Ablation device with articulated imaging transducer

1. An imaging and therapeutic delivery system comprising:

a shaft having a distal end and a proximal end;

a needle reciprocatably coupled to the shaft so that a tissue-penetrating tip on the needle is distally advancable from the shaft along an axial path;

a tip pivotally attached to the distal end of the shaft and movable between a position parallel to the axial path and a position at an acute or right angle relative to the axial path; and

an ultrasonic imaging array carried by the pivotally attached tip, wherein the pivotally attached tip is configured to be oriented to align a field of view of the imaging array with the needle as the needle is advanced along the axial path so as to sweep the ultrasound field of view relative to the needle and anatomy to be imaged;

a handle attached to the proximal end of the shaft;

a first actuation mechanism on the handle and coupled to the needle, wherein the first actuation mechanism is configured to be reciprocated to advance and retract the needle along the axial path;

a plurality of tines carried by the needle and reciprocatably attached to the needle; and

a second actuation mechanism on the handle configured to be reciprocated to advance and retract the plurality of tines relative to the needle,

wherein the first and second actuation mechanisms are movable relative to one another.

2. A system as in claim 1 , wherein the tip is offset from the axial path of the needle.

3. A system as in claim 2 , wherein the shaft is relatively rigid and the ultrasonic imaging array is flexible, wherein the ultrasonic imaging array can bend at the point where the tip is pivotally attached to the shaft.

4. A system as in claim 2 , wherein the shaft is relatively rigid and the ultrasonic imaging array is hinged at the point where the tip is pivotally attached to the shaft.

5. A system as in claim 1 , further comprising an imaging core which includes the imaging array near a distal end thereof, wherein the imaging core is removably positionable in the shaft so that the imaging array extends into the pivotally attached tip.

6. A system as in claim 1 , wherein the ultrasonic imaging array sweeps the ultrasound field of view relative to the anatomy, the needle, and the plurality of tines.

7. A system as in claim 1 , wherein the plurality of tines are arranged to radially diverge from the needle as they are advanced distally.

8. A system as in claim 7 , wherein at least one additional tine is arranged to advance axially from the needle.

9. A system as in claim 1 , wherein the needle is electrically non-conductive and the plurality of tines are electrically conductive.

10. A system as in claim 1 , wherein the handle includes a lever coupled to the pivotally attached tip by a pull rod, wherein the lever can be pivoted to pivot the tip.

11. A system as in claim 1 , wherein the first actuation mechanism comprises a first slide mechanism coupled to the needle and disposed at least partially on the handle, and wherein first slide mechanism is configured to be reciprocated to advance and retract the needle along the axial path.

12. A system as in claim 1 , wherein the second actuation mechanism comprises a second slide mechanism coupled to the plurality of tines and disposed at least partially on the handle, and wherein the second slide mechanism can be reciprocated to advance and retract the plurality of tines relative to the needle.

13. A system as in claim 1 , wherein the plurality of tines are reciprocatably attached to the needle to diverge from the needle as they are advanced distally.

14. A system as in claim 1 , wherein rotation of said ultrasonic imaging array about the axial path is independent of movement of said needle.

15. A system as in claim 1 , wherein the needle is configured to exit the shaft at an angle of 0 degrees relative to the shaft.

16. A system as in claim 1 , wherein the needle comprises a straight needle.

17. A system as in claim 1 , wherein the shaft comprises a straight shaft.

18. A system as in claim 1 , wherein the first actuation mechanism is disposed at a first location on the handle and the second actuation mechanism is disposed on a second location on the handle, the first location being different from the second location.

19. A method for treating uterine fibroids, said method comprising:

introducing a shaft into a uterus;

locating a uterine fibroid using an ultrasonic imaging transducer carried by a pivotable tip attached to a distal end of the shaft;

pivoting the ultrasonic transducer to reposition a field of view of the ultrasonic transducer;

advancing a needle axially from the distal end of the shaft into tissue near the located uterine fibroid by operating a first actuation mechanism coupled to the needle, wherein the needle is aligned in the field of view and the first actuation mechanism is disposed on a handle;

advancing a plurality of tines from the needle after the needle has been advanced into or near the uterine fibroid by operating a second actuation mechanism coupled to the plurality of tines, wherein the second actuation mechanism is disposed on the handle and is movable relative to the first actuation mechanism; and

imaging the needle and the fibroid using the ultrasound transducer.

20. A method as in claim 19 , wherein the first actuation mechanism advances and retracts the needle independently from the advancement and retraction of the plurality of tines by the second actuation mechanism such that a degree of advancement of the needle relative to the shaft is independent from a degree of advancement of the plurality of tines relative to the needle.

21. A method as in claim 19 , wherein introducing the shaft comprises transcervical introduction.

22. A method as in claim 19 , wherein locating comprises manually rotating and translating the shaft to scan the uterine wall with the ultrasonic transducer.

23. A method as in claim 22 , wherein imaging comprises rotating the ultrasound transducer relative to an axial path of the needle independently of movement of said needle to scan the uterine wall with the ultrasound transducer.

24. A method as in claim 22 , wherein locating comprises pivoting the ultrasonic transducer for imaging the plurality of tines.

25. A method as in claim 19 , wherein locating comprises pivoting the ultrasonic transducer.

26. A method as in claim 19 , further comprising delivering energy from the tines into the fibroid.

27. A method as in claim 26 , wherein the energy is radiofrequency energy.

28. A method as in claim 26 , wherein the needle remains electrically non-conductive while the energy is being delivered through the tines.

29. A method as in claim 19 , wherein the first actuation mechanism comprises a reciprocating carriage enclosed at least partially within the handle and coupled to a proximal end of the needle, and wherein the second actuation mechanism is reciprocatably coupled to the reciprocating carriage.

30. A method as in claim 19 , wherein the needle is advanced from the distal end of the shaft such that the needle exits the shaft at an angle of 0 degrees relative to the shaft.

31. An imaging and therapeutic delivery system comprising:

a shaft having a distal end and a proximal end;

a needle reciprocatably coupled to the shaft so that a tissue-penetrating tip on the needle is distally advancable from the shaft along an axial path;

a tip pivotally attached to the distal end of the shaft and movable between a position parallel to the axial path and a position at an acute or tight angle relative to the axial path; and

an ultrasonic imaging array carried by the pivotally attached tip, wherein the pivotally attached tip is configured to be oriented to align a field of view of the imaging array with the needle as the needle is advanced along the axial path so as to sweep the ultrasound field of view relative to the needle and anatomy to be imaged;

a handle attached to the proximal end of the shaft;

a first actuation mechanism on the handle and coupled to the needle, wherein the first actuation mechanism is configured to be reciprocated to advance and retract the needle along the axial path;

a plurality of tines carried by the needle and reciprocatably attached to the needle; and

a second actuation mechanism on the handle configured to be reciprocated to advance and retract the plurality of tines relative to the needle,

wherein the first actuation mechanism is configured to advance and retract the needle independently from the advancement and retraction of the plurality of tines by the second actuation mechanism such that a degree of advancement of the needle relative to the shaft is independent from a degree of advancement of the plurality of tines relative to the needle.

32. A system as in claim 31 , wherein the first actuation mechanism comprises a first slide mechanism coupled to the needle and disposed at least partially on the handle, and wherein first slide mechanism is configured to be reciprocated to advance and retract the needle along the axial path.

33. A system as in claim 31 , wherein the second actuation mechanism comprises a second slide mechanism coupled to the plurality of tines and disposed at least partially on the handle, and wherein the second slide mechanism can be reciprocated to advance and retract the plurality of tines relative to the needle.

34. A system as in claim 31 , wherein the first actuation mechanism is disposed at a first location on the handle and the second actuation mechanism is disposed on a second location on the handle, the first location being different from the second location.

35. A method for treating uterine fibroids, said method comprising:

introducing a shaft into a uterus;

locating a uterine fibroid using an ultrasonic imaging transducer carried by a pivotable tip attached to a distal end of the shaft;

pivoting the ultrasonic transducer to reposition a field of view of the ultrasonic transducer;

advancing a needle axially from the distal end of the shaft into tissue near the located uterine fibroid by operating a first actuation mechanism coupled to the needle, wherein the needle is aligned in the field of view and the first actuation mechanism is disposed on a handle;

advancing a plurality of tines from the needle after the needle has been advanced into or near the uterine fibroid by operating a second actuation mechanism coupled to the plurality of tines, wherein the first actuation mechanism is configured to advance and retract the needle independently from advancement and retraction of the plurality of tines by the second actuation mechanism such that a degree of advancement of the needle relative to the shaft is independent from a degree of advancement of the plurality of tines relative to the needle; and

imaging the needle and the fibroid using the ultrasound transducer.

36. An imaging and therapeutic delivery system comprising:

a shaft having a distal end and a proximal end;

a needle reciprocatably coupled to the shaft so that a tissue-penetrating tip on the needle is distally advancable from the shaft along an axial path;

a tip pivotally attached to the distal end of the shaft and movable between a position parallel to the axial path and a position at an acute or right angle relative to the axial path; and

an ultrasonic imaging array carried by the pivotally attached tip, wherein the pivotally attached tip is configured to be oriented to align a field of view of the imaging array with the needle as the needle is advanced along the axial path so as to sweep the ultrasound field of view relative to the needle and anatomy to be imaged;

a handle attached to the proximal end of the shaft;

a first actuation mechanism on the handle and coupled to the needle, wherein the first actuation mechanism is configured to be reciprocated to advance and retract the needle along the axial path;

a plurality of tines carried by the needle and reciprocatably attached to the needle; and

a second actuation mechanism on the handle configured to be reciprocated to advance and retract the plurality of tines relative to the needle,

wherein the first actuation mechanism comprises a reciprocating carriage enclosed at least partially within the handle and coupled to a proximal end of the needle, and wherein the second actuation mechanism is reciprocatably coupled to reciprocating carriage.

37. A system as in claim 36 , wherein the first actuation mechanism comprises a first slide mechanism coupled to the needle and disposed at least partially on the handle, and wherein first slide mechanism is configured to be reciprocated to advance and retract the needle along the axial path.

38. A system as in claim 36 , wherein the second actuation mechanism comprises a second slide mechanism coupled to the plurality of tines and disposed at least partially on the handle, and wherein the second slide mechanism can be reciprocated to advance and retract the plurality of tines relative to the needle.

39. A system as in claim 36 , wherein the first actuation mechanism is disposed at a first location on the handle and the second actuation mechanism is disposed on a second location on the handle, the first location being different from the second location.

40. A method for treating uterine fibroids, said method comprising:

introducing a shaft into a uterus;

locating a uterine fibroid using an ultrasonic imaging transducer carried by a pivotable tip attached to a distal end of the shaft;

pivoting the ultrasonic transducer to reposition a field of view of the ultrasonic transducer;

advancing a needle axially from the distal end of the shaft into tissue near the located uterine fibroid by operating a first actuation mechanism coupled to the needle, wherein the needle is aligned in the field of view and the first actuation mechanism is disposed on a handle;

advancing a plurality of tines from the needle after the needle has been advanced into or near the uterine fibroid by operating a second actuation mechanism coupled to the plurality of tines, wherein the first actuation mechanism comprises a reciprocating carriage enclosed at least partially within the handle and coupled to a proximal end of the needle, and wherein the second actuation mechanism is reciprocatably coupled to reciprocating carriage; and

imaging the needle and the fibroid using the ultrasound transducer.