摘要:
Apparatus and methods are disclosed for accessing the interior of an intervertebral disc to perform a function within the disc. One such apparatus comprises a catheter having a lumen; and a guide wire having a distal portion and a proximal portion, and configured to be positioned within and moved relative to the lumen of the catheter; wherein the guide wire is capable of navigating itself within an intradiscal section of the intervertebral disc to a selected section of the disc and the catheter is capable of being advanced relative to the guide wire such that the catheter follows a path of the guide wire within the intradiscal section of the disc to the selected section. These apparatus and methods may be used for the treatment of intervertebral disc disorders such as sealing fissures of the annulus fibrosus, which may or may not be accompanied with contained or escaped extrusions. These apparatus and methods may also be used, for example, for the removal or addition of material to the intervertebral disc.
摘要:
A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radiofrequency electrode. Preferably, the non-conductive layer is a sleeve which is axially moveable on the electrical conductor to expose a selected portion of the electrical conductor surface in the target tissue. The stylet can also be a microwave antenna. The stylet can also be a hollow tube for delivering treatment fluid to the target tissue. It can also include a fiber optic cable for laser treatment. The catheter can include one or more inflatable balloons located adjacent to the stylet port for anchoring the catheter or dilation. Ultrasound transponders and temperature sensors can be attached to the probe end and/or stylet. The stylet guide can define a stylet path from an axial orientation in the catheter through a curved portion to a lateral orientation at the stylet port.
摘要:
A surgical instrument comprising a handle and an elongated probe connected to the handle. The elongated probe has a terminus distal to the handle. At least one electrode that includes an electrode surface is positioned on the terminus so that a line from a geometric center of the electrode surface and substantially perpendicular to the electrode surface intersects at an angle a longitudinal axis formed by the elongated probe. A conductor is provided for attaching the at least one electrode to the handle.
摘要:
A medical probe device of this invention comprising a catheter having a control end and a probe end. The probe end includes a stylet guide housing having at least one stylet port and stylet guide means for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. A stylet is positioned in at least one of said stylet guide means, the stylet comprising a non-conductive sleeve having a RF electrode lumen and an optional a fluid supply lumen and a temperature sensor lumen therein. At least one portion of an opposed surface of the electrode lumen and the electrode can be spaced apart to define a liquid supply passageway for delivery of medicament liquid. The RF electrode enclosed within the non-conductive sleeve has a distal length optionally having at least one current focusing groove means thereon and a distal tip shaped to focus current crowding on its terminal end, whereby Rf current passing therefrom into surrounding tissue forms a lesion extending outward from the groove and tip. The focusing groove means can be a plurality of annular focusing grooves or a spiral focusing groove thereon.
摘要:
An electrosurgical probe is provided to vaporize, cut, coagulate or remove tissue from a body structure. A method of surgically treating a mammal includes providing a surgical instrument including a length of shaft and an active electrode having a curved current density edge with at least one convex surface; and ablating a tissue surface with said surgical instrument.
摘要:
An electrosurgical aspiration instrument that permits aspiration of an area being treated by the instrument. The instrument is coupled at a proximal end to a power source and includes an energy application surface area at a distal end. The power source supplied energy to the energy application surface area such that the distal end of the instrument may apply energy to the treatment area to modify the characteristics of biological material, such as biological tissue in the area. An aspiration lumen is formed through the instrument with an opening through the energy application surface area. The energy application surface area is configured to reduce blockage of the opening. Accordingly, aspiration may be performed simultaneously with electrosurgical treatment whereby unwanted matter such as by-products, biological debris and excess fluid is removed from the treatment area. The electrosurgical aspiration instrument also permits both functions to be performed at different times, with the advantage of not requiring instruments to be switched on during the treatment procedure or removed from the treatment site.
摘要:
Disclosed is a surgical apparatus including a surgical instrument including a housing and a cannula, and a surgical tool including a shaft and a tip, and a drive interface and an electrical interface, and the drive interface producing a surgical motion of the tip, and the electrical interface producing a cauterizing action of the tip. Also disclosed is a cutting and cauterizing device for connection to a surgical instrument. Additionally, methods for using both the surgical apparatus and the cutting and cauterizing device are disclosed.
摘要:
A medical probe device comprising a catheter having a stylet guide housing with at least one stylet port in a side thereof and stylet guide means for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. The stylet guide housing has an optical viewing means positioned for viewing the stylet and adjacent structure which includes a fiber optic channel means for receiving a fiber optic viewing device. The fiber optic channel means can include a guide port means for directing longitudinal movement of a fiber optic device with respect to the stylet guide means in a viewing zone and a flushing liquid channel in the stylet guide housing having an exit port positioned to direct flushing liquid issuing therefrom across the end of a fiber optic device when positioned in the viewing zone. The optical viewing means can comprise a viewing window positioned in the stylet guide housing for viewing the stylet when it is directed outward from its respective stylet port. The optical viewing means can include a fiber optic channel in the stylet guide housing for receiving the a fiber optic viewing device and aligning the viewing end thereof with the viewing window. Windowed devices can include a flushing liquid channel in the stylet guide housing having an exit port positioned to direct flushing liquid issuing therefrom across a surface of the viewing window.
摘要:
A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radiofrequency electrode. Preferably, the non-conductive layer is a sleeve which is axially moveable on the electrical conductor to expose a selected portion of the electrical conductor surface in the target tissue. The stylet can also be a microwave antenna. The stylet can also be a hollow tube for delivering treatment fluid to the target tissue. It can also include a fiber optic cable for laser treatment. The catheter can include one or more inflatable balloons located adjacent to the stylet port for anchoring the catheter or dilation. Ultrasound transponders and temperature sensors can be attached to the probe end and/or stylet. The stylet guide can define a stylet path from an axial orientation in the catheter through a curved portion to a lateral orientation at the stylet port.
摘要:
A method for modifying a ligament connection between two bones by applying radio frequency energy to a portion of a ligament in a patient that functions to maintain two or more bones in a standard configuration in a species to which the patient belongs, but which are in a relationship to each other that is not medically acceptable in the patient, for a time sufficient to induce thermal shrinkage of the portion of the ligament. The method is particularly useful for skeletal-shift disorders by applying radio frequency energy to one ligament of a set of ligaments of a patient that function to align two or more bones in a standard configuration in a species to which the patient belongs but which are causing a skeletal shift in the patient because of an imbalance of ligament-induced forces in the patient for a time sufficient to induce thermal shrinkage of the portion of the ligament, thereby alleviating the skeletal shift. Patellar shift and curvature of the spine are two examples of such disorders.