UTILISATION D'UN MEDICAMENT LIQUIDE DANS DES DISPOSITIFS CHIRURGICAUX A JET DE LIQUIDE HAUTE PRESSION

USE OF A LIQUID MEDICAMENT IN SURGICAL HIGH PRESSURE LIQUID JET DEVICES

Abrégé français

En général, des tumeurs sont retirées par opération chirurgicale, en étant séparées du lit tumoral puis aspergées d'un liquide cytotoxique. Ce sont deux étapes qui nécessitent inutilement une opération chirurgicale. L'inconvénient essentiel réside dans le fait que, lors du traitement ultérieur, le liquide cytotoxique n'atteint et n'élimine que les cellules tumorales de surface. Ainsi, selon la présente invention, un liquide cytotoxique est utilisé pour séparer la structure biologique et traiter simultanément le lit tumoral au moyen d'un dispositif à jet de liquide haute pression.

Abrégé anglais

Tumours are, as a rule, removed surgically, by separating them from the tumour
bed and finally rinsing the tumour bed with a cytotoxic fluid. The above
represents two sequential working steps which prolongs surgery unnecessarily.
The real disadvantage, however, is that the cytotoxic fluid in the post-
operative treatment only reaches and kills superficial tumour cells. The use
of a cytotoxic fluid by means of a high pressure liquid jet device is thus
disclosed, for separation of the biological structure and concomitant
treatment of the tumour bed.

Revendications

Patent Claims
1. Use of a liquid medicament for treatment of dissection planes/resection
surfaces
at a biological structure and for the simultaneous separation of the
biological
structure, wherein the liquid medicament is capable of being subjected with a
pressure of at least 50 bar and wherein the liquid medicament has a viscosity
capable
of forming a jet.
2. Use of a liquid medicament according to claim 1, characterized in that the
liquid
medicament is a cyto toxic liquid for combating tumors.
3. High-pressure liquid jet device for separating a biological structure and
for
simultaneous treatment of dissection planes/resection surfaces at a biological
structure, characterized in that the high-pressure liquid jet device comprises
a
pressure generator, a storage container with a separating medium to be
subjected to
pressure from the pressure generator, and an operating hand piece, wherein the
separating medium jet like flows out of the operating hand piece, wherein the
separating medium is a liquid, pressure stable medicament capable of forming a
jet.
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4. High-pressure liquid jet device according to claim 3, characterized in that
the
liquid medicament is a cyto toxic liquid for combating of tumors.
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Description

CA 02415124 2003-O1-07
Description
Use of a liquid medicament in surgical high-pressure liquid jet devices.
The invention relates to the use of a liquid medicament for treatment of
dissection planes/resection surfaces at a biological structure and to the
simultaneous
separation of a biological structure. The invention relates in particular to
the use of a
cyto toxic liquid for combating of tumors or, respectively, of tumor cells. A
corresponding high-pressure liquid jet device for performing the new method
according to the preamble of claim 3 is also subject matter of the present
invention.
Such high-pressure liquid jet devices are employed in surgical hospitals
together with
the corresponding liquid medicaments.
Dissection planes/resection surfaces of the general kind are generated
initially
by operation and are in the following treated with medicaments, wherein the
treatment with medicaments is limited to a swabbing, a coating, or a
sprinkling of the
dissection planes/resection surfaces with a medicament. The two processing
steps
are disposed therefore set apart in time, which prolongs the connected
operating
process and which interferes with the success of the treatment. A further
disadvantage comprises that the following treatment of the dissection
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planes/resection planes is performed only superficially and the effective
agents on
the medicament can only penetrate very slowly into the tissue of the
biological
structure. This prolongs the healing process.
Dissection planes/resection surfaces of the particular kind are generated
during
operating procedures for the elimination of tumors, wherein the tumors then
have to
be treated also in a particular way. Tumors are benign growth or malignant
growth,
which growth embeds itself in the most different organs with the surrounding
lymphatic tissue, fatty tissue, and connective tissue and the muscles or in a
different
biological structure. The malignant tumors grow very rapidly and thereby
penetrate
through the lymph channels, the lymphoducts and the lymph slots into the
neighboring healthy tissue, where the malignant growth then forms metastases.
Such tumors are generally treated by operation, wherein the respective tumor
carrying organ or another tumor carrying biological structure is separated out
of the
tumor bed. Despite a frequently radical expansion of the safety distance, it
is thereby
not to be prevented, that vital tumor cells in the lymph channels, the
lymphoducts,
and the lymph slots of the tumor bed tissue are not being captured by the
operational
cuts, wherein the vital tumor cells then remain in the tumor bed tissue or
also step out
from the former tumor bed during the operation. For this reason, the previous
tumor
bed is flushed out with a cyto toxic liquid in order to kill off tumor cells
disposed in
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the tumor bed and remaining in the tumor bed tissue after the removal of the
tumor
carrying organ or of the other tumor carrying biological structure. The
effective
agents of the cyto toxic liquid however are brought to the location of the
tumor
action only very imprecise and inexact with this flushing method, such that
only
superficial tumor cells are reached and a considerable part of the tumor cells
in the
tumor bed or in the tumor bed tissue remain untreated. The risk of a tumor
relapse is
therefore very large, which is proven by the observed relapse rate. Certain
successive steps such as for example a systematic chemotherapy or an
irradiation
cannot change this situation in any way.
Therefore the invention is based on the object to employ and to apply a liquid
medicament for the treatment of dissection planes/resection surfaces, in
particular a
cyto toxic liquid for combating of tumors such that the liquid medicament
reaches
also deeper disposed regions of the dissection planes/resection surfaces at a
biological structure.
This object is achieved as a method by the characterizing features of claim 1.
An advantageous embodiment results from the sub-claim 2. The object is
resolved
by the characterizing features of claim 3 with respect to a device, wherein
claim 4
shows an advantageous embodiment.
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' CA 02415124 2003-O1-07
The present invention eliminates the recited disadvantages present in the
state
of the art. The particular advantage of the invention comprises that two
properly
separate operational steps are connected to each other and are combined.
On the one hand the liquid medicament is employed for the separation of the
biological structure in an inventive way and thereby the same effect is
achieved as is
accomplished by the conventional sterile separation agents. The medicament
begins
already during the separation processs, that is in time overlap with the
separation
process, to act based on the employment of the medicament as a separating
medium.
This shortens on the one hand the operating process and intensifies on the
other hand
the treatment process.
On the other hand the liquid medicament is applied in a novel way of
application by being not any longer applied from the outside by washing over
and
flooding over the dissection planes/resection faces, but the liquid medicament
is
entered by way of injection into the adjoining tissue bed. This provides a new
effect,
because for the first time also deeper lying, for example bacteria or tumor
cells can
be reached and treated.
A high-pressure liquid device is a basis of the advantageous operating method
and treatment method, wherein the high-pressure liquid device is capable of
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CA 02415124 2003-O1-07
generating a fine liquid jet capable of separation. In addition such device
comprises
a steplessly changeable pressure automatic control device, wherein the
pressure
automatic control device permits a fine sensitive liquid jet automatic
control.
Therewith it becomes possible in the present operating procedure to adapt the
depth
effect of the medicament stream jet to the special requirements of the disease
case.
All these positive effects lead to the situation that all bacteria or all
tissue cells
affected with disease are treated optimally and combated in fact at their
present
location and therewith a relapse of the disease becomes excluded.
The invention is to be illustrated in more detail by way of an embodiment
example.
A high-pressure liquid jet device is employed for performing of an operating
procedure for example for removal of a tumor, wherein such high-pressure
liquid jet
device is described for example in the European patent document EP 0551920 B 1
and is known under the trade name HELIX HYDRO- jet. This high-pressure liquid
jet device comprises essentially a pressure generator, a piston cylinder unit
and a
separating device in the shape of a special hand piece. A cartridge is shape
matchingly inserted into the cylinder space of the piston cylinder unit,
wherein the
cartridge is filled with a separating liquid and wherein the cartridge is
connected to
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the operation hand piece. The pressure medium of the pressure generator
burdens
and charges the cartridge during operation, whereby the separating liquid is
pressed
out of the cartridge and is transported to the operating hand piece, where the
separating liquid exits under pressure in the form of a fine liquid jet. All
device units
of this high-pressure liquid jet device are constructed such and joined to
each other
such that on the one hand a continuous sterile chain is assured for the
separating
liquid and on the other hand the flowing out jet of liquid is capable of
separating
different biological structures in an intelligent way and in highest
precision.
A cyto toxic liquid is employed as a separating liquid in accordance with the
present invention, wherein the cyto toxic liquid is generally known and
wherein the
cyto toxic liquid is pressure stable up to 150 bar and wherein the cyto toxic
liquid has
a viscosity for allowing the cyto toxic liquid to form a jet.
The tumor affected organ or the other biological structure is separated from
the
surrounding lymph tissue, fat tissue and connective tissue as well as the
muscles with
the separating force of the beam or jet of the cyto toxic liquid in the course
of the
operation. This occurs at such safety distance relative to the tumor, that as
many as
possible metastases are separated also. Here the embedded tumor and all
metastases
exiting with the separating process from the lymph channels, from the
lymphoducts,
and the lymph slots into the tumor bed are necessarily already during the
separating

CA 02415124 2003-O1-07
process contacted with the cyto toxic separating liquid such that the
respective tumor
cells are caused to die off. At the same time the cyto toxic liquid, caused by
the
high-pressure of the separating jet, penetrates deeply into the lymph
channels, the
lymphoducts, and in the lymph slots of the former tumor bed tissue and
contacts also
be the metastases present there. Thus also these corresponding tumor cells die
off.
This treatment of the tumor cells occurring together with the separating
process is to be designated as an interstitial chemotherapy, where the cyto
toxic
agents of the liquid are brought deeply into the tumor bed tissue with the aid
of the
high-pressure liquid jet device in a new form of application.
_g_