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

• US 8,734,468 B2
• Filed: 03/28/2011
• Issued: 05/27/2014
• Est. Priority Date: 05/20/2005
• Status: Active Grant

• Current Assignee: Teleflex Life Sciences III LLC
• Original Assignee: NeoTract, Inc. (Teleflex Incorporated)
• Inventors: Lamson, Theodore Charles, Makower, Joshua, Catanese, Joseph III, Welch, Jacqueline Nerney, Walke, Amrish Jayprakash, Vidal, Claude, Redmond, Russell J., Collinson, Michael
• Primary Examiner(s): ANDERSON, GREGORY A
• Application Number:
  US13/073,763
• Publication Number:
  US 20110190758A1
• Time in Patent Office: 1,156 Days
• Field of Search: 606/139, 606151-153, 606215-216, 606/232
• 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 for applying suture clamps, clips or locks A61B2017/0488
• 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 for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• 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 hollow suture needles A61B2017/061
• 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 a condition in a human or animal subject wherein the prostate gland is causing undesirable constriction of the urethra, said method comprising the steps of:

A) inserting an introducer device into the subject'"'"'s body, the introducer device including a projecting member wherein a distal portion of the projecting member is longitudinally advanceable beyond a distal end of the introducer device;

B) advancing a cutting device from the introducer device through the projecting member after the distal portion of the projecting member is advanced beyond a distal end of the introducer device; and

C) using the cutting device to cut at least a portion of the prostate gland such that the constriction of the urethra is lessened, wherein the cut is formed between the lobes of the prostate gland such that the lobes separate from one another.

2. A method according to claim 1 wherein Step A comprises inserting the introducer percutaneously through the abdominal wall.

3. A method according to claim 1 wherein Step A comprises inserting the introducer percutaneously through the perineum.

4. A method according to claim 1 wherein Step A comprises inserting the introducer percutaneously through the abdominal wall, through the wall of the urinary bladder and to a position within the urinary bladder.

6. A method according to claim 1 wherein Step A comprises inserting the introducer into the rectum and wherein the method further comprises advancing either the introducer or the cutting device through an opening formed in the rectal wall.

7. A method according to claim 6 wherein the method further comprises closing the opening formed in the rectal wall.

8. A method according to claim 1 wherein Step B comprises advancing the cutting device through the prostate gland.

9. A method according to claim 1 wherein Step B comprises advancing the cutting device to a position adjacent to the outer surface of the prostate capsule.

10. A method according to claim 1 wherein the cutting element comprises a cutting member that is initially in a non-cutting configuration substantially parallel to a longitudinal axis of the shaft and may be caused to bow outwardly from the shaft thereby cutting tissue as it bows outwardly.

11. A method according to claim 10 wherein the cutting device is advanced into the prostate gland with the cutting member in its non cutting configuration and, thereafter, causing the cutting member to bow outwardly thereby forming a cut in the prostate gland.

12. A method according to claim 11 wherein:

Step A comprises inserting the introducer into the urethra;

Step B comprises advancing the cutting device through the wall of the urethra while the cutting member in its non cutting configuration; and

Step C comprises causing the cutting member to bow outwardly thereby forming a cut in the prostate gland.

13. A method according to claim 12 wherein Step B further comprises advancing a guide from the introducer, through the wall of the urethra and into the prostate gland and thereafter advancing the cutting member in its non cutting configuration.

5. A method according to 1 wherein Step A comprises percutaneously inserting the introducer through the abdominal wall and though an opening formed in a bone of the pelvis.