Tissue ablation and a lateral-lasing fiber optic device therefor

• US 5,437,660 A
• Filed: 12/30/1991
• Issued: 08/01/1995
• Est. Priority Date: 12/30/1991
• Status: Expired due to Term

• Current Assignee: Catheter Ablation Solutions LLC (Acacia Research Corporation)
• Original Assignee: Trimedyne Incorporated (InnovaQuartz, LLC)
• Inventors: Johnson, Douglas E., Hussein, Hany M. G., Loeb, Marvin P.
• Primary Examiner(s): ASCHENBRENNER, PETER
• Application Number:
  US07/814,708
• Time in Patent Office: 1,310 Days
• Field of Search: 606/2, 606/3, 606/7, 606/10-17, 128/395-398, 128/4, 128/6
• US Class Current: 606/15
• CPC Class Codes: A61B 17/4208 Instruments for rupturing the amniotic membrane
• 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 2017/22087 photodynamic
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

A method for removing unwanted material in a body lumen, cavity or organ provides the steps of using an endoscope or other viewing system to position a suitably sized lateral-lasing fiber optic device axially at one or more places in a body lumen, cavity or organ and delivering a predetermined amount of light energy for a predetermined period of time laterally in one or more directions, while delivering a biocompatible fluid at a predetermined rate of flow. The distal end of the lateral-lasing fiber optic device includes a reflectively-coated metal tip, which is capable of directing, by reflection, the light energy from the optical fiber laterally from the longitudinal axis of the light energy carrying optical fiber and outwardly toward a target tissue region.

Claims

1. A method for the removal of unwanted tissue comprising the steps of:

positioning an elongated lateral-lasing fiber optic device adjacent a selected region of the tissue to be removed;

delivering to the selected region a biocompatible fluid at a predetermined rate of flow contiguous with the positioned lateral-lasing fiber optic device; and

energizing the positioned lateral-lasing fiber optic device at a predetermined power level to emit continuous wave laser energy in a direction substantially transversely to the longitudinal axis of the lateral-lasing fiber optic device and so as to irradiate the selected region of the tissue to be removed for a predetermined time period to produce a zone of coagulation in the irradiated tissue.

2. The method according to claim 1, in which the biocompatible fluid is delivered at a flow rate in the range of 20 to 200 cubic centimeters per minute.

3. The method according to claim 1, in which said positioning is done by means of an endoscope.

4. The method according to claim 1, in which said positioning is adjacent to tissue in a body lumen, cavity or organ.

5. The method according to claim 1, in which said positioning is adjacent to the prostatic urethra.

6. The method according to claim 1, in which said positioning is adjacent to tissue in the uterus.

7. The method according to claim 1, in which said positioning is adjacent to the endometrium of the uterus.

12. The method in accordance with claim 1, wherein said unwanted tissue is infused with a photoactive agent prior to the delivery of light energy thereto.

13. The method in accordance with claim 1 wherein said light energy is delivered while the temperature of the tip is monitored.

25. The method in accordance with claim 1 wherein the lateral-lasing fiber optic device is energized to emit laser energy at a wavelength of about 1064 nanometers.

26. The method in accordance with claim 1 wherein the lateral-lasing fiber optic device is energized to emit laser energy at a wavelength generated by a holmium laser.

8. A method for removing unwanted tissue in a body lumen, cavity or organ, which comprises the steps of:

(a) using a viewing system to position in a body lumen, cavity or organ opposite said unwanted tissue a lateral-lasing fiber-optic device having at the distal end thereof a reflectively-coated metal tip mounted to an optical fiber, which tip is capable of directing by reflection the light energy from a laser laterally away from the axis of the optical fiber; and

(b) delivering, while infusing a biocompatible fluid at a predetermined flow rate, or in the presence of sufficient fluid, a predetermined amount of light energy from a laser to said unwanted tissue for a predetermined period of time to obtain the desired zone of coagulation.

9. The method according to claim 8, in which the light energy is generated by a neodymium:

YAG laser.

10. The method according to claim 8, in which the delivered light energy Is generated by a holmium laser.

11. The method according to claim 8, in which the light energy is delivered to the prostate.

14. A device for applying a laser energy beam to a selected body site comprising:

an elongated, laser energy transmitting conduit having a proximal end and a distal end;

a laser energy source optically coupled to the proximal end region of the conduit for transmitting laser energy along the conduit;

a hollow, apertured bulbous element mounted on the distal end of said conduit and provided with an internal laser energy reflective surface so that a major portion of the laser energy transmitted by the conduit to the bulbous element impinges thereon and exits from the element laterally as a laser energy beam;

said element defining a cavity within which the distal end of the conduit is received and further defining an aperture communicating with said cavity and positioned to one side of the laser energy path entering said cavity but in registry with the laterally exiting laser energy beam; and

an covering over said cavity;

said covering being permeable to the laser energy beam but preventing body tissue entry into said cavity,

17. The device according to claim 14 wherein the covering is a laser energy transparent baffle that extends partially across said cavity,

18. The device according to claim 14 wherein the covering is a laser energy transparent lid over said cavity,

19. The device according to claim 14 wherein the covering is a laser energy transparent lid over said cavity and wherein the lid and said hollow apertured element together define a sealed space therebetween.

20. The device according to claim 14 wherein the laser energy beam exits the hollow element through said covering and in a direction substantially transverse to the major axis of the elongated laser energy transmitting conduit at the distal end region of the conduit.

21. The device according to claim 14 wherein an energy reflective surface layer for receiving and reflecting the laser energy transmitted by the conduit is provided within said cavity and in the path of the laser energy beam emitted from the conduit.

22. The device according to claim 14 wherein the energy reflective mirror surface is defined by a layer of gold.

23. The device according to claim 14 wherein a reflective coating is provided on the external surface of the hollow element.

24. The device according to claim 14 wherein the energy reflective surface is provided by an inset mounted in the hollow element and situated in the path of a laser beam exiting from said conduit.

15. A device for applying a laser energy beam to a selected body site comprising:

an elongated, laser energy transmitting conduit having a proximal end and a distal end;

a laser energy source optically coupled to the proximal end region of the conduit for transmitting laser energy along the conduit;

a hollow apertured bulbous element mounted on the distal end of said conduit and provided with an internal laser energy reflective surface so that a major portion of the laser energy transmitted by the conduit to the bulbous element impinges thereon and exits from the element laterally as a laser energy beam;

said element defining a cavity within which the distal end of the conduit is received and further defining an aperture communicating with said cavity and positioned to one side of the laser energy path entering said cavity but in registry with the laterally exiting laser beam; and

a bar that extends longitudinally across said cavity and prevents body tissue entry into said cavity.

16. A device for applying a laser energy beam to a selected body site comprising:

an elongated laser energy transmitting conduit having a proximal end and a distal end;

a laser energy source optically coupled to the proximal end region of the conduit for transmitting laser energy along the conduit;

a hollow, apertured bulbous element mounted on the distal end of said conduit and provided with an internal laser energy reflective surface so that a major portion of the Laser energy transmitted by the conduit to the bulbous element impinges thereon and exits from the element laterally as a laser energy beam, said element defining a cavity within which the distal end of the conduit is received and further defining an aperture communicating with said cavity and positioned to one side of the laser energy path entering said cavity but in registry with the laterally exiting laser energy beam; and

a plurality of bars across said cavity that prevent body tissue entry into said cavity.

27. The method in accordance with claim wherein the lateral-lasing fiber optic device is energized to emit laser energy at a wavelength of about 1064 nanometers and at a power level of about 40 watts while said biocompatible fluid is delivered at a rate of about 50 cubic centimeters per minute.

28. The method in accordance with claim 27 wherein the lateral-lasing fiber optic device is positioned within prostatic urethra adjacent to a selected region of the prostate to be removed and said selected region of the prostate is irradiated for a time period of about 30 seconds.

29. The method in accordance with claim 27 wherein the lateral-lasing fiber optic device is positioned within prostatic urethra adjacent to a selected region of prostate to be removed and said selected region of the prostate is irradiated for a time period of about 60 seconds.