Cauterizing apparatus and method for laparoscopic cholecystostomy, gallbladder ablation and treatment of benign prostate hypertrophy

• US 5,159,925 A
• Filed: 01/28/1991
• Issued: 11/03/1992
• Est. Priority Date: 09/09/1988
• Status: Expired due to Term

• Current Assignee: Gynelab Incorporated Organized Under The Law of FL
• Original Assignee: Gynelab Incorporated
• Inventors: Neuwirth, Robert S., Bolduc, Lee R.
• Primary Examiner(s): HINDENBURG, MAX F
• Application Number:
  US07/646,669
• Time in Patent Office: 645 Days
• Field of Search: 128/399-402, 606/27, 606/28
• US Class Current: 607/105
• 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 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00132 Setting operation time of a device A61B2017/00123 takes precedence
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2018/00559 Female reproductive organs
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/044 the surgical action being effected by a circulating hot fluid
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2007/0054 with a closed fluid circuit, e.g. hot water
• CPC Class Codes: A61F 2007/0086 with a thermostat
• CPC Class Codes: A61F 7/123 : using a flexible balloon containing the thermal element

Abstract

A method for a laparoscopic cholecystostomy and prostate or gallbladder ablation is disclosed wherein a bladder catheter is inserted into the prostate or gallbladder then heated for a period sufficient to cause cauterization necrosis of the tissue lining of the prostate of gallbladder. Subsequently, the prostate or gallbladder is allowed to drain and is then removed. An apparatus for performing the procedure and a procedure and apparatus for treatment of benign prostate hypertrophy are also disclosed.

Claims

1. A method for effecting necrosis of gallbladder tissue lining comprising the steps of:

inserting a distendable bladder into the gallbladder;

inflating the inserted bladder with an inflation medium to an appropriate volume to assure the bladder'"'"'s contact with substantially all of the gallbladder tissue lining; and

heating the inflating medium to about 190°

fahrenheit for a period of about 2 to 6 minutes to effect necrosis of the tissue.

2. A method for effecting necrosis of gallbladder tissue lining comprising the steps of:

making an incision into the abdominal cavity;

inflating the abdomen with carbon dioxide so as to separate the abdominal wall from the organs within the abdomen;

visualizing the gallbladder and liver with a laparoscope;

grasping the gallbladder with a first puncture clamp;

exposing the cystic duct with an electrosurgical hook;

using a clip applicator to doubly clip the exposed cystic duct with first and second clips;

grasping the gallbladder tip with a second puncture clamp so as to stabilize it;

crushing stones in the stabilized gallbladder with crushing down forceps;

puncturing the tip of the gallbladder with a 4 mm trocar and cannula;

draining out the bile and crushed stones from the punctured gallbladder;

irrigating the drained gall bladder with Ringer'"'"'s Lactate so as to clean the mucosa;

removing the irrigation catheter through the irrigation cannula;

inserting a distendable bladder into the puncture site;

inflating the inserted distendable bladder with an inflation medium to an appropriate volume in order to assure the bladder'"'"'s contact with substantially all of the gallbladder'"'"'s tissue lining;

heating the inflation medium to about 190°

fahrenheit for a period of about 2 to 6 minutes so as to cauterize the tissue lining;

monitoring the heating phase with the laparoscope;

deflating the bladder at the end of the heating phase;

withdrawing the deflated bladder from the gallbladder;

inserting a 4 mm bladder catheter drain into the tip of the gallbladder left open when the bladder was removed;

inflating the inserted bladder catheter drain in order to anchor it within the gallbladder;

suturing the inflated bladder catheter drain to the abdominal wall;

removing the laparoscope, first clip, and closing the puncture wounds of the abdominal wall.

3. An apparatus for effecting necrosis of gallbladder tissue lining comprising:

a catheter a proximal end and a distal end;

distendable bladder means attached to said proximal end adapted for insertion into and distending the gallbladder;

inflating means connected to said distal end for introducing an inflation medium into said distendable bladder;

heating means for heating said inflation medium to a temperature sufficient to effect tissue necrosis positioned internal to said distendable bladder; and

control means connected to said distal end for regulating the inflating and heating of said distendable bladder.

4. A method for effecting removal of bladder neck blockage caused by a hypertrophied prostate comprising the steps of:

inserting a distendable bladder into the prostate;

inflating the inserted bladder with an inflation medium to an appropriate volume to assure the bladder'"'"'s contact with substantially all of the prostate'"'"'s tissue lining; and

heating the inflating medium to about 190°

fahrenheit for a period of about 2 to 6 minutes to effect necrosis of the tissue.

5. A method for effecting removal of bladder neck blockage caused by a hypertrophied prostate comprising the steps of:

inserting a distendable bladder into the bladder after cystoscopy;

filling the urinary bladder with sorbitol;

revealing the nature of the interior of the urinary bladder and the configuration of the hypertrophied prostate;

inflating the inserted bladder with about 10 ml of sterile 5% dextrose in water;

retracting the inflated bladder against the bladder neck and the hypertrophied prostate;

heating the dextrose in water solution in the bladder to about 190°

fahrenheit for about 5 minutes;

deflating the bladder and withdrawing it from the bladder and urethra;

inserting an indwelling foley catheter for about seven days to provide urine outflow during the period of swelling and edema following the procedure.

6. An apparatus for effecting removal of bladder neck blockage caused by a hypertrophied prostate comprising:

a catheter a proximal end and a distal end;

distendable bladder means attached to said proximal end adapted for insertion into and distending the prostate;

inflating means connected to said distal end for introducing an inflation medium into said distendable bladder;

heating means for heating said inflation medium to a temperature sufficient to effect tissue necrosis positioned internal to said distendable bladder; and

control means connected to said distal end for regulating the inflating and heating of said distendable bladder.