Automated image-guided tissue resection and treatment
A system to treat a patient comprises a user interface that allows a physician to view an image of tissue to be treated in order to develop a treatment plan to resect tissue with a predefined removal profile. The image may comprise a plurality of images, and the planned treatment is shown on the images. The treatment probe may comprise an anchor, and the image shown on the screen may have a reference image marker shown on the screen corresponding to the anchor. The planned tissue removal profile can be displayed and scaled to the image of the target tissue of an organ such as the prostate, and the physician can adjust the treatment profile based on the scaled images to provide a treatment profile in three dimensions. The images shown on the display may comprise segmented images of the patient with treatment plan overlaid on the images.
1. An apparatus to treat tissue of a patient, comprising:
an elongate treatment probe to treat a patient, the elongate treatment probe extending along an elongate treatment probe axis of the elongate treatment probe and comprising an outer elongate structure having a working channel and an inner carrier rotatable and translatable within the working channel to position and orient an energy source to release energy toward a target tissue;
an elongate imaging probe to image the target tissue of the patient, the elongate imaging probe extending along an elongate imaging probe axis of the elongate imaging probe, the elongate imaging probe axis separate from the elongate treatment probe axis;
a coupling to couple the elongate treatment probe to the elongate imaging probe when the elongate treatment probe and the elongate imaging probe have been inserted into the patient;
a first linkage connected to the inner carrier; and
a second linkage connected to the elongate imaging probe;
wherein one or more controllers comprise instructions to move the first linkage synchronously with the second linkage to move the inner carrier along the elongate treatment probe axis and move the elongate imaging probe along the elongate imaging probe axis separate from the elongate treatment probe axis in order to maintain an axial alignment of the elongate treatment probe in relation to the elongate imaging probe, and view interaction of the energy source of the inner carrier with tissue when the inner carrier moves along the elongate treatment probe axis to treat the target tissue.
2. An apparatus as in claim 1 , wherein the coupling comprises:
a base;
a first arm extending from the base and connected to a proximal end of the elongate treatment probe; and
a second arm extending from the base and connected to a proximal end of the elongate imaging probe;
wherein the base supports the elongate treatment probe and the elongate imaging probe when the first arm comprises a stiff configuration and the second arm comprises a stiff configuration.
3. An apparatus as in claim 2 , wherein the second arm comprises an actuator to manipulate the elongate imaging probe under user control when the first arm maintains a position and orientation of the elongate treatment probe.
4. An apparatus as in claim 1 , wherein the one or more controllers comprise instructions to maintain the axial alignment of the elongate treatment probe in relation to the elongate imaging probe when the elongate imaging probe and the elongate treatment probe have been inserted from opposite sides of the patient.
5. An apparatus as in claim 1 , wherein the one or more controllers comprise instructions to maintain the axial alignment of the elongate treatment probe axis of the elongate treatment probe with the elongate imaging probe axis of the elongate imaging probe when the energy source is advanced proximally and distally and rotated.
6. An apparatus as in claim 5 , wherein the coupling is configured to align the elongate treatment probe axis of the elongate treatment probe parallel with the elongate imaging probe axis of the elongate imaging probe.
7. An apparatus as in claim 1 , wherein the coupling is configured to maintain a fixed position and orientation of the elongate imaging probe in relation to the elongate treatment probe.
8. An apparatus as in claim 1 , wherein the coupling comprises a first stiff arm coupled to the elongate treatment probe and a second stiff arm coupled to the elongate imaging probe, the first stiff arm fixedly coupled to the second stiff arm, and wherein the elongate treatment probe comprises stiffness to inhibit deflection transverse to the elongate treatment probe axis and the elongate imaging probe comprises stiffness to inhibit deflection transverse to the elongate imaging probe axis.
9. An apparatus as in claim 1 , wherein the coupling comprises magnets to maintain a fixed position and orientation of the elongate imaging probe in relation to the elongate treatment probe.
10. An apparatus as in claim 1 , wherein the coupling comprises a plurality of magnets arranged at a plurality of axial locations along one or more of the elongate treatment probe or the elongate imaging probe.
11. An apparatus as in claim 1 , wherein the coupling is configured to couple the elongate treatment probe to the elongate imaging probe through a wall of a first lumen extending over a portion of the elongate treatment probe and a wall of a second lumen extending over a portion of the elongate imaging probe.
12. An apparatus as in claim 1 , wherein the elongate imaging probe is configured for insertion into a rectum of the patient and the elongate treatment probe is configured for insertion into a urethra of the patient and wherein the coupling is configured to align the elongate treatment probe with the elongate imaging probe when the elongate treatment probe is placed within the urethra and the elongate imaging probe is placed within the rectum.
13. An apparatus as in claim 1 , wherein the outer elongate structure comprises a spine to add stiffness to the elongate treatment probe such that the elongate structure inhibits deflection of the elongate treatment probe transverse to the elongate treatment probe axis.
14. An apparatus as in claim 1 , wherein the elongate imaging probe comprises a stiff distal portion to inhibit deflection of the elongate imaging probe transverse to the elongate imaging probe axis and to fix an orientation of the elongate imaging probe axis in relation to the elongate treatment probe axis.
15. An apparatus as in claim 1 , further comprising:
a processor coupled to the elongate imaging probe and the elongate treatment probe wherein the processor comprises instructions to determine a pressure, an axial location and an orientation of the energy source to ablate a target location of the tissue identified on an image from the elongate imaging probe.
16. An apparatus as in claim 15 , wherein the processor comprises instructions to determine the pressure, the axial location and orientation of the energy source in response to the target location on the image when the elongate treatment probe has been inserted on a first side of the patient and the elongate imaging probe has been inserted on a second side of the patient opposite the first side.
17. An apparatus as in claim 15 , wherein the processor comprises instructions to determine the pressure, the axial location and orientation of the energy source in response to the target location on the image when the elongate treatment probe has been coupled to the elongate imaging probe through a wall of a first lumen and a wall of a second lumen extending between the elongate treatment probe and the elongate imaging probe.
18. An apparatus as in claim 15 , wherein the processor comprises instructions to determine a first image coordinate reference of a first input target location of the image and a second image coordinate reference of a second input target location of the image and instructions to map the first image coordinate reference of the image to a first target coordinate reference of the elongate treatment probe and to map the second input target location of the image to a second target coordinate reference of the elongate treatment probe and wherein the processor comprises instructions to determine pressures and axial and rotational positions of a nozzle to provide a cut profile extending from the first input target location to the second input target location.
19. An apparatus as in claim 1 , wherein the apparatus is configured to remove living cells of the target tissue in order to provide the living cells outside the patient.