System and method for monitoring ablation size
09820813 · 2017-11-21
Assignee
Inventors
Cpc classification
A61B18/18
HUMAN NECESSITIES
International classification
Abstract
A system for monitoring ablation size includes a power source including a microprocessor for executing one or more control algorithms. A microwave antenna is configured to deliver microwave energy from the power source to tissue to form an ablation zone. A plurality of spaced-apart electrodes is operably disposed along a length of the microwave antenna. The plurality of spaced-apart electrodes is disposed in electrical communication with one another and each of the plurality of spaced-apart electrodes has a threshold impedance associated therewith corresponding to the radius of the ablation zone.
Claims
1. A method for monitoring tissue undergoing ablation, the method comprising: transmitting microwave energy from a power source to a microwave antenna to form a tissue ablation zone, the microwave antenna including: an elongated shaft; a plurality of proximal spaced-apart electrodes disposed on the elongated shaft; a distal electrode disposed on the elongated shaft; and a feedline having a distal radiating section disposed inside the elongated shaft; monitoring impedance as the tissue ablation zone forms between at least two sensors one of which is disposed on one of the plurality of proximal spaced-apart electrodes and the other of which is disposed on the distal electrode, the at least two sensors being longitudinally spaced from one another along a longitudinal length of the elongated shaft of the microwave antenna; triggering a detection signal when a predetermined impedance between the at least two sensors is reached; and adjusting the amount of microwave energy from the power source to the microwave antenna.
2. The method according to claim 1, wherein the plurality of proximal spaced-apart electrodes is disposed along the longitudinal length of the elongated shaft of the microwave antenna and in electrical communication with one another, the predetermined impedance corresponding to a specific radius of the ablation zone.
3. The method according to claim 2, wherein the distal electrode is disposed at a distal tip of the elongated shaft of the microwave antenna.
4. The method according to claim 3, wherein the monitored impedance is between the at least two sensors, the method further comprising comparing the monitored impedance with the predetermined impedance.
5. The method according to claim 3, wherein a voltage potential is present between at least one of the plurality of proximal spaced-apart electrodes and the distal electrode as a result of delivery of microwave energy to the microwave antenna such that current flows between the at least one of the plurality of proximal spaced-apart electrodes and the distal electrode and returns to the power source via a closed loop electrical circuit disposed within the microwave antenna and isolated from an electrical circuit of the power source.
6. The method according to claim 3, further comprising positioning a dielectric sheath along the elongated shaft of the microwave antenna to encase the plurality of proximal spaced-apart electrodes and the distal electrode to allow current to flow from the plurality of proximal spaced-apart electrodes to the distal electrode.
7. The method according to claim 3, further comprising: matching a desired ablation zone size with one electrode of the plurality of proximal spaced-apart electrodes; and setting the predetermined impedance.
8. The method according to claim 3, wherein the plurality of proximal spaced-apart electrodes is disposed in a linear configuration on a distal portion of the elongated shaft of the microwave antenna.
9. A method for tissue ablation, the method comprising: transmitting microwave energy from a power source to a microwave antenna including: an elongated shaft; a plurality of spaced-apart electrodes disposed along a longitudinal length of the elongated shaft and being in electrical communication with one another; and a feedline having a distal radiating section disposed inside the elongated shaft; monitoring impedance between at least one pair of sensors respectively disposed on at least one pair of the plurality of spaced-apart electrodes, the at least one pair of sensors being longitudinally spaced from one another along the longitudinal length of the elongated shaft of the microwave antenna; generating a detection signal when impedance between the at least one pair of sensors reaches a predetermined threshold impedance; and adjusting the amount of microwave energy from the power source to the microwave antenna in response to the detection signal.
10. The method according to claim 9, wherein the predetermined threshold impedance corresponds to a specific radius of an ablation zone.
11. The method according to claim 10, wherein the plurality of spaced-apart electrodes further includes: a plurality of proximal spaced-apart electrodes; and a distal electrode disposed at a distal tip of the elongated shaft of the microwave antenna.
12. The method according to claim 11, wherein a first sensor of the at least one pair of sensors is disposed on one of the plurality of proximal spaced-apart electrodes, and a second sensor of the at least one pair of sensors is disposed on the distal electrode, the method further comprising comparing the monitored impedance with the predetermined threshold impedance.
13. The method according to claim 12, further comprising: adjusting the amount of microwave energy from the power source to the microwave antenna when the monitored impedance reaches the predetermined threshold impedance.
14. The method according to claim 11, wherein the plurality of proximal spaced-apart electrodes is disposed in a linear configuration on a distal portion of the elongated shaft of the microwave antenna.
15. The method according to claim 10, further comprising: storing information pertaining to the predetermined threshold impedance in a memory of the power source.
16. The method according to claim 10, further comprising: storing information pertaining to the predetermined threshold impedance in a storage device coupled to the microwave antenna.
17. The method according to claim 16, further comprising: downloading the stored information from the storage device into a memory of the power source.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) The above and other aspects, features, and advantages of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings in which:
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DETAILED DESCRIPTION
(12) Embodiments of the presently disclosed system and method are described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. As used herein and as is traditional, the term “distal” refers to the portion which is furthest from the user and the term “proximal” refers to the portion that is closest to the user. In addition, terms such as “above”, “below”, “forward”, “rearward”, etc. refer to the orientation of the figures or the direction of components and are simply used for convenience of description.
(13) Referring now to
(14) With continued reference to
(15) Proximal electrodes 52a-52h may be formed from any suitable conductive or partially conductive material. For example, proximal electrodes 52a-52h may be formed from copper, silver, gold, etc. Proximal electrodes 52a-52h are operably positioned along an outer peripheral surface 38 of the shaft 18 in a manner suitable for the intended purposes described herein. In embodiments, the proximal electrodes 52a-52h may extend circumferentially along the outer peripheral surface 38 or partially along a length of the shaft 18. In the illustrative embodiment, proximal electrodes 52a-52h extend partially along the outer peripheral surface 38 in a linear manner forming a generally linear array along the outer peripheral surface 38 of the shaft 18. Proximal electrodes 52a-52h may be secured to the outer peripheral surface 38 and/or the shaft 18 via any suitable method(s). In one particular embodiment, the proximal electrodes 52a-52h are secured to the outer peripheral surface 38 via an epoxy adhesive (or other suitable adhesive). Proximal electrodes 52a-52h are in operative communication with one or more modules, e.g., ablation zone control module 232 (AZCM), associated with the generator 100 and/or controller 200. To this end, a portion of the proximal electrodes 52a-52h connects to one or more electrical leads (not explicitly shown) that provide an electrical interface for the proximal electrodes 52a-52h and the AZCM 232. Moreover, the electrical leads provide an electrical interface that supplies current, i.e., from a current source (or other suitable device configured to generate current, voltage source, power source, etc.) to the proximal electrodes 52a-52h.
(16) In certain embodiments, one or more sensors, e.g., sensors 53a-53h, may be in operative communication with a respective one or corresponding proximal electrode 52a-52h (as best seen in
(17) Distal electrode 54 may be formed from any suitable conductive or partially conductive material, e.g., copper, silver, gold, etc. Distal electrode 54 may have any suitable configuration. For illustrative purposes, distal electrode 54 is shown operably disposed at a distal tip 21 of the shaft 18. In the illustrated embodiment, distal electrode 54 defines a conductive tissue piercing tip. In this instance, the distal electrode 54 facilitates insertion of the microwave antenna 12 into tissue at a target tissue site. Alternatively, distal electrode 54 may have a relatively blunt configuration. An electrical lead (not explicitly shown) provides an electrical interface for returning current from the distal electrode 54 back to the current source. In certain embodiments, distal electrode 54 may be in operative communication with one or more modules, e.g., AZCM 232, associated with the generator 100 and/or controller 200. In this instance, the electrical lead may provide an electrical interface for the distal electrode 54 and the AZCM 232.
(18) In certain embodiments, one or more sensors, e.g., sensor 55, may be in operative communication with the distal electrodes 54 (see
(19) A dielectric sheath 60 having a suitable thickness and made from a suitable material is operably positioned along a length of the microwave antenna 12 and substantially encases the proximal electrodes 52a-52h and distal electrode 54 in a manner that allows current to flow from the proximal electrodes 52a-52h to the distal electrode 54. Dielectric sheath 60 may be made from any suitable material and may be affixed to the microwave antenna 12 by any suitable affixing methods. In the illustrated embodiment, the dielectric sheath 60 is a vapor deposited dielectric material, such as, for example, parylene, that is applied to the microwave antenna 12. Substantially encasing the microwave antenna 12 with dielectric sheath 60 results in capacitive impedance that can allow RF current flow to/from the electrodes 52a-52h and tissue. More particularly, during transmission of microwave energy from the generator 100 to the microwave antenna 12 and when the proximal electrodes 52a-52h and distal electrode 54 are positioned within tissue adjacent a target tissue site, current flows from proximal electrodes 52a-52h to the electrode 54. Dielectric sheath 60 is configured to focus current densities “I” at the proximal electrodes 52a-52h and/or the distal electrode 54, which, in turn, provides comprehensive and/or more accurate measurements of impedance at the proximal electrode 52a-52h, as best seen in
(20) As mentioned above, proximal electrodes 52a-52h (and in some instances distal electrode 54) is in operative communication with the generator 100 including AZCM 232 and/or controller 200. More particularly, the proximal electrodes 52a-52h and distal electrode 54 couple to the generator 100 and/or controller 200 via one or more suitable conductive mediums (e.g., a wire or cable 56) that extends from proximal electrodes 52a-52h and distal electrode 54 to the proximal end of the microwave antenna 12 and connects to the generator 100 (see
(21) With reference to
(22) The controller 200 includes microprocessor 235 having memory 236 which may be volatile type memory (e.g., RAM) and/or non-volatile type memory (e.g., flash media, disk media, etc.). In the illustrated embodiment, the microprocessor 235 is in operative communication with the power supply 137 and/or microwave output stage 138 allowing the microprocessor 235 to control the output of the generator 100 according to either open and/or closed control loop schemes. The microprocessor 235 is capable of executing software instructions for processing data received by the AZCM 232, and for outputting control signals to the generator 100 and/or supply pump 40, accordingly. The software instructions, which are executable by the controller 200, are stored in the memory 236.
(23) In accordance with the present disclosure, the microwave antenna 12 is configured to create an ablation zone “A” having any suitable configuration, such as, for example, spherical (
(24) With reference to
(25) In one particular embodiment, a control algorithm of the present disclosure uses known (or in certain instances predicted) threshold impedances Z at specific radii to create an ablation zone “A” having a radius “r.” That is, impedances Z associated with proximal electrodes 52a-52h that correspond to specific radii are compiled into one or more look-up tables “D” and are stored in memory, e.g., memory 236, accessible by the microprocessor 235 and/or the AZCM 232 (
(26) AZCM 232 may be configured to monitor impedance Z at the proximal electrodes 52a-52h by any known method(s). For example, in one particular embodiment, the AZCM 232 utilizes one or more equations (V=I×Z)) to calculate the impedance at a particular electrode 52a-52h. In this instance, the voltage V and current I is known and the AZCM 232 calculates the impedance Z. Alternatively, or in combination therewith, the sensor(s) 53a-53h may provide thermal measurements at a respective electrode 52a-52h. With the impedance of a respective proximal electrode 52a-52h calculated and/or determined, AZCM 232, microprocessor 235 and/or controller 200 may access the one or more look-up tables “D” and confirm that the threshold impedance Z has been met and, subsequently, instruct the generator 100 to adjust the amount of microwave energy being delivered to the microwave antenna 12, see
(27) In certain instances, the one or more data look-up tables may be stored into memory during the manufacture process of the generator 100 and/or controller 200 or downloaded during programming; this is particularly useful in the instance where the generator 100 is configured for use with a single type of microwave antenna. Alternatively, the one or more data look-up tables may be downloaded into memory 236 at a time prior to use of the system 10; this is particularly useful in the instance where the generator 100 is configured for use with multiple microwave antennas that are configured to perform various ablation procedures.
(28) In one particular embodiment, data look-up table “D” may be stored in a memory storage device 73 associated with the microwave antenna 12. More particularly, a data look-up table “D” may be stored in a memory storage device 73 operatively associated with the microwave antenna 12 and may be downloaded, read and stored into microprocessor 235 and/or memory 236 and, subsequently, accessed and utilized in a manner described above; this would dispose of the step of reprogramming the generator 100 and/or controller 200 for a specific microwave antenna. More particularly, the memory storage device 73 may be operably disposed on the microwave antenna 12, such as, for example, on or adjacent the hub 22 (
(29) In the embodiment illustrated in
(30) Operation of system 10 is now described. For illustrative purposes, proximal electrodes 52a-52h may be considered as individual anodes and distal electrode 54 may be considered as a cathode. Each of the proximal electrodes 52a-52h includes a predetermined threshold impedance Z that has been previously determined by any of the aforementioned methods, e.g., experimental test data. Initially, microwave antenna 12 is connected to generator 100. In one particular embodiment, one or more modules, e.g., AZCM 232, associated with the generator 100 and/or controller 200 reads and/or downloads data, e.g., the type of microwave antenna, the type of tissue that is to be treated, data look-up tables, etc., from storage device 73 associated with the antenna 12. In the present example, the AZCM module 232 recognizes the microwave antenna 12 as having 8 proximal electrodes 52a-52h each with a predetermined threshold impedance Z that corresponds to a specific ablation zone “A.” In one particular embodiment, the generator 100 prompts a user to enter the desired ablation zone size, e.g., ablation zone equal to 5 cm by 5 cm having a generally spherical configuration, see
(31) AZCM 232 transmits DC current (or in some instances an RF signal, e.g., in the KHz or low MHz frequency spectrum) to each of the proximal electrodes 52a-52h. Prior to insertion of microwave antenna 12 into tissue “T”, impedance Z associated with each of the plurality of proximal electrodes 52a-52h is relatively high, e.g., infinite; this is because an open circuit exists between the proximal electrodes 52a-52h and the distal electrode 54. Microwave antenna 12 including proximal electrodes 52a-52h may then be positioned within tissue (see
(32) It should be noted that at any time during the ablation procedure, a user may adjust the previously inputted ablation zone size information. More particularly, if a user determines that during the course of the microwave ablation procedure the original ablation zone size needs to be adjusted, e.g., original ablation zone size is too big or too small, a user may simply input the new ablation zone size, and the AZCM 232 will adjust automatically. For example, if during the above example a user decides to adjust the ablation zone size to 4 cm by 4 cm (see
(33) With reference to
(34) From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. For example, the system 10 may be adapted to connect to an RF electrosurgical power source, e.g., an RF generator that includes or is in operative communication with one or more controllers 200 including an AZCM 232.
(35) While the electrodes 52 have been described herein as including a series of proximal electrodes 52a-52h and a distal electrode 54 that is positioned at a distal tip 21 of the shaft 18, it is within the purview of the present disclosure that the distal electrode 54 may be positioned anywhere along the shaft 18, e.g., positioned adjacent the series of proximal electrodes 52a-52h. Or, in another embodiment, a distal electrode 54 may not be utilized. In this instance, one of the series of proximal electrodes 52a-52h may be configured to function in a manner as described above with respect to distal electrode 54.
(36) In certain embodiments, it may prove useful not to utilize a lead wire 56 that couples to distal electrode 54. In this instance, inner conductor 13 takes the place of the lead wire 56 and operably couples to the distal electrode 54, see
(37) AZCM 232 is configured to transmit an RF impedance measurement signal to the proximal electrodes 52a-52h and/or the distal electrode 54. In the embodiment illustrated in
(38) Operation of system 10 that includes a generator 100 with a DC block 58 that is in operative communication with a microwave antenna 12 is substantially similar to that of a generator 100 without a DC block 58 and, as a result thereof, is not described herein.
(39) While several embodiments of the disclosure have been shown in the drawings and/or discussed herein, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.