DEVICES, SYSTEMS AND METHODS FOR TREATING BENIGN PROSTATIC HYPERPLASIA AND OTHER CONDITIONS

• US 20090018523A1
• Filed: 08/13/2007
• Published: 01/15/2009
• Est. Priority Date: 05/20/2005
• Status: Active Grant

• Current Assignee: Teleflex Life Sciences III LLC
• Original Assignee: NeoTract, Inc. (Teleflex Incorporated)
• Inventors: Welch, Jacqueline Nerney, Collinson, Michael, Vidal, Claude, Catanese, Joseph III, Redmond, Russell J., Makower, Joshua, Walke, Amrish Jayprakash, Lamson, Theodore Charles
• Granted Patent: US 8,715,239 B2
• Time in Patent Office: Days
• US Class Current: 604/506
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• 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 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/00792 Plastic surgery
• CPC Class Codes: A61B 2017/00796 Breast surgery
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 : H-fasteners
• CPC Class Codes: A61B 2017/0451 : Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 : the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 : Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0462 : One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/06052 : Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61B 2018/0022 : Balloons
• CPC Class Codes: A61B 2018/00517 : Urinary bladder or urethra
• CPC Class Codes: A61B 2018/00547 : Prostate
• CPC Class Codes: A61B 2018/00589 : Coagulation
• CPC Class Codes: A61B 2018/00601 : Cutting
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/144 : Wire
• CPC Class Codes: A61F 2/82 : Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61F 2002/041 : Bile ducts

Abstract

Devices, systems and methods for compressing, cutting, incising, reconfiguring, remodeling, attaching, repositioning, supporting, dislocating or altering the composition of tissues or anatomical structures to alter their positional or force relationship to other tissues or anatomical structures. In some applications, the invention may be used to used to improve patency or fluid flow through a body lumen or cavity (e.g., to limit constriction of the urethra by an enlarged prostate gland).

Claims

1-141. -141. (canceled)

142. A transvesicular method for delivering a treatment to the prostate gland of a human or animal subject, said method comprising the steps of:

A) percutaneously inserting a device through the wall of the abdomen;

B) forming a first opening in the wall of the urinary bladder;

C) advancing the device inserted in Step A through the first opening and into the urinary bladder;

D) forming a second opening in the wall of the bladder;

E) advancing at least one treatment delivering device through the second opening in the wall of the urinary bladder to a position within or near the urinary bladder; and

F) using said at least one treatment delivering device to deliver the treatment to the prostate gland.

143. A method according to claim 142 wherein the treatment comprises implantation of an implant device within or near the prostate gland.

144. A method according to claim 143 wherein the prostate is causing constriction of the urethra and wherein the implant comprises a device that compresses the prostate in a manner that lessens constriction of the urethra.

145. A method according to claim 143 wherein the implant delivers a therapeutic substance to treat a condition of the prostate.

146. A method according to claim 145 wherein the implant delivers a therapeutic substance selected from the group consisting of:

hemostatic agents;

antimicrobial agents;

antibiotics;

antifungals;

antiprotozoals;

antivirals;

antimicrobial metals;

hemostatic and/or vasoconstricting agents;

pseudoephedrine;

xylometazoline;

oxymetazoline;

phenylephrine;

epinephrine;

cocaine;

local anesthetic agents;

lidocaine;

cocaine;

bupivacaine;

hormones;

anti-inflammatory agents;

corticosteroids;

non-steroidal anti-inflammatory agents;

hormonally active agents;

agents that enhance potency;

substances that dissolve, degrade, cut, break, weaken, soften, modify or remodel connective tissue or other tissue;

enzymes;

collagenase;

trypsin;

EDTA;

trypsin combined with EDTA;

hyaluronidase;

tosyllysylchloromethane (TLCM));

chemotherapeutic or antineoplastic agents;

substances that prevent adhesion formation;

hyaluronic acid gel;

space occupying substances;

substances that promote desired tissue ingrowth into an anchoring device or other implanted device;

substances that promote or facilitate epithelialization;

substances that create a coagulative lesion which is subsequently resorbed causing the tissue to shrink, substances that cause the prostate to decrease in size;

phytochemicals that cause the prostate to decrease in size;

alpha-1a-adrenergic receptor blocking agents;

5-alpha-reductase inhibitors;

smooth muscle relaxants and agents that inhibit the conversion of testosterone to dihydrotestosterone.

147. A method according to claim 142 wherein the treatment comprises forming a cut in the prostate in a manner that lessens constriction of the urethra.

148. A method according to claim 147 wherein the cut extends through the capsule of the prostate gland.

149. A method according to claim 148 wherein the cut is formed at or near the commissure of the prostate gland.

150. A method according to claim 142 wherein the treatment comprises forming a lesion in the prostate gland that subsequently causes shrinkage of the prostate gland.

151. A method according to claim 150 wherein the lesion is a coagulative lesion is formed by heating the tissue.

152. A method according to claim 151 wherein the coagulative lesion subsequently becomes resorbed thereby causing the tissue to shrink.

153-238. -238. (canceled)

239. An introducer device that is useable to facilitate insertion of a working device into the prostate gland of a human or animal subject, said introducer device comprising:

an elongate body that is insertable into the subject'"'"'s urethra;

a scope lumen configured to receive a cystoscope or other endoscopic device; and

a working lumen through which at least one working device may be advanced, said working lumen having an outlet through which the working device may exit the introducer device and advance through the wall of the urethra and to a position within or near the prostate gland.

240. An introducer device according to claim 239 further comprising apparatus for holding a cystoscope or other endoscopic device in a substantially fixed position in the scope lumen.

241. An introducer device according to claim 239 further comprising apparatus for adjusting the view obtained by a cystoscope or other endoscopic device disposed in the scope lumen.

242. An introducer device according to claim 239 further comprising apparatus for adjusting the view obtained by a cystoscope or other endoscopic device disposed in the scope lumen.

243. An introducer device according to claim 239 further comprising apparatus for controlling the trajectory on which the delivery device advances from the introducer device.

244. An introducer device according to claim 243 wherein the apparatus for controlling the trajectory on which the delivery device advances from the introducer device comprises a preformed or steerable guide member through which or over which the delivery device is advanceable.

245-249. -249. (canceled)