WO2013151570A1 - Vasectomy devices and methods - Google Patents

Vasectomy devices and methods Download PDF

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Publication number
WO2013151570A1
WO2013151570A1 PCT/US2012/042430 US2012042430W WO2013151570A1 WO 2013151570 A1 WO2013151570 A1 WO 2013151570A1 US 2012042430 W US2012042430 W US 2012042430W WO 2013151570 A1 WO2013151570 A1 WO 2013151570A1
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WO
WIPO (PCT)
Prior art keywords
probes
tip portion
hand piece
tubular vessel
grasping arms
Prior art date
Application number
PCT/US2012/042430
Other languages
French (fr)
Inventor
William Bruce SHINGLETON
Original Assignee
Shingleton William Bruce
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Shingleton William Bruce filed Critical Shingleton William Bruce
Priority to CN201280072254.3A priority Critical patent/CN104284633A/en
Publication of WO2013151570A1 publication Critical patent/WO2013151570A1/en
Priority to IN8419DEN2014 priority patent/IN2014DN08419A/en

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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
    • A61B18/1477—Needle-like probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00184—Moving parts
    • A61B2018/00196—Moving parts reciprocating lengthwise
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00273—Anchoring means for temporary attachment of a device to tissue
    • 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
    • A61B2018/00595—Cauterization
    • 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
    • A61B2018/0091—Handpieces of the surgical instrument or device
    • A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
    • A61B2018/0094—Types of switches or controllers
    • A61B2018/00946—Types of switches or controllers slidable
    • 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
    • A61B2018/1246—Generators therefor characterised by the output polarity
    • A61B2018/126—Generators therefor characterised by the output polarity bipolar
    • 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
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1425—Needle
    • 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
    • A61B2018/1475—Electrodes retractable in or deployable from a housing

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

Devices and methods for cauterizing a tubular vessel are disclosed. A device for cauterizing a tubular vessel can include a hand piece, a tip portion provided at an operative end of the hand piece, one or more probes extending from the tip portion, one or more grasping arms extending beyond the tip portion and movable to grasp a target tissue positioned at or near the tip portion, and a power supply configured to supply energy to the one or more probes.

Description

DESCRIPTION
VASECTOMY DEVICES AND METHODS
RELATED APPLICATIONS
This application claims the benefit of U.S. Patent Application Serial
No. 13/440,618, filed April 5, 2012, the disclosure of which is incorporated herein by reference in its entirety.
TECHNICAL FIELD
The subject matter disclosed herein relates generally to devices and methods for sterilizing a male patient. More particularly, the subject matter disclosed herein relates to vasectomy devices and methods for supplying RF energy to ablate the vas deferens of a male patient. BACKGROUND
Male sterilization is generally accomplished by vasectomy in which the ducts that carry sperm out of the testes (i.e., the vas deferens) are surgically interrupted by ligation and/or by cauterization, thereby stopping the flow of sperm from the testicle to the prostate gland. This procedure requires surgical opening of the scrotum. Ideally, a vasectomy is an outpatient procedure that is desirably completed with mild discomfort for the patient. The patient should then be capable of resuming his normal activities within a reasonable time frame. The majority of cases have this degree of successful results and limited aftereffects.
In a significant number of instances, however, prolonged exploration and manipulation accompanied by excessive discomfort both intraoperatively and postoperatively can make the results less than desirable. Complications can arise at least in part because scrotal tissue is highly elastic. Whereas a small amount of bleeding is quickly stopped by the tension that develops in non-elastic tissue, elastic tissue offers little pressure to slow the loss of blood and fluid. Thus, even the slightest amount of persistent bleeding can cause tremendously large hematomas. As a result, and in addition to causing discomfort, the healing process is slowed because of the prolonged time required to reabsorb these fluids and cells, increasing the opportunity for bacterial colonization.
In addition, another concern for the surgeon is the elusiveness of the vas deferens. This structure cannot be seen until the later stages of the procedure and must be identified by palpation. Once identified and delivered into the operative field, it must be held in place by some means of fixation.
Even a momentary release of the vas allows it to immediately return to within the spermatic cord, from which it must again be extricated. Furthermore, the injection of a local anesthetic into the scrotal skin and the area surrounding the vas makes palpation of the structure difficult. Loss of fixation of the vas can result in the need for increased dissection, and manipulation can cause increased bleeding and swelling.
Even the most experienced vasectomy surgeons occasionally encounter these problems. As a result, it would be desirable for a system and method for performing a vasectomy to alleviate these complications.
Specifically, it would be desirable for a system and method that allows a medical professional to securely and controllably holding the vas in place and to sterilize a male patient without incising the wall of the patient's scrotum.
SUMMARY
In accordance with this disclosure, devices and methods for cauterizing a tubular vessel are provided. As an example and in one aspect, a device for cauterizing a tubular vessel is provided. The device can comprise a hand piece, a tip portion provided at an operative end of the hand piece, one or more probes extending from the tip portion, one or more grasping arms extending beyond the tip portion and movable to grasp a target tissue positioned at or near the tip portion, and a power supply configured to supply energy to the one or more probes.
In another aspect, a device for cauterizing a tubular vessel can comprise a hand piece, a tip portion selectively connectable to an operative end of the hand piece, one or more probes extending from the tip portion, one or more grasping arms connected to the tip portion and extending beyond the tip portion, and a radio frequency energy generator configured to supply radio frequency energy to the one or more probes. Again, the one or more grasping arms can be movable to grasp a target tissue positioned at or near the tip portion.
In yet another aspect and in one example, a method for cauterizing a tubular vessel is provided. The method can comprise providing a device comprising a hand piece, a tip portion provided at an operative end of the hand piece, one or more probes extending from the tip portion, and one or more grasping arms extending beyond the tip portion. The method can further comprise positioning the device near to or against a physical body containing a tubular vessel, grasping the tubular vessel using the one or more grasping arms, moving the one or more probes into contact with the tubular vessel, and providing energy to the one or more probes to cauterize the tubular vessel.
Although some of the aspects of the subject matter disclosed herein have been stated hereinabove, and which are achieved in whole or in part by the presently disclosed subject matter, other aspects will become evident as the description proceeds when taken in connection with the accompanying drawings as best described hereinbelow.
BRIEF DESCRIPTION OF THE DRAWINGS
The features and advantages of the present subject matter will be more readily understood from the following detailed description which should be read in conjunction with the accompanying drawings that are given merely by way of explanatory and non-limiting example, and in which:
Figures 1A and 1 B are side views of embodiments of a vasectomy instrument according to the presently disclosed subject matter;
Figure 2 is a side view of a vasectomy instrument with a tip portion detached from a hand piece according to an embodiment of the presently disclosed subject matter;
Figure 3 a side view of a disposable tip of a vasectomy instrument according to an embodiment of the presently disclosed subject matter; Figure 4 is a top view of a vasectomy instrument according to an embodiment of the presently disclosed subject matter; and
Figures 5, 6, 7A, and 7B are representations of steps in a vasectomy procedure according to an embodiment of the presently disclosed subject matter.
DETAILED DESCRIPTION
The subject matter disclosed herein provides devices and methods for supplying energy for cauterizing a tubular vessel of a medical patient. Specifically, for example, the instrument and method can be used to ablate, coagulate, and/or otherwise block or close the vas deferens of a male patient. In one aspect illustrated for example only and without limitation in Figures 1A through 4, the subject matter disclosed herein provides a medically useful device or instrument, generally designated device 10 that can be used to perform a vasectomy procedure. Device 10 can comprise a hand piece, generally designated 20, and a tip portion, generally designated 30, that can be positioned at an operative end of hand piece 20. One or more probes 32 can extend from tip portion 30 and provide energy for a medical ablation procedure (e.g., a vasectomy procedure).
As shown in Figures 1A-4, probes 32 can constitute a bipolar electrode. Specifically, for example, probes 32 can be radio frequency ablation (RFA) probes configured to provide RF energy to a target tissue for ablation purposes. In one particular configuration, probes 32 can, for example and without limitation, be approximately 22 gauge in size and approximately 2 cm in length. Each of probes 32 can comprise an insulating sheath 33 along the length of probes 32 except for at an end distal from tip portion 30. Sheath 33 can prevent current from flowing between probes 32 other than at the exposed ends. As a result, the likelihood of inadvertent damage to tissue away from the operative end of probes 32 can be reduced.
Probes 32 can be movable with respect to tip portion 30 such that probes 32 can be selectively extended relative to a surface of the tip portion to alternately conceal or expose probes 32. As shown in Figures 1 and 2, for example, probes 32 can be movable to retract into tip portion 30. To effect this movement, device 10 can comprise a probe position control, generally designated 22, on hand piece 20 that can be moved to correspondingly move probes 32. In particular, as shown in Figures 1A and 1 B for example, probe position control 22 can be a slide button positioned on a side of hand piece 20 and movable towards tip portion 30 to extend probes 32 or away from tip portion 30 to retract probes 32. In this way, probes 32 can be moveable to a "stowed" position to protect probes 32 from damage, prevent contamination of probes 32, and/or prevent probes 32 from inadvertently piercing, scratching, or otherwise harming tissue before intended.
Device 10 can further comprise one or more grasping arms 34 that can extend from hand piece 20 beyond tip portion 30 and can be movable to grasp a target tissue and thereby hold the tissue in a position for probes 32 to act upon the target tissue. Specifically, grasping arms 34 can be configured to grasp a tubular vessel contained within a physical body. In the context of a vasectomy procedure, for example, grasping arms 34 can be configured to grasp a vas deferens of a male patient contained within the scrotum, thereby allowing probes 32 to ablate the vas.
Similarly to the control of the position of probes 32, the position of grasping arms 34 can likewise be adjusted by a control element. Namely, device 10 can comprise a grasper position control, generally designated 24, on hand piece 20 that can be moved to correspondingly move grasping arms 34. In particular, as shown in Figure 1 for example, grasper position control 24 can be a second slide button positioned on a side of hand piece 20 and movable towards tip portion 30 to move grasper arms 34 towards each other (i.e., to grasp the vas) or away from each other (i.e., to release the vas). In this way, grasping arms 34 can be selectively movable to hold and stabilize the target tissue in a position for probes 32 to ablate the tissue.
Device 10 can be connected to a power supply 40, which can supply energy to probes 32. In one particular example, power supply 40 can be a radio frequency generator. Referring to Figure 1A, device 10 can be connected to power supply 40 by a wire or cable 42. Those having ordinary skill in the art will recognize that power supply 40 can include a level control to regulate the power input supplied to probes 32. Alternatively, as shown in Figure 1 B, power supply 40 can comprise a power source 44 (e.g., a battery pack) and an RF generator 46 integrated into hand piece 20 to allow device 10 to be easily transported and operated without being tethered to a separate power supply. In either configuration, to activate probes 32, device 10 can comprise an actuator 26, which can be a trigger mechanism similar to that of a firearm as shown in Figures 1 and 2. Thus, by pulling actuator 26, the supply of energy from power supply 40 to probes 32 can be regulated.
In some configurations, tip portion 30 can be a disposable portion that can be selectively detachable from hand piece 20. As shown in Figure 2, for example, hand piece 20 can comprise mounting posts 28 extending from an end thereof. Tip portion 30 can comprise complementary recesses configured to receive mounting posts 28 and align tip portion 30 with the end of hand piece 20 (i.e., to align mechanisms for movement of probes 32). In this configuration, device 10 can be used to perform a procedure on a medical patient, and once the procedure is completed, tip portion 30 can be detached from hand piece 20 and discarded. In this way, concerns regarding contamination between patients can be diminished, since probes 32 on a given tip portion 30 can be used for only a single patient. Stated otherwise, because only the ends of probes 32 are configured for non- superficially contacting a patient, hand piece 20 can be reused with new copies of tip portion 30 for subsequent patients. In addition, concerns regarding degradation of probes 32 or mechanical wearing issues can be substantially eliminated since probes 32 can be designed for single-use operation.
Regardless of the specific configuration of vasectomy device 10, vasectomy device 10 can be used for methods for performing a vasectomy as shown in Figures 5-7B. First, as shown in Figure 5, a vas V of a patient can be grasped by the physician and brought up to a position just below the surface of scrotum S. For instance, such an arrangement can be achieved with the physician standing on one side of the patient while the patient is lying on an exam table. After cleaning the scrotum with an antibacterial liquid, a local anesthetic (e.g. 1 % lidocaine) can be injected to produce a local skin anesthesia via a needle. As shown in Figure 5, for example, this portion of the procedure can be performed while the physician is grasping vas V with his or her left hand.
As shown in Figure 6, after achieving local anesthesia, the physician can position instrument 10 with tip portion 30 adjacent to scrotum S (either directly against or merely near to scrotum S), with vas V immediately below the skin. From this position, the physician can actuate grasper position control 24 (e.g., slide grasper position control 24 towards scrotum S) to cause grasper arms 34 to encompass vas V, such as by constraining vas V between grasper arms 34. Alternatively, as shown in Figures 7A and 7B, grasper arms 34 can be configured to reach behind vas V to prevent vas V from receding back into scrotum S. In this way, grasper arms 34 can function not only to align and stabilize vas V but also hold vas V in place as pressure is applied by the extension of probes 32 against and/or into vas V.
With vas V stabilized in this manner, the physician can actuate probe position control 22 (e.g., slide probe position control 22 towards scrotum S) to extend probes 32. Device 10 can be particularly designed such that grasper arms 34 constrain vas V in a position that is aligned with probes 32. In this way, probes 32 can be extended into scrotum S (i.e., through the scrotal skin) to a position either immediately adjacent to and in contact with vas V or penetrating vas V as seen in Figures 7A and 7B.
After penetration of vas V by probes 32, the physician can provide energy to probes 32 to ablate, coagulate, or otherwise block or close vas V. For instance, where device 10 has the configuration shown in Figures 1A-4, the physician can operate actuator 26 to initiate a supply of energy (e.g., RF energy) to probes 32. As the energy moves from one of probes 32 to the other, cauterization of vas V occurs.
After adequate destruction and cauterization has occurred, actuator 26 can be released, causing cessation of the flow of energy to probes 32. At this point in the procedure, the physician can retract probes 32, such as by moving probe position control 22 (e.g., sliding probe position control 22 away from scrotum S), thereby allowing probes 32 to withdraw from within scrotum S. Grasper position control 24 can be moved (e.g., slid away from scrotum S) to release vas V from its grip. The entry points of probes 32 into scrotum S can be covered with antibiotic ointment to facilitate healing.
It is believed that the healing process with respect to this procedure can be dramatically shortened compared to typical procedures since the methods for using the devices described herein involve the creation of only two puncture entry wounds into the scrotum (after administration of local anesthesia via injection), and cauterization and destruction of vas V can be accomplished in a short time period. Accordingly, the present methods can be performed without surgical excision of a portion of vas V while still achieving the same desired effect of sterilization of the male.
The present subject matter can be embodied in other forms without departure from the spirit and essential characteristics thereof. The embodiments described therefore are to be considered in all respects as illustrative and not restrictive. For example, while discussion of the present subject matter is presented in regard to use in preforming male sterilization, it can be similarly applied in other related applications, such as cauterization of other tubular vessels or fallopian tubes. In this regard, although the present subject matter has been described in terms of certain preferred embodiments, other embodiments that are apparent to those of ordinary skill in the art are also within the scope of the present subject matter.

Claims

CLAIMS What is claimed is:
1. A device for cauterizing a tubular vessel comprising:
a hand piece;
a tip portion provided at an operative end of the hand piece;
one or more probes extending from the tip portion;
one or more grasping arms extending beyond the tip portion, the one or more grasping arms being movable to grasp a target tissue positioned at or near the tip portion; and
a power supply configured to supply energy to the one or more probes.
2. The device of claim 1 , wherein the tip portion is selectively removable from the hand piece.
3. The device of claim 2, wherein the tip portion is a disposable portion designed for a single use.
4. The device of claim 1 , wherein the one or more probes comprise two probes of a bipolar electrode.
5. The device of claim 1 , wherein the one or more probes are movable with respect to a surface of the tip portion such that the one or more probes can be selectively extended relative to the surface of the tip portion.
6. The device of claim 5, further comprising a probe position control movable with respect to the hand piece, wherein movement of the probe position control correspondingly causes movement of the one or more probes with respect to the tip portion.
7. The device of claim 6, wherein the probe position control comprises a first slide button positioned on a side of the hand piece.
8. The device of claim 1 , wherein the one or more grasping arms are connected to the tip portion.
9. The device of claim 1 , further comprising a grasper position control movable with respect to the hand piece, wherein movement of the grasper position control correspondingly causes movement of the one or more grasping arms.
10. The device of claim 9, wherein the grasper position control comprises a second slide button positioned on a side of the hand piece.
1 1. The device of claim 1 , wherein the target tissue comprises a vas deferens of a male.
12. The device of claim 1 , wherein the power supply comprises a radio frequency energy generator configured for supplying radio frequency energy to the one or more probes.
13. The device of claim 12, wherein the power supply is incorporated into the hand piece.
14. The device of claim 1 , further comprising an actuator configured to regulate the supply energy from the power supply to the one or more probes.
15. A device for cauterizing a tubular vessel comprising:
a hand piece;
a tip portion selectively connectable to an operative end of the hand piece;
one or more probes extending from the tip portion;
one or more grasping arms connected to the tip portion and extending beyond the tip portion, the one or more grasping arms being movable to grasp a target tissue positioned at or near the tip portion; and a radio frequency energy generator configured to supply radio frequency energy to the one or more probes.
16. A method for cauterizing a tubular vessel, the method comprising: providing a device comprising a hand piece, a tip portion provided at an operative end of the hand piece, one or more probes extending from the tip portion, and one or more grasping arms extending beyond the tip portion; positioning the device near to or against a physical body containing a tubular vessel;
grasping the tubular vessel using the one or more grasping arms; moving the one or more probes into contact with the tubular vessel; and
providing energy to the one or more probes to cauterize the tubular vessel.
17. The method of claim 16, wherein the tubular vessel comprises a vas deferens of a male.
18. The method of claim 16, wherein the tip portion is selectively removable from the hand piece, wherein providing a device comprises attaching the tip portion to the hand piece.
19. The method of claim 16, wherein moving the one or more probes into contact with the tubular vessel comprises puncturing the physical body.
20. The method of claim 16, wherein providing energy to the one or more probes comprises providing radio frequency energy to the one or more probes.
21. The method of claim 16, wherein providing energy to the one or more probes comprises connecting the one or more probes to a power supply.
PCT/US2012/042430 2012-04-05 2012-06-14 Vasectomy devices and methods WO2013151570A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CN201280072254.3A CN104284633A (en) 2012-04-05 2012-06-14 Vasectomy devices and methods
IN8419DEN2014 IN2014DN08419A (en) 2012-04-05 2014-10-09

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13/440,618 US8403927B1 (en) 2012-04-05 2012-04-05 Vasectomy devices and methods
US13/440,618 2012-04-05

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WO2013151570A1 true WO2013151570A1 (en) 2013-10-10

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CN (1) CN104284633A (en)
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