Electrosurgical devices with a single conductive tubular element for accessing anatomical structures

Patent metadata

Field	Value
Publication number	US-2018028263-A1
Application number	US-201715661670-A
Country	US
Kind code	A1
Filing date	Jul 27, 2017
Priority date	Jul 29, 2016
Publication date	Feb 1, 2018
Grant date	—

Abstract

An electrosurgical medical device may include a conductive tubular element disposed about an outer surface of an elongate tubular member at a distal portion of the tubular member. The conductive tubular member may be delivered to a treatment site of a gastrointestinal (GI) tract of a patient and electrically activated. While electrically activated, the conductive tubular element may create an opening in a wall of the GI tract and a pseudocyst. After the incision is made, the conductive tubular element may be withdrawn from the treatment site and a drainage device may be positioned in the incision for drainage of the pseudocyst.

First claim

1 . An electrosurgical device comprising:
an elongate tubular member that extends from a proximal portion to a distal portion, the elongate tubular member comprising a body and a wireguide lumen longitudinally extending in the body from the proximal portion to the distal portion, the body comprising an insulating material; a conductive tubular element affixed to the body of elongate tubular member and disposed about an outer surface of the body at the distal portion, wherein the insulating material of the body insulates the wireguide lumen from the conductive tubular element; and an elongate conductive member longitudinally extending adjacent the body from the proximal portion to the distal portion, wherein a distal portion of the elongate conductive member is attached and electrically connected to the conductive tubular element.

2 . The electrosurgical device of claim 1 , wherein the conductive tubular element is disposed over the distal portion of the elongate conductive member.

3 . The electrosurgical device of claim 1 , wherein the conductive tubular element comprises a conductive cannula.

4 . The electrosurgical device of claim 1 , wherein the conductive tubular element comprises a conductive coil.

5 . The electrosurgical device of claim 4 , wherein the conductive coil and the elongate conductive member are integral components of a same wire.

6 . The electrosurgical device of claim 4 , wherein the conductive coil and the elongate conductive member are parts of different wires.

7 . The electrosurgical device of claim 1 , wherein the conductive tubular element comprises a conductive coil and a conductive cannula disposed over the conductive coil.

8 . The electrosurgical device of claim 1 , wherein the elongate conductive member longitudinally extends outside and along an outer surface of the body from the proximal portion to the distal portion.

9 . The electrosurgical device of claim 1 , wherein the elongate conductive member longitudinally extends inside the body from the proximal portion to the distal portion, and wherein the distal portion of elongate conductive member extends from inside to outside of the elongate tubular member to be attached to the conductive tubular member.

10 . The electrosurgical device of claim 9 , wherein the elongate conductive member is embedded in the body.

11 . The electrosurgical device of claim 10 , wherein the elongate conductive member is in a straightened configuration while embedded in the body.

12 . The electrosurgical device of claim 11 , wherein the elongate conductive member is in a coiled configuration while embedded in the body.

13 . The electrosurgical device of claim 9 , wherein the wireguide lumen comprises a first lumen, the elongate tubular member further comprising a second lumen longitudinally extending in the body from the proximal portion to the distal portion, wherein the elongate tubular member longitudinally extends in the second lumen from the proximal portion to the distal portion.

14 . The electrosurgical device of claim 1 , wherein an outer diameter of the conductive tubular element is greater than five French (one and two-thirds millimeters) and less than ten French (three and one-third millimeters).

15 . The electrosurgical device of claim 14 , wherein the outer diameter of the conductive tubular element is six French.

16 . A method of gaining access into an anatomical structure, the method comprising:
delivering a conductive tubular element to a treatment site in a patient; electrically activating the conductive tubular element; and creating an opening in the anatomical structure by initially cutting the anatomical structure with the electrically activated conductive tubular element.

17 . The method of claim 16 , wherein creating the opening comprises creating an incision in the anatomical structure.

18 . The method of claim 16 , wherein creating the opening comprises enlarging an initial opening of the anatomical structure.

19 . The method of claim 16 , wherein creating the opening comprises creating the opening with only the electrically activated conductive tubular element.

20 . The method of claim 16 , wherein initially cutting into the anatomical structure comprises distally advancing a distal end of the conductive tubular element into the anatomical structure while the conductive tubular element is electrically activated.

21 . The method of claim 16 , wherein initially cutting into the anatomical structure comprises initially cutting into the anatomical structure with a side surface defining a distal end of the conductive tubular element.

22 . The method of claim 16 , further comprising: after creating the opening, positioning a drainage device in the opening for drainage of the anatomical structure.

23 . The method of claim 22 , further comprising:
before positioning the drainage device in the opening, distally advancing a distal portion of a wireguide through the opening to within the anatomical structure; and distally advancing the drainage device over the wireguide to the treatment site in order to position the drain device in the opening.

24 . The method of claim 23 , wherein the conductive tubular element is disposed about an elongate tubular member, and
wherein distally advancing the distal portion of the wireguide comprises distally advancing the distal portion through a wireguide lumen of the elongate tubular member.

25 . The method of claim 16 , wherein an outer diameter of the conductive tubular element is greater than five French (one and two-thirds millimeters) and less than ten French (three and one-third millimeters).

26 . The method of claim 16 , wherein the conductive tubular element comprises at least one of a conductive cannula or a conductive coil.

27 . The method of claim 16 , further comprising:
delivering electrical current in a range of 80-120 Watts to the conductive tubular element while the conductive tubular element is cutting into the anatomical structure to create the opening.

28 . The method of claim 16 , wherein delivering the conductive tubular element to the treatment site comprises delivering the conductive tubular element disposed over an elongate tubular member comprising a body and a wireguide lumen longitudinally extending through the body, the body comprising an insulating material that electrically insulates the wireguide lumen from the conductive tubular element.

29 . The method of claim 16 , wherein the treatment site is in a gastrointestinal tract of the patient.

30 . The method of claim 29 , wherein the anatomical structure is adjacent a wall of the gastrointestinal tract, the method further comprising:
cutting into the wall before cutting into the anatomical structure in order to create the opening.

31 . The method of claim 16 , wherein the anatomical structure comprises a pseudocyst.

32 . The method of claim 31 , wherein the pseudocyst is adjacent a wall outside the gastrointestinal tract.

Assignees

• Cook Medical Technologies Llc

Inventors

• Keady Fionan
• Long Margaret

Classifications

• A61B18/1206

  Generators therefor · CPC title

• A61B2018/00517

  Urinary bladder or urethra · CPC title

• A61B17/3476

  Powered trocars, e.g. electrosurgical cutting, lasers, powered knives · CPC title

• A61B2018/00601

  Cutting · CPC title

• A61B18/1477

  Needle-like probes · CPC title