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EP1216002A1 - Cryosonde comportant une gaine isolante et une gaine chauffee - Google Patents

Cryosonde comportant une gaine isolante et une gaine chauffee

Info

Publication number
EP1216002A1
EP1216002A1 EP99925826A EP99925826A EP1216002A1 EP 1216002 A1 EP1216002 A1 EP 1216002A1 EP 99925826 A EP99925826 A EP 99925826A EP 99925826 A EP99925826 A EP 99925826A EP 1216002 A1 EP1216002 A1 EP 1216002A1
Authority
EP
European Patent Office
Prior art keywords
thermal insulator
probe
cryosurgical probe
ice ball
size
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP99925826A
Other languages
German (de)
English (en)
Other versions
EP1216002A4 (fr
Inventor
Douglas O. Chinn
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority claimed from PCT/US1999/011530 external-priority patent/WO2000071037A1/fr
Publication of EP1216002A1 publication Critical patent/EP1216002A1/fr
Publication of EP1216002A4 publication Critical patent/EP1216002A4/fr
Withdrawn legal-status Critical Current

Links

Definitions

  • This invention relates to a cryosurgical probe and method for treating cancer by cryosurgicaUy destroying the cancer cells.
  • the probe is surrounded by a thermally insulating and/or heated sheath
  • Cryosurgical devices have been known for use in destroying cancerous cells in a localized tissue area of a patient undergoing treatment.
  • Early cryosurgical devices used gases or liquid nitrogen
  • cryosurgical devices are either of higher pressure (e.g. about 80 psi) liquid nitrogen systems or high pressure (e.g. 2,800 psi) argon gas systems. Such devices are typically
  • cryogen circulates to the probe tip.
  • the probe tips are adapted to penetrate the patient's tissue (e.g. the prostate, liver, breast and brain) in which the cancerous cells reside.
  • these recent cryosurgical probes cannot be easily modified to accept tip changes without significantly effecting the probe performance.
  • the cost to redesign a probe to accept different tips is expensive and often leads to operating characteristics that may not be suitable for all applications (i.e. the cryogenic effect could be severely compromised).
  • a significant problem that is faced in prostate surgery is that the size and shape of the prostate gland varies from one patient to the next. If the ice ball that is generated by the
  • cryogenic effect is too long, there is the risk that the neighboring sphincter will also be frozen resulting in the possibility of incontinence.
  • the ice ball may not adequately conform to the prostate shape, whereby to introduce a risk of incomplete freezing of the cancerous cells in the prostate gland or freezing beyond the prostate and into the bladder or rectum resulting in the possibility of a urethral-rectal fistula.
  • cryosurgical probe that is quickly, easily and inexpensively adapted to vary the size and shape of an ice ball during cryosurgery depending upon the location and
  • the size and shape of the ice ball corresponds with the dimensions of the insulating sheath which surrounds the cryosurgical probe. Therefore, the size and shape of the ice ball can be advantageously tailored to the type and location of the cancerous tissue in need of treatment and at which a cryogenic effect is to be produced.
  • a standard dilator is surrounded by the insulating sheath.
  • the sheath is preferably
  • the dilator is a hollow tube that is commonly used to stretch the patient's tissue and cut an access channel to the area in which the cancerous cells reside. Once the access channel is established, the dilator is
  • a conventional cryosurgical probe is inserted into the access channel and through the insulating sheath so that either some or all of the probe is surrounded by the sheath.
  • the probe is typically coupled to a supply of argon gas or liquid nitrogen so that an ice ball can be formed at the distal tip thereof, whereby to produce a cryogenic effect and thereby kill the cancer cells.
  • the size and shape of the ice ball can be correspondingly varied to match the size, shape and location of the effected tissue (e.g. the prostate gland).
  • the distal end of the cryosurgical probe is surrounded by a heated
  • the size and shape of the ice ball can be controllably adjusted depending upon
  • cryosurgery can be more reliably and efficiently performed without the need for a multitude of different probes or probe tips
  • FIG. 1 is an exploded view showing the relationship of the cryosurgical probe for producing an ice ball, the dilator for cutting an access channel for the probe, and the insulating sheath for
  • FIG. 2-5 show the cryosurgical probe of FIG. 1 surrounded by insulating sheaths of different dimensions so as to produce ice balls of corresponding sizes and shapes;
  • FIG. 6 shows an alternate embodiment where the cryosurgical probe is surrounded by a heated sheath to control the size and shape of the ice ball.
  • an apparatus and method are disclosed in which a conventional cryosurgical probe is surrounded by thermally insulating sheaths of varying dimensions so that the same probe can be used to generate ice balls of corresponding size
  • the size and shape of an ice ball can be tailored according to the type and location of the
  • cancerous tissue in need of treatment.
  • the cryogenic effect can be accurately localized, whereby to
  • cryosurgical probes or probe tips for use in treating different patients.
  • cryosurgical probe By merely surrounding the cryosurgical probe with an inexpensive and disposable insulating sheath, the same cryoprobe can be quickly, easily
  • cryosurgical probes were supported by test fixtures so as to be held both vertically
  • cryoprobes The sizes and shapes of the resulting ice balls at the distal tips of the cryosurgical probes were recorded for the sheathed and unsheathed cryoprobes. Measurements were made at different times for about 10 minutes. In some cases, a cryoprobe was surrounded by a single sheath thickness and
  • FIG. 1 of the drawings shows a well known dilator 2 having a rigid hollow tube of plastic or stainless steel that is commonly used to stretch the patient's tissue and cut an access channel in the
  • the dilator 2 has a relatively sharp point so as to be able to cut through the patient's tissue. The method for inserting the dilator 2 into the body cavity
  • the dilator 2 penetrates the patient's tissue while being surrounded by a peel away insulating sheath 4 of a predetermined size that is adapted to generate the particular ice ball necessary to treat the
  • the sheath surrounds and rides with the dilator 2 when the access channel is formed.
  • the dilator 2 has a relatively wide stop or handle 3 located at the end opposite the cutting tip so as to block the insulating sheath 4 from sliding proximally and off the dilator 2 when
  • the dilator penetrates the patient's tissue.
  • the minimum length of the insulating sheath 4 will vary depending upon the size and location (e.g. depth) of the cancerous tissue to be treated, it has been found that the minimum length of the insulating sheath 4 should be approximately 15 cm for treating cancerous prostate glands. However, the minimum length of the sheath 4 may change when treating other cancerous tissue.
  • the dilator 2 completes an access channel to the cancerous tissue, it is withdrawn leaving behind the insulating sheath 4.
  • a conventional cryosurgical probe 6 is inserted into the access channel and through the insulating sheath 4.
  • the cryosurgical probe 6 is typically a cylindrical tube that is adapted to produce a cryogenic effect at the
  • FIGS. 2-5 of the drawings show the conventional cryosurgical probe 6 of FIG. 1 with the cryogenic distal tip thereof either fully exposed, partially exposed or completely surrounded by an insulating sheath so as to be compatible with conventional cryosurgical methods to freeze and kill the cancerous tissue cells of a patient undergoing treatment.
  • an insulating sheath so as to be compatible with conventional cryosurgical methods to freeze and kill the cancerous tissue cells of a patient undergoing treatment.
  • cryosurgical nitrogen can be supplied to the distal tip of the cryoprobe 6 to form an ice ball and produce a cryogenic effect which is known to kill cancer cells.
  • cryosurgical for purposes of example only, the cryosurgical
  • probe 6 may be coupled to an argon gas based cryosurgical system such as that manufactured by EndoCare, Inc. of Irvine, California. Similar changes in the dimensions of the ice ball can also be achieved by using a liquid nitrogen-based cryosurgical system such as that manufactured by
  • cryosurgical probe 6 being surrounded by a 1.0 mm thick insulating sheath 14 and having a fully exposed (i.e. unsheathed) distal tip 8 as shown in FIG. 2 of the drawings could be used to form a generally egg shaped ice ball 10 that is suitable to treat a prostate gland having a
  • an insulating sheath 12 having a variable thickness in the manner shown by FIG 3 of the drawings was employed to surround the cryoprobe 6. More particularly, the thickness of sheath 12 was 2.0 mm for substantially its entire
  • the cryosurgical probe 6 was surrounded by the insulating sheath 16 of FIG. 4 of the drawings.
  • the sheath 16 had a uniform thickness of 2.0 mm along its entire length. However, the final 1.0 cm of the distal tip 8 of probe 6
  • a generally spherical ice ball 18 was produced having a diameter of 3.0 cm or less.
  • the cryosurgical probe 6 was surrounded by the insulating sheath 20 shown in FIG. 5 of the drawings. As in FIG. 4, the sheath 20 has a uniform thickness of
  • the sheath 20 covers the entire length of the probe 6 such that no
  • ice ball 22 which is ideally suited for matching the shape of the seminal vesicle. It may now be appreciated that a variety of different sheaths having different wall thickness and length would be available. The precise size, shape and thermal mapping of the different insulating materials
  • sheaths with different cryosurgical systems can be experimentally determined. However, it would be desirable for the thicker-walled sheaths to have tapered distal tips so as to allow for an easier penetration through the patient's tissue.
  • the probe shaft will sometimes freeze to the tissue of the patient undergoing treatment. In most cases, the patient's tissue will recover from the freezing.
  • a larger than required volume of tissue along the tract of the cryoprobe may freeze.
  • a potentially damaging fistula may be formed as a result of freezing more than the targeted tissue area, such as in the brain.
  • the targeted tissue area such as in the brain.
  • the surface of the liver is frozen, it may crack and hemorrhage during thawing which can be life threatening, particularly to those patients with liver cirrhosis.
  • freezing large areas of the breast tissue may result in undesirable scarring.
  • cryoprobe may be solved by surrounding the cryoprobe with a heated sheath such as that shown in FIG. 6 of the
  • a conventional cryosurgical probe 30 is surrounded by a suitable biocompatible
  • the sheath 32 that is manufactured from plastic, foil or the like.
  • the probe 30 and sheath 32 can be inserted and positioned adjacent the targeted tissue area of the patient by the same method that was described above when referring to FIG. 1.
  • the heated sheath 32 is electrically connected to a source of power so that the distal end of the cryosurgical probe 30 will be heated. Therefore, only about the last four centimeters of the sheath 32 needs to be heated. However, the precise length of the sheath 32 as well as the heated area thereof are determined by the type and location of the tissue to be treated. Moreover, only the non-heated portion of the sheath (designed 32-1 in FIG. 5) will be peel- away.
  • Heat is preferably applied to the sheath 30 by means of a heating grid 34.
  • the heating grid 34 is preferably applied to the sheath 30 by means of a heating grid 34.
  • the sheath 30 may include electrically conducting wires or thin plates that are preferably embedded in and around the sheath material during manufacture. Power is supplied to the heating grid 34 of sheath 30 via a
  • the wire set 36 is connected to a control stand 50 at which a source of electric power is available.
  • the control stand 50 has the usual controls 52 by which to regulate the electrical current being supplied to the heating grid 34 of heated sheath 30.
  • a temperature sensor 38 is either mounted outside the heated area of the sheath 32 (as shown) or embedded in the sheath material during manufacture.
  • One or more temperature sensors are located at or along the distal end of the cryosurgical probe 30 and connected to the control stand 50 via a second electrical wire set 38.
  • the control stand 50 includes a suitable display 54 by which to provide to the health care professional an indication of the heat being generated by heating grid 34 and detected by temperature sensor 38. In this way, freezing along the cryosurgical probe 30 can be prevented while the amount
  • cryosurgical probe of FIGs. 2-5 that is left uncovered (i.e. unsheathed) in combination with the dimensions (e.g. uniform or variable wall thickness) of the insulating sheath or the temperature to
  • markings e.g. circumferential rings
  • markings can be applied to the sheaths at 0.5 cm intervals, starting about 3.0 cm from each end thereof.

Landscapes

  • Surgical Instruments (AREA)
  • Thermotherapy And Cooling Therapy Devices (AREA)

Abstract

L'invention concerne une cryosonde (6) et une méthode de traitement du cancer par destruction cryochirurgique des cellules cancéreuses au moyen d'une bille de glace (10) formée à l'extrémité distale (8) de la cryosonde (6) et placée à proximité du tissu cancéreux à traiter. La sonde (6) est enveloppée d'une gaine thermo-isolante (12, 14, 16, 20). En modifiant la longueur et l'épaisseur de ladite gaine (12, 14, 16, 20) ainsi que la longueur de l'extrémité distale non enveloppée (8) de la sonde, on peut adapter la taille et la forme de la bille de glace produite par la cryosonde (6) selon la taille, la forme et l'emplacement du tissu cancéreux, de façon à localiser l'effet cryogénique. On peut éventuellement adapter la taille et la forme de la bille de glace en enveloppant la cryosonde (30) d'une gaine chauffée (32) dotée d'un élément chauffant (34) et d'un capteur de température (38) destiné à détecter la température à laquelle la gaine (32) est chauffée.
EP99925826A 1999-05-25 1999-05-25 Cryosonde comportant une gaine isolante et une gaine chauffee Withdrawn EP1216002A4 (fr)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US1999/011530 WO2000071037A1 (fr) 1997-09-19 1999-05-25 Cryosonde comportant une gaine isolante et une gaine chauffee

Publications (2)

Publication Number Publication Date
EP1216002A1 true EP1216002A1 (fr) 2002-06-26
EP1216002A4 EP1216002A4 (fr) 2003-02-12

Family

ID=22272835

Family Applications (1)

Application Number Title Priority Date Filing Date
EP99925826A Withdrawn EP1216002A4 (fr) 1999-05-25 1999-05-25 Cryosonde comportant une gaine isolante et une gaine chauffee

Country Status (3)

Country Link
EP (1) EP1216002A4 (fr)
JP (1) JP2003500097A (fr)
CA (1) CA2371776A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112512448A (zh) * 2019-01-14 2021-03-16 电冷科学有限公司 冷冻手术和电解的装置、系统和方法

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102009018291A1 (de) 2009-04-21 2010-10-28 Erbe Elektromedizin Gmbh Kryochirurgisches Instrument
AU2018250270A1 (en) 2017-04-05 2019-10-31 Miraki Innovation Think Tank Llc Point of delivery cold slurry generation
MX2019011996A (es) * 2017-04-05 2020-01-20 Miraki Innovation Think Tank Llc Contención de suspensión fría.

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4202336A (en) * 1976-05-14 1980-05-13 Erbe Elektromedizin Kg Cauterizing probes for cryosurgery
US5833685A (en) * 1994-03-15 1998-11-10 Tortal; Proserfina R. Cryosurgical technique and devices
US5658276A (en) * 1995-03-20 1997-08-19 Brymill Corporation Heated cryosurgical probe

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112512448A (zh) * 2019-01-14 2021-03-16 电冷科学有限公司 冷冻手术和电解的装置、系统和方法

Also Published As

Publication number Publication date
JP2003500097A (ja) 2003-01-07
EP1216002A4 (fr) 2003-02-12
CA2371776A1 (fr) 2000-11-30

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