U.S. patent application number 12/858519 was filed with the patent office on 2010-12-09 for electrosurgical device for restricting loss of blood during surgery.
This patent application is currently assigned to IMPERIAL COLLEGE INNOVATIONS LIMITED. Invention is credited to NAGY ADLY HABIB, Alan John Sangster.
Application Number | 20100312237 12/858519 |
Document ID | / |
Family ID | 10836774 |
Filed Date | 2010-12-09 |
United States Patent
Application |
20100312237 |
Kind Code |
A1 |
HABIB; NAGY ADLY ; et
al. |
December 9, 2010 |
ELECTROSURGICAL DEVICE FOR RESTRICTING LOSS OF BLOOD DURING
SURGERY
Abstract
A device for restricting the loss of blood during a surgical
procedure is disclosed. The device generates localized heating in
an organ or volume of tissue and includes an applicator that is
positioned against an organ or tissue to be treated, an array of
retractable needles that deliver irradiating energy in the vicinity
of a selected incision point; a switching mechanism in
communication with the needles for energizing and causing movement
of the needles and a power unit for supplying irradiating power to
the needles when extended into the organ or tissue.
Inventors: |
HABIB; NAGY ADLY; (London,
GB) ; Sangster; Alan John; (Edinburgh, GB) |
Correspondence
Address: |
OPPENHEIMER WOLFF & DONNELLY LLP
45 SOUTH SEVENTH STREET, SUITE 3300
MINNEAPOLIS
MN
55402
US
|
Assignee: |
IMPERIAL COLLEGE INNOVATIONS
LIMITED
London
GB
|
Family ID: |
10836774 |
Appl. No.: |
12/858519 |
Filed: |
August 18, 2010 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11055858 |
Feb 11, 2005 |
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12858519 |
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10625232 |
Jul 22, 2003 |
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11055858 |
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09762285 |
Apr 6, 2001 |
6628990 |
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PCT/GB99/02559 |
Aug 4, 1999 |
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10625232 |
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Current U.S.
Class: |
606/33 ;
606/49 |
Current CPC
Class: |
A61N 5/045 20130101;
A61N 5/04 20130101; A61B 18/1815 20130101; A61B 18/18 20130101 |
Class at
Publication: |
606/33 ;
606/49 |
International
Class: |
A61B 18/04 20060101
A61B018/04; A61B 18/18 20060101 A61B018/18 |
Foreign Application Data
Date |
Code |
Application Number |
Aug 5, 1998 |
GB |
9817078.0 |
Aug 4, 1999 |
GB |
PCT/GB99/02559 |
Claims
1. A device for controlling excessive bleeding from severed tissue
during a surgical procedure comprising: (i) an applicator; and (ii)
a plurality of rows of tissue-piercing needles connected to and
arranged on said applicator in a rectangular pattern wherein at
least two of said plurality of rows define a central channel
structured and arranged to be centered on a selected incision line
such that one of said at least two rows of tissue-piercing needles
is on the opposite side of said selected incision line from the
second of said at least two rows of tissue-piercing needles, said
plurality of rows of needles defining a three-dimensional space
that corresponds to a volume of tissue to be treated; wherein said
plurality of rows of needles are structured and arranged to be
energizeable together, with needles in a plurality of said
plurality of rows structured and arranged to be energized
simultaneously to deliver ablating energy between, among and across
said at least two of said plurality of rows of needles defining
said central channel resulting in a cross-flow of energy into said
volume of tissue to coagulate blood within the volume of
tissue.
2. The device as claimed in claim 1, wherein said plurality of,
rows of needles are retractable.
3. The device as claimed in claim 2 further comprising a needle
switching mechanism for advancing and retracting said plurality of
rows of needles.
4. The device of claim 3 wherein said needle switching mechanism
comprises a collar affixed to each needle comprising said plurality
of rows of needles.
5. The device of claim 4 wherein said needle switching mechanism
further comprises a solenoid acting on said collar
6. The device of claim 1 wherein said plurality of rows of needles
are positioned around the perimeter of said applicator.
7. The device of claim 1 wherein said ablating energy is
electromagnetic energy.
8. The device of claim 1 wherein said applicator defines a TM11
mode waveguide.
9. The device of claim 7 wherein said applicator further comprises
dielectric material.
10. A device for supplying localized heating to an organ, part of
an organ, or tissue along a defined incision line to minimize the
loss of blood during resection, said device comprising: (i) an
applicator; and (ii) at least two rows of needles connected to and
arranged on said applicator in a rectangular pattern wherein said
at least two rows of needles define a central channel structured
and arranged to be centered on a defined incision line such that
said at least two rows of needles straddle said defined incision
line; said at least two rows of needles structured and arranged to
be energizable together, with needles in said at least two rows of
needles energized simultaneously, so as to supply three-dimensional
ablating energy among and across said at least two rows of needles
defining a central channel resulting in a cross-flow of energy into
said volume of organ, part of organ, or tissue to coagulate blood
within the volume of organ, part of organ, or tissue along said
defined incision line.
11. The device as claimed in claim 10, wherein said at least two
rows of needles are retractable.
12. The device as claimed in claim 11 further comprising a needle
switching mechanism for advancing and retracting said at least two
rows of needles.
13. The device of claim 12 wherein said needle switching mechanism
comprises a collar affixed to each needle comprising said at least
two rows of needles.
14. The device of claim 13 wherein said needle switching mechanism
further comprises a solenoid acting on said collar
15. The device of claim 10 wherein said at least two rows of
needles are positioned at the periphery of said applicator.
16. The device of claim 10 wherein said ablating energy is
electromagnetic energy.
17. The device of claim 16 wherein said ablating energy is
microwave energy.
18. The device of claim 10 wherein said applicator defines a TM11
mode waveguide.
19. The device of claim 17 wherein said applicator further
comprises dielectric material.
20. A device for restricting the loss of blood during a surgical
procedure comprising: (i) an applicator having a face for
positioning against an organ or tissue to be treated, said
applicator including a collar; (ii) an array of retractable needles
secured to said collar and extending from said face, said array of
retractable needles capable of irradiating said organ or tissue to
be treated in a vicinity of a selected incision point; (iii) a
solenoid mechanism in communication with said array of retractable
needles for energizing and releasing said array of retractable
needles; and (iv) a power unit in communication with said array of
retractable needles for supplying irradiating power to said needles
when extended into said organ or tissue in the vicinity of the
selected incision point.
21. The device of claim 20 wherein the power unit supplies
sufficient power for a period required to raise the temperature of
said organ or tissue in the vicinity of the selected incision point
by about 20.degree. C. to about 30.degree. C.
22. The device of claim 20 wherein said array of retractable
needles provide local heating of the organ or tissue within a
volume approximately 5 cm long, 2 cm wide and 4 cm deep.
23. A device for controlling excessive bleeding from severed tissue
during a surgical procedure comprising an applicator including a
plurality of needles connected to a solenoid-activated collar
affixed to each of said plurality of needles for advancing and
retracting said plurality of needles, each said needle having a
first end and a second end, said second end structured to pierce
said tissue along a selected incision line; wherein said plurality
of needles are energizeable to deliver ablating energy to said
tissue along said selected incision line.
24. The device of claim 23 wherein said plurality of needles when
extended define a volume whose dimensions correspond to the tissue
volume to be ablated.
25. The device of claim 23 wherein said plurality of needles are
positioned around the perimeter of said applicator.
26. The device of claim 23 wherein said ablating energy is
electromagnetic energy.
27. The device of claim 23 wherein said applicator defines a TM11
mode waveguide.
28. The device of claim 27 wherein said applicator further
comprises dielectric material.
29. The device of claim 1 wherein said applicator is structured to
be operably coupled to a source of said ablating energy.
30. The device of claim 1 wherein said plurality of rows of
tissue-piercing needles comprises two rows of needles.
31. The device of claim 1 wherein said plurality of rows of
tissue-piercing needles comprises four rows of two needles each
arranged around a perimeter of said applicator.
32. The device of claim 35, wherein each needle includes a
tissue-penetrating shaft that is sleeveless and non-insulated along
the entire portion of the shaft that extends from the applicator
body and said irradiating power is supplied along the length of the
sleeveless, non-insulated tissue-penetrating shaft when extended
into said organ, part of organ, or tissue.
33. The device of claim 1 wherein each needle comprising said
plurality of rows of tissue-piercing needles include a
tissue-penetrating shaft that is sleeveless and non-insulated along
the entire portion of the shaft that extends from the applicator
body and said ablating energy is delivered into said volume of
tissue along the length of the sleeveless, non-insulated
tissue-penetrating shaft.
34. The device of claim 10 wherein each needle comprising said at
least two rows of needles include a tissue-penetrating shaft that
is non-insulated along the entire portion of the shaft that extends
from the applicator body to the tip and said energy is delivered
into said volume of tissue along the length of the non-insulated
tissue-penetrating shaft.
35. A device for controlling excessive bleeding from severed tissue
during resection comprising: (i) an applicator; and (ii) four
tissue-piercing needles connected to and arranged said applicator
in a pattern of two rows by two columns that define a central
channel structured and arranged such that at least two of said four
tissue-piercing needles are arranged to be positioned on one side
of a width of tissue and at least two of said four tissue-piercing
needles are arranged to be positioned on an opposite side of said
width of tissue, said width of tissue defining a planned incision
line corresponding with said channel, said four tissue-piercing
needles structured and arranged to be energizeable together to
deliver three-dimensional energy among and with a cross-flow across
said plurality of tissue-piercing needles and into a volume of
tissue defined by said width along the planned incision line.
36. The device as claimed in claim 35, wherein said needles are
retractable.
37. The device as claimed in claim 36 further comprising a needle
switching mechanism for advancing and retracting said needles.
38. The device of claim 37 wherein said needle switching mechanism
comprises a collar affixed to each needle.
39. The device of claim 38 wherein said needle switching mechanism
further comprises a solenoid acting on said collar
40. The device of claim 35 wherein said ablating energy is
electromagnetic energy.
41. The device of claim 35 wherein said applicator defines a TM11
mode waveguide.
42. The device of claim 35 wherein said applicator further
comprises dielectric material.
43. The device of claim 35 wherein said needles are positioned
around the periphery of said applicator.
44. The device of claim 35 wherein said ablating energy is
microwave energy.
45. The device of claim 35 wherein said rows of needles are
parallel to each other and said columns of needles are parallel to
each other.
46. The device of claim 1 wherein said rectangular pattern of
needles comprises four needles arranged in a two by two array.
47. The device of claim 10 wherein said rectangular pattern of
needles comprises an array of four needles disposed in a two by two
array.
48. A device structured to bloodlessly resect tissue during a
surgical procedure comprising: (iii) an applicator; and (iv) four
tissue-piercing needles connected to and arranged about a perimeter
of said applicator in a rectangular pattern of two by two needles
each, said pattern defining a central channel structured and
arranged to be positioned on a selected incision line such that one
of said rows of tissue-piercing needles is on the opposite side of
said selected incision line from the second of said row of
tissue-piercing needles, said two rows of needles defining a
three-dimensional space that corresponds to a volume of tissue to
be treated; wherein said two rows of needles are structured and
arranged to be energizeable together and simultaneously to deliver
ablating energy between, among and across said four needles
resulting in a cross-flow of energy into said volume of tissue to
coagulate blood within the volume of tissue.
49. A device structured to bloodlessly resect tissue during a
surgical procedure consisting essentially of: (i) an applicator;
and (ii) four tissue-piercing needles connected to and arranged
about a perimeter of said applicator in a rectangular pattern of
two by two needles each, said pattern defining a central channel
structured and arranged to be positioned on a selected incision
line such that one of said rows of tissue-piercing needles is on
the opposite side of said selected incision line from the second of
said row of tissue-piercing needles, said two rows of needles
defining a three-dimensional space that corresponds to a volume of
tissue to be treated; wherein said four needles contained within
said two rows are structured and arranged to be energizeable
together and simultaneously to deliver ablating energy between,
among and across said four needles resulting in a cross-flow of
energy into said volume of tissue to coagulate blood within the
volume of tissue.
Description
RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 11/055,858, filed Feb. 11, 2005, which is a
divisional of U.S. patent application Ser. No. 10/625,232, filed
Jul. 22, 2003, which is a continuation of U.S. patent application
Ser. No. 09/762,285, filed Apr. 6, 2001, now U.S. Pat. No.
6,628,990, which is a national stage application of International
Patent Application No. PCT/GB99/02559, filed Aug. 4, 1999, which
claims priority from GB Patent Application No. 9817078.0, filed
Aug. 5, 1998.
FIELD OF THE INVENTION
[0002] This invention relates to a device for use in the surgical
treatment of human or non-human animals. In particular, it is
concerned with a device for use in controlling excessive bleeding
from severed tissue during surgical procedures, especially on the
patient's liver.
BACKGROUND OF THE INVENTION
[0003] It is well known that raising the temperature of body tissue
tends to reduce blood flow within the tissue. If the temperature is
raised by 20-30.degree. C. above normal, blood flow within the
tissue is greatly diminished.
[0004] In surgical procedures performed on deep-seated body tissues
and organs, e.g. the liver, blood loss from severed tissue can be a
serious problem. There is an obvious need for a device which can
assist in limiting such blood loss and, as indicated above, this
can be achieved by means of the application of heat. Widespread
heating can be achieved relatively easily, but this is not
desirable. Very localised heating is required in order to minimize
damage to surrounding tissues. In liver surgery, local heating of
the liver is ideally required in a tissue volume approximately 5 cm
long by 2 cm wide by 4 cm deep; this volume is centered on the
planned point of incision. Furthermore, it is important for the
local elevation of temperature to be achieved quickly just prior to
commencing the surgical procedure.
SUMMARY OF THE INVENTION
[0005] The present invention aims to provide a device for providing
localised heating of a selected region of body tissue prior to
surgical incision of that tissue.
[0006] According to one aspect of the present invention, there is
provided a device for generating localised heating in a selected
body tissue, which device comprises an applicator including a
source of microwave radiation and an array of retractable needles
arranged so as to extend from one face of the applicator and, in
operation, to confine the irradiated microwave energy field
emanating from the applicator.
[0007] The invention also provides the use of the device as defined
above for restricting the loss of blood during a surgical procedure
on the human or animal body.
[0008] According to another aspect of the present invention, there
is provided, in the surgical treatment of the human or animal body,
a method of controlling excessive bleeding, the method comprising
inserting an array of needles into the tissue or organ being
treated; and applying microwave energy to the region undergoing
treatment for a time sufficient to raise the temperature of said
tissue or organ by 20-30 degrees C.
[0009] Conveniently, the source of microwave radiation is in the
form of a rectangular waveguide whose dimensions correspond to
those of the tissue volume which is to be heated. The waveguide is
preferably generally rectangular in form, the array of retractable
needles being positioned around the periphery of the waveguide.
[0010] The device may include a needle advance mechanism including
a collar to which the needles are secured; movement of said collar
may be actuated by a solenoid mechanism.
[0011] In operation of the device, the needles will be advanced
from the body of the applicator into the tissue which is to be
heated so that the needles function as a extension of the
waveguide; in this way, the applicator will direct the required
microwave energy into the appropriate tissue volume prior to
surgery. When the heating process is completed, the needles are
retracted back into the body of the applicator.
[0012] Generally, the needles will be disposed mutually parallel;
they can conveniently be formed of steel.
[0013] Theoretical calculations show that, in order to raise the
temperature of body tissues by 30.degree. C., an applicator
operating with 100% efficiency would need to deliver about 10 watts
of microwave power, assuming that the volume to be heated is 40
cm.sup.3. For a typical biological tissue such as muscle, this
temperature rise would be achieved in approximately 10 minutes. If
the source is increased in energy to 500 watt, and if the
applicator is assumed to be about 80% efficient, the time taken to
achieve this required temperature increase is approximately 15
seconds.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] For a better understanding of the invention, and to show how
the same may be carried into effect, reference will now be made, by
way of example, to the accompanying drawings, in which:
[0015] FIG. 1 is a schematic representation of an applicator in
accordance with this invention;
[0016] FIG. 2 is a cross-sectional view of the applicator head of
FIG. 1;
[0017] FIG. 3 is an end elevational view corresponding to FIGS. 1
and 2.
DETAILED DESCRIPTION
[0018] Referring now to the drawings, a power and control unit (1)
supplies up to 500 watts of microwave power via a coaxial cable (2)
to a rectangular applicator (3). The head (3) has a handle (4)
through which cable (2) passes, and an array (5) of retractable
needles which are designed to provide precise irradiation of the
tissue in the vicinity of the selected incision point. The unit (1)
also contains a switching mechanism and control electronics to
energise and release the array of needles.
[0019] As shown in FIGS. 2 and 3, the applicator head (3) includes
a rectangular waveguide (6) around the periphery of which the
needles of array (5) are located. The waveguide is a TM.sub.11 mode
waveguide and is filled with a suitable dielectric. For irradiation
of a region 5 cm long by 2 cm wide, the rectangular waveguide
should have corresponding dimensions and may be filled with a
medium whose dielectric constant (.di-elect cons..sub.x) is about
50. These parameters dictate that the microwave operating frequency
should be of the order of 1 GHz. The specific values given here are
by of example only; it will be appreciated that a range of
applicators designed to irradiate different volumes of tissue may
be developed and these, of necessity, will have different
dimensions and may require a different dielectric medium and a
different operating frequency from that given above. In the
illustrated embodiment, each of the needles is 3 cm long and made
of steel. When the applicator is in operation, these needles will
be advanced into the tissue where they function as an extension to
the waveguide. A typical needle array may comprise about 20
needles. By employing a TM mode waveguide, leakage of energy
through the "needle wall"--i.e., the area bounded by the array of
needles--is kept to a low level (typically less than 10%).
[0020] FIG. 2 also shows a collar (8) to which each of the needles
of the array (5) are secured. Collar (8) is acted upon by spring
(9) which forms part of a solenoid mechanism (10) for controlling
the advance and retraction of the array of needles. Power is
supplied to the solenoid mechanism (10) via cable (11). As
illustrated in FIG. 2, coaxial line (2) terminates within the
dielectric-filled waveguide (6).
[0021] In operation, a surgeon will position the applicator head
(3) against the region of tissue (e.g. liver) which is about to be
incised. Initially the needle array (5) is retracted within head
(3). When the applicator is actuated, solenoid mechanism (10)
causes the needles of array (5) to be extended into the patient's
tissue. Once they are embedded in the tissue, microwave energy at
the desired frequency (e.g. 1 GHz) is supplied to waveguide (6) and
passes therefrom into the volume of tissue enclosed by the array
(5) of needles. Energy is supplied at a typical power level of 500
watts for a duration of about 15 secs when an applicator of the
dimensions 5 cm.times.2 cm and a needle length of 3 cm is used. At
the end of the treatment period, the microwave source is switched
off and needle array (5) is retracted. The surgeon may then proceed
with the incision and any subsequent procedures as may be
necessary.
[0022] Blood loss from incision of tissue after heat treatment as
described is greatly reduced in comparison to the results obtained
in the absence of such heat treatment.
* * * * *