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WO2024246683A1 - Systèmes et/ou procédés de chauffage et/ou de refroidissement d'une aiguille cryogénique - Google Patents

Systèmes et/ou procédés de chauffage et/ou de refroidissement d'une aiguille cryogénique Download PDF

Info

Publication number
WO2024246683A1
WO2024246683A1 PCT/IB2024/055012 IB2024055012W WO2024246683A1 WO 2024246683 A1 WO2024246683 A1 WO 2024246683A1 IB 2024055012 W IB2024055012 W IB 2024055012W WO 2024246683 A1 WO2024246683 A1 WO 2024246683A1
Authority
WO
WIPO (PCT)
Prior art keywords
needle
delivery line
console
optical fiber
radiation
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.)
Pending
Application number
PCT/IB2024/055012
Other languages
English (en)
Inventor
Yeshayahu Schatzberger
Yoram KEDEM
Ichai PEREZ
Keren SCHWEITZER
Benjamin LUIKERT THOMAS
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.)
UC Care Ltd
Original Assignee
UC Care Ltd
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 UC Care Ltd filed Critical UC Care Ltd
Publication of WO2024246683A1 publication Critical patent/WO2024246683A1/fr
Anticipated expiration legal-status Critical
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1477—Needle-like probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0231—Characteristics of handpieces or probes
    • A61B2018/0262—Characteristics of handpieces or probes using a circulating cryogenic fluid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0231—Characteristics of handpieces or probes
    • A61B2018/0262—Characteristics of handpieces or probes using a circulating cryogenic fluid
    • A61B2018/0268—Characteristics of handpieces or probes using a circulating cryogenic fluid with restriction of flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0293—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument interstitially inserted into the body, e.g. needle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/2005—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser with beam delivery through an interstitially insertable device, e.g. needle

Definitions

  • Embodiments of the invention relate to systems and/or methods for heating and/or cooling a cryogenic needle, often referred to also as a cryoprobe.
  • BACKGROUND [002] Cryoablation of tissues is a medical procedure that uses extreme low temperatures to destroy abnormal or diseased tissue. During cryoablation, the low temperature conditions are created using a sealed tip, hollow needle (cryoprobe) through which substances such as liquid Nitrogen or Argon gas are circulated. Exposure to low temperature freezes the tissue, causing the cells to die and ultimately be absorbed by the body.
  • Cryoablation may be used to treat a variety of conditions, including cancerous tumors, abnormal heart rhythms, and certain skin conditions.
  • Application of cryoablation is typically performed by assistance of imaging technologies to identify a treatment site for an ablative procedure and then inserting one or more cryogenic needles (cryoprobes) into the selected site and sufficiently cooling the needles to urge the tissues surrounding the needles to reach cryoablation temperatures, typically below about - 40 (minus forty) degrees Celsius.
  • Heating the cryogenic needles (cryoprobes) is typically performed in order to free the needles from adhesion to the frozen tissue after cryoablation, permitting rapid removal of a needle from an ablation site, thereby shortening the time required for medical procedures.
  • Such heating of a cryogenic needle may also be useful when repositioning the needle for use at several treatment sites.
  • SUMMARY [005] The following embodiments and aspects thereof are described and illustrated in conjunction with systems, tools and methods which are meant to be exemplary and illustrative, not limiting in scope. [006] In at least certain embodiments, systems and/or methods are provided for heating a cryogenic needle with a laser beam, RF wave, and/or microwave. [007] In addition to the exemplary aspects and embodiments described above, further aspects and embodiments will become apparent by reference to the figures and by study of the following detailed descriptions. BRIEF DESCRIPTION OF THE FIGURES [008] Exemplary embodiments are illustrated in referenced figures.
  • Fig.1 schematically shows an embodiment in accordance with the present invention of a cryosurgical device that forms part of a system for cooling and heating a cryogenic needle of the cryosurgical device; and [010] Figs. 2A to 2D schematically show embodiments in accordance with the present invention of cryogenic needles and systems for cooling and heating the cryogenic needles.
  • Fig. 1 schematically showing a cryosurgical device 1 that includes a cryogenic needle 2 (often also referred to as a cryoprobe) at its distal side and a delivery line 3 that is attached to the needle in this example at a handle 4 of the device.
  • a cryogenic needle 2 often also referred to as a cryoprobe
  • the delivery line 3 is arranged to supply gas to the needle and evacuate the returning gas, and in various embodiments of the present invention may be configured to include additional lines (e.g. electrical wires, laser fiber, etc.) to heat the needle’s tip.
  • the cryosurgical device includes a connector 5 at its proximal side. [013] Attention is drawn to Fig. 2A showing an embodiment of a system 10 for cooling and heating a cryosurgical device 1 in accordance with an embodiment of the present invention. [014]
  • the cryosurgical device in this example includes a needle 2 at its distal side and an input tube 16 that extends from its connector 5 through delivery line 3 towards needle 2. Input tube 16 as seen includes a spirally shaped section in the needle.
  • the system can be controlled to supply gas via input tube 16 for cooling or heating a distal tip 18 of the cryogenic needle 2. Cooling of the tip may be to cryoablation temperatures when the needle is operated in cooling mode. Heating the tip may be aimed at releasing adhesion of the needle from frozen tissues at its vicinity. Gas supplied for heating the needle may be at a relatively low pressure, of e.g. between about 300 psi and 600 psi.
  • system 10 may include an optical fiber 21 and a laser system 22 that is configured to emit a laser beam through the optical fiber towards the needle’s distal tip 18 (see ‘dotted’ arrows).
  • the optical fiber in this example can be seen being threaded through delivery line 3 generally alongside input tube 16 and through the needle towards a distal end 201 of the fiber that is proximal to needle’s distal tip 18.
  • infrared radiation may be transported towards the needle tip 18 via an optic fiber, such as the optical fiber 21 seen in Fig., 2A.
  • Heat generated at the needle’s distal tip 18 as a result of the laser beam (or infrared radiation) may propagate within the outer peripheral walls 6 of the needle. Furthermore, heat may be transferred from the tip 18 of the needle to the walls 6 by the flow of gas at low pressure through input tube 16.
  • the distal end 201 of the optical fiber may be designed and/or configured to distribute the laser energy emitted out of the optical fiber in a suitable profile/pattern rather than a precise single laser point.
  • suitable profile/pattern may be achieved by adding a fiber end cap at the fiber’s distal end 201 in order to, inter alia, control the propagation of light.
  • the fiber end cap may be made from a variety of materials that are substantially optically transparent, such as glass or plastic.
  • an optical fiber coupler may be used at an interface between the cryosurgical device’s connector 5 and a needle port 24 of the system to minimize energy losses. Examples of fiber end caps and fiber couplers may be those offered by Thorlabs, Inc.
  • the energy needed may be less than 180j.
  • Figs. 2B to 2D schematically showing further embodiments of systems 100, 1000, 1100 for heating respective cryogenic needles 20, 200, 2000.
  • the needle shafts are embodied as a heat pipe, which are fully sealed two-phase heat transfer devices that take advantage of fluid’s high latent heat of vaporization to achieve a relatively high efficient heat transfer.
  • a heating outlet 7 may be located in the needle’s handle 4 and may be fed by a heating energy controller 17 which may be located in a console 101 of the system.
  • Heat may be supplied from heating energy controller 17 towards heating outlet 7 via conventional means 2111, such as (but not only) resistor, RF antenna (and the like).
  • the heating outlet 7 may be arranged to transfer its temperature to a proximal end of the needle.
  • a heat pipe formation 103 of the cryogenic needle may be configured in turn to transport the heat to the distal end of the needle to be dissipated through the needle’s tip 1800.
  • Some examples of heating outlets 7 may include (but not limited to) an electrical resistor, or a body heated by laser, by RF wave, by electromagnetic induction, or by infrared radiation.
  • RF radio-frequency
  • the RF antenna 211 is seen being channeled along the system’s delivery line 3 and along the needle’s shaft.
  • the RF antenna 211 may be formed of an outer conductor and an inner conductor (wire) 2112.
  • a dielectric material may surround the inner conductor 2112 (except an exposed distal tip thereof).
  • the RF antenna 211 may be used for emitting radiation substantially only at its very distal exposed tip, close to the needle’s tip 180, thus heating the needle’s tip material.
  • the RF wave generator may be located in the console 101.
  • the aforementioned description with respect to the embodiment seen in Fig.2B may also apply to a microwave powered system. [026] Attention is drawn back to the embodiment seen in Fig. 2C.
  • a cooling outlet 9, possibly also located within the needle’s handle 4 may be fed by a cooling energy controller 19 which may also be located within console 101. Cooling may supplied from cooling energy controller 19 towards cooling outlet 9 by conventional means166, such as (but not only) Joules-Thompson effect, liquid nitrogen, etc.
  • the cooling outlet 9 may be arranged to similarly transfer its temperature to the proximal end of the needle to be then transported to the distal end via the needle’s heat pipe formation 103.
  • the heat pipe formation 103 may be enrobed at its proximal part in a thermally insulating mantle 102 that is formed on an outer periphery of the generally cylindrical shaped heat pipe formation.
  • the heat pipe formation 1030 may include two sections, a first more proximal section that has a slightly smaller diameter than a second more distal section.
  • a thermally insulating mantle 1020 may be formed about the heat pipe’s first section and by that achieve a thermal insulation in the proximal part of the needle and a uniform diameter of the needle along its shaft.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Otolaryngology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Laser Surgery Devices (AREA)

Abstract

Un système pour affecter une température d'une aiguille cryogénique comprend une fibre optique et un système de rayonnement. Le système de rayonnement est utilisé pour émettre un rayonnement à travers la fibre optique vers la pointe distale de l'aiguille.
PCT/IB2024/055012 2023-05-29 2024-05-23 Systèmes et/ou procédés de chauffage et/ou de refroidissement d'une aiguille cryogénique Pending WO2024246683A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202363469466P 2023-05-29 2023-05-29
US63/469,466 2023-05-29

Publications (1)

Publication Number Publication Date
WO2024246683A1 true WO2024246683A1 (fr) 2024-12-05

Family

ID=93656855

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2024/055012 Pending WO2024246683A1 (fr) 2023-05-29 2024-05-23 Systèmes et/ou procédés de chauffage et/ou de refroidissement d'une aiguille cryogénique

Country Status (1)

Country Link
WO (1) WO2024246683A1 (fr)

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004016155A2 (fr) * 2002-08-16 2004-02-26 The Government Of United States Of America As Represented By The Secretary Of The Department Of Health And Human Services Appareil pour depot multifocal, analyse et procedes d'utilisation associes
US20050203419A1 (en) * 2004-02-24 2005-09-15 Nirmala Ramanujam Side-firing probe for performing optical spectroscopy during core needle biopsy
US8936593B2 (en) * 2008-01-24 2015-01-20 Syneron Medical Ltd. Device, apparatus, and method of adipose tissue treatment
US20160008057A1 (en) * 2013-02-27 2016-01-14 Empire Technology Development Llc Diagnostic needle probe
US9895184B2 (en) * 2012-02-07 2018-02-20 Cpsi Holdings Llc Dual thermal ablation device and method of use
CN212234673U (zh) * 2018-02-13 2020-12-29 南京亿高微波系统工程有限公司 一种具有冷却毛细腔的微波消融针
CN217310551U (zh) * 2022-01-18 2022-08-30 蓝线铂立生命科技(苏州)有限公司 冷冻消融系统

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004016155A2 (fr) * 2002-08-16 2004-02-26 The Government Of United States Of America As Represented By The Secretary Of The Department Of Health And Human Services Appareil pour depot multifocal, analyse et procedes d'utilisation associes
US20050203419A1 (en) * 2004-02-24 2005-09-15 Nirmala Ramanujam Side-firing probe for performing optical spectroscopy during core needle biopsy
US8936593B2 (en) * 2008-01-24 2015-01-20 Syneron Medical Ltd. Device, apparatus, and method of adipose tissue treatment
US9895184B2 (en) * 2012-02-07 2018-02-20 Cpsi Holdings Llc Dual thermal ablation device and method of use
US20160008057A1 (en) * 2013-02-27 2016-01-14 Empire Technology Development Llc Diagnostic needle probe
CN212234673U (zh) * 2018-02-13 2020-12-29 南京亿高微波系统工程有限公司 一种具有冷却毛细腔的微波消融针
CN217310551U (zh) * 2022-01-18 2022-08-30 蓝线铂立生命科技(苏州)有限公司 冷冻消融系统

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