Calculus/calculi retrieving device and method

• US 10,485,563 B2
• Filed: 03/27/2015
• Issued: 11/26/2019
• Est. Priority Date: 03/27/2015
• Status: Active Grant

• Current Assignee: Terumo Kabushiki Kaisha (Terumo Corporation)
• Original Assignee: Terumo Kabushiki Kaisha (Terumo Corporation)
• Inventors: Honda, Kei, Jinno, Makoto
• Primary Examiner(s): Severson, Ryan J.
• Assistant Examiner(s): Knauss, Christian D
• Application Number:
  US14/671,083
• Publication Number:
  US 20160278795A1
• Time in Patent Office: 1,705 Days
• 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 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/0034 adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/00553 using a turbine
• CPC Class Codes: A61B 2017/00738 part of the tool being offset with respect to a main axis, e.g. for better view for the surgeon
• CPC Class Codes: A61B 2017/22035 for retrieving or repositioning foreign objects
• CPC Class Codes: A61B 2017/22079 with suction of debris
• CPC Class Codes: A61B 2217/005 with suction drainage system

Abstract

A method of retrieving calculus in a living body and relocating the calculus to a different location in the living body involves positioning an elongated member in the living body in which the calculus is located, drawing the calculus in the living body toward the elongated member while the elongated member is positioned in the living body so that the calculus is retained by the elongated member; moving the elongated member so that the elongated member is located at a position in the living body that is different from the position of the elongated member in the living body during the drawing of the calculus toward the elongated member; and releasing the calculus from the elongated member so that the calculus is at a position in the living body different from a location of the calculus in the living body while the calculus is being drawn toward the elongated member.

Claims

1. A method of retrieving calculus in a living body and relocating the calculus to a different location in the living body, the method comprising:

positioning an elongated member, which includes a suction head disposed on a distal side of the elongated member, in the living body in which the calculus is located;

drawing the calculus in the living body toward the suction head while the suction head is positioned in the living body so that the calculus is retained by the suction head;

moving the suction head so that the suction head is located at a position in the living body that is different from the position of the suction head in the living body during the drawing of the calculus toward the suction head;

releasing the calculus from the suction head so that the calculus is at a position in the living body different from a location of the calculus in the living body while the calculus is being drawn toward the suction head;

the drawing of the calculus toward the suction head comprises rotating an impeller positioned inside the suction head in a first rotational direction;

the releasing of the calculus from the suction head comprises;

i) rotating the impeller positioned inside the suction head in a second rotational direction which is opposite the first rotational direction;

or ii) rotating the impeller positioned inside the suction head at a rotation speed slower than the rotation speed of the impeller during the drawing of the calculus toward the suction head; and

the drawing of the calculus toward the suction head comprising rotating the impeller positioned inside the suction head at a first speed and in a first rotational direction, wherein the impeller continues to rotate in the first rotational direction during the moving of the suction head, and wherein the releasing of the calculus from the suction head comprises rotating the impeller at a second rotational speed less than the first rotational speed.

2. The method according to claim 1, wherein the rotating of the impeller creates a suction that draws the calculus into a hollow retrieval space in the suction head and retaining the calculus in the hollow retrieval space during the moving of the suction head.

3. The method according to claim 1, wherein the drawing of the calculus toward the suction head comprises rotating the impeller positioned inside the suction head in a first rotational direction, and the releasing of the calculus from the suction head comprises rotating the impeller positioned inside the suction head in a second rotational direction which is opposite the first rotational direction.

4. The method according to claim 1, wherein the suction head possesses a distal end at which is located a compressible material, the distal end opening into an interior of the suction head, and wherein the calculus is retained by the suction head at a position at least partially outside the interior of the suction head by being held against the compressible material.

5. The method according to claim 1, wherein the positioning of the suction head in the living body comprises positioning the suction head in a kidney, wherein the drawing of the calculus toward the suction head comprises drawing calculus located in a lower calix of the kidney toward the suction head so that the calculus is retained by the suction head, and wherein the releasing of the calculus from the suction head comprises releasing the calculus retained by the suction head at either an upper calix or a middle calix of the kidney.

6. The method according to claim 1, wherein the suction head passes through an instrument channel in a ureteroscope and extends distally beyond a distal end portion of the ureteroscope, the distal end portion of the ureteroscope possessing a central axis and the suction head possessing a central axis, and further comprising operating the suction head so that the central axis of the suction head is at an angle other than 0°

and other than 180°

relative to the central axis of the distal end portion of the ureteroscope.

7. The method according to claim 1, wherein the suction head passes through an instrument channel in a ureteroscope and extends distally beyond a distal end portion of the ureteroscope, the distal end portion of the ureteroscope possessing a central axis and the suction head possessing a central axis, and further comprising operating the suction head so that the central axis of the suction head is at an angle of at least 25°

relative to the central axis of the distal end portion of the ureteroscope.

8. A method of retrieving calculus in a living body and relocating the calculus to a different location in the living body, the method comprising:

positioning a suction head, disposed on a distal end of a shaft, in the living body in which the calculus is located, the suction head possessing a central axis, the shaft being positioned in a lumen in an elongated member, the elongated member being located in the living body and possessing a distal end;

relatively moving the suction head and a first contact surface so that a second contact surface that is fixed to and moves together with suction head contacts the first contact surface while the suction head and the second contact surface are located outside the lumen at a position distal of the distal end of the elongated member, the contact of the second contact surface with the first contact surface changing an orientation of the central axis of the suction head to orient the suction head in an orientation permitting retrieval of the calculus in the living body;

drawing the calculus in the living body toward the suction head while the suction head is positioned in the living body and after changing the orientation of the central axis of the suction head so that the calculus is retained by the suction head;

moving the suction head so that the suction head is located at a position in the living body that is different from the position of the suction head in the living body during the drawing of the calculus toward the suction head; and

releasing the calculus from the suction head so that the calculus is at a position in the living body different from a location of the calculus in the living body while the calculus is being drawn toward the suction head.

9. The method according to claim 8, wherein the elongated member is a ureteroscope, wherein the suction head passes through an instrument channel in the ureteroscope and extends distally beyond the distal end of the ureteroscope, the first contact surface being a distal end surface of the ureteroscope.

10. The method according to claim 9, wherein the first and second contact surfaces are both curved surfaces.

11. The method according to claim 9, wherein the first contact surface is a concave surface and the second contact surface is a convex surface.

12. The method according to claim 8, wherein the first and second contact surfaces are both curved surfaces.

13. The method according to claim 8, wherein one of the first and second contact surfaces is a concave surface and the other of the first and second contact surfaces is a convex surface.

14. The method according to claim 8, wherein the drawing of the calculus toward the suction head comprises rotating an impeller positioned inside the suction head, the impeller being connected to a drive shaft so that rotation of the shaft results in rotation of the impeller, the drive shaft passing through an instrument channel in a ureteroscope, the suction head possessing a central axis and a distal end portion of the ureteroscope possessing a central axis;

the method further comprising rotating the suction head relative to the distal end of the ureteroscope between a first position in which the central axis of the suction head is parallel to and coaxial with the central axis of the ureteroscope and a second position in which the central axis of the suction head is parallel to and not coaxial with the central axis of the ureteroscope.

15. The method according to claim 8, wherein the positioning of the suction head in the living body comprises positioning the suction head in a kidney, wherein the drawing of the calculus toward the suction head comprises drawing calculus located in a lower calix of the kidney toward the suction head so that the calculus is retained by the suction head, and wherein the releasing of the calculus from the suction head comprises releasing the calculus retained by the suction head at either an upper calix or a middle calix of the kidney.

16. A method of retrieving calculus in a living body and relocating the calculus to a different location in the living body, the method comprising:

positioning an elongated member, which includes a suction head disposed on a distal side of the elongated member, in the living body in which the calculus is located, the elongated member being positioned in a lumen in a ureteroscope, the ureteroscope possessing a distal end portion, the distal end portion of the ureteroscope and the suction head each possessing a respective central axis;

drawing the calculus in the living body toward the suction head while the suction head is positioned in the living body and while the suction head is distal of the lumen in the ureteroscope so that the calculus is retained by the suction head;

moving the suction head so that the suction head is located at a position in the living body that is different from the position of the suction head in the living body during the drawing of the calculus toward the suction head;

releasing the calculus from the suction head so that the calculus is at a position in the living body different from a location of the calculus in the living body while the calculus is being drawn toward the suction head;

changing an angular orientation of the central axis of the suction head relative to the central axis of the distal end portion of the ureteroscope; and

the changing of the angular orientation of the central axis of the suction head relative to the central axis of the distal end portion of the ureteroscope comprises relatively moving a suction head contact surface that is fixed to and moves together with the suction head and an other contact surface to cause the suction head contact surface to contact the other contact surface in a way that causes the orientation of the central axis of the suction head relative the central axis of the distal end portion of the ureteroscope to change, the suction head contact surface contacting the other contact surface while the suction head and the suction head contact surface are positioned outside the lumen in the ureteroscope.

17. The method according to claim 16, wherein at least one of the suction head contact surface and the other contact surface is a curved surface.

18. The method according to claim 16, wherein at least one of the suction head contact surface and the other contact surface is a convex surface.

19. The method according to claim 16, wherein the other contact surface is an exterior surface of the ureteroscope at a distal end surface of the ureteroscope.