WO2000035364A1 - Electrosurgical probe with annular electrodes - Google Patents
Electrosurgical probe with annular electrodes Download PDFInfo
- Publication number
- WO2000035364A1 WO2000035364A1 PCT/IL1999/000124 IL9900124W WO0035364A1 WO 2000035364 A1 WO2000035364 A1 WO 2000035364A1 IL 9900124 W IL9900124 W IL 9900124W WO 0035364 A1 WO0035364 A1 WO 0035364A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- probe
- electrodes
- shaft
- high frequency
- tissue
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00547—Prostate
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
- A61B2018/124—Generators therefor switching the output to different electrodes, e.g. sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/002—Irrigation
Definitions
- Electrosurgical procedures usually operate through the application of very high frequency currents to cut or ablate tissue structures, where the operation can be monopolar or bipolar Monopolar techniques rely on external grounding of the patient, where the surgical device defines only a single electrode pole Bipolar devices comprise both electrodes for the application of current between their surfaces
- Electrosurgical procedures and techniques are particularly advantageous since they generally reduce patient bleeding and trauma associated with cutting operations Additionally, electrosurgical ablation procedures, where tissue surfaces and volume may be reshaped, cannot be duplicated through other treatment modalities
- electrosurgical procedures in electrically conductive environments, however, can be problematic
- many procedures require flushing of the region to be treated with isotonic saline (also referred to as normal saline), both to maintain an isotonic environment and to keep the field of viewing clear
- isotonic saline also referred to as normal saline
- saline which is a highly conductive electrolyte
- Such shorting causes unnecessary heating in the treatment environment and can further cause non-specific tissue destruction
- Prostate diseases such as prostate cancer and benign prostatic hypertrophy (BPH)
- BPH benign prostatic hypertrophy
- enlargement of the prostate which in turn causes a narrowing of the urethra adjacent the prostate caused by swelling of the surrounding tissue
- Such narrowing can cause difficulty in urination, resulting in discomfort and exposing the patient to further complications
- a variety of methods have been proposed for treating enlarged prostates Generally, the methods rely on either reducing the prostatic mass to lessen pressure on the urethra or resecting prostatic tissue adjacent the urethra in order to increase the luminal area for passing urine.
- the first group of methods include various protocols for directing energy, including microwave radiation, radio frequency energy, and laser energy, to induce an increase in tissue temperature within a defined volume of the prostate
- tissue temperature often referred to as "thermotherapy”
- Such an increase in tissue temperature will be maintained at a temperature and for a time sufficient to cause necrosis of the treated prostate tissue, with the necrosed tissue being subsequently sloughed off or reabsorbed into the surrounding tissue mass
- Such sloughing off or reabsorption of the necrosed tissue in turn, will cause size reduction of the prostate, relieving the symptoms of BPH
- the latter group of methods includes the use of endoscopes introduced through the urethra which allow for controlled tissue resection
- transurethral prostatic tissue resection techniques are known to employ monopolar "loop" electrodes introduced through conventional resectoscopes for excising tissue along the urethral lumen
- the treating physician can view the procedure, either directly or over a video screen, and can control the depth of cutting by manually manipulating the position of the electrode while RF energy is applied using conventional electrosurgical power supplies
- RF radio frequency
- an electrode array including a plurality of electrically isolated electrode terminals, is engaged against a wall of a body lumen, such as against the mucosal surface of the prostate within the urethra
- the electrode array is located at the distal end of a probe, the probe being introduced by conventional transurethral or suprapubic access roots
- the probe is typically passed through a conventional viewing scope having a working lumen, such as a resectoscope
- high frequency voltage is applied between the array and one or more common electrodes, in either a monopolar or a bipolar manner
- a laterally outward force is applied on the electrode array to ablate peripheral tissue in the lumen, typically in combination with axial and/or transverse translation of the surface to effect the desired depth of ablation
- the electrosurgical probe of the present invention does not perform resection and does not normally require anesthesia
- the probe of the present invention is not a resection probe but is rather inserted into the body like a catheter
- the electrosurgical probe includes a plurality of annular electrodes which can be used in a monopolar or bipolar mode Pairs of electrodes can be energized in many different kinds of combinations in order to cause necrosis of the prostate in an optimal manner in accordance with a particular treatment plan.
- probe of the present invention is described for use with prostate treatment, nevertheless the probe of the present invention is not limited to the prostate but may be used for any kind of suitable body organ or cavity
- an electrosurgical probe including a shaft having a generally cylindrical shape having a circumference, a proximal end and a distal end, a plurality of electrically isolated, annular electrodes disposed on the distal end of the shaft, each electrode at least partially encircling the circumference of the shaft, the electrodes being electrically connectable to a high frequency voltage source
- the shaft is flexible along at least a portion of its length Still further in accordance with a preferred embodiment of the present invention at least a distal portion of the shaft is rigid.
- the shaft is at least partially hollow.
- the shaft is formed with a plurality of holes for passage therethrough of fluids.
- the shaft includes a printed circuit substrate suitable for printing thereupon printed circuit lines, and the plurality of annular electrodes include a plurality of printed circuit lines printed on the substrate, the substrate being rolled into a generally, at least partially cylindrical shape.
- a controller is in electrical communication with the probe for controlling operation of the probe.
- a transrectal probe or transurethral endoscope is in electrical communication with the controller.
- Fig. 1 is a simplified pictorial illustration of an electrosurgical probe constructed and operative in accordance with a preferred embodiment of the present invention
- Fig. 2 is a simplified pictorial illustration of the electrosurgical probe of Fig. 1 inserted in a urethra;
- Fig. 3 is a simplified, side view illustration of the electrosurgical probe of Fig. 1 inserted in the urethra, used in conjunction with a transrectal probe or transurethral endoscope;
- Fig. 4 is a simplified pictorial illustration of using the electrosurgical probe of
- Fig. 1 to cause necrosis of prostate tissue in accordance with a preferred embodiment of the present invention
- Fig. 5 is a simplified pictorial illustration of an electrosurgical probe constructed and operative in accordance with another preferred embodiment of the present invention. DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT
- Electrosurgical probe 10 preferably includes a shaft 12 having a generally cylindrical shape, with a proximal end 14 (Figs 2 and 3) and a distal end 16 A plurality of electrically isolated, annular electrodes 18 are preferably disposed on the distal end 16 Electrodes 18 most preferably completely encircle the circumference of shaft 12, but depending on the application, one or more electrodes 18 may partially encircle the circumference of shaft 12 Electrodes 18 are preferably electrically connected to a high frequency voltage source 20 Although wires individually connected to each electrode 18 may extend from the proximal end 14, however, most preferably a connector 23 (Fig 2) is disposed near proximal end 14 for electrically connecting electrodes 18 to high frequency voltage source 20 Preferably electrodes 18 have generally the same potential
- shaft 12 is preferably flexible along at least a portion of its length
- at least a portion of shaft 12 be rigid, such as towards distal end 16
- Shaft 12 is preferably at least partially hollow and is preferably formed with a plurality of holes 22 for passage therethrough of fluids, such as isotonic saline, for example
- a controller 24 is preferably in electrical communication with probe 10 and controls operation thereof
- Electrodes 18 may be bipolar, in which case an auxiliary electrode 26 (Fig 3) is placed at some other location in or on the patient, such as on the back of the patient, and is energized together with one or more electrodes 18 on the probe 10 Alternatively, electrodes 18 may be monopolar, in which case different pairs of electrodes 18 on probe 10 are energized to cause necrosis of the prostate tissue
- controller 24 controls which pairs of electrodes 18 are energized in accordance with the type of treatment plan selected for the particular patient
- Fig 4 As seen in Fig 4, in the case of bipolar electrodes, controller 24 can cause energization of two adjacent electrodes A and B This causes a current to arc between the electrodes and cause necrosis in a somewhat toroidal band 30 in the region near these electrodes Subsequently, two other electrodes C and D, separated from each other by electrodes A and B, can be
- cooling apparatus 39 may be provided for supplying cooling fluid through the urethra
- Electrosurgical probe 40 preferably includes a shaft 42 constructed of a printed circuit substrate 43 suitable for printing thereupon printed circuit lines Substrate 43 is preferably rolled into a generally, at least partially cylindrical shape, having a proximal end 44 and a distal end 46 A plurality of electrically isolated, annular electrodes 48 are disposed on shaft 42 Most preferably electrodes 48 are formed on substrate 43 as a plurality of printed circuit lines printed thereupon As described similarly above for probe 10, electrodes 48 most preferably completely encircle the circumference of shaft 42, but depending on the application, one or more electrodes 48 may partially encircle the circumference of shaft 42 Electrodes 48 are preferably electrically connected to high frequency voltage source 20 and controller 24 (Figs.
- Substrate 43 is preferably formed with a plurality of holes 52 for passage therethrough of fluids
- the operation of probe 40 is preferably substantially the same as probe 10
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP99906438A EP1061862A1 (en) | 1998-12-13 | 1999-03-03 | Electrosurgical probe with annular electrodes |
AU26383/99A AU2638399A (en) | 1998-12-13 | 1999-03-03 | Electrosurgical probe with annular electrodes |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
IL127538 | 1998-12-13 | ||
IL12753898A IL127538A0 (en) | 1998-12-13 | 1998-12-13 | Electrosurgical probe with annular electrodes |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2000035364A1 true WO2000035364A1 (en) | 2000-06-22 |
Family
ID=11072258
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/IL1999/000124 WO2000035364A1 (en) | 1998-12-13 | 1999-03-03 | Electrosurgical probe with annular electrodes |
Country Status (4)
Country | Link |
---|---|
EP (1) | EP1061862A1 (en) |
AU (1) | AU2638399A (en) |
IL (1) | IL127538A0 (en) |
WO (1) | WO2000035364A1 (en) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6918906B2 (en) | 2001-03-30 | 2005-07-19 | Gary L. Long | Endoscopic ablation system with improved electrode geometry |
US7097644B2 (en) | 2001-03-30 | 2006-08-29 | Ethicon Endo-Surgery, Inc. | Medical device with improved wall construction |
US7137981B2 (en) | 2002-03-25 | 2006-11-21 | Ethicon Endo-Surgery, Inc. | Endoscopic ablation system with a distally mounted image sensor |
US7232438B2 (en) | 2004-07-09 | 2007-06-19 | Ethicon Endo-Surgery, Inc. | Ablation device with clear probe |
CN108883301A (en) * | 2016-03-24 | 2018-11-23 | 皇家飞利浦有限公司 | Dispose assessment equipment |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0643982A1 (en) * | 1993-06-25 | 1995-03-22 | DORNIER MEDICAL SYSTEMS, Inc. | Ultrasound thermotherapy probe |
US5630426A (en) * | 1995-03-03 | 1997-05-20 | Neovision Corporation | Apparatus and method for characterization and treatment of tumors |
US5643197A (en) * | 1993-12-21 | 1997-07-01 | Angeion Corporation | Fluid cooled and perfused tip for a catheter |
DE29812901U1 (en) * | 1998-07-09 | 1998-10-08 | Kleihues Hein Dr | Electrosurgical electrode assembly |
-
1998
- 1998-12-13 IL IL12753898A patent/IL127538A0/en unknown
-
1999
- 1999-03-03 WO PCT/IL1999/000124 patent/WO2000035364A1/en not_active Application Discontinuation
- 1999-03-03 AU AU26383/99A patent/AU2638399A/en not_active Abandoned
- 1999-03-03 EP EP99906438A patent/EP1061862A1/en not_active Withdrawn
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0643982A1 (en) * | 1993-06-25 | 1995-03-22 | DORNIER MEDICAL SYSTEMS, Inc. | Ultrasound thermotherapy probe |
US5643197A (en) * | 1993-12-21 | 1997-07-01 | Angeion Corporation | Fluid cooled and perfused tip for a catheter |
US5630426A (en) * | 1995-03-03 | 1997-05-20 | Neovision Corporation | Apparatus and method for characterization and treatment of tumors |
DE29812901U1 (en) * | 1998-07-09 | 1998-10-08 | Kleihues Hein Dr | Electrosurgical electrode assembly |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6918906B2 (en) | 2001-03-30 | 2005-07-19 | Gary L. Long | Endoscopic ablation system with improved electrode geometry |
US7097644B2 (en) | 2001-03-30 | 2006-08-29 | Ethicon Endo-Surgery, Inc. | Medical device with improved wall construction |
US7137981B2 (en) | 2002-03-25 | 2006-11-21 | Ethicon Endo-Surgery, Inc. | Endoscopic ablation system with a distally mounted image sensor |
US7232438B2 (en) | 2004-07-09 | 2007-06-19 | Ethicon Endo-Surgery, Inc. | Ablation device with clear probe |
CN108883301A (en) * | 2016-03-24 | 2018-11-23 | 皇家飞利浦有限公司 | Dispose assessment equipment |
Also Published As
Publication number | Publication date |
---|---|
AU2638399A (en) | 2000-07-03 |
EP1061862A1 (en) | 2000-12-27 |
IL127538A0 (en) | 1999-10-28 |
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