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WO2020152011A1 - Dispositif de surveillance de l'intégrité d'une cavité durant une procédure médicale - Google Patents

Dispositif de surveillance de l'intégrité d'une cavité durant une procédure médicale Download PDF

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Publication number
WO2020152011A1
WO2020152011A1 PCT/EP2020/050938 EP2020050938W WO2020152011A1 WO 2020152011 A1 WO2020152011 A1 WO 2020152011A1 EP 2020050938 W EP2020050938 W EP 2020050938W WO 2020152011 A1 WO2020152011 A1 WO 2020152011A1
Authority
WO
WIPO (PCT)
Prior art keywords
liquid
proximal section
distal
pressure
bladder
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/EP2020/050938
Other languages
English (en)
Inventor
Eric Stenzel
Paul Brennan
Eamonn KEEGAN
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
IDOMAN TEORANTA
Original Assignee
IDOMAN TEORANTA
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.)
Filing date
Publication date
Application filed by IDOMAN TEORANTA filed Critical IDOMAN TEORANTA
Publication of WO2020152011A1 publication Critical patent/WO2020152011A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A61B2017/4216—Operations on uterus, e.g. endometrium
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/0022—Balloons
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00559—Female reproductive organs
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • 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
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature
    • 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
    • A61B2018/044—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating the surgical action being effected by a circulating hot fluid
    • A61B2018/046—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating the surgical action being effected by a circulating hot fluid in liquid form
    • 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
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension

Definitions

  • the present invention relates to a device for monitoring cavity integrity during a medical procedure.
  • EP 1 259 180 B1 discloses a device for facilitating necrosis of tissue comprising: a distal flexible bladder; a proximal section; a single-lumen catheter joining the distal bladder and proximal section in a liquid-tight system; and a liquid inside the system to flow between the distal bladder and proximal section, wherein the liquid is in an amount that permits the distal bladder to substantially deflate when the liquid is moved out of the distal bladder; a pressurizing mechanism to apply variable pressure to the proximal section to initiate liquid flow out of the proximal section and into the distal bladder; and a heater element controlled for heating of the liquid in the proximal section.
  • such a device In performing a medical procedure, such as a thermal endometrial ablation within the uterus, such a device can be inserted within the uterine cavity so that heated liquid is transferred within the substantially closed system between the proximal section and the distal flexible bladder in either direction as needed to complete the medical procedure.
  • heated liquid in the proximal section is applied under pressure, this inflates the distal flexible bladder to substantially conform to the inner geometry of the uterine cavity.
  • Such devices can include a pressure sensor to ensure that the liquid within the system does not exceed an upper desired or safe pressure limit.
  • WO 2014/195490 discloses a catheter with a bladder which can be inflated with a hot medium.
  • the apparatus operates the inflation means in the negative direction during heating of the inflation medium.
  • An undesirable situation can occur during a uterine procedure where the uterine cavity is or can become perforated, torn or otherwise compromised. Should such a situation occur, there is a potential for a portion of the distal flexible bladder to pass through the perforated, torn or otherwise compromised uterus to an area outside of the uterus. When such a situation occurs, there is potential for thermal damage to untargeted or undesired tissue or organs such as the bowel.
  • Some systems such as those available from Minerva Surgical Inc, such as disclosed in US2018/303404; or Novacept Inc., such as disclosed in US6554780 evaluate the integrity of a uterine cavity before an ablation procedure by introducing a probe into a patient's uterine cavity, providing a flow of a fluid, such as CO2 or Argon through the probe into the uterine cavity and monitoring the rate of the flow to characterize the uterine cavity as perforated or non-perforated based on a change in the flow rate.
  • a fluid such as CO2 or Argon
  • a device for facilitating necrosis of tissue according to claim 1.
  • Embodiments according to this aspect provide improved heating of treatment liquid prior to, during or between treatment cycles of the device.
  • a device for monitoring cavity integrity during a medical procedure according to claim 21.
  • Embodiments of the device can be used to detect procedural anomalies or undesirable situations during a thermal ablation procedure to prevent or limit injury to the patient.
  • Embodiments can detect a potentially compromised uterus through measurement, calculation or otherwise quantifying pressure of treatment liquid within the device.
  • the volume of the treatment liquid within the device or the flow of treatment liquid through the device at any time point during an ablation procedure can be measured, calculated or otherwise quantified to assist in detecting a potentially compromised uterus.
  • a part of this detection can involve quantifying a change of pressure, volume or flow at a point in time during a procedure or a change over a time period during a procedure.
  • the time period can comprise a rolling window.
  • treatment is applied across a number of cycles of inflating and deflating a distal bladder and detecting a potentially compromised uterus can comprise comparing measurements of pressure and possibly volume or flow from one treatment cycle with those from a previous cycle to determine if any changes have occurred.
  • the device can take action to prevent or limit any undesired damage to untargeted tissue or organs.
  • Such an action can include the transfer of the treatment liquid from the distal flexible bladder into a proximal section of the device outside of the cavity; or any action to return the device to a safe condition before allowing the procedure to continue or aborting the procedure.
  • any suitable method can be used to heat the liquid within the chamber including direct heating with an element integral to the syringe chamber, radiative or conductive heating with an element external to the syringe chamber or indirect heating such as inductive heating.
  • Figure 1 shows schematically layout of a device according to an embodiment of the present invention
  • Figure 2 shows schematically top views of a number of collapsible heater elements which can be employed in various embodiments of the present invention
  • Figure 3 shows end views of the heater elements of Figure 2
  • Figure 4 shows further views of some of the heater elements of Figure 2; and Figure 5-8 show a number of foldable heating elements which can be employed in various embodiments of the present invention.
  • the device can have a form factor similar to the device of EP 1 259 180 B1 except instead of a proximal section comprising a flexible bladder housed within a pneumatic chamber, a syringe (3) is employed.
  • a distal flexible bladder (1 ) is connected to a fluidic connecting member (2). Also connected to the fluidic connecting member (2) is another fluidic connecting member (7) that is fluidically connected to a pressure sensor (8).
  • the distal flexible bladder (1 ) is formed of an elastically expandable material, for example, a biocompatible silicone elastomer, whereas the connecting members (2) and (7) tend to comprise a more rigid biocompatible material.
  • the connecting member (7) can be a flexible silicone tube - but not as flexible as the distal bladder.
  • the distal bladder (1 ) is typically highly elastic so that it readily conforms with the internal surface of a cavity and so that a majority of pressure measured by the sensor (8) is derived from back pressure applied by the cavity wall.
  • the syringe (3) a chamber of which contains liquid which can be heated.
  • the distal bladder (1 ), connecting member (2), connecting member (7) and syringe chamber form a substantially liquid-tight system.
  • liquids which can be used in the system include: Glycerine,
  • Triglycerides such as Oleic Acid
  • Fluoro/Silicone liquid compounds and mineral oils.
  • a flexible and collapsible heating coil can be incorporated longitudinally within the syringe chamber with electrical contacts for the heating coil passing through the chamber wall to allow electrical power to be provided to the heating coil.
  • Figures 2 (a) to (e) show schematically top views of a number of heating coils which can be employed in various embodiments of the present invention;
  • Figure 3 show respective end views of the heating coils of Figure 2; and Figure 4 shows further views of some of the heating coils of Figure 2.
  • a flexible and collapsible heating coil enables the syringe plunger to compress the heating coil when providing heated treatment fluid to the distal bladder (1 ), whereas when the plunger is retracted, the coil can expand to expose a maximum heating surface to the treatment liquid to most effectively heat or re-heat the treatment liquid.
  • a foldable, accordion type, heating element could be employed.
  • Figures 5 (a) to (c) show schematically top views of a number of such foldable heating elements which can be employed in various embodiments of the present invention.
  • each substrate 10a, 10c has a number of notches 16a, 16c or the substrate 10b has narrowed waist portions 16b formed along their length to allow the substrate to fold at those positions and so that when folded, each substrate may have a concertina form similar to that shown in Figure 6, although the number of folds may vary.
  • a number of holes 14 are provided along the length of each substrate to promote the circulation of fluid through the substrate both during heating and as the syringe plunger is moved in and out of the syringe chamber.
  • tabs 18a’, 18a”, 18b’, 18b” and 18c’, 18c” extending from each end of the substrates 10a, 10b and 10c is configured to pass through the wall of the syringe chamber with the other being configured to be fixed to the plunger.
  • These tabs along with any hole(s) 20a, 20b in the tabs, can allow for an external electrical connection to the heater and to fix the ends of the heater between the wall of the syringe chamber and the plunger and so that the heating element expands and retracts as the syringe plunger is moved in and out of the syringe chamber.
  • Figure 7 shows a still further variation of the substrate of Figure 5(b) where in this case, two parts 12d’ and 12d” of a single conductor are formed on front and back surfaces respectively of the substrate 10d.
  • the two parts connect at the tab 18d” at the remote end of the substrate which can be fixed to the plunger with the electrodes passing through the syringe chamber wall on opposite surfaces of the tab 18d’.
  • Figure 8 shows a still further variant of the substrate 10e where a single conductor 12e is wound around the substrate.
  • Transverse elongate slots 14e both promote fluid flow as well as enable the substrate to fold.
  • the heating coil of Figure 5(c) can be driven with separate signals provided across each track 12c’, 12c” - although this involves providing electrical connections at each end of the substrate 10c.
  • the ends of the tracks 12c’, 12c” on the tab 18c” could connect to a conductive trace (not shown) looping back along the opposite surface of the substrate so that the front and back traces form a single trace with the
  • substrates 10a-10e of Figures 5-8 are described as having discrete fold lines so promoting repeatable folding and unfolding characteristics as the plunger moves in and out of the syringe chamber, variants of these substrates formed of a more flexible material which can be curved back and forth along its length could also be employed.
  • the heating element can be formed of any suitable material and can either be metallic or even polymeric or a combination of the two.
  • one or more temperature sensors can be provided to indicate the temperature of liquid within the liquid-tight system.
  • Typical operating temperature ranges for the liquid are between approximately 90 to 180 Deg C as needed to provide a temperature at the balloon / tissue interface of approximately 70 to 100 Deg C.
  • the syringe (3) includes a plunger and either: a proximal end of the plunger is connected to, or the plunger is formed as, a threaded shaft (4) of a known thread pitch.
  • the proximal end of the threaded shaft (4) is connected to a bi-directional drive motor (5) which is used to move the plunger in and out of the syringe chamber either: to apply pressure and initiate liquid flow from the syringe chamber through the connecting member (2) into the distal bladder (1 ); or to remove liquid from the distal bladder (1 ) as needed.
  • a motor encoder (6) that is used to indicate rotation of the motor (5) corresponding to movement of the syringe plunger to an optical emitter/sensor (9), so enabling the axial position of the plunger within the syringe (3) to be determined.
  • any suitable sensor equivalent to the encoder (6)- emitter/sensor (9) arrangement for example, a linear slide resistor connected to the plunger where the change in plunger position is noted by a change in resistance, can be used to determine the axial position of the plunger within the syringe (3).
  • An exemplary encoder (6) comprise a circular disk (6) connected to an end of the drive motor (5).
  • the disk can have one or more holes or slots to allow light to pass through.
  • An optical emitter/sensor (9) is position to surround the rotating face of the circular disk of the motor encoder (6) such that the light emitted from one side of the optical emitter/sensor (9) can pass through a hole or slit on the circular disk of the motor encoder (6) to provide a series of electrical pulses from the optical
  • emitter/sensor (9) each time a hole or slot rotates through the emitted light.
  • each full rotation of the circular disk on the motor encoder (6) will result in one electrical pulse being detected. If the circular disk of the motor encoder (6) has multiple holes or slots, for example of the order of 100 holes/slots, each full rotation of the circular disk on the motor encoder (6) will result in multiple electrical pulses being detected. Thus, depending on the encoder, one full rotation of the shaft can be linked to one or more counts of the encoder.
  • each full or partial rotation of the threaded shaft (6) will move the plunger within the syringe (3) a known distance.
  • the volume of liquid displaced by movement of the plunger within the syringe (6) can be determined and quantified from this movement/counts.
  • RPM rotations per minute
  • N*M Newton * Meters
  • a motor can rotate at 10,000 RPM at 0.01 N*M torque while the gear reduction provides 2 RPM with 50 N*M torque.
  • gear reduction is beneficial for a number of reasons including the use of a high-speed smaller motor to produce a higher torque with a reduced speed and the ability to conduct the rotational counting with the motor encoder (6) and optical emitter/sensor (9) at the high rotational speed portion of the motor.
  • a 10,000 RPM motor with 0.01 N*M torque will produce 10,000 counts with the motor encoder (6) and optical emitter/sensor (9) while the threaded shaft (4) will only rotate twice.
  • Such an arrangement can increases the accuracy of the calculated position of the plunger within the syringe (3) by a factor of 5,000, depending on the gear ration employed in the device.
  • the position of the plunger within the syringe (3) can be calculated or quantified by adding or subtracting the optical emitter/sensor (9) pulses according to the direction the motor is rotating.
  • Each of the pressure sensor (8), the motor (5), emitter/sensor (9), heater and temperature sensor are connected to an electronic device controller (not shown) running dedicated control software and typically mounted on a custom printed circuit board (PCB) along with any additional components, such as a memory, display and operating buttons, needed to operate the device.
  • PCB printed circuit board
  • An example of the operation of the device during a complete endometrial ablation procedure could include the following steps:
  • mixing cycles bring the system to a predefined pressure by transferring liquid from the syringe (3) into the distal bladder (1 ) then immediately withdrawing the liquid back into the syringe (3).
  • the series of mixing cycles may be one or a predetermined multiple number of exchanges.
  • An exemplary pressure setpoint can be about 220mm Hg +/- 20mmHg.
  • steps 4 and 5 a predefined number of times with predefined treatment times. Such treatment times might be between approximately 30 seconds and 60 seconds and in some cases, times might increase from a starting time for a first one or more cycles to a maximum time for later cycles.
  • Each treatment cycle of steps 4 and 5 may occur with substantially no delay between inflation/deflation of the distal bladder (1 ) or these exchanges may include predefined delays between inflations/deflations.
  • the pressure sensor (8) is used to measure the pressure within the system in a substantially continuous manner. This pressure measurement is used by the device controller software for multiple purposes including, but not limited to:
  • This change can be in one or more forms such as: a) A pressure change over a set time period exceeding a predetermined allowable change. An example of this could be where the pressure within the system changes by 30mmHg over any ten second rolling window period. b) A pressure change faster than above but over a shorter moving window. An example of this could be where the pressure within the system changes by l OmmHg over any 5 second rolling window period. c) A pressure change faster than the examples above. An example of this could be where the pressure within the system changes by 5mmHg over a moving 1 second window.
  • the pressure drop can be measured against an immediately previous measurement or the pressure drop can be measured against a corresponding pressure
  • the device can abort the procedure
  • the pressure sensor (8) is used to monitor the pressure within the substantially closed system.
  • the system is brought up to the predefined pressure, the pressure is monitored throughout the process, the system self-adjusts to maintain the system at the predefined pressure, the device monitors changes in pressure over time(s) and compares these to predefined pressure change limits and the device either completes the endometrial ablation procedure or aborts the procedure at any point in the event of an undesirable condition being detected.
  • the volume of liquid transferred from the syringe in addition to measuring pressure, can be calculated and quantified and used to assist in detecting an undesirable condition.
  • heated liquid is transferred until the system reaches a predefined system pressure. If in the event a predetermined volume is transferred but the predetermined system pressure has not been reached, there may be an anomaly situation where the uterus is perforated, torn or otherwise compromised, or the distal bladder (1 ) was misplaced into an untargeted area (such as into a fallopian tube). In this case, if a predefined volume level is reached before the system obtains the predefined pressure, the procedure is aborted with the drive motor (6) engaged to transfer the heated liquid back into the syringe (3).
  • a change of volume during a given time period can be compared to predefined limits to determine if an anomaly situation has occurred.
  • This monitoring includes:
  • the device When the device is ready to start the treatment cycles, the device will deliver heated liquid to/from the distal bladder (1 ) to a predetermined system pressure.
  • the change of volume between treatment cycles can be monitored and should a volume of liquid from one treatment cycle to another exceed a predetermined volume change, the device will abort the procedure and substantially withdraw the heated liquid back into the syringe.
  • the treatment procedure starts and the distal bladder (1 ) is inflated with heated liquid until the predefined system pressure is obtained. If the volume of liquid transferred exceeds the volume used during the mixing cycles by a predefined volume difference, the device aborts and substantially withdraws the heated liquid back into the syringe (3).
  • the timed treatment cycles then begin.
  • the distal bladder (1 ) is filled with the heated liquid to a predefined system pressure
  • the heated liquid remains in the distal bladder (1 ) for a predefined time period where additional liquid, if needed, is either transferred into or withdrawn from the distal bladder (1 ) to maintain the system pressure within the predefined operating window.
  • the change of liquid volume is quantified through calculation and/or measurement during the timed cycle where the change of volume during a time window within the timed cycle is maintained. Should a volume change per predefined time window during that timed cycle be exceeded, the device aborts and substantially withdraws the heated liquid back into the syringe (3).
  • An example could include a procedure abort in response to an increase liquid volume of 10ml from the start to the finish of the timed cycle with or without achieving the required pressure, a procedural abort if the liquid volume changes 5ml during a 10 second running window within the timed cycle or a 2ml volume change over a 5 second running window within the timed window.
  • the device After the series of timed treatment cycles have begun, if the starting volume of a subsequent timed treatment cycle exceeds the final volume of the preceding volume by a predefined volume change, the device aborts and substantially withdraws the heated liquid back into the syringe (3).
  • An example of this could be where the first timed treatment cycle finishes with 10ml liquid transferred into the distal bladder (1 ) but the second timed treatment cycle starts with 15ml of liquid transferred into the distal bladder (1 ), the device aborts, if a 5ml change limit between timed treatment cycles is set as a limit, and the liquid is substantially withdrawn back into the syringe (3).
  • a flow sensor (not shown) for determining a rate of liquid flow through the fluidic connecting member (2).
  • Such a flow measurement can be used to determine if during a mixing or treatment cycle a flow of liquid through the system exceeds a threshold.
  • a number of flow thresholds can be employed. So for example, there can be an upper safety flow rate which if exceeded at any time indicates an anomalous condition, for example, a fault in the distal bladder (1 ).
  • a lower flow rate in excess of a given lower threshold for maintaining a pressure at the predetermined level during a treatment cycle could also indicate an anomalous condition such as a perforation.
  • measurements of pressure and possibly volume or flow rate of treatment liquid can be used in a number of ways to determine if an anomalous condition is occurring during a treatment process. So, for example, instantaneous measurement values can be compared with absolute thresholds, or changes in measured values within a given cycle or between cycles can be compared with thresholds. Still more sophisticated techniques employing pattern matching in either a single dimension of pressure, volume or flow or across multiple dimensions of pressure, volume or flow including employing trained classifiers or artificial neural networks can also be used to detect any one or more anomalous conditions.
  • variants of the above described embodiments can include extended functionality and can, for example, be configured for conducting a pre- or post- treatment cavity check using a fluid other than the treatment liquid.
  • an air pump incorporated within the device can pass pressurized air through a solenoid controlled valve to deliver filtered room air under pressure through an air tube running along the fluid connecting member (2) to a distal end of the device to inflate the bladder within the cavity which is to be treated to a pre-defined pressure, with each of the air pump and solenoid controlled valve being programmatically controlled by the device controller as required.
  • a separate sensor than used for sensing the pressure of heated treatment fluid during a treatment cycle is required to determine when the pre-determ ined pressure is provided.
  • the valve can be closed, and the system pressure measured for a pre determined time - perhaps as little as 2-3 seconds - to determine if the cavity is correct and suitable for treatment.
  • System volume can also be measured, for example, by tracking the amount of air pumped into the cavity to achieve the pre determined pressure and again this can be used to determine if the cavity is correct and suitable for treatment.
  • a target air pressure might be in the region of 70 - 110 mmHg.
  • the solenoid controlled valve can be actuated by the device controller and air can be bled from the system through the air tube before, in the case of a pre-check, allowing treatment to proceed as described above.
  • the air pressure and/or volume measurements can be recorded and/or compared with those from a pre-check to check the continuing integrity of the cavity.
  • CO2 or Argon could be used such as disclosed in US2018/303404 or US6554780 referred to above,
  • a UV light source could be used in order to kill bacteria and/or to sterilize air being used for the pre- or post treatment cavity check.

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Abstract

La présente invention concerne un dispositif comprenant : une vessie souple distale ; une section proximale ; un élément de connexion joignant la vessie distale et la section proximale dans un système étanche aux liquides ; et un liquide de traitement à l'intérieur du système pour s'écouler entre la vessie distale et la section proximale. Le liquide de traitement se trouve en une quantité qui permet à la vessie distale de se dégonfler sensiblement lorsque le liquide de traitement est sorti de la vessie distale. Un mécanisme de pressurisation applique une pression variable à la section proximale pour initier l'écoulement du liquide hors de la section proximale et dans la vessie distale. Un élément chauffant est commandé pour le chauffage du liquide de traitement dans la section proximale. Un capteur de pression détecte un niveau de pression du liquide de traitement à l'intérieur du système étanche aux liquides. Un dispositif de commande est relié fonctionnellement au mécanisme de pressurisation, au dispositif chauffant et au capteur de pression pour commander le traitement.
PCT/EP2020/050938 2019-01-24 2020-01-15 Dispositif de surveillance de l'intégrité d'une cavité durant une procédure médicale Ceased WO2020152011A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB1900967.9 2019-01-24
GB1900967.9A GB2572046A (en) 2019-01-24 2019-01-24 Device for monitoring cavity integrity during a medical procedure

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WO2020152011A1 true WO2020152011A1 (fr) 2020-07-30

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112383195A (zh) * 2020-11-05 2021-02-19 张也 一种发电机组用高效散热装置

Citations (8)

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Publication number Priority date Publication date Assignee Title
US6554780B1 (en) 1999-11-10 2003-04-29 Novacept System and method for detecting perforations in a body cavity
EP1259180B1 (fr) 2000-03-01 2006-09-13 Thermal Ablation Technologies Canada Inc. Dispositif d'ablation thermique d'une cavite
US20120289857A1 (en) * 2011-05-06 2012-11-15 Minerva Surgical, Inc. Methods for evaluating the integrity of a uterine cavity
WO2013130655A1 (fr) * 2012-02-27 2013-09-06 Fractyl Laboratories, Inc. Systèmes, dispositifs et méthodes de thermoablation pour le traitement de tissu
WO2014139535A1 (fr) * 2013-03-11 2014-09-18 Syddansk Universitet Ensemble d'injection de fluide médical avec chauffage par induction du fluide
WO2014195490A1 (fr) 2013-06-07 2014-12-11 Kebomed Ag Appareil pour ablation thermique
US20180133446A1 (en) * 2016-11-14 2018-05-17 Menorrx, LLC System and method for delivering therapeutic agents to the uterine cavity
US20180303404A1 (en) 2011-02-04 2018-10-25 Minerva Surgical, Inc. Methods and systems for evaluating the integrity of a uterine cavity

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