Minimally invasive devices for multi-fluid tissue ablation

• US 9,232,960 B2
• Filed: 03/08/2013
• Issued: 01/12/2016
• Est. Priority Date: 01/02/2007
• Status: Active Grant

• Current Assignee: Procept Biorobotics Corporation
• Original Assignee: AquaBeam, LLC
• Inventors: Aljuri, Nikolai, Surjan, George
• Primary Examiner(s): FARAH, AHMED M
• Application Number:
  US13/790,218
• Publication Number:
  US 20130253488A1
• Time in Patent Office: 1,040 Days
• Field of Search: 606/4, 606/7, 606 13- 15, 606/41, 606/45, 604/22, 604/23, 604/82, 604/83, 604/85, 607 88- 93, 607/100, 607/101, 607104-107, 600/101, 600103-105, 600/108, 600/109, 128/898
• US Class Current: 1/1
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 17/32037 for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/201 with beam delivery through a hollow tube, e.g. forming an articulated arm through a flexible conduit A61B18/22; Hand-pieces therefor
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/22079 with suction of debris
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00583 Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00946 slidable
• CPC Class Codes: A61B 2018/00952 rotatable
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference
• CPC Class Codes: A61B 2018/1861 : with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61F 9/007 : Methods or devices for eye surgery
• CPC Class Codes: A61F 9/00736 : Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments A61F9/008 takes precedence

Abstract

Prostate treatment using fluid stream to resect prostate tissue, thereby relieving symptoms of conditions such as BPH, prostatitis, and prostatic carcinoma. A device having a fluid delivery element is positioned within a lumen of the urethra within the prostate. A fluid stream is directed outwardly from the fluid delivery element toward a wall of the urethral lumen. The fluid delivery element is moved to scan the fluid stream over the wall to remove a volume of tissue surrounding the lumen. The fluid may be combined with therapeutically active substances or with substances that increase resection efficiency. Fluid force may be adjusted to provide selective tissue resection such that soft tissue is removed while harder tissue is left undamaged. In order to gain a working space within the urethra, another fluid may be introduced to insufflate the urethra in the region of treatment.

Claims

1. A tissue modification device, comprising:

an elongate element having a proximal end and a distal end, wherein the elongate element is configured to be inserted into an organ;

a first lumen in the elongate element configured to deliver a first fluid into the organ to create a working space;

a fluid delivery element disposed within the elongate element, wherein the fluid delivery element is configured to discharge a second fluid as a fluid stream to resect a volume of tissue with the working space; and

a second lumen in the elongate element for evacuating tissue resected with the fluid delivery element in order to remove resected products.

2. The device of claim 1, wherein the device is configured to deliver the first fluid until a pressure within the working space is in a 0.1 psi to 5 psi range.

3. The device of claim 1, wherein the device is configured to deliver the fluid stream with a fluid stream shape and fluid stream source pressure chosen to selectively resect the tissue.

4. The device of claim 1, wherein the fluid delivery element is configured to translate, rotate, oscillate, or rotationally oscillate relative to the elongate element.

5. The device as in claim 1, wherein the device is configured to deliver a sufficient amount of the first fluid to create a volume of the first fluid within the working space, such that the fluid stream travels through the volume of the first fluid.

6. The device of claim 5, wherein the first fluid is a gas and the second fluid is a liquid.

7. The device of claim 6, wherein the gas is delivered and envelopes the resection liquid fluid stream to maintain the integrity of the liquid fluid stream.

8. The device of claim 5, further comprising a visualization element disposed within the elongate element and configured to visualize the tissue.

9. The device of claim 1, further comprising an energy conduit configured to transmit energy through an interior of the fluid stream to cauterize the tissue.

10. The device of claim 8, wherein the device is configured to decrease the fluid stream force to a level that is sufficient to transmit the energy but insufficient to resect the tissue.

11. The device of claim 10, wherein the device is further configured to resect the tissue using the energy transmitted through the interior of the fluid stream.

12. The device of claim 9, wherein the energy is electromagnetic energy.

13. The device of claim 12, wherein the electromagnetic energy is light.

14. The device of claim 12, wherein the electromagnetic energy is radiofrequency energy.

15. The device of claim 1, further comprising an expandable anchor near the distal end of the elongate element, wherein the expandable anchor is configured to stabilize the elongate element during resection.

16. The device of claim 15, wherein the tissue is prostate tissue and the anchor is configured to expand within a bladder.

17. The device of claim 1, wherein the device is configured to maintain a pressure differential between the first lumen and the second lumen to evacuate resected products through the second lumen.

18. The device of claim 1, wherein the first lumen is configured to direct the first fluid towards the fluid delivery element, thereby maintaining the integrity of the fluid stream.

19. The device of claim 1, wherein the second fluid is different from the first fluid.

20. The device of claim 1, wherein the second fluid is similar to the first fluid.