Moisture transport system for contact electrocoagulation

• US 9,247,989 B2
• Filed: 03/02/2015
• Issued: 02/02/2016
• Est. Priority Date: 04/12/1996
• Status: Expired due to Fees

• Current Assignee: Hologic Incorporated
• Original Assignee: Cytyc Surgical Products II Incorporated (Hologic Incorporated)
• Inventors: Truckai, Csaba
• Primary Examiner(s): Stoklosa, Joseph
• Assistant Examiner(s): Ram, Jocelyn D
• Application Number:
  US14/635,957
• Publication Number:
  US 20150164578A1
• Time in Patent Office: 337 Days
• Field of Search: 606/41, 607/101, 607/105, 607/138
• US Class Current: 1/1
• CPC Class Codes: A61B 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00708 switching the power on or off
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2090/0409 Specification of type of protection measures
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 90/04 Protection of tissue around surgical sites against effects of non-mechanical surgery, e.g. laser surgery protection of eyes against laser radiation A61F9/022
• CPC Class Codes: A61M 16/0427 with removable and re-insertable liner tubes, e.g. for cleaning
• CPC Class Codes: A61M 16/0463 combined with suction tubes, catheters or the like; Outside connections
• CPC Class Codes: A61M 16/0481 through the cuff wall

Abstract

An apparatus and method for use in performing ablation or coagulation of organs and other tissue includes a metallized fabric electrode array which is substantially absorbent and/or permeable to moisture and gases such as steam and conformable to the body cavity. Following placement of the ablation device into contact with the tissue to be ablated, an RF generator is used to deliver RF energy to the conductive regions and to thereby induce current flow from the electrodes to tissue to be ablated. As the current heats the tissue, moisture (such as steam or liquid) leaves the tissue causing the tissue to dehydrate. Suction may be applied to facilitate moisture removal. The moisture permeability and/or absorbency of the electrode carrying member allows the moisture to leave the ablation site so as to prevent the moisture from providing a path of conductivity for the current.

Claims

1. A method for performing endometrial ablation comprising:

transcervically positioning a distal portion of an ablation device into a uterus, the distal portion comprising an energy applicator, the energy applicator comprising a tissue contacting surface and an expandable-contractible carrying member, the expandable-contractible carrying member including first and second inner flexures and first and second outer flexures, the first and second outer flexures being coupled to an outer sleeve and the first and second inner flexures being coupled to an inner sleeve, the inner sleeve being slidably and coaxially disposed within the outer sleeve;

actuating a handle coupled to a proximal portion of the ablation device to cause the carrying member to expand the energy applicator in the uterus, the handle comprising a proximal grip and a distal grip pivotally attached to one another at a pivot point, and wherein actuating the handle includes moving the proximal grip and the distal grip closer together while translating the inner sleeve relative to the proximal grip;

actuating an inflation source to further expand the energy applicator in the uterus; and

delivering energy through the energy applicator to thereby deliver energy to endometrial lining tissue of the uterus.

2. The method of claim 1 wherein the energy is delivered from at least one electrode carried by the applicator.

3. The method of claim 2, wherein the energy is delivered by bipolar electrodes carried by the applicator.

4. The method of claim 1, wherein the ablation device comprises an elongate introducer sheath.

5. A method as in claim 1, wherein the expandable-contractible carrying member comprises a balloon.

6. A method as in claim 5, wherein the ablation device comprises at least one inflation member having an inflation lumen fluidly coupled to an interior of the balloon, with a proximal end of the respective inflation member configured for fluidly coupling the respective inflation lumen with the inflation source.

7. A method as in claim 1, wherein the tissue contacting surface circumscribes the expandable-contractible carrying member.

8. A method as in claim 1, wherein the tissue contacting surface is expanded by eliminating compression of the carrying member followed by delivering a fluid from the inflation source to the applicator.

9. A method as in claim 1, wherein actuating the handle includes eliminating compression of the carrying member.

10. A method as in claim 9, wherein eliminating compression releases the carrying member to its natural size.

11. The method as in claim 1, further comprising:

transcervically positioning an elongate hollow delivery sheath into a uterus, the delivery sheath having an axial lumen and an open distal end in communication with the lumen, the energy applicator slidably disposed within the delivery sheath lumen.

12. A method as in claim 1, wherein actuating the handle includes translating the inner sleeve proximally relative to the proximal grip.

13. A method as in claim 1, wherein actuating the inflation source includes passing a fluid from the inflation source to the energy applicator via the inner sleeve.

14. A method for performing endometrial ablation comprising:

transcervically positioning a distal portion of an ablation device into a uterus, the distal portion comprising an energy applicator, the energy applicator comprising a tissue contacting member and an expandable-contractible carrying member, the expandable-contractible carrying member including first and second inner flexures and first and second outer flexures, the first and second outer flexures being coupled to an outer sleeve and the first and second inner flexures being coupled to an inner sleeve, the inner sleeve being slidably and coaxially disposed within the outer sleeve;

actuating a handle coupled to a proximal portion of the ablation device to cause the carrying member to expand the energy applicator in the uterus, the handle comprising a proximal grip, a distal grip, and a spring, the proximal grip and the distal grip being pivotally attached to one another at a pivot point, wherein actuating includes moving the proximal grip and the distal grip closer together to cause the expandable-contractible carrying member to develop an expansion force against the tissue contacting member, wherein the expansion force is limited by the spring;

actuating an inflation source to further expand the energy applicator in the uterus; and

delivering energy through the energy applicator to thereby deliver energy to endometrial lining tissue of the uterus.

15. A method as in claim 14, wherein actuating the inflation source includes passing a fluid from the inflation source to the energy applicator via the inner sleeve.

16. A method as in claim 14 wherein the spring has a proximal portion fixed to the proximal grip and a distal portion fixed to the inner sleeve.

17. A method as in claim 14, wherein the expandable-contractible carrying member comprises a balloon.

18. A method as in claim 17, wherein the ablation device comprises at least one inflation member having an inflation lumen fluidly coupled to an interior of the balloon, with a proximal end of the respective inflation member configured for fluidly coupling the respective inflation lumen with the inflation source.

19. A method as in claim 14, wherein actuating the handle includes translating the inner sleeve proximally relative to the proximal grip.