Surgical ablation instruments for forming an encircling lesion

• US 20040147911A1
• Filed: 01/13/2004
• Published: 07/29/2004
• Est. Priority Date: 08/25/1999
• Status: Abandoned Application

• Current Assignee: Edwards Lifesciences Corporation
• Original Assignee: Cardiofocus Incorporated
• Inventors: Sinofsky, Edward L.
• Application Number:
  US10/756,645
• Publication Number:
  US 20040147911A1
• Time in Patent Office: Days
• US Class Current: 606/15
• 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 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00057 Light
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/22058 reflective
• CPC Class Codes: A61B 2017/22059 transparent
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/2238 with means for selectively laterally deflecting the tip of the fibre
• CPC Class Codes: A61B 2018/2261 with scattering, diffusion or dispersion of light
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence
• CPC Class Codes: A61B 2018/2288 the optical fibre cable having a curved distal end
• CPC Class Codes: A61M 25/0105 Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

Surgical ablation instruments are disclosed for creating circumferential lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. These photoablative instruments include an elongate housing and an ablation element disposed within a lumen of the housing. A connecting element associated with the elongate housing brings together the proximal and distal ends of the elongate housing to form a loop, thereby creating an encircling lesion to be formed with the ablation energy.

Claims

1. A surgical ablation instrument comprising:

an elongate, outer housing having a proximal end, a distal end and a lumen extending therebetween;

an ablation element disposable within the lumen of the housing to ablate tissue at a target site; and

a connecting element associated with the elongate housing, the connecting element being configured to form a loop with the elongate outer housing.

2. The instrument of claim 1, wherein the connecting element is configured to allow the size of the closed loop to be adjusted during surgery.

3. The instrument of claim 1, wherein the connecting element is disposed around the distal end of the housing.

4. The instrument of claim 1, wherein the connecting element extends from the distal end of the housing.

5. The instrument of claim 1, wherein the connecting element is selected from the group comprising a hook, a cord, a snap, a clasp, and a loop of suture.

6. The instrument of claim 1, wherein the connecting element has a substantially U-shape.

7. The instrument of claim 1, wherein the connecting element is configured to mate with the proximal end of the housing.

8. The instrument of claim 1, wherein the outer housing extends to a handle, and the connecting element is configured to mate with a portion of the handle.

9. The instrument of claim 1, wherein the connecting element comprises a loop of suture suture, and the distal end of the housing includes at least one aperture for receiving the suture.

10. The instrument of claim 1, wherein a portion of the elongate outer housing is curved.

11. A method for forming an encircling lesion at a target tissue site, comprising the steps of:

providing a surgical ablation instrument comprising an elongate, outer housing having a proximal end, a distal end and a lumen extending therebetween, an ablation element disposable within the lumen of the housing to ablate tissue at a target site, and a connecting element associated with the housing, the connecting element being configured to form a loop with the elongate outer housing;

positioning the surgical ablation instrument proximate to said tissue site;

securing the elongate, outer housing in a loop;

disposing the ablation element within the loop; and

activating said ablation element to form an encircling lesion at said tissue site.

12. The method of claim 11, wherein the step of securing the housing in the form of a loop further comprises attaching the connecting element to a distal end of the housing.

13. The method of claim 11, wherein the step of securing the housing further comprises attaching a portion of the housing to another portion of the housing via the connecting element.

14. The method of claim 11, wherein the step of positioning the surgical ablation instrument further comprises placing the instrument proximate to at lease one pulmonary vein.

15. The method of claim 11, wherein a portion of the housing is formed as a loop, and the step of positioning the surgical ablation instrument further comprises placing the instrument around all four pulmonary veins.

16. The method of claim 14, wherein the step of positioning the instrument further comprises encircling at least one pulmonary vein.

17. The method of claim 16, wherein the step of positioning the instrument further comprises encircling all four pulmonary veins.

18. The method of claim 11, wherein said energy is transmitted through a transparent portion of the elongate, outer housing.

19. The method of claim 11, wherein the ablation element is a light emitter, and the step of activating the ablation element further comprises projecting light energy onto the target site.

20. The method of claim 11, wherein the step of activating the ablation element further comprises delivering photoablative radiation at a desired wavelength ranging from about 800 nm to about 1000 nm.

21. The method of claim 11, wherein the step of activating the ablation element further comprises delivering photoablative radiation at a desired wavelength ranging from about 915 nm to about 980 nm.

22. The method of claim 11, wherein said ablation element is slidable within said lumen, and further comprising the step of repeatedly advancing said ablation element through said lumen.

23. The method of claim 22, further comprising the step of repeating the steps of advancing and transmitting until a composite, encircling lesion is formed.