ABLATIVE/COAGULATIVE UROLOGICAL TREATMENT DEVICE AND METHOD
A device/system and a method of treating enlarged prostate and other urologic abnormalities are presented. A combined treatment is performed with several interstitial coagulating probes and an ablating fiber. Tissue vaporization is minimized by the denaturalizing effect of interstitial coagulative fibers. In a single device, multiple delivery systems achieve optimal tissue ablation/coagulation; a non-laser source like microwave energy coagulates tissue and a laser source ablates tissue. Another device comprises two or more laser sources with adjustable wavelengths controllable by physician as to ablative, coagulative, and tissue penetration needs. Continuous, semi-continuous, pulsed wave, or combinations are useful. In another embodiment, optical fiber has a central core for transmitting laser radiation, and a cladding layer about the core that may further transmit other laser radiation of a different or a same wavelength as the core. Fibers may have a side-firing distal end, a radial firing end, or an off-axis firing end. Feedback controls can be used. In general coagulative irradiation can use a radiofrequency or other radiant thermal source.
1 . A medical energy treatment device to carry out a Benign Prostate Hyperplasia treatment method, the device comprising:
at least one energy source capable of producing energy to coagulate tissue;
at least one laser source capable of producing radiation at a preselected wavelength, a power level and a power density to ablate tissue; and
at least one optical fiber optically coupled to said laser source and capable of transmitting said ablating radiation from said laser source to said target tissue.
2 . The medical energy treatment device according to claim 1 , wherein said energy source capable of producing energy to coagulate tissue is selected from the group consisting of a microwave source, a radiofrequency source, a laser and a thermal heat source.
3 . The medical energy treatment device according to claim 2 , wherein said coagulating energy source is preferably a non-laser energy source
4 . The medical energy treatment device of claim 1 , wherein said optical fiber comprises a distal end selected from a group consisting of a side-firing distal end, a radial firing end, and an off-axis firing end.
5 . The medical energy treatment device of claim 1 , further comprising a fiber optic probe for emitting said ablating radiation and a probe to transfer energy from said non-laser source to said target tissue.
6 . The medical energy treatment device of claim 5 , wherein said fiber optic probe comprises a termination selected from the group consisting of a bare fiber, a capped fiber, a fiber with a shaped end, a fiber with an off axis end, and combinations of these.
7 . The medical energy treatment device of claim 1 , wherein said given wavelength is selected from the group of 1470+60 nm and 1950±50 nm.
8 . The medical energy treatment device of claim 1 , wherein said at least one optical fiber has a core diameter of at least 200 μm.
9 . A device comprising of an energy source capable of emitting both ablative laser energy as well as energy for coagulative purposes for the use in urology procedures and transmitting means capable of receiving energy from each type of energy device and transmitting said energy to a treatment site.
10 . The device according to claim 9 , wherein said energy source for coagulative purposes is a microwave source, a radiofrequency source, a laser or a thermal heat source.
11 . The medical energy treatment device of claim 9 , further comprising a motorized pullback device wherein pullback speed is based on feedback parameters received from said coagulation and ablation energy.
12 . The medical energy treatment device of claim 1 , wherein said at least one optical fiber comprises a core, an inner cladding and an outer cladding, each conveying specific wavelengths.
13 . The device according to claim 12 , wherein said inner cladding has a refraction index inferior to said core and said external cladding.
14 . The device according to claim 4 wherein said optical fiber is composed of a core and two concentric claddings, an inner and an outer cladding respectively; said fiber core and said inner cladding each convey specific wavelengths; said inner cladding has a refraction index in between that of said core and said outer cladding.
15 . A method of performing both a coagulative as well as an ablative Benign Prostate Hyperplasia (BPH) treatment in one session utilizing two types of delivery systems: a coagulative type that is essentially placed and left in place giving a sufficient time to achieve sufficient coagulation and an ablative device that can be moved and manipulated by the surgeon during the treatment to assure tissue removal in the critical locations and to provide fast symptom relief.
16 . The method of BPH treatment according claim 15 , comprising the steps of:
a. introducing a system for delivering energy to coagulate tissue at a treatment site;
b. activating said coagulative system and coagulating tissue at said treatment site;
c. introducing an ablative device, a probe for transmitting laser energy to a treatment site to ablate hyperplasic tissue;
d. activating said ablative laser system to ablate hyperplasic tissue with said probe;
e. ablating preselected hyperplasic tissue in a pulsed or continuous mode of applying said laser radiation;
f. positioning and repositioning said ablative laser energy probe, as required to ablate (remove) all desired hyperplasic tissue; and
wherein steps b. and c. can be interchanged in time sequence.
17 . The method of BPH treatment according to claim 16 , wherein said step f. is replaced by:
f. positioning said ablative laser energy probe at said treatment site; and
g. employing a motorized pullback device to withdraw probes, wherein pullback speed is based on feedback parameters received from said coagulation and ablation energy systems.
18 . The method of BPH treatment according to claim 16 , wherein said step of coagulating tissue employs a non-laser energy source.