METHODS FOR BIOFILM REMOVAL

• US 20110009699A1
• Filed: 09/20/2010
• Published: 01/13/2011
• Est. Priority Date: 01/09/2007
• Status: Active Grant

• Current Assignee: Medtronic Xomed Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Xomed Incorporated (Medtronic Plc)
• Inventors: Slenker, Dale E., Prisco, John R., Norman, Gerould W., Lewis, Cecil O.
• Granted Patent: US 9,339,172 B2
• Time in Patent Office: Days
• US Class Current: 600/123
• CPC Class Codes: A61B 1/00091 Nozzles
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61M 1/774 Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently
• CPC Class Codes: A61M 3/0283 with at least two inner passageways, a first one for irrigating and a second for evacuating suction-irrigation systems A61M1/77; aspiration tips with fluid supply means A61M1/85; for negative pressure wound therapy A61M1/92

Abstract

A method of removing bacterial biofilm from a target site of a human patient. A bacterial biofilm removal system is provided that includes an endoscope, an irrigation duct and an aspiration duct. The endoscope includes a working end. The irrigation duct includes an outlet. The aspiration duct includes an inlet. The endoscope working end, the irrigation duct outlet and the aspiration duct inlet are disposed proximate a target site that includes a layer of bacterial biofilm. The target site is imaged with the endoscope working end. The fluid is dispensed through the irrigation duct outlet toward the target site to mechanically remove at least a portion of the layer of bacterial biofilm. The removed bacterial biofilm and the dispensed fluid are collected with the aspiration duct inlet.

Claims

1. A method of removing bacterial biofilm from a target site of a human patient, wherein the method comprises:

providing a bacterial biofilm removal system comprising an endoscope, an irrigation duct and an aspiration duct, wherein the endoscope comprises a working end, wherein the irrigation duct comprises an outlet and wherein the aspiration duct comprises an inlet;

disposing the endoscope working end, the irrigation duct outlet and the aspiration duct inlet proximate a target site includes a layer of bacterial biofilm;

imaging the target site with the endoscope working end;

dispensing fluid through the irrigation duct outlet toward the target site to mechanically remove at least a portion of the layer of bacterial biofilm; and

collecting the removed bacterial biofilm and the dispensed fluid with the aspiration duct inlet.

2. The method of claim 1, and further comprising covering at least a portion of the endoscope working end with the removable endoscope sheath, wherein at least one of the irrigation duct and the aspiration duct is part of the removable endoscope sheath.

3. The method of claim 1, wherein the bacterial biofilm is characterized by an adhesion force and wherein the fluid is further adapted to chemically reduce the adhesion force.

4. The method of claim 1, and further comprising applying a medicament to the target site through the irrigation duct, wherein the medicament is adapted to inhibit re-growth of the bacterial biofilm.

5. The method of claim 1, and further comprising delivering a medicament to the target site through the irrigation duct, wherein the medicament is selected from the group consisting of a surfactant, a gel, an antimicrobial, a steroid, a growth hormone or combinations thereof.

6. The method of claim 1, wherein the flow of fluid is directed through the nozzle at a flow rate of between about 2 ml/s and about 12 ml/s.

7. The method of claim 1, wherein the irrigation duct outlet and the aspiration duct inlet are non-concurrently disposed proximate the target site.

8. The method of claim 1, wherein the target site is within a sinus cavity.

9. The method of claim 1, wherein the target site includes ciliated epithelium.

10. The method of claim 1, wherein the method is performed in treating chronic rhinosinusitis.

11. The method of claim 1, wherein the endoscope further comprises an insertion tube having a bendable distal portion and wherein the endoscope further comprises a control assembly for bending of the bendable distal portion to aim the endoscope working end in a desired direction.

12. The method of claim 11, wherein the irrigation duct outlet is secured relative to the bendable distal portion such that the irrigation duct outlet can be aimed with bending of the insertion tube.

13. The method of claim 11, wherein the aspiration duct inlet is secured relative to the bendable distal portion such that the aspiration duct inlet can be aimed with bending of the insertion tube.

14. A method of removing bacterial biofilm from a target site of a human patient, wherein the method comprises:

providing an endoscope comprising a working end;

extending at least a portion of the endoscope working end into a removable endoscope sheath, wherein the removable endoscope sheath has an irrigation duct and an aspiration duct formed therein, wherein the irrigation duct comprises an outlet and wherein the aspiration duct comprises an inlet;

disposing the endoscope working end, the irrigation duct outlet and the aspiration duct inlet proximate a target site includes a layer of bacterial biofilm;

imaging the target site with the endoscope working end;

dispensing fluid through the irrigation duct outlet toward the target site to mechanically remove at least a portion of the layer of bacterial biofilm; and

collecting the removed bacterial biofilm and the dispensed fluid with the aspiration duct inlet.

15. The method of claim 14, wherein the bacterial biofilm is characterized by an adhesion force and wherein the fluid is further adapted to chemically reduce the adhesion force.

16. The method of claim 14, and further comprising applying a medicament to the target site through the irrigation duct, wherein the medicament is adapted to inhibit re-growth of the bacterial biofilm.

17. The method of claim 14, and further comprising delivering a medicament to the target site through the irrigation duct, wherein the medicament is selected from the group consisting of a surfactant, a gel, an antimicrobial, a steroid, a growth hormone or combinations thereof.

18. The method of claim 14, wherein the irrigation duct outlet and the aspiration duct inlet are non-concurrently disposed proximate the target site.

19. The method of claim 14, wherein the target site includes ciliated epithelium.

20. The method of claim 14, wherein the endoscope further comprises an insertion tube having a bendable distal portion and wherein the endoscope further comprises a control assembly for bending of the bendable distal portion to aim the endoscope working end in a desired direction.

21. The method of claim 20, wherein the irrigation duct outlet is secured relative to the bendable distal portion such that the irrigation duct outlet can be aimed with bending of the insertion tube.

22. The method of claim 20, wherein the aspiration duct inlet is secured relative to the bendable distal portion such that the aspiration duct inlet can be aimed with bending of the insertion tube.

23. A method of removing bacterial biofilm from a target site of a human patient, wherein the method comprises:

providing a bacterial biofilm removal system comprising an endoscope, an irrigation duct and an aspiration duct, wherein the endoscope comprises a working end, wherein the irrigation duct comprises an outlet and wherein the aspiration duct comprises an inlet;

disposing the endoscope working end proximate a target site includes a layer of bacterial biofilm;

imaging the target site with the endoscope working end;

directing the irrigation duct outlet toward the target site;

dispensing fluid through the irrigation duct outlet toward the target site to mechanically remove at least a portion of the layer of bacterial biofilm;

directing the aspiration duct inlet toward the target site, wherein only one of the irrigation duct outlet and the aspiration duct inlet may be concurrently disposed proximate the target site; and

collecting the removed bacterial biofilm and the dispensed fluid with the aspiration duct inlet.

24. The method of claim 23, and further comprising covering at least a portion of the endoscope working end with a removable endoscope sheath, wherein at least one of the irrigation duct and the aspiration duct is part of the removable endoscope sheath.

25. The method of claim 23, and further comprising applying a medicament to the target site through the irrigation duct, wherein the medicament is adapted to inhibit re-growth of the bacterial biofilm.

26. The method of claim 23, and further comprising delivering a medicament to the target site through the irrigation duct, wherein the medicament is selected from the group consisting of a surfactant, a gel, an antimicrobial, a steroid, a growth hormone or combinations thereof.

27. The method of claim 23, wherein the target site is within a sinus cavity.

28. The method of claim 23, wherein the endoscope further comprises an insertion tube having a bendable distal portion and wherein the endoscope further comprises a control assembly for actuating bending of the bendable distal portion to aim the endoscope working end in a desired direction.

29. The method of claim 28, wherein the irrigation duct outlet is secured relative to the bendable distal portion such that the irrigation duct outlet can be aimed with bending of the insertion tube.

30. The method of claim 28, wherein the aspiration duct inlet is secured relative to the bendable distal portion such that the aspiration duct inlet can be aimed with bending of the insertion tube.