摘要:
A catheter for insertion into and treatment of tissue in a patient comprises a radio frequency (RF) electrode having an elongated body that conducts electrical RF energy to a conductive tip. An insulating sleeve surrounding the elongated body prevents leakage of RF energy from the elongated body when the catheter is being inserted into the tissue of the patient. In a first mode of operation, the conductive tip is exposed outside the insulating sleeve and the RF electrode delivers first RF energy capable of producing sparks that erode the tissue of the patient and create a tunnel through which the catheter can advance into the tissue of the patient. In a second mode of operation, the insulating sleeve is retracted to expose a portion of the RF electrode. Second RF energy is delivered to the volume of tissue around the catheter to necrotize the tissue by heating without producing sparks.
摘要:
A catheter for insertion into and treatment of tissue in a patient comprises a radio frequency (RF) electrode having an elongated body that conducts electrical RF energy to a conductive tip. An insulating sleeve surrounds the elongated body. In a first mode of operation, the conductive tip is exposed outside the insulating sleeve and the RF electrode delivers RF energy that erodes the tissue of the patient and creates a tunnel through which the catheter can advance into the tissue of the patient. In a second mode of operation, the insulating sleeve and/or the RF electrode is retracted and a second treatment apparatus treats the tissue.
摘要:
A catheter for insertion into and treatment of tissue in a patient comprises a radio frequency (RF) electrode having an elongated body that conducts electrical RF energy to a conductive tip. An insulating sleeve surrounds the elongated body. In a first mode of operation, the conductive tip is exposed outside the insulating sleeve and the RF electrode delivers RF energy that erodes the tissue of the patient and creates a tunnel through which the catheter can advance into the tissue of the patient. In a second mode of operation, the insulating sleeve and/or the RF electrode is retracted and a second treatment apparatus treats the tissue.
摘要:
A catheter for insertion into and treatment of tissue in a patient comprises a radio frequency (RF) electrode having an elongated body that conducts electrical RF energy to a conductive tip. An insulating sleeve surrounding the elongated body prevents leakage of RF energy from the elongated body when the catheter is being inserted into the tissue of the patient. In a first mode of operation, the conductive tip is exposed outside the insulating sleeve and the RF electrode delivers first RF energy capable of producing sparks that erode the tissue of the patient and create a tunnel through which the catheter can advance into the tissue of the patient. In a second mode of operation, the insulating sleeve is retracted to expose a portion of the RF electrode. Second RF energy is delivered to the volume of tissue around the catheter to necrotize the tissue by heating without producing sparks.
摘要:
Methods and systems for securing tissues, e.g., cardiovascular tissues, are disclosed. A method in accordance with one embodiment of the invention includes inserting a portion of a catheter into an opening between a first portion of cardiovascular tissue and a second portion of cardiovascular tissue. The method can further include drawing the first and second portions of the cardiovascular tissue into contact with each other by drawing a vacuum in a region adjacent to the first and second portions of cardiovascular tissue via the catheter while the catheter is positioned between the first and second portions. The tissue portions can be fused by heating the tissue from within the opening, e.g., via radio frequency energy. This technique, and associated catheter system, can be used to close a patent foramen ovale or other openings in cardiovascular tissue.
摘要:
A multipolar electrosurgical device is described for use in neurosurgery or through the channel of an endoscope or other precision surgery procedures. The device is formed with an insulative probe body, which, in the described embodiment, is sized to pass through a channel of an endoscope to enable the electrocoagulation of blood vessels such as may be needed in the treatment of a gastrointestinal ulcer. The probe body is provided with electrically separate conductors which are formed of a plurality of electrodes distributed over the peripheral surface of the probe body. The electrically separate conductors are so sized in width W and spaced from each other by a distance S as to establish a ratio of W:S which enables effective bipolar treatment of tissue independent of probe body orientation relative to the tissue and without sticking of the probe body to coagulated material. A plurality of at least six electrodes which can form six bipolar electric fields are formed which in one embodiment are aligned longitudinally on the probe body. The electrodes extend onto the probe body's distal end to provide an omnidirectionally effective electrosurgical device. A central conductive wash channel is provided for electrical connection to a set of electrodes at the distal end of the probe body while also providing a passage for fluid to enhance the visibility of the target area for subsequent precise electrocoagulation of the bleeding site. Several embodiments are shown and described.
摘要:
A device for safe removal of abnormal deposits, primarily in the human body, where differential cutting properties provide for fracture of hard matter while safely preserving soft tissue. The device includes a rotating cutting tool having spirally shaped cutting flutes having hardness-differential cutting properties. The tool is driven from outside the body by means of a flexible drive shaft at greater than 2000 revolutions per minute. A channel is incorporated in the drive shaft for adding or removing chemical matter from the internal body space to provide systematic removal of cutting debris from abnormal deposits. The cutting tool has fluid ports which communicate with the drive shaft channel. The fluid ports may be at the nose of the tool as well as around its cicumference. In the latter instance, the ports extend from in front of a cutting flute into a center cavity with a circumferential component so that rotation tends to force blood into these ports. External mass transfer machines aid in injecting or withdrawing material, such as cutting debris. Auxiliary instrumentation, such as fluoroscopy and pressure measuring apparatus, are helpful in the clinical procedure. Multiple operational cycles are easily implemented to gradually dissect the deposit while periodically reestablishing physiological viability, such as blood flow in vessels.
摘要:
Laser radiation is coupled to an optical instrument having a relatively narrow working edge from which the radiation is emitted in a relatively narrow zone of intense radiation leakage. The working edge is placed in contact with vascularized tissues, and the laser radiation emanating from the working edge in combination with the contact between the working edge and the tissues forms an incision, and the laser radiation photocoagulates tissue adjacent the incision. The contact between the working edge and the tissues accurately positions the laser radiation with respect to the tissue, places pressure on vessels to aid hemostasis, mechanically stresses the incision line and provides the surgeon with tactile feedback. Radiation propagates from a laser to the optical instrument through a low-loss flexible fiberoptic waveguide by means of multimode optical waveguide propagation. As the radiation reaches the working edge of the optical instrument the radiation is emitted from the instrument because the incident angles of individual modes fall below the critical internal reflection angle of the instrument. Radiation leakage is further increased by the presence of blood on the working edge. The frequency of the laser radiation is selected to achieve a desired penetration depth. Deeper penetration may be necessary under some circumstances to produce a clot of sufficient size to allow adequate coagulation. A power control mounted on the handle of the optical instrument or elsewhere allows the surgeon to adjust the intensity of the radiation.
摘要:
An RF activated catheter apparatus for performing transmyocardial revascularization. The catheter apparatus including an elongate catheter shaft having proximal and distal ends, the distal end including an RF emitter which is coupled to an RF generator for cutting channels into the myocardium of a patient's heart.
摘要:
An apparatus and method for use in performing ablation of organs and other tissue includes an electrode carrying member which is substantially absorbent and/or permeable to moisture. The electrode carrying member is mounted to the distal end of an elongate shaft, and an array of electrodes is mounted to the surface of the electrode carrying member. Following placement of the ablation device into contact with the tissue to be ablated, an RF generator is used to deliver RF energy to the electrodes and to thereby induce current flow from the electrodes to tissue to be ablated. As the current heats the tissue, moisture (such as water vapor or liquid) leaves the tissue causing the tissue to dehydrate. The moisture permeability and/or absorbency of the electrode carrying member allows the moisture to leave the ablation site so as to prevent the moisture from providing a path of conductivity for the current.