Source: https://patents.google.com/patent/US20090227998
Timestamp: 2018-02-25 14:03:58
Document Index: 421532641

Matched Legal Cases: ['application No. 61', 'application No. 61', 'application No. 60', 'Application No. 2007', 'Application No. 2007', 'Application No. 2002']

US20090227998A1 - Tissue ablation and cautery with optical energy carried in fluid stream - Google Patents
US20090227998A1
US20090227998A1 US12399585 US39958509A US2009227998A1 US 20090227998 A1 US20090227998 A1 US 20090227998A1 US 12399585 US12399585 US 12399585 US 39958509 A US39958509 A US 39958509A US 2009227998 A1 US2009227998 A1 US 2009227998A1
US8814921B2 (en )
This application claims the benefit of provisional application No. 61/097,497, filed on Sep. 16, 2008, and of provisional application No. 61/034,412, filed on Mar. 6, 2008, the full disclosures of which are incorporated herein by reference. The subject matter of this application is related to that of commonly-owned application Ser. No. 11/968,445 (Attorney Docket No. 026918-000110US) which claimed the benefit of provisional application No. 60/883,097 (Attorney Docket No. 026918-000100US), filed on Jan. 2, 2007, the full disclosures of which are incorporated herein by reference.
The use of water or other fluid jets as waveguides for carrying a laser beam for cutting and other manufacturing operations is described in U.S. Patent Application No. 2007/0278195, published Canadian application 2,330436 A1, PCT publication WO 99/56907, and U.S. Pat. Nos. 7,163,875; 5,902,499; and 5,773,791. U.S. Patent Application No. 2007/0025874 describes the use of laser fluid jets for disinfecting hands. The use of lasers for cutting biological tissue is described in U.S. Patent Application No. 2002/0128637 and for ablating prostate tissue is described in U.S. Pat. Nos. 5,257,991; 5,514,669; and 6,986,764. Use of a transurethral endoscope for bipolar radiofrequency prostate vaporization is described in Boffo et al. (2001) J. Endourol. 15:313-316. Pressurized water streams for effecting surgical incisions are described in U.S. Pat. Nos. 7,122,017 and 5,620,414, and for drilling teeth are described in U.S. Pat. No. 7,326,054. U.S. Pat. Nos. 5,785,521 and 6,607,524 describe the use of laser energy to cause thermo-elastic failure and fracture of hard biological materials combined with water/air technology to cool and remove (or further fracture) the already fractured material and debris from the treatment site. Radiofrequency discharge in saline solutions to produce tissue-ablative plasmas is discussed in Woloszko et al. (2002) IEEE Trans. Plasma Sci. 30:1376-1383 and Stalder et al. (2001) Appl. Phys. Lett. 79:4503-4505. Air/water jets for resecting tissue are described in Jian and Jiajun (2001) Trans. ASME 246-248. US2005/0288639 described a needle injector on a catheter based system which can be anchored in a urethra by a balloon in the bladder. U.S. Pat. Nos. 6,890,332; 6,821,275; and 6,413,256 each describe catheters for producing an RF plasma for tissue ablation. Other patents and published applications of interest include: U.S. Pat. Nos. 7,015,253; 6,953,461; 6,890,332; 6,821,275; 6,451,017; 6,413,256; 6,378,525; 6,296,639; 6,231,591; 6,217,860; 6,200,573; 6,179,831; 6,142,991; 6,022,860; 5,994,362; 5,872,150; 5,861,002; 5,817,649; 5,770,603; 5,753,641; 5,672,171; 5,630,794; 5,562,703; 5,322,503; 5,116,615; 4,760,071; 4,636,505; 4,461,283; 4,386,080; 4,377,584; 4,239,776; 4,220,735; 4,097,578; 3,875,229; 3,847,988; US2002/0040220; US2001/0048942; WO 93/15664; and WO 92/10142.
1. A method for modifying tissue, said method comprising:
generating a stream of a light transmissive liquid medium;
coupling a source of coherent light into the light transmissive medium so that said light is transmitted through said stream by total internal reflection; and
directing the stream to tissue.
6. A method as in claim 5, further comprising positioning a probe within the lumen, directing a pressurized stream of the light transmissive liquid medium radially outwardly from the probe, and focusing the coherent light within the stream of liquid medium as the stream is directed at the tissue.
8. A method as in claim 1, wherein the tissue is soft tissue and the stream is directed at a line to cut the tissue.
9. A method as in claim 8, wherein the nozzle has a diameter in the range from 0.01 to 1 mm, the pressure is in the range from 1 psi to 1000 psi, and the coherent light has a power from 10 mW to 40 W.
10. A method as in claim 1, wherein the tissue comprises a tooth or bone and the stream is directed to drill into the tooth or cut through bone and cartilage.
11. A method as in claim 10, wherein the nozzle has an area in the range from 0.01 to 1 mm, the pressure is in the range from 1 psi to 1000 psi, and the coherent light has a power from 10 mW to 40 W.
12. A system for delivering laser energy to tissue, said system comprising:
a nozzle for emitting a stream of a light transmissive fluid;
a waveguide for transmitting coherent light; and
wherein the waveguide and nozzle are arranged so that coherent light from the waveguide is focused in and transmitted through the stream of light transmissive fluid by total internal reflection.
13. A system as in claim 12, further comprising a pump for delivering the light transmissive fluid to the nozzle at a pressure from 1 psi to 1000 psi.
14. A system as in claim 13, wherein the nozzle has a diameter in the range from 0.01 mm to 1 mm.
15. A system as in claim 12, further comprising a laser source for delivering coherent light to the waveguide at a power level in the range from 10 mW to 40 W.
16. A system as in claim 12, wherein the probe is adapted to be advanced through the luminal surfaces or lumens.
17. A system as in claim 13, wherein the probe has at least one central axial passage for delivering the light transmissive fluid to the nozzle.
18. A system as in claim 14, wherein the probe comprises an outer tube having an axial lumen and an inner fluid delivery tube reciprocably mounted in the axial lumen, wherein the central axial passage is disposed in the inner fluid delivery tube and the waveguide is disposed in the central axial passage.
19. A system as in claim 15, wherein the nozzle is disposed to emit the stream of light transmissive fluid laterally through a window in the outer tube.
20. A system as in claim 16, wherein the nozzle emits the stream of light transmissive fluid at a pressure in the range from 1 psi to 1000 psi and at a stream diameter from 0.01 mm to 1 mm and wherein the coherent light is transmitted at a power level in the range from 10 mW to 40 W.
21. A system as in claim 12, wherein the probe is hand held and adapted to deliver energy to cut soft tissue.
22. A system as in claim 21, wherein the probe comprises a shaft having an axis.
23. A system as in claim 22, wherein the nozzle is oriented to deliver the stream in an axial direction relative to the shaft.
24. A system as in claim 22, wherein the nozzle is oriented to deliver the stream in a lateral direction relative to the shaft.
25. A system as in claim 21, wherein the nozzle emits the stream of light transmissive fluid at a pressure in the range from 1 psi to 1000 psi and at a stream diameter from 0.01 mm to 1 mm and wherein the coherent light is transmitted at a power level in the range from 10 mW to 40 W.
26. A system as in claim 12, wherein the probe is hand held and adapted to deliver energy to drill teeth or cut through bone and cartilage.
27. A system as in claim 26, wherein the probe comprises a shaft having an axis.
28. A system as in claim 27, wherein the nozzle is oriented to deliver the stream in a lateral direction relative to the shaft.
29. A system as in claim 26, wherein the nozzle emits the stream of light transmissive fluid at a pressure in the range from 1 psi to 1000 psi and at a stream diameter from 0.01 mm to 1 mm and wherein the coherent light is transmitted at a power level in the range from 10 mW to 40 W.
30. A system as in claim 12, further comprising an anchor frame disposed coaxially over the probe and having a distal end adapted to engage a tissue surface when the probe is introduced into a body lumen.
US20090227998A1 true true US20090227998A1 (en) 2009-09-10
US8814921B2 US8814921B2 (en) 2014-08-26
EP2601896A1 (en) * 2011-12-05 2013-06-12 Deutsches Zentrum für Luft- und Raumfahrt e.V. Fluid jet scalpel
US20170232273A1 (en) * 2010-02-04 2017-08-17 Procept Biorobotics Corporation Cancer detection and treatment apparatus
US3847988A (en) * 1971-12-23 1974-11-12 Schering Corp Substituted imidates
US5872150A (en) * 1996-03-01 1999-02-16 Merck & Co., Inc. Treatment of prostate disease with a nonsteroidal anti-androgenic compound
US5994362A (en) * 1992-03-11 1999-11-30 Merck & Co., Inc. Method of treatment for prostatic cancer
CN1144800C (en) 1998-04-29 2004-04-07 惠氏公司 Indolyl derivatives as 5-hydroxytryptamine medicine
US6630164B2 (en) 2000-05-09 2003-10-07 Kenneth Weisman Dutasteride to prevent and treat atherosclerosis
CN102905633A (en) * 2010-02-04 2013-01-30 普罗赛普特公司 Multi fluid tissue resection methods and devices
EP2531121A1 (en) * 2010-02-04 2012-12-12 Procept Corporation Multi fluid tissue resection methods and devices
EP2531121A4 (en) * 2010-02-04 2014-03-05 Procept Corp Multi fluid tissue resection methods and devices
US20160183777A1 (en) * 2011-07-11 2016-06-30 Etview Ltd. Endobronchial tube with integrated image sensor
US9216032B2 (en) * 2011-12-05 2015-12-22 Deutsches Zentrum für Luft- und Raumfahrt e.V. Liquid jet scalpel and method for operating a liquid jet scalpel
US20130172916A1 (en) * 2011-12-05 2013-07-04 Deutsches Zentrum Fuer Luft- Und Raumfahrt E.V. Liquid jet scalpel and method for operating a liquid jet scalpel
US8814921B2 (en) 2014-08-26 grant