Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall

• US 10,631,938 B2
• Filed: 05/22/2018
• Issued: 04/28/2020
• Est. Priority Date: 05/13/2011
• Status: Active Grant

• Current Assignee: Broncus Medical Incorporated
• Original Assignee: Broncus Medical Incorporated
• Inventors: Keast, Thomas M., Laufer, Michael D., Wibowo, Henky, Cole, Cary, Kaplan, Gary S., Roschak, Edmund J.
• Primary Examiner(s): Fishback, Ashley L
• Application Number:
  US15/986,666
• Publication Number:
  US 20190117316A1
• Time in Patent Office: 707 Days
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/01 Guiding arrangements therefore
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/3209 Incision instruments
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22042 Details of the tip of the guide wire
• CPC Class Codes: A61B 2017/320056 : Tunnelers
• CPC Class Codes: A61B 2017/3425 : for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2018/00541 : Lung or bronchi
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2034/2051 : Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 : Optical tracking systems
• CPC Class Codes: A61B 2034/2057 : Details of tracking cameras
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2090/3945 : Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/062 : using magnetic field

Abstract

Methods and devices for diagnosing, monitoring, and/or treating tissue through an opening or port through an airway wall are provided herein.

Claims

1. A bronchoscopic-based method of performing a procedure on a target in a lung, the method comprising:

advancing a bronchoscope through a nose or mouth, and into a peripheral airway having an airway wall;

creating an opening through the airway wall;

creating an access tunnel from the opening in the airway wall to the target, wherein the target is spaced from the airway wall, and wherein the step of creating an access tunnel comprises;

advancing a catheter through the opening in the airway wall, through a parenchymal tissue, and to the target;

advancing a tubular elongate instrument from the airway wall, through the parenchymal tissue, and to the target;

such that both the catheter and the tubular elongate instrument extend through the opening, through the parenchymal tissue and to the target, and the catheter being contained within the tubular elongate instrument;

removing the catheter, leaving the tubular elongate instrument in place, and

performing the procedure on the target through the access tunnel formed by the tubular elongate instrument.

2. A bronchoscopic-based method of performing a procedure on a target in a lung, the method comprising:

advancing a bronchoscope through a nose or mouth, and into a peripheral airway having an airway wall;

creating an opening through the airway wall;

creating an access tunnel from the opening in the airway wall to the target, wherein the target is spaced from the airway wall, and wherein the step of creating an access tunnel comprises;

advancing a catheter through the opening in the airway wall and through a parenchymal tissue;

advancing a tubular elongate instrument from the airway wall, through the parenchymal tissue, and to the target;

such that both the catheter and the tubular elongate instrument extend through the opening, through the parenchymal tissue, and the catheter being contained within the tubular elongate instrument; and

removing the catheter, leaving the tubular elongate instrument in place, and

performing the procedure on the target through the access tunnel formed by the tubular elongate instrument.

3. The method of claim 2, wherein the tubular elongate instrument is a sheath.

4. The method of claim 2, wherein the catheter is a dissecting catheter.

5. The method of claim 2, wherein the step of creating the opening is performed with a piercing member.

6. The method of claim 5, wherein the catheter comprises a conical tip and a lumen extending therethrough, and wherein the piercing member is extendable past the conical tip.

7. The method of claim 2, wherein the step of performing the procedure on the target through the access tunnel comprises obtaining a biopsy with a biopsy instrument.

8. The method of claim 2, wherein the step of performing the procedure on the target through the access tunnel comprises ablating with an ablation instrument.

9. The method of claim 8, wherein the ablation is a type selected from the group consisting of cryo, ultrasound, microwave, laser, and radiofrequency (RF).

10. The method of claim 2, wherein the step of performing the procedure on the target through the access tunnel comprises delivering a drug or fiducial marker with a delivery catheter.

11. A bronchoscopic-based method of performing a procedure on a target in a lung, the method comprising:

advancing a bronchoscope through a nose or mouth, and into a peripheral airway having an airway wall;

creating an opening through the airway wall;

advancing a catheter through the opening in the airway wall, through a parenchymal tissue, and toward the target;

advancing a tubular elongate instrument from the airway wall, through the parenchymal tissue, and toward the target;

such that both the catheter and the tubular elongate instrument extend through the opening, through the parenchymal tissue and toward the target, and the catheter being contained within the tubular elongate instrument; and

removing the catheter from the lung;

maintaining the tubular elongate instrument in place to provide an access tunnel from the opening in the airway though the parenchymal tissue to the target; and

performing the procedure on the target through the access tunnel.

12. The method of claim 11, wherein the tubular elongate instrument is a sheath.

13. The method of claim 11, wherein the catheter is a dissecting catheter.

14. The method of claim 11 wherein the step of creating the opening is performed with a piercing member.

15. The method of claim 14, wherein the catheter comprises a conical tip and a lumen extending therethrough, and wherein the piercing member is extendable past the conical tip.

16. The method of claim 11, wherein the step of performing a procedure on the target through the access tunnel comprises obtaining a biopsy with a biopsy instrument.

17. The method of claim 11, wherein the step of performing the procedure on the target through the access tunnel comprises ablating with an ablation instrument.

18. The method of claim 17, wherein the ablation is a type selected from the group consisting of cryo, ultrasound, microwave, laser, and radiofrequency (RF).

19. The method of claim 11, wherein the step of performing the procedure on the target through the access tunnel comprises delivering a drug or fiducial marker with a delivery catheter.