Treatment of urinary incontinence and other disorders by application of energy and drugs

• US 7,326,235 B2
• Filed: 01/29/2004
• Issued: 02/05/2008
• Est. Priority Date: 09/28/1999
• Status: Expired due to Fees

• Current Assignee: Verathon Incorporated (Roper Technologies, Inc.)
• Original Assignee: Novasys Medical, Inc. (Roper Technologies, Inc.)
• Inventors: Edwards, Stuart D.
• Primary Examiner(s): GIBSON, ROY DEAN
• Application Number:
  US10/769,153
• Publication Number:
  US 20040186468A1
• Time in Patent Office: 1,468 Days
• Field of Search: 606/32, 606/41, 606/42, 606/45, 606/47, 606 48- 50, 607/101, 607/102, 607104-105
• US Class Current: 607/104
• 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 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 2017/00084 Temperature
• CPC Class Codes: A61B 2017/22062 to be filled with liquid
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00494 Stomach, intestines or bowel
• 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 2018/00654 with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00797 measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/0436 : Shielding
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61N 5/0601 : Apparatus for use inside the body
• CPC Class Codes: A61N 5/062 : Photodynamic therapy, i.e. excitation of an agent
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

The invention provides a method and system for treating disorders in parts of the body. A particular treatment can include on or more of, or some combination of: ablation, nerve modulation, three-dimensional tissue shaping, drug delivery, mapping stimulating, shrinking and reducing strain on structures by altering the geometry thereof and providing bulk to particularly defined regions. The particular body structures or tissues can include one or more of or some combination of region, including: the bladder, esophagus, vagina, penis, larynx, pharynx, aortic arch, abdominal aorta, thoracic, aorta, large intestine, sinus, auditory canal, uterus, vas deferens, trachea, and all associated sphincters. Types of energy that can be applied include radiofrequency, laser, microwave, infrared waves, ultrasound, or some combination thereof. Types of substances that can be applied include pharmaceutical agents such as analgesics, antibiotics, and anti-inflammatory drugs, bulking agents such as biologically non-reactive particles, cooling fluids, or dessicants such as liquid nitrogen for use in cryo-based treatments.

Claims

1. A method comprising steps of:

inserting a catheter into a body at a selected location;

positioning one or more electrodes and irrigation and aspiration ports in said body so that one or more electrodes are proximate to a surface of the tissue to be treated;

aspirating said tissue so as to conform it to the at least one electrode;

allowing passage of a flowable substance to said surface;

delivering any of energy and chemical treatment from one or more electrodes proximate to said one surface; and

selecting and activating said electrodes by an operator, individually and as sequences of electrodes disposed in arrays.

2. A method as in claim 1, including a step of inserting said catheter either laparoscopically or manually into said selected location.

3. A method as in claim 1, wherein said applied energy includes one or more of a group consisting of:

Rf energy at about 300 to about 500 kilohertz;

photodynamic therapy;

microwave energy in about the 915 megahertz to 2.45 gigahertz range;

sonic energy; and

infrared; and

wherein said chemical treatment includes one or more of a group consisting of;

enzymes;

acid-base reactions;

radioactive tracers; and

chemical desiccants.

4. A method as in claim 1, including a step of providing a liquid-tight seal by means of a shielding element in a region proximate to said selected location.

5. A method as in claim 4, wherein said shielding element comprises any of a group consisting of an inflatable balloon, a sponge and a polymer shield.

6. A method as in claim 1, including a step of delivering sensor output from said selected location to a location outside said body.

7. A method as in claim 1, wherein said step of delivering sensor output includes a step of providing at least one of a group consisting of:

an electromagnetic impedance sensor;

an optical sensor;

a conductivity sensor;

a pH sensor;

a pressure sensor;

a temperature sensor; and

a

sensor that detect nervous activity.

8. A method as in claim 1, including a step of regulating a temperature proximate to said selected location.

9. A method as in claim 8, wherein said step of regulating uses a chilled liquid disposed proximate to said one surface.

10. A method as in claim 8, wherein said step of regulating relies upon the volume of the said chilled liquid to shape said balloon so as to occupy the interior of said body cavity and bring said at least one electrode into proximity with said body cavity.

11. A method as in claim 10, including a step of manipulating a pullwire to alter the shape of said balloon to bring said at least one electrode into proximity with said body cavity.

12. A method as in claim 1, including a step of manipulating a pullwire to alter the position of a set of umbrella-like struts to bring said at least one electrode into proximity with said body cavity.

13. A method as in claim 1, including a step of delivering a flowable substance to said selected location, said flowable substance being responsive to any of a group consisting of said energy and chemical treatment.

14. A method as in claim 13, including a step of eliciting a selected response to any of said group consisting of energy and chemical treatment.

15. A method as in claim 14, said step of eliciting said selected response including any of the steps of:

receiving any of a group consisting of said energy and chemical treatment for any of a group consisting of ablation, coating, expansion, plumping, shaping and shrinking tissue;

mapping position of nerves and stimulating them;

shrinking a sphincter by creating a pattern of thermal lesions;

reducing compliance or stiffness in a tissue;

reducing strain on a tissue by changing the relative geometry thereof; and

delivering a drug.

16. A method as in claim 1, including a step of controlling application of said energy and/or chemical treatment within an interior region of a body cavity.

17. A method as in claim 16, wherein said step of controlling application includes a step of distributing said energy and/or chemical treatment uniformly in said interior region.

18. A method as in claim 1, including a step of delivering a flowable substance from outside the body to said selected location.

19. A method as in claim 18, wherein said flowable substance includes at least one of a group consisting of:

a drug, a gas, a radioisotope, an analgesic, anantibiotic, an antiinflammatory, an anti-spasmodic and a bulking agent.

20. A method as in claim 19, wherein said bulking agent comprises any of a group consisting of:

microbeads suspended in a delivery vehicle;

glycerin; and

saline.

21. A method as in claim 1, wherein said selected location is disposed within a human being or other mammal;

and

said energy and/or chemical treatment is delivered proximate to said selected location to any of a group consisting of a sphincter, muscle tissue, and nerve tissue.

22. A method as in claim 21, wherein said sphincter or tissue is proximate to any of a group consisting of a bladder, esophagus, uterus, fallopian tube, vas deferens, sinus cavity, aorta, larynx and pharynx.

23. A method as in claim 21, wherein the sphincter or tissue includes any of a group consisting of:

the trigone area of a bladder;

the detrusor muscles of any of a group consisting of a bladder, the bladder neck, and the urethra and nerves that inform any of a group consisting of said trigone area, said detrusor muscles, said bladder neck and said urethra.