Systems and methods for track coagulation

• US 20140257265A1
• Filed: 03/04/2014
• Published: 09/11/2014
• Est. Priority Date: 03/07/2013
• Status: Active Grant

• Current Assignee: Medtronic Holding Company Sarl (Medtronic Plc)
• Original Assignee: Baylis Medical Company Inc. (Boston Scientific Corporation)
• Inventors: Godara, Neil, Woo, Jason
• Granted Patent: US 9,877,707 B2
• Time in Patent Office: Days
• US Class Current: 606/33
• CPC Class Codes: A61B 10/025 for taking bone, bone marrow or cartilage samples
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 2018/00005 Cooling or heating of the probe or tissue immediately surrounding the probe
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00565 Bone
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00714 Temperature
• CPC Class Codes: A61B 2018/0072 Current
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00767 Voltage
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00892 Voltage
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1425 Needle

Abstract

Devices, and methods of use thereof, are disclosed for preventing tumor seeding when withdrawing the device along an entry-exit path. Some embodiments of the present invention comprise a method of withdrawing a probe through a tissue via a path that traverses at least some bone tissue, the method including withdrawing the probe through the path, and at least partially concurrently delivering energy in a bipolar manner from the probe to heat a layer of tissue surrounding the probe to a temperature sufficient for thermal coagulation necrosis of cells. The device may be withdrawn incrementally.

Claims

1. A method of withdrawing a probe through a tissue via a path that traverses at least some bone tissue, the method comprising withdrawing the probe through the path and at least partially concurrently delivering energy in a bipolar manner from the probe to heat a layer of tissue surrounding the probe to a temperature sufficient for thermal coagulation necrosis of cells.

2. The method of claim 1, wherein the probe is withdrawn incrementally.

3. The method of claim 2, further comprising measuring a temperature of the layer of tissue surrounding at least a portion of the path surrounding the probe prior to each incremental withdrawal to determine if the temperature is sufficient for thermal coagulation necrosis of cells.

4. The method of claim 3, wherein the temperature of the layer of tissue is measured using a tip temperature sensor.

5. The method of claim 1, wherein a cooling system is associated with the probe and wherein the energy is delivered with the cooling system turned off, whereby the probe is not actively cooled during withdrawal.

6. The method of claim 1, wherein the path includes a tissue transition zone from one tissue type to another tissue type.

7. The method of claim 1, wherein the energy is radiofrequency electrical energy.

8. The method of claim 1, further comprising coupling the probe to an introducer, and wherein the step of withdrawal comprises withdrawing the probe and the introducer in incremental distances of about a length of an active tip of the probe.

9. The method of claim 1, further comprising a step of electrically coupling the probe to an electrosurgical generator for supplying energy to the probe.

10. The method of claim 9, further comprising providing information regarding parameters of the probe to the generator using an interface.

11. The method of claim 9, the generator being configured to automatically detect parameters of the probe when the probe is coupled thereto.

12. The method of claim 9, further comprising a step of determining a value of an electrical parameter associated with a delivery of energy to the probe based on the probe coupled to the generator, the electrical parameter selected from the group consisting of power and voltage.

13. The method of claim 12 wherein the step of determining a value of an electrical parameter is performed automatically by the generator.

14. The method of claim 1, the probe including an active electrode and a return electrode on a single shaft.

15. The method of claim 9, further comprising steps of:

measuring a temperature of the layer of tissue surrounding at least a portion of the path surrounding the probe prior to each incremental withdrawal, providing the temperature to the generator, and subsequently delivering energy to the probe based on the temperature.

16. The method of claim 3, further comprising providing an indication to a user that the temperature is sufficient for thermal coagulation necrosis.

17. The method of claim 16, further comprising withdrawing the probe incrementally when the indication is provided.

18. The method of claim 1, wherein the probe is withdrawn by a user.

19. The method of claim 16, wherein the indication is provided when the temperature reaches at least 60°

C.

20. The method of claim 1 further comprising measuring an impedance of at least a portion of the layer of tissue and terminating delivering energy when the impedance exceeds a threshold.

21. The method of claim 20 wherein the threshold is in a range of about 1000 to about 3000 ohms.

22. A method of withdrawing a probe having an active tip through a tissue via a path, the method comprising:

withdrawing the probe through the path in increments each having an increment length; and

, for each incremental withdrawal, delivering energy from the active tip of the probe to heat a layer of tissue surrounding the probe to a temperature sufficient for thermal coagulation necrosis of cells to thereby define a coagulation volume, wherein the increment length is less than or equal to a length of the coagulation volume.

23. The method of claim 22, wherein the increment length is less than or equal to a length of the active tip.

24. The method of claim 22, further comprising, for each increment, measuring a parameter of the layer of tissue while concurrently heating the layer of tissue.

25. The method of claim 24, wherein the parameter of the layer of tissue is selected from the group consisting of temperature and impedance.

26. The method of claim 22, wherein the path comprises various tissue types.

27. The method of claim 22, wherein the active tip comprises at least one active electrode and at least one return electrode and wherein the step of delivering energy comprises delivering electrical energy in a bipolar manner.

28. A method of withdrawing a probe having an active tip through a tissue via a path, the method comprising:

continuously withdrawing the probe through the path while concurrently delivering energy from the active tip to heat a layer of tissue surrounding the probe;

measuring a tissue parameter to confirm thermal coagulation necrosis of cells adjacent the probe; and

adjusting a level of energy being delivered or a rate of probe withdrawal based on the tissue parameter.

29. The method of claim 28, wherein the tissue parameter is temperature.

30. A system including:

an electrosurgical generator;

at least one bipolar probe configured to be coupled to the electrosurgical generator, the at least one bipolar probe including at least one active electrode, at least one return electrode and at least one temperature sensor; and

at least one introducer defining a lumen sized to receive the at least one bipolar probe;

the generator being operable to;

deliver electrical energy in a radiofrequency range;

automatically detect at least one probe parameter of a probe coupled thereto;

receive a measurement of at least one tissue parameter;

substantially continuously adjust an energy delivery parameter in response to the at least one probe parameter and the at least one tissue parameter, the energy delivery parameter being selected from the group consisting of voltage and impedance; and

provide an indication to a user when the at least one tissue parameter reaches a pre-determined threshold.