Methods and apparatus for electrosurgical ventriculostomy
First Claim
1. A method of fenestrating a third ventricle of a patient, comprising:
- a) positioning a distal end of an electrosurgical instrument in at least close proximity to a boundary of a third ventricle of the patient, the instrument having an active electrode and a return electrode, the return electrode spaced from the active electrode; and
b) applying a first high frequency voltage between the active electrode and the return electrode, wherein the first high frequency voltage is sufficient to form a stoma in the boundary of the third ventricle.
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Accused Products
Abstract
Methods and apparatus for electrosurgical treatment of hydrocephalus. A method of the invention comprises electrosurgical fenestration of the floor of the third ventricle using an electrosurgical probe or catheter. The probe or catheter may be introduced via an access hole in the patient'"'"'s cranium. The access hole can be formed mechanically or electrosurgically. A stoma or window in the third ventricle can be enlarged electrosurgically and/or tissue surrounding the stoma can be coagulated, in order to maintain patency of the stoma. According to another aspect of the invention, a method of establishing patency in an occluded cerebral aqueduct comprises guiding an electrosurgical catheter into the cerebral aqueduct, positioning an active electrode in at least close proximity to the occlusion, and applying an ablative voltage to the active electrode to form a channel within the cerebral aqueduct.
257 Citations
71 Claims
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1. A method of fenestrating a third ventricle of a patient, comprising:
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a) positioning a distal end of an electrosurgical instrument in at least close proximity to a boundary of a third ventricle of the patient, the instrument having an active electrode and a return electrode, the return electrode spaced from the active electrode; and
b) applying a first high frequency voltage between the active electrode and the return electrode, wherein the first high frequency voltage is sufficient to form a stoma in the boundary of the third ventricle. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. A method of performing a third ventriculostomy on a patient, comprising:
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a) forming an access hole at a target location in the cranium of the patient;
b) via the access hole, advancing an electrosurgical instrument towards the third ventricle of the patient;
c) positioning an active electrode of the instrument in at least close proximity to a boundary of the third ventricle, the instrument having a return electrode spaced from the active electrode; and
d) applying a first high frequency voltage between the active electrode and the return electrode, wherein the first high frequency voltage is sufficient to form a stoma in the boundary of the third ventricle. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44)
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45. A method of forming an access hole in the cranium of a patient using an electrosurgical probe, comprising:
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a) positioning an active electrode of the probe in at least close proximity to a target location of the cranium;
b) delivering an electrically conductive fluid to the active electrode or to the target location; and
c) applying a high frequency voltage between the active electrode and a return electrode, wherein the high frequency voltage is sufficient to locally ablate tissue at the target location, whereby the access hole is formed in the cranium at the target location. - View Dependent Claims (46, 47, 48, 49, 50, 51, 52)
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53. A method of establishing patency in a cerebral aqueduct of a hydrocephalus patient, comprising:
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a) introducing a distal end of an electrosurgical catheter into the cerebral aqueduct of the patient, wherein the catheter includes an electrode assembly disposed on the distal end, the electrode assembly including an active electrode and a return electrode; and
b) applying a first high frequency voltage between the active electrode and the return electrode, the first high frequency voltage sufficient to ablate tissue, wherein tissue adjacent to the active electrode is volumetrically removed and patency of the cerebral aqueduct is established. - View Dependent Claims (54, 55, 56, 57, 58, 59, 60, 61, 62)
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63. An apparatus for performing electrosurgical third ventriculostomy on a hydrocephalus patient, the apparatus comprising:
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a shaft having a shaft distal end and a shaft proximal end, the shaft having at least one depth marking thereon, the shaft distal end adapted for passage into a third ventricle of the patient via a foramen of Monro, and the shaft having a diameter in the range of from about 1 mm to 5 mm;
an electrode assembly disposed at the shaft distal end, the electrode assembly including a distal active electrode and a proximal return electrode, the return electrode spaced from the active electrode by an electrically insulating spacer; and
a tracking unit disposed at the shaft distal end, the tracking unit adapted for monitoring a location of the shaft distal end with respect to the third ventricle of the patient. - View Dependent Claims (64, 65, 66, 67, 68, 69, 70, 71)
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Specification