Laparoscopic Laser Device and Method
First Claim
1. A laparoscopic laser device, for use with an insufflated bodily cavity, comprising:
- an elongate body having a proximal end and a distal end, the body adapted for insertion into an insufflated bodily cavity;
a laser energy delivery element, coupleable to a source of tissue-vaporization-capable laser energy, at the distal end of the elongate body, the laser energy delivery element capable of delivering laser energy along a laser energy path, the laser energy path extending away from the laser energy delivery element;
a smoke-suppressing liquid pathway extending along the elongate body to an exit opening at the distal end of the elongate body, the liquid pathway coupleable to a source of a smoke-suppressing liquid; and
the liquid pathway at the exit opening configured to direct the smoke-suppressing liquid generally along the laser energy path.
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Accused Products
Abstract
Laser radiation delivered to a treatment area causes vaporization of a substantially greater volume of tissue than the volume of residual coagulated tissue. The laser radiation may have a wavelength of about 300 nm to about 700 nm, may be used with a smoke suppressing irrigant, may have an average irradiance greater than about 5 kilowatts/cm2, and may have a spot size of at least 0.05 mm2. A laparoscopic laser device, for use with an insufflated bodily cavity, may include an elongate body adapted for insertion into an insufflated bodily cavity. A laser energy delivery element, at the distal end of the elongate body, may be coupleable to a source of tissue-vaporization-capable laser energy and capable of delivering laser energy along a laser energy path extending away from the laser energy delivery element. A smoke-suppressing liquid pathway, extending along the elongate body to an exit opening at the distal end, may be coupleable to a source of a smoke-suppressing liquid. The smoke-suppressing liquid is directed generally along the laser energy path. A remote visualization device may be used to view along the laser energy path.
282 Citations
65 Claims
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1. A laparoscopic laser device, for use with an insufflated bodily cavity, comprising:
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an elongate body having a proximal end and a distal end, the body adapted for insertion into an insufflated bodily cavity; a laser energy delivery element, coupleable to a source of tissue-vaporization-capable laser energy, at the distal end of the elongate body, the laser energy delivery element capable of delivering laser energy along a laser energy path, the laser energy path extending away from the laser energy delivery element; a smoke-suppressing liquid pathway extending along the elongate body to an exit opening at the distal end of the elongate body, the liquid pathway coupleable to a source of a smoke-suppressing liquid; and the liquid pathway at the exit opening configured to direct the smoke-suppressing liquid generally along the laser energy path. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28)
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29. A laparoscopic laser device, for use with an insulated bodily cavity, comprising:
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an elongate body having a proximal end and a deflectable distal end, the distal end placeable in at least two orientations, the body adapted for insertion into an insufflated bodily cavity; a laser energy delivery element coupleable to a source of tissue-vaporization-capable laser energy, the laser energy delivery element located at the distal end of the elongate body and being capable of delivering laser energy along a laser energy path, the laser energy path extending away from the laser energy delivery element; the laser energy delivery element comprising a light guiding element extending along the elongate body, the light guiding element having an exit from which the laser energy emerges for delivery generally along the laser energy path; a remote visualization device, extending along the elongate body and having an illumination element and an image receiving portion to permit a user to illuminate and view a region generally along the laser energy path; a smoke-suppressing liquid pathway extending along the elongate body to an exit opening, the liquid pathway coupleable to a source of a smoke-suppressing liquid, the laser energy being effectively unabsorbed by the liquid so that the laser energy remains tissue-vaporization-capable; a user operated steering assembly, the steering assembly comprising a steering member at the proximal end of the elongate body operably coupled to a deflectable member at the distal end of the elongate body, the steering member operable to cause the distal end to be placed in said at least two orientations by the deflectable member; and the liquid pathway at the exit opening configured to direct the smoke-suppressing liquid generally along the laser energy path.
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30. A method for treating tissue at a target site within a patient comprising:
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insufflating a bodily cavity of a patient; placing a distal portion of an elongate body of a laparoscopic laser device at a target site within the insufflated bodily cavity; directing tissue-vaporization-capable laser energy along a laser energy path from the distal portion of the body towards the target site thereby vaporizing target site tissue; and suppressing smoke created by vaporizing tissue at the target site by flowing a liquid generally along the laser energy path. - View Dependent Claims (31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50)
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51. A method for treating tissue at a target site within a patient comprising:
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insufflating a bodily cavity of a patient; placing a distal portion of an elongate body of a laparoscopic laser device at a target site within the insufflated bodily cavity; remotely viewing the target site; facilitating the remotely viewing step by selectively illuminating the target site; directing tissue-vaporization-capable laser energy, having a wavelength of 400 to 600 nm, along a laser energy path from the distal portion of the elongate body towards the target site to vaporize tissue at the target site; the laser energy directing step further comprising remotely deflecting the distal portion of the elongate body; and enhancing the remotely viewing step by; suppressing smoke at the target site created during the laser energy directing step by flowing an aqueous liquid generally along the laser energy path with the laser energy being effectively unabsorbed by the aqueous liquid and remaining tissue-vaporization-capable; and suctioning the target site to remove at least aqueous liquid from the target site.
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52. A method for performing a partial nephrectomy at a target site of a kidney within a patient comprising:
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insufflating a bodily cavity of a patient, the bodily cavity containing the patient'"'"'s kidney; placing a distal portion of an elongate body of a laparoscopic laser device at a kidney target site; remotely viewing the target site; facilitating the remotely viewing step by selectively illuminating the target site; directing tissue-vaporization-capable laser energy, having a wavelength of 400 to 600 μ
m, along a laser energy path from the distal portion of the elongate body to target tissue at the target site thereby vaporizing kidney target tissue;the laser energy directing step further comprising a remotely deflecting the distal portion of the elongate body; and enhancing the remotely viewing step by; suppressing smoke at the target site created during the laser energy directing step by flowing an aqueous liquid generally along the laser energy path with the laser energy being effectively unabsorbed by the aqueous liquid and remaining kidney-tissue-vaporization-capable; and suctioning the target site to remove at least aqueous liquid from the target site.
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53. A method for photoselective vaporization of tissue, comprising:
insufflating a bodily cavity of a patient, the bodily cavity containing target tissue; delivering laser radiation along a laser energy path and a flow of a smoke suppressant liquid generally along the laser energy path, to a treatment area on a surface of target tissue, the laser radiation causing vaporization of a volume of tissue greater than a volume of residual coagulation of tissue, and having irradiance in the treatment area greater than 5 kiloWatts/cm2 in a spot size at least 0.05 mm2.
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54. A method for photoselective vaporization of tissue, comprising:
insufflating a bodily cavity of a patient, the bodily cavity containing target tissue; delivering laser radiation along a laser energy path and a flow of a smoke suppressant liquid generally along the laser energy path, to a treatment area on a surface of target tissue, the laser radiation causing vaporization of a volume of tissue greater than a volume of residual coagulation of tissue, and having irradiance in the treatment area greater than 10 kiloWatts/cm2 in a spot size at least 0.05 mm2. - View Dependent Claims (55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65)
Specification