Thoracoscopic Methods for Treatment of Bronchial Disease

Abstract

A method and apparatus for treatment of pulmonary conditions, including a device having an end effector sized and shaped to contact a nerve component on the exterior of a bronchial segment and apply energy to that nerve component.

1 . A method of treating pulmonary disease comprising the steps of:
 a. inserting an apparatus into a thoracic cavity of a patient by passing at least a portion of its length in a location selected from: through adjacent ribs, above the sternum, or through the chest wall of the patient, said apparatus having an end effector and a source of energy secured thereto; aligning said end effector proximal to or in contact with a nerve component present on a bronchial segment; and, applying energy from said source of energy through said end effector to said nerve component.   
     
     
         2 . The method of  claim 1 , wherein said end effector has two semi-circular shapes that align to form a central pathway and sized to contain a bronchi therewithin. 
     
     
         3 . The method of  claim 1 , wherein said end effector includes two components moveable with respect to each other which may be configured to contact an outer surface of a bronchial segment therebetween. 
     
     
         4 . The method of  claim 1 , wherein said end effector is deformable or pliable so as to be wrapped about at least a portion of the bronchial segment. 
     
     
         5 . The method of  claim 1 , wherein said end effector comprises a material on its surface to conform to the surface of a bronchial segment. 
     
     
         6 . The method of  claim 1 , further comprising the step of inserting said apparatus into the body of a patient through a trocar or through a delivery port. 
     
     
         7 . The method of  claim 6 , wherein said end effector is compressed to a reduced diameter when inserted through said catheter or delivery port, and expands upon exit from said catheter or delivery port. 
     
     
         8 . The method of  claim 1 , wherein said method comprises video assisted thoracoscopic surgery techniques. 
     
     
         9 . The method of  claim 1 , wherein said end effector substantially surrounds said bronchial segment. 
     
     
         10 . The method of  claim 1 , wherein said end effector applies energy in the form of heated elements or electrodes, heated fluid such as gas or liquid, ultrasonic energy, including low-energy ultrasound or high intensity focused ultrasound, harmonic energy, direct current or cauterization exposure, electromagnetic energy, radiofrequency energy, microwaves, plasma energy, infrared, non-ionizing optical energy such as laser treatment, including pulsed laser, fractional laser, or high energy laser exposure, other radiation energy including alpha, beta, gamma, x-ray, proton, neutron, or ionic radiation. 
     
     
         11 . The method of  claim 1 , wherein said application of energy results in increased temperature, and said temperature is about 65° C. or higher. 
     
     
         12 . An apparatus for treating pulmonary disease comprising:
 a. an extended body having a proximal end and distal end;   b. an end effector at the distal end;   c. An energy source to provide energy to said end effector;
 wherein said end effector is sized and shaped to be passed into the thoracic cavity of a patient and to contact a nerve component located on at least a portion of a bronchial segment and apply energy to the exterior surface of said bronchial segment to treat said nerve component. 
   
     
     
         13 . The apparatus of  claim 12 , wherein said end effector has at least one semi-circular shape sized to contain bronchial segment therein. 
     
     
         14 . The apparatus of  claim 12 , wherein said end effector includes two components moveable with respect to each other which may be configured to contact an outer surface of a bronchial segment therebetween. 
     
     
         15 . The apparatus of  claim 12 , wherein said end effector is deformable or pliable so as to be wrapped about at least a portion of the bronchial segment. 
     
     
         16 . The apparatus of  claim 12 , wherein said end effector comprises a material on its surface to conform to the surface of the bronchial segment. 
     
     
         17 . The apparatus of  claim 12 , wherein said apparatus may be compressed so as to be inserted into the body of a patient through a catheter or delivery port. 
     
     
         18 . The apparatus of  claim 12 , wherein said end effector applies energy in the form of heated elements or electrodes, heated fluid such as gas or liquid, ultrasonic energy, including low-energy ultrasound or high intensity focused ultrasound, harmonic energy, direct current or cauterization exposure, electromagnetic energy, radiofrequency energy, microwaves, plasma energy, infrared, non-ionizing optical energy such as laser treatment, including pulsed laser, fractional laser, or high energy laser exposure, other radiation energy including alpha, beta, gamma, x-ray, proton, neutron, or ionic radiation. 
     
     
         19 . The apparatus of  claim 12 , wherein said energy may be applied through a plurality of electrodes in said end effector.