Precision ablating method

• US 7,997,278 B2
• Filed: 11/23/2005
• Issued: 08/16/2011
• Est. Priority Date: 11/23/2005
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: BARRX Medical LLC
• Inventors: Utley, David S., Garabedian, Robert, Wallace, Michael P.
• Primary Examiner(s): Johnson, III; Henry M
• Assistant Examiner(s): ROANE, AARON F
• Application Number:
  US11/286,444
• Publication Number:
  US 20070118106A1
• Time in Patent Office: 2,092 Days
• Field of Search: 128/898, 606/41
• US Class Current: 128/898
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00482 Digestive system
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2018/1495 Electrodes being detachable from a support structure
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

Methods of ablating tissue in an alimentary tract are provided. The methods include advancing an ablation structure into an alimentary tract while supporting the ablation structure with an endoscope. The methods further include a step of moving at least part of the ablation structure with respect to the endoscope and toward a tissue surface, before activating the ablation structure to ablate a tissue surface.

Claims

1. A method of ablating tissue in an alimentary tract comprising:

providing an endoscope having a central longitudinal axis, a support having a central longitudinal axis, an ablation structure supported by the support, and a coupling mechanism connected between the proximal and distal ends of the support;

attaching the support to the endoscope by passing the distal end of the endoscope completely through and extending past the coupling mechanism while allowing pivoting movement between the central longitudinal axis of the support and the central longitudinal axis of the endoscope;

advancing the endoscope into the alimentary tract;

moving the ablation structure toward a target tissue surface; and

activating the ablation structure to ablate the tissue surface.

2. The method of claim 1 wherein moving the ablation structure comprises pivoting the ablation structure with respect to the endoscope.

3. The method of claim 1 wherein the tissue surface comprises a first treatment area, the activating comprising ablating the first treatment area, the method further comprising moving the ablation structure to a second treatment area without removing the ablation structure from the patient and activating the ablation structure to ablate the second treatment area.

4. The method of claim 1, the moving step comprising positioning a plurality of electrodes supported by the ablation structure against the target tissue surface.

5. The method of claim 1 wherein the ablation structure comprises a plurality of electrodes, and there is a step of activating the plurality of electrodes to apply energy to the targeted tissue surface performed after the moving step.

6. The method of claim 1 wherein moving the ablation structure includes rotating with respect to the endoscope.

7. The method of claim 1 wherein moving the ablation structure includes providing a substantially uniform apposition force between the endoscope and the ablation structure when the ablation structure is localized at the tissue surface.

8. The method of claim 1 wherein moving the ablation structure includes deflecting the distal end of the endoscope.

9. The method of claim 8 wherein deflecting the distal end of the endoscope provides a desired degree of contact between the ablation structure and the tissue surface irrespective of the precise alignment of the distal end of the endoscope with respect to a plane of the target tissue surface.

10. The method of claim 9 wherein deflecting the distal end of the endoscope is accompanied by further movement of the ablation structure relative to the endoscope.

11. The method of claim 9 wherein deflecting the distal end of the endoscope is not accompanied by further movement of the ablation structure relative to the endoscope.

12. The method of claim 1 wherein the ablation device further includes an inflatable member attached to the distal end of the endoscope radially opposite the ablation structure, the moving step including inflating the inflatable member.

13. A method of ablating tissue in an alimentary tract comprising:

providing an endoscope having a central longitudinal axis, a support having a central longitudinal axis, an ablation structure supported by the support, and a coupling mechanism that encircles an exterior surface of the endoscope and attaches to the support between the proximal and the distal ends of the ablation structure while allowing pivoting movement between the central longitudinal axis of the support and the central longitudinal axis of the endoscope;

advancing the endoscope into the alimentary tract;

moving the ablation structure toward a target tissue surface; and

activating the ablation structure to ablate the tissue surface.

14. The method of claim 13 further comprising positioning the coupling mechanism proximal to the distal end of the endoscope so that a portion of the ablation structure is distal to the distal most end of the endoscope.

15. The method of claim 13 further comprising positioning the coupling mechanism proximal to the distal end of the endoscope so that all of the ablation structure is proximal to the distal most end of the endoscope.

16. The method of claim 13 further comprising attaching the coupling mechanism the endoscope so that the support is proximal to the distal most end of the endoscope.

17. The method of claim 16 further comprising moving the coupling mechanism relative to the endoscope.

18. The method of claim 16 further comprising positioning a portion of the support proximal to the coupling mechanism.

19. The method of claim 13 further comprising contacting the ablation structure with a tissue surface of the alimentary tract to rotate the ablation structure into alignment with a plane of the tissue surface.

20. The method of claim 13 further comprising rotating the support about the coupling mechanism from a position aligned with the central longitudinal axis of the endoscope to a position not in alignment with the central longitudinal axis of the endoscope.