Graphical user interface for monitoring and controlling use of medical devices

Information

  • Patent Grant
  • 9675403
  • Patent Number
    9,675,403
  • Date Filed
    Sunday, September 21, 2014
    3 years ago
  • Date Issued
    Tuesday, June 13, 2017
    5 months ago
Abstract
A device for treating a tissue region is supplied with a separate usage key card. The usage key card comprises a storage medium, which is formatted to contain an identification code unique to the usage key card. The usage key card is adapted to be read by a remote reader, to download the identification code for processing by a controller for the device. Processing of the identification code by the controller either enables or disables operation of the device according to prescribed criteria. A viewable image is generated on a display screen that changes in response to processing of the identification code.
Description
FIELD OF THE INVENTION

The invention is directed to systems and methods for monitoring and controlling use of medical devices.


BACKGROUND OF THE INVENTION

Use of medical devices intended to treat or diagnose conditions of the body can sometimes generate stress on the material or materials from which the devices are made. The material stress can alter the physical characteristics of the devices, making future performance of the devices unpredictable.


In addition, exposure to blood and tissue during use can entrap biological components on or within many medical devices. Despite cleaning and subsequent sterilization, the presence of entrapped biological components can lead to unacceptable pyrogenic reactions.


The effects of material stress and damage caused during a single use of a medical device, coupled with the possibility of pyrogen reactions even after resterilization, reasonably justify imposing a single use restriction upon many medical devices.


SUMMARY OF THE INVENTION

The invention provides systems and methods for monitoring and controlling use of medical devices. The systems and methods employ a controller to control operation of the device and a reader to download information to the controller. The systems and methods also include a usage key card adapted to be handled separate from the device and comprising a storage medium formatted to contain an identification code unique to the usage key card. Upon reading by the reader, the identification code is downloaded to the controller. The controller includes a first data state prior to downloading of the identification code. A processing function for processing the identification code enables operation of the device if the identification code correlates in a pre-established manner with the first data state. The processing function operates, in response to enabling operation of the device, to change the first data state to a second data state that prevents subsequent operation of the device in response to downloading of the identification code.


In one embodiment, the processing function causes the controller to create a table by registering unlike identification codes in memory as they are downloaded by the reader. The controller enables operation of the device when a new identification code is registered in the table.


In one embodiment, the processing function causes the controller to disable operation of the device when the given identification code matches an identification code in the table.


In one embodiment, the processing function causes the controller to register in the table, a time period of use of the device. In this arrangement, the processing function causes the controller to disable operation of the device when the time of use exceeds a prescribed period.


In one embodiment, the device applies radio frequency energy to the tissue region.


Features and advantages of the inventions are set forth in the following Description and Drawings, as well as in the appended Claims.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1 is a diagrammatic view of a system for treating body sphincters and adjoining tissue regions, which embodies features of the invention;



FIG. 2 is a perspective view, with portions broken away, of a device usable in association with the system shown in FIG. 1 having an operative element for contacting tissue shown in a collapsed condition;



FIG. 3 is a perspective view, with portions broken away, of the device shown in FIG. 2, with the operative element shown in an expanded condition;



FIG. 4 is a perspective view, with portions broken away, of the device shown in FIG. 2, with the operative element shown in an expanded condition and the electrodes extended for use;



FIG. 5 is an enlarged view of the operative element shown in FIG. 4, with the electrodes extended for use;



FIG. 6 is a perspective view of a kit containing a device, such as shown in FIGS. 2 to 5, and a usage key card;



FIG. 7 is an enlarged, mainly schematic view of the usage key card shown in FIG. 6, embodied as a floppy disk, and also showing the pre-formatted files it contains;



FIG. 8 is a schematic view of a controller, which the system shown in FIG. 1 incorporates, showing the pre-programmed rules by which information contained on the usage key card shown in FIGS. 6 and 7 is read and processed;



FIG. 9 is a schematic view of another processing device that reads information from the usage key card for further processing;



FIG. 10 is a left perspective views of an integrated generator/controller apparatus for use in association with a disposable treatment device, the apparatus including a graphical user interface (GUI) that aids in monitoring and controlling the incidence of use of the disposable treatment device;



FIG. 11 is a representative SETUP display that can be implemented by the GUI shown in FIG. 10 as part of monitoring and controlling the incidence of use of the disposable treatment device;



FIG. 12 is a representative EXCHANGE display that can be implemented by the GUI shown in FIG. 10 as part of monitoring and controlling the incidence of use of the disposable treatment device; and



FIG. 13 is a flow chart showing the various states and modes that the apparatus shown in FIG. 10 employs in implementing the GUI in monitoring and controlling the incidence of use of the disposable treatment device.





The invention may be embodied in several forms without departing from its spirit or essential characteristics. The scope of the invention is defined in the appended claims, rather than in the specific description preceding them. All embodiments that fall within the meaning and range of equivalency of the claims are therefore intended to be embraced by the claims.


DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS


FIG. 1 shows one embodiment of a system 10, which monitors and controls the use of an operative element 12. The system 10 is well adapted for association with single use, catheter-based devices. Therefore, in the illustrated embodiment, the operative element 12 is part of a catheter-based treatment device 26. It should be appreciated, however, that the system 10 is also adaptable for use with devices and methods that are not necessarily catheter-based.


I. The Treatment Device


In the illustrated embodiment, the device 26 includes a handle 28 made, e.g., from molded plastic. The handle 28 is sized to be conveniently held by a physician, to introduce the catheter tube 30 into the targeted tissue region.


The handle 28 carries a flexible catheter tube 30. The catheter tube 30 can be constructed, for example, using standard flexible, medical grade plastic materials. The catheter tube 30 has a distal end 34, which carries the operative element 12.


The operative element 12 can support, for example, a device for imaging body tissue, such as an endoscope, or an ultrasound transducer. The operative element 12 can also support a device to deliver a drug or therapeutic material to body tissue. The operative element 12 can also support a device for sensing a physiological characteristic in tissue, such as electrical activity, or for transmitting energy to stimulate or form lesions in tissue.


In the illustrated embodiment, the device 26, in use, is intended to treat dysfunction of sphincters and adjoining tissue regions in the upper gastrointestinal tract, e.g., in the lower esophageal sphincter and adjacent cardia of the stomach, as well as in the lower gastrointestinal tract, e.g., in the intestines, rectum and anal canal. Still, it should be appreciated that the system 10 can be used in association with other devices and methods used to treat other dysfunctions elsewhere in the body, which are not necessarily sphincter-related. For example, the various aspects of the invention have application in procedures requiring ablation of tissue throughout the body, or treatment of hemorrhoids, or restoring compliance to or otherwise tightening interior tissue or muscle regions.


In the illustrated embodiment, one function that the operative element 12 is to perform is to apply energy in a selective fashion to a targeted body region, which, for the purpose of illustration, can be the lower esophageal sphincter, or cardia, or both. The applied energy creates one or more lesions, or a prescribed pattern of lesions, below the mucosal surface of the esophagus or cardia. The subsurface lesions are formed in a manner that preserves and protects the mucosal surface against thermal damage.


It has been discovered that natural healing of the subsurface lesions leads to a physical tightening of the sphincter and/or adjoining cardia. The subsurface lesions can also result in the interruption of aberrant electrical pathways that may cause spontaneous sphincter relaxation. In any event, the treatment can restore normal closure function to the sphincter.


The structure of the operative element 12 to achieve this result can vary. A representative embodiment is shown in FIGS. 2 to 4, in which the operative element 12 comprises a three-dimensional basket 56. The basket 56 includes one or more spines 58, and typically includes from four to eight spines 58, which are assembled together by a distal hub 60 and a proximal base 62.


In the illustrated embodiment, an expandable structure 72 comprising a balloon is located within the basket 56. The balloon structure 72 can be made, e.g., from a Polyethylene Terephthalate (PET) material, or a polyamide (non-compliant) material, or a radiation cross-linked polyethylene (semi-compliant) material, or a latex material, or a silicone material, or a C-Flex (highly compliant) material.


The balloon structure 72 presents a normally, generally collapsed condition, as FIG. 2 shows. In this condition, the basket 56 is also normally collapsed about the balloon structure 72, presenting a low profile for deployment into the esophagus 10.


The catheter tube 30 includes an interior lumen, which communicates with the interior of the balloon structure 72. A fitting 76 (e.g., a syringe-activated check valve) is carried by the handle 28. The fitting 76 communicates with the lumen. The fitting 76 couples the lumen to a syringe 78 (see FIG. 3). The syringe 78 injects fluid under pressure through the lumen into the balloon structure 72, causing its expansion.


Expansion of the balloon structure 72 urges the basket 56 to open and expand (see FIG. 3). The force exerted by the balloon structure 72, when expanded, is sufficient to exert an opening force upon the tissue surrounding the basket 56.


Each spine 58 carries an electrode 66 (see FIG. 4). In the illustrated embodiment, each electrode 66 is carried within the tubular spine 58 for sliding movement. Each electrode 66 slides from a retracted position, withdrawn in the spine 58 (shown in FIG. 3) and an extended position, extending outward from the spine 58 (see FIG. 4) through a hole in the spine 58. A push-pull lever 68 on the handle 28 is coupled by one or more interior wires to the sliding electrodes 66. The lever 68 controls movement electrodes between the retracted position (by pulling rearward on the lever 68) and the extended position (by pushing forward on the lever 68). The electrodes 66 have sufficient distal sharpness and strength, when extended, to penetrate a desired depth into tissue the smooth muscle of the esophageal or cardia 20 wall. The desired depth can range from about 4 mm to about 5 mm.


In this arrangement (see FIG. 1), the system 10 includes a generator 38 to supply the treatment energy to the electrodes 66. In the illustrated embodiment, the generator 38 supplies radio frequency energy, e.g., having a frequency in the range of about 400 kHz to about 10 mHz. Of course, other forms of energy can be applied, e.g., coherent or incoherent light; heated or cooled fluid; resistive heating; microwave; ultrasound; a tissue ablation fluid; or cryogenic fluid.


A cable 40 extending from the proximal end of the handle 28 terminates with an electrical connector 42. The cable 40 is electrically coupled to the operative element 12, e.g., by wires that extend through the interior of the handle 28 and catheter tube 30. The connector 42 plugs into the generator 38, to convey the generated energy to the operative element 12.


The electrodes 66 are formed of material that conducts radio frequency energy, e.g., nickel titanium, stainless steel, e.g., 304 stainless steel, or a combination of nickel titanium and stainless steel.


In the illustrated embodiment (see FIG. 5), an electrical insulating material 70 is coated about the proximal end of each electrode 66. When the distal end of the electrode 66 penetrating the smooth muscle of the esophageal sphincter 18 or cardia 20 transmits radio frequency energy, the material 70 insulates the mucosal surface of the esophagus 10 or cardia 20 from direct exposure to the radio frequency energy. Thermal damage to the mucosal surface is thereby avoided. The mucosal surface can also be actively cooled during application of radio frequency energy, to further protect the mucosal surface from thermal damage.


In the illustrated embodiment (see FIG. 5), at least one temperature sensor 80 is associated with each electrode. One temperature sensor 80 senses temperature conditions near the exposed distal end of the electrode 66, a second temperature sensor 80 is located on the corresponding spine 58, which rests against the muscosal surface when the balloon structure 72 is inflated.


The system 10 (see FIG. 1) can also include certain auxiliary processing equipment, e.g., an external fluid delivery apparatus 44 for supplying cooling liquid to the targeted tissue, e.g., through holes in the spines, and an external aspirating apparatus 46 for conveying liquid from the targeted tissue site, e.g., through other holes in the spine or elsewhere on the basket 56.


The system 10 also includes a controller 52. The controller 52, which preferably includes a central processing unit (CPU), is linked to the generator 38, the fluid delivery apparatus 44, and the aspirating apparatus 46. Alternatively, the aspirating apparatus 46 can comprise a conventional vacuum source typically present in a physician's suite, which operates continuously, independent of the controller 52. The controller 52 governs the delivery of processing fluid and, if desired, the removal of aspirated material.


The controller 52 also governs the power levels, cycles, and duration that the radio frequency energy is distributed to the electrodes 66, to achieve and maintain power levels appropriate to achieve the desired treatment objectives. The controller 52 can condition the electrodes 66 to operate in a monopolar mode. In this mode, each electrode 66 serves as a transmitter of energy, and an indifferent patch electrode (not shown) serves as a common return for all electrodes 66. Alternatively, the controller 52 can condition the electrodes 66 to operate in a bipolar mode. In this mode, one of the electrodes comprises the transmitter and another electrode comprises the return for the transmitted energy. The bipolar electrode pairs can electrodes 66 on adjacent spines, or electrodes 66 spaced more widely apart on different spines.


The controller 52 includes an input/output (I/O) device 54. The I/O device 54 allows the physician to input control and processing variables, to enable the controller 52 to generate appropriate command signals. The I/O device 54 also receives real time processing feedback information from the temperature sensors 80, for processing by the controller 52, e.g., to govern the application of energy and the delivery of processing fluid. The I/O device 54 also includes a graphical user interface (GUI), to graphically present processing information to the physician for viewing or analysis.


II. Monitoring and Control of Reuse


The handle 28 and the catheter tube 30 form an integrated construction intended for a single use and subsequent disposal as a unit. Alternatively, the handle 28 can comprise a nondisposable component intended for multiple uses. In this arrangement, the catheter tube 30, and components carried at the end of the catheter tube 30 comprise a disposable assembly, which the physician releasably connects to the handle 28 at time of use and disconnects and discards after use. The catheter tube 30 can, for example, include a male plug connector that couples to a female plug receptacle on the handle 28.


To protect patients from the potential adverse consequences occasioned by multiple use, which include disease transmission, or material stress and instability, or decreased or unpredictable performance, the controller 52 includes a module 48 that controls use of the device 26.


In the illustrated embodiment (see FIG. 6), the device 26 is supplied as part of a kit 200 that includes, together with the device 26, a usage key card 202. The kit 200 packages the device 26 and usage key card 202 as a unitary, single use item in a sterile fashion within peripherally sealed sheets of plastic film material that are torn or peeled away at the instance of use.


The presence of the device 26 and user key card 202 packaged together in the kit 200 verifies to the physician or user that device 26 is sterile and has not be subjected to prior use. The physician or user is thereby assured that the device 26 meets established performance and sterility specifications. No unused device 26 is supplied in the kit 200 without a usage key card 202, and vice versa.


The usage key card 202 incorporates a storage medium 204 that is readable by the module 48. The storage medium 204 contains information that enables at least two use control and monitoring functions.


The first use control and monitoring function of the usage key card 202 occurs prior to use of the device 26 in association with the generator 38. To enable use of the generator 38 in association with the device 26, the physician must first present the usage key card 202 for reading by the module 48. To enable use of the device 26, the controller 52 must then find that the usage key card 202 meets the criteria necessary for its registration by the controller 52. The criteria are designed to indicate the absence of a prior use, either in absolute terms or in terms of a period of use outside a predetermined time period. If the criteria are not met, the controller 52 will not register the usage key card 202, and the controller 52 will also not enable use of the generator 38 in association with the device 26. Further details of the registration function of the controller 52 will be described later.


The second use control and monitoring function of the usage key card 202 occurs if the criteria are met and registration of the usage key card 202 occurs. During permitted use of the device 26 in association with the generator 38, the storage medium 204 of the usage key card 202 remains in the module 48 and receives, via the module 48, data generated by the controller 52 recording operating parameters and performance of the device 26. The storage medium 204 of the usage key card 202 retains and organizes the data for further off-line storage and processing. Further details of the data retention function will be described later.


The usage key card 202 can be variously configured. In the illustrated embodiment (see FIG. 7), the usage key card 202 comprises a computer-readable storage medium 204 housed within a conventional 3.5 inch floppy disk 206. In this arrangement, the module 48 comprises a conventional floppy disk drive 208 (see FIG. 8) capable of reading data from and downloading data to the storage medium 204 of the disk 206.


Alternatively, the usage key card 202 can take the form of a PC card, flash memory device, or magnetic card. In these alternative embodiments, the module 48 comprises a data reading and writing device compatible with the storage medium of the card 202.


As FIG. 7 shows, the storage medium 204 of the usage key card 202 contains at least two pre-formatted files 210 and 212. The first file 210 contains a unique identification code 214 capable of being read by the module 48 and registered by the controller 52. The second file 212 is formatted to receive and retain operational and performance data generated by the controller 52 to create from it a procedure log 220.


The identification code 214 contained in the first file 210 is created to be unique to the particular usage key card 202. That is, each usage key card 202 contains its own unique identification code 214. No two usage key cards share the same identification code 214. The unique identification code 214 can comprise, e.g., a serial number uniquely assigned to the particular device 26 found in the kit 200, or any other unique code that is not repeated for any other usage key card 202. The code 214 itself can comprise letters, numbers, or combinations thereof.


As FIG. 8 shows, the module 48 reads the identification code 214 off the usage key card 202 for input to the controller 52. This identification code will be called the “instant identification code.”


Following pre-programmed rules, the controller 52 constructs and maintains in non-volatile memory a use table 216. The use table 216 contains all prior identification codes that meet the criteria to be registered by the controller 52. These identification codes will be called the “registered identification codes.”


Following pre-programmed rules, the controller 52 compares the instant identification code 214 to all registered identification codes contained in the table 216. In the absence of a match between the instant identification code and any registered identification code, the controller 52 updates the table, i.e., the controller 52 registers the instant identification code by adding it to the table 216. Upon registering the usage key card 202, the controller 52 also enables use of generator 38 in association with the device.


The presence of a match between the instant identification code and any registered identification code indicates the usage key card 202 has been previously read by the module 48, which reflects a prior use of the device 26 or another device not packaged with the card 202. In this circumstance, the controller 52 does not add the duplicative identification code to the table 216 and does not enable use of the generator 38 in association with any device 26. Preferably, the controller 52 outputs to the GUI notice of prior use.


In an alternative arrangement, the controller 52 maintains for each registered identification code in the table 216 a time record 218. The time record 218 contains a value reflecting the period of time during which energy was applied by the generator 38 during the previous permitted use. In this embodiment, when a match occurs between the instant identification code and a registered identification code, the controller 52 ascertains whether the time period of previous use contained in the record 218 is less than a prescribed maximum time period, e.g., 45 minutes. If so, the controller 52 enables a subsequent operation of the generator 38 in association with the device 26, but only for the time period remaining. The controller 52 updates the time record 218 as further use occurs. The controller 52 preferably outputs to the GUI the time period of permitted use remaining.


If the controller 52 ascertains that the time period of previous use equals or exceeds the prescribed maximum time period, the controller 52 does not enable use of the generator 38. Preferably, the controller 52 outputs to the GUI notice of prior use.


As FIG. 9 shows, the second file 212 contained on the storage medium 204 of the usage key card 202 is formatted to receive, via the module 48, data that is generated by the controller 52 during permitted use of the device 26 in association with the generator 38. The file 212 retains the data in a formatted array according to pre-programmed rules to create a procedure log 220.


The content of the formatted log 220 can vary. For example, the log 220 can document, by date of treatment and number of treatments, the coagulation level (i.e., the depth at which the electrodes are inserted), the time duration of energy application, the magnitude of energy delivered by each electrode, and the coolant flow rate. The procedure log 220 can also record at pre-established intervals (e.g., every 5 seconds) the temperatures of the electrodes and surrounding tissue, along other parameters, e.g., sensed impedance and power delivered by each electrode.


The procedure log 220 preferably records these values in a pre-formatted data base format, to enable import of the values as data base items for storage, processing, and retrieval by an off-line data processing device 222 having a compatible data base processing application. The off-line data processing device 222 reads processing log data from the usage key card 202 (via a floppy disk drive 230 or otherwise compatible reading device).


The device 222 can process the data in various ways according to the rules of the data processing application. The device 222 can, e.g., create a print-formatted record of the procedure log 220 for printing in a hard copy version. The device 222 can also, e.g., process the procedure logs for multiple devices and patients, to create historical patient treatment records, patient reimbursement records, and the like for storage or retrieval. The device 222 thereby makes possible the establishment and maintenance of an archival patient database by processing individual procedure logs.


As FIG. 6 shows, the kit 200 can also include a label 224 that is pre-applied or that can be applied by the physician to the usage key card 202. The label 224 receives manually transcribed, visually readable information pertaining to the usage key card 202, e.g., the name of the patient being treated by the device 26, the date of treatment, and the like. In this way, usage key cards 202 can itself be physically stored and indexed.


As FIG. 6 also shows, the kit 200 can also include instructions 232 for using the usage key card 202 in the fashion described. For example, the instructions 232 can instruct the physician as to the need for having the usage key card 202 read by the module 48, in order to enable use of the device 26 in association with the generator 38. The instructions 232 can also instruct the physician regarding the content of the procedure log and the subsequent off-line processing options that are available.


As FIG. 7 shows, the storage medium 204 of the usage key card 202 can also contain at least one additional formatted file 226 that provides device information 228, which characterizes the device 26 supplied in the kit 200. For example, the device information 228, when read by the module 48, can identify the type of device 26 in terms of its operational characteristics, the inclusion of temperature sensing, and reuse criteria (e.g., no reuse after a single use, or multiple uses permitted up a prescribed maximum number of uses, or multiple uses permitted up to a maximum time period of use, or multiple uses permitted up to a maximum application of RF energy). The file 226 can also condition the GUI to display the desired images and data formats, which change depending upon the treatment procedure using the device (e.g, treatment of GERD, fecal incontinence, or urinary incontinence). In one arrangement, the controller 52 can compare the device characteristics with the operational characteristics of the controller 52 and generator 38, and disable operation of the device 26 should the characteristics of the device 26 be incompatible with the characteristics of the controller 52 and/or generator 38.


III. Graphical User Interface (GUI) For Monitoring and Controlling Reuse


In the illustrated embodiment (see FIG. 10), the radio frequency generator 38, the controller 52 with I/O device 54, and the fluid delivery apparatus 44 (e.g., for the delivery of cooling liquid) are integrated within a single housing 400. The I/O device 54 includes input connectors 402, 404, and 406. The connector 402 accepts an electrical connector 408, to which the connector 42 of the selected treatment device 26 is electrically coupled for use. The connector 404 accepts an electrical connector 410 coupled to a patch electrode 412 (for monopolar operation). The connector 406 accepts an pneumatic connector 414 coupled to a conventional foot pedal 416, when, when depressed, causes the delivery of radio frequency energy to the electrodes 66 on the device 26. These connectors 402, 404, and 406 couple these external devices to the controller 52.


The I/O device 54 also couples the controller 52 to an array of membrane keypads 422 and other indicator lights on the housing 400, for entering and indicating parameters governing the operation of the controller 52.


The I/O device 54 also couples the controller 52 to a display microprocessor 474. In the illustrated embodiment, the microprocessor 474 comprises, e.g., a dedicated Pentium®-based central processing unit. The controller 52 transmits data to the microprocessor 474, and the microprocessor 474 acknowledges correct receipt of the data and formats the data for meaningful display to the physician. In the illustrated embodiment, the dedicated display microprocessor 474 exerts no control over the controller 52.


In the illustrated embodiment, the controller 52 comprises an 68HC11 processor having an imbedded operating system. Alternatively, the controller 52 can comprise another style of processor, and the operating system can reside as process software on a hard drive coupled to the CPU, which is down loaded to the CPU during system initialization and startup.


The display microprocessor 474 is coupled to a graphics display monitor 420 in the housing 400. The controller 52 implements through the display microprocessor 474 the graphical user interface, or GUI, which is displayed on the display monitor 420.


The GUI can be realized, e.g., as a “C” language program implemented by the microprocessor 474 using the MS WINDOWS™ or NT application and the standard WINDOWS 32 API controls, e.g., as provided by the WINDOWS™ Development Kit, along with conventional graphics software disclosed in public literature.


The display microprocessor 474 is also itself coupled to the floppy disk drive 208, previously described. The display microprocessor 474 can also be coupled to a keyboard, printer, and include one or more parallel port links and one or more conventional serial RS-232C port links or Ethernet™ communication links.


Upon boot-up of the CPU (see FIG. 13), the operating system implements the START-UP function 510 for the GUI 424. The GUI 424 displays an appropriate start-up logo and title image (not shown), while the controller 52 performs a self-test.


Upon completion of the START-UP function (see FIG. 13), the controller 52 conducts a CHECK function 512. The function 512 checks for the presence of a usage key card 202 in the floppy disk drive 208. As before described, a valid usage key card 202 is a prerequisite for using a given treatment device 26.


The absence of a usage key card 202 causes the controller 52 to command the display microprocessor 474 to generate a SETUP prompt 500 on the graphics display monitor 420. FIG. 11 shows a representative SETUP prompt 500. When graphically implemented, as shown in FIG. 11, the SETUP prompt 500 leads the operator in a step-wise fashion through the tasks required to enable use of the generator 38. A first graphic field displays one or more icons and/or alpha-numeric indicia 502 that prompt the operator to connect the electrical connector 42 of the treatment device 26 to the connector cable 408. A second graphic field displays one or more icons and/or alpha-numeric indicia 504 that prompt the operator to insert a valid user key card 202 (i.e., floppy disk). A third graphic field displays one or more icons and/or alpha-numeric indicia 506 that prompt the user to select the standby-ready button 430 on the housing 400 (see FIG. 10).


With the treatment device 26 connected and a user key card 202 inserted in the floppy disk drive 208, the actuation of the standby-ready button 430 causes the controller 52 to enter the STAND-BY mode 508 (see FIG. 13). In the STAND-BY mode 508, the controller 52 executes the REGISTRATION function 514, to determine whether the user key card 202 inserted in the drive 208 contains a valid identification code 214.


The identification code 214 will not be deemed valid when the code already exists in the use table 216 of the controller 52 with a time record 218 equal to or greater than the prescribed maximum, thereby indicating a completed prior use of the device 26. When the identification code 214 is not valid, the REGISTRATION function 514 commands the display microprocessor 474 to generate an EXCHANGE prompt 516 on the graphics display monitor 420. FIG. 12 shows a representative EXCHANGE prompt 516. When graphically implemented, as shown in FIG. 12, the EXCHANGE prompt 516 leads the operator in a step-wise fashion through the tasks of replacing the previously used device 26 and its key card 202 with a new device 26 and its associated key card 202.


As shown in FIG. 12, a first graphic field displays one or more icons and/or alpha-numeric indicia 518 that prompt the operator to disconnect the electrical connector 42 of the previously used treatment device 26 and to connect a new treatment device 26. A second graphic field displays one or more icons and/or alpha-numeric indicia 520 that prompt the operator to remove the old user key card 202 and insert the new key card 202 that accompanied the new treatment device 26 in the kit 200. A third graphic field displays one or more icons and/or alpha-numeric indicia 522 that prompt the user to again select the standby-ready button 430 on the housing 400.


With the new treatment device 26 connected and the new user key card 202 inserted in the floppy disk drive 208, selection of the standby-ready button 430 causes the controller 52 to again enter the STAND-BY mode 508, and again execute the REGISTRATION function 514 (see FIG. 13).


The presence of a valid identification code 214 on the user card 202 causes the controller 52 to enter the READY mode 524. The operator deploys the treatment device 26 to the intended treatment site. The operator locates the electrodes 66 in the desired orientation. When delivery of radio frequency energy is desired, the operator depresses the foot pedal 416 (or selects the standby-ready button 430). In the illustrated embodiment, the controller 52 executes a prescribed PAUSE state 528 (e.g., 8 seconds), and then commands the generator 38 to apply radio frequency energy through the electrodes 66 carried by the treatment device 26.


The controller 52 includes an UPDATE function 526 (see FIG. 13). The UPDATE function 526 registers the time period during which radio frequency energy is applied using the device 26. The time is entered into the time record 218 of the use table 216 maintained by the controller 52. After a prescribed maximum period of use is registered (e.g., sixty minutes), the UPDATE function 526 interrupts application of radio frequency energy to the electrodes 66, and prevents further delivery by the generator 38 to the particular device 26.


In this circumstance, the UPDATE function 526 causes the controller 52 to generate the EXCHANGE prompt 516. As previously described, the EXCHANGE prompt 516 requires the operator to replace the existing device 26 and its key card 200 with a new device 26 and its associated key card 200.


In the illustrated embodiment, while radio frequency energy is being applied during the READY mode 524, the controller 52 preferably monitors impedance and/or temperature conditions at the treatment site. The controller 52 enters a DEFAULT mode 530 and returns to the PAUSE state 528 when certain localized impedance and/or temperature conditions are sensed, e.g., when impedance is outside a prescribed range (for example, less than 50 ohms or greater than 1000 ohms); or electrode tip temperature exceeds 100 degrees C.; or tissue surface temperature exceeds 50 degrees C. In the PAUSE state 528, the controller 52 prevents the application of radio frequency energy through the electrodes 66 for a prescribed period of time (e.g., 8 seconds), after which operation of the generator 38 using the foot pedal 416 or standby-ready button 430 is restored.


Other details of the GUI during operation of the device 26 can be found in co-pending U.S. patent application Ser. No. 09/305,123, filed May 4, 1999 and entitled “Graphical User Interface for Association with an Electrode Structure Deployed in Contact with a Tissue Region,” which is incorporated herein by reference.


Various features of the invention are set forth in the following claims.

Claims
  • 1. A system for controlling use of a surgical device for treating a tissue region, the surgical device including a plurality of electrodes for applying energy to the tissue region, the system comprising a controller, a generator and a graphical user interface, the controller determining if the device meets a criteria for use, wherein if the criteria is not met, the controller will not enable use of the generator to apply energy to the electrodes of the surgical device, the graphical user interface having a graphic display which generates on a first screen an indicator to exchange the device for another device if the criteria is not met, the first screen appearing subsequent to the controller performing a self-test, and the first screen appearing subsequent to a prior screen indicating the surgical device should be connected.
  • 2. The system of claim 1, wherein the controller maintains for each surgical device a time record reflecting a period of time energy was applied by the generator to the surgical device.
  • 3. The system of claim 2, wherein if the period of time in the time record is less than a prescribed period of time, then the controller enables subsequent operation of the generator, and if the period of time in the time record exceeds the prescribed period of time, then the controller does not enable use of the generator.
  • 4. The system of claim 1, wherein if the criteria is not met, an exchange prompt is displayed on the graphical user interface.
  • 5. The system of claim 4, wherein the exchange prompt leads a user in a step-wise fashion through tasks of replacing the surgical device with a new surgical device.
  • 6. The system of claim 4, wherein the first screen displays one or both of an icon and indicia to prompt the user to disconnect the surgical device.
  • 7. The system of claim 1, wherein the controller includes an update function to register a time period in which energy is applied by the generator to the electrodes of the surgical device.
  • 8. The system of claim 7, wherein after a prescribed maximum period of use is registered, application of energy to the surgical device is interrupted to prevent further delivery by the generator of energy to the surgical device.
  • 9. The system of claim 8, wherein the update function causes the controller to generate an exchange prompt requiring the user to replace the surgical device.
  • 10. A system for controlling use of a surgical device comprising a controller to control operation of the device, a reader to download information to the controller, and a graphics display monitor, the controller including a processing function and either entering from a standby mode into a ready mode enabling delivery of energy to the device or not entering into a ready mode, wherein if not entering into the ready mode an indicator on the graphics display monitor is generated to exchange the device for another device, wherein the indicator appears on a screen which appears subsequent to the controller performing a self-test and subsequent to a screen which appears after the self-test to indicate a device should be connected.
  • 11. The system of claim 10, wherein the controller executes a pause state to delay application of energy to the surgical device.
  • 12. The system of claim 10, wherein the controller will not enable use of a generator if a time record of the surgical device is equal to or greater than a prescribed maximum.
  • 13. The system of claim 10, wherein if a time record of the surgical device is equal to or greater than a prescribed maximum, a registration function commands a generation of a prompt to change the surgical device, and if the time record is less than the prescribed maximum, the controller enters the ready mode.
RELATED APPLICATIONS

This application is a continuation of patent application Ser. No. 13/084,973 filed Apr. 12, 2011, now (U.S. Pat. No. 8,845,632), which is a continuation of patent application Ser. No. 11/299,955 filed Dec. 12, 2005 (now U.S. Pat. No. 7,922,715), which is a divisional of U.S. patent application Ser. No. 10/219,798, filed Aug. 15, 2002 (now U.S. Pat. No. 6,994,704), which is a divisional of U.S. patent application Ser. No. 09/574,704, filed May 18, 2000 (now U.S. Pat. No. 6,464,689).

US Referenced Citations (191)
Number Name Date Kind
1798902 Raney Mar 1931 A
3517128 Hines Jun 1970 A
3901241 Allen, Jr. Aug 1975 A
4011872 Komiya Mar 1977 A
4196724 Wirt et al. Apr 1980 A
4411266 Cosman Oct 1983 A
4423812 Sato Jan 1984 A
4532924 Auth et al. Aug 1985 A
4565200 Cosman Jan 1986 A
4705041 Kim Nov 1987 A
4858615 Meinema Aug 1989 A
4901737 Toone Feb 1990 A
4906203 Margrave et al. Mar 1990 A
4907589 Cosman Mar 1990 A
4943290 Rexroth et al. Jul 1990 A
4947842 Marchosky et al. Aug 1990 A
4955377 Lennox et al. Sep 1990 A
4966597 Cosman Oct 1990 A
4976711 Parins et al. Dec 1990 A
5019075 Spears et al. May 1991 A
5035696 Rydell Jul 1991 A
5046512 Murchie Sep 1991 A
5047028 Qian Sep 1991 A
5057107 Parins et al. Oct 1991 A
5078717 Parins et al. Jan 1992 A
5083565 Parins Jan 1992 A
5084044 Quint Jan 1992 A
5088979 Filipi et al. Feb 1992 A
5094233 Brennan Mar 1992 A
5100423 Fearnot Mar 1992 A
5106360 Ishiwara et al. Apr 1992 A
5122137 Lennox Jun 1992 A
5125928 Parins et al. Jun 1992 A
5156151 Imran Oct 1992 A
5190541 Abele et al. Mar 1993 A
5197963 Parins Mar 1993 A
5197964 Parins Mar 1993 A
5205287 Erbel et al. Apr 1993 A
5215103 Desai Jun 1993 A
5232444 Just et al. Aug 1993 A
5233515 Cosman Aug 1993 A
5236413 Feiring Aug 1993 A
5242441 Avitall Sep 1993 A
5254126 Filipi et al. Oct 1993 A
5256138 Vurek et al. Oct 1993 A
5257451 Edwards et al. Nov 1993 A
5263493 Avitall Nov 1993 A
5275162 Edwards et al. Jan 1994 A
5275608 Forman et al. Jan 1994 A
5275610 Eberbach Jan 1994 A
5277201 Stern Jan 1994 A
5281216 Klicek Jan 1994 A
5281217 Edwards et al. Jan 1994 A
5281218 Imran Jan 1994 A
5290286 Parins Mar 1994 A
5292321 Lee Mar 1994 A
5293869 Edwards et al. Mar 1994 A
5309910 Edwards et al. May 1994 A
5313943 Houser et al. May 1994 A
5314466 Stern et al. May 1994 A
5316020 Truffer May 1994 A
5324284 Imran Jun 1994 A
5328467 Edwards et al. Jul 1994 A
5334196 Scott et al. Aug 1994 A
5336222 Durgin, Jr. et al. Aug 1994 A
5345936 Pomeranz et al. Sep 1994 A
5348554 Imran et al. Sep 1994 A
5363347 Nguyen Nov 1994 A
5363861 Edwards et al. Nov 1994 A
5365926 Desai Nov 1994 A
5365945 Halstrom Nov 1994 A
5366490 Edwards et al. Nov 1994 A
5368557 Nita et al. Nov 1994 A
5368592 Stern et al. Nov 1994 A
5370675 Edwards et al. Dec 1994 A
5370678 Edwards et al. Dec 1994 A
5383871 Carlin Jan 1995 A
5383874 Jackson et al. Jan 1995 A
5383876 Nardella Jan 1995 A
5383917 Desai et al. Jan 1995 A
5385544 Edwards et al. Jan 1995 A
5397339 Desai Mar 1995 A
5398683 Edwards et al. Mar 1995 A
5400267 Denen et al. Mar 1995 A
5401272 Perkins Mar 1995 A
5403311 Abele et al. Apr 1995 A
5409453 Lundquist et al. Apr 1995 A
5409483 Campbell et al. Apr 1995 A
5415657 Taymor-Luia May 1995 A
5421819 Edwards et al. Jun 1995 A
5423808 Edwards et al. Jun 1995 A
5423811 Imran et al. Jun 1995 A
5423812 Ellman et al. Jun 1995 A
5433739 Sluijter et al. Jul 1995 A
5435805 Edwards Jul 1995 A
5441499 Fritzsch Aug 1995 A
5443470 Stern et al. Aug 1995 A
5456662 Edwards et al. Oct 1995 A
5458596 Lax et al. Oct 1995 A
5458597 Edwards et al. Oct 1995 A
5465717 Imran et al. Nov 1995 A
5470308 Edwards et al. Nov 1995 A
5471982 Edwards et al. Dec 1995 A
5472441 Edwards et al. Dec 1995 A
5484400 Edwards et al. Jan 1996 A
5486161 Lax et al. Jan 1996 A
5490984 Freed Feb 1996 A
5496271 Burton et al. Mar 1996 A
5496311 Abele et al. Mar 1996 A
5500012 Brucker et al. Mar 1996 A
5505728 Ellman et al. Apr 1996 A
5505730 Edwards et al. Apr 1996 A
5507743 Edwards et al. Apr 1996 A
5509419 Edwards et al. Apr 1996 A
5514130 Baker May 1996 A
5514131 Edwards et al. May 1996 A
5520684 Imran May 1996 A
5531676 Edwards et al. Jul 1996 A
5531677 Lundquist et al. Jul 1996 A
5536240 Edwards et al. Jul 1996 A
5536267 Edwards et al. Jul 1996 A
5540655 Edwards et al. Jul 1996 A
5549644 Lundquist et al. Aug 1996 A
5554110 Edwards et al. Sep 1996 A
5556377 Rosen et al. Sep 1996 A
5558672 Edwards et al. Sep 1996 A
5558673 Edwards et al. Sep 1996 A
5562720 Stern et al. Oct 1996 A
5571116 Bolanos et al. Nov 1996 A
5578007 Imran Nov 1996 A
5588432 Crowley Dec 1996 A
5588960 Edwards et al. Dec 1996 A
5599345 Edwards et al. Feb 1997 A
5609151 Mulier et al. Mar 1997 A
5624439 Edwards et al. Apr 1997 A
5651780 Jackson et al. Jul 1997 A
5672153 Lax et al. Sep 1997 A
5676674 Bolanos et al. Oct 1997 A
5688266 Edwards et al. Nov 1997 A
5688490 Tournier et al. Nov 1997 A
5702438 Avitall Dec 1997 A
5709224 Behl et al. Jan 1998 A
5732698 Swanson et al. Mar 1998 A
5738096 Ben-Haim Apr 1998 A
5742718 Harman et al. Apr 1998 A
5743903 Stern et al. Apr 1998 A
5830213 Panescu et al. Nov 1998 A
5836874 Swanson et al. Nov 1998 A
5848969 Panescu et al. Dec 1998 A
5860974 Abele Jan 1999 A
5871483 Jackson et al. Feb 1999 A
5891030 Johnson et al. Apr 1999 A
5916163 Panescu et al. Jun 1999 A
5931835 Mackey Aug 1999 A
5957961 Maguire et al. Sep 1999 A
6004269 Crowley et al. Dec 1999 A
6006755 Edwards Dec 1999 A
6014581 Whayne et al. Jan 2000 A
6023638 Swanson Feb 2000 A
6044846 Edwards Apr 2000 A
6056744 Edwards May 2000 A
6063082 DeVore et al. May 2000 A
6092528 Edwards et al. Jul 2000 A
6106460 Panescu et al. Aug 2000 A
6165169 Panescu Dec 2000 A
6237604 Burnside et al. May 2001 B1
6254598 Edwards et al. Jul 2001 B1
6358245 Edwards et al. Mar 2002 B1
6387092 Burnside May 2002 B1
6391024 Sun et al. May 2002 B1
6402742 Blewett et al. Jun 2002 B1
6464689 Qin et al. Oct 2002 B1
6544226 Gaiser et al. Apr 2003 B1
6547776 Gaiser et al. Apr 2003 B1
6589238 Edwards et al. Jul 2003 B2
6645201 Utley et al. Nov 2003 B1
6695806 Gelfand et al. Feb 2004 B2
6699243 West et al. Mar 2004 B2
6733495 Bek et al. May 2004 B1
6783523 Qin et al. Aug 2004 B2
6790207 Utley et al. Sep 2004 B2
6802841 Utley et al. Oct 2004 B2
6827713 Bek Dec 2004 B2
6994704 Qin et al. Feb 2006 B2
7922715 Qin et al. Apr 2011 B2
8257346 Qin et al. Sep 2012 B2
20020151871 Gaiser et al. Oct 2002 A1
20020162555 West et al. Nov 2002 A1
20020193787 Qin et al. Dec 2002 A1
20020198519 Qin et al. Dec 2002 A1
20040089313 Utley et al. May 2004 A1
Foreign Referenced Citations (23)
Number Date Country
4 303 882 Feb 1995 DE
3 838 840 Feb 1997 DE
0 139 607 May 1985 EP
0 608 609 Aug 1994 EP
0 765 813 Apr 1997 EP
WO 9101773 Feb 1991 WO
WO 9210142 Jun 1992 WO
WO 9308755 May 1993 WO
WO 9410925 May 1994 WO
WO 9421165 Sep 1994 WO
WO 9421178 Sep 1994 WO
WO 9422366 Oct 1994 WO
WO 9426178 Nov 1994 WO
WO 9518575 Jul 1995 WO
WO 9519142 Jul 1995 WO
WO 9525472 Sep 1995 WO
WO 9600042 Jan 1996 WO
WO 9616606 Jun 1996 WO
WO 9629946 Oct 1996 WO
WO 9706857 Feb 1997 WO
WO 9732532 Sep 1997 WO
WO 9743971 Nov 1997 WO
WO 9917671 Apr 1999 WO
Non-Patent Literature Citations (11)
Entry
Castell, D. O. Gastrophageal Reflux Disease: Current Strategies for Patient Management: Arch Fam. Med 5(4): 221-7; Apr. 1996.
Reynolds, “Influence of Pathophysiology, Severity, and Cost on the Med. Management of Gastroesophageal Reflux Disease.” Am. J. Health-Syst Pharm. 53(22 suppl 3): S5-12; Nov. 1996.
Dallemagne, B. et al., “Laparoscopic Nissen Fundoplication: Preliminary.” Surgical Laparoscopy & Endoscopy. 1991 1(3) 138-43.
Kelly, KA et al., “Duodenal-Gastric Reflux and Slowed Gastric Emptying by Electrical Pacing of the Canine Duodenal Pacesetter Potential.” Gastroenterology. 1997.72(3):429-33.
Urschel J. D “Complications of Antireflux Surgery”. Am J. Surg. 1993 166(1): 68-70.
Kaneko, et al., Physiological Laryngeal Pacemaker, May 1985, Trans Am Soc. Artif. Intern Organs, vol. XXXI, pp. 293-296.
Karlstrom, L.J. et al., Extopic Jejunal Pacemakers and Enterogastric Reflux after Roux Gastrectomy: Effect of Intestinal Pacing.: Surgery 1989. 106(3): 486-495.
Mugica et al., Neurostimulation: An overview, Chapter 21, Preliminary Test of a Muscular Diaphragm Pacing System on Human Patients. 1985. pp. 263-279.
Rice, et al. Enoscopic Paranasal Sinus Surgery. Chapter 5, Functional Endoscopic Paranasal Sinus Surgery, The Technique of Messerklinger, Raven Press, 1988, pp. 75-104.
Hinder, R.A et al., “The technique of laparoscopic Nissen Fundoplication.” Surgical Laparoscopy & Endoscopy. 1992. 2(3): 265-272.
Rice et al., Endoscopic Paranasal Sinus Sugery. Chapter 6, Functional Endoscopic Paranasal Sinus Surgery, The Technique of Wigand, Raven Press, 1988, pp. 105-125.
Related Publications (1)
Number Date Country
20150011990 A1 Jan 2015 US
Divisions (2)
Number Date Country
Parent 10219798 Aug 2002 US
Child 11299955 US
Parent 09574704 May 2000 US
Child 10219798 US
Continuations (2)
Number Date Country
Parent 13084973 Apr 2011 US
Child 14492046 US
Parent 11299955 Dec 2005 US
Child 13084973 US