AU-2005305421-A1 - Devices and methods for the treatment of endometriosis

Inventors

• GRILLO FRANCIS P
• OSTROVSKY ISAAC
• MCINTYRRE JON T

Assignees

• BOSTON SCIENT LTD

Dates

Publication Date

20060518

Application Date

20051101

Priority Date

20051028

Claims (20)

1. 1. A tissue treatment device comprising: an insertion section sized and shaped for insertion into the body via a trocar; a diagnostic element coupled to the insertion section, the diagnostic element illuminating tissue with light of a wavelength selected to facilitate identification of target tissue; and an ultrasound element coupled to the insertion section for delivering to a portion of tissue illuminated by the diagnostic element ultrasound energy.
2. 2. The system according to claim 1, further comprising a control unit coupled to the diagnostic element and the ultrasound element, the control unit remaining outside of the body space while the insertion section is inserted into the body.
3. 3. The system according to claim 2, wherein the ultrasound element is coupled to an ultrasound controller located in the control unit.
4. 4. The system according to claim 3, wherein the diagnostic element includes a light source.
5. 5. The system according to claim 4, wherein the light source is one of a low-power bulb and a diode.
6. 6. The system according to claim 1, wherein the light is one of white light and blue light.
7. 7. The system according to claim 1, wherein the ultrasound element includes at least one ultrasonic crystal. WO 2006/052518 PCT/US2005/039338 9
8. 8. The system according to claim 7, wherein the at least one ultrasonic crystal has a diameter of no more than approximately 10mm. 8. The system according to claim 1, wherein the handpiece has a diameter of about 5mm to about 9mm.
9. 9. The system according to claim 1, wherein the diagnostic component and the ultrasound component are aimed at a common target area so that light from the diagnostic component is aimed at the target area as the ultrasound component is moved toward the target area.
10. 10. The system according to claim 1, wherein the ultrasound element includes an ultrasound dome filled with a coupling medium allowing propagation of ultrasonic waves therethrough.
11. 11. A method for tissue treatment, comprising: inserting into a body space an endoscopic element including an integrated illumination element illuminating a target area and an ultrasound element delivering ultrasound energy to the target area, a wavelength of light from the illumination element being selected to facilitate identification of a particular type of target tissue.
12. 12. The method according to claim 11, wherein the illumination element is aimed so that, during movement of the ultrasound element into contact with a first target portion of tissue, the illumination element illuminates the first target portion of tissue.
13. 13. The method according to claim 12, further comprising the steps of: delivering ultrasound energy to the first target portion of tissue while the ultrasound element is in contact with the first target portion of tissue; and upon completion of the delivery of energy to the first portion of target tissue, moving the ultrasound component away from the first portion of target WO 2006/052518 PCT/US2005/039338 10 tissue to contact a second portion of target tissue while illuminating the second portion of target tissue with the illumination element.
14. 14. A device comprising: a diagnostic component delivering light to a target portion of tissue within a body; an ultrasound component delivering ultrasound energy to the target portion of tissue; and a control unit coupled to the diagnostic component and the treatment component, the control unit remaining outside of the body space when in an operative position, wherein operative ends of the diagnostic component and the ultrasound component are aimed at the target area so that the light from the diagnostic component is aimed at the target area while the ultrasound component is moved into contact therewith.
15. 15. The device according to claim 14, wherein the diagnostic and ultrasound components are mounted on a distal end of an insertion section of the device, the insertion section extending distally from a handle portion which, while the insertion section is inserted into the body, remains outside the body.
16. 16. The device according to claim 14, wherein the light from the diagnostic component is approximately 440nm in wavelength.
17. 17. The device according to claim 14, wherein the ultrasound component comprises a single ultrasound crystal with a diameter of no more than about 10mm.
18. 18. The device according to claim 17, wherein the ultrasound component comprises a single ultrasound crystal with a diameter of no more than about 8mm.
19. 19. The device according to claim 14, wherein the ultrasound component comprises an array of ultrasound crystals.
20. 20. The device according to claim 14, wherein the ultrasound component comprises a compliant dome filled with a coupling liquid.

Description

WO 2006/052518 PCT/US2005/039338 1 DEVICES AND METHODS FOR THE TREATMENT OF ENDOMETRIOSIS Priority Claim [0001] This invention claims priority to U.S. Provisional Patent Application Serial No. 60/626,033 entitled "Devices and Methods for the Treatment of Endometriosis" filed November 8, 2004, the disclosure of which is incorporated, in its entirety, herein. Background of the Invention [0002] The rate of recurrence for endometriosis is high. This is partially due to difficulties in diagnosing and removing the implanted endometrial tissue. [0003] A first step in localized treatments is the identification of endometrial lesions on the walls of the peritoneal cavity. Once the lesions have been located, these areas may be treated for removal thereof. For example, heat, electricity, cold, or radiation may be directed to each of the lesions to necrose the tissue. Alternatively, the tissue may be excised or removed by another mechanism. The effectiveness of these methods depends generally on the accuracy of the localization of the lesions and the accuracy with which the therapeutic treatment is provided to those locations. [0004] Blue light (e.g., of approximately 440 nm in wavelength, but that may range from 400 to 500 nm) has been shown to be superior to white light in identifying endometriosis lesions. Current treatments generally involve the insertion of a laparoscope to an operative space (e.g., via a first trocar) and the insertion into the operative space of a second trocar for the introduction of diagnostic and therapeutic tools. To supplement the white light source of the vision system of the laparoscope, a source of diagnostic light (e.g., blue light) is inserted into the operative space via the second trocar to identify target tissue (e.g., lesions) and to physically mark the locations of this target tissue. The source of diagnostic light is then removed from the second trocar and a source of ablation energy (e.g., radio frequency energy, laser energy) is introduced through the second trocar into the operative space. Energy from the energy source is then directed to the positions earlier noted for target tissue. It is difficult to apply the treatments to the exact locations of the lesions using this method as the bleeding associated with the current treatments (e.g., laser or RF ablation) interferes with the observation of the WO 2006/052518 PCT/US2005/039338 2 target locations. In addition, the time required for these treatments is increased as the diagnostic light source is withdrawn and the energy source is inserted. SUMMARY OF THE INVENTION [0005] In one aspect, the present invention is directed to a tissue treatment device comprising an insertion section sized and shaped for insertion into the body via a trocar and a diagnostic element coupled to the insertion section, the diagnostic element illuminating tissue with light of a wavelength selected to facilitate identification of target tissue in combination with an ultrasound element coupled to the insertion section for delivering ultrasound energy to a portion of tissue illuminated by the diagnostic element. Brief Description of the Drawings [0006] Figure 1 is a diagram showing a first embodiment of a treatment system according to the present invention; and Figure 2 is a diagram showing a second embodiment of a treatment system according to the present invention. Detailed Description [0007] The present invention may be further understood with reference to the following description and the appended drawings, wherein like elements are referred to with the same reference numerals. The invention relates to devices for the treatment of tissue within body spaces or hollow organs and more specifically relates to a system and method for minimally invasively surgically treating endometriosis and other lesions. [0008] Embodiments of the present invention simplify the treatment of tissue in hollow organs and make these treatments more reliable. An exemplary system according to embodiments of the present invention integrates a diagnostic light and an ultrasound energy source into a single tool permitting a user to accurately identify and treat target tissue under visual guidance. Thus, the surgeon is able to accurately aim energy from WO 2006/052518 PCT/US2005/039338 3 the ultrasound source toward each portion of target tissue under visual control while illuminated by the diagnostic light source. According to an exemplary embodiment of the invention, a user may switch back and forth between differing illumination modes (e.g., blue and white light) without removing and re-introducing devices or illumination sources and without requiring an additional trocar. In another embodiment, a user may use both the blue light and the white light at the same time. [0009] Procedures using embodiments of the present invention are no more invasive than conventional procedures as the diagnostic light source and the ultrasound energy source are incorporated into a single tool an