Recherche Images Maps Play YouTube Actualités Gmail Drive Plus »
Connexion
Les utilisateurs de lecteurs d'écran peuvent cliquer sur ce lien pour activer le mode d'accessibilité. Celui-ci propose les mêmes fonctionnalités principales, mais il est optimisé pour votre lecteur d'écran.

Brevets

  1. Recherche avancée dans les brevets
Numéro de publicationUS20110201975 A1
Type de publicationDemande
Numéro de demandeUS 13/091,693
Date de publication18 août 2011
Date de dépôt21 avr. 2011
Date de priorité20 mai 2004
Autre référence de publicationUS7951095, US20050261585
Numéro de publication091693, 13091693, US 2011/0201975 A1, US 2011/201975 A1, US 20110201975 A1, US 20110201975A1, US 2011201975 A1, US 2011201975A1, US-A1-20110201975, US-A1-2011201975, US2011/0201975A1, US2011/201975A1, US20110201975 A1, US20110201975A1, US2011201975 A1, US2011201975A1
InventeursInder Raj S. Makin, T. Douglas Mast, Michael H. Slayton, Peter G. Barthe, Jeffrey D. Messerly, Waseem Faidi, Megan M. Runk, Paul M. Jaeger
Cessionnaire d'origineMakin Inder Raj S, Mast T Douglas, Slayton Michael H, Barthe Peter G, Messerly Jeffrey D, Waseem Faidi, Runk Megan M, Jaeger Paul M
Exporter la citationBiBTeX, EndNote, RefMan
Liens externes: USPTO, Cession USPTO, Espacenet
Ultrasound medical system
US 20110201975 A1
Résumé
An ultrasound medical system includes an ultrasound end effector and at least one non-ultrasound tissue-property-measuring sensor. The ultrasound end effector includes a medical ultrasound transducer assembly having at least one medical-treatment ultrasound transducer. The at-least-one non-ultrasound tissue-property-measuring sensor is supported by the ultrasound end effector and is positionable in contact with patient tissue.
Images(7)
Previous page
Next page
Revendications(20)
1. An ultrasound medical system comprising an ultrasound end effector and at least one non-ultrasound tissue-property-measuring sensor, wherein the ultrasound end effector includes a medical ultrasound transducer assembly having at least one medical-treatment ultrasound transducer, and wherein the at-least-one non-ultrasound tissue-property-measuring sensor is supported by the ultrasound end effector and is disposable in contact with patient tissue.
2. The ultrasound medical system of claim 1, wherein the ultrasound end effector includes a longitudinal axis, wherein the at-least-one non-ultrasound tissue-property-measuring sensor includes a first non-ultrasound tissue-property-measuring sensor and a second non-ultrasound tissue-property-measuring sensor, and wherein the at-least-one medical-treatment ultrasound transducer is disposed longitudinally between the first and second non-ultrasound tissue-property-measuring sensors.
3. The ultrasound medical system of claim 1, wherein the at-least-one non-ultrasound tissue-property-measuring sensor measures tissue temperature.
4. The ultrasound medical system of claim 3, wherein the at-least-one non-ultrasound tissue-property-measuring sensor is chosen from the group consisting of a thermistor, a thermocouple, and combinations thereof.
5. The ultrasound medical system of claim 1, wherein the at-least-one non-ultrasound tissue-property-measuring sensor measures tissue electric impedance.
6. The ultrasound medical system of claim 5, wherein the at-least-one non-ultrasound tissue-property-measuring sensor is chosen from the group consisting of a monopolar electrode, a bipolar electrode, and combinations thereof.
7. The ultrasound medical system of claim 1, wherein the ultrasound end effector is an ultrasound interstitial end effector which is interstitially insertable into patient tissue and which has an exterior surface, and wherein the at-least-one non-ultrasound tissue-property-measuring sensor is attached to the ultrasound interstitial end effector and is fixedly disposed substantially flush with the exterior surface.
8. The ultrasound medical system of claim 7, wherein the exterior surface includes at least one balloon portion which is expandable and contractible and which is expandable against patient tissue to provide at least some stabilization of the ultrasound interstitial end effector with respect to patient tissue.
9. The ultrasound medical system of claim 1, wherein the ultrasound end effector is an ultrasound interstitial end effector which is interstitially insertable into patient tissue and which has an exterior surface, and wherein the at-least-one non-ultrasound tissue-property-measuring sensor is deployable to extend away from the exterior surface into patient tissue to provide at least some stabilization of the ultrasound interstitial end effector with respect to patient tissue and is retrievable to retract back toward the exterior surface.
10. The ultrasound medical system of claim 9, wherein the at-least-one non-ultrasound tissue-property-measuring sensor is storable inside the exterior surface.
11. The ultrasound medical system of claim 9, wherein the exterior surface includes at least one balloon portion which is expandable and contractible and which is expandable against patient tissue to provide at least some stabilization of the ultrasound interstitial end effector with respect to patient tissue.
12. The ultrasound medical system of claim 1, also including a handpiece operatively connected to the ultrasound end effector, wherein the ultrasound end effector has a longitudinal axis and a shaft, wherein the medical ultrasound transducer assembly is supported by the shaft, and wherein the shaft is rotatable with respect to the handpiece about the longitudinal axis.
13. An ultrasound medical system comprising an ultrasound end effector and at least one non-ultrasound tissue-property-measuring sensor, wherein the ultrasound end effector includes a medical ultrasound transducer assembly having at least one medical-treatment ultrasound transducer, wherein the at-least-one non-ultrasound tissue-property-measuring sensor is supported by the ultrasound end effector and is disposable in contact with patient tissue, and wherein the at-least-one non-ultrasound tissue-property-measuring sensor measures tissue temperature.
14. The ultrasound medical system of claim 13, wherein the at-least-one non-ultrasound tissue-property-measuring sensor is chosen from the group consisting of a thermistor, a thermocouple, and combinations thereof.
15. The ultrasound medical system of claim 14, wherein the ultrasound end effector is an ultrasound interstitial end effector which is interstitially insertable into patient tissue and which has an exterior surface, and wherein the at-least-one non-ultrasound tissue-property-measuring sensor is attached to the ultrasound interstitial end effector and is fixedly disposed substantially flush with the exterior surface.
16. The ultrasound medical system of claim 13, wherein the ultrasound end effector is an ultrasound interstitial end effector which is interstitially insertable into patient tissue and which has an exterior surface, and wherein the at-least-one non-ultrasound tissue-property-measuring sensor is attached to the ultrasound interstitial end effector and is fixedly disposed substantially flush with the exterior surface.
17. An ultrasound medical system comprising an ultrasound end effector and at least one non-ultrasound tissue-property-measuring sensor, wherein the ultrasound end effector includes a medical ultrasound transducer assembly having at least one medical-treatment ultrasound transducer, wherein the at-least-one non-ultrasound tissue-property-measuring sensor is supported by the ultrasound end effector and is disposable in contact with patient tissue, and wherein the at-least-one non-ultrasound tissue-property-measuring sensor measures tissue electric impedance.
18. The ultrasound medical system of claim 17, wherein the at-least-one non-ultrasound tissue-property-measuring sensor is chosen from the group consisting of a monopolar electrode, a bipolar electrode, and combinations thereof.
19. The ultrasound medical system of claim 18, wherein the ultrasound end effector is an ultrasound interstitial end effector which is interstitially insertable into patient tissue and which has an exterior surface, and wherein the at-least-one non-ultrasound tissue-property-measuring sensor is attached to the ultrasound interstitial end effector and is fixedly disposed substantially flush with the exterior surface.
20. The ultrasound medical system of claim 17, wherein the ultrasound end effector is an ultrasound interstitial end effector which is interstitially insertable into patient tissue and which has an exterior surface, and wherein the at-least-one non-ultrasound tissue-property-measuring sensor is attached to the ultrasound interstitial end effector and is fixedly disposed substantially flush with the exterior surface.
Description
    CROSS REFERENCE TO RELATED APPLICATIONS
  • [0001]
    The present application is a continuation of U.S. patent application Ser. No. 10/850,038 filed on May 20, 2004, presently allowed, which is incorporated herein by reference
  • FIELD OF THE INVENTION
  • [0002]
    The present invention relates generally to ultrasound, and more particularly to ultrasound medical systems and methods.
  • BACKGROUND OF THE INVENTION
  • [0003]
    Known medical methods include using ultrasound imaging (at low power) of patients to identify patient tissue for medical treatment and include using ultrasound (at high power) to ablate identified patient tissue by heating the tissue.
  • [0004]
    Known ultrasound medical systems and methods include deploying an ultrasound end effector having an ultrasound transducer outside the body to break up kidney stones inside the body, endoscopically inserting an ultrasound end effector having an ultrasound transducer in the rectum to medically destroy prostate cancer, laparoscopically inserting an ultrasound end effector having an ultrasound transducer in the abdominal cavity to medically destroy a cancerous liver tumor, intravenously inserting a catheter ultrasound end effector having an ultrasound transducer into a vein in the arm and moving the catheter to the heart to medically destroy diseased heart tissue, and interstitially inserting a needle ultrasound end effector having an ultrasound transducer needle into the tongue to medically destroy tissue to reduce tongue volume to reduce snoring.
  • [0005]
    Rotatable ultrasound end effectors are known wherein an ultrasound transducer is non-rotatably attached to a shaft whose distal end is circumferentially and longitudinally surrounded by a sheath having a longitudinal axis and having an acoustic window. Water between the shaft and the sheath provides acoustic coupling between the ultrasound transducer and the acoustic window. The shaft is rotatable about the longitudinal axis with respect to the sheath. The sheath is non-rotatably attached to a handpiece.
  • [0006]
    Known medical systems and methods include deploying a radio-frequency (RF) end effector having an RF electrode to thermally ablate patient tissue and to take tissue electric impedance and tissue temperature measurements using electrodes integrated into the shaft or into a tine which also helps stabilize the RF end effector in patient tissue.
  • [0007]
    Still, scientists and engineers continue to seek improved ultrasound medical systems and methods.
  • SUMMARY OF THE INVENTION
  • [0008]
    An embodiment of the invention is an ultrasound medical system including an ultrasound end effector and including at least one non-ultrasound tissue-property-measuring sensor. The ultrasound end effector includes a medical ultrasound transducer assembly having at least one medical-treatment ultrasound transducer. The at-least-one non-ultrasound tissue-property-measuring sensor is supported by the ultrasound end effector and is positionable in contact with patient tissue.
  • [0009]
    Several benefits and advantages are obtained from one or more of the embodiments and methods of the invention. In one example, having a non-ultrasound tissue-property-measuring sensor (such as a tissue temperature sensor and/or a tissue electric impedance sensor) allows ultrasound tissue ablation with feedback from the sensor used to evaluate the tissue ablation and/or modify the ultrasound treatment.
  • [0010]
    The present invention has, without limitation, application in conventional interstitial, endoscopic, laparoscopic, and open surgical instrumentation as well as application in robotic-assisted surgery.
  • BRIEF DESCRIPTION OF THE FIGURES
  • [0011]
    FIG. 1 is a perspective view of a first embodiment of the present invention showing an ultrasound medical system which includes an end effector, a handpiece, and a controller;
  • [0012]
    FIG. 2 is a schematic cross-sectional view of a first embodiment of the end effector and the handpiece of the ultrasound medical system of FIG. 1 showing a medical ultrasound transducer assembly and two non-ultrasound tissue-property-measuring sensors;
  • [0013]
    FIG. 3 is a view, as in FIG. 2, but of a second embodiment of a handpiece and of an end effector having a medical ultrasound transducer assembly and two tines;
  • [0014]
    FIG. 4 is a view, as in FIG. 2, but of a third embodiment of an end effector having a medical ultrasound transducer assembly supported by a shaft and having a surrounding sheath, wherein the sheath includes two balloon portions;
  • [0015]
    FIG. 5 is a block diagram view of a method of the invention for ultrasonically treating a lesion in a patient; and
  • [0016]
    FIG. 6 is a schematic view, partially in cross-section, of a fourth embodiment of an end effector which has a medical-treatment ultrasound transducer and three end-effector-tissue-track ablation devices and which can be used in one employment of the method of FIG. 5.
  • DETAILED DESCRIPTION OF THE INVENTION
  • [0017]
    Before explaining the present invention in detail, it should be noted that the invention is not limited in its application or use to the details of construction and arrangement of parts and/or steps illustrated in the accompanying drawings and description. The illustrative embodiments and methods of the invention may be implemented or incorporated in other embodiments, methods, variations and modifications, and may be practiced or carried out in various ways. Furthermore, unless otherwise indicated, the terms and expressions employed herein have been chosen for the purpose of describing the illustrative embodiments and methods of the present invention for the convenience of the reader and are not for the purpose of limiting the invention.
  • [0018]
    It is understood that any one or more of the following-described embodiments, methods, examples, etc. can be combined with any one or more of the other following-described embodiments, methods, examples, etc.
  • [0019]
    Referring now to FIGS. 1-2 of the drawings, a first embodiment of the present invention is an ultrasound medical system 110 comprising an ultrasound end effector 112 and at least one non-ultrasound tissue-property-measuring sensor 114 and 116. The ultrasound end effector 112 includes a medical ultrasound transducer assembly 118 having at least one medical-treatment ultrasound transducer 120. The at-least-one non-ultrasound tissue-property-measuring sensor 114 and 116 is supported by the ultrasound end effector 112 and is disposable in contact with patient tissue 122.
  • [0020]
    It is noted that a medical-treatment ultrasound transducer includes a medical-treatment-only ultrasound transducer and a medical-imaging-and-treatment ultrasound transducer. In one arrangement, an ultrasound transducer has a single transducer element, and in another arrangement, an ultrasound transducer has a plurality (also called an array) of transducer elements. It is also noted that a medical ultrasound transducer assembly having at least one medical-treatment ultrasound transducer can also have at least one medical-imaging ultrasound transducer.
  • [0021]
    In one example of the embodiment of FIGS. 1-2, the ultrasound end effector 112 includes a longitudinal axis 124. In this example, the at-least-one non-ultrasound tissue-property-measuring sensor 114 and 116 includes a first non-ultrasound tissue-property-measuring sensor 114 and a second non-ultrasound tissue-property-measuring sensor 116. The at-least-one medical-treatment ultrasound transducer 120 is disposed longitudinally between the first and second non-ultrasound tissue-property-measuring sensors 114 and 116.
  • [0022]
    In one variation of the embodiment of FIGS. 1-2, the at-least-one non-ultrasound tissue-property-measuring sensor (e.g., 114) measures tissue temperature. In one modification, the at-least-one non-ultrasound tissue-property-measuring sensor (e.g., 114) is chosen from the group consisting of a thermistor, a thermocouple, and combinations thereof. In another variation, the at-least-one non-ultrasound tissue-property-measuring sensor (e.g., 116) measures tissue electric impedance. In one modification, the at-least-one non-ultrasound tissue-property-measuring sensor (e.g., 116) is chosen from the group consisting of a monopolar electrode, a bipolar electrode, and combinations thereof. It is noted that tissue temperature and/or tissue electric impedance is a measure of the degree of ultrasonic ablation of patient tissue, as can be appreciated by those skilled in the art.
  • [0023]
    In one construction of the embodiment of FIGS. 1-2, the ultrasound end effector 112 is an ultrasound interstitial end effector 126 which is interstitially insertable into patient tissue 122 and which has an exterior surface 128. The at-least-one non-ultrasound tissue-property-measuring sensor 114 and 116 is attached to the ultrasound interstitial end effector 126 and is fixedly disposed substantially flush with the exterior surface 128. In one arrangement, the exterior surface 128 includes at least one balloon portion 130 and 132 which is expandable and contractible and which is expandable against patient tissue 122 to provide at least some stabilization of the ultrasound interstitial end effector 126 with respect to patient tissue 122. In one variation, the exterior surface 128 is the exterior surface of a sheath 134 and has first and second balloon portions 130 and 132, wherein the first balloon portion 130 surrounds the medical ultrasound transducer assembly 118 and acts as an acoustic window, and wherein the second balloon portion 132 is longitudinally spaced apart from the medical ultrasound transducer assembly 118. An acoustic coupling medium, such as water, is disposable between the medical ultrasound transducer assembly 118 and the first balloon portion 130 and has been omitted from FIG. 2 for clarity. In one modification, the first balloon portion 130 is omitted and the sheath 134 terminates before the medical ultrasound transducer assembly 118 which is exposed to patient tissue. In another modification, the second balloon portion 132 is omitted. In one employment, the at-least-one balloon portion 130 and 132 is contracted during tissue insertion and withdrawal of the ultrasound interstitial end effector 126. Other constructions, arrangements, variations, and modifications are left to the artisan.
  • [0024]
    In one enablement of the embodiment of FIGS. 1-2, the ultrasound end effector 112 is an ultrasound interstitial end effector 126 which is interstitially insertable into patient tissue 122 and which has an exterior surface 128. In this enablement, the at-least-one non-ultrasound tissue-property-measuring sensor 114 and 116 is deployable to extend away from the exterior surface into patient tissue 128 to provide at least some stabilization of the ultrasound interstitial end effector 126 with respect to patient tissue 122 and is retrievable to retract back toward the exterior surface 128. In one arrangement, the at-least-one non-ultrasound tissue-property-measuring sensor 114 and 116 is storable inside the exterior surface.
  • [0025]
    In one implementation of the embodiment of FIGS. 1-2, the ultrasound medical system 110 also includes a handpiece 136 operatively connected to the ultrasound end effector 112, The ultrasound end effector 112 has a longitudinal axis 124 and a shaft 138, and the medical ultrasound transducer assembly 118 is supported by the shaft 138. The shaft 138 is rotatable with respect to the handpiece 136 about the longitudinal axis 124 and is supported by bearings 139. In one variation, a motor 140 rotates the shaft 138. In one arrangement, the ultrasound medical system 110 includes a controller 142 operatively connected to the handpiece 136 via a cable 144.
  • [0026]
    A second embodiment of the present invention, shown in FIG. 3, is an ultrasound medical system 210 comprising an ultrasound end effector 226. The ultrasound end effector 226 has an exterior surface 228. The ultrasound end effector 226 includes a medical ultrasound transducer assembly 218 having at least one medical-treatment ultrasound transducer 220, and includes at least one tine 246 and 248. The at-least-one tine 246 and 248 is deployable to extend away from the exterior surface into patient tissue to provide at least some stabilization of the ultrasound end effector 226 with respect to patient tissue and is retrievable to retract back toward the exterior surface 228.
  • [0027]
    In one example of the embodiment of FIG. 3, the ultrasound end effector 226 is insertable into a patient. In one variation, the ultrasound end effector 226 is an ultrasound interstitial end effector which is interstitially insertable into patient tissue. In other variations, the ultrasound end effector is insertable into a patient in an endoscopic, laparoscopic, and/or open surgical manner. In another example, the ultrasound end effector is disposable on the outside of a patient. Other examples and variations are left to the artisan.
  • [0028]
    In one enablement of the embodiment of FIG. 3, the at-least-one tine 246 and 248 includes a plurality of tines. In one example of the embodiment of FIG. 3, the at-least-one tine 246 and 248 is storable inside the exterior surface. It is noted that construction of deployable tines 246 and 248 in an ultrasound end effector 226 is within the level of skill of the artisan. In one arrangement, such deployment is accomplished using one or more of cables, levers, motors 249, gearing, push rods and the like to move a tine partially out of, and back into, a lumen in the end effector. In one choice of materials, the tine comprises or consists essentially of Nitinol wire or nichrome wire.
  • [0029]
    In one employment of the embodiment of FIG. 3, the at-least-one tine (e.g., 246) acts as an element chosen from the group consisting of an electrode, a thermistor, a thermocouple, an acoustic reflector, an acoustic absorber, an acoustic emitter, an acoustic receiver, a radio-frequency (RF) heater, a resistive heater, and combinations thereof. In another employment, the at-least-one tine (e.g., 248) includes a component 250 chosen from the group consisting of an electrode, a thermistor, a thermocouple, an acoustic reflector, an acoustic absorber, an acoustic emitter, an acoustic receiver, a radio-frequency (RF) heater, a resistive heater, and combinations thereof.
  • [0030]
    The embodiment, examples, constructions, implementations, etc. of the embodiment of FIGS. 1-2 are equally applicable to the embodiment, constructions, implementations, etc. of FIG. 3. In one construction of the embodiment of FIG. 3, the exterior surface 228 is like the exterior surface 128 of a previously-illustrated and described construction of the embodiment of FIGS. 1-2 including at least one balloon portion which is expandable and contractible, and which is expandable against patient tissue to provide at least some stabilization of the ultrasound end effector with respect to patient tissue. In one implementation of the embodiment of FIG. 3, the ultrasound medical system 210 also includes, like a previously-illustrated and described implementation of the embodiment of FIGS. 1-2, a handpiece operatively connected to the ultrasound end effector, wherein the ultrasound end effector has a longitudinal axis and a shaft, wherein the medical ultrasound transducer assembly is supported by the shaft, and wherein the shaft is rotatable with respect to the handpiece about the longitudinal axis.
  • [0031]
    One method, using the embodiment of FIG. 3 and enablements, examples, employments, and constructions thereof, is for ultrasonically treating a lesion in a patient and includes steps a) through f). Step a) includes obtaining the ultrasound medical system 210. Step b) includes inserting the ultrasound end effector 226 into patient tissue. Step c) includes deploying the plurality of tines 246 and 248 to extend sway from the exterior surface 228 into the patient tissue. Step d) includes ultrasonically ablating the lesion using the at-least-one medical-treatment ultrasound transducer 220. Step e) includes retrieving the plurality of tines 246 and 248 to retract back toward the exterior surface and storing the plurality of tines 246 and 248 inside the exterior surface 228. Step f) includes withdrawing the ultrasound end effector 226 from the patient tissue. Another method also includes the step of employing the plurality of tines 246 and 248 to each act as the element or using each component 250. An additional method also includes the step of expanding the at-least-one balloon portion against patient tissue and contracting the at-least-one balloon portion.
  • [0032]
    A third embodiment of the present invention, shown in FIG. 4, is an ultrasound medical system 310 comprising an ultrasound end effector 326 including a shaft 338, a sheath 334, and a medical ultrasound transducer assembly 318. The medical ultrasound transducer assembly 318 is supported by the shaft 338 and has at least one medical-treatment ultrasound transducer 320. The sheath 334 surrounds the shaft 338. The sheath 334 includes at least one balloon portion 330 and 332 which is expandable against patient tissue to provide at least some stabilization of the ultrasound end effector 326 with respect to patient tissue.
  • [0033]
    In one example of the embodiment of FIG. 4, the ultrasound end effector 326 is insertable into a patient. In one variation, the ultrasound end effector 326 is an ultrasound interstitial end effector which is interstitially insertable into patient tissue. In other variations, the ultrasound end effector is insertable into a patient in an endoscopic, laparoscopic, and/or open surgical manner. In another example, the ultrasound end effector is disposable on the outside of a patient. Other examples and variations are left to the artisan.
  • [0034]
    In one construction of the embodiment of FIG. 3, the ultrasound end effector 326 has a longitudinal axis 324, and the at-least-one balloon portion (e.g., 330) acts as an acoustic window and is disposed to longitudinally overlap the at-least-one medical-treatment ultrasound transducer 320. In one variation of this construction, the at-least-one balloon portion (e.g., 330) includes at least one through hole 352. In one modification, the at-least-one balloon portion (e.g., 330) includes a plurality of through holes 352 creating a “weeping” balloon portion, wherein some of the acoustic coupling medium inside the sheath 334 extends and/or flows outside the sheath acoustic window providing improved acoustic coupling between the at-least-one medical-treatment ultrasound transducer 320 and patient tissue.
  • [0035]
    In one arrangement of the embodiment of FIG. 3, the at-least-one balloon portion (e.g., 330) includes at least one through hole 352 and the ultrasound end effector 326 is adapted to dispense a drug 354 through the at-least-one through hole 352 to patient tissue. In one variation, the drug 354 is carried in a liquid acoustic coupling medium 356, such as water, disposed between the medical ultrasound transducer assembly 318 and the at-least-one balloon portion 330 whose pressure is controlled (such as by a pump in a handpiece operatively connected to the ultrasound end effector) to expand and contract the at-least-one balloon portion 330. In one variation, the drug 354 is at least potentiated (i.e., has its medical effect increased and/or activated) by ultrasound emitted from the at-least-one medical-treatment ultrasound transducer 320.
  • [0036]
    In the same or another arrangement of the embodiment of FIG. 3, the ultrasound end effector 326 has a longitudinal axis 324, and the at-least-one balloon portion (e.g., 332) is disposed longitudinally apart from the at-least-one medical-treatment ultrasound transducer 320. In one variation of the embodiment of FIG. 3, the at-least-one balloon portion (e.g., 330) is a fully-circumferential balloon portion. In a different variation, the at-least-one balloon portion (e.g., 332) is a blister balloon portion. In one example of the embodiment of FIG. 3, the at-least-one balloon portion 330 and 332 includes an outside surface 358 having a roughness average at least equal to 0.005-inch. In one variation, the outside surface includes ribs. Such surface roughness improves stabilization of the ultrasound end effector 326 with respect to patient tissue when the at-least-one balloon portion 330 and 332 is expanded against the patient tissue.
  • [0037]
    The embodiments, constructions, implementations, etc. of the embodiments of FIGS. 1-2 and 3 are equally applicable to the embodiment, constructions, implementations, etc. of the embodiment of FIG. 4. In one implementation of the embodiment of FIG. 3, the ultrasound medical system 310 also includes a controller, like the controller of the previously-illustrated and described arrangement of the embodiment of FIGS. 1-2, wherein the controller is operatively connected to the medical ultrasound transducer assembly, wherein the medical ultrasound transducer assembly is a medical-imaging-and-treatment ultrasound transducer assembly, and wherein the controller determines if the at-least-one balloon portion is acoustically coupled to, or acoustically decoupled from, patient tissue from ultrasonically imaging a balloon-tissue area using the medical-imaging-and-treatment ultrasound transducer assembly.
  • [0038]
    One method of the invention for ultrasonically treating a lesion in a patient is shown in block diagram form in FIG. 5, and an embodiment of an ultrasound medical system which can be used in performing the method is shown in FIG. 6. The method includes steps a) through e). Step a) is labeled as “Obtain Interstitial End Effector” in block 460 of FIG. 5. Step a) includes obtaining an interstitial end effector 426 including a distal end 462 and including a medical ultrasound transducer assembly 418 having at least one medical-treatment ultrasound transducer 420 and at least one end-effector-tissue-track ablation device 472, 474 and 476. It is noted that the distal end of an interstitial end effector is an end having a tissue-piercing tip. Step b) is labeled as “Insert End Effector Into Patient” in block 464 of FIG. 5. Step b) includes inserting the interstitial end effector 426 into the patient creating a tissue track which is surrounded by patient tissue and which ends at the distal end 462 of the inserted interstitial end effector 426. Step c) is labeled as “Ablate Lesion Using Ultrasound” in block 466 of FIG. 5. Step c) includes ultrasonically ablating the lesion using the at-least-one medical-treatment ultrasound transducer 420. Step d) is labeled as “Ablate Tissue Track Using End Effector” in block 468 of FIG. 5. Step d) includes using the at-least-one end-effector-tissue-track ablation device 472, 474 and 476 to ablate the patient tissue surrounding the tissue track along substantially the entire tissue track. Step e) is labeled as “Withdraw End Effector” in block 470 of FIG. 5. Step e) includes withdrawing the interstitial end effector 426 from the patient.
  • [0039]
    It is noted that creating a tissue track requires that the interstitial end effector 426 be interstitially inserted into patient tissue. It is also noted that the interstitial end effector 426 can be equipped with a retractable tip shield (not shown) for initial endoscopic or laparoscopic patient entry followed by interstitial insertion into patient tissue.
  • [0040]
    In one extension of the method of FIG. 5, there is included the step of using the at-least-one end-effector-tissue-track ablation device (e.g., 474) to ablate the patient tissue at the distal end 462 of the inserted interstitial end effector 426.
  • [0041]
    In one implementation of the method of FIG. 5, the at-least-one end-effector-tissue-track ablation device (e.g., 474) includes a non-ultrasound energy source, and step d) uses the non-ultrasound energy source to ablate the patient tissue surrounding the tissue track. In one variation, the non-ultrasound energy source is chosen from the group consisting of a resistive heat energy source, a hot liquid energy source, a monopolar radio-frequency (RF) energy source, a bipolar radio-frequency (RF) energy source, a capacitive heat energy source, a microwave energy source, and combinations thereof.
  • [0042]
    In another implementation of the method, the at-least-one end-effector-tissue-track ablation device (e.g., 476) includes a tissue-ablating chemical agent, and step d) uses the tissue-ablating chemical agent to ablate the patient tissue surrounding the tissue track. In one variation, the tissue-ablating chemical agent is chosen from the group consisting of fibrin, alcohol, an acidic fluid, a chemotherapeutic agent, and combinations thereof.
  • [0043]
    In a further implementation of the method, step d) uses the medical ultrasound transducer assembly 418 to ultrasonically ablate the patient tissue surrounding the tissue track. In one variation, step d) ultrasonically ablates at a higher ultrasound frequency than does step c).
  • [0044]
    In the same or another extension of the method of FIG. 5, there is included the step of monitoring (such as for acoustic coupling and/or for tissue ablation) the patient tissue surrounding the tissue track during step d). In one variation, the monitoring is chosen from the group consisting of B-mode ultrasonic image monitoring, tissue temperature monitoring, tissue electric impedance, and combinations thereof.
  • [0045]
    In the same or another extension of the method of FIG. 5, there are included, after step b) and before step c), the step of stabilizing (such as by using a balloon, a tine and/or suction) the interstitial end effector 426 with respect to the patient tissue surrounding the tissue track and, after step c) and before step d), the step of releasing the stabilizing of the interstitial end effector 426 with respect to the patient tissue surrounding the tissue track.
  • [0046]
    In one application of the method of FIG. 5, step e) includes stepwise withdrawing the interstitial end effector 426 from the patient using a plurality of positional steps, and step d) includes ablating the patient tissue surrounding the tissue track for a predetermined time with the interstitial end effector at each positional step.
  • [0047]
    A fourth embodiment of the present invention, shown in FIG. 6, is an ultrasound medical system 410 comprising an interstitial end effector 426 which is interstitially insertable into patient tissue, which includes at least one medical-treatment ultrasound transducer 420, and which includes at least one end-effector-tissue-track ablation device 472, 474 and 476.
  • [0048]
    In one enablement of the embodiment of FIG. 6, the ultrasound medical system 410 includes a controller (such as the controller 142 illustrated in FIG. 1) which is operatively connected to the at-least-one medical-treatment ultrasound transducer 420 to ultrasonically ablate a lesion in patient tissue of the patient and which is operatively connected to the at-least-one end-effector-tissue-track ablation device 472, 474 and 476 to ablate patient tissue surrounding the interstitial end effector 426 during withdrawal of the interstitial end effector 426 from the patient.
  • [0049]
    In one application of the embodiment of FIG. 6, the at-least-one end-effector-tissue-track ablation device 472, 474, 476 includes a cylindrical ultrasound transducer 472. In the same or a different application, the at-least-one end-effector-tissue-track ablation device and the at-least-one medical-treatment ultrasound transducer are a single rotatable ultrasound transducer (such as ultrasound transducer 420 made rotatable such as in a previously illustrated and described implementation of the embodiment of FIGS. 1-2). Other applications of an end-effector-tissue-track ablation device involving ultrasound are left to the artisan.
  • [0050]
    In another application of the embodiment of FIG. 6, the at-least-one end-effector-tissue-track ablation device 472, 474 and 476 includes a device 474 which uses a non-ultrasound energy source. In one variation, the non-ultrasound energy source is chosen from the group consisting of a resistive heat energy source, a hot liquid energy source, a monopolar radio-frequency (RF) energy source, a bipolar radio-frequency (RF) energy source, a capacitive heat energy source, a microwave energy source, and combinations thereof.
  • [0051]
    In a further application of the embodiment of FIG. 6, the at-least-one end-effector-tissue-track ablation device 472, 474 and 476 includes a device 476 which releases a tissue-ablating chemical agent. In one variation, the tissue-ablating chemical agent is chosen from the group consisting of fibrin, alcohol, an acidic fluid, a chemotherapeutic agent, and combinations thereof.
  • [0052]
    In one construction of the embodiment of FIG. 6, the interstitial end effector 426 has a length and an exterior surface 428 and includes position markings 478 on the exterior surface 428 along at least a portion of its length. Such position markings allow a user to withdraw the interstitial end effector 426 from patient tissue in positional steps while ablating patient tissue surrounding the end-effector tissue track for a predetermined dwell time at each positional step. In the same or a different construction, the interstitial end effector 426 has a longitudinal axis 424 and a distal end 462, and wherein the at-least-one end-effector-tissue-track ablation device 472, 474 and 476 includes an end-effector-tissue-track ablation device (such as 474) which is disposed proximate the distal end 462. It is noted that the distal end of an interstitial end effector is an end having a tissue-piercing tip. In the same or a different construction, the interstitial end effector 426 includes a tissue-ablating component (such as 474) adapted (such as by having a resistive heat energy source) to ablate (such as to thermally ablate) patient tissue longitudinally forward of the distal end 462.
  • [0053]
    In one variation, the ultrasound interstitial end effector includes a sheath 434 surrounding the medical-treatment ultrasound transducer 120 and having an acoustic window 480. In one modification, the entire sheath acts as an acoustic window. In another modification, the acoustic window is a thinner portion of the sheath. In a further modification, the acoustic window is a separate material(s) from the material(s) of the non-acoustic-window portion(s) of the sheath. Acoustic window component materials are known to those skilled in the art. Other modifications are left to the artisan.
  • [0054]
    It is noted that the embodiments, constructions, implementations, etc. of the embodiments of FIGS. 1-2, 3 and 4 are equally applicable to the embodiment, constructions, implementations, etc. of the embodiment of FIG. 6.
  • [0055]
    Several benefits and advantages are obtained from one or more of the embodiments and methods of the invention. In one example, having a non-ultrasound tissue-property-measuring sensor (such as a tissue temperature sensor and/or a tissue electric impedance sensor) allows ultrasound tissue ablation with feedback from the sensor used to evaluate the tissue ablation and/or modify the ultrasound treatment.
  • [0056]
    While the present invention has been illustrated by a description of several embodiments and methods, it is not the intention of the applicants to restrict or limit the spirit and scope of the appended claims to such detail. Numerous other variations, changes, and substitutions will occur to those skilled in the art without departing from the scope of the invention. For instance, the ultrasound medical system of the invention has application in robotic assisted surgery taking into account the obvious modifications of such systems, components and methods to be compatible with such a robotic system. It will be understood that the foregoing description is provided by way of example, and that other modifications may occur to those skilled in the art without departing from the scope and spirit of the appended Claims.
Citations de brevets
Brevet cité Date de dépôt Date de publication Déposant Titre
US3168659 *11 janv. 19602 févr. 1965Gen Motors CorpVariable focus transducer
US3779234 *30 juin 197118 déc. 1973Intersc Res InstUltrasonic catheter with rotating transducers
US3902501 *21 juin 19732 sept. 1975Medtronic IncEndocardial electrode
US3927557 *30 mai 197423 déc. 1975Gen ElectricAcoustic imaging apparatus with liquid-filled acoustic corrector lens
US4211948 *8 nov. 19788 juil. 1980General Electric CompanyFront surface matched piezoelectric ultrasonic transducer array with wide field of view
US4315514 *8 mai 198016 févr. 1982William DrewesMethod and apparatus for selective cell destruction
US4323077 *12 mars 19806 avr. 1982General Electric CompanyAcoustic intensity monitor
US4396019 *8 juin 19812 août 1983Perry Jr John DVaginal myograph method and apparatus
US4484569 *1 mars 198227 nov. 1984Riverside Research InstituteUltrasonic diagnostic and therapeutic transducer assembly and method for using
US4646756 *24 oct. 19833 mars 1987The University Of AberdeenUltra sound hyperthermia device
US4748985 *2 mai 19867 juin 1988Olympus Optical Co., Ltd.Ultrasonic imaging apparatus having circulating cooling liquid for cooling ultrasonic transducers thereof
US4757820 *12 mars 198619 juil. 1988Kabushiki Kaisha ToshibaUltrasound therapy system
US4765331 *10 févr. 198723 août 1988Circon CorporationElectrosurgical device with treatment arc of less than 360 degrees
US4787394 *23 avr. 198729 nov. 1988Kabushiki Kaisha ToshibaUltrasound therapy apparatus
US4790329 *12 juin 198713 déc. 1988Trustees Of Beth Israel HospitalAdjustable biopsy localization device
US4798215 *28 nov. 198617 janv. 1989Bsd Medical CorporationHyperthermia apparatus
US4818954 *6 févr. 19874 avr. 1989Karl Storz Endoscopy-America, Inc.High-frequency generator with automatic power-control for high-frequency surgery
US4844080 *10 juin 19884 juil. 1989Michael FrassUltrasound contact medium dispenser
US4858613 *2 mars 198822 août 1989Laboratory Equipment, Corp.Localization and therapy system for treatment of spatially oriented focal disease
US4884080 *2 juin 198728 nov. 1989Kabushiki Kaisha ToshibaColor image printing apparatus
US4932414 *2 nov. 198712 juin 1990Cornell Research Foundation, Inc.System of therapeutic ultrasound and real-time ultrasonic scanning
US4937767 *24 déc. 198726 juin 1990Hewlett-Packard CompanyMethod and apparatus for adjusting the intensity profile of an ultrasound beam
US4951653 *2 mars 198828 août 1990Laboratory Equipment, Corp.Ultrasound brain lesioning system
US4955365 *22 juin 198911 sept. 1990Laboratory Equipment, Corp.Localization and therapy system for treatment of spatially oriented focal disease
US4955366 *15 nov. 198811 sept. 1990Olympus Optical Co., Ltd.Ultrasonic therapeutical apparatus
US4960107 *30 sept. 19882 oct. 1990Kabushiki Kaisha ToshibaUltrasonic medical treatment apparatus
US4960109 *21 juin 19882 oct. 1990Massachusetts Institute Of TechnologyMulti-purpose temperature sensing probe for hyperthermia therapy
US4984575 *18 avr. 198815 janv. 1991Olympus Optical Co., Ltd.Therapeutical apparatus of extracorporeal type
US4986275 *9 août 198922 janv. 1991Kabushiki Kaisha ToshibaUltrasonic therapy apparatus
US5005580 *6 déc. 19899 avr. 1991Kabushiki Kaisha ToshibaDestroying wave treatment apparatus
US5015929 *1 déc. 198914 mai 1991Technomed International, S.A.Piezoelectric device with reduced negative waves, and use of said device for extracorporeal lithotrity or for destroying particular tissues
US5031626 *11 août 198916 juil. 1991Siemens AktiengesellschaftExtracorporeal lithotripsy apparatus with an ultrasound locating system
US5036855 *22 juin 19896 août 1991Laboratory Equipment, Corp.Localization and therapy system for treatment of spatially oriented focal disease
US5042486 *12 sept. 199027 août 1991Siemens AktiengesellschaftCatheter locatable with non-ionizing field and method for locating same
US5054470 *5 déc. 19898 oct. 1991Laboratory Equipment, Corp.Ultrasonic treatment transducer with pressurized acoustic coupling
US5065740 *23 juil. 199019 nov. 1991Kabushiki Kaisha ToshibaUltrasonic medical treatment apparatus
US5078144 *14 juin 19897 janv. 1992Olympus Optical Co. Ltd.System for applying ultrasonic waves and a treatment instrument to a body part
US5080101 *19 juin 198914 janv. 1992Edap International, S.A.Method for examining and aiming treatment with untrasound
US5080102 *21 avr. 198914 janv. 1992Edap International, S.A.Examining, localizing and treatment with ultrasound
US5095906 *2 janv. 199117 mars 1992Kabushiki Kaisha ToshibaImage processing system
US5095907 *19 juin 199017 mars 1992Kabushiki Kaisha ToshibaAcoustic wave therapy apparatus
US5117832 *20 août 19912 juin 1992Diasonics, Inc.Curved rectangular/elliptical transducer
US5143073 *14 juin 19881 sept. 1992Edap International, S.A.Wave apparatus system
US5143074 *3 mai 19911 sept. 1992Edap InternationalUltrasonic treatment device using a focussing and oscillating piezoelectric element
US5148809 *28 févr. 199022 sept. 1992Asgard Medical Systems, Inc.Method and apparatus for detecting blood vessels and displaying an enhanced video image from an ultrasound scan
US5149319 *11 sept. 199022 sept. 1992Unger Evan CMethods for providing localized therapeutic heat to biological tissues and fluids
US5150711 *23 juil. 199129 sept. 1992Edap International, S.A.Ultra-high-speed extracorporeal ultrasound hyperthermia treatment device
US5150712 *9 janv. 199129 sept. 1992Edap International, S.A.Apparatus for examining and localizing tumors using ultra sounds, comprising a device for localized hyperthermia treatment
US5158070 *18 juil. 199027 oct. 1992Edap International, S.A.Method for the localized destruction of soft structures using negative pressure elastic waves
US5158071 *27 juin 198927 oct. 1992Hitachi, Ltd.Ultrasonic apparatus for therapeutical use
US5203333 *21 août 199220 avr. 1993Kabushiki Kaisha ToshibaAcoustic wave therapy apparatus
US5209221 *20 sept. 199111 mai 1993Richard Wolf GmbhUltrasonic treatment of pathological tissue
US5238007 *12 déc. 199124 août 1993Vitatron Medical B.V.Pacing lead with improved anchor mechanism
US5240005 *22 nov. 199131 août 1993Dornier Medizintechnik GmbhAcoustic focussing device
US5242437 *7 juin 19897 sept. 1993Trimedyne Laser Systems, Inc.Medical device applying localized high intensity light and heat, particularly for destruction of the endometrium
US5295484 *19 mai 199222 mars 1994Arizona Board Of Regents For And On Behalf Of The University Of ArizonaApparatus and method for intra-cardiac ablation of arrhythmias
US5304115 *11 janv. 199119 avr. 1994Baxter International Inc.Ultrasonic angioplasty device incorporating improved transmission member and ablation probe
US5305731 *13 oct. 199226 avr. 1994Siemens AktiengesellschaftApparatus for generating acoustic wave having a liquid lens with an adjustable focal length
US5311869 *22 mars 199117 mai 1994Kabushiki Kaisha ToshibaMethod and apparatus for ultrasonic wave treatment in which medical progress may be evaluated
US5345940 *6 nov. 199213 sept. 1994Mayo Foundation For Medical Education And ResearchTransvascular ultrasound hemodynamic and interventional catheter and method
US5348017 *19 janv. 199320 sept. 1994Cardiovascular Imaging Systems, Inc.Drive shaft for an intravascular catheter system
US5354258 *7 janv. 199311 oct. 1994Edap InternationalUltra-high-speed extracorporeal ultrasound hyperthermia treatment method
US5370121 *3 sept. 19936 déc. 1994Siemens AktiengesellschaftMethod and apparatus for non-invasive measurement of a temperature change in a subject
US5391140 *27 déc. 199321 févr. 1995Siemens AktiengesellschaftTherapy apparatus for locating and treating a zone in the body of a life form with acoustic waves
US5391197 *25 juin 199321 févr. 1995Dornier Medical Systems, Inc.Ultrasound thermotherapy probe
US5398690 *3 août 199421 mars 1995Batten; Bobby G.Slaved biopsy device, analysis apparatus, and process
US5398691 *3 sept. 199321 mars 1995University Of WashingtonMethod and apparatus for three-dimensional translumenal ultrasonic imaging
US5402792 *15 mars 19944 avr. 1995Shimadzu CorporationUltrasonic medical apparatus
US5409002 *4 févr. 199425 avr. 1995Focus Surgery IncorporatedTreatment system with localization
US5413550 *21 juil. 19939 mai 1995Pti, Inc.Ultrasound therapy system with automatic dose control
US5419335 *18 août 199330 mai 1995Siemens AktiengesellschaftAcoustic lens
US5421338 *3 juin 19946 juin 1995Boston Scientific CorporationAcoustic imaging catheter and the like
US5431663 *8 déc. 199311 juil. 1995Coraje, Inc.Miniature ultrasonic transducer for removal of intravascular plaque and clots
US5435304 *24 mars 199325 juil. 1995Siemens AktiengesellschaftMethod and apparatus for therapeutic treatment with focussed acoustic waves switchable between a locating mode and a therapy mode
US5435311 *16 mai 199425 juil. 1995Hitachi, Ltd.Ultrasound therapeutic system
US5443069 *15 oct. 199322 août 1995Siemens AktiengesellschaftTherapeutic ultrasound applicator for the urogenital region
US5448994 *6 juin 199412 sept. 1995Kabushiki Kaisha ToshibaApparatus for performing medical treatment by using electroacoustic transducer element
US5458597 *8 nov. 199317 oct. 1995Zomed InternationalDevice for treating cancer and non-malignant tumors and methods
US5465724 *28 mai 199314 nov. 1995Acuson CorporationCompact rotationally steerable ultrasound transducer
US5471988 *23 déc. 19945 déc. 1995Olympus Optical Co., Ltd.Ultrasonic diagnosis and therapy system in which focusing point of therapeutic ultrasonic wave is locked at predetermined position within observation ultrasonic scanning range
US5474071 *22 févr. 199412 déc. 1995Technomed Medical SystemsTherapeutic endo-rectal probe and apparatus constituting an application thereof for destroying cancer tissue, in particular of the prostate, and preferably in combination with an imaging endo-cavitary-probe
US5485839 *2 sept. 199423 janv. 1996Kabushiki Kaisha ToshibaMethod and apparatus for ultrasonic wave medical treatment using computed tomography
US5492126 *2 mai 199420 févr. 1996Focal SurgeryProbe for medical imaging and therapy using ultrasound
US5500012 *8 juil. 199419 mars 1996Angeion CorporationAblation catheter system
US5501655 *15 juil. 199426 mars 1996Massachusetts Institute Of TechnologyApparatus and method for acoustic heat generation and hyperthermia
US5514085 *1 oct. 19937 mai 1996Yoon; InbaeMultifunctional devices for use in endoscopic surgical procedures and methods therefor
US5514130 *11 oct. 19947 mai 1996Dorsal Med InternationalRF apparatus for controlled depth ablation of soft tissue
US5520188 *2 nov. 199428 mai 1996Focus Surgery Inc.Annular array transducer
US5522869 *8 mars 19954 juin 1996Burdette; Everette C.Ultrasound device for use in a thermotherapy apparatus
US5524620 *26 janv. 199411 juin 1996November Technologies Ltd.Ablation of blood thrombi by means of acoustic energy
US5526815 *10 déc. 199318 juin 1996Siemens AktiengesellschatTherapy apparatus for locating and treating a zone located in the body of a life form with acoustic waves
US5526816 *2 juin 199518 juin 1996Bracco Research S.A.Ultrasonic spectral contrast imaging
US5526822 *24 mars 199418 juin 1996Biopsys Medical, Inc.Method and apparatus for automated biopsy and collection of soft tissue
US5588432 *10 juil. 199531 déc. 1996Boston Scientific CorporationCatheters for imaging, sensing electrical potentials, and ablating tissue
US5891134 *24 sept. 19966 avr. 1999Goble; ColinSystem and method for applying thermal energy to tissue
US20020123749 *3 janv. 20025 sept. 2002Jain Mudit K.Ablation catheter with transducer for providing one or more of pressure, temperature and fluid flow data for use in controlling ablation therapy
US20030018358 *3 juil. 200223 janv. 2003Vahid SaadatApparatus and methods for treating tissue
US20030092988 *22 mai 200215 mai 2003Makin Inder Raj S.Staging medical treatment using ultrasound
US20050261588 *21 mai 200424 nov. 2005Makin Inder Raj SUltrasound medical system
USRE33590 *22 nov. 198821 mai 1991Edap International, S.A.Method for examining, localizing and treating with ultrasound
Référencé par
Brevet citant Date de dépôt Date de publication Déposant Titre
US823280130 juin 201131 juil. 2012General Electric CompanyNuclear quadrupole resonance system and method for structural health monitoring
Classifications
Classification aux États-Unis601/2
Classification internationaleA61B8/00, A61B5/05, A61N7/00, A61B8/14, A61B5/053, A61B17/22, A61B5/00, A61N7/02, A61B8/12, A61B17/00
Classification coopérativeA61B2017/22069, A61N7/022, A61B2017/22034, A61B17/2202, A61B2017/00084, A61B8/445, A61B5/01, A61B2017/22054, A61B5/053, A61B8/12, A61B8/4272
Classification européenneA61B5/01, A61N7/02C, A61B8/12, A61B5/053, A61B17/22B2D, A61B8/44N2
Événements juridiques
DateCodeÉvénementDescription
28 nov. 2015ASAssignment
Owner name: ETHICON ENDO-SURGERY, LLC, PUERTO RICO
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:ETHICON ENDO-SURGERY, INC.;REEL/FRAME:037161/0276
Effective date: 20151106
27 févr. 2017ASAssignment
Owner name: ETHICON LLC, PUERTO RICO
Free format text: CHANGE OF NAME;ASSIGNOR:ETHICON ENDO-SURGERY, LLC;REEL/FRAME:041821/0186
Effective date: 20161230