The invention relates to a gynecological instrument for introducing an irradiation catheter. In particular, the invention relates to a tubular applicator for irradiating gynecological tumors, which is to be placed in the cervix and the bottom of the vagina.
DE4413489 shows an instrument for irradiating gynecological tumors where irradiation positions are realized by a central catheter which is introduced into the uterus, and two laterally pivotable catheters at whose ends the so-called ovoids have been provided and which are pressed against the cervix, are pushed apart at the front of the cervix. The applicator can be connected to a so-called remote afterloading machine which, via tubes, moves a radioactive source to an irradiation position in the tubes. The applicator usually comprises multiple tubes with two ovoids (egg-shaped spacers) on the two outer tubes, which ensure that the irradiation doses on the surface remain below the permissible limit. Alternatively, a so-called ring applicator tube can be used, whereby around the cervix a ring-shaped tube is applied in which a radioactive source can be moved and a dosed radiation delivery is possible. Irradiation is performed by bringing a radiation source, provided at the end of a guide cable via a guide tube and the catheter, in a desired position and allowing it to deliver radiation there for a predetermined length of time to attack the tumor.
Such applicators are often too large to allow insertion in an assembled condition and are therefore provided tube by tube and fixed by means of a screw clamp. Additionally, then, in the apparatus, in the direction of the large intestine and in the direction of the bladder, the interspace is stuffed with gauze. This is a laborious process and possibly painful and uncomfortable and often done under anesthesia which moreover is carried out differently by different doctors, which may adversely affect the success of the medical procedure.
This method accordingly has disadvantages associated with it because it depends on the skills of the medical staff whether it will yield an optimum result. Because the positioning of the central intrauterine tube and other tubes (in particular the colpostats or the ring applicator tube) may shift relative to each other, this entails risks for the patient, also because the bladder and the large intestine may thus be exposed to excessive radiation.
It is an object of the invention to provide an instrument where these disadvantages are obviated and where the catheters can be easily held at a uniform distance from each other, without the catheters being able to shift relative to each other during a treatment. At the same time, it is an object of the invention to provide an instrument which can be introduced quickly and with a minimal burden and whose positioning is accurate and reliable.
This object is achieved by an apparatus for irradiating cervical cancer, comprising multiple source guide tubes with a coupling piece situated outside the patient which connects the tubes outside the patient, characterized in that the source guide tubes are formed such that the portions of the tubes situated in the patient upon insertion hook to each other so that the tubes are fixated relative to each other.
The invention will be elucidated in more detail in and by a description of the drawings, in which:
In the drawings, the same or corresponding parts are designated by the same reference numerals.
As shown in
Preventing this excessive burdening is of major importance since otherwise serious complications may be expected. Owing to the makeup of this model of applicator (with colpostats), typically a construction is used which, to save weight, utilizes thin tubes, with the tubes blocked on the rear side as represented in
In addition, according to the invention, therefore, the source guide tubes 2 are formed such that the portions of the tubes situated in the patient upon insertion hook to each other by means of a coupling piece (stop 3) connected to the central tube 2 in the form of stop 3, so that the tubes 2 and 6 (see
During so-called tamponing (pushing away of bladder and rectum) of the tissue around the colpostat, the colpostats are pressed from their set position so that the radiation dose to be given changes unintentionally. This can entail serious errors in the dose distribution. The provision of two anchor pins on the cervical flange which anchor themselves in pre-drilled holes in the colpostats solves the problem of unwanted position change.
Finally,
Although the invention has been elucidated with reference to the examples shown in the drawings, the invention is not limited thereto but may also comprise variations or modifications without deviating from the spirit of the invention. The scope of the invention is determined by the following claims.
Number | Date | Country | Kind |
---|---|---|---|
1031785 | May 2006 | NL | national |
Number | Name | Date | Kind |
---|---|---|---|
3323511 | Holter | Jun 1967 | A |
3807386 | Rocoplan et al. | Apr 1974 | A |
4294264 | Fischell et al. | Oct 1981 | A |
5562594 | Weeks | Oct 1996 | A |
6390968 | Harmon | May 2002 | B1 |
Number | Date | Country |
---|---|---|
44 13 489 | Aug 1995 | DE |
44 13 491 | Aug 1995 | DE |
Number | Date | Country | |
---|---|---|---|
20070276177 A1 | Nov 2007 | US |