Systems and methods for treatment of premenstrual dysphoric disorders

• US 9,486,243 B2
• Filed: 10/17/2012
• Issued: 11/08/2016
• Est. Priority Date: 11/08/2011
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Eskuri, Alan D.
• Primary Examiner(s): Hupczey, Jr., Ronald D
• Assistant Examiner(s): Ekrami, Yasamin
• Application Number:
  US13/654,235
• Publication Number:
  US 20130116677A1
• Time in Patent Office: 1,483 Days
• Field of Search: 606 21- 52
• 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 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

An endoscopic procedure for the parasympathetic and sympathetic denervation of the nerves of the ovaries and uterus for management of endocrine dysphoric disorders. The tissues of selected inferior mesenteric and pelvic nerves are heated via introduction of radiofrequency energy at sufficient power and time to induce complete or partial nerve blockade while leaving the supporting tissue structurally intact. In some embodiments, the suspensory ligament of the ovary, the ovarian ligament, and/or the uterosacral ligament are heated to a range of 45° C. to 65° C. for a period of about 5 seconds to about 60 seconds.

Claims

1. A method for treating premenstrual dysphoric disorder in a mammalian being, the method comprising:

inducing denervation of a neural fiber that contributes to ovarian function by delivering energy to the neural fiber through jaw members grasping tissue including the neural fiber, wherein the grasped tissue between the jaw members includes a tissue bundle underlying the neural fiber and the tissue bundle disposed between the jaw members remains structurally intact;

terminating the delivery of the energy, the tissue bundle underlying the neural fiber and the tissue disposed between the jaw members at the termination being structurally intact; and

opening the jaw members to release the structurally intact tissue.

2. The method in accordance with claim 1, wherein the neural fiber that contributes to ovarian function is selected from the group consisting of nerves of the suspensory ligament of the ovary, nerves of the ovarian ligament, nerves of the uterosacral ligament, an inferior mesenteric nerve bundle, and a pelvic nerve bundle.

3. The method in accordance with claim 1, wherein the energy in the inducing denervation of the neural fiber comprises electrosurgical energy.

4. The method in accordance with claim 1, wherein the energy in the inducing denervation of the neural fiber comprises microwave energy.

5. The method in accordance with claim 1, wherein the energy in the inducing denervation of the neural fiber comprises acoustic energy.

6. The method in accordance with claim 5, wherein the acoustic energy comprises high frequency focused ultrasound to the neural fiber.

7. The method in accordance with claim 1, wherein inducing denervation of the neural fiber comprises increasing a temperature of the neural fiber.

8. The method in accordance with claim 7, wherein the temperature of the neural fiber is increased to a temperature in a range of about 45°

C. to about 65°

C.

9. The method in accordance with claim 1, wherein inducing denervation of the neural fiber comprises monitoring a temperature of the neural fiber.

10. The method in accordance with claim 1, wherein inducing denervation of the neural fiber comprises monitoring an impedance of the neural fiber.

11. The method in accordance with claim 1, wherein the energy is delivered to the neural fiber for a duration of about 5 seconds to about 60 seconds.

12. The method in accordance with claim 1, wherein delivery of the energy to the neural fiber is interrupted based upon a sensed neural activity of the neural fiber decreasing to a predetermined value.

13. The method in accordance with claim 1, wherein inducing denervation of the neural fiber comprises monitoring neural activity of the neural fiber.

14. A method for treating premenstrual dysphoric disorder in a mammalian being, the method comprising:

grasping between jaw members of a surgical instrument tissue including a neural fiber that contributes to ovarian function and a tissue bundle underlying the neural fiber;

supplying energy to the jaw members grasping the tissue including the neural fiber to thereby deliver the energy to the neural fiber through the jaw members to induce denervation of the neural fiber, wherein the tissue bundle underlying the neural fiber remains structurally intact;

terminating the delivery of the energy, the tissue bundle underlying the neural fiber and the tissue disposed between the jaw members at the termination being structurally intact; and

opening the jaw members to release the structurally intact tissue.