The disclosure relates to an electrosurgical device. More specifically, the disclosure relates to an electrosurgical probe and associated apparatus, and methods of use thereof.
The present inventors have discovered and reduced to practice various embodiments of an apparatus for accessing and treating tissue by delivering energy that may be used with an imaging system to provide intra-operative mappings. The system provides intra-operative mappings of the probe ablation zones of different probes relative to an imaged target tissue. The mappings provide increased certainty of ablation boundaries, increased convenience in probe selection, and allow the user greater foresight in planning probe selection and placement.
In one broad aspect, embodiments of the present invention comprise a method for intra-operative mapping of a probe ablation zone. The method comprises accessing a treatment site using one or more treatment access tools, and defining and visualizing a proximal margin and a distal margin of a probe ablation zone using the one or more treatment access tools.
In another broad aspect, alternate embodiments of a method for intra-operative mapping of a probe ablation zone comprise accessing a treatment site using one or more treatment access tools; defining a proximal margin and a distal margin of a probe ablation zone using the one or more treatment access tools, the probe ablation zone being substantially equivalent to a target tissue being targeted for ablation; and selecting a probe using the one or more treatment access tools, the probe being operable to ablate a region of tissue larger than the probe ablation zone.
In a further broad aspect, embodiments of the present invention comprise a system for treating tissue including intra-operatively mapping a probe ablation zone. The system comprises an introducer assembly comprising a cannula and a stylet, the cannula defining a lumen and the stylet configured to fit within the lumen; a medical instrument for accessing tissue at a treatment site through the lumen of the cannula, the medical instrument including one or more indicia for defining a probe ablation zone; and one or more probes, each probe corresponding to one of the indicia, each probe operable to ablate tissue within a respective probe ablation zone.
In a further broad aspect, alternate embodiments of a system for treating tissue comprise an introducer assembly comprising a cannula and a stylet, the cannula defining a lumen; a plurality of medical instruments for accessing tissue at a treatment site through the lumen of the cannula, each medical instrument defining one or more indicia, each indicia defining a probe ablation zone; and one or more probes, each corresponding to a single indicia of the medical instrument, and operable to ablate tissue within a respective probe ablation zone.
In another broad aspect, embodiments of the present invention comprise a method for intra-operative probe selection for ablation of tissue at a treatment site. The method comprises mapping a proximal margin and a distal margin of a desired probe ablation zone/volume at the treatment site using a plurality of tools having cooperating features that determine probe selection for ablating the desired volume. As a feature of this aspect, some embodiments include performing more than one ablation. Typical embodiments include performing ablations that are longitudinally aligned along a probe advancement path. In some embodiments having more than one ablation, the proximal ablation is performed first, while in alternative embodiments, the furthest distal ablation is performed first.
In yet another broad aspect, alternate embodiments of a method for intra-operative probe selection for ablation of tissue at a treatment site comprise mapping a proximal margin and a distal margin of a probe ablation zone at the treatment site using access tools having cooperating features that determine probe selection from a group of probes for achieving a desired ablation defined by the probe ablation zone.
In another broad aspect, embodiments of the present invention comprise a method of ablating a target tissue. The method comprises positioning an introducer assembly, including a cannula and a stylet positioned therethrough, within a target tissue, thereby defining a proximal margin of a probe ablation zone; imaging the proximal margin of the probe ablation zone to thereby map the proximal margin; removing the stylet from the cannula; inserting a bone drill into the cannula; and advancing the bone drill until a distal tip of the bone drill is at a distal edge of a desired ablation volume, the distal tip thereby defining a distal margin of a probe ablation zone.
In another broad aspect, embodiments of the present invention comprise a method for mapping side-by-side probe ablation zones. The method comprises positioning a medical instrument coupled to an imaging tool at a target site; defining a first lateral probe ablation zone of a probe at a first position by visualizing a pair of visualization elements of the imaging tool; repositioning the medical instrument laterally; and defining a second lateral probe ablation zone of the probe at a second position.
In yet another broad aspect, some embodiments of the present invention comprise a method for intra-operative selection of a probe temperature for ablation of tissue at a treatment site. The method comprises mapping a target tissue at a treatment site using an imaging system to define a probe ablation zone; and using access tools with cooperating features that determine, for a particular probe, a pre-defined probe temperature for achieving a desired ablation defined by the probe ablation zone.
In another broad aspect, some embodiments of the present invention comprise a method for intra-operative selection of a treatment plan to ablate a target tissue requiring one or more ablations. The method comprises mapping a target tissue at a treatment site using an imaging system to define a probe ablation zone, and using access tools having cooperating features to determine a treatment plan for achieving a desired ablation defined by the probe ablation zone.
In order that the invention may be readily understood, embodiments of the invention are illustrated by way of examples in the accompanying drawings, in which:
Procedures comprising the ablation of tissue typically require pre-operative imaging and mapping of the treatment site. For example, the ablation of spinal tumours requires a surgeon to pre-operatively map the size of the targeted tumor. As the tumor may grow between the time of imaging and the procedure, the surgeon must also estimate the expected growth rate of the tumor to predict its size on the procedure date, a task which may be challenging and potentially inaccurate. Furthermore, a surgeon may wish to plan an ablation procedure, including selecting probes and determining their position for one or more deliveries of energy. Computing such a plan is time consuming and often technically difficult.
The present inventors have discovered and reduced to practice various embodiments of an apparatus/system/kit for accessing and treating tissue by delivering energy that may be used with an imaging system to provide intra-operative mappings. The system provides intra-operative mappings of the probe ablation zones of different probes relative to an imaged target tissue. The mappings provide increased certainty of ablation boundaries, increased convenience in probe selection, and allow for greater foresight in planning probe selection and placement.
In particular, the inventors have conceived of tools used to gain access to a treatment site that have co-operating features which, under imaging, map the ablation zones of corresponding probes, facilitating the selection of probes for a desired ablation volume. In this description, the term “imaging” is used to describe the process of visualizing tissue as well as apparatus using an imaging system such as a fluoroscopic imaging system. The use of imaging coupled with the intra-operative delineation of the ablation zones using such access tools also supplies information about anatomy surrounding an ablation zone, which aids in avoiding the destruction of important body structures close to the target tissue. In some embodiments, a bone drill with markings/indicia is used with a cannula having a feature that cooperates with the drill markings to selectively position the distal tip of the bone drill to define and map the distal margin of a probe ablation zone. The particular bone drill marking or indicium chosen for mapping the ablation zone also identifies which probe should be used to produce the mapped ablation zone. In such embodiments, the cannula is part of an introducer assembly used in a method of defining a proximal margin of the probe ablation zone. Thus, the combination of the bone drill and introducer assembly functions to map, delineate, or define the proximal and distal margins of the ablation zone.
The selected marking or indicium on the bone drill may also identify other energy delivery parameters, such as time and probe temperature, that may be used to create a lesion corresponding to the probe ablation zone. The inventors have also discovered methods for positioning and re-positioning the access apparatus in situations when a desired ablation volume does not sufficiently correspond with the probe ablation zones of the available probes, and for situations requiring more than one delivery of energy.
While the above description includes using a bone drill, the invention is not limited to the above described apparatus. In some alternative embodiments for use in tissue that is not bone, such as soft tissue (i.e. tissue that is softer than bone), a needle for piercing tissue is used instead of a bone drill. For the purpose of this application, the term ‘medical instrument’ may refer to either a bone drill or a needle. Furthermore, embodiments comprising a bone drill may alternately comprise a needle, and embodiments comprising a needle may alternately comprise a bone drill.
Disclosed herein is a method for treating tissue including intra-operatively mapping a probe ablation zone, i.e., the extent to which a particular probe will ablate tissue in the probe's longitudinal direction. The method uses a system that maps the proximal and distal margins of the probe ablation zone with tools used to access the ablation target. In some embodiments, the tools comprise an introducer assembly, including a cannula and a stylet, and a bone drill. These tools are used with medical imaging systems for visualization purposes.
Further disclosed is a method for treating tissue, including intra-operative probe selection for ablation. The method comprises mapping a proximal margin and a distal margin of a probe ablation zone using tools with features or markings that cooperate to indicate the appropriate probe for achieving a particular ablation target or desired ablation volume. The method includes mapping at one or more locations. The method further facilitates probe placement for delivering energy to treat (ablate) a desired ablation volume of a target tissue by mapping both the target tissue and possible probe ablation zones.
With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of certain embodiments of the present invention only. Before explaining at least one embodiment of the invention in detail, it is to be understood that the invention is not limited in its application to the details of construction and the arrangement of the components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments or of being practiced or carried out in various ways. Also, it is to be understood that the phraseology and terminology employed herein is for the purpose of description and should not be regarded as limiting.
Apparatus
Making reference to
The embodiment of
In general, cannula length marking 136 will cooperate with a feature of a cannula (i.e. a cooperating feature such as a window or slot in the cannula) to indicate that the distal end of bone drill 130 is at a distal end of the cannula. In the embodiment of
In general, bone drill 130 (the medical instrument) has one or more indicia that correspond with one or more probes, with each of the probes operable to create an ablation zone having a unique length. Each indicium corresponds with a specific probe, and in some embodiments the indicia are color coded to correspond with color coded probes and/or a color coding system associated with the probes. The apparatus may further comprise packaging for the probes that includes the corresponding probe color codes. Bone drill 130 of
Embodiments of the invention typically include a generator for supplying electrical energy to the probes. In some embodiments, the electrical energy is in the radiofrequency range. In some embodiments, the generator supplies energy between about 1 watt and about 100 watts. In other embodiments, the generator supplies energy between about 1 watt and about 50 watts. In yet other embodiments, the generator supplies energy greater than about 100 watts or less than about 1 watt.
Some embodiments comprise a temperature look-up table for storing the operating temperatures of each probe 140. The look-up table may be stored in a generator, or alternatively, in another device. In some embodiments the operating temperature is referenced using the indicia (e.g. probe selection markings 138). The operating temperatures may be referenced using operating temperature color codes that also correspond with probe color codes. For example, some embodiments include generator switches for selecting probe operating temperatures that are color coded to correspond with probe color codes and/or indicia color codes.
In some examples, the system further comprises a generator that communicates with a connected probe, and the system is operable to detect a probe identifier and select a corresponding operating temperature from the temperature look-up table.
Details about probes that may be used in the disclosed methods are described in U.S. application Ser. Nos. 13/643,310 and 13/660,353, each incorporated by reference in its entirety.
Methods
The method includes withdrawing stylet 110 and replacing it with a medical instrument such as a bone drill 130.
The bone drill 130 of
In the illustrated embodiment, a probe operable to produce ablation zone 210 corresponds with probe selection marking 138b. Alternatively, a physician could advance bone drill 130 from the position of
In summary, the method includes advancing a medical instrument such as a bone drill 130 through the lumen defined by a positioned cannula 100 such that one of the indicia (probe selection marking 138) on the medical instrument indicates that a distal end of the medical instrument is positioned to define the distal margin of a probe ablation zone that may be produced by a probe corresponding with the indicia. Imaging of the positioned distal end of the medical instrument maps the distal margin of a probe ablation zone. In alternative embodiments, the indicia are selected from the group consisting of bumps, grooves, symbols and any feature that may cooperate with a feature of cannula 100. In alternative embodiments, the feature of cannula 100 is selected from the group consisting of windows, slots, detents and any feature that may cooperate with the indicia. In some embodiments, bone drill 130 has one indicium and is used with one probe. The above described method of mapping may also be used with such an embodiment.
In the embodiment of
Furthermore, the location of proximal margin 212 of probe ablation zone 210 is defined using the distal tip of an introducer assembly 120 (typically trocar tip 116), and the physician maps the location of proximal margin 212 by visualizing the positioned tip of introducer assembly 120. The length of the probe ablation zone is substantially equal to the distance bone drill 130 extends beyond the proximal edge 206 of desired ablation volume 204. In general, a probe ablation zone is considered to be mapped when the corresponding proximal margin 212 and distal margin 214 are mapped.
The mapped probe ablation zone provides a representation of where a corresponding probe (the probe indicated by the indicia) will ablate tissue when it delivers energy. Also, a desired ablation volume 204 is typically defined by a physician visualizing the relevant target tissue 203 using the imaging system to estimate the location of proximal edge 206 and distal edge 208 of desired ablation volume 204. Proximal edge 206 and distal edge 208 of the desired ablation volume may also be mapped using an introducer and bone drill, respectively, in the same manner as are proximal margin 212 and distal margin 214 of the probe ablation zone.
In the method of
The feature on cannula 100 cooperates with indicia (probe selection markings 138) of bone drill 130 to indicate which probe the physician should select to create a desired ablation result, thereby providing intra-operative probe selection for ablation. In some embodiments, probe selection markings 138a, 138b and 138c are color coded such that each probe selection marking corresponds with a color coding associated with each probe (e.g. probe identifier 143 of
In some embodiments, a probe temperature during ablation ranges from about 40.degree. C. to about 100.degree. C. In other embodiments, a probe temperature during ablation ranges from about 65.degree. C. to about 70.degree. C. In a specific embodiment, the probe temperature during ablation is about 70.degree. C.
In some embodiments in which the temperature of the probe during ablation is about 70.degree. C., the probe delivers energy for a period of time ranging from about 6.5 minutes to about 15 minutes. The method may include the probe delivering energy for a period of time of about 6.5 minutes, a period of time of about 7.5 minutes, or a period of time of about 15 minutes.
One embodiment comprises a set of three color coded probes. The first probe has an active tip 7 mm long and is typically operated at a temperature of 70.degree. C. for a period of 6.5 minutes and may produce a lesion that has a length of about 10 mm and a diameter of about 10 mm. The second probe has an active tip 10 mm long and is typically operated at a temperature of 70.degree. C. for a period of 7.5 minutes and may produce a substantially prolate spheroid shaped lesion that has a length of about 17 mm and a diameter of about 13 mm. The third probe has an active tip 20 mm long and is typically operated at a temperature of 70.degree. C. for a period of 15 minutes and may produce a substantially prolate spheroid shaped lesion that has a length of about 29 mm and a diameter of about 21 mm.
The method of
In other words, the physician determines that bone drill 130 is positioned for mapping by one of the indicia (probe selection marking 138b) lining up with the cooperating feature of the cannula (the cannula proximal end). Probe selection marking 138b also indicates the corresponding probe operable to produce the mapped ablation zone of
The step of withdrawing and positioning the cannula and the bone drill is done such that the defined probe ablation zone 210 includes the desired ablation volume 204. It is optional for the physician to attempt to position the bone drill 130 and cannula such that the desired ablation volume is centered within the defined probe ablation zone 210 as illustrated in the example of
Starting from the situation of
The method of
In the example of
In the embodiment of
In alternative embodiments of the method, after comparing the probe ablation zones and desired ablation volume of
With appropriate modifications, the above methods of comparing probe ablation zones and the desired ablation volume to plan for probe positioning as described for
The above described methods of positioning a probe for a second ablation of target tissue as described with respect to
The step of withdrawing and positioning the cannula and the bone drill is done such that the defined probe ablation zone 210 includes the desired ablation volume 204. It is optional for the physician to attempt to position the bone drill 130 and cannula such that the desired ablation volume 204 is centered within the defined probe ablation zone 210, as illustrated in the example of
Following the delivery of energy, probe 140 is withdrawn and bone drill 130 re-inserted into cannula 100. It is not necessary to re-install the stylet as is done when advancing an introducer assembly after an ablation. Bone drill 130 is advanced until it protrudes from the distal end of cannula 100 a distance about equal to the distance which stylet 110 protrudes from cannula 100 when the stylet is fully inserted (which is about the same as the distance of the above mentioned gap of
At the physician's discretion, he/she may withdraw the cannula a distance to line up a different indicium than used for the
In use, an imaging system projects X-rays from a location in-line with the shaft 134 and proximal of the imaging tool to cast shadows visible using the imaging system and corresponding to each of the shadow casting pieces 244. The shadow casting pieces of the first extending member and the shadow casting pieces of the second extending member comprise pairs that are equidistant from the collar. The first pair of shadow casting pieces 244 cast a pair of shadows defining opposite side radial margins of a probe ablation zone of a corresponding first probe (not show in picture). Each pair of shadow casting pieces has an indicium 250 corresponding with a probe.
In use, X-rays projected by an imaging system will strike all the radiopaque shadow casting pieces, causing shadows to be cast for all of the pieces. For explanatory purpose,
The concepts of the above method can be applied in other types of imaging systems other than X-ray systems in which first member and second member visualization elements are used.
In other embodiments, a physician may select a probe with the probe ablation zone 210 of
The apparatus of
In the example of
Example: An ablation target has a length of 16 mm. Probe A has a ablation length of 5 mm, probe B has an ablation length of 6 mm, and probe C has an ablation length of 10 mm. When using the apparatus of
When using this method, the physician does not need to determine which combination of probes should be used in a given situation. The probe combinations have been previously optimized and are provided to the physician in a look-up chart. As understood by those who are skilled in the art, this method can be extended to map lesions radially, or both radially and axially simultaneously.
Thus, as described herein above, a method for treating tissue includes an intra-operative mapping of a probe ablation zone. The method uses a system that maps the proximal and distal margins of the probe ablation zone using tools to access the ablation target. In some embodiments the tools comprise a bone drill, and an introducer assembly including a cannula and a stylet.
An additional method for treating tissue includes intra-operative probe selection for ablation. The method comprises mapping a proximal margin and a distal margin of a probe ablation zone using tools with features or markings that cooperate to indicate which probe to use to achieve a desired ablation volume. In some embodiments, the method includes the mapping of at least two locations. The method further facilitates probe placement for delivering energy to treat (ablate) a desired ablation volume of a target tissue by mapping both the target tissue as well as possible probe ablation zones.
1. A method for intra-operative mapping of a probe ablation zone, the method comprising accessing a treatment site using one or more treatment access tools, and defining a proximal margin and a distal margin of a probe ablation zone using the one or more treatment access tools.
2. The method of example 1, the one or more treatment access tools comprising an introducer assembly including a cannula and a stylet positioned therein, wherein accessing the treatment site comprises advancing the introducer assembly to a proximal edge of a desired ablation volume.
3. The method of example 2, wherein the proximal margin of the probe ablation zone is mapped by visualizing a distal tip of the introducer assembly positioned at the proximal edge of the desired ablation volume.
4. The method of example 2, wherein the proximal margin of the probe ablation zone is mapped by visualizing a distal tip of the cannula positioned at the proximal edge of the desired ablation volume.
5. The method of example 3, further comprising withdrawing the stylet from the cannula and inserting a medical instrument into the cannula.
6. The method of example 5, wherein the treatment site includes bone tissue and wherein the medical instrument is a bone drill for accessing bone tissue at the treatment site.
7. The method of example 5, wherein the treatment site includes soft tissue and wherein the medical instrument is a needle for piercing tissue at the treatment site.
8. The method of example 5, the medical instrument including a marking located so as to indicate that a distal end of the medical instrument is aligned with a distal end of the cannula when the marking is aligned with a cooperating feature of the cannula, the method further comprising advancing the medical instrument through the cannula until the marking is aligned with the cooperating feature of the cannula.
9. The method of example 8, the medical instrument comprising one or more indicia located proximal of the marking, the method further comprising defining a distal margin of the probe ablation zone by advancing the medical instrument and aligning one of the one or more indicia with the cooperating feature of the cannula, whereby the position of the distal end of the medical instrument defines the distal margin of the probe ablation zone.
10. The method of example 9, further comprising mapping the distal margin of the probe ablation zone by visualizing the distal tip of the medical instrument.
11. The method of any one of examples 1 to 10, wherein fluoroscopic imaging is used for visualizing.
12. The method of any one of examples 1 to 10, wherein visualization is accomplished using an imaging modality selected from the group consisting of X-ray imaging and computed tomography (CT).
13. The method of example 10, further comprising selecting a probe for ablating tissue at the treatment site based upon which of the one or more indicia is aligned with the cooperating feature of the cannula.
14. The method of example 13, further comprising withdrawing the medical instrument from the cannula, inserting the probe into the cannula, and delivering energy to ablate the tissue at the treatment site.
15. A system for treating tissue, the system comprising:
an introducer assembly comprising a cannula, the cannula defining a lumen;
a medical instrument for accessing tissue at a treatment site through the lumen of the cannula, the medical instrument defining one or more indicia, each indicia for defining a probe ablation zone; and
one or more probes, each probe corresponding to a single indicia of the medical instrument, each probe operable to ablate tissue within a respective probe ablation zone.
16. The system of example 15, wherein the introducer assembly defines a trocar tip.
17. The system of example 15, wherein the medical instrument is a bone drill.
18. The system of example 15, wherein the medical instrument is a needle for piercing tissue.
19. The system of example 15, wherein the medical instrument defines a marking located so as to indicate that a distal end of the medical instrument is aligned with a distal end of the cannula when the medical instrument is inserted through the cannula such that the marking is aligned with a cooperating feature of the cannula.
20. The system of example 15, wherein the indicia are color coded.
21. The system of example 15, the one or more indicia comprising at least two indicia longitudinally spaced apart from one another on the medical instrument.
22. The system of example 15, wherein the one or more indicia are located along the medical instrument such that, when one of the one or more indicia is aligned with a cooperating feature of the cannula when the medical instrument is inserted through the cannula, a distance by which a distal end of the medical instrument extends beyond a distal end of the cannula is substantially equivalent to a length of the probe ablation zone operable to be ablated by the probe having the feature corresponding to the one of the one or more indicia.
23. The system of example 15, further comprising an imaging system.
24. The system of example 23, wherein the imaging system is a fluoroscopic imaging system.
25. The system of example 23, wherein the imaging system is a computed tomography (CT) imaging system.
26. The system of example 15, wherein each of the probes is operable to deliver electrical energy in a bipolar manner.
27. The system of example 15, wherein each of the probes has a different respective active tip size.
28. The system of example 15, further comprising a generator for supplying electrical energy to any of the probes connected thereto.
29. The system of example 28, wherein the generator is operable to supply energy at about 1 watt to about 100 watts.
30. The system of example 28, wherein the generator is operable to supply energy at about 1 watt to about 50 watts.
31. The system of example 28, wherein the generator is operable to supply energy at greater than about 100 watts.
32. A method for intra-operative probe selection for ablation of tissue at a treatment site, the method comprising mapping a proximal margin and a distal margin of a probe ablation zone at the treatment site using tools having features that cooperate to determine probe selection for achieving a desired ablation defined by the probe ablation zone.
33. The method of example 32, wherein the tools comprise an introducer assembly including a cannula and a stylet positioned therewithin, the method comprising advancing the introducer assembly and positioning the introducer assembly at a first location at the treatment site such that a distal tip of the introducer assembly defines the proximal margin of the probe ablation zone.
34. The method of example 33, wherein the tools further comprise a medical instrument selected from the group consisting of a bone drill and a needle, and wherein the method further comprises withdrawing the stylet from the cannula and inserting the medical instrument into the cannula.
35. The method of example 34, further comprising advancing the medical instrument through the cannula and observing a marking on the medical instrument which cooperates with a cooperating feature of the cannula to indicate when a distal end of the medical instrument is aligned with a distal end of the cannula.
36. The method of example 35, the medical instrument comprising one or more indicia located proximal of the marking, the method further comprising advancing the medical instrument through the cannula, observing the indicia and aligning one of the indicia with the cooperating feature of the cannula in order to define a distal margin of the probe ablation zone at a location of the distal end of the medical instrument.
37. The method of example 36, further comprising selecting a probe operable to ablate tissue between the proximal and distal margins of the probe ablation zone based on the indicia aligned with the cooperating feature of the cannula.
38. The method of example 36, wherein at least two indicia are longitudinally displaced along the medical instrument.
39. The method of example 36, wherein the indicia are color coded.
40. The method of example 39, wherein each of the indicia has a color code which corresponds with a color coding associated with the selected probe.
41. The method of example 35, wherein the cooperating feature of the cannula is a cannula marking.
42. The method of example 35, wherein the cooperating feature of the cannula is a proximal end of the cannula.
43. The method of example 37, further comprising withdrawing the medical instrument, inserting the probe into the cannula and advancing the probe to the first location.
44. The method of example 43, wherein the probe is advanced until it is limited from further advancement through the cannula.
45. The method of example 43, further comprising supplying energy to the probe for ablating tissue, including at least a portion of a target tissue, at the first location.
46. The method of example 45, wherein a temperature at the probe during ablation ranges from about 40.degree. C. to about 100.degree. C.
47. The method of example 45, wherein a temperature at the probe during ablation ranges from about 65.degree. C. to about 70.degree. C.
48. The method of example 45, wherein a temperature at the probe during ablation is about 100.degree. C.
49. The method of example 45, wherein a temperature at the probe during ablation is about 90.degree. C.
50. The method of example 45, wherein a temperature at the probe during ablation is about 70.degree. C.
51. The method of example 45, wherein energy is delivered from the probe for a period of time ranging from about 6.5 minutes to about 15 minutes.
52. The method of example 45, wherein energy is delivered from the probe for a period of time of about 6.5 minutes.
53. The method of example 45, wherein energy is delivered from the probe for a period of time of about 7.5 minutes.
54. The method of example 45, wherein energy is delivered from the probe for a period of time of about 15 minutes.
55. The method of any one of examples 32 to 54, further comprising visualization of one or more of the tools using an imaging system selected from the group consisting of X-ray imaging, fluoroscopic imaging, and Computed Tomography (CT).
56. The method of example 45, wherein at least a portion of the ablation zone is within or surrounded by bone tissue.
57. The method of example 56, wherein the bone tissue comprises a vertebra.
58. The method of example 45, further comprising withdrawing the probe from the cannula and inserting the stylet into the cannula after ablating at the first location.
59. The method of example 58, further comprising advancing the introducer assembly to the distal margin of the probe ablation zone of the first location to thereby define a probe ablation zone proximal margin at a second location, and mapping the probe ablation zone proximal margin at the second location by visualizing the distal tip of the introducer assembly.
60. The method of example 59, further comprising: withdrawing the stylet from the cannula and inserting the medical instrument into the cannula; defining a distal margin of the probe ablation zone at the second location by advancing the medical instrument and aligning one of the one or more indicia with the cooperating feature of the cannula, whereby the position of the distal end of the medical instrument defines the distal margin of the probe ablation zone at the second location; and mapping the distal margin of the probe ablation zone at the second location by visualizing the distal tip of the medical instrument.
61. The method of example 60, further comprising imaging a remaining portion of the target tissue.
62. The method of example 61, wherein the distal tip of the medical instrument is positioned distal of a distal edge of a desired ablation volume at the second location.
63. The method of example 62, further comprising confirming that the tissue within the probe ablation zone at the second location is acceptable for ablation.
64. The method of example 63, further comprising:
selecting a corresponding probe operable to ablate tissue between the proximal and distal margins of the probe ablation zone at the second location based on the indicia aligned with the corresponding feature of the cannula;
withdrawing the medical instrument and inserting the corresponding probe into the cannula; and
advancing the corresponding probe to a position for ablating tissue within the probe ablation zone at the second location.
65. The method of example 64, further comprising delivering energy to ablate a quantity of the tissue within the probe ablation zone at the second location.
66. The method of example 62, further comprising withdrawing the cannula and medical instrument until the distal tip of the medical instrument is positioned at the distal edge of the desired ablation volume at the second location while retaining alignment between the one of the one or more indicia of the medical instrument with the cooperating feature of the cannula.
67. The method of example 66, further comprising:
selecting a corresponding probe based on the one of the one or more indicia aligned with the corresponding feature of the cannula;
withdrawing the medical instrument;
inserting the probe into the cannula; and
advancing the probe to a position for ablating tissue within the probe ablation zone at the second location.
68. The method of example 67, further comprising delivering energy to ablate a quantity of the tissue within the probe ablation zone at the second location.
69. The method of example 62, further comprising withdrawing the cannula while maintaining the position of the distal tip of the medical instrument distal to the distal edge of the desired ablation volume at the second location while the tip of the cannula is positioned proximal of a proximal edge of the desired ablation volume at the second location to define the proximal margin of the probe ablation zone at the second location.
70. The method of example 69, wherein the desired ablation volume at the second location is centered within the probe ablation zone.
71. The method of example 69, further comprising:
selecting a corresponding probe operable to ablate tissue between the proximal and distal margins of the probe ablation zone at the second location based on the one of the one or more indicia aligned with the corresponding feature of the cannula;
withdrawing the medical instrument;
inserting the probe into the cannula; and
advancing the probe to a position for ablating tissue within the probe ablation zone at the second location.
72. The method of example 71, further comprising delivering energy to ablate a quantity of the tissue within the probe ablation zone at the second location.
73. The method of example 59, further comprising:
withdrawing the stylet from the cannula and inserting the medical instrument into the cannula;
defining a first distal margin of the probe ablation zone at the second location by advancing the medical instrument and aligning one of the one or more indicia with the cooperating feature of the cannula, whereby the position of the distal end of the medical instrument defines the first distal margin of the probe ablation zone at the second location; and
mapping the first distal margin of the probe ablation zone at the second location by visualizing the distal tip of the medical instrument.
74. The method of example 73, further comprising:
defining a second distal margin of the probe ablation zone at the second location by further advancing the medical instrument and aligning a second of the one or more indicia with the cooperating feature of the cannula, whereby the position of the distal end of the medical instrument defines the second distal margin of the probe ablation zone at the second location; and
mapping the second distal margin of the probe ablation zone at the second location by visualizing the distal tip of the medical instrument.
75. The method of example 74, further comprising mapping a desired ablation volume at the second location by visualizing a portion of target tissue distal to the probe ablation zone of the first location.
76. The method of example 75, further comprising:
determining a first distance defined by the distance between the proximal margin of the probe ablation zone at the second location and the first distal margin of the probe ablation zone at the second location wherein the first distance is a length of a probe ablation zone of a first probe;
determining a second distance defined by the distance between the proximal margin of the probe ablation zone at the second location and the second distal margin of the probe ablation zone at the second location wherein the second distance is a length of a probe ablation zone of a second probe;
comparing the first distance and the second distance to a third distance defined by a length of the desired ablation volume at the second location and determining whether the length of the probe ablation zone of the first probe or the length of the probe ablation zone of the second probe is desired for ablating at the second location; and
selecting a probe from the first probe and the second probe for at least one delivery of energy.
77. The method of example 76, the method further comprising:
withdrawing the medical instrument;
inserting the selected probe into the cannula;
advancing the selected probe to a position for ablating tissue; and
supplying energy to the selected probe for ablating tissue, including at least a portion of the target tissue, at the second location.
78. The method of example 77, wherein the distal margin of the probe ablation zone at the second location is within the desired ablation volume, the method further comprising:
mapping a probe ablation zone at a third location for the selected probe, wherein a distal margin of the probe ablation zone at the third location is equivalent to a distal edge of the desired ablation volume;
wherein the probe ablation zone at the second location and the probe ablation zone at the third location are longitudinally aligned and overlapping.
79. The method of example 77, wherein the distal margin of the probe ablation zone at the second location is within the desired ablation volume, the method further comprising:
mapping a probe ablation zone at a third location for the selected probe, wherein a distal margin of the probe ablation zone at the third location is proximal of a distal edge of the desired ablation volume;
wherein the probe ablation zone at the second location and the probe ablation zone at the third location are longitudinally aligned and positioned end-to-end.
80. The method of example 76, the method further comprising confirming that tissue within the probe ablation zone of the selected probe at the second location is acceptable for ablation.
81. The method of examples 78 or 79, further comprising confirming that tissue within the probe ablation zone of the selected probe at the third location is acceptable for ablation.
82. The method of example 81, further comprising: withdrawing the medical instrument; inserting the selected probe into the cannula; advancing the selected probe to a position for ablating tissue; and supplying energy to the selected probe and ablating tissue.
83. The method of examples 1 or 32, further comprising saving a screen image as a stored image whereby the stored image may be viewed at a later time.
84. The method of examples 1 or 32, wherein an imaging system includes at least two viewing screens and wherein the method further comprises viewing a screen image using at least one of the at least two viewing screens.
85. The method of example 84, further comprising transferring the screen image from a first viewing screen to a second viewing screen.
86. The system of example 20, wherein each of the indicia has an indicium color code which corresponds with a probe color code of one of the one or more probes.
87. The system of example 86, further comprising a respective packaging for each of the one or more probes, each respective packaging indicating a packaging color code corresponding to the color code associated with the one or more probes associated with the respective packaging.
88. The system of example 19, wherein the cooperating feature of the cannula is a slot.
89. The system of example 19, wherein the cooperating feature of the cannula is an aperture.
90. The system of example 19, wherein the cooperating feature of the cannula is a cannula marking.
91. The system of example 19, wherein the cooperating feature of the cannula is a proximal end of the cannula.
92. The system of example 91, the cannula including a handle, and a hub projecting proximally from the handle, wherein the handle and hub define a longitudinal portion of the lumen, and wherein the hub defines the proximal end of the cannula.
93. The system of example 26, wherein each of the probes is operable to deliver electrical energy in a radiofrequency range.
94. The system of example 28, the generator comprising a temperature look-up table for storing one or more operating temperatures of the one or more probes.
95. The system of example 94, wherein each indicium corresponds with one of the one or more operating temperatures.
96. The system of example 94, wherein each of the indicia is color coded and each of the operating temperatures is color coded with a corresponding color code.
97. The system of example 94, the generator being operable to detect a probe of the one or more probes connected thereto and to select a corresponding one of the one or more operating temperatures from the temperature look-up table.
98. The system of example 28, further comprising at least two color coded generator switches for selecting probe operating temperatures wherein each color coded switch corresponds with a color code of a respective probe.
99. A method of ablating a target tissue, comprising the steps of:
positioning an introducer assembly, including a cannula and a stylet positioned therethrough, within a target tissue, thereby defining a proximal margin of a probe ablation zone;
imaging the proximal margin of the probe ablation zone to thereby map the proximal margin;
removing the stylet from the cannula;
inserting a bone drill into the cannula; and
advancing the bone drill until a distal tip of the bone drill is at a distal edge of a desired ablation volume, the distal tip thereby defining a distal margin of a probe ablation zone.
100. The method of example 99, further comprising:
withdrawing the cannula a until an indicium associated with the bone drill aligns with a corresponding feature of the cannula while maintaining a position of the bone drill; and
visualizing the distal tip of the bone drill to thereby map the distal margin of the probe ablation zone.
101. The method of example 100, further comprising:
removing the bone drill from the cannula;
inserting a probe corresponding to the indicium into the cannula and advancing it until it is at an ablation position of the probe; and
delivering energy through the probe to form a lesion corresponding to the probe ablation zone.
102. The method of example 101, further comprising:
withdrawing the probe from the cannula;
re-inserting the bone drill into the cannula; and
advancing the bone drill until it protrudes from a distal end of the cannula, a distal tip of the bone drill is at the proximal margin of the probe ablation zone, and the tip of the bone drill also defines a distal edge of a next desired ablation volume and a distal margin of the next probe ablation zone.
103. The method of example 102, further comprising maintaining the position of the bone drill while withdrawing the cannula a distance until one of the one or more indicia lines up with the corresponding feature at which time the distal tip of the bone drill still defines a distal edge of the next desired ablation volume.
104. The system of example 86, wherein the probe color code is located on a hub of the one of the one or more probes.
105. The method of example 36, further comprising imaging a target tissue at the first location.
106. The method of example 105, wherein the distal end of the medical instrument is positioned distal of a distal edge of a desired ablation volume at the first location.
107. The method of example 106, further comprising confirming that the tissue within the probe ablation zone at the first location is acceptable for ablation.
108. The method of example 107, further comprising:
selecting a corresponding probe operable to ablate tissue between the proximal and distal margins of the probe ablation zone based on the indicia aligned with the corresponding feature of the cannula;
withdrawing the medical instrument and inserting the corresponding probe into the cannula; and
advancing the corresponding probe to a position for ablating tissue within the probe ablation zone.
109. The method of example 108, further comprising delivering energy to ablate a quantity of the tissue within the probe ablation zone.
110. The method of example 106, further comprising withdrawing the cannula and medical instrument until the distal end of the medical instrument is positioned at the distal edge of the desired ablation volume at the first location while retaining alignment between the one of the indicia of the medical instrument with the cooperating feature of the cannula.
111. The method of example 110, further comprising:
selecting a corresponding probe based on the one of the indicia aligned with the corresponding feature of the cannula;
withdrawing the medical instrument;
inserting the probe into the cannula; and
advancing the probe to a position for ablating tissue within the probe ablation zone.
112. The method of example 111, further comprising delivering energy to ablate a quantity of the tissue within the probe ablation zone.
113. The method of example 106, further comprising withdrawing the cannula while maintaining the position of the distal end of the medical instrument distal to the distal edge of the desired ablation volume at the first location while the tip of the cannula is positioned proximal of a proximal edge of the desired ablation volume at the first location to define the proximal margin of the probe ablation zone at the first location.
114. The method of example 113, wherein the desired ablation volume is centered within the probe ablation zone at the first location.
115. The method of example 114, further comprising:
selecting a corresponding probe operable to ablate tissue between the proximal and distal margins of the probe ablation zone at the first location based on the one of the indicia aligned with the corresponding feature of the cannula;
withdrawing the medical instrument;
inserting the corresponding probe into the cannula; and
advancing the probe to a position for ablating tissue within the probe ablation zone at the first location.
116. The method of example 115, further comprising delivering energy to ablate a quantity of the tissue within the probe ablation zone.
117. The system of example 15, further comprising a measuring instrument operable to be coupled to a proximal portion of the medical instrument for marking distances perpendicular to a longitudinal axis of the medical instrument.
118. The method of example 35, the medical instrument comprising one or more indicia, the method further comprising:
defining a first distal margin corresponding to a first probe ablation zone by advancing the medical instrument and aligning a first of the one or more indicia with the cooperating feature of the cannula, the first distal margin being defined by the distal end of the medical instrument; and
mapping the first distal margin by visualizing the distal end of the medical instrument.
119. The method of example 118, further comprising:
defining a second distal margin corresponding to a second probe ablation zone by further advancing the medical instrument and aligning a second of the one or more indicia with the cooperating feature of the cannula, whereby the position of the distal end of the medical instrument defines the second distal margin; and
mapping the second distal margin by visualizing the distal tip of the medical instrument.
120. The method of example 119, further comprising mapping a desired ablation volume by visualizing a target tissue.
121. The method of example 120, the method further comprising:
selecting a probe for at least one delivery of energy based on one of the one or more indicia.
122. The method of example 121, the method further comprising:
withdrawing the medical instrument;
inserting the selected probe into the cannula;
advancing the selected probe to a position for ablating tissue; and
supplying energy to the selected probe for ablating tissue, including at least a portion of the target tissue.
123. The system of example 15, further comprising an imaging tool, the imaging tool comprising:
a collar having a center hole for receiving a shaft of the medical instrument;
a first extending member extending outwardly from the collar; and
at least one first member visualization element associated with the first extending member.
124. The system of example 123, wherein the imaging tool further comprises a second extending member extending outwardly from the collar in a direction opposite to the first extending member.
125. The system of example 124, wherein the second extending member comprises at least one second member visualization element and wherein one of the at least one first member visualization elements and one of the at least one second member visualization elements are equidistant from the collar and define a first pair of visualization elements.
126. The system of example 125, wherein the first pair of visualization elements are operable to be visualized using an imaging system to thereby define opposite side radial margins of a first probe ablation zone when the imaging tool is coupled to the medical instrument.
127. The system of example 126, wherein the first pair of visualization elements defines a first imaging tool indicator corresponding to a first probe of the one or more probes.
128. The system of example 127, further comprising a second pair of visualization elements comprising a second of the at least one first member visualization elements and a second of the at least one second member visualization elements.
129. The system of example 128, wherein the second pair of visualization elements is operable to be visualized using the imaging system to thereby define opposite side radial margins of a second probe ablation zone when the imaging tool is coupled to the medical instrument.
130. The system of example 129, wherein the second pair of visualization elements defines a second imaging tool indicator corresponding with a second probe of the one or more probes.
131. A method for mapping side-by-side probe ablation zones, the method comprising:
positioning a medical instrument coupled to an imaging tool, as described in any one of examples 123-130, at a target site;
defining a first lateral probe ablation zone of a probe at a first position by visualizing a pair of visualization elements of the imaging tool;
repositioning the medical instrument laterally; and
defining a second lateral probe ablation zone of the probe at a second position.
132. The method of example 131, wherein the first lateral probe ablation zone and the second lateral probe ablation zone are substantially adjacent one another.
133. The method of example 131, wherein the first lateral probe ablation zone and the second lateral probe ablation zone are at least partially overlapping one another.
134. A method for intra-operative mapping of a probe ablation zone, the method comprising:
accessing a treatment site using one or more treatment access tools and defining a proximal margin and a distal margin of a probe ablation zone using the one or more treatment access tools, the probe ablation zone being substantially equivalent to a target tissue being targeted for ablation; and
selecting a probe using the one or more treatment access tools, the probe being operable to ablate a region of tissue larger than the probe ablation zone.
135. The method of example 134, further comprising adjusting a power setting of an energy system providing power to the probe to provide an expanded margin of ablation around the target tissue.
136. A method for intra-operative probe selection for ablation of tissue at a treatment site, the method comprising mapping a proximal margin and a distal margin of a probe ablation zone at the treatment site using access tools having features that cooperate to determine probe selection from a group of probes for achieving a desired ablation defined by the probe ablation zone.
137. A method for intra-operative selection of a probe temperature for ablation of tissue at a treatment site, the method comprising mapping a target tissue at a treatment site using an imaging system to define a probe ablation zone, and using access tools having features that cooperate to determine, for a particular probe, a pre-defined probe temperature for achieving a desired ablation defined by the probe ablation zone.
138. The method of example 137, wherein the access tools comprise an introducer assembly including a cannula.
139. The method of example 138, wherein the access tools further comprise a medical instrument selected from the group consisting of a bone drill and a needle.
140. The method of example 139, further comprising advancing the medical instrument through the cannula until it advances to a distal boundary of the probe ablation zone and visualizing a temperature selection marking on the medical instrument which aligns with a cooperating feature of the cannula to select the pre-defined probe temperature.
141. A method for intra-operative selection of a treatment plan to ablate a target tissue requiring one or more ablations, the method comprising mapping a target tissue at a treatment site using an imaging system to define a probe ablation zone and using access tools having cooperating features to determine a treatment plan for achieving a desired ablation defined by the probe ablation zone.
142. The method of example 141, wherein the access tools comprise an introducer assembly including a cannula.
143. The method of example 142, wherein the access tools further comprise a medical instrument selected from the group consisting of a bone drill and a needle.
144. The method of example 143, further comprising advancing the medical instrument through the cannula until it advances to a distal boundary of the probe ablation zone and visualizing a plan selection marking on the medical instrument which aligns with a cooperating feature of the cannula to indicate the treatment plan for ablating the target tissue.
145. The method of example 144, further comprising referencing a data storage system using the plan selection marking to select at least one probe, from a plurality of probes, to effect the treatment plan.
146. The system of example 117, the measuring instrument comprising a plurality of measurement indicia.
147. A system for treating tissue, the system comprising:
an introducer assembly comprising a cannula and a stylet, the cannula defining a lumen;
a plurality of medical instruments for accessing tissue at a treatment site through the lumen of the cannula, each medical instrument defining one or more indicia, each indicium for defining a probe ablation zone; and
one or more probes, each probe corresponding to a single indicium of the medical instrument, each probe operable to ablate tissue within a respective probe ablation zone.
148. The system of example 147, wherein the stylet comprises a plurality of stylet indicia.
149. The system of example 147, wherein each of the plurality of stylet indicia corresponds to a respective one of the plurality of medical instruments.
The embodiments of the invention described above are intended to be exemplary only. The scope of the invention is therefore intended to be limited solely by the scope of the appended claims.
It is appreciated that certain features of the invention, which are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the invention, which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable sub-combination.
Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the broad scope of the appended claims. All publications, patents and patent applications mentioned in this specification are herein incorporated in their entirety by reference into the specification, to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated herein by reference. In addition, citation or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present invention.
This application is a continuation of U.S. application Ser. No. 14/852,761, filed Sep. 14, 2015; which is a continuation-in-part of International Application No. PCT/IB2014/059846, filed Mar. 14, 2014; which claims the benefit of U.S. Provisional Application No. 61/786,986, filed Mar. 15, 2103; all of which are hereby incorporated by reference in their entirety. Corresponding U.S. application Ser. No. 13/660,353, filed Oct. 25, 2012 (now U.S. Pat. No. 9,241,760), and U.S. application Ser. No. 13/643,310, filed Oct. 25, 2012 (now U.S. Pat. No. 9,173,700) are hereby incorporated by reference in their entirety.
Number | Name | Date | Kind |
---|---|---|---|
3224436 | Le Massena | Dec 1965 | A |
3447161 | Weikel | Jun 1969 | A |
4532924 | Auth | Aug 1985 | A |
4674499 | Pao | Jun 1987 | A |
4696308 | Meller | Sep 1987 | A |
4849596 | Riordan | Jul 1989 | A |
4946460 | Merry | Aug 1990 | A |
5100388 | Behl et al. | Mar 1992 | A |
5261399 | Klatz | Nov 1993 | A |
5300068 | Rosar | Apr 1994 | A |
5300069 | Hunsberger | Apr 1994 | A |
5433739 | Sluijter | Jul 1995 | A |
5462552 | Kiester | Oct 1995 | A |
5743903 | Stern | Apr 1998 | A |
5766167 | Eggers | Jun 1998 | A |
5807395 | Mulier | Sep 1998 | A |
5810806 | Ritchart | Sep 1998 | A |
5843086 | Huyser et al. | Dec 1998 | A |
5951567 | Javier, Jr. | Sep 1999 | A |
6066139 | Ryan | May 2000 | A |
6129726 | Edwards et al. | Oct 2000 | A |
6190378 | Jarvinen | Feb 2001 | B1 |
6200314 | Sherman | Mar 2001 | B1 |
6206876 | Levine | Mar 2001 | B1 |
6293943 | Panescu et al. | Sep 2001 | B1 |
6319249 | Tollner | Nov 2001 | B1 |
6355031 | Edwards et al. | Mar 2002 | B1 |
6398782 | Pecor | Jun 2002 | B1 |
6451015 | Rittman, III | Sep 2002 | B1 |
6468268 | Abboud | Oct 2002 | B1 |
6471700 | Burbank et al. | Oct 2002 | B1 |
6478793 | Cosman | Nov 2002 | B1 |
6511418 | Shahidi et al. | Jan 2003 | B2 |
6524308 | Muller et al. | Feb 2003 | B1 |
6558379 | Batchelor | May 2003 | B1 |
6562033 | Shah et al. | May 2003 | B2 |
6634363 | Danek | Oct 2003 | B1 |
6845264 | Skladnev et al. | Jan 2005 | B1 |
6858025 | Maurice | Feb 2005 | B2 |
6881214 | Cosman et al. | Apr 2005 | B2 |
7108696 | Daniel et al. | Sep 2006 | B2 |
7160296 | Pearson et al. | Jan 2007 | B2 |
7186222 | Callister | Mar 2007 | B1 |
7216001 | Hacker et al. | May 2007 | B2 |
7435250 | Francischelli | Oct 2008 | B2 |
7824398 | Woloszko et al. | Nov 2010 | B2 |
7824404 | Godara et al. | Nov 2010 | B2 |
7914492 | Heuser | Mar 2011 | B2 |
7959629 | Young et al. | Jun 2011 | B2 |
8167878 | VanDusseldorp | May 2012 | B2 |
8473067 | Hastings et al. | Jun 2013 | B2 |
8475449 | Werneth et al. | Jul 2013 | B2 |
8486063 | Werneth et al. | Jul 2013 | B2 |
8512335 | Cheng et al. | Aug 2013 | B2 |
8591507 | Kramer et al. | Nov 2013 | B2 |
8667674 | Buysse | Mar 2014 | B2 |
8690868 | Moorman | Apr 2014 | B2 |
8709087 | Cragg | Apr 2014 | B2 |
8740895 | Mayse | Jun 2014 | B2 |
8771269 | Sherman et al. | Jul 2014 | B2 |
8936594 | Wolf et al. | Jan 2015 | B2 |
8936631 | Nguyen et al. | Jan 2015 | B2 |
9044245 | Condie et al. | Jun 2015 | B2 |
9173700 | Godara | Nov 2015 | B2 |
9241760 | Godara | Jan 2016 | B2 |
9757196 | Moss | Sep 2017 | B2 |
10729490 | Godara | Aug 2020 | B2 |
20010014804 | Goble | Aug 2001 | A1 |
20010023348 | Ashley | Sep 2001 | A1 |
20010025177 | Woloszko | Sep 2001 | A1 |
20020077627 | Johnson et al. | Jun 2002 | A1 |
20020115995 | Lesh | Aug 2002 | A1 |
20030045870 | Madsen | Mar 2003 | A1 |
20030083655 | Van Wyk | May 2003 | A1 |
20030088245 | Woloszko et al. | May 2003 | A1 |
20030093007 | Wood | May 2003 | A1 |
20030130711 | Pearson et al. | Jul 2003 | A1 |
20030148247 | Sicurelli, Jr. et al. | Aug 2003 | A1 |
20030149407 | DiResta | Aug 2003 | A1 |
20030171744 | Leung | Sep 2003 | A1 |
20030176816 | Maguire | Sep 2003 | A1 |
20030212394 | Pearson | Nov 2003 | A1 |
20030212395 | Woloszko et al. | Nov 2003 | A1 |
20040030333 | Goble | Feb 2004 | A1 |
20040127963 | Uchida | Jul 2004 | A1 |
20040167517 | Desinger et al. | Aug 2004 | A1 |
20040181219 | Goble | Sep 2004 | A1 |
20040193152 | Sutton et al. | Sep 2004 | A1 |
20050004634 | Ricart | Jan 2005 | A1 |
20050010205 | Hovda et al. | Jan 2005 | A1 |
20050027235 | Knudsen et al. | Feb 2005 | A1 |
20050038422 | Maurice | Feb 2005 | A1 |
20050070894 | McClurken | Mar 2005 | A1 |
20050177209 | Leung et al. | Aug 2005 | A1 |
20050177210 | Leung | Aug 2005 | A1 |
20050192564 | Cosman et al. | Sep 2005 | A1 |
20060015095 | Desinger et al. | Jan 2006 | A1 |
20060064101 | Arramon | Mar 2006 | A1 |
20060079867 | Berzak et al. | Apr 2006 | A1 |
20060111706 | Truckai et al. | May 2006 | A1 |
20060178666 | Cosman | Aug 2006 | A1 |
20060217705 | Godara | Sep 2006 | A1 |
20070016185 | Tullis et al. | Jan 2007 | A1 |
20070027449 | Godara et al. | Feb 2007 | A1 |
20070073282 | McGaffigan et al. | Mar 2007 | A1 |
20070123824 | Kaveckis | May 2007 | A1 |
20070129715 | Eggers | Jun 2007 | A1 |
20070161977 | Moorman et al. | Jul 2007 | A1 |
20070179497 | Eggers | Aug 2007 | A1 |
20070203551 | Cronin | Aug 2007 | A1 |
20070260237 | Sutton et al. | Nov 2007 | A1 |
20070265617 | Falkenstein | Nov 2007 | A1 |
20080004615 | Woloszko et al. | Jan 2008 | A1 |
20080015561 | Abboud | Jan 2008 | A1 |
20080021447 | Davison et al. | Jan 2008 | A1 |
20080021465 | Shadduck et al. | Jan 2008 | A1 |
20080033418 | Nields et al. | Feb 2008 | A1 |
20080051777 | Haemmerich | Feb 2008 | A1 |
20080065062 | Leung | Mar 2008 | A1 |
20080077128 | Woloszko | Mar 2008 | A1 |
20080097424 | Wizeman | Apr 2008 | A1 |
20080097429 | McClurken | Apr 2008 | A1 |
20080103504 | Schmitz et al. | May 2008 | A1 |
20080147056 | van der Weide | Jun 2008 | A1 |
20080172117 | Skubitz | Jul 2008 | A1 |
20080183165 | Buysse | Jul 2008 | A1 |
20080249350 | Marchitto | Oct 2008 | A1 |
20080255571 | Truckai et al. | Oct 2008 | A1 |
20080294155 | Cronin | Nov 2008 | A1 |
20090005775 | Jones | Jan 2009 | A1 |
20090012525 | Buehlmann et al. | Jan 2009 | A1 |
20090024124 | Lefler | Jan 2009 | A1 |
20090043301 | Jarrard | Feb 2009 | A1 |
20090054962 | Lefler | Feb 2009 | A1 |
20090069807 | Eggers | Mar 2009 | A1 |
20090156981 | Fay et al. | Jun 2009 | A1 |
20090204060 | Desinger | Aug 2009 | A1 |
20090264879 | McClurken | Oct 2009 | A1 |
20090312806 | Sherman et al. | Dec 2009 | A1 |
20090326527 | Ocel | Dec 2009 | A1 |
20100016854 | Carmel | Jan 2010 | A1 |
20100049190 | Long | Feb 2010 | A1 |
20100125269 | Emmons | May 2010 | A1 |
20100152725 | Pearson et al. | Jun 2010 | A1 |
20100204687 | Abboud | Aug 2010 | A1 |
20100211058 | Winterbottom et al. | Aug 2010 | A1 |
20100331883 | Schmitz | Dec 2010 | A1 |
20110022041 | Ingle et al. | Jan 2011 | A1 |
20110077451 | Marchitto | Mar 2011 | A1 |
20110077646 | Dahla | Mar 2011 | A1 |
20110137156 | Razzaque et al. | Jun 2011 | A1 |
20110152853 | Manley et al. | Jun 2011 | A1 |
20110152855 | Mayse | Jun 2011 | A1 |
20110166518 | Nguyen | Jul 2011 | A1 |
20110218526 | Mathur | Sep 2011 | A1 |
20110319880 | Prakash | Dec 2011 | A1 |
20120004594 | Schulz et al. | Jan 2012 | A1 |
20120010490 | Kauphusman | Jan 2012 | A1 |
20120016174 | De Taboada et al. | Jan 2012 | A1 |
20120029420 | Rittman, III | Feb 2012 | A1 |
20120065495 | Richards-Kortum et al. | Mar 2012 | A1 |
20120157890 | Govari et al. | Jun 2012 | A1 |
20120172858 | Harrison | Jul 2012 | A1 |
20120209257 | van der Weide et al. | Aug 2012 | A1 |
20120215221 | Woloszko | Aug 2012 | A1 |
20120239049 | Truckai et al. | Sep 2012 | A1 |
20120310230 | Willis | Dec 2012 | A1 |
20130012940 | Desinger | Jan 2013 | A1 |
20130041369 | Godara | Feb 2013 | A1 |
20130060244 | Godara et al. | Mar 2013 | A1 |
20130085488 | Brannan | Apr 2013 | A1 |
20130096549 | Organ et al. | Apr 2013 | A1 |
20130172864 | Ibrahim | Jul 2013 | A1 |
20130211383 | Racz | Aug 2013 | A1 |
20130226271 | Ferree | Aug 2013 | A1 |
20130253518 | Mitchell et al. | Sep 2013 | A1 |
20130296647 | Mayse | Nov 2013 | A1 |
20130323232 | Sathyanarayanan et al. | Dec 2013 | A1 |
20130324996 | Pellegrino et al. | Dec 2013 | A1 |
20130331835 | Leung | Dec 2013 | A1 |
20140081260 | Cosman | Mar 2014 | A1 |
20140128861 | Leung | May 2014 | A1 |
20140257265 | Godara | Sep 2014 | A1 |
20140303619 | Pappone | Oct 2014 | A1 |
20150105690 | Hathaway | Apr 2015 | A1 |
20150150627 | Brannan | Jun 2015 | A1 |
20150272655 | Condie et al. | Oct 2015 | A1 |
20160045256 | Godara et al. | Feb 2016 | A1 |
20160113704 | Godara | Apr 2016 | A1 |
Number | Date | Country |
---|---|---|
2521019 | Oct 2004 | CA |
1403062 | Mar 2003 | CN |
101132743 | Feb 2008 | CN |
101325919 | Dec 2008 | CN |
101355912 | Jan 2009 | CN |
201194837 | Feb 2009 | CN |
101795636 | Aug 2010 | CN |
101897618 | Oct 2010 | CN |
103393464 | Nov 2013 | CN |
3756522 | Mar 2006 | JP |
10-2012-0112470 | Oct 2012 | KR |
3020144 | Mar 2003 | WO |
2007008954 | Jan 2007 | WO |
2007113866 | Oct 2007 | WO |
2008137300 | Nov 2008 | WO |
2013076440 | May 2013 | WO |
Entry |
---|
Examination Report dated Jan. 8, 2021 in Canadian Patent Application No. 2,906,286. |
Notice of Preliminary Rejection dated Dec. 23, 2020 in Korean Patent Application No. 10-2015-7029265. |
First Office Action dated May 18, 2017 in Chinese Application No. 201480028563. |
First Office Action dated Jan. 17, 2018 in Chinese Application No. 201480028563. |
First Office Action dated Aug. 6, 2018 in Chinese Application No. 201480028563. |
Examination Report dated Jul. 27, 2018 in Australian Patent Application No. 2014229253. |
Extended Search Report dated Sep. 23, 2016 in European Application No. 14764517.0. |
Extended Search Report dated Jul. 10, 2020 in European Application No. 20162357.6. |
European Search Report for EP14764517 the counterpart application dated Sep. 13, 2016, two pages. |
Examination Report and Search Report dated Oct. 4, 2019 from corresponding Canadian Application No. 2,906,286. |
International Preliminary Report on Patentability dated Sep. 15, 2015 from International Application No. PCT/IB2014/059846. |
Extended European Search Report for EP20162357.6 dated Jul. 10, 2020, 8 pages. |
Hacker, et al., “Bipolar and Multipolar Radio Frequency Ablation With Resistance Controlled Power Output: Standardized Ex Vivo Kidney Tissue Evaluation”, from the Departments of Uroloty (AH, SV, TK, MSM), Biomathematics (CW) and Pathology (RG), All University Hospital Mannheim, Ruprecht-Karis University of Heidelberg, Heidelberg and Celon AG Medical Instruments (TS), Teltow, Germany. The Journal of Urology, Copyright© 2006 by American Urological Association, vol. 175, 1122-1126, Mar. 2006, 5 pages. |
International Report on Patentability for Application: PCT/CA2011/050203 dated Oct. 30, 2012. |
International Search Report for Application: PCT/CA2011/050203 dated Jul. 14, 2011. |
International Search Report and Written Opinion for PCT/US2016/058832 the counterpart application, dated Jan. 17, 2017. |
International Search Report and Written Opinion for PCT/US2016/061557 the counterpart application dated Feb. 16, 2017, 9 pages. |
Non-Final Office Action for U.S. Appl. No. 13/643,310, dated Dec. 15, 2014. |
Non-Final Office Action and Response for U.S. Appl. No. 13/660,353 dated Nov. 21, 2014. |
Non-Final Office Action for U.S. Appl. No. 13/660,353 dated Apr. 6, 2015. |
Office Action and Translation dated Apr. 30, 2020 from corresponding Chinese Application No. 201680066459.9. |
Restriction Requirement and Response for U.S. Appl. No. 13/643,310 dated Sep. 25, 2014. |
Restriction Requirement and Response for U.S. Appl. No. 13/660,353 dated Sep. 8, 2014. |
Supplementary European Search Report dated Jun. 18, 2019 of corresponding European Application No. 16866893.7. |
Office Action dated May 28, 2020 in corresponding Canadian Patent Application No. 2,906,286. |
Number | Date | Country | |
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20200330152 A1 | Oct 2020 | US |
Number | Date | Country | |
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61786986 | Mar 2013 | US |
Number | Date | Country | |
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Parent | 14852761 | Sep 2015 | US |
Child | 16896363 | US |
Number | Date | Country | |
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Parent | PCT/IB2014/059846 | Mar 2014 | US |
Child | 14852761 | US |