Method for treating fecal incontinence

• US 8,597,290 B2
• Filed: 04/20/2010
• Issued: 12/03/2013
• Est. Priority Date: 07/14/1999
• Status: Expired due to Fees

• Current Assignee: Mederi Rf, LLC
• Original Assignee: Mederi Therapeutics, Inc. (Respiratory Technology Corp.)
• Inventors: Utley, David, West, Scott, Gaiser, John, Croft, Rachel
• Primary Examiner(s): Dvorak, Linda
• Assistant Examiner(s): Ram, Jocelyn D
• Application Number:
  US12/799,169
• Publication Number:
  US 20110257646A1
• Time in Patent Office: 1,323 Days
• Field of Search: 600/29, 607/101, 607/116, 607/138, 606/32, 606/41, 128/898
• US Class Current: 606/41
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• 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 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/149 bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/005 Rectum
• CPC Class Codes: A61B 2018/00553 Sphincter
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/00994 combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2018/1869 with an instrument interstitially inserted into the body, e.g. needles
• CPC Class Codes: A61B 2018/2005 : with beam delivery through an interstitially insertable device, e.g. needle
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00

Abstract

A sphincter tissue region is treated using a support structure sized for advancement into the anal canal. At least one electrode is carried by the structure. A mechanism is coupled to the electrode to move the electrode between a first position retracted in the support structure and a second position extended from the support structure through surface tissue to penetrate a subsurface tissue region at or near a sphincter in the anal canal. A cable is coupled to the electrode to conduct energy for application by the electrode to form a lesion in the subsurface tissue region.

Claims

1. A method for treating fecal incontinence comprising

inserting a transparent structure into an anal cavity, the transparent structure having a plurality of guide channels,

visualizing from outside the anal cavity a dentate line within the anal canal through the transparent structure,

while visualizing the dentate line, slidably advancing a plurality of electrodes through the guide channels into tissue at or near an anal sphincter above the dentate line, the electrodes having a bend,

applying energy through the electrodes to create a lesion in the sphincter, and

conveying fluid into contact with the tissue to cool the tissue while applying energy to the electrodes.

2. A method according to claim 1, wherein the electrodes are deployed through openings in the transparent structure, the electrodes returning from a straightened position to a bent position when advanced from the transparent structure.

3. A method according to claim 2, wherein the electrodes are mounted on a shuttle and movement of an actuator slides the shuttle distally to advance the electrodes through the guide channels and out of openings in the transparent structure.

4. A method according to claim 3, wherein the shuttle is coupled by a pivot link to a lever.

5. A method according to claim 1, wherein the energy applied is radiofrequency energy.

6. A method according to claim 1, further comprising the steps of inserting an introducer through the transparent structure for insertion of the introducer and transparent structure together into the anal cavity and removing the introducer after insertion through the anal cavity and positioning of the transparent structure.

7. A method according to claim 1, wherein the step of slidably advancing the plurality of electrodes advances the electrodes on only one side of the transparent structure.

8. A method according to claim 1, wherein the electrodes have penetrating tips and the step of slidably advancing the electrodes advances the penetrating tips through tissue.

9. A method according to claim 1, wherein the transparent structure includes a distal port for aspiration and further includes a proximal region, the proximal region having a first fitting for connection to a fluid delivery apparatus and a second fitting for connection to an aspirating apparatus.

10. A method according to claim 1, wherein the electrodes include insulating material and in the step of applying energy through the electrodes the insulating material insulates a mucosal surface of a patient'"'"'s rectum from direct exposure to energy.

11. A method according to claim 1, wherein the electrodes are deployed in a posterior direction and not in an anterior direction.

12. A method according to claim 1, further comprising the step of sensing temperature near the electrodes utilizing temperature sensors carried by the electrodes.

13. A method according to claim 12, further comprising the step of sensing tissue surface temperature conditions near the electrodes utilizing temperature sensors carried by the transparent structure.

14. A method according to claim 1, further comprising a locking pawl to lock an advanced position of the electrodes and a release to free the locking pawl.