Ablation device with jaws

• US 20060047278A1
• Filed: 06/02/2005
• Published: 03/02/2006
• Est. Priority Date: 06/02/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Rothstein, Paul T., Daigle, Tom P., Christian, Steven C.
• Granted Patent: US 7,566,334 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• 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 2017/2944 Translation of jaw members
• CPC Class Codes: A61B 2018/00363 Epicardium
• CPC Class Codes: A61B 2018/00375 Ostium, e.g. ostium of pulmonary vein or artery
• CPC Class Codes: A61B 2018/00577 Ablation

Abstract

System, device and method for ablating target tissue adjacent pulmonary veins of a patient through an incision. An ablation device can include a hinge including a cam assembly, a moving arm, a floating jaw, and a lower jaw. Fingers can engage the floating jaw to hold the floating jaw in a first position with respect to the moving arm. Some embodiments of the invention can provide an ablation device including a central support, an upper four-bar linkage coupled to the central support, an upper jaw coupled to the upper linkage, a lower four-bar linkage coupled to the central support, and a lower jaw coupled to the lower linkage. Some embodiments of the invention can provide an ablation device having an upper jaw including a first cannula connection and a lower jaw including a second cannula connection. The system can include a first catheter coupled to the first cannula connection and a second catheter coupled to the second cannula connection. The first and second catheters can be inserted through the incision and can move the upper and lower jaws adjacent the pulmonary veins.

Claims

1. An ablation device for ablating target tissue adjacent pulmonary veins of a patient, the ablation device comprising:

a hinge including a cam assembly, the cam assembly including at least one rider and at least one finger;

a moving arm coupled to the hinge, the moving arm including a cam surface that engages the at least one rider;

a floating jaw coupled to the moving arm, the at least one finger engaging the floating jaw to hold the floating jaw in a first position with respect to the moving arm, the floating jaw including a first electrode that receives ablation energy; and

a lower jaw coupled to the hinge, the lower jaw including a channel that receives the at least one finger, the channel allowing the floating jaw to move to a second position with respect to the moving arm, the lower jaw including a second electrode that receives ablation energy.

2. The ablation device of claim 1 wherein the cam assembly includes two riders and two fingers.

3. The ablation device of claim 1 wherein the floating jaw swivels between the first position and the second position.

4. The ablation device of claim 1 wherein the first electrode and the second electrode receive ablation energy including at least one of radio frequency energy, thermal energy, cryogenic energy, and microwave energy.

5. The ablation device of claim 1 and further comprising a neck coupled to the hinge, a collar coupled to the neck, a hinge assembly coupled to the collar, a thumb ring coupled to the hinge assembly, and a trigger coupled to the hinge assembly.

6. The ablation device of claim 5 and further comprising a cable coupled between the trigger and at least one of the moving arm and the floating jaw.

7. An ablation device for ablating target tissue adjacent pulmonary veins of a patient, the ablation device comprising:

a central support;

an upper four-bar linkage coupled to the central support;

an upper jaw coupled to the upper linkage, the upper jaw including an upper electrode receiving ablation energy;

a lower four-bar linkage coupled to the central support; and

a lower jaw coupled to the lower linkage, the lower jaw including a lower electrode receiving ablation energy.

8. The ablation device of claim 7 wherein the ablation energy includes at least one of radio frequency energy, thermal energy, cryogenic energy, and microwave energy.

9. The ablation device of claim 7 wherein the upper four-bar linkage includes a first link and a second link and the lower four-bar linkage includes a third link and a fourth link.

10. The ablation device of claim 7 wherein at least one of the upper four-bar linkage and the lower four-bar linkage includes an aperture that receives a pin.

11. The ablation device of claim 7 and further comprising a cable coupled to the upper four-bar linkage and the lower four-bar linkage, the cable being movable in order to position the upper jaw and the lower jaw.

12. The ablation device of claim 7 wherein the upper four-bar linkage is coupled to the central support by a first pivot and the lower four-bar linkage is coupled to the central support by a second pivot.

13. The ablation device of claim 7 wherein at least one of the upper jaw and the second jaw rotates about at least one pin according to a distance defined by an aperture.

14. The ablation device of claim 7 wherein at least one of the upper four-bar linkage and the lower four-bar linkage includes a stop member and at least one of the upper jaw and the lower jaw includes a first recess that receives the stop member.

15. The ablation device of claim 7 and further comprising a cable assembly that wraps around a first portion of the upper four-bar linkage and a second portion of the lower four-bar linkage.

16. The ablation device of claim 7 and further comprising at least one spring coupled between the central support and at least one of the upper four-bar linkage and the lower four-bar linkage.

17. The ablation device of claim 7 and further comprising a flexible spacer coupled to the upper jaw and the lower jaw to prevent tissue from contacting the upper four-bar linkage and the lower four-bar linkage.

18. The ablation device of claim 7 wherein at least one of the upper jaw and the lowerjaw can rotate approximately 30 degrees without binding a cable control assembly.

19. The ablation device of claim 7 and further comprising a gear coupled to the upper four-bar linkage and the lower four-bar linkage;

and a socket coupled to the central support, the socket receiving the gear.

20. A method of ablating target tissue adjacent pulmonary veins of a patient, the method comprising:

providing an ablation device with at least one floating jaw including at least one electrode;

locking the at least one floating jaw;

inserting the at least one floating jaw into a side of the patient;

approaching the pulmonary veins substantially directly from the side of the patient with the at least one floating jaw;

unlocking the at least one floating jaw;

articulating the at least one floating jaw with respect to a central support to accommodate target tissue adjacent the pulmonary veins; and

providing ablation energy to the at least one electrode.

21. The method of claim 20 and further comprising allowing the floating jaw to float with respect to pivot points.

22. The method of claim 20 and further comprising biasing the floating jaw with respect to the central support.

23. The method of claim 20 and further comprising providing two floating jaws.

24. The method of claim 20 and further comprising providing at fixed jaw.

25. The method of claim 20 and further comprising providing ablation energy including at least one of radio frequency energy, thermal energy, cryogenic energy, and microwave energy.

26. An ablation system for ablating target tissue adjacent pulmonary veins of a patient through an incision in the patient, the ablation system comprising:

an ablation tool including a handle, an upper jaw, a lower jaw, and a hinged connection, the upper jaw including a first cannula connection, the lower jaw including a second cannula connection, at least one electrode coupled to at least one of the upper jaw and the lower jaw, the at least one electrode receiving ablation energy;

a first catheter coupled to the first cannula connection, the first catheter capable of being inserted through the incision, the first catheter capable of moving the upper jaw adjacent the pulmonary veins; and

a second catheter coupled to the second cannula connection, the second catheter capable of being inserted through the incision, the second catheter capable of moving the lower jaw adjacent the pulmonary veins.

27. The ablation system of claim 26 wherein at least one of the first cannula connection and the second cannula connection includes a nipple.

28. The ablation system of claim 26 wherein the ablation energy includes at least one of radio frequency energy, thermal energy, microwave energy, and cryogenic energy.

29. The ablation system of claim 26 wherein the upper jaw includes at least one upper electrode and the lower jaw includes at least one lower electrode.

30. The ablation system of claim 26 wherein the upper jaw includes a body, lateral supports, and a central support, and wherein the body can move with respect to at least one of the lateral supports and the central support.

31. The ablation system of claim 26 wherein the handle includes a first circular portion and a second circular portion.

32. The ablation system of claim 26 wherein the ablation tool includes an elongated neck coupled to a collar of the handle.

33. The ablation system of claim 26 wherein at least one of the upper jaw and the lower jaw can move within at least one plane with respect to the hinge connection.

34. The ablation system of claim 26 wherein the first catheter and the second catheter are positioned through at least one of a third intercostal incision and a sixth intercostal incision.

35. A method of ablating target tissue adjacent pulmonary veins of a patient through an incision in the patient, the method comprising:

inserting a first catheter through the incision and positioning the first catheter on a first side of the pulmonary veins;

inserting a second catheter through the incision and positioning the second catheter on a second side of the pulmonary veins;

coupling an upper jaw of an ablation tool to the first catheter;

coupling a lower jaw of the ablation tool to the second catheter;

moving the upper jaw adjacent the pulmonary veins with the first catheter;

moving the lower jaw adjacent the pulmonary veins with the second catheter; and

providing ablation energy to at least one electrode coupled to at least one of the upper jaw and the lower jaw.

36. The method of claim 35 and further comprising connecting a nipple of at least one of the upper jaw and the lower jaw to at least one of the first catheter and the second catheter.

37. The method of claim 35 and further comprising providing ablation energy including at least one of radio frequency energy, thermal energy, microwave energy, and cryogenic energy.

38. The method of claim 35 and further comprising performing bipolar ablation.

39. The method of claim 35 and further comprising moving a body of the upper jaw with respect to at least one of lateral supports and a central support of the upper jaw.

40. The method of claim 35 and further comprising moving at least one of the upper jaw and the lower jaw within at least one plane with respect to a hinge connection of the ablation tool.

41. The method of claim 35 and further comprising inserting the first catheter and the second catheter through at least one of a third intercostal incision and a sixth intercostal incision.