# US 11,298,178 B2 · Monitoring and controlling energy delivery of an electrosurgical device

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- Number: US 11,298,178 B2
- Document ID: US11298178B2
- Status: Granted
- Kind: B2
- Application number: 16/364,952
- Filed: 2019-03-26
- Published: 2019-07-18
- Granted: 2022-04-12
- Earliest claimed: 2006-09-29
- Assignees: Baylis Medical Company Inc.
- Applicants: Baylis Medical Company Inc.
- Inventors: Jason Woo; Taras Juzkiw; Jonathan Dandy
- Web page: https://patentgrep.com/patent/US11298178B2

## CPC

- A61B 18/1233: {with circuits for assuring patient safety}
- A61B 46/10: specially adapted for instruments{, e.g. microscopes}
- A61B 90/04: {Protection of tissue around surgical sites against effects of non-mechanical surgery, e.g. laser surgery (protection of eyes against laser radiation A61F9/022)}
- A61B 8/12: in body cavities or body tracts, e.g. by using catheters
- A61B 18/14: Probes or electrodes therefor
- A61B 18/16: Indifferent or passive electrodes for grounding
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 2017/00119: {alarm; indicating an abnormal situation}
- A61B 2018/00577: {Ablation}
- A61B 2018/00601: {Cutting}
- A61B 2018/00642: {with feedback, i.e. closed loop control}
- A61B 2018/00666: {using a threshold value}
- A61B 2018/00678: {upper}
- A61B 2018/00702: {Power or energy}
- A61B 2018/0072: {Current}
- A61B 2018/00827: {Current}
- A61B 2018/00845: {Frequency}
- A61B 2018/00869: {Phase}
- A61B 2018/00875: {Resistance or impedance}
- A61B 2018/00886: {Duration}
- A61B 2018/00892: {Voltage}
- A61B 2018/00898: {Alarms or notifications created in response to an abnormal condition}
- A61B 2018/1213: {creating an arc}
- A61B 2034/2059: {Mechanical position encoders}
- A61B 2090/061: {for measuring dimensions, e.g. length}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A method is disclosed for delivering energy to a region of tissue within a patient's body using a medical treatment system. The medical treatment system comprises an energy delivery device coupled to an energy source and the method includes steps of delivering energy, measuring an energy delivery parameter, determining distance of the energy delivery device from a conductive object and optionally adjusting a position of the energy delivery device based on the determined distance.

## Claims

### Claim 1

A method for delivering energy to a region of tissue within a patient's body using a medical treatment system, the medical treatment system comprising an energy delivery device coupled to an energy delivery source, the method comprising the steps of:
(1) delivering energy through said energy delivery device;
(2) monitoring an energy delivery parameter associated with the delivery of energy by the medical treatment system;
(3) detecting one or more errors if one or more values of the energy delivery parameter exceed a predetermined magnitude threshold;
(4) determining an extent of the errors detected; and
(5) controlling the delivery of energy if the extent of the errors detected exceeds a sensitivity threshold over a predetermined time period.

### Claim 2 (depends on 1)

The method of claim 1, wherein the step of determining the extent of the errors comprises a step of determining the number of errors detected.

### Claim 3 (depends on 1)

The method of claim 1, wherein the step of determining the extent of the errors comprises a step of determining the duration of time during which the one or more errors are detected.

### Claim 4 (depends on 3)

The method of claim 3, wherein the energy delivery parameter is selected from the group consisting of: current, voltage, impedance and power.

### Claim 5 (depends on 1)

The method of claim 1, wherein the energy delivery device is selected from the group consisting of an RF (radiofrequency) cutting device and an RF (radiofrequency) ablation device.

### Claim 6 (depends on 1)

The method of claim 1, wherein the energy delivery parameter is current.

### Claim 7 (depends on 6)

The method of claim 6, wherein the threshold is between about 0.3 Amps to about 1.0 Amps.

### Claim 8

A method for delivering energy to a region of tissue within a patient's body using a medical treatment system, the medical treatment system comprising a medical device coupled to an energy delivery source, the method comprising:
(1) delivering energy from a medical device to material within a patient's body;
(2) measuring an energy delivery parameter while the energy is being delivered;
(3) detecting at least one error if one or more values of the energy delivery parameter cross a pre-determined threshold;
(4) upon detection of at least one error, assessing an extent of the at least one error to determine whether the medical device is sufficiently distanced from a conductive object to allow for safe delivery of the energy to the material within the patient's body; and
(5) if the medical device is determined to not be sufficiently distanced from the conductive object, adjusting a position of the medical device and repeating steps (2)-(4) until the medical device is sufficiently distanced from the conductive object.

### Claim 9 (depends on 8)

The method of claim 8, wherein the energy delivery parameter is selected from the group consisting of: current, voltage, phase, frequency and impedance.

### Claim 10 (depends on 8)

The method of claim 8, wherein the step of assessing an extent of the at least one error comprises quantifying a number of times the energy delivery parameter crosses the threshold.

### Claim 11 (depends on 8)

The method of claim 8, wherein the step of assessing an extent of the at least one error comprises determining if a collective magnitude of the one or more values of the energy delivery parameter exceeds a sensitivity threshold over a predetermined time period.

### Claim 12 (depends on 11)

The method of claim 11, wherein the sensitivity threshold is fixed.

### Claim 13 (depends on 12)

The method of claim 12, wherein the sensitivity threshold is adjustable.

### Claim 14 (depends on 8)

The method of claim 8 wherein the step of assessing an extent of the at least one error comprises determining a duration of time over which the energy delivery parameter exceeds the threshold.

### Claim 15 (depends on 8)

The method of claim 8, wherein the medical device is selected from the group consisting of a radiofrequency cutting device and a radiofrequency ablation device.

### Claim 16

A method for delivering energy to a region of tissue within a patient's body using a medical treatment system, the medical treatment system comprising a medical device coupled to an energy delivery source, the method comprising the steps of:
(1) delivering energy from the medical device to a material within a patient's body;
(2) measuring a return current while the energy is being delivered;
(3) detecting if the return current exceeds a threshold;
(4) if the threshold is exceeded, assessing an extent by which the return current exceeds the threshold to determine if the medical device is sufficiently distanced from a conductive object; and
(5) if the medical device is determined to not be sufficiently distanced from the conductive object, adjusting a position of the medical device and repeating steps (2)-(4) until the medical device is sufficiently distanced from the conductive object.

### Claim 17 (depends on 16)

The method of claim 16, wherein the threshold is equal to a base value, and wherein the method further comprises a step of determining a base value by measuring the current upon advancing the medical device to a target site within the patient's body.

### Claim 18 (depends on 17)

The method of claim 17, further comprising a step of imaging the medical device, wherein the steps of advancing the medical device and measuring the base value are performed concurrently with the step of imaging the medical device.

### Claim 19 (depends on 16)

The method of claim 16, further comprising a step of imaging the medical device, wherein the step of adjusting the position of the medical device is performed concurrently with the step of imaging the medical device.

### Claim 20 (depends on 18)

The method of claim 18, wherein the step of imaging the medical device is performed using an imaging modality selected from the group consisting of: fluoroscopy, magnetic resonance imaging, computerized tomography scan, electro-anatomical mapping and magnetic positioning system.

### Claim 21 (depends on 19)

The method of claim 19, wherein the step of imaging the medical device is performed using an imaging modality selected from the group consisting of: fluoroscopy, magnetic resonance imaging, a magnetic positioning system.

### Claim 22 (depends on 16)

The method of claim 16, further comprising a step of providing a feedback to a user if the distance between the medical device and the conductive object is determined to be decreasing.

### Claim 23 (depends on 22)

The method of claim 22, wherein the feedback is selected from the group consisting of a visual indication, an electrical control signal and an acoustic indication.

### Claim 24 (depends on 23)

The method of claim 23, wherein the acoustic indication is selected from the group consisting of a volume based acoustic indication and a frequency based acoustic indication.

### Claim 25 (depends on 16)

The method of claim 16, wherein the step of adjusting the position of the medical device is performed automatically.

### Claim 26 (depends on 25)

The method of claim 25, wherein the step of adjusting a position of the medical device is performed using an automated navigation system.

### Claim 27 (depends on 22)

The method of claim 22, wherein the step of adjusting a position of the medical device is performed automatically using an automated navigation system, and wherein the step of providing feedback to the user comprises providing an electrical control signal that is receivable by the automated navigation system.
