WO2006094105A1 - System and method for marking body cavities - Google Patents
System and method for marking body cavities Download PDFInfo
- Publication number
- WO2006094105A1 WO2006094105A1 PCT/US2006/007381 US2006007381W WO2006094105A1 WO 2006094105 A1 WO2006094105 A1 WO 2006094105A1 US 2006007381 W US2006007381 W US 2006007381W WO 2006094105 A1 WO2006094105 A1 WO 2006094105A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- marking material
- calyx
- body cavity
- marking
- inspecting
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3937—Visible markers
Definitions
- a surgeon may inspect the calices of a patient's kidney to search for and remove kidney stones.
- FIG. 1 illustrates a typical kidney 10 that is representative of a kidney that a surgeon may need to inspect. As is shown in
- FIG. I 3 the kidney 10 includes an outer capsule 12 that surrounds a renal cortex 14 in which a plurality of minor calices 16 are formed. Each of the minor calices 16 may extend from a major calyx 18 that, in turn, extends from the renal pelvis 20.
- the renal pelvis 20 is connected to the ureteropelvic junction 22, which leads down to the ureter
- a viewing device such as an endoscope
- Fluoroscopy may also be used during such a procedure to
- surgeon may revisit one or more calices one or more times to ensure that it has been checked and does not contain any stones.
- one or more stones or stone fragments may remain which can act as seeds for further stone formation.
- lithotripsy may be performed to break the stone into smaller fragments.
- a system includes means for inspecting a body cavity, and means for
- a method includes inspecting a body cavity, and marking the body cavity with a marking material to provide a visual indication regarding the cavity.
- a marking material for marking a body cavity includes a radiopaque contrast agent that is viewable through fluoroscopy, and a colored dye that
- FIG. 1 is a schematic cross-sectional view of a kidney.
- FIG. 2A is a schematic cross-sectional view of a kidney, illustrating inspection
- FIG. 2B is a schematic cross-sectional view of a kidney, illustrating marking the
- FIG. 2C is a schematic cross-sectional view of a kidney, illustrating inspection of
- FIG. 2D is a schematic cross-sectional view of a kidney, illustrating removal of a stone from the second calyx using a retrieval device.
- FIG. 2E is a schematic cross-sectional view of a kidney, illustrating marking the second calyx with a marking material.
- FIG. 3 A is a schematic cross-sectional view of a kidney, illustrating marking a third calyx with a marking material.
- FIG. 3B is a schematic cross-sectional view of a kidney, illustrating removal of a stone from the third calyx using a retrieval device.
- FIG 4 is a schematic cross-sectional view of a kidney, illustrating filling of a group of calices with a first marking material, and filing a separate calyx with a second
- a marking material can be used to mark one or more cavities that have already been inspected.
- a marking material can be used to mark one or more cavities of interest, for example that contain an object to be removed.
- a first type of marking material can be used to mark cavities of a first type (e.g., that contain
- a second type of marking material can be used to mark cavities of a second type (e.g., that contain no objects to be removed).
- FIGS. 2A-E illustrate various steps in an embodiment of a marking substance that can be viewed with a viewing device and/or that can be viewed fluoroscopically.
- the marking substance may comprise a dye.
- the marking substance may comprise a contrast agent.
- the body cavities comprise calices of a kidney that are to be inspected for kidney stones.
- the present disclosure is intended to cover applications beyond kidney inspection and stone removal.
- kidney 10 first described in relation
- the kidney 10 comprises a plurality of calices 16 that may comprise kidney stones that are to be removed (none visible in the view of FIG. 2A). While the bodies of some of the calices 16 are visible in FIG. 2A, only the
- openings of other calices are visible (indicated by circles in FIGS. 2A-2E).
- an internal viewing device 30 has been inserted into the kidney 10 via the ureter 24.
- the viewing device 30 comprises a ureteroscope that has been inserted through a ureteral access sheath 32 that has been inserted into the urinary tract via the external meatus.
- an access sheath 32 is depicted in FIG. 2 A, the viewing device 30 could, alternatively,
- the viewing device 30 can be introduced into the kidney 10 using other methods, for
- the viewing device 30 has been maneuvered into a first calyx 34 of the upper portion of the kidney 10.
- That calyx 34 may, for example, be a suitable calyx to start with in a top-to-bottom inspection procedure, such as that described in the foregoing.
- the calyx 34 is clear of any stones or other objects that would require removal. Because of this, no further action is required in relation to the calyx 34, and the surgeon may move on to the next calyx 16 of the kidney 10.
- marking can be achieved by filling the calyx 34 with a marking material. Such a procedure is illustrated in FIG. 2B. As is indicated in that figure, the calyx 34 has been filled with a marking material 36.
- the calyx (or other cavity) could be marked by filling only a portion of the calyx with the marking material.
- the marking material 36 could be used to fill just the entrance to the calyx 34, if desired.
- the marking material 36 can be deposited using various different devices and techniques.
- the marking material 36 is injected into the calyx 34 (or other cavity) using a working or irrigation channel of the viewing device 30.
- the marking material 36 is delivered using a separate catheter that is inserted through the urinary tract (not shown).
- the marking material 36 is percutaneously injected into the desired site using an external injection device, such as a syringe.
- the marking material 36 contains a marking substance that is visible using one or both of the
- the marking material 36 is
- Suitable dyes that enable the surgeon to readily identify the marking material when viewing the kidney interior using the viewing device 30. Suitable dyes
- methylene dyes such as methylene blue and methylene red.
- methylene blue and methylene red When such a dye is used, the surgeon will be able to readily determine that the calyx
- the marking material 36 further or alternatively includes a contrast agent that enables identification of the marking material
- the contrast agent can be either water soluble or water insoluble.
- water soluble contrast agents include metrizamide, iopamidol, iothalamate sodium, iodomide
- water insoluble contrast agents include tantalum, tantalum oxide and barium sulfate, each of which is commercially available in the proper form for in vivo use.
- Other water insoluble contrast agents include gold,
- the contrast agent assists the surgeon in
- the marking material 36 is in liquid form prior to deposition, but forms a gel after or during deposition. In some embodiments,
- the marking material 36 can be a temperature-sensitive material that is in liquid form below normal body temperature, but that forms a gel at or above body temperature.
- Such materials include lower critical solution temperature materials, such as
- PEO-PPO polyoxyethylene-polyoxypropylene
- the material can be deposited within the
- calyx 34 calyx 34 and cooled to form a gel.
- examples of such materials include gelatin
- the marking material 36 comprises two separate
- crosslinkable polymers that form a gel when contacted with a crosslinking
- Crosslinkable polymers that may be suitable for use in the invention include both ionically crosslinkable and non-ionically crosslinkable polymers.
- Crosslinking agents that may be employed include both ionic crosslinking agents and non-ionic
- Ionically crosslinkable polymers include anionic crosslinkable
- anionic crosslinking agents and cationic crosslinking agents, respectively.
- the marking material is a temporary implant that it is automatically or manually removed once it is
- the marking material 36 is a temperature-sensitive material
- the material will slowly degrade within the kidney and be excreted.
- the speed with which the temperature-sensitive gel breaks down can be increased by either cooling or
- marking material 36 depending upon whether the material forms a gel at higher or lower temperatures.
- the marking material 36 comprises two separate components
- breakdown of the marking material can, for example, be
- marking material 36 includes a crosslinkable polymer, a suitable de-crosslinking agent
- Suitable de-crosslinking agents include sodium phosphate, sodium citrate, inorganic
- organic phosphates e.g., cellulose phosphate
- inorganic phosphates e.g.,
- nitrilotriacetic acid maleic acid, oxalate, polyacrylic acid, sodium, potassium,
- the gel may be removed by drawing the gel out of
- the calyx using a lumen of the viewing device or a separate catheter.
- marking material 36 may, in some cases, naturally degrade and
- the marking material will remain in place for at least the
- the marking material 36 will continue to provide a visual
- the surgeon has manipulated the viewing device 30
- the surgeon can identify the stone using the viewing device 30, and then
- the retrieval device 42 is inserted through a working channel of the viewing device 30. In such a case, the retrieval device 42 and
- the viewing device 30 can be withdrawn from the body together (e.g., via the access sheath 32) to remove the stone 40.
- the retrieval device 42 can be inserted into the kidney 10 separate from the viewing device 30.
- the calyx can be marked with the marking material 36 in similar
- the second calyx 38 can, for example, be filled with the marking material 36 as is
- FIG. 2E Again, such filling can be accomplished using a working or irrigation channel of the viewing device 30, a separate catheter, or a percutaneous injection device.
- lithotripsy is performed. Specifically, once a calyx 16, or its entrance, has been filled with a gel-based marking material, fragments that break off of a stone during lithotripsy will not be able to enter the calyx. Therefore, the surgeon
- FIGS. 3 A and 3 B illustrate an example of a further marking application.
- a given calyx 44 comprises a plurality of stones 46 that are
- the stones 46 comprise fragments of a larger stone that was broken up through lithotripsy. Assuming that the surgeon can only remove one stone 46 at a time, or at least cannot remove all of the stones at once, the surgeon may need to return to the calyx 44 one or more times after withdrawing the viewing device 30. In such a case, it may be difficult for the surgeon to relocate the
- calyx 44 or distinguish it from other calices 16 of the kidney 10.
- the surgeon can mark the calyx 44 with the marking material 36, as is
- the surgeon can then remove the stones 46 (e.g., one by one) from the calyx through the marking material 36 using the retrieval device 42.
- the marking material 36 is a gel
- FIG. 4 illustrates a further marking application.
- several of the calices 48 have been marked with a first marking material 50 to indicate a first
- the first condition is absence of any
- the marking material 50 is distinguishable from the marking material 54 in one or more ways.
- the marking material 50 comprises a different colored dye than the marking material 54 comprises. In such a case, the surgeon can distinguish the marking material 50 from the marking material 54 in one or more ways.
- each of the calices 48 extends from a major calyx 58.
- the cavities to be marked comprise all of the cavities of a given group or branch of cavities
- the entire calyx 58 can be filled with the marking material 50 to indicate that that entire portion of the kidney 10 has already been inspected.
Abstract
Description
Claims
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2007558204A JP2008537730A (en) | 2005-03-02 | 2006-03-01 | System and method for marking body cavities |
AU2006218556A AU2006218556B2 (en) | 2005-03-02 | 2006-03-01 | System and method for marking body cavities |
CA002599354A CA2599354A1 (en) | 2005-03-02 | 2006-03-01 | System and method for marking body cavities |
EP06736662A EP1871268B1 (en) | 2005-03-02 | 2006-03-01 | System for marking body cavities |
ES06736662T ES2399100T3 (en) | 2005-03-02 | 2006-03-01 | System for marking body cavities |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/070,813 US7907991B2 (en) | 2005-03-02 | 2005-03-02 | System and method for marking body cavities |
US11/070,813 | 2005-03-02 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2006094105A1 true WO2006094105A1 (en) | 2006-09-08 |
Family
ID=36589319
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2006/007381 WO2006094105A1 (en) | 2005-03-02 | 2006-03-01 | System and method for marking body cavities |
Country Status (7)
Country | Link |
---|---|
US (2) | US7907991B2 (en) |
EP (1) | EP1871268B1 (en) |
JP (1) | JP2008537730A (en) |
AU (1) | AU2006218556B2 (en) |
CA (1) | CA2599354A1 (en) |
ES (1) | ES2399100T3 (en) |
WO (1) | WO2006094105A1 (en) |
Families Citing this family (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7907991B2 (en) * | 2005-03-02 | 2011-03-15 | C. R. Bard, Inc. | System and method for marking body cavities |
CN102159143A (en) * | 2006-09-29 | 2011-08-17 | 普拉罗美德公司 | Methods for preventing retropulsion of concretions and fragments during lithotripsy |
US8280496B2 (en) * | 2007-12-13 | 2012-10-02 | Boston Scientific Scimed, Inc. | Extended spectral sensitivity endoscope system and method of using the same |
EP3153090A1 (en) | 2014-07-15 | 2017-04-12 | Olympus Corporation | Navigation system and navigation system operation method |
US9743943B2 (en) * | 2015-03-31 | 2017-08-29 | Terumo Kabushiki Kaisha | Method for removing calculus from an access sheath |
CN105167737B (en) * | 2015-08-28 | 2016-10-05 | 江苏省中医院 | A kind of correcting device for correcting combination type Flexible ureteroscope surgical field of view |
US20190269468A1 (en) * | 2018-03-01 | 2019-09-05 | Auris Health, Inc. | Methods and systems for mapping and navigation |
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EP1491147A1 (en) * | 1998-12-24 | 2004-12-29 | Vivant Medical, Inc. | Device and method for safe location and marking of a cavity and sentinel lymph nodes |
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US4945895A (en) * | 1989-03-20 | 1990-08-07 | Vance Products Incorporated | Remote fiber optic medical procedure and device |
JPH04146741A (en) * | 1990-10-08 | 1992-05-20 | Toshiba Corp | Biopsy clamp |
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US7907991B2 (en) * | 2005-03-02 | 2011-03-15 | C. R. Bard, Inc. | System and method for marking body cavities |
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-
2005
- 2005-03-02 US US11/070,813 patent/US7907991B2/en not_active Expired - Fee Related
-
2006
- 2006-03-01 CA CA002599354A patent/CA2599354A1/en not_active Abandoned
- 2006-03-01 AU AU2006218556A patent/AU2006218556B2/en not_active Ceased
- 2006-03-01 WO PCT/US2006/007381 patent/WO2006094105A1/en active Application Filing
- 2006-03-01 ES ES06736662T patent/ES2399100T3/en active Active
- 2006-03-01 EP EP06736662A patent/EP1871268B1/en not_active Not-in-force
- 2006-03-01 JP JP2007558204A patent/JP2008537730A/en active Pending
-
2011
- 2011-02-18 US US13/030,687 patent/US20110144485A1/en not_active Abandoned
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US4485812A (en) * | 1981-12-11 | 1984-12-04 | Kabushiki Kaisha Medos Kenkyusho | High frequency incising device |
US4802461A (en) | 1987-08-26 | 1989-02-07 | Candela Laser Corporation | Rigid endoscope with flexible tip |
EP1491147A1 (en) * | 1998-12-24 | 2004-12-29 | Vivant Medical, Inc. | Device and method for safe location and marking of a cavity and sentinel lymph nodes |
US6427081B1 (en) * | 1999-02-02 | 2002-07-30 | Senorx, Inc. | Methods and chemical preparations for time-limited marking of biopsy sites |
US6589998B1 (en) * | 1999-06-11 | 2003-07-08 | Cytyc Health Corporation | Gel composition for filling a breast milk duct prior to surgical excision of the duct or other breast tissue |
US20020119116A1 (en) | 2001-02-28 | 2002-08-29 | Scimed Life Systems, Inc. | Immobilizing objects in the body |
Also Published As
Publication number | Publication date |
---|---|
EP1871268A1 (en) | 2008-01-02 |
AU2006218556B2 (en) | 2011-01-27 |
CA2599354A1 (en) | 2006-09-08 |
JP2008537730A (en) | 2008-09-25 |
US7907991B2 (en) | 2011-03-15 |
US20060200024A1 (en) | 2006-09-07 |
US20110144485A1 (en) | 2011-06-16 |
EP1871268B1 (en) | 2013-01-09 |
AU2006218556A1 (en) | 2006-09-08 |
ES2399100T3 (en) | 2013-03-25 |
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