Systems and methods for track coagulation

• US 9,877,707 B2
• Filed: 03/04/2014
• Issued: 01/30/2018
• Est. Priority Date: 03/07/2013
• Status: Active Grant

• Current Assignee: Medtronic Holding Company Sarl (Medtronic Plc)
• Original Assignee: Kyphon SARL (Medtronic Plc)
• Inventors: Godara, Neil, Woo, Jason
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): ZINK, AMANDA L
• Application Number:
  US14/195,972
• Publication Number:
  US 20140257265A1
• Time in Patent Office: 1,428 Days
• CPC Class Codes: A61B 10/025 for taking bone, bone marrow or cartilage samples
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 2018/00005 Cooling or heating of the probe or tissue immediately surrounding the probe
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00565 Bone
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00714 Temperature
• CPC Class Codes: A61B 2018/0072 Current
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00767 Voltage
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00892 Voltage
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1425 Needle

Abstract

Devices, and methods of use thereof, are disclosed for preventing tumor seeding when withdrawing the device along an entry-exit path. Some embodiments of the present invention comprise a method of withdrawing a probe through a tissue via a path that traverses at least some bone tissue, the method including withdrawing the probe through the path, and at least partially concurrently delivering energy in a bipolar manner from the probe to heat a layer of tissue surrounding the probe to a temperature sufficient for thermal coagulation necrosis of cells. The device may be withdrawn incrementally.

Claims

1. A method of withdrawing a probe through a tissue via a path that traverses at least some bone tissue, the method comprising:

withdrawing the probe incrementally through the path and at least partially concurrently delivering energy in a bipolar manner from an active tip of the probe to heat a layer of tissue surrounding the probe to a temperature sufficient for thermal coagulation necrosis of cells;

measuring a temperature of the layer of tissue surrounding the probe along at least a portion of the path prior to each incremental withdrawal to determine if the temperature of the layer of tissue surrounding the probe is sufficient for the thermal coagulation necrosis of the cells, the measuring of the temperature of the layer of tissue surrounding the probe being measured by a temperature sensor, the temperature sensor being positioned on an exterior surface of the active tip of the probe;

providing an indication to a user when the temperature of the layer of tissue surrounding the probe reaches the temperature sufficient for the thermal coagulation necrosis of the cells; and

deactivating a cooling system that is associated with the probe when the energy is being delivered to the probe, the probe being not actively cooled by the cooling system during the withdrawal of the probe.

2. The method of claim 1, wherein the path includes a tissue transition zone from one tissue type to another tissue type.

3. The method of claim 1, wherein the energy is radiofrequency electrical energy.

4. The method of claim 1, further comprising coupling the probe to an introducer, wherein the withdrawing of the probe includes withdrawing the probe and the introducer in incremental distances of about a length of the active tip of the probe.

5. The method of claim 1, further comprising electrically coupling the probe to an electrosurgical generator for supplying the energy to the probe.

6. The method of claim 5, further comprising providing information regarding parameters of the probe to the electrosurgical generator using an interface.

7. The method of claim 5, wherein the electrosurgical generator is configured to automatically detect parameters of the probe.

8. The method of claim 5, further comprising determining a value of an electrical parameter associated with the delivery of the energy to the probe based on the probe being electrically coupled to the electrosurgical generator, the electrical parameter selected from a group including of power and voltage.

9. The method of claim 8, wherein the determining of the value of the electrical parameter is performed automatically by the electrosurgical generator.

10. The method of claim 5, further comprising:

providing the temperature of the layer of tissue surrounding the probe to the electrosurgical generator,

wherein the delivering of the energy to the probe is based on the temperature of the layer of tissue surrounding the probe.

11. The method of claim 1, wherein the probe includes an active electrode and a return electrode on a single shaft.

12. The method of claim 1, wherein the withdrawing of the probe occurs incrementally when the indication is provided.

13. The method of claim 1, wherein the probe is withdrawn by the user.

14. The method of claim 1, wherein the indication is provided when the temperature of the layer of tissue surrounding the probe reaches at least 60°

C.

15. The method of claim 1, further comprising:

measuring an impedance of at least a portion of the layer of tissue surrounding the probe; and

terminating the delivering of the energy when the impedance exceeds a threshold.

16. The method of claim 15, wherein the threshold is in a range of about 1000 to about 3000 ohms.

17. A method of withdrawing a probe through a tissue via path that traverses at least some bone tissue, the method comprising:

withdrawing the probe incrementally through the path in increments, the increments each having an increment length;

for each incremental withdrawal, at least partially concurrently delivering energy in a bipolar manner from an active tip of the probe to heat a layer of tissue surrounding the probe to a temperature sufficient for thermal coagulation necrosis of cells thereby defining a coagulation volume, the increment length being less than or equal to a length of the coagulation volume, and the energy being supplied to the probe by an electrosurgical generator that is electrically coupled to the probe; and

deactivating a cooling system that is associated with the probe when the energy is being delivered to the probe, the probe being not actively cooled by the cooling system during the withdrawal of the probe.

18. A method of withdrawing a probe having an active tip through a tissue via a path that traverses at least some bone tissue, the method comprising:

withdrawing the probe through the path in increments, the increments each having an increment length;

for each incremental withdrawal, delivering energy from the active tip of the probe to heat a layer of tissue surrounding the probe to a temperature sufficient for thermal coagulation necrosis of cells to thereby define a coagulation volume, wherein the increment length is less than or equal to a length of the coagulation volume, the energy being supplied to the probe by an electrosurgical generator that is electrically coupled to the probe;

for each of the increments, measuring a temperature of the layer of tissue surrounding the probe while concurrently heating the layer of tissue surrounding the probe, the measuring of the temperature of the layer of tissue surrounding the probe being measured by a temperature sensor, the temperature sensor being positioned on an exterior surface of the active tip of the probe;

automatically detecting at least one probe parameter of the probe;

substantially continuously adjusting an energy delivery parameter of the electrosurgical generator in response to the at least one probe parameter and the temperature of the layer of tissue surrounding the probe, the energy delivery parameter being selected from a group including of voltage and impedance; and

providing an indication to a user when the temperature of the layer of tissue surrounding the probe reaches the temperature sufficient for the thermal coagulation necrosis of the cells.

19. The method of claim 18, wherein the increment length is less than or equal to a length of the active tip of the probe.

20. The method of claim 18, wherein the path includes various tissue types.

21. The method of claim 18, wherein the active tip of the probe includes at least one active electrode and at least one return electrode, and wherein the delivering of the energy includes delivering electrical energy in a bipolar manner.

22. A method of withdrawing a probe having an active tip through a tissue via a path that traverses at least some bone tissue, the method comprising:

continuously withdrawing the probe through the path while concurrently delivering energy from the active tip to heat a layer of tissue surrounding the probe, the energy being supplied to the probe by an electrosurgical generator that is electrically coupled to the probe;

measuring a temperature of the layer of tissue surrounding the probe to confirm thermal coagulation necrosis of cells adjacent to the probe, the measuring of the temperature of the layer of tissue surrounding the probe being measured by a temperature sensor, the temperature sensor being positioned on an exterior surface of the active tip of the probe;

automatically detecting at least one probe parameter of the probe;

substantially continuously adjusting an energy delivery parameter of the electrosurgical generator or a rate of probe withdrawal based on the at least one probe parameter and the temperature of the layer of tissue surrounding the probe, the energy delivery parameter being selected from a group including of voltage and impedance; and

providing an indication to a user when the temperature of the layer of tissue surrounding the probe reaches the temperature sufficient for the thermal coagulation necrosis of the cells adjacent to the probe.

23. A system for withdrawing probes through a tissue via a path that traverses at least some bone tissue, the system comprising:

an electrosurgical generator;

at least one bipolar probe configured to be electrically coupled to the electrosurgical generator, the at least one bipolar probe including;

at least one active electrode,

at least one return electrode, and

at least one temperature sensor,

the at least one active electrode and the at least one return electrode being longitudinally displaced from each other on the least one bipolar probe,

the at least one temperature sensor being positioned on an exterior surface of the at least one bipolar probe; and

at least one introducer defining a lumen sized to receive the at least one bipolar probe;

the electrosurgical generator being operable to;

deliver electrical energy in a radiofrequency range to the at least one bipolar probe;

automatically detect at least one probe parameter of the at least one bipolar probe;

receive a measurement of a temperature of a layer of tissue surrounding the at least one bipolar probe to confirm thermal coagulation necrosis of cells adjacent to the at least one bipolar probe;

substantially continuously adjust an energy delivery parameter in response to the at least one probe parameter and the temperature of the layer of tissue surrounding the at least one bipolar probe, the energy delivery parameter being selected from a group including of voltage and impedance; and

provide an indication to a user when the temperature of the layer of tissue surrounding the at least one bipolar probe reaches a temperature sufficient for the thermal coagulation necrosis of the cells adjacent to the at least one bipolar probe.