WO1999044675A1 - Electrode extensible destinee a etre implantee dans un organisme vivant et procede d'implantation d'une telle electrode - Google Patents

Electrode extensible destinee a etre implantee dans un organisme vivant et procede d'implantation d'une telle electrode Download PDF

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Publication number
WO1999044675A1
WO1999044675A1 PCT/SE1999/000216 SE9900216W WO9944675A1 WO 1999044675 A1 WO1999044675 A1 WO 1999044675A1 SE 9900216 W SE9900216 W SE 9900216W WO 9944675 A1 WO9944675 A1 WO 9944675A1
Authority
WO
WIPO (PCT)
Prior art keywords
electrode
living organ
aperture
cannula
condition
Prior art date
Application number
PCT/SE1999/000216
Other languages
English (en)
Inventor
Hans LÖNROTH
Original Assignee
Hälso-Och Sjukvårdens Innovationscenter
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Hälso-Och Sjukvårdens Innovationscenter filed Critical Hälso-Och Sjukvårdens Innovationscenter
Priority to AU27520/99A priority Critical patent/AU2752099A/en
Publication of WO1999044675A1 publication Critical patent/WO1999044675A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/42—Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
    • A61B5/4222—Evaluating particular parts, e.g. particular organs
    • A61B5/4238—Evaluating particular parts, e.g. particular organs stomach
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/296—Bioelectric electrodes therefor specially adapted for particular uses for electromyography [EMG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode

Definitions

  • the present invention concerns an electrode intended to be implanted into a living organ, such as the stomach, for emission or reception of electrical signals, and to 5 be connected to an electric device, such as e.g. a pacemaker .
  • the invention also concerns a method of implanting an electrode into a living organ.
  • gastropares i.e. cease of motor function in the stomach
  • gastropares i.e. cease of motor function in the stomach
  • the pacemaker technique is often resorted to.
  • the pacemaker technique is well-known for mechanical-electrical control of the nerves of a living organ.
  • the technique involves implantation of at least
  • Insulated lines connect the electrode to a pacemaker which is implanted underneath the patient's skin.
  • the pacemaker generates electric impulses controlling the functions of the organ via lines and electrodes.
  • the electrodes are implanted in the wall of the stomach.
  • the electrodes supplied for this purpose are implanted by being sewn into the stomach wall, which is done in open abdominal surgical operations or with the aid of the laparoscopic surgery technique. Both implantation methods are serious operations requiring that the patient be anaesthetised.
  • Implantation of electrodes into a hollow living organ poses special problems since the organ wall yields as the electrodes are being implanted. In addition, the risks of inadvertent puncture of the organ wall are not negligible.
  • the object of the present invention is to provide an electrode that is easier to implant than existing electrodes, particularly in the stomach.
  • an electrode which is characterised in that from a condition of insertion, in which the electrode is insertable into a living organ via an aperture, such as e.g. a cannula aperture, the electrode is expandable into an expanded condition m which the extension of the electrode perpendicularly to the direction of introduction exceeds its extension in the condition of insertion, whereby in its expanded condition said electrode opposes its retraction via the aperture of insertion, thus making the electrode attachable to the living organ.
  • an aperture such as e.g. a cannula aperture
  • the inventive electrode When in its condition of insertion, the inventive electrode may be introduced in a living organ through a small aperture, for instance by means of a cannula.
  • the electrode having expanded following its insertion such that the extension of the electrode perpendicularly to the direction of introduction exceeds its extension m the condition of insertion, is thus prevented from being retracted via the aperture of insertion.
  • An electrode in accordance with the invention thus may be implanted m a living organ in a minor and simple surgical operation that may be performed quickly and does not require complete anaesthetisation of the patient .
  • the electrode is arranged to expand automatically, i.e. it expands by itself and assumes its expanded condition as soon as it leaves the cannula. This is an advantageous feature in that no space-requiring mechanical means are needed to control the electrode expansion.
  • the automatic expansion is achieved by configuring the electrode with an end portion which assumes the shape of a coil m the expanded condition of the electrode.
  • the coil consists of a wire-like material possessing such properties that m the condition of insertion of the electrode the end portion of the coil may be compressed but from that condition endeavours to resume its original expanded configuration.
  • the expansion of the electrode end portion is achieved by configuring the end portion not as a coil but m the shape of a T. Both electrode embodiments are reliable and owing to their simplicity, easy to manufacture.
  • the material of the electrode embodiments preferably is inert spring steel or a metal possessing memorious qualities.
  • memorious qualities is to be understood in this context that the metal lends itself to compression transversely of the direction of introduction but resumes its original configuration thereafter.
  • Another object of the invention is to suggest a method of implanting electrodes m a living organ, such as the stomach, that is minimally invasive and that allows the implantation to be performed under local anaesthetisation of the patient.
  • This object is achieved by means of a method of implanting an electrode in a living organ, which is char- acterised by forming an aperture n the organ, by inserting an expandable electrode through the aperture and by securing the electrode m the living organ by allowing the electrode to expand in a direction perpendicularly to the direction of its introduction. It is advantageous to use a cannula to form the aperture m the organ. The electrode may then be inserted in the organ by way of the cannula.
  • the method is applicable also for the implantation of electrodes m a wall of a hollow organ, in which case a gastroscopical technique is used for two important purposes.
  • the first one is inflation of the organ to expand the organ wall, thus solving the problem connected with the wall yielding as the aperture is to be formed therein.
  • the second pur- pose is to allow viewing of the wall from within while the aperture is being formed, thus ensuring that the organ wall is not penetrated inadvertently.
  • the method is particularly suitable for implantation of electrodes in the wall of the stomach.
  • the electrode preferably is positioned n the connective tissue between the mucous membrane of the stomach and the muscle layer of the stomach wall.
  • Physiological saline solution may advantageously be injected through the aperture before the electrode is inserted. In this way a liquid-filled cavity is formed in the organ, which facilitates introduction and attachment of the electrode m the organ.
  • the saline solution preferably is injected via the cannula. This mode of operation is advantageous also m the respect that remaining tissue, if any, is removed from the cannula.
  • the electrode is associated with an insulated conductor to be connected to an electric device. Upon insertion of an electrode which is connected to a conductor it is advantageous to use a cannula which is divisible m its lengthwise extension.
  • the electrode and the conductor associated therewith are inserted by way of the cannula with the conductor extending through the cannula. After securement of the electrode, the cannula is opened up and retracted without being obstructed by the conductor.
  • a considerable advantage associated with the claimed implantation method is that it may be performed under a local anaesthetic of the patient.
  • the implantation of the electrodes may be performed also for diagnostic purposes. Measurement methods for this purpose have hitherto been out of the question because they involved an extensive surgical operation in order to implant the electrodes. For a diagnosis to be made, it is desirable that the function of the organ concerned be orserved for some length of time. For this reason, the electrodes are connected to a measurement instrument which may be located externally of the patient's body during the observation period.
  • Fig. 1 is a view of an electrode 1 m accordance with the present invention m the electrode introduction position.
  • the electrode 1 is positioned inside a cannula 2 for insertion into a living organ 3.
  • Fig. 2 is a view of the electrode 1 of Fig. 1 m its expanded condition.
  • the electrode 1 is implanted in a living organ 3.
  • Fig. 3 is a view of another embodiment of the elec- trode, the latter being shown in its expanded condition with the electrode end portion configured as a coil.
  • Fig. 4 is a view of a further embodiment of the electrode, the latter being shown m its expanded condition with the electrode end portion configured as a helically wound coil.
  • Fig. 5 is a view of yet another embodiment of the electrode, the latter being shown m its expanded condition with the electrode end portion being configured as a T.
  • Fig. 6 is a view of an electrode 1 implanted in the wall 3 of the stomach.
  • Fig. 1 illustrates a preferred embodiment of an automatically expanding electrode 1 m accordance with the invention m a condition of insertion of said electrode.
  • the electrode 1 is located inside a cannula 2 to be inserted in a living organ 3.
  • the cannula 2 is introduced into the organ 3.
  • the elec- trode is compressed into an essentially elongate shape allowing introduction thereof into the organ 3 via an aperture 4 which is produced by the cannula 3.
  • the electrode 1 is connected to an insulated conductor 5. When the electrode 1 leaves the cannula 2 it expands automatically and assumes its expanded condition.
  • Fig. 2 illustrates the electrode 1 in an expanded condition inside the living organ 3.
  • the cannula 2 has been removed.
  • the extension of the electrode 1 perpendicularly to the direction of mtro- duction exceeds its extension m the condition of insertion, a feature which prevents the electrode 1 from being pulled outwardly via the insertion aperture 4.
  • Figs 3, 4 and 5 show some possible embodiments in accordance with the invention.
  • the electrodes m accordance with all embodiments are shown in their expanded conditions.
  • the end portion of the electrode is configured as a coil extending m one plane.
  • the end portion of the electrode is configured as a helically wound coil extending m more than one plane.
  • the end portion of the electrode is configured in the shape of a T. All varieties of the electrodes pre- ferably are manufactured from inert spring steel or a metal possessing memorious qualities.
  • the end portion of the electrode may be configured in many different ways, and have an extension in the expanded condition of the electrode being n one plane or m several planes. It should be appreciated that the electrode could be manufactured from other electrically conductive materials than those mentioned above.
  • the electrode may also be associated with an insulated conductor for connection to an electric device.
  • the method is used to attach an electrode together with its associated conductor m the stomach wall.
  • Fig. 6 illustrates an electrode 1 implanted m the stomach by means of the inventive method.
  • the stomach wall 3 has a porous connective tissue layer 7 sandwiched betwen the mucosa 6 of the stomach and a muscular layer 8.
  • the stomach is inflated and is viewed from within by means of a gastroscopic instrument.
  • a cannula is made to penetrate the abdominal wall and the stomach wall 3 to be posi- tioned in the connective tissue layer 7.
  • the cannula is in position m the connective tissue layer 7 when the mucosa 6, as determined by the gastroscopic instrument, is seen to cave inwards under the pressure from the cannula.
  • Physiological saline solution is then injected through the cannula, thus removing from the cannula any tissue remaining therein and creating a cavity 9 m the connective tissue 7.
  • An electrode 1 of an automatically expanding type with a conductor 5 attached thereto is introduced, while in its condition of insertion, into the cannula and further into the cavity 9 created in the connective tissue layer 7. As the electrode 1 leaves the cannula, it expands and in doing so attaches itself to the stomach wall 3. The cannula is then removed.
  • a cannula of a kind that may be divided into sections, allowing it to be easily removed without impediment from the electrode 1 and the conductor 5 attached thereto. To be removed, the cannula is separated into its two sections.
  • the conductor 5 is connected to an electric device for the purpose of control of or observation of the organ.
  • a device of control type for instance a pacemaker, preferably may be implanted under the patient's skin.
  • a measurement device for observation of the organ is advantageously positioned externally of the patient.
  • the method may be used to implant electrodes into a non-hollow organ, m which case the use of a gastroscopic technique is not necessary.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Cardiology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Endocrinology (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Physiology (AREA)
  • Electrotherapy Devices (AREA)

Abstract

Cette invention concerne une électrode (1) qui est destinée à être implantée dans un organe vivant, afin d'émettre ou de recevoir des signaux électriques, et qui est prévue pour être connectée à un dispositif électrique tel qu'un rythmeur cardiaque par exemple. L'électrode (1) est extensible par rapport à son état au moment de l'insertion où elle est introduite dans un organe vivant (3) par une ouverture (4) telle que par exemple une ouverture de canule, jusqu'à un état déployé dans lequel l'extension de l'électrode perpendiculairement au sens d'introduction dépasse sa dimension au moment de l'insertion. A l'état déployé ladite électrode ne peut sortir par l'ouverture (4) utilisée pour l'introduction et peut donc être fixée à l'organe vivant (3). Cette invention concerne également un procédé d'implantation d'une électrode (1) dans un organe vivant (3). Ce procédé est tout particulièrement approprié pour implanter une électrode (1) dans l'estomac au moyen d'une technique de gastroscopie.
PCT/SE1999/000216 1998-03-06 1999-02-18 Electrode extensible destinee a etre implantee dans un organisme vivant et procede d'implantation d'une telle electrode WO1999044675A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU27520/99A AU2752099A (en) 1998-03-06 1999-02-18 Expandable electrode for implantation in a living organ and method for implanting the electrode

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE9800714-9 1998-03-06
SE9800714A SE9800714D0 (sv) 1998-03-06 1998-03-06 Elektrod

Publications (1)

Publication Number Publication Date
WO1999044675A1 true WO1999044675A1 (fr) 1999-09-10

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/SE1999/000216 WO1999044675A1 (fr) 1998-03-06 1999-02-18 Electrode extensible destinee a etre implantee dans un organisme vivant et procede d'implantation d'une telle electrode

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Country Link
AU (1) AU2752099A (fr)
SE (1) SE9800714D0 (fr)
WO (1) WO1999044675A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1852143A1 (fr) 2006-05-03 2007-11-07 Lönroth, Hans Électrode pour l'implantation dans un organe vivant et méthode pour implanter l'électrode

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1514347A1 (ru) * 1987-06-02 1989-10-15 Rizhskij Med Inst Зонд для исследования желудочно-кишечного тракта
US4946457A (en) * 1987-12-03 1990-08-07 Dimed, Incorporated Defibrillator system with cardiac leads and method for transvenous implantation
SU1724260A1 (ru) * 1989-08-08 1992-04-07 Иркутский Государственный Медицинский Институт Способ исследовани функции привратника
US5282468A (en) * 1990-06-07 1994-02-01 Medtronic, Inc. Implantable neural electrode
US5545206A (en) * 1994-12-22 1996-08-13 Ventritex, Inc. Low profile lead with automatic tine activation

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1514347A1 (ru) * 1987-06-02 1989-10-15 Rizhskij Med Inst Зонд для исследования желудочно-кишечного тракта
US4946457A (en) * 1987-12-03 1990-08-07 Dimed, Incorporated Defibrillator system with cardiac leads and method for transvenous implantation
SU1724260A1 (ru) * 1989-08-08 1992-04-07 Иркутский Государственный Медицинский Институт Способ исследовани функции привратника
US5282468A (en) * 1990-06-07 1994-02-01 Medtronic, Inc. Implantable neural electrode
US5545206A (en) * 1994-12-22 1996-08-13 Ventritex, Inc. Low profile lead with automatic tine activation

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1852143A1 (fr) 2006-05-03 2007-11-07 Lönroth, Hans Électrode pour l'implantation dans un organe vivant et méthode pour implanter l'électrode
WO2007128470A2 (fr) * 2006-05-03 2007-11-15 Hasse Abrahamsson Électrode À implantER dans un organe vivant et procÉdÉ d'implantation de l'Électrode
WO2007128470A3 (fr) * 2006-05-03 2008-01-03 Hasse Abrahamsson Électrode À implantER dans un organe vivant et procÉdÉ d'implantation de l'Électrode

Also Published As

Publication number Publication date
SE9800714D0 (sv) 1998-03-06
AU2752099A (en) 1999-09-20

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