| 摘要 |
An apparatus (20) for transcervical sterilization or transcatheter embolizat ion with a controlled bipolar RF catheter (21) for creating thermal lesions (22) in t he fallopian tubes (23) or thrombosing vessels has a catheter (21) elongate along an axis there of with a patient end (24). The catheter (21) is circular and sized for transcervical insertio n into the fallopian tube or transcatheter vessel insertion, respectively. A connector (25) on an end of the catheter (21) opposite the patient end (24) has the terminations (26) for RF and monitoring and is shaped for the surgeon to manipulate during placement and withdrawal. Two or more bipolar electrodes (29, 30 and 31)on the patient end (24) are pl aced so each electrode is spaced from another with each circumscribing the catheter (21). A mucosa or thrombus sensor responsive to applied RF energy passing between the two or m ore bipolar electrodes (29, 30 and 31)determines the condition of the transmural formati on of a lesion or the thrombus between each of the electrodes. The sensor is a temperature sensor positioned in the space (34) between the electrodes measures the change in m ucosal layer temperature or the thrombus during the application of RF energy. An RF gener ator (27) electrically coupled to the electrodes and the sensor is alternately a phase detector(35) in circuit with the coupling determines reactance of tissue as an indicator of lag or lead of the voltage wave form or current wave form delivered or is an impedance responsi ve circuit (39) positioned in the RF generator (27) to determine voltage and current de livered so a calculator finds impedance delivered for finding initial electrode contact w ith the tissue and for measuring the change in mucosal layer. A blunt tip at the patient end (2 4) facilitates introduction into the tube or vessel to avoid perforation. The temperature s ensor connects to an RF generator (27) with control circuitry regulating delivery to a temp erature range. A proportional controller regulates the RF energy delivery to control temper ature rise time and to maintain the temperature near the mid point of the temperature range. A method for sterilization has the steps of inserting a catheter (21), delivering RF and monitoring the effect on the mucosa or thrombus, circumscribing the catheter (21) with two or more bipolar electrodes, each of the electrodes spaced from one another and passi ng RF energy therebetween.
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