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WO2003055397A1 - Procede et dispositif de decoupage de tissus au jet - Google Patents

Procede et dispositif de decoupage de tissus au jet Download PDF

Info

Publication number
WO2003055397A1
WO2003055397A1 PCT/DE2002/004671 DE0204671W WO03055397A1 WO 2003055397 A1 WO2003055397 A1 WO 2003055397A1 DE 0204671 W DE0204671 W DE 0204671W WO 03055397 A1 WO03055397 A1 WO 03055397A1
Authority
WO
WIPO (PCT)
Prior art keywords
abrasive
tissue
magnesium alloy
jet
line element
Prior art date
Application number
PCT/DE2002/004671
Other languages
German (de)
English (en)
Inventor
Carl Joachim Wirth
Henning Windhagen
Stephan Schmolke
Frank Witte
Ludger Kirsch
Friedrich-Wilhelm Bach
Hartmut Louis
Frank Pude
Volker Kaese
Peter Wilk
Original Assignee
Universität Hannover
Medizinische Hochschule Hannover
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 Universität Hannover, Medizinische Hochschule Hannover filed Critical Universität Hannover
Priority to EP02798287A priority Critical patent/EP1460949A1/fr
Priority to AU2002363837A priority patent/AU2002363837A1/en
Publication of WO2003055397A1 publication Critical patent/WO2003055397A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/3203—Fluid jet cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1644—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans using fluid other than turbine drive fluid
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B24—GRINDING; POLISHING
    • B24C—ABRASIVE OR RELATED BLASTING WITH PARTICULATE MATERIAL
    • B24C11/00—Selection of abrasive materials or additives for abrasive blasts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/54—Chiropodists' instruments, e.g. pedicure
    • A61B17/545—Chiropodists' instruments, e.g. pedicure using a stream or spray of abrasive particles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00004—(bio)absorbable, (bio)resorbable or resorptive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1644—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans using fluid other than turbine drive fluid
    • A61B2017/1648—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans using fluid other than turbine drive fluid as cutting jet
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320004—Surgical cutting instruments abrasive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/005—Auxiliary appliance with suction drainage system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C3/00—Dental tools or instruments
    • A61C3/02—Tooth drilling or cutting instruments; Instruments acting like a sandblast machine
    • A61C3/025—Instruments acting like a sandblast machine, e.g. for cleaning, polishing or cutting teeth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4619—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof for extraction

Definitions

  • the invention relates to a method for jet cutting human or animal tissue, in particular bone tissue, by means of a fluid jet, to which a body-compatible and at the same time pharmacologically acceptable abrasive is added to increase the removal rate.
  • the invention further relates to a device for carrying out the method and an abrasive intended for use in the method.
  • Such a method for removing an implant or a prosthesis from bone tissue is known, for example, from DE 198 04 065, by means of which a substantial part of the bone cement can be removed with the aid of a high-pressure liquid jet and a water-soluble abrasive.
  • the implant can be removed with only a small amount of force and is therefore gentle on the tissue.
  • the comparatively thin fluid jet is ideally suited for this purpose, because it enables a large depth of cut to be achieved with little loss of substance.
  • the parameters of the liquid jet can be adjusted by supplying a suitable abrasive in such a way that damage to the bone tissue is excluded in any case. Therefore, incorrect operation, which could lead to injury to the patient, is also ruled out with manual guidance.
  • a device for separating a biological structure is also known from DE 42 00 976 C2, which allows the surgeon to make a sensitive and reproducible setting of the fluid pressure by appropriate arrangement of the components.
  • the fluid is introduced into the bone tissue in a supercritical state. Simply bringing the bone tissue into contact with the supercritical fluid is intended to increase its mechanical strength even during the extraction of the organic matter.
  • DE 198 43 683 A1 discloses a partially metallic abrasive which contains particles from industrial sludges, for example grinding sludge or rolled and forged scale, and a process for the production thereof by deoiling and drying these sludges.
  • these slurries are not suitable for use in jet cutting of human or animal tissue, since residues of particles of the abrasive in the tissue create an increased risk of infection.
  • the present invention has for its object to provide a way to further improve the use and application of jet cutting with abrasives. Furthermore, an apparatus for performing the method and a suitable abrasive are to be created.
  • the first-mentioned object is achieved according to the invention with a method according to the features of patent claim 1.
  • the subclaims relate to particularly expedient developments of the invention.
  • a method is therefore provided in which an abrasive consisting of essentially biodegradable constituents is used.
  • an abrasive consisting of essentially biodegradable constituents.
  • a particularly advantageous embodiment of the invention is achieved in that a magnesium alloy is used as the abrasive. Due to its essential character, it is ideally suited as an abrasive agent for bodily functions and flushing out overdoses via the urinary tract. Furthermore, the magnesium introduced into the body can increase the strength of the tooth enamel and the trabeculae or the substitution of the calcium. Magnesium is also cardioprotective by being antiarrhythmic and lowering blood pressure. The magnesium corrodes in the body in saline immersion, so that the desired mechanical resilience, which is decisive for the removal performance, is achieved when hitting, for example, bone tissue with the optimal biodegradable property required at the same time.
  • the second task a device for jet cutting body tissue, which works according to the known injector or the suspension jet principle, with a line element through the outlet opening of which a fluid jet, which contains an abrasive which increases the removal capacity, can be fed to the body tissue, for carrying out the To create a method is achieved according to the invention in that the line element has, at least in the region of the outlet opening, essentially biodegradable material components.
  • the line element can also be provided with a corresponding coating, which may or may not be renewable Be provided stratification, which is optionally renewable or can be replaced together with an interchangeable component of the line element.
  • the line element has a focusing tube which consists of a biodegradable metal, at least in the region of its inner wall.
  • the focusing tube is subject to increased stress from the fluid jet and thus increased wear.
  • the hardness or the abrasion resistance of the biodegradable material components of the line element is greater than that of the abrasive used, in order to minimize the wear of the line element, in particular of the focusing tube.
  • the line element has a magnesium alloy as an essential material component, in order to obtain the desired, comparatively favorable surface quality with sufficient hardness and the desired biodegradability, in particular by optimal selection of the magnesium alloy.
  • the further mentioned task of creating a body-compatible and at the same time pharmacologically acceptable abrasive for use in jet cutting of human or animal tissue, in particular bone tissue, which is added to the fluid jet to increase the removal rate, is achieved according to the invention by a biodegradable metal as an essential material component reached.
  • a biodegradable metal as an essential material component reached.
  • a particularly promising embodiment is also achieved by using a magnesium alloy as an essential material component.
  • a magnesium alloy as an essential material component.
  • the good physical tolerance of the magnesium can be used.
  • the material properties problem-free adaptation to different material removal rates and operating conditions.
  • the removal rate can be set independently of the fluid parameters by means of a composition of the magnesium alloy determined in accordance with the desired degree of hardness of the abrasive thus obtained. For example, this enables problem-free adaptation to soft tissue on the one hand and hard tissue, in particular bone tissue, on the other.
  • Another particularly advantageous embodiment of the abrasive according to the invention is achieved by a composition of the magnesium alloy which is determined in accordance with the desired surface condition of the abrasive thus obtained.
  • the properties of the cutting edges are changed by the alloy components and can thus be adapted to the respective application, for example for removing or cutting the tissue in a manner that is gentle on the substance.
  • the invention permits various embodiments. To further clarify its basic principle, one of these is shown in the drawing and is described below. This is shown in a schematic diagram in
  • FIG. 2 shows a device for jet cutting according to the injector jet principle.
  • FIG. 1 shows a schematic diagram of a device 1 according to the invention for jet cutting body tissue 2.
  • a fluid 3 inside a pressure vessel 4 is supplied with a biodegradable abrasive 5 which contains a magnesium alloy as an essential material component.
  • the fluid 3 is in operation by a line element 6 and an outlet opening 7 is directed onto the body tissue 2.
  • the line element 6 At least in the area of the outlet opening 7, the line element 6 also has biodegradable material components, in order to prevent impairment due to the inevitable removal of these material components.
  • the line element 6 can be made interchangeable or can be provided with a renewable coating.
  • FIG. 2 shows a device 8 for jet cutting according to the injector jet principle.
  • the abrasive 5 is supplied to the fluid 3 only immediately before it exits through an outlet opening 9 of a focusing tube 10 of a line element 11, so that due to the short residence time in the fluid 3 before it hits the body tissue 2, a dissolution process does not occur or only in an extremely high degree to a small extent.
  • soluble abrasives 5 can therefore also be used in particular.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Mechanical Engineering (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgical Instruments (AREA)
  • Materials For Medical Uses (AREA)

Abstract

La présente invention concerne un procédé et un dispositif (1) pour découper au jet des tissus (2) humains ou animaux, notamment des tissus osseux, au moyen d'un jet de liquide. Afin d'augmenter la capacité d'enlèvement de matière, un agent abrasif (5) biocompatible et pharmaceutiquement acceptable est ajouté au jet de liquide. L'utilisation d'un agent abrasif (5) contenant des composantes sensiblement biodégradables qui se dissolvent dans le corps par un processus de corrosion, permet d'obtenir un enlèvement de matière important accompagné d'une biocompatibilité élevée indépendamment de la solubilité de l'agent abrasif (5) dans le liquide (3), ce qui rend inoffensifs les résidus d'agent abrasif (5) dans les tissus (2).
PCT/DE2002/004671 2001-12-28 2002-12-19 Procede et dispositif de decoupage de tissus au jet WO2003055397A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP02798287A EP1460949A1 (fr) 2001-12-28 2002-12-19 Procede et dispositif de decoupage de tissus au jet
AU2002363837A AU2002363837A1 (en) 2001-12-28 2002-12-19 Method and device for sectioning tissue by means of a jet

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE2001164024 DE10164024A1 (de) 2001-12-28 2001-12-28 Verfahren und Vorrichtung zum Strahlschneiden von Gewebe
DE10164024.2 2001-12-28

Publications (1)

Publication Number Publication Date
WO2003055397A1 true WO2003055397A1 (fr) 2003-07-10

Family

ID=7710915

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE2002/004671 WO2003055397A1 (fr) 2001-12-28 2002-12-19 Procede et dispositif de decoupage de tissus au jet

Country Status (4)

Country Link
EP (1) EP1460949A1 (fr)
AU (1) AU2002363837A1 (fr)
DE (1) DE10164024A1 (fr)
WO (1) WO2003055397A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1676535A1 (fr) * 2004-12-29 2006-07-05 DePuy Mitek, Inc. Système chirurgical de coupe abrasive
WO2013164409A1 (fr) * 2012-05-04 2013-11-07 Kendlbacher Andreas Dispositif de découpe d'os au jet

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE430112C (de) * 1924-06-18 1926-06-10 Heinrich Friedrich Jakobsen Einrichtung zum Bearbeiten (Abschleifen, Bohren u. dgl.) von Zaehnen im Munde
CH527276A (de) * 1969-08-20 1972-08-31 Tsnii Travmatologii I Ortopedi Legierung auf Magnesiumgrundlage für die Verwendung in der Knochenchirurgie
DE19731021A1 (de) * 1997-07-18 1999-01-21 Meyer Joerg In vivo abbaubares metallisches Implantat
DE19804065A1 (de) * 1998-02-04 1999-12-23 Matthias Honl Flüssigkeitsabrasivstrahltrennverfahren für biologische Gewebe, Stoffe und Organe wie z. B. Knochen, Knorpel, Zähne und Häute für Biomaterialen wie z. B. Knochenzement (PMMA oder andere Polymere), Verbundwerkstoffe und Metalle sowie für technische Materialien
DE19904640A1 (de) * 1999-02-05 2000-08-10 Wittenstein Gmbh & Co Kg Verfahren zum Trennen oder Entfernen einer biologischen Struktur, insbesondere Knochen
US20010049502A1 (en) * 1998-11-25 2001-12-06 Light Sciences Corporation Guide sheath for repeated placement of a device

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL206506A (fr) * 1949-02-24
DE4200976C2 (de) * 1992-01-16 1995-08-24 Andreas Pein Vorrichtung zum Trennen einer biologischen Struktur, insbesondere des menschlichen Gewebes
FR2699408B1 (fr) * 1992-12-21 1995-03-24 Bioland Procédé de traitement de tissus osseux et biomatériaux implantables correspondants.
DE19843683B4 (de) * 1998-09-24 2004-02-05 Hans Prof. Dr.-Ing.habil. Lutze Abrasivmittel, Verfahren zu seiner Herstellung und seine Verwendung

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE430112C (de) * 1924-06-18 1926-06-10 Heinrich Friedrich Jakobsen Einrichtung zum Bearbeiten (Abschleifen, Bohren u. dgl.) von Zaehnen im Munde
CH527276A (de) * 1969-08-20 1972-08-31 Tsnii Travmatologii I Ortopedi Legierung auf Magnesiumgrundlage für die Verwendung in der Knochenchirurgie
DE19731021A1 (de) * 1997-07-18 1999-01-21 Meyer Joerg In vivo abbaubares metallisches Implantat
DE19804065A1 (de) * 1998-02-04 1999-12-23 Matthias Honl Flüssigkeitsabrasivstrahltrennverfahren für biologische Gewebe, Stoffe und Organe wie z. B. Knochen, Knorpel, Zähne und Häute für Biomaterialen wie z. B. Knochenzement (PMMA oder andere Polymere), Verbundwerkstoffe und Metalle sowie für technische Materialien
US20010049502A1 (en) * 1998-11-25 2001-12-06 Light Sciences Corporation Guide sheath for repeated placement of a device
DE19904640A1 (de) * 1999-02-05 2000-08-10 Wittenstein Gmbh & Co Kg Verfahren zum Trennen oder Entfernen einer biologischen Struktur, insbesondere Knochen

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1676535A1 (fr) * 2004-12-29 2006-07-05 DePuy Mitek, Inc. Système chirurgical de coupe abrasive
JP2006187616A (ja) * 2004-12-29 2006-07-20 Depuy Mitek Inc 切削研磨システムおよび方法
US8425517B2 (en) 2004-12-29 2013-04-23 Depuy Mitek, Inc. Abrasive cutting system and method
WO2013164409A1 (fr) * 2012-05-04 2013-11-07 Kendlbacher Andreas Dispositif de découpe d'os au jet

Also Published As

Publication number Publication date
DE10164024A1 (de) 2003-07-17
AU2002363837A1 (en) 2003-07-15
EP1460949A1 (fr) 2004-09-29

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