Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall

• US 8,932,316 B2
• Filed: 04/07/2014
• Issued: 01/13/2015
• Est. Priority Date: 05/13/2011
• Status: Active Grant

• Current Assignee: Broncus Medical Incorporated
• Original Assignee: Broncus Medical Incorporated
• Inventors: Keast, Thomas, Laufer, Michael D., Wibowo, Henky, Cole, Cary, Kaplan, Gary S., Roschak, Edmund J.
• Primary Examiner(s): FISHBACK, ASHLEY LAUREN
• Application Number:
  US14/246,951
• Publication Number:
  US 20140222015A1
• Time in Patent Office: 281 Days
• Field of Search: 128/898, 604/500, 604/506, 604/507, 604/508, 604/510, 606/151, 606/184, 606/185
• US Class Current: 606/185
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/01 Guiding arrangements therefore
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• 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 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/3209 Incision instruments
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• 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 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22042 Details of the tip of the guide wire
• CPC Class Codes: A61B 2017/320056 : Tunnelers
• CPC Class Codes: A61B 2017/3425 : for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2018/00541 : Lung or bronchi
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2034/2051 : Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 : Optical tracking systems
• CPC Class Codes: A61B 2034/2057 : Details of tracking cameras
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2090/3945 : Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/062 : using magnetic field

Abstract

Methods and devices for diagnosing, monitoring, and/or treating tissue through an opening or port through an airway wall are provided herein.

Claims

1. A method of accessing and treating a target tissue in a lung, the method comprising:

creating an opening through an airway wall at a target site with a hole-making instrument, the opening leading to the target tissue;

tunneling from the opening in the airway wall to the target tissue by advancing an elongate instrument and a dissector positioned therein from the opening to the target tissue;

removing the dissector from the elongate instrument such that the elongate instrument defines an access channel to the target tissue; and

treating the target tissue through the access channel defined by the previously positioned elongate instrument leading to the target tissue.

2. The method of claim 1, wherein the step of treating comprises removing the target tissue.

3. The method of claim 2, wherein the removing is carried out by snaring the target tissue with a tissue-snare catheter.

4. The method of claim 2, wherein the removing is carried out by morcellating the target tissue with a morcellating-tip catheter.

5. The method of claim 1, wherein the step of treating comprises ablating the target tissue with an energy-delivering catheter.

6. The method of claim 1, wherein the step of treating comprises destroying the target tissue.

7. The method of claim 6, wherein the destroying comprises injecting an agent into the target tissue.

8. The method of claim 7, wherein the agent comprises at least one of a chemotherapy drug and a radioactive substance.

9. The method of claim 6, wherein the destroying comprises advancing an implant into the target tissue.

10. The method of claim 9, wherein the implant is one selected from the group consisting of a capsule, coil, and electrode.

11. The method of claim 10, wherein the implant is a capsule, and the capsule is configured to release radiation.

12. The method of claim 11, wherein the capsule is activated by a mechanism selected from the group consisting of chemical and electronic mechanisms.

13. The method of claim 12, wherein the capsule is activated electronically from an energy source outside the body.

14. The method of claim 9, wherein the implant is an electrode and configured to deliver alternating current to the tumor.

15. The method of claim 14, wherein the electrode is activated from an external source selected from the group consisting of an electromagnetic and magnetic field.

16. The method of claim 14, wherein the electrode is excited repeatedly.

17. The method of claim 1, further comprising dilating the opening with a balloon catheter;

and performing imaging to guide the elongate instrument to the target tissue.

18. The method of claim 1, wherein the target tissue is a tumor.

19. The method of claim 1, further comprising locating the target site on the airway wall, wherein the target site is in a location that allows for creation of the opening leading to the target tissue and for advancement of the elongate instrument through the opening to the target tissue along a substantially straight path.

20. The method of claim 1, further comprising articulating the elongate instrument.