Direction-oriented and spatially controlled bipolar coagulator for in-situ cauterization of adherent cranial tissue occluding a ventricular catheter previously implanted in-vivo

• US 6,761,718 B2
• Filed: 09/06/2001
• Issued: 07/13/2004
• Est. Priority Date: 09/06/2001
• Status: Expired due to Fees

• Current Assignee: Children's Medical Center Corporation
• Original Assignee: Children's Medical Center Corporation
• Inventors: Madsen, Joseph R.
• Primary Examiner(s): ROLLINS, ROSILAND STACIE
• Application Number:
  US09/947,707
• Publication Number:
  US 20030045870A1
• Time in Patent Office: 1,041 Days
• Field of Search: 606/41, 606/45, 606/46, 606/47, 606/48, 606/49, 606/50
• US Class Current: 606/50
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• 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 2018/00446 Brain
• CPC Class Codes: A61B 2018/00595 Cauterization
• 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 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/1213 creating an arc
• CPC Class Codes: A61B 2018/126 bipolar

Abstract

The present invention provides a bipolar coagulator which can be passed through the internal lumen of a ventricular catheter previously implanted into a cranial ventricle of a living subject and engaged in-situ. The bipolar coagulator will provide bipolar electrical arc currents for coagulation cauterization of adherent brain tissues, such as the choroid plexus, which occludes fluid flow into the intake drainage holes in the implanted ventricular catheter and often becomes adherent to the catheter in-situ. The cautery current provided by the bipolar coagulator is direction oriented and spatially controlled; thereby providing a better distribution of electrical current and heat within the surrounding cranial tissues; and thereby avoiding major complications of damage to intracranial structures such as blood vessels as well as avoiding the severe subarachnoid hemorrhages which are typical using other kinds of coagulation instruments.

Claims

1. A bipolar coagulator suitable for passage through the internal lumen of a catheter and for in-vivo coagulation cauterization of tissue then occluding at least one sidewall hole leading to the internal lumen of a catheter previously implanted into the body of a living subject for in-vivo flow release of fluids, said bipolar coagulator comprising:

a sized flexible obturator of fixed dimensions and substantially cylindrical form which will fit within and pass through the inner diameter of the internal lumen of the catheter previously implanted in-vivo, said sized flexible obturator

(i) having a shaped proximal end section able to pass within the inner diameter of the internal lumen of the implanted catheter, a distal end section, and a flexible body section able to pass through and around such internal lumen bends as exist within the implanted catheter, and

(ii) being constituted at least in part of an electrically insulating material;

at least two electrodes spatially disposed at different and direction-oriented positions on the exterior surface of said proximal end section of said flexible obturator, wherein each of said electrodes comprises a discrete electrode tip disposed on said exterior proximal end surface of said obturator at a pre-chosen position and an electrically communicating electrode body which is joined to said electrode tip and which extends into the interior of said obturator, and whereby said at least two direction-oriented disposed electrodes present at least one positively charged electrode pole and at least one negatively charged electrode pole which collectively provide

(a) a demarcated surface area lying between said disposed electrode poles on said exterior surface of said obturator,

(b) a discrete gapped space which exists adjacent to and over said demarcated surface area between said disposed electrode poles as a cauterization zone, and

(c) an on-demand electrode system for generating a direction-oriented and spatially-controlled flow of electrical arc current sufficient to coagulate and cauterize tissue in-vivo, and

(d) direction-oriented coagulation cauterization of tissue from within the lumen of an occluded catheter in-vivo via said gapped space of said obturator; and

electrical current conveyance apparatus which provides sufficient electric cower for tissue coagulation in-vivo, is contained internally at least within said proximal end section of said obturator, and is joined to each electrode spatially disposed on the surface of said obturator.

5. The bipolar coagulator as recited in claim 1, 2, 3 or 4 wherein said obturator body further comprises at least one internal body cavity adjacent to said proximal end of said obturator.

6. The bipolar coagulator as recited in claim 1, 2, 3 or 4 further comprising a sensor apparatus disposed on the exterior surface of said proximal end section of said obturator.

2. A complete bipolar coagulator suitable for passage through the lumen of a catheter and for in-vivo coagulation cauterization of tissue which is occluding at least one sidewall hole leading to the internal lumen of a catheter previously implanted into the body of a living subject for in-vivo flow release of fluids, said bipolar coagulator comprising:

a sized flexible obturator of fixed dimensions and substantially cylindrical form which will fit within and pass through the inner diameter of the internal lumen of the catheter previously implanted in-vivo, said sized flexible obturator

(i) having a shaped proximal end section able to pass within the inner diameter of the internal lumen of the implanted catheter, a distal end section, and a flexible body section able to pass through and around such internal lumen bends as exist within the implanted catheter, and

(ii) being constituted at least in part of an electrically insulating material;

at least two electrodes spatially disposed at different and direction-oriented positions on the exterior surface of said proximal end section of said flexible obturator, wherein each of said electrodes comprises a discrete electrode tip disposed on said exterior proximal end surface of said obturator at a pre-chosen position and an electrically communicating electrode body which is joined to said electrode tip and which extends into the interior of said obturator, and whereby said at least two direction-oriented disposed electrodes present at least one positively charged electrode pole and at least one negatively charged electrode pole which collectively Provide

(a) a demarcated surface area lying between said disposed electrode poles on said exterior surface of said obturator,

(b) a discrete gapped space which exists adjacent to and over said demarcated surface area between said disposed electrode poles as a cauterization zone, and

(c) an on-demand electrode system for generating a direction-oriented and spatially-controlled flow of electrical arc current sufficient to coagulate and cauterize tissue in-vivo, and

(d) direction-oriented coagulation cauterization of tissue from within the lumen of an occluded catheter in-vivo via said gapped space of said obturator;

electrical current conveyance apparatus which provides sufficient electric rower for tissue coagulation in-vivo, is contained internally at least within said proximal end section of said obturator, and is joined to each electrode spatially disposed on the surface of said obturator; and

a source of electrical current in electrical flow communication with said electrical current conveyance apparatus.

3. A bipolar coagulator suitable for passage through the internal lumen of a catheter and for in-vivo coagulation cauterization of cranial tissue which is occluding at least one sidewall hole leading to the internal lumen of a ventricular catheter previously implanted into a cranial ventricle of a living subject for in-vivo flow release of cranial fluids, said bipolar coagulator comprising:

a sized flexible obturator of fixed dimensions and substantially cylindrical form which will fit within and pass through the inner diameter of the internal lumen of the ventricular catheter previously implanted in-vivo, said sized flexible obturator

(i) having a shaped proximal end section able to pass within the inner diameter of the internal lumen of the implanted ventricular catheter, a distal end section, and a flexible body section able to pass through and around such internal lumen bends as may exist within the implanted ventricular catheter, and

(ii) being constituted at least in part of an electrically insulating material;

at least two electrodes spatially disposed at different and direction-oriented positions on said exterior surface of said proximal end section of said flexible obturator, wherein each of said electrodes comprises a discrete electrode tip disposed on said exterior proximal end surface of said obturator at an individual pre-chosen position and an electrically communicating electrode body which is joined to said electrode tip and which extends into the interior of said obturator, and whereby said at least two direction-oriented disposed electrodes present at least one positively charged electrode pole and at least one negatively charged electrode pole which collectively provide

(a) a demarcated surface area lying between said disposed electrode poles on said exterior surface of said obturator,

(b) a discrete gapped space which exists adjacent to and over said demarcated surface area between said disposed electrode poles as a cauterization zone, and

(c) an on-demand electrode system for generating a direction-oriented and spatially-controlled flow of electrical arc current sufficient to coagulate and cauterize tissue in-vivo, and

(d) direction-oriented coagulation cauterization of tissue from within the lumen of an occluded catheter in-vivo via said gapped space of said obturator; and

electrical current conveyance apparatus which provides sufficient electric power for tissue coagulation in-vivo, is contained internally at least within said proximal end section of said obturator, and is joined to each electrode spatially disposed on the surface of said obturator.

4. A complete bipolar coagulator suitable for passage through the internal lumen of a catheter and for in-vivo coagulation cauterization of cranial tissue which is occluding at least one sidewall hole leading to the internal lumen of a ventricular catheter previously implanted into a cranial ventricle of a living subject for in-vivo flow release of cranial fluids, said bipolar coagulator comprising:

a sized flexible obturator of fixed dimensions and substantially cylindrical form which will fit within and pass through the inner diameter of the internal lumen of the ventricular catheter previously implanted in-vivo, said sized flexible obturator

(i) having a shaped proximal end section able to pass within the inner diameter of the internal lumen of the implanted ventricular catheter, a distal end section, and a flexible body section able to pass through and around such internal lumen bends as exist within the implanted ventricular catheter, and

(ii) being constituted at least in part of an electrically insulating material;

at least two electrodes spatially disposed at different and direction-oriented positions on said exterior surface of said proximal end section of said flexible obturator, wherein each of said electrodes comprises a discrete electrode tip disposed on said exterior proximal end surface of said obturator at a pre-chosen position and an electrically communicating electrode body which is joined to said electrode tip and which extends into the interior of said obturator, and whereby said at least two direction-oriented disposed electrodes present at least one positively charged electrode pole and at least one negatively charged electrode pole which collectively provide

(a) a demarcated surface area lying between said disposed electrode poles on said exterior surface of said obturator,

(b) a discrete gapped space which exists adjacent to and over said demarcated surface area between said disposed electrode poles as a cauterization zone, and

(c) an on-demand electrode system for generating a direction-oriented and spatially-controlled flow of electrical arc current sufficient to coagulate and cauterize tissue in-vivo, and

(d) direction-oriented coagulation cauterization of tissue from within the lumen of an occluded catheter in-vivo via said gapped space of said obturator;

electrical current conveyance apparatus which provides sufficient electric power for tissue coagulation in-vivo, is contained internally at least within said proximal end section of said obturator, and is joined to each electrode spatially disposed on the surface of said obturator; and

a source of electrical current in electrical flow communication with said electrical current conveyance apparatus.

7. A method for in-vivo coagulation cauterization of tissue which is occluding at least one sidewall hole leading to the internal lumen of a catheter previously implanted into the body of a living subject for in-vivo flow release of fluids, said method comprising:

obtaining a bipolar coagulator device comprising

a flexible obturator of fixed dimensions and substantially cylindrical form which is configured to fit within and pass through the inner diameter of the internal lumen of the catheter previously implanted in-vivo, said flexible obturator

(i) comprising a shaped proximal end section adapted for passage within the inner diameter of the internal lumen of the implanted catheter, a distal end section, and a flexible body section adapted for passage through and around such internal lumen bends as may exist within the implanted catheter, and

(ii) being constituted at least in part of an electrically insulating material;

at least two electrodes spatially disposed at different, direction-oriented, pre-chosen positions on the exterior surface of said proximal end section of said flexible obturator, each of said electrodes comprising a discrete electrode tip disposed on said exterior proximal end surface of said obturator at a pre-chosen position and an electrically communicating electrode body which is joined to said electrode tip and which extends into the interior of said obturator, said at least two direction-oriented disposed electrodes providing at least one positively charged electrode pole and at least one negatively charged electrode pole which collectively identify

(a) a demarcated surface area lying between said disposed electrode poles on said exterior surface of said obturator,

(b) a discrete gapped space which exists adjacent to and over said demarcated surface area between said disposed electrode poles as a cauterization zone, and

(c) an on-demand electrode system for generating a direction-oriented and spatially-controlled flow of electrical arc current for coagulation cauterization over said gapped space of said obturator; and

electrical current conveyance apparatus which is contained internally at least within said proximal end section of said obturator and is joined to each electrode spatially disposed on the surface of said obturator;

introducing said bipolar coagulator device into the internal lumen of the previously implanted catheter;

advancing said introduced bipolar coagulator device within the lumen of the previously implanted catheter until occluding tissue in-situ is encountered;

applying electrical current to said electrical current conveyance apparatus of said bipolar coagulator device; and

coagulating the occluding tissue in-situ using a direction-oriented and spatially controlled electric arc current generated by said bipolar coagulator device.

8. A method for in-vivo coagulation cauterization of cranial tissue which is occluding at least one sidewall hole leading to the internal lumen of a ventricular catheter previously implanted into a cranial ventricle of a living subject for in-vivo flow release of cranial fluids, said method comprising:

obtaining a bipolar coagulator device comprising

a flexible obturator of fixed dimensions and substantially cylindrical form which is configured to fit within and pass through the inner diameter of the internal lumen of the catheter previously implanted in-vivo, said flexible obturator

(i) comprising a shaped proximal end section adapted for passage within the inner diameter of the internal lumen of the implanted catheter, a distal end section, and a flexible body section adapted for passage through and around such internal lumen bends as may exist within the implanted catheter, and

(ii) being constituted at least in part of an electrically insulating material;

at least two electrodes spatially disposed at different, direction-oriented, pre-chosen positions on the exterior surface of said proximal end section of said flexible obturator, each of said electrodes comprising a discrete electrode tip disposed on said exterior proximal end surface of said obturator at a pre-chosen position and an electrically communicating electrode body which is joined to said electrode tip and which extends into the interior of said obturator, said at least two direction-oriented disposed electrodes providing at least one positively charged electrode pole and at least one negatively charged electrode pole which collectively identify

(a) a demarcated surface area lying between said disposed electrode poles on said exterior surface of said obturator,

(b) a discrete gapped space which exists adjacent to and over said demarcated surface area between said disposed electrode poles as a cauterization zone, and

(c) an on-demand electrode system for generating a direction-oriented and spatially-controlled flow of electrical arc current for coagulation cauterization over said gapped space of said obturator; and

electrical current conveyance apparatus which is contained internally at least within said proximal end section of said obturator and is joined to each electrode spatially disposed on the surface of said obturator;

introducing said bipolar coagulator device into the internal lumen of the previously implanted catheter;

advancing said introduced bipolar coagulator device within the internal lumen of the previously implanted ventricular catheter until occluding tissue in-situ is encountered;

applying electrical current to said electrical current conveyance apparatus of said bipolar coagulator device; and

coagulating the occluding tissue in-situ using a direction-oriented and spatially controlled electric arc current generated by said bipolar coagulator device.