# US 10,765,838 B2 · Medical device, medical device assembly, balloon device, and treatment method for treating urethral stricture

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- Number: US 10,765,838 B2
- Document ID: US10765838B2
- Status: Granted
- Kind: B2
- Application number: 15/053,150
- Filed: 2016-02-25
- Published: 2016-08-25
- Granted: 2020-09-08
- Earliest claimed: 2015-02-25
- Assignees: Terumo Kabushiki Kaisha
- Applicants: Terumo Kabushiki Kaisha
- Inventors: Kosuke Nishio; Riyaheh S. Hazama
- Web page: https://patentgrep.com/patent/US10765838B2

## CPC

- A61M 25/1011: {Multiple balloon catheters}
- A61B 17/0469: {Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery}
- A61B 17/062: Needle manipulators
- A61B 17/3478: {Endoscopic needles, e.g. for infusion (biopsy needles A61B10/0233; catheters with injection needles A61M25/0067)}
- A61F 2/958: Inflatable balloons for placing stents or stent-grafts
- A61B 17/0487: {Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks (suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122)}
- A61B 2017/00274: {Prostate operation, e.g. prostatectomy, turp, bhp treatment}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/0417: {T-fasteners}
- A61B 2017/0464: {for soft tissue}
- A61B 2017/22044: {with a pointed tip}
- A61B 2017/22047: {Means for immobilising the guide wire in the patient}
- A61F 2/92: Stents in the form of a rolled-up sheet expanding after insertion into the vessel {, e.g. with a spiral shape in cross-section}
- A61F 2002/047: {Urethrae}
- A61M 25/04: in the body, e.g. expansible {(A61M25/10, A61M16/0488 take precedence)}
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- 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 (dental prosthetics A61C)

## Abstract

A medical device is disclosed for delivering a medical member which is intended to indwell in a treatment site of a urethra includes a flexible main body that extends in an axial direction, a balloon that includes an effectively dilatable portion on which the medical member is mounted, that has a dilating space into which a pressurizing medium flows between an outer surface of the main body and the balloon, and that is capable of dilating deformation and deflating deformation, an elongated guide member that is arranged across the treatment site and the outside of a living body via the urethra, and an attachment portion to which at least a portion of the guide member is detachably attached at a position between both end portions in the axial direction of the main body.

## Claims

### Claim 1

A medical system comprising:
a medical device and a medical member, the medical device configured to deliver the medical member, the medical device comprising:
a flexible main body that extends in an axial direction;
a balloon that includes a dilatable portion on which the medical member is mounted, the balloon having a dilating space into which a pressurizing medium flows between an outer surface of the flexible main body and an inner surface of the balloon;
an elongated guide member configured to extend across the treatment target site and outside of a living body via the biological lumen;
an attachment portion to which at least a portion of the guide member is detachably attached to the flexible main body at a position between end portions of the flexible main body in the axial direction;
the flexible main body being configured to be movable inside the biological lumen along a route having the elongated guide member arranged in the flexible main body, in a state where the guide member is attached to the attachment portion, the flexible main body having a lumen which extends in the axial direction, an opening portion for inserting the guide member into the lumen, and a hole portion configured to guide the guide member from the lumen to an outside of the flexible main body, and an extracting portion configured to guide the guide member from the hole portion to an outer surface side of the balloon, the extracting portion having a through-hole disposed in the balloon, and wherein a portion of an outer surface of the balloon around the through-hole is fixed to a periphery of the hole portion of the flexible main body; and
wherein the medical member is a sheet shaped member configured to provide a biological tissue with an epithelial function, and wherein the sheet shaped member is configured to be introduced into the biological lumen in a state where the sheet shaped member is wound around the dilatable portion of the balloon, and a gap in the sheet shaped member through which the guide member can be inserted in a state in which the sheet shaped member is wrapped around the dilatable portion of the balloon in a circumferential direction; and
a puncture tool including a main body having a lumen configured to receive the guide member and a puncture needle to which the guide member is attached so as to be connectable to the puncture needle and detachable from the puncture needle.

### Claim 2 (depends on 1)

The medical system according to claim 1,
wherein the extracting portion is configured to include the through-hole disposed in a thermally welded portion of the balloon formed by thermally welding the portion of the balloon to the periphery of the hole portion of the flexible main body.

### Claim 3 (depends on 1)

The medical system according to claim 1,
wherein the attachment portion is disposed in a central position in the axial direction of the flexible main body; and
wherein the dilatable portion of the balloon has a symmetrically dilated shape at the central position in the axial direction of the flexible main body.

### Claim 4 (depends on 1)

The medical system according to claim 1, comprising:
a stopper configured to be disposed inside the flexible main body and/or outside the flexible main body and configured to restrict mobility of the guide member.

### Claim 5 (depends on 1)

The medical system according to claim 1, wherein the puncture tool further comprises:
a hub having a lock mechanism configured to switch between fixing and unfixing of the guide member.

### Claim 6 (depends on 1)

The medical system according to claim 1, wherein the medical device is configured to deliver the medical member to a urethral stricture.

### Claim 7 (depends on 1)

The medical system according to claim 1, wherein the sheet shaped member has a cylindrical shape upon dilation of the dilating portion of the balloon in a treatment target site.

### Claim 8 (depends on 1)

The medical system according to claim 1, wherein the sheet shaped member includes an agent, gel, micro beads, and a synthetic polymer configured to promote regeneration of an epithelial function, or a material serving to replace recovery of the epithelial function; and
a suture thread configured to fix the sheet shaped member into a cylindrical shape in the state where the sheet shaped member is wound around the dilatable portion of the balloon.

### Claim 9

A medical system comprising:
a balloon device, the balloon device including a flexible main body that extends in an axial direction, the flexible main body has a lumen which extends in the axial direction, an opening portion for inserting an elongated guide member into the lumen, and a hole portion which extracts the guide member from the lumen to outside of the flexible main body, and an extracting portion configured to guide the guide member from the hole portion to an outer surface side of the balloon, the extracting portion having a through-hole disposed in the balloon, and wherein a portion of an outer surface of the balloon around the through-hole is fixed to a periphery of the hole portion of the flexible main body;
a balloon having a dilatable portion on which a medical member is attached, the balloon having a dilating space into which a pressurizing medium flows between an outer surface of the flexible main body and an inner surface of the balloon, the medical member being a rectangular shaped sheet wound around an outer surface of the balloon in a circumferential direction before a dilation of the balloon, and a gap in the medical member through which the guide member can be inserted in a state in which the medical member is wrapped around the dilatable portion of the balloon in the circumferential direction;
wherein the balloon includes an extracting portion configured to guide the guide member from the hole portion to an outer surface side of the balloon; and
a puncture tool including a main body having a lumen configured to receive the guide member and a puncture needle to which the guide member is attached so as to be connectable to the puncture needle and detachable from the puncture needle.

### Claim 10 (depends on 9)

The medical system according to claim 9,
wherein the extracting portion is configured to include the through-hole disposed in a thermally welded portion of the balloon formed by thermally welding the portion of the balloon to the periphery of the hole portion of the main body.

### Claim 11 (depends on 9)

The medical system according to claim 9,
wherein the attachment portion is disposed in a central position in the axial direction of the flexible main body; and
wherein the dilatable portion of the balloon has a symmetrically dilated shape at the central position in the axial direction of the flexible main body.

### Claim 12 (depends on 9)

The medical system according to claim 9, wherein the medical member has a cylindrical shape upon dilation of the dilating portion of the balloon in a treatment target site.

### Claim 13 (depends on 9)

The medical system according to claim 9, wherein the medical member includes an agent, gel, micro beads, and a synthetic polymer configured to promote regeneration of an epithelial function, or a material serving to replace recovery of the epithelial function; and
a suture thread configured to fix the medical member into a cylindrical shape in the state where the medical member is wound around the dilatable portion of the balloon.

### Claim 14

A treatment method for a urethral stricture comprising:
forming a treatment site by performing predetermined treatment on a scar tissue formed in a urethra;
arranging an elongated guide member at the treatment site via the urethra;
delivering a medical device including a balloon having a medical member mounted on the balloon to the treatment site along the guide member, the medical device including a flexible main body that extends in an axial direction, the balloon having a dilating space into which a pressurizing medium flows between an outer surface of the flexible main body and an inner surface of the balloon, the elongated guide member configured to extend across the treatment target site and outside of a living body via the biological lumen, an attachment portion to which at least a portion of the guide member is detachably attached to the flexible main body at a position between end portions of the flexible main body in the axial direction, the flexible main body being configured to be movable inside the biological lumen along a route having the elongated guide member arranged in the flexible main body, in a state where the guide member is attached to the attachment portion, and wherein the medical member is a sheet shaped member configured to provide a biological tissue with an epithelial function, and wherein the sheet shaped member is configured to be introduced into the biological lumen in a state where the sheet shaped member is wound around the dilatable portion of the balloon, and a gap in the sheet shaped member through which the guide member can be inserted in a state in which the sheet shaped member is wrapped around the dilatable portion of the balloon in a circumferential direction; attaching the guide member to a puncture tool, the puncture tool including a main body having a lumen configured to receive the guide member and a puncture needle to which the guide member is attached so as to be connectable to the puncture needle and detachable from the puncture needle; and
causing the medical member to indwell over a predetermined period of time by dilating the balloon positioned at the treatment site and maintaining a state where the medical member is brought into contact with the treatment site.

### Claim 15 (depends on 14)

The treatment method for a urethral stricture according to claim 14, comprising:
inserting the guide member into the outside of the urethra from the inside of the urethra.

### Claim 16 (depends on 15)

The treatment method for a urethral stricture according to claim 15, comprising:
connecting the guide member and a stopper to each other outside the urethra.
