Patent Application
20090105695
The invention relates generally to a device for the treatment of tissue, and more particularly to a device for treatment of human or animal tissue by means of a magnetically movable instrument.
During the treatment of human or animal tissue, in particular during minimally invasive operations or even during therapies, instruments are often introduced into the body and have to be moved at a site of application. Additionally, it is often necessary to perform mechanical work at the site of application. Typical examples of this are the devitalisation and/or removal of tumour tissue. Another typical example is the treatment of a cholecystolithiasis (gall-bladder stone) or the removal of nephroliths from kidney tracts or urinary tracts. In many cases, working with an endoscope is problematical because the movement of the actual instrument seated at the distal end of the endoscope presents problems.
Accordingly, a device that facilitates the movement of an instrument within a body or an area of tissue without a mechanical connection to the exterior is desired.
In disclosed embodiments, a commercially available device, for example a magnetic resonance tomograph (MRT) (e.g., a nuclear magnetic resonance tomograph), generates a strong, static magnetic field which is used, in conjunction with a separately generated magnetic field of a conductor loop through which current flows, to generate a force which is applied to the instrument. This force can in turn be used to move the instrument within the body or tissue and also to effect mechanical work on the tissue.
If an MRT is used, the entire treatment can be simultaneously observed using imaging techniques. Thus, “two birds are killed with one stone”, because the magnetic field on the one hand forms the basis of the imaging technique and is used on the other for performing mechanical work.
Movement of an instrument within a body or an area of tissue without a mechanical connection to the exterior may be achieved by a device by means of a movable instrument. The device comprises a means (e.g., an MRT) for generating a magnetic stator field in which the tissue is located. The device further comprises at least one conductor loop on or in the instrument and a generator for generating a current that flows through the conductor loop in order to generate a magnetic useful field which, in conjunction with the stator field, generates a resulting action for applying a useful force to the instrument. An explicit means may be used to generate the required stator field. Accordingly, the means for generating the magnetic field is not restricted to an MRT.
Disclosed embodiments may include a plurality of conductor loops arranged respectively at a certain solid angle with respect to each other (e.g., three conductor loops arranged at a solid angle of 90° with respect to each other). The generator for supplying a current that passes through the conductor loops is provided and designed in such a way that the direction and magnitude of the useful force can be adjusted. This facilitates better “maneuvering” of the instrument.
In disclosed embodiments, the generator for generating an alternating current is designed so that the instrument can execute vibrations. It may be of advantage to design the generator in such a way that the frequency of the alternating current can be adjusted to a resonance frequency of the instrument. In order to utilize a mechanical resonance of this kind, it is possible to generate relative high vibration amplitudes even with a low energy input. If the generator is designed to supply an additional direct current component, a “net propulsion” can be generated so that, for example, the instrument does not have to overcome any static friction on the one hand but, on the other, experiences a propulsion component so that it may be maneuvered to a target site.
Alternatively (or additionally), it is possible to design the generator for generating a rotating field and the instrument in such a way that the instrument or drilling or milling parts located thereon may be caused to rotate. Different movement components or force components may coincide in such a way that in addition to a rotating movement, a vibrating (striking) movement occurs.
A magnetic resonance tomograph may be used for generating a stator field for an electrical machine to drive a surgical or therapeutic instrument.
In the following discussion, example embodiments are explained in more detail with reference to the enclosed drawings.
In the following description, the same reference numbers are used for identical parts and parts with identical functions.
In
An instrument 10 is located in the hollow organ 1. Three conductor loops 11, 12 and 13, which are shown to be coils for illustrative purposes, are arranged in the interior of the instrument 10. The directions of the coils 11-13 are depicted schematically in the X, Y, Z coordinate system.
The three conductor loops 11-13 are connected by a lead 15 to a generator 20, which can pass current through each of the conductor loops 11-13 individually so that, in conjunction with the static magnetic field B, a resulting force forms on the instrument 10. The generator 10 may pass current through the conductor loops 11-13 in such a way that the instrument 10 on the one hand experiences a force component in the X-direction (that is in the direction of the hollow organ 1), and, on the other, this uniform force is superimposed by a vibration which causes the instrument 10 together with a milling head 14 located on its tip to vibrate in the direction of movement. Additionally, a torque can be generated by the application of a suitable rotating field to the conductor loops 11-13, so that the instrument 10 (or optionally only the milling head 14) rotates. In this way, for example, an object (e.g., a kidney stone) located in the hollow organ 1 can be comminuted.
In addition to the generation of the dynamic action with the aid of the static field B, an electromechanical transformer 16 (e.g., an ultrasonic vibrator) can be provided in the instrument 10. The generator 20 passes a current through the electromechanical transformer 16, causing the milling head 14 to vibrate (e.g., ultrasonically).
In
The active region experiences a torque in the clockwise or counterclockwise direction depending on the instantaneous current direction. The active region is deflected in the corresponding direction due to the elasticity of the shaft 17 (and parts of the device attached therein). The degree of the deflection is determined by the elasticity of the shaft 17, the magnitude of the current, the magnitude of the magnetic field, and the angle adopted by the axis of the conductor loop 11 with respect to the direction of the magnetic field lines.
Consequently, an alternating current flowing through the first conductor loop 11 can cause the active region to vibrate. With a suitable choice of current frequency, relatively high amplitudes can be generated with a relatively strong current in such a way that they correspond to the resonance frequency of the shaft 17, which is defined by the elasticity of the shaft 17 and the mass distribution within the shaft 17 (active region to inactive region).
The lead 15 may be constructed coaxially outside the active region, so that the Lorentz forces formed by the current flowing in the magnetic field cancel each other out.
In an embodiment, the instrument is designed as a needle-shaped probe, so that the active region is introduced into the target tissue to be treated. In this embodiment, the vibrations generated are transferred into the adjacent and surrounding tissue, so that the mechanically generated energy is converted into thermal energy there. The resulting heat can be used for the selective thermal devitalisation of tumour tissue, for example. The cell structures of the target tissue may be mechanically destroyed by the vibrations of a corresponding frequency in order to effect the devitalisation or defragmentation of the tissue.
It will be recognized by persons skilled in the relevant art(s) that the different individual ideas described above in connection with the first and second embodiments can be combined.
| Number | Date | Country | Kind |
|---|---|---|---|
| 10 2006 019 680.5 | Apr 2006 | DE | national |
| 10 2006 029 455.6 | Jun 2006 | DE | national |
This application claims the benefit of the filing date of International Patent Application No. PCT/EP2007/003659, filed Apr. 25, 2007, which claims the benefit of the filing date of German Patent Application No. 10 2006 019 680.5, filed Apr. 27, 2006, and German Patent Application No. 10 2006 029 455.6, filed Jun. 27, 2006. International Patent Application No. PCT/EP2007/003659, filed Apr. 25, 2007, is incorporated herein by reference in its entirety.
| Filing Document | Filing Date | Country | Kind | 371c Date |
|---|---|---|---|---|
| PCT/EP07/03659 | 4/25/2007 | WO | 00 | 10/24/2008 |
