JP2018534000A - 切除装置 - Google Patents
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
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- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
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Abstract
Description
本出願は、2015年10月20日出願の米国仮特許出願第62/243,961号、および2016年3月11日出願の米国仮特許出願第62/307,291号の利益を主張するものである。
[0003]本開示は電気外科的装置に関する。より具体的には、本開示は、アンカー特徴部を備えた切除装置に関する。
[0005]肺における組織の肺小結節、病変、腫瘍、および他のがん領域または前がん領域は、侵襲手術手技で治療するのが困難な場合があり、出血多量、感染リスク、空気漏れ、気胸、および他のそのような問題などの合併症が付随する。具体的には、肺の奥深くの領域は、従来方法を用いてアクセスするのが困難となり得、治療の難しさがさらに増す。
[0009]よって、本発明の一態様に従って、内腔を画定する内表面を備えた針と、針の内腔内部の第1の位置に位置付けられた第1の電極と、を含む医療装置が企図される。第1の電極は、針内部で第1の位置と第2の位置との間で移動可能である。第1の電極は、第2の位置では針の遠位端部を越えて延び、患者の解剖学的構造における組織の所定の部分に入り込む1つまたは複数のアンカーを含む。第1の電極は、第1の電極で組織の所定の部分を切除するために通電される。
[0024]図面を参照すると、本発明の原理を具体化する電気外科的装置が、図1Aおよび図1Bに例示され、10で示される。電気外科的装置10は、電極ハンドル12と、電極ハンドル12内部に位置付けられた針ハンドル14と、を含む。1組のリード線11が、電極ハンドル12および針ハンドル14から、例えば、コントローラ、ならびに電気外科的装置10に通電するために選択的に制御される電源へと、延びる。電極ハンドル12は、深さ設定器20によりシースクランプ22に連結される。電気外科的装置10は、電気外科的装置が例えば気管支鏡などの器具に接続されるのを可能にする、アダプタ26をさらに含む。
A)針30および電極31、131、または231を組織の所定の部分に挿入するために、医師などの電気外科的装置10の操作者は:
1)針ハンドルねじ16を締め、これにより電極ハンドル12を針ハンドル14にロックし;
2)針30および電極31、131、または231がシース28内に後退した状態で、患者に既に挿入されている気管支鏡に電気外科的装置10を挿入し、電気外科的装置10を気管支鏡アダプタ26により気管支鏡上にロックし;
3)シース28を前進させシースねじ24を締めて、シース28の深さを設定し;
4)電極ハンドルねじ18を緩め電極ハンドル12を移動させて、針30を組織の所定の部分内に位置付け;
5)針30および電極31を所望の場所に位置付けた後、すべての移動可能な構成要素が所定の場所にロックされるように、電極ハンドルねじ18を締めて電極31を深さ設定器20にロックし、電極31の移動を防止し;
6)針ハンドルねじ16を緩めて針30を電極ハンドル12内部でスライドさせ;
7)針ハンドル14を後ろにスライドさせて電極31を露出させ、針ハンドルねじ16を締めて針ハンドル14を所定の場所にロックし;
8)電気外科的装置10に連結された発電機を用いて組織を凝固させ;
9)食塩水を食塩水マニホールドに通して電気外科的装置10に送り込み;
10)工程4〜9を必要に応じて繰り返し、組織の所定の部分を凝固させる。
1)針ハンドルねじ16を緩め、針ハンドル14を前にスライドさせて、電極31、131、または231を針30内部に完全に捕捉し;
2)針ハンドルねじ16を締めて、針ハンドルおよび電極ハンドル12を共にロックし;
3)電極ハンドルねじ16を緩め、電極ハンドル12を移動させて針30を後退させ;
4)針30および電極31、131、または231がシース28内へと完全に後退したら、電極ハンドルねじ18を下方に締め;
5)すべての移動可能な構成要素が所定の場所にロックされるように、シースねじ24を緩め、シースを後退させ、その後、シースねじ24を再び締め;
6)気管支鏡アダプタにより電気外科的装置10を気管支鏡からロック解除し;
7)電気外科的装置10を気管支鏡から引き抜く。
Claims (15)
- 患者を治療するための電気外科的装置であって、
内腔を画定する内表面を備えた針と、
前記針の前記内腔内部の第1の位置に位置付けられた第1の電極と、
を含み、
前記第1の電極は、前記針内部で前記第1の位置と複数の他の位置との間を移動可能であり、前記第1の電極は、前記複数の他の位置で前記針の遠位端部を越えて延び、
前記第1の電極は、前記複数の他の位置のそれぞれにおいて、前記位置が前記針から最も離れた状態で始めたときに、前記第1の電極で組織の所定の部分を切除するために通電される、電気外科的装置。 - 前記針が第2の電極として作用し、前記第1の電極が前記組織の所定の部分を切除するために前記複数の他の位置にあるときに前記組織の所定の部分に所望レベルのエネルギーを送達するように前記第1の電極および前記針が配列される、請求項1に記載の電気外科的装置。
- 前記針を前記第1の電極から電気的に絶縁する絶縁体をさらに含む、請求項1に記載の電気外科的装置。
- 前記針が前記針の外部にエコー源性特徴部を有する、請求項1に記載の電気外科的装置。
- 前記エコー源性特徴部が、前記針の外部の一部に沿って離間した複数の円形スロットである、請求項1に記載の電気外科的装置。
- 前記第1の電極が、前記針の前記内腔を通って延びるワイヤに取り付けられる、請求項1に記載の電気外科的装置。
- 前記ワイヤが形状記憶合金で作られる、請求項6に記載の電気外科的装置。
- 前記形状記憶合金がニチノールである、請求項7に記載の電気外科的装置。
- 前記第1の電極が、前記第1の電極および前記ワイヤにクリンプされたチューブによって前記ワイヤに取り付けられる、請求項6に記載の電気外科的装置。
- 前記チューブがエコー源性特徴部を含む、請求項9に記載の電気外科的装置。
- 前記エコー源性特徴部が、前記チューブの外部の周りに分布した複数のくぼみである、請求項10に記載の電気外科的装置。
- 1つまたは複数のアンカーのうちの少なくとも1つが、前記組織の所定の部分に入り込む先端部と、前記第1の電極を前記組織の所定の部分に結びつけるために前記組織の所定の部分上に留められる湾曲部材と、を含む、請求項1に記載の電気外科的装置。
- 患者の解剖学的構造における組織の所定の部分を治療する方法であって、
第1の電極を針の内腔内部に位置付ける工程と、
前記針の遠位端部を前記組織の所定の部分に位置付ける工程と、
前記第1の電極が前記針の前記遠位端部を越えて延びるように前記針を前記第1の電極に対して後退させる工程と、
前記組織の所定の部分を前記第1の電極で切除するために前記第1の電極に通電する工程と、
前記第1の電極を前記針の近くの位置に移動させる工程と、
前記組織の所定の部分を前記第1の電極で切除するために前記第1の電極に通電する工程と、
を含む、方法。 - 前記針が第2の電極として作用し、前記第1の電極が前記組織の所定の部分を切除するために所定の位置にあるときに前記組織の所定の部分に所望レベルのエネルギーを送達するように前記第1の電極および前記針が配列される、請求項13に記載の方法。
- 1つまたは複数のアンカーのうちの少なくとも1つが、前記組織の所定の部分に入り込む先端部と、前記第1の電極を前記組織の所定の部分に結びつけるために前記組織の所定の部分上に留められる湾曲部材と、を含む、請求項13に記載の方法。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
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US201562243961P | 2015-10-20 | 2015-10-20 | |
US62/243,961 | 2015-10-20 | ||
US201662307291P | 2016-03-11 | 2016-03-11 | |
US62/307,291 | 2016-03-11 | ||
PCT/US2016/055338 WO2017069940A1 (en) | 2015-10-20 | 2016-10-04 | Ablation device |
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JP2018534000A true JP2018534000A (ja) | 2018-11-22 |
JP6995041B2 JP6995041B2 (ja) | 2022-01-14 |
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JP2018512242A Active JP6995041B2 (ja) | 2015-10-20 | 2016-10-04 | 切除装置 |
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US (1) | US11039879B2 (ja) |
JP (1) | JP6995041B2 (ja) |
CN (1) | CN108135655B (ja) |
DE (1) | DE112016003790B4 (ja) |
GB (1) | GB2557813B (ja) |
WO (1) | WO2017069940A1 (ja) |
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GB2567764B (en) * | 2016-08-30 | 2021-11-24 | Gyrus Acmi Inc | Medical device handle lock |
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DE112016003790T5 (de) | 2018-05-09 |
US20180344389A1 (en) | 2018-12-06 |
GB2557813B (en) | 2020-10-28 |
WO2017069940A1 (en) | 2017-04-27 |
US11039879B2 (en) | 2021-06-22 |
GB2557813A (en) | 2018-06-27 |
JP6995041B2 (ja) | 2022-01-14 |
DE112016003790B4 (de) | 2022-06-09 |
GB201805244D0 (en) | 2018-05-16 |
CN108135655A (zh) | 2018-06-08 |
CN108135655B (zh) | 2021-08-06 |
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