Calculus retrieving/removing device and method

• US 9,517,080 B2
• Filed: 03/21/2014
• Issued: 12/13/2016
• Est. Priority Date: 03/21/2014
• Status: Active Grant

• Current Assignee: Terumo Kabushiki Kaisha
• Original Assignee: Terumo Kabushiki Kaisha
• Inventors: Honda, Kei
• Primary Examiner(s): Severson, Ryan J
• Application Number:
  US14/222,021
• Publication Number:
  US 20150265298A1
• Time in Patent Office: 998 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising
• CPC Class Codes: A61B 2017/22071 Steering
• CPC Class Codes: A61B 2017/22082 after introduction of a substance
• CPC Class Codes: A61B 2217/007 with irrigation system

Abstract

A method of removing/retrieving calculus in a renal pelvis includes moving a renal cover part along a ureter toward the renal pelvis, introducing the renal cover part into the renal pelvis, positioning the renal cover part in the renal pelvis so that the renal cover part covers one part of the renal pelvis, while an other part of the renal pelvis is not covered by the renal cover part, introducing fluid into the other part of the renal pelvis, while the one part of the renal pelvis is covered by the renal cover part, to cause the calculus in the other part of the renal pelvis to be washed-out of the renal pelvis, and moving the renal cover part out of the renal pelvis and into the ureter.

Claims

1. A method of removing calculus in a renal pelvis, the method comprising:

moving an elongated device along a ureteral lumen of a ureter toward the renal pelvis, the elongated device including a renal cover part and an irrigation port, the renal cover part configured to expand to only one direction in a radial direction of the elongated device, and the irrigation port placed distal to the renal cover part;

introducing both the renal cover part and the irrigation port into the renal pelvis;

deploying the renal cover part to cover one part of the renal pelvis, while an other part of the renal pelvis is not covered by the renal cover part;

washing the other part of the renal pelvis that is not be covered by the renal cover part by discharging fluid from the irrigation port to move the calculus in the renal pelvis; and

releasing the renal cover part and withdrawing the elongated device, together with the renal cover part, from the renal pelvis.

2. The method of claim 1, wherein the elongated device includes at least one lumen possessing a distal opening, the discharging of the fluid from the irrigation port comprising advancing the irrigation port towards and beyond the distal opening and then discharging the fluid from irrigation port.

3. The method of claim 1, wherein the elongated device includes at least one lumen possessing a distal opening, the discharging of the fluid from the irrigation port comprising advancing the irrigation port towards and beyond the distal opening, and orienting the irrigation port at an objective calyx in the renal pelvis at which the calculus is collected before discharging fluid from the irrigation port.

4. The method of claim 1, further comprising collecting the calculus in the other part of the renal pelvis.

5. The method of claim 4, wherein the irrigation port is an open distal end of a flushing fluid tube, and wherein the introducing of the fluid into the other part of the renal pelvis includes positioning the flushing fluid tube so that the open distal end is positioned in the renal pelvis and is pointing towards the other part of the renal pelvis, the other part of the renal pelvis being a calyx in the renal pelvis.

6. The method of claim 1, further comprising collecting the calculus in the other part of the renal pelvis by washing the calculus out of the one part of the renal pelvis so that the calculus is collected in the other part, the other part of the renal pelvis being a minor calyx of the renal pelvis.

7. The method of claim 1, further comprising collecting the calculus in the other part of the renal pelvis by washing the calculus out of the one part of the renal pelvis, the other part of the renal pelvis being an inferior calyx of the renal pelvis.

8. The method of claim 1, wherein the renal pelvis is connected to a bladder by way of a ureter, the method further comprising raking out the calculus in the renal pelvis or the ureteral lumen using the renal cover part.

9. The method of claim 1, further comprising:

inserting the elongated device into a lumen of a ureteroscope; and

moving the renal cover part toward and into the renal pelvis while observing the calculus using the ureteroscope.

10. The method of claim 1, wherein the elongated device possesses a distal portion and includes a pressure sensor at the distal portion of the elongated device that provides pressure information, the method further comprising monitoring pressure in the renal pelvis based on the pressure information from the pressure sensor.

11. The method of claim 10, further comprising a control unit issuing an alert that there exists a high intra-renal pressure compared with a certain pressure and/or stopping discharge of additional fluid into the renal pelvis.

12. The method of claim 1, wherein the renal pelvis is connected to a bladder by way of the ureter, and further comprising withdrawing the renal cover part out of the renal pelvis and toward the bladder while also raking-out the calculus in the renal pelvis and/or the ureter.

13. The method of claim 1, wherein the renal pelvis is connected to a bladder by way of the ureter, the renal cover part being inflatable, the deploying of the renal cover part including inflating the renal cover part to cover the one part of the renal pelvis, the method further comprising deflating the renal cover part before withdrawing the elongated device from the renal pelvis, the withdrawing of the elongated device from the renal pelvis comprising moving the deflated renal cover part into the ureter, the method further comprising inflating the renal cover part that has been moved into the ureter and then moving the inflated renal cover part toward the bladder to rake-out the calculus in the ureter.

14. A method of removing calculus in a renal pelvis, the method comprising:

moving a renal cover part along a ureter toward the renal pelvis;

introducing the renal cover part into the renal pelvis;

positioning the renal cover part in the renal pelvis so that the renal cover part covers one part of the renal pelvis, while an other part of the renal pelvis is not covered by the renal cover part;

introducing a fluid into the other part of the renal pelvis, while the one part of the renal pelvis is covered by the renal cover part, to cause the calculus in the other part of the renal pelvis to be washed-out of the renal pelvis, and wherein the fluid is introduced distally of the one part of the renal covered by the renal pelvis cover part; and

moving the renal cover part out of the renal pelvis and into the ureter.

15. The method of claim 14, wherein the fluid is introduced into the renal pelvis by way of an irrigation port forming part of a flushing fluid tube, the flushing fluid tube being movably positioned in an elongated tube which possesses a distal-most end, the method further comprising relatively moving the flushing fluid tube and the elongated tube until the irrigation port is positioned distally beyond the distal most end of the elongated tube, the introducing of the fluid into the other part of the renal pelvis occurring after the irrigation port is positioned distally beyond the distal most end of the elongated tube.

16. The method of claim 14, further comprising collecting the calculus in the other part of the renal pelvis by washing the calculus out of the one part of the renal pelvis, the other part of the renal pelvis being either a minor calyx of the renal pelvis or an inferior calyx of the renal pelvis.

17. The method of claim 14, wherein the renal pelvis is connected to a bladder by way of the ureter, the method further comprising:

raking-out the calculus in the renal pelvis using the renal cover part so that the calculus in the renal pelvis is removed from the renal pelvis or the ureteral lumen.

18. The method of claim 14, further comprising:

inserting the renal cover part into a lumen of a ureteroscope, and moving the renal cover part toward and into the renal pelvis while observing the calculus using the ureteroscope.

19. The method of claim 14, further comprising:

positioning the renal cover part in the renal pelvis while observing the calculus using a ureteroscope, and deploying the renal cover part to cover one part of the renal pelvis.

20. The method of claim 14, wherein the renal cover part is configured to expand in size and contract in size, the method further comprising:

expanding the renal cover part after introducing the renal cover part into the renal pelvis;

contracting the renal cover part after introducing the fluid into the other part of the renal pelvis;

moving the contracted renal cover part into the ureter; and

expanding the renal cover part and moving the expanded renal part away from the renal pelvis to rake-out the calculus in the ureter.