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WO2025096867A1 - Dispositif de traitement au plasma et méthode d'utilisation - Google Patents

Dispositif de traitement au plasma et méthode d'utilisation Download PDF

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Publication number
WO2025096867A1
WO2025096867A1 PCT/US2024/054017 US2024054017W WO2025096867A1 WO 2025096867 A1 WO2025096867 A1 WO 2025096867A1 US 2024054017 W US2024054017 W US 2024054017W WO 2025096867 A1 WO2025096867 A1 WO 2025096867A1
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WO
WIPO (PCT)
Prior art keywords
plasma
application apparatus
energy
energy application
control system
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PCT/US2024/054017
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English (en)
Inventor
Kester Julian Batchelor
Christoph Martin KNOPF
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Gyrus ACMI Inc
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Gyrus ACMI Inc
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Publication of WO2025096867A1 publication Critical patent/WO2025096867A1/fr
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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
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/042—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating using additional gas becoming plasma
    • 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
    • A61B2018/00583—Coblation, i.e. ablation using a cold plasma
    • 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
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00702—Power or energy
    • 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
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00863—Fluid 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
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00875—Resistance or impedance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2051—Electromagnetic tracking systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2061—Tracking techniques using shape-sensors, e.g. fiber shape sensors with Bragg gratings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
    • A61B2090/366—Correlation of different images or relation of image positions in respect to the body using projection of images directly onto the body

Definitions

  • cold plasma technology can be used to achieve biological plasma effects to treat wounds, hemostasis and treatment of medical conditions, such as cancers.
  • Cold plasma technology can also be used to reduce microbial loads while not affecting healthy surrounding tissue.
  • the application of cold atmospheric plasma can operate under atmospheric conditions, for example below approximately 40 degrees Celsius.
  • cold plasma can be formed using a weakly ionized gas where a small fraction of gas atoms and molecules, which are the main carriers of heat, collide with electrically generated highly energetic electrons. This can result in further excitation, ionization, and dissociation, while the plasma remains cold.
  • Figure 1 illustrates an example method of application of energy according to at least one example of the present disclosure.
  • Figures 2A – 2D illustrate an example of a method of application of energy according to at least one example of the present disclosure.
  • Figure 3A illustrates an example of an energy application device according to at least one example of the present disclosure.
  • Figure 3B illustrates an example of an energy application device according to at least one example of the present disclosure.
  • SLW Matter No.5409.897WO1 Figure 4 illustrates a schematic diagram of an example of a computer-based clinical decision support system (CDSS) according to at least one example of the present disclosure.
  • CDSS computer-based clinical decision support system
  • Figures 5A - 5C illustrate an example of a tissue displayed on a visualization device with a treatment map according to at least one example of the present disclosure.
  • Figure 5D illustrates an example of a tissue with a treatment map according to at least one example of the present disclosure.
  • Figure 5E illustrates an example of a treatment map associated with a target site according to at least one example of the present disclosure.
  • Figures 6A illustrates an energy application device and treatment method according to at least one example of the present disclosure.
  • Figure 6B illustrates an energy application device and treatment method according to at least one example of the present disclosure.
  • Figures 7A and 7B each illustrates an example of a tissue with a treatment map according to at least one example of the present disclosure.
  • Figure 8 illustrates an example method of treating a target tissue according to at least one example of the present disclosure.
  • Figure 9 illustrates an example method of treating a target tissue according to at least one example of the present disclosure.
  • energy such as plasma or cold plasma, can be used to treat some types of cancers, lesions, precancerous state tissues, hemostasis, wound healing or other affected tissues.
  • the application of energy associated with physical and technical properties, such as temperature, electrical currant, radiation emissions, and the like, and the application of energy that can be required for biological plasma effects, such as the concentration of chemical species, to reach the desired outcome on affected tissues can be difficult to achieve.
  • too much plasma energy can result in damage to viable tissues and too little plasma energy can result in unsuccessful treatment to the affected tissue or cells.
  • understanding the quantity of plasma energy that can be delivered to a specified area can be useful in reducing ineffective delivery or undesired delivery of such energy.
  • identifying areas of application of energy before and during a medical procedure can be useful during treatment of a target site.
  • the distance between an energy application device, such as one that includes a plasma application apparatus, and the target site can be adjusted to control the amount of energy delivered to the target site.
  • Understanding a distance that the energy travels from an energy application apparatus to a target site, or ground, can impact the delivery of Reactive Oxygen Nitrogen Species (RONS) to the target tissue.
  • RONS Reactive Oxygen Nitrogen Species
  • the distance between a working end of an energy application apparatus and the target tissue can be measured, adjusted, and controlled.
  • a control system is in communication with an adjustment mechanism that can adjust or alter the position of the working end according to measurements received by the control system.
  • the measurement of RONS includes a calculation of resistivity or impedance between the working end and the target tissue.
  • the measurement includes radiant energy or intensity of light.
  • DETAILED DESCRIPTION Certain medical treatments and apparatuses that use energy for performing treatment methods can be used to minimize, eliminate or otherwise address a target tissue in a body, such as a human body.
  • Target tissue can include tissue that has been affected by cancers, abnormalities, irregularities or other afflictions to the tissue.
  • the type of energy applied can include applications of heat or cold, applications of plasma, or applications of electricity such as by ablation or electroporation. Applying specific types of energy can be used to treat target tissue externally or internally of the body.
  • the target tissue can be a small group of cells or a larger area of affected tissue.
  • the target tissue can be microscopic and detectable with specific medical imaging equipment.
  • the target tissue can be visible with the human eye.
  • the target tissue at a target site can be a tumor or an area of cancerous cells.
  • the target tissue can be areas of a tissue that benefit from treatment to alleviate abnormalities or irregularities.
  • the target tissue can be surrounded with unaffected tissue (e.g., healthy tissue).
  • a target site can include a specified region of tissue including the target tissue, or the tissue to be treated and unaffected tissue, or tissue that does not need to be treated (e.g., healthy tissue).
  • a treatment method for addressing the target tissue can include directing the treatment to a target site in which the target tissue is contained.
  • the treatment method can be a focused treatment for the specific target tissue.
  • the treatment method can be one that treats both the target tissue, and to a lesser extent, the healthy tissue.
  • the healthy tissue can be treated in certain situations when the treatment requires or benefits from a wider area of treatment, for example, to minimize recurrences of the malady.
  • the treatment method can include applying specific types of energy to the target tissue or the target site such as heat or cold, applications of plasma or applications of electricity such as by ablation or electroporation.
  • the type of energy applied can depend on the type of target tissue to be treated.
  • the tissues to be treated can have their own signatures that can affect treatment methods. For example, different types of target tissues have their own reactive oxygen and nitrogen species (RONS) values or signatures and the energy emission for treatment can vary, depending on the desired results.
  • Reactive species are byproducts of cellular metabolism and are regulated within the cells. For example, each cell within a body has a baseline level of reactive species.
  • cancer cells in contrast to healthy cells, have an accelerated metabolism and can have a higher baseline of reactive oxygen nitrogen species than healthy cells.
  • tissues in an area can have different RONS that can be applied.
  • the method of application of energy such as plasma or cold plasma
  • the method of application of energy can be dependent on the type of target tissue and the reactive oxygen-nitrogen species (“RONS”) required to treat the target tissue.
  • RONS are the unstable species containing oxygen and nitrogen that react quicky with other molecules in cells of a tissue.
  • the treatment such as a plasma or cold plasma treatment, is dependent on the type of target tissue and the reactive species of that target tissue.
  • the target tissue, or target cells can include cancerous cells or other affected cells.
  • Illustrated in Figure 1 is an illustration of RONS interaction when applied to target tissue.
  • a quantity of target tissue 10 (such as a group of target cells) can occur in the same or proximate to healthy cells 20.
  • the healthy cells 20 can have a healthy cell baseline 22 RONS level and the target tissue 10 can have a target tissue baseline 12 RONS level.
  • the healthy cell baseline 22 RONS level can be a level associated with the type of healthy tissue.
  • the target tissue baseline 12 can have a higher RONS level and greater oxidative stress level than the healthy cell baseline 22 RONS level and oxidative SLW Matter No.5409.897WO1 stress.
  • Energy such as plasma can be applied to a treatment site (discussed further as related to Figures 2A-2D) to add a quantity of RONS to the target tissue to surpass the specific threshold 40.
  • the added RONS can cause apoptosis to the specific target tissue 10.
  • the quantity of RONS from the plasma can be a specified quantity that, when combined with the RONS level for the healthy cells 20, does not reach an apoptosis level for the healthy cell.
  • the specified quantity of plasma and RONS delivered can cause apoptosis (death) of the unhealthy cells, such as a cancer cells, while the healthy cells remain undamaged.
  • FIG. 2A – 2D Illustrated in Figures 2A – 2D, is an example of a method for treating a target tissue 65, such as cancer cells.
  • the method illustrated in Figures 2A-2D includes an example of a target site 60 including cancer cells, as the target tissue 65 penetrating the target site 60.
  • Figure 2A illustrates an example of a specified quantity of plasma 50 that can be applied to a target site 60.
  • the quantity of plasma 50 emitted toward the target site 60 can, in some examples, not extend to the full perimeter of the target site 60. For example, only a portion of the target site 60 receives direct application of plasma 50.
  • the area that receives a direct application of RONS can be less than the perimeter of the target site 60.
  • the RONS emitted with the plasma can have a short life.
  • the plasma can be emitted for a specified time according to the type of target tissue and the lifetime of the RONS emitted. For example, the time the target site 60 is exposed to the plasma and RONS is between approximately a few seconds to over a minute.
  • the depth that the plasma and RONS penetrate the target tissue is related to the diffusion radius of the RONS. For example, the longer the lifetime of the RONS the higher the diffusion radius and the greater the penetration depth in the tissue.
  • the lifetime depends on the chemical reactivity and stability of the RONS (e.g., radical hydroxyl is short-lived and hydrogen peroxide is long-lived).
  • Figures 2B and 2C illustrate a secondary effect that can be caused by application of plasma 50 to at least a portion of the target site 60.
  • the secondary effect is known as a bystander effect.
  • the secondary effect is a chemical reaction, biological response or communication resulting from an event between neighboring or adjacent cells of the same type. For example, if a cell 70 is treated with an application of RONS, the effect on that cell 70 is communicated to adjacent or neighboring cells 72.
  • the effect on the cell 70 can be apoptosis since the dose of RONS applied to the cell 70 can exceed the threshold for apoptosis for that type of cell.
  • apoptosis can be SLW Matter No.5409.897WO1 communicated to the same type of adjacent cell 72 and cause apoptosis to those adjacent cells 72.
  • Figure 2D illustrates an example of the last step of the secondary effect, an abscopal effect.
  • the abscopal effect is an immunogenetic cell death (ICD) that initiates a systemic immune system response in cells at distant sites.
  • ICD immunogenetic cell death
  • the abscopal effect is uncontrollable.
  • the quantity of target tissue 80 in Figure 2D can be remote from the cells 70 in the original target site 60.
  • the effect on the cells 70 in the original target site 60 such as apoptosis, can be communicated via an immune response to similar target tissue 80 in a remote location of a body.
  • the immune response in the target tissue 80 can similarly be apoptosis.
  • a secondary effect in cell communication can include transmitting stress signals to untreated neighboring cells that can lead to cell death. This process can be mediated by the generation of secondary dioxygen (O 2 ) and inactivation of membrane-bound catalase.
  • gap junctions can propagate cell death signals by passing calcium ions (Ca 2+ ) ions from apoptotic to non-apoptotic cancer cells.
  • Figures 3A and 3B illustrates an example medical treatment system 100 for treating target tissue 122 in a body. The medical treatment system 100 can be used to treat affected tissue such as cancerous tissue or cells.
  • the medical treatment system 100 can be an energy application apparatus 110 that can supply energy towards a target site for treatment of a target tissue.
  • the energy application apparatus 110 can deliver or emit specified quantities of energy towards the target tissue 122 to treat the target tissue 122 according to the amount and type of energy beneficial for treatment.
  • the energy application apparatus 110 supplies energy towards the target tissue 122 through a working end 117. as the working end 117 can be proximate to a distal region, that discharges energy, such as plasma, from the energy application apparatus 110 towards a target site 120 containing the target tissue 122.
  • the medical treatment system 100 can include an energy application apparatus 110, a control system 150, and a one or more grounding sources 160a, 160b.
  • the energy application apparatus 110 can be an ablation apparatus.
  • the energy application apparatus can be an irreversible electroporation apparatus.
  • the energy application apparatus can be a system that can use a DC or AC current to induce cell death.
  • Each of the methods or modalities of the below described energy application apparatus 110 can be applied as related to the specific energy application apparatus, for example as those previously described.
  • SLW Matter No.5409.897WO1 [0033] As discussed previously related to Figures 1 and 2A-D, a quantity of plasma can deliver or emit RONS towards a target site, thereby resulting in apoptosis to a target tissue or target cells.
  • the energy application apparatus 110 can be designed to emit or deliver a specified quantity of plasma, including RONS, towards a target site 120.
  • the energy application apparatus 110 can dispense or emit (hereinafter, “emit” can refer to dispensing, applying or otherwise releasing energy, such as plasma from a plasma application apparatus) a specified quantity of cold plasma from the energy application apparatus 110 towards the target site 120.
  • the specified quantity of cold plasma and resultant RONS are dependent on the type of target tissue 122.
  • RONS are formed according to one or more of adjustments of one or more of the type of gas used in the energy application apparatus 110, the size of the nozzle of the energy application apparatus 110, the rate the gas flows or is emitted from the medical treatment system, the distance from the energy application apparatus 110 to the target site, or the addition of other gases to the medical treatment system 100.
  • Cold plasma can be a weakly ionized gas. In a cold plasma application, only a small fraction of gas atoms and molecules, which can be the main carriers of heat, collide with electrically generated highly energetic electrons. In cold plasma applications, electrons have a higher temperature compared to ions and neutral atoms. In other words, the electron temperature is higher while the gas temperature is approximately room temperature.
  • FIG. 3A illustrates an example of the energy application apparatus 110 that can be used to form plasma and can emit plasma towards a target site 120.
  • Plasma can be formed within the energy application apparatus 110 by dispensing a specific gas, such as an inert gas, proximate to an electrical source.
  • a specific gas such as an inert gas
  • cold plasma can be formed by passing an inert gas through an electrical field.
  • the energy application apparatus 110 can be coupled with a gas source 111 and an energy source 115.
  • the energy application apparatus 110 can include a gas passage 112 that can transmit a gas 113 from the gas source SLW Matter No.5409.897WO1 111 towards an electrical discharge 114.
  • the gas contained within the gas source 111 can be a single gas or a pure gas.
  • the gas can also be a mixture of a base gas and oxygen. In an example with a gas mixture, there can be a greater quantity of the base gas than the oxygen.
  • the combination of the base gas and the oxygen can be a mixture that can result in an increased the quantity of RONS.
  • Other gases or substances can also be added to the base gas to increase the efficacy of the gas transitioning to a plasma, or to increase the efficacy of the gas in the system.
  • at least one fluorescence dye can be added to the gas before it is dispensed, as discussed further below.
  • the gas source 111 can be coupled with a control system 150 (as described further related to Figure 4).
  • the control system 150 can provide signals to the gas source 111 to alter the quantity of gas dispensed from the gas source 111.
  • the control system 150 can include instructions, libraries, data or the like that can control the quantity of gas emitted.
  • the control system 150 in other example can control other substances (e.g., other gases, additives or the like) that can be added to the base gas, as described previously.
  • the control system 150 can be used to control the quantity or characteristics of the gas dispensed to, for example, increase the efficacy of the gas used for the plasma that can be dispensed.
  • Plasma can be formed by subjecting the dispensed gas from the gas source 111 to the electrical discharge 114.
  • the electrical discharge 114, applied toward the gas to form plasma can be internal of the energy application apparatus 110 and proximate to a nozzle 116, as a working end or a dispense opening.
  • the electrical discharge 114 can be used to generate energy at higher frequency alternating current (AC) ranges.
  • AC alternating current
  • the AC range can be higher than a radio frequency.
  • the electrical discharge can be a high voltage emission but can have a low current. In a high voltage-low current application, the electrical discharge can generate or apply more energy towards the gas with less current.
  • the electrical discharge 114 can be in communication with control system 150.
  • the electrical discharge 114 can receive communications from the control system 150 to control the type, quantity, or frequency of electricity discharged from the electrical discharge 114.
  • the control system 150 can include data, instructions or the like, that can assist in controlling the electricity emitted from the electrical discharge 114.
  • the medical treatment system 100 can include one or more grounding sources 160a, 160b (or returns) to form a complete electrical circuit with the electrical discharge 114.
  • the one or more grounding sources 160a, 160b can be operatively connected with or within the medical treatment system 100 to provide a ground when energy is generated by the SLW Matter No.5409.897WO1 system.
  • the energy application apparatus 110 includes one or more external grounding sources 160a or one or more internal grounding sources 160b.
  • the external grounding source 160a can be the patient.
  • the one or more grounding sources 160a is external to the energy application apparatus 110, such as the grounding source can be the patient.
  • the patient can be a ground up to 30 watts, or the maximum wattage according to the International Electrotechnical Commission (IEC) 60601 standards.
  • IEC International Electrotechnical Commission
  • the energy application apparatus 180 of Figure 3B can be adjustable (e.g., movable, repositioned or the like) relative to the target tissue 122.
  • the energy application apparatus 180 can be a component of a handheld device, an endoscopic apparatus, or a static device with an adjustable mechanism to alter the position of the energy application apparatus 180 relative to the target site 120.
  • the energy application apparatus 180 can be positioned within a working end of an endoscope and housed within a working channel at an end portion of an endoscope (as illustrated in Figure 6B). In another option, the energy application apparatus 180 can be positioned within a device that can be held by a user and controlled by the user proximate to the target site 120. In yet another option, the energy application apparatus 180 can be retained within a medical device that can be positioned outside of a patient but directed and adjusted relative to the patient. The type of device that holds, retains, houses or the like, the energy application apparatus 180 can be determined based on the energy application apparatus’ desired use. [0041] The energy application apparatus 180 can be positioned closer to the target tissue 122 with an endoscopic device.
  • a handheld device can more accurately position the energy application apparatus 180.
  • an external energy application apparatus can more accurately or efficiently position the energy application apparatus 180.
  • the energy application apparatus 180 can move towards the target tissue 122 or away from the target tissue 122.
  • the energy application apparatus 180 can be further positioned by adjustment of, for example, at least a portion of the energy application apparatus 180.
  • the energy application apparatus 180 can be adjusted according to one or more axes of orientation (e.g., x, y, and z). Adjusting the position of the energy application apparatus 180 also repositions the nozzle 182 relative to the target tissue 122.
  • the nozzle 182 of the energy application apparatus 180 SLW Matter No.5409.897WO1 can be adjustable relative to the target tissue 122, such as being repositioned separately from the remaining components of the energy application apparatus 180.
  • the energy application apparatus 180, or the nozzle 182, alone or together, can be controlled to regulate the amount of energy, such as plasma, dispensed form the energy application apparatus 180. Adjusting the position of the energy application apparatus 180 towards the target tissue 122 can increase the amount of plasma, or RONS, that are applied to the target tissue 122. Conversely, adjusting the position of the energy application apparatus 180 away from the target tissue 122 can decrease the amount of plasma, or RONS, that is applied to the target tissue 122.
  • Adjusting the position of the energy application apparatus 180 can more effectively apply a desired quantity of plasma, such as cold plasma, towards the target tissue 122.
  • the control system 150 can be in communication with the energy application apparatus 180 to adjust the position of the energy application apparatus 180 relative to the target tissue 122.
  • an adjustable energy application apparatus 180 can be adjusted so a stand-off distance (e.g., a distance which the nozzle 182 is held from the target tissue) is altered according to the quantity of plasma emitted from the energy application apparatus 180.
  • control system 150 can receive communications from the energy application apparatus 180 related to one of the distance from the target tissue 122, the amount of plasma or RONS being delivered, the amount of plasma or RONS that has been delivered, the status of treatment of the target tissue, or the like.
  • the control system 150 can include a processor that processes the received communication and can determine from a look-up table, presets, live calculations or the like if the position of the energy application apparatus 180 should be adjusted.
  • control system 150 can use the received communication from the energy application apparatus 180 to calculate a flow rate of plasma emitted, a flow rate of the gas provided through the gas passage 112, or the like to be delivered to the target tissue 122 based on the distance between the nozzle 182 and the target tissue 122.
  • the control system 150 can adjust the position of the energy application apparatus 180 to a specified or calculated distance from the target tissue 122.
  • the amount of plasma delivered from the energy application apparatus 180 to the target tissue 122 can be adjusted based on, for example, a resistivity measured, calculated or determined between the nozzle 182 and the one or more grounding SLW Matter No.5409.897WO1 sources 160a.
  • current or voltage can be used to measure, calculate or determine the distance between the nozzle 182 and the one or more grounding sources 160a.
  • the resistance in energy application apparatus 180 can be calculated if a known or preselected environment (e.g., ambient air, carbon dioxide, water, normal saline or others) and a known or set flow rate of the gas to generate the plasma emitted and the electrical input parameters are used. This can be used to set a distance from the target tissue 122 to deliver a specified amount (or range of an amount) of plasma, energy, or RONS.
  • a circuit can be formed between the nozzle 182 emitting plasma and the one or more grounding sources 160a.
  • the resistance within the circuit can be calculated according to the distance between the nozzle 182 and the one or more grounding sources 160a. For instance, if more voltage is supplied through the energy application apparatus 180 to convert the gas into plasma forms an arc of plasma to reach the one or more grounding sources 160a, the control system 150 can communicate with the energy application apparatus 180 to move closer to the one or more grounding sources 160a. Conversely, if less voltage is being supplied to form the arc of plasma to reach the one or more grounding sources 160a, the control system 150 can communicate with the energy application apparatus 180 to move further away from the one or more grounding sources 160a. [0047] In another example, the distance between the energy application apparatus 180 or the nozzle 182 can be measured, determined, or sensed though the use of a sensor.
  • the senor can include one or more of an optical sensor 190, electromagnetic sensor, biophysical sensor, or biochemical sensor.
  • the optical sensor 190 can include an electrical signal source or light source, such as a laser fiber.
  • the control system 150 can be in communication with the optical sensor 190. Using feedback data from either electricity or light emitted (or a combination) from the optical sensor 190, the position of the energy application apparatus 180 can be recognized.
  • the optical sensor 190 can receive information related to appropriately the position the energy application apparatus 180 or the nozzle 182 to provide the specified amount of energy, such as plasma (e.g., cold plasma), to the target tissue 122.
  • plasma e.g., cold plasma
  • the user can adjust the position of the energy application apparatus 180 via a wheel, dial, slide, lever, actuator or other control mechanism when the user recognizes or realizes the energy emitted from the energy application apparatus 180 is not approximately the specified amount (e.g., the amount of plasma emitted is less than or greater than approximate to a specified amount or range).
  • the user can SLW Matter No.5409.897WO1 input into the control system 150 a new position of the energy application apparatus 180. The control system 150 can then communicate an adjusted position to the energy application apparatus 180.
  • the energy application apparatus 180 can include internal mechanisms 185 that can adjust the position of the nozzle 182 relative to the target tissue 122.
  • the energy application apparatus 180 can include one or more wheels 186, such as stabilization wheels, on which the energy application apparatus 180 rides.
  • the energy application apparatus 180 can adjust the position of the nozzle 182 with one or more of magnets, rack and pinion, pulleys or other mechanisms.
  • the position of the energy application apparatus 180 can be adjusted with an engagable actuation mechanism.
  • the engagable actuation mechanism can be a device designed to be attached to a medical instrument, such as an endoscope, to provide additional control functionality during a medical procedures. For instance, the engagable mechanism, as described in Application no.
  • PCT/US2024/045131 can be coupled with an endoscope and in communication with the energy application apparatus 180 (as illustrated in Figure 6B).
  • the present application incorporates by reference the entirety of Engagable Actuation Mechanism PCT application no. PCT/US2024/045131, filed on 4 September 2024 which is hereby fully incorporated by reference as if fully set forth herein.
  • the control system 150 can be coupled with an indicator 141 to notify a user of the position of the energy application apparatus 180.
  • the indicator 141 can be a visual indicator (e.g., lights, signs, wording, or the like) on a visualization system 143 such as a screen, flashed or otherwise visually notifying the user of the placement of the nozzle 116 or the energy application apparatus 180 relative to the one or more grounding sources 160a.
  • the indicator 141 can be an auditory indicator (e.g., alarm, beep, voice, or the like) that notifies the user of the placement of the nozzle 116 or energy application apparatus 180 relative to the one or more grounding sources 160a.
  • the indicator 141 can be a sensory indication such as a vibration.
  • the indicator 141 can be coupled with the energy application apparatus 180 such that a user receives an indication that the energy application apparatus 180 should be repositioned and the user manages repositioning of the energy application apparatus 180.
  • the amount of plasma discharged (e.g., emitted, dispensed, streamed or the like) from the energy application apparatus 110, 180 and applied to a target tissue 122 can be monitored, tracked or recorded by the control system 150 (as described further below SLW Matter No.5409.897WO1 related to Figure 4) during the treatment process.
  • the energy application apparatus 110, 180 can adjust the amount of plasma discharged based on a comparison between the desired/optimal distance and the current distance between the nozzle 116 of the energy application apparatus 110, 180 and the target site 120.
  • the internal mechanism 185 can transmit motion to the energy application apparatus 180, such as the nozzle 182, can be manual (e.g., manually adjusted by the user) or automated (e.g., adjusted by communications received from the control system 150). For instance, a user can adjust the mechanism discussed in PCT Application No.
  • the control system 150 can be a component of the medical treatment system 100 that can include one or more of the energy application apparatus 110 and external components such as the gas source 111, one or more energy sources 115 or one or more grounding sources 160a, 160b.
  • the control system 150 in an example, can be external of the energy application apparatus 110 or can be housed within the energy application apparatus 110.
  • the control system 150 can control, instruct or record the amount of plasma discharged, how the plasma is discharged or where the plasma is discharged.
  • the control system 150 can include a processor, and can be in communication with a processor, or be a component of or coupled with a computer.
  • FIG.4 shows a schematic diagram of an exemplary computer-based clinical decision support system (CDSS) 152 that is configured to determine the quantity of RONS to be applied to a target tissue or to control the application of the quantity of RONS applied to a target tissue based on one or more of the target tissue122, distance from the target tissue, environment surrounding the target tissue, or the like.
  • CDSS computer-based clinical decision support system
  • the CDSS 152 includes an input interface 153 through which the level of RONS for treatment of the target tissue 122, specific to a patient are provided as input features to an artificial intelligence (AI) model 155, a processor 157 which performs an inference operation in which the one or more of the target tissue 122, distance from the target tissue 122, environment surrounding the target tissue 122, or the like are applied to the AI model to generate the appropriate level of SLW Matter No.5409.897WO1 plasma, such as cold plasma, and a user interface (UI) through which appropriate level of plasma, such as cold plasma, is communicated to a user, e.g., a clinician.
  • AI artificial intelligence
  • UI user interface
  • the input interface 153 may be a direct data link between the CDSS 152 and one or more medical devices that generate at least some of the input features.
  • the input interface 153 may transmit one or more of a characteristic of the target tissue 122, distance from the target tissue 122, environment surrounding the target tissue 122, or the like directly to the CDSS during a therapeutic and/or diagnostic medical procedure.
  • the input interface 153 may be a classical user interface that facilitates interaction between a user and the CDSS 152
  • the input interface 153 may facilitate a user interface through which the user may manually enter specifics related to one or more of the target tissue 122, distance between the energy application apparatus 110 and the target tissue 122, environment surrounding the target tissue 122, or the quantity of RONS or type or quantity of plasma to be applied.
  • the input interface 153 may provide the CDSS 152 with access to an electronic patient record from which one or more input features may be extracted.
  • the input interface 153 is configured to collect one or more of the following input features in association with a specific patient on or before a time at which the CDSS 152 is used to assess how much RONS have been delivered to the patient, the length of time the plasma has been applied, a determination if a target site has been treated, partially treated or completely treated, and areas of target tissue that remain to be treated. [0056] Based on one or more of the above input features, the processor 157 performs an inference operation using the AI model to generate a specific plasma or quantity of RONS to be applied to the target site 120.
  • input interface 153 may deliver information related to the treatment of the target site, such as the quantity of plasma or RONS, energy application apparatus 110 parameters, or information related to the patient or the target site 120 into an input layer of the AI model which propagates these input features through the AI model to an output layer.
  • the AI model can provide a computer system the ability to perform tasks, without explicitly being programmed, by making inferences based on patterns found in the analysis of data.
  • AI model explores the study and construction of algorithms (e.g., machine-learning algorithms) that may learn from existing data and make predictions about new data. Such algorithms operate by building an AI model from example training data in order to make data-driven predictions or decisions expressed as outputs or assessments.
  • SLW Matter No.5409.897WO1 There are two common modes for machine learning (ML): supervised ML and unsupervised ML.
  • Supervised ML uses prior knowledge (e.g., examples that correlate inputs to outputs or outcomes) to learn the relationships between the inputs and the outputs.
  • the goal of supervised ML is to learn a function that, given some training data, best approximates the relationship between the training inputs and outputs so that the ML model can implement the same relationships when given inputs to generate the corresponding outputs.
  • Unsupervised ML is the training of an ML algorithm using information that is neither classified nor labeled and allowing the algorithm to act on that information without guidance. Unsupervised ML is useful in exploratory analysis because it can automatically identify structure in data.
  • Common tasks for supervised ML are classification problems and regression problems.
  • Classification problems also referred to as categorization problems, aim at classifying items into one of several category values (for example, is this object an apple or an orange?).
  • Regression algorithms aim at quantifying some items (for example, by providing a score to the value of some input).
  • Some examples of commonly used supervised-ML algorithms are Logistic Regression (LR), Naive-Bayes, Random Forest (RF), neural networks (NN), deep neural networks (DNN), matrix factorization, and Support Vector Machines (SVM).
  • Some common tasks for unsupervised ML include clustering, representation learning, and density estimation.
  • Some examples of commonly used unsupervised-ML algorithms are K-means clustering, principal component analysis, and autoencoders.
  • federated learning also known as collaborative learning
  • This approach stands in contrast to traditional centralized machine- learning techniques where all the local datasets are uploaded to one server, as well as to more classical decentralized approaches which often assume that local data samples are identically distributed.
  • Federated learning enables multiple actors to build a common, robust machine learning model without sharing data, thus allowing to address critical issues such as data privacy, data security, data access rights and access to heterogeneous data.
  • the AI model may be trained continuously or periodically prior to performance of the inference operation by the processor 157.
  • the patient specific input features provided to the AI model may be propagated from an input layer, through one or more hidden layers, and ultimately to an output layer that SLW Matter No.5409.897WO1 corresponds to generate a specific plasma or quantity of RONS to be applied to the target site 120.
  • the control system 150 can be used to receive patient specific information from a database 154, such as the type of tissue and the quantity of RONS that can be used to treat the target tissue 122.
  • the type of plasma that can be used and the parameters of the energy application apparatus 110 are optionally stored in the control system 150 as an input 156 that is received from a medical professional, e.g., physician, providing the input to, for example, a computer system 158.
  • the control system 150 through the use of the CDSS 152 can be configured to output a specific RONS and output a specific quantity of RONS to reduce the quantity of target tissue 122 present in the patient.
  • the plasma application may be communicated to the user via the user interface (UI) and/or automatically cause the energy application apparatus 110 to apply the specific quantity of plasma or RONS for performing treatment.
  • the control system 150 can control the amount of energy transmitted from the external energy source 115 to the electrical discharge 114 of the energy application apparatus, or the energy application apparatus 110, 180.
  • the amount of energy transmitted to the electrical discharge 114 can be specified according to the type of system and the specified usage of the electricity that can be discharged.
  • the control system 150 can alter the amount of energy transmitted from the energy source 115 to the electrical discharge 114.
  • the control system 150 can alter the quantity of electrical discharge 114 applied to the gas 113 to control the quantity of plasma emitted towards the target site 120.
  • the control system 150 can alter the amount of energy transmitted from both the energy source 115 to the electrical discharge 114 and from the electrical discharge 114 towards the target site 120.
  • the control system 150 can determine the amount of plasma that can be discharged from the energy application apparatus 110, 180 based on variables of the medical treatment system 100.
  • Such variables can include the type of gas transmitted though the energy application apparatus 110, 180, the distance of the energy application apparatus 110 from the target site 120, the type or quantity of the plasma discharged from the energy application apparatus 110, 180 or the type of target tissue 122.
  • the control system 150 can determine or regulate the type of gas, amount of gas, or the rate the gas flows through the gas passage 112.
  • the control system 150 can control the amount and type of gas transmitted from a gas source 111 to the energy SLW Matter No.5409.897WO1 application apparatus 110, 180.
  • the control system 150 can control the communication between the gas source 111 and the gas energy application apparatus 110.
  • the control system 150 can control the amount of gas 113 transmitted to the energy application apparatus 110 through the gas passage 112.
  • the control system 150 can also control the rate at which the gas 113 can pass through the gas passage 112.
  • the gas passage 112 can be proximate to or in contact with the electrical discharge 114.
  • the control system 150 can control how much gas 113 passes through an electrical field generated by the electrical discharge 114.
  • the control system 150 can include a database, a log, or a record of variables that can affect the formation or emission of plasma from the energy application apparatus 110.
  • the formation of plasma can be dependent on variables of the energy application apparatus 110 such as the type of target tissue 122, the distance of the nozzle 116 from the target tissue 122, or environment conditions surrounding the patient or the target tissue.
  • control system 150 can control the interaction between the gas 113 passing through the passage 112 with the electrical discharge 114.
  • the interaction between the electrical discharge 114 and the gas 113 can form a quantity of plasma 170 that can be discharged from the nozzle 116 of the energy application apparatus 110.
  • the control system 150 can control the direction the plasma 170 that can be dispensed from the nozzle 116.
  • the control system can control the location of the nozzle 116 relative to the target tissue 122.
  • instructions communicated from the control system 150 to the energy application apparatus 110 can locate of the nozzle 116 relative to the target tissue 122.
  • the control system 150 can be coupled with or in communication with a visualization system 180, 143.
  • the visualization system 180, 143 can include a visualization device such as a monitor, screen, augmented reality (AR) glasses, projectors or the like.
  • the visualization system 180, 143 can show images in real-time of at least one of the target sites, the target tissue or surrounding tissue.
  • the visualization system 180, 143 can include a screen of an endoscope system.
  • the visualization system 180, 143 can be a component of augmented reality (AR) system and the screen on which the image is highlighted or shown can be glasses.
  • the visualization system 180, 143 can be operated by a user, such as a medical professional performing the treatment method using the electrical application system to view SLW Matter No.5409.897WO1 the areas being treated.
  • the visualization system 180, 143 is operated by a computer system operating AI or ML as discussed related to Figure 4.
  • the user or control system 150 can communicate data regarding the target tissue, or the target site, between the visualization system 180, 143 and the control system 150.
  • the control system 150 or the user can direct the control system 150 based on images shown or recognized by the visualization system 180, 143.
  • the visualization system 180, 143 can communicate characteristics sensed within the system to the control system to record the sensed characteristic or store data related to the sensed characteristic regarding the target tissue or the target site.
  • the data transmitted can be input into the control system 150 by the user.
  • the visualization system 180, 143 can include programing that allows the user to have a greater understanding of the target tissue or the target site.
  • secondary sources such as sensors or dyes can be used to assist in visualization of the target tissue 122 or target site 120.
  • a dye can be transported by a feed gas to the target tissue 122.
  • the tissue cells of the target tissue 122 process or bind to the chemicals in the dye.
  • the tissue cells process or bind to the chemicals depend on the type of tissue and the type of dye.
  • the dye attaches specifically to a specified target tissue cell type.
  • the tissue cells can become fluorescent and emit light under excitation with a specific wavelength or the dye itself is fluorescent.
  • the emission of light can be used to mark areas that have already been treated or, optionally, to identify borders of the treatment area. In other examples, the emission of light can be used to mark transition areas of the target site 120 from unhealthy to healthy tissue. In other examples, modified dyes that have dose-dependent fluorescence imaging capabilities can be used to mark the target tissue 122 or target site 120, according to the specified use. In examples, the fluorescence intensity associated with the reaction of the chemicals in the dye can be proportional to the location- dependent time of application and also to the amount of RONS. [0071] In some examples, a first dye can be added to identify one of healthy cells (or tissue) or unhealthy or cancerous cells (or tissue).
  • a first dye and a second dye can be added to the emitted gas so both healthy cells and unhealthy or cancerous cells can be identified.
  • the first dye, and the second dye if used can attach to the type of cells or tissue for which it is specified.
  • the light can emit with an intensity proportional to the amount of plasma dispensed.
  • control system 150 can identify the target site 120 (e.g., region or location of the cancerous tissue) through means other than visual recognition.
  • a visualization system 280 can display a treatment map on a visualization device.
  • a treatment map 200 can be displayed over an image of the target site 250.
  • the treatment map 200 can include a graphical display of the target tissue and the target site.
  • the treatment map 200 can be applied to treat any target tissue 210, using an energy application apparatus, as discussed previously. It is also contemplated to use the treatment map 200, discussed related to the method of treatment below, to treat or address any of a number of medical conditions.
  • the treatment map 200 can be used to treat abnormalities within or on organs, such as a bladder, intestines, stomach, lungs, skin or the like.
  • the treatment map 200 can be used during a plasma treatment process.
  • the target tissue 210 viewed with the treatment map 200 can be heart tissue that requires ablation.
  • the treatment map 200 can be associated with target tissue 210 with cancerous cells that requires irreversible electroporation.
  • a treatment method can employ plasma such as cold plasma in the treatment method. The method of use of the treatment map 200 can be similarly applied to any medical treatment where mapping, visualization or progressive treatment identification can be beneficial.
  • a treatment map 200 can be virtually overlayed or be projected on to the target tissue 210 or the target site 250 including areas surrounding the target tissue 210.
  • Illustrated in Figures 5A – 5E is an example method of treating a target tissue 210 within a target site 250.
  • the target tissue 210 can be an area of cancerous cells within a bladder, stomach, colon or other area of the body where cancerous cells can form. While treatment of cancer will be discussed herein, the methodology can be applied to any target tissue, such as lesions, polyps, sores, burns, or other forms of abnormalities.
  • the target tissue 210 or cancerous cells can form within the tissue and extend through different levels of the tissue.
  • the target tissue 210 can be on the surface of any of the above-described anatomical structures, or the like, and extend into the tissues of the previously described SLW Matter No.5409.897WO1 anatomical structures.
  • the treatment method discussed herein can, in some situations, be applied to identify healthy tissue.
  • the treatment map 200 can be displayed on the visualization system 280, as previously described.
  • the visualization system 280 can display at least one anatomical structure associated with the target tissue 210.
  • the visualization system 280 can display the treatment map 200 overlaying the target tissue 210 and the target site 250.
  • the user can identify, or the control system 150 can identify, the target tissue 210 such as a cancer.
  • the treatment map 200 can overlay a portion of the tissue.
  • the treatment map 200 can overlay a portion of the tissue that extends from a superior side of the bladder that is in communication with the ureters to the urethra at an inferior side.
  • the visualization system 280 can be used throughout the treatment method described herein, and similar methods to those described.
  • Figure 5B illustrates a more detailed view of the target tissue 210 within a target site 250.
  • the target site 250 can be identified by outlining an area surrounding or extending beyond the target tissue 210.
  • a scope can be used to view and identify possible areas of target tissue 210.
  • the identification of the target tissue 210 can either be by the user from the user’s experience or training, or automatically identified by the control system 150.
  • the target tissue 210 or the target site 250 can be input into the treatment map 200 by the user or communicated from sensed characteristics by sensors in communication with the control system 150.
  • the user or the control system 150 can communicate or identify, for example, the location of target tissue 210, by such apparatus and methods as narrow band imaging, photodynamic diagnosis, advanced algorithms, machine learning, artificial intelligence (AI) or other such advanced techniques or combinations of any of these methodologies.
  • AI artificial intelligence
  • the user can highlight the target tissue 210 with either a dye-like marker, an inserted component, such as a coil marker, needle marker or chip set emitting component.
  • the control system 150 can be implemented to identify the target tissue 210 or the target site 250 of the target tissue 210 through means other than visual recognition. [0079] When identifying the target tissue 210, the user can input data related to the target tissue 210 into the control system 150.
  • the control system 150 using the data input, collected or, optionally, with machine learning or pre-programmed algorithm, AI, or users’ experience, can overlay the treatment map 200 on the anatomical SLW Matter No.5409.897WO1 image displayed on the visualization system 280 (similar to the visualization system previously discussed related to Figure 3A).
  • the treatment map 200 can be projected directly onto the target tissue 205, as illustrated in Figure 5D.
  • an image projector can project an image of the treatment map 200 on the target tissue 205.
  • the image projector projects the treatment map onto the target tissue 205 and optionally, additionally, on a display system.
  • the treatment map 200 can outline the target site 250.
  • the expected extent of the cancer can be added to the function from areas that have been identified from one or more of an algorithm, computer learning, true AI, real-time in-vivo histopathology systems like confocal laser endomicroscopy, Raman spectroscopy or optical coherence tomography, the user’s experience or a combination of these, This step of identifying the cancerous tissue, or the target tissue 210, may not be visible to the user.
  • the treatment map 200 can be divided into one or more target sites 252, and each of the one or more target site 252 can contain at least some occurrences of target tissue 210.
  • the treatment map 200 can also include surrounding target sites 252a.
  • the surrounding target sites 252a can be areas that do not contain target tissue 210 or may not have identifiable target tissue.
  • the surrounding target sites 252a can be safety zones or buffers, such as an area of tissue that can be treated to minimize the likelihood of reoccurrence or formation of target tissue.
  • the surrounding target sites 252a can also be areas of tissue that can be a buffer zone between areas of treatment and areas of tissue that are not treated. [0082] After, or shortly after (e.g., a few minutes, less than one minute, less than ten seconds, less than one second) to, the preparation of treatment map 200, the control system 150 or the medical professional can determine the amount of energy that can be applied to the treatment area.
  • a specific amount of reactive oxygen and nitrogen species can be applied, and a specified method of application can be used.
  • plasma can deliver RONS to the treatment target site containing the target tissue.
  • the plasma is a cold plasma.
  • the cold plasma can be formed by supplying a predetermined quantity of low- pressure gases through an electrical discharge. This electrical discharge can be generated at higher frequency AC ranges, such as radio frequency and higher. The electrical discharge generated can have a high voltage but low current. In another example, electrical discharges can also be generated by use of lower frequency ranges down to DC or specific waveforms. SLW Matter No.5409.897WO1 The electrical discharge can depend on the plasma source and the form of plasma specific to the purpose.
  • An energy application apparatus (as discussed related to Figures 3A and 3B) can convert the predetermined quantity of gas with the application of electricity into plasma.
  • the amount of plasma emitted from the plasma application device and subsequently delivered can be dependent on the type of target tissue, such as cancerous cells or even the type of cancerous cells.
  • the amount of plasma emitted can be a known quantity stored in the control system 150.
  • the amount of plasma emitted can be an experiential quantity based on user experience or knowledge.
  • a specified quantity of cold plasma can be emitted toward the target site to be delivered to the target tissue.
  • the amount of plasma, or cold plasma, applied can require monitoring.
  • the amount of plasma delivered can be monitored via feedback and response from the control system.
  • the control system 150 or the medical professional can adjust the amount of energy or plasma, such as cold plasma, emitted toward the target site according to such variables as the type of tissue to be treated, the distance from the target site, or the length of time of application.
  • the plasma application system can implement a complete circuit including a potential and a ground.
  • the active source as one potential source, can be contained or housed in the plasma application device.
  • the ground (or return) can be the patient (as discussed related to Figures 3A and 3B), a grounding pad proximate to the patient or a grounding source within the plasma application device.
  • the present electrical standards can allow energy application using a patient as a ground (or return) with energies up to 30 watts.
  • the energy SLW Matter No.5409.897WO1 that the system can deliver in a cold plasma system that uses an active source (one potential source) in the device can have the other potential being the natural ground of the patient.
  • the patient can be used as a return or grounding source such that the grounding source is opposed to the cold plasma application apparatus.
  • This arrangement can provide a more accurate RONS delivery in a less complicated system.
  • the patient can be placed proximate to a return pad, rather than relying on the natural ground state of the patient.
  • the distance of the plasma application device from the body can affect the energy delivery and the energy delivered can be easier to calculate more accurately.
  • the distance from a nozzle or end portion of the plasma application device from the target tissue can be a controllable variable.
  • This quantity of cold plasma or the quantity of RONS delivered can be determined by calculations that can include at least one of the following elements of the circuit: current, voltage, resistance, phase angle, power, etc. This determination can also include understanding the frequency of energy delivery, the gas type and the speed the gas or plasma is delivered.
  • the gas or mixture of gas can be determined as required by the system and the type of cancerous tissue to be treated.
  • the medical professional or the control system such as control system 150, can use visual indicators to influence or determine the known amount of energy being delivered (length of plume, movement of plume, width of plume, plume contact area with tissue, or the like) or any combinations of these mechanisms mentioned.
  • a medical treatment system such as medical treatment system 100, can employ at least one sensor configured to communicate with the plasma application apparatus or the control system to determine the quantity of plasma that can be delivered.
  • the at least one sensor can include an optical sensor, electromagnetic sensor, biophysical sensor, or biochemical sensor.
  • the next step can include applying the appropriate amount of plasma to the target tissue 210.
  • the plasma can be applied in regions according to the treatment map 200 and the identified one or more target sites 252.
  • the one or more target sites 252 can be individually identified by alpha numeric or other symbols.
  • the one or more target sites 252 can be identified areas in SLW Matter No.5409.897WO1 three-dimensional space within a target site 252.
  • the one or more target sites 252 can be a group of target sites.
  • the control system 150 or the user can activate the plasma application device to apply the appropriate quantity of plasma to be delivered to each of the one or more target sites 252.
  • the treatment map 200 can have one or more target sites 252 that can have various values attributed to them. These values can be stored, recorded or accessed in or by the control system 150.
  • the one or more target sites 252 can include the RONS level associated with each target site 252.
  • the values associated with the treatment map 200 can relate to the specified treatment that can be applied to individual one or more target sites 252 depending on the expected or known extent of the cancerous tissue infiltration.
  • the treatment map 200 can be centered where a higher level of RONS is to be applied.
  • the treatment map 200 can indicate higher levels of RONS spaced throughout the treatment map 200.
  • the treatment map 200 can have targets sites 252 spaced apart from other surrounding one or more target sites 252 where less application of RONS is required. For example, the same amount of RONS can be delivered throughout the treatment map 200 or throughout several of the one or more target sites 252.
  • a user can adjust the treatment map 200 according to the specified usage and treatment required.
  • the control system according to algorithms, data or the like can adjust the treatment map 200 according to a specified treatment according to the target tissue 210.
  • the medical treatment system 300 can include a working portion 321 at the end of a lumen such as an endoscope 310, catheter or the like.
  • the distal portion 312 of the endoscope 310 can include an energy application device 322.
  • the energy application device 322 can be coupled with a gas source, energy source, control system and the like.
  • the energy application device 322 can include similar components to the energy application apparatus of Figures 3A and 3B.
  • the energy application device 322 can be movably coupled within endoscope 310.
  • the energy application device 322 can extend from the distal SLW Matter No.5409.897WO1 portion 312 of the endoscope.
  • the energy application device 322 can retract within the endoscope 310 when not in use and extend from the endoscope 310 when in use.
  • the energy application device 322 can telescope or otherwise extend from the distal portion 312 and retract to be housed, or at least partially housed within the distal portion 312.
  • the energy application device 322 can be placed proximate to or adjacent to the desired target site 252 by, for example, placing the distal portion 312 proximate to the energy application device 322 or extending the energy application device 322 from the distal portion 312.
  • the medical professional or the control system can guide the endoscope 310 to a target site 252.
  • the medical professional or the control system can extend or retract the energy application device 322 from the distal portion 312 according to the distance specified by the specified application of plasma or RONS required to treat the target tissue 210.
  • a user such as a medical professional, can recognize where treatment has been applied according to a specified treatment area on the treatment map 200.
  • an energy application device 322 can be a component of a medical apparatus such as an endoscope 310, catheter or the like.
  • the energy application device 322 can be housed within the endoscope 310 and positioned proximate to a distal portion 312 of the endoscope 310.
  • the energy application device 322 can include similar components to the energy application apparatus 110, 180 of Figures 3A or 3B.
  • the energy can be emitted from proximate to the distal portion 312 of the endoscope 310.
  • the energy application device 322 can extend from a working channel 314 of the endoscope 310.
  • the energy application device 322 can be coupled with a gas source, energy source, grounding source, control system and the like.
  • the energy application device 322 can be in communication with (e.g., includes, receives, or the like) the gas source and energy source to receive gas and emit energy at frequency levels approximate to radio frequency.
  • the emission of gas and energy e.g., radio frequency
  • the energy application device 322 can be in communication with a control system 330 similar to the control system 150 discussed previously to control the energy generated and emitted or dispensed according to the specified levels to treat the target tissue 350.
  • the energy application device 322 can be positioned proximate to or adjacent to a target site 352 to deliver the desired energy, such as plasma (e.g., cold plasma).
  • the energy application device 322 can be in contact with the target site 352, such as at or proximate to the target tissue 350.
  • the energy application device 322 can be removed a predetermined distance, or within a threshold distance, from the target site 352 or the target tissue 350.
  • the energy application device 322 can be adjusted between positions where the energy application device 322 is in contact with the target site 352 or target tissue 350 and removed a distance from the target site 352 or target tissue 350.
  • the adjustable characteristics of the energy application device 322 can provide a user with the ability to more accurately position the energy application device 322 relative to the target site 352.
  • the energy application device 322 can be movably coupled within the endoscope 310.
  • the energy application device 322 is adjustable similar to energy application apparatus 180.
  • the energy application device 322 can be adjustable to deliver a specified amount of energy (e.g., plasma, RONS, ablation or electroporation) to the target site 352 or target tissue 350.
  • a specified amount of energy e.g., plasma, RONS, ablation or electroporation
  • the energy application device 322 telescopes, articulates, extends or the like, from the distal portion 312 and the energy application device 322 can retract to be at least partially housed within the distal portion 312.
  • the medical professional or the control system 330 can guide the endoscope 310 to the target site 352.
  • the medical professional or the control system 330 can extend or retract the energy application device 322 from the distal portion 312.
  • the distance the energy application device is positioned from the target tissue 350 can be based on the plasma or RONS preferred to treat the target tissue 350.
  • the user can operate an adjustment mechanism 360 (e.g., wheel, dial, slide, actuator or the like) that is coupled with the energy application device 322.
  • the adjustment mechanism 360 can adjust the position of the energy application device 322 relative to the distal portion of the endoscope 310, similar to the energy application apparatus 180 of Figure 3B.
  • the user after adjusting the position to the desired location, can initiate the application of energy, such as plasma or RONS, towards the target tissue 350.
  • the user such as a medical professional, can understand or recognize where treatment has SLW Matter No.5409.897WO1 been applied according to a specified treatment area on the treatment map 320.
  • the distal portion 312 of the endoscope 310 or the energy application device 322 can be tracked by the control system 330 or the user.
  • the control system 330 can communicate an indication of treated target sites on the display.
  • the treated target sites 354 can be tracked with, for example, an optical sensor.
  • the optical sensor 355 can, for example, sense a target site characteristic including untreated tissue (including both heathy tissue and unhealthy tissue), treated tissue or partially treated tissue.
  • the optical sensor 355, for example, communicates with the control system 330 sensed target site characteristics.
  • the control system 330 can control the placement of the energy application device 322 or the adjustment mechanism 360 according to the sensed target site characteristic.
  • One example optical sensor tracking can include a Fiber Bragg Grating type system.
  • Another optical sensor can include a magnetic coil navigation type system.
  • a user can record the treated target sites 354 by visual recognition of elements of the device, elements of the device, a plume, or an end of the plume or combinations of these.
  • the treatment map 320 can indicate treated target sites 354, as illustrated in Figures 6A, 6B, 7A and 7B.
  • the treated target sites 354 can be differentiated from untreated target sites 352 as the treated target sites 354 have successfully received an appropriate amount of treatment.
  • the treated target sites 354 can have a different visual indicator shown on a display 370 for the untreated one or more target sites 352.
  • completed application of plasma can be realized or identified through visual indication, audio indication or other feedback.
  • completed application of plasma can be sensed, detected, measured or recognized by sensors coupled with or in communication with the plasma application device. Additionally, the plasma source can be deactivated manually or automatically when the desired dose has been applied.
  • the treatment map 320 can change, by either removing the treated target sites as an area to be treated or by showing that treated target sites 354 have been treated by for example, changing the color, blocking out, marking or the like.
  • the treatment map 320 can change, by either removing the treated target sites as an area to be treated or by showing that treated target sites 354 have been treated by for example, changing the color, blocking out, marking or the like.
  • the treatment map 320 can indicate to the user that the target tissue 350 has been treated. After receiving the indication of completion, the user can look for further tissue anomalies that require treatment or recognize that all or substantially all of the target tissue has been treated.
  • Illustrated in Figure 8 is a method of treating unhealthy tissue in a body.
  • the method can include identifying a target site containing the unhealthy tissue, as indicated in 410.
  • a medical professional can use, for example diagnostic equipment or visual indicators to identify the target site and the target tissue.
  • the medical professional either using their own expertise or using a control system, as discussed previously, can prepare a treatment map, as indicated in 412.
  • the treatment map can aid the medical professional in performing an efficient and effective treatment of unhealthy tissue.
  • the treatment map can include the target tissue and, optionally, surrounding tissue.
  • the surrounding tissue can be a buffer zone.
  • the buffer zone can include tissue that may contain target tissue that is unidentified, or it may be healthy tissue.
  • the treatment map can, for example be divided (e.g., separated, segmented, partitioned, or the like) into individual target sites, as indicated in 414.
  • the treatment map can be displayed using a visualization system or displayed directly on the patient.
  • the target sites can be determined by a medical professional’s expertise or, in another option, based on information stored in databases, catalogues, libraries or the like of a control system.
  • a specified amount of gas to form the desired plasma can be determined, as indicated in 416.
  • the specific amount of gas to be dispensed can be dependent on one or more of a quantity of plasma (e.g., cold plasma), quantity of RONS, distance between the patient and a plasma application device, environmental conditions, or the like.
  • the specified amount of gas can also be dependent on the type and quantity of energy that is used to form the plasma.
  • the specified amount of gas can be supplied the through a plasma application apparatus, as indicated in 418.
  • Forming plasma includes subjecting the specified amount of gas to an electrical current, as indicated in 417. The interaction between the electrical current and the gas can convert the gas to plasma, as indicated in 419.
  • the electrical current applied SLW Matter No.5409.897WO1 to the gas can be dependent on the type of energy supplied and the type of gas to form the type and quantity of plasma.
  • the plasma e.g., cold plasma
  • the plasma is discharged according to the quantity of RONS the plasma can supply to the target site.
  • the quantity of RONS can be dependent on the target tissue, the distance between the plasma application apparatus and the patient, environmental conditions, or the like.
  • the application of the plasma can be ceased when the portion of the target site has received a threshold amount of plasma, as indicated in 422.
  • the plasma application apparatus can be moved, adjusted, repositioned or can transition locations to a different target site, or target tissue.
  • Illustrated in Figure 9 is another method of treating unhealthy tissue in a body using an optional adjustable energy application apparatus.
  • the method can include identifying a target site containing the unhealthy tissue, as indicated in 510.
  • a medical professional can use, for example diagnostic equipment or visual indicators to identify the target site and the target tissue.
  • the medical professional either using their own expertise or using a control system, as discussed related to Figures 3A, 3B or 4, can prepare a treatment map, as indicated in 512.
  • the treatment map can include the target tissue and, optionally, surrounding tissue.
  • the surrounding tissue can be a buffer zone, similar to the buffer zone discussed previously.
  • the treatment map can, for example be divided (e.g., separated, segmented, partitioned, or the like) into individual target sites, as indicated in 514.
  • the treatment map can be configured to be displayed using a visualization system or displayed directly on the patient.
  • the target sites can be determined by a medical professional’s expertise or based on information contained in databases of a control system.
  • a specified amount of gas to form the desired plasma can be determined, as indicated in 516.
  • the specific amount of gas to be applied can be dependent on one or more of a quantity of plasma (e.g., cold plasma), quantity of RONS, distance between the patient and an energy application apparatus, such as a plasma application apparatus, environmental conditions, or the like.
  • the specified amount of gas can also be dependent on the type and quantity of energy that is used to form the plasma.
  • SLW Matter No.5409.897WO1 [0119]
  • the specified amount of gas can be supplied the through an energy application apparatus, as indicated in 518.
  • Forming the desired quantity of plasma can include subjecting the specified amount of gas to an electrical current, as indicated in 520.
  • the interaction between the electrical current and the gas can convert the gas to plasma, as indicated in 522.
  • the electrical current applied to the gas can be dependent on the type of energy supplied and the type of gas to form the type and quantity of plasma.
  • the plasma e.g., cold plasma
  • the plasma can be discharged from the energy application apparatus towards at least a portion of the target site, as indicated in 524.
  • the plasma can be discharged according to the quantity of RONS the plasma can supply to the target site.
  • the quantity of RONS can be dependent on the target tissue, the distance between the energy application apparatus and the patient, environmental conditions, or the like.
  • the energy application apparatus is adjusted as indicated in 525.
  • the energy application apparatus can be adjusted to an appropriate location for emission of a specified quantity or range of energy towards the target site.
  • the energy application apparatus can be adjusted to deliver energy at a specified intensity that is dependent, at least in part, on the distance between the energy application apparatus and the patient.
  • the adjustment is, for example, made based on a measured resistance or other parameter of an electrical circuit formed between the energy application apparatus and the ground, as described previously related to Figure 3B.
  • the application of the plasma can be ceased when the portion of the target site has received a threshold amount of plasma, as indicated in 526.
  • the energy application apparatus can be moved or can transition locations to a different target site, or target tissue.
  • Aspect 1 can include subject matter such as a medical treatment system for treating unhealthy tissue, the medical treatment system comprises: an energy application apparatus, including: an electrical source; and a working end configured to deliver energy to the unhealthy tissue; a grounding source operatively coupled to the energy application apparatus; a visualization system including: a visualization device; and a treatment map SLW Matter No.5409.897WO1 identifying a target site containing the unhealthy tissue; and a control system coupled with the energy application apparatus and the visualization system.
  • Aspect 2 can include, or can optionally be combined with the subject matter of Aspect 1, to optionally include the energy application apparatus includes at least one gas source; wherein the energy application apparatus emits cold plasma.
  • Aspect 3 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1 or 2 to optionally include the visualization device includes a screen; wherein the target site and the treatment map are displayed on the screen and the treatment map is displayed over the target site.
  • Aspect 4 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-3 to optionally include the treatment map includes one or more treated target sites and one or more untreated target sites.
  • Aspect 5 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-4 to optionally include the grounding source is a patient.
  • Aspect 6 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-5 to optionally include the control system controls a discharge from the energy application apparatus; wherein the energy application apparatus is configured to discharge at least one of an electrical field, heat, cold energy, or plasma.
  • Aspect 7 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-6 to optionally include the visualization system is configured to display the treatment map on the visualization device, the treatment map including one or more target sites, each of the one or more target sites including an indication of a threshold energy to be delivered to each of the one or more target sites; wherein the visualization system displays the one or more target sites and a visual indicator relate to the energy delivered from the energy application apparatus; wherein the control system is configured to detect the quantity of energy being delivered to the one or more target sites; wherein the control system is configured to move the energy application apparatus to an untreated target site when the threshold energy has been delivered.
  • Aspect 8 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-7 to optionally include the target site includes cancerous cells.
  • Aspect 9 can include subject matter such as a medical treatment system for treating a target tissue, the medical treatment system comprises: an energy application SLW Matter No.5409.897WO1 apparatus, including: a plasma application device; and a working end configured to deliver a quantity of plasma toward the target tissue; a grounding source configured to be opposed to the energy application apparatus; a visualization system including: an image projector configured to project a treatment map; and a control system coupled with the energy application apparatus and the visualization system.
  • Aspect 10 can include, or can optionally be combined with the subject matter of Aspect 9, to optionally include the image projector is configured to project the treatment map onto the target tissue.
  • Aspect 11 can include, or can optionally be combined with the subject matter of Aspect 9-10, to optionally include the image projector is configured to project the treatment map on a display system.
  • Aspect 12 can include, or can optionally be combined with the subject matter of Aspect 9-11, to optionally include the quantity of plasma includes a quantity of RONS; wherein the treatment map is divided into a plurality of target sites, each target site of the plurality of target sites includes an indication of a threshold of the quantity of RONS to be delivered; wherein the control system is configured to determine the quantity of RONS delivered, the determination of the quantity of RONS delivered based on one or more of a type of gas used, a flow rate of the gas, dimensions of the energy application apparatus, and a distance between the working end and the target tissue; wherein the control system is configured to move the energy application apparatus to a subsequent target site after the threshold of quantity of RONS has been delivered.
  • Aspect 13 can include, or can optionally be combined with the subject matter of Aspect 9-12, to optionally include the plasma application device is configured to emit specified quantities of cold plasma.
  • Aspect 14 can include, or can optionally be combined with the subject matter of Aspect 9-13, to optionally include the working end is configured to be located a spaced distance from the target tissue, the spaced distance dependent on the target tissue.
  • Aspect 15 can include, or can optionally be combined with the subject matter of Aspect 9-14, to optionally the energy application apparatus is configured to emit a threshold quantity of plasma according to values in a database in the control system.
  • Aspect 16 can include, or can optionally be combined with the subject matter of Aspect 9-15, to optionally include the image projector is configured to alter at least one portion of the treatment map when a threshold quantity of plasma has been emitted; wherein SLW Matter No.5409.897WO1 the threshold quantity is determined according to values stored in a database in the control system.
  • Aspect 17 can include subject matter such as a method of treating unhealthy tissue in a body, the method comprising: identifying a target site containing the unhealthy tissue; preparing a treatment map containing the target site; determining a specified amount of a gas to be used to form plasma; wherein the plasma is be applied to at least one target site within the treatment map; supplying the specified amount of the gas through a plasma application apparatus, including: subjecting the specified amount of the gas to an electrical current; and converting the specified amount of the gas to plasma; discharging the plasma from the plasma application apparatus towards at least a portion of the target site; and ceasing application of the plasma when the portion of the target site has received a threshold amount of plasma.
  • Aspect 21 can include subject matter such as a medical treatment device comprising: an energy application apparatus including: an electrical source; and a working end configured to deliver energy to target tissue; an adjustment mechanism configured to alter a position of the working end; and a control system coupled with one or more of the energy application apparatus and the adjustment mechanism; wherein the control system receives communications from one or more of the energy application apparatus and the adjustment mechanism to alter the position of the working end.
  • Aspect 22 can include, or can optionally be combined with the subject matter of Aspect 1, to optionally include the energy application apparatus is operable to emit a quantity of plasma through the working end towards the target tissue.
  • Aspect 23 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1 or 2 to optionally include the control system configured to calculate a flow rate of plasma emitted from the working end.
  • Aspect 24 can include, or can optionally be combined with the subject matter of SLW Matter No.5409.897WO1 one or any combination of Aspects 1-3 to optionally include the flow rate of plasma emitted from the working end is calculated based on a characteristic of a circuit, the circuit including the working end and a grounding source; wherein the characteristic is measured between the working end and the grounding source.
  • Aspect 25 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-4 to optionally include the energy application apparatus includes: at least one gas source; and a radio frequency circuit configured to generate an electrical discharge.
  • Aspect 26 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-5 to optionally include the control system is configured to alter the position of the working end according to a measured resistance of an emission of plasma from the working end.
  • Aspect 27 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-6 to optionally include the control system is configured to alter the position of the working end according to a calculated resistance of an emission of plasma from the working end.
  • Aspect 28 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-7 to optionally include a circuit formed between the working end and a grounding source; wherein resistance is calculated according to a relationship between a voltage and a current within the circuit.
  • Aspect 29 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-8 to optionally include the energy application apparatus is housed in an endoscope.
  • Aspect 30 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-9 to optionally include the position of the working end is configured to be altered according to a quantity of energy emitted or a quantity of energy received by the target tissue.
  • Aspect 31 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-10 to optionally include the communications received by the control system include one or more of types of gas transmitted through the energy application apparatus, distance from the working end to the target tissue, the quantity of energy emitted from the energy application apparatus, or the type of target tissue.
  • Aspect 32 can include, or can optionally be combined with the subject matter of SLW Matter No.5409.897WO1 one or any combination of Aspects 1-11 to optionally include a visualization system including: a visualization device; and a treatment map identifying a target site containing the target tissue; and the control system is configured to be operably coupled with the energy application apparatus and the visualization system; wherein the control system is configured to control one or more of a visualization of the target site, or application of energy displayed on the visualization device.
  • a visualization system including: a visualization device; and a treatment map identifying a target site containing the target tissue; and the control system is configured to be operably coupled with the energy application apparatus and the visualization system; wherein the control system is configured to control one or more of a visualization of the target site, or application of energy displayed on the visualization device.
  • Aspect 33 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-12 to optionally include a visualization system; wherein the visualization system is configured to display a treatment map on a visualization device, the treatment map including one or more target sites, each of the one or more target sites including an indication of a threshold energy to be delivered to each of the one or more target sites; wherein the visualization system displays the one or more target sites and a visual indicator related to the energy delivered from the energy application apparatus; wherein the control system is configured to detect a quantity of energy being delivered to the one or more target sites; and wherein the control system is configured to move the energy application apparatus to an untreated target site when the threshold energy has been delivered.
  • the visualization system is configured to display a treatment map on a visualization device, the treatment map including one or more target sites, each of the one or more target sites including an indication of a threshold energy to be delivered to each of the one or more target sites; wherein the visualization system displays the one or more target sites and a visual indicator related to the energy delivered
  • Aspect 34 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-12 to optionally include a circuit including the working end and a grounding source; wherein the control system is configured to detect the quantity of energy being delivered according to a resistance measured within the circuit.
  • Aspect 35 can include, or can optionally be combined with the subject matter of one or any combination of Aspects 1-13 to optionally include a sensor in communication with the visualization system and the control system; wherein the sensor includes one or more an optical sensor, an electromagnetic sensor, a biophysical sensor, or a biochemical sensor; wherein the sensor is configured to sense a target site characteristic; wherein the sensor is configured to provide signals related to locations of treated target sites, untreated target sites, or both to the control system.
  • Aspect 36 can include subject matter such as a medical treatment system for treating a target tissue, the medical treatment system comprising: an energy application apparatus, including: a plasma application apparatus; and a working end configured to deliver a quantity of plasma toward the target tissue; a grounding source configured to be opposed to the energy application apparatus; a control system coupled with the energy application apparatus, the control system configured to measure electrical resistance between the working SLW Matter No.5409.897WO1 end and the grounding source, and the control system is configured to receive electrical resistance feedback signals; an adjustment mechanism coupled with the energy application apparatus and in communication with the control system, the adjustment mechanism configured to alter a position of the working end; and a visualization system in communication with the control system, the visualization system including: an image projector configured to project a treatment map.
  • an energy application apparatus including: a plasma application apparatus; and a working end configured to deliver a quantity of plasma toward the target tissue
  • a grounding source configured to be opposed to the energy application apparatus
  • a control system coupled with the energy application apparatus, the control system configured to measure
  • Aspect 37 can include, or can optionally be combined with the subject matter of Aspect 16, to optionally include the adjustment mechanism is a manual adjustment mechanism.
  • Aspect 38 can include, or can optionally be combined with the subject matter of Aspect 16-17, to optionally include an optical system operably coupled with the energy application apparatus and the control system; wherein the optical system is configured to detect a treatment characteristic of the target tissue, the optical system configured to communicate the treatment characteristic to the control system; wherein the control system is configured to communicate with the adjustment mechanism based on the treatment characteristic.
  • Aspect 39 can include, or can optionally be combined with the subject matter of Aspect 16-18, to optionally include the control system is configured to communicate the treatment characteristic to the visualization system; wherein the visualization system is configured to adjust the treatment map according to the treatment characteristic.
  • Aspect 40 can include, or can optionally be combined with the subject matter of Aspect 16-19, to optionally include the energy application apparatus includes: at least one gas source; and a radio frequency circuit configured to generate an electrical discharge; wherein the electrical discharge includes plasma.
  • Aspect 41 can include, or can optionally be combined with the subject matter of Aspect 16-20, to optionally include the plasma includes cold plasma.
  • Aspect 42 can include, or can optionally be combined with the subject matter of Aspect 16-11, to optionally include the working end includes a nozzle; wherein the control system is configured to detect the quantity of plasma being delivered through the nozzle according to a resistance measured within a circuit formed between the working end and the grounding source.
  • Aspect 43 can include, or can optionally be combined with the subject matter of Aspect 16-22, to optionally include an endoscope including the energy application apparatus, SLW Matter No.5409.897WO1 the endoscope including: a catheter coupled with the endoscope; and a laser fiber extending within the catheter, the laser fiber configured emit light or energy to measure a distance from the working end to a target site.
  • Aspect 44 can include, or can optionally be combined with the subject matter of Aspect 16-23, to optionally include a flow rate of plasma delivered from the working end is calculated based on a resistivity measured between the working end and the grounding source.
  • Aspect 45 can include, or can optionally be combined with the subject matter of Aspect 16-24, to optionally include the energy application apparatus is configured to emit plasma; wherein the plasma includes a quantity of RONS; wherein the treatment map is divided into a plurality of target sites, each target site of the plurality of target sites includes an indication of a threshold of the quantity of RONS to be delivered; wherein the control system is configured to determine the quantity of RONS delivered, the determination of the quantity of RONS delivered based on one or more of a type of gas used, a flow rate of the gas, dimensions of the energy application apparatus, a distance between the working end and the target tissue, or resistivity between the working end and the grounding source; and wherein the control system is configured to adjust the energy application apparatus to
  • Aspect 46 can include subject matter such as a method for treating a target tissue comprising: generating plasma within an energy application apparatus; emitting the plasma from a working end of the energy application apparatus toward a target site; measuring a resistance between an emission portion of the working end and a ground; and adjusting a position of the working end based on the resistance measured.
  • Aspect 47 can include, or can optionally be combined with the subject matter of Aspect 26, to optionally include comprising: preparing a treatment map containing the target site; displaying the treatment map on a visualization device; determining a specified amount of a gas to be used to form plasma; applying plasma to at least one target site according to the measured resistance; and adjusting the treatment map according to the plasma applied to the at least one target site.
  • Aspect 48 can include, or can optionally be combined with the subject matter of Aspect 26-27, to optionally include wherein generating plasma includes: emitting a gas towards a radio frequency circuit; subjecting the gas to energy from the radio frequency circuit; and converting the gas into cold plasma.
  • Aspect 49 can include, or can optionally be combined with the subject matter of Aspect 26-28 to optionally include measuring the resistance is performed continuously; and wherein the adjusting the position includes adjusting the position of the working end in real- time.
  • Aspect 50 can include, or can optionally be combined with the subject matter of Aspect 26-29 to optionally include the target tissue includes tissue affected by one or more of cancer, tumors, burns, or ulcers.
  • Aspect 51 can include, or can optionally be combined with the subject matter of Aspect 26-30 to optionally include a quantity of plasma applied is calculated based on a distance from the working end to the target site.
  • the present inventors also contemplate aspects or examples in which only those elements shown or described are provided. Moreover, the present inventors also contemplate aspects or examples using any combination or permutation of those elements shown or described (or one or more features thereof), either with respect to a particular aspects or examples (or one or more features thereof), or with respect to other Aspects (or one or more features thereof) shown or described herein. [0176] In the event of inconsistent usages between this document and any documents so incorporated by reference, the usage in this document controls.
  • Geometric terms such as “parallel”, “perpendicular”, “round”, or “square”, are not intended to require absolute mathematical precision, unless the context indicates otherwise. Instead, such geometric terms allow for variations due to manufacturing or equivalent functions. For example, if an element is described as “round” or “generally round,” a component that is not precisely circular (e.g., one that is slightly oblong or is a many-sided polygon) is still encompassed by this description.
  • the above description is intended to be illustrative, and not restrictive. For example, the above-described aspects or examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments can be used, such as by one of ordinary skill in the art upon reviewing the above description.

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Abstract

L'invention concerne un système de traitement médical comprenant un appareil d'application d'énergie. L'appareil d'application d'énergie peut comprendre une source électrique et une extrémité opératoire conçue pour délivrer de l'énergie à un site cible. Le site cible peut contenir un tissu non sain. Le système de traitement médical peut également comprendre une source de mise à la terre couplée fonctionnelle à l'appareil d'application d'énergie. Un système de visualisation peut également être inclus dans le système de traitement médical. Le système de visualisation peut comprendre un dispositif de visualisation qui peut afficher une carte de traitement sur laquelle est identifié un site cible contenant le tissu non sain.
PCT/US2024/054017 2023-11-01 2024-10-31 Dispositif de traitement au plasma et méthode d'utilisation Pending WO2025096867A1 (fr)

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Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006087547A1 (fr) * 2005-02-17 2006-08-24 Rhytec Limited Système de traitement de tissu
US20150165243A1 (en) * 2004-09-24 2015-06-18 Guided Therapy Systems, Llc System and Method for Treating Cartilage and Injuries to Joints and Connective Tissue
US20180103991A1 (en) * 2016-10-18 2018-04-19 Btl Holdings Limited Device and method for tissue treatment by combination of energy and plasma
US20190336215A1 (en) * 2017-01-27 2019-11-07 Apyx Medical Corporation Apparatus and method for cold plasma skin resurfacing
US20200038530A1 (en) * 2018-07-31 2020-02-06 L'oreal Generating cold plasma away from skin, and associated systems and methods
WO2021133734A2 (fr) * 2019-12-27 2021-07-01 L'oreal Dispositif de génération de plasma froid avec commande de position et réseau de génération de plasma froid
US20210196340A1 (en) * 2019-12-30 2021-07-01 L'oreal Cold plasma generating device with positional control
US20210196337A1 (en) * 2019-12-26 2021-07-01 Jerome Canady Research Institute for Advanced Biological and Technological Sciences Method for treatment for combination cold atmospheric plasma therapy of solid tumors
US20230233871A1 (en) * 2020-06-03 2023-07-27 Cosmetic Edge Pty Ltd Adaptive dermal care methods and apparatus
US20240074695A1 (en) * 2022-09-07 2024-03-07 Erbe Elektromedizin Gmbh Treatment device and method for creating a treatment plan map

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20150165243A1 (en) * 2004-09-24 2015-06-18 Guided Therapy Systems, Llc System and Method for Treating Cartilage and Injuries to Joints and Connective Tissue
WO2006087547A1 (fr) * 2005-02-17 2006-08-24 Rhytec Limited Système de traitement de tissu
US20180103991A1 (en) * 2016-10-18 2018-04-19 Btl Holdings Limited Device and method for tissue treatment by combination of energy and plasma
US20190336215A1 (en) * 2017-01-27 2019-11-07 Apyx Medical Corporation Apparatus and method for cold plasma skin resurfacing
US20200038530A1 (en) * 2018-07-31 2020-02-06 L'oreal Generating cold plasma away from skin, and associated systems and methods
US20210196337A1 (en) * 2019-12-26 2021-07-01 Jerome Canady Research Institute for Advanced Biological and Technological Sciences Method for treatment for combination cold atmospheric plasma therapy of solid tumors
WO2021133734A2 (fr) * 2019-12-27 2021-07-01 L'oreal Dispositif de génération de plasma froid avec commande de position et réseau de génération de plasma froid
US20210196340A1 (en) * 2019-12-30 2021-07-01 L'oreal Cold plasma generating device with positional control
US20230233871A1 (en) * 2020-06-03 2023-07-27 Cosmetic Edge Pty Ltd Adaptive dermal care methods and apparatus
US20240074695A1 (en) * 2022-09-07 2024-03-07 Erbe Elektromedizin Gmbh Treatment device and method for creating a treatment plan map

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