Endoscopic sympathectomy systems and methods

• US 10,226,633 B2
• Filed: 03/14/2018
• Issued: 03/12/2019
• Est. Priority Date: 05/29/2012
• Status: Active Grant

• Current Assignee: Autonomix Medical, Inc.
• Original Assignee: Autonomix Medical, Inc.
• Inventors: Toth, Landy, Schwartz, Robert
• Primary Examiner(s): Abouelela, May
• Application Number:
  US15/920,775
• Publication Number:
  US 20180200524A1
• Time in Patent Office: 363 Days
• Field of Search: 600549, 600546, 606 46
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00345 Micromachines, nanomachines, microsystems
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00345 Vascular system
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00505 Urinary tract
• CPC Class Codes: A61B 2018/00511 Kidney
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00648 using more than one sensed parameter
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/143 multiple needles
• CPC Class Codes: A61B 2562/0214 Capacitive electrodes
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/1107 : Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/24 : Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/283 : Invasive
• CPC Class Codes: A61B 5/296 : for electromyography [EMG]
• CPC Class Codes: A61B 5/4839 : combined with drug delivery
• CPC Class Codes: A61B 5/4848 : Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/4875 : Hydration status, fluid retention of the body
• CPC Class Codes: A61B 5/6852 : Catheters
• CPC Class Codes: A61B 7/04 : Electric stethoscopes microphones, acoustic transducers therefor H04R
• CPC Class Codes: A61M 2202/0275 : Nitric oxide [NO]
• CPC Class Codes: A61M 2202/048 : Anaesthetics
• CPC Class Codes: A61M 2202/0484 : Alcohol
• CPC Class Codes: A61M 2202/049 : Toxic
• CPC Class Codes: A61M 5/14 : Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
• CPC Class Codes: A61N 1/05 : for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0553 : Paddle shaped electrodes, e.g. for laminotomy
• CPC Class Codes: A61N 1/0556 : Cuff electrodes
• CPC Class Codes: A61N 1/37205 : Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A system for controlled sympathectomy procedures is disclosed. A system for controlled micro ablation procedures is disclosed. Methods for performing a controlled surgical procedure are disclosed. A system for performing controlled surgical procedures in a minimally invasive manner is disclosed. An implantable device for monitoring and/or performing a neuromodulation procedure is disclosed.

Claims

1. A microsurgical tool comprising:

an endoscopically deliverable elongate structure configured so as to extend from an entry site within a body to a vicinity of an organ;

at least one sensing tip electrically and mechanically coupled to the endoscopically deliverable elongate structure, the at least one sensing tip comprising a plurality of electrodes arranged on at least one surface thereof, the at least one sensing tip being configured;

to interface with tissues in the vicinity of the organ;

to measure local neural activity associated with the tissues in the vicinity of the organ utilizing one or more of the plurality of electrodes; and

to convey one or more electrophysiological signals associated with an electrophysiological activity;

wherein the at least one surface of the at least one sensing tip comprises a self-wrapping tool; and

wherein the at least one surface of the at least one sensing tip comprises one or more microchannels, the one or more microchannels being configured to provide a vacuum to provide movement of the self-wrapping tool.

2. The microsurgical tool in accordance with claim 1, wherein the electrophysiological signals are related to one or more of water concentration, tissue tone, evoked potential, remotely stimulated nervous activity, sympathetic nervous activity, an electromyographic signal [EMG], a mechanomyographic signal [MMG], a local field potential, an electroacoustic event, vasodilation, vessel wall stiffness, muscle sympathetic nerve activity [MSNA], central sympathetic drive, nerve traffic, or combinations thereof.

3. The microsurgical tool in accordance with claim 1, wherein the at least one sensing tip is electrically coupled with a microcircuit, the microcircuit configured to condition the one or more electrophysiological signals prior to conveying the one or more electrophysiological signals outside the body.

4. The microsurgical tool in accordance with claim 3, wherein the microcircuit is embedded into the at least one sensing tip.

5. The microsurgical tool in accordance with claim 3, wherein conditioning the one or more electrophysiological signals prior to conveying the one or more electrophysiological signals outside the body comprises one or more of pre-amplification, radio frequency (RF) signal routing, analog to digital conversion, signal buffering, signal isolation, multiplexing and demultiplexing functions, and communication with externally located hardware.

6. The microsurgical tool in accordance with claim 1, wherein the plurality of electrodes comprise one or more stimulating electrodes configured to provide at least one of a stimulating and an ablating current to adjacent tissues.

7. The microsurgical tool in accordance with claim 1, wherein one or more of the plurality of electrodes on the at least one surface of the at least one sensing tip are arranged to bias towards the tissues when the self-wrapping tool is bent there around.

8. The microsurgical tool in accordance with claim 1, wherein at least one of the plurality of electrodes comprises at least one of an embossed, a plated, and a filament loaded structure thereupon.

9. The microsurgical tool in accordance with claim 1, wherein at least one of the plurality of electrodes comprises at least one of one or more needle electrodes and one or more whiskers, each having a characteristic length and a tip and being arranged so as to extend from the sensing tip into the tissues adjacent thereto.

10. A microsurgical tool comprising:

an endoscopically deliverable elongate structure configured so as to extend from an entry site within a body to a vicinity of an organ;

at least one sensing tip electrically and mechanically coupled to the endoscopically deliverable elongate structure, the at least one sensing tip comprising a plurality of electrodes arranged on at least one surface thereof, the at least one sensing tip being configured;

to interface with tissues in the vicinity of the organ;

to measure local neural activity associated with the tissues in the vicinity of the organ utilizing one or more of the plurality of electrodes; and

to convey one or more electrophysiological signals associated with an electrophysiological activity;

wherein the at least one surface of the at least one sensing tip comprises a self-wrapping tool; and

wherein the at least one surface of the at least one sensing tip comprises an electroactive material actuator electrically and mechanically coupled to the endoscopically deliverable elongate structure, the electroactive material actuator being configured to provide movement of the self-wrapping tool.

11. The microsurgical tool in accordance with claim 10, wherein the electroactive material actuator comprises an active material configured to change shape upon command.

12. The microsurgical tool in accordance with claim 11, wherein the active material comprises one or more of a shape memory material, an electroactive polymer and a piezoceramic material.

13. A microsurgical tool comprising:

an endoscopically deliverable elongate structure configured so as to extend from an entry site within a body to a vicinity of an organ;

at least one sensing tip electrically and mechanically coupled to the endoscopically deliverable elongate structure, the at least one sensing tip comprising a plurality of electrodes arranged on at least one surface thereof, the at least one sensing tip being configured;

to interface with tissues in the vicinity of the organ;

to measure local neural activity associated with the tissues in the vicinity of the organ utilizing one or more of the plurality of electrodes; and

to convey one or more electrophysiological signals associated with an electrophysiological activity;

wherein the at least one surface of the at least one sensing tip comprises a self-wrapping tool; and

wherein the at least one surface of the at least one sensing tip comprises one or more tendons, the one or more tendons arranged so as to run along a length of the endoscopically deliverable elongate structure to provide movement of the self-wrapping tool when pulled.

14. A system comprising:

a microsurgical tool comprising an endoscopically deliverable elongate structure configured so as to extend from an entry site within a body to a vicinity of an organ and at least one sensing tip electrically and mechanically coupled to the endoscopically deliverable elongate structure, the at least one sensing tip comprising a plurality of electrodes arranged on at least one surface thereof, the at least one surface of the at least one sensing tip comprises a self-wrapping tool; and

a controller coupled to the microsurgical tool, the controller being configured to actuate the at least one surface of the at least one sensing tip to provide movement of the self-wrapping tool;

wherein the at least one sensing tip is configured;

to interface with tissues in the vicinity of the organ responsive to actuation by the controller providing movement of the self-wrapping tool;

to measure local neural activity associated with the tissues in the vicinity of the organ utilizing one or more of the plurality of electrodes; and

to convey one or more electrophysiological signals associated with an electrophysiological activity;

wherein the at least one surface of the at least one sensing tip comprises at least one of;

an electroactive material actuator electrically and mechanically coupled to the endoscopically deliverable elongate structure, the electroactive material actuator being configured to provide movement of the self-wrapping tool;

one or more microchannels, the one or more microchannels being configured to provide a vacuum to provide movement of the self-wrapping tool; and

one or more tendons, the one or more tendons arranged so as to run along a length of the endoscopically deliverable elongate structure to provide movement of the self-wrapping tool when pulled.

15. The system of claim 14, wherein the plurality of electrodes comprise one or more stimulating electrodes configured to provide at least one of a stimulating and ablating current to adjacent tissues.

16. The system of claim 14, wherein one or more of the plurality of electrodes on the at least one surface of the at least one sensing tip are arranged to bias towards the tissues when the self-wrapping tool is bent there around.

17. The system of claim 14, wherein the at least one surface of the at least one sensing tip comprises the electroactive material actuator electrically and mechanically coupled to the endoscopically deliverable elongate structure, the electroactive material actuator comprising an active material configured to change shape upon command.

18. The system of claim 14, wherein the at least one surface of the at least one sensing tip comprises the one or more microchannels.

19. The system of claim 14, wherein the at least one surface of the at least one sensing tip comprises the one or more tendons.

20. The system of claim 17, wherein the active material comprises one or more of a shape memory material, an electroactive polymer and a piezoceramic material.