JP6000126B2 - 頭蓋内の非直交および直交の経路を通した医療装置の挿入および使用方法 - Google Patents
頭蓋内の非直交および直交の経路を通した医療装置の挿入および使用方法 Download PDFInfo
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- JP6000126B2 JP6000126B2 JP2012546147A JP2012546147A JP6000126B2 JP 6000126 B2 JP6000126 B2 JP 6000126B2 JP 2012546147 A JP2012546147 A JP 2012546147A JP 2012546147 A JP2012546147 A JP 2012546147A JP 6000126 B2 JP6000126 B2 JP 6000126B2
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Description
伝達に電極自身が使用される開示はない。
1.)フレームまたはフレームレス位置確認のどちらかで定位位置確認を用いて目標を識別する。
2.)構成の決定。例えば単一の電極、単一の目標の周辺に複数、単一のラインのいずれか(図7および図8参照)。
3.)1つのスタブ切開5〜10mm。
4.)部分的に2〜4mmの厚さの穿頭孔を穿孔する(これはドリルが角部で角度を持つことができるよう「縁部」を持たせることを可能にし、偏角の経路を得られる)。
5.)定位位置確認を用いて目標および中央部分的穿頭孔からの深さを識別する。
6.)目標に基き経路を設計し、パイロット孔を穿孔または自己穿孔、自己タッピングCranionTMを使用してCranionTM装置を挿入する。
6a.)パイロット孔の穿孔は孔の深さを正確に知ることを可能にするが、尖った先端部を取り除くことが可能なカニューレ挿入CranionTM(図9参照)も、硬膜外腔に入ったかどうか判断する発端を得られる。
7.)他のCranionTMを取り付け、それらを配線で接続(図9参照)または無線で接続する。またはヘッド装置を用いる。
8.)頭蓋骨から完全に出す必要がない追加のバッテリのような、他の構成要素を追加する。
9.)傷口を閉じる。
Claims (14)
- 挿入部位において皮膚、筋肉、組織、骨、または頭蓋骨を通して挿入されるよう構成された2つ以上のシャフトと、
前記2つ以上のシャフトのそれぞれに関連する、エフェクタまたはセンサを有する少なくとも1つの構成要素であって、前記少なくとも1つの構成要素のそれぞれが、前記2つ以上のシャフトのそれぞれの中に収容されること、前記2つ以上のシャフトのそれぞれを通過すること、または前記2つ以上のシャフトのそれぞれに装着されることのうち1つまたは複数により、その関連する前記シャフトに連結される、構成要素と、を備え、
前記2つ以上のシャフトのそれぞれおよびその前記関連する構成要素が、挿入部位において表面の接線に平行と前記挿入部位において表面の接線に垂直の間の角度および平行と垂直を含む角度で挿入されるよう構成され、
前記2つ以上のシャフトのそれぞれが、前記挿入部位において、全ての他のシャフトとは異なる経路で挿入されるよう構成され、
それぞれの前記シャフトおよびその前記関連する構成要素の長さが、他の前記シャフトおよびそれらの前記関連する構成要素と無関係であり、かつ前記挿入部位において皮膚、筋肉、組織、骨、または頭蓋骨の厚さに限定されず、
前記2つ以上のシャフトのそれぞれは、経路に沿って完全に挿入される場合に、前記シャフトの近位端が挿入部位を通過して、それにより別のシャフトが異なる経路で挿入部位を通じて挿入されることが可能となるように構成されている、
生体内の目標部位に効果を及ぼすように、または周辺のデータを収集するように構成された装置。 - 前記エフェクタまたは前記センサを有する前記構成要素が、バッテリ、電極、再充電器、発信器、受信器、送受信機、センサ、レコーダ、キャパシタ、変圧器、システム制御ユニット、プログラム記憶領域、アドレス/位置決めユニット、温度センサ、温度調節器、熱電素子、熱電発電器、機械動力発生器、光学/光発生器、紫外線光発生器、赤外線発生器、光学刺激装置、レーザ、高周波発生器、磁界発生器、機械振動発生器、超音波発生器、電界発生器、放射線発生器、燃料電池、薬剤送達ユニット、遺伝子療法送達ユニット、薬剤および放射性物質貯蔵部、および身体内に放出される物質貯蔵部からなる群から選択される、請求項1に記載の装置。
- 予め開けられた孔が存在しない場合、それぞれの前記シャフトが皮膚、組織、または骨を通して挿入されるよう構成され、前記シャフトが自己穿孔、および/または自己タッピングである、請求項1に記載の装置。
- 前記目標部位が患者の脳内であり、かつ前記エフェクタの効果が前記患者の脳へおよび、または前記センサを作動させる刺激が前記患者の脳から得られるように、前記エフェクタまたは前記センサが前記目標部位と通信する、請求項1に記載の装置。
- 前記骨が頭蓋骨であり、前記2つ以上のシャフトの長さは、
前記2つ以上のシャフトが
(i)皮膚、脂肪組織、結合組織、靭帯、腱、粘膜または筋肉内の頭蓋骨の表面
(ii)骨または頭蓋骨の中
(iii)硬膜外(硬膜上方)
(iv)硬膜下(硬膜下方)
(v)軟膜上(軟膜上方)
(vi)脳組織内、または
(vii)脳室または脳に関連する槽内
に取り付けられるような長さである、請求項1に記載の装置。 - 前記2つ以上のシャフトのうちの少なくとも1つに関連する少なくとも1つの構成要素が、前記2つ以上のシャフトのうちの少なくとも1つを通して挿入され、かつ、
i)機械的方向転換
ii)前記構成要素の強磁性または電磁先端部が、身体の内側または外側のどちらかで磁気または電磁気メカニズムにより誘発される磁界によって誘導、操縦、または移動される、前記構成要素の磁気的操縦
iii)目標への定位誘導
iv)内視鏡の視覚化および誘導
のメカニズムのうちの1つまたは組み合わせにより目標位置へ導かれる、請求項5に記載の装置。 - ヘッドユニットをさらに備え、
前記ヘッドユニットが、前記2つ以上のシャフトのうちの少なくとも1つを受け入れるようそれぞれ構成された1つ以上のドッキングステーションを有し、
ドッキングステーションのそれぞれが、1つ以上の孔または連結器を有し、それによって前記2つ以上のシャフトのうちの1つが、前記ヘッドユニットを通して挿入、前記ヘッドユニットに取り付け、連結または接続され、
複数のシャフトが、同一の前記ヘッドユニットを通して単一の共用の前記挿入部位で挿入され、かつ前記ヘッドユニットの周りを垂直に下側へ、半径方向に外側へ、または半径方向に内側へ異なる角度で方向付けられてもよいように、ドッキングステーションが前記ヘッドユニットの周りに半径方向に離間される、
請求項1に記載の装置。 - 前記ヘッドユニットが、複数の埋め込まれた構成要素、これらの前記構成要素を収容する前記シャフト、および/または装置を接続し、
前記ヘッドユニットが、共用の前記挿入部位を通して挿入された2つ以上のシャフトまたは前記2つ以上のシャフトに関連する構成要素の間の直接の電気的接触を可能にし、それによって前記2つ以上のシャフトまたは前記2つ以上のシャフトに関連する構成要素の間の直接の通信、接続、電力の移送を可能にする、請求項7に記載の装置。 - 前記効果が、電気、温度、磁気、光、超音波エネルギー、振動、極超音速エネルギー、電波、マイクロ波、および赤外線のうち1つ以上を用いて発生させられる、請求項1に記載の装置。
- 前記装置が、温度、光、密度、インピーダンス、電波、マイクロ波、および分光のうちの1つ以上に関するデータを収集するように構成される、請求項1に記載の装置。
- 前記2つ以上のシャフトのそれぞれが、
直線状、
湾曲、
骨または頭蓋骨の輪郭の湾曲にそって湾曲、
前記挿入部位を通して身体または頭蓋内へ突く螺旋内で湾曲、
挿入時、挿入プロセスの間形状を変更可能、
硬質、
少なくとも部分的に可撓性がある、
硬質な状態と可撓性の状態の間を変化、
尖った先端部を有する、
鈍い先端部を有する、
皮質骨を刺すのに十分尖ってはいない先端部を有する、
予め開けられた前記挿入部位内に容易に挿入可能な非外傷性の湾曲した先端部を有する、
螺刻かつ位置内にねじ込むよう構成される、
異なる分子を特異的に吸収、伝達、反発、および溶出する、選択的透過性素材で製作される、
中に埋め込まれるセルを有する、選択的透過性素材で製作される、
および/または
ナノ多孔質メッシュである、選択的透過性素材で製作される、
の特性を含む、他のシャフトと同様または異なる物理的特性を有する、請求項1に記載の装置。 - 少なくとも1つの前記エフェクタを有し、前記エフェクタが保護収容部内に入れられ、かつ収容部を通したエネルギーの伝達により組織の刺激が可能な、請求項1に記載の装置。
- 少なくとも1つの前記エフェクタまたは前記センサを有し、前記エフェクタまたは前記センサが前記シャフトの端部から突出、または前記シャフトの表面上に位置付けられる、請求項1に記載の装置。
- 前記目標部位は、患者の脳内であり、
それぞれのシャフトの長さは、経路に沿って完全に挿入される場合に、シャフトが患者の脳内まで到達しないように選択され、および
前記2つ以上のシャフトのうちの少なくとも1つの長さは、挿入部位における頭蓋骨の厚さよりも長い、
請求項1に記載の装置。
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PCT/US2010/061531 WO2011084788A2 (en) | 2009-12-21 | 2010-12-21 | Insertion of medical devices through non-orthogonal and orthogonal trajectories within the cranium and methods of using |
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EP2515750A4 (en) | 2009-12-21 | 2013-07-10 | Sherwin Hua | INSERTING MEDICAL DEVICES THROUGH NON-ORTHOGONAL AND ORTHOGONAL TRAJECTORIES IN SKULLS AND METHOD OF USE THEREOF |
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US20140194720A1 (en) | 2014-07-10 |
US9642552B2 (en) | 2017-05-09 |
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AU2010339720A1 (en) | 2012-07-05 |
AU2010339720B2 (en) | 2016-07-28 |
US10736533B2 (en) | 2020-08-11 |
US20120046531A1 (en) | 2012-02-23 |
CN102791185A (zh) | 2012-11-21 |
BR112012015108A2 (pt) | 2016-05-17 |
JP2013514870A (ja) | 2013-05-02 |
CA2785285A1 (en) | 2011-07-14 |
RU2012123549A (ru) | 2014-01-27 |
EP2515750A4 (en) | 2013-07-10 |
WO2011084788A3 (en) | 2011-11-17 |
US20180000372A1 (en) | 2018-01-04 |
EP2515750A2 (en) | 2012-10-31 |
MX2012007150A (es) | 2012-07-23 |
US9179875B2 (en) | 2015-11-10 |
US9820668B2 (en) | 2017-11-21 |
US20150245781A1 (en) | 2015-09-03 |
WO2011084788A2 (en) | 2011-07-14 |
US20180153429A1 (en) | 2018-06-07 |
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