Multi fluid tissue resection methods and devices

• US 10,251,665 B2
• Filed: 11/25/2015
• Issued: 04/09/2019
• Est. Priority Date: 01/02/2007
• Status: Active Grant

• Current Assignee: AquaBeam, LLC
• Original Assignee: AquaBeam, LLC
• Inventors: Aljuri, Nikolai, Perkins, Rodney
• Primary Examiner(s): Farah, Ahmed M
• Application Number:
  US14/952,840
• Publication Number:
  US 20160074059A1
• Time in Patent Office: 1,231 Days
• Field of Search: 606 13- 18, 606 20- 23, 606 34, 606 39, 606 41, 606 45, 606167, 606180, 606191-193, 606197, 606198, 604 19- 24, 604 26, 604514, 604517, 604158, 604161, 604163, 60416401-16403, 607 96, 607100, 607101, 607104, 607105, 607115, 607143
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 17/32037 for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/201 with beam delivery through a hollow tube, e.g. forming an articulated arm through a flexible conduit A61B18/22; Hand-pieces therefor
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/22079 with suction of debris
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00583 Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00946 slidable
• CPC Class Codes: A61B 2018/00952 rotatable
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference
• CPC Class Codes: A61B 2018/1861 : with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61F 9/007 : Methods or devices for eye surgery
• CPC Class Codes: A61F 9/00736 : Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments A61F9/008 takes precedence

Abstract

Prostate treatment using fluid stream to resect prostate tissue, thereby relieving symptoms of conditions such as BPH, prostatitis, and prostatic carcinoma. A device having a fluid delivery element is positioned within a lumen of the urethra within the prostate. A fluid stream is directed outwardly from the fluid delivery element toward a wall of the urethral lumen. The fluid delivery element is moved to scan the fluid stream over the wall to remove a volume of tissue surrounding the lumen. The fluid may be combined with therapeutically active substances or with substances that increase resection efficiency. Fluid force may be adjusted to provide selective tissue resection such that soft tissue is removed while harder tissue is left undamaged. In order to gain a working space within the urethra, another fluid may be introduced to insufflate the urethra in the region of treatment.

Claims

1. A prostate resection device comprising:

a shaft having a proximal end and a distal end; and

at least one energy source positioned in an energy delivery region on the shaft for delivering energy radially outwardly;

wherein the energy source is movable relative to the shaft to selectively direct energy at different regions of the prostate and wherein the energy source is adapted to be translated, rotated, oscillated, and rotationally oscillated relative to the shaft.

2. A device as in claim 1, wherein the at least one energy source comprises a high pressure fluid ejector comprising a nozzle.

3. A device as in claim 2, wherein the shaft is configured to be positioned within a urethra, the device further comprising a lumen in the shaft for pressurizing the urethra surrounding the energy source to expand the urethra to space tissue away from the nozzle.

4. A device as in claim 3, further comprising a lumen in the shaft for aspirating the urethra surrounding the nozzle to remove ablation products.

5. A device as in claim 4, further comprising a lumen in the shaft for flushing the urethra with a fluid to help remove the ablation products.

6. A device as in claim 1, wherein the shaft has a width in the range from 1 mm to 10 mm and a length in the range from 15 cm to 25 cm.

7. A device as in claim 1 wherein the energy source comprises a laser energy source.

8. A device as in claim 7, wherein the energy source further comprises a mirror for reflecting the laser energy.

9. A device as in claim 1 wherein the energy source comprises a conductive fluid source and a radio frequency energy source.

10. A device as in claim 1 wherein the energy source comprises an electrode that can be positioned against the urethral wall.

11. A device as in claim 1, further comprising an expandable anchor.

12. A device as in claim 11, wherein the expandable anchor comprises a balloon adapted to expand in the bladder.