Partial ablation procedure and device therefor

• US 6,673,071 B2
• Filed: 09/10/2002
• Issued: 01/06/2004
• Est. Priority Date: 02/24/2000
• Status: Expired due to Term

• Current Assignee: Arthur Mccausland, Endomedical Concepts, Inc.
• Original Assignee: Arthur M. Mccausland, Gregg A. Vandusseldorp, Vance Mccausland
• Inventors: VanDusseldorp, Gregg A., McCausland, Vance, McCausland, Arthur M.
• Primary Examiner(s): Shay, David M.
• Application Number:
  US10/065,014
• Publication Number:
  US 20030032953A1
• Time in Patent Office: 483 Days
• Field of Search: 606/41, 606/44, 606/46-52
• US Class Current: 606/41
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00577 Ablation

Abstract

A device and procedure for performing resections and ablations, and more particularly for performing a partial ablation of the endometrium to treat uterine bleeding (menorrhagia), by which complications caused by “total” endometrial ablation or resection are avoided. The device includes a support member, a first conductor member supported with the support member and reciprocable relative to the support member, the first conductor member having an end that extends beyond the support member, a nonconducting member interconnecting the end of the first conductor member with the support member, and at least one flexible conductor member supported with the support member and interconnected with the end of the first conductor member. Retraction of the first conductor member relative to the support member causes the nonconducting member and the flexible conductor member to expand outward from the first conductor member in substantially opposite directions.

Claims

1. A partial ablation device comprising:

a support member;

a first conductor member supported with the support member and reciprocable relative to the support member, the first conductor member having an end that extends beyond the support member;

at least one nonconducting member interconnecting the first conductor member with the support member; and

at least one flexible conductor member supported with the support member, extending along the first conductor member, and interconnected with the first conductor member;

wherein the device has a stowed position in which the first conductor member is extended from the support member and the nonconducting member and the flexible conductor member are disposed alongside the first conductor member;

wherein the support member, the first conductor member, the nonconducting member and the flexible conductor member are interconnected so that retraction of the first conductor member relative to the support member causes the end of the first conductor member to move toward the support member and causes the nonconducting member and the flexible conductor member to expand outward and away from the first conductor member and away from each other; and

wherein, when the first conductor member is retracted to expand the nonconducting member and the flexible conductor member the flexible conductor member is operative to perform ablation of a first wall region of a cavity of the human body while a second wall region of the cavity is held apart from the first wall region by the nonconducting member so that the second wall region does not undergo ablation.

2. A partial ablation device according to claim 1, wherein the device comprises two of the nonconducting members.

3. A partial ablation device according to claim 1, wherein the first conductor member has an internal channel therein and at least one outlet port fluidically connected thereto, the internal channel and the at least one outlet port being operative to cause a fluid flowing through the internal channel to be discharged from the first conductor member through the at least one outlet port.

4. A partial ablation device according to claim 1, further comprising a channel disposed along the support member, the channel being sized to receive a telescope therein.

5. A partial ablation device according to claim 1, further comprising a cap on the end of the first conductor member, the nonconducting member interconnecting the cap and the support member.

6. A partial ablation device according to claim 5, wherein the cap is nonconducting.

7. A partial ablation device according to claim 1, wherein the device is in a deployed position and the nonconducting member and the flexible conductor member are elastically displaced radially outward along substantially their entire lengths when the first conductor member is retracted relative to the support member.

8. A partial ablation device according to claim 7, wherein the device further comprises ratchet means for retracting the first conductor member relative to the support member, wherein the device has a plurality of deployed positions.

9. A partial ablation device according to claim 1, wherein the device comprises a plurality of flexible conductor members, the device further comprising an electrically-conductive material supported by and between the flexible conductor members.

10. A partial ablation device according to claim 9, wherein the electrically-conductive material is chosen from the group consisting of metal foil, wire mesh, and resilient plastic with a conductive film deposited or otherwise carried thereon.

11. A partial endometrial ablation device comprising:

an elongate support member;

an elongate first conductor member reciprocably supported within the support member for reciprocating movement relative thereto in oppositely-disposed first and second directions, the first conductor member having an end that extends outside the support member;

at least one flexible nonconducting member having a first end interconnected with the support member and having a second end interconnected with the end of the first conductor member; and

a plurality of flexible conductor members, each having a first end interconnected with the support member and having a second end electrically interconnected with the end of the first conductor member for conducting a current through the first and flexible conductor members;

wherein the support member, the first conductor member, the flexible nonconducting member and the flexible conductor members are interconnected so that extension of the first conductor member in the first direction relative to the support member causes the end of the first conductor member to move away from the support member and establishes a stowed position in which the flexible nonconducting member and the flexible conductor members are substantially parallel to and alongside the first conductor member and wherein retraction of the first conductor member in the second direction relative to the support member causes the end of the first conductor member to move toward the support member and establishes a deployed position in which the flexible nonconducting member and the flexible conductor members are expanded outward and away from the first conductor member and in substantially opposite directions to each other; and

wherein, when the first conductor member is retracted to expand the flexible nonconducting member and the flexible conductor members the flexible conductor members are operative to perform ablation of a first wall region of an intrauterine cavity of the human body while an oppositely-disposed second wall region of the intrauterine cavity is held apart from the first wall region by the flexible nonconducting member so that the second wall region does not undergo ablation.

12. A partial ablation device according to claim 11, further comprising a nonconducting cap on the end of the first conductor member, the flexible nonconducting member interconnecting the cap and the support member.

13. A partial ablation device according to claim 11, wherein the device comprises two of the flexible nonconducting members.

14. A partial ablation device according to claim 11, wherein the device further comprises ratchet means for retracting the first conductor member relative to the support member such that the device has a plurality of deployed positions.

15. A partial ablation device according to claim 11, further comprising a channel disposed along the support member the channel being sized to receive a telescope therein.

16. A partial ablation device according to claim 11, the device further comprising an electrically-conductive material supported by and between the flexible conductor members the electrically-conductive material being chosen from the group consisting of metal foil, wire mesh, and resilient plastic with a conductive film deposited or otherwise carried thereon.

17. A partial endometrial ablation procedure to treat menorrhagia, the procedure comprising the steps of

inserting a partial ablation device within the intrauterine cavity of the human body;

and then

causing a current to flow through at least one flexible conductor of the ablation device to cut and/or coagulate tissue of a first wall region of the intrauterine cavity while an oppositely-disposed second wall region of the intrauterine cavity is held apart from the first wall region by at least one nonconducting member.

18. A partial endometrial ablation procedure according to claim 17, wherein the partial ablation device comprises a first conductor member, the at least one nonconducting member and the at least one flexible conductor member that are substantially parallel to each other when the partial ablation device is inserted into the intrauterine cavity, the procedure further comprising the step of expanding the nonconducting member and the flexible conductor member outward from the first conductor member in substantially opposite directions, the nonconducting member contracting one of the anterior or posterior walls of the intrauterine cavity the flexible conductor member contacting the other of the anterior or posterior walls of the intrauterine cavity, the current flowing through the flexible conductor member to cut and/or coagulate tissue on the other of the anterior or posterior walls of the intrauterine cavity.

19. A partial endometrial ablation procedure according to claim 17, wherein the partial ablation device comprises a support member, a first conductor member supported with the support member and reciprocable relative to the support member, the first conductor member having an end that extends beyond the support member, the at least one nonconducting member interconnecting the end of the first conductor member with the support member and the at least one flexible conductor member supported with the support member and interconnected with the end of the first conductor member, and wherein following the insertion step the first conductor member is retracted relative to the support member to move the end of the first conductor member toward the support member, causing the nonconducting member and the at least one flexible conductor member to expand outward from the first conductor member in substantially opposite directions, the nonconducting member contacting one of the anterior or posterior walls of the intrauterine cavity, the flexible conductor member contacting the other of the anterior or posterior walls of the intrauterine cavity, the current flowing through the flexible conductor member to cut and/or coagulate tissue on the other of the anterior or posterior walls of the intrauterine cavity.

20. A partial endometrial ablation procedure comprising the steps of:

inserting an ablation device within the intrauterine cavity of the human body; and

then

causing a current to flow through at least one conductor member of the ablation device to perform a controlled and selective electrosurgical ablation of a first wall region of the intrauterine cavity and not a second wall region of the intrauterine cavity by holding the second wall region apart from the first wall region with at least a second member through which current does not flow.

21. A partial endometrial ablation procedure according to claim 20, wherein the ablation device is a partial ablation device comprising a first conductor member, the second member and the at least one conductor member, the procedure further comprising the step of expanding the second member and the at least one conductor member outward from the first conductor member in substantially opposite directions, the second member contacting the second wall region of the intrauterine cavity, the at least one conductor member contacting the first wall region of the intrauterine cavity, the current flowing through the at least one conductor member to cut and/or coagulate tissue of the first wall region of the intrauterine cavity.