U.S. patent number 3,664,344 [Application Number 05/072,317] was granted by the patent office on 1972-05-23 for tyned cryosurgical probe.
This patent grant is currently assigned to Brymill Corp.. Invention is credited to Michael D. Bryne.
United States Patent |
3,664,344 |
Bryne |
May 23, 1972 |
TYNED CRYOSURGICAL PROBE
Abstract
Freezing of large tissue masses to significant depths is
achieved by utilizing a tyned cryosurgical probe having sharpened
tynes that are embedded directly into the tissue to be frozen.
Nitrogen is delivered in substantially liquid form directly to the
exposed ends of the tynes or to metallic surfaces metallurgically
bonded thereto. Examples of uses include starting a deep iceball
with a tyned probe in accordance herewith and advancing the iceball
deeper with other apparatus.
Inventors: |
Bryne; Michael D. (Vernon,
CT) |
Assignee: |
Brymill Corp. (Vernon,
CT)
|
Family
ID: |
22106839 |
Appl.
No.: |
05/072,317 |
Filed: |
September 15, 1970 |
Current U.S.
Class: |
606/23; 607/105;
62/293 |
Current CPC
Class: |
A61B
18/02 (20130101) |
Current International
Class: |
A61B
18/00 (20060101); A61B 18/02 (20060101); A61b
017/36 (); A61f 007/12 (); F25d 003/00 () |
Field of
Search: |
;62/293
;128/303.1,303.18,329,400,401 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Pace; Channing L.
Claims
Having thus described particular embodiments of my invention, that
which I claim as new and desire to secure by Letters Patent of the
United States is:
1. In cryosurgery, the method of freezing a mass of soft, living
tissue comprising the steps of:
inserting into a mass of soft, living tissue to be frozen a
plurality of closely spaced sharp metal tynes which are
metallurgically bonded to the outside surface of a metallic wall of
a chamber; and
thereafter directing a sufficient flow of liquefied gas cryogenic
fluid having a boiling point below -100.degree. C. to the inner
surface of the metallic wall of said chamber to which said tynes
are metallurgically bonded to solidly freeze the entire portion of
said mass included between said tynes.
2. A cryosurgical instrument for destroying living animal tissue by
the rapid, active cooling of heat conducting tynes embedded in said
tissue, comprising:
a chamber formed of walls and having a proximal end adapted to
receive a cryogenic fluid and a distal end closed by a thermally
conductive metallic end wall;
a plurality of closely spaced sharp metal tynes adapted to be
inserted into living animal tissue which is to be destroyed, said
tynes being metallurgically bonded to said end wall of said chamber
and oriented outwardly therefrom; and
cryogenic fluid delivery means connected to said chamber and
including a reservoir adapted to receive a liquefied gas cryogenic
fluid having a boiling point below -100.degree. C., for delivering,
with said cryogenic fluid in said reservoir, a sufficient flow of
said cryogenic fluid to said proximal end of said chamber, when
said chamber is in position with said tynes inserted into the
tissue, so as to solidly freeze the entire portion of the tissue
included between said tynes.
Description
BACKGROUND OF THE INVENTION
1. Field of Invention
This invention relates to cryosurgery, and more particularly to a
tyned cryosurgical probe.
2. Description of the Prior Art
The field of cryosurgery has recently undergone a rebirth, with new
techniques for utilizing cryogenic instruments to treat various
types of disorders and disfigurements. An important advance has
been development of the technique of applying cryogenic fluid, in
substantially liquid form, directly to tissue which is to be
frozen, as set forth in my prior co-pending application Ser. No.
683,351 filed on Nov. 15, 1967, now U.S. Pat. No. 3,534,739 and
entitled CRYOSURGICAL DELIVERY AND APPLICATION OF LIQUIFIED GAS
COOLANT. In cases where uncontrolled application of cryogenic fluid
may adversely affect surrounding tissue, the cryogen may be
confined and its point of contact closely controlled by means of
chambers, as set forth in my prior co-pending application Ser. No.
728,536 filed on May 13, 1968 and entitled CRYOGENIC APPLICATION
CHAMBERS AND METHODS. In other cases, closed probes in which the
cryogen freely circulates may be used.
In each of the above techniques, the application of cryogenic
temperatures is limited to the surface of the tissue which is to be
frozen. When the surface freezes, it forms ice, which aids in
conducting the heat out of the tissue, so that an iceball grows
into the tissue over a period of time as the cryogenic temperature
is applied. Assuming a round application pattern is used, the
iceball which can be formed through surface application generally
has a configuration which is less deep than the radius of the
surface area of application. Additionally, this necessarily limits
the ultimate depth which can be achieved in any given case, since
freezing of an extremely large surface area would be required in
order to get the desired depth of a much smaller area. In cases
where the surface of the tissue to be frozen is relatively dry, in
contrast with wet masses, this problem is further compounded.
SUMMARY OF THE INVENTION
An object of the present invention is to provide a cryosurgical
probe having an extremely high freezing capability; another object
of the present invention is to provide a cryosurgical probe capable
of freezing with a greater ratio of depth to surface area than has
heretofore been obtainable.
According to the present invention, a closed cryosurgical probe has
tynes mounted in the application surface thereof, said tynes being
adapted to be inserted into a mass of tissue to be frozen, said
probe adapted to receive liquid cryogenic fluid at a surface
immediately adjacent and metallurgically bonded to said tynes.
The present invention can be configured in a variety of ways so as
to permit utilization in a wide variety of surgical procedures. The
invention in accordance herewith is readily adapted to be utilized
with a wide variety of cryogenic fluid delivery systems. The
invention provides the capability of achieving freezes with large
ratios of depth to surface area in a carefully controlled
manner.
Other objects, features and advantages of the present invention
will become more apparent in the light of the following detailed
description of preferred embodiments thereof, as illustrated in the
accompanying drawing.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 is a sectioned side elevation of a first embodiment of a
cryosurgical probe in accordance with the present invention;
FIG. 2 is a front elevation of the embodiment illustrated in FIG.
1;
FIG. 3 is a sectioned, side elevation illustrative of the
utilization of a cryosurgical probe in accordance with the present
invention in freezing tissue;
FIG. 4 is a partially sectioned, side elevation of a second
embodiment of a cryosurgical probe in accordance with the present
invention; and
FIG. 5 is a perspective view illustrating further the embodiment of
FIG. 4.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to FIGS. 1 and 2, a simple embodiment of a probe 8 in
accordance with the present invention includes a chamber 10 formed
by a cylinder 12 which is provided with threads 14 at an open,
proximal end 16 thereof, and is closed by a distal end wall 18 at
an application end 20 thereof. Metallurgically bonded to the wall
18 are a plurality of tynes 22. In the embodiments herein, the
tynes 22 are solid cylinders having conical tips to permit easily
piercing tissue to be frozen, and each is provided with a portion
24 having a reduced diameter for insertion into related holes 26
formed in the wall 18, thereby to provide a maximum surface joint
for maximum heat conductivity between the wall 18 and the tynes 22,
as well as sturdy construction. In accordance with the invention,
it is preferred that the tynes 22 be metallurgically bonded to the
wall 18; this aspect is satisfied if the wall 18 and the tynes 22
are machined from a single block of starting material, and is
equally satisfied if the tynes 22 are soldered, brazed or welded to
the wall 18. Although utilization of the reduced portion 24 for
insertion into the hole 26 is preferred, the tynes 22 may instead
butt onto the outer surface of the wall 18, provided suitable
metallurgical bonding is utilized.
The threads 14 are adapted to receive similar threads 28 at the
application end of a cryogenic fluid delivery apparatus, a portion
30 of which is illustrated in FIG. 1. The nature of the delivery
apparatus is not significant, so long as it is capable of providing
cryogenic fluid having a boiling point below -100.degree. C., such
as nitrogen, in substantially liquid form to the application end 20
of the probe 8, and venting the gas which results from the cryogen
being boiled by the heat of the tissue to which the probe is
applied. As illustrated in FIG. 1, such a delivery system may have
a coaxial arrangement with an inner tube 32 for delivering the
liquid cryogen, spaced from an outer wall 34 so as to provide a
passage 36 to permit gases to return toward the instrument. A
simple delivery system capable of delivering cryogenic fluid to the
probe of FIG. 1 is illustrated in my co-pending U.S. Pat. No.
3,534,739 referred to hereinbefore. Numerous other suitable
delivery systems are known and generally available.
Utilization of the present invention is illustrated in FIG. 3.
Therein, the probe 8 is forced against substantially the central
portion of tissue 38 which is to be frozen, so that the tynes 22
are firmly embedded in the tissue. Then, a flow of cryogenic fluid
is provided to the chamber 10 so that the wall 18 and that portion
of the tynes 22 exposed to the chamber 10 are in direct contact
with the cryogenic fluid. In a preferred utilization of the present
invention, nitrogen in substantially liquid form is introduced
directly to the chamber 10 so that the tynes are exposed to a
temperature of substantially -196.degree. C. (-320.degree. F.). In
such utilization, it has been found that the tynes can be
maintained at at least -180.degree. C. without regard to the
character of the tissue in which it is embedded: even with tissue
having a lot of warm blood flowing therethrough, the nitrogen is
capable of maintaining the tissue at -180.degree. C. so as to
establish a substantial, deep iceball as illustrated by the dotted
line 40. The depth of the iceball has been found to be much greater
with respect to the cross sectional area of surface which is frozen
than is obtainable with any cryosurgical instruments or application
methods known in the art heretofore.
One manner of utilizing the present invention is to establish an
iceball as described with respect to FIG. 3 hereinbefore, and then
advance the margin of freezing still deeper by means of nitrogen
applied directly to the surface, after removing the probe 8 from
the position shown in FIG. 3. Although this phenomenon is not fully
understood, it is believed that this process results from the fact
that the gross heat removed by the tyned probe makes subsequent
freezing easier; also, the ice conducts the heat to the surface.
This can have the effect of advancing the iceball deeper as
illustrated by the dashed lines 42.
Another embodiment of a probe in accordance with the present
invention is illustrated in FIG. 4. Therein, the probe 8a is
comprised of two cylinders 12a, 12b mounted at right angles to each
other. As is also illustrated in FIG. 5, this probe may be
manufactured by providing a 45.degree. cut 44 at the application
end of the cylinder 12a, providing a hole 46 through the longer
side of the cylinder 12a, shaping the cylinder 12b to match the
cylinder 12a (as illustrated in FIG. 5), and joining the cylinders
together. In a preferred form as illustrated in FIG. 4, the probe
8a is provided with a nitrogen delivery tube 48 which is
spot-welded at a point adjacent to the hole 46 so as to insure that
cryogenic fluid will communicate between the chamber 10a provided
in the cylinder 12b and the cryogenic fluid tube 48. The tube 48 is
adapted to be received by a suitable fluid duct 50 in a
cryosurgical delivery instrument 30a, which instrument must provide
cryogenic fluid to the probe 8a and vent the gases therefrom as is
described with respect to FIGS. 1 and 2 hereinbefore. Notice
however that it has been found immaterial to the operation of the
present invention whether the cryogenic fluid is delivered through
the tube 48 and vented through the chamber 10b formed within the
cylinder 12a outside of the tube 48, or whether the cryogenic fluid
is delivered to the chamber 10b and the gases thereof vented
through the tube 48 and thence through a venting duct 52 in the
delivery apparatus 30a. Thus, the present invention is readily
adapted to be used with cryogenic delivery instruments 30a which
have a center feed and outside return, or an outside feed and a
center return, alternatively. The remainder of the probe 8a is
similar to that described with respect to the probe 8 of FIGS. 1
and 2 hereinbefore, and will not be described further. However, it
is important that there be delivery of cryogenic fluid directly to
the chamber 10a so that the tynes 20 receive maximum heat transfer
therewith, as described hereinbefore.
A procedure to which the embodiment of FIG. 4 is particularly
well-suited relates to large lesions at the base of the tongue with
no permanent damage to the large blood vessels that nurture the
remainder of the tongue. Thus, while the necrotized area heals, the
remainder of the tongue is maintained in a suitably healthy
condition, since there has been no loss of blood flow thereto.
Alternative procedures which are available include a relatively
superficial freeze utilizing surface-applied cryogens and cryogenic
probes in accordance with the prior art, and also include the
rather drastic procedure of a total glossectomy (in which the
entire tongue is cut off at the base). Thus, a significantly less
disabling alternative procedure is made available by the
utilization of the present invention.
Other procedures for which the present invention is well-suited,
include the removal of any large or especially thick lesions, or
any carcinomas of a significant size. Thus, although the direct
application of liquid cryogen to the surface of a lesion provides
the greatest cooling ability at the surface, the present invention
provides an ability to achieve greater depth and therefore finds
application in a variety of procedures.
Although the invention has been shown and described with respect to
preferred embodiments thereof, it should be understood by those
skilled in the art that the foregoing and various other changes and
omissions in the form and detail thereof may be made therein
without departing from the spirit and the scope of the
invention.
* * * * *