Methods for delivering energy into a target tissue of a body
An instrument and method for tissue thermotherapy including an inductive heating means to generate a vapor phase media that is used for interstitial, intraluminal, intracavity or topical tissue treatment. In one method, the vapor phase media is propagated from a probe outlet to provide a controlled vapor-to-liquid phase change in an interface with tissue to thereby apply ablative thermal energy delivery.
1. A method for treating a tissue region in a gastrointestinal tract of a patient, the method comprising:
delivering a catheter into the gastrointestinal tract adjacent to the tissue region, the catheter comprising an elongate shaft having an energy applicator portion configured with a first pathway that is fluidly coupled to a source of a heated flowable media; and
applying the heated flowable media to the tissue region using the energy applicator portion to create a thin ablation layer of a wall of the gastrointestinal tract; and
withdrawing the heated flowable media through a second pathway in the catheter;
wherein the thin ablation layer alters a function of the tissue region of the gastrointestinal tract.
2. The method of claim 1 , wherein the tissue region is within an intestine of the patient.
3. The method of claim 1 , wherein the heated flowable media has a temperature of at least 80 degrees Celsius.
4. The method of claim 1 , wherein the heated flowable media has a temperature of at least 90 degrees Celsius.
5. The method of claim 1 , wherein the heated flowable media is provided over a time interval ranging from 1 second to 30 seconds.
6. The method of claim 1 , further comprising applying the heated flowable media sequentially to at least one adjacent tissue region in the gastrointestinal tract.
7. The method of claim 1 , wherein the source of heated flowable media is provided from a remote source and heating mechanism coupled to an inflow channel in the catheter.
8. The method of claim 1 , wherein the catheter is configured to circulate movement of the heated flowable media.
9. The method of claim 1 , further comprising a controller configured to control a flow of the heated flowable media to the energy applicator portion.
10. The method of claim 1 , further comprising delivering a cooling fluid.
11. A method of treating a patient having Type 2 diabetes or a diabetic disorder, the method comprising introducing through a device having a first flow channel a flowable media having a temperature of at least 80 degrees Celsius for a selected time interval into a lumen of a duodenum of the patient, wherein the flowable media ablates a thin layer of a wall of a duodenum in a small intestine sufficient to both close a terminal portion of a secretory ducts and to ablate a plurality of receptors that provide a signal for a release of hormones in the patient; and providing a second flow channel in the device to permit outflow of the flowable media.
12. The method of claim 11 , wherein the selected time interval comprises a range between 1 second to 120 seconds.
13. The method of claim 11 , wherein the flowable media has a temperature of at least 90 degrees Celsius.
14. The method of claim 11 , further comprising treating a plurality of adjacent regions of the wall of the duodenum.
15. The method of claim 14 , wherein the plurality of adjacent regions extend over a length of 40 cm or less of the duodenum.
16. The method of claim 11 , wherein the flowable media is introduced through an inflow channel in a catheter from a remote flowable media source that is operatively coupled to a heating mechanism.
17. The method of claim 16 , further comprising causing an outflow of flowable media through an outflow channel in the catheter.
18. The method of claim 11 , wherein the flowable media is sterile water.
19. The method of claim 11 , further comprising delivering a cooling fluid to a tissue in the small intestine.
20. A method of treating Type 2 diabetes or a related disorder of a patient by altering a hormonal function of a duodenum of the patient, the method comprising:
providing a catheter having a length suited for trans-esophageal introduction into a lumen of the duodenum, the catheter comprising an elongate flexible shaft with a working end carrying an energy applicator and at least one balloon;
inserting the working end of the catheter into the lumen of the duodenum;
identifying a targeted length of the lumen for treatment, wherein the targeted length is less than 40 cm;
applying a first ablative energy from the energy applicator by delivering a fluid media from a first flow channel to a first segment of the targeted length to ablate a thin layer of a first region of a wall of the duodenum ; and
applying second ablative energy by delivering the fluid media from the first flow channel to a second adjacent segment of the targeted length wherein to ablate a second thin layer of a second region of the wall of the duodenum;
wherein delivery of the fluid media alters the hormonal function of the duodenum; and
providing a second flow channel to allow outflow of the fluid media.
21. The method of claim 20 , wherein the fluid media comprises a temperature of at least 80 degrees Celsius.
22. The method of claim 21 , wherein the temperature is at least 90 degrees Celsius.
23. The method of claim 20 , wherein the first ablative energy and the second ablative energy are provided over a time interval ranging from 1 second to 30 seconds.
24. The method of claim 1 , wherein the gastrointestinal tract comprises an organ selected from an esophagus, a stomach, a small intestine, a large intestine, and a duodenum.
25. The method of claim 1 , wherein the thin ablation layer treats a Berrett's esophagus.
26. The method of claim 1 , wherein the gastrointestinal tract contains a plurality of secretory ducts and receptors, wherein the thin ablation layer affects the plurality of secretory ducts and receptors to alter hormonal function of the tissue region.