WO1997043970A1 - Apparatus and methods for ablating turbinates - Google Patents

Apparatus and methods for ablating turbinates Download PDF

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Publication number
WO1997043970A1
WO1997043970A1 PCT/US1997/002960 US9702960W WO9743970A1 WO 1997043970 A1 WO1997043970 A1 WO 1997043970A1 US 9702960 W US9702960 W US 9702960W WO 9743970 A1 WO9743970 A1 WO 9743970A1
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WIPO (PCT)
Prior art keywords
substance
turbinate
exudable
energy
porous membrane
Prior art date
Application number
PCT/US1997/002960
Other languages
French (fr)
Inventor
Stuart D. Edwards
Original Assignee
Somnus Medical Technologies, 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 Somnus Medical Technologies, Inc. filed Critical Somnus Medical Technologies, Inc.
Priority to AU21916/97A priority Critical patent/AU2191697A/en
Publication of WO1997043970A1 publication Critical patent/WO1997043970A1/en

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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
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1477—Needle-like probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/06—Electrodes for high-frequency therapy
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/0022—Balloons
    • A61B2018/0025—Multiple balloons
    • A61B2018/00261—Multiple balloons arranged in a line
    • 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
    • A61B2018/00761—Duration
    • 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
    • A61B2018/00886—Duration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/02—Radiation therapy using microwaves
    • A61N5/04—Radiators for near-field treatment

Definitions

  • the nasal structures (such as turbinates) can become enlarged, causing air space through the nasal passages to become restricted In these cases it would be desirable to reduce the size of the turbinates and thus alleviate the constriction of the nasal passages
  • the invention provides apparatus and a method for ablating at least a portion of a turbinate
  • a catheter having a porous membrane coupled to a source of an exudable substance is disposed proximate to the turbinate, whereby the exudable substance is emitted from the catheter and contacts the turbinate
  • an electrode is disposed proximate to the turbinate, whereby the exudable substance aids the electrode in delivering ablating energy to the turbinate
  • the exudable substance is preferably a dielectric substance, such as saline, which aids in delivery of energy, and may include substances with other bioactive, chemoactive, or radioactive effects
  • the energy delivered to the turbinate is preferably RF energy which ablates the turbinate by heat and cell destruction
  • the catheter is preferably coupled to an energy source which provides energy delivered to the turbinate
  • the catheter preferably includes at least one sensor, such as a temperature sensor, and a communication link coupling the sensor to apparatus which controls the energy source, whereby feedback from the sensor is used to control operation of the energy source
  • the catheter may include a lumen which delivers the exudable substance to the porous membrane
  • the porous membrane may be microporous, or may include holes which allow the exudable substance to flow out from the catheter BRIEF DESCRIPTION OF THE DRAWINGS
  • Figure 1 shows a cut-away cross section of a patient's nose, showing a nasal cavity and a set of turbinates.
  • Figure 2 shows apparatus for ablating turbinates.
  • Figure 1 shows a cut-away cross section of a patient's nose, showing a nasal cavity and a set of turbinates.
  • the patient is a mature adult human being.
  • the patient may be a child, a neonate, a fetus in utero.
  • the patient may be an animal subject to veterinary medicine.
  • a patient's nose 100 comprises at least one nasal cavity 101; the nasal cavity 101 comprises a set of turbinates 102, including a middle nasal concha (turbinate) 103 and an inferior nasal concha (turbinate) 104.
  • the inferior nasal concha (turbinate) 104 comprises an anterior portion
  • Ablating the inferior nasal concha (turbinate) 104, and preferably ablating the anterior portion 105, does not substantially degrade the function of the inferior nasal concha 104. Ablating the inferior nasal concha (turbinate) 104, and preferably the anterior portion 105, can therefore be performed to achieve the goals of ablating the turbinates 102 without substantial suffering of disadvantages of ablating the turbinates 102.
  • a method embodying the present invention is to ablate the turbinates 102, but to limit that ablation to the inferior nasal concha 104, and preferably to limit that ablation to the anterior portion 105 thereof.
  • the anterior portion 105 is defined as being no larger than about one-third the volume of the inferior nasal concha 104.
  • the anterior portion 105 is ablated, no more than about one-third of the inferior nasal concha 104 is ablated.
  • a catheter assembly 200 comprises a catheter tip 201 and a catheter tube 202.
  • the catheter tip 201 comprises an structure having a distal end 203, a proximal end 204, a center 205 having a lumen 206, and a surface 207.
  • the catheter tip 201 has a straight elongated shape.
  • the catheter tip 201 may have another shape, such as a curved shape, or a shape adapted to fit into or to avoid a body structure, such as a curved shape disposed to fit inside a blood vessel or an eyelid.
  • the catheter tip 201 is manufactured with a predetermined (straight) shape.
  • the catheter tip 201 may be bendable or otherwise malleable to adopt a selected shape, may be dynamically adaptable to shapes selected by an operator, or may be actively adaptive to take on new shapes as it encounters obstructions or other body structures.
  • the center 205 of the catheter tip 201 is coupled to the catheter tube 202 at the proximal end 204 of the catheter tip 201, so that substances can flow from the catheter tube 202 into the lumen 206
  • the substance flowed from the catheter tube 202 into the lumen 206 comprises saline, the saline comprising distilled water with a NaCl content of less than about 10% by weight.
  • the flowed substance may comprise saline with another amount of salt or another salt, may comprise a solution of other substances in other water or other solvents, or may comprise a substance with bioactive, chemoactive, or radioactive effects, such as an ablative acidic or alkaline substance, an antibiotic, a compound used for chemotherapy, or a fluorescent or radioactive dye or marker, or some combination of these substances with each other or with some other substance.
  • the surface 207 of the catheter tip 201 comprises a sheath 208.
  • the sheath 208 has a generally cylindrical shape, thus surrounding the lumen 206, and comprises a plurality of holes 209 disposed so that substances can flow from the lumen 206 out through the sheath 208 to outside the catheter tip 201
  • the sheath 208 comprises a relatively inert and relatively hard substance, such as metallic copper or metallic silver.
  • the sheath 208 may comprise other relatively inert and relatively hard substances, such as gold, stainless steel, titanium, various plastic compounds, or some combination of these substances with each other or with some other substance
  • the sheath 208 has a traverse diameter of about 6 french One french is about 0 015 inches, thus 6 french is about 0 090 inches
  • the sheath 208 may have another size, such as less than 2 french, between about 2 to about 6 french, or more than 6 french
  • the sheath 208 has a thickness of about 0 001 inches, this embodiment is particularly preferred in the case when the sheath 208 is copper
  • the surface 207 of the catheter tip 201 also comprises a porous membrane 210 surrounding the sheath 208, disposed so that when substances flow out from the lumen 206, they encounter the membrane 210 and are trapped therein. As the membrane 210 is porous, the substances flow out through the membrane 210 and into proximity with the turbinate (specifically, the anterior portion 105 of the inferior nasal concha 104)
  • the membrane 210 comprises a microporous and inflatable balloon As the substances flow into the membrane 210, pressure from the flow causes the balloon to inflate and to come into contact with the turbinate's anterior portion 105
  • the catheter tip 201 comprises at least one ring electrode 21 1 disposed proximate to the membrane 210 There may be a plurality of ring electrodes 21 1, disposed for example parallel with a first ring electrode 211 shown in figure 2 with their axes aligned with a long axis of the catheter tip 201.
  • the ring electrode 211 is coupled to a conductor 212 for coupling to an RF energy source 213
  • a surface (preferably an outside surface) of the membrane 210 is disposed with a plurality of electrodes
  • An example of a suitable surface for disposition on the membrane is shown in Application Serial No 08/319,373, "Thin Layer Ablation Apparatus", filed
  • the catheter tip 201 may comprise a combination of the first and second preferred embodiment disclosed hereinabove may be used, such as a surface coupled using a conductor to a ring electrode 21 1 , which is itself coupled to a conductoi 212 for coupling to an RF energy source 213
  • the RF energy source 213 comprises a power source (or a power regulator coupled to a standard power source such as a wall socket or battery), a signal generator (such as a generator for pulses, sine waves, square waves, or some combination of these wave forms with each other or with some other wave form), and a processor for controlling the signal generator
  • the signal generator generates pulses of RF energy having an RF radiation frequency between about 300 megahertz and about 700 megahertz, such as preferably about 465 megahertz
  • the RF energy may have an RF radiation frequency in the microwave range or in another range of the electromagnetic spectrum
  • the processor controls the signal generator to generate pulses to provide an effective amount of RF energy so as to deliver between about 5 and about 30 watts of RF energy to the turbinate's anterior portion 105, so as to raise a temperature of at least a part of the turbinate's anterior portion 105 to a temperature between about 40 degrees
  • the catheter tip 201 comprises at least one temperature sensor 214, such as a thermocouple or thermistor.
  • the temperature sensor 214 is coupled to a communication link 215 (such as a conductor), which is coupled to the processor.
  • the communication link 215 may comprise a D/A converter coupled to a register disposed for reading by the processor
  • the processor reads an sensor value from the sensor and, responsive thereto, controls the signal generator so as to achieve delivery of an effective amount of RF energy to the turbinate's anterior portion 105
  • the processor thus uses the signal generator, catheter tip 201, ring electrode 21 1, and temperature sensor 214 as a feedback loop for controlled delivery of RF energy to the turbinate's anterior portion 105
  • the processor may control the delivery of RF energy to achieve delivery of a selected amount of energy, to achieve a selected temperature, or to achieve a selected amount of ablation of the turbinate's anterior portion 105
  • the catheter tip 201 may control the delivery of RF energy to achieve delivery of a

Abstract

The invention provides apparatus and a method for ablating at least a portion of an anterior part of the inferior nasal concha (turbinate). A catheter having a porous membrane coupled to a source of an exudable substance is disposed near the turbinate, whereby the exudable substance is emitted from the catheter and contacts the turbinate. An electrode is disposed near the turbinate, whereby the exudable substance aids the electrode in delivering ablating energy to the turbinate. The exudable substance is preferably a dielectric substance, such as saline, which aids in delivery of energy, and may include substances with other bioactive, chemoactive, or radioactive effects. The energy delivered to the turbinate is preferably RF energy which ablates the turbinate by heat and cell destruction. The catheter is preferably coupled to an energy source which provides energy delivered to the turbinate. The catheter preferably includes at least one sensor, such as a temperature sensor, and a communication link coupling the sensor to apparatus which controls the energy source, whereby feedback from the sensor is used to control operation of the energy source. The catheter may include a lumen which delivers the exudable substance to the porous membrane. The porous membrane may be microporous, or may include holes which allow the exudable substance to flow out from the catheter.

Description

APPARATUS AND METHODS FOR ABLATING TURBINATES
Cross Reference to Related Applications
This application is a continuation-in-part of the following co-pending applications Application Serial No 08/265,459, "Thin Layer Ablation Apparatus", filed June 24, 1994, in the name of Stuart D Edwards, Each of these applications is hereby incorporated by reference as if fully set forth herein
BACKGROUND OF THE INVENTION
Field of the Invention This invention relates to apparatus and methods for ablating turbinates
Description of Related Art
In certain known medical conditions, the nasal structures (such as turbinates) can become enlarged, causing air space through the nasal passages to become restricted In these cases it would be desirable to reduce the size of the turbinates and thus alleviate the constriction of the nasal passages
Known methods of reducing the size of the turbinates include surgery and pharmaceutical treatment However, while these known methods achieve the goal of reducing the size of turbinates, they are subject to several drawbacks Surgery has the drawback that it is complex, difficult, expensive, and sometimes subjects the patient to risk which is disproportionate to the adverse medical condition Pharmaceuticals have the drawback that they are sometimes not completely efficacious or efficient, and that they sometimes have adverse side effects It sometimes happens that a patient is not a good candidate for surgery and is unable to achieve relief from pharmaceutical treatment Another known method for reducing the size of body structures is ablation Known methods of ablation include use of chemical or laser ablation, or the use of mechanical devices such as rotatable blades, and using radiated RF energy While known methods of chemical, laser, mechanical, or radiated RF energy ablation could achieve the goal of reducing the size of the patient's turbinates, these known methods have the drawback that they are difficult to control and could therefore cause indiscriminate ablation of turbinates Indiscriminate ablation of turbinates can cause loss of the proper function of that body structure Since known methods of ablation have been unable to avoid substantial unnecessary loss of proper function of the patient's turbinates, these known methods have heretofore been inapplicable to turbinates Accordingly, it would be advantageous to provide improved apparatus and methods for ablation of turbinates
SUMMARY OF THR INVENTION The invention provides apparatus and a method for ablating at least a portion of a turbinate A catheter having a porous membrane coupled to a source of an exudable substance is disposed proximate to the turbinate, whereby the exudable substance is emitted from the catheter and contacts the turbinate In a preferred embodiment, an electrode is disposed proximate to the turbinate, whereby the exudable substance aids the electrode in delivering ablating energy to the turbinate The exudable substance is preferably a dielectric substance, such as saline, which aids in delivery of energy, and may include substances with other bioactive, chemoactive, or radioactive effects
The energy delivered to the turbinate is preferably RF energy which ablates the turbinate by heat and cell destruction The catheter is preferably coupled to an energy source which provides energy delivered to the turbinate
The catheter preferably includes at least one sensor, such as a temperature sensor, and a communication link coupling the sensor to apparatus which controls the energy source, whereby feedback from the sensor is used to control operation of the energy source The catheter may include a lumen which delivers the exudable substance to the porous membrane The porous membrane may be microporous, or may include holes which allow the exudable substance to flow out from the catheter BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 shows a cut-away cross section of a patient's nose, showing a nasal cavity and a set of turbinates.
Figure 2 shows apparatus for ablating turbinates.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Figure 1 shows a cut-away cross section of a patient's nose, showing a nasal cavity and a set of turbinates.
In a preferred embodiment, the patient is a mature adult human being. In alternative embodiments, the patient may be a child, a neonate, a fetus in utero. In further alternative embodiments, the patient may be an animal subject to veterinary medicine.
A patient's nose 100 comprises at least one nasal cavity 101; the nasal cavity 101 comprises a set of turbinates 102, including a middle nasal concha (turbinate) 103 and an inferior nasal concha (turbinate) 104. The inferior nasal concha (turbinate) 104 comprises an anterior portion
105 and a posterior portion 106.
Ablating the inferior nasal concha (turbinate) 104, and preferably ablating the anterior portion 105, does not substantially degrade the function of the inferior nasal concha 104. Ablating the inferior nasal concha (turbinate) 104, and preferably the anterior portion 105, can therefore be performed to achieve the goals of ablating the turbinates 102 without substantial suffering of disadvantages of ablating the turbinates 102.
Accordingly, a method embodying the present invention is to ablate the turbinates 102, but to limit that ablation to the inferior nasal concha 104, and preferably to limit that ablation to the anterior portion 105 thereof.
In a preferred embodiment, the anterior portion 105 is defined as being no larger than about one-third the volume of the inferior nasal concha 104. Thus, in a method embodying the present invention, when the anterior portion 105 is ablated, no more than about one-third of the inferior nasal concha 104 is ablated. Apparatus for Ablating Turbinates
Figure 2 shows apparatus for ablating turbinates. A catheter assembly 200 comprises a catheter tip 201 and a catheter tube 202. The catheter tip 201 comprises an structure having a distal end 203, a proximal end 204, a center 205 having a lumen 206, and a surface 207. In a preferred embodiment, the catheter tip 201 has a straight elongated shape. In alternative embodiments, the catheter tip 201 may have another shape, such as a curved shape, or a shape adapted to fit into or to avoid a body structure, such as a curved shape disposed to fit inside a blood vessel or an eyelid. In a preferred embodiment, the catheter tip 201 is manufactured with a predetermined (straight) shape. In alternative embodiments, the catheter tip 201 may be bendable or otherwise malleable to adopt a selected shape, may be dynamically adaptable to shapes selected by an operator, or may be actively adaptive to take on new shapes as it encounters obstructions or other body structures. The center 205 of the catheter tip 201 is coupled to the catheter tube 202 at the proximal end 204 of the catheter tip 201, so that substances can flow from the catheter tube 202 into the lumen 206
In a preferred embodiment, the substance flowed from the catheter tube 202 into the lumen 206 comprises saline, the saline comprising distilled water with a NaCl content of less than about 10% by weight. In alternative embodiments, the flowed substance may comprise saline with another amount of salt or another salt, may comprise a solution of other substances in other water or other solvents, or may comprise a substance with bioactive, chemoactive, or radioactive effects, such as an ablative acidic or alkaline substance, an antibiotic, a compound used for chemotherapy, or a fluorescent or radioactive dye or marker, or some combination of these substances with each other or with some other substance.
The surface 207 of the catheter tip 201 comprises a sheath 208. The sheath 208 has a generally cylindrical shape, thus surrounding the lumen 206, and comprises a plurality of holes 209 disposed so that substances can flow from the lumen 206 out through the sheath 208 to outside the catheter tip 201
In a preferred embodiment, the sheath 208 comprises a relatively inert and relatively hard substance, such as metallic copper or metallic silver. In alternative embodiments, the sheath 208 may comprise other relatively inert and relatively hard substances, such as gold, stainless steel, titanium, various plastic compounds, or some combination of these substances with each other or with some other substance
In a preferred embodiment, the sheath 208 has a traverse diameter of about 6 french One french is about 0 015 inches, thus 6 french is about 0 090 inches In alternative embodiments, the sheath 208 may have another size, such as less than 2 french, between about 2 to about 6 french, or more than 6 french In a preferred embodiment, the sheath 208 has a thickness of about 0 001 inches, this embodiment is particularly preferred in the case when the sheath 208 is copper The surface 207 of the catheter tip 201 also comprises a porous membrane 210 surrounding the sheath 208, disposed so that when substances flow out from the lumen 206, they encounter the membrane 210 and are trapped therein. As the membrane 210 is porous, the substances flow out through the membrane 210 and into proximity with the turbinate (specifically, the anterior portion 105 of the inferior nasal concha 104)
In a preferred embodiment, the membrane 210 comprises a microporous and inflatable balloon As the substances flow into the membrane 210, pressure from the flow causes the balloon to inflate and to come into contact with the turbinate's anterior portion 105
In a first preferred embodiment, the catheter tip 201 comprises at least one ring electrode 21 1 disposed proximate to the membrane 210 There may be a plurality of ring electrodes 21 1, disposed for example parallel with a first ring electrode 211 shown in figure 2 with their axes aligned with a long axis of the catheter tip 201. The ring electrode 211 is coupled to a conductor 212 for coupling to an RF energy source 213
In a second preferred embodiment, a surface (preferably an outside surface) of the membrane 210 is disposed with a plurality of electrodes An example of a suitable surface for disposition on the membrane is shown in Application Serial No 08/319,373, "Thin Layer Ablation Apparatus", filed
October 6, 1994, in the name of inventors James Baker, et al , and hereby incorporated by reference as if fully set forth herein The surface is coupled to a conductor 212 for coupling to an RF energy source 213
In alternative embodiments, the catheter tip 201 may comprise a combination of the first and second preferred embodiment disclosed hereinabove may be used, such as a surface coupled using a conductor to a ring electrode 21 1 , which is itself coupled to a conductoi 212 for coupling to an RF energy source 213
RF energy is supplied by an RF energy source 213 In a preferred embodiment, the RF energy source 213 comprises a power source (or a power regulator coupled to a standard power source such as a wall socket or battery), a signal generator (such as a generator for pulses, sine waves, square waves, or some combination of these wave forms with each other or with some other wave form), and a processor for controlling the signal generator In a preferred embodiment, the signal generator generates pulses of RF energy having an RF radiation frequency between about 300 megahertz and about 700 megahertz, such as preferably about 465 megahertz In alternative embodiments, the RF energy may have an RF radiation frequency in the microwave range or in another range of the electromagnetic spectrum The processor controls the signal generator to generate pulses to provide an effective amount of RF energy so as to deliver between about 5 and about 30 watts of RF energy to the turbinate's anterior portion 105, so as to raise a temperature of at least a part of the turbinate's anterior portion 105 to a temperature between about 40 degrees Celsius and about 120 degrees Celsius, preferably above about 90 degrees Celsius In a preferred embodiment, the exudable substance, preferably saline, acts as an electrode or an electrolyte for delivering RF energy to the turbinate's anterior portion 105.
The catheter tip 201 comprises at least one temperature sensor 214, such as a thermocouple or thermistor. The temperature sensor 214 is coupled to a communication link 215 (such as a conductor), which is coupled to the processor. For example, in the case where the temperature sensor 214 comprises a thermocouple, the communication link 215 may comprise a D/A converter coupled to a register disposed for reading by the processor The processor reads an sensor value from the sensor and, responsive thereto, controls the signal generator so as to achieve delivery of an effective amount of RF energy to the turbinate's anterior portion 105 The processor thus uses the signal generator, catheter tip 201, ring electrode 21 1, and temperature sensor 214 as a feedback loop for controlled delivery of RF energy to the turbinate's anterior portion 105 For example, the processor may control the delivery of RF energy to achieve delivery of a selected amount of energy, to achieve a selected temperature, or to achieve a selected amount of ablation of the turbinate's anterior portion 105 In alternative embodiments, the catheter tip 201 may comprise other sensors, in addition to or instead of the temperature sensor 214, such as a chemical or biochemical sensor to detect ablation.

Claims

1 Ablation apparatus, comprising a source of an exudable substance, a porous membrane coupled to said source, means for disposing said porous membrane proximate to a turbinate, and an electrode disposed proximate to the turbinate
2 Apparatus as in claim 1, said means for disposing is positioned so that said exudable substance is emitted from the catheter and contacts said turbinate
3 Apparatus as in claim 1, wherein said electrode is disposed a distance from said turbinate to deliver an effective amount of energy to ablate at least a portion of said turbinate
4 Apparatus as in claim 3, wherein said energy comprises RF energy having an RF radiation frequency between about 300 megahertz and about 700 megahertz
5 Apparatus as in claim 3, wherein said energy comprises microwaves
6 Apparatus as in claim 1, comprising a conductor coupled to said electrode, a signal generator coupled to said conductor and coupled to a power source, and a processor coupled to and disposed for controlling said signal generator
7 Apparatus as in claim 6, wherein said processor is disposed for controlling said signal generator to generate pulses to provide an effective amount of RF energy so as to deliver between about 5 and about 30 watts of RF energy to at least a portion of said turbinate
8. Apparatus as in claim 6, wherein said processor is disposed for controlling said signal generator to generate pulses to provide an effective amount of RF energy so as to raise a temperature of at least a portion of said turbinate to a temperature above about 40 degrees Celsius.
9. Apparatus as in claim 6, comprising at least one sensor disposed proximate to said turbinate and coupled to said processor.
10 Apparatus as in claim 9, wherein said sensor is disposed proximate to said means for disposing
1 1 Apparatus as in claim 9, wherein said sensor is disposed proximate to said electrode.
12 Apparatus as in claim 9, wherein said sensor comprises a temperature sensor.
13 Apparatus as in claim 1 , wherein said porous membrane comprises an inflatable element.
14 Apparatus as in claim 1, wherein said porous membrane comprises a microporous element.
15 Apparatus as in claim 1, wherein said source of an exudable substance comprises a lumen, wherein said porous membrane comprises a sheath substantially surrounding said lumen on a plurality of sides, said sheath defining a plurality of passages through which said exudable substance may flow; and wherein said porous membrane comprises an inflatable microporous element substantially surrounding said sheath on a plurality of sides
16 Apparatus as in claim 1 , wherein said means for disposing and said electrode are disposed so that said exudable substance provides substantial aid to said electrode in delivering energy to said turbinate
17 Apparatus as in claim 1, wherein said exudable substance compπses saline
18 Apparatus as in claim 1 , wherein said exudable substance comprises a substance which aids in delivery of energy
19 Apparatus as in claim 1 , wherein said exudable substance comprises a substance with a bioactive, chemoactive, or radioactive effect
20 Apparatus as in claim 1, wherein said exudable substance compπses an ablative substance
21 Apparatus as in claim 1 , wherein said exudable substance compπses an antibiotic
22 Apparatus as in claim 1 , wherein said exudable substance comprises a dye or marker
23 A method for ablation, said method comprising the steps of exuding a substance through a porous membrane into a region proximate to a turbinate, and delivering an amount of RF energy effective to ablate said turbinate 24 A method as in claim 23, wherein said region contacts said turbinate
25 A method as in claim 23, wherein said RF energy has an RF radiation frequency between about 300 megahertz and about 700 megahertz
26 A method as in claim 23, wherein said RF energy comprises microwaves
27 A method as in claim 23, wherein said amount of RF energy is effective to deliver between about 5 and about 30 watts of RF energy to at least a portion of said turbinate
28 Apparatus as in claim 6, wherein said processor is disposed for controlling said signal generator to generate pulses to provide an effective amount of RF energy so as to raise a temperature of at least a portion of said turbinate to a temperature above about 40 degrees Celsius
29 A method as in claim 23, wherein said exudable substance provides substantial aid to said electrode in delivering energy to said turbinate
30 A method as in claim 23, wherein said exudable substance comprises saline
31 A method as in claim 23, wherein said exudable substance comprises a substance with a bioactive, chemoactive, or radioactive effect
32 A method as in claim 23, wherein said exudable substance comprises an ablative substance 33. A method as in claim 23, wherein said exudable substance comprises an antibiotic.
34 A method as in claim 23, wherein said exudable substance comprises a dye or marker.
PCT/US1997/002960 1996-05-22 1997-02-28 Apparatus and methods for ablating turbinates WO1997043970A1 (en)

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US6081749A (en) * 1997-08-13 2000-06-27 Surx, Inc. Noninvasive devices, methods, and systems for shrinking of tissues
US6091995A (en) * 1996-11-08 2000-07-18 Surx, Inc. Devices, methods, and systems for shrinking tissues
US6216704B1 (en) 1997-08-13 2001-04-17 Surx, Inc. Noninvasive devices, methods, and systems for shrinking of tissues
US6237605B1 (en) 1996-10-22 2001-05-29 Epicor, Inc. Methods of epicardial ablation
US6292700B1 (en) 1999-09-10 2001-09-18 Surx, Inc. Endopelvic fascia treatment for incontinence
US6361531B1 (en) 2000-01-21 2002-03-26 Medtronic Xomed, Inc. Focused ultrasound ablation devices having malleable handle shafts and methods of using the same
US6409720B1 (en) 2000-01-19 2002-06-25 Medtronic Xomed, Inc. Methods of tongue reduction using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions
US6413254B1 (en) 2000-01-19 2002-07-02 Medtronic Xomed, Inc. Method of tongue reduction by thermal ablation using high intensity focused ultrasound
US6595934B1 (en) 2000-01-19 2003-07-22 Medtronic Xomed, Inc. Methods of skin rejuvenation using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions
US6692450B1 (en) 2000-01-19 2004-02-17 Medtronic Xomed, Inc. Focused ultrasound ablation devices having selectively actuatable ultrasound emitting elements and methods of using the same
US7004942B2 (en) 1998-01-14 2006-02-28 Solarant Medical, Inc. Ribbed electrodes and methods for their use
US7317949B2 (en) 1996-11-08 2008-01-08 Ams Research Corporation Energy induced bulking and buttressing of tissues for incontinence
US8932208B2 (en) 2005-05-26 2015-01-13 Maquet Cardiovascular Llc Apparatus and methods for performing minimally-invasive surgical procedures
US8968284B2 (en) 2000-10-02 2015-03-03 Verathon Inc. Apparatus and methods for treating female urinary incontinence
US9011428B2 (en) 2011-03-02 2015-04-21 Arthrocare Corporation Electrosurgical device with internal digestor electrode
US9023031B2 (en) 1997-08-13 2015-05-05 Verathon Inc. Noninvasive devices, methods, and systems for modifying tissues
US9055959B2 (en) 1999-07-19 2015-06-16 St. Jude Medical, Atrial Fibrillation Division, Inc. Methods and devices for ablation
US9168082B2 (en) 2011-02-09 2015-10-27 Arthrocare Corporation Fine dissection electrosurgical device
US9254166B2 (en) 2013-01-17 2016-02-09 Arthrocare Corporation Systems and methods for turbinate reduction
US9271784B2 (en) 2011-02-09 2016-03-01 Arthrocare Corporation Fine dissection electrosurgical device
US9788882B2 (en) 2011-09-08 2017-10-17 Arthrocare Corporation Plasma bipolar forceps
US10058380B2 (en) 2007-10-05 2018-08-28 Maquet Cordiovascular Llc Devices and methods for minimally-invasive surgical procedures
US10448992B2 (en) 2010-10-22 2019-10-22 Arthrocare Corporation Electrosurgical system with device specific operational parameters

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Cited By (30)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6237605B1 (en) 1996-10-22 2001-05-29 Epicor, Inc. Methods of epicardial ablation
US6772013B1 (en) 1996-11-08 2004-08-03 Solarant Medical, Inc. Devices, methods, and systems for shrinking tissues
US6091995A (en) * 1996-11-08 2000-07-18 Surx, Inc. Devices, methods, and systems for shrinking tissues
US7317949B2 (en) 1996-11-08 2008-01-08 Ams Research Corporation Energy induced bulking and buttressing of tissues for incontinence
US7167757B2 (en) 1996-11-08 2007-01-23 Ams Research Corporation Energy induced bulking and buttressing of tissue for incontinence
US6836688B2 (en) 1996-11-08 2004-12-28 Solarant Medical, Inc. Devices, methods, and systems for shrinking tissues
US6081749A (en) * 1997-08-13 2000-06-27 Surx, Inc. Noninvasive devices, methods, and systems for shrinking of tissues
US6216704B1 (en) 1997-08-13 2001-04-17 Surx, Inc. Noninvasive devices, methods, and systems for shrinking of tissues
US6035238A (en) * 1997-08-13 2000-03-07 Surx, Inc. Noninvasive devices, methods, and systems for shrinking of tissues
US9023031B2 (en) 1997-08-13 2015-05-05 Verathon Inc. Noninvasive devices, methods, and systems for modifying tissues
US7004942B2 (en) 1998-01-14 2006-02-28 Solarant Medical, Inc. Ribbed electrodes and methods for their use
US9055959B2 (en) 1999-07-19 2015-06-16 St. Jude Medical, Atrial Fibrillation Division, Inc. Methods and devices for ablation
US6751507B2 (en) 1999-09-10 2004-06-15 Solarant Medical, Inc. Endopelvic fascia treatment for incontinence
US6292700B1 (en) 1999-09-10 2001-09-18 Surx, Inc. Endopelvic fascia treatment for incontinence
US6692450B1 (en) 2000-01-19 2004-02-17 Medtronic Xomed, Inc. Focused ultrasound ablation devices having selectively actuatable ultrasound emitting elements and methods of using the same
US6595934B1 (en) 2000-01-19 2003-07-22 Medtronic Xomed, Inc. Methods of skin rejuvenation using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions
US6413254B1 (en) 2000-01-19 2002-07-02 Medtronic Xomed, Inc. Method of tongue reduction by thermal ablation using high intensity focused ultrasound
US6409720B1 (en) 2000-01-19 2002-06-25 Medtronic Xomed, Inc. Methods of tongue reduction using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions
US6361531B1 (en) 2000-01-21 2002-03-26 Medtronic Xomed, Inc. Focused ultrasound ablation devices having malleable handle shafts and methods of using the same
US8968284B2 (en) 2000-10-02 2015-03-03 Verathon Inc. Apparatus and methods for treating female urinary incontinence
US8932208B2 (en) 2005-05-26 2015-01-13 Maquet Cardiovascular Llc Apparatus and methods for performing minimally-invasive surgical procedures
US10058380B2 (en) 2007-10-05 2018-08-28 Maquet Cordiovascular Llc Devices and methods for minimally-invasive surgical procedures
US10993766B2 (en) 2007-10-05 2021-05-04 Maquet Cardiovascular Llc Devices and methods for minimally-invasive surgical procedures
US10448992B2 (en) 2010-10-22 2019-10-22 Arthrocare Corporation Electrosurgical system with device specific operational parameters
US9168082B2 (en) 2011-02-09 2015-10-27 Arthrocare Corporation Fine dissection electrosurgical device
US9271784B2 (en) 2011-02-09 2016-03-01 Arthrocare Corporation Fine dissection electrosurgical device
US9011428B2 (en) 2011-03-02 2015-04-21 Arthrocare Corporation Electrosurgical device with internal digestor electrode
US9788882B2 (en) 2011-09-08 2017-10-17 Arthrocare Corporation Plasma bipolar forceps
US9254166B2 (en) 2013-01-17 2016-02-09 Arthrocare Corporation Systems and methods for turbinate reduction
US9649144B2 (en) 2013-01-17 2017-05-16 Arthrocare Corporation Systems and methods for turbinate reduction

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