Method of using electrosurgical device for restricting loss of blood during surgery

• US 8,753,342 B2
• Filed: 03/25/2013
• Issued: 06/17/2014
• Est. Priority Date: 08/05/1998
• Status: Expired due to Fees

• Current Assignee: Boston Scientific Limited (Boston Scientific Corporation)
• Original Assignee: EMcision Ltd. (Boston Scientific Corporation)
• Inventors: Habib, Nagy Adly, Sangster, Alan John
• Primary Examiner(s): ROANE, AARON F
• Application Number:
  US13/849,848
• Publication Number:
  US 20130218155A1
• Time in Patent Office: 449 Days
• Field of Search: 606 41- 49, 607/96, 607 98-101, 128/898
• US Class Current: 606/49
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61N 5/04 Radiators for near-field treatment
• CPC Class Codes: A61N 5/045 specially adapted for treatment inside the body

Abstract

A device for generating localized heating in a selected body tissue includes an applicator having a source of microwave radiation and an array of retractable needles arranged so as to extend from one face of the applicator and, in operation, to confine the irradiated microwave energy field emanating from the applicator. The device has application for controlling excessive bleeding from severed tissue during surgical procedures.

Claims

1. In the surgical treatment of a human or animal body, a method of severing a portion of diseased liver from the liver without excessive bleeding, the method comprising:

providing a device, the device comprising an applicator having at least one face and including an array of four identical needles arranged in a rectangular pattern of two rows by two columns that define a central channel structured and arranged such that two of said four tissue-piercing needles are positioned on one side of a width of liver tissue 2 cm across or less, and two of said needles are arranged to be positioned on an opposite side of said width of diseased liver tissue 2 cm across or less said width of tissue defining a planned incision line corresponding with said channel, said plurality of four tissue-piercing needles structured and arranged to be energizeable together to deliver three-dimensional energy among and with a cross-flow across said plurality of identical tissue-piercing needles, said applicator structured to be operably coupled to a source of electromagnetic energy;

positioning said array of four needles arranged in two rows by two columns such that two of said four tissue-piercing needles are positioned on one side of a width of liver tissue 2 cm across or less and two of said needles are positioned on an opposite side of said width of liver tissue 2 cm across or less such that said positioning defines a planned incision line corresponding with said channel, said array of needles serving to confine and transmit the electromagnetic energy field three-dimensionally;

inserting the tissue-piercing distal tips of said array of needles from said at least one face of the applicator into said liver tissue at a point on the planned incision line such that said four needles define a volume of liver tissue to be treated;

applying said electromagnetic energy three-dimensionally among said array of four needles into the volume of liver tissue at said point on the planned incision line such that localized heating of said volume of liver tissue is achieved and blood vessels within said volume of liver tissue are coagulated;

removing the tissue-piercing distal tips of said array of needles from the volume of tissue to be treated;

advancing the applicator along the planned incision line in step-wise manner, inserting the tissue-piercing distal tips of said array of needles into a subsequent volume of tissue to be treated along said planned incision line, and applying said electromagnetic energy three-dimensionally among said array of four needles into the volume of the tissue to be treated along said planned incision line until said electromagnetic energy has been applied along the length of said incision line and blood vessels in the liver tissue along said planned incision line are coagulated; and

severing the diseased liver tissue from the liver by incision along said planned incision line without excessive bleeding.

2. The method as claimed in claim 1 further comprising applying electromagnetic energy to the volume of the tissue to be treated for a time sufficient to raise the temperature of the tissue or organ by 20 to 30°

C.

3. The method as claimed in claim 1, wherein said array of needles includes at least one row of said array of needles.

4. The method as claimed in claim 1, wherein said needles are parallel with one another.

5. The method as claimed in claim 1, wherein said needles are straight.

6. The method of claim 1 wherein said source of microwave energy comprises a wave guide for microwave transmission to said array of needles.

7. A method of severing tissue from a human or animal body without excessive bleeding, the method comprising:

(a) inserting a device into tissue or a part of an organ to be treated, the device comprising an applicator structured to be operably coupled to a source of electromagnetic energy, said applicator including an array of four needles arranged in a rectangular pattern of two by two needles thereon, each needle having tissue piercing means;

(b) positioning the tissue-piercing means of said array of four needles into a desired depth of approximately 40 millimeters in a volume of the tissue to be treated defined by said four needles;

(c) applying the electromagnetic energy to the desired depth of the volume of tissue to be treated to heat the tissue;

(d) advancing the tissue-piercing means of said array of needles along the length of a planned incision line;

(e) creating a heat-treated tissue volume as long as the length of the planned incision line, as deep from the surface as the desired depth, having a width that extends across the planned incision line between said needles arranged in said rectangular pattern of two by two needles, wherein the heat-treated tissue volume includes the planned incision line and further wherein blood vessels located within said tissue are coagulated to said desired depth;

(f) making an incision into the desired depth of the volume of tissue which has been heated along said planned incision line; and

(g) severing the tissue or part of organ from the body by incision along said planned incision line without excessive bleeding.

8. The method as claimed in claim 7, in which the step of applying electromagnetic energy comprises heating said tissue by 20 to 30°

C.

9. The method as claimed in claim 7, wherein said electromagnetic energy is provided at microwave frequency.

10. The method as claimed in claim 7, wherein said array includes at least one row of said needles.

11. The method as claimed in claim 7, wherein said array of needles is rectangular.

12. The method as claimed in claim 7, wherein said needles are the same length as one another.

13. The method as claimed in claim 7, wherein positioning the tissue-piercing means of said array of needles to the desired depth of the volume of the tissue to be treated further includes actuating said applicator to cause said tissue-piercing means of said array of needles to extend into said desired depth of the volume of tissue.

14. The method of claim 13 wherein extending the tissue-piercing means of said array of needles into a desired depth of a volume of the tissue to be treated further includes retracting said needles from said tissue.

15. A method of surgically severing tissue from a human or animal body without excessive bleeding, the method comprising:

(a) providing an applicator structured to be operably coupled to a source of electromagnetic energy, said applicator having an array of more than 3 identical needles thereon, each needle having a sharp tissue piercing end;

(b) selecting in a tissue volume a planned incision plane with a planned incision depth and containing tissue which is prone to substantial bleeding upon incision thereinto;

(c) at said planned incision plane, perforatingly inserting said sharp tissue-piercing ends of said needles to an identical planned insertion depth to pierce said tissue which is prone to bleeding;

(d) applying said electromagnetic energy via said needles to said tissue volume to coagulate tissue in a coagulation volume, said coagulation volume containing said planned incision plane, straddling said incision plane and extending to the planned incision depth, in order to convert tissue in said coagulated volume from tissue prone to bleeding upon incision thereinto into tissue resistant to bleeding upon incision thereinto; and

(e) making an incision to the planned incision depth along said planned incision plane to sever said tissue from the body without excessive bleeding.

16. A method as claimed in claim 15 which includes removing said needles from said coagulation volume before said step of making an incision.

17. A method as claimed in claim 15 which includes repeating steps (c) and (d) at a location advanced along said planned incision plane.

18. A method as claimed in claim 15 in which said perforatingly inserting said sharp tissue piercing ends to a planned incision depth comprises inserting a needle array of two by two needles such that two needles straddle either side of said planned incision plane, and in which the applying electromagnetic energy including applying said energy three dimensionally between needles across said planned incision plane.

19. A method as claimed in claim 15 in which the slice has a width of about 2 cm and is bisected by said planned incision plane.

20. A method as claimed in claim 15 which includes providing each needle of metal conducting material with a metal cylindrical conducting surface extending therealong, and in which said step of applying electromagnetic energy comprising providing a voltage to each needle so as to convert tissue into said coagulation volume by way of ablation energy transmitted into said tissue all of the way along said metal cylindrical conducting surfaces.

21. A method as claimed in claim 20 in which said step of applying electromagnetic energy comprising providing a voltage between needles in the array which are inserted into said tissue and located straddling the planned incision plane.