Visual electrode ablation systems

• US 9,155,587 B2
• Filed: 05/14/2009
• Issued: 10/13/2015
• Est. Priority Date: 05/11/2007
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Willis, N. Parker, Malchano, Zachary J., Rothe, Chris A., Saadat, Vahid, Peh, Ruey-Feng, Miller, David, Tam, Edmund
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): FOWLER, DANIEL WAYNE
• Application Number:
  US12/465,903
• Publication Number:
  US 20090227999A1
• Time in Patent Office: 2,343 Days
• Field of Search: 606/41
• US Class Current: 1/1
• CPC Class Codes: A61B 1/00089 Hoods
• CPC Class Codes: A61B 1/012 characterised by internal passages or accessories therefor
• 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 2017/00106 ultrasonic
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00809 measured thermochromatically
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2218/002 Irrigation

Abstract

Visual electrode ablation systems are described herein which include a deployment catheter and an attached imaging hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. An electric current may be passed through the fluid such that it passes directly to the tissue region being imaged and the electrical energy is conducted through the fluid without the need for a separate ablation probe or instrument to ablate the tissue being viewed.

Claims

1. A tissue ablation apparatus, comprising:

a hood projecting from a deployment catheter and defining a field when the hood is expanded from an insertion configuration to a deployed configuration which defines a single aperture through which fluid is permeable, the aperture having a diameter that is less than an outer diameter of the hood;

an energy source spaced from the aperture such that energy from the energy source passes through a purging fluid introduced into the field and into a tissue surface when adjacent to the aperture;

an imaging element positioned within or along the hood and adapted to image the tissue surface adjacent to the hood when the field is purged of blood via the purging fluid, the imaging element being positioned to provide for visualization of the tissue surface through the purging fluid while the energy source conducts the energy through the purging fluid; and

a transparent, distal membrane through which the aperture is defined, the distal membrane comprising markings located distally of and visible with the imaging element for visual measurement of the tissue surface adjacent to the hood;

wherein introduction of the purging fluid displaces blood from the field such that the tissue surface is temporarily isolated from a surrounding blood-filled environment by the hood whereby a lesion is formed by the energy passed into the tissue surface.

2. The apparatus of claim 1 wherein the lesion defines a pattern when formed within the temporarily isolated field.

3. The apparatus of claim 1 wherein the barrier or membrane defines a conical structure.

4. The apparatus of claim 1 wherein the purging fluid comprises saline.

5. The apparatus of claim 1 wherein the energy source comprises an electrode configured to conduct electrical energy through the purging fluid.

6. The apparatus of claim 1 wherein the energy source comprises laser energy or thermal energy.

7. The apparatus of claim 1 wherein the energy source is positioned within the barrier or membrane proximally of the field.

8. The apparatus of claim 1 wherein the energy source is configured as a support strut positioned along the barrier or membrane.

9. The apparatus of claim 1 wherein the energy source is configured as a ring electrode extending from a support member positioned within the field proximally of the aperture.

10. The apparatus of claim 1 further comprising one or more ultrasound transducers along an outer surface of the barrier or membrane for contacting the tissue surface.

11. The tissue ablation apparatus of claim 1, wherein, the markings extending radially from the aperture.

12. The tissue ablation apparatus of claim 1, wherein, the markings comprise concentric circles centered on the aperture.

13. The tissue ablation apparatus of claim 1, wherein, the markings comprise a rectangular grid.