Medical instrument and method of use

• US 20060135955A1
• Filed: 10/05/2005
• Published: 06/22/2006
• Est. Priority Date: 01/18/2003
• Status: Active Grant

• Current Assignee: Tsunami MedTech, LLC
• Original Assignee: Tsunami MedTech, LLC
• Inventors: Shadduck, John H.
• Granted Patent: US 8,016,823 B2
• Time in Patent Office: Days
• US Class Current: 606/27
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• 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 2017/00504 Tissue welding
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/0041 Removal of thrombosis
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/048 in gaseous form
• CPC Class Codes: A61B 2018/1213 creating an arc
• CPC Class Codes: A61B 2218/002 Irrigation

Abstract

This invention relates to surgical instruments for applying energy to tissue. In one embodiment, an elongated introducer has a handle portion that includes an interior chamber that is supplied with a biocompatible liquid under pressure. An energy source causes a liquid-to-vapor phase change within the interior chamber and ejects a flow of vapor media from the working end of the introducer. The flow of vapor is controlled by a computer controller to cause a selected pressure, a selected volume of vapor, and an optional aspiration of vapor condensate. Contemporaneous with tissue contact, the vapor undergoes a vapor-to-liquid phase transition which delivers large amount of energy to the targeted tissue. In one embodiment, the system is configured for volumetric removal of tissue by means of high velocity ejection of a vapor media from a first vapor port proximate to soft tissue wherein the vapor-to-liquid phase change of the media applies energy to the tissue. The system provides a second port coupled to a suction source that cooperates with the first vapor port to suction tissue debris from the targeted site.

Claims

1-36. -36. (canceled)

37. A method of applying energy to soft tissue comprising the steps of generating a flow of vapor, and introducing a flow of vapor to interfacing soft tissue wherein the vapor delivers energy sufficient to modify the tissue.

38. The method of claim 37 wherein the introducing step includes the vapor undergoing a vapor-to-liquid phase transition thereby delivering thermal energy.

39. The method of claim 37 wherein the introducing step includes injecting the vapor at a high velocity thereby delivering mechanical energy.

40. The method of claim 37, further comprising controlling the parameters of the flow of vapor, the parameters selected from the group of the heat of vaporization of the vapor, the pressure of the flow of vapor, the volume of the flow of vapor and the duration of the flow of vapor.

41. The method of claim 37 further including reducing the mass average temperature of the flow of vapor by controlled introduction of a selected media into the flow, the selected media consisting of at least one of a gas, a liquid or particulate matter.

42. The method of claim 41 wherein the selected media includes at least one of depressurized CO₂, N₂, O₂ or H₂O.

43. A method as in claim 37 further comprising applying aspiration forces about the interface of the flow of vapor with the soft tissue.

44. The method of claim 37 wherein modifying tissue includes at least one of tissue ablation, obliteration, scouring and volumetric removal.

45. The method of claim 40 including controlling the parameters of the flow of vapor to obliterate a selected softer tissue while preventing obliteration of a selected harder tissue.

46. The method of claim 37 wherein the tissue includes at least one of disc tissue, adipose tissue, tumorous tissue and ocular tissue.

47. The method of claim 37 further comprising generating the flow of vapor by at least one of resistive heating means, radiofrequency (Rf) energy means, microwave energy means, photonic energy means, magnetic induction energy means, compression and decompression means, and ultrasonic energy means.

48. A method of applying energy to mammalian tissue comprising the steps of generating a flow of vapor, introducing a flow of vapor into an interface with tissue, and controlling the parameters of the flow for discriminating between first tissue and second adjacent tissues for volumetric removal of the first tissue without volumetric removal of the second tissue.

49. A method as in claim 48 further comprising applying aspiration forces about the interface of the flow of vapor with the tissue for extracting the tissue.

50. A method as in claim 48 wherein the first tissue is a less fibrous tissue and the second tissue is more fibrous tissue.

51. A method as in claim 48 wherein the first tissue is a disc nucleus portion and the second tissue is a disc annulus portion.

52. A method as in claim 48 wherein the first tissue is adipose tissue and the second tissue is non-adipose tissue.

53. A method as in claim 48 wherein the first tissue is less dense tissue and the second tissue is more dense tissue.

54. A method as in claim 48 wherein the first tissue is soft tissue and the second tissue is vascular tissue.

55. A method as in claim 48 wherein the first tissue is tumorous tissue and the second tissue is non-tumorous tissue.

56. A surgical system for applying energy to tissue,

a probe having a handle end that extends to a working end;

a source of a vaporized fluid media that communicates with at least one vapor outlet in the working end; and

a negative pressure source that communicates with at least one aspiration port in the working end.

57. The surgical system of claim 56 wherein the at least one vapor outlet is directed toward the at least one aspiration port.

58. The surgical system of claim 56 wherein the at least one vapor outlet is in a recessed portion of the working end.

59. The surgical system of claim 56 wherein at least one aspiration port is in a recessed portion of the working end.

60. The surgical system of claim 56 wherein the at least one aspiration port has an open cross-section that is substantially larger than the open cross-section of the at least one vapor outlet.

61. The surgical system of claim 56 further including an extendable cutting loop that is extendable from the working end and a rotation mechanism for rotating the working end.

62. The surgical system of claim 56 further comprising a controller for controlling at least on of the pressure of the source of a vaporized fluid media and the pressure of the negative pressure source.

63. The surgical system of claim 56 further comprising a MEMS sensor in the working end.