Apparatus and method for nerve ablation in the wall of the gastointestinal tract

Abstract

Catheter for real-time evaluation of duodenal ablation, the catheter including an expandable member configured to stretch the duodenal wall and to generate a fixed distance between a center of the catheter and the duodenal wall; a laser transmitting element coupled with the catheter body and configured to transmit a first laser beam and a second laser beam; wherein the first laser beam is configured to cause ablative damage in a region of the duodenal wall as a result of its impingement thereon, and wherein the second laser beam is configured to detect modifications in the region of the duodenal wall resulting from the impingement of the first laser beam thereon.

1 . A duodenal ablation device comprising:
 a catheter comprising   an expandable member configured to stretch a duodenal wall and to generate a fixed distance between a center of the catheter and the duodenal wall;   a laser transmitting element configured to couple to the catheter and to transmit a first laser beam and a second laser beam; wherein the first laser beam has a first infrared wavelength; and wherein the second laser beam has a second blue-red wavelength and is configured to transmitted to a second region of the duodenal wall; and   a deflective optical element functionally coupled with a laser emitting element and configured to direct the first and/or second laser beam to a region on and/or beneath the duodenal wall;   wherein the first and second laser beams are configured to be transmitted towards and/or cause ablative damage to different regions of the duodenal wall.   
     
     
         2 . The device of  claim 1 , wherein the laser emitting element comprises a first optical fiber configured to transmit the first laser beam and a second optical fiber configured to transmit the second laser beam, wherein the first and second fibers are spatially off-set. 
     
     
         3 . The device of  claim 1  wherein the deflective element is rotatable. 
     
     
         4 . The device of  claim 1 , wherein the laser transmitting element further comprises a lens configured to deflect the first laser beam. 
     
     
         5 . The device of  claim 1 , wherein said laser emitting element comprises a double cladded fiber, wherein the first laser beam is delivered through a core of the double cladded fiber and wherein the second beam is delivered through the clad of the double cladded fiber. 
     
     
         6 . The device of  claim 1 , wherein the laser transmitting element further comprises a dispersive element configured to selectively refract the first and/or second laser beam. 
     
     
         7 . The device of  claim 1 , wherein the first wavelength is 1550 nm or 1567 nm. 
     
     
         8 . The device of  claim 1 , wherein the second wavelength is a blue-green wavelength. 
     
     
         9 . The device of  claim 1 , wherein the second wavelength is 532 nm. 
     
     
         10 . The device of  claim 1 , wherein the first laser beam has a first spot diameter and the second laser beam has a second spot diameter and wherein the second spot diameter is larger than the first spot diameter. 
     
     
         11 . The device of  claim 1 , wherein the second laser beam is transmitted trough a multimode fiber. 
     
     
         12 . A duodenal ablation method comprising:
 inserting a catheter into a duodenum of a subject;   deploying an expandable member delivered by the catheter, thereby stretching a duodenal wall and generating a fixed distance between a center of the catheter and the duodenal wall;   transmitting a first laser beam in a direction essentially perpendicular to a longitudinal axis of the catheter, towards the duodenal wall, wherein the first laser beam has a first infrared wavelength;   transmitting a second laser beam essentially perpendicularly to the longitudinal axis of the catheter,   wherein the second laser beam has a second blue-red wavelength,   and wherein the first and second laser beams are transmitted towards different regions of the duodenal wall.   
     
     
         13 . The method of  claim 12 , wherein the first and/or second laser beam are directed using the deflective optical element. 
     
     
         14 . The method of  claim 12 , wherein the first laser beam has a first spot diameter, and the second laser beam has a second spot diameter. 
     
     
         15 . The method of  claim 12 , wherein the first wavelength is in the range of 1450-1600 nm. 
     
     
         16 . The method of  claim 12 , wherein the first wavelength is 1550 nm and wherein the second wavelength is 980 nm. 
     
     
         17 . The method of  claim 12 , wherein the second wavelength has a blue-green wavelength. 
     
     
         18 . The method of  claim 12 , wherein the second wavelength is 532 nm. 
     
     
         19 . The method of  claim 12 , wherein the second laser beam is transmitted at a delay relative to the transmission of the first laser beam. 
     
     
         20 . The method of  claim 12 , wherein the first and second laser beams are transmitted simultaneously towards the different regions of the duodenal wall.