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US20030018255A1 - Method and apparatus for medical procedures using high-intensity focused ultrasound - Google Patents

Method and apparatus for medical procedures using high-intensity focused ultrasound Download PDF

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US20030018255A1
US20030018255A1 US10171149 US17114902A US2003018255A1 US 20030018255 A1 US20030018255 A1 US 20030018255A1 US 10171149 US10171149 US 10171149 US 17114902 A US17114902 A US 17114902A US 2003018255 A1 US2003018255 A1 US 2003018255A1
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tissue
transducer
energy
fig
ultrasound
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Roy Martin
Lawrence Crum
Shahram Vaezy
Stephen Carter
W. Helton
Michael Gaps
Peter Kaczkowski
Andrew Proctor
George Keilman
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Martin Roy W.
Crum Lawrence A.
Shahram Vaezy
Carter Stephen J.
Helton W. Scott
Michael Gaps
Kaczkowski Peter J.
Andrew Proctor
George Keilman
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • AHUMAN NECESSITIES
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    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/225Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A61B17/2251Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient
    • AHUMAN NECESSITIES
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    • A61B8/4209Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames
    • AHUMAN NECESSITIES
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    • A61B8/4218Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames characterised by articulated arms
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    • A61B8/4254Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient using sensors mounted on the probe
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    • A61B8/4461Features of the scanning mechanism, e.g. for moving the transducer within the housing of the probe
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    • A61B17/225Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A61B17/2255Means for positioning patient, shock wave apparatus or locating means, e.g. mechanical aspects, patient beds, support arms, aiming means
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    • A61B2017/12004Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding
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    • A61B17/22004Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B2017/22005Effects, e.g. on tissue
    • A61B2017/22007Cavitation or pseudocavitation, i.e. creation of gas bubbles generating a secondary shock wave when collapsing
    • A61B2017/22008Cavitation or pseudocavitation, i.e. creation of gas bubbles generating a secondary shock wave when collapsing used or promoted
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    • A61B90/04Protection of tissue around surgical sites against effects of non-mechanical surgery, e.g. laser surgery
    • A61B2090/0472Protection of tissue around surgical sites against effects of non-mechanical surgery, e.g. laser surgery against ultrasound energy
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    • A61B8/4272Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue
    • A61B8/4281Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue characterised by sound-transmitting media or devices for coupling the transducer to the tissue
    • AHUMAN NECESSITIES
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    • A61N2007/0065Concave transducers
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Abstract

Methods and apparatus for enabling substantially bloodless surgery and for stemming hemorrhaging. High intensity focused ultrasound (“HIFU”) is used to form cauterized tissue regions prior to surgical incision, for example, forming a cauterized tissue shell around a tumor to be removed. The procedure is referred to as “presurgical volume cauterization.” In one embodiment, the method is particularly effective for use in surgical lesion removal or resection of tissue having a highly vascularized constitution, such as the liver or spleen, and thus a propensity for hemorrhaging. In further embodiments, methods and apparatus for hemostasis using HIFU is useful in both surgical, presurgical, and medical emergency situations. In an apparatus embodiment, a telescoping, acoustic coupler is provided such that depth of focus of the HIFU energy is controllable. In other embodiments, apparatus characterized by portability are demonstrated, useful for emergency medical situations.

Description

  • [0001] The invention described herein was made in the course of work under a grant or award from the U.S. Department of Defense, Office of Naval Research.
  • BACKGROUND OF THE INVENTION
  • [0002]
    1. Field of the Invention
  • [0003]
    The present invention relates generally to uses of ultrasonics in medical technology applications, more particularly to a method and apparatus for performing presurgical and surgical procedures using high-intensity focused ultrasound.
  • [0004]
    2. Description of Related Art
  • [0005]
    Studies in the use of ultrasound—sound with frequency above 20,000 Hz, the upper limit of human hearing—began in the early 1940's [see e.g., A New Method for the Generation and Use of Focused Ultrasound in Experimental Biology, Lynn et al., Focused Ultrasound in Experimental Biology, Journal of General Physiology, 1943, pp. 179-193]. It is widely accepted that the first refined system for the use of ultrasound in the medical arts was developed by William and Francis Fry at the University of Illinois, Urbana, in the 1950's (a paper was published as part of the Scientific Program of the Third Annual Conference of the American Institute of Ultrasonics in Medicine, Washington D.C., Sep. 4, 1954, pp. 413-423).
  • [0006]
    In the main, research and development has been concerned with diagnostic and therapeutic applications. Therapeutic ultrasound refers to the use of high intensity ultrasonic waves to induce changes in tissue state through both thermal effects—induced hyperthermia—and mechanical effects—induced cavitation. High frequency ultrasound has been employed in both hyper-thermic and cavitational medical applications, whereas low frequency ultrasound has been used principally for its cavitation effect. Diagnostic medical ultrasonic imaging is well known, for example, in the common use of sonograms for fetal examination.
  • [0007]
    Various aspects of diagnostic and therapeutic ultrasound methodologies and apparatus are discussed in depth in an article by G. ter Haar, Ultrasound Focal Beam Surgery, Ultrasound in Med. & Biol., Vol. 21, No. 9, pp. 1089-1100, 1995, and the IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, November 1996, Vol. 43, No. 6 (ISSN 0885-3010). The IEEE journal is quick to point out that: “The basic principles of thermal effects are well understood, but work is still needed to establish thresholds for damage, dose effects, and transducer characteristics . . . . ” Id., Introduction , at page 990.
  • [0008]
    In high-intensity focused ultrasound (HIFU) hyperthermia treatments, intensity of ultrasonic waves generated by a highly focused transducer increases from the source to the region of focus where it can reach a very high temperature, e.g. 980 Centigrade. The absorption of the ultrasonic energy at the focus induces a sudden temperature rise of tissue—as high as one to two hundred degrees Kelvin/second which causes the irreversible ablation of the target volume of cells, the focal region. Thus, for example, HIFU hyperthermia treatments can cause necrotization of an internal lesion without damage to the intermediate tissues. The focal region dimensions are referred to as the depth of field, and the distance from the transducer to the center point of the focal region is referred to as the depth of focus. In the main, ultrasound is a promising non-invasive surgical technique because the ultrasonic waves provide a non-effective penetration of intervening tissues, yet with sufficiently low attenuation to deliver energy to a small focal target volume. Currently there is no other known modality that offers noninvasive, deep, localized focusing of non-ionizing radiation for therapeutic purposes. Thus, ultrasonic treatment has a great advantage over microwave and radioactive therapeutic treatment techniques.
  • [0009]
    A major issue facing the use of HIFU techniques is cavitation effects. In some quarters, it is recognized that cavitation can be used advantageously. See e.g., Enhancement of Sonodynamic Tissue Damage Production by Second-Harmonic Superimposition: Theoretical Analysis of Its Mechanism, Unmemura et al. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, Vol. 43, No. 6, 11/96 at page 1054. Cavitation can occur in at least three ways important for consideration in the use of ultrasound for medical procedures. The first is gaseous cavitation, where dissolved gas is pulled from solution during a negative pressure phase of an acoustic wave. The second is vaporous cavitation due to the negative pressure in the negative pressure phase becoming low enough for a fluid to convert to its vapor form at the ambient temperature of the tissue fluid. The third is where the ultrasonic energy is absorbed to an extent to raise the temperature above boiling at ambient pressure. At lower frequencies, the time that the wave is naturally in the negative pressure phase is longer than at higher frequencies, providing time for gas or vapor to come out of the fluid. All other factors being equal, a lower frequency will have a lower intensity level for cavitation than a higher frequency. Higher frequencies are more rapidly absorbed and therefore raise the temperature more rapidly for the same applied intensity than a lower frequency. Thus, gaseous and vaporous cavitation are promoted by low frequencies and boiling cavitation by high frequency.
  • [0010]
    For HIFU applications it has been found that ultrasonically induced cavitation occurs when an intensity threshold is exceeded such that tensile stresses produced by acoustic rarefaction generates vapor cavities within the tissue itself. Subsequent acoustic compressions drive the cavities into a violent, implosive collapse; because non-condensing gases are created, there are strong radiating pressure forces that exert high shear stresses. Consequently, the tissue can shred or be pureed into an essentially liquid state. Control of such effects has yet to be realized for practical purposes; hence, it is generally desirable to avoid tissue damaging cavitation whenever it is not a part of the intended treatment.
  • [0011]
    Another problem facing the designer of ultrasound medical devices is that the attenuation and absorption rate of ultrasound in tissue is known to exponentially increase in proportion to the frequency. In other words, a very high frequency, e.g., 30 MHz wave would be absorbed nearly immediately by the first tissue it is applied to. Yet, lower frequencies, e.g., 30 KHz-60 KHz, are associated with cavitation effects because of the longer rarefaction time periods, allowing gaseous vapor formation. Thus, the effect of ultrasound energy is quite different at a frequency of 30 KHz versus 30 MHz. The rate of heat generation in tissue is proportional to the absorption constant. For example, for the liver, the attenuation constant is approximately 0.0015 at 30 KHz, but is approximately 0.29 at 3 MHz. Therefore, all other variables being equal, the heat generated in liver tissue is about 190 times greater at 3 MHz than at 30 KHz. While this means hyperthermia can be achieved more quickly and to a much greater level with high frequencies, the danger to intervening tissue between the transducer and the focal region is much more prevalent.
  • [0012]
    Thus, there is a continuing need in the field for means of improving heating penetration, spatial localization, and dynamic control of ultrasound for medical applications, along with the discovery of new methodologies of their use.
  • [0013]
    An even less explored field of ultrasound use is as a direct surgical tool for non-invasive surgical procedures. While ultrasound has been used as a electromechanical driver for cutting tool implementations (see e.g., U.S. Pat. No. 5,324,299 to Davison et al. for an ultrasonic scalpel blade, sometimes referred to as a “harmonic scalpel”), the use of ultrasonic radiation directly in a device for performing presurgical and surgical procedures, rather than therapeutic procedures, has been limited. An ultrasonic diagnostic and therapeutic transducer assembly and method of use for ophthalmic therapy is shown by Driller et al. in U.S. Pat. No. 4,484,569. The acoustic coupler in the Driller device is a fluid-filled, conical shell, mounted to a transducer apparatus and having a flexible membrane across the apertured, distal end of the cone. Depth of focus is controlled by changing the aperture size and the spacing from the focal point of a fixed focal point transducer by using cones of varying axial length. The problem with this construct is that the focal point is fixed and that the cones must be manually changed (compare Driller's FIG. 2 and FIG. 5).
  • [0014]
    During invasive surgery, an obvious primary problem is bleeding. The most common surgical technique in the state of the art for coagulating bleeding vessels is to apply an electrical cauterizing probe to the bleeding site (see, e.g., U.S. Pat. No. 4,886,060, to Wiksell for an ultrasonically driven, oscillating knife having a means for emitting high-frequency electrical energy which induces heat in the tissue). However, if a bleeding vessel is more than about 1.5 mm in diameter, or in an organ such as the liver, which is highly vascularized and where uncontrolled hemorrhage is the primary cause of death in hepatic trauma, direct electro-cauterization is ineffective. A more complicated technique of clamping of a large blood vessel and electrical cauterization via the clamp or with laser light can sometimes be effective. A major problem that is not solved with either electrical or laser cauterization techniques is the control of a rapidly bleeding vessel because the blood egress is often sufficiently large enough to carry the heat away before coagulation or tissue necrosis is accomplished. In liver surgery, neither is effective. Moreover, organs such as the liver and spleen are subject to bleeding profusely from cracks in the parenchyma, which is usually diffuse and non-pulsatile due to the large number of small vessels. In another example, the control of bleeding is the most important variable in determining the length of neurosurgical craniotomy procedures.
  • [0015]
    Another important application in need of technologically advanced medical treatment is for emergency hemorrhaging situations, e.g., an accidently severed femoral artery, massive internal bleeding, or puncture wounds due to bullets, knives, or automobile accidents. Prompt stemming of visible hemorrhaging is literally a matter of life or death. Standard procedure to arrest visible bleeding is to maintain pressure on the puncture site until coagulation is sufficient to stem the flow of blood. Without sophisticated hospital equipment and invasive surgery, the problem of internal bleeding lacks suitable emergency treatment devices.
  • [0016]
    The present invention meets the various needs in the field of technology by presenting a method and apparatus using high intensity focused ultrasound for inducing coagulative necrosis and hemostasis that can be used in presurgical procedures such that substantially bloodless surgery can be achieved. The present invention further provides methods and apparatus using high intensity focused ultrasound for stemming hemorrhaging in emergency situations or with organs where tradition methodologies are ineffective.
  • SUMMARY OF THE INVENTION
  • [0017]
    In its basic aspects, the present invention provides a method of performing surgery with minimized bleeding, including the steps of: determining each path of incision to be made in a tissue volume; cauterizing each path using ultrasonic energy to form at least one surgical pathway in the tissue volume prior to incising; and making surgical incisions only along a surgical pathway.
  • [0018]
    In another basic aspect, the present invention provides a method for presurgical treatment of highly vascularized organic tissue to minimize bleeding during surgical procedures including the steps of: determining each path of incision to be made in the tissue; and prior to incising the tissue, exposing each path to high intensity focused ultrasound energy having a predetermined frequency for a time period sufficient to form at least one coagulative necrosed pathway in the tissue such that making surgical incisions only along a coagulative necrosed pathway is subject to minimized bleeding.
  • [0019]
    In another basic aspect, the present invention provides a method for causing hemostasis including the steps of: exposing a hemorrhaging blood vessel or parenchyma; and exposing said blood vessel or parenchyma to sonic energy comprising high intensity focused ultrasound such that said hemorrhaging blood vessel or parenchyma is cauterized by said sonic energy.
  • [0020]
    In another basic aspect, the present invention provides a presurgical device for preparing an organ of a patient for surgical incisions. The device includes: a transducer mechanism for emitting energy as high frequency focused ultrasound; and a mechanism for controlling focal position and focal intensity of energy emissions from said transducer such that acoustic energy at selective focal zones produces coagulative necrosed tissue in the form of predetermined surgical pathways within the tissue such that surgical incisions along the surgical pathways is subject to substantially no bleeding. Various embodiments of devices are disclosed, including screw-type and bellows-type focusing apparatus.
  • [0021]
    In another basic aspect, the present invention provides a method for causing hemostasis in a visible hemorrhaging wound, including the steps of: using a transducer means, having an ultrasonic transducer having a transmitting surface emitting high frequency focused ultrasound having a frequency in the approximate range of 0.5 MHZ to 20 MHz and a depth of focus substantially immediately adjacent said transducer means, applying high intensity focused ultrasound energy onto outer regions of a hemorrhaging vessel adjacent to a puncture; and controlling energy level and the duration of exposure to cause closure of fibrous sheath tissue surrounding the puncture of the hemorrhaging vessel without substantially damaging wall tissue of the vessel itself.
  • [0022]
    In another basic aspect, the present invention provides a method for causing hemostasis of an internal hemorrhage, without surgical incision, by exposing a blood vessel or parenchyma source of the hemorrhage to sonic energy comprising high intensity focused ultrasound such that the hemorrhaging blood vessel or parenchyma is cauterized by the sonic energy.
  • [0023]
    In another basic aspect, the present invention provides a method of using high intensity focused ultrasound for surgical procedures, including the steps of: prior to incising tissue of a surgery patient, applying ultrasonic energy at a combination of frequency, time of exposure, and power intensity to cause controlled coagulation and necrotization of tissue in the patient such that a volume cauterized tissue region is formed in said tissue at predetermined locations within said tissue that are to be cut.
  • [0024]
    In another basic aspect, the present invention provides a high intensity focused ultrasound medical instrument. The instrument includes a pencil-like handle; fixedly mounted on a tip of the handle, a sealed acoustic coupling mechanism for interfacing ultrasonic energy into a patient; mounted subjacent the acoustic coupling mechanism, a ultrasound transducer mechanism, including at least one transducer for emitting ultrasonic energy through the acoustic coupling mechanism such that a focal region is produced immediately adjacent the acoustic coupling mechanism; and, incorporated through the handle, mechanisms for coupling the transducer mechanism to an electronic controller.
  • [0025]
    In another basic aspect, the present invention provides a high intensity focused ultrasound medical instrument including a palm-of-the-hand shaped and dimensioned handle; fixedly mounted on a first surface of the handle, a sealed acoustic coupling mechanism for interfacing ultrasonic energy into a patient; mounted on a second surface of the handle subjacent the acoustic coupling mechanism, an ultrasound transducer mechanism, including at least one transducer for emitting sonic energy through the acoustic coupling mechanism; and mounted on a third surface of the handle opposing the first surface, mechanisms for coupling the transducer mechanism to an electronic controller.
  • [0026]
    It is an advantage of the present invention that it provides a method for performing surgery while limiting hemorrhaging.
  • [0027]
    It is an advantage of the present invention that it provides a device for performing HIFU surgical procedures, particularly suited to performing percutaneous cauterization, hemostasis, and coagulative necrosis of tissue.
  • [0028]
    It is an advantage of the present invention that it provides a surgical device which can produce hemostasis along a defined focal path without deep penetration into tissues, without substantial charring of a cut tissue interface, and without harmful cavitation-related tissue damage.
  • [0029]
    It is another advantage of the present invention that it provides a method and apparatus for medical situations where conventional hemostatic mechanisms are either too slow or not functioning properly due to blood platelet or coagulation factor deficiencies.
  • [0030]
    It is another advantage of the present invention that it provides a method and apparatus that can substantially shorten the time of surgery, thereby reducing costs.
  • [0031]
    It is another advantage of the present invention that it provides a method and apparatus that decrease both the risk of bleeding and the need for transfusions.
  • [0032]
    It is still another advantage of the present invention that it provides a method and apparatus for reducing the morbidity and death associated with surgical procedures in which hemorrhaging is a frequent problem.
  • [0033]
    It is yet another advantage of the present invention that it allows the use of HIFU for medical procedures with the ability to focus and localize HIFU effects without effecting intervening or subjacent tissue and organs.
  • [0034]
    It is still another advantage of the present invention that it provides for a device that can be adapted to either open or laparoscopic surgical procedures.
  • [0035]
    It is a further advantage of the present invention that it provides a device for performing percutaneous embolization and partial resection operations, eliminating the need for organ removal.
  • [0036]
    It is yet a further advantage of the present invention that it provides a device suited for emergency surgical procedures for stemming bleeding due to vascular breaches.
  • [0037]
    It is a further advantage of the present invention that it provides a device for non-invasively stemming internal hemorrhaging.
  • [0038]
    It is still a further advantage of the present invention that it can be used in an emergency medical situation to decrease the effects of traumatic injury while the injured is transported to a fully equipped medical facility.
  • [0039]
    Other objects, features and advantages of the present invention will become apparent upon consideration of the following explanation and the accompanying drawings, in which like reference designations represent like features throughout the drawings.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0040]
    [0040]FIGS. 1A and 1B are schematic depictions of a presurgical medical procedure methodology in accordance with the present invention in which:
  • [0041]
    [0041]FIG. 1A is a top view of a section of a body organ having a tumor, and FIG. 1B is a side view of the depiction of FIG. 1A in which presurgical volume cauterization has been performed.
  • [0042]
    [0042]FIGS. 2A through 2D are schematic depictions of various steps of the procedure as shown in FIGS. 1A-1B in which:
  • [0043]
    [0043]FIG. 2A depicts a first step involved in producing a vertical coagulated and necrotized line or plane,
  • [0044]
    [0044]FIG. 2B depicts a second step involved in producing a vertical coagulated and necrotized line or plane,
  • [0045]
    [0045]FIG. 2C depicts a third step involved in producing a vertical coagulated and necrotized line or plane, and
  • [0046]
    [0046]FIG. 2D depicts a final step involved in producing a vertical coagulated and necrotized line or plane.
  • [0047]
    [0047]FIGS. 3A through 3F are perspective views depicting steps in the procedure as shown in FIGS. 1A-2D in which:
  • [0048]
    [0048]FIG. 3A depicts bottom burn paths using an apparatus as depicted in FIGS. 1A-2D,
  • [0049]
    [0049]FIG. 3B is a subsequent step depicting a completed bottom burn as shown in FIG. 3A,
  • [0050]
    [0050]FIG. 3C is a subsequent step depicting side burn paths,
  • [0051]
    [0051]FIG. 3D is a subsequent step depicting a partially complete cauterization shell,
  • [0052]
    [0052]FIG. 3E depicts a subsequent step depicting further side burn paths, and
  • [0053]
    [0053]FIG. 3F depicts a subsequent step depicting a completed bottom and side plane cauterization shell.
  • [0054]
    [0054]FIGS. 4A through 4C are schematic drawings of an apparatus in accordance with the present invention for performing the procedures depicted in FIGS. 1A-3F in which:
  • [0055]
    [0055]FIG. 4A is a top view of the apparatus,
  • [0056]
    [0056]FIG. 4B is a side view of the apparatus,
  • [0057]
    [0057]FIG. 4C is a perspective view, schematic drawing of the mechanism of element 401 of FIGS. 4A and 4B,
  • [0058]
    [0058]FIG. 4D is a perspective view, schematic drawing showing detail of element 411 of FIG. 4C, and
  • [0059]
    [0059]FIG. 4E is a perspective view, schematic drawing showing detail of the dynamic operating mechanism of element 401 of FIGS. 4A-4C.
  • [0060]
    [0060]FIGS. 5A through 5C are schematic diagrams in cross section (side view) showing an alternative embodiment of the apparatus as shown in FIGS. 4A-4C in which:
  • [0061]
    [0061]FIG. 5A is a top view of the apparatus,
  • [0062]
    [0062]FIG. 5B is a side view of the apparatus, and
  • [0063]
    [0063]FIG. 5C is a schematic drawing of the inner mechanism of element 501 of FIGS. 5A and 5B.
  • [0064]
    [0064]FIGS. 6A through 6C are schematic diagrams showing an alternative embodiment of the apparatus of the present invention depicting a side focusing unit in which:
  • [0065]
    [0065]FIG. 6A shows the unit projecting a depth of focus of a first depth,
  • [0066]
    [0066]FIG. 6B shows the unit projecting a depth of focus of a second depth, and
  • [0067]
    [0067]FIG. 6C shows the unit projecting a depth of focus of a third depth.
  • [0068]
    [0068]FIG. 7 is a schematic diagram showing an alternative embodiment of the apparatus of the present invention presenting a front focusing unit.
  • [0069]
    [0069]FIGS. 8A through 8E are schematic diagrams showing another alternative embodiment of the apparatus of the present invention depicting a hand-held unit, in which:
  • [0070]
    [0070]FIG. 8A shows a top view of the unit,
  • [0071]
    [0071]FIG. 8B shows a bottom view of the unit,
  • [0072]
    [0072]FIG. 8C shows the unit being used within a body cavity,
  • [0073]
    [0073]FIG. 8D shows an alternative set of transducers for the unit as shown in FIG. 8B, and
  • [0074]
    [0074]FIG. 8E shows the embodiment of FIG. 8D in use.
  • [0075]
    [0075]FIG. 9 is a perspective view, schematic drawing of a line focus transducer adaptable to use in accordance with the present invention such as shown in FIGS. 1B through 5B.
  • [0076]
    [0076]FIG. 10 is a block diagram of an electrical controller for a single channel system in accordance with the present invention.
  • [0077]
    [0077]FIG. 11 is a block diagram of an electrical controller for a single channel system in accordance with the present invention having a focal depth controller as shown in FIGS. 5A-5B.
  • [0078]
    [0078]FIG. 12 is a block diagram of an electrical controller for a multi-channel system in accordance with the present invention as shown in FIG. 8B.
  • [0079]
    [0079]FIGS. 13A and 13B are schematic drawings in cross section (elevation) of a telescoping embodiment of a device in accordance with the present invention in which:
  • [0080]
    [0080]FIG. 13A depicts the device in a fully retracted position, and FIG. 13B depicts the device in an extended position.
  • [0081]
    [0081]FIG. 14 is an exemplary automated drive system for the apparatus as shown in FIGS. 13A-13B.
  • [0082]
    [0082]FIGS. 15A through 15C are an alternative transducer mount and telescoping device for the embodiment as shown in FIGS. 13A and 13B in which:
  • [0083]
    [0083]FIG. 15A is an elevation view,
  • [0084]
    [0084]FIG. 15B is a perspective view, and
  • [0085]
    [0085]FIG. 15C is a perspective view in which part of the device has been removed.
  • [0086]
    [0086]FIG. 16 is a graph showing an optimal HIFU Frequency vs. Tissue Depth plot.
  • [0087]
    The drawings referred to in this specification should be understood as not being drawn to scale except if specifically noted.
  • DESCRIPTION OF THE PREFERRED EMBODIMENT
  • [0088]
    Reference is made now in detail to a specific embodiment of the present invention, which illustrates the best mode presently contemplated by the inventors for practicing the invention. Alternative embodiments are also briefly described as applicable. In order to describe the various aspects of the present invention and as several apparatus embodiments are disclosed, the methodologies of use are presented first. Subtitles provided herein are for convenience of the reader only and are not intended to define, describe, or place any limitation on the scope of the invention; no such intent nor limitation should be implied therefrom. Presurgical procedures As set forth in the Background section, ultrasonic energy can be focused to produce hemo-coagulation and necrosis in living tissue. In FIG. 1A, there is shown a section of a liver 101, having a tumor 103. While such tumors are operable, because of the highly vascularized nature of the liver's pathological constitution (the average blood flow is about 25% of the resting cardiac output and the liver is a relatively soft organ that tears easily), liver surgery places the patient at high risk, making the arresting of rapid liver hemorrhage or even slow oozing of blood with conventional methods a time-consuming and difficult task.
  • [0089]
    Looking also to FIG. 1B, a simplistically depicted, high-intensity focused ultrasound (“HIFU” hereinafter) apparatus 105, including an ultrasound transducer device 107 supported by a top arm 109 is brought into contact with the liver 101 by an acoustic coupler 111 used to couple acoustic energy to the liver tissue. The coupler 111 contains an acoustic-transmissive medium inside a flexible membrane. The membrane is highly elastic to conform to the anatomy, able to withstand the high ultrasonic intensities near the acoustic focus, sufficiently tough to survive in the surgical environment, and bio-compatible. It has been found that a polyether polyurethane provides a preferred material. The material is available commercially as PT9300 Dureflex™ polyurethane film, medical grade, 50 microns (0.002 inches) thick, made by Deerfield Urethane, South Deerfield, Mass. For certain of the coupling methods, e.g., water-filled cones as described herein, the elasticity requirements are relaxed, and it may be possible to use other types of plastic films.
  • [0090]
    A bottom arm 113 slips under the tissue and aids in fixing the distance between the transducer device 107 and the tumor 103. The transducer device 107 is then activated and used to describe a shell 115 of coagulated and necrotized tissue around the tumor 103. In other words, prior to any surgical incision, the tumor is encapsulated by a shell 115 of tissue that has been thoroughly cauterized using HIFU energy. The procedure for producing the shell 115 is referred to as “presurgical volume cauterization,” the shell 115 comprising a volume of tissue equal to the surface area times the thickness of the shell.
  • [0091]
    Changes in the appearance of the cauterized planes 117, 119, and the like, of the shell 115 are highly visible after the volume cauterization process. The tissue is essentially “cooked;” that is, it hardens and is warm to the touch. The shell 115 then provides a coagulated surgical pathway. That is, surgical incisions are made along the coagulated pathway and little to no bleeding results. Note that while in this exemplary embodiment a box shaped shell 115 has been formed in the liver tissue, depending upon the surgery to be performed, virtually any shape necrosed surface can be formed as needed, e.g., flat planar, curved surface, open or closed cubes and rectangles, inverted wedge shapes, inverted pyramids, open or closed cylinders, or the like as would provide appropriate necrosed surgical pathways for the following operation. The goal is to isolate a region of tissue from the blood supply to it by surrounding the surgical target with a necrosed surface. The particular surface chosen is selected to minimize the removal of viable non-diseased tissue as well as to make it a practical resection procedure for the surgeon.
  • [0092]
    FIGS. 2A-2D depict specific steps of forming a vertical coagulated and necrotized line or plane during the volume cauterization process in further detail. In FIG. 2A, the transducer 107 provides a focal region 201 with a dimensional shape having a depth of field “a” at a depth of focus “b”. The aperture dimensions, frequency, and physics of ultrasound energy propagation dictate the focal zone 201 dimensions. Note that the FIGURES are not intended to be to scale; in typical practice, it has been found that in preferred embodiments the length of the focal region can be about ten times its lateral width in order to optimize HIFU effects at the target. Tissue lesions generated by the HIFU beam are similar in shape to the focal region, but slightly broader nearer the transducer.
  • [0093]
    Appropriate continuous wave or pulsed acoustic energy (represented by phantom lines) is applied for a predetermined time (as also will be discussed in detail hereinafter) to necrotize the tissue of the exemplary liver 101. The depth of focus is then changed sequentially as depicted in FIGS. 2B-2D, producing a vertical coagulated and necrosed line, or plane, 203, FIG. 2D.
  • [0094]
    The concept of how the position of the focal point of the transducer can be varied to scan and produce a volume cauterization is shown in three dimension in FIGS. 3A-3F. FIG. 3A represents a transducer 107 focusing acoustic energy into a tissue mass 101 through an acoustic coupler 111. The transducer is being moved laterally in FIGS. 3A and 3B in order for form a burn path in the tissue approximating a planar surface, such as by cauterizing rows of adjacent tissue burns. In FIG. 3B, the entire planar surface is shown which actually forms a contiguous necrotized tissue volume having a small thickness equal to the depth of field of the particular transducer 107 in use. This contiguous necrotized tissue volume might be, for example, a plane beneath a tumor to be removed surgically. In FIG. 3C, the transducer is moved laterally to scribe a line defining the perimeter of a complete shell region to be cauterized, then moved vertically to scribe the next superjacent perimeter, et seq. as depicted in FIGS. 3D through 3F. In FIG. 3F, a complete open cubic volume shell has been formed. The shell so produced provides a surgical pathway where the surgeon may cut through the tissue with substantially no resultant bleeding.
  • [0095]
    It should be noted that in addition to the hyperthermia effects some cavitation effects may be present in tissue so treated in accordance with the foregoing procedures. The operative effect may thus be a combination of hyperthermia and cavitation; thus, further study is warranted.
  • [0096]
    HIFU Apparatus
  • [0097]
    A first embodiment of an apparatus 105 for performing presurgical volume cauterization as shown in FIGS. 2A through 3F is shown in FIGS. 4A-4E. Again, the liver 101 is used as an exemplary organ on which an invasive surgical procedure is to be performed. A bottom arm 113 is provided for resting under the tissue of the organ to aid in fixing the distance between the transducer device 107 and the focal points within the organ.
  • [0098]
    Note also that the bottom arm 113 can carry an acoustic absorber on the distal side of the tissue from where the ultrasound energy is applied. The general purpose is to absorb the ultrasound energy that passes through the tissue beyond the focal point, thereby insulating subjacent tissues from being insonified. One characteristic of such an absorber is that acoustic impedance (density times the speed of sound) should be ideally equal to the tissue. With such a characteristic most of the energy is absorbed and there is little reflection of the impinging energy back into the tissue. A second beneficial characteristic is to have the absorber have good acoustic absorbing properties at the frequency of the transducer emission, allowing acoustic energy to be absorbed rapidly. A third beneficial characteristic is to have the absorber material have a thickness and thermal properties such that the surface abutting the tissue does not become hot enough to affect it.
  • [0099]
    Tan gum rubber has a lower impedance, approximately 1.5 Mrayls, but its loss is only about 4.3 dB/cm at 1.0 MHZ. This is the best material known to date and, though requiring a thicker layer, such aids in distributing heat caused by energy absorbed and thus avoids developing a hot surface. An alternative is neoprene, commercially available (e.g., Gardico Inc., 1107 Elliott W., Seattle, Wash.), which has an impedance of 2.4 Mrayls, which results in only about a five percent reflection. Red SBR rubber has similar loss characteristics, but a higher impedance. However, red SBR rubber is adverse to wetting and an air layer between the rubber and tissue will greatly increase the reflection coefficient. Hydrophobic materials should be wetted with alcohol before immersion to minimize such effects.
  • [0100]
    In an alternative embodiment, material placed on the bottom arm 113 could be acoustically reflective. If the coefficient of reflectivity is high enough, little impinging energy will be transmitted to tissue or organs beyond, thus the same goal as using an absorber is achieved. The reflected energy can be used to enhance the procedure in the tissue of interest. A suitable reflector should have a characteristic of having an acoustic impedance much different from the tissue, either lower (such as air or an air-filled material like Styrofoam™) or much higher (e.g., ceramics). For a low impedance reflector, a 180° phase reversal is produced at the point of reflection. This tends to cancel the effect of the impinging and reflected wave in the region proximate to the reflector. For a high impedance reflector, there is no phase reversal, so the impinging and reflected waves superimpose, producing an increased heating effect. Thus, a high impedance reflector should be immediately subjacent the target region. Furthermore, a mirror-reflection of a diverging beam impinging on the reflector is further diverging. Therefore, it is possible to obtain a broader area of effect in the region proximate the reflector surface. If the focal point is closer to the transducer than the reflector, it is possible by superimposition to produce effects with broader beams beyond the maximum depth of focus.
  • [0101]
    The transducer 107 and its acoustic coupler 111—in this embodiment a simple flexible cuff filled with water—are connected to a transducer aligning mechanism 401 by a top arm 109. The transducer aligning mechanism 401 is provided with a thumb trigger 403 adjacent an apparatus handle 405. The transducer aligning mechanism 401 detail is shown in FIG. 4C. The top arm 113 also bears electrical cabling 407 connected to an electronic controller (not shown, but see FIGS. 10-12).
  • [0102]
    Turning to FIGS. 4C-4E, the transducer aligning mechanism 401 provides one degree of motion in the Z-axis (FIG. 4B) to lower or elevate the transducer 107 with respect to the tissue, which essentially is used to change the depth of focus. The aligning mechanism 401 has a casing 411 having a hollow through channel 413 (FIG. 4D) and a slide channel 415 (FIGS. 4C and 4D). Arm 109 (FIGS. 4A, 4B, 4C and 4E) fits through the slide channel 415 to have freedom of motion in the Z-axis. Four ball bearing channels 417 (FIG. 4D) are provided in each interior corner of the casing 411. An upper end cap 421 and lower end cap 423 close the through channel 413 of casing 411 at each end. As shown in FIGS. 4D and 4E, the arm 109 is mounted between an upper bellows 425 and a lower bellows 427 contained within the through channel 413 by a mount 429 at an end distally located from the transducer 107 (FIGS. 4A and 4B). The bellows-arm mount 429 has a size and exterior shape conforming to through channel 413 for a sliding fit therein. A ball bearing 431 mounted for rotation in cavities in each corner of the bellows-arm mount 429 to fit in respective ball bearing channels 417 of the casing 411 so that the mount rides freely in the Z-axis. The end caps 421, 423 are provided with bellows pressurizing apertures 433 (lower cap aperture not shown) for connecting a suitable pressurizing/depressurizing medium, e.g., an air supply and tubing (not shown), to each bellows 425, 427. The thumb trigger 403 (FIGS. 4A & 4B) is coupled to the air supply and used to pneumatically control Z-axis motion of the arm 109 via the bellows 425, 427. Selectively increasing the pressure in one bellows while decreasing the pressure in the other allows the bellows to expand and contract respectively, causing the arm 109 to move in the slide channel 415 and directly translated to the transducer 107. The rate of flow of pressurized air is set at the pressure source to a limited value to control the speed that the bellows inflate-deflate, controlling the speed that the arm 109 is raised or lowered.
  • [0103]
    Motion in directions other than the Z-axis are done manually. That is, using the handle 405, the surgeon slides the apparatus 105 towards or away from himself or laterally across the surface of the organ 101 to move the focal point in a line. If the transducer is of a semi-cylindrical configuration that is forming a line of coagulated and necrosed tissue (see FIG. 9 described hereinafter), moving the apparatus 105 towards or away from himself describes a horizontal plane; moving the apparatus in the Z-axis then describes a vertical plane. Thus, as can now be recognized by a person skilled in the art, a variety of transducer configurations, described hereinafter, and relative motion will produce a variety of shapes and sizes of volume cauterization regions.
  • [0104]
    An advanced embodiment is shown in FIGS. 5A-5C in which the transducer aligning mechanism 401 of FIGS. 4A-4C has been replaced with an electro-mechanically controlled transducer positioning assembly for moving the top arm 109, or top and bottom arms 109, 113, in the X-, and Z-axes. Turning to FIG. 5C for details of the transducer positioning assembly 501, the mechanism 401 (FIG. 4C) has been modified to add the additional degree of motion control. The arm 109 is moved in the X-axis by turning the transducer aligning mechanism 401 to a horizontal orientation. Two pneumatic bellows 503, 505 are linked together to produce the Z-axis motion. A top bellows cap 507 and bottom bellows cap 509 are provided with apertures for receiving air supply tubes 511, 513 in the same manner as the caps 421, 423 of the transducer aligning mechanism 401, now shown as tubes 435, 437. Left bellows corner struts 515, 517 and right bellows corner struts (not shown) are used as guides for ball bearings 519 captured in the external corners of transducer aligning mechanism end caps 421, 423 for mating with the struts such that inflating and deflating the top bellows 503 and bottom bellows 505 causes controlled motion in the Z-axis. Thus, the four corner struts hold the assembly rigid and allow the X-axis mechanism 401 to move up and down using the external pneumatic controller (not shown).
  • [0105]
    In another embodiment, not shown, a third pair of bellows can be added to the assembly of FIG. 5C to provide y-axis control (FIG. 5A). The operator's control can be a joy-stick, foot controls, or the like, as would be known in the art.
  • [0106]
    Depth of focus can be more easily accomplished by an alternate embodiment as shown in FIGS. 6A-6C. A side-radiating HIFU unit 601, having a housing which doubles as a handle, 602 uses an acoustic energy reflector 603 to focus ultrasonic energy, represented by the phantom lines, transmitted through a suitable fluid medium 611, out through an acoustic energy window 605 into the organ 101. The HIFU reflector 603 is at an angle of approximately 45° to the handle 602 orientation, bending the ultrasound beam 90°. The depth of focus is varied using a drive screw 607 powered by a motor, or other linear drive mechanism, 609 to change the distance between the emitter face of the transducer 107 and the acoustic energy reflector 603. Electrical energy for the motor 609 and transducer 107 is provided using a flexible cable 613. FIGS. 6A-6C again illustrate how a line or plane of coagulation can be produced by moving the position of the transducer with respect to the reflector. In a further refinement, the reflector 603 can be oscillated about its center line to sweep a point focus precisely in a plane perpendicular to the axis of the handle 602.
  • [0107]
    [0107]FIG. 7 demonstrates an even further simplified HIFU tool 701 in the nature of a pencil-like probe 703. The probe 703 has a transducer 107 with an appropriate electrical connection 705. Acoustic energy 707 is transmitted through a fluid coupling window 709. The combination of an essentially zero depth of field characteristic with a short, fixed, focal length 711 provides for cauterizing tissue immediately in front of the window 709 to the extent of the depth of field of the transducer 107. Thus, a surgeon could cauterize a line of tissue, cut the line with a scalpel, then reapply the probe 703 to cauterize a next line of tissue to be cut—viz., cauterize, cut, cauterize, cut, etc.—as needed step by step in the operation. Such an embodiment would be more useful in a more general exploratory surgery or emergency surgical situations where an exact surgical target location is undefined.
  • [0108]
    Ultrasound is strongly reflected by air and bone interfaces. Thus, the application of HIFU surgery must be limited to those soft tissues in which a target region is identified. Intervening bones and air, viz., in the lungs, must be moved aside. FIGS. 8A-8C demonstrate yet another embodiment which is a hand-held HIFU surgical instrument 801, especially suited to emergency situation use or use within a region of the body cavity where it may be difficult to reach or see with more complex instruments such as shown in FIGS. 1A through 6C.
  • [0109]
    The imaging transducer 803 is a linear array used for steering as would be known in the art. An imaging device, such as a central linear transducer array 803, connected via cabling 804 to appropriate imaging equipment as would be known in the art, aids the surgeon in determining where to produce the HIFU cauterization effects. As the user moves the instrument 801 around within the patient, they receive an image of the underlying organ to guide placement of the instrument 801 in order to align HIFU transducer array elements 805 of a cauterizing transducer array set. Such an array is advantageous in this embodiment since electronically controlled depth of focus control can be provided through phase alignment of the elements 805. The HIFU transducer is a group of square or rectangular elements 805 located around the imaging transducer 803. The array is used as the HIFU application transducer, allowing an electronically controlled change of the focal depth, depending on the phasing of excitation to each element 805. Thus, the instrument 801 can be steered to some extent as well as focused at different depths and beam diameters depending on the phasing of the excitation to each element 805.
  • [0110]
    [0110]FIGS. 8D and 8E shows an alternative for the transducer arrangement using an annular array 806. [Some annular array instruments are known in the art. For example, in U.S. Pat. No. 5,520,188, Hennige et al., assignors to Focus Surgery, Inc., describe an annular array transducer for use in a localization and therapeutic ultrasound system where elements operate together to focus a continuous wave (CW) ultrasound beam at a focal zone that is a variable distance from the elements, including a mechanism to adjust the focal distance via adjusting the phase of the signals imparted to each element. See also e.g., Intracavity Ultrasound Phased Arrays for Noninvasive Prostate Surgery, Hutchinson and Hynynen, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, November 1996, Vol. 43, No. 6 (ISSN 0885-3010), pages 1032-1042; Ultrasound Surgery: Comparison of Strategies Using Phased Array Systems, Hong Wan et al., on multiple focal length designs, id. at pages 1085-1098; and Sparse Random Ultrasound Phased Array for Focal Surgery, Goss et al., id., pages 1111-1121; and Design of Focused Ultrasound Surgery Transducers, Rivens et al., ibid. at pages 1023-1031, discussing a method for determination of transducer configurations for different fixed focal lengths.] The annular transducer elements 807 enable an adjustable focal depth having a wider range than other configurations. Cutaway region 809 shows a sectional view of dicing pitch of the transducer elements 807. Providing linear separation of the elements, in perpendicular axes, also allows beam steering without the requirement of complex X-, Y-, and Z-axis driving mechanisms as shown in FIGS. 4A through 5B and equivalents thereof.
  • [0111]
    Other Transducers
  • [0112]
    A variety of transducer designs as would be known to a person skill in the art can be made for use in accordance with the present invention. For example, current state of the art for focused bowl transducers is discussed by Rivens et al., Design of Focused Ultrasound Surgery Transducers, IEEE Transactions, supra. In commercial therapeutic treatment, Sonic Focus Inc., Fremont, Calif., manufactures a HIFU system, Sonablate-1™, providing a transrectal probe for prostate hyperthermia treatments.
  • [0113]
    An exemplary embodiment for producing a focal line is shown in FIG. 9. The transducer 901 has an acoustic energy emitting surface 903 which is a portion of a cylinder 905. This cylindrical transducer 901 focuses ultrasonic energy (indicated by phantom lines 907) into a line 911. The distance of this focal line 911 from the transducer face 903 is approximately the radius of curvature of the cylindrical element 905.
  • [0114]
    Controllers
  • [0115]
    A variety of means for targeting acoustic transducers are well known in the art (see e.g., U.S. Pat. Nos. 4,484,569, 4,858,613, 5,520,188; Hynynen et al., Feasibility of Using Ultrasound Phased Arrays for MRI Monitored Noninvasive Surgery; and Thomas et al., Ultrasonic Beam Focusing Through Tissue Inhomogeneities with a Time Reversal Mirror: Application to Transskull Therapy, IEEE Transactions, supra). Generally, a further description of specific target acquisition, such as finding a tumor within the liver, is not necessary to an understanding of the present invention.
  • [0116]
    [0116]FIG. 10 is a schematic diagram for a single channel controller embodiment of the present invention such as exemplified in FIGS. 6A-6C and 7. A frequency, or function, generator 1001 (such as a Hewlett-Packard™ Model 33120 Function Waveform Generator) is used to generate a waveform for exciting the transducer 107. The waveform signal is transmitted through an on/off switching control 1003 that is operator activated (see broken line arrow labeled “Operator Activation”); alternatively, preset timer activation can be provided. A power amplifier 1005 (e.g., an Electronic Navigation Industries™ Model API 400B) increases the generator 1001 output and sends it through an electrical matching network 1007 (having appropriate air or liquid cooling, if required) to the transducer 107. The matching network 1007 transforms the complex electrical input impedance of the transducer 107 into a nominally real impedance compatible with the output stage of the power amplifier 1005. As described above, the transducer 107 emits ultrasound energy in a pattern and intensity to produce tissue coagulation at particular intra-tissue sites. The frequency range useful in accordance with the present is approximates one-half (0.5) to twenty (20) MHZ. At higher frequencies, absorption is almost immediate, providing negligible penetration through living tissue It is intended that the frequency and amplitude are adjustable to suit a particular implementation or surgical need. The amplitude of the waveform signal at the output of the generator has enough amplitude, e.g., one volt RMS, so that the power amplifier 1005 will increase it to a magnitude whereby the transducer will have a sufficiently high enough output to produce tissue coagulation. For example, the electrical power being transmitted from the power amplifier 1005 may be in the region of 200 watts, which for a 50-ohm load would require 100 volts RMS output across the load. In turn the transducer 107 may then deliver intensity at a focal point of 1500 W/cm2. It is believed that a spatial peak intensity in the range of 1300 to 3000 W/cm2 may be applied to obtain appropriate results sought to be achieved present invention. Note carefully that intensity required to depends upon the chosen ultrasonic frequency and the frequency-dependent tissue attenuation rate. The values that are given may be appropriate in accordance with actual experimental studies that were performed at 1 to 3 MHZ (further details of which are not necessary to an understanding of the present invention). At higher frequencies (e.g., 5 to 10 MHZ) tissue attenuation will be proportionately higher, and the required focal intensity may be much lower. In terms of the desired thermal bio-effect, values can be converted to a specific absorption rate (“SAR”) value, in units of Watts per kilogram. SAR values are commonly used in ultrasound hyperthermia studies and analysis. The SAR value specifies the amount of thermal energy that is being deposited per unit weight in the tissue, and it includes the effect of frequency-dependent attenuation. To achieve a certain temperature rise within a specified period, it may be more meaningful to use the SAR value. Equivalently, one could specify the ultrasonic intensity, the ultrasonic frequency, and the tissue attenuation rate.
  • [0117]
    While temperature elevation by ultrasound has been studied and reported upon (see e.g., Nyborg et al., Temperature Elevation in a Beam of Ultrasound, Ultrasound in Med. & Biol., Vol. 9, No. 6, pp. 611-620, 1983), in addition to specific transducer instrument operating parameters, various power, frequency, and time of application combinations are also dependent on a number of factors. For example, the type of tissue in which coagulation and necrotization is desired must be taken into consideration as different tissue will promote different absorption effects. Absorption of sonic energy are both frequency and tissue dependent. Another obvious variable is whether the HIFU energy is being applied in a pulsed or continuous wave form. Moreover, frequency independent data is an artifact of empirically competing effects of the absorption of sonic energy increasing with frequency and the size of the acoustic focal point depth of field decreasing with increased frequency. In other words, the energy intensity level, the sonic frequency employed, and the time of exposure, in either a pulsed or continuous wave modes, is primarily an empirical function. Each specific implementation may require empirically determined operational criteria.
  • [0118]
    If the ultrasonic frequency that is employed is too low, most of the energy will propagate past the depth of interest. Although this can be overcome by increasing the energy input, the energy that is deposited beyond the depth of interest is likely to damage tissues beyond the treatment zone. If an acoustic absorber is used, the waste energy will be converted to heat; this may protect deeper tissues, but significant heating may occur in the vicinity of the absorber.
  • [0119]
    Similarly, if the ultrasonic frequency that is employed is too high, most of the energy will be absorbed proximal to the depth of interest. Although this can be overcome by increasing the energy input, the energy that is deposited proximal to the depth of interest is likely to damage tissues.
  • [0120]
    In a homogeneous attenuative medium that behaves linearly with respect to pressure amplitude, it can be shown mathematically that for a plane wave, optimal energy deposition occurs at a depth “z” when the ultrasonic intensity at that depth is equal to:
  • I(z)=I 0 /e≅0.368*I 0,
  • [0121]
    where:
  • [0122]
    I0=ultrasonic intensity at the surface of the attenuative region.
  • [0123]
    The above formula maximizes the energy deposited at depth “z” for a given amount of input power. Given the frequency dependence of the attenuation, one can calculate the optimal frequency to deposit energy at depth “z” (see attached graph of FIG. 16). Following this formula, note that only 37% of the input energy propagates beyond depth “z”; 63% is deposited between the surface and depth “z”.
  • [0124]
    Focusing makes this argument more complex, but it does not alter the basic result. Weak focusing can be used to uniformly deposit energy from the surface to a depth “z” in a truncated conic zone; in this case, the beam cross-sectional area at depth “z” must be equal to:
  • A(z)=A 0 /e≅0.368*A 0,
  • [0125]
    where:
  • [0126]
    A0=beam cross-sectional area at the surface of the attenuative region.
  • [0127]
    Thus, to produce high ultrasonic intensity at a depth “z”, a focal intensity gain that is significantly greater than e≅2.718 is required.
  • [0128]
    In HIFU, attenuation is believed to be weakly non-linear with pressure amplitude in pre- and post-focal regions, and moderately non-linear near the focus. Nonetheless, the formulas above can be used to identify initial conditions. In practice, each specific clinical application will require some experimental optimization.
  • [0129]
    Note that optimal energy deposition requires a system and transducer capable of delivering energy at higher frequencies at shallow depths, and lower frequencies at deeper depths.
  • [0130]
    A second controller embodiment is shown in FIG. 11. Here the system is used to control the variation of the depth of focus for embodiments such as shown in FIGS. 4A-5B. In operation, activation of the on/off control 1003 causes the system to begin applying energy at a distal point in the tissue, moving it progressively closer to the transducer 107 with time. Under programmed control 1101, the circuitry automatically arms itself to position the transducer to perform a distal to proximal scan and then signals when ready. The operator turns on the apparatus and a scan is performed. After the scan, the transducer 107 is repositioned via transducer positioning assembly 501 to the next line or plane to be coagulated where a next scan is required.
  • [0131]
    Shown in FIG. 12 is an electronic scanning system, useful with a phased array embodiment such as shown in FIG. 8B, or other electronically focused transducer. Added to the system are phase shifters 1201-1201N in order to accommodate each transducer element 107-107N in the annular array 805 (FIG. 8B). Programmed electronic depth of focus is provided as would be well known in the state of the art. Note that the controller can be adapted to provide a pulsed, continuous wave, or combination pulsed and continuous wave sonic energy emission from the transducer.
  • [0132]
    Independent control 1203 1-1203 n over amplitude and phase is provided. Independent amplitude control is necessary to produce desired apodization (shading) functions across the array aperture, which in turn results in control of side lobe levels. High side lobe levels may cause unwanted tissue damage in adjacent structures. These levels are easily reduced by the use of appropriate apodization functions. This is well known in the prior art. Independent channel gain controls would also be required if the transducer includes elements with unequal areas. In certain embodiments, e.g., an annular array with a central rectangular opening for an imaging array as depicted in FIG. 8D, the array elements will clearly have different elemental areas, requiring channel-independent gain.
  • [0133]
    Variable Depth of Focus Instrument Embodiments
  • [0134]
    As depicted in several drawing heretofore, a flexible bag 111 is provided as an acoustic coupler between the transducer 107 and the organic tissue 111. While adequate for certain uses, because of its inherent flaccid nature, there can be difficulty in maintaining both constant contact between the bag and the tissue and an accurate depth of focus.
  • [0135]
    A HIFU tool assembly, having a true variable depth of focus in accordance with a preferred embodiment of the apparatus of the present invention is shown in FIGS. 13A and 13B. FIG. 13A depicts a presurgical device 1301 for preparing an organ of a patient for surgical incisions using HIFU energy to produce coagulation and necrosis in the tissue along each predetermined incision pathway, or using a very shallow depth of focus setting, for producing localized hemostasis (discussed in further detail hereinafter).
  • [0136]
    A transducer mount 1303 holds a transducer, or transducer array, 1305 in a substantially fixed configuration. A housing 1307, such as of a molded, clear, plexiglass, forms an internal chamber 1309. The device 1301 is mounted on a suitable handle, such as handle 109 of FIGS. 3A-4B, having inlet and outlet tubes (not shown; but see FIGS. 4A-5B, re element 407) allowing a suitable acoustic energy transmitting medium, such as water to flow into and out of the chamber 1309. The handle also carries any electrical wires or cables needed to power the transducer 1305. The housing 1307 has a rotatable collar 1327, having a fixed radial position relative to the transducer's energy emitting surface 1319 and an inner wall 1329 of the housing 1307. The housing inner wall 1329 at least partially forms the sides of the internal chamber 1309. The rotatable collar 1327 has screw threads 1331 on an interior surface thereof. A selectively movable focusing cone 1333 is coupled to the rotatable collar 1327 via focusing cone member screw threads 1335. When so mated, distally located from the transducer's energy emitting surface 1319, there is an acoustic window 1321 at a conical, lower extremity 1333′ of the focusing cone 1333. An acoustically-transmissive, flexible membrane 1323 is stretched across the window 1321, secured to the housing 1307 by a suitable mount, such as an o-ring, 1325. Thus, by rotating the collar 1327, the device 1301 provides a telescoping-type construct. FIG. 13A shows the construct in an extended position; FIG. 13B shows the construct in a fully retracted position. In the extended position of FIG. 13A, the internal chamber 1309 of the housing is substantially enlarged by the volume of cavity 1309′ of the movable focusing cone 1333. Water is added via the inlet tubes as the volume of the entire chamber 1309, 1309′ increases when the collar 1327 is rotated and withdrawn as the volume decreases when the collar is counter-rotated. Suitable mounting and sealing o-rings 1311, 1313, 1317 and screw 1315 are provided as necessary to complete the device 1301.
  • [0137]
    As can now be recognized, a telescoping action is produced between the rotatable collar 1327 and the focusing cone member 1333 when the collar 1327 is rotated about its longitudinal axis of rotation, “R-R.” Rotating collar 1327 changes the gap, “Fn,” between the transducer's energy emitting surface 1319 and the acoustic window 1321. As the gap varies, for example from length F1 in FIG. 13A to F2 in FIG. 13B, the depth of focus of the device 1301 varies; distance F1 establishing the deepest focal point or focal zone penetration. As will be recognized by a person skilled in the art, the device's construct is adaptable to a variety of transducer types and size implementations.
  • [0138]
    The rotating collar may be manually or electro-mechanically rotated. FIG. 14 depicts a schematic for an automated focus dept adjustment system. A motor Ml, such as a stepper motor, is coupled by drive shaft S1 to a gear train G1, G2, G3, gear shaft S2, G4, G5 and G6. The rotating collar 1327 is coupled to gear G6 such that by activation of the motor, e.g., via a surgeon operated foot switch (not shown), precise depth of focus can be achieved as focusing cone 1333 moves with rotation as shown by the arrow labeled “With Rotation 1333 Moves”. Since the mechanism will necessarily be used under sterile conditions, this configuration allows a single motor and gear train G1-G4 to be enclosed in a sealed section; gear G5 and the combined unit of gear G6 and the transducer system (FIGS. 13A & 13B) within rotating collar 1327 are removable from the shaft for cleaning and sterilization.
  • [0139]
    An alternative embodiment of a device 1501 having a focusing mechanism is shown in FIGS. 15A-15C. A base 1503 (similarly, see also FIG. 13A, element 1303) holds a transducer (not shown) projecting inwardly through a cavity 1505, FIG. 15C, of the device. The cavity 1505 is formed by a plurality of telescopic cylinders 1507, 1509, 1511, 1513. The cavity 1505 is adapted for filling with an acoustic coupling fluid, e.g., degassed water. Again, fluid couplings not shown, but as would be obvious to a person skilled in the art, are provided to keep the cavity filled during expansion and contraction. A spring 1515 is mounted inside the cavity to bias against an end plate 1517 (FIGS. 15A & 15B only). A bellows 1519 surrounds the telescopic cylinders 1507-1513 and the end plate 1517 is attached thereto in contact with the spring 1515 and the telescopic cylinders distally from the base 1503. Thus, the device is in an expanded condition unless compressed by pushing the end plate against the tissue to a degree to force the spring and bellows to begin to collapse.
  • [0140]
    The end plate 1517 is rigid on its circumference for connection to the bellows. The inner radial region of the end plate 1517 may be of a different material, but essentially must be transparent to ultrasonic energy. The purpose of the telescoping sections is to maintain the axial alignment with the center of the axis, C—C, running through the aligned base 1503 and the end plate 1517. Thus, the ultrasound energy emitted by the transducer will not encounter the inner walls of the telescopic cylinders 1507-1513. A flexible bag acoustic coupler 111 lacks this ability.
  • [0141]
    Note that this embodiment can be adapted for use with either a fixed system as exemplified in FIGS. 1B-5B and 14, or can be hand held as in FIGS. 8A-8C.
  • [0142]
    Hemostasis Procedures
  • [0143]
    As another example of the methodology of the present invention, consider traumatic bleeding. For example, uncontrolled hemorrhage of the liver is a primary cause of death in hepatic trauma, occurring in 30% of penetrating and 15-20% of blunt abdominal trauma, with a mortality rate of 10-15%. Abdominal trauma patients are often already in hemorrhagic shock prior to arrival at surgery. Another application is for treating a punctured vessel in a medical situation where a catheter has been removed from the artery, resulting in bleeding. Additionally, emergency rescue teams are often faced with massive bleeding injuries with nothing more than tourniquets to use to stem the flow of blood.
  • [0144]
    In accordance with the present invention, ultrasound having a frequency in a range of 0.5 MHZ-20 MHz is focused onto the outer regions of the vessel adjacent to where the puncture or tear occurred. The energy level and the duration of exposure is monitored such that the application of HIFU causes the closure of the fibrous sheath surround a vessel without damaging or irreversibly damaging the wall tissue of the vessel itself. [But cf., Potential Adverse Effects of High-Intensity Focused Ultrasound Exposure on Blood Vessels In Vivo, Hynynen et al., Ultrasound in Med. & Biol., Vol. 22, No. 2, pp. 193-201, 1996.]
  • [0145]
    Particularly suited to this process and portable implementations are apparatus such as depicted in FIGS. 7 and 8A-8C since they provide simple, hand-held embodiments. Having a fixed depth of focus immediately adjacent the front of the instrument, makes the embodiment of FIG. 7 particularly useful in a roadside, medical emergency where portability is a factor. Specific instrument design factors, viz., frequency, transducer size, power, and the like as discussed heretofore, will determine the duration of application to cause hemostasis. Again, treatment parameters are device specific and must be determined empirically. As an example, a device similar to the embodiments shown in FIGS. 8A-8B was used for experiments (performed in accordance with the appropriate laws and guidelines of the U.S. Nation Institute of Health for the use of laboratory animals). A HIFU, spherically curved transducer had an aperture of 6.34 cm2, producing a depth of focus at 4 cm. It was operated at 3.3 MHZ, CW, by applying 300 V peak-to-peak, producing an acoustic power of 65W, measured with an absorber-type radiation force balance and a spatial peak intensity at the focal region of approximately 3000 W/cm2. For 94% of incisions in rabbit liver, major hemostasis was achieved in a time of less than approximately two minutes of continuous application of HIFU. The average±standard deviation of the major hemostasis time was 1.4±0.69 minutes. When a large vessel was cut, in approximately 80% of the incisions, complete hemostasis was achieved in a time less than or equal to 3 minutes of continuous HIFU application.
  • [0146]
    Note that occurrence of trauma to a specific tissue or organ may start bleeding internally. This may produce a hematoma, a shunt between the arterial and venous system caused by an artery punctured or ruptured in close proximity to a ruptured or punctured vein, or bleeding into some non-cardiovascular cavity.
  • [0147]
    While shunts can occur substantially anywhere in the cardiovascular system, yet another medical problem that involves vascular shunts between the arterial and venous system are congenital defects known as arterial-venous (“AV”) malformations. AV malformations often occur in the brain and liver. In a shunt, blood flow may be contained to a local region by reason of the adjacent tissue remaining normal or intact. An open venous pathway provides a pressure release and site for blood to flow from the higher arterial pressure system. Additionally, a shunt can occur between a vessel with higher pressure to a vessel with a lower pressure. Whatever the cause, the medical problem is that normal tissue does not receive proper blood perfusion. Of further difficulty is that AV malformations themselves have a higher tendency to hemorrhage. In a similar manner, HIFU energy is applied to the region where the internal bleeding is detected, that is, specifically to the vessels with the higher pressure from which the blood is leaking. In accordance with the present invention, such shunts or other internal bleeding can be closed without having to disturb or cut through adjacent tissue, occluding the artery feeding the shunt, the shunt itself, or the vein receiving the shunt blood flow. Alternatively, the whole tissue region or malformation of the vessel feeding the shunt, the shunt, and the vessel receiving the shunt is coagulated using HIFU energy, coagulating the specific volume of tissue involved.
  • [0148]
    The present invention provides a useful method and apparatus for a variety of presurgical and traumatic bleeding applications.
  • [0149]
    The foregoing description of the preferred and alternative embodiments of the present invention has been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise form or to exemplary embodiments disclosed. Obviously, many modifications and variations will be apparent to practitioners skilled in this art. Similarly, any process steps described might be interchangeable with other steps in order to achieve the same result. While liver surgery has been discussed at length in an exemplary embodiment, the volume cauterization procedure is applicable to virtually all organ surgery. The embodiment was chosen and described in order to best explain the principles of the invention and its best mode practical application, thereby to enable others skilled in the art to understand the invention for various embodiments and with various modifications as are suited to the particular use or implementation contemplated. It is intended that the scope of the invention be defined by the claims appended hereto and their equivalents.

Claims (37)

    What is claimed is:
  1. 1. A method of performing surgery with minimized bleeding, comprising the steps of:
    a) determining each path of incision to be made in a tissue volume;
    b) cauterizing each path using ultrasonic energy to form at least one surgical pathway in the tissue volume prior to incising; and
    c) making surgical incisions only along a surgical pathway formed in accordance with step b).
  2. 2. The method as set forth in claim 1, the step of cauterizing further comprising the step of:
    isolating a region of tissue from the blood supply to the region.
  3. 3. The method as set forth in claim 1, the step of cauterizing further comprising the step of:
    encapsulating a volume of tissue with an encasement of coagulative necrosed tissue.
  4. 4. The method as set forth in claim 1, the step of cauterizing further comprising the step of:
    surrounding a tissue volume to be surgically excised with a coagulated necrotized surface of tissue having a predetermined thickness.
  5. 5. The method as set forth in claim 1, said step of cauterizing further comprising the step of:
    using high intensity focused ultrasound energy at a level sufficient to produce coagulation and necrosis in the tissue along each pathway.
  6. 6. The method as set forth in claim 1, said step of cauterizing further comprising the step of:
    applying ultrasonic energy having a frequency in the range of 0.5 MHZ to 20 MHz.
  7. 7. The method as set forth in claim 1, said step of cauterizing further comprising the steps of:
    A) determining a first point on an edge of a plane of a path to be cut;
    B) focusing the energy to have a first focal point at the first point;
    C) moving the first focal point to follow the edge of the plane, producing a first line of coagulation having a cross-sectional width;
    D) refocusing the energy to have a second focal point aligned with the first line and proximate to the first point;
    E) moving the second focal point to follow the plane of the path to be cut, producing a second line of coagulation along said plane; and
    F) repeating said steps of refocusing and moving until the plane for incision is substantially entirely coagulated.
  8. 8. The method as set forth in claim 7, further comprising the steps of:
    repeating steps A) through F) for each path of incision.
  9. 9. The method as set forth in claim 7, said step of cauterizing further comprising the step of:
    applying ultras sonic energy causing a temperature gradient at each focal point in a range of approximately 59° C. to approximately 99° C.
  10. 10. The method as set forth in claim 7, said step of cauterizing further comprising the step of:
    applying ultrasonic energy causing an intensity of acoustic radiation at each focal point in a range of approximately 1000 W/cm2 to approximately 3000 W/cm2.
  11. 11. A method for presurgical treatment of highly vascularized organic tissue to minimize bleeding during surgical procedures, the method comprising the steps of:
    determining each path of incision to be made in the tissue; and
    exposing each path to high intensity focused ultrasound energy having a predetermined frequency for a time period sufficient to form at least one coagulative necrosed pathway in the tissue such that making subsequent surgical incisions only along a coagulative necrosed pathway is subject to minimized bleeding.
  12. 12. The method as set forth in claim 11, further comprising the steps of:
    determining each path of incision necessary to remove a volume of tissue including a lesion from the tissue; and
    surrounding the volume of tissue to be surgically excised with a coagulated necrotized surface having a predetermined thickness permitting surgical incisions there through.
  13. 13. The method as set forth in claim 11, further comprising the steps of:
    determining each path of incision necessary to resection the tissue; and
    prior to incising the tissue, cauterizing each path using high frequency focused ultrasound energy to form at least one coagulative necrosed pathway in the tissue such that making surgical incisions only along a coagulative necrosed pathway minimizes bleeding.
  14. 14. The method as set forth in claim 11, further comprising the step of:
    applying ultrasound energy having a frequency in the range of 0.5 MHZ to 20 MHz.
  15. 15. The method as set forth in claim 11, the step of exposing further comprising:
    the ultrasonic energy causing an intensity of acoustic radiation at each focal point in a range of approximately 1000 W/cm2 to approximately 3000 W/cm2 for a duration of time such that hyper-thermic effects or a combination of hyper-thermic effects and cavitation effects are produced in the tissue.
  16. 16. A method for causing hemostasis comprising the steps of:
    baring a hemorrhaging blood vessel or parenchyma; and
    exposing said blood vessel or parenchyma to sonic energy comprising high intensity focused ultrasound such that said hemorrhaging blood vessel or parenchyma is cauterized by said sonic energy.
  17. 17. The method as set forth in claim 16, the step of exposing further comprising the step of:
    applying ultrasound energy having a frequency in the approximate range of 0.5 MHZ to 20 MHz.
  18. 18. A method for causing hemostasis in a visible hemorrhaging wound, comprising the steps of:
    using a transducer means, having an ultrasonic transducer having a transmitting surface emitting high frequency focused ultrasound having a frequency in the approximate range of 0.5 MHZ to 20 MHz and a depth of focus substantially immediately adjacent said transducer means, applying high intensity focused ultrasound energy onto outer regions of a hemorrhaging vessel adjacent to a vascular breach; and
    controlling energy level and the duration of exposure to cause closure of fibrous sheath tissue surrounding the breach of the hemorrhaging vessel without substantially damaging wall tissue of the vessel itself.
  19. 19. A presurgical device for preparing an organ of a patient for surgical incisions, comprising:
    a transducer means for emitting energy as high frequency focused ultrasound; and
    means for controlling focal position and focal intensity of energy emissions from said transducer means such that acoustic energy at selective focal zones produces coagulative necrosed tissue in the form of predetermined surgical pathways within the tissue such that surgical incisions along the surgical pathways is subject to substantially no bleeding.
  20. 20. The device as set forth in claim 19, further comprising:
    tissue backing means for protecting tissue beyond a selective focal zone from exposure effects of emitted energy from the transducer.
  21. 21. The device as set forth in claim 20, said tissue backing means further comprising:
    an acoustic energy absorber having an acoustic impedance approximately equal to acoustic impedance of the tissue at the frequency of the emitted energy and a thickness and thermal properties such that abutting the tissue does not become heated by said absorber.
  22. 22. The device as set forth in claim 20, said tissue backing means further comprising:
    means for reflecting said emitted energy back to said focal zone.
  23. 23. The device as set forth in claim 19, further comprising:
    said transducer means emits high intensity focused ultrasound energy having a depth of focus and depth of field in respective ranges in combination with said means for controlling such that the device provides cauterization of visible hemorrhaging.
  24. 24. The device as set forth in claim 19, said transducer means further comprises:
    said transducer means having at least one surface for emitting acoustic energy having a frequency in the range of 0.5 MHZ to 20 MHz; and
    mounted to said transducer, means for acoustically coupling said energy to the tissue, including a liquid-filled chamber mounted proximate said surface and having an acoustic energy window at a position distal from said surface and a means for varying gap distance from said surface to said window such that depth of said selective focal zone position changes as said gap distance is increased and decreased using said means for varying gap distance.
  25. 25. The device as set forth in claim 24, wherein said means for acoustically coupling further comprises:
    a telescoping construct having a fully retracted position providing a shallow tissue penetration depth of focus, a fully extended position providing a predetermined deep tissue penetration depth of focus, and providing a substantially continuous range of depth of focus positions between said shallow tissue penetration depth of focus and said deep tissue penetration depth of focus.
  26. 26. The device as set forth in claim 25, said telescoping construct further comprising:
    first means for mounting a high intensity focused ultrasound transducer and for providing an acoustic coupling medium chamber adjacent the transducer; and
    second means for mounting an acoustic window for focusing ultrasound energy emitted by said transducer, wherein said second means is coupled to said first means by a screw-type interface such that a gap between said transducer and said acoustic window is variable such that depth of focus of the ultrasound energy is selected by using said screw-type interface to vary the gap.
  27. 27. The device as set forth in claim 25, said telescoping construct further comprising:
    first means for mounting a high intensity focused ultrasound transducer and for providing an acoustic coupling medium chamber adjacent the transducer; and
    second means for mounting an acoustic window for focusing ultrasound energy emitted by said transducer, wherein said second means is coupled to said first means by a bellows-type interface such that a gap between said transducer and said acoustic window is variable such that depth of focus of the ultrasound energy is selected by using said bellows-type interface to vary the gap.
  28. 28. A method of using high intensity focused ultrasound for surgical procedures, comprising the steps of:
    prior to incising tissue of a surgery patient, applying ultrasonic energy at a combination of frequency, time of exposure, and power intensity to cause controlled coagulation and necrotization of tissue in the patient such that a volume cauterized tissue region is formed in said tissue at predetermined locations within said tissue that are to be cut.
  29. 29. A high intensity focused ultrasound medical instrument for use with an electronic controller means, the instrument comprising:
    a pencil-like handle;
    fixedly mounted on a tip of the handle, sealed acoustic coupling means for interfacing ultrasonic energy into a patient;
    mounted subjacent the acoustic coupling means, ultrasound transducer means, including at least one transducer for emitting ultrasonic energy through the acoustic coupling means such that a focal region is produced immediately adjacent the acoustic coupling means; and
    incorporated through the handle, means for coupling the transducer means to the electronic controller.
  30. 30. A high intensity focused ultrasound medical instrument for use with an electronic controller means, the instrument comprising:
    a palm-of-the-hand shaped and dimensioned handle;
    fixedly mounted on a first surface of the handle, sealed acoustic coupling means for interfacing ultrasonic energy into a patient;
    mounted on a second surface of the handle subjacent the acoustic coupling means, ultrasound transducer means, including at least one transducer for emitting sonic energy through the acoustic coupling means; and
    mounted on a third surface of the handle opposing the first surface, means for coupling the transducer means to the electronic controller.
  31. 31. The instrument as set forth in claim 30, said transducer means further comprising:
    at least one imaging transducer;
    at least one high intensity focused ultrasonic transducer means for emitting ultrasonic energy through said acoustic coupling means in a frequency in an approximate range of 0.5 MHZ to 20 MHz.
  32. 32. The instrument as set forth in claim 31, said high intensity focused ultrasonic transducer means further comprising:
    a plurality of transducers forming a discretely targetable set of ultrasonic emitters.
  33. 33. The instrument as set forth in claim 31, said high intensity focused ultrasonic transducer means further comprising:
    an annular array transducer system.
  34. 34. A method for causing hemostasis of an internal hemorrhage, comprising the steps of:
    without surgical incision, exposing a blood vessel or parenchyma source of said hemorrhage to sonic energy comprising high intensity focused ultrasound such that said hemorrhaging blood vessel or parenchyma is cauterized by said sonic energy.
  35. 35. The method as set forth in claim 34, the step of exposing further comprising the step of:
    closing a shunt or other internal bleeding without affecting or cutting through adjacent tissue.
  36. 36. The method as set forth in claim 35, the step of exposing further comprising the step of:
    occluding a blood vessel feeding the shunt, the shunt itself, or the vessel receiving shunt blood flow.
  37. 37. The method as set forth in claim 35, the step of exposing further comprising the step of:
    coagulating a specific volume of tissue encompassing a whole tissue region or malformation of a blood vessel feeding the shunt, the shunt, and the vessel receiving the shunt.
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Cited By (114)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040039312A1 (en) * 2002-02-20 2004-02-26 Liposonix, Inc. Ultrasonic treatment and imaging of adipose tissue
US20040059265A1 (en) * 2002-09-12 2004-03-25 The Regents Of The University Of California Dynamic acoustic focusing utilizing time reversal
WO2004075987A1 (en) * 2003-02-28 2004-09-10 Koninklijke Philips Electronics, N.V. Motion-tracking improvements for hifu ultrasound therapy
US20060052701A1 (en) * 1998-09-18 2006-03-09 University Of Washington Treatment of unwanted tissue by the selective destruction of vasculature providing nutrients to the tissue
US20060074313A1 (en) * 2004-10-06 2006-04-06 Guided Therapy Systems, L.L.C. Method and system for treating cellulite
US20060184069A1 (en) * 2005-02-02 2006-08-17 Vaitekunas Jeffrey J Focused ultrasound for pain reduction
US20060235303A1 (en) * 2004-09-16 2006-10-19 Shahram Vaezy Acoustic coupler using an independent water pillow with circulation for cooling a transducer
WO2006121851A2 (en) * 2005-05-05 2006-11-16 Volcano Corporation Capacitive microfabricated ultrasound transducer-based intravascular ultrasound probes
US20070004984A1 (en) * 1997-10-31 2007-01-04 University Of Washington Method and apparatus for preparing organs and tissues for laparoscopic surgery
US20070078326A1 (en) * 2003-12-16 2007-04-05 Hideki Yoshikawa Ultrasonic motion detecting device, and image producing device and ultrasonic therapeutic using the detecting device
US20070106157A1 (en) * 2005-09-30 2007-05-10 University Of Washington Non-invasive temperature estimation technique for hifu therapy monitoring using backscattered ultrasound
WO2006130287A3 (en) * 2005-05-31 2007-10-04 Sikorsky Aircraft Corp Rotor hub fairing system for a counter-rotating, coaxial rotor system
US20070239000A1 (en) * 2005-10-20 2007-10-11 Charles Emery Systems and methods for ultrasound applicator station keeping
US20070239076A1 (en) * 2005-11-11 2007-10-11 Zimmer Elektromedizin Gmbh Method and apparatus for injecting ultrasound into tissue
US20080021310A1 (en) * 2006-07-21 2008-01-24 Louis-Philippe Amiot Non-invasive tracking of bones for surgery
US20080033292A1 (en) * 2006-08-02 2008-02-07 Insightec Ltd Ultrasound patient interface device
US20080051656A1 (en) * 1999-09-17 2008-02-28 University Of Washington Method for using high intensity focused ultrasound
US20080269608A1 (en) * 2005-10-20 2008-10-30 The General Hospital Corporation D/B/A Massachusetts General Hospital Non-Invasive Treatment of Fascia
US20090036774A1 (en) * 1999-11-26 2009-02-05 Therus Corporation Controlled high efficiency lesion formation using high intensity ultrasound
US20090062724A1 (en) * 2007-08-31 2009-03-05 Rixen Chen System and apparatus for sonodynamic therapy
US20090082703A1 (en) * 2007-09-26 2009-03-26 Robert Muratore Method and apparatus for the treatment of tendon abnormalities
US20090112098A1 (en) * 2005-09-16 2009-04-30 Shahram Vaezy Thin-profile therapeutic ultrasound applicators
US20090149842A1 (en) * 2007-12-05 2009-06-11 David Muller Eye therapy system
US20090171254A1 (en) * 2008-01-02 2009-07-02 Leonid Kushculey Time-reversal ultrasound focusing
US20090171252A1 (en) * 2003-12-30 2009-07-02 Liposonix, Inc. Therapy head for use with an ultrasound system
US20090187173A1 (en) * 2008-01-23 2009-07-23 David Muller System and method for reshaping an eye feature
US20090187184A1 (en) * 2008-01-23 2009-07-23 David Muller System and method for reshaping an eye feature
US20090192503A1 (en) * 2008-01-24 2009-07-30 Haim Epshtein Device, apparatus, and method of adipose tissue treatment
US20090209954A1 (en) * 2008-01-23 2009-08-20 David Muller System and method for reshaping an eye feature
US7591996B2 (en) 2005-08-17 2009-09-22 University Of Washington Ultrasound target vessel occlusion using microbubbles
US20090259127A1 (en) * 2008-03-12 2009-10-15 Reichert, Inc. Disposable High Frequency Multi-Focus Silicone Self-Contained Water Bath Offset
US20090275936A1 (en) * 2008-05-01 2009-11-05 David Muller System and method for applying therapy to an eye using energy conduction
US20090299180A1 (en) * 2005-06-03 2009-12-03 Theraclion Distance-determining method and treatment apparatus which uses said method
US7632235B1 (en) 2004-11-22 2009-12-15 Pacesetter, Inc. System and method for measuring cardiac output via thermal dilution using an implantable medical device with an external ultrasound power delivery system
US20100004536A1 (en) * 2008-07-03 2010-01-07 Avner Rosenberg Method and apparatus for ultrasound tissue treatment
US20100016761A1 (en) * 2008-07-16 2010-01-21 Avner Rosenberg Applicator for skin treatement with automatic regulation of skin protrusion magnitude
US20100076423A1 (en) * 2008-09-19 2010-03-25 Avedro, Inc. Eye therapy system
US7686763B2 (en) 1998-09-18 2010-03-30 University Of Washington Use of contrast agents to increase the effectiveness of high intensity focused ultrasound therapy
US20100094280A1 (en) * 2008-10-01 2010-04-15 Avedro, Inc. Eye therapy system
US20100094197A1 (en) * 2008-09-30 2010-04-15 John Marshall Eye therapy system
US20100160781A1 (en) * 2008-12-09 2010-06-24 University Of Washington Doppler and image guided device for negative feedback phased array hifu treatment of vascularized lesions
US20100198134A1 (en) * 2008-01-17 2010-08-05 Shimon Eckhouse Hair removal apparatus for personal use and the method of using same
US20100204577A1 (en) * 2005-07-13 2010-08-12 Acoustx Corporation Systems and methods for performing acoustic hemostasis of deep bleeding trauma in limbs
US20100234728A1 (en) * 1999-09-17 2010-09-16 University Of Washington Ultrasound guided high intensity focused ultrasound treatment of nerves
US20100280420A1 (en) * 2004-09-16 2010-11-04 Guided Therapy Systems, Llc System and method for variable depth ultrasound treatment
US20100280509A1 (en) * 2009-04-02 2010-11-04 Avedro, Inc. Eye Therapy System
US20110009734A1 (en) * 2003-12-16 2011-01-13 University Of Washington Image guided high intensity focused ultrasound treatment of nerves
US20110021913A1 (en) * 1999-10-25 2011-01-27 Kona Medical, Inc. Use of focused ultrasound for vascular sealing
US20110028867A1 (en) * 2009-07-29 2011-02-03 Seh-Eun Choo Apparatus and method for non-invasive delivery and tracking of focused ultrasound generated from transducer
US20110040172A1 (en) * 2008-04-09 2011-02-17 Alexandre Carpentier Medical system comprising a percutaneous probe
US20110077559A1 (en) * 2003-12-30 2011-03-31 Medicis Technologies Corporation Ultrasound therapy head with movement control
US20110112405A1 (en) * 2008-06-06 2011-05-12 Ulthera, Inc. Hand Wand for Ultrasonic Cosmetic Treatment and Imaging
US20110118600A1 (en) * 2009-11-16 2011-05-19 Michael Gertner External Autonomic Modulation
US20110118654A1 (en) * 2009-10-21 2011-05-19 Avedro, Inc. Eye Therapy
US20110118598A1 (en) * 2009-10-12 2011-05-19 Michael Gertner Targeted Inhibition of Physiologic and Pathologic Processes
US20110118716A1 (en) * 2009-10-30 2011-05-19 Avedro, Inc. System and Method for Stabilizing Corneal Tissue After Treatment
US20110137149A1 (en) * 2009-10-12 2011-06-09 Michael Gertner Nerve treatment system
US20110166559A1 (en) * 2008-09-21 2011-07-07 Shimon Eckhouse Method and apparatus for personal skin treatment
US20110172527A1 (en) * 2009-10-12 2011-07-14 Michael Gertner Systems for externally delivered energy to modulate neural structures
US20110237999A1 (en) * 2010-03-19 2011-09-29 Avedro Inc. Systems and methods for applying and monitoring eye therapy
US20120022512A1 (en) * 2008-01-24 2012-01-26 Boris Vaynberg Device, apparatus, and method of adipose tissue treatment
US20120022504A1 (en) * 2008-09-11 2012-01-26 Syneron Medical Ltd. Device, apparatus, and method of adipose tissue treatment
US20120046547A1 (en) * 2004-10-06 2012-02-23 Guided Therapy Systems, Llc System and method for cosmetic treatment
US8166332B2 (en) 2005-04-25 2012-04-24 Ardent Sound, Inc. Treatment system for enhancing safety of computer peripheral for use with medical devices by isolating host AC power
US8202272B2 (en) 2007-07-19 2012-06-19 Avedro, Inc. Eye therapy system
US8235909B2 (en) 2004-05-12 2012-08-07 Guided Therapy Systems, L.L.C. Method and system for controlled scanning, imaging and/or therapy
US8282554B2 (en) 2004-10-06 2012-10-09 Guided Therapy Systems, Llc Methods for treatment of sweat glands
US8366622B2 (en) 2004-10-06 2013-02-05 Guided Therapy Systems, Llc Treatment of sub-dermal regions for cosmetic effects
US8409097B2 (en) 2000-12-28 2013-04-02 Ardent Sound, Inc Visual imaging system for ultrasonic probe
US8444562B2 (en) 2004-10-06 2013-05-21 Guided Therapy Systems, Llc System and method for treating muscle, tendon, ligament and cartilage tissue
US8460193B2 (en) 2004-10-06 2013-06-11 Guided Therapy Systems Llc System and method for ultra-high frequency ultrasound treatment
US8469904B2 (en) 2009-10-12 2013-06-25 Kona Medical, Inc. Energetic modulation of nerves
US8469952B2 (en) 2008-01-23 2013-06-25 Avedro, Inc. System and method for positioning an eye therapy device
US20130165795A1 (en) * 2011-12-21 2013-06-27 Canon Kabushiki Kaisha Object information acquisition apparatus
US8480585B2 (en) 1997-10-14 2013-07-09 Guided Therapy Systems, Llc Imaging, therapy and temperature monitoring ultrasonic system and method
US8517962B2 (en) 2009-10-12 2013-08-27 Kona Medical, Inc. Energetic modulation of nerves
KR101307551B1 (en) 2013-03-26 2013-09-12 (주)클래시스 Handpiece of ultrasonic apparatus
US8535228B2 (en) 2004-10-06 2013-09-17 Guided Therapy Systems, Llc Method and system for noninvasive face lifts and deep tissue tightening
US8663112B2 (en) 2004-10-06 2014-03-04 Guided Therapy Systems, Llc Methods and systems for fat reduction and/or cellulite treatment
US8690779B2 (en) 2004-10-06 2014-04-08 Guided Therapy Systems, Llc Noninvasive aesthetic treatment for tightening tissue
US8712536B2 (en) 2009-04-02 2014-04-29 Avedro, Inc. Eye therapy system
US8715186B2 (en) 2009-11-24 2014-05-06 Guided Therapy Systems, Llc Methods and systems for generating thermal bubbles for improved ultrasound imaging and therapy
EP2730314A1 (en) * 2012-11-08 2014-05-14 Storz Medical Ag Endoscopic device for generating acoustic waves with variable focus
US8764687B2 (en) 2007-05-07 2014-07-01 Guided Therapy Systems, Llc Methods and systems for coupling and focusing acoustic energy using a coupler member
US8858471B2 (en) 2011-07-10 2014-10-14 Guided Therapy Systems, Llc Methods and systems for ultrasound treatment
US8857438B2 (en) 2010-11-08 2014-10-14 Ulthera, Inc. Devices and methods for acoustic shielding
US8882757B2 (en) 2008-11-11 2014-11-11 Avedro, Inc. Eye therapy system
US8915870B2 (en) 2004-10-06 2014-12-23 Guided Therapy Systems, Llc Method and system for treating stretch marks
US8986231B2 (en) 2009-10-12 2015-03-24 Kona Medical, Inc. Energetic modulation of nerves
US8986211B2 (en) 2009-10-12 2015-03-24 Kona Medical, Inc. Energetic modulation of nerves
US8992516B2 (en) 2007-07-19 2015-03-31 Avedro, Inc. Eye therapy system
US8992447B2 (en) 2009-10-12 2015-03-31 Kona Medical, Inc. Energetic modulation of nerves
US9011336B2 (en) 2004-09-16 2015-04-21 Guided Therapy Systems, Llc Method and system for combined energy therapy profile
US9011337B2 (en) 2011-07-11 2015-04-21 Guided Therapy Systems, Llc Systems and methods for monitoring and controlling ultrasound power output and stability
US9020580B2 (en) 2011-06-02 2015-04-28 Avedro, Inc. Systems and methods for monitoring time based photo active agent delivery or photo active marker presence
US9044308B2 (en) 2011-05-24 2015-06-02 Avedro, Inc. Systems and methods for reshaping an eye feature
US9066679B2 (en) 2004-08-31 2015-06-30 University Of Washington Ultrasonic technique for assessing wall vibrations in stenosed blood vessels
USD733319S1 (en) 2014-01-10 2015-06-30 Celleration, Inc. Ultrasonic treatment wand
USD733321S1 (en) 2014-01-10 2015-06-30 Celleration, Inc. Ultrasonic treatment device
US9114247B2 (en) 2004-09-16 2015-08-25 Guided Therapy Systems, Llc Method and system for ultrasound treatment with a multi-directional transducer
US9144421B1 (en) * 2008-12-17 2015-09-29 Mirabilis Medica Inc. Optimization of acoustic window and target depth for transabdominal ultrasound treatment or imaging of the uterus
US9149658B2 (en) 2010-08-02 2015-10-06 Guided Therapy Systems, Llc Systems and methods for ultrasound treatment
US9216276B2 (en) 2007-05-07 2015-12-22 Guided Therapy Systems, Llc Methods and systems for modulating medicants using acoustic energy
US9241683B2 (en) 2006-10-04 2016-01-26 Ardent Sound Inc. Ultrasound system and method for imaging and/or measuring displacement of moving tissue and fluid
US9263663B2 (en) 2012-04-13 2016-02-16 Ardent Sound, Inc. Method of making thick film transducer arrays
US9492687B2 (en) 2009-12-31 2016-11-15 ZetrOZ Systems, LLC Low-profile ultrasound transducer
US9498122B2 (en) 2013-06-18 2016-11-22 Avedro, Inc. Systems and methods for determining biomechanical properties of the eye for applying treatment
US9498114B2 (en) 2013-06-18 2016-11-22 Avedro, Inc. Systems and methods for determining biomechanical properties of the eye for applying treatment
US9504446B2 (en) 2010-08-02 2016-11-29 Guided Therapy Systems, Llc Systems and methods for coupling an ultrasound source to tissue
US9510802B2 (en) 2012-09-21 2016-12-06 Guided Therapy Systems, Llc Reflective ultrasound technology for dermatological treatments
US9566454B2 (en) 2006-09-18 2017-02-14 Guided Therapy Systems, Llc Method and sysem for non-ablative acne treatment and prevention
US9694212B2 (en) 2004-10-06 2017-07-04 Guided Therapy Systems, Llc Method and system for ultrasound treatment of skin
US9707126B2 (en) 2009-10-21 2017-07-18 Avedro, Inc. Systems and methods for corneal cross-linking with pulsed light
US9827449B2 (en) 2004-10-06 2017-11-28 Guided Therapy Systems, L.L.C. Systems for treating skin laxity

Families Citing this family (225)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7052493B2 (en) 1996-10-22 2006-05-30 Epicor Medical, Inc. Methods and devices for ablation
US6840936B2 (en) * 1996-10-22 2005-01-11 Epicor Medical, Inc. Methods and devices for ablation
US8709007B2 (en) 1997-10-15 2014-04-29 St. Jude Medical, Atrial Fibrillation Division, Inc. Devices and methods for ablating cardiac tissue
US6311692B1 (en) 1996-10-22 2001-11-06 Epicor, Inc. Apparatus and method for diagnosis and therapy of electrophysiological disease
US6161543A (en) 1993-02-22 2000-12-19 Epicor, Inc. Methods of epicardial ablation for creating a lesion around the pulmonary veins
US6805128B1 (en) 1996-10-22 2004-10-19 Epicor Medical, Inc. Apparatus and method for ablating tissue
US6719755B2 (en) * 1996-10-22 2004-04-13 Epicor Medical, Inc. Methods and devices for ablation
US5897553A (en) 1995-11-02 1999-04-27 Medtronic, Inc. Ball point fluid-assisted electrocautery device
US8308719B2 (en) 1998-09-21 2012-11-13 St. Jude Medical, Atrial Fibrillation Division, Inc. Apparatus and method for ablating tissue
WO2001005306A1 (en) 1999-07-19 2001-01-25 Epicor, Inc. Apparatus and method for ablating tissue
US6096037A (en) 1997-07-29 2000-08-01 Medtronic, Inc. Tissue sealing electrosurgery device and methods of sealing tissue
US6007499A (en) * 1997-10-31 1999-12-28 University Of Washington Method and apparatus for medical procedures using high-intensity focused ultrasound
US6417602B1 (en) * 1998-03-03 2002-07-09 Sensotech Ltd. Ultrasonic transducer
FR2778573B1 (en) * 1998-05-13 2000-09-22 Technomed Medical Systems frequency adjustment in a ultrasound treatment apparatus High Intensity Focused
US6409722B1 (en) 1998-07-07 2002-06-25 Medtronic, Inc. Apparatus and method for creating, maintaining, and controlling a virtual electrode used for the ablation of tissue
US6537248B2 (en) 1998-07-07 2003-03-25 Medtronic, Inc. Helical needle apparatus for creating a virtual electrode used for the ablation of tissue
US6706039B2 (en) 1998-07-07 2004-03-16 Medtronic, Inc. Method and apparatus for creating a bi-polar virtual electrode used for the ablation of tissue
US6425867B1 (en) 1998-09-18 2002-07-30 University Of Washington Noise-free real time ultrasonic imaging of a treatment site undergoing high intensity focused ultrasound therapy
FR2788959B1 (en) * 1999-02-01 2002-03-08 Siemens Ag Device for a therapy head for receiving a locating device and therapy head comprising a device of this kind
US8506519B2 (en) 1999-02-16 2013-08-13 Flowcardia, Inc. Pre-shaped therapeutic catheter
US6217530B1 (en) * 1999-05-14 2001-04-17 University Of Washington Ultrasonic applicator for medical applications
US6666835B2 (en) * 1999-05-14 2003-12-23 University Of Washington Self-cooled ultrasonic applicator for medical applications
EP1200155A1 (en) * 1999-06-14 2002-05-02 Exogen, Inc. Self-contained ultrasound applicator
DE19928491A1 (en) * 1999-06-22 2001-01-04 Wolf Gmbh Richard Device, in particular therapy device, for sonication of objects with focused sound
US6193658B1 (en) * 1999-06-24 2001-02-27 Martin E Wendelken Method and kit for wound evaluation
JP3848572B2 (en) * 1999-09-10 2006-11-22 プロリズム,インコーポレイテッド Device for closing the anatomy
US20040097996A1 (en) * 1999-10-05 2004-05-20 Omnisonics Medical Technologies, Inc. Apparatus and method of removing occlusions using an ultrasonic medical device operating in a transverse mode
US20050240170A1 (en) * 1999-10-25 2005-10-27 Therus Corporation Insertable ultrasound probes, systems, and methods for thermal therapy
JP2004512856A (en) * 1999-12-23 2004-04-30 シーラス、コーポレイションTherus Corporation Imaging and therapeutic ultrasound transducer
US6692450B1 (en) 2000-01-19 2004-02-17 Medtronic Xomed, Inc. Focused ultrasound ablation devices having selectively actuatable ultrasound emitting elements and methods of using the same
US6595934B1 (en) 2000-01-19 2003-07-22 Medtronic Xomed, Inc. Methods of skin rejuvenation using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions
US6413254B1 (en) 2000-01-19 2002-07-02 Medtronic Xomed, Inc. Method of tongue reduction by thermal ablation using high intensity focused ultrasound
US8221402B2 (en) 2000-01-19 2012-07-17 Medtronic, Inc. Method for guiding a medical device
US6409720B1 (en) 2000-01-19 2002-06-25 Medtronic Xomed, Inc. Methods of tongue reduction using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions
US7706882B2 (en) 2000-01-19 2010-04-27 Medtronic, Inc. Methods of using high intensity focused ultrasound to form an ablated tissue area
US6361531B1 (en) 2000-01-21 2002-03-26 Medtronic Xomed, Inc. Focused ultrasound ablation devices having malleable handle shafts and methods of using the same
EP1435867B1 (en) 2001-09-05 2010-11-17 Salient Surgical Technologies, Inc. Fluid-assisted medical devices and systems
US8048070B2 (en) 2000-03-06 2011-11-01 Salient Surgical Technologies, Inc. Fluid-assisted medical devices, systems and methods
US6613004B1 (en) * 2000-04-21 2003-09-02 Insightec-Txsonics, Ltd. Systems and methods for creating longer necrosed volumes using a phased array focused ultrasound system
US6514250B1 (en) 2000-04-27 2003-02-04 Medtronic, Inc. Suction stabilized epicardial ablation devices
DE60111517T2 (en) 2000-04-27 2006-05-11 Medtronic, Inc., Minneapolis Vibration-sensitive ablation
WO2001089723A1 (en) * 2000-05-22 2001-11-29 Miwa Science Laboratory Inc. Ultrasonic irradiation apparatus
US6926669B1 (en) 2000-10-10 2005-08-09 Medtronic, Inc. Heart wall ablation/mapping catheter and method
US6821274B2 (en) 2001-03-07 2004-11-23 Gendel Ltd. Ultrasound therapy for selective cell ablation
EP1353723A2 (en) 2000-11-17 2003-10-22 Gendel Limited Ablation of cells using combined electric field and ultrasound therapy
US7914470B2 (en) 2001-01-12 2011-03-29 Celleration, Inc. Ultrasonic method and device for wound treatment
US8235919B2 (en) 2001-01-12 2012-08-07 Celleration, Inc. Ultrasonic method and device for wound treatment
US7740623B2 (en) 2001-01-13 2010-06-22 Medtronic, Inc. Devices and methods for interstitial injection of biologic agents into tissue
US6533750B2 (en) * 2001-01-23 2003-03-18 Advanced Medical Optics Conically shaped phaco tip
US6960173B2 (en) * 2001-01-30 2005-11-01 Eilaz Babaev Ultrasound wound treatment method and device using standing waves
US6478754B1 (en) 2001-04-23 2002-11-12 Advanced Medical Applications, Inc. Ultrasonic method and device for wound treatment
US7959626B2 (en) 2001-04-26 2011-06-14 Medtronic, Inc. Transmural ablation systems and methods
US6807968B2 (en) 2001-04-26 2004-10-26 Medtronic, Inc. Method and system for treatment of atrial tachyarrhythmias
US6699240B2 (en) 2001-04-26 2004-03-02 Medtronic, Inc. Method and apparatus for tissue ablation
US6663627B2 (en) 2001-04-26 2003-12-16 Medtronic, Inc. Ablation system and method of use
US20030013972A1 (en) * 2001-05-29 2003-01-16 Makin Inder Raj. S. Treatment of lung lesions using ultrasound
US7846096B2 (en) 2001-05-29 2010-12-07 Ethicon Endo-Surgery, Inc. Method for monitoring of medical treatment using pulse-echo ultrasound
FR2827149B1 (en) * 2001-07-13 2003-10-10 Technomed Medical Systems sonication probe FOCUSED
JP2003033365A (en) * 2001-07-23 2003-02-04 Hitachi Ltd Ultrasonic wave treatment apparatus
US6989891B2 (en) 2001-11-08 2006-01-24 Optiscan Biomedical Corporation Device and method for in vitro determination of analyte concentrations within body fluids
JP4309278B2 (en) * 2001-12-17 2009-08-05 チョンチン ハイフ (エイチアイエフユー) テクノロジー カンパニー リミテッド Ultrasound therapy device
US7967816B2 (en) 2002-01-25 2011-06-28 Medtronic, Inc. Fluid-assisted electrosurgical instrument with shapeable electrode
US20030181890A1 (en) * 2002-03-22 2003-09-25 Schulze Dale R. Medical device that removably attaches to a bodily organ
US7310545B1 (en) * 2002-04-12 2007-12-18 Medtronic, Inc. Method and device to form a sensor using isolated cardiomyocytes
US7118566B2 (en) 2002-05-16 2006-10-10 Medtronic, Inc. Device and method for needle-less interstitial injection of fluid for ablation of cardiac tissue
US7294143B2 (en) 2002-05-16 2007-11-13 Medtronic, Inc. Device and method for ablation of cardiac tissue
WO2003099382A1 (en) 2002-05-23 2003-12-04 Gendel Limited Ablation device
US7776027B2 (en) * 2002-07-11 2010-08-17 Misonix, Incorporated Medical handpiece with automatic power switching means
US6855123B2 (en) 2002-08-02 2005-02-15 Flow Cardia, Inc. Therapeutic ultrasound system
US7008421B2 (en) * 2002-08-21 2006-03-07 Resect Medical, Inc. Apparatus and method for tissue resection
US7223264B2 (en) * 2002-08-21 2007-05-29 Resect Medical, Inc. Thermal coagulation of tissue during tissue resection
US7137963B2 (en) 2002-08-26 2006-11-21 Flowcardia, Inc. Ultrasound catheter for disrupting blood vessel obstructions
US7758510B2 (en) 2003-09-19 2010-07-20 Flowcardia, Inc. Connector for securing ultrasound catheter to transducer
US7909782B2 (en) * 2002-10-28 2011-03-22 John Perrier Ultrasonic medical device
US7083620B2 (en) 2002-10-30 2006-08-01 Medtronic, Inc. Electrosurgical hemostat
US7604608B2 (en) 2003-01-14 2009-10-20 Flowcardia, Inc. Ultrasound catheter and methods for making and using same
US20040138621A1 (en) 2003-01-14 2004-07-15 Jahns Scott E. Devices and methods for interstitial injection of biologic agents into tissue
US20040162507A1 (en) * 2003-02-19 2004-08-19 Assaf Govari Externally-applied high intensity focused ultrasound (HIFU) for therapeutic treatment
US6942677B2 (en) 2003-02-26 2005-09-13 Flowcardia, Inc. Ultrasound catheter apparatus
US7220233B2 (en) 2003-04-08 2007-05-22 Flowcardia, Inc. Ultrasound catheter devices and methods
US7497857B2 (en) 2003-04-29 2009-03-03 Medtronic, Inc. Endocardial dispersive electrode for use with a monopolar RF ablation pen
EP1479412B1 (en) * 2003-05-19 2008-10-22 UST Inc. Geometrically shaped coupling hydrogel standoffs for high intensity focused ultrasound
US7303555B2 (en) * 2003-06-30 2007-12-04 Depuy Products, Inc. Imaging and therapeutic procedure for carpal tunnel syndrome
US7037306B2 (en) * 2003-06-30 2006-05-02 Ethicon, Inc. System for creating linear lesions for the treatment of atrial fibrillation
US8419728B2 (en) * 2003-06-30 2013-04-16 Depuy Products, Inc. Surgical scalpel and system particularly for use in a transverse carpal ligament surgical procedure
US20050070961A1 (en) * 2003-07-15 2005-03-31 Terumo Kabushiki Kaisha Energy treatment apparatus
US7294125B2 (en) * 2003-08-22 2007-11-13 Scimed Life Systems, Inc. Methods of delivering energy to body portions to produce a therapeutic response
EP1520536A1 (en) * 2003-10-01 2005-04-06 HMT High Medical Technologies AG Device for the application of acoustic shockwaves
US7335180B2 (en) 2003-11-24 2008-02-26 Flowcardia, Inc. Steerable ultrasound catheter
US20050154332A1 (en) * 2004-01-12 2005-07-14 Onda Methods and systems for removing hair using focused acoustic energy
US7247141B2 (en) * 2004-03-08 2007-07-24 Ethicon Endo-Surgery, Inc. Intra-cavitary ultrasound medical system and method
US8333764B2 (en) 2004-05-12 2012-12-18 Medtronic, Inc. Device and method for determining tissue thickness and creating cardiac ablation lesions
WO2005112812A1 (en) 2004-05-14 2005-12-01 Medtronic, Inc. Method and devices for treating atrial fibrillation by mass ablation
US7883468B2 (en) 2004-05-18 2011-02-08 Ethicon Endo-Surgery, Inc. Medical system having an ultrasound source and an acoustic coupling medium
US7951095B2 (en) 2004-05-20 2011-05-31 Ethicon Endo-Surgery, Inc. Ultrasound medical system
US7695436B2 (en) * 2004-05-21 2010-04-13 Ethicon Endo-Surgery, Inc. Transmit apodization of an ultrasound transducer array
EP1750606B1 (en) 2004-06-02 2010-05-05 Medtronic, Inc. Compound bipolar ablation device
EP1750607A2 (en) 2004-06-02 2007-02-14 Medtronic, Inc. Loop ablation apparatus and method
WO2005120376A9 (en) 2004-06-02 2006-06-29 Medtronic Inc Ablation device with jaws
EP1761188B1 (en) 2004-06-02 2011-07-20 Medtronic, Inc. Clamping ablation tool
US7806839B2 (en) 2004-06-14 2010-10-05 Ethicon Endo-Surgery, Inc. System and method for ultrasound therapy using grating lobes
US8409219B2 (en) 2004-06-18 2013-04-02 Medtronic, Inc. Method and system for placement of electrical lead inside heart
US8926635B2 (en) 2004-06-18 2015-01-06 Medtronic, Inc. Methods and devices for occlusion of an atrial appendage
US8663245B2 (en) 2004-06-18 2014-03-04 Medtronic, Inc. Device for occlusion of a left atrial appendage
US7540852B2 (en) 2004-08-26 2009-06-02 Flowcardia, Inc. Ultrasound catheter devices and methods
EP1789136B1 (en) * 2004-09-16 2010-12-29 University of Washington Interference-free ultrasound imaging during hifu therapy, using software tools
US7850611B2 (en) * 2004-09-20 2010-12-14 Innervision Medical Technologies Inc. System and methods for improved ultrasound imaging
US8234923B2 (en) * 2004-09-20 2012-08-07 Innervision Medical Technologies Inc. Systems and methods for ultrasound imaging
US7530958B2 (en) * 2004-09-24 2009-05-12 Guided Therapy Systems, Inc. Method and system for combined ultrasound treatment
KR20140013044A (en) * 2004-10-06 2014-02-04 가이디드 테라피 시스템스, 엘.엘.씨. System for controlled thermal treatment of human superficial tissue
US7530356B2 (en) * 2004-10-06 2009-05-12 Guided Therapy Systems, Inc. Method and system for noninvasive mastopexy
US20060079868A1 (en) * 2004-10-07 2006-04-13 Guided Therapy Systems, L.L.C. Method and system for treatment of blood vessel disorders
JP2008516635A (en) * 2004-10-19 2008-05-22 ザ ガバメント オブ ザ ユナイテッド ステイツ オブ アメリカ, アズ リプレゼンティッド バイ ザ セクレタリー, デパートメント オブ ヘルス アンド ヒューマン サービシーズ, ナショナル イ The methods and compositions for protecting cells from ultrasound-mediated cytolysis
US7833221B2 (en) 2004-10-22 2010-11-16 Ethicon Endo-Surgery, Inc. System and method for treatment of tissue using the tissue as a fiducial
US8221343B2 (en) 2005-01-20 2012-07-17 Flowcardia, Inc. Vibrational catheter devices and methods for making same
US7918795B2 (en) 2005-02-02 2011-04-05 Gynesonics, Inc. Method and device for uterine fibroid treatment
US8801701B2 (en) * 2005-03-09 2014-08-12 Sunnybrook Health Sciences Centre Method and apparatus for obtaining quantitative temperature measurements in prostate and other tissue undergoing thermal therapy treatment
US7771418B2 (en) * 2005-03-09 2010-08-10 Sunnybrook Health Sciences Centre Treatment of diseased tissue using controlled ultrasonic heating
US8932208B2 (en) 2005-05-26 2015-01-13 Maquet Cardiovascular Llc Apparatus and methods for performing minimally-invasive surgical procedures
US7621873B2 (en) * 2005-08-17 2009-11-24 University Of Washington Method and system to synchronize acoustic therapy with ultrasound imaging
US7364562B2 (en) 2005-10-06 2008-04-29 Optiscan Biomedical Corp. Anti-clotting apparatus and methods for fluid handling system
US20070088345A1 (en) * 2005-10-13 2007-04-19 Ust Inc. Applications of HIFU and chemotherapy
US20070088346A1 (en) * 2005-10-14 2007-04-19 Mirizzi Michael S Method and apparatus for varicose vein treatment using acoustic hemostasis
US20070167825A1 (en) * 2005-11-30 2007-07-19 Warren Lee Apparatus for catheter tips, including mechanically scanning ultrasound probe catheter tip
US20070167821A1 (en) * 2005-11-30 2007-07-19 Warren Lee Rotatable transducer array for volumetric ultrasound
US20070167824A1 (en) * 2005-11-30 2007-07-19 Warren Lee Method of manufacture of catheter tips, including mechanically scanning ultrasound probe catheter tip, and apparatus made by the method
EP1962691A2 (en) * 2005-12-14 2008-09-03 Philips Electronics N.V. Method and apparatus for guidance and application of high intensity focused ultrasound for control of bleeding due to severed limbs
EP1962692B1 (en) * 2005-12-14 2011-08-17 Koninklijke Philips Electronics N.V. Transducer cuff for guidance and application of high intensity focused ultrasound for control of bleeding due to severed limbs
CN101330874B (en) * 2005-12-14 2011-10-05 皇家飞利浦电子股份有限公司 Method and apparatus for guidance and application of high intensity focused ultrasound for control of bleeding due to severed limbs
US9357977B2 (en) 2006-01-12 2016-06-07 Gynesonics, Inc. Interventional deployment and imaging system
US20070161905A1 (en) * 2006-01-12 2007-07-12 Gynesonics, Inc. Intrauterine ultrasound and method for use
US20070239011A1 (en) * 2006-01-13 2007-10-11 Mirabilis Medica, Inc. Apparatus for delivering high intensity focused ultrasound energy to a treatment site internal to a patient's body
WO2007143281A3 (en) * 2006-01-13 2008-10-16 Michael J Connolly Methods and apparatus for the treatment of menometrorrhagia, endometrial pathology, and cervical neoplasia using high intensity focused ultrasound energy
CN100463660C (en) 2006-01-18 2009-02-25 重庆海扶(Hifu)技术有限公司 Ultrasonic therapeutic pincers
US20070173798A1 (en) * 2006-01-23 2007-07-26 Adams Mark L Minimally invasive methods for thermal treatment
WO2007092054A3 (en) 2006-02-06 2009-04-23 Donald F Specht Method and apparatus to visualize the coronary arteries using ultrasound
US20070208331A1 (en) * 2006-03-02 2007-09-06 Chu Michael S Systems and methods of treatment within a gastrointestinal lumen
US9107798B2 (en) * 2006-03-09 2015-08-18 Slender Medical Ltd. Method and system for lipolysis and body contouring
US20090048514A1 (en) * 2006-03-09 2009-02-19 Slender Medical Ltd. Device for ultrasound monitored tissue treatment
US8006570B2 (en) * 2006-03-29 2011-08-30 Alcon, Inc. Non-invasive flow measurement
US9282984B2 (en) 2006-04-05 2016-03-15 Flowcardia, Inc. Therapeutic ultrasound system
EP2016402A2 (en) 2006-04-11 2009-01-21 Optiscan Biomedical Corporation Anti-clotting apparatus and methods for fluid handling system
EP2010062A2 (en) * 2006-04-13 2009-01-07 Elena Kachiguina Method and device for male contraception
US7874986B2 (en) 2006-04-20 2011-01-25 Gynesonics, Inc. Methods and devices for visualization and ablation of tissue
US7815571B2 (en) 2006-04-20 2010-10-19 Gynesonics, Inc. Rigid delivery systems having inclined ultrasound and needle
US20090155199A1 (en) * 2006-04-24 2009-06-18 Eilaz Babaev Apparatus and methods for pain relief using ultrasound energized polymers
US20080039746A1 (en) 2006-05-25 2008-02-14 Medtronic, Inc. Methods of using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions
US7431704B2 (en) 2006-06-07 2008-10-07 Bacoustics, Llc Apparatus and method for the treatment of tissue with ultrasound energy by direct contact
US8562547B2 (en) 2006-06-07 2013-10-22 Eliaz Babaev Method for debriding wounds
US7678109B2 (en) * 2006-06-23 2010-03-16 St. Jude Medical, Atrial Fibrillation Division, Inc. Ablation device and method comprising movable ablation elements
KR20090068214A (en) 2006-08-25 2009-06-25 에이라즈 피. 바베브 Portable ultrasound device for the treatment of wounds
US9247926B2 (en) 2010-04-14 2016-02-02 Maui Imaging, Inc. Concave ultrasound transducers and 3D arrays
WO2008051639A3 (en) 2006-10-25 2008-09-25 Maui Imaging Inc Method and apparatus to produce ultrasonic images using multiple apertures
US8246643B2 (en) 2006-11-07 2012-08-21 Flowcardia, Inc. Ultrasound catheter having improved distal end
US8133236B2 (en) 2006-11-07 2012-03-13 Flowcardia, Inc. Ultrasound catheter having protective feature against breakage
WO2008065561A1 (en) * 2006-11-28 2008-06-05 Koninklijke Philips Electronics, N.V. Apparatus for 3d ultrasound imaging and therapy
US8491521B2 (en) 2007-01-04 2013-07-23 Celleration, Inc. Removable multi-channel applicator nozzle
US9782608B2 (en) * 2007-01-05 2017-10-10 Angel Science & Technology (Canada) Inc. High intensity focused ultrasound treatment head and system
US8382689B2 (en) * 2007-02-08 2013-02-26 St. Jude Medical, Atrial Fibrillation Division, Inc. Device and method for high intensity focused ultrasound ablation with acoustic lens
WO2008144575A3 (en) 2007-05-18 2009-02-05 Optiscan Biomedical Corp Fluid injection and safety system
US8052604B2 (en) * 2007-07-31 2011-11-08 Mirabilis Medica Inc. Methods and apparatus for engagement and coupling of an intracavitory imaging and high intensity focused ultrasound probe
US8088072B2 (en) 2007-10-12 2012-01-03 Gynesonics, Inc. Methods and systems for controlled deployment of needles in tissue
US20100274161A1 (en) * 2007-10-15 2010-10-28 Slender Medical, Ltd. Implosion techniques for ultrasound
WO2009054845A1 (en) * 2007-10-23 2009-04-30 Eliaz Babaev Apparatus and methods using ultrasonically energized polymers for topical pain relief
EP3229010A3 (en) 2007-10-25 2018-01-10 Washington University in St. Louis Confocal photoacoustic microscopy with optical lateral resolution
US8187270B2 (en) * 2007-11-07 2012-05-29 Mirabilis Medica Inc. Hemostatic spark erosion tissue tunnel generator with integral treatment providing variable volumetric necrotization of tissue
US8439907B2 (en) * 2007-11-07 2013-05-14 Mirabilis Medica Inc. Hemostatic tissue tunnel generator for inserting treatment apparatus into tissue of a patient
JP5095380B2 (en) * 2007-12-26 2012-12-12 ジーイー・メディカル・システムズ・グローバル・テクノロジー・カンパニー・エルエルシー Ultrasonic imaging apparatus
WO2009086448A1 (en) 2007-12-28 2009-07-09 Salient Surgical Technologies, Inc. Fluid-assisted electrosurgical devices, methods and systems
US20090264755A1 (en) * 2008-04-22 2009-10-22 National Taiwan University High-Intensity Ultrasonic Vessel Ablator Using Blood Flow Signal for Precise Positioning
US8821488B2 (en) 2008-05-13 2014-09-02 Medtronic, Inc. Tissue lesion evaluation
US8353833B2 (en) 2008-07-18 2013-01-15 University Of Rochester Low-cost device for C-scan photoacoustic imaging
US9248318B2 (en) * 2008-08-06 2016-02-02 Mirabilis Medica Inc. Optimization and feedback control of HIFU power deposition through the analysis of detected signal characteristics
US8216161B2 (en) * 2008-08-06 2012-07-10 Mirabilis Medica Inc. Optimization and feedback control of HIFU power deposition through the frequency analysis of backscattered HIFU signals
WO2010017396A3 (en) * 2008-08-07 2010-05-06 University Of Rochester Medical Center Robotic localizing aid for high intensity focused ultrasound delivery
US8206300B2 (en) 2008-08-26 2012-06-26 Gynesonics, Inc. Ablation device with articulated imaging transducer
WO2010029555A1 (en) * 2008-09-12 2010-03-18 Slender Medical, Ltd. Virtual ultrasonic scissors
CA2739425A1 (en) * 2008-10-03 2010-04-08 Mirabilis Medica, Inc. Method and apparatus for treating tissues with hifu
US9050449B2 (en) 2008-10-03 2015-06-09 Mirabilis Medica, Inc. System for treating a volume of tissue with high intensity focused ultrasound
US20100089406A1 (en) * 2008-10-14 2010-04-15 Elena Kachiguina Method and device for male contraception
CA2743158C (en) * 2008-11-17 2016-04-05 Sunnybrook Health Sciences Centre Focused ultrasound system
US9351705B2 (en) 2009-01-09 2016-05-31 Washington University Miniaturized photoacoustic imaging apparatus including a rotatable reflector
US9254168B2 (en) 2009-02-02 2016-02-09 Medtronic Advanced Energy Llc Electro-thermotherapy of tissue using penetrating microelectrode array
JP5592409B2 (en) 2009-02-23 2014-09-17 サリエント・サージカル・テクノロジーズ・インコーポレーテッド Fluid assisted electrosurgical devices and methods of use thereof
CN101810913B (en) * 2009-02-25 2013-03-27 西门子公司 Ultrasonic transducer
US8262574B2 (en) * 2009-02-27 2012-09-11 Gynesonics, Inc. Needle and tine deployment mechanism
US8473239B2 (en) 2009-04-14 2013-06-25 Maui Imaging, Inc. Multiple aperture ultrasound array alignment fixture
US9282945B2 (en) 2009-04-14 2016-03-15 Maui Imaging, Inc. Calibration of ultrasound probes
US20100286518A1 (en) * 2009-05-11 2010-11-11 General Electric Company Ultrasound system and method to deliver therapy based on user defined treatment spaces
US20100286520A1 (en) * 2009-05-11 2010-11-11 General Electric Company Ultrasound system and method to determine mechanical properties of a target region
US8226566B2 (en) 2009-06-12 2012-07-24 Flowcardia, Inc. Device and method for vascular re-entry
US9177543B2 (en) 2009-08-26 2015-11-03 Insightec Ltd. Asymmetric ultrasound phased-array transducer for dynamic beam steering to ablate tissues in MRI
WO2011031748A1 (en) 2009-09-08 2011-03-17 Salient Surgical Technologies, Inc. Cartridge assembly for electrosurgical devices, electrosurgical unit and methods of use thereof
EP2489034B1 (en) 2009-10-14 2016-11-30 Insightec Ltd. Mapping ultrasound transducers
EP2536339A4 (en) 2010-02-18 2014-08-06 Maui Imaging Inc Point source transmission and speed-of-sound correction using multi-aperture ultrasound imaging
US9707413B2 (en) 2010-03-09 2017-07-18 Profound Medical Inc. Controllable rotating ultrasound therapy applicator
WO2011112251A1 (en) * 2010-03-09 2011-09-15 Profound Medical Inc. Fluid circuits for temperature control in a thermal therapy system
WO2011112991A1 (en) 2010-03-11 2011-09-15 Salient Surgical Technologies, Inc. Bipolar electrosurgical cutter with position insensitive return electrode contact
US20110237930A1 (en) * 2010-03-14 2011-09-29 Sean Donaldson MRI compatible motor and positioning system
US9086365B2 (en) 2010-04-09 2015-07-21 Lihong Wang Quantification of optical absorption coefficients using acoustic spectra in photoacoustic tomography
US9852727B2 (en) 2010-04-28 2017-12-26 Insightec, Ltd. Multi-segment ultrasound transducers
US20110295249A1 (en) * 2010-05-28 2011-12-01 Salient Surgical Technologies, Inc. Fluid-Assisted Electrosurgical Devices, and Methods of Manufacture Thereof
US9138289B2 (en) 2010-06-28 2015-09-22 Medtronic Advanced Energy Llc Electrode sheath for electrosurgical device
US8906012B2 (en) 2010-06-30 2014-12-09 Medtronic Advanced Energy Llc Electrosurgical devices with wire electrode
US8920417B2 (en) 2010-06-30 2014-12-30 Medtronic Advanced Energy Llc Electrosurgical devices and methods of use thereof
US9788813B2 (en) 2010-10-13 2017-10-17 Maui Imaging, Inc. Multiple aperture probe internal apparatus and cable assemblies
US9023040B2 (en) 2010-10-26 2015-05-05 Medtronic Advanced Energy Llc Electrosurgical cutting devices
US8997572B2 (en) 2011-02-11 2015-04-07 Washington University Multi-focus optical-resolution photoacoustic microscopy with ultrasonic array detection
US9427281B2 (en) 2011-03-11 2016-08-30 Medtronic Advanced Energy Llc Bronchoscope-compatible catheter provided with electrosurgical device
US9082393B2 (en) 2011-03-17 2015-07-14 Covaris, Inc. Acoustic treatment vessel and method for acoustic treatment
KR101249954B1 (en) 2011-05-17 2013-04-03 주식회사 하이로닉 High intensity focused ultrasound generating device with a function of adjusting focus length
EP2574375A1 (en) * 2011-09-27 2013-04-03 Koninklijke Philips Electronics N.V. Therapeutic apparatus for sonicating a moving target
US9750565B2 (en) 2011-09-30 2017-09-05 Medtronic Advanced Energy Llc Electrosurgical balloons
CA2851839A1 (en) 2011-10-17 2013-04-25 Butterfly Network, Inc. Transmissive imaging and related apparatus and methods
US8870864B2 (en) 2011-10-28 2014-10-28 Medtronic Advanced Energy Llc Single instrument electrosurgery apparatus and its method of use
WO2013100235A1 (en) * 2011-12-29 2013-07-04 알피니언메디칼시스템 주식회사 Apparatus and method for forming beam for enhancing beam-forming resolution
KR20140107648A (en) 2011-12-29 2014-09-04 마우이 이미징, 인코포레이티드 M-mode ultrasound imaging of arbitrary paths
KR20140129246A (en) 2012-02-21 2014-11-06 마우이 이미징, 인코포레이티드 Determining material stiffness using multiple aperture ultrasound
WO2013140738A1 (en) * 2012-03-23 2013-09-26 テルモ株式会社 Therapeutic device of blood vessel insertion type
EP2833791A4 (en) 2012-03-26 2015-12-16 Maui Imaging Inc Systems and methods for improving ultrasound image quality by applying weighting factors
JP6270843B2 (en) 2012-08-10 2018-01-31 マウイ イマギング,インコーポレーテッド Calibration of multiple openings ultrasound probe
WO2014160291A1 (en) 2013-03-13 2014-10-02 Maui Imaging, Inc. Alignment of ultrasound transducer arrays and multiple aperture probe assembly
US9667889B2 (en) 2013-04-03 2017-05-30 Butterfly Network, Inc. Portable electronic devices with integrated imaging capabilities
US9883848B2 (en) 2013-09-13 2018-02-06 Maui Imaging, Inc. Ultrasound imaging using apparent point-source transmit transducer
CN106964081A (en) * 2016-01-14 2017-07-21 宝健科技股份有限公司 Shockwave head structure having bending angle

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4484569A (en) * 1981-03-13 1984-11-27 Riverside Research Institute Ultrasonic diagnostic and therapeutic transducer assembly and method for using
US5230334A (en) * 1992-01-22 1993-07-27 Summit Technology, Inc. Method and apparatus for generating localized hyperthermia
US5443069A (en) * 1992-11-16 1995-08-22 Siemens Aktiengesellschaft Therapeutic ultrasound applicator for the urogenital region
US5471988A (en) * 1993-12-24 1995-12-05 Olympus 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
US5520188A (en) * 1994-11-02 1996-05-28 Focus Surgery Inc. Annular array transducer
US5657760A (en) * 1994-05-03 1997-08-19 Board Of Regents, The University Of Texas System Apparatus and method for noninvasive doppler ultrasound-guided real-time control of tissue damage in thermal therapy
US5762066A (en) * 1992-02-21 1998-06-09 Ths International, Inc. Multifaceted ultrasound transducer probe system and methods for its use
US5827204A (en) * 1996-11-26 1998-10-27 Grandia; Willem Medical noninvasive operations using focused modulated high power ultrasound
US5882302A (en) * 1992-02-21 1999-03-16 Ths International, Inc. Methods and devices for providing acoustic hemostasis
US6315741B1 (en) * 1997-10-31 2001-11-13 Roy W. Martin Method and apparatus for medical procedures using high-intensity focused ultrasound

Family Cites Families (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2529112C3 (en) * 1975-06-30 1978-03-23 Siemens Ag, 1000 Berlin Und 8000 Muenchen
DE2902331A1 (en) * 1979-01-22 1980-07-31 Gerhart Dr Med Tepohl Medical instrument for varicose vein treatment - has ring of crystals to concentrate ultrasonic energy on treatment zone, with focus adjustment
US4363326A (en) * 1980-12-22 1982-12-14 Advanced Diagnostic Research Corporation Ultrasonic apparatus for needle insertion
US4530360A (en) * 1981-11-19 1985-07-23 Duarte Luiz R Method for healing bone fractures with ultrasound
DE3608877C2 (en) * 1986-03-17 1992-03-19 Non-Invasive Therapeutic Techniques A/S, Virum, Dk
DE3751580D1 (en) 1987-03-20 1995-12-07 Surgical Technology Group Ltd Device for use in surgical procedures for the purpose of tissue removal.
US4858613A (en) 1988-03-02 1989-08-22 Laboratory Equipment, Corp. Localization and therapy system for treatment of spatially oriented focal disease
US5186162A (en) * 1988-09-14 1993-02-16 Interpore Orthopaedics, Inc. Ultrasonic transducer device for treatment of living tissue and/or cells
JPH02297354A (en) * 1989-02-23 1990-12-07 Vses N Ts Medicinsk Reabilitatsii I Fiz Terap Into-sinus ultrasonic irradiator
JPH03295544A (en) * 1990-04-16 1991-12-26 Toshiba Corp Ultrasonic probe
US5324299A (en) 1992-02-03 1994-06-28 Ultracision, Inc. Ultrasonic scalpel blade and methods of application
US5873828A (en) * 1994-02-18 1999-02-23 Olympus Optical Co., Ltd. Ultrasonic diagnosis and treatment system
US5626554A (en) * 1995-02-21 1997-05-06 Exogen, Inc. Gel containment structure
DE19507478C1 (en) * 1995-03-03 1996-05-15 Siemens Ag Therapy device for treatment with focused ultrasound
EP0734742B1 (en) * 1995-03-31 2005-05-11 Kabushiki Kaisha Toshiba Ultrasound therapeutic apparatus
WO1997006766A1 (en) * 1995-08-11 1997-02-27 Chattanooga Group, Inc. Ultrasound therapeutic apparatus having identification and calibration for ultrasound applicators and method of applying therapeutic treatment with same
US5895356A (en) * 1995-11-15 1999-04-20 American Medical Systems, Inc. Apparatus and method for transurethral focussed ultrasound therapy
US5676692A (en) * 1996-03-28 1997-10-14 Indianapolis Center For Advanced Research, Inc. Focussed ultrasound tissue treatment method
JPH09276274A (en) * 1996-04-10 1997-10-28 Olympus Optical Co Ltd Probe for ultrasonic treatment
US5769790A (en) * 1996-10-25 1998-06-23 General Electric Company Focused ultrasound surgery system guided by ultrasound imaging
US5897503A (en) * 1997-08-01 1999-04-27 Acuson Corporation Ultrasound transducer probe having case handle grip surfaces

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4484569A (en) * 1981-03-13 1984-11-27 Riverside Research Institute Ultrasonic diagnostic and therapeutic transducer assembly and method for using
US5230334A (en) * 1992-01-22 1993-07-27 Summit Technology, Inc. Method and apparatus for generating localized hyperthermia
US5882302A (en) * 1992-02-21 1999-03-16 Ths International, Inc. Methods and devices for providing acoustic hemostasis
US5762066A (en) * 1992-02-21 1998-06-09 Ths International, Inc. Multifaceted ultrasound transducer probe system and methods for its use
US5443069A (en) * 1992-11-16 1995-08-22 Siemens Aktiengesellschaft Therapeutic ultrasound applicator for the urogenital region
US5471988A (en) * 1993-12-24 1995-12-05 Olympus 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
US5657760A (en) * 1994-05-03 1997-08-19 Board Of Regents, The University Of Texas System Apparatus and method for noninvasive doppler ultrasound-guided real-time control of tissue damage in thermal therapy
US5520188A (en) * 1994-11-02 1996-05-28 Focus Surgery Inc. Annular array transducer
US5827204A (en) * 1996-11-26 1998-10-27 Grandia; Willem Medical noninvasive operations using focused modulated high power ultrasound
US6315741B1 (en) * 1997-10-31 2001-11-13 Roy W. Martin Method and apparatus for medical procedures using high-intensity focused ultrasound

Cited By (232)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8480585B2 (en) 1997-10-14 2013-07-09 Guided Therapy Systems, Llc Imaging, therapy and temperature monitoring ultrasonic system and method
US9272162B2 (en) 1997-10-14 2016-03-01 Guided Therapy Systems, Llc Imaging, therapy, and temperature monitoring ultrasonic method
US9198635B2 (en) 1997-10-31 2015-12-01 University Of Washington Method and apparatus for preparing organs and tissues for laparoscopic surgery
US20070004984A1 (en) * 1997-10-31 2007-01-04 University Of Washington Method and apparatus for preparing organs and tissues for laparoscopic surgery
US7722539B2 (en) 1998-09-18 2010-05-25 University Of Washington Treatment of unwanted tissue by the selective destruction of vasculature providing nutrients to the tissue
US20060052701A1 (en) * 1998-09-18 2006-03-09 University Of Washington Treatment of unwanted tissue by the selective destruction of vasculature providing nutrients to the tissue
US7686763B2 (en) 1998-09-18 2010-03-30 University Of Washington Use of contrast agents to increase the effectiveness of high intensity focused ultrasound therapy
US20110201929A1 (en) * 1999-09-17 2011-08-18 University Of Washington Method for using high intensity focused ultrasound
US20080051656A1 (en) * 1999-09-17 2008-02-28 University Of Washington Method for using high intensity focused ultrasound
US20100234728A1 (en) * 1999-09-17 2010-09-16 University Of Washington Ultrasound guided high intensity focused ultrasound treatment of nerves
US7850626B2 (en) 1999-09-17 2010-12-14 University Of Washington Method and probe for using high intensity focused ultrasound
US8197409B2 (en) 1999-09-17 2012-06-12 University Of Washington Ultrasound guided high intensity focused ultrasound treatment of nerves
US8337434B2 (en) 1999-09-17 2012-12-25 University Of Washington Methods for using high intensity focused ultrasound and associated systems and devices
US20110178403A1 (en) * 1999-10-25 2011-07-21 Kona Medical, Inc. Methods and devices to target vascular targets with high intensity focused ultrasound
US8388535B2 (en) 1999-10-25 2013-03-05 Kona Medical, Inc. Methods and apparatus for focused ultrasound application
US20110118602A1 (en) * 1999-10-25 2011-05-19 Kona Medical, Inc. Methods and apparatus for focused ultrasound application
US20110178445A1 (en) * 1999-10-25 2011-07-21 Kona Medical, Inc. Methods and devices to target vascular targets with high intensity focused ultrasound
US20110021913A1 (en) * 1999-10-25 2011-01-27 Kona Medical, Inc. Use of focused ultrasound for vascular sealing
US8277398B2 (en) 1999-10-25 2012-10-02 Kona Medical, Inc. Methods and devices to target vascular targets with high intensity focused ultrasound
US8137274B2 (en) 1999-10-25 2012-03-20 Kona Medical, Inc. Methods to deliver high intensity focused ultrasound to target regions proximate blood vessels
US20110066085A1 (en) * 1999-11-26 2011-03-17 Kona Medical, Inc. Formation of ultrasound based heating regions adjacent blood vessels
US8622937B2 (en) 1999-11-26 2014-01-07 Kona Medical, Inc. Controlled high efficiency lesion formation using high intensity ultrasound
US20090036774A1 (en) * 1999-11-26 2009-02-05 Therus Corporation Controlled high efficiency lesion formation using high intensity ultrasound
US9907535B2 (en) 2000-12-28 2018-03-06 Ardent Sound, Inc. Visual imaging system for ultrasonic probe
US8409097B2 (en) 2000-12-28 2013-04-02 Ardent Sound, Inc Visual imaging system for ultrasonic probe
US7841984B2 (en) 2002-02-20 2010-11-30 Medicis Technologies Corporation Ultrasonic treatment and imaging of adipose tissue
US7258674B2 (en) * 2002-02-20 2007-08-21 Liposonix, Inc. Ultrasonic treatment and imaging of adipose tissue
US20040039312A1 (en) * 2002-02-20 2004-02-26 Liposonix, Inc. Ultrasonic treatment and imaging of adipose tissue
US20080045864A1 (en) * 2002-09-12 2008-02-21 The Regents Of The University Of California. Dynamic acoustic focusing utilizing time reversal
US20040059265A1 (en) * 2002-09-12 2004-03-25 The Regents Of The University Of California Dynamic acoustic focusing utilizing time reversal
WO2004075987A1 (en) * 2003-02-28 2004-09-10 Koninklijke Philips Electronics, N.V. Motion-tracking improvements for hifu ultrasound therapy
US8211017B2 (en) 2003-12-16 2012-07-03 University Of Washington Image guided high intensity focused ultrasound treatment of nerves
US20110040171A1 (en) * 2003-12-16 2011-02-17 University Of Washington Image guided high intensity focused ultrasound treatment of nerves
US8562531B2 (en) * 2003-12-16 2013-10-22 Hitachi Medical Corporation Ultrasonic motion detecting device, and image producing device and ultrasonic therapeutic using the detecting device
US8206299B2 (en) 2003-12-16 2012-06-26 University Of Washington Image guided high intensity focused ultrasound treatment of nerves
US20110009734A1 (en) * 2003-12-16 2011-01-13 University Of Washington Image guided high intensity focused ultrasound treatment of nerves
US20070078326A1 (en) * 2003-12-16 2007-04-05 Hideki Yoshikawa Ultrasonic motion detecting device, and image producing device and ultrasonic therapeutic using the detecting device
US20090171252A1 (en) * 2003-12-30 2009-07-02 Liposonix, Inc. Therapy head for use with an ultrasound system
US20110077559A1 (en) * 2003-12-30 2011-03-31 Medicis Technologies Corporation Ultrasound therapy head with movement control
US8926533B2 (en) 2003-12-30 2015-01-06 Liposonix, Inc. Therapy head for use with an ultrasound system
US8235909B2 (en) 2004-05-12 2012-08-07 Guided Therapy Systems, L.L.C. Method and system for controlled scanning, imaging and/or therapy
US9066679B2 (en) 2004-08-31 2015-06-30 University Of Washington Ultrasonic technique for assessing wall vibrations in stenosed blood vessels
US20100280420A1 (en) * 2004-09-16 2010-11-04 Guided Therapy Systems, Llc System and method for variable depth ultrasound treatment
US9011336B2 (en) 2004-09-16 2015-04-21 Guided Therapy Systems, Llc Method and system for combined energy therapy profile
US8611189B2 (en) 2004-09-16 2013-12-17 University of Washington Center for Commercialization Acoustic coupler using an independent water pillow with circulation for cooling a transducer
US20060235303A1 (en) * 2004-09-16 2006-10-19 Shahram Vaezy Acoustic coupler using an independent water pillow with circulation for cooling a transducer
US9114247B2 (en) 2004-09-16 2015-08-25 Guided Therapy Systems, Llc Method and system for ultrasound treatment with a multi-directional transducer
US8708935B2 (en) * 2004-09-16 2014-04-29 Guided Therapy Systems, Llc System and method for variable depth ultrasound treatment
US9095697B2 (en) 2004-09-24 2015-08-04 Guided Therapy Systems, Llc Methods for preheating tissue for cosmetic treatment of the face and body
US9895560B2 (en) 2004-09-24 2018-02-20 Guided Therapy Systems, Llc Methods for rejuvenating skin by heating tissue for cosmetic treatment of the face and body
US8523775B2 (en) 2004-10-06 2013-09-03 Guided Therapy Systems, Llc Energy based hyperhidrosis treatment
US8663112B2 (en) 2004-10-06 2014-03-04 Guided Therapy Systems, Llc Methods and systems for fat reduction and/or cellulite treatment
US9694211B2 (en) 2004-10-06 2017-07-04 Guided Therapy Systems, L.L.C. Systems for treating skin laxity
US9440096B2 (en) 2004-10-06 2016-09-13 Guided Therapy Systems, Llc Method and system for treating stretch marks
US8672848B2 (en) 2004-10-06 2014-03-18 Guided Therapy Systems, Llc Method and system for treating cellulite
US8535228B2 (en) 2004-10-06 2013-09-17 Guided Therapy Systems, Llc Method and system for noninvasive face lifts and deep tissue tightening
US9427601B2 (en) 2004-10-06 2016-08-30 Guided Therapy Systems, Llc Methods for face and neck lifts
US9707412B2 (en) 2004-10-06 2017-07-18 Guided Therapy Systems, Llc System and method for fat and cellulite reduction
US9421029B2 (en) 2004-10-06 2016-08-23 Guided Therapy Systems, Llc Energy based hyperhidrosis treatment
US9039619B2 (en) 2004-10-06 2015-05-26 Guided Therapy Systems, L.L.C. Methods for treating skin laxity
US9700340B2 (en) 2004-10-06 2017-07-11 Guided Therapy Systems, Llc System and method for ultra-high frequency ultrasound treatment
US8690779B2 (en) 2004-10-06 2014-04-08 Guided Therapy Systems, Llc Noninvasive aesthetic treatment for tightening tissue
US8444562B2 (en) 2004-10-06 2013-05-21 Guided Therapy Systems, Llc System and method for treating muscle, tendon, ligament and cartilage tissue
US9694212B2 (en) 2004-10-06 2017-07-04 Guided Therapy Systems, Llc Method and system for ultrasound treatment of skin
US8920324B2 (en) 2004-10-06 2014-12-30 Guided Therapy Systems, Llc Energy based fat reduction
US8932224B2 (en) 2004-10-06 2015-01-13 Guided Therapy Systems, Llc Energy based hyperhidrosis treatment
US9320537B2 (en) 2004-10-06 2016-04-26 Guided Therapy Systems, Llc Methods for noninvasive skin tightening
US9833640B2 (en) 2004-10-06 2017-12-05 Guided Therapy Systems, L.L.C. Method and system for ultrasound treatment of skin
US8915870B2 (en) 2004-10-06 2014-12-23 Guided Therapy Systems, Llc Method and system for treating stretch marks
US9833639B2 (en) 2004-10-06 2017-12-05 Guided Therapy Systems, L.L.C. Energy based fat reduction
US8915854B2 (en) 2004-10-06 2014-12-23 Guided Therapy Systems, Llc Method for fat and cellulite reduction
US8915853B2 (en) 2004-10-06 2014-12-23 Guided Therapy Systems, Llc Methods for face and neck lifts
US9522290B2 (en) 2004-10-06 2016-12-20 Guided Therapy Systems, Llc System and method for fat and cellulite reduction
US8366622B2 (en) 2004-10-06 2013-02-05 Guided Therapy Systems, Llc Treatment of sub-dermal regions for cosmetic effects
US8282554B2 (en) 2004-10-06 2012-10-09 Guided Therapy Systems, Llc Methods for treatment of sweat glands
US8460193B2 (en) 2004-10-06 2013-06-11 Guided Therapy Systems Llc System and method for ultra-high frequency ultrasound treatment
US8636665B2 (en) 2004-10-06 2014-01-28 Guided Therapy Systems, Llc Method and system for ultrasound treatment of fat
US20060074313A1 (en) * 2004-10-06 2006-04-06 Guided Therapy Systems, L.L.C. Method and system for treating cellulite
US8641622B2 (en) 2004-10-06 2014-02-04 Guided Therapy Systems, Llc Method and system for treating photoaged tissue
US8333700B1 (en) 2004-10-06 2012-12-18 Guided Therapy Systems, L.L.C. Methods for treatment of hyperhidrosis
US9427600B2 (en) 2004-10-06 2016-08-30 Guided Therapy Systems, L.L.C. Systems for treating skin laxity
US9827450B2 (en) 2004-10-06 2017-11-28 Guided Therapy Systems, L.L.C. System and method for fat and cellulite reduction
US9713731B2 (en) 2004-10-06 2017-07-25 Guided Therapy Systems, Llc Energy based fat reduction
US9533175B2 (en) 2004-10-06 2017-01-03 Guided Therapy Systems, Llc Energy based fat reduction
US20120046547A1 (en) * 2004-10-06 2012-02-23 Guided Therapy Systems, Llc System and method for cosmetic treatment
US8133180B2 (en) * 2004-10-06 2012-03-13 Guided Therapy Systems, L.L.C. Method and system for treating cellulite
US8506486B2 (en) 2004-10-06 2013-08-13 Guided Therapy Systems, Llc Ultrasound treatment of sub-dermal tissue for cosmetic effects
US9283410B2 (en) 2004-10-06 2016-03-15 Guided Therapy Systems, L.L.C. System and method for fat and cellulite reduction
US8690780B2 (en) 2004-10-06 2014-04-08 Guided Therapy Systems, Llc Noninvasive tissue tightening for cosmetic effects
US9283409B2 (en) 2004-10-06 2016-03-15 Guided Therapy Systems, Llc Energy based fat reduction
US9827449B2 (en) 2004-10-06 2017-11-28 Guided Therapy Systems, L.L.C. Systems for treating skin laxity
US8690778B2 (en) 2004-10-06 2014-04-08 Guided Therapy Systems, Llc Energy-based tissue tightening
US7632235B1 (en) 2004-11-22 2009-12-15 Pacesetter, Inc. System and method for measuring cardiac output via thermal dilution using an implantable medical device with an external ultrasound power delivery system
US7553284B2 (en) 2005-02-02 2009-06-30 Vaitekunas Jeffrey J Focused ultrasound for pain reduction
US20060184069A1 (en) * 2005-02-02 2006-08-17 Vaitekunas Jeffrey J Focused ultrasound for pain reduction
US8166332B2 (en) 2005-04-25 2012-04-24 Ardent Sound, Inc. Treatment system for enhancing safety of computer peripheral for use with medical devices by isolating host AC power
US8868958B2 (en) 2005-04-25 2014-10-21 Ardent Sound, Inc Method and system for enhancing computer peripheral safety
US8231535B2 (en) 2005-05-05 2012-07-31 Volcano Corporation Capacitative microfabricated ultrasound transducer-based intravascular ultrasound probes
US7914458B2 (en) 2005-05-05 2011-03-29 Volcano Corporation Capacitive microfabricated ultrasound transducer-based intravascular ultrasound probes
WO2006121851A2 (en) * 2005-05-05 2006-11-16 Volcano Corporation Capacitive microfabricated ultrasound transducer-based intravascular ultrasound probes
WO2006121851A3 (en) * 2005-05-05 2007-09-07 Volcano Corp Capacitive microfabricated ultrasound transducer-based intravascular ultrasound probes
US20110172543A1 (en) * 2005-05-05 2011-07-14 Volcano Corporation Multipurpose Host System for Invasive Cardiovascular Diagnostic Measurement Acquisition and Display
WO2006130287A3 (en) * 2005-05-31 2007-10-04 Sikorsky Aircraft Corp Rotor hub fairing system for a counter-rotating, coaxial rotor system
US20090299180A1 (en) * 2005-06-03 2009-12-03 Theraclion Distance-determining method and treatment apparatus which uses said method
US20100204577A1 (en) * 2005-07-13 2010-08-12 Acoustx Corporation Systems and methods for performing acoustic hemostasis of deep bleeding trauma in limbs
US7591996B2 (en) 2005-08-17 2009-09-22 University Of Washington Ultrasound target vessel occlusion using microbubbles
US20090112098A1 (en) * 2005-09-16 2009-04-30 Shahram Vaezy Thin-profile therapeutic ultrasound applicators
US8414494B2 (en) * 2005-09-16 2013-04-09 University Of Washington Thin-profile therapeutic ultrasound applicators
US8016757B2 (en) 2005-09-30 2011-09-13 University Of Washington Non-invasive temperature estimation technique for HIFU therapy monitoring using backscattered ultrasound
US20070106157A1 (en) * 2005-09-30 2007-05-10 University Of Washington Non-invasive temperature estimation technique for hifu therapy monitoring using backscattered ultrasound
US20070239000A1 (en) * 2005-10-20 2007-10-11 Charles Emery Systems and methods for ultrasound applicator station keeping
US8167805B2 (en) 2005-10-20 2012-05-01 Kona Medical, Inc. Systems and methods for ultrasound applicator station keeping
US20110230796A1 (en) * 2005-10-20 2011-09-22 Kona Medical, Inc. System and method for treating a therapeutic site
US8372009B2 (en) 2005-10-20 2013-02-12 Kona Medical, Inc. System and method for treating a therapeutic site
US20110230763A1 (en) * 2005-10-20 2011-09-22 Kona Medical, Inc. System and method for treating a therapeutic site
US8357095B2 (en) 2005-10-20 2013-01-22 The General Hospital Corporation Non-invasive treatment of fascia
US9220488B2 (en) 2005-10-20 2015-12-29 Kona Medical, Inc. System and method for treating a therapeutic site
US8777858B2 (en) 2005-10-20 2014-07-15 The General Hospital Corporation Non-invasive treatment of fascia
US20080269608A1 (en) * 2005-10-20 2008-10-30 The General Hospital Corporation D/B/A Massachusetts General Hospital Non-Invasive Treatment of Fascia
US8702630B2 (en) * 2005-11-11 2014-04-22 Zimmer Medizinsysteme Gmbh Method and apparatus for injecting ultrasound into tissue
US20070239076A1 (en) * 2005-11-11 2007-10-11 Zimmer Elektromedizin Gmbh Method and apparatus for injecting ultrasound into tissue
US8152726B2 (en) 2006-07-21 2012-04-10 Orthosoft Inc. Non-invasive tracking of bones for surgery
US20080021310A1 (en) * 2006-07-21 2008-01-24 Louis-Philippe Amiot Non-invasive tracking of bones for surgery
US20080021309A1 (en) * 2006-07-21 2008-01-24 Louis-Philippe Amiot Non-invasive tracking of bones for surgery
US7938777B2 (en) 2006-07-21 2011-05-10 Orthosoft Inc. Non-invasive tracking of bones for surgery
US20080033292A1 (en) * 2006-08-02 2008-02-07 Insightec Ltd Ultrasound patient interface device
US9566454B2 (en) 2006-09-18 2017-02-14 Guided Therapy Systems, Llc Method and sysem for non-ablative acne treatment and prevention
US9241683B2 (en) 2006-10-04 2016-01-26 Ardent Sound Inc. Ultrasound system and method for imaging and/or measuring displacement of moving tissue and fluid
US9216276B2 (en) 2007-05-07 2015-12-22 Guided Therapy Systems, Llc Methods and systems for modulating medicants using acoustic energy
US8764687B2 (en) 2007-05-07 2014-07-01 Guided Therapy Systems, Llc Methods and systems for coupling and focusing acoustic energy using a coupler member
US8992516B2 (en) 2007-07-19 2015-03-31 Avedro, Inc. Eye therapy system
US8202272B2 (en) 2007-07-19 2012-06-19 Avedro, Inc. Eye therapy system
US8652131B2 (en) 2007-07-19 2014-02-18 Avedro, Inc. Eye therapy system
US20090062724A1 (en) * 2007-08-31 2009-03-05 Rixen Chen System and apparatus for sonodynamic therapy
US20090082703A1 (en) * 2007-09-26 2009-03-26 Robert Muratore Method and apparatus for the treatment of tendon abnormalities
US8545487B2 (en) 2007-12-05 2013-10-01 Avedro Inc. Eye therapy system
US20090149842A1 (en) * 2007-12-05 2009-06-11 David Muller Eye therapy system
US20090171254A1 (en) * 2008-01-02 2009-07-02 Leonid Kushculey Time-reversal ultrasound focusing
US9301588B2 (en) 2008-01-17 2016-04-05 Syneron Medical Ltd Hair removal apparatus for personal use and the method of using same
US20100198134A1 (en) * 2008-01-17 2010-08-05 Shimon Eckhouse Hair removal apparatus for personal use and the method of using same
US8348935B2 (en) 2008-01-23 2013-01-08 Avedro, Inc. System and method for reshaping an eye feature
US8469952B2 (en) 2008-01-23 2013-06-25 Avedro, Inc. System and method for positioning an eye therapy device
WO2009094470A1 (en) * 2008-01-23 2009-07-30 Avedro, Inc. System and method for reshaping an eye feature
US8409189B2 (en) 2008-01-23 2013-04-02 Avedro, Inc. System and method for reshaping an eye feature
US20090187184A1 (en) * 2008-01-23 2009-07-23 David Muller System and method for reshaping an eye feature
US20090187173A1 (en) * 2008-01-23 2009-07-23 David Muller System and method for reshaping an eye feature
US20090209954A1 (en) * 2008-01-23 2009-08-20 David Muller System and method for reshaping an eye feature
US20120022512A1 (en) * 2008-01-24 2012-01-26 Boris Vaynberg Device, apparatus, and method of adipose tissue treatment
US20090192503A1 (en) * 2008-01-24 2009-07-30 Haim Epshtein Device, apparatus, and method of adipose tissue treatment
US8936593B2 (en) 2008-01-24 2015-01-20 Syneron Medical Ltd. Device, apparatus, and method of adipose tissue treatment
US8771263B2 (en) 2008-01-24 2014-07-08 Syneron Medical Ltd Device, apparatus, and method of adipose tissue treatment
US20090259127A1 (en) * 2008-03-12 2009-10-15 Reichert, Inc. Disposable High Frequency Multi-Focus Silicone Self-Contained Water Bath Offset
US8942781B2 (en) 2008-04-09 2015-01-27 Universite Pierre Et Marie Curie (Paris 6) Medical system comprising a percutaneous probe
US20110040172A1 (en) * 2008-04-09 2011-02-17 Alexandre Carpentier Medical system comprising a percutaneous probe
US20090275936A1 (en) * 2008-05-01 2009-11-05 David Muller System and method for applying therapy to an eye using energy conduction
US20110112405A1 (en) * 2008-06-06 2011-05-12 Ulthera, Inc. Hand Wand for Ultrasonic Cosmetic Treatment and Imaging
US20100004536A1 (en) * 2008-07-03 2010-01-07 Avner Rosenberg Method and apparatus for ultrasound tissue treatment
US20100016761A1 (en) * 2008-07-16 2010-01-21 Avner Rosenberg Applicator for skin treatement with automatic regulation of skin protrusion magnitude
US9295858B2 (en) 2008-07-16 2016-03-29 Syneron Medical, Ltd Applicator for skin treatment with automatic regulation of skin protrusion magnitude
US20120022504A1 (en) * 2008-09-11 2012-01-26 Syneron Medical Ltd. Device, apparatus, and method of adipose tissue treatment
US8398628B2 (en) 2008-09-19 2013-03-19 Avedro, Inc. Eye therapy system
US20100076423A1 (en) * 2008-09-19 2010-03-25 Avedro, Inc. Eye therapy system
US20110166559A1 (en) * 2008-09-21 2011-07-07 Shimon Eckhouse Method and apparatus for personal skin treatment
US8778003B2 (en) 2008-09-21 2014-07-15 Syneron Medical Ltd Method and apparatus for personal skin treatment
US9271793B2 (en) 2008-09-21 2016-03-01 Syneron Medical Ltd. Method and apparatus for personal skin treatment
US8366689B2 (en) 2008-09-30 2013-02-05 Avedro, Inc. Method for making structural changes in corneal fibrils
US20100094197A1 (en) * 2008-09-30 2010-04-15 John Marshall Eye therapy system
US20100094280A1 (en) * 2008-10-01 2010-04-15 Avedro, Inc. Eye therapy system
US8460278B2 (en) 2008-10-01 2013-06-11 Avedro, Inc. Eye therapy system
US8882757B2 (en) 2008-11-11 2014-11-11 Avedro, Inc. Eye therapy system
US20100160781A1 (en) * 2008-12-09 2010-06-24 University Of Washington Doppler and image guided device for negative feedback phased array hifu treatment of vascularized lesions
US9144421B1 (en) * 2008-12-17 2015-09-29 Mirabilis Medica Inc. Optimization of acoustic window and target depth for transabdominal ultrasound treatment or imaging of the uterus
US20100280509A1 (en) * 2009-04-02 2010-11-04 Avedro, Inc. Eye Therapy System
US8712536B2 (en) 2009-04-02 2014-04-29 Avedro, Inc. Eye therapy system
US20110028867A1 (en) * 2009-07-29 2011-02-03 Seh-Eun Choo Apparatus and method for non-invasive delivery and tracking of focused ultrasound generated from transducer
US8986211B2 (en) 2009-10-12 2015-03-24 Kona Medical, Inc. Energetic modulation of nerves
US9005143B2 (en) 2009-10-12 2015-04-14 Kona Medical, Inc. External autonomic modulation
US8992447B2 (en) 2009-10-12 2015-03-31 Kona Medical, Inc. Energetic modulation of nerves
US8986231B2 (en) 2009-10-12 2015-03-24 Kona Medical, Inc. Energetic modulation of nerves
US9358401B2 (en) 2009-10-12 2016-06-07 Kona Medical, Inc. Intravascular catheter to deliver unfocused energy to nerves surrounding a blood vessel
US20110137149A1 (en) * 2009-10-12 2011-06-09 Michael Gertner Nerve treatment system
US20110172529A1 (en) * 2009-10-12 2011-07-14 Michael Gertner Flow directed heating of nervous structures
US9119951B2 (en) 2009-10-12 2015-09-01 Kona Medical, Inc. Energetic modulation of nerves
US9119952B2 (en) 2009-10-12 2015-09-01 Kona Medical, Inc. Methods and devices to modulate the autonomic nervous system via the carotid body or carotid sinus
US9125642B2 (en) 2009-10-12 2015-09-08 Kona Medical, Inc. External autonomic modulation
US20110172527A1 (en) * 2009-10-12 2011-07-14 Michael Gertner Systems for externally delivered energy to modulate neural structures
US8295912B2 (en) 2009-10-12 2012-10-23 Kona Medical, Inc. Method and system to inhibit a function of a nerve traveling with an artery
US9174065B2 (en) 2009-10-12 2015-11-03 Kona Medical, Inc. Energetic modulation of nerves
US9579518B2 (en) 2009-10-12 2017-02-28 Kona Medical, Inc. Nerve treatment system
US9199097B2 (en) 2009-10-12 2015-12-01 Kona Medical, Inc. Energetic modulation of nerves
US8556834B2 (en) 2009-10-12 2013-10-15 Kona Medical, Inc. Flow directed heating of nervous structures
US8374674B2 (en) 2009-10-12 2013-02-12 Kona Medical, Inc. Nerve treatment system
US8715209B2 (en) 2009-10-12 2014-05-06 Kona Medical, Inc. Methods and devices to modulate the autonomic nervous system with ultrasound
US8512262B2 (en) 2009-10-12 2013-08-20 Kona Medical, Inc. Energetic modulation of nerves
US8517962B2 (en) 2009-10-12 2013-08-27 Kona Medical, Inc. Energetic modulation of nerves
US20110118598A1 (en) * 2009-10-12 2011-05-19 Michael Gertner Targeted Inhibition of Physiologic and Pathologic Processes
US8469904B2 (en) 2009-10-12 2013-06-25 Kona Medical, Inc. Energetic modulation of nerves
US9352171B2 (en) 2009-10-12 2016-05-31 Kona Medical, Inc. Nerve treatment system
US9498642B2 (en) 2009-10-21 2016-11-22 Avedro, Inc. Eye therapy system
US8870934B2 (en) 2009-10-21 2014-10-28 Avedro, Inc. Eye therapy system
US20110118654A1 (en) * 2009-10-21 2011-05-19 Avedro, Inc. Eye Therapy
US8574277B2 (en) 2009-10-21 2013-11-05 Avedro Inc. Eye therapy
US9707126B2 (en) 2009-10-21 2017-07-18 Avedro, Inc. Systems and methods for corneal cross-linking with pulsed light
US20110118716A1 (en) * 2009-10-30 2011-05-19 Avedro, Inc. System and Method for Stabilizing Corneal Tissue After Treatment
US8177778B2 (en) 2009-10-30 2012-05-15 Avedro, Inc. System and method for stabilizing corneal tissue after treatment
US20110118600A1 (en) * 2009-11-16 2011-05-19 Michael Gertner External Autonomic Modulation
US9039617B2 (en) 2009-11-24 2015-05-26 Guided Therapy Systems, Llc Methods and systems for generating thermal bubbles for improved ultrasound imaging and therapy
US9345910B2 (en) 2009-11-24 2016-05-24 Guided Therapy Systems Llc Methods and systems for generating thermal bubbles for improved ultrasound imaging and therapy
US8715186B2 (en) 2009-11-24 2014-05-06 Guided Therapy Systems, Llc Methods and systems for generating thermal bubbles for improved ultrasound imaging and therapy
US9492687B2 (en) 2009-12-31 2016-11-15 ZetrOZ Systems, LLC Low-profile ultrasound transducer
US20110237999A1 (en) * 2010-03-19 2011-09-29 Avedro Inc. Systems and methods for applying and monitoring eye therapy
US9504446B2 (en) 2010-08-02 2016-11-29 Guided Therapy Systems, Llc Systems and methods for coupling an ultrasound source to tissue
US9149658B2 (en) 2010-08-02 2015-10-06 Guided Therapy Systems, Llc Systems and methods for ultrasound treatment
US8857438B2 (en) 2010-11-08 2014-10-14 Ulthera, Inc. Devices and methods for acoustic shielding
US9044308B2 (en) 2011-05-24 2015-06-02 Avedro, Inc. Systems and methods for reshaping an eye feature
US9020580B2 (en) 2011-06-02 2015-04-28 Avedro, Inc. Systems and methods for monitoring time based photo active agent delivery or photo active marker presence
US8858471B2 (en) 2011-07-10 2014-10-14 Guided Therapy Systems, Llc Methods and systems for ultrasound treatment
US9452302B2 (en) 2011-07-10 2016-09-27 Guided Therapy Systems, Llc Systems and methods for accelerating healing of implanted material and/or native tissue
US9011337B2 (en) 2011-07-11 2015-04-21 Guided Therapy Systems, Llc Systems and methods for monitoring and controlling ultrasound power output and stability
US9033881B2 (en) * 2011-12-21 2015-05-19 Canon Kabushiki Kaisha Object information acquisition apparatus
US20130165795A1 (en) * 2011-12-21 2013-06-27 Canon Kabushiki Kaisha Object information acquisition apparatus
US9263663B2 (en) 2012-04-13 2016-02-16 Ardent Sound, Inc. Method of making thick film transducer arrays
US9802063B2 (en) 2012-09-21 2017-10-31 Guided Therapy Systems, Llc Reflective ultrasound technology for dermatological treatments
US9510802B2 (en) 2012-09-21 2016-12-06 Guided Therapy Systems, Llc Reflective ultrasound technology for dermatological treatments
EP2730314A1 (en) * 2012-11-08 2014-05-14 Storz Medical Ag Endoscopic device for generating acoustic waves with variable focus
US9123326B2 (en) 2012-11-08 2015-09-01 Storz Medical Ag Endoscopic device for generating acoustic waves with variable focus
KR101307551B1 (en) 2013-03-26 2013-09-12 (주)클래시스 Handpiece of ultrasonic apparatus
WO2014157787A1 (en) * 2013-03-26 2014-10-02 (주)클래시스 Handpiece for ultrasonic device
US9498122B2 (en) 2013-06-18 2016-11-22 Avedro, Inc. Systems and methods for determining biomechanical properties of the eye for applying treatment
US9498114B2 (en) 2013-06-18 2016-11-22 Avedro, Inc. Systems and methods for determining biomechanical properties of the eye for applying treatment
USD733319S1 (en) 2014-01-10 2015-06-30 Celleration, Inc. Ultrasonic treatment wand
USD733321S1 (en) 2014-01-10 2015-06-30 Celleration, Inc. Ultrasonic treatment device

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