Devices, methods, and systems for shrinking tissues

• US 6,836,688 B2
• Filed: 09/04/2001
• Issued: 12/28/2004
• Est. Priority Date: 11/08/1996
• Status: Expired due to Term

• Current Assignee: Verathon Incorporated (Roper Technologies, Inc.)
• Original Assignee: Solarant Medical, Inc. (Endo International PLC)
• Inventors: Laufer, Michael D., Ingle, Frank, Carter, Garry
• Primary Examiner(s): GIBSON, ROY DEAN
• Application Number:
  US09/946,907
• Publication Number:
  US 20020032441A1
• Time in Patent Office: 1,211 Days
• Field of Search: 606/41, 606/45, 606/46, 606/48, 606/50, 607/96, 607/98, 607/99, 607/101, 607/102, 607/104, 607/105
• US Class Current: 607/138
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• 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 2018/00148 with metal
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00232 having an irregular shape
• CPC Class Codes: A61B 2018/00505 Urinary tract
• CPC Class Codes: A61B 2018/00517 Urinary bladder or urethra
• CPC Class Codes: A61B 2018/00523 Treatment of incontinence
• CPC Class Codes: A61B 2018/00553 Sphincter
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61N 1/06 for high-frequency therapy
• CPC Class Codes: A61N 1/403 for thermotherapy, e.g. hyperthermia

Abstract

Devices, systems, and method for treating urinary incontinence generally rely on energy delivered to a patient'"'"'s own pelvic support tissue to selectively contract or shrink at least a portion of that pelvic support tissue so as to reposition the bladder. The energy will preferably be applied to the endopelvic fascia and/or an arcus tendineus fascia pelvis. The invention provides a variety of devices and methods for applying gentle resistive heating of these and other tissues to cause them to contract without imposing significant injury on the surrounding tissue structures. Alternatively, heat-applying probes are configured to heat tissue structures which comprise or support a patient'"'"'s urethra. By applying sufficient energy over a predetermined time, the tissue can be raised to a temperature which results in contraction without significant necrosis or other tissue damage. By selectively contracting the support tissues, the bladder neck, sphincter, and other components of the urinary tract responsible for the control of urinary flow can be reconfigured or supported in a manner which reduces urinary leakage.

Claims

1. A treatment method for correcting descent of a bladder neck, the method comprising:

thermally inducing shrinkage of a pelvic floor.

2. The method of claim 1, wherein the shrinkage of the pelvic floor is induced by applying radiofrequency energy to the pelvic floor with an electrosurgical instrument.

3. The method of claim 2, further comprising controlling the radiofrequency energy applied to the instrument with a controller coupled to the instrument.

4. The method of claim 1, wherein the thermal shrinkage is induced in one or more members of the group including the pelvic viscera, pelvic muscles including the levator ani muscle group, endopelvic fascia, and ligaments.

5. The method of claim 1, further comprising thermally inducing shrinkage of the pelvic floor selectively adjacent the bladder neck, wherein the thermally induced shrinkage of the pelvic floor alters support of the bladder neck.

6. The method of claim 1, wherein the thermally induced shrinkage is induced by applying radiofrequency energy in the presence of an electrically-conductive fluid.

7. A method for treatment of a subject having a bladder neck, the method comprising:

thermally inducing shrinkage of a support tissue near the bladder neck so that the shrinkage of the support tissue alters structural support of the bladder neck.