Apparatus and method for local application of polymeric material to tissue
An apparatus is provided for applying to a surface of mammalian tissue including soft, living tissue an initially fluent material and then activating the material by exposure to an energy source. The material may be a liquid capable of polymerization to a non-fluent state by exposure to actinic light. The device, and methods that may be practiced in association with the device, enable a wide range of medical conditions to be treated including, for example, the application of a barrier to soft tissue to prevent post-surgical adhesions.
1. A method, comprising:
applying from an applicator, via pressurized gas, a photopolymerizable material to a tissue internally of a mammal.
2. The method of claim 1 , wherein the applying step comprises applying a predetermined volume of photopolymerizable material to the tissue.
3. The method of claim 2 , wherein the applying step defines a first cycle of a cyclical procedure, the method further comprising applying a second predetermined volume of photopolymerizable material to the tissue in a second cycle.
4. The method of claim 3 , wherein the predetermined volume and the second predetermined volume are essentially the same.
5. The method of claim 1 , wherein the applying step comprises applying the photopolymerizable material in a group of adjacent and overlapping patterns.
6. The method of claim 1 , wherein the applying step comprises spraying the photopolymerizable material onto the tissue.
7. The method in claim 6 , wherein the step of spraying the photopolymerizable material comprises delivering a bolus of fluid into a gas stream moving at a velocity sufficient to atomize the fluid to form a spray comprising the photopolymerizable material.
8. The method of claim 6 , wherein the spraying step comprises spraying the photopolymerizable material onto the tissue in a generally conical spray pattern.
9. The method of claim 1 , wherein the applying step comprises applying the photopolymerizable material to the tissue as a thin film.
10. The method of claim 1 , wherein the applying step comprises emitting the photopolymerizable material from an emission element located at a distal portion of the applicator having a proximal portion and a distal portion.
11. The method of claim 10 , wherein the emission element comprises a nozzle.
12. The method of claim 1 , further comprising the step of irradiating in situ at least a portion of the photopolymerizable material.
13. The method of claim 12 , wherein the irradiating step comprises irradiating the photopolymerizable material with light.
14. The method of claim 13 , wherein the light is able to cause at least a portion of the photopolymerizable material to polymerize.
15. The method of claim 13 , wherein the light is able to be used as a guide to orient the applicator at a selected location with respect to the tissue.
16. The method of claim 13 , wherein the light initiates polymerization of the photopolymerizable tissue.
17. The method of claim 12 , wherein the irradiating step comprises irradiating the tissue in a shape that is substantially the same shape as that in which the photopolymerizable material is applied.
18. The method of claim 1 , wherein the applicator comprises a distal portion adapted for insertion into the mammal and a proximal portion adapted to remain outside the mammal, the method further comprising inserting the distal portion of the applicator into the mammal.
19. The method of claim 1 , wherein the photopolymerizable material further comprises a biologically active agent.
20. The method of claim 1 , wherein the photopolymerizable material is biodegradable.
21. The method of claim 1 , wherein the photopolymerizable material serves as one or more of a tissue adhesive, a barrier to prevent tissue adhesions, a protective tissue coating a local application of a biologically active species, and a method for controlled release of biologically active species to achieve systemic and local effects.
22. The method of claim 1 , wherein the photopolymerizable material is an adherent tissue coating.
23. The method of claim 1 , wherein the photopolymerizable material comprises one or more reactive groups selected from acrylates, diacrylates, oligoacrylates, methacrylates, dimethacrylates, oligomethacrylates, isocyanates, isothiocyanates and amines.
24. An apparatus, comprising:
an applicator having a proximal end and a distal end;
the distal end of the applicator having a fluent emission element constructed and arranged to emit a mixture of a gas and a prepolymeric material onto tissue from a pressurized source of gas and a source of prepolymeric material; and
means at the distal end of the applicator for applying energy to the prepolymeric material.
25. The apparatus of claim 24 , wherein the means for applying energy comprises:
means defining an optical path from a light source to the distal end of the applicator; and an optical emission aperture at the distal end of the optical path.
26. The apparatus of claim 24 , wherein the fluent emission element at the distal end of the applicator comprises a nozzle adapted to emit the prepolymeric material and disperse it in a predetermined pattern.
27. The apparatus of claim 26 , wherein the nozzle and the means for applying energy are constructed to direct the prepolymeric material and energy in the same direction.
28. The apparatus of claim 26 , wherein the means for applying energy is adapted to apply the energy to the tissue in a pattern at least as large as the spray pattern of the nozzle.
29. The apparatus of claim 26 , wherein the means for applying energy is constructed and arranged to emit the energy in a pattern substantially the same shape as that in which the material is applied.
30. The apparatus of claim 26 , wherein the nozzle is adapted to emit the material in a spray.
31. The apparatus of claim 24 , further comprising control means for automatically operating the means for applying energy after the emission element has emitted the prepolymeric material.
32. The apparatus of claim 24 , wherein the applicator has a grippable member at its proximal end and a shaft extending distally from the grippable member and further comprising:
the shaft having conduits for transmission of at least, energy and the prepolymeric material.
33. The apparatus of claim 32 , further comprising:
the grippable member, containing a reservoir of the prepolymeic material and a pump mechanism for pumping prepolymeic material from a reservoir to and out of the emission element; and
control means exposed externally of the grippable member for operating the pump and the means for applying energy.
34. The apparatus of claim 24 , wherein the applicator includes a shaft extending to the distal end.
35. The apparatus of claim 34 , wherein at least part of the shaft is non-rigid.
36. The apparatus of claim 24 , further comprising:
means for emitting a predetermined volume of prepolymeric material from the emission element for each cycle of operation of the apparatus.
37. The apparatus of claim 24 , wherein the emission element is constructed to apply the material in the form of a coating on the tissue.
38. The apparatus of claim 24 , wherein the prepolymeric material is photopolymerizable.
39. The apparatus of claim 24 , wherein the energy comprises light.