Endoscopic Resection Using Bipolar Electrodes and Hydrodissection
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Solution Overview
Problem
Current endoscopic mucosal resection methods face challenges in efficiently removing flat adenomas with minimal tissue trauma, controlling bleeding, and retrieving uniform tissue samples while minimizing damage to surrounding anatomy, often requiring multiple devices and increasing procedural time and patient discomfort.
Innovation Solution
The method involves injecting fluid into the submucosa to raise the targeted tissue, positioning electrically conductive snare loops within the fluid pocket, and applying current between the loops to excise the tissue, allowing for precise control of the resection process and coagulation of the site.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If electrosurgical methods are used to stem bleeding, then bleeding control is improved, but tissue trauma and burning beyond the treatment site increase
Solution Approach 1:
The patent applies local quality by using bipolar electrodes that concentrate electrical current flow between two closely spaced points, creating a localized heating zone only at the treatment site. This confines the electrosurgical effect to the immediate area of interest, preventing widespread burning and tissue trauma while maintaining effective bleeding control through coagulation at the specific treatment location.
Solution Approach 2:
The patent introduces an intermediary approach by using a liquid medium (such as saline or conductive fluid) as a bridge between the bipolar electrodes and the tissue. This liquid intermediary allows controlled current distribution through the tissue, enabling precise electrosurgical cutting and coagulation while limiting the spread of thermal damage to surrounding areas.
2Adaptability or versatility
If multiple catheters are used for different functions, then functional versatility is improved, but procedural time and complexity increase
Solution Approach 1:
The patent applies universality by designing a single catheter system that integrates multiple functions: the catheter can deliver liquid for hydrodissection, position bipolar electrodes for electrosurgery, and provide working channels for instrumentation. This multi-functional design eliminates the need to exchange between separate catheters for different procedures, significantly reducing procedural time while maintaining functional versatility.
Solution Approach 2:
The patent merges previously separate functional components into a single integrated catheter assembly. The liquid delivery system, electrode positioning mechanisms, and working channels are combined within one catheter structure, allowing all functions to be performed through a single device insertion and eliminating the time loss associated with exchanging multiple catheters.
3Shape
If forceps or vacuum are used to raise flat adenoma, then tissue elevation is improved, but tissue trauma increases
Solution Approach 1:
The patent applies hydraulics by using liquid injection (hydrodissection) to raise flat adenomas. The liquid is injected through the catheter into the submucosal space, creating a fluid pocket that gently elevates the adenoma from the bowel wall. This hydraulic method provides smoother, more controlled tissue elevation compared to mechanical forceps or vacuum, reducing tissue trauma while achieving the necessary elevation for subsequent resection.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach enables efficient removal of tissue with reduced trauma, clean margins, and controlled bleeding, improving the efficiency and precision of endoscopic mucosal resection by using a single device for both hydrodissection and electrosurgical functions.
Implementation Method 1
injecting fluid into the submucosa so as to create a pocket or opening below the tissue to raise the flat adenoma above the underlying tissue
Implementation Method 2
applying current between the loops to excise the tissue
Implementation Method 3
applying current between the first and second electrodes and the targeted tissue is excised with the second electrode
Implementation Method 4
applying current between the first and second electrodes and the targeted tissue is excised with the second electrode
Data Source
AI summary
Embodiments of the invention are directed to a method of excising tissue including injecting fluid into the submucosa to raise targeted tissue. A first electrode is positioned below the targeted tissue within the injected fluid and a second electrode is positioned adjacent a surface of the raised targeted tissue opposite the first electrode. Electrical current is applied between the first and second electrodes and the targeted tissue is excised with the second electrode.