Non-invasive and minimally invasive and tightly targeted minimally invasive therapy methods and devices for parathyroid treatment

Abstract

Systems and method for treating organic tissue of a patient's body in precisely controlled regions of the body such as the parathyroid glands. The systems and methods include introducing an energy or substance into contact with target tissue to control functionality of the target tissue and preventing the energy or substance from contacting surrounding non-target tissues sufficiently that functionality of critical non-target tissues is substantially not affected.

1 . A method for treating a target tissue, comprising:
 locating the target tissue within a patient's body, the target tissue having a perimeter and surrounding non-target tissue;   positioning a delivery device relative to the target tissue such that the delivery device is configured to deliver to the target tissue within the perimeter a predetermined quantity of at least one of energy or substance sufficient to control a hormonal function of the target tissue without delivering the predetermined quantity of the at least one of energy or substance to the surrounding non-target tissue; and   delivering the predetermined quantity of at least one of energy or substance to the target tissue.   
     
     
         2 . The method of  claim 1 , further comprising:
 positioning an insulation device relative to the surrounding non-target tissue; and   insulating the surrounding non-target tissue to prevent the at least one of energy or substance delivered to the surrounding non-target tissue from exceeding the predetermined quantity.   
     
     
         3 . The method of  claim 1 , wherein the energy comprises at least one of electromagnetic energy, kinetic energy, vibrational or mechanical energy, thermal energy, cryotherapy, hyperthermia, radiofrequency (RF) energy, microwave energy, infrared radiation (IR), visible light, ultraviolet radiation, x-ray, gamma ray, radioactive energy, brachytherapy, electric current, irreversible electroporation, electrocautery, ultrasound energy, high intensity focused ultrasound energy (HIFU), magnetic energy or forces, a vacuum, positive and negative pressure energy or forces. 
     
     
         4 . The method of  claim 1 , wherein the substance includes one or more of solids, liquids, gels, plasmas, or gases. 
     
     
         5 . The method of  claim 1 , wherein the target tissue comprises a parathyroid gland and the non-target tissue comprises at least a laryngeal nerve or a vagus nerve. 
     
     
         6 . The method of  claim 1 , wherein positioning the delivery device relative to the target tissue comprises:
 inserting at least one of a percutaneous member, a subcutaneous member, or a conduit into the patient's body; and   transmitting the at least one of energy or substance percutaneously or through an incision.   
     
     
         7 . The method of  claim 1 , wherein positioning the delivery device relative to the target tissue comprises:
 inserting at least one of a percutaneous member, a subcutaneous member, or a conduit into the patient's body; and   transmitting the at least one of energy or substance non percutaneously, laproscopically, angiographically, endoscopically, or transcutaneously.   
     
     
         8 . The method of  claim 1 , wherein:
 the delivery device has a delivery surface area from which the at least one of energy or substance is delivered; and   positioning the delivery device comprises positioning the delivery surface area completely within the perimeter of the target tissue.   
     
     
         9 . The method of  claim 1  further comprising measuring the at least one of energy or substance delivered to at least one of the target tissue and the surrounding non-target tissue. 
     
     
         10 . The method of  claim 9 , further comprising controlling the amount of at least one of energy or substance delivered to at least one of the target tissue and the surrounding non-target tissue in response to the measured at least one energy or substance delivered. 
     
     
         11 . The method of  claim 10 , further comprising maintaining a temperature of the surrounding non-target tissue below a predetermined threshold temperature. 
     
     
         12 . The method of  claim 1 , wherein locating the target tissue comprises at least one of conducting a nuclear medicine study, using an ultrasound device, using a magnetic resonance imaging device, using a computed tomography device, or using a thermography device. 
     
     
         13 . The method of  claim 1 , wherein positioning the delivery device relative to the target tissue comprises inserting a portion of the delivery device into the target tissue. 
     
     
         14 . The method of  claim 1 , further comprising monitoring at least one physical characteristic of the patient as the at least one of energy or substance is applied to the target tissue, wherein the physical characteristic comprises at least one of parathyroid hormone activity, temperature, calcium levels, ionizing calcium, electrolytes, local temperature around the target tissue, nervous function, characteristics of the larynx and associated innervation, respiratory functions, sympathetic and parasympathetic (primary and secondary) function, arterial flow, venal flow, brain function, cardiac functions, blood pressure, chromography, and vital, hormonal, and physiologic measurements, signs and symptoms, and biological functions. 
     
     
         15 . The method of  claim 1 , wherein the target tissue comprises a parathyroid gland and the surrounding non-target tissue comprises neural tissue. 
     
     
         16 . A device for delivering at least one of energy or substance to a target tissue within a patient's body and for insulating surrounding non-target tissue from contact with the energy or substance, the device comprising:
 a delivery device configured to deliver a predetermined amount of at least one of energy or substance to a target tissue within the patient's body; and   an insulator positioned around at least a portion of the delivery device, wherein the insulator is configured to insulate the surrounding non-target tissue from at least one of the energy or substance delivered by the delivery device.   
     
     
         17 . The device of  claim 16 , further comprising at least one measuring device configured to measure the at least one of energy or substance delivered to the target tissue near the target tissue. 
     
     
         18 . The delivery device of  claim 17 , further comprising a controller configured to control the amount of at least one of energy or substance delivered to the target tissues and to the non-target tissues in response to the measured energy. 
     
     
         19 . The device of  claim 18  wherein the insulator comprises one or more physical, substance, or energy inhibitor to at least one of energy transmission or substance delivery. 
     
     
         20 . The device of  claim 16 , wherein the insulator is adjustable to vary at least one of the intensity, duration, direction, periodicity or frequency of application of the at least one of energy or substance. 
     
     
         21 . The device of  claim 16 , wherein:
 the delivery device comprises an elongated member or conduit having a proximal end and a distal end; and   the insulator comprises a sheath or guide extending substantially along the delivery device between the proximal end to the distal end of the delivery device.   
     
     
         22 . The device of  claim 16 , wherein the device further comprises a second insulator positioned between the insulator and non-target tissue to inhibit the at least one of energy or substance from transferring from the target tissue to the non-target tissue. 
     
     
         23 . The device of  claim 22 , wherein the second insulator is positioned between a portion of the target tissue that receives a high concentration of the at least one of energy or substance from the delivery device. 
     
     
         24 . The device of  claim 16 , wherein the delivery device is configured to deliver energy in the form of at least one of electromagnetic energy, kinetic energy, vibrational or mechanical energy, thermal energy, cryotherapy, hyperthermia, radiofrequency (RF) energy, microwave energy, infrared radiation (IR), visible light, ultraviolet radiation, x-ray, gamma ray, radioactive energy, brachytherapy, electric current, irreversible electroporation, electrocautery, ultrasound energy, high intensity focused ultrasound energy and/or substance (HIFU), magnetic energy and/or substance or forces, a vacuum, and positive and negative pressure energy and/or substance or forces. 
     
     
         25 . The device of  claim 16 , wherein:
 the delivery device has a delivery area from which the at least one of energy or substance is delivered; and   the delivery area is smaller than the target tissue.   
     
     
         26 . The device of  claim 25 , wherein the delivery area is positioned to contact a sufficiently small quantity of the non-target tissue such that functionality of the non-target tissue is substantially not affected. 
     
     
         27 . The device of  claim 16 , further comprising at least one treatment-inhibiting energy and/or substance delivery conduit or member configured to deliver at least one of treatment-inhibiting energy or substance to the non-target tissue. 
     
     
         28 . The device of  claim 16 , wherein the target tissue comprises parathyroid tissue. 
     
     
         29 . The device of  claim 16  wherein the predetermined amount of at least one of energy or substance is sufficient to control hormonal control of the target tissue. 
     
     
         30 . A method of treating a target tissue without substantially treating surrounding non-target tissue, the method comprising:
 positioning a delivery device into operable proximity with the target tissue of a patient's body;   delivering at least one of energy or substance to the target tissue through the delivery device sufficiently to at least partially accomplish at least one of modulate, activate, deactivate, neutralize, partially ablate, fully ablate, damage, or modify the target tissue;   monitoring the quantity of the at least one of energy or substance at the target tissue and surrounding non-target tissue; and   adjusting the amount of the at least one of energy or substance delivered through the delivery device to maintain the energy or substance delivered to the target tissue within a treatment range in which the treatment is modulated, activated, deactivated, neutralized, partially ablated, fully ablated, damaged, or modified and to maintain the at least one of energy or substance delivered to the surrounding non-target tissues outside the treatment range to maintain viability of critical non-target tissue.   
     
     
         31 . The method of  claim 30 , wherein:
 the treatment range is defined in terms of temperature; and   the treatment range includes 5 degrees C. and below and 46 degrees C. and above.   
     
     
         32 . The method of  claim 30 , further comprising:
 monitoring a biological characteristic of the patient; and   controlling the amount of the at least one of energy or substance applied through the delivery device as a function of the biological characteristic.   
     
     
         33 . The method of  claim 32 , wherein the biological characteristic comprises at least one of parathyroid hormone activity, temperature, calcium levels, ionizing calcium, electrolytes, local temperature around the target tissue, nervous function, characteristics of the larynx and associated innervation, respiratory functions, sympathetic and parasympathetic (primary and secondary) function, arterial flow, venal flow, brain function, cardiac functions, blood pressure, chromography, vital, hormonal, and physiologic measurements, signs and symptoms, and biological functions. 
     
     
         34 . The method of  claim 30 , further comprising insulating the surrounding non-target tissue to prevent the at least one of energy or substance delivered to the surrounding non-target tissue from exceeding a predetermined threshold limit. 
     
     
         35 . The method of  claim 30 , wherein the delivery device has a delivery area sizeable relative to the target tissue such that delivering the at least one of energy or substance to the target tissue from the delivery area modulates the functionality of the target tissue and does not substantially affect surrounding non-target tissues. 
     
     
         36 . The method of  claim 30 , further comprising controlling biological functions of the target tissues by applying the at least one of energy or substance to the target tissue. 
     
     
         37 . The method of  claim 30 , further comprising at least one of modulating, activating, deactivating, neutralizing, partially ablating, or fully ablating at least a portion of the target tissue without modulating, activating, deactivating, neutralizing, partially ablating, or fully ablating any significant portion of the non-target tissue. 
     
     
         39 . The method of  claim 30  wherein delivering at least one of energy or substance comprises controlling hormonal function of the target tissue. 
     
     
         40 . The method of  claim 30  wherein the target tissue comprises parathyroid tissue