The present invention relates to a treatment method for enhancing the peristaltic movement of the gastrointestinal tract, and a medical device.
Constipation is a common disease that is highly prevalent throughout the world, affecting some 25-30% of the population. Chronic constipation is defined as having less than three bowel movements per week with difficulty in defecating. Decreased frequency of defecation is known to cause symptoms of abdominal fullness, abdominal pain, dyspepsia and discomfort on defecation, frequent small bowel movements, and significantly impairs the patient's social activity and mental health.
Many patients with chronic constipation do not seek medical attention, but when they do, they are treated with medications aimed at normalizing the frequency of bowel movements and relieving the various abdominal symptoms of constipation. Drugs with a mechanism of promoting peristalsis and drugs with a mechanism of promoting secretion or inhibiting reabsorption from the gastrointestinal tract and softening and swelling the stool have been used in the past as therapeutic agents, and some have been newly developed (for example, see WO 2013-168671).
However, it is widely known that the majority of patients receiving such medication at medical institutions are not satisfied with their current treatment, and drug treatment is not a sufficient solution for the treatment of constipation.
There are two types of chronic constipation: primary (idiopathic) and secondary. Secondary constipation is caused by organic diseases such as colorectal cancer, drugs such as opioids used for pain relief, and systemic diseases such as neurological diseases and collagen diseases. Primary (idiopathic) constipation, on the other hand, can be divided into organic and functional constipation, depending on the presence or absence of organic abnormalities (such as dilatation) in the colon. Functional constipation without any organic abnormality in the colon is called “slow transit time constipation” when the peristalsis of the gastrointestinal tract is decreased, resulting in a delay in the passage of stool and causing constipation. For patients with severe constipation who do not respond to medical treatment, a total or partial resection of the colon may be recommended, but it is not widely accepted due to its invasive nature.
After diligent study, the inventors of the present invention have found an effective and minimally invasive method of treatment for various symptoms and diseases caused by a decrease or lack of peristalsis of the gastrointestinal tract.
The method of treatment according to one embodiment includes increasing peristaltic movement of the gastrointestinal tract by performing a procedure that reduces the activity of the autonomic nervous system in a blood vessel having a perineural nerve that innervates the patient's gastrointestinal tract.
According to the disclosure herein, the peristaltic motion of the gastrointestinal tract of a patient can be enhanced.
Embodiments of the present invention will be described with reference to the accompanying drawings. The following description is not intended to limit the significance of the technical scope or terms described in the claims. The dimensional ratios in the drawings are exaggerated for the sake of explanation and may differ from actual ratios. The range “X to Y” as shown herein means “X or greater, Y or less”.
Referring to
The blood vessel V to which the treatment method is applied is not particularly limited if it is possible to increase the peristaltic movement of the gastrointestinal tract of the patient (subject) by the application of the predetermined treatment (e.g., the impartation of energy, as described below) pertaining to the embodiment, but at least one of the superior mesenteric artery Va, the celiac artery Vb, and the inferior mesenteric artery Vc, for example, can be suitably selected.
The treatment site (range, location, etc.) to which the treatment is applied in the blood vessel V is not particularly limited as long as it is possible to enhance the peristaltic movement of the gastrointestinal tract. For example, within the blood vessel V, the treatment may be performed on any range (site) in the direction of travel of the blood vessel V (direction of extension) or on any range (site) in the circumferential direction (circumferential direction of the transverse section) of the blood vessel V. The treatment may be performed on the same blood vessel V. The treatment may be performed multiple times for multiple treatment sites of the same blood vessel V, or may be performed multiple times for any treatment site of a different blood vessel V. In other words, the treatment method according to this embodiment is not limited to the type of blood vessel to be treated, the treatment site of the blood vessel, the specific content of the treatment, the equipment and instruments used for the treatment, and the like, as long as it is possible to increase the peristaltic movement of the gastrointestinal tract of the patient by performing at least one treatment.
Next, referring to
In the treatment according to the present embodiment, an operator such as a physician (hereinafter referred to as “operator”) performs a treatment for decreasing the activity of the autonomic nerve in a blood vessel V having a circumferential nerve (plexus) Sa that innervates the gastrointestinal tract of a patient, thereby enhancing the peristaltic motion of the gastrointestinal tract. By performing such a procedure, the operator facilitates alleviation of at least one symptom of abdominal distention, abdominal pain, perineal discomfort, frequent stools (at least one symptom group resulting from alleviation of constipation and/or abnormalities of peristaltic movement of the patient's gastrointestinal tract) caused by constipation and/or abnormalities of peristaltic movement of the gastrointestinal tract.
It is preferred to select at least one of the superior mesenteric artery Va, celiac artery Vb, and inferior mesenteric artery Vc as the blood vessel V to be treated, as described above. The surgeon then imparts energy to one or a plurality of surrounding nerves Sa as a procedure. Thereby, the surgeon impairs the perineural nerve Sa and increases peristaltic movement of the gastrointestinal tract by completely or partially blocking autonomic nerve transmission to the gastrointestinal tract by the perineural nerve Sa.
The following may be considered as the reason why the peristaltic motion of the gastrointestinal tract is activated by performing the treatment for decreasing the activity of the autonomic nerve in the blood vessel V having the surrounding nerve Sa. When the surrounding nerve Sa is innervated by the energy applied from the blood vessel V and the autonomic nerve transmission to the gastrointestinal tract by the surrounding nerve Sa is completely or partially blocked, the sympathetic is relatively weakened and the parasympathetic nervous system becomes dominant. In addition, the blocking of inhibitory nerve stimulation from the central nervous system causes the enteric nervous system, which autonomously controls gastrointestinal movement in the periphery, to become dominant, and the peristaltic movement of the gastrointestinal tract is activated. The activation of the peristaltic movement of the gastrointestinal tract promotes and normalizes colon transit time, thus promoting relief of at least one of the symptoms of abdominal bloating, abdominal pain, perineal discomfort, and frequent stools caused by constipation and/or abnormal intestinal peristaltic movement. In particular, the treatment method according to this embodiment can suitably promote relief of the symptoms of delayed transit time constipation in functional constipation in which there is no organic abnormality in the colon and in which the peristalsis of the colon is decreased and thus a delay in the transit time of the stool is observed, resulting in constipation.
The operator may perform a procedure using a given medical device 100, for example, as shown in
The medical device 100 may be a catheter device including an elongated catheter body 110 and an energy transfer member 120 disposed at a distal end portion of the catheter body 110 near an end portion in the insertion direction into the blood vessel V. The catheter body 110 includes a lumen (not shown) extending in the longitudinal direction (extending direction) of the catheter body 110, and a hub (not shown) disposed at the proximal end (near the end opposite to the insertion direction into the blood vessel V) of the catheter body 110. The medical device 100 is capable of passing a medical instrument, such as a guidewire 200, through a lumen and a hub, or flowing a liquid, such as a priming fluid. As a specific structure of the medical device 100, a known catheter device, for example, a therapeutic catheter device such as an ablation device, can be appropriately employed.
The energy transfer member 120 included in the medical device 100 may be configured to apply, for example, at least one of the group consisting of simple radio frequency, bipolar radio frequency, high-density focused ultrasound, ultrasound, microwave, light, heat, cold radiation, engineering therapy, magnetic, electrical, electromagnetic, cryotherapy, plasma, mechanical energy, chemical energy, kinetic energy, potential energy, nuclear energy, elastic energy, and hydrodynamic energy from the inside of the blood vessel V.
The operation of the energy transfer member 120 can be controlled, for example, via a controller (not shown). As the controller, for example, a known control device including a CPU and a storage unit can be used. The storage unit includes a ROM for storing various programs and data, a RAM for temporarily storing programs and data as a work area, a hard disk capable of storing various programs and data, and the like. A series of programs necessary for operation control of the medical device 100 can be stored in the storage unit. The energy transfer member 120 is electrically connected to a power supply unit (not shown), and can control ON/OFF of operation, the amount of energy applied to the blood vessel V, and the like via the power supply unit. Further, the transmission form of the operation command to the energy transmission member 120 can include, for example, a form by wire through a telecommunication line, a form by wireless without through a telecommunication line, a form which performs transmission based on an input from an operator or the like through an operation unit incorporated in a control device, a form which performs transmission based on an input from an external communication means or the like prepared as a device different from the control device, and the like, but the specific form is not particularly limited. In addition, the treatment according to the present embodiment may be performed by a medical device such as a treatment robot for replacing the work performed by the operator, for example. In this case, the treatment may be performed by controlling the treatment robot in a medical site such as an operating room or by controlling the treatment robot in a remote place.
The catheter body 110 of the medical device 100 is preferably configured to be movable to follow the curvature or flexion of the patient's blood vessel in order to deliver the energy transfer member 120 to the superior mesenteric artery Va, the celiac artery Vb, or the inferior mesenteric artery Vc. The catheter body 110 may employ various materials, structures, and the like used in known catheter devices having, for example, flexibility, torque transmission, kink resistance, and the like, in order to provide the above-described performance.
When inserting the medical device 100 into the blood vessel V, the operator can use the guide wire 200 and the guide catheter 300, for example, as shown in
After delivering the energy transfer member 120 to a desired location within the blood vessel V, as shown in
When performing a procedure, the operator can apply energy in at least one form, for example, in the entire circumferential direction of the blood vessel V (such a form that there is no intermittence along the inner wall of the blood vessel V), in a portion of the circumferential direction of the blood vessel V (such a form that only a portion of the inner wall of the blood vessel V is in a circumferential direction, for example, less than a half circumference), in a half circumference of the blood vessel V (such a form that the inner wall of the blood vessel V is in a shape that the inner wall of the blood vessel V is in a shape that it is continuous with a constant length in the circumferential direction, in a linear shape, and in a radial shape (such a direction that the inner wall of the blood vessel V is spaced radially outward. The operator can also perform a treatment by arbitrarily combining the above energy application forms.
When performing a treatment, the operator can adjust the output of the energy transfer member 120 so as to apply energy of, for example, 100° C. or less to the blood vessel V.
The operator can also control the range of application of energy in any range, e.g., from 0° to 360° of the cross-section of the blood vessel V, in the direction indicated by arrow al in
The medical device 100 may also include one or more expandable structures near the distal end of the medical device 100. When the medical device 100 is configured in this manner, the operator can hold the medical device 100 in place in a direction parallel to the lumen of the blood vessel by expanding the expandable structure within the blood vessel V and temporarily fixing it to the blood vessel wall. The expandable structure may, for example, be configured integrally with the catheter body 110 or as a separate device from the catheter body 110. When the expandable structure is integrally formed with the catheter body 110, for example, a portion of the catheter body 110 is configured to be expandable. In this case, for example, the vicinity of the distal end portion of the catheter body 110 can be formed of a material having self-expandability or the like. Also, if the expandable structure is configured separately from the catheter body 110, for example, the expandable structure can be configured with a balloon catheter including a shaft having a lumen through which the medical device 100 can be inserted and projected distally, and a balloon that can be expanded and contracted.
When performing a procedure using the medical device 100, the operator may place the center position of the medical device 100, for example, at a position close to a predetermined position (a position deflected from the center position C1) in the circumferential direction of the blood vessel V from the center position C1 on the cross-section of the blood vessel V. By arranging the medical device 100 in this manner, the operator can effectively apply energy to the peripheral nerve Sa from any position in the circumferential direction of the blood vessel V. The medical device 100 can be appropriately provided with a positioning mechanism for arranging the medical device 100 as described above. The positioning mechanism may comprise, for example, a portion of the catheter body as well as the expandable structure, or may comprise a balloon.
The medical device 100 may also include one or more sensors that enable temperature measurement near the distal end of the medical device 100. When the medical device 100 is configured in this manner, the operator can control the output of energy based on the measurement result of the sensor. By appropriately controlling the output of the energy based on the measurement result of the sensor, the operator can prevent the effect of enhancing the peristaltic motion due to insufficient energy to be applied or the formation of a stenosis or the like in the blood vessel V due to excessive energy being applied to the blood vessel V. Note that there is no particular limitation on the type, arrangement position, number, and the like of the sensors.
Note that the medical device used in the treatment method according to the first embodiment is not particularly limited in specific structure, arrangement of members, and the like as long as energy can be applied in a blood vessel. For example, omission of the installation of the components (structures) of the medical device described by the illustration, use of additional components of other not specifically described, modifications to devices in the form other than catheter devices, and the like may be appropriately carried out.
Further, the specific procedure is not particularly limited as long as the treatment method at least includes enhancing the peristaltic movement by performing the treatment for reducing the activity of the autonomic nerve in a blood vessel having a peripheral nerve innervating the gastrointestinal tract of the patient.
Next, a treatment method and a medical device according to a second embodiment of the present invention will be described. In the description of the second embodiment, the detailed description of the constituent members, the procedure, and the like already described in the first embodiment is omitted. Content, which is not specifically described in the description of the second embodiment, may be the same as the above-described embodiment.
<Treatment method> Referring to
As shown in
In the procedure method in the second embodiment, as in the procedure method in the first embodiment, the operator increases the peristaltic movement of the gastrointestinal tract by performing a procedure to decrease the activity of the autonomic nervous system in the blood vessels having surrounding nerves (plexus) that control the gastrointestinal tract of the patient (the subject). By performing such a procedure, the operator can facilitate alleviation of at least one symptom of abdominal distention, abdominal pain, perineal discomfort, frequent stools (at least one symptom of a symptom group resulting from alleviation of constipation and/or abnormalities of peristaltic movement of the patient's gastrointestinal tract) caused by constipation and/or abnormalities of peristaltic movement of the gastrointestinal tract.
In the following description, an example is shown in which a blood vessel to be treated according to the embodiment is the superior mesenteric artery Va, and another blood vessel connected to the superior mesenteric artery Va is the aorta Vd.
As shown in
As shown in
Referring to
The treatment target region S preferably includes a range of 0 mm to 20 mm (a range indicated by the sign L1) along the extension direction of the superior mesenteric artery Va with reference to the opening of the superior mesenteric artery Va. By applying energy within the above-mentioned range of the superior mesenteric artery Va, it is possible to suitably suppress the transfer of energy to an organ located on the distal side of the superior mesenteric artery Va, for example, the pancreas or the duodenum. From the viewpoint of more reliably suppressing the transfer of energy to the organ located on the distal side of the superior mesenteric artery Va, it is particularly preferable that the application of energy from the superior mesenteric artery Va is performed only within the range of 0 mm to 20 mm along the extension direction of the superior mesenteric artery Va.
When energy is applied to the treatment target site S from the superior mesenteric artery Va side and the aorta Vd side as in the treatment method according to the present embodiment, the treatment target site S preferably includes a range of 0 mm to 100 mm (a range indicated by L2) along the extension direction of the aorta Vd with reference to the branch portion of the superior mesenteric artery Va. By applying energy from the aorta Vd side in such a range, it becomes possible to efficiently apply energy from both the aorta Vd side and the superior mesenteric artery Va side to the treatment target site S located outside each of the blood vessels Va and Vd.
The depth of energy from the superior mesenteric artery Va side (distance indicated by d1) is preferably at least 3 mm to 5 mm from the adventitia of the superior mesenteric artery Va. It is preferable that the depth of energy from the aorta Vd side (distance indicated by d2) is 3 to 5 mm from the adventitia of the aorta Vd. Surrounding nerves that lie outside the superior mesenteric artery Va lie 3-5 mm deeper from the adventitia in Vao around the origin of the superior mesenteric artery Va. More specifically, the surrounding nerves are present in bundles supported by connective tissue within the adipose tissue outside the superior mesenteric artery Va. Therefore, when energy is applied from the portion Vdp near the origin of the superior mesenteric artery Va in the vicinity Vao of the origin of the superior mesenteric artery Va and the aorta Vd, the peripheral nerve can be efficiently denervated by allowing the energy to reach the position of 3 to 5 mm from the adventitia of each blood vessel Va, Vd. The treatment target portion S can be set in an arbitrary range with respect to the outer circumferential direction of the superior mesenteric artery Va.
Depending on the blood vessel in which the denervation treatment is performed, organs may be present on the peripheral side of the blood vessel. For example, when the superior mesenteric artery Va is selected as a blood vessel to be treated, the pancreas and duodenum exist on the peripheral side of the superior mesenteric artery Va. It is preferable that the energy radiated from the superior mesenteric artery Va when the denervation is performed is not transmitted to the organ as much as possible in consideration of the influence on the health condition of the patient. According to the treatment method of the present embodiment, it is possible to suppress the transfer of energy to the pancreas and duodenum located on the distal side of the superior mesenteric artery Va.
Further, in the present embodiment, as shown in
However, the form of energy to be applied to the treatment target site S is not particularly limited as long as one or a plurality of peripheral nerves existing in the treatment target site S can be denervated, and is not limited to only high-frequency energy using the bipolar electrodes 211 and 221. For example, the form of energy of other can be selected from at least one of the group consisting of ultrasound, microwave, optical, thermal, cold radiation, engineering, magnetic, electric, electromagnetic, cryotherapy, plasmas, chemical energy, potential energy, nuclear energy, elastic energy, and hydrodynamic energy. Note that in the case where a microwave is used as the form of energy, the center frequency of the microwave can be set to any of 915 MHz, 2.45 GHz, 5.8 GHz, and 24.125 GHz, for example.
When applying energy to the treatment target region S, the operator supplies a current to each of the electrodes 211 and 221, and flows a current between each of the electrodes 211 and 221. While energy is applied from the electrodes 211 and 221 to the treatment target portion S, it is preferable to keep the electrodes 211 and 221 disposed in the vicinity of the treatment target portion S. Details of the medical device 10 (the treatment device 200 and the holding mechanism 100) used to apply energy to the treatment target site S will be described later.
In addition, it is preferable that the range (denervation range) in which energy is applied to the periphery Vao of the originating portion of the superior mesenteric artery Va is, for example, 50% or less in the outer circumferential direction of the superior mesenteric artery Va (180° or less in the circumferential direction on the cross section of the blood vessel). If the denervation range is 50% or more in the circumferential direction of the superior mesenteric artery Va, the increase of the peristaltic motion after denervation may be excessively promoted. Therefore, it is preferable to denervate the nerve in the above range.
<Medical Devices> As shown in
As shown in
In the description of the present embodiment, the side on which the electrodes 211 and 221 are arranged in each of the catheter devices 210 and 220 is the distal side, the side on which the hubs 215 and 225 are arranged in each of the catheter devices 210 and 220 is the proximal side, and the direction in which the catheter shafts 213 and 223 extend is the axial direction (longitudinal direction). In the description of the present embodiment, the distal end means a certain range including the distal end (most distal end) and its periphery, and the proximal end means a certain range including the proximal end (most proximal end) and its periphery.
As shown in
The second catheter device 220 may be a device having substantially the same structure as the first catheter device 210. The second catheter device 220 includes a flexible catheter shaft 223, a second electrode 221 disposed at the distal end of the catheter shaft 223, and a hub 225 disposed at the proximal end of the catheter shaft 223. An electric wire for supplying an electric current to the second electrode 221 is inserted into the catheter shaft 223. The wires are drawn from the hub 225 and connected to the energy source 300. Like the first catheter device 210, the structure, material, and the like of each part of the second catheter device 220 can be appropriately adopted as a structure of a catheter known in the medical field.
The supply/stop of current to each of the electrodes 211 and 221, the adjustment of the current value, and the like can be controlled by the energy supply source 300. The energy supply source 300 includes a CPU and a storage unit. The storage unit may include a ROM for storing various programs and data, a RAM for temporarily storing programs and data as a work area, a hard disk capable of storing various programs and data, and the like. The storage unit can store a series of programs necessary for control such as supply/stop of current, adjustment of current value, and the like. The mode of transmitting and receiving the operation command of the energy supply source 300 may include, for example, a wired mode via a telecommunication line, a wireless mode without a telecommunication line, a mode of transmitting and receiving based on an input from an operator or the like via a controller, a mode of transmitting and receiving based on an input from an external communication means or the like prepared as a device different from the energy supply source 300, but the specific mode is not particularly limited. In addition, the treatment using each of the catheter devices 210 and 220 may be performed by a medical device such as a treatment robot that replaces the work performed by the operator. In this case, the treatment robot may be controlled in a medical site such as an operating room, or the treatment robot may be controlled in a remote place.
As shown in
The guiding catheter 100 has a distal end opening 112 opened at the distal end of the catheter shaft 110 and a side hole 111 formed at a predetermined position on the proximal end side of the distal end of the catheter shaft 110. Although not shown, a lumen communicating with the distal opening 112 and a lumen communicating with the side hole 111 may be provided inside the catheter shaft 110.
As shown in
When performing a procedure using each of the catheter devices 210 and 220, the operator projects the first electrode 211 located at the distal end of the first catheter device 210 from the side hole 111 of the catheter shaft 110 into the superior mesenteric artery Va with the catheter shaft 110 of the guiding catheter 100 in contact with the inner wall Vdi of the aorta Vd. The operator also causes the second electrode 221 located at the distal end of the second catheter device 220 to protrude from the aorta Vd from the distal end opening 112 of the catheter shaft 110. The operator can guide each of the electrodes 211 and 221 to a predetermined position at the time of performing the treatment on the treatment target portion S by performing the above-described operation. In addition, the operator can maintain the position of each electrode 211, 221 by maintaining the catheter shaft 110 in contact with the inner wall Vdi of the aorta Vd while performing the treatment by each electrode 211, 221.
In the present embodiment, since the form in which energy is applied to the treatment target portion S from each of the electrodes 211 and 221 constituting the bipolar electrode is adopted, there are the following advantages. (i) Since it is possible to apply energy from the blood vessels of both the superior mesenteric artery Va and the aorta Vd to the treatment target site S located between the blood vessels Va and Vd, it is possible to efficiently denervate the surrounding nerves existing in the treatment target site S. (ii) The range of influence of the energy radiated from each electrode 211, 221 is limited to a certain range between and around each electrode 211, 221. Therefore, it is possible to locally denervate a partial region in the patient's body. (iii) When a device capable of radiating an electromagnetic wave such as an antenna (e.g., a microwave) is mounted on a catheter device, it is possible to deepen the depth of energy penetration or to apply energy to the outside of a blood vessel in a state where it is not in contact with the inner wall of the blood vessel. However, since it is difficult in terms of technology to have directionality in the radial direction of the electromagnetic wave, the catheter device needs to be designed so that the catheter device can locally irradiate the electromagnetic wave to any position in the circumferential direction of the blood vessel. This complicates the apparatus configuration of the catheter device. On the other hand, according to the catheter devices 210 and 220 in which the electrodes 211 and 221 constituting the bipolar electrodes are mounted, there is no need to provide a mechanism for perfusing the fluid, a mechanism for adjusting the radiation direction of the energy, and the like, so that the configuration of the apparatus can be simplified. It should be noted that the treatment device (catheter device) may be configured by, for example, a single catheter device including an antenna element capable of radiating electromagnetic waves (e.g., microwaves). In this case, the catheter device may include a single catheter shaft in which an antenna element is disposed at the distal end, and may be configured to be able to apply energy to the periphery Vao of the origination portion of the superior mesenteric artery Va.
Next, each modification of the second embodiment will be described. As will be described below, the treatment methods and the medical devices according to the second embodiment are not limited to a specific content as long as at least the treatment for reducing the activity of the autonomic nerve with respect to the vicinity of the origin of the blood vessel can be performed in the blood vessel having the peripheral nerve innervating the gastrointestinal tract of the patient. In the description of the modification, the description of Content described above in the second embodiment is omitted. In addition, unless otherwise stated, the constituent members and the like of the respective modified examples can be the same as those of the above-described embodiment.
<First Modification> As shown in
The catheter device 400 according to the first modification includes a catheter shaft 403 and first and second electrodes 401a and 401b, which are disposed at different positions in the longitudinal direction of the catheter shaft 403 and constitute bipolar electrodes, respectively.
As shown in
The catheter shaft 403 has a distal end portion in which the first electrode 401a is disposed, and a curved portion 403a which is connected to the proximal end side of the distal end portion and in which the second electrode 401b is disposed. The curved portion 403a formed on the catheter shaft 403 constitutes a holding mechanism capable of holding the first electrode 401a against the inner wall Vai of the blood vessel in the vicinity Vao of the origin of the superior mesenteric artery Va.
As shown in
The catheter shaft 403 is shaped so as to have the shape shown in
In the first modification shown in
<Second Modification> As shown in
<Third Modification> As shown in
In the third modification shown in
<Fourth Modification> As shown in
The electrode 711 can be formed of, for example, a unipolar electrode or an antenna element capable of radiating microwaves. As the balloon 705, a known balloon that can be expanded and contracted in accordance with supply and discharge of a fluid can be used. Note that the specific shape, position, size, and the like of the balloon 705 are not particularly limited. The balloon 705 may be configured separately from the catheter shaft 703.
<Fifth Modification> As shown in
The electrode 811 can be formed of, for example, a unipolar electrode or an antenna element capable of radiating microwaves. As the basket structure 805, for example, a basket structure composed of a metal material having self-expandability (for example, a known titanium-based alloy) or a shaped resin material (for example, a known shape memory polymer) can be used. Note that the specific shape, position, size, and the like of the basket structure 805 are not particularly limited.
<Sixth Modification>As shown in
The electrode 911 can be formed of, for example, a unipolar electrode or an antenna element capable of radiating microwaves. The support structure 905 can be composed of, for example, a plurality of wires shaped in the shape shown in
Although the treatment method and the medical device according to the present invention have been described above through the embodiments, the present invention is not limited to content described in the specification, and can be modified as appropriate based on the description of the claims.
The structures described in each embodiment and each modification can be appropriately combined as long as the essential effects of the invention can be exhibited.
The medical device used in the treatment method according to the first embodiment is not particularly limited in specific structure, arrangement of members, and the like as long as energy can be applied in a blood vessel. For example, omission of the installation of the components (structures) of the medical device described by the illustration, use of additional components of other not specifically described, modifications to devices in the form other than catheter devices, and the like may be appropriately carried out. The specific procedure of the treatment method according to the first embodiment is not particularly limited as long as it includes at least enhancing the peristaltic movement of the gastrointestinal tract by performing a treatment for reducing the activity of the autonomic nerve in a blood vessel having surrounding nerves innervating the gastrointestinal tract of the patient.
The material, shape, size, arrangement, connection structure between members, and the like of each member constituting the treatment device (catheter device) and the holding mechanism according to the second embodiment are not particularly limited as long as the effect of the present invention is exhibited, and can be arbitrarily changed and substituted. In addition, any component or the like not specifically described in the specification can be appropriately added to the treatment device (catheter device) and the holding mechanism, and additional components described in the specification can be appropriately omitted. In addition, any procedure not specifically described in the specification can be appropriately added to the treatment method, and omission of the additional procedure described in the specification can also be appropriately performed. As for the treatment method, as long as the effect of the invention can be exhibited, the order of the procedures can be changed as appropriate. The blood vessels to be treated are not limited to those described in the embodiment.
Number | Date | Country | Kind |
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2019-037598 | Mar 2019 | JP | national |
This application is a continuation of International Patent Application PCT/JP2019/013892, filed Mar. 28, 2019, which claims priority to PCT/JP2018/012839, filed Mar. 28, 2018 and claims priority to Japanese Patent Application No. 2019-037598, filed Mar. 1, 2019, the entire disclosures of which are hereby incorporated by reference.
Number | Date | Country | |
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Parent | PCT/JP2019/013892 | Mar 2019 | US |
Child | 17032897 | US | |
Parent | PCT/JP2018/012839 | Mar 2018 | US |
Child | PCT/JP2019/013892 | US |