Method and apparatus for electrosurgically obtaining access...

Details Method and apparatus for electrosurgically obtaining access... Method and apparatus for electrosurgically obtaining access...

A - Human Necessities

61

M

A61M 25/00 (2006.01) A61B 18/12 (2006.01) A61F 2/84 (2006.01)

Patent

CA 2203126

This invention is a method of electro-surgically obtaining access to the biliary tree of a patient and visualizing a duct (40) thereof using a catheter (10) having at least a first lumen (32), and a second lumen (34). The first lumen (32) has a needle knife (206) disposed therein, which knife (206) may be moved between a deployed position and a sheathed position, and is in electrical communication with a power source. The method includes the steps of (a) inserting the catheter (10) through an endoscope (36) and into the duodenum (38) of a patient proximal to the entrance to the common bile duct (40); (b) deploying the needle knife (206); (c) manipulating the needle knife (206) and applying current thereto to incise tissue proximal to the entrance to the common bile duct (40); (d) withdrawing the needle knife (206) into the sheathed position; (e) advancing the catheter (10) into the common bile duct to a desired location within said duct (40); and (f) infusing a contrast medium through the second lumen (34) of the catheter (10) to visualize the common bile duct (40) through the use of the contrast medium while the needle knife (206) remains in the first lumen (32) of the catheter.

Cette invention se rapporte à un procédé permettant d'avoir accès par électrochirurgie à l'arbre biliaire et à visualiser un de ses conduits (40) à l'aide d'un cathéter (10) comportant au moins un premier lumen (32) et un second lumen (34). Dans le premier lumen (32) est placé un bistouri à aiguille (206) qui peut être déplacé entre une position déployée et une position rentrée et qui communique avec une source de courant électrique. Le procédé consiste à: (a) insérer le cathéter (10) dans un endoscope (36) et dans le duodénum (38) du patient à proximité de l'entrée menant au canal cholédoque (40); (b) déployer le bistouri à aiguille (206); (c) manipuler le bistouri à aiguille (206) et y appliquer un courant afin d'inciser le tissu proche de l'entrée menant au canal cholédoque (40); (d) dégager le bistouri à aiguille (206) et l'amener en position rentrée; (e) faire avancer le cathéter (10) dans le canal cholédoque jusqu'à un endroit désiré dans le canal (40); et (f) injecter un milieu de contraste dans le second lumen (34) du cathéter (10) afin de visualiser le canal cholédoque (40) à l'aide de ce milieu de contraste tout en laissant le bistouri à aiguille (206) dans le premier lumen (32) du cathéter.

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