WO2003053267A1 - Electrocatheter for bile duct ablation - Google Patents

Electrocatheter for bile duct ablation Download PDF

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Publication number
WO2003053267A1
WO2003053267A1 PCT/IT2002/000764 IT0200764W WO03053267A1 WO 2003053267 A1 WO2003053267 A1 WO 2003053267A1 IT 0200764 W IT0200764 W IT 0200764W WO 03053267 A1 WO03053267 A1 WO 03053267A1
Authority
WO
WIPO (PCT)
Prior art keywords
catheter
ablation
bile duct
flexible portion
distal
Prior art date
Application number
PCT/IT2002/000764
Other languages
French (fr)
Inventor
Luigi Venturelli
Original Assignee
Fogazzi Di Venturelli Andrea & C. S.N.C.
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 Fogazzi Di Venturelli Andrea & C. S.N.C. filed Critical Fogazzi Di Venturelli Andrea & C. S.N.C.
Priority to AU2002366759A priority Critical patent/AU2002366759A1/en
Publication of WO2003053267A1 publication Critical patent/WO2003053267A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements 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
    • A61B2017/22038—Implements 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 with a guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00023—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids closed, i.e. without wound contact by the fluid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00553—Sphincter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature
    • A61B2018/00821—Temperature measured by a thermocouple
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1435—Spiral
    • A61B2018/1437—Spiral whereby the windings of the spiral touch each other such as to create a continuous surface

Definitions

  • This invention generally concerns the catheter field for surgical use and refers in particular to a catheter for bile duct ablation.
  • catheters used for performing various treatments on parts or organs of the body are known by passing through ducts or natural vessels. These catheters generally have a substantially non flexible distal portion and for this reason, introducing them into ducts or vessels with curves and deviations to follow, they present some difficulty, and even become risky for the walls of the ducts themselves. Then, catheters for treatments employing radio frequency have a terminal electrode through which the various functional elements pass. From one side of the same, a line of retractable thermocouples usually emerges, but it is anyway rigid thus hindering the insertion of the catheter into a duct or vessel by which to reach the zone to be treated. Summary of the Invention
  • a purpose of this invention therefore is to provide a catheter with a distal portion structured to favour its insertion into the ducts or vessels of the body, so as to be able to reach the parts to be treated, even in the presence of curves or deviations to be followed. Here, insertion may even be hindered by the walls of the ducts themselves.
  • Another purpose of this invention is to provide a radio frequency catheter with a flexible portion, also cooled if necessary, and one that can also accept a mandrel, a guide wire and/or a line of thermocouples for measuring the temperature of the treated zone.
  • Another purpose of this invention is to achieve and provide a radio frequency catheter especially suitable for a bile duct ablation treatment.
  • a catheter which comprises one or more tubes or longitudinal lumen, a proximal portion connected via bushings and specific connectors to various supply and control equipment with various functions, and a distal partion carrying the functional elements for the treatment to be performed, and wherein said catheter distal portion includes also a spring for flexibility and an electrode that is also flexible for connection to a radio frequency generator and to a guide wire or a mandrel.
  • the flexible distal portion extends beyond a rigid tubular element from which it protrudes, from one side of which at least a thermocouple needle comes out in a retractable form to read the temperature of the zone around that part of the catheter.
  • Fig. 1 shows an example of the catheter according to the invention in partial section
  • Fig. 2 shows an enlarged longitudinal section made according to arrows A - A on Figure 1 ;
  • Fig. 3 shows an enlarged longitudinal section of the flexible distal portion of the catheter
  • Fig. 4 shows a further enlarged detail in section of the zone of catheter ringed in Figure 3.
  • the catheter has a body 10 composed of several tubes 11 , 12, 13, and 14 lying longitudinally together and enclosed by an elastic sheath 15.
  • the catheter body 10 has a tubular element 16 from which a flexible portion of catheter 17 extends, created with a special material and with a longitudinal hole 18.
  • the flexible portion has a conical tip 19, made of Teflon ® for example, to which a so-called mandrel or guide wire 20 may be associated.
  • a helical spring 21 is preferably incorporated, aimed at aiding the return of the flexible portion to a straight line position after each bending action.
  • the flexible portion 17 of the catheter carries an electrode constituted by a strip line 22, that is a conductor of the radio frequency used for the established treatment.
  • the line or strip 22 is wound in a helical way around the flexible portion 17 so as to be able to follow the bending thereof, without risking breaking.
  • one tube 11 is designed for the passage of a so-called needle 23. This needle extends to the point of coming out in a retractable form from one side of the tubular element 16 from which the flexible distal portion 17 protrudes.
  • the needle 23 is tubular and provided with an external coating 24, and the wires of a thermocouple 25 for temperature measurement pass through said tubular needle 23.
  • Another tube 12 is designed for the passage of a radio frequency cable 26 that goes as far as to electrode 22 for its supply, according to need.
  • the other tubes, 13 and 14 are provide, for example, for circulating a refrigerant fluid for the cooling of the electrode; these tubes extend as far as a cooling compartment close to the electrode.
  • thermocouple 28 In the space between the tubes lying alongside each other, and enclosed in the sheath 15, other wires may be housed for the thermocouple 28 for reading the temperature at the level of the treatment electrode 22.
  • the catheter body is fixed, by way of a bush, to a support cone 30, and the various tubes are united by a resinous lump 31 enclosed in the said support body, to stop their unwanted sliding.
  • a grip 33 is attached to this support body by way of a connector 32, located and held on by two flanges and rings, 34 and 35 respectively.
  • This said grip has a command slide 36 for the longitudinal movements of needle 23 in its tube 11 , located in its middle between the two rings 35.
  • the grip has a connector 37 on its back that can be connected to a radio frequency generator and to the respective control instruments.
  • Tubes 13, and 14 of the cooling circuit each terminates in a fitting 39, and the device for circulating the cooling fluid are fixed to another part of the support body. Also, the tube in which the guide wire that reaches the tip or mandrel at the free end of the distal flexible portion of the catheter passes is fixed by a second bush 40 to another part of the support body.

Landscapes

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

Abstract

The invention concerns a catheter especially for bile duct ablation, with a proximal part that can be connected to equipment foreseen for supplying and controlling the various functions of the catheter and a distal part carrying the functional elements for the intervention to be performed. This distal part of the catheter includes a flexible or bending portion (17) that incorporates a spring (21) for elasticity and which carries at least one equally flexible electrode. This electrode can be connected to a radio frequency generator by means of a cable housed in a tube or channel extending within the catheter body.

Description

E ECTROCATHETER FOR BILE DUCT ABLATION
Technical Filed
This invention generally concerns the catheter field for surgical use and refers in particular to a catheter for bile duct ablation. Prior Art
Numerous types of catheters used for performing various treatments on parts or organs of the body are known by passing through ducts or natural vessels. These catheters generally have a substantially non flexible distal portion and for this reason, introducing them into ducts or vessels with curves and deviations to follow, they present some difficulty, and even become risky for the walls of the ducts themselves. Then, catheters for treatments employing radio frequency have a terminal electrode through which the various functional elements pass. From one side of the same, a line of retractable thermocouples usually emerges, but it is anyway rigid thus hindering the insertion of the catheter into a duct or vessel by which to reach the zone to be treated. Summary of the Invention
A purpose of this invention therefore is to provide a catheter with a distal portion structured to favour its insertion into the ducts or vessels of the body, so as to be able to reach the parts to be treated, even in the presence of curves or deviations to be followed. Here, insertion may even be hindered by the walls of the ducts themselves. Another purpose of this invention is to provide a radio frequency catheter with a flexible portion, also cooled if necessary, and one that can also accept a mandrel, a guide wire and/or a line of thermocouples for measuring the temperature of the treated zone. Another purpose of this invention is to achieve and provide a radio frequency catheter especially suitable for a bile duct ablation treatment.
These purposes are reached, according to the invention, with a catheter which comprises one or more tubes or longitudinal lumen, a proximal portion connected via bushings and specific connectors to various supply and control equipment with various functions, and a distal partion carrying the functional elements for the treatment to be performed, and wherein said catheter distal portion includes also a spring for flexibility and an electrode that is also flexible for connection to a radio frequency generator and to a guide wire or a mandrel. The flexible distal portion extends beyond a rigid tubular element from which it protrudes, from one side of which at least a thermocouple needle comes out in a retractable form to read the temperature of the zone around that part of the catheter. Brief Description of the Drawings Greater details of the catheter of the present invention will become evident following this description, made with reference to the indicative and non-limiting drawings enclosed, in which:
Fig. 1 shows an example of the catheter according to the invention in partial section; Fig. 2 shows an enlarged longitudinal section made according to arrows A - A on Figure 1 ;
Fig. 3 shows an enlarged longitudinal section of the flexible distal portion of the catheter; and
Fig. 4 shows a further enlarged detail in section of the zone of catheter ringed in Figure 3. Detailed Description of the Invention
In the represented example, the catheter has a body 10 composed of several tubes 11 , 12, 13, and 14 lying longitudinally together and enclosed by an elastic sheath 15.
At one of its distal portion, the catheter body 10 has a tubular element 16 from which a flexible portion of catheter 17 extends, created with a special material and with a longitudinal hole 18. At its free end, the flexible portion has a conical tip 19, made of Teflon® for example, to which a so-called mandrel or guide wire 20 may be associated. At the zone close to the tip of the flexible portion 17, a helical spring 21 is preferably incorporated, aimed at aiding the return of the flexible portion to a straight line position after each bending action.
At another part, between the flexibility spring 21 and tubular element 16, the flexible portion 17 of the catheter carries an electrode constituted by a strip line 22, that is a conductor of the radio frequency used for the established treatment. The line or strip 22 is wound in a helical way around the flexible portion 17 so as to be able to follow the bending thereof, without risking breaking. Of the tubes forming the catheter body, one tube 11 is designed for the passage of a so-called needle 23. This needle extends to the point of coming out in a retractable form from one side of the tubular element 16 from which the flexible distal portion 17 protrudes. The needle 23 is tubular and provided with an external coating 24, and the wires of a thermocouple 25 for temperature measurement pass through said tubular needle 23.
Another tube 12 is designed for the passage of a radio frequency cable 26 that goes as far as to electrode 22 for its supply, according to need. The other tubes, 13 and 14 are provide, for example, for circulating a refrigerant fluid for the cooling of the electrode; these tubes extend as far as a cooling compartment close to the electrode.
In the space between the tubes lying alongside each other, and enclosed in the sheath 15, other wires may be housed for the thermocouple 28 for reading the temperature at the level of the treatment electrode 22.
At its proximal portion, the catheter body is fixed, by way of a bush, to a support cone 30, and the various tubes are united by a resinous lump 31 enclosed in the said support body, to stop their unwanted sliding. A grip 33 is attached to this support body by way of a connector 32, located and held on by two flanges and rings, 34 and 35 respectively.
This said grip has a command slide 36 for the longitudinal movements of needle 23 in its tube 11 , located in its middle between the two rings 35. The grip has a connector 37 on its back that can be connected to a radio frequency generator and to the respective control instruments. The wires of thermocouple 25, of needle 23, the radio frequency cable 26 feeding the electrode and the wires of thermocouple 28 associated to electrode 22, lead up to connector 37.
Tubes 13, and 14 of the cooling circuit each terminates in a fitting 39, and the device for circulating the cooling fluid are fixed to another part of the support body. Also, the tube in which the guide wire that reaches the tip or mandrel at the free end of the distal flexible portion of the catheter passes is fixed by a second bush 40 to another part of the support body.
Even though many aspects constituting the described catheter are certainly known, the distal flexible portion of the catheter as well as the configuration and structure of the same represent a certainly original and advantageous innovation. This in fact permits, as also mentioned above, the easy insertion of the catheter all the way to the parts to be treated, such as the bile duct, not otherwise reachable with known catheters.

Claims

"CATHETER FOR BILE DUCT ABLATION"CLAIMS
1. A catheter especially for bile duct ablation, comprising a body catheter composed of one or morel longitudinal tubes or lumen and having a proximal body catheter portion connectable to various devices for supplying and controlling the various functions of the catheter by way of bushes and specific connectors, a distal body catheter portion carrying functional elements for a treatment to be made, characterised in that the said distal portion of the catheter includes a flexible, bending portion (17) carrying at least an equally flexible electrode (22), said electrode being connectable to a radio frequency generator through a cable housed in a tube or lumen of the catheter body.
2. The catheter especially for bile duct ablation, according to claim 1, in which the distal flexible portion (17) is of a bending material and incorporates an helical spring (21) for the flexibility of said distal portion.
3. The catheter especially for bile duct ablation, according to claims 1 and
2, in which the electrode on the distal flexible portion includes a line or strip (22) wrapped helically around the said flexible portion (17).
4. The catheter especially for bile duct ablation, according to the previous claims, in which the said distal flexible portion (17) extends from a tubular element from one side of which a retractable needle (23) emerges including wires of a thermocouple, in which said distal flexible portion ends with a conical tip, and in which the elastic spring (21) located in a zone of the flexible portion proximal to the tip and the electrode formed by the line or strip (29) wrapped around the said flexible portion is located in an another zone of the flexible portion contiguous to the said tubular element.
5. The catheter especially for bile duct ablation, according to claim 4 in which the distal flexible portion is associated with a mandrel or a guid wire extending in a tube or lumen of the catheter body and accessible from the proximal portion of the catheter.
6. The catheter especially for bile duct ablation, according to claim 4 or 5, in which a cooling system fed with refrigerant liquid passing through tubes or lumen in the catheter body is associated to the flexible portion.
7. The catheter especially for bile duct ablation, according to claim 4, 5 or
6, in which a thermocouple for temperature measuring is associated to the electrode carried by the distal flexible portion.
8. The use of a catheter according to the previous claims for bile duct ablation.
PCT/IT2002/000764 2001-12-20 2002-12-06 Electrocatheter for bile duct ablation WO2003053267A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2002366759A AU2002366759A1 (en) 2001-12-20 2002-12-06 Electrocatheter for bile duct ablation

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITBS2001A000109 2001-12-20
ITBS20010109 ITBS20010109A1 (en) 2001-12-20 2001-12-20 CATHETER FOR ABLATION OF THE BILIARY DUCT

Publications (1)

Publication Number Publication Date
WO2003053267A1 true WO2003053267A1 (en) 2003-07-03

Family

ID=11440807

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IT2002/000764 WO2003053267A1 (en) 2001-12-20 2002-12-06 Electrocatheter for bile duct ablation

Country Status (3)

Country Link
AU (1) AU2002366759A1 (en)
IT (1) ITBS20010109A1 (en)
WO (1) WO2003053267A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11432870B2 (en) 2016-10-04 2022-09-06 Avent, Inc. Cooled RF probes

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0440385A2 (en) * 1990-02-02 1991-08-07 Everest Medical Corporation Electrosurgical instrument for conducting endoscopic retrograde sphicterotomy
WO1999025260A1 (en) * 1997-11-17 1999-05-27 Rita Medical Systems, Inc. Multiple electrode ablation apparatus and method

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0440385A2 (en) * 1990-02-02 1991-08-07 Everest Medical Corporation Electrosurgical instrument for conducting endoscopic retrograde sphicterotomy
WO1999025260A1 (en) * 1997-11-17 1999-05-27 Rita Medical Systems, Inc. Multiple electrode ablation apparatus and method

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11432870B2 (en) 2016-10-04 2022-09-06 Avent, Inc. Cooled RF probes

Also Published As

Publication number Publication date
AU2002366759A1 (en) 2003-07-09
ITBS20010109A1 (en) 2003-06-20

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