WO1997043970A1 - Dispositif et procedes d'ablation des cornets - Google Patents
Dispositif et procedes d'ablation des cornets Download PDFInfo
- Publication number
- WO1997043970A1 WO1997043970A1 PCT/US1997/002960 US9702960W WO9743970A1 WO 1997043970 A1 WO1997043970 A1 WO 1997043970A1 US 9702960 W US9702960 W US 9702960W WO 9743970 A1 WO9743970 A1 WO 9743970A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- substance
- turbinate
- exudable
- energy
- porous membrane
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1477—Needle-like probes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/06—Electrodes for high-frequency therapy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
- A61B2018/0022—Balloons
- A61B2018/0025—Multiple balloons
- A61B2018/00261—Multiple balloons arranged in a line
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00761—Duration
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00886—Duration
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/02—Radiation therapy using microwaves
- A61N5/04—Radiators for near-field treatment
Definitions
- the nasal structures (such as turbinates) can become enlarged, causing air space through the nasal passages to become restricted In these cases it would be desirable to reduce the size of the turbinates and thus alleviate the constriction of the nasal passages
- the invention provides apparatus and a method for ablating at least a portion of a turbinate
- a catheter having a porous membrane coupled to a source of an exudable substance is disposed proximate to the turbinate, whereby the exudable substance is emitted from the catheter and contacts the turbinate
- an electrode is disposed proximate to the turbinate, whereby the exudable substance aids the electrode in delivering ablating energy to the turbinate
- the exudable substance is preferably a dielectric substance, such as saline, which aids in delivery of energy, and may include substances with other bioactive, chemoactive, or radioactive effects
- the energy delivered to the turbinate is preferably RF energy which ablates the turbinate by heat and cell destruction
- the catheter is preferably coupled to an energy source which provides energy delivered to the turbinate
- the catheter preferably includes at least one sensor, such as a temperature sensor, and a communication link coupling the sensor to apparatus which controls the energy source, whereby feedback from the sensor is used to control operation of the energy source
- the catheter may include a lumen which delivers the exudable substance to the porous membrane
- the porous membrane may be microporous, or may include holes which allow the exudable substance to flow out from the catheter BRIEF DESCRIPTION OF THE DRAWINGS
- Figure 1 shows a cut-away cross section of a patient's nose, showing a nasal cavity and a set of turbinates.
- Figure 2 shows apparatus for ablating turbinates.
- Figure 1 shows a cut-away cross section of a patient's nose, showing a nasal cavity and a set of turbinates.
- the patient is a mature adult human being.
- the patient may be a child, a neonate, a fetus in utero.
- the patient may be an animal subject to veterinary medicine.
- a patient's nose 100 comprises at least one nasal cavity 101; the nasal cavity 101 comprises a set of turbinates 102, including a middle nasal concha (turbinate) 103 and an inferior nasal concha (turbinate) 104.
- the inferior nasal concha (turbinate) 104 comprises an anterior portion
- Ablating the inferior nasal concha (turbinate) 104, and preferably ablating the anterior portion 105, does not substantially degrade the function of the inferior nasal concha 104. Ablating the inferior nasal concha (turbinate) 104, and preferably the anterior portion 105, can therefore be performed to achieve the goals of ablating the turbinates 102 without substantial suffering of disadvantages of ablating the turbinates 102.
- a method embodying the present invention is to ablate the turbinates 102, but to limit that ablation to the inferior nasal concha 104, and preferably to limit that ablation to the anterior portion 105 thereof.
- the anterior portion 105 is defined as being no larger than about one-third the volume of the inferior nasal concha 104.
- the anterior portion 105 is ablated, no more than about one-third of the inferior nasal concha 104 is ablated.
- a catheter assembly 200 comprises a catheter tip 201 and a catheter tube 202.
- the catheter tip 201 comprises an structure having a distal end 203, a proximal end 204, a center 205 having a lumen 206, and a surface 207.
- the catheter tip 201 has a straight elongated shape.
- the catheter tip 201 may have another shape, such as a curved shape, or a shape adapted to fit into or to avoid a body structure, such as a curved shape disposed to fit inside a blood vessel or an eyelid.
- the catheter tip 201 is manufactured with a predetermined (straight) shape.
- the catheter tip 201 may be bendable or otherwise malleable to adopt a selected shape, may be dynamically adaptable to shapes selected by an operator, or may be actively adaptive to take on new shapes as it encounters obstructions or other body structures.
- the center 205 of the catheter tip 201 is coupled to the catheter tube 202 at the proximal end 204 of the catheter tip 201, so that substances can flow from the catheter tube 202 into the lumen 206
- the substance flowed from the catheter tube 202 into the lumen 206 comprises saline, the saline comprising distilled water with a NaCl content of less than about 10% by weight.
- the flowed substance may comprise saline with another amount of salt or another salt, may comprise a solution of other substances in other water or other solvents, or may comprise a substance with bioactive, chemoactive, or radioactive effects, such as an ablative acidic or alkaline substance, an antibiotic, a compound used for chemotherapy, or a fluorescent or radioactive dye or marker, or some combination of these substances with each other or with some other substance.
- the surface 207 of the catheter tip 201 comprises a sheath 208.
- the sheath 208 has a generally cylindrical shape, thus surrounding the lumen 206, and comprises a plurality of holes 209 disposed so that substances can flow from the lumen 206 out through the sheath 208 to outside the catheter tip 201
- the sheath 208 comprises a relatively inert and relatively hard substance, such as metallic copper or metallic silver.
- the sheath 208 may comprise other relatively inert and relatively hard substances, such as gold, stainless steel, titanium, various plastic compounds, or some combination of these substances with each other or with some other substance
- the sheath 208 has a traverse diameter of about 6 french One french is about 0 015 inches, thus 6 french is about 0 090 inches
- the sheath 208 may have another size, such as less than 2 french, between about 2 to about 6 french, or more than 6 french
- the sheath 208 has a thickness of about 0 001 inches, this embodiment is particularly preferred in the case when the sheath 208 is copper
- the surface 207 of the catheter tip 201 also comprises a porous membrane 210 surrounding the sheath 208, disposed so that when substances flow out from the lumen 206, they encounter the membrane 210 and are trapped therein. As the membrane 210 is porous, the substances flow out through the membrane 210 and into proximity with the turbinate (specifically, the anterior portion 105 of the inferior nasal concha 104)
- the membrane 210 comprises a microporous and inflatable balloon As the substances flow into the membrane 210, pressure from the flow causes the balloon to inflate and to come into contact with the turbinate's anterior portion 105
- the catheter tip 201 comprises at least one ring electrode 21 1 disposed proximate to the membrane 210 There may be a plurality of ring electrodes 21 1, disposed for example parallel with a first ring electrode 211 shown in figure 2 with their axes aligned with a long axis of the catheter tip 201.
- the ring electrode 211 is coupled to a conductor 212 for coupling to an RF energy source 213
- a surface (preferably an outside surface) of the membrane 210 is disposed with a plurality of electrodes
- An example of a suitable surface for disposition on the membrane is shown in Application Serial No 08/319,373, "Thin Layer Ablation Apparatus", filed
- the catheter tip 201 may comprise a combination of the first and second preferred embodiment disclosed hereinabove may be used, such as a surface coupled using a conductor to a ring electrode 21 1 , which is itself coupled to a conductoi 212 for coupling to an RF energy source 213
- the RF energy source 213 comprises a power source (or a power regulator coupled to a standard power source such as a wall socket or battery), a signal generator (such as a generator for pulses, sine waves, square waves, or some combination of these wave forms with each other or with some other wave form), and a processor for controlling the signal generator
- the signal generator generates pulses of RF energy having an RF radiation frequency between about 300 megahertz and about 700 megahertz, such as preferably about 465 megahertz
- the RF energy may have an RF radiation frequency in the microwave range or in another range of the electromagnetic spectrum
- the processor controls the signal generator to generate pulses to provide an effective amount of RF energy so as to deliver between about 5 and about 30 watts of RF energy to the turbinate's anterior portion 105, so as to raise a temperature of at least a part of the turbinate's anterior portion 105 to a temperature between about 40 degrees
- the catheter tip 201 comprises at least one temperature sensor 214, such as a thermocouple or thermistor.
- the temperature sensor 214 is coupled to a communication link 215 (such as a conductor), which is coupled to the processor.
- the communication link 215 may comprise a D/A converter coupled to a register disposed for reading by the processor
- the processor reads an sensor value from the sensor and, responsive thereto, controls the signal generator so as to achieve delivery of an effective amount of RF energy to the turbinate's anterior portion 105
- the processor thus uses the signal generator, catheter tip 201, ring electrode 21 1, and temperature sensor 214 as a feedback loop for controlled delivery of RF energy to the turbinate's anterior portion 105
- the processor may control the delivery of RF energy to achieve delivery of a selected amount of energy, to achieve a selected temperature, or to achieve a selected amount of ablation of the turbinate's anterior portion 105
- the catheter tip 201 may control the delivery of RF energy to achieve delivery of a
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Animal Behavior & Ethology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Physics & Mathematics (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Heart & Thoracic Surgery (AREA)
- Otolaryngology (AREA)
- Plasma & Fusion (AREA)
- Radiology & Medical Imaging (AREA)
- Surgical Instruments (AREA)
Abstract
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU21916/97A AU2191697A (en) | 1996-05-22 | 1997-02-28 | Apparatus and methods for ablating turbinates |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US65179696A | 1996-05-22 | 1996-05-22 | |
US08/651,796 | 1996-05-22 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1997043970A1 true WO1997043970A1 (fr) | 1997-11-27 |
Family
ID=24614256
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1997/002960 WO1997043970A1 (fr) | 1996-05-22 | 1997-02-28 | Dispositif et procedes d'ablation des cornets |
Country Status (2)
Country | Link |
---|---|
AU (1) | AU2191697A (fr) |
WO (1) | WO1997043970A1 (fr) |
Cited By (24)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6035238A (en) * | 1997-08-13 | 2000-03-07 | Surx, Inc. | Noninvasive devices, methods, and systems for shrinking of tissues |
US6081749A (en) * | 1997-08-13 | 2000-06-27 | Surx, Inc. | Noninvasive devices, methods, and systems for shrinking of tissues |
US6091995A (en) * | 1996-11-08 | 2000-07-18 | Surx, Inc. | Devices, methods, and systems for shrinking tissues |
US6216704B1 (en) | 1997-08-13 | 2001-04-17 | Surx, Inc. | Noninvasive devices, methods, and systems for shrinking of tissues |
US6237605B1 (en) | 1996-10-22 | 2001-05-29 | Epicor, Inc. | Methods of epicardial ablation |
US6292700B1 (en) | 1999-09-10 | 2001-09-18 | Surx, Inc. | Endopelvic fascia treatment for incontinence |
US6361531B1 (en) | 2000-01-21 | 2002-03-26 | Medtronic Xomed, Inc. | Focused ultrasound ablation devices having malleable handle shafts and methods of using the same |
US6409720B1 (en) | 2000-01-19 | 2002-06-25 | Medtronic Xomed, Inc. | Methods of tongue reduction using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions |
US6413254B1 (en) | 2000-01-19 | 2002-07-02 | Medtronic Xomed, Inc. | Method of tongue reduction by thermal ablation using high intensity focused ultrasound |
US6595934B1 (en) | 2000-01-19 | 2003-07-22 | Medtronic Xomed, Inc. | Methods of skin rejuvenation using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions |
US6692450B1 (en) | 2000-01-19 | 2004-02-17 | Medtronic Xomed, Inc. | Focused ultrasound ablation devices having selectively actuatable ultrasound emitting elements and methods of using the same |
US7004942B2 (en) | 1998-01-14 | 2006-02-28 | Solarant Medical, Inc. | Ribbed electrodes and methods for their use |
US7317949B2 (en) | 1996-11-08 | 2008-01-08 | Ams Research Corporation | Energy induced bulking and buttressing of tissues for incontinence |
US8932208B2 (en) | 2005-05-26 | 2015-01-13 | Maquet Cardiovascular Llc | Apparatus and methods for performing minimally-invasive surgical procedures |
US8968284B2 (en) | 2000-10-02 | 2015-03-03 | Verathon Inc. | Apparatus and methods for treating female urinary incontinence |
US9011428B2 (en) | 2011-03-02 | 2015-04-21 | Arthrocare Corporation | Electrosurgical device with internal digestor electrode |
US9023031B2 (en) | 1997-08-13 | 2015-05-05 | Verathon Inc. | Noninvasive devices, methods, and systems for modifying tissues |
US9055959B2 (en) | 1999-07-19 | 2015-06-16 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Methods and devices for ablation |
US9168082B2 (en) | 2011-02-09 | 2015-10-27 | Arthrocare Corporation | Fine dissection electrosurgical device |
US9254166B2 (en) | 2013-01-17 | 2016-02-09 | Arthrocare Corporation | Systems and methods for turbinate reduction |
US9271784B2 (en) | 2011-02-09 | 2016-03-01 | Arthrocare Corporation | Fine dissection electrosurgical device |
US9788882B2 (en) | 2011-09-08 | 2017-10-17 | Arthrocare Corporation | Plasma bipolar forceps |
US10058380B2 (en) | 2007-10-05 | 2018-08-28 | Maquet Cordiovascular Llc | Devices and methods for minimally-invasive surgical procedures |
US10448992B2 (en) | 2010-10-22 | 2019-10-22 | Arthrocare Corporation | Electrosurgical system with device specific operational parameters |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0392837A2 (fr) * | 1989-04-13 | 1990-10-17 | Leslie Alexander Geddes | Appareil de destruction thermique des tissus |
WO1995025472A1 (fr) * | 1994-03-23 | 1995-09-28 | Vidamed, Inc. | Systeme de transmission d'energie hf a deux canaux |
US5458597A (en) * | 1993-11-08 | 1995-10-17 | Zomed International | Device for treating cancer and non-malignant tumors and methods |
WO1995031142A1 (fr) * | 1994-05-11 | 1995-11-23 | Applied Medical Resources Corporation | Systeme de catheter pour angioplastie et procede de fabrication |
WO1996000042A1 (fr) * | 1994-06-24 | 1996-01-04 | Vidacare International | Dispositif d'ablation d'une couche mince |
-
1997
- 1997-02-28 WO PCT/US1997/002960 patent/WO1997043970A1/fr active Application Filing
- 1997-02-28 AU AU21916/97A patent/AU2191697A/en not_active Abandoned
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0392837A2 (fr) * | 1989-04-13 | 1990-10-17 | Leslie Alexander Geddes | Appareil de destruction thermique des tissus |
US5458597A (en) * | 1993-11-08 | 1995-10-17 | Zomed International | Device for treating cancer and non-malignant tumors and methods |
WO1995025472A1 (fr) * | 1994-03-23 | 1995-09-28 | Vidamed, Inc. | Systeme de transmission d'energie hf a deux canaux |
WO1995031142A1 (fr) * | 1994-05-11 | 1995-11-23 | Applied Medical Resources Corporation | Systeme de catheter pour angioplastie et procede de fabrication |
WO1996000042A1 (fr) * | 1994-06-24 | 1996-01-04 | Vidacare International | Dispositif d'ablation d'une couche mince |
Cited By (30)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6237605B1 (en) | 1996-10-22 | 2001-05-29 | Epicor, Inc. | Methods of epicardial ablation |
US6772013B1 (en) | 1996-11-08 | 2004-08-03 | Solarant Medical, Inc. | Devices, methods, and systems for shrinking tissues |
US6091995A (en) * | 1996-11-08 | 2000-07-18 | Surx, Inc. | Devices, methods, and systems for shrinking tissues |
US7317949B2 (en) | 1996-11-08 | 2008-01-08 | Ams Research Corporation | Energy induced bulking and buttressing of tissues for incontinence |
US7167757B2 (en) | 1996-11-08 | 2007-01-23 | Ams Research Corporation | Energy induced bulking and buttressing of tissue for incontinence |
US6836688B2 (en) | 1996-11-08 | 2004-12-28 | Solarant Medical, Inc. | Devices, methods, and systems for shrinking tissues |
US6081749A (en) * | 1997-08-13 | 2000-06-27 | Surx, Inc. | Noninvasive devices, methods, and systems for shrinking of tissues |
US6216704B1 (en) | 1997-08-13 | 2001-04-17 | Surx, Inc. | Noninvasive devices, methods, and systems for shrinking of tissues |
US6035238A (en) * | 1997-08-13 | 2000-03-07 | Surx, Inc. | Noninvasive devices, methods, and systems for shrinking of tissues |
US9023031B2 (en) | 1997-08-13 | 2015-05-05 | Verathon Inc. | Noninvasive devices, methods, and systems for modifying tissues |
US7004942B2 (en) | 1998-01-14 | 2006-02-28 | Solarant Medical, Inc. | Ribbed electrodes and methods for their use |
US9055959B2 (en) | 1999-07-19 | 2015-06-16 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Methods and devices for ablation |
US6751507B2 (en) | 1999-09-10 | 2004-06-15 | Solarant Medical, Inc. | Endopelvic fascia treatment for incontinence |
US6292700B1 (en) | 1999-09-10 | 2001-09-18 | Surx, Inc. | Endopelvic fascia treatment for incontinence |
US6692450B1 (en) | 2000-01-19 | 2004-02-17 | Medtronic Xomed, Inc. | Focused ultrasound ablation devices having selectively actuatable ultrasound emitting elements and methods of using the same |
US6595934B1 (en) | 2000-01-19 | 2003-07-22 | Medtronic Xomed, Inc. | Methods of skin rejuvenation using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions |
US6413254B1 (en) | 2000-01-19 | 2002-07-02 | Medtronic Xomed, Inc. | Method of tongue reduction by thermal ablation using high intensity focused ultrasound |
US6409720B1 (en) | 2000-01-19 | 2002-06-25 | Medtronic Xomed, Inc. | Methods of tongue reduction using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions |
US6361531B1 (en) | 2000-01-21 | 2002-03-26 | Medtronic Xomed, Inc. | Focused ultrasound ablation devices having malleable handle shafts and methods of using the same |
US8968284B2 (en) | 2000-10-02 | 2015-03-03 | Verathon Inc. | Apparatus and methods for treating female urinary incontinence |
US8932208B2 (en) | 2005-05-26 | 2015-01-13 | Maquet Cardiovascular Llc | Apparatus and methods for performing minimally-invasive surgical procedures |
US10058380B2 (en) | 2007-10-05 | 2018-08-28 | Maquet Cordiovascular Llc | Devices and methods for minimally-invasive surgical procedures |
US10993766B2 (en) | 2007-10-05 | 2021-05-04 | Maquet Cardiovascular Llc | Devices and methods for minimally-invasive surgical procedures |
US10448992B2 (en) | 2010-10-22 | 2019-10-22 | Arthrocare Corporation | Electrosurgical system with device specific operational parameters |
US9168082B2 (en) | 2011-02-09 | 2015-10-27 | Arthrocare Corporation | Fine dissection electrosurgical device |
US9271784B2 (en) | 2011-02-09 | 2016-03-01 | Arthrocare Corporation | Fine dissection electrosurgical device |
US9011428B2 (en) | 2011-03-02 | 2015-04-21 | Arthrocare Corporation | Electrosurgical device with internal digestor electrode |
US9788882B2 (en) | 2011-09-08 | 2017-10-17 | Arthrocare Corporation | Plasma bipolar forceps |
US9254166B2 (en) | 2013-01-17 | 2016-02-09 | Arthrocare Corporation | Systems and methods for turbinate reduction |
US9649144B2 (en) | 2013-01-17 | 2017-05-16 | Arthrocare Corporation | Systems and methods for turbinate reduction |
Also Published As
Publication number | Publication date |
---|---|
AU2191697A (en) | 1997-12-09 |
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