Smooth muscle controller

• US 20030055467A1
• Filed: 10/29/2002
• Published: 03/20/2003
• Est. Priority Date: 07/16/1997
• Status: Active Grant

• Current Assignee: MetaCure Limited (MetaCure (USA), Inc.)
• Original Assignee: MetaCure Limited (MetaCure (USA), Inc.)
• Inventors: Ben-Haim, Shlomo, Darvish, Nissim, Mika, Yuval, Shemer, Isaac, Fenster, Maier, Felzen, Bella
• Granted Patent: US 7,221,978 B2
• Time in Patent Office: Days
• US Class Current: 607/40
• 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 1/20 continuous direct currents
• CPC Class Codes: A61N 1/205 for promoting a biological process
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators

Abstract

A method of promoting the healing of a lesion in a smooth muscle, comprising selecting a smooth muscle portion having a lesion and applying a non-excitatory electrical field to the portion, which field reduces the mechanical activity of the portion.

Claims

1. A method of promoting the healing of a lesion in a smooth muscle, comprising:

selecting a smooth muscle portion having a lesion; and

applying a non-excitatory electric field to the portion, which field reduces the mechanical activity at the portion.

2. A method according to claim 1, wherein applying an electric field comprises desensitizing the smooth muscle portion.

3. A method according to claim 1, wherein applying an electric field comprises blocking the electrical activity of smooth muscle surrounding the lesion.

4. A method according to claim 1, wherein the lesion is an ischemic portion of the muscle.

5. A method according to claim 1, wherein the lesion is a sutured portion of the muscle.

6. A method according to claim 1, wherein reducing the mechanical activity comprises inhibiting mechanical activity at the location.

7. A method according to claim 1, wherein the smooth muscle portion is part of a gastrointestinal (GI) tract.

13. A method according to any of claims 1 and 8-12, wherein applying an electric field comprises applying the electric field at a delay after a local activation time.

8. A method of treating diarrhea, comprising:

selecting a portion of irritated intestine; and

applying an electric field to the portion, which field reduces the mechanical activity at the portion.

9. A method of treating obesity, comprising:

selecting at least a portion of a stomach; and

applying an electric field to the portion, which field delays or prevents the emptying of the stomach.

10. A method of treating nausea, comprising,

selecting at least a portion of a stomach;

and

applying an electric field to the portion, which field reduces the mechanical activity of the stomach.

11. A method of controlling emptying of a stoma, comprising:

applying an electric field to an exit portion of the stoma, which field reduces the motility of the end portion; and

removing said field when emptying of the stoma is desired.

12. A method according to claim 11, further comprising applying a second electric field to the exit portion, which second field increases the motility of the stoma, when emptying of the stoma is desired.

14. A method of selectively exciting only a layer of muscle in a smooth muscle in the GI tract having a plurality of muscle layers, each with a different fiber orientation, comprising:

applying an inhibitory electrical field, parallel to the a fiber orientation of a first layer of muscle, to the muscle; and

applying an excitatory electric field to the muscle, which electrical field excites a second layer of the muscle.

15. A method of selectively increasing the force of contraction of only a layer of muscle in a smooth muscle in the GI tract having a plurality of muscle layers, each with a different fiber orientation, comprising:

applying an inhibitory electrical field, parallel to the a fiber orientation of a first layer of muscle, to the muscle; and

applying a second electric field to the muscle, which second electric field is oriented parallel to the fiber orientation of a second layer of muscle and which second field increases the force of contraction in the second layer of muscle.

16. A method of multi-point pacing for a smooth muscle in the GI tract, comprising:

applying excitatory electric fields at a plurality of locations on said muscle; and

applying at least one inhibitory electric field at a second plurality of locations, situated among said plurality of locations, wherein said inhibitory electric field prevents the propagation of an activation signal between said first plurality of paced locations.

17. Apparatus for controlling at least the local activity of a portion of an in vivo smooth muscle in the GI tract, comprising:

a plurality of electrodes, adapted to be in contact with a portion of smooth muscle to be controlled; and

a controller which electrifies said electrodes with an electrical field which does not generate a propagating action potential in the smooth muscle, which electrical field modifies the reaction of the smooth muscle to an activation signal.

18. Apparatus according to claim 17, additionally comprising an electrical activity sensor which detects electrical activity at the portion and wherein the controller electrifies the electrodes responsive to signals from said sensor.

19. Apparatus according to claim 18, wherein the electrification at each of the electrodes is responsive to its local electrical activity.

20. Apparatus according to claim 18, wherein the electrical activity sensor senses electrical activity through ones of the plurality of electrodes.

21. Apparatus according to claim 17, additionally comprising an impedance sensor, which senses at least one impedance between selected ones of the plurality of electrodes.

22. Apparatus according to claim 17, additionally comprising a force transducer which detects mechanical activity at the portion and wherein the controller electrifies the electrodes responsive to signals from said transducer.

23. Apparatus according to claim 22, wherein the controller applies an inhibitory electric field to the muscle, when the mechanical activity is above a certain threshold.

24. Apparatus according to claim 22, wherein the electrification at each of said electrodes is responsive to its local mechanical activity.

25. Apparatus according to claim 17, wherein the non-excitatory field inhibits mechanical activity at the portion.

26. Apparatus according to claim 17, wherein the non-excitatory field reduces the force of contraction at the portion.

27. Apparatus according to claim 17, wherein the non-excitatory field increases the force of contraction at the portion.

28. Apparatus according to claim 17, wherein the controller electrifies at least one of the electrodes with an excitatory electric field.

29. Apparatus according to claim 17, wherein the plurality of electrodes are arranged in a two-dimensional matrix.

30. Apparatus according to claim 17, wherein the controller selectively electrifies ones of the plurality of electrodes to selectively generate one of two perpendicular electric fields.

31. Apparatus according to claim 17, wherein the controller is adapted to be implanted inside a stomach and attached to the stomach wall.

32. Apparatus according to claim 17, wherein the controller is adapted to be implanted inside the body and outside a portion of the GI tract.

33. Apparatus according to claim 17, wherein the electrodes are adapted to be implanted inside the body while the controller is adapted to be situated outside the body.

34. Apparatus according to claim 33, wherein the electrodes are adapted to be disconnected from the smooth muscle from outside the body.

35. An anastomosis button comprising:

a sleeve portion for joining two portions of a GI tract;

at least two electrodes adapted to be in electrical contact with the GI tract, at either side of the button; and

a controller which electrifies the electrodes to reduce the force of contraction in the GI tract near the button.

36. An anastomosis button according to claim 35, wherein the controller transmits a pacing signal from the GI tract on one side of the button to the GI tract on the other side of the button.

37. An anastomosis button according to claim 35, wherein reducing the force comprises inhibiting electrical activity of the GI tract at the button.

38. Apparatus for inhibiting a returning wave in an intestine, comprising:

at least one electrode for applying an inhibiting electric field to a portion of the intestine;

a sensor which senses the propagation of waves in the intestine; and

a controller which electrifies said electrode responsive to a sensed propagating wave.

39. Apparatus according to claim 38, wherein the sensor detects the returning wave.

40. Apparatus for advancing a bolus comprising:

at least one first electrode, for applying an electrical field to a first portion of the GI tract adjacent said bolus;

at least one second electrode, for applying an electric field to a second portion of the GI tract downstream from said bolus; and

a controller which electrifies the at least one first electrode with a non-excitatory field which increases the force of contraction at the first portion and which electrifies the at least one second electrode with a non-excitatory electric field which relaxes the muscle at the second portion.

41. Apparatus according to claim 40, further comprising an impedance sensor for detecting the existence of a bolus at the first portion of the GI tract.

42. A method of aiding the examination of a GI tract, comprising:

providing an elongated probe, having a tip, inside a portion of a GI tract; and

applying a non-excitatory electric field to the portion of the GI tract adjacent the tip of the probe, which electric field is operative to relax the portion of the GI tract.

43. A method according to claim 42, comprising inflating the portion of the GI tract after applying the field.

44. A method according to claim 42, wherein the portion of the GI tract is a portion adjacent a bile duct.

45. A method of advancing an elongated probe having a tip and inserted in a portion of the GI tract, comprising:

applying a first electric field at the tip, which field constricts the portion of GI tract to grasp the probe; and

applying a second electric field to a second portion of the GI tract adjacent a portion of the probe distal from the tip, which electric field causes the elongation of the second portion of the GI tract.

46. A method according to claim 45, further comprising applying a third electrical field to a third portion of the GI tract, adjacent portions of the probe distal from the tip, which electrical field relaxes the third portion of the GI tract so that it does not constrict around the probe.

47. A method according to claim 45 or claim 46, further comprising applying an inhibitory electric field to block the propagation of activation signals between the first portion and other portions of the GI tract.

51. A method according to any of claims 45-46 and 48-49, wherein the probe is an endoscope.

52. A method according to any of claims 45-46 and 48-49, wherein the probe is a colonoscope.

48. A method of advancing an elongated probe, comprising:

providing an elongated probe, having a tip, inside a portion of a GI tract; and

applying an excitatory electric field to the portion of the GI tract, which excitatory electric field causes the bowel to transport the probe in a desired direction.

49. A method according to claim 48, wherein the excitatory field is selectively applied either at the tip or at a different location along the probe, proximal from the tip, depending on the desired direction of transport.

50. A method according to claim 48 or claim 49, additionally comprising applying an inhibitory electric field, to the portion, to block the propagation of activation signals between the portion and the rest of the GI tract.

53. An elongated probe adapted for advancing in a GI tract, comprising:

an elongated body having a tip;

a plurality of electrodes disposed at least at the tip; and

a controller which selectively electrifies the electrodes to produce non-excitatory electric fields which affect the contraction of smooth muscle.

54. A probe according to claim 53, further comprising a second plurality of electrodes distributed along at least a portion of the body of the probe.

55. A probe according to claim 53 or claim 54, wherein the controller electrifies the first plurality of electrodes to cause the portion of GI tract to selectively advance or retreat the probe.

56. A probe according to claim 53 or claim 54, wherein the controller electrifies ones of the first and the second pluralities of electrodes to inhibit the propagation of activation signals from the portion of the GI tract adjacent the tip of the probe to other portions of the GI tract.

57. A method of controlling the activation profile of a smooth muscle organ of the GI tract, comprising:

determining a desired activation profile for the organ; and

applying at least one non-excitatory field to a portion of the organ to modify its activation profile.

58. A method according to claim 57, wherein the activation profile comprises a mechanical activation profile.

59. A method according to claim 58, comprising:

measuring a tension in the smooth muscle; and

modifying the application of the non-excitatory field responsive to the measured tension.

60. A method according to claim 58, comprising:

measuring a pressure in the smooth muscle; and

modifying the application of the non-excitatory field responsive to the measured pressure.

61. A method according to claim 58, further comprising, applying at least one excitatory electric field to the smooth muscle.

62. A method according to claim 58, wherein applying a non-excitatory field comprises applying an inhibitory electric field to the muscle.

63. A method according to claim 58, wherein applying a non-excitatory field comprises applying an electric field which reduces the force of contraction in the muscle.

64. A method according to claim 58, wherein applying a non-excitatory field comprises applying an electric field which increases the force of contraction in the muscle.

65. A method according to claim 57, wherein the organ is a stomach.

66. A method according to claim 57, wherein the organ is a small intestine.

67. A method according to claim 57, wherein the organ is a large intestine.