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WO2025160398A3 - Apparatuses, systems, and methods for control of energy delivery to tissue including waveform examples - Google Patents

Apparatuses, systems, and methods for control of energy delivery to tissue including waveform examples

Info

Publication number
WO2025160398A3
WO2025160398A3 PCT/US2025/012956 US2025012956W WO2025160398A3 WO 2025160398 A3 WO2025160398 A3 WO 2025160398A3 US 2025012956 W US2025012956 W US 2025012956W WO 2025160398 A3 WO2025160398 A3 WO 2025160398A3
Authority
WO
WIPO (PCT)
Prior art keywords
electrodes
segments
examples
control
energy delivery
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/US2025/012956
Other languages
French (fr)
Other versions
WO2025160398A2 (en
Inventor
Kenneth AYCOCK
Timothy O'brien
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Intuitive Surgical Operations Inc
Original Assignee
Intuitive Surgical Operations Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Intuitive Surgical Operations Inc filed Critical Intuitive Surgical Operations Inc
Publication of WO2025160398A2 publication Critical patent/WO2025160398A2/en
Publication of WO2025160398A3 publication Critical patent/WO2025160398A3/en
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00482Digestive system
    • A61B2018/00494Stomach, intestines or bowel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/0075Phase
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00761Duration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00767Voltage
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/124Generators therefor switching the output to different electrodes, e.g. sequentially
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/1253Generators therefor characterised by the output polarity monopolar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/126Generators therefor characterised by the output polarity bipolar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1266Generators therefor with DC current output
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1407Loop
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/142Electrodes having a specific shape at least partly surrounding the target, e.g. concave, curved or in the form of a cave
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1467Probes or electrodes therefor using more than two electrodes on a single probe
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/20Applying electric currents by contact electrodes continuous direct currents
    • A61N1/30Apparatus for iontophoresis, i.e. transfer of media in ionic state by an electromotoric force into the body, or cataphoresis
    • A61N1/303Constructional details
    • A61N1/306Arrangements where at least part of the apparatus is introduced into the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/327Applying electric currents by contact electrodes alternating or intermittent currents for enhancing the absorption properties of tissue, e.g. by electroporation

Landscapes

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

Abstract

Example described herein include energizing techniques for ablation. In some examples, a self-sizable ablation device may include a flexible circuit including multiple segments of electrodes. Generator circuitry may individually energize electrodes of the multiple segments. The generator circuitry may utilize pulsed electric fields to control activation of selected segments of electrodes of the multiple segments of electrodes to control an amount of energy applied to the treatment region below an energy threshold for muscle stimulation. In some examples, the generator circuitry may provide pulses to segments of electrodes in a bipolar or monopolar manner. By selecting areas of ablation by selectively activating segments of electrodes in a sequence, and an amount and polarities of voltages or currents for energizing electrodes, muscle stimulation may be reduced. Examples of waveforms for use in energy delivery are described.
PCT/US2025/012956 2024-01-24 2025-01-24 Apparatuses, systems, and methods for control of energy delivery to tissue including waveform examples Pending WO2025160398A2 (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US202463624613P 2024-01-24 2024-01-24
US63/624,613 2024-01-24
US202463719029P 2024-11-11 2024-11-11
US63/719,029 2024-11-11

Publications (2)

Publication Number Publication Date
WO2025160398A2 WO2025160398A2 (en) 2025-07-31
WO2025160398A3 true WO2025160398A3 (en) 2025-09-04

Family

ID=94733132

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2025/012956 Pending WO2025160398A2 (en) 2024-01-24 2025-01-24 Apparatuses, systems, and methods for control of energy delivery to tissue including waveform examples

Country Status (1)

Country Link
WO (1) WO2025160398A2 (en)

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013052590A1 (en) * 2011-10-04 2013-04-11 Vessix Vascular, Inc. Apparatus and method for treatment of in-stent restenosis
EP3173043A1 (en) * 2008-11-11 2017-05-31 Shifamed Holdings, LLC Low profile electrode assembly
EP3248561A1 (en) * 2016-05-23 2017-11-29 Covidien LP An electrosurgical generator, a system and non-surgical test method for temperature enhanced irreversible electroporation
US20180303543A1 (en) * 2017-04-24 2018-10-25 Medtronic Cryocath Lp Enhanced electroporation of cardiac tissue
WO2020051241A1 (en) * 2018-09-04 2020-03-12 Inter Science Gmbh Methods, systems, and apparatuses for tissue ablation using a modulated exponential decay pulse
WO2021081131A1 (en) * 2019-10-21 2021-04-29 DyaMX, Inc. Devices, systems, and methods for pulsed electric field treatment of the duodenum
WO2021113463A1 (en) * 2019-12-03 2021-06-10 St. Jude Medical, Cardiology Division, Inc. Electroporation system and method
WO2023049954A1 (en) * 2021-10-01 2023-04-06 Microfield Global Pty Ltd Method, systems, apparatuses and devices for cardiac tissue characterization and ablation using reversible electroporation and electrolysis
WO2023205469A1 (en) * 2022-04-22 2023-10-26 Intuitive Surgical Operations, Inc. Permeabilization and electrolysis for ablation with extracellular matrix retention

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3173043A1 (en) * 2008-11-11 2017-05-31 Shifamed Holdings, LLC Low profile electrode assembly
WO2013052590A1 (en) * 2011-10-04 2013-04-11 Vessix Vascular, Inc. Apparatus and method for treatment of in-stent restenosis
EP3248561A1 (en) * 2016-05-23 2017-11-29 Covidien LP An electrosurgical generator, a system and non-surgical test method for temperature enhanced irreversible electroporation
US20180303543A1 (en) * 2017-04-24 2018-10-25 Medtronic Cryocath Lp Enhanced electroporation of cardiac tissue
WO2020051241A1 (en) * 2018-09-04 2020-03-12 Inter Science Gmbh Methods, systems, and apparatuses for tissue ablation using a modulated exponential decay pulse
WO2021081131A1 (en) * 2019-10-21 2021-04-29 DyaMX, Inc. Devices, systems, and methods for pulsed electric field treatment of the duodenum
WO2021113463A1 (en) * 2019-12-03 2021-06-10 St. Jude Medical, Cardiology Division, Inc. Electroporation system and method
WO2023049954A1 (en) * 2021-10-01 2023-04-06 Microfield Global Pty Ltd Method, systems, apparatuses and devices for cardiac tissue characterization and ablation using reversible electroporation and electrolysis
WO2023205469A1 (en) * 2022-04-22 2023-10-26 Intuitive Surgical Operations, Inc. Permeabilization and electrolysis for ablation with extracellular matrix retention

Also Published As

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