WO2005084747A1 - Therapeutic instrument and arrangement for treating tumours - Google Patents

Therapeutic instrument and arrangement for treating tumours Download PDF

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Publication number
WO2005084747A1
WO2005084747A1 PCT/DE2005/000362 DE2005000362W WO2005084747A1 WO 2005084747 A1 WO2005084747 A1 WO 2005084747A1 DE 2005000362 W DE2005000362 W DE 2005000362W WO 2005084747 A1 WO2005084747 A1 WO 2005084747A1
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WIPO (PCT)
Prior art keywords
base body
electrodes
electrode
therapeutic instrument
tumor
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PCT/DE2005/000362
Other languages
German (de)
French (fr)
Inventor
Andreas Schönfeld
Original Assignee
Schoenfeld Andreas
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Publication date
Application filed by Schoenfeld Andreas filed Critical Schoenfeld Andreas
Priority to DE112005001024T priority Critical patent/DE112005001024A5/en
Publication of WO2005084747A1 publication Critical patent/WO2005084747A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1477—Needle-like probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1425—Needle
    • A61B2018/143—Needle multiple needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1475—Electrodes retractable in or deployable from a housing

Definitions

  • the invention relates to a therapeutic instrument according to the preamble of claim 1 for the treatment of tumors, with a base body which has at least one electrode. Furthermore, the invention relates to a device for treating tumors according to the preamble of claim 4, with at least one current source and at least one electrode, by means of which current can be introduced or discharged into the tumor.
  • Such a therapeutic instrument or device is known for example from DE 101 26 509 A1.
  • current supplied by current sources is introduced or discharged into a tumor by means of needle-shaped electrodes.
  • a controller ensures that the current through each electrode can be limited to a maximum value.
  • the needle-shaped electrodes are inserted into the tumor and then supplied with current by the current source or sources.
  • current flows from one electrode of a certain polarity to another electrode of a different polarity, which is intended to kill cancer cells.
  • each electrode Due to the separate current control or limitation of each electrode, it is possible to supply the electrodes with maximum current in each case without the risk that more current escapes or enters an electrode than the tissue can tolerate without suffering injuries ,
  • the known device is also very effective, it has nevertheless been shown that it can only be used to a limited extent, in particular in the case of very small tumors or tumors in poorly accessible places. Because it is often very difficult to position the electrodes exactly or very close to each other.
  • the known device cannot yet be optimally used, particularly in cases in which a tumor is located in an area which is difficult to access, but which adjoins a hollow organ such as a bile duct or a pancreatic duct.
  • a therapeutic instrument for treating tumors with a base body which has at least one first electrode is characterized in that the base body is hollow and has at least one opening in its wall through which the at least one electrode can be guided outwards ,
  • a device for treating tumors with at least one current source and at least one electrode, by means of which current is introduced or discharged into the tumor characterized in that the electrode is designed as a therapeutic instrument according to one of claims 1 to 3 is.
  • the base body is hollow and has at least one opening in its wall through which the at least one electrode can exit, tumors, for example, can advantageously be achieved which adjoin a hollow organ such as a bile duct or a pancreatic duct.
  • the therapeutic instrument can be guided through the hollow organ to the point at which the tumor adjoins the wall of the hollow organ. If the therapeutic instrument is positioned at this point, the electrodes can emerge through the openings in the wall of the therapeutic instrument and penetrate the wall of the hollow organ, as a result of which they reach the tumor.
  • the therapeutic instrument can also be inserted directly into a tumor. Since the electrodes are located inside the base body, the base body has no protruding parts, which makes it very easy to pierce the tumor. After the base body has reached its predetermined position, the electrodes can emerge from the base body, whereby they penetrate into the tumor. Since the position of the electrodes is determined by the distance between the openings in the base body, they can be arranged very close to one another without the risk of the electrodes touching one another. As a result, the therapeutic instrument can be used particularly in the case of very small tumors.
  • the electrodes can advantageously consist of a so-called memory material, as a result of which the lateral exit of the electrodes can be implemented in a simple manner through the wall of the base body.
  • the electrodes can also be brought out through the openings in any other way.
  • the base body is formed such that its outer periphery is changeable "t.
  • the circumference of the base body can be changed, for example, by increasing its volume.
  • the base body consists of an elastic material and it has at least one chamber which can be filled with a gas or a liquid.
  • the enlargement of the outer circumference of the base body can, however, also be achieved in that an inflatable body or a body that can be filled with a liquid is arranged on the side opposite the openings.
  • the arrangement of a flat element that can be moved mechanically away from the base body is also possible at the point mentioned.
  • the base body or the electrodes are first brought to their predetermined position and then the outer periphery or, if appropriate, the volume of the base body is enlarged.
  • the enlargement of the outer circumference of the base body ensures that the wall of the base body lies very firmly against the tissue surrounding the base body or against the wall of a hollow organ. As a result, the electrodes can be inserted very well into the tissue, or the wall of the hollow organ can be pierced better.
  • the distance between the electrodes is fixed to one another. Instead of inserting two or more needle-shaped electrodes into the tumor, only one base body needs to be inserted into the tumor. There is no longer any danger of electrodes touching when inserted into the tumor. This considerably facilitates the insertion of the electrodes into the tumor, particularly in the case of very small tumors.
  • the base body can be needle-shaped, and the tip can also be designed as an electrode.
  • very precise current can be introduced into the tumor at locations that would not be accessible using conventional needle electrodes. For example, it can be achieved that the current flows in certain areas inside the tumor, without current also flowing on the surface of the tumor.
  • electrodes of the same or different polarity can be arranged in the base body.
  • a predetermined arrangement of the electrodes can thus be used to determine in advance how current should flow through the tumor.
  • the current flow through each electrode can be controlled separately.
  • the base body advantageously has carbon fibers or consists entirely of carbon fibers.
  • Carbon fibers have the advantage that, in addition to their very high mechanical strength, they are biocompatible and, in particular, are not visible in imaging processes.
  • the base body could also consist of another biocompatible material of high strength, such as polyethylene.
  • Platinum has very good electrical conductivity and is also biocompatible.
  • FIG. 1 shows a first embodiment of a therapeutic instrument according to the invention
  • Figure 2 shows a second embodiment of a therapeutic instrument according to the invention.
  • Figure 3 shows an arrangement according to the invention for the treatment of tumors.
  • the base body 3 is hollow on the inside and has two openings 4a, 4b leading to the outside in its wall.
  • the base body 3 is further designed such that its circumference can increase. In this way it can be achieved that the diameter of the base body 3 corresponds to the inside diameter of the hollow organ or that the base body 3 at times partially almost completely fills the hollow organ, as a result of which the wall of the base body 3 bears firmly against the wall of the hollow organ. This allows a simpler and more effective piercing of the wall of the hollow organ with the electrodes 1, 2. Instead of the electrodes 1, 2 being made of a memory material, they could already be angled inside the base body 3.
  • the movement to the outside could then take place through an element which is arranged in the space 5a behind the electrodes 1, 2 and exerts a force on the electrodes 1, 2, as a result of which the electrodes 1, 2 emerge from the inside of the base body 3 can.
  • the reverse movement could take place in the same way, as a result of which the element would then have to be arranged in the space 5b in front of the electrodes 1, 2.
  • the element can be designed as an inflatable body or a body that can be filled with a liquid. But it can also be formed by mechanically adjustable parts.
  • FIG. 2 essentially corresponds to the embodiment shown in FIG. 1.
  • the same elements are therefore provided with the same reference numerals; to distinguish them, however, they have a line.
  • the base body 3 ' has a tip 3'.
  • the openings 4a ', 4b' are formed in the tip 3a 'and point in different directions.
  • the electrodes 1 ', 2' can be pushed out through the openings 4a ', 4b'.
  • the tip 3a ' can also be designed as an electrode, that is to say it is electrically conductive and has a platinum layer. It is arranged electrically insulated from the electrodes V, 2 '.
  • the base body 3 'does not need to be formed in one piece but can consist of several sub-elements.
  • the tip 3a ' can be designed as a separate part and can be plugged into the rest of the base body.
  • a therapeutic instrument 8 is introduced into a tumor 6 and is supplied with electricity by means of a generator 7.
  • the therapeutic instrument 8 can be designed in accordance with the embodiments shown in FIG. 1.

Abstract

The invention relates to a therapeutic instrument for treating tumours (6), comprising a base body (3) which comprises at least one first electrode (1; 2). The invention is characterised in that the base body (3) is hollow and at least one opening (4a, 4b) is arranged in the wall thereof and the at least one electrode (1,2) can be guided therethrough from the outside. The invention also relates to an arrangement for treating tumours (6), comprising at least one current source (7) and at least one electrode (8), by which means current can be conducted into and out of the tumour (6). The invention is also characterised in that the electrode (8) is embodied as a therapeutic instrument according to claims 1 to 3.

Description

Therapeutisches Instrument sowie Anordnung zur Behandlung von Tumoren Therapeutic instrument and arrangement for the treatment of tumors
Die Erfindung betrifft ein therapeutisches Instrument nach dem Oberbegriff des Anspruchs 1 zur Behandlung von Tumoren, mit einem Grundkörper, welcher wenigstens eine Elektrode aufweist. Des Weiteren betrifft die Erfindung eine Vorrichtung zur Behandlung von Tumoren nach dem Oberbegriff des Anspruchs 4, mit wenigstens einer Stromquelle und wenigstens einer Elektrode, mittels welcher Strom in den Tumor einleitbar beziehungsweise ausleitbar ist.The invention relates to a therapeutic instrument according to the preamble of claim 1 for the treatment of tumors, with a base body which has at least one electrode. Furthermore, the invention relates to a device for treating tumors according to the preamble of claim 4, with at least one current source and at least one electrode, by means of which current can be introduced or discharged into the tumor.
Ein derartiges therapeutisches Instrument beziehungsweise eine derartige Vorrichtung ist beispielsweise aus der DE 101 26 509 A1 bekannt. Bei der bekannten Vorrichtung wird von Stromquellen gelieferter Strom mittels nadeiförmiger Elektroden in einen Tumor eingeleitet beziehungsweise ausgeleitet. Mittels einer Steuerung wird gewährleistet, dass der Strom durch jede Elektrode jeweils auf einen Maximalwert begrenzbar ist. Zur Behandlung werden die nadeiförmigen Elektroden in den Tumor eingestochen und anschließend von der Stromquelle beziehungsweise den Stromquellen mit Strom versorgt. Hierbei fließt Strom von einer Elektrode einer bestimmten Polarität zu einer anderen Elektrode einer anderen Polarität, wodurch Krebszellen abgetötet werden sollen.Such a therapeutic instrument or device is known for example from DE 101 26 509 A1. In the known device, current supplied by current sources is introduced or discharged into a tumor by means of needle-shaped electrodes. A controller ensures that the current through each electrode can be limited to a maximum value. For the treatment, the needle-shaped electrodes are inserted into the tumor and then supplied with current by the current source or sources. Here, current flows from one electrode of a certain polarity to another electrode of a different polarity, which is intended to kill cancer cells.
Durch die separate Stromsteuerung beziehungsweise -begrenzung einer jeden Elektrode ist es möglich, die Elektroden jeweils mit maximalem Strom zu versorgen, ohne dass dabei die Gefahr besteht, dass an einer Elektrode mehr Strom aus- beziehungsweise eintritt, als das Gewebe ohne Verletzungen zu erleiden vertragen kann.Due to the separate current control or limitation of each electrode, it is possible to supply the electrodes with maximum current in each case without the risk that more current escapes or enters an electrode than the tissue can tolerate without suffering injuries ,
Wenngleich die bekannte Vorrichtung auch sehr wirksam ist, so hat sich dennoch gezeigt, dass sie insbesondere bei sehr kleinen Tumoren oder Tumoren an schlecht zugänglichen Stellen nur eingeschränkt verwendbar ist. Denn es ist häufig sehr schwierig, die Elektroden exakt beziehungsweise sehr nahe beieinander zu positionieren.Although the known device is also very effective, it has nevertheless been shown that it can only be used to a limited extent, in particular in the case of very small tumors or tumors in poorly accessible places. Because it is often very difficult to position the electrodes exactly or very close to each other.
Des Weiteren lässt sich die bekannte Vorrichtung insbesondere in solchen Fällen, in denen sich ein Tumor an einer schlecht zugänglichen Stelle befindet, welche aber an ein Hohlorgan wie beispielsweise einen Gallengang oder einen Pankreas- gang angrenzt, noch nicht optimal verwenden.Furthermore, the known device cannot yet be optimally used, particularly in cases in which a tumor is located in an area which is difficult to access, but which adjoins a hollow organ such as a bile duct or a pancreatic duct.
Es ist Aufgabe der Erfindung, ein eingangs genanntes therapeutisches Instrument beziehungsweise eine eingangs genannte Vorrichtung derart auszubilden, dass es beziehungsweise dass sie insbesondere bei sehr kleinen Tumoren und sehr schwer zugänglichen Tumoren leichter verwendbar ist.It is an object of the invention to design a therapeutic instrument or a device mentioned at the outset in such a way that it is easier to use, in particular in the case of very small tumors and very difficult to access tumors.
Die Lösung dieser Aufgabe ergibt sich aus den Merkmalen des kennzeichnenden Teils des Anspruchs 1. Vorteilhafte Weiterbildungen der Erfindung ergeben sich aus den Unteransprüchen.This object is achieved from the features of the characterizing part of claim 1. Advantageous further developments of the invention result from the subclaims.
Gemäß der Erfindung ist ein therapeutisches Instrument zur Behandlung von Tumoren, mit einem Grundkörper, welcher wenigstens eine erste Elektrode aufweist, dadurch gekennzeichnet, dass der Grundkörper hohl ist und in seiner Wandung wenigstens eine Öffnung aufweist, durch welche die wenigstens eine Elektrode nach außen führbar ist.According to the invention, a therapeutic instrument for treating tumors with a base body which has at least one first electrode is characterized in that the base body is hollow and has at least one opening in its wall through which the at least one electrode can be guided outwards ,
Des weiteren ist gemäß der Erfindung eine Vorrichtung zur Behandlung von Tumoren, mit wenigstens einer Stromquelle und wenigstens einer Elektrode, mittels welcher Strom in den Tumor eingeleitet beziehungsweise ausgeleitet wird, dadurch gekennzeichnet, dass die Elektrode als therapeutisches Instrument nach einem der Ansprüche 1 bis 3 ausgebildet ist. Dadurch, dass der Grundkörper hohl ist und in seiner Wandung wenigstens eine Öffnung aufweist, durch welche die wenigstens eine Elektrode austreten kann, lassen sich beispielsweise in vorteilhafter Weise insbesondere Tumore erreichen, welche an ein Hohlorgan wie beispielsweise einen Gallengang oder einen Pank- reasgang angrenzen. Das therapeutische Instrument kann durch das Hohlorgan an die Stelle geführt werden, an die der Tumor an die Wandung des Hohlorgans angrenzt. Ist das therapeutische Instrument an dieser Stelle positioniert, können die Elektroden durch die Öffnungen in der Wandung des therapeutischen Instruments austreten und die Wandung des Hohlorgans durchstoßen, wodurch sie in den Tumor gelangen.Furthermore, according to the invention, a device for treating tumors with at least one current source and at least one electrode, by means of which current is introduced or discharged into the tumor, characterized in that the electrode is designed as a therapeutic instrument according to one of claims 1 to 3 is. Due to the fact that the base body is hollow and has at least one opening in its wall through which the at least one electrode can exit, tumors, for example, can advantageously be achieved which adjoin a hollow organ such as a bile duct or a pancreatic duct. The therapeutic instrument can be guided through the hollow organ to the point at which the tumor adjoins the wall of the hollow organ. If the therapeutic instrument is positioned at this point, the electrodes can emerge through the openings in the wall of the therapeutic instrument and penetrate the wall of the hollow organ, as a result of which they reach the tumor.
Selbstverständlich lässt sich das therapeutische Instrument auch direkt in einen Tumor einbringen. Da die Elektroden sich im Inneren des Grundkörpers befinden, weist der Grundkörper keine hervorstehenden Teile auf, wodurch er sich sehr einfach in den Tumor einstechen lässt. Nachdem der Grundkörper seine vor >e- stimmte Position erreicht hat, können die Elektroden aus dem Grundkörper austreten, wodurch sie in den Tumor eindringen. Da die Position der Elektroden durch den Abstand der Öffnungen im Grundkörper bestimmt ist, können sie s- ehr eng beieinander angeordnet sein, ohne dass die Gefahr besteht, dass sich di e Elektroden berühren. Hierdurch lässt sich das therapeutische Instrument insbesondere bei sehr kleinen Tumoren verwenden.Of course, the therapeutic instrument can also be inserted directly into a tumor. Since the electrodes are located inside the base body, the base body has no protruding parts, which makes it very easy to pierce the tumor. After the base body has reached its predetermined position, the electrodes can emerge from the base body, whereby they penetrate into the tumor. Since the position of the electrodes is determined by the distance between the openings in the base body, they can be arranged very close to one another without the risk of the electrodes touching one another. As a result, the therapeutic instrument can be used particularly in the case of very small tumors.
In vorteilhafter Weise können die Elektroden aus einem so genannten Memory- Material bestehen, wodurch der seitliche Austritt der Elektroden durch die Wan- düng des Grundkörpers auf einfache Weise realisiert werden kann. Die Elektroden können selbstverständlich aber auch auf jede andere Art und Weise durch die Öffnungen nach außen gebracht werden.The electrodes can advantageously consist of a so-called memory material, as a result of which the lateral exit of the electrodes can be implemented in a simple manner through the wall of the base body. Of course, the electrodes can also be brought out through the openings in any other way.
Bei einer besonderen Ausführungsform der Erfindung ist vorgesehen, dass der Grundkörper derart ausgebildet ist, dass sein äußerer Umfang veränderbar is"t. Die Veränderung des Umfangs des Grundkörpers lässt sich beispielsweise dadurch erreichen, dass sein Volumen vergrößert wird. Dies kann beispielsweise dadurch erreicht werden, dass der Grundkörper aus einem elastischen Material besteht und er wenigstens eine Kammer aufweist, welche mit einem Gas oder einer Flüssigkeit befüllbar ist.In a particular embodiment of the invention it is provided that the base body is formed such that its outer periphery is changeable "t. The The circumference of the base body can be changed, for example, by increasing its volume. This can be achieved, for example, in that the base body consists of an elastic material and it has at least one chamber which can be filled with a gas or a liquid.
Die Vergrößerung des äußeren Umfangs des Grundkörpers kann aber auch dadurch erreicht werden, dass an der den Öffnungen gegenüberliegenden Seite ein aufblasbarer oder mit einer Flüssigkeit befüllbarer Körper angeordnet ist. Auch ist an der genannten Stelle die Anordnung eines vom Grundkörper mechanisch wegbewegbaren flächigen Elements möglich.The enlargement of the outer circumference of the base body can, however, also be achieved in that an inflatable body or a body that can be filled with a liquid is arranged on the side opposite the openings. The arrangement of a flat element that can be moved mechanically away from the base body is also possible at the point mentioned.
Durch die Vergrößerung des äußeren Umfangs lässt sich erreichen, dass der Grundkörper beziehungsweise die Elektroden zunächst an ihre vorbestimmte Position gebracht werden und dann der äußere Umfang beziehungsweise gegebenenfalls das Volumen des Grundkörpers vergrößert wird. Durch die Vergrößerung des äußeren Umfangs des Grundkörpers wird erreicht, dass sich die Wandung des Grundkörpers sehr fest an das den Grundkörper umgebende Gewebe beziehungsweise an die Wandung eines Hohlorgans anlegt. Hierdurch lassen sich die Elektroden sehr gut in das Gewebe einbringen, beziehungsweise lässt sich die Wandung des Hohlorgans besser durchstechen.By enlarging the outer circumference, it can be achieved that the base body or the electrodes are first brought to their predetermined position and then the outer periphery or, if appropriate, the volume of the base body is enlarged. The enlargement of the outer circumference of the base body ensures that the wall of the base body lies very firmly against the tissue surrounding the base body or against the wall of a hollow organ. As a result, the electrodes can be inserted very well into the tissue, or the wall of the hollow organ can be pierced better.
Dadurch, dass die Elektroden in einem Körper angeordnet sind, ist der Abstand der Elektroden zueinander fixiert. Statt zwei oder mehrere nadeiförmige Elektro- den in den Tumor einzustechen, braucht nur ein Grundkörper in den Tumor eingestochen zu werden. Die Gefahr, dass sich Elektroden beim Einbringen in den Tumor berühren, ist nicht mehr vorhanden. Dies erleichtert das Einbringen der Elektroden in den Tumor insbesondere bei sehr kleinen Tumoren erheblich. In vorteilhafter Weise kann der Grundkörper nadeiförmig ausgebildet sein, wobei auch die Spitze als Elektrode ausgebildet sein kann. Des Weiteren lässt sich durch die Fixierung der Elektroden an dem Grundkörper sehr präzise Strom an Stellen in den Tumor einleiten, welche mittels herkömmlicher Nadelelektroden nicht erreichbar wären. So lässt sich beispielsweise errei- chen, dass der Strom in bestimmten Bereichen im Inneren des Tumors fließt, ohne dass hierbei auch an der Oberfläche des Tumors Strom fließt.Because the electrodes are arranged in a body, the distance between the electrodes is fixed to one another. Instead of inserting two or more needle-shaped electrodes into the tumor, only one base body needs to be inserted into the tumor. There is no longer any danger of electrodes touching when inserted into the tumor. This considerably facilitates the insertion of the electrodes into the tumor, particularly in the case of very small tumors. Advantageously, the base body can be needle-shaped, and the tip can also be designed as an electrode. Furthermore, by fixing the electrodes to the base body, very precise current can be introduced into the tumor at locations that would not be accessible using conventional needle electrodes. For example, it can be achieved that the current flows in certain areas inside the tumor, without current also flowing on the surface of the tumor.
Des Weiteren lassen sich Elektroden gleicher oder unterschiedlicher Polarität in dem Grundkörper anordnen. Es lässt sich somit durch eine vorbestimmte Anord- nung der Elektroden im Vorfeld festlegen, in welcher Weise Strom durch den Tumor fließen soll. Insbesondere kann der Stromfluss durch jede Elektrode separat gesteuert werden.Furthermore, electrodes of the same or different polarity can be arranged in the base body. A predetermined arrangement of the electrodes can thus be used to determine in advance how current should flow through the tumor. In particular, the current flow through each electrode can be controlled separately.
In vorteilhafter Weise weist der Grundkörper Kohlefasern auf beziehungsweise besteht vollständig aus Kohlefasern. Kohlefasern haben den Vorteil, dass sie neben einer sehr hohen mechanischen Festigkeit biokompatibel sind und insbesondere in bildgebenden Verfahren nicht sichtbar sind. Der Grundkörper könnte aber auch aus einem anderen biokompatiblen Material hoher Festigkeit wie beispielsweise Polyethylen bestehen.The base body advantageously has carbon fibers or consists entirely of carbon fibers. Carbon fibers have the advantage that, in addition to their very high mechanical strength, they are biocompatible and, in particular, are not visible in imaging processes. However, the base body could also consist of another biocompatible material of high strength, such as polyethylene.
Als sehr vorteilhaft hat es sich erwiesen, platinbeschichtete Elektroden zu verwenden. Platin hat eine sehr gute elektrische Leitfähigkeit und ist darüber hinaus biokompatibel.It has proven to be very advantageous to use platinum-coated electrodes. Platinum has very good electrical conductivity and is also biocompatible.
Weitere Einzelheiten, Merkmale und Vorteile der vorliegenden Erfindung ergeben sich aus der nachfolgenden Beschreibung eines besonderen Ausführungsbeispiels unter Bezugnahme auf die Zeichnung. Es zeigtFurther details, features and advantages of the present invention result from the following description of a particular exemplary embodiment with reference to the drawing. It shows
Figur 1 eine erste Ausführungsform eines erfindungsgemäßen therapeutischen Instruments,FIG. 1 shows a first embodiment of a therapeutic instrument according to the invention,
Figur 2 eine zweite Ausführungsform eines erfindungsgemäßen therapeutischen Instruments, undFigure 2 shows a second embodiment of a therapeutic instrument according to the invention, and
Figur 3 eine erfindungsgemäße Anordnung zur Behandlung von Tumoren.Figure 3 shows an arrangement according to the invention for the treatment of tumors.
Wie Figur 1 entnommen werden kann, ist der Grundkörper 3 innen hohl und weist in seiner Wandung zwei nach außen führende Öffnungen 4a, 4b auf.As can be seen in FIG. 1, the base body 3 is hollow on the inside and has two openings 4a, 4b leading to the outside in its wall.
Im Inneren des Grundkörpers 3 sind zwei aus einem so genannten Memory- Material bestehende Elemente angeordnet, deren Spitzen 1 , 2 platinbeschichtet sind und die erste Elektrode 1 und die zweite Elektrode 2 bilden. Werden die Elemente in den Grundkörper 3 eingeschoben, treten sie aufgrund ihres Memory- Effekts selbständig durch die Öffnungen 4a, 4b aus. Befindet sich der Grundkörper 3 in einem Hohlorgan, können die Elektroden 1 , 2 die Wandung des Hohlorgans durchstechen und in einen hinter der Wandung des Hohlorgans liegenden Tumor eindringen.In the interior of the base body 3, two elements made of a so-called memory material are arranged, the tips 1, 2 of which are platinum-coated and form the first electrode 1 and the second electrode 2. If the elements are pushed into the base body 3, they exit independently through the openings 4a, 4b due to their memory effect. If the base body 3 is in a hollow organ, the electrodes 1, 2 can pierce the wall of the hollow organ and penetrate into a tumor located behind the wall of the hollow organ.
Der Grundkörper 3 ist des Weiteren so ausgebildet, dass sich sein Umfang vergrößern kann. Hierdurch kann erreicht werden, dass der Durchmesser des Grundkörpers 3 dem Innendurchmesser des Hohlorgans entspricht beziehungsweise dass der Grundkörper 3 das Hohlorgan zeitweise teilweise nahezu vollständig ausfüllt, wodurch die Wandung des Grundkörpers 3 fest an der Wandung des Hohlorgans anliegt. Dies erlaubt ein einfacheres und effektiveres Durchstechen der Wandung des Hohlorgans mit den Elektroden 1 , 2. Statt dass die Elektroden 1, 2 aus einem Memory-Material bestehen, könnten sie bereits abgewinkelt im Inneren des Grundkörpers 3 angeordnet sein. Die Bewegung nach außen könnte dann durch ein Element geschehen, welches in dem Raum 5a hinter den Elektroden 1 , 2 angeordnet ist und auf die Elektroden 1 , 2 eine Kraft ausübt, wodurch die Elektroden 1 , 2 aus dem Inneren des Grundkörpers 3 nach außen treten können. Die umgekehrte Bewegung könnte im Prinzip auf dieselbe Weise geschehen, wodurch dann das Element in dem Raum 5b vor den Elektroden 1, 2 angeordnet sein müsste. Das Element kann als ein aufblasbarer oder mit einer Flüssigkeit befüllbarer Körper ausgebildet sein. Er kann aber auch durch mechanisch verstellbare Teile gebildet sein.The base body 3 is further designed such that its circumference can increase. In this way it can be achieved that the diameter of the base body 3 corresponds to the inside diameter of the hollow organ or that the base body 3 at times partially almost completely fills the hollow organ, as a result of which the wall of the base body 3 bears firmly against the wall of the hollow organ. This allows a simpler and more effective piercing of the wall of the hollow organ with the electrodes 1, 2. Instead of the electrodes 1, 2 being made of a memory material, they could already be angled inside the base body 3. The movement to the outside could then take place through an element which is arranged in the space 5a behind the electrodes 1, 2 and exerts a force on the electrodes 1, 2, as a result of which the electrodes 1, 2 emerge from the inside of the base body 3 can. In principle, the reverse movement could take place in the same way, as a result of which the element would then have to be arranged in the space 5b in front of the electrodes 1, 2. The element can be designed as an inflatable body or a body that can be filled with a liquid. But it can also be formed by mechanically adjustable parts.
Die in Figur 2 dargestellte Ausführungsform entspricht im Wesentlichen der in Figur 1 dargestellten Ausführungsform. Gleiche Elemente sind daher mit denselben Bezugszeichen versehen; zur Unterscheidung weisen sie jedoch einen Strich auf.The embodiment shown in FIG. 2 essentially corresponds to the embodiment shown in FIG. 1. The same elements are therefore provided with the same reference numerals; to distinguish them, however, they have a line.
Im Unterschied zu der in Figur 1 dargestellten Ausführungsform weist der Grundkörper 3' eine Spitze 3' auf. Die Öffnungen 4a', 4b' sind in der Spitze 3a' ausgebildet und weisen in unterschiedliche Richtungen. Die Elektroden 1', 2' können durch die Öffnungen 4a', 4b' nach außen geschoben werden.In contrast to the embodiment shown in FIG. 1, the base body 3 'has a tip 3'. The openings 4a ', 4b' are formed in the tip 3a 'and point in different directions. The electrodes 1 ', 2' can be pushed out through the openings 4a ', 4b'.
Wenngleich dies Figur 2 auch nicht entnommen werden kann, kann die Spitze 3a' ebenfalls als Elektrode ausgebildet sein, das heißt, sie ist elektrisch leitend und weist eine Platinschicht auf. Sie ist gegenüber den Elektroden V, 2' elektrisch isoliert angeordnet.Although this cannot be seen in FIG. 2, the tip 3a 'can also be designed as an electrode, that is to say it is electrically conductive and has a platinum layer. It is arranged electrically insulated from the electrodes V, 2 '.
Selbstverständlich braucht der Grundkörper 3' nicht einstückig ausgebildet sein sondern kann aus mehreren Teilelementen bestehen. So kann insbesondere die Spitze 3a' als separates Teil ausgebildet sein und mit dem übrigen Grundkörper steckbar verbunden sein. Wie Figur 3 entnommen werden kann, wird in einen Tumor 6 ein therapeutisches Instrument 8 eingebracht, welches mittels eines Generators 7 mit Strom versorgt wird. Das therapeutische Instrument 8 kann entsprechend der in Figur 1 darge- stellten Ausführungsformen ausgebildet sein. Of course, the base body 3 'does not need to be formed in one piece but can consist of several sub-elements. In particular, the tip 3a 'can be designed as a separate part and can be plugged into the rest of the base body. As can be seen in FIG. 3, a therapeutic instrument 8 is introduced into a tumor 6 and is supplied with electricity by means of a generator 7. The therapeutic instrument 8 can be designed in accordance with the embodiments shown in FIG. 1.

Claims

Patentansprüche claims
1. Therapeutisches Instrument zur Behandlung von Tumoren (6), mit einem Grundkörper (3; 3'), welcher wenigstens eine erste Elektrode (1 , 2; 1', 2') aufweist, dadurch gekennzeichnet, dass der Grundkörper (3; 3') hohl ist und in seiner Wandung wenigstens eine Öffnung (4a, 4b; 4a', 4b') aufweist, durch welche die wenigstens eine Elektrode (1, 2; V, 2') nach außen führbar ist.1. Therapeutic instrument for the treatment of tumors (6), with a base body (3; 3 '), which has at least one first electrode (1, 2; 1', 2 '), characterized in that the base body (3; 3 ') is hollow and has at least one opening (4a, 4b; 4a', 4b ') in its wall through which the at least one electrode (1, 2; V, 2') can be guided to the outside.
2. Therapeutisches Instrument nach Anspruch 1 , dadurch gekennzeichnet, dass der Grundkörper (3; 3') derart ausgebildet ist, dass sein äußerer Umfang veränderbar ist.2. Therapeutic instrument according to claim 1, characterized in that the base body (3; 3 ') is designed such that its outer circumference can be changed.
3. Therapeutisches Instrument nach einem der Ansprüche 1 oder 2, dadurch gekennzeichnet, dass die Elektroden (1 , 2; 1', 2') aus einem Memory-Material bestehen.3. Therapeutic instrument according to one of claims 1 or 2, characterized in that the electrodes (1, 2; 1 ', 2') consist of a memory material.
4. Anordnung zur Behandlung von Tumoren (6), mit wenigstens einer Stromquelle (7) und wenigstens einer Elektrode (8), mittels welcher Strom in den Tumor (6) einleitbar beziehungsweise ausleitbar ist, dadurch gekennzeichnet, dass die Elektrode (8) als therapeutisches Instrument nach einem der Ansprüche 1 bis 3 ausgebildet ist. 4. Arrangement for the treatment of tumors (6), with at least one current source (7) and at least one electrode (8), by means of which current can be introduced or discharged into the tumor (6), characterized in that the electrode (8) as therapeutic instrument according to one of claims 1 to 3 is formed.
PCT/DE2005/000362 2004-03-02 2005-03-02 Therapeutic instrument and arrangement for treating tumours WO2005084747A1 (en)

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US20030055421A1 (en) * 2001-09-19 2003-03-20 Curon Medical, Inc. Devices, systems and methods for treating tissue regions of the body
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Publication number Priority date Publication date Assignee Title
US5531676A (en) * 1992-08-12 1996-07-02 Vidamed, Inc. Medical probe device and method
US20020002329A1 (en) * 1993-12-03 2002-01-03 Boaz Avitall Mapping and ablation catheter system
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US20030144605A1 (en) * 1998-04-08 2003-07-31 Senorx, Inc. Biopsy anchor device with cutter
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