# US 2010/0168561 A1 · Intraoperative Tissue Mapping and Dissection Systems, Devices, Methods, and Kits

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- Number: US 2010/0168561 A1
- Document ID: US20100168561A1
- Status: Published application
- Kind: A1
- Application number: 12/519,495
- Filed: 2007-12-18
- Published: 2010-07-01
- Earliest claimed: 2006-12-18
- Assignees: Trillium Precision Surgical, Inc.
- Inventors: Rolfe C. Anderson
- Web page: https://patentgrep.com/patent/US20100168561A1

## CPC

- A61B 17/3403: {Needle locating or guiding means}
- A61B 17/32: Surgical cutting instruments ({A61B18/042 takes precedence; suture cutters A61B17/0467;} implements for ligaturing and cutting {A61B17/122, A61B17/12; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133})
- A61B 90/36: {Image-producing devices or illumination devices not otherwise provided for}
- A61B 90/39: {Markers, e.g. radio-opaque or breast lesions markers}
- A61B 90/98: using electromagnetic means, e.g. transponders
- A61N 1/05: for implantation or insertion into the body, e.g. heart electrode (A61N1/06 takes precedence)
- A61B 17/22004: {using mechanical vibrations, e.g. ultrasonic shock waves (A61B17/225 takes precedence)}
- A61B 18/02: by cooling, e.g. cryogenic techniques
- A61B 18/042: {using additional gas becoming plasma}
- A61B 18/14: Probes or electrodes therefor
- A61B 2017/00022: {Sensing or detecting at the treatment site}
- A61B 2017/00026: {Conductivity or impedance, e.g. of tissue}
- A61B 2017/00053: {Mapping}
- A61B 2017/00411: {actuated by application of energy from an energy source outside the body}
- A61B 2090/3933: {Liquid markers}
- A61B 2090/3937: {Visible markers}
- A61B 2090/395: {with marking agent for marking skin or other tissue}
- A61B 2090/3954: {magnetic, e.g. NMR or MRI}
- A61B 2090/3975: {active}
- A61B 2090/3987: {Applicators for implanting markers}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)

## Abstract

Intraoperative devices are described that assist the surgeon in identifying the location and characteristics of tissues and structures. Devices are also described that have the added capability of marking the location of the identified tissues and structures. This invention also includes devices that can selectively ablate adjacent tissues while avoiding damage and trauma to the identified tissues and structures by combining ablation with sensing, where sensing of either tissue properties, markings made by another device or surgeon, or a reference probe can be used. Devices are also described that protect tissue in the proximity of reference markings or probes by closed loop inhibition of the ablation process. The devices, systems, methods and kits described are adapted and configured to facilitate locating a target structure or target tissue within a body of a mammal, including nerves, peripheral nerves, blood vessels, and tubes such as the ureter. The devices, systems and methods may discriminate between different tissues by exploiting the electrical, mechanical, and physiological properties of the body.

## Claims

### Claim 1

An intraoperative device for detecting a spacing between a plurality of tools used on a target area of tissue during surgery comprising:
a. a probe element in communication with a signal generator; and
b. a reference element in communication with a signal generator
wherein the reference element is positionable within a detectable signal range.

### Claim 2

(canceled)

### Claim 3 (depends on 1)

The device of claim 1 further comprising a dissection element modulatable in response to a spacing between the probe element and the reference element.

### Claim at position 4

-9. (canceled)

### Claim 10 (depends on 1)

The device of claim 1 wherein a detectable signal generated by the probe element is selected from a magnetic signal, an optical signal, an acoustic signal, a thermal signal, or any other suitable detectable signal.

### Claim 11 (depends on 1)

The device of claim 1 wherein a detectable signal generated by the reference element is selected from a magnetic signal, an optical signal, an acoustic signal, a thermal signal, or any other suitable detectable signal.

### Claim at position 7

-13. (canceled)

### Claim 14 (depends on 1)

The device of claim 1 wherein the reference element has detectable properties.

### Claim 15 (depends on 14)

The device of claim 14 wherein the detectable properties are selected from the group of magnetic, electrical, radioactive, optical, acoustic, or thermal properties.

### Claim at position 10

-20. (canceled)

### Claim 21 (depends on 1)

The device of claim 1 further comprising a plurality of reference elements.

### Claim at position 12

-75. (canceled)

### Claim 76

An intraoperative device for mapping an area of tissue during a surgical procedure comprising:
a. at least one excitation element for interacting with a tissue of interest with a stimulus to generate a detectable signal;
b. a remote interrogation element; and
c. a marking element for creating a detectable mark on a tissue.

### Claim at position 14

-80. (canceled)

### Claim 81 (depends on 76)

The device of claim 76 wherein the excitation element stimulus for stimulating the tissue of interest is selected from electrical stimulation, magnetic stimulation, mechanical stimulation, acoustic stimulation, optical stimulation, thermal stimulation, electromagnetic stimulation, mechanical vibration, ultrasound, stimulus arrays, imaging, or any other suitable excitation element stimulus.

### Claim 82 (depends on 76)

The device of claim 76 wherein the detectable signal detected from the tissue of interest is selected from an electrical signal, a mechanical signal, an electromagnetic signal, a magnetic signal, a thermal signal, ultrasound, detection arrays, imaging methods, or any other suitable detectable signal.

### Claim at position 17

-84. (canceled)

### Claim 85 (depends on 76)

The device of claim 76 wherein the detectable mark is selected from a fluorescent dye or radioactive material.

### Claim 86 (depends on 76)

The device of claim 76 wherein the detectable mark is selected from a particle, a quantum dot, a carbon nanotube, a paramagnetic particle, a ferromagnetic particle, a metallic particle, a radioactive particle, or a colored particle.

### Claim 87 (depends on 76)

The device of claim 76 wherein the detectable mark is selected from paraffin wax, wax, sucrose solution, or any other suitable material that forms a gel upon deposition.

### Claim 88 (depends on 76)

The device of claim 76 wherein the detectable mark is stored on a computer.

### Claim at position 22

-112. (canceled)

### Claim 113

A device for selective dissection of tissue comprising:
a. a tissue characterization system for identifying a tissue of interest; and
b. a dissection element for dissecting a tissue adjacent the tissue of interest.

### Claim 114 (depends on 113)

The device of claim 113 wherein the tissue characterization system comprises an excitation element and a sensing element.

### Claim at position 25

-131. (canceled)