CA2564352A1 - Surgical clamp having transmurality assessment capabilities - Google Patents

Surgical clamp having transmurality assessment capabilities Download PDF

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Publication number
CA2564352A1
CA2564352A1 CA002564352A CA2564352A CA2564352A1 CA 2564352 A1 CA2564352 A1 CA 2564352A1 CA 002564352 A CA002564352 A CA 002564352A CA 2564352 A CA2564352 A CA 2564352A CA 2564352 A1 CA2564352 A1 CA 2564352A1
Authority
CA
Canada
Prior art keywords
jaw
medical device
ablation
proximal
sensor
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002564352A
Other languages
French (fr)
Other versions
CA2564352C (en
Inventor
Dan Wittenberger
Daniel Nahon
Marwan Abboud
Jean-Pierre Lalonde
Cristian Petre
Real Ste-Marie
Allan Skanes
Alan H. Menkis
Sean Carroll
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Medtronic Cryocath LP
Original Assignee
Cryocath Technologies Inc.
Dan Wittenberger
Daniel Nahon
Marwan Abboud
Jean-Pierre Lalonde
Cristian Petre
Real Ste-Marie
Allan Skanes
Alan H. Menkis
Sean Carroll
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cryocath Technologies Inc., Dan Wittenberger, Daniel Nahon, Marwan Abboud, Jean-Pierre Lalonde, Cristian Petre, Real Ste-Marie, Allan Skanes, Alan H. Menkis, Sean Carroll filed Critical Cryocath Technologies Inc.
Publication of CA2564352A1 publication Critical patent/CA2564352A1/en
Application granted granted Critical
Publication of CA2564352C publication Critical patent/CA2564352C/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/2812—Surgical forceps with a single pivotal connection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • 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
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • 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
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B18/0218—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques with open-end cryogenic probe, e.g. for spraying fluid directly on tissue or via a tissue-contacting porous tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/2812—Surgical forceps with a single pivotal connection
    • A61B17/282—Jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00026—Conductivity or impedance, e.g. of tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00084—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00738—Aspects not otherwise provided for part of the tool being offset with respect to a main axis, e.g. for better view for the surgeon
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2905—Details of shaft flexible
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2931—Details of heads or jaws with releasable head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2944—Translation of jaw members
    • 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
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • 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
    • A61B2018/00744—Fluid flow
    • 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
    • A61B2018/00791—Temperature
    • 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
    • A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
    • 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
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0212—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument inserted into a body lumen, e.g. catheter
    • 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
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0225—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument for clamping tissue, e.g. forceps
    • 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
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0231—Characteristics of handpieces or probes
    • A61B2018/0262—Characteristics of handpieces or probes using a circulating cryogenic fluid
    • 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
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B2018/145—Probes having pivoting end effectors, e.g. forceps wherein the effectors remain parallel during closing and opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor

Abstract

A medical device is provided having a means for actuating a pair of opposing jaw members. The jaw members are movable relative to one another from a first position, wherein the jaw members are disposed in a spaced apart relation relative to one another, to a second position, wherein the jaw members cooperate to grasp tissue therebetween. An ablation mechanism is connected to at least one of the jaws members, such that the jaw members are capable of conducting ablation energy through the tissue grasped therebetween.

Claims (27)

1. A medical device for evaluating transmurality of a lesion comprising:

an ablation device having a first and a second jaw, the first jaw including a sensor mechanism and the second jaw including an ablation element;

a jaw actuation mechanism for manipulating the first and the second jaw around a target tissue; and a temperature assessment mechanism for determining the temperature of the target tissue between the first jaw and the second jaw.
2. A medical device for evaluating transmurality of a lesion comprising:

a shaft assembly having malleability such that the shaft assembly retains a first shap until manipulated to a second shape;

a proximal jaw operably connected to the shaft assembly;
a sensor mechanism extending from the proximal jaw;

a handle assembly attached to the shaft assembly opposite the proximal jaw, the handle assembly being operably connected to the proximal jaw to move the sensor mechanism from a first position to a second position proximate an ablation site; and a temperature reading mechanism to measure temperature at the ablation site and at point opposite the ablation site.
3. The medical device according to claim 2, wherein the sensor mechanism includes a proximal and a distal sensor, the distal sensor including a distal jaw operably connected to the shaft assembly, wherein the distal jaw includes an ablation element.
4. The medical device according to claim 2, wherein the sensor mechanism further includes a removable reinforcement element.
5. The medical device according to claim 2, wherein the sensor mechanism includes a pair of impedance sensors.
6. The medical device according to claim 3, wherein the sensor mechanism includes temperature sensors.
7. The medical device according to claim 2, further comprising a jaw actuation mechanism for orienting the proximal jaw.
8. The medical device according to claim 7, wherein the jaw actuation mechanism further includes a force limiting mechanism for preventing tissue damage.
9. The medical device according to claim 7, wherein the jaw actuation mechanism allows the proximal jaw to be deflected in any direction.
10. The medical device according to claim 7, further comprising a control unit for controlling the jaw actuation mechanism.
11. The medical device according to claim 2, wherein the proximal jaw is removable.
12. The medical device according to claim 2, wherein the proximal jaw is slidable coupled to the shaft assembly.
13. A medical device having ablation and transmurality assessment capabilities comprising a malleable surgical clamp having transmurality capability, and a flexible ablation mechanism removably insertable within the surgical clamp.
14. The medical device of claim 13, wherein the removably insertable ablation mechanism includes a malleable shaft and imparts this malleability to a shaft assembly of the clamp.
15. The medical device of claim 13, wherein the removably insertable ablation mechanism further comprising a heat exchange mechanism operably located within the bod of the ablation mechanism.
16. The medical device of claim 13, wherein the removably insertable ablation mechanism further comprising an eyelet tip located at a distal end of the ablation mechanism
17. The medical device of claim 13, wherein the malleable surgical clamp comprises:
a shaft assembly;

a proximal jaw operably connected to the shaft assembly;
a sensor mechanism extending from the proximal jaw;

a handle assembly attached to the shaft assembly opposite the proximal jaw, the handle assembly being operably connected to the proximal jaw to move the sensor mechanism from a first position to a second position proximate an ablation site; and a temperature reading mechanism to assess temperature at the ablation site and at a point opposite the ablation site.
18. The medical device according to claim 17, wherein the sensor mechanism includes a proximal and a distal sensor, the distal sensor having a distal jaw operably connected to the shaft assembly, wherein the distal jaw includes an ablation element.
19. The medical device according to claim 17, wherein the sensor mechanism further includes a removable reinforcement element.
20. The medical device according to claim 17, wherein the sensor mechanism includes impedance sensors.
21. The medical device according to claim 18, wherein the sensor mechanism includes temperature sensors.
22. The medical device according to claim 17, further comprising a jaw actuation mechanism for orienting the proximal jaw.
23. The medical device according to claim 22, wherein the jaw actuation mechanism further includes a force limiting mechanism for preventing tissue damage.
24. The medical device according to claim 22, wherein the jaw actuation mechanism allows the proximal jaw to be deflected in any direction.
25. The medical device according to claim 22, further comprising a control unit for controlling the jaw actuation mechanism.
26. The medical device according to claim 17, wherein the proximal jaw is removable.
27. The medical device according to claim 17, wherein the proximal jaw is slidably coupled to the shaft assembly.
CA2564352A 2004-05-07 2005-05-06 Surgical clamp having transmurality assessment capabilities Active CA2564352C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US10/841,955 US7819860B2 (en) 2003-06-10 2004-05-07 Surgical clamp having trasmurality assessment capabilities
US10/841,955 2004-05-07
PCT/US2005/016122 WO2005110246A2 (en) 2004-05-07 2005-05-06 Surgical clamp having trasmurality assessment capabilities

Publications (2)

Publication Number Publication Date
CA2564352A1 true CA2564352A1 (en) 2005-11-24
CA2564352C CA2564352C (en) 2010-07-20

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Family Applications (1)

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CA2564352A Active CA2564352C (en) 2004-05-07 2005-05-06 Surgical clamp having transmurality assessment capabilities

Country Status (4)

Country Link
US (2) US7819860B2 (en)
EP (1) EP1755464B1 (en)
CA (1) CA2564352C (en)
WO (1) WO2005110246A2 (en)

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US20070149969A1 (en) 2007-06-28
WO2005110246A3 (en) 2007-05-03
EP1755464B1 (en) 2014-10-29
EP1755464A4 (en) 2011-01-05
CA2564352C (en) 2010-07-20
WO2005110246A2 (en) 2005-11-24
US7955325B2 (en) 2011-06-07
US7819860B2 (en) 2010-10-26
US20040254606A1 (en) 2004-12-16
EP1755464A2 (en) 2007-02-28

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