外国特許コード F180009663
整理番号 1710
掲載日 2018年11月21日
出願国 世界知的所有権機関(WIPO)
国際出願番号 2008JP054025
国際公開番号 WO 2008108425
国際出願日 平成20年3月6日(2008.3.6)
国際公開日 平成20年9月12日(2008.9.12)
  • 特願2007-055868 (2007.3.6) JP
発明の概要(英語) In a probe-type device for removing a body tissue, both of the reduction in the probe diameter and the improvement in the removal efficiency can be established and, furthermore, the cost and maintenance properties are also improved owing to a simplified structure. A probe-type device for removing a body tissue via suction having a probe unit comprising a probe, which is in the shape of a narrow tube and has an opening for sucking the body tissue thereinto, and a cutter, which is provided within the above-described probe and by which the body tissue having been sucked from the opening of the above-described probe into the probe is cut into small pieces; wherein a sucking power supplier for supplying a sucking power to the above-described probe unit and a cutting energy supplier for supplying a power or energy for driving the function of the above-described cutter are connected to the above-described probe unit, and the above-described probe is inserted into the body tissue which is then sucked via the above-described opening and cut with the above-described cutter, characterized in that the above-described probe has a plurality of openings.
従来技術、競合技術の概要(英語) BACKGROUND ART opthalmologic of recent of the surgical field, for example Cataracts is in operation, the post-operative astigmatism after surgery is reduced, the wound healing of early , flame of the eye in the decreased, of the invasive surgery for reducing, the procedure of surgical incision Nfrg to the development and is respectively. Moreover, the retinal surgical hyaline also in the body, the plaque yellow hyaline body with respect to the circle hole surgery, boundary ESWL in the peeling film, under queyrat Buprenex yellow, yellow queyrat ESWL movement, the nipple Papilledema episiotomy ESWL of the surgical procedure such as new to the development and is respectively. postsurgical keratometers reduced to the same, the wound healing of early , eye of decrease in the flame, surgical infestations of reduced to small incision of for a surgical procedure is proposed by with which the respectively.
Such as surgical this procedure to be in the for the, such as biological tissue of the eye to body is inserted into the glass and the like of the gel-tissue and off while the fine probe to remove the suction of tissue biological -cut to provide the device with which the respectively. The probe-tissue ablation device is a living body, tissue of the eye such as a gel to the biological tissue is inserted in the tubular shaped probe to a, the side of the probe provided hole opening from the living body tissue to the suction and off while the thin and can be removed by suction to, such as a biological transvitreal of the tissue to cut to.
body of glass such as biological tissue is in the form of gel molecule is biological to fibrous and are linked to. For this , the biological tissue to the order to the ablation, the opening hole tissue from the probe to within the portion of the suction to draw and at the same time, the draw tissue which cut off a portion of the pores in the in the probe is necessary is performed. The disconnection of fine is as a method, the driving of the cutter machine blade to the equation is used (for example Patent Document 1) and method, a method using a laser light (for example Patent Document 2) and is present. In addition, in order to increase the efficiency of the ablation to both the user and in combination with the method is also (e.g. 3 patent document).
In addition, the tubular probe probe or in the form of a held in the hand holder to portion including the portion is determined to be the name of the defined does not, the chip contact or the like of the hand piece called and also the and respectively.
DISCLOSURE TECHNICAL PROBLEM and the above-described conventional technique of to the next is such a problem as the which is even . First, in a portion of the probe to specifically to draw the biological tissue which system of the machine as the state of the fine driving of the cutter blade the formula used is also of , within the probe and movable to incorporate a mechanism for, when the pore diameter of the probe is difficult in and, further, and the complexity of the structure by high and the burden on the cost of maintenance and increase , degradation of the cutter blade such as a decrease in sharpness due to the problem is that even .
On the other hand, as a method off fine of the laser light is used also , ablation is not necessarily high efficiency is the problem that even . Thus, for example as described in the patent literature 2 is in the state of the, laser light emitted from the surface of the to the flat shape and, the flat surface of the opening to the exit of the hole in the upper portion of the wall along the probe to such as can be the row and the ending are . However, the probe structure of this fine to prevent thinning.
efficiency for the cut, the cutter blade is used even method and is not sufficiently specifically, the metal catalyst and improved are to the alphabet. Therefore, as in the patent literature 3 of, in combination with the system to both the proposed method and also to the respectively , this is the case , probe in both the configuration of the system can be incorporated to made for, when the diameter of the narrow probe and the like is difficult to further, a machine cutter blade type of the used drive is the problem and the enlarged will.
Of the probe diameter is a pore , for example by cutting with the above-described minimum of the surgical procedure is a very important in is a problem in that , and the above-described conventional probe of the biological tissue ablation device type is also any , the diameter of the narrow probe is difficult in that the problem has a was not.
Incidentally, the pore diameter of the probe can be of a living body and to be of the reduction in the invasive . On the other hand, a pore diameter of the probe by probe also to decrease the rigidity. site that is used by the lower rigidity can be handled by by the operation of the poor efficiency, is also the effect of lowering . In addition, the pore diameter by cutting may decrease the efficiency of the results themselves. is to result, the suction hole of the probe and the cutter by closing the blade by the mechanical cutter in the formula is in the closing cycle is cut rate can be suppressed by the suction the biological tissue are the many and , ablation is to improve the efficiency the present method. However, for example, ophthalmic surgical of the retina when the surgical of the glass body to the , the suction by the vitreous and to many of the body, the suction force by the retina and the towing is high and there is a possibility that due to the, such as damage to the retina is to provide a possibility to have the problem of the safe is generated. Therefore, the cut and raised rate such as the suction force be suppressed to a biological tissue cutting the influence of other than to suppress such is taken by the method of the, the cut rate of increase for such a structure of a machine built also to control to be difficult- which is even.
invention is the present invention, to solve the problem described above of the and for which such in the even and the , the purpose is , ablation probe biological device-tissue diameter of the pores in the probe and to improve the efficiency of the ablation and to achieve both the, further reduction of the structure by simply low-cost and maintenance of improved -also to be possible in certain to.
Is provided to present TECHNICAL SOLUTION invention to solve is the following means as in the invention. (1) A to form the capillary and the biological to the tissue inside the opening of the suction hole for a probe unit to which the, wherein the probe is provided in which the opening of said probe from the probe within the hole to by suction and the biological tissue to to the fine pore cut off and the device which provided the probe has , the biological tissue through a probe suction force to suction and remove to the probe The suction force is supplied to the supplying device, and, the function of the state of the fine to exert a power probe or to the energy supplied to said for the interruption of the driving source of the pore is supplied to the device , the probe And the connected , the probe to the biological tissue and the inserted hole through the opening portion of the biological tissue while the suction and in the state of the pores means the pore and removing the suction the disconnection of the probe-tissue ablation in the living body or the device, the opening of the probe hole provided with a plurality of parts can be characterized and to the tissue ablation probe-biometric device.
(2) The method of the probe opening portion of the hole number, hole shape of , the size of the hole or holes of the position of the at least one of whether any to which the variable are configured to be and the probe features of the described (1) biometric device-tissue ablation. (3) The method of the probe in the form of tubule in the outer circumferential surface that is in contact with the surface as the probe and the movement in the said adjusting is possible to fit the opening with the adjusting hole has tube, the opening of the adjusting hole adjusted to move the tube can be by , the opening hole by adjusting the tube opening of the probe hole and the degree of closing unit The adjusted probe and the opening of the hole number of , the shape of the hole , the size of the hole of the at least whether any one can be a change to the described (2) features and of the biological tissue ablation probe type device. (4) The adjusted tube to the opening hole for adjusting the opening hole is provided and provided to, the movement of the adjusting opening tube and adjusted, the adjusting hole and for opening hole opening of a probe according to the degree of overlap and can be adjusted to in a , the opening of the probe portion of the hole number, hole shape of , the size of the hole or holes position of at least any one of or a change to be and the described (2) features of the living body tissue exsection type probe apparatus.
(5) The method of the fine means is interrupted, the in-pipe surface of the probe to the outer circumferential surface is in contact with its to as the probe and in the longitudinal The to the moving direction to be reciprocating provided with the pores in the interruption of the blade even , in the reciprocating off of the thin blade is moved to the the biological tissue The pore to pore the interruption of the interruption of the blade to be of fine by the state of the is to be characterized at description (1) of the probe and the living tissue excised type device. (6) The off the fine means, wherein the opening of the probe space inside of the hole portion to the laser beam toward unit to the emitted light has a light guide body, the light emitted from the light guide body the laser light is in the living body tissue The fine to the interruption can be also of a feature in certain description (1) of the probe and the living tissue excised device type.
(7) The light guide body is , wherein the probe is provided in which in the optical fiber and , the light of the optical fiber probe and between the inner wall, which is off the fine tissue of the biological intake, the discharge path is formed which can be characterized in that the are a of the probe and the described (6) tissue exsection -biometric device. (8) The outside diameter of the probe 20G is greater than or equal to be at (equal to or less than about 0.9mm) and the feature of the described (1) biological tissue ablation probe device type.
(9) The method of the biological tissue for the disconnection of the narrow laser light as Er: YAG laser, Ho: YAG laser, Nd: YAG whether any of the laser used and by the feature description (6) of the biological tissue exsection type probe apparatus.
(1 0) The light guide body is , quartz fiber is in - or sapphire to be characterized and the described (6) of the biological tissue ablation probe device type.
(1 1) Capillary and the living-tissue with respect to the inside of the suction for the opening of the hole with a unit and the probe, wherein the probe is provided in which the opening of the probe from the probe within the hole to which the suction and the biological tissue to a narrow pore is interrupted and the interruption of the device with the probe in a and, the probe through the living body tissue to the suction force to suction removal of the probe to the supplied force supplied to the suction device, and, the disconnection of fine to exert a function of the device power or energy to probe supplied to in the order of the fine driving device off the supply source, wherein the professional And connected to the baby unit , the probe to the biological tissue the insertion opening and said biological tissue through hole and the suction The interruption and while in the fine pores and means for the disconnection type suction probe to remove tissue ablation to biological are used to probe the device in the even , the opening of the probe provided to a plurality of holes which unit can be characterized and to the the probe unit.
ADVANTAGEOUS EFFECTS probe-tissue in the biological probe apparatus of the ablation exsection and the pore diameter to improve the efficiency of both the and can be achieved, and further by simple structure of a low-cost of maintenance and can also achieve the improved. action/effect of the other is for , as described herein and the appended claims of the to the drawings in the callus.
BEST MODE Fig. 1 is, according to the present invention probe- device of the biological tissue ablation in one embodiment the shown. To the same probe type shown in Fig. a living body tissue is excised device, probe 10 unit, holder 30 unit, the light source laser 40, such as by a suction device is 50 and the are . The suction 50 apparatus is, wherein the biological tissue through a probe 10 removing the suction force to suction the probe supplied to the suction force corresponds and is supplied to the device, the light source is laser 40, the probe and to which a the laser light to be described later using of the pores to the state of the device to operate a function of the energy probe for the supply of the the interruption of the supply source for driving small to the corresponding device. In addition, one of the device is this , the chip contact or the hand piece also referred to as such and which are to be , according to the present invention also device thereof in the same object and can be used in certain .
Is probe 10 portion, and probe 12, disposed in the inside thereof and and the light is configured by the fiber 20 and, attached to the mounting fixture to 16 respectively. 12 SUS of the probe such as the corrosion of the metal capillary - and is used to form the respectively . This 12 is the probe, the end mounting unit group is attached to the fastener are 16 on the other hand, the side close to the tip unit to a plurality of opening portion of the hole is provided with the unit 14 respectively.
Probe 12 20 to the optical fiber is in the inserted coaxial and the like in the are . The light is laser light 20 fiber to the light guide and emitted to form the light guide body in the even of also, the surface of the light emitted from the laser is formed on the surface of the tip opening of the hole inner 14 unit to the space are facing unit. That is, the tip of the probe laser 12 direction emitted light to the to .
10 unit is in the probe, and the suction port is provided with 18 and are, connected to the fixture and the pinna 32 holder unit (hand and is also referred to as piece) 3 0 can be connected to the detachable is the as is in the being . By this, the probe can be detached from the unit 10 in the probe is exchanged components used can be as , or replacement of a new probe 12 to the application in response to the probe 12 to the simple editing of the can becomes to such. this case, the probe is , the ablation probe 12 device can be mounted in the detachable to the minimum of the member for (jig member such as a boss or fixture) as the only possible to a if, and a portion of the minimum replacement and the economy is achieved can be can be.
18 port is sucked, the suction of the flexible tube and flexible 52 50 and the suction device via the communication passage is connected to and are on. In addition, the holder is 30 unit, the laser light source is from output 40 laser light pulse in the form of a flexible-flexible transmitted to the light guide and the optical cable is drawn 42 respectively.
Probe holder 30 10 portion and in between is of the, both connected to the fixture via 32 and the connected state and the optical emission of the light guide at 42 in light of the probe 12 fiber light input to light 20 to the light coupler is formed (shown omitted ) as is to the is are on.
guide the light in the light body is in the optical fiber probe 12 20 is coaxial to the through-the and that are, in the light of the optical fiber probe 12 20 and is in between, and the pore biometric off the tissue of the intake, the discharge path is formed which are on. The outside diameter of the probe is 12 20G or more of the pore diameter (less than about 0.9mm) to the formed is, the side close to the tip unit is in and the plurality of independent 14 hole opening adjacent each other and the portion to which the provided respectively.
invasive biological to that of the viewpoint of low 12 25 g is from the probe of the pore diameter (about 0.5 mm) of the even is preferred. However, due to the rigidity of the narrow diameter lower of handling by the efficiency, the effect of lowering the suction and also, efficiency is a priority the rigidity to be 20 g it is preferable that (about 0.9 mm). Moreover, cases by is, low-invasive and efficiency, and the effect of the consideration to balance and the intermediate 23 g that is of the appropriate selected (about 0.6 mm) are the .
Is a laser light source 40, and particularly not limited to the is is, the water absorption and to easily laser light wavelength of the oscillation is to be a particularly desirable , to a specific is, Er: laser YAG, Ho: laser YAG, Nd: YAG are suitable to the laser. In particular, Er: YAG is a laser, the absorption coefficient for water 2.94μm a specific wavelength in the vicinity of a high laser oscillation of the light to, including many biological the moisture to the tissue, tissue to the peripheral thermal influence of the base resin is not possible from and preferably also in, the, particularly the eyeball portion of a large transparent tissue by the heat of the tissue is opaque and also- , use of the present invention to to suitable is the most are.
20 as the optical fiber, generally of the laser beam of the transmitted efficiency may be selected of the even and the , quartz or sapphire is preferably - fiber, Er: when the laser beam used to YAG is, transmission efficiency may be a sapphire fiber of the - particular preferred.
Of the above configuration is as and the biological tissue ablation probe device type in the , such as the eye tissue 12 probe of the biological tissue in the form of gel to and in the inserted state, in the probe by suction 12 50 device of the suction and while, opening a hole in the side space 14 unit to the laser beam toward the optical to a pulse-emitted for .
By this, a part of the living body tissue 14 12 probe from the opening hole in the portion drawn by . to the drawn portion of the tissue which the light is laser by the narrow pulse is off. Is off and the fine 12 tissue from the probe is within the piece of flexible-flexible suction 52 and the suction tube through the device is removed in the suction 50 . In addition, the laser light to the living body tissue and the case where the irradiation, the biological tissue of the hyaline such as a fiber also in the case of soft to the present invention, the biological tissue layer of fibers of the binding between the molecule and the separated , such as the liquefied and to the suction state is removed can be made to the is.
And to the as the biometric and to cut the tissue is going can be is in the can of the , the mechanisms of ablation is, in the conventional basic of the device to be of the same is in the . However, the interest should be in to is, in the biological tissue to the probe 12 to draw the opening portion of the hole is 14 unit, in a conventional one which is to the, in the present invention is the multiple is divided and are provided to be in the certain to.
is conventional, the gel-tissue efficiency as well as biological is for the cut-in, the tissue in the biological probe to be pulled in the efficiency of pore need to be off in the and, that is to the probe for opening hole is provided of a diameter of the opening portion can be increased to of the can in effect and is considered the to the not.
However, this is the actual user invention to know et al. and according to the at and, the opening of the hole opening to the large diameter and to cut efficiency is also improved by not necessarily and is found and the . Further, it is believed that in the conventional is the contrary, the present invention is user et al., the opening diameter of the hole open 14 unit to the small and even , the opening of the hole small 14 can be provided a plurality of portions of the lateral , to improve the efficiency of the ablation that contribute to the increase of the to be reached to know with.
this is, in the conventional technique is no surprising and could be expected to not even know in which such is , such as new to know this based on the configuration and which is in the embodiment of the probe-tissue exsection the biometric device, the driving of the cutter machine equation using a blade such as by simply not structure, a pore diameter of the probe and low 12 is possible to cost- are to become . and thereby, to significantly cut efficiency is improved to be a possible cause and in which.
A plurality of opening holes 14 unit to be divided and provided by the ablation is to improve the efficiency for reasons is, although not necessarily in the is, for example such as the next of the can used is considered . That is, a plurality of living body tissue is opening 14 small hole in each divided unit is in a state in which the in the probe is retracted 12 . this order, the interruption of the laser light by fine is that the tissue and the divided to the individual for a portion over a row is to made as . this time, laser light is fine off by one of a large tissue portion of collectively performed with respect to the even more , and the divided small of the plurality of individual tissue performed with respect to the portion to the lateral , efficiency can be improved and the row is ending be used. In the case of the latter is further , which is fine and the tissue disconnection piece of small size can be made by is, the suction is removed to smooth be made and used. These together so that the ablation phase of a greatly improved efficiency when is achieved is considered and also of the used .
In any case , suction 12 provided to probe for hole opening of the plurality of unit 14 to be divided and provided in the , structure and complexity of the associated not possible, the probe diameter of the very fine 12 suitable to the configuration in which with the , the cut to greatly improve the efficiency is to be to be in.
2 the opening is a hole in the example of the configuration shown in 14 . According to the present invention in apparatus is, of the same (a) - (d) Fig. to as shown in, the opening is at least one hole 14 2 unit to which the one or more the divided are provided to the . this case, the same shown in Fig. of to as, the opening is only one hole 14 portion when the opening diameter of the is large can be , is cut open efficiency than the diameter of the opening also 14 divided into the number of the holes to be increased is dependent on the and has been found.
Fig. 3 is, the probe of the opening of the hole 12 14 installed and the number of the cut graph the relationship between the characteristics-and are shown. In the same graph A-E Fig. each line is, (a) - (e) of Fig. 2 12 in which the probes shown in the eye tissue pig exsection (hyaline body) of the case of the ablation is performed exsection and time (horizontal axis ) of the relationship between the amount of the (vertical axis ) shown. of the insulator body in the cutting efficiency pigs eye evaluation weight glass body is cut, before the cutting of the pig from the eye of the entire weight of a cut after the weight measurement and, to reduce the amount of the vitreous and weight and a cut-out, and the time of the comparison . Each probe is also any , the outer diameter of the tubule 0.9 mm (inner diameter 0.58 mm) and the used , off of the laser beam for fine Er is the source: used by the laser YAG . Laser light is laser 80mJ output, a pulse in the period 5 0msec of the outside diameter 0.44mm of the light emitted through the optical fiber and the .
Is a graph respectively A-E line, the- (a) Fig. 2 12 shown in the probe of a characteristic showing the ablation , the comparison of graph line A-E such as to be apparent from, the plurality of opening holes 14 is provided by which the Fig. - (a) (d) of 2 12 is also any of the probe, the single opening of the hole is 14 2 are provided (e) of the probe with respect to Fig. 12, ablation efficiency is greatly improved to and are provided to the. In particular, one of the hole 6 is opening 14 which are provided in the Fig. (a) of the probe 2 12, the one of the hole opening 6 14 area of the total opening unit is, the opening of a single 2 Fig. 14 area of the hole and opening unit is substantially the same in the , is cut at the very efficient which is a large difference appears .
Next, (1) the material of the light fiber by cutting 20 efficiency of the difference of the difference method, (2) the state of the pores by efficiency difference of the cut, (3) the two opening holes 1 portion of the case (prior art) and one of the (present) 6 by the difference of the case and the efficiency of the ablation of the difference measure to the application for , or a combination of test of which is carried out. That is, first, the light guide body as , by using a quartz fiber and - in the case where, by using a sapphire fiber and - if the test and to separately with. When the laser light is of , Er-YAG 2.94μm wavelength of the laser by using an a - - . In addition, in the case where this , as also as the second probe 10 may be of the type of the test of the divided and the . That is, in the embodiment shown in of laser light was in a narrow glass off of the body, the liquefied so-called laser cutter is used for the insulator body when the and, in a machine of small tissue to a so-called off cutter to machine by using the formula of the case and the case is in the second as . Further, the number of opening holes 1 unit is one in the case of conventional and is, in the case of one of the 6 of the present and the case in which the test was separately . When this , opening a hole in the one 1 unit is in the case(...)
  • 出願人(英語)
  • ※2012年7月以前掲載分については米国以外のすべての指定国
  • Kyoto University
  • 発明者(英語)
  • HANGAI, Masanori
  • YOSHIMURA, Nagahisa
  • NAKAHARA, Masaaki
  • MIYATA, Kazunori
  • EGUCHI, Tetsuya
  • OSAKABE, Yasuhiro