Methods for laser treatment of soft tissue

• US 6,554,824 B2
• Filed: 12/15/2000
• Issued: 04/29/2003
• Est. Priority Date: 12/15/2000
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Laserscope (Endo International PLC)
• Inventors: Coleman, Tony, Davenport, Scott, Murray, Steven C.
• Primary Examiner(s): Walberg, Teresa
• Assistant Examiner(s): DAHBOUR, HENRY
• Application Number:
  US09/737,721
• Publication Number:
  US 20030018324A1
• Time in Patent Office: 865 Days
• Field of Search: 606/3, 606/2, 606/10, 606/11, 606/12, 606/16, 606/17, 606/7, 606/15, 606/27, 606/28, 606/29, 606/30, 606/31, 600/2, 600/3, 607/89, 607/90, 607/92, 607/100, 607/101, 607/102
• US Class Current: 606/3
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/2035 Beam shaping or redirecting; Optical components therefor A61B2018/2255 takes precedence
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence

Abstract

Methods are provided for treating prostate glands or other targeted soft tissue using a solid-state laser. The laser can be operated to generate a pulsed output beam having pulse durations of between 0.1 and 500 milliseconds. The output beam is delivered to the targeted tissue through an optical fiber, preferably terminating in a side-firing probe or diffusing tip. By operating the laser in a long-duration pulse mode, charring of the targeted tissue is initiated quickly, thereby increasing ablation rates and reducing overall procedure time.

Claims

1. A method for treating benign prostatic hypertrophy (BPH), comprising:

providing a solid-state laser emitting light with a wavelength of 200 to 1000 nm having a laser element positioned to receive pump radiation from a pump radiation source;

modulating the pump radiation source to cause the laser element to emit laser light having pulse duration between 0.1 and 500 milliseconds and pulse frequencies between 1 and 500 Hz; and

delivering the laser light to targeted tissue through an optical fiber, wherein the optical fiber terminates in a side-firing probe emitting the laser light in a direction transverse to the longitudinal axis of the optical fiber.

2. The method of claim 1, wherein the light is of a wavelength that is better absorbed by human tissue than by a substance in an intermediate position between the tissue and a device used to deliver the laser light to the tissue.

3. The method of claim 1, wherein the output power density of the light delivered to the targeted tissue is high enough to vaporize the tissue.

4. The method of claim 1, wherein the laser light has a repetition rate of between 1 Hertz and 500 Hertz.

5. The method of claim 1, wherein the laser element is fabricated from neodymium doped YAG (Nd:

YAG).

6. The method of claim 1, wherein the pump radiation source is a flash lamp.

7. The method of claim 1, wherein the tissue is soft tissue and the laser light has an average power exceeding 20 watts.

8. The method of claim 7, wherein the laser light has a repetition rate of between 1 and 500 Hertz.

9. A method for treating benign prostatic hypertrophy (BPH), comprising:

providing a solid-state laser emitting light with a wavelength of 200 to 1000 nm having a laser element positioned to receive pump radiation from a pump radiation source;

modulating the pump radiation source to cause the laser element to emit laser light having pulse duration between 0.1 and 500 milliseconds and pulse frequencies between 1 and 500 Hz; and

delivering the laser light to targeted tissue, wherein the laser further comprises a frequency doubling element.

10. The method of claim 9, wherein the step of delivering the laser light further comprises transmitting the laser light through an optical fiber.

11. The method of claim 9 wherein the frequency doubling element is fabricated from potassium-titanyl-phosphate (KTP).

12. A method for treating benign prostatic hypertrophy (BPH), comprising:

providing a solid-state laser emitting light with a wavelength of 200 to 1000 nm having a laser element positioned to receive pump radiation from a pump radiation source;

modulating the pump radiation source to cause the laser element to emit laser light having pulse duration between 0.1 and 500 milliseconds and pulse frequencies between 1 and 500 Hz; and

delivering the laser light to targeted tissue, further comprising the step of Q-switching the laser to produce a train of micropulses, each micropulse train collectively form a pulse.

13. The method of claim 12, wherein the step of delivering the laser light comprises transmitting the laser light through an optical fiber.

14. A method for treating benign prostatic hypertrophy (BPH), comprising:

providing a solid-state laser emitting light with a wavelength of 200 to 1000 nm having a laser element positioned to receive pump radiation from a pump radiation source;

modulating the pump radiation source to cause the laser element to emit laser light having pulse duration between 0.1 and 500 milliseconds and pulse frequencies between 1 and 500 Hz; and

delivering the laser light to targeted tissue;

wherein the pump radiation source is a laser diode.

15. The method of claim 14, wherein the step of delivering the laser light further comprises transmitting the laser light through an optical fiber.

16. A method for treating benign prostatic hypertrophy (BPH), comprising:

providing a solid-state laser emitting light with a wavelength of 200 to 1000 nm having a laser element positioned to receive pump radiation from a pump radiation source;

modulating the pump radiation source to cause the laser element to emit laser light having pulse duration between 0.1 and 500 milliseconds and pulse frequencies between 1 and 500 Hz; and

delivering the laser light to targeted tissue;

wherein the pump radiation source is an arc lamp.

17. The method of claim 16, wherein the step of delivering the laser light further comprises transmitting the laser light through an optical fiber.

18. A method for treating benign prostatic hypertrophy (BPH), comprising:

providing a solid-state laser emitting light with a wavelength of 200 to 1000 nm having a laser element positioned to receive pump radiation from a pump radiation source;

modulating the pump radiation source to cause the laser element to emit laser light having pulse duration between 0.1 and 500 milliseconds and pulse frequencies between 1 and 500 Hz; and

delivering the laser light to targeted soft tissue, and the laser light has an average power exceeding 20 watts, wherein the laser has a frequency doubling element.

19. The method of claim 18, wherein the step of delivering the laser light further comprises transmitting the laser light through an optical fiber.

20. A method for treating benign prostatic hypertrophy (BPH), comprising:

providing a solid-state laser emitting light with a wavelength of 200 to 1000 nm having a laser element positioned to receive pump radiation from a pump radiation source;

modulating the pump radiation source to cause the laser element to emit laser light having pulse duration between 0.1 and 500 milliseconds and pulse frequencies between 1 and 500 Hz; and

delivering the laser light to targeted soft tissue, and the laser light has an average power exceeding 20 watts, further comprising Q-switching the laser to produce a train of micropulses, each micropulse train collectively form said pulse.

21. The method of claim 20, wherein the step of delivering the laser light further comprises transmitting the laser light through an optical fiber.

22. A method for treating benign prostatic hypertrophy (BPH), comprising:

providing a solid-state laser emitting light of a wavelength of 200 to 1000 nm having a laser element positioned to receive pump radiation from a pump radiation source and

the laser has a beam quality (M2) that is less than or equal to 100 and

delivering the laser light to prostate tissue.

23. The method of claim 22 wherein the light is of a wavelength that is better absorbed by human tissue than by a substance in an intermediate position between the tissue and a device used to deliver the laser light to the tissue.

24. The method of claim 22 wherein the output power density of the light delivered to the targeted tissue is high enough to vaporize the tissue.

25. The method of claim 22, wherein said delivering the laser light comprises transmitting the laser light through an optical fiber.

26. The method of claim 25, wherein the optical fiber terminates in a side-firing probe emitting the laser light in a direction transverse to the longitudinal axis of the optical fiber.

27. The method of claim 22, wherein the laser further comprises a frequency doubling element.

28. The method of claim 27 wherein the frequency doubling element is fabricated from potassium-titanyl-phosphate (KTP).

29. The method of claim 22 wherein the laser element is fabricated from neodymium doped YAG (Nd:

YAG).

30. The method of claim 22, further comprising Q-switching the laser to produce a train of micropulses, each micropulse train collectively comprising a pulse.

31. The method of claim 22 wherein the pump radiation source is a flashlamp.

32. The method of claim 22 wherein the pump radiation source is an arclamp.

33. The method of claim 22 wherein the pump radiation source is a laser diode.

34. The method of claim 22 wherein the tissue is soft tissue and the laser light that is output has an average power exceeding 20 watts.

35. The method of claim 34, wherein said delivering the laser light comprises transmitting the laser light through an optical fiber.

36. The method of claim 34, wherein the laser has a frequency doubling element.

37. The method of claim 34, further comprising Q-switching the laser to produce a train of micropulses.

38. The method of claim 22, wherein the step of delivering the laser light further comprises transmitting the laser light through an optical fiber.

39. A method comprising:

irradiating soft tissue of a body with coherent radiation from a laser having

a pump radiation source that does not produce enough heat in a lasing element to create a significant amount of thermal lensing in the lasing element

a wavelength such that the radiation is preferentially absorbed by the tissue rather than a fluid; and

a temperature that is generated by the lasing element that is low enough so that a number of modes of the radiation are few enough so that an average power density is high enough to ablate the tissue leaving less thermal damage than a 60 Watt laser emitting a wavelength near 532 nm.

40. The method of claim 39, wherein an absorptive layer of denatured tissue is formed on the tissue that absorbs the coherent radiation.

41. The method of claims 39, wherein the radiation is pulsed.

42. The method of claims 39, wherein the radiation has micro pulses grouped into macro pulses.

43. The method of claim 39, further comprising frequency converting the radiation prior to irradiating the tissue.

44. The method of claim 39, wherein the radiation has an intensity profile that has a high enough beam quality so that an ablative power density can be projected on the tissue.

45. The method of claim 39, wherein the radiation has an intensity profile that has a sufficient beam quality so that the radiation is able to ablate the tissue

without being so high as to be absorbed by water, and

without causing significant damage to tissue significantly deeper in the body than the tissue ablated.