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

• US 8,900,252 B2
• Filed: 03/15/2013
• Issued: 12/02/2014
• Est. Priority Date: 05/20/2005
• Status: Active Grant

• Current Assignee: Teleflex Life Sciences LLC (Teleflex Incorporated)
• 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:
  US13/844,020
• Publication Number:
  US 20130325143A1
• Time in Patent Office: 627 Days
• Field of Search: 606/139, 606151-153, 606/213, 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
• 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 hyperplasia in a subject, said method comprising the steps of:

penetrating with a tethering element, in a direction transverse to a longitudinal axis of the urethra of the subject; and

implanting the tethering element to compress the prostate tissue transverse to the longitudinal 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 urethra as a consequence of the benign prostatic hyperplasia.

2. The method of claim 1 wherein the penetrating step comprises penetrating a capsule of the prostate tissue of the subject.

3. The method of claim 2 further comprising placing an endpiece connected to the tethering element beyond the outer surface of the capsule of the prostate tissue of the subject.

4. The method of claim 1 further comprising attaching a stop to the tethering element on a urethral side of the prostatic tissue of the subject.

5. The method of claim 4 wherein the stop invaginates within the prostatic tissue of the subject.

6. The method of claim 1 further comprising adjusting the length of the tethering element so as to relieve at least some of the constriction in that transverse direction created by the prostate tissue on the urethra as a consequence of the benign prostatic hyperplasia.

7. The method of claim 1 further comprising penetrating, with a penetrating device, in a direction transverse to a longitudinal axis of the subject'"'"'s urethra, prostate tissue of the subject wherein the penetrating device is configured to be removed from the subject subsequent to the penetrating step.

8. The method of claim 7 wherein the penetrating device carries the tethering element during the penetration step.

9. The method of claim 7 wherein the penetrating device carries the tethering element and an endpiece connected to the tethering element during the penetration step.

10. A method for reducing at least one symptom of benign prostatic hyperplasia said method comprising the steps of:

passing a retaining member and an endpiece through a penetration path created in prostatic tissue of a subject, wherein the retaining member is connected to the endpiece; and

placing the retaining member at least partially within the prostatic tissue of the subject such that at least one symptom of benign prostatic hyperplasia is reduced.

11. The method of claim 10 wherein the penetration path is transverse to a longitudinal axis of the subject'"'"'s urethra.

12. The method of claim 10 wherein the penetration path extends through a capsule of the prostatic tissue of the subject.

13. The method of claim 10 further comprising placing the endpiece beyond a capsule of the prostatic tissue of the subject.

14. The method of claim 10 further comprising placing a stop on the retaining member such that the stop is closer to a urethral portion of the prostatic tissue than the endpiece.

15. The method of claim 14 wherein placing the stop adjusts the length of the retaining member.

16. The method of claim 10 further comprising creating the penetration path using a penetrating device.

17. The method of claim 16 wherein the penetrating device carries the retaining member.

18. A method for treating benign prostatic hyperplasia in a subject, said method comprising the steps of:

puncturing prostatic tissue of the subject with a puncturing device wherein the puncturing device carries a tissue retainer; and

withdrawing the puncturing device, wherein the tissue retainer remains at least partially within the prostatic tissue and the tissue retainer has a longitudinal axis which is transverse to a longitudinal axis of the subject'"'"'s urethra subsequent to the withdrawing.

19. The method of claim 18 further comprising puncturing a capsule of the prostate tissue of the subject.

20. The method of claim 19 further comprising placing an endpiece connected to the retaining member outside the capsule of the prostate tissue of the subject.