Catheter for delivery of energy to a surgical site

• US 6,749,605 B2
• Filed: 02/01/2001
• Issued: 06/15/2004
• Est. Priority Date: 10/23/1996
• Status: Expired due to Term

• Current Assignee: NeuroTherm, Inc. (Abbott Laboratories Incorporated)
• Original Assignee: Oratec Interventions Incorporated
• Inventors: Saal, Joel, Saal, Jeffrey A., Sharkey, Hugh R., Ashley, John E.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US09/776,186
• Publication Number:
  US 20010023348A1
• Time in Patent Office: 1,230 Days
• Field of Search: 606/27, 606/41-50, 607/117, 607/118, 607/122, 607/96, 607/101, 600/585, 604/95.05, 604/528, 604/530, 604/531, 604/510
• 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 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3496 Protecting sleeves or inner probes; Retractable tips for protecting body piercing guide needles A61M25/0612
• 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 18/14 Probes or electrodes therefor
• 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 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/0011 piezoelectric
• CPC Class Codes: A61B 2017/00119 : alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00261 : Discectomy
• CPC Class Codes: A61B 2017/00274 : Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/003 : Steerable
• CPC Class Codes: A61B 2017/00336 : with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/00455 : Orientation indicators, e.g. recess on the handle
• CPC Class Codes: A61B 2017/00867 : shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/22044 : with a pointed tip
• CPC Class Codes: A61B 2017/22049 : Means for locking the guide wire in the catheter
• CPC Class Codes: A61B 2017/22082 : after introduction of a substance
• CPC Class Codes: A61B 2017/22087 : photodynamic
• CPC Class Codes: A61B 2017/2905 : flexible
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/320008 : Scrapers
• CPC Class Codes: A61B 2017/320044 : Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/32113 : with extendable or retractable guard or blade
• CPC Class Codes: A61B 2017/3445 : used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2018/00011 : with fluids
• CPC Class Codes: A61B 2018/00267 : having a basket shaped structure
• CPC Class Codes: A61B 2018/00434 : Neural system
• CPC Class Codes: A61B 2018/0044 : Spinal cord
• CPC Class Codes: A61B 2018/00547 : Prostate
• CPC Class Codes: A61B 2018/00625 : Vaporization
• CPC Class Codes: A61B 2018/00654 : with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/046 : in liquid form
• CPC Class Codes: A61B 2018/1266 : with DC current output
• CPC Class Codes: A61B 2018/1405 : Electrodes having a specific shape
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1412 : Blade
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/1435 : Spiral
• CPC Class Codes: A61B 2018/1455 : having a moving blade for cutting tissue grasped by the jaws
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/1807 : using light other than laser radiation
• CPC Class Codes: A61B 2090/0454 : by reflection
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3937 : Visible markers
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 2217/007 : with irrigation system
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61F 2/442 : Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2007/0298 : with a section for heating and a section for cooling
• CPC Class Codes: A61M 2025/0063 : having means, e.g. stylets, mandrils, rods or wires to reinforce or adjust temporarily the stiffness, column strength or pushability of catheters which are already inserted into the human body
• CPC Class Codes: A61M 2025/0064 : which become stiffer or softer when heated
• CPC Class Codes: A61M 2025/0163 : Looped catheters
• CPC Class Codes: A61M 25/0144 : having flexible regions as a result of inner reinforcement means, e.g. struts or rods
• CPC Class Codes: A61M 25/0155 : with hydraulic or pneumatic means, e.g. balloons or inflatable compartments
• CPC Class Codes: A61M 25/0158 : with magnetic or electrical means, e.g. by using piezo materials, electroactive polymers, magnetic materials or by heating of shape memory materials
• 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

Abstract

A catheter for delivering energy to a surgical site is disclosed. The catheter includes at a proximal end a handle and at a distal end a probe. The catheter includes at least one energy delivery device and an activation element. The at least one energy delivery device is located at the distal end of the catheter to deliver energy to portions of the surgical site. The activation element is located at the distal end of the catheter, to transition the probe from a linear to a multi-dimensional shape, within the surgical site. Methods for deploying the probe from the linear to multi-dimensional shape are disclosed. In another embodiment of the invention, the catheter includes a heating element fabricated on a substrate by photo-etching to deliver thermal energy to portions of the surgical site.

In another embodiment of the invention, the catheter includes an energy delivery element, a tip and a blade. The energy delivery element is located at the distal end of the catheter to deliver energy to portions of the intervertebral disc. The blade is positioned within a first lumen of the tip and is extensible beyond the tip, to cut selected portions within the intervertebral disc. In another embodiment of the invention, a catheter includes both energy and material transfer elements and an interface on the handle thereof. The interface couples the energy delivery element and the material transfer element to external devices for energy and material transfer to and from the intervertebral disc.

Claims

1. A method for deploying a probe within an intervertebral disc, the method comprising:

configuring a probe in a substantially linear configuration;

applying a sufficient force to advance the probe through a nucleus pulposus of an intervertebral disc, which force is insufficient to puncture an annulus fibrosus of the disc; and

deploying the probe in a substantially arcuate configuration within the nucleus pulposus.

2. The method of claim 1 further comprising providing the probe with a resilient material which in a relaxed state effects the substantially arcuate configuration and which upon application of external stress assumes the substantially linear configuration.

3. The method of claim 1 further comprising providing the probe with at least two materials previously joined to one another and having different coefficients of thermal expansion such that at a first temperature the at least two materials assume the substantially linear configuration and at a second temperature the at least two materials assume the substantially arcuate configuration.

4. The method of claim 1 further comprising providing the probe with a material with a temperature dependent shape memory such that at a first temperature the material assumes the substantially linear configuration and at a second temperature the material assumes the substantially arcuate configuration.

5. The method of claim 1 wherein applying the sufficient force comprises applying the sufficient force to a catheter that includes the probe at a distal end.

6. The method of claim 1 wherein:

the probe comprises a mandrel, and

deploying the probe in the substantially arcuate configuration comprises bending the mandrel to effect a transition of the mandrel from a substantially linear configuration to a substantially arcuate configuration.

7. The method of claim 6 wherein bending the mandrel comprises applying electricity to the mandrel to effect the transition of the mandrel from a substantially linear configuration to a substantially arcuate configuration.

8. The method of claim 7 wherein applying electricity to the mandrel comprises applying an electrical stimulus to a piezo-electric material joined to the mandrel to effect the transition of the mandrel from a substantially linear configuration to a substantially arcuate configuration.

9. The method of claim 6 wherein bending the mandrel comprises applying tension to the mandrel to effect the transition of the mandrel from a substantially linear configuration to a substantially arcuate configuration.

10. The method of claim 1 wherein:

the probe comprises two side members extending axially along a longitudinal axis of the probe, and

deploying the probe comprises moving the two side members from a first position proximate to the longitudinal axis of the probe to a second position radially displaced about the longitudinal axis of the probe.

11. The method of claim 10 wherein:

the two side members each include a resilient material that in a relaxed state effects a substantially linear configuration and that assumes a substantially arcuate configuration upon introduction of a compressive force between first ends and second ends of the two side members, and

moving the two side members comprises moving a draw member to apply the compressive force to the resilient material to effect a transition of the two side members from a substantially linear configuration to a substantially arcuate configuration.

12. The method of claim 1 further comprising delivering energy to a portion of the intervertebral disc using the probe.

13. The method of claim 12 wherein delivering energy comprises delivering thermal energy.

14. The method of claim 13 wherein delivering thermal energy comprises using a resistive coil.

15. The method of claim 12 wherein delivering energy comprises delivering radio frequency energy.

16. The method of claim 2 wherein configuring the probe in the substantially linear configuration comprises applying external stress to the resilient material using an introducer.

24. The method of claim 6 wherein the mandrel has a longitudinal axis and a differential bending ability in two orthogonal axes that are orthogonal to the longitudinal axis.

17. A method for deploying a probe within an intervertebral disc, the method comprising:

inserting a probe into an intervertebral disc, the probe including an activation element; and

activating the activation element to cause the probe to adopt an arcuate shape abutting at least a portion of an inner wall of the intervertebral disc.

18. The method of claim 17 further comprising delivering energy from an energy delivery device of the probe to a portion of the intervertebral disc.

19. The method of claim 17 wherein:

the activation element comprises a resilient material which in a relaxed state assumes an arcuate configuration and which upon application of external stress assumes a substantially linear configuration, and

activating the activation element comprises allowing the resilient material to assume a relaxed state to cause the probe to adopt the arcuate shape.

20. The method of claim 17 wherein:

the activation element comprises a material with a temperature dependent shape memory such that at a first temperature the material assumes a substantially linear configuration and at a second temperature the material assumes an arcuate configuration, and

activating the activation element comprises maintaining the material at the second temperature to cause the probe to adopt the arcuate shape.

21. The method of claim 17 wherein:

the activation element comprises a mandrel, and

activating the activation element comprises bending the mandrel to effect a transition of the mandrel from a substantially linear configuration to an arcuate configuration to cause the probe to adopt the arcuate shape.

22. The method of claim 21 wherein bending the mandrel comprises applying electricity to the mandrel.

23. The method of claim 21 wherein bending the mandrel comprises applying tension to the mandrel.

25. The method of claim 21 wherein the mandrel has a longitudinal axis and a differential bending ability in two orthogonal axes that are orthogonal to the longitudinal axis.