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Method of laser-assisted prostatectomy and apparatus for carrying out the method

  • US 5,320,617 A
  • Filed: 06/25/1993
  • Issued: 06/14/1994
  • Est. Priority Date: 06/25/1993
  • Status: Expired due to Fees
First Claim
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1. A method of laser-assisted prostatectomy comprising the steps of:

  • providing an apparatus which comprises an elongated tubular sheath which has a distal end and a proximal end and contains a first tube for guiding an axially moveable laser fiber that has at its distal end lateral laser-beam emitting openings, and that can be turned around its longitudinal axis;

    a second guide tube for guiding a fiber-optic lens system for observation of the operation site; and

    a third guide tube for guiding one of an auxiliary instrument selected from a group consisting of a balloon catheter, an ultrasonic sound for measuring the depth and degree of ablation of the tissue, and a rotating cleaning brush;

    each said auxiliary instrument can be inserted into said third guide tube and removed therefrom during the operation of said apparatus;

    said first, second, and third tubes being arranged parallel to each other in said sheath, the space between the inner surface of said tubular sheath and the outer surface of said guide tubes forming at least two longitudinal channels isolated from each other, one said channel being connected at its proximal end through a shut-off valve to a source of the supply of a flushing and cooling liquid, and another to a reservoir for the removal of said cooling and flushing liquid after its use;

    inserting said apparatus into the urethra of a patent suffering from the obstruction of the prostatic part of the urethra to the position in which said distal end of said sheath is in said prostatic part of the urethra;

    inserting said balloon catheter through said third guide tube to the position of the inflatable tip of said catheter inside the bladder;

    inflating said inflatable tip so as to fix the balloon catheter and to isolate an area between said inflated tip and the operation area within said prostatic urethra from the urinary bladder;

    initiating an inflow of said washing and cooling liquid to said prostatic part of the urethra through said first guide tube and outflow of said liquid through said spaces, thus maintaining constant circulation of said liquid through the operation area and said distal end of said laser fiber;

    inserting said laser fiber into said first guide tube to the position of said distal end of said laser fiber in said prostatic part; and

    firing said laser fiber and directing a laser beam laterally from said laser fiber onto said prostatic part of said urethra and rotating said laser fiber during the operation for directing said laser beam to a required area.

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