Gynecological ablation procedure and system

• US 20050149013A1
• Filed: 01/10/2005
• Published: 07/07/2005
• Est. Priority Date: 08/09/2000
• Status: Active Grant

• Current Assignee: Acessa Health Inc. (Hologic Incorporated)
• Original Assignee: Halt Medical, Inc. (Hologic Incorporated)
• Inventors: Lee, Bruce B.
• Granted Patent: US 7,678,106 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras

Abstract

A method for treating tumors, such as uterine leiomyomata, includes inserting an ablation apparatus into a pelvic region and positioning the ablation apparatus into a pelvic tumor. The method further includes using a laparoscope and an imaging device, such as an ultrasound machine, to confirm the location of the pelvic tumor and placement of the ablation apparatus. The method further includes delivering electromagnetic energy or other energy through the ablation apparatus to the pelvic tumor to directly ablate the tumor. A surgical system for ablating pelvic tumors is also provided.

Claims

1. A method of treating a tumor, comprising:

inserting an ablation device into a pelvic region, the ablation device including an electrode;

positioning the electrode within a tumor;

delivering a first amount of energy through the electrode to pre-heat the tumor;

exposing a larger area of the electrode within the tumor; and

delivering a second amount of energy through the electrode to directly ablate the tumor.

2. The method of claim 1, wherein the first amount of energy heats the tumor to a temperature under 100 degrees Celsius.

3. The method of claim 1, wherein the second amount of energy heats the tumor to a higher temperature than the first amount of energy.

4. A method of treating a pelvic tumor, comprising:

inserting an ablation device into a pelvic region, the ablation device including an electrode;

positioning the electrode within a pelvic tumor with an imaging probe separate from the ablation device; and

delivering energy through the electrode to directly ablate the pelvic tumor.

5. The method of claim 4, wherein inserting the ablation device includes inserting into a uterus.

6. The method of claim 4, wherein inserting the ablation device includes inserting through an abdomen and into the uterus.

7. The method of claim 4, wherein inserting the ablation device includes inserting through a cervix and into the uterus.

8. The method of claim 4, further comprising repositioning the uterus relative the ablation device.

9. The method of claim 4, wherein the imaging probe is capable of manipulating the position of the uterus relative to the electrode.

10. The method of claim 4, further comprising rotating the ablation device during insertion to reduce movement of the uterus.

11. The method of claim 4, wherein the ablation device includes a plurality of deployable arms and further comprising deploying the plurality of arms completely within the pelvic tumor.

12. The method of claim 4, wherein the imaging probe includes an intra-abdominal ultrasound probe.

13. The method of claim 4, further comprising inserting an ultrasound probe into an incision proximate a top of a uterus.

14. The method of claim 4, wherein delivering energy includes delivering RF energy to the pelvic tumor.

15. The method of claim 4, wherein delivering energy includes heating the pelvic tumor to a temperature between approximately 65°

C. and approximately 100°

C. for at least 3 minutes.

16. The method of claim 15, wherein the pelvic tumor is maintained at the temperature for between approximately 3 minutes and approximately 10 minutes.

17. The method of claim 4, wherein the pelvic tumor is a uterine fibroid.

18. The method of claim 4, further comprising positioning the electrode with a laparoscope.

19. The method of claim 4, further comprising:

providing a patient on an operating table;

providing at least one monitor for the laparoscope and the imaging probe, the at least one monitor being located across the operating table from a surgeon and proximate the patient'"'"'s waist; and

providing the energy source and the imaging probe adjacent to the at least one monitor, the energy source and the imaging probe being located proximate the patient'"'"'s knees.

20. The method of claim 19, wherein the patient is in a dorsal position on the operating table.

21. The method of claim 4, further comprising removing the ablation device from the pelvic region, including cauterizing a track of the ablation device.

22. The method of claim 4, further comprising:

repositioning the electrode within a second pelvic tumor;

positioning the electrode within the second pelvic tumor with the imaging probe separate from the ablation device; and

delivering energy through the electrode to directly ablate the second pelvic tumor.

23. The method of claim 4, wherein the second pelvic tumor is located closer to a vasculature than a first pelvic tumor.

24. The method of claim 4, further comprising performing an intra-abdominal Doppler analysis of the pelvic area.

25. The method of claim 4, further comprising occluding an artery entering the uterus.

26. A surgical system for ablating pelvic tumors, comprising:

an ablation device including an electrode for insertion into a pelvic tumor;

an imaging probe separate from the ablation device for positioning the electrode within the pelvic tumor; and

an energy source coupled to the ablation device for providing energy to the electrode to directly ablate the pelvic tumor.

27. The surgical system of claim 26, wherein the ablation device includes three or more electrodes deployable from a tip.

28. The surgical system of claim 26, wherein the imaging probe includes an intra-abdominal ultrasound probe.

29. The surgical system of claim 26, wherein the imaging probe is capable of manipulating a location of the ablation device within the pelvic region of the patient.

30. The surgical system of claim 26, wherein the energy source is selected from the group consisting of an RF energy source, a microwave energy source, a light energy source, and an acoustic energy source.

31. The surgical system of claim 26, further comprising a laparoscope, wherein the laparoscope and the imaging probe are operably coupled to at least one monitor.

32. The surgical system of claim 26, wherein the at least one monitor is located along a first side of an operating table, and wherein the energy source is located adjacent the at least one monitor along the first side of the operating table.

33. The surgical system of claim 26, further comprising a second monitor located along a second side of the operating table.

34. The surgical system of claim 26, further comprising an operator control operably coupled to the energy source and located along a second side of the operating table.

35. The surgical system of claim 26, wherein the operator control is a foot pedal.