Medical probe device and method

• US 6,610,054 B1
• Filed: 11/27/1996
• Issued: 08/26/2003
• Est. Priority Date: 08/12/1992
• Status: Expired due to Fees

• 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.
• Primary Examiner(s): Bockelman, Mark
• Application Number:
  US08/757,282
• Time in Patent Office: 2,463 Days
• Field of Search: 604/19-22, 606/33, 606/39, 606/41, 606/42, 606/45, 607/100-102, 128/642, 128/734
• US Class Current: 606/41
• 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 10/0241 for prostate
• 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 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1206 Generators 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
• CPC Class Codes: A61B 2017/22072 with an instrument channel, e.g. for replacing one instrument by the other
• 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 2018/1412 : Blade
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/1861 : with an instrument inserted into a body lumen or cavity, e.g. a catheter
• 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: 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 25/008 : Strength or flexibility characteristics of the catheter tip
• CPC Class Codes: A61M 25/0082 : Catheter tip comprising a tool
• 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 comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radiofrequency electrode. Preferably, the non-conductive layer is a sleeve which is axially moveable on the electrical conductor to expose a selected portion of the electrical conductor surface in the target tissue. The stylet can also be a microwave antenna. The stylet can also be a hollow tube for delivering treatment fluid to the target tissue. It can also include a fiber optic cable for laser treatment. The catheter can include one or more inflatable balloons located adjacent to the stylet port for anchoring the catheter or dilation. Ultrasound transponders and temperature sensors can be attached to the probe end and/or stylet. The stylet guide can define a stylet path from an axial orientation in the catheter through a curved portion to a lateral orientation at the stylet port.

Claims

1. A retractable RF electrode assembly for ablating and measuring the impedance of a body tissue portion, comprising:

a) a first RF electrode having a distal end and a proximal end, said first RF electrode being disposed within an insulating sheath;

b) elongated guide means encasing said first RF electrode and said insulating sheath, for guiding said first RF electrode into a predetermined angle value with respect to a longitudinal axis of said elongated guide means;

c) electrode movement mechanism means, attached to said proximal end of said first RF electrode, for moving said first RF electrode within said guide means, said distal end of said first RF electrode being extendable beyond an open end of said guide means up to a predetermined length value and engagable with and insertable into said body tissue portion;

d) energy source means, in electrical communication with said proximal end of said first RF electrode, for transmitting energy into said distal end of said first RF electrode when it is extended beyond said guide means and into said body tissue portion so as to ablate said body tissue portion; and

e) tissue impedance measurement means, in electrical communication with said proximal end of said first RF electrode, for measuring an impedance associated with said body tissue portion engaged with said distal end of said first RF electrode when it is extended beyond said guide means.

2. A retractable RF electrode assembly as recited in claim 1 which further includes:

a) at least one other second RF electrode having a distal end and a proximal end, said second RF electrode being disposed within a second insulating sheath;

b) elongated second guide means encasing said second RF electrode and said second insulating sheath for guiding said second RF electrode into a second predetermined angle value from the longitudinal axis of said single access conduit, said second RF electrode separated from said first RF electrode by a predetermined width value;

c) said proximal end of said second RF electrode is attached to said electrode movement mechanism means, and said distal end of said second RF electrode is extendable beyond an open end of said second guide means up to a second predetermined length value so as to be engagable with and insertable into said body tissue portion;

d) said proximal end of said second RF electrode is in electrical communication with said energy source means and said tissue impedance measurement means; and

e) whereby said electrode movement mechanism means moves each of said first RF and said second RF electrodes within each of associate guide means, and said distal ends of each of said first RF electrode and said second RF electrode is extendable beyond and retractable within each of said associated guide means, and when each of said distal ends of each RF electrode is extended beyond said associated guide means said energy source means is energized to pass electrical current from one RF electrode to the other and said tissue impedance measurement means measures the impedance of tissue engaged between each of said distal ends of each RF electrode.

3. A retractable RF electrode assembly as recited in claim 2, further including:

a) means for bending each of said guide means for each of said first RF electrode and said second RF electrode to vary each of said predetermined and said second predetermined angle values.

4. A retractable RF electrode assembly as recited in claim 1, further including:

a) means for bending said guide means to vary said predetermined angle value.

5. A medical probe device comprising

a) a first RF electrode having a distal end and a proximal end, said first RF electrode being enclosed within an insulating sleeve,

b) an elongated member having a first guide passageway disposed therein, said first RF electrode and said insulating sleeve being positioned within said guide passageway to guide said first RF electrode into a preselected angle from the central axis of said elongated member,

c) an electrode positioning member attached to said first RF electrode, said distal end of said first RF electrode being extendable beyond an open end of said guide passageway up to a predetermined length and insertable into a target tissue,

d) an energy source in electrical communication with said first RF electrode, and

e) a tissue impedance monitoring device in electrical communication with said first RF electrode.

6. A medical probe device as recited in claim 5 which further includes

a) a second RF electrode having a distal end and a proximal end, said second RF electrode being enclosed within a second insulating sleeve,

b) said elongated member having a second guide passageway disposed therein, said second RF electrode and said second insulating sleeve being positioned within said second guide passageway to guide said second RF electrode into a second preselected angle from the central axis of said elongated member, said second RF electrode is separated from said first RF electrode by a third angle,

c) said second RF electrode is attached to said electrode positioning member, and said distal end of said second RF electrode being extendable beyond an open end of said second guide passageway up to a second predetermined length and insertable into said target tissue,

d) said second RF electrode is in electrical communication with said energy source and said tissue impedance monitoring device, and

e) said electrode positioning member moves said first and second RF electrodes within said first and second guide passageways, respectively, and said distal ends of said first and second RF electrodes are extendable beyond and retractable within said first and second guide passageways, respectively, and when said distal ends of said first and second RF electrodes are extended beyond said first and second guide passageways said energy source is energized to pass electrical current from said first RF electrode to said second RF electrode, and said tissue impedance monitoring device monitors the impedance of said target tissue engaged between said distal ends of said first and second RF electrodes.

7. A medical probe device as recited in claim 6, further including

a guide adjusting system coupled to said first and second guide passageways to vary the preselected angles of said first and second guide passageways.

8. A medical probe device as recited in claim 5, further including

a guide adjusting system coupled to said guide passageway to vary the preselected angle of said guide passageway.