Systems and methods for biofilm removal, including a biofilm removal endoscope for use therewith

• US 8,206,349 B2
• Filed: 03/01/2007
• Issued: 06/26/2012
• Est. Priority Date: 03/01/2007
• Status: Active Grant

• Current Assignee: Medtronic Xomed Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Xomed Incorporated (Medtronic Plc)
• Inventors: Slenker, Dale E., Lewis, Cecil O., Norman, Gerould W., Prisco, John R.
• Primary Examiner(s): Vu, Quynh-Nhu H
• Application Number:
  US11/680,781
• Publication Number:
  US 20080214891A1
• Time in Patent Office: 1,944 Days
• Field of Search: 604/19, 604 21- 22, 604 27- 28, 604/35, 604/39, 604 43- 44, 604/48, 604/500, 604/514, 604/516, 604/164.01, 604/164.12, 606 15- 16, 606/101, 606/129, 606/139, 606/153
• US Class Current: 604/109
• CPC Class Codes: A61B 1/00091 Nozzles
• CPC Class Codes: A61B 1/012 characterised by internal passages or accessories therefor
• CPC Class Codes: A61B 1/0125 Endoscope within endoscope
• CPC Class Codes: A61B 1/015 Control of fluid supply or evacuation
• CPC Class Codes: A61B 1/12 with cooling or rinsing arrangements
• CPC Class Codes: A61B 1/227 for ears, i.e. otoscopes
• CPC Class Codes: A61B 1/233 for the nose, i.e. nasoscopes , e.g. testing of patency of Eustachian tubes
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61M 1/76 Handpieces specially for suction-irrigation A61M1/774, aspiration tips A61M1/84

Abstract

Systems and methods of removing bacterial biofilm from a target site using a biofilm removal endoscope. The endoscope has an insertion portion including an imaging channel terminating at a viewing window and an irrigation channel terminating at a nozzle. The imaging and irrigation channels are permanently affixed relative to one another. The insertion portion is inserted into the patient, with a working end thereof being disposed proximate the target site. The target site is imaged and a flow of fluid is dispensed via the nozzle to mechanically remove bacterial biofilm from the target site.

Claims

1. A method of removing bacterial biofilm from a target site of a human patient, the method comprising:

providing a bacterial biofilm removal system including;

a biofilm removal endoscope having an insertion portion terminating at a working end, the insertion portion forming an imaging channel terminating at a viewing window disposed at the working end, and

an irrigation channel terminating at a nozzle carried at the working end and projecting distally beyond the viewing window, the imaging and irrigation channels -being permanently affixed relative to one another;

inserting the insertion portion into the patient;

disposing the working end proximate the target site, the target site including a layer of bacterial biofilm adhered to a surface;

imaging the target site with the biofilm removal endoscope via the viewing window; and

dispensing a flow of fluid directly toward the target site and away from the endoscope with the biofilm removal endoscope via the nozzle to mechanically remove a substantial portion of the layer of bacterial biofilm from the surface.

2. The method of claim 1, wherein the insertion portion includes a flexible distal segment, and further wherein disposing the working end proximate the target site includes:

spatially articulating the distal segment relative to a handle of the endoscope to alter an angle of attack of the nozzle.

3. The method of claim 2, wherein spatially articulating the distal segment includes:

delivering the working end to a first location relative to the target site;

evaluating a position of the nozzle when the working end is at the first location in subsequently performing a biofilm removal procedure based upon an obtained image; and

actuating an actuator external the patient to effectuate a bend in the distal segment to alter an angle of attack of the nozzle relative to the target site from a first angle of attack to a second angle of attack.

4. The method of claim 1, further comprising:

aspirating the removed bacterial biofilm from the target site.

5. The method of claim 4, wherein dispensing a flow of fluid and aspirating the removed bacterial biofilm occur simultaneously.

6. The method of claim 4, wherein the insertion portion of the endoscope further forms an aspiration channel terminating at an aspiration inlet at the working end, the aspiration channel being permanently affixed relative to the imaging and irrigation channels, and further wherein the aspiration of the removed biofilm is facilitated by the biofilm removal endoscope via the aspiration inlet.

7. The method of claim 1, wherein substantially all of the layer of bacterial biofilm is removed from the target site with the dispensed fluid.

8. The method of claim 1, further comprising applying a medicament to the target site through the irrigation channel, the medicament adapted to interfere with bacterial biofilm regrowth.

9. The method of claim 8, wherein the medicament is selected from the group consisting of:

a surfactant, a gel, an antimicrobial, a steroid, a growth hormone, and combinations thereof.

10. The method of claim 1, wherein the flow of fluid is directed through the nozzle at a flow rate from about 2 ml/sec to about 12 ml/sec.

11. The method of claim 1, wherein the target site is within a sinus cavity.

12. The method of claim 1, wherein the target site includes ciliated epithelium.

13. The method of claim 1, wherein the method is performed in treating chronic rhinosinusitis.