CN101448466A - Apparatus and method for treating tissue such as tumours - Google Patents

Abstract

A catheter (4) may be introduced into the body of a patient to provide electromagnetic power, such as RF power, directly to a stent (2) to cause heating of surrounding tissue for ablation. The stent may have a conducting portion (14) and insulated portions (13). Struts (15) on the catheter may be deployed by a balloon (103) to contact the stent. The stent may have radial or sector segments (16) which may be individually powered for treating asymmetric tumours.

Description

Be used for the treatment of equipment and method such as the tissue of tumor

The present invention relates to a kind of being used for the treatment of such as equipment and method around the tissue of chamber or vascular or the obstructive tumours in chamber or vascular, chamber or vascular are for example esophagus, trachea and bile duct or any other chamber that may get clogged.

When tumor around vascular, when forming in vascular or in the wall at vascular, tumor can be surrounded the vascular body gradually, and causes occlusion lumen, this will have strict medical significance.The conventional method for the treatment of this obstruction is that the support that will for example be presented among Fig. 1 is inserted in the vascular.This support (2) is inserted in the chamber (1), not closed to keep blocking (3).Although this method holding chamber is opened in a short time, thereby allow material normally to pass vascular, this method has defective in long-term, and promptly the chamber may be owing to the depression effect (constraining effect) of tumor is got back to its initial size.In addition, support is inserted vascular can not stop tumor growth, therefore may produce hypertrophy, be organized in the support and regrow, and this is with further occlusion lumen.

Overcome these problems related, just need to keep the obstruction that causes by tumor not closed, and treat tumor simultaneously, with restriction or reduce its size with the conventional bracket method.US 6 238 421 (

Deng the people) disclose a kind of be used to heat surround for example system and method for the cell of the metal implant of support.RF (radio frequency) signal of telecommunication is affacted induction coil, thereby produce alternating magnetic field in coil.When the part that comprises metal implant of biology was positioned at coil aperture, magnetic field produced heats on metal implant, and this causes the hot injury to those cells that surround implant again.Induction coil need be big, so that be enough to hold people with metal implant or at least a portion of other live body.Another remarkable shortcoming of this method of the cell of heating encirclement support is that induction heat only acts on metal rack, and does not directly act on tissue.Therefore, organize self only by conduction of heat heating from support.Because the increase of support place temperature will promptly reduce,, and may be uneven so conduction of heat is limited at it to penetrating of surrounding tissue.But metal implant will heat equably, and therefore will damage surrounding tissue equably, and no matter it has comprised tumor or health tissues.Therefore, expectation has the compact devices that is used for the tumor of vascular is produced local heat.And expectation only heating comprises the tissue of tumor, and does not heat health tissues, can cause vascular to penetrate to the heating of health tissues.And expectation directly runs up to heat in the tissue, heats and need not rely on by conduction of heat.

In US 2005/0125046, support can be heated by the alternating current field of external action.Even heating will make health tissues undesirably to be heated.

The objective of the invention is to alleviate at least to a certain extent the problem of prior art.

The present invention's statement in the claims.Provide a kind of with voltage or directly affact compactness and the method that can bear of support such as other form energy of for example ultransonic circulating pressure energy (cyclic pressure power).And, be connected to a plurality of support members (strut) of conduit by setting, can obtain selectable heating to concrete tissue regions.

Especially, the present invention makes the energy such as radio frequency (RF) or other electromagnetic energy or circulating pressure energy can affact support (or other implant) with for example weekly regular intervals, so that tumor is shunk the feasible simultaneously damage minimum to surrounding health tissue.Because in some preferred implementations, can conduit be inserted in the support via body orifice, so the present invention is favourable when for example treating old patient, and alternate tumor is carried out surgical operation will be the selection that has more risk.Be connected to support/implant from the outside direct physical of health and allow to control well the to be acted on that part of of support/implant.

In case the conduit according to some embodiments is inserted in the support, just provide RF voltage from the RF generator of connecting duct.Also imagine the energy of microwave for example or ultransonic other form.The voltage that is acted on and the persistent period of effect and frequency can be according to the characteristic variations of tumor.And according to one embodiment of the present invention, the single support member of the conduit that RF voltage affacts can separately launch, and the RF voltage that can supply with change level according to the character and the shape of tumor.RF voltage is affacted the heating that support causes the tissue that surrounds support, and this causes the drying of tissue and melts, thereby causes shrinking.Also imagination is used microwave frequency.

The direct application of energy for example by physically contacting support, allows those tissues to be heated near support are carried out good control, and need not the patient and be accommodated in the large equipment as prior art.

Equipment of the present invention and method allow user to treat the tumor in the vessels/lumens at interval fully with rule (or other plan), make damage minimum to health tissues simultaneously, and avoid the obstruction in the chamber that the existence of these tumors may cause simultaneously.

Now will by way of example and with reference to the accompanying drawings embodiments of the present invention be described, wherein:

Fig. 1 has shown the in-situ prior art support of intracavity;

Fig. 2 has shown the front view according to the support of embodiment of the present invention;

Fig. 3 has shown the front view according to the conduit of first embodiment of the invention;

Fig. 4 has shown the front view of in-situ support in Fig. 3 conduit and the vascular;

Fig. 5 has shown the electricity setting of conduit, support and radio-frequency signal generator;

Fig. 6 has shown the front view according to the conduit of second embodiment of the invention;

Fig. 7 has shown according to in-situ support in the conduit of third embodiment of the invention and the vascular;

Fig. 8 has shown the front view of Fig. 7 conduit;

Fig. 9 has shown the front view of the optional embodiment of support;

Figure 10 A and 10B have shown the side view and the cutaway view of the further embodiment of support respectively;

Figure 11 has shown the embodiment of the support with plug connection;

Figure 12 A, 12B, 13 and 14 have shown the preferred implementation of the equipment that is similar to Fig. 2 equipment, and wherein the expansible one-tenth of pin or support member contacts support or analog, and energy is supplied to support or analog;

Figure 15 has shown support and expansion/energy supply equipment (powering device), and support is in folding configuration (collapsed configuration) simultaneously, is used for percutaneous/endoscopic applications;

Figure 16 has shown Figure 15 equipment, and wherein its sleeve shrinks, and its drainage screen expansion;

Figure 17 has shown Figure 15 and Figure 16 equipment, and wherein support member expansion makes support enlarge;

Figure 18 is the normal axomometric drawing of Figure 15 to 17 support;

Figure 19 is tab (alignment lug) and the enlarged drawing that is positioned at the circle of Figure 18 support;

Figure 20 and 21 has shown how ultrasonic vibration can affact the support member/pin of Figure 15 to 17 equipment, in case make it at a time be in the appropriate location, just remove the material that forms on the support, so that improve electrically contacting between support member and the support, the energy that is used to improve support is supplied with;

Figure 22 and 23 has shown the modification of Figure 18 support, is in its corresponding folding and enlarges configuration;

Figure 24 has shown that the notion use RF energy according to preferred implementation carries out good long-range direct-fired example to the tissue near support; And

Figure 25 has shown the further example according to the support of embodiment of the present invention.

With reference to figure 2, can see the support (2) of embodiment of the present invention in detail.Support (2) comprises the substantial cylindrical metal level net with hollow inside.According to the embodiment that is presented among Fig. 2, for fear of heating and ablation of normal tissue, two end sections (13) of support (2) are insulated.Middle body (14) is uninsulated, so as will be explained in more detail, when to support (2) when applying voltage, middle body (14) will heat adjacent tissue.

Fig. 3 has shown the conduit (4) (or conductor) that is used for RF voltage is applied to support (2).Conduit (4) comprises inside subject (20) and outer body assembly (21).A plurality of support members (5) are tied up inside subject (20) at their far-end, and are connected to the far-end of outer body assembly (21) at their other end place.Outer body assembly (21) is configured such that it can longitudinally slide with respect to inside subject (20), so that the size distortion of support member (5) makes that when launching with contact support (2) its shape can be from the straight crooked arc that becomes.Support member (5) is connected to connecting line (22) separately, and connecting line (22) is comprised in the inner tube (23) and the space between the exterior tube (24) of outer body assembly (21).As selection, support member (5) can be connected to the semirigid line (not shown) of being arranged to respect to inside subject (20) and outer body assembly (21) slip.In this was provided with, outer body assembly (21) was fixed with respect to inside subject (20).

As be presented in the Figure 4 and 5, for RF or other suitable voltage being applied to the support (2) of original place in vascular, conduit (4) is inserted in the hollow open 2A of support (2), and support (2) is contacted with support member (5).Conduit (4) but percutaneous or insert by body orifice and is connected to a terminal of RF generator (10) by line (9).Another terminal of generator is connected to the big patient electrode (patient electrode) (12) that is generally used for medical RF application type by second line (11).When radio-frequency voltage affacts support (2) by support member (5) and line (9), the RF electric current will flow in the tissue of the nonisulated part of support (2), and heat this tissue, with the drying that causes tissue with melt, thereby cause tumor (102) contraction.Conduit (firing equipment) (14) contact support provides energy energy has directly been affacted support (2) to the mode of support.In case tumor (102) is shunk, will alleviate the obstruction in chamber.Gas cell (103) is shown as in Fig. 3 partly and expands, but from other accompanying drawing, omit in order to know, and gas cell (103) expands in the mode that is similar to conventional angioplasty gas cell (angioplasty balloon), gas cell (103) can further expand subsequently, with further stent (2), and the diameter of increase chamber 2C.

In other embodiment, the line or the contact that play with support member (5) identical function can be positioned on the outer surface of gas cell (103).

In case tumor (102) in last secondary action after-contraction, so just can repeat RF is affacted support (2) by conduit (4) by regular intervals.The frequency of voltage and the persistent period of effect and frequency can change according to the character of tumor.For example, the frequency that is acted on can be in the scope of 100kHz to 2MHz, and voltage can be in 10 volts to 200 volts scope.The frequency of effect depends on tumor/organize and how to shrink, but can be for example weekly.

This method of radio frequency voltage provides the means of treatment tumor when normal structure is caused minimal damage regularly in the original place of tumor locus.

As be presented among Fig. 4, detector (6) can be installed in the outside of support (2), and embeds in the tumor (102).This detector (6) can be monitored the temperature of tumor (102), and allows accurately to control heating, to avoid damaging normal structure.

In addition,, can separately launch each independent support member (5), be provided to support (2) with contact and/or with energy according to one embodiment of the present invention.In this case, support member is supravasal circle, as is presented among Fig. 8 and is labeled as (33).Therefore asymmetric and do not need to run through in the situation of treatment of the same degree around it in tumor, can be according to being come the voltage of control action by the character of tumor tissues in the zone of the RF voltage influence of supplying with by support member (5) to each support member (5).

Fig. 6 has shown the optional embodiment of the conduit (4) that is used to be connected to support (2).Replace using support member (5), realize connecting by the line (26) that spiral is provided with, line (26) is tied up in inside subject (27) at 26A place, an end, and ties up in outer body assembly (28) at the other end 26B place.Conduit (4) can be inserted in the support (2) as described above.In case conduit (4) is inserted into, it just can be by launching with respect to inside subject (27) rotation outer body assembly (28).This will make helix launch, and increase its diameter, contact with support (2) up to this point.Radio-frequency voltage affacts support (2) by the line (26) that spiral is provided with subsequently, and this causes as according to the described identical heats of first embodiment of conduit (4).

Fig. 7 has shown had excess tissue (3) or outgrowth situation in support (2).Conduit (31) is provided with (contacting arrangement) in conjunction with two kinds of contacts, is used for support (2) and excess tissue (30) are electrically connected.In this example, a kind of contact is set to the helix (32) that contacts with support (2), and another kind of contact setting has the form with the deformable support member (33) of organizing (30) to contact.These contact settings are connected to two terminals of RF generator, make the RF electric current flow through the excess tissue (30) in the support (2), thereby it is melted.If excess tissue (30) is about the vascular circular symmetry, so can by with current switching to independent support member (33) or change the level of the electric current between the independent support member (33) and will melt the different angles part that imports tissue.

Fig. 8 shows the combined catheter that is presented among Fig. 7 in greater detail.There are three concentric tubular assemblies.An end of each support member (33) is all tied up in inside subject (34).The other end is tied up in next-door neighbour's main body (35).Can launch support member (33) by the inside subject (34) of longitudinally sliding with respect to next-door neighbour's main body (35).An end (32A) of helix (32) is also tied up in next-door neighbour's main body (35).The other end (32B) of helix (32) is connected to outer body (36).By launching helix with respect to other main body rotation outer body (36).To understand, although Fig. 8 has shown an example of combined catheter, the contact setting of other combination is possible.

Fig. 9 has shown further embodiment of the present invention, and its medium-height trestle (2) is divided into two or more conduction portions (16).Partly (16) can be radial or are fan-shaped.Partly conduct (16), and separate with adjacent part (16) by insulated part (17).According to the specific embodiment that is presented among Fig. 9, be used for heating and be configured to have several deformable support members that are connected that align with conduction portion (16) around the conduit (not shown) of the tissue of support (2).For independent connection support member, can be connected to the RF generator dividually, make and have only a part (16) at every turn by energy supply.This allows around support (2) local heat.When treatment when for example those are not exclusively around the asymmetric tumor of vascular, this will be useful.

In the present embodiment, one or more support members (6) are connected to the outside of support.As the support member (6) that is presented among Fig. 9 has the hygrosensor (15) that is installed in its far-end.Two terminals of support member (6) locate to be connected to different conduction portion (16A, 16B) at contact (18A, 18B), and this allows by conduit (4) hygrosensor (15) to be inquired.When support (2) when being unfolded, support member (6) will embed in the tissue in support (2) outside, and can monitor the temperature in support (2) outside.This monitoring temperature allows accurately to control the heating to support (2), and this is used to make the damage minimum to the normal structure that centers on tumor.Heat the ability of different location about and also avoided heating and damage healthy tissues.

Support (2) is by metal wire structure, normally rustless steel or for example marmem of Nitinol (nitinol).Usually, metal wire adopts the form of net or lattice, but will understand, and other possible configuration also is possible.As already discussed, for fear of the damage normal structure, at least a portion of expectation support is insulating.The main body of conduit can be by being that significantly any appropriate material is constructed to the technical staff.The expectation of the support member of conduit is constructed with elastic line by conduction, for example by the rustless steel or the marmem structure of Nitinol for example.The insulation of locating at insulated part (17) can provide by the coated polymer of for example Parylene (Speciality Coatings Ltd).

Figure 10 A and 10B have shown the embodiment of the biliary tract prosthesis (100) that comprises successive pipe.Support is not expansible, and has the main body (102) that is generally plastic pipe.Electrode (104) has cylindrical structural, and is installed on the outer surface (106) of main body (102).This support can be installed into makes its part, and promptly it first connects end (108) and protrude from bile duct, and enters duodenum.This means, can use the clip (110) that is schematically illustrated among Figure 10 B to locate in the end (108) of support (100) to realize being electrically connected, and clip (110) can be connected to a kind of electromagnetism power supply (not shown) that is similar to the generator (10) that is presented among Fig. 5 by electric wire (112).Owing to can utilize the outer surface (106) of support (100), so can use clip (110).Conducting electrode can be use sputter (sputtering) or evaporation (evaporation) or the next sedimentary metal coating of other known metal coating technology on the tubular body.Alternatively, electrode can be the coiling or the litzendraht wire zone of the conducting electrode coupling part (conductive electrode link section) (112) that is arranged in support (100).Therefore, electrode (104) can be the part of pipe, and the remainder of pipe be included in pipe distant place edge insulated part (114) and at the insulated part (116) and the conduction join domain (118) of the office of edge part nearby of pipe.Can be not with the tissue contact be connected or contact area can form by the mode that is similar to electrode (104).Connection from contact area (118) to electrode (104) is by covered wire (120) or be similar to the subsurface propagation track that is used for multi-layer PCB and realize, covered wire (120) can embed in the wall (122) of main body (102) of support (100).Alternatively or extraly, join domain (118) electrically contact the part (126) can be on the inner surface (128) of support (100), for example can use and be similar to the means (via) that are used for multi-layer PCB and be connected to lateral electrode (104), and in this case, with the contact area on the inner surface (128), can use to be similar to according to shown those the conduit of previous embodiment described herein provides electric energy.One or more clips (110) can be connected to the conductor part (126) of electrode, and no matter it is to go up or be on the inner surface (128) by the outer surface (106) that the fastening means that the percutaneous that uses conduit for example or endoscope's tweezer or other endoscopic tools transmits is in support (100).Support (100) can be operated by monopolar mode.In some embodiments, imagination can be provided with the conducting electrode at a plurality of intervals in the conduction portion (112) of support (100), and via join domain (118) the conduct power path that separates is offered generator, is used for operating by double pole mode.

Figure 11 shown have the person in charge (210) but and the embodiment of the support (200) of at least two active electrodes (212,214), each electrode is connected to different electrical connector (220) by insulating electric track (electrical pathway) (216,218).In this embodiment, connector (220) can comprise can be by the socket (220) of plug (222) joint, so that support (200) is connected to the power supply (224) that is positioned at the health outside, its medium-height trestle is located by line (226), therefore can operate by double pole mode.Use endoscope or percutaneous connector instrument that plug 222 removably is connected to socket (220).If desired, can use similar plug connector to come to support with microwave frequency or RF frequencies operations.

Although the present invention is described to use radio-frequency (RF) energy, will understand, any appropriate electromagnetic energy all can be applicable to support, to realize the thermal result that adds of expectation.For example, it is possible using microwave energy to activate support.

Also imagination uses the energy of other form use on support that tissue is heated, for example physical vibration or such as ultransonic circulating pressure energy.

Before energy supplied to support, expectation obtained the tumor to be treated or the accurate assessment of tissue regions.This assessment can be used external ultrasound equipment or obtain by the ultrasonic scanning of use endoscope.In the further embodiment of the present invention, conduit further comprises the instrument that is used for realizing to around endoscope's ultrasonic scanning of the tissue of support before acting on the energy of electromagnetic energy for example.This makes surgeon or other user can determine to be sent to by support the amount of each regional energy of tumor or other tissue.

In other embodiment, the imagination support can be controlled by airborne chip or near the chip of support setting, is used to switch the chosen conductive area on the support, and it is centered around change in the zone of the heated support of therapeutic process.

The present invention described herein has multiple advantage for user and patient.Conduit is provided to energy on in-situ support in the vascular that wherein is formed with tumor or other tissue.Because energy is supplied with in the original place, rather than from the source of health outside, so this minimizes the damage to the health tissues that need not to treat.Thereby energy can be by conduit with the regular intervals effect, reducing the size of tumor, and the health tissues around tumor is not caused over-drastic damage.In a preferred embodiment, the invention provides a kind of method that selectively electromagnetic energy of varying level is affacted independent tissue regions according to the density and the character of this position tissue.

But because conduit percutaneous or insert,, and thereby help the patient so this Therapeutic Method is a Wicresoft by body orifice.The present invention can be used as that surgery is removed substituting of tumor and the size that is used to reduce tumor in the vascular.In addition, the present invention need not big and equipment costliness, for example induction coil.For medical practitioner, this will allow preferred implementation easily to realize, and therefore can be by the general acquisition of patient.

In the equipment that is similar to Fig. 2 equipment in Figure 12 A to 14, pin or support member (200) can be expanded, and conduct support (300) or analog with contact, and the energy of for example RF or microwave energy is supplied to conduction support (300) or analog.As shown, the soft tip (202) by the guide line guiding is provided with locking cone (locking cone) (204).The operator comes conversion equipment by the step that is presented among Figure 12 A to 14, so that use the electromagnetic energy of the flexible conduction in (206) and edge Nitinol arm/pin/support member (200) effect from the patient outside along inner shaft to activate support subsequently, arm/pin/support member (200) is as contacting support (300) energy is provided to the electrode that support (300) is used for heat tissue.Outer sleeve (208) can be gone up at bar (206) and slide, and is used for covering or exposing arm (200).On endoscope ground or percutaneously equipment is loaded in the process of support (300) original place, arm is locked at the appropriate location in the locking cone (204), as is presented among Figure 12 A.Locking cone (204) is engaged, and begins to launch to allow arm.As be presented among Figure 12 B, towards fixed ring (212) pivot cup (pivot collar) (210) of pulling back, thereby make rustless steel tie-rod (214) rotation, with the distal tip (216) that forces arm (200) against support (300).In case support is by energy activated, this configuration can be by reversing to the step of Figure 12 A configuration from Figure 14 configuration, and outer sleeve (208) can be gone up towards locking cone (204) towards front slide at arm (200), and equipment can be removed from the patient.

Figure 15 has shown the variation of Figure 12 A equipment in the process of the chamber that is deployed into the patient (400).Similarly reference number represent with Figure 12 A in similar parts.Generally, four arms (200) are provided.In the embodiment of Figure 15, arm (200) is flexible, and initial support (300) can be included in the outer sleeve (208).In case use guide line and X ray to locate catheter/device (406), just can drag back sleeve (208), exposing support (300) and arm (200), and expand filter cage (filtercage) (404), as be presented among Figure 16.Drainage screen (404) can be net, the fiber on self expandable framework (self-expanding frame) (410) or has the gas cell filter bag (balloon sock) of micropore (408), in case outer sleeve (208) passes it and recalls, self expandable framework (410) is expansion automatically just.As be presented among Figure 17, can be by coming stent towards pivot cup (212) pulling pivot cup (210), and towards pivot cup (212) pulling pivot cup (210) be by from patient's the outside remotely the bar (410) in the pull lever (412) realize.In Figure 17, arm (200) is shown as the circle (420) by support (300) is engaged.In case support (300) is expanded to the expanded configuration that is presented among Figure 17 by the contracted configuration of arm (200) from be presented at Figure 18, the elastic ring (422) of support (300) just allows expansion, arm (200) can axially skid off circle (420), and the conduit (406) that comprises outer sleeve (208), arm (200) and tip (202) can be removed, thereby support (300) is stayed in the interior appropriate location, chamber (400).Behind a period of time interval, conduit can be inserted into again in the support (300), to the configuration that is presented at Figure 17 and Figure 21, guiding piece (426) is used for arm (200) is directed to circle (420).It is inboard and by the ultrasonic piezoelectric transducer (ultrasonic piezo electric transducer) (430) along the inboard cable energy supply of extending of outer sleeve (208) that dependence is positioned at pivoting point (212), arm (200) can be along the direction vibration that is presented at the arrow (440) among Figure 21, and the sharp-pointed tip (442) of arm (200) can against or engage or swipe near the surface, inside (444) of support (300), to remove the material that growth forms on the inboard of support owing to the expansion of support, material (446) is filtered device (404) subsequently and obtains.Therefore, this cleaning course of ultrasonic piezoelectricity can improve electrically contacting between support (300) and the arm (200), thereby makes energy efficient and affact support (300) reliably, so that heat the tissue in its zone, is used for ablation.In optional embodiment, need not ultrasonicly to clean support (300) and arm (200) is inserted in the circle (420) in order to use.Ultrasonic can going up at arm (200) produces revolving force, but not is presented at the longitudinal force among Figure 21.

Figure 22 and 23 has shown the improved procedure of the support (300) that is presented among Figure 18, and Figure 22 and 23 support (500) have hinge (502).Support (500) can have side lever (504), and side lever (504) is steel or is plastics, comprises the conduction portion on it, is used for RF or other heating purposes.Can use the frame system of the arm (200) that is presented among Figure 17 to 21 to come stent (500), or can use gas cell to be used for this expansion in other cases.

In some cases, in the embodiment of Figure 21, ultrasonic friction (ultrasonic rubbing) technology self can be enough to cause the local heat of tissue and melt in the zone of support (300).But because friction allows clean Surface to contact, heating is favourable for RF so clean the ability of support member of these supports.

Material (446) can for example comprise biomembrane, mineral, tissue and/or the lipidosis that causes stent occlusion.

The support (300) that is presented among Figure 18 can be silver-palladium support, and this is intended to have the advantage that reduces the biomembranous formation on the support.

Therefore in some applications, filter (404) is optional for conduit (406), and can not have filter (404) in some embodiments, for example, and when conduit at first is used for when being placed on patient's the appropriate location of chamber/vascular.

The prototype stent (700) that has the cylindrical electrode (704) of 4mm diameter in Figure 25 design is inserted in the muscular tissue (ex-vivo porcine muscle tissue) of external pig.Connecting ring nearby (708) is connected to a utmost point of radio-frequency signal generator by suitable clip.Form and be connected to another utmost point by 10 square centimeters conductive foil with ground mat (ground pad) that a side of tissue closely contacts.Monitor the temperature of support tube inboard with thermocouple.

With the electrode of the 20W RF energy under the frequency 450KHz to support.Initial impedance is 44 ohm, and initial temperature is 30 ℃.Heat after 3 minutes, temperature is 98 ℃, and impedance is reduced to 35 ohm.After the heating, remove support, and incised tissue, as seen in Figure 24.The zone that is clear that coagulation of tissues is the cylindrical of diameter 14mm and length 25mm.

In one embodiment, use Nitinol spring or clip (not shown) that support is remained on the charging appliance of conduit for example.When support was heated, clip swings was opened, to allow removing conduit from support.In case stent cools, clip are just got back to make position.Clip allows support to remove by engaging from the chamber again with the conduit of removing, or allows to reheat support by reorientating with electrode catheter.And nitinol clip can be used for locking plastic tubing rack, and it will be removed from the chamber from the metal electrode support subsequently independently.

Figure 24 has shown by the direct remote action of EM energy is tested the successful result of long-range heat tissue (600) by the energy transfer equipment of foundation general concept disclosed herein to support (602).Behind incised tissue, as by as shown in heated zone (606), the lasting heat tissue of expecting in this particular case is illustrated in the stent area.

Imagination support or support energy supply equipment can have at least one magnetic contact or magnetisable contact, so that its energy supply is come provide good electrical contact for support in the process of heat tissue at EM.

Can carry out various modifications to example described herein, and not depart from the scope of explaining according to Patent Law of the present invention that claims defined.

Claims (49)

1. one kind is used for the treatment of around the chamber or at the tumor of intracavity or the equipment of other tissue, described equipment comprises support, and wherein said support is arranged to come heat tissue by using percutaneous or endoscope's fastening means directly to connect power supply.

2. one kind is used for the treatment of the tumor that is formed on intracavity or the equipment of other tissue, and described equipment comprises support, and wherein said support is arranged to come heat tissue by directly acting on energy by energy supply equipment.

3. as claim 1 or the described equipment of claim 2, wherein said support is arranged to can be positioned on intracavity tumor to be treated or other tissue site.

4. as each the described equipment in the claim 1 to 3, wherein said support is arranged in heat tissue under the energy, so that ablation of tissue.

5. as each the described equipment in the claim 1 to 4, wherein said support comprises at least one in insulated part and the conduction portion.

6. equipment as claimed in claim 5, it comprise be used for the function of current to the tissue described conduction portion and be used to be connected to firing equipment so that the join domain of energy to be provided to described support.

7. equipment as claimed in claim 6, wherein said join domain comprise the connection gasket at the place, an end that is positioned at described support.

8. equipment as claimed in claim 6, wherein said join domain comprises the connection gasket that is positioned at described support, described support has tubular form.

9. as claim 6 or the described equipment of claim 7, wherein said join domain is positioned on the outer surface of described support.

10. as each the described equipment in the claim 6 to 9, wherein said conduction portion is positioned on the outer surface of described support.

11. as each the described equipment in the claim 6 to 10, wherein said conduction portion is spaced apart by described insulated part and described join domain, and wherein at least one insulation current path extends to described conduction portion by described insulated part from described join domain, energy is provided to described conduction portion.

12. as each the described equipment in the claim 5 to 11, wherein said conduction portion comprises metal coating.

13. equipment as claimed in claim 12, wherein said coating are formed on the main body that is formed by plastic material of described support.

14. as each the described equipment in the claim 5 to 11, wherein said conduction portion comprises coiling or litzendraht wire zone.

15. equipment as claimed in claim 14, wherein said conduction portion are formed on the main body that is formed by plastic material of described support.

16. as each the described equipment in the claim 1 to 15, wherein said support has the main body that is formed by plastic material.

17. as each the described equipment in the claim 1 to 16, wherein said support is essentially cylindrical.

18. equipment as claimed in claim 17, wherein said support forms pipe.

19. as each the described equipment in the claim 1 to 5, but wherein said support transversely deforming.

20. as each the described equipment in claim 1 to 5 and 19, it further comprises gas cell, wherein said gas cell is provided to expand, and described support is laterally broadened.

21. as each the described equipment in the claim 1 to 20, it further comprises hygrosensor.

22. a support that is used for the chamber of health, described support has outer surface and heating part, and described heating part has to be arranged to the electrode of the function of current to tissue, and described electrode is exercisable to the part of described outer surface only.

23. a support that is used for the chamber of health, described support have the roughly circumference and the heating part of circumference in its a kind of configuration, the described heating part of described support is arranged in the regional internal heating tissue of the part of described circumference.

24. equipment as claimed in claim 23, it comprises a plurality of transport elements, and described transport element by at least one insulated part separately is used for heating selectively the selected portion of described support.

25. support that is used for the chamber of health, described support has different electrical connector parts and is electrically connected to the operation heating part of described electrical connector part, described electrical connector partly is provided to be connected to power supply, and described operation heating part tissue in the heat tissue zone when being arranged in energy to described connector part.

26. as the described equipment of arbitrary aforementioned claim, it adopts bipolar operation.

27. as the described equipment of arbitrary aforementioned claim, it comprises formation electrical connector part thereon.

28. equipment as claimed in claim 27, wherein said electrical connector partly comprises plug or socket.

29. one kind is used for the treatment of the tumor that is formed on intracavity or the energy supply equipment of other tissue, it comprises percutaneous or endoscope's energy transfer equipment (for example conduit or speculum forceps), and wherein said percutaneous or endoscope's energy transfer equipment are arranged to energy is directly affacted the support or the implant of intracavity.

30. equipment as claimed in claim 29, wherein said percutaneous or endoscope's energy transfer equipment are arranged to by a plurality of connection support member effect energy, and the longitudinal axis that described support member preferably can be launched into respect to described percutaneous or endoscope's energy transfer equipment laterally moves.

31. as each the described equipment in claim 29 and 30, wherein said support member deformable, and can have straight or curved configuration.

32. as each the described equipment in claim 29 or 31, wherein said support member is connected to generator by connecting line.

33. as each the described equipment in the claim 29 to 32, wherein said support member utilisable energy activates separately.

34. equipment as claimed in claim 29, wherein said percutaneous or endoscope's energy transfer equipment are arranged to come energize by helix.

35. equipment as claimed in claim 34, the width of wherein said helix is transformable, and an end of described line can be with respect to its another end rotation, so that wide variety.

36. as each the described equipment in claim 29 and 35, it further comprises hygrosensor.

37. be used for the treatment of around the chamber or the equipment of the tumor of intracavity or other tissue, it comprises as each described energy supply equipment in the claim 29 to 36 and the support described in the claim 1 to 28 each.

38. equipment as claimed in claim 37, wherein said energy supply equipment is arranged to can be inserted in the described support.

39. a treatment is formed on intracavity or the tumor that forms around the chamber or the method for other tissue, it comprises:

(a) support is inserted into the intracavity that wherein has tumor or other tissue regions;

(b) energy is directly affacted described support, heating described support, and melt described tumor or other tissue regions.

40. method as claimed in claim 39, it comprises percutaneous or endoscope's connection device is connected to described support, and percutaneously or endoscope's ground effect energy.

41. method as claimed in claim 39, it comprises conduit is inserted in the described support, and by described conduit effect energy.

42. as claim 39 or claim 40 or the described method of claim 41, wherein said energy is the electromagnetic energy of radio frequency.

43. as claim 39 or claim 40 or the described method of claim 41, wherein said energy is a microwave energy.

44. as each the described equipment in the claim 1 to 38, heat tissue when it is arranged in the effect electromagnetic energy.

45. as each the described equipment in the claim 1 to 38, heat tissue when it is arranged in effect circulating pressure energy.

46. equipment as claimed in claim 45, wherein said circulating pressure energy comprises ultrasonic energy.

47. as each the described equipment in the claim 30 to 33, wherein said support member comprises framework, on described framework, described support member pivotally links together at one end place, and can laterally moving of described support member relative to free end, with splice holder, and with energy to described support.

48. as each the described equipment in claim 30 to 33 or 47, its involving vibrations equipment, described vibratory equipment described support member that is used to vibrate is with at least one electric contact piece on the cleaning support.

49. as each the described equipment in claim 1 to 38 or 44 to 48, it comprises magnetic part, described magnetic part is used to guarantee the electric interlock between support and the support energy supply equipment.

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