Device and method for heating tissue in a patient's body

• US 4,955,377 A
• Filed: 10/28/1988
• Issued: 09/11/1990
• Est. Priority Date: 10/28/1988
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Corporation
• Inventors: Lennox, Charles D., Sahatjian, Ronald, Noddin, Richard A.
• Primary Examiner(s): Hindenburg, Max
• Application Number:
  US07/263,815
• Time in Patent Office: 683 Days
• Field of Search: 128/303.1, 128/303.12, 128/399-402, 128/784-786, 128/804, 606/27-31
• US Class Current: 607/105
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00088 using thermistors
• CPC Class Codes: A61B 2017/00132 Setting operation time of a device A61B2017/00123 takes precedence
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/22062 to be filled with liquid
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/044 the surgical action being effected by a circulating hot fluid

Abstract

Device and method for heating tissue, the device having a catheter shaft for insertion into a patient'"'"'s body, a chamber formed by a collapsible balloon mounted on the catheter shaft and filled with an electrically conductive fluid, two or more electrical contacts enclosed within the chamber, a power supply for applying an electrical potential to the contacts, and a two or more conductors for connecting each of the contacts to the power supply. The fluid is heated on the basis of I² R losses by a radio frequency electric current flowing between the electrodes, and the fluid in turn heats the surrounding tissue by heat transfer through the wall of the chamber. According to the method, the apparatus is inserted into the patient'"'"'s body, the chamber is filled with an electrically conductive fluid, and an electrical potential is applied to the contacts. The apparatus functions as a temperature source. A thermister sensor in the balloon or in contact with tissue responds to the heating effect to control the application of the current. Advantageously, by periodic sensing of temperature, and application of controlled rf power, a preset constant temperature is maintained at the selected sensing point, either at the internal body site or the liquid within the balloon. In this way carefully controlled therapy can be conducted at constant temperature.

Claims

1. Device for heating tissue, comprising

a chamber constructed for insertion into a patient'"'"'s body,

an electrically conductive fluid preselected for resistive heating for filling the chamber,

a plurality of spaced electrical contacts enclosed within the chamber and a corresponding plurality of conductors for connecting the electrical contacts to a power supply for applying a radio frequency electrical potential between the contacts, said contacts being exposed to the fluid-containing space of said chamber so that said radio frequency electrical potential can cause current to flow through fluid between the contacts, said chamber and said contacts being cooperatively constructed and arranged to cause said current to be confined to said fluid within the chamber,

whereby on the basis of I² R losses of said radio frequency electric current flowing between the electrical contacts, the fluid can be heated and the fluid in turn can heat the surrounding tissue by thermal conduction through a wall of the chamber.

2. The device of claim 1 wherein said chamber is defined by an expandable wall, the chamber adapted to be empty and the expandable wall collapsed at the time of introduction into the patient and wherein a conduit is adapted to fill the chamber with said fluid after introduction of the chamber into the patient'"'"'s body.

3. The device of claim 1 or 2 wherein the chamber is defined by an inflatable balloon.

4. The device of claim 1 wherein said electrical contacts are radiopaque and serve as radiopaque markers.

5. The device of any of the claims 1 wherein the impedance between a pair of said electrodes, when said chamber is filled with said preselected fluid, is less than 1000 ohms.

6. The device of claim 5 wherein said impedance is in the range of 50 to 500 ohms.

7. The device of any of the claim 1 including a power supply constructed to operate at a frequency between 100 khz and 1 Mhz.

8. The device of claim 7 wherein the electrical potential applied across the contacts by the power source is about 100 volts or less.

9. The device of claim 7 further comprising

a temperature sensor, and

a temperature control circuit for controlling the output of the power supply in response to information received from the temperature sensor.

10. The device of any of the claim 1 wherein a temperature sensor constructed to sense the temperature of said fluid for controllinq the application of said electrical potential to said contacts is located within the chamber.

11. The device of any of the claim 1 associated with an temperature sensor located outside the chamber in contact with tissue surrounding the chamber for controlling the application of said electrical potential to said contacts is located within the chamber.

12. The device of any of the claims 1 wherein said chamber is filled with a saline solution.

13. The device of any of the claims 1 wherein said chamber is filled with a fluid that is radiopaque.

14. The device of any of the claims 1 sized and constructed for insertion into a blood vessel.

15. The device of any of the claim 1 sized and constructed for insertion into the body to apply heat to the prostate gland.

16. The device of any of the claim 1 wherein said chamber is coated with a coating that prevents said chamber from sticking to said tissue.

17. The device of any of the claim 1 including a power supply adapted to apply said current at a level sufficient to cause localized boiling of said fluid at said electrical contacts, to cause mixing of the fluid in said chamber and produce uniform heating of the chamber wall.

18. The device of claim 17 including a pressure transducer exposed to sense fluid pressure in said chamber and means constructed and arranged to control the energy applied to said electrical contacts in response to information received from the pressure transducer.

19. The device of any of the claim 1 associated with a power supply controlled by a thermister sensor, and a control constructed and arranged to operate alternately in a power application mode in which rf potential is applied to said contacts and a sensing mode during which application of rf potential to said contacts is disrupted

20. The device of any of the claim 1 including a thermister exposed to fluid in said chamber, said thermister connected to one of said electrical contacts, said device adapted to be used with a power supply controlled to alternately apply potential to said electrical contacts and to sense the temperature of the fluid in the absence of rf potential on the contacts.

21. A method for heating tissue, comprising inserting into a patient'"'"'s body a chamber containing electrically conductive fluid preselected for resistive heating, there being a plurality of spaced electrical contacts encodes within the chamber and a corresponding plurality of conductors for connecting the electrical contacts to a power supply for applying a radio frequency electrical potential to the contacts, said contacts being exposed to the fluid-containing space of said chamber so that said radio frequency electrical potential can cause current to flow through fluid between the contacts,

said chamber and said contacts being cooperatively constructed and arranged to cause said current to be confined to said fluid within the chamber,

and applying radio frequency potential between said electrical contacts,

whereby on the basis of I² R losses of said radio frequency electric current flowing between the electrical contacts, the fluid is heated and the fluid in turn heats the surrounding tissue by thermal conduction through a wall of the chamber.

22. The method of claim 21, wherein said radio frequency potential applied across said contacts is at frequency in the range between about 100 khz and 1 Mhz.

23. The method of claim 21, including controlling the electrical current between the electrical contacts to induce localized boiling at the contacts.

24. A method of constant temperate heating, comprising inserting into a patient'"'"'s body a chamber containing electrically conductive fluid preselected for resistive heating, there being a plurality of electrical contacts enclosed within the chamber and a corresponding plurality of conductors for connecting the electrical contacts to a power supply for applying a radio frequency electrical potential to the contacts, said contacts being exposed to the fluid-containing space of said chamber so that said radio frequency electrical potential can cause current to flow through fluid between the contacts,

said chamber and said contacts being cooperatively constructed and arranged to cause said current to be confined to said fluid within the chamber,

applying radio frequency potential, between said electrical contacts,

monitoring temperature at a point influenced by the temperature of said liquid and in response thereto controlling the radio frequency energy applied to said electrical contacts to maintain said temperature constant,

whereby on the basis of I² R losses of said controlled radio frequency electric current flowing between the electrical contacts, the fluid is heated and the fluid in turn heats the surrounding tissue by thermal conduction through a wall of the chamber.

25. The method of claim 24 wherein said chamber comprises a balloon on a catheter introduced into a lumen or cavity of the body.

26. The method of claim 24 or 25 wherein temperature at a point in the body adjacent said chamber is monitored and used to control the application of energy to said electrodes to maintain temperature at said point constant for a selected duration, on the basis of thermal transfer from liquid heated in said balloon to said point.

27. The method of claim 24 or 25 wherein temperature of the liquid in said chamber is monitored and used to control the application of energy to said electrodes to maintain temperature of said fluid constant at a set point whereby it is assured that tissue in the vicinity of said chamber is not heated above said set point.