Needle kit and method for microwave ablation, track coagulation, and biopsy

• US 6,582,426 B2
• Filed: 04/06/2001
• Issued: 06/24/2003
• Est. Priority Date: 06/17/1999
• Status: Expired due to Term

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Vivant Medical, Inc. (Johnson Controls International plc)
• Inventors: Moorman, Jack W., Bush, M. Elizabeth
• Primary Examiner(s): Kearney, Rosiland S.
• Application Number:
  US09/827,528
• Publication Number:
  US 20010039416A1
• Time in Patent Office: 809 Days
• Field of Search: 606/33, 606/34, 606/35, 606/41, 607/100, 607/101, 604/19-22, 600/562-572
• US Class Current: 606/33
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 10/0275 with sample notch, e.g. on the side of inner stylet
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 2018/00577 Ablation
• CPC Class Codes: A61B 2018/183 characterised by the type of antenna
• CPC Class Codes: A61B 2018/1846 Helical antennas
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

A modular biopsy, ablation and track coagulation needle apparatus is disclosed that allows the biopsy needle to be inserted into the delivery needle and removed when not needed, and that allows an inner ablation needle to be introduced and coaxially engaged with the delivery needle to more effectively biopsy a tumor, ablate it and coagulate the track through ablation while reducing blood loss and track seeding. The ablation needle and biopsy needle are adapted to in situ assembly with the delivery needle. In a preferred embodiment, the ablation needle, when engaged with the delivery needle forms a coaxial connector adapted to electrically couple to an ablating source. Methods for biopsying and ablating tumors using the device and coagulating the track upon device removal are also provided.

Claims

1. A modular needle kit for ablation through a puncture site, comprising:

a delivery needle insertable through the puncture site, said delivery needle having an open proximal end and an open distal end with a lumen extending therebetween;

an ablation needle adapted for ablating tissue abnormalities and coagulating an insertion track, said ablation needle comprising a transmission line and a microwave antenna electrically coupled to said transmission line, wherein said microwave antenna is insertable through said open proximal end of said delivery needle and extends beyond said distal end of said delivery needle when said ablation needle is distally displaced within said lumen of said delivery needle; and

a positional connector adapted to detachably couple to said ablation needle in a fixed positional relationship with said delivery needle.

2. The kit of claim 1, wherein:

said delivery needle further comprises a first connector for electrically coupling to an outer conductor of said transmission line,

said ablation needle further comprises a second connector electrically coupled to a center conductor of said transmission line, and

said first and second connectors can be coupled to form a coaxial connector comprising said positional connector.

3. The kit of claim 1, wherein said positional connector comprises an external clamp attachable about the proximal ends of said ablation needle and said delivery needle.

4. The kit of claim 1, wherein said positional connector is adapted to detachably couple said ablation needle with said delivery needle in a fixed positional relationship for coagulation of an insertion track, wherein said fixed positional relationship is different from a positional relationship used for ablating tissue abnormalities.

5. The kit of claim 1, wherein said delivery needle comprises a distal portion having a diameter of 17 gauge smaller.

6. The kit of claim 1, further comprising a biopsy needle, said biopsy needle formed to be slidably disposed within said lumen of said delivery needle, wherein said biopsy needle extends beyond said distal end of said delivery needle when said biopsy needle is distally displaced within said lumen of said delivery needle.

7. The kit of claim 6, wherein said biopsy needle is adapted for use as an obturator of said delivery needle.

8. The kit of claim 6, wherein said biopsy needle is of an aspirating type or a coring type.

9. The kit of claim 1, wherein said delivery needle is formed of a nonconductive material.

10. The kit of claim 1, wherein said delivery needle is formed of plastic.

11. The kit of claim 1, wherein said delivery needle comprises a flat distal end.

12. The kit of claim 1, wherein said microwave antenna comprises a flat distal end.

13. A system for ablation of tissue comprising:

the kit of claim 1, and

a microwave power source, wherein said transmission line is adapted to electrically couple to said microwave power source.

14. A method of ablating abnormalities in tissue, the method comprising the steps of:

providing the system of claim 13;

introducing the distal end of the delivery needle into tissue in a predetermined area;

inserting the distal end of the ablating needle into the lumen of the delivery needle through the open proximal end of the delivery needle;

advancing the distal end of the ablating needle to protrude from the distal end of the delivery needle; and

ablating the tissue in the predetermined site by delivering microwave power to the microwave antenna through the transmission line.

15. The method of claim 14, wherein said introducing step comprises percutaneously introducing the distal end of the delivery needle into the tissue.

16. The method of claim 14, wherein said introducing step comprises laparoscopically introducing the distal end of the delivery needle into the tissue.

17. The method of claim 14, wherein said introducing step comprises introducing the distal end of the delivery needle into the tissue through an open surgical incision.

18. The method of claim 14, wherein said introducing step forms an insertion track, said method further comprising the steps of:

coupling said ablation needle in a fixed positional relationship with said delivery needle;

partially withdrawing the delivery needle and the ablation needle after said ablating step; and

coagulating at least a portion of the insertion track.

19. The method of claim 14, further comprising the steps of:

providing a biopsy needle formed to be slidably disposable within the lumen of the delivery needle;

inserting the distal end of the biopsy needle into the lumen of the delivery needle through the open proximal end of the delivery needle before said step of inserting the distal end of the ablating needle into the lumen of the delivery needle;

sampling a tissue sample with the biopsy needle; and

removing the biopsy needle from the delivery needle.

20. The method of claim 19, wherein said introducing step occurs while the biopsy needle is inserted through the lumen of the delivery needle.

21. A method of ablating an abnormality in tissue, the method comprising the steps of:

providing a system for ablation of tissue comprising;

a microwave antenna,

a transmission line coupled to the microwave antenna, and

a microwave power source, wherein the transmission line is adapted to electrically couple to the microwave power source;

introducing the distal end of the microwave antenna into tissue containing an abnormality to be ablated, whereby an insertion track is created proximal of the abnormality;

ablating the abnormality by applying microwave power to create a microwave field suitable for ablation of the abnormality in the tissue containing the abnormality;

altering the microwave field to produce a field suited for track coagulation; and

coagulating at least a portion of the insertion track.

22. The method of claim 21, wherein said step of altering the microwave field comprises:

decreasing the diameter of the microwave field, increasing the length of the microwave field, or both.

23. The method of claim 21, wherein said step of altering the microwave field comprises decreasing the microwave power applied.

24. The method of claim 21, wherein said step of alternating the microwave field comprises changing the frequency of the microwave power applied.

25. The method of claim 21, wherein said step of altering the microwave field comprises changing the physical dimensions of the microwave antenna.

26. The method of claim 25, wherein said introducing step comprises introducing the microwave antenna through a lumen of a delivery needle, and wherein the physical dimensions of the microwave antenna are changed by displacing the antenna within the lumen of the delivery needle.

27. The method of claim 26, wherein the antenna is displaced proximally with respect to the delivery needle.

28. The method of claim 26, wherein the antenna is displaced distally with respect to the delivery needle.

29. The method of claim 25, wherein the physical dimensions of the microwave antenna are changed by removing the microwave antenna and replacing it with a second microwave antenna of different physical dimensions.

30. The method of claim 21, wherein said step of ablating the abnormality comprises creating a predetermined isotherm at a first predetermined distance from the antenna, and wherein said step of coagulating the insertion track comprises creating the predetermined isotherm at a second predetermined distance from the antenna, wherein said second predetermined distance is less than said first predetermined distance.

31. The method of claim 21, wherein said step of coagulating the insertion track comprises:

coagulating a first portion of the insertion track;

repositioning the antenna; and

coagulating a second portion of the insertion track.

32. The method of claim 31, wherein the system for ablation comprises markings, and wherein said markings are used to determine the new position of the antenna during said repositioning step.

33. A method of ablating abnormalities in tissue, the method comprising the steps of:

introducing a delivery needle into a patient until the delivery needle is suitably positioned with respect to a tumor;

displacing a biopsy needle within a lumen of the delivery needle until a distal end of the biopsy needle protrudes from a distal end of the delivery needle;

performing a biopsy;

removing the biopsy needle from the delivery needle;

detachably positioning an ablation needle through the delivery needle into the tumor;

applying microwave power to the ablation needle to ablate the tumor;

removing the ablation needle from the tumor; and

removing the delivery needle from the patient.

34. The method of claim 33, wherein said introducing step comprises percutaneously introducing the distal end of the delivery needle into the patient.

35. The method of claim 33, wherein said introducing step comprises laparoscopically introducing the distal end of the delivery needle into the patient.

36. The method of claim 33, wherein said introducing step comprises introducing the distal end of the delivery needle into the patient through an open surgical incision.

37. The method of claim 33, wherein said displacing step occurs after said introducing step, such that the biopsy needle protrudes from the delivery needle into the tumor.

38. The method of claim 33, wherein said displacing step occurs before said introducing step, such that the biopsy needle acts as the obturator for the delivery needle, and such that the delivery needle and biopsy needle are introduced as a unit into the patient.

39. The method of claim 33, wherein said displacing step comprises displacing a coring-type biopsy needle within a lumen of the delivery needle.

40. The method of claim 33, wherein said displacing step comprises displacing an aspirating-type biopsy needle within the lumen of the delivery needle.

41. The method of claim 33, wherein said detachably positioning step comprises inserting an ablation needle having a sharpened distal end through the delivery needle into the tumor.

42. The method of claim 33, wherein said detachably positioning step comprises inserting an ablation needle having a flat distal end through the delivery needle into the tumor.

43. The method of claim 33, further comprising the step of mechanically coupling the ablation needle to the delivery needle.

44. The method of claim 43, wherein said mechanically coupling step comprises attaching an external clamp about the proximal end of the ablation needle and the proximal end of the delivery needle.

45. The method of claim 33, further comprising the steps of:

adjusting the relative position of the ablation needle and the delivery needle for track coagulation as compared to tumor ablation; and

coagulating the track.

46. The method of claim 45, further comprising the step of coagulating the track by steps.

47. The method of claim 33, further comprising the steps of:

performing a second biopsy through the delivery needle after said step of removing the ablating needle; and

removing the biopsy needle.

48. A method of ablating abnormalities in tissue, the method comprising the steps of:

introducing a delivery needle into a patient until the delivery needle is suitably positioned with respect to a tumor;

detachably positioning an ablation needle through a lumen of the delivery needle into or adjacent to the tumor;

applying microwave power to the ablation needle to ablate the tumor; and

removing the ablation needle from the patient while continuing to apply microwave power to the ablation needle.

49. The method of claim 48, further comprising the step of displacing a biopsy needle within a lumen of the delivery needle until a distal end of the biopsy needle protrudes from a distal end of the delivery needle prior to the step of detachably positioning.

50. The method of claim 49, further comprising the step of performing a biopsy.

51. The method of claim 50, further comprising the step of removing the biopsy needle from the delivery needle.

52. The method of claim 48, wherein said introducing step comprises percutaneously introducing the distal end of the delivery needle into the patient.

53. The method of claim 48, wherein said introducing step comprises introducing the distal end of the delivery needle into the patient through an open surgical incision.

54. The method of claim 48, wherein said detachably positioning step comprised inserting an ablation needle having a sharpened distal end through the delivery needle into the tumor.

55. The method of claim 48, wherein said detachably positioning step comprises inserting an ablation needle having a flat distal end through the delivery needle into the tumor.

56. The method of claim 48, wherein said removing step comprises removing the ablation needle and the delivery needle simultaneously while continuing to apply microwave power to the ablation needle.

57. The method of claim 48, wherein said removing step comprises removing the ablation needle in a stepped manner.