Instrument and method for intraluminally relieving stenosis
First Claim
1. An instrument for use in effectively removing anatomical constrictions of the prostatic urethra, the instrument comprising:
- a catheter casing sufficiently long so that a portion of the casing can be inserted into the prostatic urethra within the anatomical constrictions;
an inflatable balloon, substantially transparent to selected laser radiation and supported on the portion of the catheter casing so that the balloon is insertable into the prostatic urethra within said anatomical constrictions, the balloon being size so that when inflated within the prostatic urethra the balloon assumes a substantially fixed and uniform cross-sectional dimension so as to reconfigure at least a selected part of the tissue of the urethra into a smooth uniform cylindrical shape having an axial direction such that a corresponding portion of the prostate is squeezed from within the urethra and balloon excluding means for comprising the tissue and associated blood vessels of the corresponding portion of the prostate so as to decrease blood flow and promote hemostasis in the tissue, and means for providing for uniformity and increased depth of penetration of said selected laser radiation in the corresponding portion of the prostate;
a probe axially and rotatably movable within the casing and the balloon;
means, fixed relative to said probe, for transmitting a beam of said selected laser radiation in a direction transverse to said axial direction through the balloon into at least a volumetric portion of the tissue compressed by the balloon where an anatomical constriction exists;
a control unit, coupled to said catheter casing and said probe, including means for setting a rotational position of said probe so as to set the transverse direction of the beam of laser radiation relative to said balloon when compressed tissue is exposed to said beam of radiation, and means for moving the probe within and relative to the casing and balloon along the prostatic urethra so as to move said means for transmitting said beam of laser radiation relative to said balloon while transmitting said beam of said selected laser radiation through the balloon directly into at least a portion of the tissue compressed by the balloon; and
means, fixed relative to said probe and movable relative to said casing and balloon, for ultrasonically observing said volumetric portion of said tissue as the tissue is exposed to the beam of laser radiation.
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Accused Products
Abstract
An instrument for and method of effectively treating the prostatic urethra so as to relieve the symptoms associated with an enlarged urethra is disclosed. The tissue of at least selected portions of the prostate are compressed (preferably with a balloon inserted into the prostatic urethra so as to enhance hemostasis) and at least selected portions of the compressed tissue are directly irradiated (preferably with a laser beam transmitted from within the passageway in selected radial directions and moved along the prostatic urethra while exposing the tissue) so as to cause coagulation necrosis of selected portions of the compressed tissue so that as the tissue heals, the necrosed tissue slowly sloughs off during normal urination through the urinary tract so as to effectively remove the constricted portions of the prostatic urethra. Ultrasonic transducers are used from within the prostatic urethra to image the tissue as it is irradiated so as to monitor the procedure to insure proper exposure to the laser beam.
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Citations
17 Claims
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1. An instrument for use in effectively removing anatomical constrictions of the prostatic urethra, the instrument comprising:
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a catheter casing sufficiently long so that a portion of the casing can be inserted into the prostatic urethra within the anatomical constrictions; an inflatable balloon, substantially transparent to selected laser radiation and supported on the portion of the catheter casing so that the balloon is insertable into the prostatic urethra within said anatomical constrictions, the balloon being size so that when inflated within the prostatic urethra the balloon assumes a substantially fixed and uniform cross-sectional dimension so as to reconfigure at least a selected part of the tissue of the urethra into a smooth uniform cylindrical shape having an axial direction such that a corresponding portion of the prostate is squeezed from within the urethra and balloon excluding means for comprising the tissue and associated blood vessels of the corresponding portion of the prostate so as to decrease blood flow and promote hemostasis in the tissue, and means for providing for uniformity and increased depth of penetration of said selected laser radiation in the corresponding portion of the prostate; a probe axially and rotatably movable within the casing and the balloon; means, fixed relative to said probe, for transmitting a beam of said selected laser radiation in a direction transverse to said axial direction through the balloon into at least a volumetric portion of the tissue compressed by the balloon where an anatomical constriction exists; a control unit, coupled to said catheter casing and said probe, including means for setting a rotational position of said probe so as to set the transverse direction of the beam of laser radiation relative to said balloon when compressed tissue is exposed to said beam of radiation, and means for moving the probe within and relative to the casing and balloon along the prostatic urethra so as to move said means for transmitting said beam of laser radiation relative to said balloon while transmitting said beam of said selected laser radiation through the balloon directly into at least a portion of the tissue compressed by the balloon; and means, fixed relative to said probe and movable relative to said casing and balloon, for ultrasonically observing said volumetric portion of said tissue as the tissue is exposed to the beam of laser radiation. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method of effectively removing one or more anatomical constrictions of a prostatic urethra and relieve the signs and symptoms associated with such constrictions, said method including the steps of:
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inserting a portion of an instrument including an inflatable balloon which is transparent to selected radiation into the prostatic urethra so that the boon is positioned within at least a selected part of the prostatic urethra including at least one anatomical construction; inflating the balloon so that at least a selected part of said prostate is compressed from within the anatomical constriction so as to (a) compress the tissue and associated blood vessels of the selected part so as to decrease the flow of blood in the tissue and promote hemostasis, and (b) provide for uniformity and increased depth of penetration of the selected laser radiation into the selected part of the prostate; moving a beam of said selected laser radiation from within the prostatic urethra and balloon, in a direction relative to the compressed tissue, so as to irradiate one or more selected portions of the compressed tissue and associated blood vessels of the prostate at said constriction so that coagulation necrosis of selected portions of the prostate is caused by the laser irradiation, ultimately resulting in treated tissue being expelled through the urethra, which is turn results in an increase of cross-sectional dimensions of the prostatic urethra; and ultrasonically observing the selected portions of the tissue and associated blood vessel forming said prostatic urethra in order to control the amount of irradiation of said tissue by said laser means. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17)
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Specification