Delivery device with coaxial cable, apparatus comprising said device and method
11540882 · 2023-01-03
Assignee
Inventors
- Leonardo Masotti (Sesto Fiorentino, IT)
- Mauro Galli (Sesto Fiorentino, IT)
- Riccardo Stocchi (Seano, IT)
- Paolo Corsini (Prato, IT)
- Marco Bini (Pistoia, IT)
- Amleto Ignesti (Vicchio, IT)
- Cristiano Riminesi (Florence, IT)
- Samuele Beni (Cavriglia, IT)
Cpc classification
A61B2018/00023
HUMAN NECESSITIES
A61B2018/00464
HUMAN NECESSITIES
A61B2018/00458
HUMAN NECESSITIES
International classification
A61N1/40
HUMAN NECESSITIES
A61B18/18
HUMAN NECESSITIES
Abstract
The device comprises an outer conductor (7) and an inner conductor (9) arranged approximately coaxial with each other. The outer conductor surrounds the inner conductor. The outer conductor (7) and the inner conductor (9) are arranged and configured to generate an electromagnetic field with lines of force extending from a front surface (9A) of the inner conductor (9) to a front surface (7C) of the outer conductor (7). The device further comprises an energy delivery window (13) arranged in front of the outer conductor and the inner conductor.
Claims
1. A device for delivering radiofrequency energy, the device comprising: an outer conductor and an inner conductor arranged substantially coaxial with each other, the outer conductor surrounding the inner conductor, wherein the outer conductor and the inner conductor are arranged and configured to generate an electric field with lines of force extending from a front surface of the inner conductor to an annular front surface of the outer conductor and orthogonal to the front surface of the inner conductor and the front surface of the outer conductor, when the device is placed in contact with a surface to be treated, wherein the front surface of the inner conductor and the annular front surface of the outer conductor are arranged at a reciprocal distance in an axial direction not greater than a diameter of the inner conductor; an energy delivery window arranged in front of the outer conductor and the inner conductor, wherein the delivery window is closed by a plate made of a material substantially transparent at the frequency of the energy delivered by the device; a cooling system, comprising coolant flowing ducts fluidly coupled to an inner space of the delivery device, configured to cool the plate closing the delivery window, wherein the inner conductor and the outer conductor form an open-ended coaxial line, the delivery window being orthogonal to an axis of the open-ended coaxial line.
2. The delivery device according to claim 1, wherein the outer conductor is cup-shaped, the outer conductor comprising an inner space, the inner conductor being housed in the inner space of the outer conductor, the inner space being closed, at a front of the inner space, by the delivery window.
3. The delivery device according to claim 1, wherein the inner space comprises a gap between the front surface of the inner conductor and the plate closing the delivery window.
4. The delivery device according to claim 1, wherein the annular front surface of the outer conductor is substantially coaxial to the front surface of the inner conductor, wherein the front surface of the inner conductor is substantially flat, wherein the annular front surface of the outer conductor is substantially flat.
5. The delivery device according to claim 4, wherein the front surface of the inner conductor and the annular front surface of the outer conductor are arranged at an axial distance not greater than half the diameter of the inner conductor.
6. The delivery device according to claim 4, wherein the reciprocal distance in the axial direction is not greater than one-fourth of the diameter of the inner conductor.
7. The delivery device according to claim 4, wherein the reciprocal distance in the axial direction is not greater than one-fifth of the diameter of the inner conductor.
8. The delivery device according to claim 4, wherein the reciprocal distance in the axial direction is not greater than one-eighth of the diameter of the inner conductor.
9. The delivery device according to claim 1, wherein the outer conductor defines a space for housing the inner conductor, the outer conductor having an inner diameter, wherein a ratio between the inner diameter of the outer conductor and the diameter of the inner conductor is comprised between 1 and 2.
10. The delivery device according to claim 1, wherein the plate is connected to the outer conductor via a flange, wherein a portion of the flange is located radially adjacent to an outer surface of the outer conductor with respect to a longitudinal axis of the outer conductor.
11. A radiofrequency energy delivering apparatus, comprising: a radiofrequency generator; a connector; and a delivery device comprising: an outer conductor and an inner conductor arranged substantially coaxial with each other, the outer conductor surrounding the inner conductor, wherein the outer conductor and the inner conductor are arranged and configured to generate an electric field with lines of force extending from a front surface of the inner conductor to an annular front surface of the outer conductor and orthogonal to the front surface of the inner conductor and the annular front surface of the outer conductor, when the device is placed in contact with a surface to be treated, wherein the front surface of the inner conductor and the annular front surface of the outer conductor are arranged at a reciprocal distance in an axial direction not greater than a diameter of the inner conductor; an energy delivery window arranged in front of the outer conductor and the inner conductor, wherein the energy delivery window is closed by a plate made of a material substantially transparent at the frequency of the energy delivered by the delivery device; a cooling system, comprising coolant flowing ducts fluidly coupled to an inner space of the delivery device, configured to cool the plate closing the energy delivery window, wherein the inner conductor and the outer conductor form an open-ended coaxial line, the energy delivery window being orthogonal to an axis of the open-ended coaxial line.
12. The apparatus according to claim 11, wherein the radiofrequency generator generates a current, wherein a frequency of the current is comprised between 2 GHz and 6 GHz.
13. The apparatus according to claim 11, wherein the connector is a coaxial cable.
14. The apparatus according to claim 13, wherein the coaxial cable has a coaxial cable inner conductor, which is electrically connected to the inner conductor of the delivery device, and an outer portion, which is electrically connected to the outer conductor of the delivery device.
15. The apparatus according to claim 11, further comprising a control unit configured and arranged to control an emission of the radiofrequency generator.
16. The apparatus according to claim 15, wherein the control unit interfaces with a cooling circuit and the control unit is configured and arranged to control a temperature of at least one portion of the delivery device.
17. The apparatus according to claim 16, further comprising a temperature detection system to detect at least one of the temperature of the at least one portion of the delivery device, a temperature of a coolant or a temperature of a tissue surface where the delivery device is applied.
18. The apparatus according to claim 11, wherein the outer conductor defines a space for housing the inner conductor, the space having an inner diameter, wherein a ratio between the inner diameter and the diameter of the inner conductor is comprised between 1 and 2.
19. The apparatus according to claim 11, wherein the plate is connected to the outer conductor via a flange, wherein a portion of the flange is located radially adjacent to an outer surface of the outer conductor with respect to a longitudinal axis of the outer conductor.
20. A method for the removal of adipose tissues, the method comprising the following steps: applying, to an epidermis portion, a delivery device comprising: an outer conductor and an inner conductor arranged substantially coaxial with each other, the outer conductor surrounding the inner conductor, wherein the outer conductor and the inner conductor are arranged and configured to generate an electric field with lines of force extending from a front surface of the inner conductor to an annular front surface of the outer conductor and orthogonal to the front surface of the inner conductor and the annular front surface of the outer conductor, when the device is placed in contact with a surface of the epidermis portion to be treated, wherein the front surface of the inner conductor and the annular front surface of the outer conductor are arranged at a reciprocal distance in an axial direction not greater than a diameter of the inner conductor; an energy delivery window, arranged in front of the outer conductor and the inner conductor, wherein the energy delivery window is closed by a plate made of a material substantially transparent at the frequency of the energy delivered by the delivery device; a cooling system, comprising coolant flowing ducts fluidly coupled to an inner space of the delivery device, configured to cool the plate closing the energy delivery window, wherein the inner conductor and the outer conductor form an open-ended coaxial line, the energy delivery window being orthogonal to an axis of the open-ended coaxial line; generating, by the delivery device, a radiofrequency electromagnetic field in a tissue volume below the epidermis portion, wherein the lines of force extend orthogonally with respect to the epidermis portion and sequentially cross the epidermis portion, derma and an adipose tissue below the derma, wherein a current flow generated by the electromagnetic field causes a localized heating of the adipose tissue up to a temperature sufficient to cause destruction of at least part of adipocytes forming the adipose tissue.
21. The method according to claim 20, wherein a frequency of the electromagnetic field is comprised between 2 GHz and 6 GHz.
22. The method according to claim 20, wherein power supplied by the electromagnetic field is comprised between 10 W and 150 W.
23. The method according to claim 20, wherein the electromagnetic field is generated in the tissue volume for a time comprised between 5 and 20 minutes.
24. The method according to claim 20, wherein power delivered and a delivery time are selected so as to heat the adipose tissue to be removed up to a temperature comprised between 40° C. and 50° C. causing apoptosis in the adipocytes.
25. The method according to claim 20, wherein the outer conductor defines a space for housing the inner conductor, the space having an inner diameter, wherein a ratio between the inner diameter and the diameter of the inner conductor is comprised between 1 and 2.
26. A device for delivering radiofrequency energy, the device comprising: an outer conductor and an inner conductor arranged substantially coaxial with each other, the outer conductor surrounding the inner conductor, wherein the outer conductor and the inner conductor are arranged and configured to generate an electric field with lines of force extending from a front surface of the inner conductor to an annular front surface of the outer conductor and orthogonal to the front surface of the inner conductor and the annular front surface of the outer conductor, when the device is placed in contact with a surface to be treated; an energy delivery window arranged in front of the outer conductor and the inner conductor, wherein the delivery window is closed by a plate made of a material substantially transparent at the frequency of the energy delivered by the device; a cooling system, comprising coolant flowing ducts fluidly coupled to an inner space of the delivery device, configured to cool the plate closing the delivery window, wherein the inner conductor and the outer conductor form an open-ended coaxial line, the delivery window being orthogonal to an axis of the open-ended coaxial line, wherein the inner conductor comprises a diameter and the outer conductor comprises an inner diameter defining a space for housing the inner conductor, wherein an axial distance between the annular front surface of the outer conductor and the front surface of the inner conductor is not greater than half the diameter of the inner conductor, wherein a ratio between the inner diameter and the diameter of the inner conductor is comprised between 1.2 and 1.5.
Description
BRIEF DESCRIPTION OF THE DRAWING
(1) The invention will be better understood by following the description and the accompanying drawing, which shows non-limiting practical embodiments of the invention. More particularly, in the drawing:
(2)
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DETAILED DESCRIPTION OF EMBODIMENTS
(10) The following detailed description of the exemplary embodiments refers to the accompanying drawings. The same reference numbers in different drawings identify the same or similar elements. Additionally, the drawings are not necessarily drawn to scale. Also, the following detailed description does not limit the invention. Instead, the scope of the invention is defined by the appended claims.
(11) Reference throughout the specification to “one embodiment” or “an embodiment” or “some embodiments” means that the particular feature, structure or characteristic described in connection with an embodiment is included in at least one embodiment of the subject matter disclosed. Thus, the appearance of the phrase “in one embodiment” or “in an embodiment” or “in some embodiments” in various places throughout the specification is not necessarily referring to the same embodiment(s). Further, the particular features, structures or characteristics may be combined in any suitable manner in one or more embodiments.
(12) With initial reference to
(13) In the embodiment of
(14) The inner conductor 9 has a front surface 9A facing towards the outside.
(15) The conductors 7 and 9 form a coaxial line with an open end and a closed end at the exit of the coaxial cable 3 for the connection to the radiofrequency generator.
(16) The outer conductor 7 may be cup-shaped and may have a first end 7A formed by a cover and substantially closed, except for the presence of a central hole allowing the passage of the center conductor 3C of the coaxial cable 3, and particularly the dielectric interposed between shield and center conductor and the same center conductor. The end 7A forms the bottom of the cup. The reference number 7B indicates an opposite open end having a substantially annular front surface 7C. The outer conductor 7 defines an inner space 8 where the inner conductor 9 is housed and contained. The inner conductor 9 can be held in a position approximately coaxial with the outer conductor 7. For example, an insert may be provided, made of low-loss dielectric material 11, interposed between the outer conductor 7 and the inner conductor 9.
(17) The inner conductor 9 may be constituted by a solid cylindrical element.
(18) The open end 7B of the outer conductor 7 defines a window delimited by the front surface 7C.
(19) The front surface 7C of the outer conductor 7 and the front surface 9A of the inner conductor 9 have a reciprocal distance in axial direction indicated with “d”. In other words, the front surface 7C of the outer conductor 7 protrudes in axial direction by a distance “d” with respect to the front surface 9A of the inner conductor 9. This distance is practically the distance between two parallel planes containing the front surface 9A and the front surface 7C respectively.
(20) The front surfaces 9A and 7C are preferably flat, except for the presence of grooves suitable to receive sealing rings, as shown in the drawing. In order to have a better distribution of the electric field lines, the surfaces 9A and 7C have preferably low roughness. They can be, for example, lapped or polished surfaces.
(21) Preferably, in order to have a better coupling between the electric field, generated by the delivery device, and the patient's body subjected to lipolysis, the distance “d” is advantageously lower than the outer diameter D9 (see
(22) In some embodiments, the outer conductor 7 may have a front surface 7C that is arranged backwards with respect to the front surface 9A of the inner conductor 9.
(23) The distance “d” in axial direction between the surfaces 7C and 9A is kept small in order to achieve an effective operation of the device. In fact, in this way the electric field lines extending between the front surface 9A of the inner conductor 9 and the front surface 7C of the outer conductor 7 mostly propagate outside the volume defined by the outer conductor 7 and arrange themselves orthogonally to the above-mentioned front surfaces. This is an advantage because, as will be better detailed below, in this way an optimal current flow is generated in the treated tissues, which achieves the adipose layers where the thermal increase is required in order to liquefy the adipose cells.
(24) In
(25) The inner space 8 may be closed at the front by means of a wall transparent to the electromagnetic radiation used, so as to allow the propagation of an electromagnetic field through the transparent wall. For example, the transparent wall may comprise a plate 13 made of sapphire (alumina Al.sub.2O.sub.3 and other atoms in low percentage) or other suitable dielectric material with good heat conductivity. The plate 13 may be fastened to the outer conductor 7 by means of a flange 15. The plate 13 is advantageously configured so as to be in contact with the epidermis of a patient, to whom the radiofrequency energy shall be delivered for lipolysis treatment.
(26) In some embodiments, the delivery device 1 comprises a cooling system, so configured as to remove heat from the plate 13, during the use of the delivery device 1, thus limiting the temperature of the epidermis and the derma that are heated due to the dissipation of the electromagnetic energy flowing therethrough, and thus avoiding burns or troubles for the patient.
(27) In the illustrated embodiment, the cooling system comprises a coolant inlet duct (17) and a coolant outlet duct (19). The coolant flowing ducts 17, 19 may extend parallel to the axis A-A of the delivery device 1. In advantageous embodiments, the coolant flowing ducts 17, 19 are provided in the outer conductor 7 or they are housed in seats provided in the thickness of the outer conductor 7, as shown in
(28) The number of coolant flowing ducts may be different than that represented, for example in order to have a more efficient coolant circulation. The coolant may be gaseous or, preferably, liquid.
(29) In the illustrated embodiment, the two coolant flowing ducts 17, 19 are fluidly coupled through a gap 21 provided between the plate 13 and the front surface 9A of the inner conductor 9 facing towards the plate 13.
(30) With this arrangement, the coolant can circulate in the gap 21 so as to remove heat from the plate 13 through forced convection, and to keep the outer surface of the plate at a sufficiently low temperature to avoid burns or just an overheating feeling for the patients.
(31)
(32) The lines of force, or field lines, of the electric field generated by the radiofrequency current supplied through the coaxial cable 3 are indicated with the letter F. They extend from one to the other of the inner conductor 9 and the outer conductor 7. More in particular, the lines of force F extend from the front surface 9A of the inner conductor 9 and close on the front surface 7C of the outer conductor 7. As it is well known, the electric field lines arrange themselves orthogonally to the surface of the conductor by which they have been generated. Therefore, the electric field lines F are orthogonal to the front surface 9A of the inner conductor 9 and to the front surface 7C of the outer conductor 7. This orthogonality of the field lines is optimized by making these surfaces with low roughness, for example by lapping or polishing them. In this way, the field lines are not deformed in correspondence of any roughness.
(33) As it is easily understood from the schematic view of
(34) From an electric point of view, the layers E, A and M may be considered as electric impedances arranged in series, thus crossed by the same current (induction and displacement current) induced by the electromagnetic field generated by the open-ended coaxial cable.
(35) The resistive part of the impedance of the adipose tissue A is greater than the resistive part of the impedance of the epidermis and the derma E, as well as of the muscle layers M, so that the energy conveyed by the electric field exiting from the two coaxial conductors 7, 9 is dissipated to a greater extent in the adipose tissue and to a lesser extent in the adjacent layers. Therefore, in the adipose tissues a greater energy amount is deposited, causing a localized heating of the adipose tissue up to a temperature greater than the temperature achieved by the adjacent tissues (epidermis, derma and muscles). In this way, a greater efficiency of the delivery device 1 is provided with respect to other devices (for example of the radiative type) where the electromagnetic field is polarized parallel to the tissue stratification. In these delivery devices, the tissue stratification behaves like an arrangement of resistances in parallel. In this way, the current preferably flows in the tissue with lower resistance (skin and muscle), with consequently greater heating of these layers, and lower efficiency of the delivery device, as well as with more troubles for the patient.
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(37) The dimension of the components of the delivery device 1 may be selected suitably, for example based on the body part to be treated. Smaller delivery devices may be provided for treating small body areas and/or body areas that are more difficult to be achieved, for example the inner thigh. Larger delivery devices may be used for treating larger areas and/or more accessible areas, such as abdomen, back and buttocks.
(38) The open-ended coaxial line conformation of the conductors 7 and 9 is such that, when the delivery device is moved away from the body surface, the power supply stops, as the coaxial cable is designed so as to have a characteristic impedance suitable for biological tissues, and therefore the electromagnetic field cannot propagate in the air constituting an unmatched load. This makes the device 1 intrinsically safe.
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(40) The radiofrequency generator may be configured so as to generate current at a frequency comprised between approximately 2 GHz and approximately 6 GHz, preferably between approximately 2.3 GHz and approximately 5.2 GHz, more preferably between approximately 2.3 GHz and approximately 3 GHz, even more preferably about 2.4-2.5 GHz.
(41) The apparatus 10 with the delivery device 1 may be used to implement a method for reducing the mass of fat tissues as follows. The radiofrequency generator 5 is actuated and the delivery device 1 is put onto the epidermis portion, below which the adipose tissue to be eliminated or reduced is located. As mentioned above, the radiofrequency generator 5 may be actuated even before putting the delivery device 1 onto the skin, as substantially no radiations are emitted from the open-ended coaxial line formed by the conductors 7 and 9 until it is coupled to the epidermis.
(42) Once the delivery device 1 has been put into contact with the epidermis, with the use, if necessary, of a thin layer of gel or biocompatible oils facilitating the coupling, the delivery device 1 may be kept still for a certain time. Alternatively, the delivery device 1 may be moved at a suitable speed, manually or through a scanning system, not shown, so as to treat a portion of surface S of epidermis E larger than the contact area of the delivery device 1, substantially defined by the window formed by the plate 13.
(43) If the delivery device 1 is kept fixed in a given position, the power delivered to the epidermis and the time the delivery device remains in position are such as to achieve a temperature in the adipose tissue that is suitable to trigger apoptosis and/or other adipose cell destruction mechanisms. Preferably, the temperature is sufficiently low to avoid significant tissue denaturation effects. In some embodiments, the temperature achieved in the adipose tissue to be treated may be comprised between approximately 40° C. and approximately 50° C., preferably between approximately 42° C. and approximately 47° C. The power delivered by the electromagnetic field may be comprised between approximately 10 W and approximately 150 W, preferably between approximately 20 W and approximately 130 W, more preferably between approximately 30 W and approximately 110 W. In other embodiments, the delivered power may be comprised between approximately 70 W and approximately 150 W, preferably between approximately 90 W and approximately 130 W, more preferably between approximately 95 W and approximately 110 W.
(44) With this order of magnitude, and taking into account the heat dissipation from the tissues due to thermal diffusion and thermoregulation of the blood system, the time the delivery device 1 can remain on a given treatment area may be comprised between approximately 5 and approximately 20 minutes, preferably between approximately 7 and approximately 15 minutes, more preferably between approximately 8 and approximately 12 minutes.
(45) During the treatment it is possible to detect the epidermis surface temperature through a temperature sensor, not shown, that may be integrated in the delivery device and interfaced with the central control unit 31. The control unit may also modulate the delivered power and/or it may act on the parameters of the cooling system, so as to keep the epidermis surface temperature at a suitable preset value. This value may be lower than the body temperature, in order to protect the whole derma against over-temperatures. The central control unit may be programmed, for example, so as to decrease or increase the temperature of the coolant supplied to the inlet duct 17, based on the detected temperature and on an error signal caused by a difference between the preset temperature and the temperature detected on the epidermis.
(46) Moreover, the central control unit 31 may be programmed so as to interrupt the delivered power if, for example because of a fault, the cooling system stops working or is not sufficient to keep the epidermis temperature at the preset value. If the epidermis temperature is higher than that required, in spite of an increase in the coolant flow rate and/or a decrease in the coolant temperature, the central control unit 31 may be programmed so as to be actuated secondarily, reducing the delivered radiofrequency power also if it has exceeded the preset limits because of a fault or an error by the operator. These last two cases (faults of the cooling system or of the radiofrequency energy delivery system) may act simultaneously also actuating the alarm for the operator.
(47) The operator may be also alerted if, due to a fault or an error, the correct trend of the temperatures is not measured as it should occur if the treatment would be performed according to the temperature range and the corresponding dynamics are not respected.
(48) The detected parameters, the treatment duration, the estimated temperature in the adipose tissues, the overall delivered energy, the instant power, and other parameters may be displayed on the user interface 33 that, to this end, may comprise a monitor, a display or other displaying devices. The central control unit 31 may be also programmed so as to interrupt the delivery when a given preset delivery time has been achieved, or when a given threshold of total delivered energy has been achieved.
(49) As mentioned with reference to
(50) The power is distributed by the coaxial line 7, 9 according to an approximately cylindrical volume under the epidermis in the area directly adjacent to the delivery device 1, with a heat distribution having a maximum at a depth that may be preset when the delivery device is dimensioned. This is an intrinsic feature of the morphology of the delivery device with open-ended coaxial cable. In this way, if the area of the window 13 of the delivery device 1 is lower than what is necessary for treating the whole volume where the temperature increase is required for reducing the number of adipocytes, the process may be repeated for subsequent areas, if necessary also marking on the epidermis the already treated areas, in order to avoid a repeated exposure of the same volumes to radiofrequency.
(51) The adipocyte damage caused by the localized temperature increase in the adipose tissues practically causes the adipocytes to be transformed into compounds that are subsequently absorbed and metabolized by the organism.
(52) However, it is also possible to intervene later with a step of sucking the liquid resulting from lipolysis by means of suction cannulas according to some currently used methods.
(53) In the embodiment of the delivery device 1 illustrated in detail in
(54) In some embodiments, it is preferable to decrease this distance as most as possible, even to reduce it to zero. For example, in some embodiments, the cooling circuit may be configured so as to avoid the presence of the cooling gap 21.
(55)
(56) In some embodiments, the delivery device 1 may be not cooled, or the cooling may be performed by means of a cooling system (not shown) arranged outside the outer conductor 7. In further embodiments, as schematically shown in
(57) In order to facilitate manufacturing of the cooling ducts adjacent to the front surfaces 7C and 9A, the front portions of the conductors 7 and 9 may be formed by mechanical components separate with respect to a cylindrical body forming the main portion of the respective conductor.
(58) In case there is no gap 21 where a fluid (which can be pressurized) flows, the plate 13, which closes the inner space 8 where the inner conductor 9 is housed, may be thinner. In some cases, the plate 13 may be omitted. In some embodiments, instead of the plate 13 a thin laminar interchangeable element may be provided, applied frontally in order to protect the delivery device 1 and to avoid, for example, the penetration in the delivery device 1 of dirt or of any gel applied on the delivery device 1 to improve the coupling thereof with the patient's body. By reducing the thickness of the plate 13, or by eliminating the plate, it is possible to have a better coupling between the electric field and the tissues to be treated.
(59) The lack of fluid circulation between the outer conductor 7 and the inner conductor 9 allows to eliminate the seal formed on the front surface 7C of the outer conductor 7 and therefore also to eliminate the annular groove provided for housing it. This allows to have a completely flat front surface 7C, which optimizes the pattern of the electric field lines.