Abstract:
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.
Abstract:
A method and an apparatus is disclosed for delivering controlled heat to perform ablation to treat the benign prosthetic hypertrophy or hyperplasia (BPH). According to the method and the apparatus, the energy is transferred directly into the tissue mass which is to be treated in such a manner as to provide tissue ablation without damage to surrounding tissues. Automatic shut-off occurs when any one of a number of surrounding areas to include the urethra or surrounding mass or the adjacent organs exceed predetermined safe temperature limits. The constant application of the radio frequency energy over a maintained determined time provides a safe procedure which avoids electrosurgical and other invasive operations while providing fast relief to BPH with a short recovery time. The procedure may be accomplished in a doctor's office without the need for hospitalization or surgery.
Abstract:
A transurethral needle ablation device for use with the human hand for radio frequency ablation of a target volume in the tissue of a prostate of a human male having a bladder with a base and a penis with a urethra therein formed by a urethral wall extending into the base of the bladder along a longitudinal axis with the tissue of the prostate surrounding the urethra near the base of the bladder. The device comprises a bridge having proximal and distal extremities and having a passage therein extending from the proximal extremity to the distal extremity. A sheath having proximal and distal extremities is secured to the bridge and has a passageway therein in communication with the passage in the bridge. The sheath is sized so that it can enter the urethra and has a length so that when its distal extremity is in the vicinity of the prostate, the proximal extremity is outside the urethra. A disposable needle assembly having proximal and distal extremities is removably mounted in the passage in the bridge and extends through the passageway in the sheath. The needle assembly includes at least one needle electrode and an insulating sleeve coaxially disposed on the needle electrode. The proximal extremity of the needle assembly is caused to be moved sideways at an angle with respect to the longitudinal axis to face the urethral wall. A mechanism is carried by the proximal extremity of the needle assembly and the bridge for causing advancement of the needle electrode and the insulation sleeve thereon through the urethral wall and into the target volume in the tissue of the prostate with a portion of the electrode being free of the insulation but with the insulation extending through the urethral wall.
Abstract:
A transurethral needle ablation device for the treatment of the prostate of a human male using radio frequency energy wall comprising a sheath having a lumen extending therethrough. A guide tube assembly is slidably mounted in the lumen in the sheath and having a lumen extending therethrough. A needle electrode is slidably mounted in the lumen in the guide tube assembly. An insulating sheath is disposed about the needle electrode so that the distal extremity of the needle electrode is exposed. A handle adapted to be gripped by the human hand is mounted on the proximal extremity of the sheath. Levers are carried by the handle for causing bending of the distal extremity of the guide tube assembly at an angle with respect to its longitudinal axis whereby the lumen in the guide tube assembly can be directed so that it faces the urethral wall. A control is carried by the handle and coupled to the needle electrode and the insulating sleeve for advancing and retracting the needle electrode with respect to the guide tube assembly whereby when the sheath is positioned in the urethra with its distal extremity in the vicinity of the prostate, the needle electrode can be advanced through the urethral wall and into the tissue of the prostate to permit the application of radio frequency energy to the tissue of the prostate surrounding the needle electrode to form a lesion in the prostate.
Abstract:
A transurethral needle ablation device for use with the human hand for radio frequency ablation of a target volume in the tissue of a prostate of a human male having a bladder with a base and a penis with a urethra therein formed by a urethral wall extending into the base of the bladder along a longitudinal axis with the tissue of the prostate surrounding the urethra near the base of the bladder. The device comprises a bridge having proximal and distal extremities and having a passage therein extending from the proximal extremity to the distal extremity. A sheath having proximal and distal extremities is secured to the bridge and has a passageway therein in communication with the passage in the bridge. The sheath is sized so that it can enter the urethra and has a length so that when its distal extremity is in the vicinity of the prostate, the proximal extremity is outside the urethra. A disposable needle assembly having proximal and distal extremities is removably mounted in the passage in the bridge and extends through the passageway in the sheath. The needle assembly includes at least one needle electrode and an insulating sleeve coaxially disposed on the needle electrode. The proximal extremity of the needle assembly is caused to be moved sideways at an angle with respect to the longitudinal axis to face the urethral wall. A mechanism is carried by the proximal extremity of the needle assembly and the bridge for causing advancement of the needle electrode and the insulation sleeve thereon through the urethral wall and into the target volume in the tissue of the prostate with a portion of the electrode being free of the insulation but with the insulation extending through the urethral wall.
Abstract:
A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and guide means 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 transducers and temperature sensors can be attached to the probe end and/or stylet.
Abstract:
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.
Abstract:
A medical probe device for treatment of the prostate of a human male having a bladder with a base with a urethra formed by a urethral wall extending into the base of the bladder with the prostate having tissue surrounding the urethra near the base of the bladder with a catheter having a control end and a probe end and a passageway extending from the control end to the probe end along a longitudinal axis. A flexible stylet assembly is slidably mounted in the passageway in the catheter and has a distal extremity. The stylet assembly includes a conductive electrode and a sleeve of insulating material surrounding the conductive electrode and permitting a predetermined portion of the conductive electrode to be exposed. A control device is secured to the stylet assembly and to the control end of the catheter for causing movement of the distal extremity of the stylet assembly between a retracted position disposed within the passageway and an extended position disposed outwardly from the probe end whereby the stylet assembly can extend through the urethral wall into the tissue of the prostate with the conductive electrode being disposed in the tissue of the prostate and the sleeve being disposed in the urethral wall. A radio frequency generator is coupled to the conductive electrode for supplying radio frequency energy to the conductive electrode for causing ablation of tissue in the prostate while the urethral wall is protected from the radio frequency energy supplied to the electrode.
Abstract:
A medical probe apparatus comprising a catheter having a stylet guide housing with at least one stylet port in a side thereof and a stylet guide for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. The stylet guide has a biopsy sample device or other tissue manifesting device at the distal end thereof to gather tissue or perform other operations at the point of the desired tissue such as emitting electromagnetic energy as ablative power to target tissues;.One embodiment of the biopsy sample stylet includes a hollow core sampler including a biopsy needle apparatus for gathering sample tissue. The hollow core sampler has a sharpened end for facilitating the penetration into and gathering of the sample tissue. A second embodiment of the biopsy sample stylet includes a harpoon-like sample stylet when the sharp tip thereof allows for easy entry into the target tissue. The sharpened barbed side opening allows for certain desired tissue to be sampled to be drawn into the side opening for individual cell gathering or complete sample excise or gathering of the desired tissue. The third embodiment is a clam shell or alligator type biopsy jaw device whereby the sharpened biopsy tip thereof allows a tissue sample to be clipped or cut upon activation of the stylet jaws. Still another embodiment comprises a biopsy knife device in conjunction with an electromagnetic emitter for selective tissue sampling or electromagnetic heat ablation, or both, of selected tissue.
Abstract:
A method and an apparatus is disclosed for delivering controlled heat to perform ablation to treat the benign prosthetic hypertrophy or hyperplasia (BPH). According to the method and the apparatus, the energy is transferred directly into the tissue mass which is to be treated in such a manner as to provide tissue ablation without damage to surrounding tissues. Automatic shut-off occurs when any one of a number of surrounding areas to include the urethra or surrounding mass or the adjacent organs exceed predetermined safe temperature limits. The constant application of the radio frequency energy over a maintained determined time provides a safe procedure which avoids electrosurgical and other invasive operations while providing fast relief to BPH with a short recovery time. The procedure may be accomplished in a doctor's office without the need for hospitalization or surgery.