Apparatus for thermal treatment of tissue

• US 5,993,447 A
• Filed: 08/16/1996
• Issued: 11/30/1999
• Est. Priority Date: 08/16/1996
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Stone, Corbett W., Blewett, Jeffrey J., Maurer, Christopher W.
• Primary Examiner(s): Peffley, Michael
• Application Number:
  US08/699,091
• Time in Patent Office: 1,201 Days
• Field of Search: 606/41, 606/42, 606/45-50, 128/642, 607/100-105, 607/122, 600/104, 600/105, 600/374
• US Class Current: 606/50
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2018/00547 Prostate

Abstract

An auxiliary electromagnetic thermal treatment apparatus for use with an endoscope to provide the endoscope with electromagnetic thermal treatment capabilities is provided. The auxiliary apparatus includes a handle portion and an elongate portion connected to the handle portion and dimensioned to be at least partially inserted within a working channel of an endoscope. The elongate portion includes at least one delivery tube having a memory portion comprised of a shape memory material and defining a normally unstressed curved configuration. The one delivery tube is longitudinally moveable relative to the handle portion to extend the memory portion beyond the working channel of the endoscope such that the memory portion assumes the normal unstressed curved configuration thereof. An electromagnetic probe is disposed within the delivery tube and is longitudinally moveable relative to the delivery tube to extend a probe end portion thereof beyond the delivery tube and within tissue. The electromagnetic probe is adapted to follow the curved configuration of the memory portion of the delivery tube for deployment at an angularly oriented relation with respect to the endoscope. A first actuator is mounted to the handle portion and operatively connected to the delivery tube. A second actuator is also mounted to the handle portion and is operatively connected to the electromagnetic probe. The actuator is moveable to extend the probe end portion beyond the delivery tube. The present disclosure is also directed to a combination of an endoscope and an auxiliary thermal treatment device. A method for thermally treating tissue is also disclosed.

Claims

1. An apparatus for thermal treatment of tissue, which comprises:

an elongate portion dimensioned for insertion within a narrow body passage, the elongate portion including;

a delivery catheter having proximal and distal end portions, and a memory portion at the distal end portion thereof, the memory portion comprised of shape memory material and defining an arcuate configuration when in a normal unstressed condition;

an electromagnetic probe disposed within and electrically isolated from the delivery catheter and longitudinally moveable relative to and within the delivery catheter between a first position contained within the delivery catheter and a second position wherein at least a probe end portion thereof extends beyond the delivery catheter and within tissue, the electromagnetic probe being adapted to follow the arcuate configuration of the memory portion of the delivery catheter in the normal unstressed condition, the electromagnetic probe including a first outer electrode and a second inner electrode disposed within the outer electrode, the second inner electrode extending beyond the first outer electrode, the probe being connectable to a thermal energy source; and

a handle portion connected to the elongate portion, the handle portion including a single actuating portion operatively connected to the electromagnetic probe, the actuating portion moveable to move the electromagnetic probe including the first outer electrode and the second inner electrode between the first and second positions.

2. The apparatus according to claim 1, wherein the electromagnetic probe includes a monopolar electrode.

3. The apparatus according to claim 1 including a thermocouple generally disposed adjacent to and operatively cooperating with the electromagnetic probe for detecting temperature of tissue within a treatment area generated by the electromagnetic probe.

4. The apparatus according to claim 3 including a thermocouple generally disposed adjacent to and operatively cooperating with the delivery catheter for detecting temperature of tissue adjacent a treatment area generated by the electromagnetic probe.

5. The apparatus according to claim 1 including a thermocouple generally disposed adjacent to and operatively cooperating with the delivery catheter for detecting temperature of tissue adjacent a treatment area generated by the electromagnetic probe.

6. The apparatus according to claim 1 including a source of dissipating agent operatively connected to the elongate portion for facilitating dissipation of thermal energy at the treatment site and wherein the dissipating agent is distally conveyed through a channel extending through the elongate portion.

7. The apparatus according to claim 6 wherein the electromagnetic probe defines a hollow passageway, the passageway defining the channel for conveyance of the dissipating agent.

8. The apparatus according to claim 1 wherein the elongate portion is dimensioned for insertion within a working channel of a cystoscope.

9. The apparatus according to claim 1 wherein the thermal energy source is a radio frequency (RF) energy source.

10. The apparatus according to claim 9 wherein the first outer electrode and the second inner electrode are configured as bipolar RF electrodes.

11. A system for thermal treatment of tissue, which comprises:

an endoscope including an elongate body having a working channel;

an auxiliary thermal treatment device including;

a handle portion;

an elongate portion extending distally from the handle portion and being dimensioned for at least partial insertion within the working channel of the endoscope, the elongate portion including;

at least one delivery member defming a longitudinal axis and having proximal and distal end portions, the delivery member longitudinally moveable within the working channel of the endoscope to extend therebeyond; and

an electromagnetic probe assembly disposed within the delivery member and longitudinally moveable within the delivery member between an initial position confined within the delivery catheter and an advanced position wherein a probe end portion extends beyond the delivery member and within tissue, the probe assembly including an electrode and an insulating layer coaxially mounted about the electrode, the probe connectable to a thermal energy source;

a first actuator portion mounted to the handle portion and operatively connected to the delivery member, the first actuator portion moveable relative to the handle portion to move the delivery member such that the distal end portion thereof extends beyond the working channel of the endoscope; and

a second actuator portion mounted to the handle portion and operatively connected to the electromagnetic probe assembly, the second actuator portion moveable relative to the handle portion to move the electromagnetic probe assembly between the initial position and the advanced position.

12. The system according to claim 11 further comprising a thermal energy source connected to the electromagnetic probe assembly.

13. The system according to claim 11, wherein the delivery member includes a memory portion disposed at the distal end portion thereof, the memory portion comprised of shape memory material and defining a normally unstressed configuration angularly oriented relative to the longitudinal axis and the electromagnetic probe is adapted to follow the normally unstressed configuration of the memory portion.

14. The system according to claim 13, wherein the electromagnetic probe assembly including a first outer electrode and a second inner electrode disposed within the outer electrode, the second inner electrode extending distally beyond the first outer electrode and having a penetrating end portion at a distal end thereof.

15. The system according to claim 14 wherein the first and second electrodes are configured as bipolar RF electrodes.

16. The system according to claim 15 wherein the elongate portion defines a passageway for conveying a dissipating fluid to the operative site to facilitate dissipation of thermal energy generated by the thermal energy source.

17. The system according to claim 16 wherein the second electrode has a channel, the channel being the passageway for conveying the dissipating fluid.

18. An auxiliary electromagnetic thermal treatment apparatus for use with an endoscope to provide the endoscope with electromagnetic thermal treatment capabilities, which comprises:

a handle portion; and

an elongate portion extending distally from the handle portion, the elongate portion being dimensioned for at least partial insertion within the working channel of an endoscope, the elongate portion including;

at least one delivery tube longitudinally moveable relative to the handle portion to extend a portion thereof beyond the working channel of the endoscope; and

an electromagnetic probe disposed within the delivery tube and defining a probe end portion, the electromagnetic probe longitudinally moveable relative to the delivery tube between an unadvanced position wherein the probe end portion is disposed within the delivery tube and an advanced position wherein the probe end portion extends beyond the delivery tube and within tissue, at least the probe end portion being guided by the delivery tube into the tissue during movement of the electromagnetic probe to the advanced position, the electromagnetic including an electrode and an insulating layer coaxially mounted about the electrode;

a first actuator mounted to the handle portion and operatively connected to the delivery tube, the first actuator movable to move the delivery tube between a first retracted position and a second deployed position, and

a second actuator mounted to the handle portion and operatively connected to the electromagnetic probe, the second actuator movable to move the electromagnetic probe between the unadvanced position and the advanced position.

19. The auxiliary apparatus according to claim 18, wherein the delivery tube includes a memory portion comprised of shape memory material and defining a normally unstressed curved configuration, wherein movement of the memory portion beyond the working channel of the endoscope causes the memory portion to assume the normal unstressed curved configuration.

20. The auxiliary apparatus according to claim 19, wherein the electromagnetic probe is adapted to follow the curved configuration of the memory portion of the delivery tube in the normal unstressed condition thereof.

21. The auxiliary apparatus according to claim 20 wherein the elongate portion includes first and second delivery tubes, the first and second delivery tubes each having an electromagnetic probe disposed therein.

22. The auxiliary apparatus according to claim 21 wherein the first and second delivery tubes are connected along respective longitudinal portions thereof.

23. The auxiliary apparatus according to claim 21 wherein the probes are each configured as a bipolar electrode.

24. The auxiliary apparatus according to claim 20 wherein the elongate portion includes a flexible outer sleeve, the one delivery tube being at least partially disposed within the outer sleeve.

25. A system for thermal treatment of tissue, which comprises:

an endoscope including;

a frame; and

an elongated endoscopic portion extending from the frame, the endoscopic portion having a working channel extending along a portion of the length thereof; and

an auxiliary thermal treatment device including;

a handle portion;

an elongate body extending from the handle portion and positionable within the working channel of the endoscopic portion of the endoscope, the elongate body having an axial bore extending at least partially therethrough;

at least two delivery tubes supported within the elongate body and mounted for movement within the elongate body, each delivery tube having proximal and distal end portions, the distal end portion including a memory portion comprised of a shape memory material and defining a normal curved orientation;

an electromagnetic probe mounted for reciprocal movement within each delivery tube and defining a probe end portion, the electromagnetic probe movable from a position wherein the probe end portion is confined within the delivery tube to a position wherein the probe end portion extends beyond the delivery tube, the electromagnetic probe including an electrode and an insulating layer coaxially mounted about the electrode;

a first actuator mounted to the handle portion and operatively connected to the proximal end portions of the delivery tubes, the first actuator actuable to cause movement of the delivery tubes to extend the distal end portions of the delivery tubes beyond the elongate body, to thereby permit the memory portion of each delivery tube to assume their normal curved orientation thereof; and

a second actuator mounted to the handle portion and operatively connected to the electromagnetic probes, the second actuator actuable to cause movement of the electromagnetic probes to extend the probe end portions beyond the delivery tubes to penetrate tissue, the probe end portions following the path defined by the delivery tubes in the normal curved orientation thereof.

26. The combination of claim 25 wherein the endoscopic portion of the endoscope defines a distal end face and wherein the working channel of the endoscopic portion includes an axial bore extending through the distal end face of the endoscopic portion.

27. The combination of claim 26 wherein the elongate body of the thermal treatment device includes an axial bore extending through the distal end face of the elongate body, the delivery tubes and electromagnetic probes being deployed through the distal end face of the elongate portion.

28. The combination of claim 27 wherein the endoscope includes an optical system for viewing an image of an object.

29. The combination of claim 28 wherein the endoscope includes an illumination system for providing illuminating light.

30. A method for thermally treating tissue, comprising the steps of:

accessing targeted tissue to be thermally treated with an endoscope;

inserting an auxiliary thermal treatment apparatus at least partially into a working channel of the endoscope, the thermal treatment apparatus including a handle portion and an elongate body dimensioned for insertion into the working channel, at least one delivery tube having a memory portion comprised of a shape memory material and movable relative to the handle portion, and an electromagnetic probe disposed within the delivery tube and having a distal end portion and being movable relative to the handle portion, the electromagnetic probe having an electrode and an insulating layer mounted about the electrode;

advancing the delivery tube relative to the handle portion through the elongate body to extend the memory portion of the delivery tube beyond the elongate body and beyond the working channel of the endoscope, whereby the memory portion assumes a normal curved unstressed orientation;

advancing the electromagnetic probe relative to the handle portion and within the delivery tube to extend the distal end portion of the electromagnetic probe confined beyond the delivery tube and into the targeted tissue, whereby the electromagnetic probe follows the path defined by the delivery tube in the normal curved orientation thereof; and

supplying electromagnetic energy to the electromagnetic probe to thermally treat the prostatic tissue.

31. The method of claim 30 wherein the step of advancing the delivery tube includes activating a proximally positioned actuator connected to the delivery tube to selectively advance the delivery tube.

32. The method of claim 31 wherein the step of advancing the electromagnetic probe includes activating a proximally positioned actuator connected to the electromagnetic probe to selectively advance the electromagnetic probe.