Medical probe device

• US 5,421,819 A
• Filed: 05/13/1993
• Issued: 06/06/1995
• Est. Priority Date: 08/12/1992
• Status: Expired due to Term

• Current Assignee: Vidamed, Inc. (Medtronic Plc)
• Original Assignee: Vidamed, Inc. (Medtronic Plc)
• Inventors: Sharkey, Hugh R., Edwards, Stuart D., Lax, Ronald G., Lundquist, Ingemar H., Baker, James A. Jr.
• Primary Examiner(s): Rosenbaum, C. Fred
• Assistant Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US08/061,647
• Time in Patent Office: 754 Days
• Field of Search: 604/164, 604/280, 604/19-22, 604/53, 128/74 AA, 606/39, 606/45, 606/32, 607/96, 607/98, 607/99-102, 607/113, 607/115, 607/116, 607/138, 607/156, 601/2
• US Class Current: 604/22
• CPC Class Codes: A61B 1/00188 with focusing or zooming features
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 10/0241 for prostate
• CPC Class Codes: A61B 10/0275 with sample notch, e.g. on the side of inner stylet
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• 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 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00092 using thermocouples
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00867 : shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/22072 : with an instrument channel, e.g. for replacing one instrument by the other in cannulas A61B17/3417
• CPC Class Codes: A61B 2017/22077 : with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/22082 : after introduction of a substance
• CPC Class Codes: A61B 2017/248 : Operations for treatment of snoring, e.g. uvulopalatoplasty
• CPC Class Codes: A61B 2017/2939 : Details of linkages or pivot points
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2018/00005 : Cooling or heating of the probe or tissue immediately surrounding the probe
• CPC Class Codes: A61B 2018/00011 : with fluids
• CPC Class Codes: A61B 2018/00083 : low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00095 : high, i.e. heat conducting
• CPC Class Codes: A61B 2018/00196 : reciprocating lengthwise
• CPC Class Codes: A61B 2018/0022 : Balloons
• CPC Class Codes: A61B 2018/00547 : Prostate
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00678 : upper
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00726 : Duty cycle
• CPC Class Codes: A61B 2018/00744 : Fluid flow
• CPC Class Codes: A61B 2018/0075 : Phase
• CPC Class Codes: A61B 2018/00761 : Duration
• 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 2018/00869 : Phase
• CPC Class Codes: A61B 2018/00886 : Duration
• CPC Class Codes: A61B 2018/0091 : Handpieces of the surgical instrument or device
• CPC Class Codes: A61B 2018/00916 : with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 2018/00946 : slidable
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1253 : monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1273 : including multiple generators in one device
• CPC Class Codes: A61B 2018/128 : generating two or more frequencies
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/2238 : with means for selectively laterally deflecting the tip of the fibre
• CPC Class Codes: A61B 2090/0814 : Preventing re-use
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2090/3925 : ultrasonic
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 2217/007 : with irrigation system
• CPC Class Codes: A61K 31/465 : Nicotine; Derivatives thereof
• CPC Class Codes: A61M 2025/0086 : the needles having bent tips, i.e. the needle distal tips are angled in relation to the longitudinal axis of the catheter
• CPC Class Codes: A61M 2025/0087 : Multiple injection needles protruding laterally from the distal tip
• CPC Class Codes: A61M 2025/0089 : Single injection needle protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip
• CPC Class Codes: A61M 2025/009 : the needle having a bent tip, i.e. the needle distal tip is angled in relation to the longitudinal axis of the catheter
• CPC Class Codes: A61M 2025/0096 : being laterally outward extensions or tools, e.g. hooks or fibres
• CPC Class Codes: A61M 2025/018 : Catheters having a lateral opening for guiding elongated means lateral to the catheter
• CPC Class Codes: A61M 25/0032 : characterized by at least one unconventionally shaped lumen, e.g. polygons, ellipsoids, wedges or shapes comprising concave and convex parts
• CPC Class Codes: A61M 25/0045 : multi-layered, e.g. coated coating materials A61L29/08
• CPC Class Codes: A61M 25/008 : Strength or flexibility characteristics of the catheter tip
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 1/40 : Applying electric fields by inductive or capacitive coupling microwave apparatus A61N5/00; Applying radio-frequency signals
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia
• CPC Class Codes: A61N 5/02 : using microwaves
• CPC Class Codes: A61N 5/04 : Radiators for near-field treatment
• CPC Class Codes: A61N 5/045 : specially adapted for treatment inside the body

Abstract

A medical probe device of this invention comprising a catheter having a control end and a probe end. The probe end includes a stylet guide housing having at least one stylet port and stylet guide means for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. A stylet is positioned in at least one of said stylet guide means, the stylet comprising a non-conductive sleeve having a RF electrode lumen and an optional a fluid supply lumen and a temperature sensor lumen therein. At least one portion of an opposed surface of the electrode lumen and the electrode can be spaced apart to define a liquid supply passageway for delivery of medicament liquid. The RF electrode enclosed within the non-conductive sleeve has a distal length optionally having at least one current focusing groove means thereon and a distal tip shaped to focus current crowding on its terminal end, whereby Rf current passing therefrom into surrounding tissue forms a lesion extending outward from the groove and tip. The focusing groove means can be a plurality of annular focusing grooves or a spiral focusing groove thereon.

Claims

1. A medical probe device for medical treatment of tissue of a prostate through a urethra defined by a urethral wall comprising a guide housing having proximal and distal extremities, means carried by the guide housing providing a first lumen and a second lumen extending therethrough, a stylet slidably mounted in the first lumen and including a flexible radio frequency electrode with a sharpened tip and an insulating sleeve coaxially mounted on the radio frequency electrode and movable relative to the radio frequency electrode, means carried by the distal extremity of the guide housing and in communication with the first lumen for directing the radio frequency and the insulating sleeve sideways of the guide housing, handle means mounted on the proximal extremity of the guide housing for introducing the distal extremity of the guide housing into the urethra so that the distal extremity of the guide housing is in the vicinity of the prostate, means mounted on the proximal extremity of the guide housing for advancing the radio frequency electrode from the first lumen to cause the sharpened tip of the radio frequency electrode to penetrate the urethral wall and to extend into the tissue with the insulating sleeve extending through the urethal wall, means connected to the handle means for causing relative movement between the insulating sleeve and the radio frequency electrode to expose a predetermined length of radio frequency electrode in the tissue of the prostate with the insulating sleeve extending through the urethral wall, means for supplying radio frequency energy to the radio frequency electrode to cause the temperature of the tissue of the prostate adjacent the predetermined length of radio frequency electrode to be raised to cause destruction of cells in the tissue of the prostate and means coupled to the guide housing for supplying a liquid to the second lumen for delivery into the uretha.

2. A medical probe device as in claim 1, wherein the insulating sleeve has a distal extremity together with a temperature sensor positioned on the distal extremity of the insulating sleeve.

3. A medical probe device as in claim 2 wherein the temperature sensor is a thermocouple.

4. A medical probe device as in claim 2, together with an additional temperature sensor positioned on the insulating sleeve and spaced from the first named temperature sensor whereby when the insulating sleeve extends through the urethral wall the first named and additional temperature sensors are located on opposite sides of the urethral wall.

5. A device as in claim 1 wherein the first lumen is sized so that when the insulating sleeve is disposed therein there remains an annular space together with means for supplying a medicament to the annular space.

6. A medical probe device for medical treatment of tissue of a prostate through a urethra defined by a urethral wall comprising a guide housing having proximal and distal extremities, a styler carried by the guide housing including an insulating sleeve slidably mounted in the guide housing and having a lumen extending therethrough, a flexible radio frequency conductive electrode with a sharpened tip disposed within the lumen of the insulating sleeve and removable relative to the insulating sleeve, the radio frequency electrode and the insulating sleeve being slidably mounted in the lumen, said lumen having a size so that with the insulating sleeve disposed therein there remains an annular space extending longitudinally of the lumen, means carried by the distal extremity of the guide housing and in communication with the lumen for directing the radio frequency electrode and the insulating sleeve sidewise of the guide housing, handle means mounted on the proximal extremity of the guide housing for introducing the distal extremity of the styler through urethra so that the distal extremity of the guide housing is in the vicinity of the prostate, means mounted on the proximal extremity of the guide housing for advancing the radio frequency electrode from the lumen to cause the sharpened tip of the radio frequency electrode to penetrate the urethral wall and to extend into the tissue of the prostate with the insulating sleeve extending through the urethral wall, means connected to the handle means for causing relative movement between the insulating sleeve and the radio frequency electrode to expose a predetermined length of radio frequency electrode in the tissue of the prostate with the insulating sleeve extending;

through the urethral wall, means for supplying radio frequency energy to the radio frequency electrode to cause the temperature of the tissue of the prostate adjacent the predetermined length of radio frequency electrode to be raised to cause destruction of cells in the tissue of the prostate and means coupled to the insulating sleeve for supplying a medicament liquid to the lumen for delivery alongside the electrode into engagement with the tissue of the prostate.

7. A medical probe device as in claim 6 wherein the insulating sleeve has a distal extremity together with temperature sensing means positioned on the distal extremity of the insulating sleeve

8. A medical probe device as in claim 7 wherein the temperature sensing means includes a thermocouple.

9. A medical probe device as in claim 7 together with an additional temperature sensing means positioned on the insulating sleeve and spaced proximal from the first named temperature sensing means whereby when the insulating sleeve is disposed in the urethral wall the first named and additional temperature sensing means are located on opposite sides of the urethral wall.

10. A medical probe device for medical treatment of tissue of a prostate through a urethra defined by a urethral wall comprising a guide housing having proximal and distal extremities, a styler slidably mounted in said passageway including a flexible radio frequency electrode with a sharpened tip and an insulating sleeve coaxially mounted on the radio frequency electrode, means carried by the distal extremity of the guide housing and in communication with the passageway for directing the radio frequency electrode and the insulating sleeve sidewise of the guide housing, handle means mounted on the proximal extremity of the guide housing for introducing the distal extremity of the guide housing into the urethra so that the distal extremity of the guide housing is in the vicinity of the prostate, means mounted on the proximal extremity of the guide housing for advancing the radio frequency electrode to cause the sharpened tip of the radio frequency electrode to penetrate the urethral wall and to extend into the tissue of the prostate with the insulating sleeve extending through the urethral wall, means connected to the handle means for causing relative movement between the insulating sleeve and the radio frequency electrode to expose a predetermined length of radio frequency electrode in the tissue of the prostate with the insulating sleeve extending through the urethral wall, means for supplying radio frequency energy to the radio frequency electrode to cause the temperature of the tissue of the prostate adjacent the predetermined length of radio frequency electrode to. be raised to cause destruction of cells in the tissue of the prostate and temperature sensing means earned by the insulating sleeve and disposed in close proximity to the urethral wall for sensing temperatures adjacent the urethral wall when the insulating sleeve extends through the urethral wall to monitor temperatures adjacent the urethral wall.

11. A medical probe device as in claim 10 wherein the insulating sleeve has a distal extremity and wherein the temperature sensing means is positioned on the distal extremity of the insulating sleeve.

12. A medical probe device as in claim 11 together with an additional temperature sensing means spaced proximal from the first named temperature sensing means whereby when the insulating sleeve is disposed in the urethral wall the first named and additional temperature sensing means are located on opposite sides of the urethral wall.

13. A medical probe device for medical treatment of tissue at a treatment site through a natural body opening defined by a wall comprising a guide housing having proximal and distal extremities and having a passageway extending from the proximal extremity to the and distal extremity, a styler slidably mounted in said passageway including a flexible conductive electrode with a sharpened tip and an insulating sleeve coaxially mounted on the electrode but exposing the sharpened tip, means carried by the distal extremity of the guide housing and in communication with the passageway for directing the electrode and the insulating sleeve sidewise of the guide housing, handle means mounted on the proximal extremity of the guide housing for introducing the distal extremity of the guide housing into the natural body opening to a position adjacent the treatment site, means mounted on the proximal extremity of the guide housing for advancing the stylet to cause the sharpened tip of the electrode to penetrate the wall and extend into the tissue at the treatment site with the insulating sleeve extending though the wall and means for supplying electrical energy to the electrode to cause a thermal effect in the tissue at the treatment site and temperature sensing means carried by the insulating sleeve.