Laser resectoscope and method

• US 5,061,266 A
• Filed: 06/19/1990
• Issued: 10/29/1991
• Est. Priority Date: 03/30/1988
• Status: Expired due to Fees

• Current Assignee: 3H Inc.
• Original Assignee: Said I. Hakky
• Inventors: Hakky, Said I.
• Primary Examiner(s): HINDENBURG, MAX F
• Application Number:
  US07/540,072
• Time in Patent Office: 497 Days
• Field of Search: 128/6, 128/395, 128/398, 128/660.03, 128/660.07, 128/661.03, 128/662.06, 604/20, 604/22, 606/2, 606/13-16, 606/170, 606/167, 606/180
• US Class Current: 606/15
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• 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 2017/00685 Archimedes screw
• CPC Class Codes: A61B 2018/00547 Prostate

Abstract

A resectoscope for prostate surgery is provided which includes a rotating cutting element mounted within an outer sheath adapted to be inserted into the urethra. The cutting element has helical threads along the length thereof and a cutting blade at its distal end. The outer sheath has a covered distal end portion which extends beyond and over the cutting blade and has an opening therethrough adjacent the cutting blade. Within the outer sheath is an inner sheath surrounding the cutting element except for the cutting blade. A fiber optic laser filament connected to a laser generator is positioned within the space between the inner and outer sheaths and extends along the length of the inner sheath to a position adjacent the cutting blade. The optic filament is surrounded by a third sheath and is adapted to be moved by the rotation of the cutting element so that the laser light beam from the optic filament advances through tissue to cut and coagulate the resected area before the cutting blade of the cutting element reaches the resected tissue. Irrigation fluid is provided to the area between the inner and outer sheaths and is withdrawn through the inner sheath. A telescope is also provided through the cutting element for viewing the area being resected. The invention further provides for the use of ultrasound in conjunction with the laser resectoscope to plot the area of the prostate to be removed and with the assistance of a computer to control the operation of the laser to prevent cutting of tissue beyond the area of tissues to be removed.

Claims

1. A surgical apparatus for prostate surgery comprising:

a resectoscope for cutting prostate tissue, said resectoscope being comprised of;

cutting means for cutting and removing said prostate tissue,

sheath means surrounding said cutting means for enclosing said cutting means therein, and

laser means extending through said sheath means; and

ultrasound means for scanning the organic tissue to be cut and for scanning the position of said cutting means when said tissue is cut; and

computer means connected to said laser means and said ultrasound means for generating an image of the tissue to be cut derived from the scannings by said ultrasound means and for controlling the operation of said laser means based on the scanned position of said resectoscope during cutting of said tissue.

2. A method of transurethral prostate resectioning using a laser resectoscope, an ultrasound probe device and a computer connected to the probe and the laser, said method comprising the steps of:

scanning said prostate with said ultrasound probe and feeding the ultrasound scan information into said computer to produce a three dimensional image of said prostate;

identifying the boundaries on the scanned prostate image of the prostate area not to be resected and storing this information in said computer; and

performing said resection using said laser resectoscope and continuing the ultrasound scanning of said prostate during at least a portion of the resection procedure to identify the location of said resectoscope in relation to the identified boundaries of the prostate not to be removed and feeding this ultrasound scan information into the computer to compare the location of the resectoscope to the previously determined boundaries, whereby if said resectoscope comes too close to said boundaries, said computer recognizes the location of the resectoscope and turns off the laser to prevent any cutting beyond the predetermined boundaries.