Methods and systems for determining physiologic characteristics for treatment of the esophagus

• US 20060095032A1
• Filed: 10/04/2005
• Published: 05/04/2006
• Est. Priority Date: 11/16/1999
• Status: Abandoned Application

• Current Assignee: BÂRRX Medical, Inc. (Medtronic Plc)
• Original Assignee: BÂRRX Medical, Inc. (Medtronic Plc)
• Inventors: Utley, David S., Jackson, Jerome, Stern, Roger A.
• Application Number:
  US11/244,385
• Publication Number:
  US 20060095032A1
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• 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 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/00482 with a code
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00482 Digestive system
• CPC Class Codes: A61B 2018/00488 Esophagus
• CPC Class Codes: A61B 2018/00494 Stomach, intestines or bowel
• CPC Class Codes: A61B 2018/00553 Sphincter
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 : with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00738 : Depth, e.g. depth of ablation
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/00898 : Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1807 : using light other than laser radiation
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 5/053 : Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0538 : invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/1076 : for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/4233 : oesophagus
• CPC Class Codes: A61B 5/6885 : Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61M 25/10181 : Means for forcing inflation fluid into the balloon
• CPC Class Codes: A61M 25/10184 : Means for controlling or monitoring inflation or deflation
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 2005/0609 : Stomach and/or esophagus
• CPC Class Codes: A61N 5/062 : Photodynamic therapy, i.e. excitation of an agent

Abstract

A method and apparatus for treating abnormal mucosa in the esophagus is disclosed, such that the depth of the treated tissue is controlled. The depth of ablation is controlled by monitoring the tissue impedance and/or the tissue temperature. A desired ablation depth is also achieved by controlling the energy density or power density, and the amount of time required for energy delivery. A method and apparatus is disclosed for measuring an inner diameter of a body lumen, where a balloon is inflated inside the body lumen at a fixed pressure.

Claims

1. A method for measuring an inner diameter of a body lumen comprising:

inserting a balloon in the body lumen;

inflating the balloon inside the body lumen using an expansion medium; and

monitoring a mass of the expansion medium inside the balloon.

2. The method of claim 1, wherein monitoring the mass of the expansion medium is performed using a mass flow sensor.

3. The method of claim 1, wherein the expansion medium is a gas.

4. The method of claim 1, wherein the expansion medium is a liquid.

5. The method of claim 1, wherein the balloon is inflated at a fixed pressure.

6. The method of claim 1, wherein the fixed pressure is approximately 4 psig.

7-17. -17. (canceled)

18. A method for treating abnormal tissue inside a body lumen, the method comprising:

automatically determining an inner diameter of the body lumen at a location proximal to the abnormal tissue;

deploying an electrode structure at a surface of the tissue at the proximal location; and

delivering energy to the electrode structure for treating the tissue.

19. The method of claim 18, wherein the inner diameter is determined by automatically inflating and deflating a balloon inside the body lumen using an expansion medium.

20. The method of claim 19, further comprising monitoring a mass of the expansion medium inside the balloon.

21. The method of claim 18, further comprising controlling a depth of treated tissue.

22. The method of claim 21, wherein controlling the depth of treated tissue comprises controlling an amount of power delivered to the tissue over time.

23. The method of claim 21, wherein controlling the depth of treated tissue comprises normalizing power delivered to the tissue over time.

24. The method of claim 21, wherein controlling the depth of treated tissue comprises controlling an amount of energy delivered to the tissue over time.

25. The method of claim 21, wherein controlling the depth of treated tissue comprises controlling delivered energy density.

26. The method of claim 21, wherein controlling the depth of treated tissue comprises monitoring and controlling tissue impedance over time.

27. The method of claim 21, wherein controlling the depth of treated tissue comprises monitoring and controlling tissue temperature over time.

28. The method of claim 18, further comprising controlling an amount of power delivered to the tissue by rapidly increasing the power until it reaches a set target value.

29. The method of claim 28, wherein controlling the amount of power delivered is performed using a proportional integral derivative controller.

30. An apparatus for treating a tissue inside a body lumen comprising:

an electrode structure adapted to be positioned at a surface of the tissue inside the body lumen, wherein the electrode structure is coupled to an expansion member; and

a generator for producing and delivering energy to the electrode structure;

wherein the generator is adapted to automatically inflate the expansion member inside the body lumen and control the pressure inside the expansion member during treatment of the tissue.

31. The apparatus of claim 30, wherein the expansion member is a balloon coupled to a catheter.

32. The apparatus of claim 30, further comprising a storage device for storing generator settings.

33. The apparatus of claim 32, wherein the storage device is an EEPROM.

34. The apparatus of claim 30, further comprising a pump for automatically inflating and deflating the expansion member.

35. The apparatus of claim 30, wherein the generator is adapted to determine an inner diameter of the body lumen using an inflatable balloon.

36. The apparatus of claim 35, wherein the generator is adapted to control the amount of energy delivered to the tissue over time based on the measured diameter of the esophagus.

37. The apparatus of claim 35, wherein the generator is adapted to normalize the density of energy delivered to the tissue based on the measured diameter of the esophagus.

38. The apparatus of claim 35, wherein the generator is adapted to control the amount of power delivered to the tissue over time based on the measured diameter of the esophagus.

39. The apparatus of claim 30, wherein the generator is adapted to control the energy delivered to the electrode structure.

40. The apparatus of claim 30, wherein the generator is adapted to control the power delivered to the electrode structure.

41. The apparatus of claim 30, wherein the generator is adapted to normalize the amount of power delivered to the tissue over time based on the measure diameter of the esophagus.

42. The apparatus of claim 30, wherein the generator is adapted to detect whether a catheter is attached thereto and to identify a characteristic of the attached catheter.

43. The apparatus of claim 42, further comprising a storage device adapted to store information about the attached catheter.

44. The apparatus of claim 30, further comprising a footswitch coupled to the generator and adapted to control the energy delivered to the electrode structure.

45. The apparatus of claim 30, further comprising a display for displaying information to a user.

46. The apparatus of claim 30, wherein the generator is adapted to be manually controlled by a user such that the user controls the energy delivered to the electrode structure over time.

47. The apparatus of claim 30, further comprising a proportional integral derivative controller adapted to gradually increase power delivered to the electrode structure until it reaches a set target value.

48. An apparatus for treating a tissue inside a body lumen comprising:

an electrode structure adapted to be positioned at a surface of the tissue inside the body lumen, wherein the electrode structure is coupled to an expansion member; and

a generator for producing, delivering and controlling energy delivered to the electrode structure;

wherein the generator is adapted to determine an inner diameter of the body lumen.