Systems and methods for treating the prostate

• US 9,968,395 B2
• Filed: 12/10/2014
• Issued: 05/15/2018
• Est. Priority Date: 12/10/2013
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: NxThera, Inc (Boston Scientific Corporation)
• Inventors: Hoey, Michael, Hastings, Roger Noel
• Primary Examiner(s): Neal, Timothy J
• Assistant Examiner(s): Fairchild, Aaron B
• Application Number:
  US14/566,448
• Publication Number:
  US 20150157384A1
• Time in Patent Office: 1,252 Days
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/307 for the urinary organs, e.g. urethroscopes, cystoscopes
• 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 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00904 Automatic detection of target tissue
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/048 in gaseous form
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis

Abstract

A vapor delivery system and method is provided that is adapted for treating prostate tissue. The vapor delivery system includes a vapor delivery needle configured to deliver condensable vapor energy to tissue. In one method, the vapor delivery system is advanced transurethrally into the patient to access the prostate tissue. The vapor delivery system is properly positioned by measuring and advancing the system based on a field-of-view of an endoscope or camera disposed within the system.

Claims

1. A method for treating a prostate, comprising the steps of:

inserting a vapor delivery system into a urethra of a patient;

advancing a distal portion of the vapor delivery system to a bladder neck of the patient;

viewing the distal portion of the vapor delivery system with a camera disposed on or within the vapor delivery system;

measuring a distance from the bladder neck to a first treatment region in a first lobe of the prostate with a field of view of the camera;

pulling the distal portion of the vapor delivery system proximally across the field of view of the camera to the first treatment region;

deploying a vapor delivery needle from the vapor delivery system into the first treatment region of the first lobe; and

delivering vapor into the first treatment region of the first lobe of the prostate to ablate tissue in the prostate.

2. The method of claim 1, further comprising, prior to the measuring step, measuring a distance from the bladder neck to a veru of the patient.

3. The method of claim 2, further comprising determining a number of treatments to perform based on the distance from the bladder neck to the veru.

4. The method of claim 1, wherein the delivering step comprises delivering between 160-300 calories of energy into the prostate.

5. The method of claim 1, wherein the measuring step further comprises determining a distance traveled by the vapor delivery system when it is moved across the field of view of the camera.

6. The method of claim 1, further comprising measuring a distance from the first treatment region in the prostate to a second treatment region in the prostate with the field of view of the camera;

pulling the distal portion of the vapor delivery system proximally across the field of view of the camera to the second treatment region;

deploying a vapor delivery needle from the vapor delivery system into the second treatment region of the prostate; and

delivering vapor into the second treatment region of the prostate to ablate tissue in the prostate.

7. The method of claim 6, wherein the second treatment region overlaps with the first treatment region.

8. The method of claim 7, wherein a center of the first treatment region is approximately 1 cm apart from a center of the second treatment region.

9. The method of claim 6, further comprising measuring a distance from the second treatment region in the prostate to a third treatment region in the prostate with the field of view of the camera;

pulling the distal portion of the vapor delivery system proximally across the field of view of the camera to the third treatment region;

deploying a vapor delivery needle from the vapor delivery system into the third treatment region of the prostate; and

delivering vapor into the third treatment region of the prostate to ablate tissue in the prostate.

10. The method of claim 9, wherein the third treatment region overlaps with the second treatment region.

11. The method of claim 1, further comprising repeating the measuring, pulling, deploying, and delivering steps for a second lobe of the prostate.

12. The method of claim 1, wherein the field of view of the camera spans a distance of approximately 0.5 cm.

13. The method of claim 1, wherein the measuring step further comprises identifying an anatomical landmark near a proximal portion of the field of view of the camera, and wherein the pulling step further comprises pulling the distal portion of the vapor delivery system proximally across the field of view of the camera until the anatomical landmark is positioned near a distal portion of the field of view of the camera.

14. The method of claim 13, further comprising automatically tracking the anatomical landmark with a digital image processing software running on an electronic controller of the vapor delivery system.

15. The method of claim 1, further comprising sensing an orientation of the vapor delivery needle with a sensor of the vapor delivery system.

16. The method of claim 15, wherein the sensor comprises an accelerometer.

17. The method of claim 15, wherein the sensor comprises a gyroscope.