CA2339496A1 - Device for use in surgery - Google Patents
Device for use in surgery Download PDFInfo
- Publication number
- CA2339496A1 CA2339496A1 CA002339496A CA2339496A CA2339496A1 CA 2339496 A1 CA2339496 A1 CA 2339496A1 CA 002339496 A CA002339496 A CA 002339496A CA 2339496 A CA2339496 A CA 2339496A CA 2339496 A1 CA2339496 A1 CA 2339496A1
- Authority
- CA
- Canada
- Prior art keywords
- needles
- array
- applicator
- tissue
- waveguide
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/02—Radiation therapy using microwaves
- A61N5/04—Radiators for near-field treatment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/02—Radiation therapy using microwaves
- A61N5/04—Radiators for near-field treatment
- A61N5/045—Radiators for near-field treatment specially adapted for treatment inside the body
Abstract
A device for generating localised heating in a selected body tissue is disclosed. The device comprises an applicator including a source of microwav e radiation and an array of retractable needles arranged so as to extend from one face of the applicator and, in operation, to confine the irradiated microwave energy field emanating from the applicator. The use of this device in surgical procedures is described.
Description
_.__.. _ _ .. . _ . ~ _ ~- ~ _. _~r~_:~...,__ :_ .. ~,1~1_ Q.z~ c~~us-~ ~4s gs wlw This invention rel$tes to a device for use in the surgical treatment of human yr non-human animals. In partzcula=, it is concerned with a device for use in controlling excessive bl~edinq from severed tissue during su,rgicai procedures, especially on the patient's liver.
It is well known that raising the temperature of body tissue tends to reduce blood flow within the tissue. If the ternparature i$ raised by 2fl-30°C above normal, blood flow w~.thin the tissue is greatly diminished.
=n surgical procedures performed on deep-seated.
body tissues and organs, e.g. the liver, b~.ood loss ~rom severed tissue oan be a serious problem. There is an obvious need for a device which can assist in limiting such blood Loss and, as indicated above, this can be achieved by means of the application of heat.
Widespread heating can be achieved relatively easily, but this is not desirable. Very localised heating is required in order to minimise damage to surrounding 2S tissues. In liver surgery, local heating of the liver is ideally required in a tissue volume approxa.mately 5cm long by 2cm voids by 4cm deep: this volume is centred an the planned point of incision. Furthermor~, it is important for the ~.ooel elev8tion of temperature to be achieved quickly just prior to commencing the surgical procedure.
US 4,974,5$7 discloses a device for heating biological tissues, comprising a microwave generator 3S and an array of eiectro-magnetic ~M energy applicators being microwave antennae or LCF capacitance type ;r __. ........._. ~,LEI~~CHEN o~ :14._ s_ o : is ~~ : oz ; ~ q.vo osos, +4~
ss : GB 009902559 14-08-2000 - - _ _ . _ _ __ _ _. _ _2_ electrodes attached to an envelope fiilgd with a high dielectric fluid. The electrodes are insortwd into tubes on the surface of the envelope, This insertion process may be controlled by a positioning unit.
EP 0 073 709 discloses a device for generating localised haati~xg in body tissue, the source of microwave being in the form of a cylindrical waveguide.
The present invention ai.am to provide a device far providing localised heating of a swl8cted region of body tissue prior to surgiCa~ incision of that tissue.
According tp on~ aspect of the present invention, there ie provided a devise for generating localised heating in a eel~eted body tissue, wherein the said device comprises an applicator includix~g a source of microwave radiation, aharaateris~d in that:
(A) the sours of microwave radiation is irr the form of a waveguide:
(8) the applicator includes an array of retractable needles arranged so as to extend from on~ face of the applicator;
(C) the waveguide and the array of aesdlc~s, when extended, defines a volume whale dimer~,sions correspond to those of the tissue volume which is to be heated;
3~ and (D) in operation, the array of needles serves to evnfine the irradiated microwave etvergy field Bmsnating from the applicator.
- . _ _ ..~-~ ~L~_ _ .,~_. _ = 1~ _ ~s a : 1 g : y; : 0171 4 20 11505-~ +4~ g9 14-OS-2000 - _. _ _. . . _ __ . _ -2d-as defined above for restricting the loss of blood during a surgical procedure on the human or animal body.
According to another aspect of the present invention, there is provided, ins the aurgicai. trea~traent of the human or animal bcd~s, a method of aoatrollirg excessive bleeding, the method comprising inserting an __.._ a~ay_°f__neegles_ into_the_t~asue. ar__.organ__being_-____. _.
.__ _.
treated; Brit applying microwave energy to the region undergoing treatment for a time sufficient to rai$e the temperature of said tissue or organ by 20-30 degr~es C.
Conveniently, the source of microwave radiation is in the forte of a rectangular wavaguide t~chose dimensions correspond to those of the tissue volume which is to b~
heated. The waveguide is preferably generally rectangular fn form, the array of retractable n~edl~s being position~d around the periphery of the waveguide.
The device may include a needle advance mechanism including a collar to which the needles are secured;
movement of Bait coZLar may be actuated by a solenoid mechanism.
It is well known that raising the temperature of body tissue tends to reduce blood flow within the tissue. If the ternparature i$ raised by 2fl-30°C above normal, blood flow w~.thin the tissue is greatly diminished.
=n surgical procedures performed on deep-seated.
body tissues and organs, e.g. the liver, b~.ood loss ~rom severed tissue oan be a serious problem. There is an obvious need for a device which can assist in limiting such blood Loss and, as indicated above, this can be achieved by means of the application of heat.
Widespread heating can be achieved relatively easily, but this is not desirable. Very localised heating is required in order to minimise damage to surrounding 2S tissues. In liver surgery, local heating of the liver is ideally required in a tissue volume approxa.mately 5cm long by 2cm voids by 4cm deep: this volume is centred an the planned point of incision. Furthermor~, it is important for the ~.ooel elev8tion of temperature to be achieved quickly just prior to commencing the surgical procedure.
US 4,974,5$7 discloses a device for heating biological tissues, comprising a microwave generator 3S and an array of eiectro-magnetic ~M energy applicators being microwave antennae or LCF capacitance type ;r __. ........._. ~,LEI~~CHEN o~ :14._ s_ o : is ~~ : oz ; ~ q.vo osos, +4~
ss : GB 009902559 14-08-2000 - - _ _ . _ _ __ _ _. _ _2_ electrodes attached to an envelope fiilgd with a high dielectric fluid. The electrodes are insortwd into tubes on the surface of the envelope, This insertion process may be controlled by a positioning unit.
EP 0 073 709 discloses a device for generating localised haati~xg in body tissue, the source of microwave being in the form of a cylindrical waveguide.
The present invention ai.am to provide a device far providing localised heating of a swl8cted region of body tissue prior to surgiCa~ incision of that tissue.
According tp on~ aspect of the present invention, there ie provided a devise for generating localised heating in a eel~eted body tissue, wherein the said device comprises an applicator includix~g a source of microwave radiation, aharaateris~d in that:
(A) the sours of microwave radiation is irr the form of a waveguide:
(8) the applicator includes an array of retractable needles arranged so as to extend from on~ face of the applicator;
(C) the waveguide and the array of aesdlc~s, when extended, defines a volume whale dimer~,sions correspond to those of the tissue volume which is to be heated;
3~ and (D) in operation, the array of needles serves to evnfine the irradiated microwave etvergy field Bmsnating from the applicator.
- . _ _ ..~-~ ~L~_ _ .,~_. _ = 1~ _ ~s a : 1 g : y; : 0171 4 20 11505-~ +4~ g9 14-OS-2000 - _. _ _. . . _ __ . _ -2d-as defined above for restricting the loss of blood during a surgical procedure on the human or animal body.
According to another aspect of the present invention, there is provided, ins the aurgicai. trea~traent of the human or animal bcd~s, a method of aoatrollirg excessive bleeding, the method comprising inserting an __.._ a~ay_°f__neegles_ into_the_t~asue. ar__.organ__being_-____. _.
.__ _.
treated; Brit applying microwave energy to the region undergoing treatment for a time sufficient to rai$e the temperature of said tissue or organ by 20-30 degr~es C.
Conveniently, the source of microwave radiation is in the forte of a rectangular wavaguide t~chose dimensions correspond to those of the tissue volume which is to b~
heated. The waveguide is preferably generally rectangular fn form, the array of retractable n~edl~s being position~d around the periphery of the waveguide.
The device may include a needle advance mechanism including a collar to which the needles are secured;
movement of Bait coZLar may be actuated by a solenoid mechanism.
2~
In operation of the device, the needles will be advanced from the body of the applicator into the tissue which is to be heated so that the needles function as a extension of the waveguide; in this way, the applicator will direct the required microwave energy into the appropriate tissue volume prior to surgery. When the heating process is completed, the needles are retracted back into the body of the applicator.
Generally, the needles will be disposed mutually parallel; they can conveniently be formed of steel.
Theoretical calculations show that, in order to raise the temperature of body tissues by 30°C, an applicator operating with 100% efficiency would need to deliver about 10 watts of microwave power, assuming that the volume to be heated is 40cm~. For a typical biological tissue such as muscle, this temperature rise would be achieved in approximately 10 minutes. If the source is increased in energy to 500 watt, and if the applicator is assumed to be about 80% efficient, the time taken to achieve this required temperature increase is approximately 15 seconds.
For a better understanding of the invention, and to show how the same may be carried into effect, reference will now be made, by way of example, to the accompanying drawings, in which:
Figure 1 is a schematic representation of an applicator in accordance with this invention;
Figure 2 is a cross-sectional view of the applicator head of Figure 1;
Figure 3 is an end elevational view corresponding .. .,..... ..... ~~~iF;NCHE1~ (y : m.- $_ o : lfs::~s ; oi;z ~.?o o~qs~ +~.'~
~~ GB 009902559 14-08-2000 - ~ -- -- - - - - -- - - _ to Figures i and 2.
Referring now to the dre~wings, a power and control unit (1) suppli~s up to 500 watts of miorowave poorer via a coaxial cable (2) to a rectangular applicator (3). The head (3) has a handle (4) through which cable (2) passes, and an array (5) of retractable needles whir~a are designed to prvvids precise irradiation of t~ _tissue -in the_vici~ty Qf_the___seleated__-incision_._ _--. _ __ _ point. The unit (1) also contains a switching meoh~sniem end c~Qntrol electronics to activate the xelesse of the array of needles.
As shown in Figures 2 and 3, the applicator head I5 (3) includes a rectangular waveguide (s) around the periphery of which the needles of array {5y are located . The wavegui.de is 2~ TM., mode wsveguide and is filled with a suitable dielectric. For irradiation of a region 5cm long by 2cm wide, the r~ctangular 2fl waveguide should have corresponding dimensions and may bg filled with a medium whose d~.eleatric constant (e~) is about 50. These parameters dictate that the microwave operating frequency should be of the order of I G~iz. The specific values given here are by of 2d ezempie omlY; it will be sppreoiated that a range of applicators designed to irradi~te different volumes of tissue may be developed and these, of n~cessity, Will have different dimensions and may require s diff~reat dielectric med~.mn and a different operating freguency 30 from that given abav~. In the illustrated embodime_~rt, each of the needles is 3cm long and made of st~el.
Wren the applicator is in operation, these needles urill be advanced into the tissue where they function as an extension to the waveguide. A typ~.cal ne~,d~,e gray may 35 comprise about ZC needles. 8y employing a TM mode wavsguide, leakage of energy through the ~needls wall"
In operation of the device, the needles will be advanced from the body of the applicator into the tissue which is to be heated so that the needles function as a extension of the waveguide; in this way, the applicator will direct the required microwave energy into the appropriate tissue volume prior to surgery. When the heating process is completed, the needles are retracted back into the body of the applicator.
Generally, the needles will be disposed mutually parallel; they can conveniently be formed of steel.
Theoretical calculations show that, in order to raise the temperature of body tissues by 30°C, an applicator operating with 100% efficiency would need to deliver about 10 watts of microwave power, assuming that the volume to be heated is 40cm~. For a typical biological tissue such as muscle, this temperature rise would be achieved in approximately 10 minutes. If the source is increased in energy to 500 watt, and if the applicator is assumed to be about 80% efficient, the time taken to achieve this required temperature increase is approximately 15 seconds.
For a better understanding of the invention, and to show how the same may be carried into effect, reference will now be made, by way of example, to the accompanying drawings, in which:
Figure 1 is a schematic representation of an applicator in accordance with this invention;
Figure 2 is a cross-sectional view of the applicator head of Figure 1;
Figure 3 is an end elevational view corresponding .. .,..... ..... ~~~iF;NCHE1~ (y : m.- $_ o : lfs::~s ; oi;z ~.?o o~qs~ +~.'~
~~ GB 009902559 14-08-2000 - ~ -- -- - - - - -- - - _ to Figures i and 2.
Referring now to the dre~wings, a power and control unit (1) suppli~s up to 500 watts of miorowave poorer via a coaxial cable (2) to a rectangular applicator (3). The head (3) has a handle (4) through which cable (2) passes, and an array (5) of retractable needles whir~a are designed to prvvids precise irradiation of t~ _tissue -in the_vici~ty Qf_the___seleated__-incision_._ _--. _ __ _ point. The unit (1) also contains a switching meoh~sniem end c~Qntrol electronics to activate the xelesse of the array of needles.
As shown in Figures 2 and 3, the applicator head I5 (3) includes a rectangular waveguide (s) around the periphery of which the needles of array {5y are located . The wavegui.de is 2~ TM., mode wsveguide and is filled with a suitable dielectric. For irradiation of a region 5cm long by 2cm wide, the r~ctangular 2fl waveguide should have corresponding dimensions and may bg filled with a medium whose d~.eleatric constant (e~) is about 50. These parameters dictate that the microwave operating frequency should be of the order of I G~iz. The specific values given here are by of 2d ezempie omlY; it will be sppreoiated that a range of applicators designed to irradi~te different volumes of tissue may be developed and these, of n~cessity, Will have different dimensions and may require s diff~reat dielectric med~.mn and a different operating freguency 30 from that given abav~. In the illustrated embodime_~rt, each of the needles is 3cm long and made of st~el.
Wren the applicator is in operation, these needles urill be advanced into the tissue where they function as an extension to the waveguide. A typ~.cal ne~,d~,e gray may 35 comprise about ZC needles. 8y employing a TM mode wavsguide, leakage of energy through the ~needls wall"
- i.e., the area bounded by the array of needles - is kept to a low level (typically less than 10%).
Figure 2 also shows a collar (8) to which each of the needles of the array (5) are secured. Collar (8) is acted upon by spring (9) which forms part of a solenoid mechanism (10) for controlling the advance and retraction of the array of needles. Power is supplied to the solenoid mechanism (10) via cable (11). As illustrated in Figure 2, coaxial line (2) terminates within the dielectric-filled waveguide (6).
In operation, a surgeon will position the applicator head (3) against the region of tissue (e. g. liver) which is about to be incised. Initially the needle array (5) is retracted within head (3).
When the applicator is actuated, solenoid mechanism (10) causes the needles of array (5) to be extended into the patient's tissue. Once they are embedded in the tissue, microwave energy at the desired frequency (e. g. 1 GHz) is supplied to waveguide (6) and passes therefrom into the volume of tissue enclosed by the array (5) of needles. Energy is supplied at a typical power level of 500 watts for a duration of about 15 sees when an applicator of the dimensions 5cm x 2cm and a needle length of 3cm is used. At the end of the treatment period, the microwave source is switched off and needle array (5) is retracted. The surgeon may then proceed with the incision and any subsequent procedures as may be necessary.
Blood loss from incision of tissue after heat treatment as described is greatly reduced in comparison to the results obtained in the absence of such heat treatment.
Figure 2 also shows a collar (8) to which each of the needles of the array (5) are secured. Collar (8) is acted upon by spring (9) which forms part of a solenoid mechanism (10) for controlling the advance and retraction of the array of needles. Power is supplied to the solenoid mechanism (10) via cable (11). As illustrated in Figure 2, coaxial line (2) terminates within the dielectric-filled waveguide (6).
In operation, a surgeon will position the applicator head (3) against the region of tissue (e. g. liver) which is about to be incised. Initially the needle array (5) is retracted within head (3).
When the applicator is actuated, solenoid mechanism (10) causes the needles of array (5) to be extended into the patient's tissue. Once they are embedded in the tissue, microwave energy at the desired frequency (e. g. 1 GHz) is supplied to waveguide (6) and passes therefrom into the volume of tissue enclosed by the array (5) of needles. Energy is supplied at a typical power level of 500 watts for a duration of about 15 sees when an applicator of the dimensions 5cm x 2cm and a needle length of 3cm is used. At the end of the treatment period, the microwave source is switched off and needle array (5) is retracted. The surgeon may then proceed with the incision and any subsequent procedures as may be necessary.
Blood loss from incision of tissue after heat treatment as described is greatly reduced in comparison to the results obtained in the absence of such heat treatment.
Claims (7)
1. A device for generating localised heating in a selected body tissue, wherein the said device comprises an applicator (3) including a source (1) of microwave radiation, characterised in that:
(A) the source (I) of microwave radiation is in the form of a waveguide (6);
(B) the applicator includes an array (5) of retractable needles arranged so as to extend from one face of the applicator (3);
(C) the waveguide. (6) and the array (5) of needles, when extended, define a volume whose dimensions correspond to those of the tissue volume which is to be heated; and (D) in operation, the array (5) of needles serves to confine the irradiated microwave energy field emanating from the applicator (3).
(A) the source (I) of microwave radiation is in the form of a waveguide (6);
(B) the applicator includes an array (5) of retractable needles arranged so as to extend from one face of the applicator (3);
(C) the waveguide. (6) and the array (5) of needles, when extended, define a volume whose dimensions correspond to those of the tissue volume which is to be heated; and (D) in operation, the array (5) of needles serves to confine the irradiated microwave energy field emanating from the applicator (3).
2. A device as claimed in claim 1, characterised in that said waveguide (6) is a generally rectangular waveguide around the periphery of which said array (5) of retractable needles is positioned.
3. A device as claimed in claim 1 or 2, characterised in that said retractable needles are formed of steel.
4. A device as claimed in any preceding claim, characterised in that it comprises a needle advance mechanism including a collar (8) to which the needles are secured.
5. A device as claimed in claim 4, characterised in that movement of said collar (8) is actuated by s solenoid mechanism (10).
6. Use of the device is claimed in say preceding claim for restricting the loss of blood during a surgical procedure on the human or animal body.
7. In the surgical treatment of the human or animal body a method of controlling excessive bleeding, the method comprising inserting an array (5) of needles into the tissue or organ being treated and applying microwave energy to the region undergoing treatment for a time sufficient to raise the temperature of said tissue or organ by 20-30 degrees C.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| GB9817078.0 | 1998-08-05 | ||
| GBGB9817078.0A GB9817078D0 (en) | 1998-08-05 | 1998-08-05 | Device for liver surgery |
| PCT/GB1999/002559 WO2000007666A1 (en) | 1998-08-05 | 1999-08-04 | Applicator for microwave radiation treatment |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2339496A1 true CA2339496A1 (en) | 2000-02-17 |
Family
ID=10836774
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002339496A Abandoned CA2339496A1 (en) | 1998-08-05 | 1999-08-04 | Device for use in surgery |
Country Status (8)
| Country | Link |
|---|---|
| US (6) | US6628990B1 (en) |
| EP (2) | EP1504791A1 (en) |
| JP (1) | JP4180242B2 (en) |
| AT (1) | ATE279235T1 (en) |
| CA (1) | CA2339496A1 (en) |
| DE (1) | DE69921143T2 (en) |
| GB (1) | GB9817078D0 (en) |
| WO (1) | WO2000007666A1 (en) |
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- 1998-08-05 GB GBGB9817078.0A patent/GB9817078D0/en not_active Ceased
-
1999
- 1999-08-04 DE DE69921143T patent/DE69921143T2/en not_active Expired - Lifetime
- 1999-08-04 JP JP2000563347A patent/JP4180242B2/en not_active Expired - Lifetime
- 1999-08-04 EP EP04077808A patent/EP1504791A1/en not_active Ceased
- 1999-08-04 CA CA002339496A patent/CA2339496A1/en not_active Abandoned
- 1999-08-04 WO PCT/GB1999/002559 patent/WO2000007666A1/en active IP Right Grant
- 1999-08-04 US US09/762,285 patent/US6628990B1/en not_active Expired - Lifetime
- 1999-08-04 AT AT99936873T patent/ATE279235T1/en not_active IP Right Cessation
- 1999-08-04 EP EP99936873A patent/EP1100585B1/en not_active Expired - Lifetime
-
2003
- 2003-07-22 US US10/625,232 patent/US20060047274A1/en not_active Abandoned
-
2005
- 2005-02-11 US US11/055,858 patent/US20050143795A1/en not_active Abandoned
-
2010
- 2010-08-18 US US12/858,519 patent/US20100312237A1/en not_active Abandoned
- 2010-09-15 US US12/882,612 patent/US20110004206A1/en not_active Abandoned
-
2013
- 2013-03-25 US US13/849,848 patent/US8753342B2/en not_active Expired - Fee Related
Also Published As
| Publication number | Publication date |
|---|---|
| JP2002522126A (en) | 2002-07-23 |
| EP1100585A1 (en) | 2001-05-23 |
| WO2000007666A1 (en) | 2000-02-17 |
| US8753342B2 (en) | 2014-06-17 |
| US20110004206A1 (en) | 2011-01-06 |
| ATE279235T1 (en) | 2004-10-15 |
| US20100312237A1 (en) | 2010-12-09 |
| DE69921143D1 (en) | 2004-11-18 |
| GB9817078D0 (en) | 1998-10-07 |
| US20060047274A1 (en) | 2006-03-02 |
| US6628990B1 (en) | 2003-09-30 |
| DE69921143T2 (en) | 2005-03-17 |
| EP1100585B1 (en) | 2004-10-13 |
| JP4180242B2 (en) | 2008-11-12 |
| US20130218155A1 (en) | 2013-08-22 |
| EP1504791A1 (en) | 2005-02-09 |
| US20050143795A1 (en) | 2005-06-30 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| FZDE | Discontinued |