ABLATION DEVICE FOR ATTACHMENT TO AN ENDOSCOPE
20230157750 · 2023-05-25
Assignee
Inventors
Cpc classification
A61B2018/0016
HUMAN NECESSITIES
A61B2018/1475
HUMAN NECESSITIES
A61B2018/00982
HUMAN NECESSITIES
A61B1/00137
HUMAN NECESSITIES
International classification
Abstract
An ablation cap including a body having a lumen for receiving a distal end of an endoscope, the body having a central axis extending therethrough, and at least one guide for receiving at least one lateral extension of an electrode platform, wherein at least a portion of the at least one guide extends at an angle relative to the central axis of the body.
Claims
1. An ablation cap comprising: a body having a lumen for receiving a distal end of an endoscope, the body having a central axis extending therethrough; and, at least one guide for receiving at least one lateral extension of an electrode platform, wherein at least a portion of the at least one guide extends at an angle relative to the central axis of the body.
2. The ablation cap of claim 1, wherein the angle relative to the central axis of the body is between 30 degrees and 60 degrees.
3. The ablation cap of claim 1, wherein the angle relative to the central axis of the body is less than 30 degrees.
4. The ablation cap of claim 1, wherein the at least one guide comprises a proximal portion parallel to the central axis of the body.
5. The ablation cap of claim 1, wherein the at least one guide comprises a distal portion angled relative to the central axis of the body.
6. The ablation cap of claim 1, further comprising a cover portion extending from a side of the body, the cover portion defining a recess between the cover portion and the body; wherein the at least one guide extends along at least a portion of the cover portion within the recess.
7. (canceled)
8. The ablation cap of claim 1, wherein the body comprises an angled portion formed at an angle relative to the central axis of the body; wherein the at least one guide extends along the angled portion.
9. (canceled)
10. The ablation cap of claim 1, wherein the at least one guide includes a first portion extending at a first angle relative to the central axis of the body and a second portion extending at a second angle relative to the central axis of the body, the second angle being different than the first angle.
11. (canceled)
12. (canceled)
13. (canceled)
14. (canceled)
15. (canceled)
16. An ablation device comprising: a body having a lumen for receiving a distal end of an endoscope, the body having a central axis extending therethrough; a cover portion extending from a side of the body, the cover portion defining a recess between the cover portion and the body; an electrode platform having at least one lateral extension, the electrode platform movable between a covered position, where the electrode platform is covered by the cover portion, and an exposed position, where the electrode platform is not covered by the cover portion; and, at least one guide for receiving the at least one lateral extension of the electrode platform, wherein a portion of the at least one guide extends at an angle relative to the central axis of the tubular body.
17. The ablation device of claim 16, wherein the at least one extension of the electrode platform is slidable within the at least one guide.
18. The ablation device of claim 16, wherein the at least one lateral extension comprises a hook for engaging the at least one guide.
19. The ablation device of claim 16, wherein the at least one lateral extension comprises a wheel for engaging the at least one guide.
20. The ablation device of claim 16, wherein the at least one lateral extension comprises a mechanical bearing for engaging the at least one guide.
21. The ablation device of claim 16, further comprising at least one electrode formed on the electrode platform.
22. The ablation device of claim 16, further comprising a drive catheter extending proximally from the electrode platform; wherein the electrode platform is pivotable relative to the drive catheter.
23. (canceled)
24. (canceled)
25. (canceled)
26. The ablation device of claim 16, wherein the at least one guide comprises a proximal portion parallel to the central axis of the body.
27. The ablation device of claim 16, wherein the at least one guide comprises a distal portion angled relative to the central axis of the body.
28. The ablation device of claim 16, wherein the at least one guide extends along at least a portion of the cover portion within the recess.
29. The ablation device of claim 16, wherein the body comprises an angled portion formed at an angle relative to the central axis of the body, wherein the at least one guide extends along the angled portion.
30. (canceled)
31. The ablation device of claim 16, wherein the at least one guide includes a first portion extending at a first angle relative to the central axis of the body and a second portion extending at a second angle relative to the central axis of the body, the second angle being different than the first angle.
32-43. (canceled)
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0036] The embodiments can be better understood with reference to the following drawings and description. The components in the figures are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the disclosure. Moreover, in the figures, like referenced numerals designate corresponding parts throughout the different views.
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DETAILED DESCRIPTION
[0055] In the present application, the term “proximal” refers to a direction that is generally towards a physician during a medical procedure, while the term “distal” refers to a direction that is generally towards a target site within a patient’s anatomy during a medical procedure. As used herein to describe example embodiments, the term “fluid” may refer to a gas or a liquid.
[0056]
[0057] The distal portion 18 of the ablation cap 10 may extend beyond the distal end 20 of the endoscope 22. The distal portion 18 may be cylindrical. In some embodiments, the distal portion 18 may be formed from a material having sufficient transparency so that the operator using an imaging device 100 of the endoscope 22 may observe a portion of the tissue to be treated by viewing the tissue through a wall 24 of the distal portion 18 of the ablation cap 10. The distal portion 18 may also include a portion that is formed from a material for magnifying the tissue under observation.
[0058] The cap 10 may further include a hood or a cover portion 29 that includes a recess 30 formed as part of the ablation cap 10. The cover portion 29 may be integrally formed with the cap 10 or provided as a separate portion and connected to the cap 10. The cover portion 29 is at least partially spaced apart from the tubular body to form the recess 30. The recess 30 may be sized and shaped to hold an extendable electrode platform 34 within the recess 30 in a covered position, as shown in
[0059] In some embodiments, a distal end 36 of the electrode platform 34 is extended less than the extension as shown in
[0060] In some embodiments, at least a portion of the electrode platform 34 may be viewable through the endoscope. The electrode platform 34 may move into and out of the view of the endoscope, for example, when the electrode platform 34 has been extended a certain percent relative to the cap 10, the electrode platform 34 may be viewed through the endoscope. By way of non-limiting example, the electrode platform 34 may be viewed when 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100% or other amount has been extended distally from the retracted position of
[0061] A cross-sectional side view of the ablation cap 10 is shown in
[0062] As shown in
[0063] In some embodiments, the electrode platform 34 may include a support member 62 upon which one or more electrodes 64 are positioned.
[0064] Electrical wires 72 may extend through a lumen 74 of the drive catheter 42 as shown in
[0065] As shown in
[0066] The electrodes 64 are operably connected to an energy source (not shown). In some embodiments, the energy source may be a radio frequency source. However, other types of energy sources may also be used to provide energy to the electrodes. By way of non-limiting example, additional possible energy sources may include microwave, ultraviolet, cryogenic and laser energies.
[0067] In some embodiments, the ablation cap may be made primarily of a substantially transparent or translucent polymer such as polytetrafluorothylene (PTFE). Additional possible materials include, but are not limited to the following, polyethylene ether ketone (PEEK), fluorinated ethylene propylene (FEP), perfluoroalkoxy polymer resin (PFA), polyamide, polyurethane, high density or low density polyethylene, and nylon. In some embodiments, the ablation cap may be formed from a lubricious material such as PTFE and the like for easy slidability within the patient’s lumen for delivery to the treatment site. In some embodiments, the ablation cap or a portion thereof may be formed from magnifying or other image enhancing materials. The ablation cap or a portion thereof may also be coated or impregnated with other compounds and materials to achieve the desired properties. Exemplary coatings or additives include, but are not limited to, parylene, glass fillers, silicone hydrogel polymers and hydrophilic coatings.
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[0070] Similar to prior embodiments,
[0071] The distal portion 218 of the ablation cap 210 may extend beyond the distal end 20 of the endoscope 22. The distal portion 218 may form a generally cylindrical wall. However, unlike the ablation cap 10, in the distal portion 218 of the ablation cap 210, the tubular body 212 forms an angled portion 219, providing for movement of an electrode platform in a direction of or toward the angled portion 219. In some embodiments, the distal portion 218 may be formed from a material having sufficient transparency so that the operator using an imaging device 100 of the endoscope 22 may observe a portion of nearby tissue to be treated by viewing the tissue through a wall of the distal portion 218 of the ablation cap 210. The distal portion 218 may also include a portion that is formed from a material for magnifying the tissue under observation.
[0072] The cap 210 may further include a hood or a cover portion 229 that includes a recess 230 formed as part of the ablation cap 210. The cover portion 229 may be integrally formed with the cap 210 or provided as a separate portion and connected to the cap 210. The cover portion 229 is at least partially spaced apart from the tubular body to form the recess 230. The recess 230 may be sized and shaped to hold an extendable electrode platform 234 within the recess 230 in a covered position, as shown in
[0073] In some embodiments, at least a portion of the electrode platform 234 may be viewable through the endoscope. The electrode platform 234 may move into and out of the view of the endoscope, for example, when the electrode platform 234 has been extended a certain percent relative to the cap f210, the electrode platform 234 may be viewed through the endoscope. By way of non-limiting example, the electrode platform 234 may be viewed when 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100% or other amount has been extended distally from the retracted position of
[0074] As shown in
[0075] The drive catheter 242 is distally movable to extend the electrode platform 234 from the recess 230 of the cover portion 229 and proximally movable to re-position the electrode platform 234 within the recess 230. Typically, the electrode platform 234 is positioned within the recess 230 of the cover portion 229 when the ablation cap 210 is being delivered to a treatment site or being repositioned within a patient’s lumen for additional treatment at one or more additional sites. Positioning of the electrode platform 234 within the recess 230 also helps to prevent accidental energy delivery, for example to healthy tissue. The electrode platform 234 is at least partially distally extended from the recess 230 of the cover portion 229 for treatment at a site, and energy is delivered to the tissue to ablate the diseased tissue as described in more detail below.
[0076] The electrode platform 234 may include a support member upon which one or more electrodes 264 are positioned. The electrode platform 234, and the one or more electrodes 264, may be constructed and formed in the same manner as the electrode platform 34, and the electrodes 64, described above. Electrical wires 272 may extend through a lumen of the drive catheter 242 and connect to the electrodes 264 to supply the energy for ablation. Alternatively, the electrical wires 272 may extend through a lumen of the endoscope 22 .
[0077] In some embodiments, as described below, the electrode platform may include one or more lateral extensions 280 configured to slidably engage one or more guides 282 formed on the ablation cap 210. The lateral extensions may be formed, for example, as wings (as shown), or as cylindrical rods. Notably, when the lateral extensions 280 are formed as cylindrical rods, the lateral extensions 280 and electrode platform 234 may rotate or pivot within the slot, about a central axis of the rods.
[0078] The ablation cap 210 differs from the ablation cap 10 in that it includes at least one guide 282 formed in the hood or cover portion 229, and at least along a portion of the angled portion 219 of the tubular body 212. In some embodiments, as shown, the ablation cap 210 includes two opposing guides 282. The guides 282 may be formed as a channel, or a slot, formed in the cover portion 229, and/or along the angled portion 219, and are configured to receive the lateral extensions 280 of the electrode platform 282 in a sliding engagement. Notably, because the lateral extensions 280 are received within the guides 282, the lateral extensions 280 are not exposed to tissue, thereby preventing an end or a portion of the lateral extensions 280 from catching onto any tissue, which could cause perforation of the tissue, when the electrode platform 234 and lateral extensions 280, pivot in and/or slide along the guides 282. In other embodiments, the guides 282 may be formed as a rail on which the lateral extensions are slidably mounted, for example, with a hook structure, a wheel, or other mechanical bearing.
[0079] The guides 282 may form multiple portions. For example, in a first portion formed within the hood or cover portion 229, the guides 282 may extend in the proximal-distal direction, generally parallel to a central axis of the tubular body 212. In a second portion formed along the angled portion 219, the guides 282 may extend at an angle relative to the central axis of the tubular body 212 and/or the direction of the guides 282 formed in the cover portion 229. In some embodiments, the guides 282 may transition from the first portion, extending in the proximal-distal direction, to the second portion, formed along the angled 219, via a curved portion 284. The curved portion may be configured to enable the lateral extensions 280 to slide within the guides 282 from the first portion to the second portion. In some embodiments, the guides 282 may extend along the angled portion 219 at an angle of 45 degrees relative to the central axis of the tubular body 212. In other embodiments, the guides 282 may extend along the angled portion 219 at an angle of 30 to 60 degrees relative to the central axis of the tubular body 212. In other embodiments, the guides 282 may extend along the angled portion 219 at an angle of less than 30 degrees relative to the central axis of the tubular body 212.
[0080] In this way, as the electrode platform 234 is advanced via the drive catheter 242 distally from a retracted position, shown in
[0081] In yet other embodiments, the guides 282 may extend along the angled portion 219 at multiple different angles relative to the central axis of the tubular body 212. For example, the guides 282 may include a first portion formed within the hood or cover portion 229, a second portion extending along the angled portion 219 at an angle of 30 degrees relative to the central axis of the tubular body 212, and a third portion, distal of the second portion, extending along the angled portion 219 at an angle of 45 degrees relative to the central axis of the tubular body 212. In yet other embodiments, the guides 282 may extend along the angled portion 219 through a range of gradually increasing angles relative to the central axis of the tubular body 212 to form a curved portion, where advancing the lateral extensions 280 distally through the curved portion of the guides 282 gradually increases the angle of the electrode platform 234 relative to the central axis of the tubular body 212.
[0082] As described above, the ablation cap 210 and rotatable or pivotable electrode platform 234 provide a clinician with an ablation device having increased flexibility and maneuverability, thereby enabling a wider range of permissible treatment sites and applications, as compared to ablation devices having a rigid electrode platform and drive catheter. And, as with existing ablation devices, the ablation cap 210 may be attached to the distal end of an endoscope, permitting endoscopic visualization of the target tissue and ablation treatment, while providing the increased functionality described herein.
[0083] In some embodiments, the electrode platform 234 and drive catheter 242 may be coupled to a proximal control handle, or user interface. For example,
[0084] In some embodiments, the slot 290 may comprise a plurality of regions. For example, a first region 292 may be defined as a fully-retracted position, where the electrode platform 234 is fully retracted within the hood or cover portion 229 of the ablation cap 210, as illustrated in
[0085] In some embodiments, the slot 290 may have one or more locking and/or resistance mechanisms disposed therein to provide a user with tactile feedback and/or resist movement of the trigger 288 within the slot 290. Suitable locking or resistance mechanisms may include protrusions, detents, frictional zones, narrowed slot width, or other suitable means. For example, a resistance mechanism may be associated with a proximal end of the first region 292, corresponding to the fully retracted position of the electrode platform 234, illustrated in
[0086] Although the subject matter has been described in language specific to structural features and/or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described. Rather, the specific features and acts are disclosed as illustrative forms of implementing the claims.
[0087] One skilled in the art will realize that a virtually unlimited number of variations to the above descriptions are possible, and that the examples and the accompanying figures are merely to illustrate one or more examples of implementations.
[0088] It will be understood by those skilled in the art that various other modifications can be made, and equivalents can be substituted, without departing from claimed subject matter. Additionally, many modifications can be made to adapt a particular situation to the teachings of claimed subject matter without departing from the central concept described herein. Therefore, it is intended that claimed subject matter not be limited to the particular embodiments disclosed, but that such claimed subject matter can also include all embodiments falling within the scope of the appended claims, and equivalents thereof.
[0089] In the detailed description above, numerous specific details are set forth to provide a thorough understanding of claimed subject matter. However, it will be understood by those skilled in the art that claimed subject matter can be practiced without these specific details. In other instances, methods, devices, or systems that would be known by one of ordinary skill have not been described in detail so as not to obscure claimed subject matter.
[0090] Reference throughout this specification to “one embodiment” or “an embodiment” can mean that a particular feature, structure, or characteristic described in connection with a particular embodiment can be included in at least one embodiment of claimed subject matter. Thus, appearances of the phrase “in one embodiment” or “an embodiment” in various places throughout this specification are not necessarily intended to refer to the same embodiment or to any one particular embodiment described. Furthermore, it is to be understood that particular features, structures, or characteristics described can be combined in various ways in one or more embodiments. In general, of course, these and other issues can vary with the particular context of usage. Therefore, the particular context of the description or the usage of these terms can provide helpful guidance regarding inferences to be drawn for that context.