Steerable Endoscope and RF Catheter for Posterior Epistaxis
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Solution Overview
Problem
Current methods for treating epistaxis, particularly severe cases originating from the Stamm's S-point region, face challenges due to difficult access and incorrect diagnosis, often resulting in therapeutic failures, as traditional endoscopic access is limited by the small and tortuous nasal cavity with rigid instruments being unable to effectively reach the posterior nasal region.
Innovation Solution
A system comprising a steerable endoscope with a working channel and an RF ablation catheter, equipped with position sensors and a control system for real-time navigation, allows for precise placement and ablation of vascular pedicles in the posterior nasal region, including the Stamm's S-point, using RF energy, enabling effective treatment of severe epistaxis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If traditional rigid endoscopic instruments are used, then the device structure is simple, but the instruments cannot effectively reach the posterior nasal region due to the small and tortuous nasal cavity
Solution Approach 1:
The system is divided into separate functional components: a steerable endoscope for navigation and visualization, and a separate RF ablation catheter for treatment. This segmentation allows each component to be optimized independently - the endoscope for access and the catheter for ablation - resolving the contradiction between ease of operation in difficult anatomy and device complexity.
Solution Approach 2:
The endoscope incorporates a steerable distal end with articulation capability, transforming it from a rigid straight instrument to a dynamically controllable tool. This allows the distal end to be steered into the posterior nasal region by manipulating control elements at the proximal end, enabling access to previously unreachable areas while maintaining a relatively simple overall device structure.
2Reliability
If the nasal cavity is accessed using conventional methods, then the procedure is straightforward, but severe epistaxis from Stamm's S-point region cannot be effectively treated due to difficult access
Solution Approach 1:
The steerable endoscope acts as an intermediary tool that enables access to the posterior nasal region and Stamm's S-point area. By using the endoscope as a mediator, the system can navigate through the tortuous nasal cavity to reach the bleeding source, allowing effective treatment of severe epistaxis that cannot be accessed by conventional direct approaches.
Solution Approach 2:
The RF ablation catheter is designed to pass through the working channel of the endoscope, creating a nested configuration. This allows the treatment catheter to be delivered through the navigation instrument to the target site, enabling both access and treatment through a single procedural pathway and improving reliability of treatment for difficult-to-reach bleeding sources.
3Adaptability or versatility
If rigid endoscopic instruments are used, then the device is simple to manufacture, but the instruments are unable to navigate the tortuous nasal cavity pathways
Solution Approach 1:
The endoscope incorporates a steerable distal end with articulation capability, transforming it from a rigid straight instrument to a dynamically controllable tool. This allows the distal end to be steered into the posterior nasal region by manipulating control elements at the proximal end, enabling access to previously unreachable areas while maintaining a relatively simple overall device structure.
Solution Approach 2:
The endoscope shaft incorporates flexible segments that allow bending and articulation of the distal end. This flexibility enables the instrument to navigate the tortuous pathways of the nasal cavity while maintaining structural integrity, providing adaptability to complex anatomical structures without requiring excessive device complexity.
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
The system enhances access and precision in treating posterior epistaxis by allowing the steerable endoscope and RF ablation catheter to navigate through the nasal cavity, accurately targeting and ablating the source of bleeding, thereby improving treatment outcomes for severe cases.
Implementation Method 1
ablating tissue in a posterior nasal region of the nasal cavity using RF energy transmitted by the RF ablation catheter
Data Source
AI summary
A method of treating epistaxis includes inserting a distal end of an endoscope into a nasal cavity of a patient. At least the distal end of the endoscope includes a working channel. The method includes advancing a distal end of an RF ablation catheter through the working channel of the endoscope. The method also includes ablating tissue in a posterior nasal region of the nasal cavity using RF energy transmitted by the RF ablation catheter.