CA2632970A1 - System for dissociation and removal of proteinaceous tissue - Google Patents

System for dissociation and removal of proteinaceous tissue Download PDF

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Publication number
CA2632970A1
CA2632970A1 CA002632970A CA2632970A CA2632970A1 CA 2632970 A1 CA2632970 A1 CA 2632970A1 CA 002632970 A CA002632970 A CA 002632970A CA 2632970 A CA2632970 A CA 2632970A CA 2632970 A1 CA2632970 A1 CA 2632970A1
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CA
Canada
Prior art keywords
tissue
electrodes
proteinaceous
electrical field
pulsed
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.)
Granted
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CA002632970A
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French (fr)
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CA2632970C (en
Inventor
Steven W. Kovalcheck
John C. Huculak
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Alcon Inc
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Individual
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Publication of CA2632970C publication Critical patent/CA2632970C/en
Expired - Fee Related legal-status Critical Current
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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
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery

Abstract

An apparatus and method for the dissociation of soft proteinaceous tissue using pulsed rapid variable direction en-ergy field flow fractionization is disclosed. The pulsed rapid disruptive energy field is created by the use of a probe which surrounds the soft proteinaceous tissue to be removed. Once the adhesive mechanism between tissue constituents has been compromised, flu-idic techniques are used to remove the dissociated tissue.

Claims (43)

1. A system for breaking the bonds which hold portions of soft tissue together, said system comprising:
a probe for surrounding the soft tissue;
said probe including a plurality of electrodes;
a system for creating a pulsed rapid disruptive electrical field between multiple pairs of said plurality of electrodes;
an aspiration system associated with said probe;
whereby said pulsed rapid disruptive electrical field will partially liquefy a proteinaceous complex and cause momentary dissociation of the adhesive mechanism between consistent parts of the soft tissue, and said aspiration system will remove said dissociated tissue.
2. The system, as defined in Claim 1, wherein said pulsed rapid disruptive electrical field is substantially orthogonal to the soft tissue to be dissociated.
3. The system, as defined in Claim 1, wherein said pulsed rapid disruptive electrical field between multiple pairs of said electrodes is created by continual reversal of electrode polarity and sequential changing of active electrodes.
4. The system, as defined in Claim 1, wherein said pulsed rapid disruptive electrical field between multiple pairs of said electrodes is created by reversal of electrode polarity, by switching active electrodes, or by combinations of both.
5. The system, as defined in Claim 1, wherein said aspiration system removes the dissociated soft tissue at the moment of dissociation.
6. The system, as defined in Claim 1, wherein said plurality of electrodes is immersed in a conducting medium.
7. The system, as defined in Claim 1, where irrigation fluid is provided to maintain stable impedance between electrodes.
8. The system, as defined in Claim 1, wherein the pulse shape, the pulse repetition rate, and the pulse train lengths are tuned to the tissue to be dissociated.
9. A method for dissociation of macroscopic volume of proteinaceous tissue, said method comprising the step of:
creation of a proteinaceous liquid complex by establishing a confined, localized, non-thermal disruptive region of electrical force within the extracellular matrix of the proteinaceous tissue.
10. The method, as defined in Claim 9, wherein said creation of a confined, localized, non-thermal disruptive region of electrical force within the extracellular matrix of the proteinaceous tissue creates momentary dissociation of the proteinaceous complexes and local liquefaction of the macroscopic volume of proteinaceous tissue.
11. The method, as defined in Claim 10, further including the step of applying aspiration when the confined, localized, non-thermal, disruptive region of electrical force is created.
12. The method, as defined in Claim 10, including stage of applying irrigation to dilute and maintain stable impedance.
13. The method, as defined in Claim 11, wherein the aspiration is sufficient to remove the dissociated macroscopic volume of tissue before the momentary dissociation of the proteinaceous complexes and local liquefaction terminates.
14. The method, as defined in Claim 9, wherein said creation of a confined, localized, non-thermal disruptive region of electrical force weakens the hydrophobic and hydrostatic bonds in the proteinaceous tissue.
15. The method, as defined in Claim 13, wherein the weakening of the hydrophobic and hydrostatic bonds in the proteinaceous tissue increases fluidity of particulate proteins and proteinaceous structures.
16. The method, as defined in Claim 9, wherein the creation of a confined, localized, non-thermal disruptive region of electrical force is created by use of a variable direction high-intensity pulsed electrical field.
17. The method, as defined in Claim 16, wherein said pulsed electrical field includes a square pulse of electrical energy of nanosecond duration.
18. The method, as defined in Claim 16, wherein said pulsed electrical field includes pulses with rise-and-fall times of < 5 nanoseconds.
19. The method, as defined in Claim 16, wherein the strength of said electrical field is > 1kV/cm.
20. The method, as defined in Claim 9, wherein the creation of a confined, localized, non-thermal disruptive region of electrical force is directly or indirectly created by use of microwave energy.
21. The method, as defined in Claim 9, wherein the creation of a confined, localized, non-thermal disruptive region of electrical force is directly or indirectly created by use of lasers.
22. The method, as defined in Claim 21, wherein the laser operates with pulse duration in the femtosecond range and at substantially the peak absorption frequency of water.
23. The method, as defined in Claim 9, wherein the creation of a confined, localized, non-thermal disruptive region of electrical force is directly or indirectly created by use of ultrasound.
24. A method of performing vitreoretinal surgery, including tissue dissociation, said method comprising the steps of:
inserting a hollow probe into posterior region of the eye using a pars plana approach;
surrounding a volume of tissue with said hollow probe;
creating a high-intensity ultrashort-pulsed electrical field with electrodes located within said hollow probe to create disorder in the electrons involved in the noncovalent bonds holding vitreous complexes together;
removal of said volume of tissue before reassembly of non-covalent proteinaceous relationships can occur.
25. The method, as defined in Claim 24, wherein said high-intensity ultrashort-pulsed electrical field includes a stepwise continual change in the direction of the field.
26. The method, as defined in Claim 24, wherein said high-intensity ultrashort-pulsed electrical field includes a stepwise continual change in the polarity of the field.
27. The method, as defined in Claim 24, wherein said high-intensity ultrashort-pulsed electrical field is substantially orthogonal to said volume of tissue to be dissociated.
28. The method, as defined in Claim 24, wherein said volume of tissue is removed by aspiration.
29. The method, as defined in Claim 24, wherein a conducting medium is used to maintain a stable electrical environment for said high-intensity ultrashort-pulsed electrical field.
30. The method, as defined in Claim 24, wherein the pulses in said high-intensity ultrashort-pulsed electrical field are used to dissociated proteinaceous components of tissue.
31. A system for creating a high-intensity, ultrashort-pulsed electrical field between electrodes of the tip of a hollow surgical probe surrounding a volume of tissue, said system comprising:
a pulse power generator;
a pulse-forming network connected to said pulse power generator;
a switching circuit connected to said pulse-forming network, said switching circuit controlling the duration and the frequency of electrical pulses between the electrodes;
whereby the high-intensity, ultrashort-pulsed electrical field is sufficient to create a proteinaceous liquid complex allowing for momentary dissociation of the volume of tissue.
32. The system, as defined in Claim 31, wherein said switching circuit changes the activation sequence of the electrodes.
33. The system, as defined in Claim 31, wherein said switching circuit changes the polarity of the electrodes.
34. The system, as defined in Claim 31, wherein said switching circuit changes the field direction between electrodes.
35. The system, as defined in Claim 31, further including a conducting medium between the electrodes.
36. The system, as defined in Claim 31, further including a fluid between the electrodes that maintains a stable electrical environment.
37. The system, as defined in Claim 31, further including an aspiration system to remove said dissociated tissue at said moment of dissociation.
38. The system, as defined in Claim 31, wherein said switching circuit changes the voltage amplitude per pulse burst cycle.
39. The system, as defined in Claim 31, wherein said switching circuit changes the frequency per pulse burst cycle.
40. The system, as defined in Claim 31, wherein said switching circuit changes the duty cycle per pulse burst cycle.
41. The system, as defined in Claim 31, wherein said switching circuit changes the pulse pattern per pulse burst cycle.
42. The system, as defined in Claim 31, further comprising irrigation fluid with pH properties conducive to electric filed induced dissociation of protetinaceous tissue.
43. The system, as defined in Claim 31, further comprising irrigation fluid with ingredients conducive to electric filed induced dissociation of protetinaceous tissue.
CA2632970A 2006-01-03 2006-12-11 System for dissociation and removal of proteinaceous tissue Expired - Fee Related CA2632970C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US75583906P 2006-01-03 2006-01-03
US60/755,839 2006-01-03
PCT/US2006/047185 WO2007081474A2 (en) 2006-01-03 2006-12-11 System for dissociation and removal of proteinaceous tissue

Publications (2)

Publication Number Publication Date
CA2632970A1 true CA2632970A1 (en) 2007-07-19
CA2632970C CA2632970C (en) 2012-01-24

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US (2) US7824870B2 (en)
EP (1) EP1968470B1 (en)
JP (1) JP5032500B2 (en)
KR (1) KR101296325B1 (en)
CN (1) CN101389280B (en)
AR (1) AR058905A1 (en)
AT (1) ATE466537T1 (en)
AU (1) AU2006335194B2 (en)
BR (1) BRPI0620895B8 (en)
CA (1) CA2632970C (en)
DE (1) DE602006014206D1 (en)
ES (1) ES2342790T3 (en)
IL (1) IL192344A (en)
MX (1) MX2008008598A (en)
RU (1) RU2419394C2 (en)
TW (1) TWI360410B (en)
WO (1) WO2007081474A2 (en)

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