Endoscopic ablation system with sealed sheath

• US 20020183739A1
• Filed: 03/25/2002
• Published: 12/05/2002
• Est. Priority Date: 03/30/2001
• Status: Abandoned Application

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Long, Gary L.
• Application Number:
  US10/105,609
• Publication Number:
  US 20020183739A1
• Time in Patent Office: Days
• US Class Current: 606/41
• 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 18/1815 using microwaves
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00488 Esophagus
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2018/1495 Electrodes being detachable from a support structure
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference

Abstract

An endoscopic ablation system is provided for use with a flexible endoscope for the ablative treatment of diseased tissue on the interior lining a body lumen. The endoscopic ablation system includes a support member for supporting at least two electrodes that can be electrically connected to a RF generator. The support member also includes a side opening, and can include a sheath having a seal, so that the aspiration means of an endoscope may be used to evacuate the air from inside the body lumen and pull the tissue to be treated into intimate contact with the electrodes on the support member.

Claims

1. An endoscopic ablation system for use with a flexible endoscope for electrosurgically treating bodily tissue of a patient, said endoscopic ablation system comprising:

at least two electrodes;

an ablation cap for creating space in the lumen of a bodily organ, wherein said ablation cap includes a rigid support member, and at least two electrodes are positioned on said rigid support member;

a side opening in said rigid support member, said side opening in close proximity to said at least two electrodes;

an RF generator electrically connected to said at least two electrodes, wherein the operator may actuate said RF generator to ablate tissue between said electrodes;

a sheath attached to said rigid support member, wherein the distal end of the flexible endoscope may be inserted through said sheath and at least partially into said ablation end cap; and

a seal located near the proximal end of said sheath, said seal adapted to allow passage of the distal end of the flexible endoscope, whereby said sheath and said ablation cap form an enclosure substantially sealed from the air external to the patient.

2. An endoscopic ablation system according to claim 1, wherein said ablation cap further comprises a tapered end cover.

3. An endoscopic ablation system according to claim 2, wherein said tapered end cover is normally closed and is adapted to open in order to allow passage of the distal end of an endoscope therethrough.

4. An endoscopic ablation system according to claim 2, wherein said tapered end cover is normally open and is adapted to allow passage of the distal end of an endoscope therethrough.

5. An endoscopic ablation system according to claim 2, wherein said tapered end cover is made from a transparent, flexible material and is shaped like a bougie tube and is adapted to be passed over a guide wire.

6. An endoscopic ablation system according to claim 1 further including a rotation knob attached at the proximal end of said sheath.

7. An endoscopic ablation system according to claim 1 further including a timer electrically connected in series between said electrodes and said RF generator, wherein said timer electrically connects the output of said RF generator to said electrodes for a predetermined period of time when the operator switches on said RF generator.

9. An endoscopic ablation system according to claim 1 further including a viewing window between an adjacent pair of at least two electrodes, and said viewing window is made of a transparent material and forms a portion of said rigid support member.

10. An endoscopic ablation system according to claim 1 further including a flexible coupling made of a highly flexible material that connects the distal end of said sheath to said rigid support member.

8. An endoscopic ablation system according to claim 8 further including an actuator, whereby said timer is operable only when the operator actuates said actuator.

11. A method of ablating tissue on the interior lining of a lumen of a bodily organ, said method comprising:

providing a flexible endoscope having aspiration means;

providing an endoscopic ablation system, wherein said endoscopic ablation system comprises;

at least two electrodes;

an ablation cap for creating space in the lumen of a bodily organ, wherein said at least two electrodes are positioned on said ablation cap, and said ablation cap includes a relatively rigid support member;

a viewing window between an adjacent pair of said at least two electrodes, wherein said viewing window is made of a transparent material and forms at least a part of said rigid support member;

an RF generator electrically connected to said at least two electrodes, wherein the operator may actuate said RF generator to ablate tissue between said electrodes;

a sheath, wherein the distal end of said sheath is attached to said rigid support member by a flexible coupling made of a highly flexible material, and the distal end of the flexible endoscope may be inserted through said sheath, said flexible coupling, and at least partially into said ablation end cap; and

a seal located near the proximal end of said sheath, said seal adapted to allow passage of the distal end of the flexible endoscope, whereby said sheath and said ablation cap form an enclosure substantially sealed from the air external to the patient, and said enclosure is fluidly connected to the interior of the lumen of the bodily organ;

inserting the distal end of said flexible endoscope into said sheath and at least partially into said ablation cap;

intubating the distal end of said flexible endoscope with said sheath and said ablation cap into the lumen of a bodily organ;

positioning under endoscopic visualization said viewing window against tissue to be treated;

actuating the aspiration means on the flexible endoscope to evacuate air and other fluids from the lumen of the bodily organ next to said rigid support member, thereby causing the lumen of the bodily organ to collapse around said rigid support member, and bringing said viewing window and said electrodes into intimate contact with the interior lining of the lumen of the bodily organ; and

actuating said RF generator to ablate the tissue between said electrodes.

13. The apparatus of claim 12 wherein the support member comprises first and second electrodes, and wherein the side opening in the support member is disposed opposite the first and second electrodes.

14. The apparatus of claim 12 wherein the support member is relatively rigid with respect to the sheath.

15. The apparatus of claim 12 wherein the support member is transparent.

16. The apparatus of claim 12 wherein the seal is disposed in a proximal portion of the sheath.

17. The apparatus of claim 12 wherein the support member is flexibly coupled to the sheath.

12. A medical apparatus comprising:

a sheath;

a lumen support member disposed at a distal end of the sheath, the support member having a central bore and a side opening; and

a seal for restricting fluid flow through the sheath.

18. A method of ablating tissue on the interior lining of a body lumen, the method comprising:

providing a support member for stabilizing a portion of the body lumen, the support member having a side opening therein;

positioning first and said second electrodes at a tissue site to be treated;

operatively associating a vacuum source with the side opening in the support member; and

ablating tissue with the electrodes.

21. A medical apparatus comprising:

a hollow support member having a central bore extending along the length of the support member; and

at least two electrodes disposed on the support member;

wherein the support member comprises a side opening.

22. The apparatus of claim 22 wherein the support member has a generally cylindrical outside shape.

19. The method of claim 20 further comprising the step of viewing tissue between the electrodes during the step of ablating tissue.

20. The method of claim 20 wherein the electrodes are disposed on the support member, and wherein the side opening is positioned in the support member opposite from the first and second electrodes.

23. The apparatus of claim 22 wherein at least a portion of the support member between the first and second electrodes is substantially transparent to allow viewing of tissue disposed between the electrodes.

24. The apparatus of claim 22 wherein the side opening is disposed on the support member opposite the first and second electrodes.