Devices, systems and methods for treating benign prostatic hyperplasia and other conditions

• US 7,758,594 B2
• Filed: 05/20/2005
• Issued: 07/20/2010
• Est. Priority Date: 05/20/2005
• Status: Active Grant

• Current Assignee: Teleflex Life Sciences LLC (Teleflex Incorporated)
• Original Assignee: NeoTract, Inc. (Teleflex Incorporated)
• Inventors: Catanese, III., Welch, Jacqueline Nerney, Collinson, Michael, Vidal, Claude, Redmond, Russell J., Makower, Joshua, Walke, Amrish Jayprakash, Lamson, Theodore Charles
• Primary Examiner(s): Erezo; Darwin P
• Assistant Examiner(s): ANDERSON, GREGORY A
• Application Number:
  US11/134,870
• Publication Number:
  US 20060276871A1
• Time in Patent Office: 1,887 Days
• Field of Search: 606151-153, 606/139, 606/213, 606215-216, 606/232, 600 29- 31, 600 38- 41, 128/898
• US Class Current: 606/139
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06109 Big needles, either gripped by hand or connectable to a handle
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 17/42 Gynaecological or obstetrical instruments or methods ligaturing clamps or clips for the umbilical cord A61B17/122; curettage A61B17/320708; dilators A61M29/00
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/00792 Plastic surgery
• CPC Class Codes: A61B 2017/00796 Breast surgery
• CPC Class Codes: A61B 2017/00805 Treatment of female stress urinary incontinence
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 : H-fasteners
• CPC Class Codes: A61B 2017/0451 : Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 : the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 : Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0462 : One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/06052 : Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61B 2018/0022 : Balloons
• CPC Class Codes: A61B 2018/00517 : Urinary bladder or urethra
• CPC Class Codes: A61B 2018/00547 : Prostate
• CPC Class Codes: A61B 2018/00589 : Coagulation
• CPC Class Codes: A61B 2018/00601 : Cutting
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/144 : Wire
• CPC Class Codes: A61F 2/82 : Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61F 2002/041 : Bile ducts

Abstract

Devices, systems and methods for compressing, cutting, incising, reconfiguring, remodeling, attaching, repositioning, supporting, dislocating or altering the composition of tissues or anatomical structures to alter their positional or force relationship to other tissues or anatomical structures. In some applications, the invention may be used to used to improve patency or fluid flow through a body lumen or cavity (e.g., to limit constriction of the urethra by an enlarged prostate gland).

Claims

1. A method for treating benign prostatic hypertrophy in a subject wherein prostate tissue located adjacent to an anatomical structure is creating undesired constriction of the anatomical structure, said method comprising the steps of:

creating a penetration path transverse to a longitudinal axis of an urethra;

penetrating the prostate tissue with at least one tension device; and

implanting the at least one tension device through the penetration path of the subject to compress the prostate tissue transverse to the axis of the urethra so as to relieve at least some of the constriction in that transverse direction created by the prostate tissue on the anatomical structure.

2. A method according to claim 1 wherein the anatomical structure is the urethra.

3. A method according to claim 2 further comprising:

advancing an introducer device into the subject'"'"'s urethra and using said introducer device to introduce the tension device.

4. A method according to claim 3 wherein the introducer device comprises an elongate body having a scope lumen through which a scope may be inserted and a working lumen through which the tension device may be introduced.

5. A method according to claim 2 wherein an opening is formed in the urethra adjacent to a prostate and at least a portion of said tension device is advanced through that opening in the urethra.

6. A method according to claim 2 wherein said method further comprises the step of:

incising a capsule of a prostate.

7. A method according to claim 6 wherein the incising step comprises inserting a cutting device transurethrally, advancing the cutting device through an opening formed in a wall of the urethra and using the cutting device to incise the capsule of the prostate.

8. A method according to claim 1 wherein the implanting step comprises:

placing a first anchor at a first location on, in or adjacent to a prostate;

placing a second anchor at a second location on, in or adjacent to the prostate; and

placing a connecting member between the first and second anchors, said connecting member drawing at least one of said first and second anchors toward the other thereby compressing at least a portion of the prostate.

9. A method according to claim 8 wherein one of the first and second anchors is placed within a lumen of an urethra adjacent to the prostate.

10. A method according to claim 8 wherein one of the first and second anchors is placed within a wall of an urethra adjacent to the prostate.

11. A method according to claim 8 wherein one of the first and second anchors is placed within the prostate adjacent to the wall of an urethra.

12. A method according to claim 8 wherein an opening is formed in an urethra and an introducer is advanced through the opening in the urethra to a position where it is used to implant the first anchor wherein the introducer is then retracted to another position where it is used to implant the second anchor.

13. A method according to claim 8 wherein a length of the connecting member is adjustable.

14. A method according to claim 13 wherein the step of placing the connecting member comprises adjusting the length of the connecting member.

15. A method according to claim 14 wherein the method further comprises the step of:

subsequently readjusting the length of the connecting member at least one time.

16. A method according to claim 1 wherein the at least one tension device implanted within the body comprises i) a first anchor, ii) a second anchor and iii) a tensioning member that extends between the first and second anchors, and wherein the method comprises:

causing the first anchor to be anchored at a first location;

causing the second anchor to be anchored at a second location; and

causing the tensioning member to be under sufficient tension to compress prostate tissue between the first and second anchors.

17. A method according to claim 1 wherein the compression created by the implanting step causes necrosis of at least a portion of the prostate tissue.