US20010007938A1 - Method and aparatus for automated biopsy and collection of soft tissue - Google Patents
Method and aparatus for automated biopsy and collection of soft tissue Download PDFInfo
- Publication number
- US20010007938A1 US20010007938A1 US09/790,134 US79013401A US2001007938A1 US 20010007938 A1 US20010007938 A1 US 20010007938A1 US 79013401 A US79013401 A US 79013401A US 2001007938 A1 US2001007938 A1 US 2001007938A1
- Authority
- US
- United States
- Prior art keywords
- balloon
- electrode
- electrosurgical instrument
- expandable sleeve
- balloon electrode
- 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.)
- Abandoned
Links
Images
Classifications
-
- 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
- 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
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
-
- 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
-
- 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
- A61B2018/00273—Anchoring means for temporary attachment of a device to tissue
- A61B2018/00279—Anchoring means for temporary attachment of a device to tissue deployable
- A61B2018/00285—Balloons
-
- 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
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00482—Digestive system
-
- 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
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00482—Digestive system
- A61B2018/00488—Esophagus
-
- 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
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00482—Digestive system
- A61B2018/00494—Stomach, intestines or bowel
-
- 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
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00553—Sphincter
-
- 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
- A61B2018/00898—Alarms or notifications created in response to an abnormal condition
-
- 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
- A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
Abstract
A bipolar electrosurgical instrument is described which may be used for heating the inner lining of a lumen or cavity within a patient. In particular, the present invention is directed to an electrosurgical instrument including a flexible elongated tube having a proximal and a distal end, a first balloon electrode attached to the distal end of the flexible elongated tube. The first balloon electrode includes a first expandable sleeve formed from an electrically insulating material and a first electrically conductive fluid in the expandable sleeve. A first electrode is positioned in electrical contact with the first electrically conductive fluid. A return balloon electrode is spaced proximally from the first balloon electrode, wherein the return balloon electrode includes a second expandable formed from an electrically insulating material and a second electrically conductive fluid disposed within the second expandable sleeve. A return electrode is positioned in electrical contact with the second electrically conductive fluid.
Description
- The present invention relates, in general, to an electrosurgical instrument for heating the inner lining of a lumen or cavity within a patient and, more particularly, a bipolar RF balloon electrosurgical instrument for the treatment of Barrett's Esophagus.
- The human body has a number of internal body lumens or cavities located within, many of which have an inner lining or layer. These inner linings can be susceptible to disease. In some cases, surgical intervention can be required to remove the inner lining in order to prevent the spread of a disease to otherwise healthy tissue located nearby.
- Barrett's Esophagus is a disease wherein the healthy inner mucosal lining (stratified squamous epithelium) of the esophagus is replaced with diseased tissue (abnormal columnar epithelium). Barrett's Esophagus results from chronic exposure of the mucosal lining to irritating gastric secretions. In gastroesophageal reflux disease (GERD) the lower esophageal sphincter fails to close properly and gastric secretions or reflux migrate upwards from the stomach to the lower portions of the esophagus exposing the esophagus to gastric secretions which may cause Barrett's Esophagus. The occasional exposure of the esophagus to gastric secretions is not harmful, but chronic exposure can irritate the mucosal lining and create abnormal mucosal cells. In a certain percentage of the population, the abnormal cells can be a precursor to the development of esophageal cancer. Esophageal cancer is one of the most lethal of all cancers and initial diagnosis is difficult without a visual inspection of the esophagus.
- Treatment of GERD ranges from the administration of anti acids in mild cases to surgery such as a Nissen fundoplication. The Nissen fundoplication requires surgical opening of the patient, and the wrapping and suturing of a portion of the stomach around the lower portion of the esophagus to create an esophageal sphincter. Due to age, health, severity of GERD, and other factors, not all patients are candidates for surgery such as the Nissen fundoplication. As a consequence, the medical profession has tended to treat GERD symptoms rather than eradicating the root cause.
- When a patient is diagnosed as having Barrett's Esophagus, the traditional treatment has been monitoring of the condition and, as a last resort, surgical removal of the diseased inner mucosal layer. Due to the location of the esophagus within the thoracic cavity and its' close proximity to the lungs, heart and other vascular structures, open surgery is a major undertaking.
- Medical experimentation has shown that heating or cooking the inner lining of an organ, body structure, or lumen results in the sloughing off of the heated inner lining and (in many cases) elimination of the disease condition. The mucosal inner lining regrows as healthy tissue if the underlying tissue is not diseased or damaged. There are a variety of methods of heating or cooking the inner lining such as the application of laser light, plasma, resistance heating, the application of warm fluids or warm objects, photodynamic therapy, microwaves, or the application of Radio Frequency (RF) energy to the tissue. An overview of several of these methods of treatment can be found in an article by Richard E. Sampliner entitled “New Treatments for Barrett's Esophagus” which was published inSeminars in Gastrointestinal Disease, Vol 8. No. 2 (April), 1997: pp 68-74.
- In the above list of possible methods of heating tissue for treatment of Barrett's Esophagus, the application of RF energy has special interest, and in particular, the use of a RF balloon surgical instrument to deliver the energy to a body lumen or cavity. As described in U.S. Pat. No. 2,032,859 by F. C. Wappler, a RF balloon is especially effective for superficial desiccation or heating of tissue, such as the inner layer or lining of a lumen or cavity. The RF balloon described by F.C. Wappler was of monopolar design. Monopolar RF balloon devices use a first pole ground pad placed upon the exterior of the patient and a second (mono)pole balloon electrode placed within the patient and in contact with the diseased tissue. The second pole balloon electrode has an expandable made from a dielectric or non-conducting material, is filled with a conductive fluid, and has an electrode adjacent to the balloon and in contact with the conductive fluid. When applying RF energy to the human body with a bipolar electrosurgical device, it is important to establish firm contact with the tissue to reduce the possibility of burns. The balloon electrode, when inflated within a lumen or cavity within the body, expands outwards to adjust to the irregular contours of the lumen or cavity and firmly contacts the diseased tissue. The use of a non-conducting balloon as the tissue contact surface does not allow the direct coupling of RF energy to the tissue but rather forms a capacitive coupling with the tissue. The capacitive coupling of RF energy results in a gentle heating of the tissue in contact with the balloon electrode.
- Whereas the Wappler bipolar RF balloon was indeed a breakthrough, the invention required the insertion of a limp or non-rigid balloon into a body lumen or cavity. Insertion of a non-rigid balloon into a muscular body cavity or lumen was difficult at best. Geddes et al. in U.S. Pat. No. 4,979,948 addressed this issue by describing a monopolar RF Balloon having a rigid elongated member extending longitudinally into the balloon. The elongated member is attached to the proximal base of the balloon and extends freely into the remainder of the balloon. This elongated member provides the necessary rigidity to support the un-inflated balloon during insertion into a body lumen or cavity. Additionally, the second pole electrode of this invention is placed around the elongated member extending within the balloon for contact with the electrolytic or conducting fluid used to expand the balloon.
- The Geddes et al. monopolar invention was indeed easier to insert into the patient, but the attachment of the base of the balloon to the elongated member left the proximal end of the balloon free to move relative to the elongated member. When the instrument is placed into a body lumen or cavity and the balloon is inflated, it is possible to bias the distal end of the balloon relative to the distal end of the supporting member. This moves the second pole electrode off center relative to the balloon and may result in uneven heating of the tissue closest to the second pole electrode.
- What was needed was an RF balloon instrument that reduces the possibilities of uneven tissue heating or balloon burn through. U.S. Pat. No. 4,7676,258 was issued to Kiyoshi Inokuchi et al. for a flexible monopolar balloon that attaches both proximally and distally to the distal end of a flexible shaft of the instrument. Whereas the Inokuchi et al. monopolar balloon utilized proximal and distal attachment of the balloon to the flexible shaft of the instrument, the monopolar design required the use of a second electrode that is placed on the outer circumference of the patient and the use of a constant flow of cooling fluid. An elongated resilient flexible electrode member (made from conductive material) that extends into an electrosurgical balloon is described in the F. C. Wappler U.S. Pat. No. 2,043,083.
- All RF balloon inventions described above are monopolar and require the use of a return pole electrode or pad placed in contact with the exterior of the patient. U.S. Pat. No. 5,578,008 was issued to Shinji Hara for a bipolar balloon catheter wherein both the proximal and the distal end of the RF balloon is attached to the catheter (rigid support member) and has both (bipolar) electrodes located within the balloon. The bipolar RF balloon is fixed relative to both the catheter and reduces the possibilities of uneven heating described above. The bipolar electrode design heats the cooling liquid within the balloon and the heated liquid heats the tissue in contact with the balloon.
- It is frequently difficult for a surgeon to access a surgical site, particularly when the goal is to access the surgical site without cutting or opening the patient. Atraumatic access is typically achieved by admitting the surgical instrument into the patient through a natural body orifice, and manipulating or maneuvering the surgical instrument to the desired location. Since the human body rarely has linear passageways or structures, access to a surgical site can require the surgical instrument to bend or flex. As the surgeon is manipulating the surgical instrument around corners to attain access to the surgical site, care must be taken to avoid traumatic tissue damage caused by the instrument. Thus, it would be advantageous to design an RF balloon end effector with a means to help guide the end effector around corners and, more particularly, to guide the end effector around corners when navigating a torturous lumen or passage. A U.S. Pat. No. 5,558,672 by Edwards et al. teaches a porous monopolar RF balloon that has viewing optics that extend from the distal end of the balloon.
- It would further be advantageous to provide the surgeon with a RF balloon electrosurgical instrument that can fit down the operating channel of an endoscope enabling the surgeon to visually place the balloon electrode at the surgical site. Shinji Hara in U.S. Pat. No. 5,578,008 and Jackson et al. in U.S. Pat. No. 4,676,258 describe the use of pulses or bursts to deliver energy from the electrosurgical generator to the balloon electrode. What is not disclosed in these inventions is the delivery of pulsed or burst RF electrical energy in a preset pattern to produce specific tissue effects.
- The present invention is directed to a bipolar electrosurgical instrument for heating the inner lining of a lumen or cavity within a patient. In particular, the present invention is directed to an electrosurgical instrument including a flexible elongated tube having a proximal and a distal end, a first balloon electrode attached to the distal end of the flexible elongated tube. The first balloon electrode includes a first expandable sleeve formed from an electrically insulating material and a first electrically conductive fluid in the expandable sleeve. A first electrode is positioned in electrical contact with the first electrically conductive fluid. A return balloon electrode is spaced proximally from the first balloon electrode, wherein the return balloon electrode includes a second expandable sleeve formed from an electrically insulating material and a second electrically conductive fluid disposed within the second expandable sleeve. A return electrode is positioned in electrical contact with the second electrically conductive fluid.
- Further embodiments of the present invention are directed to a bipolar electrosurgical instrument having some or all of the following characteristics. The first expandable sleeve is expanded such that a portion of the first expandable sleeve is in contact with a first portion of the inner lining and a portion of the second expandable sleeve is in contact with a second portion of the inner lining such that the second portion of the inner lining is at least twice as large in area as the first portion of the inner lining. The second expandable sleeve has a length L wherein a proximal end of the first expandable sleeve is positioned a distance of at least 2L from a distal end of the second expandable sleeve. The electrically insulating material has a lower electrical permeativity than the flexible elongated tube. A bipolar electrosurgical instrument wherein the instrument includes a non-conducting semi-rigid support extending distally within the expandable sleeve from a distal end of the flexible elongated tube.
- The novel features of the invention are set forth with particularity in the appended claims. The invention itself, however, both as to organization and methods of operation, together with further objects and advantages thereof, may best be understood by reference to the following description, taken in conjunction with the accompanying drawings in which:
- FIG. 1 is an isometric view of a bipolar electrosurgical instrument;
- FIG. 2 is an isometric view of a bipolar electrosurgical instrument wherein the electrosurgical instrument is attached to an endoscope;
- FIG. 3 is a side view of a locking mechanism locking the bipolar electrosurgical instrument about a shaft of the endoscope.
- FIG. 4 is a side view, of the balloon electrode illustrated in FIG. 3;
- FIG. 5 is a side view, in cross section, showing the elements of the balloon electrode of FIG. 4;
- FIG. 6 is an exploded isometric view of the balloon electrode illustrated in FIG. 5;
- FIG. 7 is a side view, in cross section, of the balloon electrode of FIG. 6 wherein the balloon electrode has been expanded;
- FIG. 8 is a side view, in cross section, of an alternate embodiment of the second pole balloon electrode;
- FIG. 9 is a side view, in cross section, of the alternate embodiment of the second pole balloon electrode showing the current flow patterns;
- FIG. 10 is a side view of the return balloon electrode of the bipolar electrosurgical instrument of FIG. 1;
- FIG. 11 is a side view, in cross section, of the return balloon electrode of FIG. 1 showing an expandable sleeve in an expanded position (dashed lines) and an unexpanded position (solid lines);
- FIG. 12 is a cross sectional view of the lower portion of the esophagus and the upper portion of the stomach showing a disease condition called Barrett's Esophagus;
- FIG. 13 is a cross sectional view of a patient wherein an endoscope has been inserted into the patient's mouth and esophagus to position an expanded balloon electrode and a return balloon electrode of the bipolar electrosurgical instrument at the surgical site;
- FIG. 14 is a cross sectional view of the lower portion of the esophagus and the upper portion of the stomach of FIG. 12 showing the placement of an expanded balloon electrode at the surgical site prior to treatment;
- FIG. 15 is a cross sectional view of the lower portion of the esophagus and the upper portion of the stomach of FIG. 12 showing the placement of the balloon electrode and the return balloon electrode of the bipolar electrosurgical instrument at the surgical site prior to treatment;
- FIG. 16 is a cross sectional view of the lower portion of the esophagus and the upper portion of the stomach of FIG. 12 showing the movement of the return balloon electrode of the bipolar electrosurgical instrument to a preferred spacing from the balloon electrode at the surgical site prior to treatment;
- FIG. 17 is a cross sectional view of a flexible return sleeve of the bipolar return sleeve of FIG. 16;
- FIG. 18 is a cross sectional view of the lower portion of the esophagus and the upper portion of the stomach of FIG. 12 showing the improved visibility that a translucent balloon electrode provides when visually positioning the balloon electrode at a preferred position at the surgical site;
- FIG. 19 is a cross sectional view of the lower portion of the esophagus and the upper portion of the stomach of FIG. 12 showing the improved visibility that a transparent balloon electrode provides when visually positioning the balloon electrode at a preferred position at the surgical site;
- FIG. 20 is a cross sectional view of a distal end of an alternate embodiment of the bipolar balloon electrode wherein a pair of balloons are located side by side to the longitudinal axis of the bipolar electrosurgical instrument;
- FIG. 21 is a side view of an alternate embodiment of the bipolar electrosurgical instrument having switchable balloons for selective lumen ablation;
- FIG. 22 is a view of a typical sinusoidal RF waveform produced by an electrosurgical generator for cauterizing tissue;
- FIG. 23 illustrates a current range produced by a typical continuous sinusoidal waveform from the electrosurgical generator; and
- FIG. 24 illustrates a burst mode output of an electrosurgical generator showing discreet bursts of energy with increased current.
- The present invention is directed to an electrosurgical instrument for heating a lumen or a cavity within a patient. In particular, the present invention is directed to a bipolar electrosurgical instrument for the treatment of Barrett's Esophagus. A bipolar electrosurgical instrument according to one embodiment of the present invention uses a plurality of RF balloon electrodes to heat an inner lining or layer of the esophagus to destroy diseased tissue, and to stimulate the regrowth of a new healthy inner lining. The embodiment illustrated is minimally invasive and requires the placement of the expandable RF balloon electrodes into contact with the inner lining of the esophagus for the application of RF electrical energy. One embodiment of a bipolar electrosurgical instrument60 is shown in FIGS. 1-6 and FIGS. 9-11. Methods of using such a bipolar electrosurgical instrument according to the present invention are illustrated generally shown FIGS. 13-17
- As illustrated in FIG. 1, bipolar electrosurgical instrument60 has a pair of expandable electrodes for placement within an inner lining of a lumen or cavity of a patient. Unlike monopolar electrosurgical balloon instruments, bipolar electrosurgical instruments do not have return electrodes placed on the exterior of the patient. The bipolar electrosurgical instrument 60 has two distinct elongated members, a
first pole member 70 and asecond pole member 90, each member having a balloon electrode near the distal end. Thefirst pole member 70 has aballoon electrode 70 a at the distal end of a flexibleelongated tube 71 and thesecond pole member 90 has areturn balloon electrode 90 a at a distal end of aflexible return sleeve 92. In one embodiment of the present invention, thereturn balloon electrode 90 a has at least twice the surface area of theballoon electrode 70 a to confine the tissue-heating effects to tissue directly adjacent toballoon electrode 70 a. - The
second pole member 90 has areturn sleeve body 100 at the proximal end of theflexible return sleeve 92 and thereturn balloon electrode 90 a at the distal end. The flexibleelongated tube 71 of thefirst pole member 70 is connected to thereturn sleeve body 100 of thesecond pole member 90 by aflexible coupling tube 104 for the passage of aconductive fluid 74, and afirst pole wire 105 for the conduction of electrical energy. -
Flexible return sleeve 92 and flexibleelongated tube 71 have hollow passageways for the passage ofconductive fluid 74 to the balloon electrodes (FIGS. 5 and 17), and electrical wiring or conductors to conduct RF electrical energy to the balloon electrodes. The electrical wiring and hollow passageways from the elongated members are brought together at thereturn sleeve body 100. A balloonelectrode fluid line 103 and a returnballoon fluid line 102 are attached to thereturn sleeve body 100 for the passage ofconductive fluid 74 to theballoon electrode 70 a and to thereturn balloon electrode 90 a, respectively, for the expansion of the balloon electrodes. The proximal ends of the balloonelectrode fluid line 103 and the returnballoon fluid line 102 are connected to a pressurizedfluid source 51 for the expansion of the balloon electrodes. Bipolar electrosurgical instrument 60 has aconnector cable 67 and an electrical connector 66 (FIG. 1) that are electrically connected to a RF generator 50 (FIG. 13). The RF (Radio Frequency)electrosurgical generator 50 provides RF energy to the electrosurgical instrument, preferably at a frequency between the range of 0.5 MHz to 20 MHz. Theconnector wire 67 is electrically connected to theballoon electrode 70 a by afirst pole wire 105 and to thereturn balloon electrode 90 a byfirst pole conductor 94. - As illustrated in FIGS. 2 and 3, the bipolar electrosurgical instrument60 is adapted for use with an
endoscope 40. Theendoscope 40 is commercially available and has a proximal endoscope handle 41 for the surgeon to grasp, a bendable orarticulatable endoscope shaft 42 extending distally from the endoscope handle 41 for insertion into a patient, and a hollowoperative channel 43 within theendoscope shaft 42. The hollowoperative channel 43 extends from anendoscope access port 45 to a distal end of theendoscope shaft 42 for the placement of surgical instruments within. The distal end of theendoscope shaft 42 has aviewing optics 44 located therein providing the surgeon with a view from the distal end of theendoscope 40. It is recommended that the bipolar electrosurgical instrument 60 be attached to theendoscope 40 prior to the placement of the endoscope into a patient 33 (FIG. 13). - The
second pole member 90 of the bipolar electrosurgical instrument 60 slideably mounts on the exterior of theendoscope shaft 42 by passing the distal end of theendoscopic shaft 42 into thehollow lumen 99 of theflexible return sleeve 92. Anattachment knob 101 is located on thereturn sleeve body 100 and rotation of theattachment knob 101 locks thesecond pole member 90 to theendoscope shaft 42. Theattachment knob 101 is attached to a threadedshaft 101 a (FIG. 3) that rotates in a threadedhole 100 a in thereturn sleeve body 100. Rotation of theknob 101 moves the threadedshaft 101 a inward into thebore 106 of thereturn sleeve body 100 and into contact with the exterior of theendoscope shaft 42. This contact locks thesecond pole member 90 to theendoscope shaft 42. - The
balloon electrode 70 a at the distal end of flexibleelongated tube 71 is placed into theendoscope access port 45 and emerges from the distal end of the operative channel 43 (FIG. 2) of theendoscope shaft 42 to expose theballoon electrode 70 a. It is important to note that theballoon electrode 70 a is spaced a distance “L” from thereturn balloon electrode 90 a wherein “L” is at least twice the longitudinal length of theballoon electrode 70 a. Theballoon electrodes - The
distal balloon electrode 70 a and the flexibleelongated tube 71 are shown in greater detail in FIGS. 4, 5, 6, and 9. Both theballoon electrode 70 a and the flexibleelongated tube 71 are filled with a conductive fluid 74 (FIG. 5) for the conduction of RF energy to tissue in contact with theballoon electrode 70 a. To ensure contact between theballoon electrode 70 a and the diseased inner lining of the esophagus, theballoon electrode 70 a has anexpandable sleeve 75 that is expanded by pressurizing theconductive fluid 74. - The elements of the
balloon electrode 70 a and the flexibleelongated tube 71 are illustrated in FIGS. 4, 5, and 6. Theballoon electrode 70 a of FIG. 4 has theexpandable sleeve 75 extending from the distal end of the flexibleelongated tube 71 and anend guide cap 80 attached to the distal end of theexpandable sleeve 75. Ideally, theexpandable sleeve 75 is formed from silicone, polyurethane, polyethylene, polypropylene, Teflon, or any one of a number of elastic or semi-elastic engineering materials with low electrical conductivity (e.g. acts as an electrical isolator) and heat resistant properties. The flexibleelongated tube 71 is formed from a flexible engineering thermoplastic such as nylon, polyurethane, polyethylene, polypropylene, Teflon and the like. Theexpandable sleeve 75 has a lower electrical permeativity than the flexibleelongated tube 71. This can be accomplished by a judicious use of materials or, if the same material is used for both elements, a thinner cross section is used with theexpandable sleeve 75. Theexpandable sleeve 75 is hermetically attached to the end guide cap by adistal retaining sleeve 77 and to the flexibleelongated tube 71 by a proximal retainingsleeve 76. Whereas the illustrated embodiment uses a heat shrinkable tubing for the distal retainingsleeve 77 and the proximal retainingsleeve 76, other hermetic attachment methods are available such as glue, heat staking, crimp fittings, and the like. The flexibleelongated tube 71, theexpandable sleeve 75, and theend guide cap 80, of the illustrated embodiment are filled with a conductive fluid 74 (Figures) such as saline and the like for the conduction of electricity from afirst pole electrode 72 into theexpandable sleeve 75. - FIG. 5 shows a cross section view of the
balloon electrode 70 a and the elements within flexibleelongated tube 71 and FIG. 6 shows an exploded view of these elements. Ahollow spacer tube 78 is fixed (not shown) longitudinally within the flexibleelongated tube 71. Afirst pole electrode 72 is fixedly attached about thespacer tube 78 and is located within and proximally recessed from both the distal end of the flexibleelongated tube 71 and theexpandable sleeve 75. Thefirst pole electrode 72 is formed from wire braid and is electrically connected to theelectrical connector 66 and the RF electrosurgical generator 50 (FIG. 13). - A non-conductive
semi-rigid support 73 extends from theflexible spacer tube 78 and into theend guide cap 80. Thesemi-rigid support 73 of the illustrated embodiment is a non-conductive spring formed from the distal end of thespacer tube 78. It should be obvious to one skilled in the art that thesemi-rigid support 73 can be formed as a separate piece distinct fromspacer tube 78. Theend guide cap 80 has an annularinner ring 81 for the reception of thesemi-rigid support 73. Theinner ring 81 is hermetically attached to a rigid or semi-rigid guide cap plug 82 and theexpandable sleeve 75 by the distal retainingsleeve 77. - The guide cap plug82 and the distal retaining
sleeve 77 of theend guide cap 80, are rounded to provide an atraumatic tissue contact surface upon the distal end of theballoon electrode 70 a. The non-conductivesemi-rigid support 73 attaches theend guide cap 80 to the flexibleelongated tube 71 and deflects to reduce possible tissue impact trauma. Additionally, the non-conductivesemi-rigid support 73 bends the balloon electrode to the shape of the lumen or cavity and around corners when maneuvering a torturous lumen or passage. - FIG. 7 is a cross sectional view of the
balloon electrode 70 a showing theexpandable sleeve 75 in the expanded position. Pressurizing theconductive fluid 74 with a pressurizable fluid source 51 (FIGS. 1 and 2) forces additionalconductive fluid 74 into the flexibleelongated tube 71 and thehollow spacer tube 78 and expands theexpandable sleeve 75. The pressurizablefluid source 51 can be a pressurized saline line such as found in an operating room, aconductive fluid 74 filled hypodermic, aconductive fluid 74 filled pressure squeeze bulb, or any other apparatus or method of delivering additionalconductive fluid 74 to theexpandable sleeve 75. - FIGS. 8 and 9 illustrate an alternate embodiment of the
balloon electrode 70 a shown in FIG. 7. In FIG. 8, the recessed first pole electrode 72 (FIG. 7) is replaced with an isolatedfirst pole electrode 85 within the non-conductivesemi-rigid support 73. In the illustrated embodiment of the alternate design the isolatedfirst pole electrode 85 is a conductive material attached to an inner surface 73 a of thesemi-rigid support 73. The such isolatedfirst pole electrode 85 can be a layer of conductive plating or a thin layer of metal such as silver, copper, aluminum, or any other conductive material adhered to or placed within the inner surface 73 a of thesemi-rigid support 73. Aninsulated electrode wire 86 electrically connects the isolatedfirst pole electrode 85 to the first pole wire 105 (FIG. 2). During operation, thesemi-rigid support 73 acts as a protective isolator for isolatedfirst pole electrode 85 and prevents possible damage to theexpandable sleeve 75. It is also obvious to one skilled in the art to replace the conductive plating or layer of metal of the isolatedfirst pole electrode 85 with a metallic form such as a conductive spring of proper length and diameter to lie within thesemi-rigid support 73. - FIG. 9 is a section view of the
inflated balloon electrode 70 a of the alternate embodiment wherein the bipolar electrosurgical instrument 60 is energized. It is important to note that the isolatedfirst pole electrode 85 is spaced away from the proximal and distal ends of theexpandable sleeve 75 and is centered in the areas of maximum saline volume. This is done to confine the current flow to the areas adjacent to the areas of maximum saline volume and to eliminate possible hot spots in theballoon electrode 70 a. Acurrent flow pattern 87 is shown emanating from thespiral opening 73 b of thesemi-rigid support 73. As shown in the cross section of FIG. 9, thecurrent flow pattern 87 is emitted in the shape of a truncated cone through thespiral opening 73 b and flows from the inner surface 73 a outwards through thespiral opening 73 b. Thespiral opening 73 b in the non-conductingsemi-rigid support 73 bleeds off the high energy density created within thesemi-rigid support member 73. Whereas the illustrated embodiment has thespiral opening 73 b in thesemi-rigid support 73, it is within the scope of the present invention to use a number of openings of sufficient size to bleed off the high energy density in the manner described above. - The elements of the expandable
return balloon electrode 90 a are shown in FIGS. 10, 11, and 17. Thereturn balloon electrode 90 a has an outer expandablereturn balloon sleeve 95 that forms a proximal and a distal hermetic seal with theflexible return sleeve 92, and asecond pole electrode 91 within. It is important to note that the expandablereturn balloon sleeve 95 of the expandablereturn balloon electrode 90 a has at least twice the surface area of theexpandable sleeve 75 of theballoon electrode 70 a.Second pole electrode 91 is electrically isolated from contact with the patient 33 by the expandablereturn balloon sleeve 95 and theflexible return sleeve 92. The expandablereturn balloon sleeve 95 can be formed from the same materials as theexpandable sleeve 75 described above and has a lower electrical permeativity than the flexibleelongated tube 71 and theflexible return sleeve 92. Afluid passage 93 and afirst pole conductor 94 run longitudinally within theflexible return sleeve 92 which is formed from a flexible engineering thermoplastic such as nylon, polyurethane, polyethylene, or the like (FIG. 17). Thefluid passage 93 connects thereturn balloon electrode 90 a with thereturn sleeve body 100 and the returnballoon fluid line 102 for the passage of pressurized conductive fluid 74 to inflate thereturn balloon electrode 90 a (dashed lines in FIG. 11). Thefirst pole conductor 94 is electrically connected to theelectrical connector 66 by thesecond pole electrode 91 and theconnector cable 67 for the passage of RF energy. Adistal sleeve 98 and aproximal sleeve 97 are used to attach and hermetically seal the expandablereturn balloon sleeve 95 to theflexible return sleeve 92. Like the balloon sleeve attachment methods described above, the expandablereturn balloon sleeve 95 is attached using heat shrinkable tubing (for the distal retainingsleeve 77 and the proximal retaining sleeve 76). Other hermetic attachment methods are available such as glue, heat staking, crimp fittings and the like. - FIG. 12 is a cross section view of the
lower esophagus 25 and the upper portion of thestomach 27 showing the diseased inner lining of theesophagus 25, henceforth referred to as Barrett's Esophagus. Barrett's Esophagus is identified by a change in the mucosalinner lining 29 of theesophagus 25. The chronic exposure of theinner lining 29 to gastric secretions that leak past a defective loweresophageal sphincter 28 changes the healthy epithelium of theinner lining 29 to a diseasedcolumnar epithelium 30. A possibly pre-canceroussquamous epithelium 31 condition of theinner lining 29 is also shown. A circularesophageal muscle 32 lies beneath theinner lining 29 of theesophagus 25. - FIG. 13 is a section view of the
patient 33, showing theendoscope shaft 42 of theendoscope 40 insertion into themouth 26 and esophagus of apatient 33. The bipolar electrosurgical instrument 60 is attached to the endoscope and theballoon electrode 70 a is extending distally from the operative channel 43 (FIG. 2) of theendoscope 40. Theexpandable sleeve 75 of theballoon electrode 70 a is expanded into contact with theinner lining 29 of theesophagus 25 by the connection of the balloonelectrode fluid line 103 to the pressurizablefluid source 51. Theendoscope shaft 42 is curved to place the un-expandedreturn balloon electrode 90 a into contact with theinner lining 29 of theesophagus 25 to provide the return path for the electrical energy. Thereturn balloon electrode 90 a is larger in diameter than theballoon electrode 70 a and need not be expanded if enough surface area of the expandablereturn balloon sleeve 95 is in contact with tissue. Theelectrical connector 66 of the bipolar electrosurgical instrument 60 is connected to theRF electrosurgical generator 50. - FIG. 14 shows the placement of the
balloon electrode 70 a at the site of thecolumnar epithelium 30 prior to the application of RF energy to the diseased area of theinner inning 29. Theballoon electrode 70 a is visible in aviewing angle 46 of theviewing optics 44 and the surgeon has visually maneuvered theballoon electrode 70 a into contact with thecolumnar epithelium 30. Ideally, this maneuvering is done prior to the expansion of theexpandable sleeve 75. Theexpandable sleeve 75 is shown expanded to contact the diseasedcolumnar epithelium 30. - FIGS. 15 and 16 shows the placement of the
return balloon electrode 90 a of the bipolar electrosurgical instrument 60 just prior to the application of RF energy. Both theballoon electrode 70 a and thereturn balloon electrode 90 a are expanded and in contact with tissue. In FIG. 16, theballoon electrode 70 a is contacting thecolumnar epithelium 30 found on the inner lining of theesophagus 25 and thereturn balloon electrode 90 a is moving from the initial position shown in FIG. 15 to the final position shown in FIG. 16. This movement spaces thereturn balloon electrode 90 a the previously described distance “L” from theballoon electrode 70 a and the effects of this action will now be described. - There is a threshold of energy density in tissue that must be met before tissue effects can occur. When the energy density is below the threshold, the tissue is unaffected by the application of energy. When the energy density rises above the threshold, the tissue is affected by the energy and begins to heat or cook. With the illustrated bipolar electrosurgical surgical instrument60, the energy density is spread between the two
balloon electrodes distal balloon electrode 70 a and dilute the energy density at the larger proximalreturn balloon electrode 90 a. - This is accomplished in two ways, first, the
return balloon electrode 90 a is at least twice as large as theballoon electrode 70 a and second, thereturn balloon electrode 90 a must be spaced at least the distance “L” (described above) from thedistal balloon electrode 70 a. In bipolar balloon energy devices, energy density is distributed evenly per unit of surface area on each balloon and likewise within adjacent surrounding tissue. Since thereturn balloon electrode 90 a has twice the surface area of theballoon electrode 70 a, the energy density in the tissue directly adjacent to returnballoon electrode 90 a is half of that found near theballoon electrode 70 a and below the threshold of energy density necessary to heat tissue. The energy density in tissue directly adjacent to thesmaller balloon electrode 70 a is twice that of thereturn balloon electrode 90 a and over the energy density threshold to heat tissue. - Electrical energy seeks the shortest path, and separating the balloon electrodes spreads the energy densities found in tissue located directly between the two balloon electrodes to below the energy density threshold. When the path between the balloon electrodes is short, the energy tries to flow from the closest surface to the closest surface and the energy density is concentrated or funneled into the tissue between the balloon electrodes. This heats tissue directly in the path between the two balloon electrodes. Separating the balloon electrodes has the effect of spreading the current density out in the tissue directly between the balloon electrodes and concentrating the energy density in the tissue adjacent to the balloon electrodes. This ensures that the smallest of the two balloon electrodes,
distal balloon electrode 70 a, has the highest current density surrounding it to confine tissue-heating effects to tissue directly adjacent toballoon electrode 70 a. If the two balloon electrodes are spaced apart at a distance less than “L”, then the surgeon runs the risk of shifting the highest current density to the tissue between the balloon electrodes and moving the tissue heating effects away from thesmaller balloon electrode 70 a. - The
balloon electrode 70 a and thereturn balloon electrode 90 a are shown in the expanded condition by the connection of the first pole fluid line (FIG. 9 and 10) and the flexibleelongated tube 71 to the pressurizable fluid source 51 (FIG. 10). Electrical energy is applied to thesecond pole electrode 91 and thefirst pole electrode 72 to gently heat (not shown) theinner lining 29 surrounding theballoon electrode 70 a by capacitive coupling. After the application of electrical energy to heat the tissue, theballoon electrode 70 a and thereturn balloon electrode 90 a are deflated and the bipolar electrosurgical instrument is removed from the patient (not shown). - FIGS. 18 and 19 shows alternate embodiments of the
balloon electrode 70 a of the bipolar electrosurgical instrument 60 wherein theexpandable sleeve 75 is made from a translucent or transparent material such as silicone, polyurethane, polyethylene, polypropylene, Teflon, or the like. The translucent expandable sleeve 111 (FIG. 18) provides increased visibility of the surgical site during placement of theballoon electrode 70 a by enabling the surgeon to view through the translucentexpandable sleeve 111. Additionally, tissue-heating effects can be monitored through the translucentexpandable sleeve 111. As shown in FIG. 19, a transparentexpandable sleeve 110 would offer even greater visibility over the translucentexpandable sleeve 111 and could be formed from the same materials listed above. - FIG. 20 is a cross sectional view along the longitudinal axis of an alternate embodiment of a bipolar dual balloon end effector120. Instead of a
single balloon electrode 70 a at the distal end of the flexibleelongated tube 71, the dual balloon end effector 120 of the alternate embodiment has a pair of expandable electrodes side by side in a longitudinal orientation. FIG. 20 is a cross sectional view taken perpendicular to the longitudinal axis of the dual balloon end effector 120 and shows a cross section of a firstpole balloon electrode 125 on the left and a cross section of a secondpole balloon electrode 130 on the right. Firstpole balloon electrode 125 and secondpole balloon electrode 130 are separated by anisolator wall 121 to prevent contact between the balloon electrodes and are backed by aproximal end plate 122. Eachballoon electrode pole balloon electrode 125 has a firstpole balloon sleeve 126 that is expandable by the addition of conductive fluid 74 from the pressurizablefluid source 51. Theconductive fluid 74 is conducted into the firstpole balloon sleeve 126 by a firstpole fluid passage 127 that extends through the flexibleelongated tube 71 that is connected to the pressurizablefluid source 51. A firstdual electrode 128 is recessed into theproximal end plate 122 for the delivery of electrical energy to the first pole balloon electrode. Like the mirror imagefirst pole electrode 125 described above, thesecond pole electrode 130 has a secondpole balloon sleeve 131, a secondpole fluid passage 132, and a seconddual electrode 133. The application of RF energy to bipolar dual balloon end effector 120 heats the adjacent tissue by capacitive coupling much in the manner described above. Heating effects from this design are more pronounced along a horizontal plane that runs through the firstdual electrode 128 and second poleballoon fluid passage 132. Less heating is found along a vertical plane established by theisolator wall 121. This type of end effector provides the surgeon with localized and opposite lobes of heating which can leave healthy tissue between the lobes unscathed. - FIG. 25 shows yet another alternative embodiment of an alternate bipolar
electrosurgical instrument 140 wherein the alternate embodiment has a multiplicity of expandable electrodes spaced longitudinally along the longitudinal axis of the alternate bipolarelectrosurgical instrument 140. In FIG. 21, three balloon electrodes are shown,distal balloon electrode 70 a,return balloon electrode 90 a, and analternate balloon electrode 141 located proximally fromreturn balloon electrode 90 a. A switching network 142 is provided to switch the application of bipolar RF energy from thedistal balloon electrode 70 a and thereturn balloon electrode 90 a to thealternate balloon electrode 141 and thereturn balloon electrode 90 a. This switching effectively enables the surgeon to move the application of RF energy from the distalmost balloon electrode 70 a to the proximal mostalternate balloon electrode 141 without moving the bipolar electrosurgical instrument 120. It is important to note that the centralreturn balloon electrode 90 a is at least twice the size of the proximalalternate balloon electrode 141 and thedistal balloon electrode 70 a. Also of note is the distance “L” between the pair of selected balloon electrodes is at least twice the longitudinal length of thereturn balloon electrode 90 a oralternate balloon electrode 141. This ensures that the smaller of the two balloon electrodes selected has the highest current density surrounding it to confine tissue-heating effects to tissue directly adjacent to the smaller balloon electrode. - In yet another embodiment of the invention and as shown in FIGS.22-24 the output of the
RF electrosurgical generator 50 to the bipolar balloon electrodes is altered from a continuous sinusoidal output 150 (FIG. 22) to a pulsed “burst” mode 155 (FIG. 24). The output of aRF generator 51 in cautery mode is a continuoussinusoidal output 150 of a frequency dependent on the generator and at a typical current of 0.75 to 1 amps (FIG. 23). In “burst”mode 155, thesinusoidal output 150 of the generator is retained but the application of the waveform to tissue is broken up into discreet “bursts” or pulses of energy separated by periods of no energy application. The bursts ofenergy 156 are applied for approximately 2-100 milliseconds, and most preferably around 10 milliseconds. The bursts ofenergy 156 are applied at a rate of 2 to 500 Hz and most preferably between 50-100 Hz. The current 151 applied during the pulse is increased to between 1.5 to 5 amps and most preferably at 2 amps. Providing bursts of increased current 151 results in the average power being kept between 2-100 watts and most preferably below 20 watts. By providing short bursts ofenergy 156 of higher current 151, the net energy applied to the tissue is less or equal to the energy applied by the steadysinusoidal output 150 of an unmodified RF generator. - Testing has shown that the application of pulsed RF energy in the manner described above results in decreased internal heating of the conductive fluid within the balloon electrode, and limits the depth of penetration of the RF energy into the wall of the lumen. Additionally, tissue effects produced by the bursts of
energy 156 are visually different from tissue treated with a continuousoutput sinusoidal waveform 150, and have more of a “sunburned tissue” effect than the more typical “cooked tissue” effect produced by the application of continuous sinusoidal RF energy. - While preferred embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. Accordingly, it is intended that the invention be limited only by the spirit and scope of the appended claims.
Claims (11)
1. A bipolar electrosurgical instrument for heating the inner lining of a lumen or cavity within a patient, said electrosurgical instrument comprising:
a flexible elongated tube having a proximal and a distal end;
a first balloon electrode attached to said distal end of said flexible elongated tube wherein said first balloon electrode comprises:
a first expandable sleeve formed from an electrically insulating material;
a first electrically conductive fluid in said expandable sleeve
a first electrode in electrical contact with said first electrically conductive fluid;
a return balloon electrode spaced proximally from said first balloon electrode, wherein said return balloon electrode comprises:
a second expandable sleeve formed from an electrically insulating material;
a second electrically conductive fluid disposed within said second expandable sleeve; and
a return electrode in electrical contact with said second electrically conductive fluid.
2. A bipolar electrosurgical instrument according to , wherein said first expandable sleeve is expanded such that a portion of said first expandable sleeve is adapted to be in contact with a first portion of said inner lining and a portion of said second expandable sleeve is adapted to be in contact with a second portion of said inner lining, wherein said second portion of said inner lining is at least twice as large in area as said first portion of said inner lining.
claim 1
3. A bipolar electrosurgical instrument according to , wherein said second expandable sleeve has a length L and wherein a proximal end of said first expandable sleeve is positioned a distance of at least 2L from a distal end of said second expandable sleeve.
claim 2
4. A bipolar electrosurgical instrument according to wherein said electrically insulating material has a lower electrical permeativity than said flexible elongated tube.
claim 2
5. A bipolar electrosurgical instrument according to further comprising a non-conducting semi-rigid support extending distally within said expandable sleeve from a distal end of said flexible elongated tube.
claim 1
6. A bipolar electrosurgical instrument according to wherein said non-conducting semi-rigid support is a spring.
claim 5
7. A bipolar electrosurgical instrument according to further comprising an end guide cap attached to a distal end of said expandable sleeve and a distal end of said non-conducting semi-rigid support, said guide cap for guiding said electrosurgical instrument into said lumen or cavity.
claim 5
8. A bipolar electrosurgical instrument according to wherein said first electrode is located within and recessed proximally from said distal end of said flexible elongated tube.
claim 1
9. A bipolar electrosurgical instrument according to wherein said first electrode is a braided metallic wire.
claim 8
10. A bipolar electrosurgical instrument according to wherein said first expandable sleeve includes a conductive coating on an inner surface thereof.
claim 1
11. A bipolar electrosurgical instrument according to wherein the electrical energy applied to said first balloon electrode is radio frequency energy at a frequency of 0.5 MHz. to 20 MHz.
claim 1
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/790,134 US20010007938A1 (en) | 1999-06-29 | 2001-02-21 | Method and aparatus for automated biopsy and collection of soft tissue |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/342,945 US6238392B1 (en) | 1999-06-29 | 1999-06-29 | Bipolar electrosurgical instrument including a plurality of balloon electrodes |
US09/790,134 US20010007938A1 (en) | 1999-06-29 | 2001-02-21 | Method and aparatus for automated biopsy and collection of soft tissue |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/342,945 Continuation US6238392B1 (en) | 1999-06-29 | 1999-06-29 | Bipolar electrosurgical instrument including a plurality of balloon electrodes |
Publications (1)
Publication Number | Publication Date |
---|---|
US20010007938A1 true US20010007938A1 (en) | 2001-07-12 |
Family
ID=23343981
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/342,945 Expired - Lifetime US6238392B1 (en) | 1999-06-29 | 1999-06-29 | Bipolar electrosurgical instrument including a plurality of balloon electrodes |
US09/790,134 Abandoned US20010007938A1 (en) | 1999-06-29 | 2001-02-21 | Method and aparatus for automated biopsy and collection of soft tissue |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/342,945 Expired - Lifetime US6238392B1 (en) | 1999-06-29 | 1999-06-29 | Bipolar electrosurgical instrument including a plurality of balloon electrodes |
Country Status (6)
Country | Link |
---|---|
US (2) | US6238392B1 (en) |
EP (1) | EP1064886B1 (en) |
JP (1) | JP2001037773A (en) |
AU (1) | AU766781C (en) |
CA (1) | CA2312539C (en) |
DE (1) | DE60030044T2 (en) |
Cited By (13)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20040098017A1 (en) * | 2002-09-30 | 2004-05-20 | Advanced Polymers, Incorporated | Apparatus and methods for bone, tissue and duct dilatation |
US20070288001A1 (en) * | 2006-06-12 | 2007-12-13 | Pankaj Patel | Endoscopically introducible expandable cautery device |
US20080275445A1 (en) * | 2007-05-04 | 2008-11-06 | Barrx Medical, Inc. | Method and apparatus for gastrointestinal tract ablation for treatment of obesity |
US20090012512A1 (en) * | 2007-07-06 | 2009-01-08 | Utley David S | Method and Apparatus for Gastrointestinal Tract Ablation to Achieve Loss of Persistent and/or Recurrent Excess Body Weight Following a Weight-Loss Operation |
CN104602632A (en) * | 2012-06-26 | 2015-05-06 | 柯惠有限合伙公司 | Ablation device having an expandable chamber for anchoring the ablation device to tissue |
US9358372B2 (en) | 2011-03-25 | 2016-06-07 | Vention Medical Advanced Components, Inc. | Apparatus and methods for accessing and dilating bone structures using a narrow gauge cannula |
US20160183963A1 (en) * | 2010-02-09 | 2016-06-30 | Medinol Ltd. | Device for Traversing Vessel Occlusions and Method of Use |
WO2017074920A1 (en) * | 2015-10-27 | 2017-05-04 | Mayo Foundation For Medical Education And Research | Devices and methods for ablation of tissue |
US9782572B2 (en) | 2002-09-30 | 2017-10-10 | Nordson Corporation | Apparatus and methods for treating bone structures, tissues and ducts using a narrow gauge cannula system |
US10314647B2 (en) | 2013-12-23 | 2019-06-11 | Medtronic Advanced Energy Llc | Electrosurgical cutting instrument |
US10426923B2 (en) | 2014-02-03 | 2019-10-01 | Medinol Ltd. | Catheter tip assembled with a spring |
US10813686B2 (en) | 2014-02-26 | 2020-10-27 | Medtronic Advanced Energy Llc | Electrosurgical cutting instrument |
US10850065B2 (en) | 2010-02-09 | 2020-12-01 | Medinol Ltd. | Catheter tip assembled with a spring |
Families Citing this family (139)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6464697B1 (en) * | 1998-02-19 | 2002-10-15 | Curon Medical, Inc. | Stomach and adjoining tissue regions in the esophagus |
WO2001045878A2 (en) * | 1999-10-25 | 2001-06-28 | Tei Tooling & Equipment International | Apparatus and method for casting |
US20060095032A1 (en) | 1999-11-16 | 2006-05-04 | Jerome Jackson | Methods and systems for determining physiologic characteristics for treatment of the esophagus |
AU780278B2 (en) | 1999-11-16 | 2005-03-10 | Covidien Lp | System and method of treating abnormal tissue in the human esophagus |
US20040215235A1 (en) | 1999-11-16 | 2004-10-28 | Barrx, Inc. | Methods and systems for determining physiologic characteristics for treatment of the esophagus |
US7089054B2 (en) * | 2002-10-02 | 2006-08-08 | Standen Ltd. | Apparatus and method for treating a tumor or the like |
AU6314301A (en) * | 2000-11-16 | 2002-05-27 | Robert A Ganz | System and method of treating abnormal tissue in the human esophagus |
US6907295B2 (en) | 2001-08-31 | 2005-06-14 | Biocontrol Medical Ltd. | Electrode assembly for nerve control |
US6838074B2 (en) | 2001-08-08 | 2005-01-04 | Bristol-Myers Squibb Company | Simultaneous imaging of cardiac perfusion and a vitronectin receptor targeted imaging agent |
US6907297B2 (en) * | 2001-09-28 | 2005-06-14 | Ethicon, Inc. | Expandable intracardiac return electrode and method of use |
US7756583B2 (en) | 2002-04-08 | 2010-07-13 | Ardian, Inc. | Methods and apparatus for intravascularly-induced neuromodulation |
US8347891B2 (en) | 2002-04-08 | 2013-01-08 | Medtronic Ardian Luxembourg S.A.R.L. | Methods and apparatus for performing a non-continuous circumferential treatment of a body lumen |
US20120303080A1 (en) * | 2003-06-13 | 2012-11-29 | Bio Control Medical (B.C.M.) Ltd. | Parasympathetic nerve stimulation |
US20060167445A1 (en) | 2002-08-27 | 2006-07-27 | Gal Shafirstein | Selective conductive interstitial thermal therapy device |
US6780177B2 (en) * | 2002-08-27 | 2004-08-24 | Board Of Trustees Of The University Of Arkansas | Conductive interstitial thermal therapy device |
DE10327237A1 (en) * | 2003-06-17 | 2005-01-13 | Trumpf Medizin Systeme Gmbh + Co. Kg | Electrosurgical instrument for an endoscope |
EP3045136B1 (en) | 2003-09-12 | 2021-02-24 | Vessix Vascular, Inc. | Selectable eccentric remodeling and/or ablation of atherosclerotic material |
US7150745B2 (en) | 2004-01-09 | 2006-12-19 | Barrx Medical, Inc. | Devices and methods for treatment of luminal tissue |
WO2006000888A2 (en) | 2004-06-23 | 2006-01-05 | Trod Medical | Flexible endoscope for endo luminal access radio frequency tumor ablation |
US9713730B2 (en) | 2004-09-10 | 2017-07-25 | Boston Scientific Scimed, Inc. | Apparatus and method for treatment of in-stent restenosis |
US8396548B2 (en) | 2008-11-14 | 2013-03-12 | Vessix Vascular, Inc. | Selective drug delivery in a lumen |
US8920414B2 (en) | 2004-09-10 | 2014-12-30 | Vessix Vascular, Inc. | Tuned RF energy and electrical tissue characterization for selective treatment of target tissues |
EP2438877B1 (en) | 2005-03-28 | 2016-02-17 | Vessix Vascular, Inc. | Intraluminal electrical tissue characterization and tuned RF energy for selective treatment of atheroma and other target tissues |
US7803156B2 (en) | 2006-03-08 | 2010-09-28 | Aragon Surgical, Inc. | Method and apparatus for surgical electrocautery |
US8728072B2 (en) | 2005-05-12 | 2014-05-20 | Aesculap Ag | Electrocautery method and apparatus |
US9339323B2 (en) | 2005-05-12 | 2016-05-17 | Aesculap Ag | Electrocautery method and apparatus |
US8696662B2 (en) | 2005-05-12 | 2014-04-15 | Aesculap Ag | Electrocautery method and apparatus |
US7862565B2 (en) | 2005-05-12 | 2011-01-04 | Aragon Surgical, Inc. | Method for tissue cauterization |
US7959627B2 (en) | 2005-11-23 | 2011-06-14 | Barrx Medical, Inc. | Precision ablating device |
US8702694B2 (en) | 2005-11-23 | 2014-04-22 | Covidien Lp | Auto-aligning ablating device and method of use |
US7997278B2 (en) | 2005-11-23 | 2011-08-16 | Barrx Medical, Inc. | Precision ablating method |
US8019435B2 (en) | 2006-05-02 | 2011-09-13 | Boston Scientific Scimed, Inc. | Control of arterial smooth muscle tone |
US8574229B2 (en) | 2006-05-02 | 2013-11-05 | Aesculap Ag | Surgical tool |
US20070287994A1 (en) * | 2006-06-12 | 2007-12-13 | Pankaj Amrit Patel | Endoscopically Introducible Expandable Bipolar Probe |
AU2007310991B2 (en) | 2006-10-18 | 2013-06-20 | Boston Scientific Scimed, Inc. | System for inducing desirable temperature effects on body tissue |
ES2560006T3 (en) | 2006-10-18 | 2016-02-17 | Vessix Vascular, Inc. | Induction of desirable temperature effects on body tissue |
US8496653B2 (en) | 2007-04-23 | 2013-07-30 | Boston Scientific Scimed, Inc. | Thrombus removal |
US8784338B2 (en) | 2007-06-22 | 2014-07-22 | Covidien Lp | Electrical means to normalize ablational energy transmission to a luminal tissue surface of varying size |
BRPI0813579A2 (en) | 2007-07-06 | 2014-12-30 | Barrx Medical Inc | Methods for treating a bleeding area in a gastrointestinal tract and ablatively treating a target site within a bleeding area of a gastrointestinal tract and ablation system. |
US8273012B2 (en) | 2007-07-30 | 2012-09-25 | Tyco Healthcare Group, Lp | Cleaning device and methods |
US8646460B2 (en) | 2007-07-30 | 2014-02-11 | Covidien Lp | Cleaning device and methods |
US8870867B2 (en) | 2008-02-06 | 2014-10-28 | Aesculap Ag | Articulable electrosurgical instrument with a stabilizable articulation actuator |
US8483831B1 (en) | 2008-02-15 | 2013-07-09 | Holaira, Inc. | System and method for bronchial dilation |
EP2265196B9 (en) | 2008-03-31 | 2013-10-02 | Applied Medical Resources Corporation | Electrosurgical system with means for measuring permittivity and conductivity of tissue |
CN102014779B (en) | 2008-05-09 | 2014-10-22 | 赫莱拉公司 | Systems, assemblies, and methods for treating a bronchial tree |
US8540708B2 (en) * | 2008-10-21 | 2013-09-24 | Hermes Innovations Llc | Endometrial ablation method |
WO2010056745A1 (en) | 2008-11-17 | 2010-05-20 | Minnow Medical, Inc. | Selective accumulation of energy with or without knowledge of tissue topography |
US8551096B2 (en) | 2009-05-13 | 2013-10-08 | Boston Scientific Scimed, Inc. | Directional delivery of energy and bioactives |
CN112089394A (en) * | 2009-10-27 | 2020-12-18 | 努瓦拉公司 | Delivery device with coolable energy emitting assembly |
WO2011060200A1 (en) | 2009-11-11 | 2011-05-19 | Innovative Pulmonary Solutions, Inc. | Systems, apparatuses, and methods for treating tissue and controlling stenosis |
BR112012003356B1 (en) | 2010-02-04 | 2021-02-02 | Aesculap Ag | electrosurgical device |
US8419727B2 (en) | 2010-03-26 | 2013-04-16 | Aesculap Ag | Impedance mediated power delivery for electrosurgery |
US8827992B2 (en) | 2010-03-26 | 2014-09-09 | Aesculap Ag | Impedance mediated control of power delivery for electrosurgery |
CA2795229A1 (en) | 2010-04-09 | 2011-10-13 | Vessix Vascular, Inc. | Power generating and control apparatus for the treatment of tissue |
US9192790B2 (en) | 2010-04-14 | 2015-11-24 | Boston Scientific Scimed, Inc. | Focused ultrasonic renal denervation |
US8473067B2 (en) | 2010-06-11 | 2013-06-25 | Boston Scientific Scimed, Inc. | Renal denervation and stimulation employing wireless vascular energy transfer arrangement |
US9155589B2 (en) | 2010-07-30 | 2015-10-13 | Boston Scientific Scimed, Inc. | Sequential activation RF electrode set for renal nerve ablation |
US9084609B2 (en) | 2010-07-30 | 2015-07-21 | Boston Scientific Scime, Inc. | Spiral balloon catheter for renal nerve ablation |
US9463062B2 (en) | 2010-07-30 | 2016-10-11 | Boston Scientific Scimed, Inc. | Cooled conductive balloon RF catheter for renal nerve ablation |
US9408661B2 (en) | 2010-07-30 | 2016-08-09 | Patrick A. Haverkost | RF electrodes on multiple flexible wires for renal nerve ablation |
US9358365B2 (en) | 2010-07-30 | 2016-06-07 | Boston Scientific Scimed, Inc. | Precision electrode movement control for renal nerve ablation |
US9173698B2 (en) | 2010-09-17 | 2015-11-03 | Aesculap Ag | Electrosurgical tissue sealing augmented with a seal-enhancing composition |
EP2621389B1 (en) | 2010-10-01 | 2015-03-18 | Applied Medical Resources Corporation | Electrosurgical instrument with jaws and with an electrode |
US8974451B2 (en) | 2010-10-25 | 2015-03-10 | Boston Scientific Scimed, Inc. | Renal nerve ablation using conductive fluid jet and RF energy |
US9220558B2 (en) | 2010-10-27 | 2015-12-29 | Boston Scientific Scimed, Inc. | RF renal denervation catheter with multiple independent electrodes |
US9028485B2 (en) | 2010-11-15 | 2015-05-12 | Boston Scientific Scimed, Inc. | Self-expanding cooling electrode for renal nerve ablation |
US9089350B2 (en) | 2010-11-16 | 2015-07-28 | Boston Scientific Scimed, Inc. | Renal denervation catheter with RF electrode and integral contrast dye injection arrangement |
US9668811B2 (en) | 2010-11-16 | 2017-06-06 | Boston Scientific Scimed, Inc. | Minimally invasive access for renal nerve ablation |
US9326751B2 (en) | 2010-11-17 | 2016-05-03 | Boston Scientific Scimed, Inc. | Catheter guidance of external energy for renal denervation |
US9060761B2 (en) | 2010-11-18 | 2015-06-23 | Boston Scientific Scime, Inc. | Catheter-focused magnetic field induced renal nerve ablation |
US9192435B2 (en) | 2010-11-22 | 2015-11-24 | Boston Scientific Scimed, Inc. | Renal denervation catheter with cooled RF electrode |
US9023034B2 (en) | 2010-11-22 | 2015-05-05 | Boston Scientific Scimed, Inc. | Renal ablation electrode with force-activatable conduction apparatus |
US20120157993A1 (en) | 2010-12-15 | 2012-06-21 | Jenson Mark L | Bipolar Off-Wall Electrode Device for Renal Nerve Ablation |
WO2012100095A1 (en) | 2011-01-19 | 2012-07-26 | Boston Scientific Scimed, Inc. | Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury |
US10278774B2 (en) | 2011-03-18 | 2019-05-07 | Covidien Lp | Selectively expandable operative element support structure and methods of use |
EP2694150A1 (en) | 2011-04-08 | 2014-02-12 | Covidien LP | Iontophoresis drug delivery system and method for denervation of the renal sympathetic nerve and iontophoretic drug delivery |
EP2701623B1 (en) | 2011-04-25 | 2016-08-17 | Medtronic Ardian Luxembourg S.à.r.l. | Apparatus related to constrained deployment of cryogenic balloons for limited cryogenic ablation of vessel walls |
US9339327B2 (en) | 2011-06-28 | 2016-05-17 | Aesculap Ag | Electrosurgical tissue dissecting device |
US9084592B2 (en) * | 2011-07-11 | 2015-07-21 | C2 Therapeutics, Inc. | Focal ablation assembly |
CN103813745B (en) | 2011-07-20 | 2016-06-29 | 波士顿科学西美德公司 | In order to visualize, be directed at and to melt transcutaneous device and the method for nerve |
WO2013016203A1 (en) | 2011-07-22 | 2013-01-31 | Boston Scientific Scimed, Inc. | Nerve modulation system with a nerve modulation element positionable in a helical guide |
WO2013055826A1 (en) | 2011-10-10 | 2013-04-18 | Boston Scientific Scimed, Inc. | Medical devices including ablation electrodes |
EP2765940B1 (en) | 2011-10-11 | 2015-08-26 | Boston Scientific Scimed, Inc. | Off-wall electrode device for nerve modulation |
US9420955B2 (en) | 2011-10-11 | 2016-08-23 | Boston Scientific Scimed, Inc. | Intravascular temperature monitoring system and method |
US9364284B2 (en) | 2011-10-12 | 2016-06-14 | Boston Scientific Scimed, Inc. | Method of making an off-wall spacer cage |
US9162046B2 (en) | 2011-10-18 | 2015-10-20 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
WO2013059202A1 (en) | 2011-10-18 | 2013-04-25 | Boston Scientific Scimed, Inc. | Integrated crossing balloon catheter |
CN104023662B (en) | 2011-11-08 | 2018-02-09 | 波士顿科学西美德公司 | Hole portion renal nerve melts |
WO2013074813A1 (en) | 2011-11-15 | 2013-05-23 | Boston Scientific Scimed, Inc. | Device and methods for renal nerve modulation monitoring |
US9119632B2 (en) | 2011-11-21 | 2015-09-01 | Boston Scientific Scimed, Inc. | Deflectable renal nerve ablation catheter |
US9265969B2 (en) | 2011-12-21 | 2016-02-23 | Cardiac Pacemakers, Inc. | Methods for modulating cell function |
US9174050B2 (en) | 2011-12-23 | 2015-11-03 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
EP2797534A1 (en) | 2011-12-28 | 2014-11-05 | Boston Scientific Scimed, Inc. | Device and methods for nerve modulation using a novel ablation catheter with polymeric ablative elements |
US9050106B2 (en) | 2011-12-29 | 2015-06-09 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
WO2013169927A1 (en) | 2012-05-08 | 2013-11-14 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices |
CN104540465A (en) | 2012-08-24 | 2015-04-22 | 波士顿科学西美德公司 | Intravascular catheter with a balloon comprising separate microporous regions |
WO2014043687A2 (en) | 2012-09-17 | 2014-03-20 | Boston Scientific Scimed, Inc. | Self-positioning electrode system and method for renal nerve modulation |
WO2014047454A2 (en) | 2012-09-21 | 2014-03-27 | Boston Scientific Scimed, Inc. | Self-cooling ultrasound ablation catheter |
US10398464B2 (en) | 2012-09-21 | 2019-09-03 | Boston Scientific Scimed, Inc. | System for nerve modulation and innocuous thermal gradient nerve block |
KR102174907B1 (en) | 2012-09-26 | 2020-11-05 | 아에스쿨랍 아게 | Apparatus for tissue cutting and sealing |
US10835305B2 (en) | 2012-10-10 | 2020-11-17 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices and methods |
GB2508905A (en) * | 2012-12-14 | 2014-06-18 | Gyrus Medical Ltd | Endoscopic instrument with bypass lead |
US9693821B2 (en) | 2013-03-11 | 2017-07-04 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9956033B2 (en) | 2013-03-11 | 2018-05-01 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9808311B2 (en) | 2013-03-13 | 2017-11-07 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
JP6220044B2 (en) | 2013-03-15 | 2017-10-25 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Medical device for renal nerve ablation |
JP6139772B2 (en) | 2013-03-15 | 2017-05-31 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Control unit for use with electrode pads and method for estimating leakage |
US10265122B2 (en) | 2013-03-15 | 2019-04-23 | Boston Scientific Scimed, Inc. | Nerve ablation devices and related methods of use |
WO2014205399A1 (en) | 2013-06-21 | 2014-12-24 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation having rotatable shafts |
CN105473091B (en) | 2013-06-21 | 2020-01-21 | 波士顿科学国际有限公司 | Renal denervation balloon catheter with co-movable electrode supports |
US9707036B2 (en) * | 2013-06-25 | 2017-07-18 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation using localized indifferent electrodes |
JP6204579B2 (en) | 2013-07-01 | 2017-09-27 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Renal nerve ablation medical device |
CN105377169B (en) | 2013-07-11 | 2019-04-19 | 波士顿科学国际有限公司 | Device and method for neuromodulation |
EP3019106A1 (en) | 2013-07-11 | 2016-05-18 | Boston Scientific Scimed, Inc. | Medical device with stretchable electrode assemblies |
WO2015010074A1 (en) | 2013-07-19 | 2015-01-22 | Boston Scientific Scimed, Inc. | Spiral bipolar electrode renal denervation balloon |
CN105392435B (en) | 2013-07-22 | 2018-11-09 | 波士顿科学国际有限公司 | Renal nerve ablation catheter with twisting sacculus |
US10342609B2 (en) | 2013-07-22 | 2019-07-09 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
CN105473093B (en) | 2013-08-22 | 2019-02-05 | 波士顿科学国际有限公司 | Flexible circuit with the improved adhesion strength to renal nerve modulation sacculus |
CN105555218B (en) | 2013-09-04 | 2019-01-15 | 波士顿科学国际有限公司 | With radio frequency (RF) foley's tube rinsed with cooling capacity |
EP3043733A1 (en) | 2013-09-13 | 2016-07-20 | Boston Scientific Scimed, Inc. | Ablation balloon with vapor deposited cover layer |
US11246654B2 (en) | 2013-10-14 | 2022-02-15 | Boston Scientific Scimed, Inc. | Flexible renal nerve ablation devices and related methods of use and manufacture |
WO2015057521A1 (en) | 2013-10-14 | 2015-04-23 | Boston Scientific Scimed, Inc. | High resolution cardiac mapping electrode array catheter |
JP6259098B2 (en) | 2013-10-15 | 2018-01-10 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Medical device and method for manufacturing the medical device |
US9770606B2 (en) | 2013-10-15 | 2017-09-26 | Boston Scientific Scimed, Inc. | Ultrasound ablation catheter with cooling infusion and centering basket |
EP3057521B1 (en) | 2013-10-18 | 2020-03-25 | Boston Scientific Scimed, Inc. | Balloon catheters with flexible conducting wires |
WO2015061457A1 (en) | 2013-10-25 | 2015-04-30 | Boston Scientific Scimed, Inc. | Embedded thermocouple in denervation flex circuit |
CN105899157B (en) | 2014-01-06 | 2019-08-09 | 波士顿科学国际有限公司 | Tear-proof flexible circuit assembly |
WO2015119890A1 (en) | 2014-02-04 | 2015-08-13 | Boston Scientific Scimed, Inc. | Alternative placement of thermal sensors on bipolar electrode |
US11000679B2 (en) | 2014-02-04 | 2021-05-11 | Boston Scientific Scimed, Inc. | Balloon protection and rewrapping devices and related methods of use |
US10709490B2 (en) | 2014-05-07 | 2020-07-14 | Medtronic Ardian Luxembourg S.A.R.L. | Catheter assemblies comprising a direct heating element for renal neuromodulation and associated systems and methods |
AU2015258819B2 (en) | 2014-05-16 | 2019-12-12 | Applied Medical Resources Corporation | Electrosurgical system |
EP3369392A1 (en) | 2014-05-30 | 2018-09-05 | Applied Medical Resources Corporation | Electrosurgical seal and dissection systems |
US10420603B2 (en) | 2014-12-23 | 2019-09-24 | Applied Medical Resources Corporation | Bipolar electrosurgical sealer and divider |
USD748259S1 (en) | 2014-12-29 | 2016-01-26 | Applied Medical Resources Corporation | Electrosurgical instrument |
EP3363398A1 (en) * | 2017-02-15 | 2018-08-22 | Cook Medical Technologies LLC | Cutting system for medical treatment |
US11033294B2 (en) | 2017-03-13 | 2021-06-15 | Cook Medical Technologies Llc | Method of treatment for aortic dissection |
US10801144B2 (en) * | 2018-02-07 | 2020-10-13 | Hsien-Chang Tseng | Hollow pipe joint structure for a sewing machine |
US11864812B2 (en) | 2018-09-05 | 2024-01-09 | Applied Medical Resources Corporation | Electrosurgical generator control system |
KR20210092263A (en) | 2018-11-16 | 2021-07-23 | 어플라이드 메디컬 리소시스 코포레이션 | electrosurgical system |
Family Cites Families (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US510360A (en) | 1893-12-05 | Car-coupling | ||
US2032859A (en) | 1932-03-30 | 1936-03-03 | Wappler Frederick Charles | Method and means for therapeutic application of high-frequency current |
US2043083A (en) | 1932-07-08 | 1936-06-02 | Wappler Frederick Charles | Therapeutic electrode and plug therefor |
CA1244889A (en) | 1983-01-24 | 1988-11-15 | Kureha Chemical Ind Co Ltd | Device for hyperthermia |
US4958634A (en) * | 1987-05-06 | 1990-09-25 | Jang G David | Limacon geometry balloon angioplasty catheter systems and method of making same |
JPS6446056U (en) * | 1987-09-17 | 1989-03-22 | ||
US4979948A (en) | 1989-04-13 | 1990-12-25 | Purdue Research Foundation | Method and apparatus for thermally destroying a layer of an organ |
CA2081896A1 (en) | 1990-06-15 | 1991-12-16 | James E. Shapland | Drug delivery apparatus and method |
US5578008A (en) | 1992-04-22 | 1996-11-26 | Japan Crescent, Inc. | Heated balloon catheter |
US5277201A (en) * | 1992-05-01 | 1994-01-11 | Vesta Medical, Inc. | Endometrial ablation apparatus and method |
WO1994007446A1 (en) * | 1992-10-05 | 1994-04-14 | Boston Scientific Corporation | Device and method for heating tissue |
AU1937795A (en) * | 1994-03-08 | 1995-09-25 | Cardima, Inc. | Intravascular rf occlusion catheter |
US5505730A (en) * | 1994-06-24 | 1996-04-09 | Stuart D. Edwards | Thin layer ablation apparatus |
US5891135A (en) | 1996-01-19 | 1999-04-06 | Ep Technologies, Inc. | Stem elements for securing tubing and electrical wires to expandable-collapsible electrode structures |
US5871483A (en) | 1996-01-19 | 1999-02-16 | Ep Technologies, Inc. | Folding electrode structures |
US5776129A (en) * | 1996-06-12 | 1998-07-07 | Ethicon Endo-Surgery, Inc. | Endometrial ablation apparatus and method |
AU2114299A (en) * | 1998-01-14 | 1999-08-02 | Conway-Stuart Medical, Inc. | Electrosurgical device for sphincter treatment |
US5992419A (en) * | 1998-08-20 | 1999-11-30 | Mmtc, Inc. | Method employing a tissue-heating balloon catheter to produce a "biological stent" in an orifice or vessel of a patient's body |
-
1999
- 1999-06-29 US US09/342,945 patent/US6238392B1/en not_active Expired - Lifetime
-
2000
- 2000-06-27 CA CA002312539A patent/CA2312539C/en not_active Expired - Fee Related
- 2000-06-27 AU AU42710/00A patent/AU766781C/en not_active Ceased
- 2000-06-28 EP EP00305442A patent/EP1064886B1/en not_active Expired - Lifetime
- 2000-06-28 DE DE60030044T patent/DE60030044T2/en not_active Expired - Lifetime
- 2000-06-28 JP JP2000194797A patent/JP2001037773A/en active Pending
-
2001
- 2001-02-21 US US09/790,134 patent/US20010007938A1/en not_active Abandoned
Cited By (37)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9782572B2 (en) | 2002-09-30 | 2017-10-10 | Nordson Corporation | Apparatus and methods for treating bone structures, tissues and ducts using a narrow gauge cannula system |
US20120053611A1 (en) * | 2002-09-30 | 2012-03-01 | Saab Mark A | Apparatus and methods for bone, tissue and duct dilatation |
US8454646B2 (en) | 2002-09-30 | 2013-06-04 | Advanced Polymers, Inc. | Apparatus and methods for bone, tissue and duct dilatation |
US8454647B2 (en) | 2002-09-30 | 2013-06-04 | Advanced Polymers, Inc. | Apparatus and methods for bone, tissue and duct dilatation |
US7488337B2 (en) * | 2002-09-30 | 2009-02-10 | Saab Mark A | Apparatus and methods for bone, tissue and duct dilatation |
US20090177236A1 (en) * | 2002-09-30 | 2009-07-09 | Advanced Polymers, Inc. | Apparatus and methods for bone, tissue and duct dilatation |
US20090177235A1 (en) * | 2002-09-30 | 2009-07-09 | Advanced Polymers, Inc. | Apparatus and methods for bone, tissue and duct dilatation |
US20090177153A1 (en) * | 2002-09-30 | 2009-07-09 | Advanced Polymers, Inc. | Apparatus and methods for bone, tissue and duct dilatation |
US20090177200A1 (en) * | 2002-09-30 | 2009-07-09 | Advanced Polymers, Inc. | Apparatus and methods for bone, tissue and duct dilatation |
US8394056B2 (en) * | 2002-09-30 | 2013-03-12 | Mark A. Saab | Apparatus and methods for bone, tissue and duct dilatation |
US8177744B2 (en) | 2002-09-30 | 2012-05-15 | Advanced Polymers, Inc. | Apparatus and methods for bone, tissue and duct dilatation |
US8216182B2 (en) | 2002-09-30 | 2012-07-10 | Advanced Polymers, Inc. | Apparatus and methods for bone, tissue and duct dilatation |
US20040098017A1 (en) * | 2002-09-30 | 2004-05-20 | Advanced Polymers, Incorporated | Apparatus and methods for bone, tissue and duct dilatation |
US20070288001A1 (en) * | 2006-06-12 | 2007-12-13 | Pankaj Patel | Endoscopically introducible expandable cautery device |
US9993281B2 (en) * | 2007-05-04 | 2018-06-12 | Covidien Lp | Method and apparatus for gastrointestinal tract ablation for treatment of obesity |
US20140088581A1 (en) * | 2007-05-04 | 2014-03-27 | Covidien Lp | Method and apparatus for gastrointestinal tract ablation for treatment of obesity |
US20080275445A1 (en) * | 2007-05-04 | 2008-11-06 | Barrx Medical, Inc. | Method and apparatus for gastrointestinal tract ablation for treatment of obesity |
US8641711B2 (en) * | 2007-05-04 | 2014-02-04 | Covidien Lp | Method and apparatus for gastrointestinal tract ablation for treatment of obesity |
US20120289952A1 (en) * | 2007-07-06 | 2012-11-15 | Tyco Healthcare Group, Lp | Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight loss operation |
US9364283B2 (en) * | 2007-07-06 | 2016-06-14 | Covidien Lp | Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight loss operation |
US20090012512A1 (en) * | 2007-07-06 | 2009-01-08 | Utley David S | Method and Apparatus for Gastrointestinal Tract Ablation to Achieve Loss of Persistent and/or Recurrent Excess Body Weight Following a Weight-Loss Operation |
US20170020592A1 (en) * | 2007-07-06 | 2017-01-26 | Covidien Lp | Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight loss operation |
US9839466B2 (en) * | 2007-07-06 | 2017-12-12 | Covidien Lp | Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight loss operation |
US8251992B2 (en) * | 2007-07-06 | 2012-08-28 | Tyco Healthcare Group Lp | Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight-loss operation |
US10850065B2 (en) | 2010-02-09 | 2020-12-01 | Medinol Ltd. | Catheter tip assembled with a spring |
US20160183963A1 (en) * | 2010-02-09 | 2016-06-30 | Medinol Ltd. | Device for Traversing Vessel Occlusions and Method of Use |
US9814510B2 (en) | 2011-03-25 | 2017-11-14 | Nordson Corporation | Apparatus and methods for accessing and dilating bone structures using a narrow gauge cannula |
US9358372B2 (en) | 2011-03-25 | 2016-06-07 | Vention Medical Advanced Components, Inc. | Apparatus and methods for accessing and dilating bone structures using a narrow gauge cannula |
CN106974726A (en) * | 2012-06-26 | 2017-07-25 | 柯惠有限合伙公司 | With the ablating device for ablating device to be fixed to structural inflatable chamber |
US9566111B2 (en) | 2012-06-26 | 2017-02-14 | Covidien Lp | Ablation device having an expandable chamber for anchoring the ablation device to tissue |
CN104602632A (en) * | 2012-06-26 | 2015-05-06 | 柯惠有限合伙公司 | Ablation device having an expandable chamber for anchoring the ablation device to tissue |
US10314647B2 (en) | 2013-12-23 | 2019-06-11 | Medtronic Advanced Energy Llc | Electrosurgical cutting instrument |
US10426923B2 (en) | 2014-02-03 | 2019-10-01 | Medinol Ltd. | Catheter tip assembled with a spring |
US11458284B2 (en) | 2014-02-03 | 2022-10-04 | Medinol Ltd. | Catheter tip assembled with a spring |
US10813686B2 (en) | 2014-02-26 | 2020-10-27 | Medtronic Advanced Energy Llc | Electrosurgical cutting instrument |
US11864824B2 (en) | 2014-02-26 | 2024-01-09 | Medtronic Advanced Energy Llc | Electrosurgical cutting instrument |
WO2017074920A1 (en) * | 2015-10-27 | 2017-05-04 | Mayo Foundation For Medical Education And Research | Devices and methods for ablation of tissue |
Also Published As
Publication number | Publication date |
---|---|
AU766781C (en) | 2006-04-13 |
EP1064886A1 (en) | 2001-01-03 |
US6238392B1 (en) | 2001-05-29 |
CA2312539C (en) | 2009-08-11 |
AU4271000A (en) | 2001-01-04 |
DE60030044T2 (en) | 2007-01-18 |
CA2312539A1 (en) | 2000-12-29 |
JP2001037773A (en) | 2001-02-13 |
AU766781B2 (en) | 2003-10-23 |
DE60030044D1 (en) | 2006-09-28 |
EP1064886B1 (en) | 2006-08-16 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US6238392B1 (en) | Bipolar electrosurgical instrument including a plurality of balloon electrodes | |
US7591818B2 (en) | Cardiac ablation devices and methods | |
JP5438072B2 (en) | System and method for treating abnormal tissue in the human esophagus | |
US9101364B2 (en) | Cardiac ablation devices and methods | |
AU2005206098B2 (en) | System and method for treating abnormal epithelium in an esophagus | |
US20170119465A1 (en) | Electrical ablation devices comprising an injector catheter electrode | |
US6119041A (en) | Apparatus and method for linear lesion ablation | |
US6032077A (en) | Ablation catheter with electrical coupling via foam drenched with a conductive fluid | |
US20020147447A1 (en) | Endoscopic ablation system with improved electrode geometry | |
US6488658B1 (en) | Method of treating the inner lining of an organ using a bipolar electrosurgical instrument including a plurality of balloon electrodes | |
AU2002254494A1 (en) | Endoscopic ablation system with improved electrode geometry | |
AU2001263143A1 (en) | System and method of treating abnormal tissue in the human esophagus | |
KR20190055059A (en) | Bipolar tissue transfer device and method of use thereof | |
US20030125724A1 (en) | Method of treating the inner lining of an organ using a bipolar electrosurgical instrument including a plurality of balloon electrodes | |
EP1689285A2 (en) | Cardiac ablation devices and methods | |
AU2013200263B2 (en) | System and method for treating abnormal epithelium in an esophagus | |
AU2002309525B2 (en) | Endoscopic ablation system with sealed sheath |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |