Medical treatment of deeply seated tissue using optical radiation

• US 5,454,807 A
• Filed: 12/30/1993
• Issued: 10/03/1995
• Est. Priority Date: 05/14/1993
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Corporation
• Inventors: Lennox, Charles D., Beaudet, Stephen P.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US08/175,787
• Time in Patent Office: 642 Days
• Field of Search: 606/7, 606/13-18, 607/89, 604/21
• US Class Current: 606/15
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/22064 transparent liquid
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00035 with return means
• CPC Class Codes: A61B 2018/00547 Prostate
• 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 2090/036 abutting on tissue or skin

Abstract

The invention features a treatment method of deeply seated tissue and a corresponding medical instrument. The medical instrument includes a light guide adapted to transmit light energy of a selected wavelength from a light source to a selected volume of tissue, a conduit constructed to deliver a flow of coolant from a source of coolant to a surface of the selected tissue volume through which the light energy passes in reaching the volume. The irradiation and cooling is governed by control means adapted to regulate the intensity of the light energy in respect of the flow of coolant delivered to the surface to prevent substantial damage of surface tissue while irradiating the tissue volume.

Claims

1. A device for laterally directing laser light from an optical fiber onto target tissue deep within a patient, comprising:

an elongated catheter body extending along an axis and constructed to be delivered from outside the patient along a narrow pathway to said target tissue inside the patient, said catheter body having high torsional rigidity and including an inner lumen for receiving an optical fiber substantially along its axis in a manner to permit rotation of said catheter body about said fiber, said catheter body further including lumenal space for receiving and directing a flow of fluid along its length,

an alignment element fixed near the distal end of said catheter body and rotatable with said catheter body, said alignment element including support surfaces for receiving the distal end of said fiber and maintaining said distal end of said fiber substantially on said catheter body axis in a manner to permit rotation of said catheter body and said alignment element about said fiber, and said alignment element further including fluid flow directing surfaces that are aligned to direct fluid flow distally beyond said alignment element,

a light directing optic, fixed near the distal end of said catheter body and rotatable with said catheter body and said alignment element, said light directing optic positioned to receive laser light emitted from said distal end of said fiber and fluid directed by said alignment element, and to direct said laser light and said fluid laterally onto a target arc-segment of tissue adjacent the directing optic that varies in dependence on the rotational orientation of said optic, and

a coupler connected to the proximal end of said catheter body remaining outside of said patient, said coupler being constructed to direct fluid into said catheter body and to receive said fiber such that said fiber extends through said coupler and into said catheter body, said coupler further including a locking structure to hold said fiber rotationally and axially stationary and said coupler further including a rotatable attachment to said catheter body so that said catheter body, alignment element, and light directing optic can be rotated together about said fiber to vary the orientation of the optic to direct said laser light and fluid flow onto a desired target arc-segment of tissue.

2. The device of claim 1 wherein said catheter is a single-lumen catheter and said fluid flow follows a path parallel to said fiber through said lumen.

3. The device of claim 1 or 2 wherein said fluid flow directing surfaces direct said fluid to create a flow substantially parallel to the surface of the directing optic that receives said laser light.

4. The device of claim 3 wherein said directing optic is a flat mirror.

5. The device of claim 1 wherein said locking structure releasably friction fits against said fiber.

6. The device of claim 1 wherein said directing optic is a mirror.

7. The device of claim 1 wherein said fluid flow directing surfaces define a flow aperture positioned radially opposite the lateral tissue arc-segment to which said laser light and fluid are directed by said optic.

8. The device of claim 7 wherein said light directing optic is a mirror.

9. The device of any one of claims 1, 2, 6, 7, or 8 wherein said catheter body and light directing optic are sized to pass through a urethral cystoscope.

10. The device of claim 9 further including a laser power source set to deliver laser energy at energy levels in the range of about 60-100 watts.