Abstract:
A medical probe apparatus comprising a catheter having a stylet guide housing with one or more stylet ports therein and stylet guides for directing one or more flexible stylets outward through respective stylet ports and through intervening tissue to target tissue. The active stylets emit radio frequency RF energy which establishes an RF current in the patient. The current, being densest at the stylet tips, causes heating of the surrounding tissue to initiate ablation of the target tissue. One aspect of the invention includes temperature sensing stylets at the location of the RF emitting stylets to monitor the temperature of the tissue being ablated. This allows the surgeon to have increased knowledge about the abating action under way in order to control the intensity of the applied RF current, or to adjust the amount of time the current is applied, or both. Further included herein is a plurality of temperature sensors mounted on an ultrasound probe to be used to monitor tissue temperature at the ultrasound probe while allowing the ultrasound device to monitor the position and orientation of the medical probe apparatus of the present invention.
Abstract:
A medical probe for the treatment by radio frequency ablation of a target volume in tissue of a human having a urethral channel extending into the base of a bladder along a longitudinal axis. The probe comprises an elongate probe member having proximal and distal extremities and is sized so that it can be introduced into the urethra. The elongate probe member has a passage extending from the proximal extremity to the distal extremity. Guide cannulae are mounted in the passage of the elongate probe member and have proximal and distal extremities with the distal extremities of the guide cannulae being in the vicinity of the distal extremity of the elongate probe member. Each of the guide cannulae have a lumen extending therethrough from the proximal extremity to the distal extremity. A radio frequency conductive electrode is disposed in each lumen. An insulating sleeve is coaxially disposed on each radio frequency electrode. A control handle is secured to the proximal extremity of the elongate probe member. The control handle is connected to each radio frequency electrode and each insulating sleeve so that each radio frequency electrode and each insulating sleeve can be advanced and retracted.
Abstract:
A medical ablation device comprising a flexible RF electrode wire or tube, the terminal portion thereof extending through an insulating sleeve axially moveable thereon. The electrode and surrounding sleeve extend through a portion of a rigid tube having a distal end adapted to be inserted into the body of a patient. Tabs are attached to the proximal end of the sleeve and electrode for advancing them together from the terminal end of the tube, for retracting the sleeve from the distal end of the electrode to expose a predetermined area of electrode surface, and for retracting them together into the terminal end of the tube. The electrode can also be a hollow tube, the proximal end thereof being adapted to be connected to a suction source for aspiration of tissue adjacent its distal end or it can optionally contain a fiber optic, the end thereof being enclosed within the tube and closely adjacent its distal end. In one embodiment, the electrode is a hollow electrode tube of highly flexible memory metal, preformed to have a curved memory configuration. The portion of the electrode tube and its surrounding sleeve extending beyond the distal end of the outer tube adopts the curved memory configuration, causing it to follow a curved path when extended through intervening tissue to reach a target tissue to be ablated.
Abstract:
A method of this invention for treating body tissues containing cancerous cells or non-malignant tumors with RF ablation, alone or in combination with systemic or localized chemotherapy comprising introducing a stylet comprising an electrode surface and a sleeve longitudinally moveable thereon into the vicinity of the body tissues, retracting the sleeve from a portion of the electrode surface, and supplying RF power to the electrode surface sufficient to heat the tissue to a temperature of above about 45.degree. C. for a time to cause reduction of tissue mass in the vicinity of the electrode. The RF power supplied to the electrode surface is sufficient to effect a desiccated fluid diffusion barrier capsule surrounding the body tissue being treated. The stylet can include a hollow tube having fluid distribution ports therein, and the method can include the step of passing fluid through one or more distribution ports into the body tissue being treated. The fluid can be saline or a chemotherapeutic fluid such as liquid or gas containing a cytotoxic agent, for example. The fluid can be administered in a variety of procedures. The fluid can be passed through a distribution port into the body tissue before, during and/or after the RF power is supplied to the electrode surface, for example. Preferably, the fluid is introduced after a barrier capsule has been formed. The devices comprises electrodes havming a hollow core and a closed sharpened distal tip. The electrode has a plurality of fluid distribution ports therein for distribution of fluid treatment agents into the tissue.
Abstract:
An improved assembly for steering and orienting a functional element at the distal end of a catheter tube holds the functional element with its major axis aligned with the axis of the catheter tube for convenient steering to a tissue site. The mechanism can also pivot the functional element in response to an external force to orient the major axis of the functional element generally parallel to the plane of the tissue site, without bending the catheter tube.
Abstract:
A method and apparatus for contacting heart valve tissue with a catheter tip electrode adapted for atrioventricular (AV) node mapping and modification is provided. The tip is conformed to rest stably and comfortably on a cardiac valve such as the mitral or tricuspid valve. The tip has a peanut shape consisting of two electrode lobes joined by a narrower connecting piece. The tip rests on the valve at the connecting piece and is secured by the adjoining lobes. The connecting piece itself may either be insulating or electrically conductive. The catheter may also include standard mapping and/or pacing electrodes. The catheter may further include a steering mechanism for positioning the catheter at various treatment sites in the heart.
Abstract:
An apparatus includes an expandable member. The expandable member is sized to be positionable in a sphincter. An energy delivery device is positioned on a surface of the expandable member. The energy delivery device has a configuration that provides sufficient energy delivery to create lesions in the interior of the sphincter. When the expandable member is removed from the sphincter, the sphincter returns to its closed or contracted configuration.
Abstract:
A sphincter treatment apparatus includes an energy delivery device introduction member including a proximal end with a first radius of curvature and a distal end with a second radius of curvature. The introduction member is configured to be introduced into the sphincter in a non-deployed state and to be expanded to a deployed state to at least partially expand the sphincter or an adjoining structure. An energy delivery device is coupled to the introduction member. A retainer member is coupled to the energy delivery device introduction member and configured to controllably position the introduction member in an orifice of the sphincter.
Abstract:
A method of treating a sphincter provides a sphincter electropotential mapping device with at least one of a mapping electrode or a treatment electrode. The sphincter electropotential mapping device is introduced into at least a portion of the sphincter, the lower esophageal sphincter, stomach, the cardia or the fundus. Bioelectric activity causing a relaxation of the sphincter is detected and energy is delivered from either the mapping electrode or the treatment electrode to treat the bioelectric activity. A method of treating a sphincter provides a sphincter electropotential mapping device with at least one of a mapping electrode or a treatment electrode. The sphincter electropotential mapping device is introduced into at least a portion of the sphincter, the lower esophageal sphincter, stomach, the cardia or the fundus. Bioelectric activity causing a relaxation of the sphincter is detected and energy is delivered from either the mapping electrode or the treatment electrode to treat the bioelectric activity.
Abstract:
Methods of accessing and ablating abnormal epithelium tissue in an alimentary canal are provided. The methods can include steps of (i) inserting an operative element into an alimentary canal such that the proximate to a portion of the alimentary canal having tissue to be ablated; and (ii) using the operative element to apply cryogenic ablation to a site of abnormal tissue.