| Device and system for surgical dissection and/or guidance of other medical devices into body -> Monitor Keywords |
|
|
  Device and system for surgical dissection and/or guidance of other medical devices into bodyUSPTO Application #: 20070219550Title: Device and system for surgical dissection and/or guidance of other medical devices into body Abstract: A device for dissecting tissue and/or guidance of a second device to a desired physiological location, the device comprising: an elongate shaft comprising a proximal portion and a distal portion, wherein the distal portion comprises a plurality of segments that articulate with respect to one another; and a handle attached to the proximal portion of the shaft, wherein the handle comprises controls for articulating the plurality of segments of the distal portion of the shaft with respect to one another. A system for dissecting tissue and/or guiding a medical device to a desired physiological location. (end of abstract) Agent: Kagan Binder, PLLC - Stillwater, MN, US Inventors: Mark Thompson, Darrin Dickerson, Brett S. Bowman, Christopher F. Kelly, William W. Malecki, David Francischelli, Mark Stewart, Thomas Daigle, Douglas Gubbin, David Kim, Paul Rothstein, Adam Podbelski, Christopher Plott, Benjamin K. Yaffe USPTO Applicaton #: 20070219550 - Class: 606041000 (USPTO) Related Patent Categories: Surgery, Instruments, Electrical Application, Applicators The Patent Description & Claims data below is from USPTO Patent Application 20070219550. Brief Patent Description - Full Patent Description - Patent Application Claims
CROSS REFERENCE TO RELATED APPLICATIONS [0001] This application claims the benefit of both U.S. Provisional Application having Ser. No. 60/762,683, filed Jan. 27, 2006, entitled "MEDICAL DEVICE," and U.S. Provisional Application having Ser. No. 60/852,145, filed Oct. 17, 2006, entitled "MEDICAL DEVICE," which applications are incorporated herein by reference in their entireties. [0002] This application also incorporates by reference in its entirety co-pending U.S. patent application having Ser. No. ______, filed on the same day as the present application, entitled "METHOD OF SURGICAL DISSECTION AND/OR GUIDANCE OF OTHER MEDICAL DEVICES INTO BODY" and having Attorney Docket No. MTI0052/US (P-22921.03). FIELD OF THE INVENTION [0003] The present invention relates generally to a medical device and method for surgical dissection and/or guidance of other medical devices into a body and, in particular, a medical device and method for both dissecting cardiac tissue prior to positioning an ablation device, and guiding the ablation device into a beating heart to perform lesions on the heart during a minimally invasive procedure. BACKGROUND OF THE INVENTION [0004] Various specialized medical devices, such as ablation devices, cardiac leads, ultrasonic catheters, balloon angioplasty catheters, electrophysiological diagnostic catheters, pressure monitoring catheters, etc., may require the use of a delivery system for deploying the device in a desired internal body space, such as the heart, for example. In addition, in some cases, dissection of tissue is desired or necessary to guide or deliver such specialized medical devices to a desired location. [0005] Although the present invention contemplates devices and systems for dissecting tissue and/or guiding other specialized medical devices to many areas of the body, in particular, the present application will focus on one exemplary desired location and one exemplary specialized medical device. The focus will be primarily on delivery of an ablation device to an area on or near the heart, which, in particular, is around the two separate pairs of pulmonary veins on both sides of the heart. Similarly, the present invention contemplates the use of the present inventive devices and systems to treat various conditions. However, in particular, the present application will focus on treatment for heart arrhythmias (e.g., atrial fibrillation) using ablation procedures. [0006] In a normal heart, contraction and relaxation of the heart muscle (myocardium) takes place in an organized fashion as electrochemical signals pass sequentially through the myocardium from the sinoatrial (SA) node located in the right atrium to the atrialventricular (AV) node and then along a well-defined route which includes the His-Purkinje system into the left and right ventricles. Sometimes abnormal rhythms occur in the atrium which are referred to as atrial arrhythmia. Three of the most common arrhythmias are ectopic atrial tachycardia, atrial fibrillation, and atrial flutter. Arrhythmia can result in significant patient discomfort and even death because of a number of associated problems, including the following: (1) an irregular heart rate, which causes a patient discomfort and anxiety; (2) loss of synchronous atrioventricular contractions, which compromises cardiac hemodynamics resulting in varying levels of congestive heart failure; and (3) stasis of blood flow, which increases vulnerability to thromboembolism. It is sometimes difficult to isolate a specific pathological cause of the arrhythmia, although it is believed that the principal mechanism is one or a multitude of stray circuits within the left and/or right atrium. These circuits or stray electrical signals are believed to interfere with the normal electrochemical signals passing from the SA node to the AV node and into the ventricles. [0007] Treatment of arrhythmias may be accomplished by a variety of approaches, including drugs, surgery, implantable pacemakers/defibrillators, and catheter ablation. While arrhythmic drugs may be the treatment of choice for many patients, these drugs may only mask the symptoms and do not cure the underlying cause. Implantable devices, on the other hand, usually can correct an arrhythmia only after it occurs. Surgical and catheter-based treatments, by contrast, may actually cure the problem usually by ablating the abnormal arrhythmogenic tissue or abnormal pathway responsible for the arrhythmia. The catheter-based treatments rely on the application of various destructive energy sources to the target tissue including direct current energy sources to the target tissue, including direct current electrical energy, radiofrequency electrical energy, microwave energy, laser energy, cryoenergy, ultrasound, and the like. [0008] One surgical method of treating arrhythmia is the "Maze" procedure, which relies on a prescribed pattern of incisions to anatomically create a convoluted path, or maze, for electrical propagation within the left and right atria. The procedure employs incisions in the right and left atria, which divide the atria into electrically isolated portions, and which in turn results in an orderly passage of a depolarization wave front from the SA node to the AV node, while preventing reentrant wave front propagation. The Maze procedure has been effective in curing arrhythmias, but the procedure is technically difficult. The procedure also requires open heart surgery, in which the breastbone is divided and the surgeon has direct access to the heart. [0009] More recently, Maze-like procedures have been developed utilizing ablation catheters that can form lesions on the endocardium to effectively create a maze for electrical conduction in a predetermined path. Typically, the lesions are formed by ablating tissue with an electrode carried by a catheter. Ablative energy, e.g., high intensity focused ultrasound (HIFU) energy, radiofrequency (RF) energy, microwave energy and/or laser energy, applied to the electrode, causes significant physiological effects in the tissue resulting from thermal and/or mechanical changes or effects. By controlling the energy level, the amount of heat generated in the tissue and the degree of tissue damage or change can also be controlled. Ablation uses lower levels of voltage that creates sufficient heat to cause a desired cell damage, but leaves the tissue structure intact so as to effectively block electrical pathways within the tissue. Irrigation of the electrode(s) with saline or other conductive fluid can decrease the interface impedance, cool the tissue, and allow for a greater lesion depth. [0010] A treatment for atrial fibrillation, in particular, includes ablation around the pulmonary veins, which procedure is called pulmonary vein antrum isolation. Almost all the atrial fibrillation signals are believed to come from the four pulmonary veins and move to the atria. Ablation of the area of the atria that connects to the pulmonary veins provides circular scar tissue that blocks impulses firing within the pulmonary veins from moving to the atria, thereby disconnecting the pathway of abnormal rhythm and preventing atrial fibrillation. [0011] Most ablation devices are designed to access the heart via a mid-line sternotomy. More recently, ablation of cardiac tissue can be carried out through a minimally invasive route, such as between the ribs, through a sub-xyphoid incision or via catheter that is introduced through a vein, and into the heart. Such minimally invasive procedures are generally performed off-pump, which means the heart is beating during the procedure. Such procedures accordingly require several ports for medical devices to enter the area of the heart and perform the procedures. [0012] Ablation of a precise location within the heart requires precise placement of an ablation device within or near the heart. Precise positioning of the ablation device is especially difficult because of the physiology of the heart, particularly as such recently developed procedures generally occur off-pump. As discussed earlier, in some cases, dissection of tissue is necessary to guide or deliver specialized medical devices to their desired location in the body. In particular, with regard to pulmonary vein antrum isolation, tissue connecting each pair of pulmonary veins to pericardial reflections is often dissected allowing ablation device placement on and/or around the pulmonary veins. [0013] In general, if prior art devices for dissection are used, and if guidance of a specialized medical device to a location after the dissection is desired, separate devices are used for dissection and for placing the specialized medical device. Prior art devices that allow for both dissection and placement of another device, in particular with regard to ablation devices, require suturing a catheter at or near the end of the device while the end of the device is near the heart. Suturing near a beating heart involves risk of negative consequences. [0014] Thus, there is a need for an improved device that can dissect tissue and guide specialized medical devices to particular locations in the body. In particular, an improved device and method for dissecting cardiac tissue and placement of ablation devices during minimally invasive procedures on a beating heart are desired. SUMMARY OF THE INVENTION [0015] The present invention relates to dissection of soft tissue during general, ear, nose and throat (ENT), thoracic, urological, and gynecological surgical procedures. The present invention is of particular applicability for use during minimally invasive surgical procedures or endoscopic procedures, such as during procedures on a beating heart involving ablation (e.g., pulmonary vein antrum isolation). The device includes a shaft with an articulating end that is adjusted by controls in a handle. The articulated end helps to navigate soft tissue around anatomic structures. The articulating end preferably comprises a plurality of moveable or articulable segments that help to dissect tissue and move around anatomic structures. Preferably, the articulated end is also illuminated for identification of distal tip location. [0016] The device may be part of a system used to dissect tissue and/or guide a specialized medical device to a location in the body. The device may be inserted into a location in the body, as described above, via a given entry route, for dissection of tissue. While the device is in the location in the body for dissection purposes, the device may also be used with other components of a system to place a second device in the body. In order to place the second device, the system preferably includes a guide wire that may be fed through a lumen in the device and that may be advanced through the device and connected to one end of a guide member, which has two ends, and that is separate from the device. The guide wire may then be retracted back through the device, with the guide member attached, in order to pull the first end of the guide member to a location in the body, and preferably adjacent or near the distal tip of the device. The second end of the guide member may be attached to a second device, such as a specialized medical device (e.g., an ablation device). The device, with guide member attached, may then be removed from the body by withdrawing the device back through the port of entry, thereby pulling the guide member through the same port, and furthermore pulling the second device on the second end of the guide member into the location in the body at or near where the dissection took place. [0017] The present invention provides advantages over prior art devices and methods for dissection of tissue and/or guidance of medical devices into a body. One advantage is that a plurality of articulable segments of a distal end of the device can have different configurations allowing the end of the device to have, for example, a straight configuration for insertion and removal through a port during a minimally invasive surgical procedure and also allowing the end of the device to articulate into controlled curves while inside the body for dissection and placement purposes. Another advantage is that a portion of the device can remain outside of the body so as to indicate both a plane of articulation and an amount of articulation of the articulating end of the device for informing the user of such relevant information. Yet another advantage of the present invention is the presence of an on-off switch for an illumination source on the distal end of the device, which allows the user to control whether or not an illumination source is turned on. Also, an illumination source indicator is preferably located on the handle, which provides the advantage of allowing the user to know whether or not the illumination source is turned on. A still further advantage is that a guide wire may be used, through a lumen in the device, such as in the case of an ablation procedure in particular, to place a device, which avoids suturing inside the body (e.g., near the beating heart in ablation procedures). Also, with regard to ablation procedures in particular, an additional advantage is that the variability of the articulation of the articulating end of the device allows a surgeon some flexibility in the type of surgical approach chosen for a given procedure and patient. For example, in pulmonary antrum isolation procedures, a surgeon may choose to use either a superior or an inferior approach to the procedure using the device and/or system of the present invention. [0018] A first embodiment of the present invention is a device for dissecting tissue and/or guidance of a second device to a desired physiological location, the device comprising: an elongate shaft comprising a proximal portion and a distal portion, wherein the distal portion comprises a plurality of segments that articulate with respect to one another; and a handle attached to the proximal portion of the shaft, wherein the handle comprises controls for articulating the plurality of segments of the distal portion of the shaft with respect to one another. The plurality of segments may include a distal segment that includes an illumination source. The device may include a switch for turning the illumination source off and on. The device may include a means for indicating whether the illumination source is turned off or on. The means for indicating may be a light or illumination source located on the handle. The device may include an articulation indicator to indicate the amount of articulation of the distal portion. The articulation indicator may be located on the handle. The device may further comprise a guide wire tube having a proximal and a distal end, wherein the guide wire tube can be disposed along at least a portion of the length of the device and the guide wire tube can have openings at both the proximal and distal ends. The device may also further comprise a guide wire lock connected to the proximal end of the guide wire tube, wherein the guide wire lock in one position can allow a guide wire to pass through the guide wire tube at the proximal end and in a second position can hold the guide wire in place in the guide wire tube. The plurality of segments may articulate and the articulation may start at a distal segment and move proximally through the plurality of segments. The plurality of segments may have piston lumens disposed length-wise within the segments, the plurality of segments including a distal segment, and controls for articulating the plurality of segments comprising: a control wheel; a rack; a pinion, wherein the pinion is connected to the control wheel and rotatably supported in the rack; a push/pull rod having distal and proximal ends, wherein the proximal end is connected to the rack; and a plurality of pistons, wherein one of the plurality of pistons is disposed in each piston lumen of each segment, the pistons are articulably connected to each other, a distal piston is connected to the distal segment, and a proximal piston is articulably attached to the distal end of the push/pull rod, wherein rotation of the control wheel rotates the pinion, which causes the rack and attached push/pull rod to be pulled or pushed and further causes the pistons and corresponding segments in which the pistons are disposed to articulate with respect to one another. The device may further comprise a locking mechanism that can retain the control wheel in a position. The locking mechanism may comprise a friction lock. The lock may both lock and unlock (i.e., is reversible). When the plurality of segments articulates, the articulation may begin at the distal segment and move proximally through the plurality of segments. The device may further comprise an articulation indicator to indicate the amount of articulation of the distal portion. The articulation indicator may be located on the handle. [0019] A second embodiment of the present invention is a system for dissecting tissue and/or guiding a medical device to a desired physiological location, the system comprising: a dissecting/guiding device, comprising: an elongate shaft comprising a proximal portion and a distal portion, wherein the distal portion comprises a plurality of segments that articulate with respect to one another; a handle attached to the proximal portion of the shaft, wherein the handle comprises controls for articulating the plurality of segments of the distal portion of the shaft with respect to one another; and a guide wire tube through at least a portion of the length of the dissecting/guiding device, wherein the guide wire tube comprises proximal and distal ends each having an opening; a guide wire that may be fed into the proximal end of the guide wire tube, through the guide wire tube and out through the distal opening of the guide wire tube; and a guide member comprising an elongate structure with two ends, wherein a first end may attach to a distal end of the guide wire and a second end that may attach to a medical device, such that when the guide wire, with a medical device attached, is retracted back through the guide wire tube, a medical device is guided to a desired physiological location. The system may further comprise a medical device. The medical device of the system may be an ablation device. BRIEF DESCRIPTION OF THE DRAWINGS Continue reading... Full patent description for Device and system for surgical dissection and/or guidance of other medical devices into body Brief Patent Description - Full Patent Description - Patent Application Claims Click on the above for other options relating to this Device and system for surgical dissection and/or guidance of other medical devices into body patent application. ###  How KEYWORD MONITOR works... a FREE service from FreshPatents1. Sign up (takes 30 seconds). 2. Fill in the keywords to be monitored. 3. Each week you receive an email with patent applications related to your keywords. Start now! - Receive info on patent apps like Device and system for surgical dissection and/or guidance of other medical devices into body or other areas of interest. ### Previous Patent Application: Surgical instrument Next Patent Application: Medical device with flexible printed circuit Industry Class: Surgery ### FreshPatents.com Support Thank you for viewing the Device and system for surgical dissection and/or guidance of other medical devices into body patent info. IP-related news and info Results in 0.44364 seconds Other interesting Feshpatents.com categories: Medical: Surgery , Surgery(2) , Surgery(3) , Drug , Drug(2) , Prosthesis , Dentistry |
||
