Systems and methods for regulating organ and/or tumor growth rates, function, and/or development
A system for controlled neuromodulation procedures is disclosed. A system for controlled micro ablation procedures is disclosed. Systems and methods for imaging, monitoring, stimulating, and/or ablating neurological structures coupled to one or more organs of the lower urinary tract (LUT) are disclosed. Such processes may be used to alter the hormonal secretions from one or more organs, to modulate the growth of an organ, alter the growth rate or rate of perineural invasion of a tumor, or the like. In particular such processes may be used to slow, halt and/or reverse the growth of a prostate gland or a prostate tumor.
1. A tool, comprising:
an elongate member with a distal tip, the distal tip shaped and dimensioned so as to fit within a lumen of a body, the elongate member shaped and dimensioned so as to extend from outside the body, through an entry site on the body and into the lumen; and
the distal tip comprising a plurality of elements arranged there upon and coupled to the distal tip such that biasing of the distal tip towards a prostate engages one or more of the elements with a wall of the lumen;
wherein the tool is configured for at least one of monitoring and altering electrophysiological activity within the vicinity of the prostate within the body;
wherein the plurality of elements comprises an array of electrodes arranged on a face of the distal tip such that biasing of the distal tip towards the wall of the lumen brings the electrodes into intimate contact with the prostate through the wall of the lumen;
wherein the plurality of elements comprises one or more imaging elements, one or more sensing elements and a plurality of energy delivery elements;
wherein the plurality of energy delivery elements are configured to be individually controlled based on feedback from one or more of the imaging elements and sensing elements to direct energy into surrounding tissues with a desired pattern and desired penetration depth; and
wherein the distal tip comprises a dual tip comprising a first tip and a second tip, the first tip comprising a first subset of the plurality of elements arranged on a first curved surface thereof, the second tip comprising a second subset of the plurality of elements arranged on a second curved surface thereof;
a controller configured to actuate a deployment mechanism to adjust a positioning of the dual tips to position the first curved surface and the second curved surface to cup a target organ;
wherein at least a given one of the first curved surface of the first tip and the second curved surface of the second tip comprises:
a first region, arranged on a given face of the given one of the first curved surface and the second curved surface that cups the target organ, comprising one or more of the imaging elements and one or more of the sensing elements; and
a second region, arranged on the given face of the given one of the first curved surface and the second curved surface that cups the target organ, comprising one or more of the energy delivery elements.
2. The tool of claim 1 , wherein the one or more imaging elements are configured to couple with tissues in the vicinity of the prostate upon biasing of the distal tip towards the prostate, wherein information obtained from the one or more imaging elements is utilized to control energy delivery from the plurality of energy delivery elements to focus energy delivery on a target tissue in the vicinity of the prostate while minimizing energy delivery to an adjacent tissue site.
3. The tool of claim 2 , wherein the one or more imaging elements comprise one or more of an ultrasound transducer array, an ultrasound element, a transducer, a piezoelectric element, an optical coherence tomography (OCT) element, a capacitive micromachined ultrasound transducer, a camera, an infrared camera, a near infrared camera, a deep tissue penetrating imaging element, a fiber optic array, or a combination thereof.
4. The tool of claim 2 , wherein the one or more imaging elements are configured to convey information about a neural structure in the vicinity of the prostate to an operator during operation of the tool.
5. The tool of claim 4 , wherein the information pertains to at least one of a location, health state, a quantity, blood flow to, blood flow through, temperature, a stiffness, and changes therein, of an artery, a vein, a nerve, a neural plexus, a prostatic plexus, a prostatic artery, a dorsal nerve, a cavernous nerve, a vesical plexus, a hypogastric nerve, a splanchnic nerve, a pudendal nerve, an organ, a urethra, the prostate, a reference point, or a combination thereof.
6. The tool of claim 1 , wherein one or more of the sensing elements are configured to monitor one or more electrophysiological signals associated with a tissue in the vicinity of the prostate while engaged with the wall, the electrophysiological signals related to one or more of water concentration, tissue tone, evoked potential, remotely stimulated nervous activity, sympathetic nervous activity, an electromyographic signal [EMG], a mechanomyographic signal [MMG], a local field potential, an electroacoustic event, vasodilation, vessel wall stiffness, muscle sympathetic nerve activity [MSNA], central sympathetic drive, nerve traffic, or a combination thereof.
7. The tool of claim 1 , wherein one or more of the sensing elements are electrically coupled with a microcircuit, the microcircuit configured to condition one or more of the signals conveyed therefrom; and wherein the microcircuit is embedded into the tool and at least a portion of the electrical coupling is provided via the elongate member.
8. The tool of claim 1 , wherein one or more of the sensing elements comprises a microelectrode configured to interface with an adjacent tissue volume within or beyond the wall of the lumen while engaged with the wall, the microelectrode having an area of less than 5000 μm 2 .
9. The tool of claim 1 , comprising a fluid delivery means for providing a coupling fluid to the distal tip to at least one of: (i) enhance the engagement of one or more of the sensing elements, imaging elements, and energy delivery elements with the wall when biased there against; and (ii) to protect the wall during the passage of energy there through.
10. The tool of claim 1 , further comprising one or more chemical delivery elements comprising one or more probes at least one of mechanically, fluidly, and electrically coupled with the distal tip, arranged so as to penetrate through the wall upon engagement there with or upon a deployment procedure, one or more of the probes comprising a lumen configured to deliver at least one of a diagnostic substance and a therapeutic substance to a tissue site beyond the wall of the lumen.
11. The tool of claim 10 , wherein one or more of the sensing elements are configured to monitor the effect of the at least one diagnostic substance and therapeutic substance on at least one tissue site and tissues related thereto.
12. The tool of claim 11 , wherein the therapeutic substance is a selected from a neurotoxin, a botulinum toxin, a tetrodotoxin, a tetraethylammonium, a chlorotoxin, a curare, a conotoxin, a bungarotoxin, arsenic, ammonia, ethanol, hexane, nitric oxide, glutamate, resiniferatoxin, alchohol, phenol, capaicin, an anesthetic, lidocaine, tetanus toxin, quaternary ammonium salts, a pachycurare, a leptocurare, acetylcholine, aminosteroids, or a combination thereof.
13. The tool of claim 10 , wherein the at least one diagnostic and therapeutic substance is selected from a chemical, a drug substance, a neuromodulating substance, a neuroblocking substance, an acid, a base, a denervating agent, or a combination thereof.
14. The tool of claim 1 , wherein the lumen is one of a rectum, a urethra, an artery, a vein, and a duct.
15. The tool of claim 1 , wherein the one or more sensing elements comprise a plurality of sensing elements configured to collectively map electrophysiological activity in the vicinity of the prostate while engaged with the wall.
16. The tool of claim 1 , wherein one or more of the energy delivery elements is configured to provide at least one of a radio frequency current, a microwave current, thermal energy, cryoablating action, and ultrasound energy, to a volume of tissue in the vicinity of the prostate while engaged with the wall.
17. The tool of claim 1 , wherein one or more of the energy delivery elements comprise one or more stimulating electrodes electrically and mechanically coupled to at least one of the distal tip and the elongate member, the stimulating electrodes configured to provide at least one of a stimulating and an ablating current to a tissue site in the vicinity of the prostate while engaged with the wall.
18. The tool of claim 1 , wherein the plurality of energy delivery elements are configured to be individually controlled by selectively applying energy to a subset of the plurality of energy delivery elements.
19. The tool of claim 1 , wherein the plurality of energy delivery elements are configured to be individually controlled by adjusting current flow to respective ones of the plurality of energy delivery elements.
20. The tool of claim 19 , further comprising a microcircuit embedded in the distal tip, the microcircuit comprising one or more switches for directing current flow to respective ones of the energy delivery elements.
21. The tool of claim 1 , wherein the deployment mechanism when actuated moves one or more of the first and second regions towards a target location.
22. The tool of claim 21 , wherein movement of the first and second regions on the first curved surface and the second curved surface comprises in-plane and out-of-plane movement.
23. The tool of claim 1 , wherein one or more of the electrodes comprises a non-stick coating.
24. The tool of claim 1 , further comprising a cooling subsystem comprising:
one or more temperature sensors arranged on the given face of the given one of the first curved surface and the second curved surface to monitor temperature rise during energy delivery via the plurality of energy delivery elements; and
one or more fluid delivery elements arranged on the given face of the given one of the first curved surface and the second curved surface configured to deliver fluid to one or more portions of the given face of the given one of the first curved surface and the second curved surface to cool a wall of a rectum during energy delivery via the plurality of energy delivery elements based on feedback from one or more of the temperature sensors arranged on the given face of the given one of the first curved surface and the second curved surface.
25. The tool of claim 1 , wherein the controller is configured to actuate the deployment mechanism to control a pressure applied by the first region and the second region on the target organ.