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 movable 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 medical device for the treatment by radio frequency ablation of a target volume in tissue of a prostate comprising an elongate probe member having proximal and distal extremities and having a passage therein extending from the proximal extremity to the distal extremity. The elongate probe member is sized so that it can be introduced into the urethra. At least one guide tube having proximal and distal extremities is mounted in the passage of the elongate probe member for nonlongitudinal movement therein. The at least one guide tube has a lumen extending therethrough from the proximal extremity to the distal extremity. A radio frequency conductive electrode is disposed in the lumen. A handle is coupled to the proximal extremity of the elongate probe member and includes a finger actuatable mechanism secured to the radio frequency electrode for advancing and retracting the radio frequency electrode with respect to the at least one guide tube. The distal extremity of the at least one guide tube has a curved surface for directing the radio frequency electrode sidewise of the longitudinal axis into the tissue of the prostate.
Abstract:
An endocardial ablation apparatus, for introduction into a heart chamber formed by a wall, is provides. The ablation apparatus includes an inflatable, flexible porous membrane adapted to receive an electrolytic solution, and become inflated to substantially conform an exterior surface of the membrane to the wall of the heart chamber. An inner lumenal member is surrounded by and attached to the membrane. The inner lumenal member includes a lumen that permits blood flow through the inner lumenal member and heart chamber. An introducer catheter introduces the membrane and inner lumenal member into a selected heart chamber. A plurality of RF electrodes define a circuit positioned in the membrane or on an exterior surface of the inner lumenal member. The RF electrodes transfer thermal energy to the electrolytic solution. The electrolytic solution is the electrode that provides ablation of a selected site of the heart chamber. An RF power source is coupled to the RF electrodes. A source of electrolytic solution is coupled to the membrane.
Abstract:
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.
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 medical device which includes an elongate probe member sized to be able to enter a urethra of a female human body and having a length so that when the distal extremity is disposed in the vicinity of a target volume of tissue surrounding the urethra the proximal extremity is outside of the urethra. The elongate probe member has a passage extending from the proximal extremity to the distal extremity. At least one tubular needle is disposed in the passage and has first and second extremities and a flow passageway therein extending longitudinally from the first extremity to at least one opening provided in the second extremity of the at least one tubular needle. A control handle is secured to the proximal extremity of the elongate probe member for causing movement of the at least one tubular needle in the passage. A guide passageway causes movement of the at least one tubular needle through a curved path extending at an angle to the longitudinal axis. A supply assembly is carried by the proximal extremity of the elongate probe member and is in communication with the flow passageway of the at least one tubular needle for introducing an agent into the flow passageway. A method for use of the device is provided.
Abstract:
A method and an apparatus for delivering controlled heat independently on separate channels to perform ablation to treat benign prosthetic hypertrophy or hyperplasia (BPH). The dual channel power system provides independent control of radio frequency energy to each of two stylets protruding from a catheter into a human prostate through the urethra. The energy is independently transferred directly into the respective tissue around the stylets in such a manner as to provide respective tissue ablation without damage to surrounding tissues. Automatic shut-off of both channels occurs when any one of a number of surrounding areas to include the urethra or surrounding mass or the adjacent organs exceeds predetermined safe temperature limits. Automatic shut off of the individual channels occurs when the temperature of the tissue proximal to the respective stylet exceeds respective predetermined values. The dual channel system is microprocessor controlled and contains self-test startup and thermocouple autocalibration circuitry.
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:
An ablation apparatus includes an ablation energy source producing an electromagnetic energy output. A multiple antenna device is included, and has a primary antenna with a longitudinal axis, a central lumen and a distal end, and a secondary antenna with a distal end. The secondary antenna is deployed from the primary antenna central lumen in a lateral direction relative to the longitudinal axis. The multiple antenna device is coupled to the ablation energy source.
Abstract:
Apparatus and methods are provided for treating female urinary incontinence by applying a form of energy to tissue in the vicinity of the urethra and/or bladder outlet to change tissue compliance without substantially narrowing the urethral and/or bladder outlet lumen. The apparatus comprises an elongated shaft having a means for treating urethral tissue and an expandable member deployable distal of the means for treating. The expandable member is configured to be anchored against the bladder outlet to dispose the means for treating at a desired treatment site in the urethra using only tactile feedback. The means for treating may include a needleless RF electrode, an ultrasound transducer, or a cryogenic probe configured to be advanced through a hollow needle, each of which are designed to reduce or eliminate symptoms associated with urinary incontinence.