Flexible application device for the high-frequency treatment of biological tissue

Abstract

The invention concerns a flexible application device including a tubular high-frequency catheter with a flexible shaft tube having at least one lumen passing therethrough, a head electrode arranged at the distal end of the catheter, an electric line with a connection for a generator ,and a connecting element arranged at the proximal end of the shaft tube between the shaft tube and the line. An electrically conducting traction element extends in the lumen between the head electrode and the connecting element and is fixedly connected to the head electrode on the one hand and the connecting element on the other hand in such a way and which is of such a tensile strength that all external forces which occur during a treatment and which act on the catheter can be transmitted to the connecting element by way of the head electrode and the traction element.

1 . A method for medical treatment of a body part of a patient by high frequency coagulation, comprising the steps of:
 a) introducing a counterpart electrode into a body of the patient, the counterpart electrode being configured for electrical association with a head electrode;   b) introducing a high-frequency element, having the head electrode configured for coagulation treatment, into proximity with the body part;   c) applying a high frequency ac voltage with the head electrode to the body part at a voltage sufficient to effect a coagulation thereof;   d) withdrawing the high frequency element from proximity with the body part with, if necessary, continued coagulation of a length of the body part by the high frequency ac voltage on the body part, for an extent, as needed for the medical treatment.   
     
     
         2 . The method of medical treatment of  claim 1 , wherein the body part is a blood vessel vein, the medical treatment is of varicose veins, and the high-frequency element comprises a high frequency catheter, with the method comprising the steps of:
 a) introducing the counterpart electrode into the body of the patient;   b) opening a blood vessel vein in the proximity of an ankle of the patient;   c) introducing the high frequency catheter with its distal end, having the head electrode, leading into the opened vein and advancing the distal end to an end of the vein;   d) after the distal end, with the head electrode is positioned, applying high-frequency ac voltage to the electrode and applying the electrode to the end of the vein to effect coagulation and contraction of the vein;   e) contracting the vein over a desired length by the coagulation, with the distal end of the catheter being retracted in a proximal direction at a speed adapted to the dimensions and geometry of the vein being treated and the extent of applied high-frequency ac voltage; and removing the head electrode from the vein being treated, with the electrodes being separated from the high frequency ac voltage, and the high-frequency catheter being withdrawn from the patient's body.   
     
     
         3 . The method of  claim 2 , wherein, the high-frequency catheter is bipolar, and a proximal ring electrode is associated therewith as the counterpart electrode with the high-frequency ac voltage being applied between the head electrode and the associated proximal ring electrode. 
     
     
         4 . The method of  claim 2 , wherein blood, which is in the vein, is pressed out over the entire length of the vein prior to the application of the high-frequency ac voltage. 
     
     
         5 . The method of  claim 2 , wherein the position of the electrode head at the distal end of the high-frequency catheter within the vein, during coagulation, is estimated by at least one of sonographic imaging, palpitation, and a tensioned cord, which is positioned in parallel relationship with the high-frequency catheter in such a way that either an end or a marked position of the cord, outside the patient's body, is approximately level with the head electrode within the patient. 
     
     
         6 . The method of  claim 2 , wherein an acoustic or optical signal dependent on the impedance between the head electrode and the counterpart electrode is used to control speed of the withdrawal of the high-frequency catheter and the magnitude of the high-frequency ac voltage, as required. 
     
     
         7 . The method of  claim 1 , wherein the body part is a Fallopian tube, the medical treatment is the constriction or sclerosing of the Fallopian tube for effecting sterilization and the high frequency element comprises an hysteroscope, wherein the method comprises the introducing of the head electrode from a uterus of a female patient into the Fallopian tube by means of the hysteroscope and coagulating regions of the Fallopian tube therewith to form a contracted diameter and a closing thereof. 
     
     
         8 . The method of  claim 1 , wherein the high frequency catheter is introduced into a working passage of an endoscope for interstitial-endoscopic operation and then advancing the high frequency catheter into proximity with a body part, for the medical treatment. 
     
     
         9 . The method of  claim 8 , wherein the high frequency catheter is advanced as far as a treatment location and then penetrated into tissue to be treated, with the tissue being destroyed with the application of the high frequency ac voltage. 
     
     
         10 . The method of  claim 9 , wherein the medical treatment is the treatment of a pancreatic tumor and the endoscope is a flexible endoscope, wherein the method comprises the steps of:
 a) introducing the high frequency catheter into a stomach of the patient through a working passage of the flexible endoscope, and fitting the high frequency catheter to a stomach wall over a pancreas;   b) puncturing the pancreas with the catheter while monitoring the puncture site with a sonograph; and   c) destroying the pancreatic tumor by coagulation thereof with the application of the high frequency ac voltage thereto.   
     
     
         11 . The method of  claim 9 , wherein the medical treatment is the treatment of a bronchial tumor blocking a bronchus and the endoscope is a bronchoscope, wherein the method comprises the steps of:
 a) introducing the high frequency catheter into the bronchus of the patient through a working passage of the bronchoscope, and placing a distal end tip of the high frequency catheter in front of the tumor;   b) puncturing the tumor at least once with the distal end tip; and   c) applying high frequency ac voltage to tissues of the tumor with each puncture to coagulate the bronchial tumor tissue to reduce volume of the tumor tissue and increase of cross section of obstruction-free passage in the bronchus.   
     
     
         12 . The method of  claim 9 , wherein the medical treatment is the treatment of an obstructive tumor in or on a bile duct and the endoscope is a gastroscope, wherein the method comprises the steps of:
 a) introducing the high frequency catheter into the bile duct of the patient through a working passage of the gastroscope, and placing a distal end tip of the high frequency catheter in front of the tumor;   b) puncturing the tumor at least once with the distal end tip;   c) applying high frequency ac voltage to tissues of the tumor with each puncture to coagulate the bile tumor tissue to reduce volume of the tumor tissue and increase of cross section of obstruction fee passage in the bile duct; and   d) inserting a stent into the bile duct to effect immediate drainage of bile fluid.   
     
     
         13 . The method of  claim 9 , wherein the medical treatment is the treatment of gastro-esophageal reflux disease (GERD, wherein the method comprises the steps of:
 a) introducing the high frequency catheter into a stomach entrance sphincter of the patient through a working passage of the endoscope,;   b) placing a distal end tip of the high frequency catheter at an angle of between 30-90° at a level of the sphincter;   c) advancing the head electrode to penetrate into the sphincter tissue;   d) applying high frequency ac voltage to the sphincter tissue to coagulate the sphincter tissue to thereby constrict the stomach entrance and to prevent or retard reflux of gastric acid into the esophagus through the stomach entrance.   
     
     
         14 . A method for medical treatment of a body part of a patient by high frequency coagulation, comprising the steps of:
 a) introducing a counterpart electrode into a body of the patient, the counterpart electrode being configured for electrical association with a head electrode;   b) introducing a high-frequency element, having the head electrode configured for coagulation treatment, into proximity with the body part;   c) applying a high frequency ac voltage with the head electrode to the body part at a voltage sufficient to effect a coagulation thereof;   d) withdrawing the high frequency element from proximity with the body part with, if necessary, continued coagulation of a length of the body part by the high frequency ac voltage on the body part, for an extent, as needed for the medical treatment   wherein the high frequency catheter is introduced into a working passage of an endoscope for interstitial-endoscopic operation and then advancing the high frequency catheter into proximity with a body part, for the medical treatment,   wherein the high frequency catheter is advanced as far as a treatment location and then penetrated into tissue to be treated, with the tissue being destroyed with the application of the high frequency ac voltage,   wherein the medical treatment is the treatment of a bronchial tumor blocking a bronchus and the endoscope is a bronchoscope, and   wherein the method comprises the step of puncturing the tumor at least once with a distal end tip of the high frequency catheter.   
     
     
         15 . A method for medical treatment of a body part of a patient by high frequency coagulation, comprising the steps of:
 a) introducing a counterpart electrode into a body of the patient, the counterpart electrode being configured for electrical association with a head electrode;   b) introducing a high-frequency element, having the head electrode configured for coagulation treatment, into proximity with the body part;   c) applying a high frequency ac voltage with the head electrode to the body part at a voltage sufficient to effect a coagulation thereof;   d) withdrawing the high frequency element from proximity with the body part with, if necessary, continued coagulation of a length of the body part by the high frequency ac voltage on the body part, for an extent, as needed for the medical treatment,   wherein the high frequency catheter is introduced into a working passage of an endoscope for interstitial-endoscopic operation and then advancing the high frequency catheter into proximity with a body part, for the medical treatment,   wherein the high frequency catheter is advanced as far as a treatment location and then penetrated into tissue to be treated, with the tissue being destroyed with the application of the high frequency ac voltage,   wherein the medical treatment is the treatment of an obstructive tumor in or on a bile duct and the endoscope is a gastroscope, and   wherein the method further comprises the step of puncturing the tumor at least once with distal end tip of the high frequency catheter.   
     
     
         16 . A method for medical treatment of a body part of a patient by high frequency coagulation, comprising the steps of:
 a) introducing a counterpart electrode into a body of the patient, the counterpart electrode being configured for electrical association with a head electrode;   b) introducing a high-frequency element, having the head electrode configured for coagulation treatment, into proximity with the body part;   c) applying a high frequency ac voltage with the head electrode to the body part at a voltage sufficient to effect a coagulation thereof;   d) withdrawing the high frequency element from proximity with the body part with, if necessary, continued coagulation of a length of the body part by the high frequency ac voltage on the body part, for an extent, as needed for the medical treatment,   wherein the high frequency catheter is introduced into a working passage of an endoscope for interstitial-endoscopic operation and then advancing the high frequency catheter into proximity with a body part, for the medical treatment,   wherein the high frequency catheter is advanced as far as a treatment location and then penetrated into tissue to be treated, with the tissue being destroyed with the application of the high frequency ac voltage,   wherein the medical treatment is the treatment of an obstructive tumor in or on a bile duct and the endoscope is a gastroscope, and   wherein the method further comprises the step of inserting a stent into the bile duct to effect immediate drainage of bile fluid.