Surgery – Truss – Pad
Patent
1987-09-23
1989-05-09
Hindenburg, Max
Surgery
Truss
Pad
128 4, 1283031, 128653, A61B 1704
Patent
active
048279315
DESCRIPTION:
BRIEF SUMMARY
This invention relates to operating catheters for use in surgical procedures.
Catheters in accordance with the invention are characterized in that they are composed of non-magnetic materials which are opaque or translucent under Nuclear Magnetic Resonance (NMR) examination. Suitable materials may be hydron, or strongly paramagnetic materials such as gadolinium. The catheters are preferably of axially segmented construction, having segments of highly opaque material alternating with segments of less opacity, so that the precise location of the catheter is readily apparent under NMR examination and visually at the distal end.
The catheters have, in each case, a main central lumen for the passage, e.g., of optic fibres for laser surgery, or of drugs for perfusion into an organ or into a cancer, or of control elements for the manipulation of surgical instruments carried at the distal end of the catheter.
Additionally, small lumens may be provided through the length of the catheter wall for the passage of guidance wires, or gas, or drugs.
The catheters are preferably coated, internally and externally, with thin layers of silicone rubber.
In each case, these catheters permit the conduct of many operations and treatments which would otherwise be carried out under X-ray. When operations are of long duration or require repetitions, the patient is subjected to undesirable high exposure to X-ray radiation. The present catheters make it possible to conduct various procedures under NMR examination, which is non-invasive and not subject to the risks attendant upon exposure to radiation.
Some catheters in accordance with the invention and attachments for use therewith will now be described by way of example, with reference to the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a diagrammatic cross-section of a first embodiment of catheter according to the present invention and for use in cancer treatment;
FIG. 2 is an axial section, drawn to a larger scale, of the catheter of FIG. 1;
FIG. 3 is a perspective sketch of a second embodiment of catheter, for use in laser surgery;
FIG. 4 is a perspective sketch of a third embodiment of catheter, fitted with a suturing device;
FIG. 5 is a front end view of a fourth embodiment of catheter, fitted with a suturing device;
FIGS. 6 and 7 are axial sections on the lines A',A' and A,B respectively, of FIG. 5; and
FIG. 8 is a front end view showing a suture needle in position.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
The catheter 1 of FIGS. 1 and 2 is in the form of an elongated element composed of alternating annular segments 1A, 1B of materials which are highly opaque to NMR examination and less opaque, respectively. The catheter has thin coatings of silicone rubber on its external surface and the internal surface of its main, central lumen 2. For the treatment of cancers, the lumen is charged with a quantity of embolising material which can be selectively discharged through the distal end of the catheter by a plunger (not shown) of NMR opaque material operable from the proximal end of the catheter.
A secondary lumen 3 formed through the wall of the catheter is charged with sclerosing materials. Three equi-spaced fine lumens 4 also extend longitudinally through the catheter wall and form passages for high tensile guide wires 6. At the distal end, these wires are secured to the catheter wall, and at the proximal end they are coupled to a joystick or rollerball control which permits the wires to be selectively and individually tightened or relaxes so as to permit guidance of the distal end of the catheter.
In use of the catheter, embolising material can be selectively discharged into an artery supplying a tumour, or a vein draining it or both. The secondary lumen 3 may be used for the injection of sclerosing materials into the arterial system before embolisation.
Use of the catheter under NMR examination has the additional advantage that the efficacy of embolisation cn be monitored while the treatment is under way by NMR examination of blood flow seque
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