Medical probe device with optical viewing capability

• US 5,749,846 A
• Filed: 06/07/1995
• Issued: 05/12/1998
• Est. Priority Date: 08/12/1992
• Status: Expired due to Term

• Current Assignee: Allseas Group S.A.
• Original Assignee: Vidamed, Inc. (Medtronic Plc)
• Inventors: Sharkey, Hugh R., Edwards, Stuart D., Lax, Ronald G., Lundquist, Ingemar H., Baker, James Allen Jr.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US08/485,802
• Time in Patent Office: 1,070 Days
• Field of Search: 604/19-22, 604/53, 604/164, 604/280, 601/2, 606/39, 606/45, 606/32, 606/47, 606/48, 607/96, 607/113, 607/115, 607/116, 607/138, 607/156, 607/101, 607/102
• US Class Current: 604/22
• 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 18/1442 Probes having pivoting end effectors, e.g. forceps
• 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 2017/00101 using an array of thermosensors
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00123 and automatic shutdown
• CPC Class Codes: A61B 2017/00181 Means for setting or varying the pulse energy
• CPC Class Codes: A61B 2017/00194 : Means for setting or varying the repetition rate
• 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 2017/00296 : mounted on an endoscope
• 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 2018/00023 : closed, i.e. without wound contact by the fluid
• 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 2018/00101 : low, i.e. thermally insulating
• CPC Class Codes: A61B 2018/00196 : reciprocating lengthwise
• CPC Class Codes: A61B 2018/0022 : Balloons
• CPC Class Codes: A61B 2018/00291 : using suction
• CPC Class Codes: A61B 2018/00327 : Ear, nose or throat
• 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 2018/00761 : 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 2018/00875 : Resistance or impedance
• 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 2018/1412 : Blade
• 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 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2090/3786 : receiver only
• 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: A61B 2218/003 : using a spray or a foam
• CPC Class Codes: A61F 2007/0054 : with a closed fluid circuit, e.g. hot water
• 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 25/0068 : Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
• CPC Class Codes: A61M 25/0069 : Tip not integral with tube
• CPC Class Codes: A61M 25/0082 : Catheter tip comprising a tool
• CPC Class Codes: A61M 3/0279 : Cannula; Nozzles; Tips; their connection means
• 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 5/04 : Radiators for near-field treatment
• CPC Class Codes: A61N 5/045 : specially adapted for treatment inside the body

Abstract

A medical probe device comprising a catheter having a stylet guide housing with at least one stylet port in a side thereof and stylet guide means for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. The stylet guide housing has an optical viewing means positioned for viewing the stylet and adjacent structure which includes a fiber optic channel means for receiving a fiber optic viewing device. The fiber optic channel means can include a guide port means for directing longitudinal movement of a fiber optic device with respect to the stylet guide means in a viewing zone and a flushing liquid channel in the stylet guide housing having an exit port positioned to direct flushing liquid issuing therefrom across the end of a fiber optic device when positioned in the viewing zone. The optical viewing means can comprise a viewing window positioned in the stylet guide housing for viewing the stylet when it is directed outward from its respective stylet port. The optical viewing means can include a fiber optic channel in the stylet guide housing for receiving the a fiber optic viewing device and aligning the viewing end thereof with the viewing window. Windowed devices can include a flushing liquid channel in the stylet guide housing having an exit port positioned to direct flushing liquid issuing therefrom across a surface of the viewing window.

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 and having a passageway extending from the proximal extremity to the distal extremity, a stylet mounted in the guide housing, means carried by the distal extremity of the guide housing and in communication with said passageway for directing the stylet sidewise of the guide housing, the stylet including a flexible radio frequency electrode and an insulating sleeve coaxially mounted on the electrode, handle means coupled to the proximal extremity of the guide housing for introducing the distal extremity of the guide housing into the urethra into the vicinity of the prostate, said handle means including means secured to the stylet for advancing the stylet from the passageway of the guide housing to cause the radio frequency electrode and the insulating sleeve to penetrate the urethral wall and to extend into the tissue of the prostate with the insulating sleeve extending through the urethral wall and the radio frequency electrode having a predetermined length in the tissue of the prostate, 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 the radio frequency electrode to be raised to cause destruction of cells in the tissue of the prostate and an optical viewing device positioned in the guide housing having a viewing field that extends forwardly and sidewardly of the guide housing to permit viewing of the radio frequency electrode and the insulating sleeve as they are deployed sidewise from the distal extremity of the guide housing.

2. A medical probe device as in claim 1 wherein the guide housing includes a channel receiving said optical viewing device and permitting longitudinal movement of the optical viewing device with respect to the guide housing to shift the viewing field.

3. A medical probe device as in claim 2 wherein the distal extremity of the guide housing has a tip and wherein the optical device viewing channel terminates at a position proximal of the tip.

4. A medical probe device as in claim 3 wherein said guide housing is provided with a transverse depression proximal of the tip and within the viewing field of the optical viewing device.

5. A medical probe device as in claim 3 wherein the distal extremity of the guide housing has a tip which includes a window extending across the viewing field.

6. A medical probe device as in claim 2 wherein the distal extremity of the guide housing has a tip and wherein the optical viewing device channel extends through the tip.

7. A medical probe device as in claim 6 wherein the distal extremity of the guide housing is provided with a transverse depression extending through and across the optical device viewing channel.

8. A medical probe device as in claim 1 wherein said guide housing includes a flushing liquid channel for directing a flushing liquid into the viewing field.

9. A medical probe device as in claim 8 wherein said guide housing includes at least one flushing liquid return lumen.

10. A medical probe device as in claim 1 wherein the optical viewing device comprises an eyepiece, a fiber optic, a focal lens and means for adjusting the longitudinal position of the focal lens with respect to the fiber optic.

11. 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 and having a passageway extending from the proximal extremity to the distal extremity, a stylet mounted in the guide housing, means carried by the distal extremity of the guide housing and in communication with said passageway for directing the stylet sidewise of the guide housing, the stylet including a flexible radio frequency electrode and a layer of insulating material coaxially mounted on the electrode, handle means coupled to the proximal extremity of the guide housing for introducing the distal extremity of the guide housing into the urethra into the vicinity of the prostate, said handle means including means secured to the stylet for advancing the stylet from the passageway of the guide housing to cause the radio frequency electrode and the layer of insulating material to penetrate the urethral wall and to extend into the tissue of the prostate with the layer of insulating material extending through the urethral wall and the radio frequency electrode having a length in the tissue of the prostate, means for supplying radio frequency energy to the radio frequency electrode to cause the temperature of the tissue of the prostate adjacent the length of the radio frequency electrode to be raised to cause destruction of cells in the tissue of the prostate and an optical viewing device positioned in the guide housing having a viewing field that extends forwardly and sidewardly of the guide housing to permit viewing of the radio frequency electrode and the layer of insulating material as they are deployed sidewise from the distal extremity of the guide housing.

12. A medical probe device as in claim 11 wherein the distal extremity of the guide housing has a tip and wherein the optical viewing device terminates at a position proximal of the tip.

13. A medical probe device as in claim 12 wherein the distal extremity of the guide housing is provided with a transverse depression proximal of the tip and within the viewing field of the optical viewing device.

14. A medical probe device as in claim 11 wherein the distal extremity of the guide housing has a tip which includes a window extending across the viewing field.

15. A medical probe device as in claim 11 wherein at least a portion of the distal extremity of the guide housing is transparent to permit the optical viewing device to view the radio frequency electrode and the layer of insulating material through the distal extremity of the guide housing as they are deployed sidewise from the distal extremity of the guide housing.

16. 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 and having a passageway extending from the proximal extremity to the distal extremity, a flexible radio frequency electrode mounted in the guide housing, means carried by the distal extremity of the guide housing and in communication with said passageway for directing the radio frequency electrode sidewise of the guide housing, handle means coupled to the proximal extremity of the guide housing for introducing the distal extremity of the guide housing into the urethra into the vicinity of the prostate, said handle means including means secured to the radio frequency electrode for advancing the radio frequency electrode from the passageway of the guide housing to cause the radio frequency electrode to penetrate the urethral wall and to extend into the tissue of the prostate, means for supplying radio frequency energy to the radio frequency electrode to cause the temperature of the tissue of the prostate adjacent the radio frequency electrode to be raised to cause destruction of cells in the tissue of the prostate and an optical viewing device positioned in the guide housing having a viewing field that extends forwardly and sidewardly of the guide housing to permit viewing of the radio frequency electrode as it is deployed sidewise from the distal extremity of the guide housing.

17. A medical probe device as in claim 16 together with a layer of insulating material coaxially mounted about at least a portion of the radio frequency electrode.

18. A medical probe device as in claim 16 wherein the radio frequency electrode is provided with a longitudinal lumen extending therethrough.

19. A medical probe device for use in a human body comprising an elongate member having proximal and distal extremities and having a passageway therein extending along a longitudinal axis from the proximal extremity to the distal extremity, an elongate needle mounted in the passageway and having proximal and distal extremities, handle means coupled to the proximal extremity of the elongate member for introducing the distal extremity of the elongate member into the body, means connected to the elongate needle for causing advancement of the elongate needle through the passageway, the distal extremity of the elongate member being in communication with the passageway and permitting the distal extremity of the elongate needle to be advanced out of the passageway sideways at an angle with respect to the longitudinal axis, an optical viewing device having a distal extremity with a field of view and means carried by the proximal extremity of the elongate member for mounting the distal extremity of the optical viewing device within the distal extremity of the elongate member and for moving the distal extremity of the optical viewing device relative to the elongate member from a first longitudinal position to permit viewing forward of the elongate member for guiding the distal extremity of the elongate member within the body to a second longitudinal position proximal of the first longitudinal position to permit viewing the distal extremity of the elongate needle as it is advanced from the passageway sideways of the longitudinal axis.

20. A device as in claim 19 wherein the passageway extends to a port at the distal extremity of the elongate member and wherein the first longitudinal position is distal of the port and the second longitudinal position is proximal of the port.

21. A device as in claim 20 wherein the distal extremity of the elongate member has a rounded tip and a transversely extending recess proximal of the rounded tip, the port disposed between the rounded tip and the recess.

22. A device as in claim 19 wherein the elongate needle is a needle electrode, an insulating sleeve coaxially mounted on the needle electrode.

23. A device as in claim 22 together with means mounted on the proximal extremity of the elongate member and connected to the handle means and to the insulating sleeve for causing the insulating sleeve to move relative to the needle electrode.

24. A medical probe device comprising an elongate guide housing having proximal and distal extremities and having a passageway therein extending from the proximal extremity to the distal extremity along a longitudinal axis, a stylet mounted in the guide housing and having proximal and distal extremities, handle means coupled to the proximal extremity of the guide housing, the handle means including means connected to the stylet for causing advancement of the stylet through the passageway, the distal extremity of the guide housing being in communication with the passageway and permitting the distal extremity of the stylet to be advanced out of the passageway sidewise at an angle with respect to the longitudinal axis and an optical viewing device mounted in the guide housing and having a distal extremity positioned in the distal extremity of the guide housing and having a field of view which permits viewing the distal extremity of the stylet as it is advanced from the passageway sidewise of the longitudinal axis.

25. A device as in claim 24 wherein the stylet includes a conductive radio frequency electrode and an insulating sleeve coaxially mounted on the conductive radio frequency electrode and exposing a length of the conductive radio frequency electrode.

26. A device as in claim 24 for use in a human body together with means carried by the proximal extremity of the guide housing for mounting the distal extremity of the optical viewing device within the distal extremity of the guide housing and for moving the distal extremity of the optical viewing device relative to the guide housing from a first longitudinal position to permit viewing forward of the guide housing for guiding the distal extremity of the guide housing within the body to a second longitudinal position proximal of the first longitudinal position to permit viewing the distal extremity of the stylet as it is advanced from the passageway sidewise of the longitudinal axis.

27. A medical probe device for medical treatment of tissue of a prostate in a human body through a urethra defined by a urethral wall comprising an elongate member having proximal and distal extremities and having a passageway therein extending along a longitudinal axis from the proximal extremity to the distal extremity, a stylet mounted in the passageway and having proximal and distal extremities, the stylet including a flexible radio frequency electrode and a layer of insulating material coaxially mounted on the radio frequency electrode, handle means coupled to the proximal extremity of the elongate member for introducing the distal extremity of the elongate member into the body, the handle means including means connected to the stylet for causing advancement of the stylet through the passageway, the distal extremity of the elongate member having means for directing the distal extremity of the stylet out of the passageway sideways at an angle with respect to the longitudinal axis, an optical viewing device having a distal extremity with a field of view and means carried by the proximal extremity of the elongate member for mounting the distal extremity of the optical viewing device within the distal extremity of the elongate member and for moving the distal extremity of the optical viewing device relative to the elongate member from a first longitudinal position to permit viewing forward of the elongate member for guiding the distal extremity of the elongate member within the body to a second longitudinal position proximal of the first longitudinal position to permit viewing the distal extremity of the stylet as it is advanced from the passageway sideways of the longitudinal axis into the tissue of the prostate.

28. A medical probe device as in claim 27 wherein at least a portion of the distal extremity of the elongate member is transparent to permit the optical viewing device to view the distal extremity of the stylet through the distal extremity of the elongate member as it is advanced from the passageway sideways of the longitudinal axis into the tissue of the prostate.

29. 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 and having a passageway extending from the proximal extremity to the distal extremity, a stylet for delivering radio frequency energy into the tissue of the prostate mounted in the guide housing, means carried by the distal extremity of the guide housing and in communication with said passageway for directing the stylet sidewise of the guide housing, handle means coupled to the proximal extremity of the guide housing for introducing the distal extremity of the guide housing into the urethra into the vicinity of the prostate, said handle means including means secured to the stylet for advancing the stylet from the passageway of the guide housing to cause the stylet to penetrate the urethral wall and to extend into the tissue of the prostate, means for supplying radio frequency energy to the stylet to cause the temperature of the tissue of the prostate adjacent the stylet to be raised to cause destruction of cells in the tissue of the prostate and an optical viewing device positioned in the guide housing having a viewing field that extends forwardly and sidewardly of the guide housing to permit viewing of the stylet as it is deployed sidewise from the distal extremity of the guide housing.

30. 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 and having a passageway extending from the proximal extremity to the distal extremity, a stylet mounted in the guide housing, means carried by the distal extremity of the guide housing and in communication with said passageway for directing the stylet sidewise of the guide housing, the stylet including a flexible radio frequency electrode and a layer of insulating material coaxially mounted on the electrode, handle means coupled to the proximal extremity of the guide housing for introducing the distal extremity of the guide housing into the urethra into the vicinity of the prostate, said handle means including means secured to the stylet for advancing the stylet from the passageway of the guide housing to cause the radio frequency electrode and the layer of insulating material to penetrate the urethral wall and to extend into the tissue of the prostate with the layer of insulating material extending through the urethral wall and the radio frequency electrode having a length in the tissue of the prostate for causing the temperature of the tissue of the prostate adjacent the length of the radio frequency electrode to be raised and thus destroy cells in the tissue of the prostate and an optical viewing device positioned in the guide housing having a viewing field that extends forwardly and sidewardly of the guide housing, at least a portion of the distal extremity of the guide housing being transparent to permit the optical viewing device to view the radio frequency electrode and the layer of insulating material through the distal extremity of the guide housing as they are deployed sidewise from the distal extremity of the guide housing.