angle intersections are formed Point 145 is configured to form the tangential radii drawn from each salient angle center.Advantageously, configuration cusp reduces tooth by this way Wheel 133 and 134 clashes into the potentially possible of wall 143.
Charging and communication system
With reference to Fig. 8 A, Fig. 8 B and Fig. 9, the charging of the present present invention described in more detail and communication system 150 are (corresponding to figure The system 30 of 1).In a preferred embodiment, charging and communication system 150 include handpiece 151 and base 31 (see Fig. 1). The base 31 provided includes the bracket for recharging handpiece 151, and preferably comprises transformator and for by often The DC electric current that rule 120V electrical power services is converted to be suitable for is with the circuit charged it when handpiece 151 is coupled to base.Alternative Ground, handpiece 151 can include the circuit for charging the battery of handpiece, and dismountable power line.In this enforcement In example, handpiece 151 is directly inserted into conventional 120V wall socket for charging, and power line is when handpiece is for can It is removed when implanting equipment charge.
As shown in Figure 9, handpiece 151 comprises controller 152, is illustratively coupled to nonvolatile memory 153 (such as, EEPROM or flash memory), volatile memory 154, radio transceiver 155, sensor circuit 156, battery 157, instruction The processor of the micro controller unit of device 158 and display 159.Controller 152, memorizer 153 and 154 and transceiving Device 155 can be included into single micro controller unit, and (such as MPS430 family microprocessor, it is from Texas Instruments Incorporated, Dallas, Texas can obtain.Transceiver 155 be coupled to antenna 160 for implantable devices 20 send and Reception information.Battery 157 is coupled to adapter 161, and adapter 161 couples with the adapter in base 31 with to electricity removedly Battery recharge.Port 162 (such as USB port or comparable radio-circuit) is coupled to controller 152 with permission information at handpiece Swap between 151 and monitoring and control system.Sensor circuit 156 is coupled to coil 163.Input equipment 164 is (preferably, Multifunctional button) it is also coupled to controller 152 to enable the patient to input the order of limited quantity.Indicator 158 is illustratively Including multiple LED, it illuminates to indicate the charge-coupled quality realized between handpiece and implantable devices, and therefore assists Help to optimize and recharging the period handpiece 151 location relative to implantable devices.In a preferred embodiment, finger is eliminated Showing device 158, and provide strip indicator on display 159, the instruction of this strip indicator is produced by the coupling of coil 163 and 84 Charging quality.
In a preferred embodiment, handpiece 151 includes the device identifier being stored in nonvolatile memory 153, should Device identifier is corresponding to being stored in the device identifier in the nonvolatile memory 71 of implantable devices, so that handpiece The most corresponding implantable devices 20 is communicated by 151.Selectively, configurable for use in the office of doctor Handpiece can include following ability: inquiry implantable devices is to ask the unique device identifier of this equipment, and then will The device identifier of monitoring and control system 40 changes into the device identifier of the implantable devices of patient, in order to imitate patient's Handpiece.So, if patient leaves behind with oneself his handpiece 151 during accessing the office of doctor, then doctor can adjust The configuration of whole implantable devices.
Controller 152 performs to be stored in the firmware in nonvolatile memory 153, and this firmware controls the logical of implantable devices Letter and charging.In doctor's office during the visit, controller 152 is additionally configured to transmission and stores such as event log etc Data (these data are uploaded to handpiece 151 from implantable devices), are retransmitted to be monitored and controlled by port 162 for later System 40.Alternatively, handpiece 151 can be configured to identify doctor office in appointment WAP, and Office during the visit be monitored and controlled system 40 radio communication.As further alternative, base 31 can include It is uploaded to doctor by secure connection for auto dialing and the information (such as warning information) that will be stored on handpiece 151 The telephone circuit of website.
Controller 152 preferably includes low-power operating mode and includes internal clocking, so that controller is periodically Wake up up with implantable devices communication to record data or perform charge function.Controller 152 is preferably configured as working as Wake up up when being placed near implantable devices to perform communication and charge function, and transmit use input equipment 164 input Order.Controller 152 can include programming the information received with evaluation from implantable devices further, and at display Alert message is generated on 159.Controller 152 can also include that firmware is for the order transmission that input equipment 164 will be used to input To implantable devices, and (such as, boosting or fine motion/shake at gear pump operate with clearly term of execution these are ordered Except blocking during) monitoring implantable devices operation.Additionally, controller 152 controls and monitors the various power of handpiece 151 Operation, including: in the operation recharging period sensor circuit 156 of implantable devices, show the charged state of battery 74, and Control the display of the charging status information of charging and battery 157.
Nonvolatile memory 153 preferably includes flash memory or EEPROM, and stores for its relevant implantable devices Unique device identifier, the firmware performed by controller 152, configuration set-point and alternatively transceiver 155 and/or sense Answer the coding performed on circuit 156.It is stored in the firmware on nonvolatile memory 153 and set-point data can pass through port 162 uses are updated by the information controlled and monitoring system 40 provides.Volatile memory 154 is coupled to controller 152, And the operation of a held controller 152, and store the data and event log information uploaded from implantable devices 20.
Additionally, in a preferred embodiment, nonvolatile memory 153 storage makes charging and communication system be able to carry out one The most initial startup function and with the programming that do not communicates of the system of monitoring and control.Particularly, memorizer 153 can include routine, This routine makes only to use charging and communication system to test implantable devices during implanting in " from the suction mode " of operation Possible.In such a case, it is possible to offer button, this button allows doctor to manually boot pump, and display 159 is used for carrying The most successfully feed back for pumping session.The display 159 of charging and communication system can be also used for showing error message, this mistake Mistake message is designed to assist a physician and adjusts implantable devices or inflow catheter or flow out the position of conduit.These functions are preferred Ground is disabled after initially implanting implantable devices.
Transceiver 155 preferably includes and such as meets bluetooth or the RF transceiver of IEEE 802.11 wireless standard, and Transceiver circuit 76 two-way communication being configured to antenna 160 and be arranged in implantable devices.Transceiver 155 also may be used To include low-power operating mode, so that it periodically wakes up to intercept incoming message, and only in response to including distribution Those message to the unique device identifier of its relevant implantable devices.Transceiver 155 preferably by encryption routine, with Guarantee to be sent to implantable devices or the information from implantable devices reception cannot be trapped or forge.
Inductive circuit 156 is coupled to coil 163, and is configured to coil 84 inductive with implantable devices with right The battery 74 of implantable devices recharges.In one embodiment, inductive circuit 156 is coupled to indicator 158, it is therefore preferable to many Individual LED, the plurality of LED are luminous to indicate the magnetic couplings degree (and being therefore charging quality) between coil 163 and 84, from And assist to position handpiece 151 relative to implantable devices.In a preferred embodiment, when operation is at 315kHz or less Time at frequency, induction coil 84 and 163 can set up good coupling by the breach of 35 millimeters.Including at implantable devices can In the embodiment of the infrared LED 83 of choosing, charging and communication system 30 can include optional infrared sensor (not shown), should Infrared sensor detects the infrared light sent by LED 83 and assists further to position to optimize coil 163 to handpiece 151 And the magnetic couplings between 84, thus bring up to the energy transmission of implantable devices.
According to one aspect of the present invention, controller 152 can be configured to periodically with implantable devices communication with Obtaining temperature data, this temperature data is generated by temperature sensor 78 during the induction charging of battery 74 and is stored in storage In device 72.Controller 152 can include that firmware, to analyze battery temperature, and regulates and provides to the charging merit of inductive circuit 163 Rate, to maintain below predetermined threshold (such as, higher than body temperature less than 2 DEG C) by the temperature of implantable devices.This threshold value can be by Arrange to reduce battery and electronic unit around and the thermal expansion of mechanical part, such as, reduce motor component and gear The thermal expansion of pump part, and reduce the thermal strain of the sealing being applied between the low portion 92 of shell and upper case 93. In a preferred embodiment, in response to the temperature recorded in implantable devices, it is provided that to the power of induction coil 163 at high power Circulate between (such as 120mA) and low-power (such as 40mA) charging interval.
About the inductive circuit 75 of implantable devices, as discussed above, sensor circuit 156 can be joined alternatively It is set to transmit extra power to implantable devices with " boosting " pattern or jog mode by inductive circuit 75 and battery 74 (unblock) gear pump dredged by motor 73.Particularly, if motor 73 such as stops due to the blocking that produced by ascites The alarm turned is sent to controller 152, then patient can select to use input equipment 164 to apply to carry out self-inductance to motor 73 The overvoltage of circuit 75 unblocks with predetermined time period.Alternatively, activate input equipment 164 and can cause controller 152 command processors 70 perform routine, with by carrying out fine motion or shake reversely and operating rapidly motor 74 on the direction of forward Moving gear pump is to disintegrate blocking.Because such operator scheme may use than higher energy desired during normal operating Consumption, so inductive circuit 156 and 75 can be configured to the energy of directly storage from battery 157 rather than consume implantable setting Standby battery 74 operates the energy providing extra for such motor.
Battery 157 preferably includes can the lithium ion of extended operation (such as up to 3 years) or lithium polymer battery.Electricity Pond 157 has enough capacity provides power for when disconnecting with base 31 and setting implantable to handpiece 151 Controller 152, transceiver 155, inductive circuit 156 and associated electronic device is operated during standby charging.In a preferred embodiment, electricity Pond 157 has enough capacity and enters the battery 74 of implantable devices from the state exhausted within the time period of about 2-4 hour Row recharges completely.Battery 157 also should be able to recharge in about 2-4 hour.Anticipated for the day removing 700 milliliters of liquid Often for operation, battery 157 and inductive circuit 156 should be able to by inductive circuit 75 transmit enough electric charges to battery 74 with In about 30 minutes, battery is recharged.Battery capacity is preferably used electric charge accumulator algorithm and is carried out by controller 152 Supervision.
Referring again to Fig. 8 A and Fig. 8 B, handpiece 151 preferably includes has multifunctional button 166 (defeated corresponding to Fig. 9 Enter equipment 164) and the shell 165 of display 167 (corresponding to the display 159 of Fig. 9).Multiple LED 168 are arranged in handpiece The lower section of the translucent portion of 151, and corresponding to the indicator 158 of Fig. 9.Port 169 enables handpiece to be coupled to monitoring With control system 40 (and corresponding to port 162 of Fig. 9), and adapter 170 (adapter 161 corresponding in Fig. 9) allows Handpiece is coupled to base 31 to recharge battery 157.Multifunctional button 166 provides patient limited to implantable devices input The ability of the order of quantity.Display 167 (preferably, OLED or LCD display) provide have been received by using multi-functional by The visible confirmation of the desired order of button 166 input.Display 167 can also show the battery 74 of implantable devices state and State of charge, the state of the battery 157 of handpiece 151 and state of charge, the signal intensity of radio communication, quality of charging, mistake With the information of maintenance.The induction coil part 171 of shell 165 accommodates induction coil 163.
LED 168 is visible by the material of shell 165 when illuminated, and is preferably arranged for three rows, often arranges Two LED.In charging process, LED lights to show the degree of the magnetic couplings between induction coil 163 and 84, such as, as Determined by the energy loss of origin self-inductance circuit 156, and can be by patient for relative to implantable devices exactly Location handpiece 151.Illuminating it is therefoie, for example, lower coupling degree can correspond to only two LED, intermediate coupling degree has four Individual LED illuminates, and preferred degree of coupling is illuminated by all six LED and reflects.Utilizing this information, patient can be can The overlying regions that implantation equipment is positioned at adjusts the position of handpiece 151, to obtain the optimum position of handpiece, causes the shortest Recharge time.In a preferred embodiment, the simulation strip display that LED 168 is shown on device 167 is replaced, its instruction Charge-coupled quality.
Monitoring and control system
Turn to Figure 10, presently describe the monitoring and control system of Fig. 1 that software realizes.Software 180 includes schematically retouching Paint some functional devices in Fig. 10, including main piece 184, logout block 182, data download block 183, configuration arrange block 184, User interface block 185, include infect prediction the alarm detection block 186 of block 191, pick up calibration block 187, firmware upgrade block 188, Device identifier block 189 and status information block 190.Software is preferably write with C++ and uses OO form.? In one preferred embodiment, software is configured at Microsoft(it is positioned at Redmond, Washington's The registered trade mark of Microsoft Corporation) or the top layer of operating system based on Unix on run, the most such operating system It is commonly used to desk computer and laptop computer.The computer of operational monitoring and Control System Software 180 preferably wraps Including FPDP (such as USB port or comparable wireless connections), this FPDP allows the handpiece 151 of charging and communication system Coupled by port 169.Alternatively, as discussed above, computer can include that wireless network card (such as meets IEEE 802.11 standards) so that software 180 radio communication that handpiece 151 can run with computer.As the most standby Choosing, charging and communication system can include telephone circuit, its auto dialing and from handpiece 151 to can by patient doctor visit The security website asked uploads data (such as data with alert).
Preferably it is made up of the main software routine performed on the computer of doctor, and controls other merits for main piece 184 The overall operation of energy block.The event data and the warning information that enable a physician to for main piece 184 to will be stored on handpiece 151 download to His office computer, and also allow to control directly to control implantable when being coupled to handpiece 151 with monitoring of software 180 The operation of equipment.Main piece also enables a physician to upload firmware and updates and configure data to implantable devices.
Event log block 182 is the record of the operation data downloaded from implantable devices by charging and communication system, and And such as pump startup and dwell time, motor position, peritoneum (or pleura or pericardium) chamber and heavy chamber (such as wing can be included Guang) sensing data of pressure, patient temperature, breathing rate or temperature of liquid, pump discharge pressure, humidity, pump temperature, battery electricity Stream, cell voltage, battery status etc..Event log can also include the event (behaviour under such as pump blocking, supercharging or jog mode Make, alarm or other abnormal conditions) generation.
It is such routine that data download block 183, and this routine handles the communication with handpiece 151, to couple at handpiece Data are downloaded from volatile memory 154 after the monitoring and control software 180 that computer runs.Data download block 183 can (or automatically or under the agitating of doctor) is for the number being stored in event log being initiated by user interface block 185 According to download.
It is such routine that configuration arranges block 184, and the configuration of this routine is stored in the parameter in nonvolatile memory 71, should The operation of state modulator implantable devices.Interval timing parameters may determine that such as processor be waken up with monitoring wireless electricity lead to Believe or how long control the pump operated sleep pattern of holding before.Interval timing parameters can control, and such as, is used for liquid from peritoneum (or pleura or pericardium capsule) moves to the pump operated persistent period in heavy chamber, and prevents implantable devices and inflow catheter and stream Interval between the ticking motion of periodicity of the blocking going out conduit.It is transferred to implantable devices from software 180 is monitored and controlled When interval time set is it may also be determined that event data and is the most once written into nonvolatile memory 71, and joins Putting the timing parameters used by firmware, this firmware is performed by the processor 152 of the handpiece 151 charged with communication system.Block 184 Can also be used for configuring the parameter being stored in nonvolatile memory 71 by doctor, this parameter and processor 70 and motor 73 Operational limits value relevant.These values can be included in inflow catheter and flow out the minimum pressure at conduit and maximum pressure Power, the maximum temperature difference during charging, pump can be with the time etc. that cannot operate.The limits value set by block 184 also configures that Control the parameter of the operation of the processor 152 of handpiece 151.Block 184 can also configure and be stored in the non-volatile of implantable devices Parameter in property memorizer 71, this parameter relates to the control of the operation of processor 70 and motor 73.These values can include treating The target day capacity of the liquid of conveying, often pumping session are by the capacity of liquid to be delivered, often pumping session electromotor velocity And the persistent period.Block 184 can also operation boost mode during (when being coupled to handpiece 151) and operation shaking During dynamic/jog mode, (when only using battery 74 to run implantable devices) specifies the operating parameter of motor 73.Such Parameter can include motor speed and voltage, when alternate between forward and inverse direction the rotation of motor reel hold Continuous time/quantity, etc..
User interface block 185 is handled and is downloaded what block 183 was fetched from monitoring and control system and implantable devices by data The display of information, and present this information for doctor's examination with form directly perceived, understandable.As described below, about figure 11 arrive Figure 15, such information can include the state of the state of implantable devices, charging and control system, the pressure of measurement, The capacity of the liquid of each pumping session or conveying every day, etc..User interface block 185 also generates user interface screen, this screen Allow doctor to input information and come configuration space timing, the restriction about block 184 discussed above and pump operation parameter.
Alarm detection block 186 can include for evaluate from implantable devices or charging and communication system retrieval data with And labelling abnormal conditions are to cause the routine of the attention of doctor.Such as, alarm detection block 186 can include infecting prediction block 191, It is configured to infect based on following conditional forecasting or detection: such as, the body temperature of patient is higher than the predefined increase of threshold value, patient Breathing rate higher than one or more higher than in the increase of predefined threshold value of the increase of predefined threshold value and/or liquid.This The mark of sample by changing the positioning indicator presented by user interface block 185, or can pass through via user interface block 185 Show that the body temperature about patient, breathing rate or the customizing messages of liquid viscosity increase are communicated to doctor Xiang doctor.
Pick up calibration block 187 can include for test or measure the sensor 70,78-used in implantable devices The routine of 81 drifts such as caused due to aging or humidity change.Then block 187 can calculate for correction from sensor The deviant of measurement data, and by the transmission of this information to implantable devices to be stored in nonvolatile memory 71.Example As, pressure transducer 104a-104d can experience the drift caused due to aging or variations in temperature.Therefore block 187 can calculate Deviant, then this deviant is transmitted and is stored in implantable devices to explain such drift.
Firmware upgrade block 188 can include for checking the processor or motor controller being arranged on implantable devices The routine of the version number of firmware and/or the processor firmware in charging and communication system, and determine whether there is upgrading Firmware.If it is, this routine can notify doctor and allow doctor that the firmware of amendment is downloaded to implantable devices to deposit Storage downloads to charging and communication system to be stored in non-volatile depositing in nonvolatile memory 71 or by the firmware of amendment In reservoir 153.
Device identifier block 189 is by the unique identifier for implantable devices being stored in nonvolatile memory 71 And for reading the routine of these data when monitoring and control system is coupled to implantable devices by charging and communication system. As it has been described above, the radio communication that this device identifier is received from charging and communication system for confirmation by implantable devices is intended to pin To this specific implantable devices.Similarly, this information is by charging and the handpiece 151 of communication system is for determining that receive disappears Whether breath is generated by the implantable devices associated with this handpiece.Finally, device identifier information is by software 180 is monitored and controlled For confirming that handpiece and implantable devices constitute set of matches.
Status information block 190 includes, for inquiring implantable devices by handpiece 151 when being connected, setting from implantable The routine on current state date retrieved by standby and/or handpiece 151.Such information can include such as battery status, implantable Date and time on the internal clocking of equipment and handpiece, for currently used firmware and hardware version control information with And sensing data.
With reference now to Figure 11-Figure 15, for ascites treating system, describe and generated by the user interface block 187 of software 180 Exemplary screen shots.Figure 11 shows main screen 200, and this main screen is displayed to operational monitoring and controls software 180 Doctor.Main screen 200 includes state region, and this state region display status information, this status information is by the block corresponding to Figure 10 The routine of 190 obtains from implantable devices with charging and communication system.More particularly, state region includes for charging and leading to The state region 201 of communication system (referred to as " intelligent charger ") and the state area for implantable devices (referred to as " ALFA pump ") Territory 202.Each state region includes showing the icon of respective system the most properly functioning (being indicated by check mark), for this system Device identifier, and whether system connects or effectively.If parameter is alerted detection, block 186 is evaluated as exceeding standard, then icon Can include on the contrary alerting symbol.Menu bar 203 identifies various screen, and by being highlighted corresponding menu item, doctor is permissible Move between screen.Region, working area 204 is provided at below state region, and includes according to the menu item change selected Display.Below region, working area 204, showing Navigation Pane 205, it includes the version number of software 180 and makes work Make the radio button that the display in region 204 can be refreshed.
In fig. 11, the menu item " information " with Submenu Items " implant " is highlighted in menu bar 203.Right In the selection of this menu item, region, working area 204 is illustratively shown the battery status window for implantable devices 204a, measured pressure window 204b and firmware version control window 204c.Battery status window 204a includes representing battery 74 The icon of middle residual charge, and full, 3/4ths full, 1/2nd full, 1/4th full or displays can be described as The warning that battery almost exhausts.Time the parts instruction such as the current time received from implantable devices, Qi Zhong of window 204a Phase represents with the form of day month year, and the time based on 24 hours clocks with time/form of point/second represents.Measured pressure window Mouth 204b shows the bladder pressure in units of mBar, the abdomen measured respectively by sensor 104a, 104b and 104d (see Fig. 6 A) Film pressure and ambient pressure.Version Control window 204c indicates the firmware version of processor 70, the firmware version of motor controller This, and the hardware version of implantable devices.The patient parameter window 204d display body temperature of patient, breathing rate and liquid glue Degree.Alarm situations window 204e shows any change (block 191 in Figure 10) of the parameter that may develop that may indicate that infection. Such as, the most as illustrated, alarm situations window 204e can remind the abnormal body temperature ground height of doctor patient, so that doctor is right After the probability that can just infect follow the tracks of patient.In certain embodiments, show based in window 204b, 204d and/or 204e Information, doctor can such as use below with reference to the interface described by Figure 14 to regulate the operating parameter of pump.
Forward Figure 12 to, describe corresponding to selecting the screen of " intelligent charger " Submenu Items in Figure 11 to show 206.Figure 12 include for charging and the state region 201 of communication system, state region 202 for implantable devices, menu bar 203, Region, working area 204 and Navigation Pane 205, as discussed above with respect to Figure 11.Screen shows that 206 are different from screen and show It is in place of 200 that " intelligent charger " Submenu Items is highlighted, and region, working area 204 is for charging and control system Display battery status window 207a and Version Control window 207b.Battery status window 207a includes representing residue in battery 157 The icon of electric charge, can be depicted as full, and 3/4ths is full, and 1/2nd is full, and 1/4th completely or show that battery almost consumes Most warning.The time parts instruction such as current time received from handpiece 151 of window 207a, wherein the date is with day month year Form represent, and the time based on 24 hours clocks with time/form of point/second represents.At Version Control window 207b instruction The firmware version of reason device 152, and charge and the hardware version of control system.
With reference now to Figure 13, describe corresponding to selecting " download " menu item in Figure 11 and " journal file " Submenu Items Screen show 208, and realize the function of the block 183 of software 180.Figure 13 includes the state area for charging and communication system Territory 201, state region 202, menu bar 203, region, working area 204 and Navigation Pane 205 for implantable devices, all These are described above.Screen shows 208 to be different from place of " information " screen shows to be that " journal file " Submenu Items is highlighted Show, and region, working area 204 shows downloading process window 209a and store path window 209b.Window 209a includes catalogue Path, event log can download to this catalogue by charging and communication system from implantable devices.Window 209a also includes " beating Open download folder " radio button and progress bar, this radio button allows the catalogue that doctor selects event log to be downloaded to Path, this progress bar is updated to reflect that the data volume of download.Window 209b includes can being activated to download event log The radio button in the path of regulation in window 209a, and also include that " abandoning " radio button is to interrupt download progress.
Figure 14 is the exemplary description that screen shows 210, and this screen shows corresponding to selecting " pump setting " dish in Figure 11 Individual event and " liquid conveying " Submenu Items, and realize the function of the block 184 and 190 of software 180.Figure 14 include for charging and The state region 201 of communication system, the state region 202 for implantable devices, menu bar 203, region, working area 204 and Navigation Pane 205, all these as mentioned above.Screen shows that 210 are different from place of " information " screen shows and are that " liquid is defeated Send " Submenu Items is highlighted, and region, working area 204 include session capacity (session volume) window 211a, Single choice in liquid conveying program window 211b, minimum day capacity window 211c, pressure window 211d and Navigation Pane 205 is pressed Button, this radio button allows the value keyed in window 211a, 211b and 211d be transmitted and be stored in implantable devices In nonvolatile memory 71.Session capacity window 211a show the maximum day capacity for being pumped by implantable devices, Interval time between pumping session, time that every day, pump can be activated, total day pump time and each pumping session The current setting of session capacity.
Maximum day capacity of display in window 211a transfers to the liquid of bladder within the period of 24 hours corresponding to pump The upper limit, although the actual capacity of pumping may be relatively low in the case of implantable devices detects low fluid conditions.This value is General status based on patient and day ascites yield, and can have the allowed band of such as 20ml to 4000ml.Show Being configured to arrange routine (block 184 of Figure 10) interval time in window 211a to be used for calculating session capacity, it is preferably at 3ml To 30ml, and more preferably in the range of 10ml to 20ml.In window 211a, the pump of display can be effective Time period define timetable, during this timetable, liquid can be moved to bladder by implantable devices effectively;At this Outside a little time periods, implantable devices will not move liquid and can realize the ticking operation of said pump to rotate gear termly Prevent gear from blocking.In window 211a, the day pump time of display illustrates, in a read-only format because it is key in time period frame The total of the time period entered.Finally, display session capacity in window 211a is calculated as in single pumping session by block 183 Transfer to the amount of liquid of bladder.
Based on the parameter using the block 184 of software 180 to arrange, liquid conveying program window 211b shows that control is implantable The state of the program of the operation of the pump of equipment.If pump activity must stop due to any reason, then can pass through window The Close button in 211b carrys out stop liquid conveying program, and this will result in pump and stops pumping, until it is opened the most again Open.In one embodiment, liquid conveying program can be turned on again by " unlatching " button in pressing window 211b. Because implantable devices is preferably implanted in the case of pump cuts out, so doctor or surgeon can use window 211b to exist Liquid conveying program is opened after implanting implantable devices first.
Minimum shows the expection amount of liquid by being pumped to bladder by implantable devices at day capacity window 211c, and by configuring Arrange routine to input based on length and the interval timing of the time period of regulation in window 211a and be calculated as session capacity and be multiplied by The number of sessions of every day.
The pressure window 211d of Figure 14 allow doctor's input for control the operation of implantable pump maximum bladder pressure and The value of minimum peritoneum pressure.If specified it is therefoie, for example, the bladder pressure detected by pressure transducer exceedes in window 211d Value, then order motor 73 is stopped current pumping session, or the time period determined in window 211a by processor 70 Period skips the pumping session of plan.Equally, if the peritoneum pressure detected by pressure transducer is less than window 211d middle finger Fixed value, then order motor 73 is stopped current pumping session, or the time determined in window 211a by processor 70 The pumping session of plan is skipped during Duan.If configured as operating in the above described manner, then implantable devices will neither pass through Degree fills the bladder of patient and causes patient uncomfortable, does not the most cause peritoneum, pleura or pericardial cavity to become excessively and is dried.
With reference now to Figure 15, describe corresponding to selecting " test " menu item in Figure 11 and " manual test operation " sub-dish The screen of individual event shows the example plot of 212.Figure 15 includes for charging and the state region 201 of communication system, for can The state region 202 of implantation equipment, menu bar 203, region, working area 204 and Navigation Pane 205, all these as above institutes State.Screen shows that 212 are different from place of " information " screen shows and are that " manual test operation " Submenu Items is highlighted, and And region, working area 204 includes manual pump cycle window 213.Manual pump cycle window 213 includes that radio button " starts test ", This radio button sends order to cause processor 70 by predetermined for pumped work by charging and communication system to implantable devices A period of time (the most several seconds).Processor 70 receive from the hall effect sensor in motor 73 position data and The pressure data of cross-pressure force transducer 104c and 104d recorded.Processor 70 calculates session capacity and by charging and communicating The data recorded and target session capacity are compared and provide test by system by this information back to software 10, this software Result (the percentage ratio of the session target capacity such as, completed or pass through/failure icon.The session capacity that records, session target Capacity and test result show in window 213.
Although above-mentioned exemplary embodiment relates to treat the liquid management system of chronic ascites, but the liquid of the present invention Body management system can be easily adaptable treatment pleural effusion or pericardial effusion.In such embodiments, pleural space is caused In pericardial cavity due to breathe or normal heart activity and the fluctuation of pressure that occurs with avoid by all liq from chamber drain and Disturbing normal pulmonary function or cardiomotility will be favourable.For being intended to the liquid management system for treating hydrothorax, This can be such as by being programmed for during breath cycle measuring the pressure in pleural space by the processor 70 of implantable devices Power realizes.Then this information can be used to calculate the average pressure being used to determine when to stop pumping liquid from pleural space. Similarly, for the liquid management system that present invention aims to for treating pericardial effusion, the processor 70 of implantable devices can To be programmed to during cardiac cycle measure the pressure in pericardial cavity.Then this information can be used to calculate for really The fixed average pressure when stopped from pericardium capsule pumping liquid, in order to guarantee that some liquid stay lubrication pericardium capsule interior due to just The heart movement that normal cardiomotility produces.
Although the foregoing describing the various illustrative embodiment of the present invention, but to those skilled in the art will It is readily apparent that variations and modifications can be carried out wherein without departing from the present invention.Claims are intended to cover Fall in true spirit and scope of the present invention all such changes and modifications.

Claims (20)

1. for suffering from a system for the non-intruding monitor of the cancerous tumor cell of the patient of cancer, including:
Inflow catheter, has arrival end and the port of export, and described arrival end is suitable to be placed on and has the hydrops including cancerous tumor cell Body cavity in;
Flow out conduit, there is arrival end and be suitable to the port of export being placed in bladder;
Implantable pump, has the first controller, the ingress port coupleding to the described port of export of described inflow catheter and coupling To the outlet port of described arrival end of described outflow conduit, described first controller be programmed to optionally to activate described can Implantable pump is to enter the described liquid including cancerous tumor cell from described in described inflow catheter during the predetermined time period Mouth end moves to described bladder;And
Analysis station, be configured to analyze urinate period from the liquid including cancerous tumor cell of described bladder drainage to determine instruction Being in progress or for treating the parameter of the curative effect of the plan of described cancer of described cancer.
System the most according to claim 1, the described arrival end of wherein said inflow catheter be suitable to be placed on peritoneal cavity, In pleural space or pericardial cavity.
System the most according to claim 1, wherein said implantable devices also includes being configured to measure inflow catheter pressure First pressure transducer of power and be configured to measure the second pressure transducer flowing out catheter pressure.
System the most according to claim 1, wherein said implantable devices also includes preventing from described outflow conduit to institute State at least one valve of the adverse current of inflow catheter.
System the most according to claim 1, wherein said implantable devices also includes coupleding to described first controller Battery, first transceiver and the first inductive charge circuit, and described system also includes:
Charging and communication system, including coupleding to second transceiver and the second controller of the second inductive charge circuit, described in fill Electricity and communication system are configured to via described first transceiver and described second transceiver and described implantable devices channel radio Letter, and by energy wireless transmission extremely described first sensor circuit from described second sensor circuit with to described first battery Charging.
System the most according to claim 5, wherein said charging and communication system also include:
Handpiece, has deposited described second controller, described second transceiver, described second inductive charge circuit and the second electricity Pond;And
Base, comprises for the circuit to described second battery charging.
System the most according to claim 5, also includes:
Software being monitored and controlled, is configured to run on computers, described monitoring and control software is configured to join operation Number is conveyed to described implantable devices to control the operation of described pump via described charging and communication system.
System the most according to claim 7, wherein said first controller is programmed in response to by described monitoring and control The operating parameter that software processed is passed on, automatically activates described pump with during the predetermined time period and with predetermined Capacity movable liquid.
9. it is used for a system for the non-intruding monitor of cancerous tumor cell, including:
Liquid management system, including:
Implantable pump, has the first controller;
Inflow catheter, has and is suitable to be placed on endoceliac arrival end and be configured to couple to described implantable pump The port of export, described body cavity has the hydrops including cancerous tumor cell;And
Flow out conduit, have and be configured to couple to the arrival end of described implantable pump and be suitable to be placed in bladder The port of export,
Wherein said first controller is programmed to optionally activate described implantable pump including described in cancerous tumor cell Liquid moves to described bladder from the described arrival end of described inflow catheter;And
Analysis station, is configured to analyze described cancerous tumor cell.
System the most according to claim 9, wherein said analysis station is set away from described liquid management system.
11. systems according to claim 9, the described arrival end of wherein said inflow catheter is suitable to be placed on peritoneum In chamber, pleural space or pericardial cavity.
12. systems according to claim 9, wherein said implantable devices also includes being configured to measure inflow catheter pressure First pressure transducer of power and be configured to measure the second pressure transducer flowing out catheter pressure.
13. systems according to claim 9, wherein said implantable devices also includes preventing from described outflow conduit to institute State at least one valve of the adverse current of inflow catheter.
14. systems according to claim 9, wherein said implantable devices also includes coupleding to described first controller Battery, first transceiver and the first inductive charge circuit, and described liquid management system also includes:
Charging and communication system, including coupleding to second transceiver and the second controller of the second inductive charge circuit, described in fill Electricity and communication system are configured to via described first transceiver and described second transceiver and described implantable devices channel radio Letter, and by energy wireless transmission extremely described first sensor circuit from described second sensor circuit with to described first battery Charging.
15. systems according to claim 14, wherein said charging and communication system also include:
Handpiece, has deposited described second controller, described second transceiver, described second inductive charge circuit and the second electricity Pond;And
Base, comprises for the circuit to described second battery charging.
16. systems according to claim 14, also include:
Software being monitored and controlled, is configured to run on computers, described monitoring and control software is configured to join operation Number is conveyed to described implantable devices to control the operation of described pump via described charging and communication system.
17. systems according to claim 16, wherein said first controller be programmed in response to by described monitoring and Control the operating parameter that software is passed on, automatically activate described pump with during the predetermined time period and with predetermined Capacity movable liquid.
18. 1 kinds of methods for the non-intruding monitor to the cancerous tumor cell in the patient suffering from cancer, described method bag Include:
Via implantable pump, the body fluid including cancerous tumor cell is pumped to bladder supply and discharge from the body cavity of the hydrops with described body fluid Let out;
It is collected in period of urinating from the liquid of described bladder drainage;And
Analyze cancerous tumor cell that described liquid contains to determine the progress or the curative effect of cancer treatment plans indicating described cancer Parameter.
19. methods according to claim 18, also include the progress analyzing described cancerous tumor cell to evaluate treatment of cancer.
20. methods according to claim 18, wherein pump described body fluid from described body cavity and include from peritoneal cavity, pleural space Or pericardial cavity pumping body fluid.
CN201580004504.3A 2014-01-14 2015-01-09 Apparatus and method for the non-intruding monitor of cancerous tumor cell Pending CN106102561A (en)

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Families Citing this family (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8202248B2 (en) 2004-08-18 2012-06-19 Sequana Medical Ag Dialysis implant and methods of use
CN103492015A (en) 2011-02-16 2014-01-01 塞奎阿纳医疗股份公司 Apparatus and methods for treating intracorporeal fluid accumulation
US8585635B2 (en) 2012-02-15 2013-11-19 Sequana Medical Ag Systems and methods for treating chronic liver failure based on peritoneal dialysis
US10769244B2 (en) 2016-08-26 2020-09-08 Sequana Medical Nv Systems and methods for managing and analyzing data generated by an implantable device
US10716922B2 (en) 2016-08-26 2020-07-21 Sequana Medical Nv Implantable fluid management system having clog resistant catheters, and methods of using same
JP7053647B2 (en) * 2017-03-07 2022-04-12 ユニヴァーシティ・オブ・サウザンプトン Intrauterine monitoring system
US10918778B2 (en) 2017-05-24 2021-02-16 Sequana Medical Nv Direct sodium removal method, solution and apparatus to reduce fluid overload in heart failure patients
US11559618B2 (en) 2017-05-24 2023-01-24 Sequana Medical Nv Formulations and methods for direct sodium removal in patients having severe renal dysfunction

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004012806A1 (en) * 2002-08-02 2004-02-12 Potencia Medical Ag Apparatus for distributing liquid in a patient's body
CN1636139A (en) * 2001-01-12 2005-07-06 耶鲁大学 Detection of survivin in the biological fluids of cancer patients
US20050273034A1 (en) * 2002-02-25 2005-12-08 Burnett Daniel R Implantable fluid management system for the removal of excess fluid
US20110034986A1 (en) * 2007-07-18 2011-02-10 Chou Tony M Systems and methods for treating a carotid artery
US20130211322A1 (en) * 2012-02-15 2013-08-15 Thomas Werner Degen Systems and methods for treating chronic liver failure based on peritoneal dialysis
WO2013122580A1 (en) * 2012-02-15 2013-08-22 Sequana Medical Ag Systems and methods for treating chronic liver failure based on peritioneal dialysis
CN103492015A (en) * 2011-02-16 2014-01-01 塞奎阿纳医疗股份公司 Apparatus and methods for treating intracorporeal fluid accumulation

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4240434A (en) 1978-10-10 1980-12-23 Newkirk John B Peritoneo-venous shunt
US4657530A (en) 1984-04-09 1987-04-14 Henry Buchwald Compression pump-catheter
GB8824855D0 (en) * 1988-10-24 1988-11-30 Byrne P O Dialysis
US7776518B2 (en) * 2001-01-12 2010-08-17 Yale University Detection of survivin in the biological fluids of cancer patients
US8398577B2 (en) 2003-11-03 2013-03-19 Sequana Medical Ag Implantable fluid management device for the removal of excess fluid
US8202248B2 (en) * 2004-08-18 2012-06-19 Sequana Medical Ag Dialysis implant and methods of use
US20060094984A1 (en) * 2004-10-28 2006-05-04 Wood Nathan P Urine cell sample enhancement
US20090171241A1 (en) * 2006-03-03 2009-07-02 Garcia Maurice M System and method for urinary tract cell collection, diagnosis, and chemotherapy
CN201930383U (en) * 2010-12-08 2011-08-17 栾晓东 Double-cavity drainage device after breast cancer operation

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1636139A (en) * 2001-01-12 2005-07-06 耶鲁大学 Detection of survivin in the biological fluids of cancer patients
US20050273034A1 (en) * 2002-02-25 2005-12-08 Burnett Daniel R Implantable fluid management system for the removal of excess fluid
WO2004012806A1 (en) * 2002-08-02 2004-02-12 Potencia Medical Ag Apparatus for distributing liquid in a patient's body
US20110034986A1 (en) * 2007-07-18 2011-02-10 Chou Tony M Systems and methods for treating a carotid artery
CN103492015A (en) * 2011-02-16 2014-01-01 塞奎阿纳医疗股份公司 Apparatus and methods for treating intracorporeal fluid accumulation
US20130211322A1 (en) * 2012-02-15 2013-08-15 Thomas Werner Degen Systems and methods for treating chronic liver failure based on peritoneal dialysis
WO2013122580A1 (en) * 2012-02-15 2013-08-22 Sequana Medical Ag Systems and methods for treating chronic liver failure based on peritioneal dialysis

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EP3094233A1 (en) 2016-11-23

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