Ablation method

• US 9,510,898 B2
• Filed: 08/18/2013
• Issued: 12/06/2016
• Est. Priority Date: 07/01/2005
• Status: Active Grant

• Current Assignee: Acessa Health Inc. (Hologic Incorporated)
• Original Assignee: Halt Medical, Inc. (Hologic Incorporated)
• Inventors: Epstein, Gordon, Lee, Bruce, Delonzor, Russell, Hagmann, Adam, Spero, Richard
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US13/969,605
• Publication Number:
  US 20150066020A1
• Time in Patent Office: 1,206 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00648 using more than one sensed parameter
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/143 multiple needles
• CPC Class Codes: A61B 2018/1432 curved
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing

Abstract

A method of ablating a uterine fibroid using a particular trocar is disclosed. The trocar comprises a plurality of ablation stylets. The trocar is adjustable to assume a plurality of configurations, each of the configurations having the stylets extended to a different extent from the trocar. A region to he ablated is imaged, The size of the region to be ablated is noted. The size of the region to be ablated is compared to a matrix of known ablation regions, each of the known ablation regions being associated with one of the configurations of the particular trocar. The region to be ablated is associated with a most nearly matching known ablation region by comparison of the region to be ablated to the known ablation regions. A trocar is inserted into the uterine fibroid at a position, which more closely matches the position of the particular trocar with respect to the known ablation region. The stylets are deployed from the trocar to an extent corresponding to the configuration.

Claims

1. A method of ablating a region of a uterine fibroid, comprising:

(a) employing a trocar comprised of a plurality of ablation stylets, an arrangement of ablation elements, and a trocar point, said trocar being adjustable to assume a plurality of configurations;

(b) imaging a region to be ablated;

(c) noting size of the region to be ablated;

(d) comparing the size of the region to be ablated to a matrix of known ablation regions, each of the known ablation regions being associated with one of the configurations of the trocar, each of the known ablation regions being associated with a position of the trocar relative to the known ablation region;

(e) associating the region to be ablated with a most nearly matching known ablation region by comparison of the region to be ablated to the known ablation regions;

(f) inserting the trocar with effectively the same arrangement of ablation elements and trocar point into the uterine fibroid at a location which most closely matches the location of the trocar at the known ablation region; and

(g) deploying the stylets from the trocar to an extent corresponding to the configuration associated with the most closely matching known ablation region.

2. The method for ablating a uterine fibroid according to claim 1, further comprising:

(h) insufflating the abdominal cavity of the patient to create an air pocket adjacent to said uterus and within the abdominal cavity; and

(i) placing a laparoscope in said air pocket in a position to optically image said uterus.

3. The method for ablating a uterine fibroid according to claim 2, wherein the known ablation region is associated with a particular length for each stylet deployment of the trocar and an associated ablation time, and wherein each of the stylets are deployed to the particular length, and further comprising:

(j) applying RF power to the stylets and the trocar for the associated ablation time; and

(k) withdrawing said trocar.

4. The method for ablating a uterine fibroid according to claim 3, wherein cautery RF power it is applied to said trocar during withdrawal of said trocar.

5. The method for ablating a uterine fibroid according to claim 3, further comprising:

(l) noting the orientation of the region to be ablated.

6. The method for ablating a uterine fibroid according to claim 3, wherein a temperature of at least one stylet is measured, and wherein RF power is maintained during the procedure at a level which results in the temperature having an average value in the range between 90°

centigrade and 100°

centigrade during the ablation procedure.

7. The method for ablating a uterine fibroid according to claim 3, wherein the stylets are deployed between 2.5 and 60.0 mm, wherein RF power is applied for between 15seconds and 900 seconds, wherein a temperature of at least one stylet is measured, and wherein RF power is maintained during the procedure at a level which results in the temperature having an average value in the range between 80°

centigrade and 110°

centigrade during the ablation procedure.

8. A method of ablating a region of a uterine fibroid, comprising:

(a) employing a trocar comprised of a plurality of ablation stylets, an arrangement of ablation elements, and a trocar point, said trocar being adjustable to assume a plurality of configurations;

(b) imaging a region to be ablated;

(c) noting size of the region to be ablated;

(d) comparing the size of the region to be ablated to a matrix of known ablation regions, each of the known ablation regions being associated with one of the configurations of the trocar, each of the known ablation regions being associating the region to be ablated with a most nearly matching known ablation region by comparison of the region to be ablated to the known ablation regions;

(e) associating the region to be ablated with a most nearly matching known ablation region by comparison of the region to be ablated to the known ablation regions;

(f) inserting the trocar with effectively the same arrangement of ablation elements and trocar point into the uterine fibroid at a location which most closely matches the location of the trocar at the known ablation region; and

(g) applying a substantially fixed RF power to the trocar for a fixed period of time.

9. A method of ablating an anatomical feature, comprising:

(a) employing a trocar comprised of a plurality of ablation stylets, an arrangement of ablation elements, and a trocar point, said trocar being adjustable to assume a plurality of configurations;

(b) imaging a region to be ablated;

(c) noting size of the region to be ablated;

(d) comparing the size of the region to be ablated to a matrix of known ablation regions, each of the known ablation regions being associated with one of the configurations of the trocar, each of the known ablation regions being associated with a position of the trocar relative to the known ablation region;

(e) associating the region to be ablated with a most nearly matching known ablation region by comparison of the region to be ablated to the known ablation regions;

(f) inserting the trocar with effectively the same arrangement of ablation elements and trocar point into anatomical feature at a location which most closely matches the location of the trocar at the known ablation region; and

(g) applying a substantially fixed RF power to the trocar for a fixed period of time.

10. The method for ablating an anatomical feature according to claim 9, further comprising noting the orientation of the region to be ablated, wherein each known ablation region is associated with an RF power and application time which is employed during the application of RF power.

11. The method for ablating an anatomical feature according to claim 9, wherein a temperature of at least one stylet is measured, and wherein RF power is maintained during the procedure at a level which results in the temperature having an average value in the range between 90°

centigrade and 100°

centigrade during the ablation procedure.

12. The method for ablating an anatomical feature according to claim 9, wherein the stylets are deployed between 2.5 and 60.0 mm, wherein RF power is applied for between 15 seconds and 900 seconds, wherein a temperature of at least one stylet is measured, and wherein RF power is maintained during the procedure at a level which results in the temperature having an average value in the range between 80°

centigrade and 110°

centigrade during the ablation procedure.