TEMPERATURE RESPONSIVE ABLATION RF DRIVING FOR MODERATING RETURN ELECTRODE TEMPERATURE

• US 20090187183A1
• Filed: 01/21/2008
• Published: 07/23/2009
• Est. Priority Date: 03/13/2007
• Status: Abandoned Application

• Current Assignee: Acessa Health Inc. (Hologic Incorporated)
• Original Assignee: Acessa Health Inc. (Hologic Incorporated)
• Inventors: EPSTEIN, Gordon
• Application Number:
  US12/017,272
• Publication Number:
  US 20090187183A1
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1233 with circuits for assuring patient safety
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• 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 18/16 Indifferent or passive electrodes for grounding
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00797 measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00821 measured by a thermocouple
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems

Abstract

The inventive method for ablating a tissue mass associated with a human or animal patient being treated comprises positioning an ablating electrode in a tissue mass to be ablated. A plurality of return electrodes are positioned on the patient. Electrical energy is applied between the return electrodes and the ablating electrode. The temperature of the return electrodes is measured to generate a temperature measurement signal which is used to control ablation current through the return electrodes.

Claims

1. A method for ablating a tissue mass associated with a human or animal patient being treated, comprising:

(a) positioning an ablating electrode in a tissue mass to be ablated;

(b) positioning a plurality of return electrodes on the patient;

(c) applying electrical energy to said return electrodes and said ablating electrode;

(d) measuring the temperature of said return electrodes to generate a temperature measurement signal; and

(e) varying the electrical energy applied between said return electrodes and said ablating electrode in response to said temperature measurement signal.

2. A method as in claim 1, wherein the electrical energy is RF energy.

3. A method as in claim 1, wherein said temperature is measured on a portion of said return electrode which is more proximate to said tissue mass than other portions of said return electrode.

4. A method as in claim 3, wherein said temperature is measured on an edge of said return electrode.

5. A method as in claim 1, wherein said varying of electrical energy comprises shutting off one or more of said return electrodes.

6. A method as in claim 1, wherein said varying of electrical energy comprises apportioning electrical energy between said electrodes.

7. A method as in claim 6, wherein said control of the coupling of said ablation current to said return electrodes comprises apportionment of current between said return electrodes, said apportionment being made by sending more electrical energy to electrodes which are less likely to become overheated.

8. A method as in claim 7, wherein said electrical energy is apportioned by varying the duty cycle of electrical energy sent to each of the return electrodes.

9. A method as in claim 6, wherein said control of the coupling of said ablation current to said return electrodes comprises apportionment of current between said return electrodes, said apportionment being made by sending more electrical energy to electrodes which are more likely to cool rapidly, proportionately on the basis of cooling rate.

10. A method as in claim 6, wherein said control of the coupling of said ablation current to said return electrodes comprises apportionment of current between said return electrodes, said apportionment being made by sending more electrical energy to electrodes which are less likely to become overheated and by sending more electrical energy to electrodes which are more likely to cool rapidly, proportionately on the basis of inverse heating rate and cooling rate, respectively.

11. A method as in claim 1, further comprising measuring the impedance path of return electrodes to determine the existence of a poor electrical connection.

41. A method as in claim 1, wherein:

(a) the varying of the electrical energy applied between said return electrodes and said ablating electrode is varied as a function of temperature history.

42. A method as in claim 41, wherein measurement of temperature of said return like those is done using temperature measurement transducers which are secured to their respective return electrodes.

43. A method as in claim 41, wherein the amount of electrical energy sent to a return electrode is varied individually.

44. A method as in claim 41, wherein return electrode temperatures are displayed and said display of return electrode temperature is a first color, such as green or blue, when the return electrode is cool, a second color, such as amber, when the return electrode is becoming significantly warmed, and a third color, such as red, when electrode has exceeded acceptable threshold temperature.

45. A method as in claim 41, wherein said electrical energy is radio frequency ablation current and the amount of ablation current being sent to one of said return electrodes is varied as a function of temperature in accordance with a first algorithm, and the amount of ablation current being sent to another of said return electrodes is varied as a function of temperature in accordance with a second algorithm, said second algorithm being different from said first algorithm.

46. A method as in claim 41, wherein the system collects information for operation type, or surgeon identity, or another factor to generate initial parameters for the system.

12. A device for ablating tissue masses associated with a human or animal patient, comprising:

(a) an electrical source for generating an ablation current;

(b) a coupling circuit coupled to said electrical source;

(c) an ablation electrode coupled to said coupling circuit;

(d) a plurality of return electrodes coupled to said coupling circuit to receive ablation current;

(e) a plurality of temperature measurement transducers, each of said temperature transducers being associated with a respective return electrode, said temperature transducers each providing a temperature measurement signal; and

(f) a computing device coupled to said temperature measurement signals for producing signals to control the coupling of said ablation current to said return electrodes by said coupling circuit.

13. A device as in claim 12, wherein at least one of said temperature measurement transducers is positioned on a portion of and secured to its respective one of said return electrodes which portion is closer to said ablation electrode than other portions of said one of said return electrodes.

14. A device as in claim 12, wherein each of said temperature measurement transducers are positioned on a portion of its respective return electrode which is closer to said ablation electrode than other portions of said respective return electrode.

15. A device as in claim 12, wherein said computing device is a personal computer and said coupling circuit is personal computer interface device, such as a PC board.

16. A device as in claim 12, wherein said coupling circuit can vary the duty cycle of said ablation current and wherein at least two of said return electrodes are located on a common substrate.

17. A device as in claim 12, wherein said computing device is a personal computer and said coupling circuit is personal computer interface device, such as a PC board, and wherein the operation of said computer is controlled by software which causes the display of return electrode temperature on the screen of said personal computer.

18. A device as in claim 17, wherein said display of return electrode temperature is in a first color, such as green or blue, when the electrode is cool, in a second color, such as amber, when the return electrode is becoming significantly warmed, and in a third color, such as red, when said return electrode has exceeded acceptable threshold temperature.

19. A device as in claim 17, wherein said threshold temperature is adjustable.

20. A device as in claim 17, wherein a return electrode which has a temperature which exceeds an acceptable threshold temperature is disabled and does not receive ablation current.

21. A device as in claim 17, wherein the amount of energy sent to a return electrode is varied individually, as a function of its temperature.

22. A device as in claim 17, wherein the amount of energy sent to a return electrode is varied individually, as a function of its temperature history.

23. A device as in claim 12, wherein the amount of ablation current being sent to one of said return electrodes is varied as a function of temperature in accordance with a first algorithm, and the amount of ablation current being sent to another of said return electrodes is varied as a function of temperature in accordance with a second algorithm, said second algorithm being different from said first algorithm.

24. A device as in claim 12, wherein a surgeon may override the control signal provided by said computing device, for example to restore power to an electrode which has been shut off by said computing device on account of its temperature exceeding a threshold.

25. A device as in claim 12, wherein only the coolest electrodes are provided with ablation current.

26. A device as in claim 12, wherein temperature is periodically assessed by the system.

27. A device as in claim 12, wherein the impedance of a current path associated with each is said to electrodes is periodically checked and further comprising an alarm device, coupled to said computing device for indicating a likely defective condition in the current path.

28. A device as in claim 12, wherein the computing device selects electrodes for receiving ablation current and varies the magnitude of ablation current sent to each electrode.

29. A device as in claim 12, wherein the system collects information for operation type, or surgeon identity, or another factor to generate initial operating parameters for the system.

30. A device as in claim 12, wherein an initial set of operating parameters are deployed when the device is first activated, and said operating parameters are varied in response to heating and/or cooling of the electrodes.

31. A device as in claim 12, wherein the signals for controlling the coupling of said return electrodes to said coupling circuit apportion ablation current between said return electrodes, said apportionment of ablation current being a function of the amount of time that the surgeon is applying an ablation current.

32. A device as in claim 31, wherein the amount of energy sent to a return electrode is varied individually.

33. A device as in claim 31, wherein a return electrode which has a temperature which exceeds at an acceptable threshold temperature is disabled and does not receive ablation current.

34. A device as in claim 31, wherein the amount of energy sent to a return electrode is varied individually, as a function of its temperature.

35. A device as in claim 31, wherein the amount of energy sent to a return electrode is varied individually, as a function of its temperature history.

36. A device as in claim 35, wherein the amount of energy sent to a return electrode is varied individually, as a function of its temperature history.

37. A device as in claim 35, wherein the impedance of a current path associated with each is said to electrodes is periodically checked and further comprising an alarm for indicating a likely defective condition in the current path.

38. A device as in claim 31, wherein the amount of ablation current being sent to one of said return electrodes is varied as a function of temperature in accordance with a first algorithm, and the amount of ablation current being sent to another of said return electrodes is varied as a function of temperature in accordance with a second algorithm, said second algorithm being different from said first algorithm.

39. A device as in claim 31, wherein the amount of energy sent to a return electrode is varied individually and ablation current is varied by varying the duty cycle of the ablation current.

40. A device as in claim 12, wherein said temperature measurement transducers are secured to their respective return electrodes.