This patent application claims priority from Italian patent application no. 102021000003197 filed on Feb. 12, 2021, the entire disclosure of which is incorporated herein by reference.
The present invention relates to a diagnostic device and system and a method for the production thereof.
In particular, the present invention relates to a diagnostic device for performing endoscopic clinical examinations. More specifically, the present invention relates to a diagnostic device for carrying out clinical examinations of the esophagus, stomach, intestine or similar. For example, it is also possible to use the diagnostic device according to the present invention to perform different types of clinical examinations, such as cardiac examinations.
Advantageously, the present invention finds application in the diagnostic procedure of esophageal manometry.
The use of endoscopic diagnostic devices in clinical examinations is known, which are introduced into a cavity (esophagus, stomach, intestine, uterus, circulatory system) of the human body through natural orifices (nose, mouth, rectum and similar) or through artificial orifices (namely, passageways created by incision of the human body to access certain cavities) to acquire the information required for the respective diagnostic examination to be performed. Once the diagnostic device has been inserted into the patient's body through the orifice, the diagnostic device must follow a path inside the cavity which can be particularly tortuous.
For example, for an esophageal manometry, the diagnostic device must follow a path that has several bends which may require the diagnostic device to be bent at an angle of even more than 30°.
To carry out the esophageal manometry there are two types of diagnostic devices, known as: water-perfused catheter and solid-state catheter.
The water-perfused catheter diagnostic device has too low a dynamic response (refresh rate of the order of 20 Hz) and provides accurate data. Therefore, this type of instrumentation is almost no longer used, solid-state diagnostic devices being preferred. The solid-state catheters currently known have a solid circular section, with a rigid structure having a rectangular section inside [a thin/laminar body with a dimension (length) predominant over the others] positioned in the area of the central axis to provide axial rigidity to the system.
Given the shape of the diagnostic device, it can only be bent in one direction, which is substantially perpendicular to a longitudinal axis.
However, the bending required for the correct insertion of the catheter into the cavity may take place on different anatomical planes. Therefore, during insertion of a solid-state catheter of a known type, it is necessary to carry out twisting manoeuvres which are difficult for the patient to tolerate.
Furthermore, a known type of solid-state catheter has the disadvantage that its solid section does not allow the use of endoscopic guide, which would be necessary for patients with abnormalities that may obstruct the passage of the diagnostic device. Therefore, it is often not possible to perform the examination with the known type of diagnostic devices in patients with severe abnormalities.
Furthermore, the known type of solid-state catheter is expensive to manufacture and is multiuse, namely, it must be washed and sterilised after each use so that it can be used for another patient later on. Given that the known type of solid-state catheter is multiuse, it must guarantee a prolonged use over time without presenting any deterioration resulting in alteration of the examination performed. Therefore, the known solid-state catheter must be produced with a material that is easy to clean, resistant over time both to corrosion (due, for example, to gastric juices and to cleaning/sterilisation products and methods) and in terms of fatigue strength (phenomenon due to the application of one-way loads, namely applied in one direction with two opposite ways, variable over time and linked to the succession of elastic bends).
In other words, the material used must be easy to clean, resistant and must be able to deform elastically (in the same direction, but in two opposite ways), without presenting any residual deformation after use. The materials typically used are therefore very expensive and require particular processing, which makes the diagnostic device itself difficult to produce and very expensive. Therefore, to amortise the high cost of the diagnostic device, it is necessary to use it for a number of procedures ranging from 100 to 200 times.
In addition, the known type of solid-state catheter is often damaged due to the high and repeated number of uses and stresses to which it is subjected. Therefore, the known type of solid-state catheter often requires extraordinary maintenance, further increasing its management cost.
Therefore, the aim of the present invention is to provide a diagnostic device and a method for the production thereof which are free from the drawbacks of the state of the art and which are easy and inexpensive to implement.
According to the present invention, a method for the production of the diagnostic device is provided according to what is claimed in the appended claims.
According to the present invention, a diagnostic device is provided according to what is claimed in the appended claims.
According to the present invention, a diagnostic system is provided according to what is claimed in the appended claims.
For a better understanding of the invention embodiments are described, purely by way of example, where:
In
By way of example, without loss of generality,
The esophageal manometry is performed by means of a system 100 that comprises, in turn, a diagnostic device 1 (substantially similar to a catheter, namely, a probe) provided with pressure sensors 5 (hereinafter called indistinctly detection pads or sensitive elements 5) distributed along its own central axis X, as will be described in detail hereinafter, and with a control unit 110. The diagnostic device 1 is configured to exchange signals detected by the pressure sensors 5 with the control unit 110. The exchange of signals between the diagnostic device 1 and the control unit 110 may take place via cables or wirelessly. Purely by way of example, in the figures the connection between the diagnostic device 1 and the control unit 110 for the exchange of signals is physical, namely, by means of a cable.
The control unit 110 comprises, in turn: a software component S for detecting and processing signals; and/or a memory unit 111; and a user interface 112 for exchanging input and/or output data with an external user. According to the example illustrated, the user interface 112 is a display that shows, at output, graphs relative to the variation in pressure along the central axis X of the diagnostic device 1 during use.
According to the example illustrated in
Advantageously, the system 100, in particular the software component S, is configured to acquire and analyse the signals relative to the peristaltic pressure wave that travels down the esophagus during swallowing.
In this regard, the diagnostic device 1 is configured to detect signals, which once processed by the software component S are useful to discriminate, during swallowing, a physiological behaviour from a pathological behaviour.
Advantageously, the presence of the user interface 112 allows information to be exchanged directly and substantially intuitively with an operator to show the patient swallowing.
According to what is illustrated in
What follows in relation to the diagnostic device 1 may be applied, without difficulty, to any diagnostic device that has a shape similar to a catheter.
In use, the diagnostic device 1, after being positioned inside the esophagus as indicated above, is capable of acquiring, as will be better illustrated below, a plurality of signals relative to intra-esophageal pressure in the various segments of the esophagus (as illustrated in the pressure-time diagram shown on the left side of
According to what is illustrated in
Advantageously, the diagnostic device 1 comprises a main internal structure 2 that has a development predominant along the central axis X and having a tubular shape, in particular having an annular section.
Advantageously, the diagnostic device 1 has the central axis X which is also an axis of symmetry. In other words, the diagnostic device 1 has a tubular body 9 that is substantially axisymmetric relative to the central axis X.
The diagnostic device 1 is flexible. The diagnostic device 1, in particular its tubular body 9, is configured to selectively be arranged in any position between a linear configuration (illustrated for example in
Advantageously, the tubular body 9 of the diagnostic device 1 is elastically deformable along any deformation direction that is transverse, in particular orthogonal, to the longitudinal direction (parallel to the central axis X in the linear configuration) of the main structure 2 and the extent of deformation is substantially the same for each deformation direction. In other words, the main structure 2 may be bent (namely, is bendable) relative to a plurality of deformation axes (in particular, radial axes) with different directions from each other. Therefore, the diagnostic device 1 is bendable around any deformation axis and does not have a preferred deformation direction (namely, bending direction).
The main structure 2 is the internal skeleton of the diagnostic device 1.
The main structure 2 comprises at least two support bands 3 each of which is provided with: at least one or more electrical tracks 4 (illustrated by way of example schematically and partially in
Advantageously, each detection pad 5 is obtained by a local variation of surface of the respective support band 3.
Advantageously, both support bands 3 are manufactured from a same sheet of insulating material, namely, a material that does not conduct electric current. The detection pads 5 define the detection sensors to acquire a respective signal, such as, for example, intra-esophageal pressure.
As can be seen in
According to a first and preferred embodiment, illustrated in
Advantageously, according to what is illustrated in
Advantageously, according to the embodiment illustrated in
In more detail, each transverse partition 6 has a central portion PC which is arranged between the support bands 31 and 311 to connect them and two peripheral portions PP opposite one another, each of which projects outwards from the respective support band 31 or 311, that is, from the opposite side of the support band 3 relative to the central portion PC. In other words, the two peripheral portions PP extend outwards from each support band 31 or 311.
The peripheral portions PP of the same transverse partition 6 are connected to each other so as to form a ring and fix the tubular shape of the main structure 2.
According to the example illustrated in
Advantageously according to the example illustrated in
The diagnostic device 1 has an electrically conductive coating 7, an auxiliary matrix 8 and preferably a further electrically conductive coating 10 (
The electrically conductive coating 7 is applied on the detection pads 5 radially inwards (relative to the central axis X) of the main structure 2 and defines a sensitive element for detecting pressure (namely, for generating the signal proportional to the pressure). The electrically conductive coating 7 is preferably applied directly to the detection pads as indicated in
Advantageously, the electrically conductive coating 10 is applied radially more on the outside relative to the electrically conductive coating 7 and is configured to shield the diagnostic device 1 from the electromagnetic field generated by the human body. In other words, the electrically conductive coating 10 prevents the electromagnetic field from interfering with the detected signal and, therefore, from making an incorrect or altered acquisition of the signal, in particular pressure.
It should be noted that the terms radially “innermost” and “outermost” refer to the position along the radial direction (in particular, to the distance from the central axis X along the radial direction) in the diagnostic device 1, as illustrated in
According to a possible variation illustrated in
Advantageously, the electrically conductive coating 10 is applied to the entire surface of the support band 3I and 3II. In other words, the electrically conductive coating 10 is applied as a continuous layer on the radially outermost surface of the main structure 2.
According to a variation illustrated in
Advantageously, the electrically conductive coating 10 is applied to the entire surface of the auxiliary matrix 8. In other words, the electrically conductive coating 10 is applied as a continuous layer in the area of the radially outermost surface of the auxiliary matrix 8.
The auxiliary matrix 8 is configured to support, sustain and maintain the shape of the main structure 2 which is embedded therein. In particular, the auxiliary matrix 8 has mechanical and technological characteristics (for example, in terms of elastic modulus, that is, the so-called Young's modulus) such as to obtain the detected signal, in particular the pressure signal, which is comprised within a predefined range.
The auxiliary matrix 8 accommodates the structure 2 and isolates one detection pad 5 from the other (that is, one sensitive element from the other). In particular, the auxiliary matrix 8 wraps (in particular, incorporates at least partially, preferably completely) the main structure 2 and fills the gaps G (such as, for example, crevices or free cavities) between the support bands 3 to define the tubular body 9. The tubular body 9 (namely, the main structure 2 incorporated in the auxiliary matrix 8) substantially defines a hollow probe having a central through channel 13 within it. The central channel 13 enables introduction of any auxiliary equipment, such as, for example, a guide wire for introducing the catheter via endoscopic guidance and/or for administering drugs. As illustrated in
As illustrated in
Advantageously, the diagnostic device 1 is of the disposable type, namely, single use. In other words, the diagnostic device 1 is not multi-use.
Advantageously, the main structure 2 is made of a plastic material, in particular of a film made of polyimide, and has a thickness ranging from 0.1 to 0.5 mm, in particular ranging from 0.2 to 0.3 mm. A possible material for creating the main structure 2 is, for example, the material marketed under the name Kapton®. Kapton® is usually marketed with a film of insulating material that is arranged on both sides (namely, the larger surfaces). It should be noted that in this case the electrically conductive coating 7 and the electrically conductive coating 10 are applied to opposite sides of the film of insulating material of Kapton®.
Advantageously, the electrically conductive coating 7 is made of silver, copper or materials with a high index of electrical conductivity.
Advantageously, the electrically conductive coating 10 is also made of silver, copper or materials with a high electrical conductivity index.
Alternatively, the electrically conductive coating 10 may be made of a material with conductive material particles dispersed therein, such as, for example, a silicone with carbon nanotube particles dispersed therein.
Advantageously, the auxiliary matrix 8 is made of an insulating material that has a dynamic viscosity ranging from 3 to 20 cP [with the abbreviation cP or cps we mean the unit of measurement “Centipoise” which is commonly used in the industry to indicate the dynamic viscosity of a material. According to the International System SI, 1 cP is equivalent to 1 mPas. Therefore, with reference to the International System, the auxiliary matrix 8 is made of an insulating material that has a dynamic viscosity ranging from 3 to 20 mPas] and a tensile strength from 200 to 550 psi [with the abbreviation psi we mean a unit of measurement, of the US customary system, of: pressure, stress, Young's modulus and maximum tensile strength. According to the International System SI, 1 psi is equivalent to approximately 0.006894757 N/mm2. Therefore, with reference to the International System, the auxiliary matrix 8 is made of an insulating material having a tensile strength ranging from approximately 1.37895 to 3.79211 N/mm2]. For example, the auxiliary matrix 8 is made of a silicone which is different from that of the electrically conductive coating 10.
According to the example illustrated in
According to a third and alternative embodiment, illustrated in
Therefore, as illustrated in the cross-section of
Without loss of generality, all the support bands 3 of a diagnostic device 1 may:
The method for the production of a diagnostic device 1 according to the present invention is described hereinafter.
The method for the production of the diagnostic device 1 provides for a plurality of steps illustrated in
The diagnostic device 1 is obtained starting from a blank 14 (illustrated in
The method provides for a step of obtaining a blank 14 from a plastic material sheet (illustrated in
According to the preferred embodiment illustrated in
Preferably, the step of obtaining a blank 14 comprises a previous sub-step in which the blank 14 is obtained from a plastic material sheet, in particular made of polyimide or KAPTON®, by cutting (for example, by laser cutting) or punching.
The method also has a step of providing one or more sensitive elements 5, in particular detection pads 5, for each band 3. Each sensitive element 5 is configured to acquire signals, in particular pressure signals. For each band 3, electrical tracks 4 are connected to the sensitive elements 5 (that is, to the detection pads 5) for the transmission of signals.
Next, the method provides for a step of applying an electrically conductive coating 7.
The application step provides for applying the electrically conductive coating 7 on the blank 14 in the area of the detection pads 5.
Advantageously, as illustrated in
Advantageously, in a different sub-step of application, the electrically conductive coating 7 is also applied in the area of the inner surface of the central channel 13, such as to make it electrically conductive and therefore allow it to act, in use, as a ground electrode.
Alternatively, an electrical ground wire, namely an earth wire, may be arranged on the blank 14. The electrical ground wire may be arranged on the blank 14 after the step of applying the electrically conductive coating 7, or it may be introduced at a later step.
Next, as illustrated in
In particular, for the implementation of the embodiments illustrated in
The main three-dimensional structure 2 is formed through rolling, which is therefore defined by a single element, without the need for further assembly operations.
In accordance with
In particular, for creating the main structure 2 in accordance with the alternative illustrated in
Advantageously, once the main structure 2 has been obtained from the blank 14, a sub-step of connection, preferably by means of welding, of the respective peripheral portions PP of the same transverse partition 6 is carried out in order to define each detection pad 5.
Finally, a step is envisaged to create the auxiliary matrix 8, thus incorporating the main structure 2, fill the gaps G between the support bands 3 and form, namely obtain, the tubular body 9.
Advantageously, the auxiliary matrix 8 is created by casting, namely injection, of the material into a mould so that the main structure 2 is embedded within it.
Advantageously, the method comprises a step of applying the electrically conductive coating 10.
If the electrically conductive coating 10 is applied directly on the main structure 2 (as illustrated in
Advantageously, if the electrically conductive coating 10 is applied on the auxiliary matrix 8 (as in the variation illustrated in
In use, the proximal end EP of the diagnostic device 1 is connected to the control unit 110; whereas the distal end ED is inserted into the patient's orifice. Once the diagnostic device 1 is positioned within the patient's cavity (for example, the esophagus), the device 1 undergoes radial deformations due to the pressure wave during swallowing.
Signals proportional to the perceived pressure and relative to the specific application are generated by means of the detection pads 5.
In particular, the signals are generated according to the following mathematical relationship:
C=ε*A/d
These signals are exchanged with the control unit 100, which acquires the data required for the prescribed examination (such as, for example, intra-esophageal pressure, while performing an established diagnostic protocol) according to a certain logic.
In particular, as illustrated in
The capacitive technology provides for acquisition of the signal by means of a voltage generator Vs arranged in parallel to the capacitor Cs, after which the acquired signal is sent to a signal amplifier A and then the signal is conditioned in retraction with the help of a resistor Rf and a capacitor Cf arranged in parallel. Furthermore, there is an envelope detector (not shown) which is arranged upstream of the signal conversion from analogue-to-digital to reduce the sampling frequency.
Alternatively, other detection technologies, other than capacitive technology, may also be applied.
The diagnostic device 1 and the production method subject of the present invention have a number of advantages.
Firstly, thanks to the netlike main structure 2, the diagnostic device 1 is equally flexible and deformable in any direction orthogonal to the central axis X. Therefore, with the diagnostic device 1 it is no longer necessary to perform unpleasant twists of the diagnostic device 1 in order to bend it during introduction into the patient's cavity, with obvious advantages for the patient's well-being.
Secondly, the diagnostic device 1 is quick and inexpensive to manufacture, which allows it to be used as a single-use diagnostic device 1. Therefore, after each use, the diagnostic device 1 does not have to be cleaned and disinfected; instead, it can be disposed of.
Furthermore, the diagnostic device 1 enables reliable pressure measurements to be carried out.
Advantageously, the presence of the central channel 13 makes it possible to introduce (through the central channel 13) auxiliary devices and/or the administration of drugs topically into the diagnostic device 1. Therefore, the diagnostic device 1 also has a therapeutic function in addition to the diagnostic function.
Advantageously, the central channel 13 allows the introduction of an endoscopic guide to ease the opening of the patient's cavity and the insertion of the diagnostic device 1.
The central channel 13 also provides greater axial rigidity, thus increasing the compressive strength to which the diagnostic device 1 is subjected during insertion.
The auxiliary matrix 8 which wraps the main structure 2 provides mechanical support and protection to the main structure 2. Furthermore, the auxiliary matrix 8 allows the relative arrangement of the support bands 3 to be maintained and therefore to maintain the shape of the main structure 2.
By using the diagnostic device 1 with capacitive technology, it is possible to keep manufacturing costs low while achieving high performance.
The diagnostic device 1 subject of the present invention, with the same diameter and length as known devices, allows to have a spatial resolution at the maximum of clinical relevance.
The method for manufacturing the diagnostic device 1 is simple and also has low production costs.
In addition, by using an internal main structure 2 like the one illustrated in
Finally, by manufacturing the diagnostic device 1 with the electrically conductive coating 10, it is possible to obtain a more accurate signal acquisition, as there is no interference with the electromagnetic field generated by the human body. In fact, as the electrically conductive coating 10 is applied radially more on the outside relative to the electrically conductive coating 7, it acts as a shield.
Number | Date | Country | Kind |
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102021000003197 | Feb 2021 | IT | national |
Filing Document | Filing Date | Country | Kind |
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PCT/IB2022/051248 | 2/11/2022 | WO |